Midterm Questions with Answers for Physical Therapy Students, Exams of Nursing

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566 Midterm Questions With Correct Answers A+ 2024 /

A physical therapist is treating a 25-year-old female with complaints of episodes of sharp low back pain when she makes quick movements. Lumbopelvic rhythm is reversed and PA testing reveals hypermobility throughout the lumbar spine. Which of the following diagnoses would you consider to be most likely?

a. Ankylosing spondylitis

b. Low back pain with motor coordination deficits

c. Lumbar stenosis

d.Low back pain with mobility deficits - ANS-b. Low back pain with motor coordination deficits

Which of the following conditions should be screened for in all patients low back pain since it is a common associated finding?

a. Osteoarthritis

b. Osteoporosis

c. Depression

d. Diabetes - ANS-c. Depression

Which is the most common type of fracture following a lateral ankle sprain?

a. Burst

b. Compound

c. Avulsion

d.Jones - ANS-d.Jones

Which of the following is a hallmark sign of a meniscal injury?

a. Quad inhibition

b. Positive Lachman test

c. Hamstring weakness

d.Pain with compression - ANS-a. Quad inhibition

Which of the following clinical findings is consistent with a diagnosis of gluteus medius muscle strain?

a. Negative Ober test

b. Anterior groin pain

c. Pain with resisted abduction testing

d.Tenderness to palpation over the origin of the Tensor Fascia Lata - ANS-c. Pain with resisted abduction testing

A 15-year-old female presents with knee pain. Examination negative knee findings, but reveals weak hip musculature, a leg leg-length difference of 3cm, and decreased ROM in hip IR and abduction. What is the most likely pathology?

a. Legg Calve Perthes

b. Posterior hip dislocation

c. Mid-shaft femur fracture

d. Slipped capped femoral epiphysis - ANS-d. Slipped capped femoral epiphysis

Which type of femoral neck stress fracture would require ORIF?

a. Tension side

b. Compression side

c. Lateral side

d. Inferior side - ANS-a. Tension side

Progressive onset of pain, numbness, weakness, and tingling in the low back and buttocks of an older adult that is increased by standing and walking and eased by sitting, is a hallmark of which condition:

a. Facet joint dysfunction

b. Lateral stenosis

d. Positive straight leg raise test - ANS-a. Urinary retention

What is surmised to be the primary cause of low back pain?

a. Herniation of the intervertebral disc

b. Narrowing of the spinal canal

c. Degeneration of the IVD

d. In 85% of cases the actual cause of LBP cannot be identified - ANS-d. In 85% of cases the actual cause of LBP cannot be identified

A 34-year-old female presents with complaints of centralized low back pain (6/10NPRS) that began two weeks prior. They have had a previous history of back pain, with episodes about once per year for 5 years. Examination reveals the following key findings: SLR 85, hypomobile lumbar spine with PA springing, pain worse with extension (8/10 NPRS), +PIT test, reversed lumbopelvic rhythm. What is the best diagnosis for this patient?

a. LBP with mobility impairments

b. Facet dysfunction

c. Non-specific LBP likely to respond to exercise

d. Disc derangement - ANS-a. LBP with mobility impairments

A 34-year-old female presents with complaints of centralized low back pain (6/10NPRS) that began two weeks prior. They have had a previous history of back pain, with episodes about once per year for 5 years. Examination reveals the following key findings: SLR 85, hypomobile lumbar spine with PA springing, pain worse with extension (8/10 NPRS), +PIT test, reversed lumbopelvic rhythm. What is the intervention that would result in the most likely treatment success?

a. Lumbar traction

b. Transverse abdominis activation

c. Lumbar HVLA technique

d. Facet joint mobilization - ANS-c. Lumbar HVLA technique

A 60-year-old patient has been receiving physical therapy for 3 weeks for her low back pain. The patient presents with signs/symptoms of spinal stenosis and the physical therapist has been using a regional manual therapy approaching including spinal manipulation and exercise, and body-weight supported treadmill training. The patient reports minimal gains on a PSFS, and her symptoms have remained relatively unchanged. She asks you about acupuncture for her pain? What is the most appropriate action?

