Free NPTE Scenario Quiz – NPTE Final Frontier

Setting: N/a

Sex: Female

Age: 43 years

Presenting Problem/Current Problem:

• Left ankle discomfort

Past Medical History:

• Type 1 Diabetes mellitus

Other Information:

• Lives in one-story home with husband and five children
• Patient reports noticing left ankle beginning to swell more frequently, especially with standing and activity, over the past two months, but swelling will “go away with elevation”
• Patient reports no new skin changes associated with swelling

Physical Therapy Examination(s):

• Pain: Currently 1/10, worst 5/10, best 0/10
• Palpation: Left ankle soft pitting edema
• Painful and limited active ankle plantar flexion, dorsiflexion, eversion, and inversion
• Integumentary: Tissue appears “normal”
• Special Tests: Stemmer Sign (-)

Physical Therapy Plan of Care:

• None, this is first physical therapy session

Based on the patient’s past medical history, the patient is MOST likely at a risk of developing which type of ulcer?

Setting: N/a

Sex: Female

Age: 43 years

Presenting Problem/Current Problem:

• Left ankle discomfort

Past Medical History:

• Type 1 Diabetes mellitus

Other Information:

• Lives in one-story home with husband and five children
• Patient reports noticing left ankle beginning to swell more frequently, especially with standing and activity, over the past two months, but swelling will “go away with elevation”
• Patient reports no new skin changes associated with swelling

Physical Therapy Examination(s):

• Pain: Currently 1/10, worst 5/10, best 0/10
• Palpation: Left ankle soft pitting edema
• Painful and limited active ankle plantar flexion, dorsiflexion, eversion, and inversion
• Integumentary: Tissue appears “normal”
• Special Tests: Stemmer Sign (-)

Physical Therapy Plan of Care:

• None, this is first physical therapy session

Patient reports that her sister has lipedema and is concerned she may also develop the condition. Which of the following clinical features is MOST  LIKELY to be present with this diagnosis?

Setting: N/a

Sex: Female

Age: 43 years

Presenting Problem/Current Problem:

• Left ankle discomfort

Past Medical History:

• Type 1 Diabetes mellitus

Other Information:

• Lives in one-story home with husband and five children
• Patient reports noticing left ankle beginning to swell more frequently, especially with standing and activity, over the past two months, but swelling will “go away with elevation”
• Patient reports no new skin changes associated with swelling

Physical Therapy Examination(s):

• Pain: Currently 1/10, worst 5/10, best 0/10
• Palpation: Left ankle soft pitting edema
• Painful and limited active ankle plantar flexion, dorsiflexion, eversion, and inversion
• Integumentary: Tissue appears “normal”
• Special Tests: Stemmer Sign (-)

Physical Therapy Plan of Care:

• None, this is first physical therapy session

Which of the following stages of lymphedema is MOST CONSISTENT with the patient’s presentation?

Setting: OP-Orthopedics

Sex: Female

Age: 18 years

Presenting Problem/Current Problem:

• Onset of severe low back pain with back handsprings for 1 month

Past Medical History:

• Tonsillectomy

Other Information:

• Patient lives with parents, 2 sisters, 1 brother, and 1 dog in two story home
• Patient has been a competitive gymnast for 10 years
• Patient’s mother reports that over the past two months the patient has reported more severe back pain with each gymnastics practice
• Patient practices 3 hours per night, 4 nights per week 
• Patient reports that during school, she experiences no pain sitting in chair for extended periods, but picking up backpack to leave to/from school is painful 

Physical Therapy Examination(s):

• Pain: Currently 3/10, worst 8/10, best 2/10
• AROM: All thoracolumbar motions are within normal limits, but extension is painful, flexion alleviates symptoms slightly
• Special Tests: Straight Leg Raise (-)

Physical Therapy Plan of Care:

• None, this is the patient’s first physical therapy session

Based on the patient presentation in the scenario, what is the MOST LIKELY diagnosis for this patient?

Setting: OP-Orthopedics

Sex: Female

Age: 18 years

Presenting Problem/Current Problem:

• Onset of severe low back pain with back handsprings for 1 month

Past Medical History:

• Tonsillectomy

Other Information:

• Patient lives with parents, 2 sisters, 1 brother, and 1 dog in two story home
• Patient has been a competitive gymnast for 10 years
• Patient’s mother reports that over the past two months the patient has reported more severe back pain with each gymnastics practice
• Patient practices 3 hours per night, 4 nights per week 
• Patient reports that during school, she experiences no pain sitting in chair for extended periods, but picking up backpack to leave to/from school is painful 

Physical Therapy Examination(s):

• Pain: Currently 3/10, worst 8/10, best 2/10
• AROM: All thoracolumbar motions are within normal limits, but extension is painful, flexion alleviates symptoms slightly
• Special Tests: Straight Leg Raise (-)

Physical Therapy Plan of Care:

• None, this is the patient’s first physical therapy session

Which of the following findings during a Straight Leg Raise test would MOST LIKELY be seen in a positive test?

Setting: OP-Orthopedics

Sex: Female

Age: 18 years

Presenting Problem/Current Problem:

• Onset of severe low back pain with back handsprings for 1 month

Past Medical History:

• Tonsillectomy

Other Information:

• Patient lives with parents, 2 sisters, 1 brother, and 1 dog in two story home
• Patient has been a competitive gymnast for 10 years
• Patient’s mother reports that over the past two months the patient has reported more severe back pain with each gymnastics practice
• Patient practices 3 hours per night, 4 nights per week 
• Patient reports that during school, she experiences no pain sitting in chair for extended periods, but picking up backpack to leave to/from school is painful 

Physical Therapy Examination(s):

• Pain: Currently 3/10, worst 8/10, best 2/10
• AROM: All thoracolumbar motions are within normal limits, but extension is painful, flexion alleviates symptoms slightly
• Special Tests: Straight Leg Raise (-)

Physical Therapy Plan of Care:

• None, this is the patient’s first physical therapy session

The physical therapist wants to use a special test for the patient in the scenario. Which of the following special tests would the physical therapist MOST LIKELY use based on the patient’s presentation?

Setting: Inpatient  

Sex: Female

Age: 72 years old

• Presenting Problem / Current Condition
  •         Patient is 2 days status post  L CVA
  •         Reports she experienced sudden onset of numbness in the extremities and difficulty walking 2 days prior
  •         Since diagnosis she reports symptoms of fatigue, RLE weakness, and difficulty with coordination and balance

  Other Information

  •         Patient lives with husband on second floor of a retirement home with access to stairs and an elevator
  •         She has two adult children who live 10 minutes away
  •         Patient was previously independent in self-care and home upkeep
  •         Prior to incident, patient would watch her grandchildren twice a week

  Physical Therapy Examination(s)

  •         ROM: all AROM of the LE on the right side impaired
  •         Strength: all R muscles tested were 3+/5 except for the hamstrings group, which is 5/5
  •         Gait: demonstrates hip hiking as well as decreased coordination of movements

  ·         Balance: Sharpened Romberg with eyes open: 12 sec; eyes closed: 4 sec

  The patient’s primary goal is to return to walking as quickly as possible. What is the BEST INITIAL treatment to progress toward the patient’s goal?

Setting: Inpatient  

Sex: Female

Age: 72 years old

Presenting Problem / Current Condition

•         Patient is 2 days status post  L CVA
•         Reports she experienced sudden onset of numbness in the extremities and difficulty walking 2 days prior
•         Since diagnosis she reports symptoms of fatigue, RLE weakness, and difficulty with coordination and balance

Other Information

•         Patient lives with husband on second floor of a retirement home with access to stairs and an elevator
•         She has two adult children who live 10 minutes away
•         Patient was previously independent in self-care and home upkeep
•         Prior to incident, patient would watch her grandchildren twice a week

Physical Therapy Examination(s)

•         ROM: all AROM of the LE on the right side impaired
•         Strength: all R muscles tested were 3+/5 except for the hamstrings group, which is 5/5
•         Gait: demonstrates hip hiking as well as decreased coordination of movements

·         Balance: Sharpened Romberg with eyes open: 12 sec; eyes closed: 4 sec

While practicing gait, the patient demonstrates R foot drop. The therapist decides to implement a modality into today’s treatment. Which of the following modalities below would MOST LIKELY assist the patient?

Setting: Inpatient  

Sex: Female

Age: 72 years old

 Presenting Problem / Current Condition

•         Patient is 2 days status post  L CVA
•         Reports she experienced sudden onset of numbness in the extremities and difficulty walking 2 days prior
•         Since diagnosis she reports symptoms of fatigue, RLE weakness, and difficulty with coordination and balance

Other Information

•         Patient lives with husband on second floor of a retirement home with access to stairs and an elevator
•         She has two adult children who live 10 minutes away
•         Patient was previously independent in self-care and home upkeep
•         Prior to incident, patient would watch her grandchildren twice a week

Physical Therapy Examination(s)

•         ROM: all AROM of the LE on the right side impaired
•         Strength: all R muscles tested were 3+/5 except for the hamstrings group, which is 5/5
•         Gait: demonstrates hip hiking as well as decreased coordination of movements
•         Balance: Sharpened Romberg with eyes open: 12 sec; eyes closed: 4 sec

During one of your sessions, the patient becomes frustrated that she is unable to walk and function like she used to and that rehab is taking too long. The therapist decides to discuss tissue healing times and expectations with the patient. Which of the following pieces of patient education would MOST LIKELY be included during this session?

Setting: Outpatient Orthopedic

Sex: Female

Age: 56

Presenting Problem / Current Condition

•   Patient presents to PT with a referral that states “R deltoid strain, evaluate and treat”
•   Symptoms include pain with overhead motions, slow decline in strength, and difficulty with sleeping 

Other Information

•   Patient is an avid tennis player and is continuing to play but at a lower intensity due to the pain with overhead motions
•   Lives in a two story home with her husband who has been assisting her with her chores around the home

Physical Therapy Examination(s)

•   Strength: Tests with full strength but painful right shoulder flexion, abduction, and external rotation
•   ROM: Slight decrease noted in right shoulder flexion and abduction, significant limitation in functional internal rotation
•   Joint mobility: Hypomobile and painful inferior glide of the right glenohumeral joint
•   Special tests: (-) Drop Arm Test, (+) Infraspinatus Test, (+) Yocum’s, (+) Belly Press Test

According to this evaluation and exam results presented above, what is the MOST LIKELY patient diagnosis?