a. Refer to physician

b. Alter treatment plan to include specific core exercise

c. Alter treatment plan to include lumbar traction

d. Refer to acupuncture - ANS-a. Refer to physician

A Maisonneuve fracture is a fracture of the fibula associated with a syndesmosis sprain.

a. True

b. False - ANS-a. True

A patient experienced forceful eversion and external rotation of the foot and ankle upon stepping into a hole while running. A physical therapist conducting an examination determined a positive talar tilt test denoting laxity in the deltoid ligament. What functional motion is likely to be most painful?

a. Weight-bearing dorsiflexion

b. Weight bearing heel raises

c. Inversion to end-range

d. Anterior Drawer test - ANS-a. Weight-bearing dorsiflexion

A physical therapist is working with a patient for gait training following an auto-pedestrian injury which resulted in two fractured metatarsals and a non-weight bearing restriction. During the examination, the therapist observes palor of the foot and toes. The patient complains of severe pain that is worse than during the initial injury following placement of a hard cast. Which is the most appropriate action?

a. Leave a note in the chart for the physician about the change in pain status

b. Tell the nursing desk about the change in pain status

d. Mild-moderate edema, joint line tenderness, positive McMurray and Appley Grind tests, quad inhibition. - ANS-c. Mild-moderate edema, positive McMurray and Appley Grind tests, quad inhibition, positive Thessaly test

d. Mild-moderate edema, joint line tenderness, positive McMurray and Appley Grind tests, quad inhibition.

Of the hip fracture sites listed below, which is the most common?

a. Femoral neck

b. Acetabulum

c. Greater trochanter

d. Femoral head - ANS-a. Femoral neck

A patient has internal snapping hip that is painful and limits motion. Which of the following tests would most likely be positive?

a. Ober's test

b. Thomas test

c. Ely's test

d. Wright's test - ANS-a. Ober's test

b. Thomas test

Which of the following is a primary source of pain that results from a normal inflammatory response after an MCL sprain, for example?

a. Swelling stretches and tears the tissues and activates nociceptors.

b. The presence of red blood cells in the interstitial space activates nociceptors.

c. The presence of prostaglandins and other chemical mediators activates nociceptors.

d. Capillary permeability into the interstitial space activates nociceptors. - ANS-c. The presence of prostaglandins and other chemical mediators activates nociceptors.

A 28-year-old female endurance athlete presents to your clinic with a 3-week history of insidious onset of L hip pain. She reports increased pain with weight bearing and activity, decreased with rest. She has also recently increased her mileage and intensity of her runs prior to competition. What is the most likely differential diagnosis based on this limited history?

a. Hip OA

b. Acetabular Impingement

c. Femoral Neck Stress Fracture

d. Labral Tear - ANS-

Practice/Write scripts to instruct a patients for their post-surgical precautions following a THA for both a posterior-lateral and an anterio-lateral approach. - ANS-

Explain in your own words, the difference between nociception and pain? - ANS-

What three structures are commonly injured in the knee with valgus and internal rotation injury mechanisms. What about these structures causes them to commonly be injured together? - ANS-

Describe the differences between the medial and lateral meniscus. How does this translate to likelihood of injury? - ANS-

Name several bones/locations that are common locations for stress fractures to occur. What are risk factors for stress fractures? - ANS-

A patient enters your clinic complaining of severe right knee pain. He said he jumped off the bed of a truck and landed with a fully extended knee at work yesterday. Since then, he has been unable to bear weight through his leg and has increased pain with range of motion. Based on the location of symptoms and the mechanism of injury, you suspect your patient to have a most likely due to

a. an anterior cruciate ligament injury from a hyperextension mechanism

b. a tibial plateau fracture from an axial compression mechanism

Which stage of tissue healing is distinguished by the presence of fibroblasts and subsequent production of new collagen?

a. Inflammation

b. Remodeling

c. Proliferation - ANS-c. Proliferation

Pain may be deep or poorly localized with compression. Gentle motion sometimes reduces pain. Tissue damaged? - ANS-Articular surfaces

Usually localized to damaged area. Tissue damaged? - ANS-Muscle

Localized to tendon, myotendinous junction, or bony insertion. Tissue damaged? - ANS-Tendon

Pain at attachment points. Unstable joint. Tissue damaged? - ANS-Ligament

Maisonneuve fracture - ANS-Spiral fracture of the proximal one-third of the fibula

Lisfranc fracture - ANS-Fracture of one or more metatarsals with displacement

March fracture - ANS-Stress fracture of metatarsals without displacement

Jones fracture - ANS-Fracture of the fifth metatarsal

Which condition is caused, in part, by traction forces transmitted through the Achilles tendon?

a. Sever's disease

b. Equinovarus

c. Bunion

d. Jones fracture - ANS-a. Sever's disease

What is another name for hallux valgus?

a. Fat pad syndrome

b. Tarsal tunnel syndrome

c. Bunion

d. Haglund's deformity - ANS-c. Bunion

Match the affected ligaments with the correct grade of ankle sprain. (Use multiple)

Grade 1

Grade II

Grade III

a. ATFL

b. CFL

c. PTFL - ANS-Grade 1= ATFL

Grade II= ATLF, CFL

Grade III= ATFL, CFL, PTFL

What factors from a patient's history can help you identify a particular type of ankle sprain? - ANS-MOI & direction of that motion rolled/ twisted

For which of the following type of ankle sprains would weight bearing be problematic for several weeks?

a. Eversion sprain

b. Syndesmotic sprain

4. Decreased ankle dorsiflexion

a. 2 and 3

b. 1, 3, and 4

c. Only 3

d. All of the above - ANS-d. All of the above

A patient was backing their motorcycle into a parking spot when their leg became trapped between the bike and an unseen metal object. The result was that the weight of the motorcycle momentarily rested on the patient's anterior tibia. The patient, after spending the day at work with the leg in a dependent position, presented to urgent care with complaints of painful and weak dorsiflexion, swelling, bruising on the shin, and resting pain of 7/10 NPRS. What is the injury this patient is experiencing?

a. Compartment syndrome

b. Tendinitis of anterior tibialis muscle

c. Soft tissue injury

d. Bone bruise - ANS-a. Compartment syndrome

Hyaline cartilage receives its nutrition via which of the following methods?

a. Osmosis

b. Diffusion

c. Arterial supply

d. Transdermally - ANS-b. Diffusion

Which of the following is NOT a clinical sign associated with knee OA?

a. Palpable warmth

b. Palpable bony enlargement

c. Morning stiffness < 30 minutes

d. Palpable tenderness - ANS-a. Palpable warmth

What is the response of articular cartilage to immobilization and how might this affect our rehab process? - ANS-Immobilization, especially lack of weight bearing, compromises the health of articular cartilage. After prolonged immobilization, articular cartilage is weaker and this provides the reason for gradual exposure to weight-bearing and functional activities after these periods ... after a femur fracture has healed, for example.

Which injury to the articular cartilage has the best prognosis for healing on its own?

a. A small, superficial tear to the articular cartilage.

b. An injury that extends to the subchondral bone. - ANS-b. An injury that extends to the subchondral bone.

Which meniscus injury likely has the best prognosis for healing?

a. A tear in the middle one-third of the lateral meniscus

b. A tear in the inner one-third of the medial meniscus

c. A tear in the outer one-third of the lateral meniscus

d. A tear in the middle one-third of the medial meniscus - ANS-c. A tear in the outer one-third of the lateral meniscus

A 36-year-old patient presents to a physical therapy clinic via direct access and complains of "achy" knee pain that has persisted for 3 months. The patient reports pain in the morning upon waking and again in the evening after a job that requires standing most of the day. The pain began after a hard landing during skydiving. The physical therapist finds limited joint effusion and full range of motion. The joint appears otherwise normal, and the patient denies any previous history of knee injury.

Consider the pertinent findings of this case vignette and determine the most likely diagnosis.

a. Localized articular cartilage injury

b. Knee osteoarthritis - ANS-a. Localized articular cartilage injury

a. Peripheral edema

b. Quad contusion

c. Quadriceps strain

d. Patellar tendon rupture - ANS-c. Quadriceps strain

What do you think the optimal treatment for a patient with knee osteoarthritis would consist of given the underlying pathophysiology? - ANS-Cyclical loading and supportive strength along with maintenance of joint mobility seem like good ideas for an arthritic joint. Check out the American College of Rheumatology Guidelines for Non-Pharmacological Interventions

Your patient is a 52 yo male with a history that leads you to a primary hypothesis of L hip OA. However, during your exam you note that his L hip IR and flexion ROM are 25 and 120, respectively, and that hip IR is painful. Which of the following clinical findings, if also present, would support your primary hypothesis of hip OA?

a. Morning stiffness < 60 min

b. Positive Trendelenburg sign

c. Weak gluteus maximus

d. Positive Thomas test for tight psoas - ANS-a. Morning stiffness < 60 min

Which of the following is NOT an extra-articular cause of hip pain?

a. Snapping hip

b. Greater trochanteric bursitis

c. Piriformis syndrome

d. Labral tears - ANS-d. Labral tears

With internal snapping hip, which tendon most commonly causes the snap?

a. Adductor magnus

b. Psoas

c. Tensor fascia latae

d. Rectus femoris - ANS-b. Psoas

"Sports hernia" typically involves all of the following EXCEPT

a. Muscle imbalance between the core muscles and the adductors

b. Tears in the conjoined tendon

c. Tears in the origin of the adductor longus

d. Pain with ballistic movements - ANS-c. Tears in the origin of the adductor longus

The hip is most commonly dislocated in which direction?

a. Anterior

b. Posterior

c. Lateral

d. Medial - ANS-b. Posterior

Which of the following types of stress fractures of the femoral neck is considered unstable and may require surgical stabilization?

a. Tension side stress fractures of the femoral neck

b. Compression side stress fractures of the femoral neck

c. Tension side stress fractures of the subtrochanter

d. Compression side stress fractures of the subtrochanter - ANS-a. Tension side stress fractures of the femoral neck

The parents of a 2-year-old girl report their daughter has been noticeably fussy and uncomfortable for the past 2 days. The baby becomes especially irritable during diaper changes when her left hip is moved and the area appears to be excessively warm. They state that she hasn't eaten much lately and developed a high fever last night that has been persistent. Given the findings in the case above, which of the following diagnoses is most probable?

a. Hamstrings

b. Quadriceps

c. Glut med

d. Glut max - ANS-b. Quadriceps

Which of the following motions should be protected after a reverse total shoulder arthroplasty?

a. Internal rotation

b. External rotation

c. Flexion

d. Abduction - ANS-a. Internal rotation

What activity would be problematic 2 months postop from a THA completed with a posterior approach?

a. Getting a sock off the floor

b. Getting up from a chair

c. Using the toilet

d. Seated hamstring stretch - ANS-d. Seated hamstring stretch

Which of the following is true concerning a reverse total shoulder arthroplasty?

a. The concave surface is on the scapula.

b. The concave surface is on the humerus. - ANS-b. The concave surface is on the humerus.

True or false: A reverse total hip arthroplasty follows the same biomechanical principles as a reverse total shoulder arthroplasty.

a. True

b. False - ANS-b. False

Which of the following is the most common complication following joint arthroplasty?

a. Deep vein thrombosis

b. Joint dislocation - ANS-a. Deep vein thrombosis

In most cases of low back pain, MRIs should not be obtained as an initial test.

a. True

B. False - ANS-a. True

Psychological factors are more predictive of low back pain than are physical findings.

a. True

b. False - ANS-a. True

Some low back pain injuries are the product of specific pathoanatomical impairments.

a. True

b. False - ANS-a. True

Most low back pain injuries have unclear causation and no specific pathoanatomical impairments can be identified.

a. True

b. False - ANS-a. True

In the face of uncertainty about a specific cause of low back pain from a pathoanatomical perspective, physical therapists can utilize classification-based approached to understanding how to manage low back pain and make management decisions.

a. True

b. False - ANS-a. True