Setting: Outpatient Orthopedic

Sex: Female

Age: 56

Presenting Problem / Current Condition

•   Patient presents to PT with a referral that states R deltoid strain, evaluate and treat
•   Symptoms include pain with overhead motions, slow decline in strength, and difficulty with sleeping 

Other Information

•   Patient is an avid tennis player and is continuing to play but at a lower intensity due to the pain with overhead motions
•   Lives in a two story home with her husband who has been assisting her with her chores around the home

Physical Therapy Examination(s)

•   Strength: Tests with full strength but painful right shoulder flexion, abduction, and external rotation
•   ROM: Slight decrease noted in right shoulder flexion and abduction, significant limitation in functional internal rotation
•   Joint mobility: Hypomobile and painful inferior glide of the right glenohumeral joint

●   Special tests: (-) Drop Arm Test, (+) Infraspinatus Test, (+) Yocum’s, (+) Belly Press Test

At the end of the evaluation the patient states that she will be leaving for two weeks on vacation and will not have access to equipment. What would be the BEST plan for physical therapy at this time?

Setting: Outpatient Orthopedic

Sex: Female

Age: 56

Presenting Problem / Current Condition

•   Patient presents to PT with a referral that states R deltoid strain, evaluate and treat
•   Symptoms include pain with overhead motions, slow decline in strength, and difficulty with sleeping 

Other Information

•   Patient is an avid tennis player and is continuing to play but at a lower intensity due to the pain with overhead motions
•   Lives in a two story home with her husband who has been assisting her with her chores around the home

Physical Therapy Examination(s)

•   Strength: Tests with full strength but painful right shoulder flexion, abduction, and external rotation
•   ROM: Slight decrease noted in right shoulder flexion and abduction, significant limitation in functional internal rotation
•   Joint mobility: Hypomobile and painful inferior glide of the right glenohumeral joint
•   Special tests: (-) Drop Arm Test, (+) Infraspinatus Test, (+) Yocum’s, (+) Belly Press Test

After explaining to the patient your suspected PT diagnosis, she does not understand how this could have happened without a traumatic injury to her shoulder. What would be the BEST explanation as to why this injury occurred?

Setting: Outpatient Orthopedic

Sex: Male

Age: 55

 Presenting Problem / Current Condition

•       Patient presents with lateral elbow pain that limits ability to perform work activities as a mechanic and participate in recreational sports such as volleyball
•       Patient cannot describe a specific mechanism of injury, stating that pain started increasing gradually 

Other Information

•       Works 10-12 hours a day as a mechanic 

●       Likes to ride a motorcycle as his main form of transportation

Physical Therapy Examination(s)

•       Pain: 2/10 at best, 5/10 currently, 7/10 at worst
•       Strength: pain with wrist extension and ulnar deviation
•       ROM: limited wrist flexion which reproduces his lateral elbow pain
•       Special tests: (+) Maudsley’s, (+) chair push-up test
•       Joint mobility: humeroulnar and proximal radioulnar joint is hypomobile

Which other special test would confirm the diagnosis?

Setting: Outpatient Orthopedic

Sex: Male

Age: 55

Presenting Problem / Current Condition

•       Patient presents with lateral elbow pain that limits ability to perform work activities as a mechanic and participate in recreational sports such as volleyball
•       Patient cannot describe a specific mechanism of injury, stating that pain started increasing gradually 

Other Information

•       Works 10-12 hours a day as a mechanic 
•       Likes to ride a motorcycle as his main form of transportation 

Physical Therapy Examination(s)

•       Pain: 2/10 at best, 5/10 currently, 7/10 at worst
•       Strength: pain with wrist extension and ulnar deviation
•       ROM: limited wrist flexion which reproduces his lateral elbow pain
•       Special tests: (+) Maudsley’s, (+) chair push-up test
•       Joint mobility: humeroulnar and proximal radioulnar joint is hypomobile

Given the information in the case, what other possible diagnosis could the patient be experiencing?

Setting: Outpatient Orthopedic

Sex: Male

Age: 55

 Presenting Problem / Current Condition

•       Patient presents with lateral elbow pain that limits ability to perform work activities as a mechanic and participate in recreational sports such as volleyball
•       Patient cannot describe a specific mechanism of injury, stating that pain started increasing gradually 

Other Information

•       Works 10-12 hours a day as a mechanic 
•       Likes to ride a motorcycle as his main form of transportation 

Physical Therapy Examination(s)

•       Pain: 2/10 at best, 5/10 currently, 7/10 at worst
•       Strength: pain with wrist extension and ulnar deviation
•       ROM: limited wrist flexion which reproduces his lateral elbow pain
•       Special tests: (+) Maudsley’s, (+) chair push-up test
•       Joint mobility: humeroulnar and proximal radioulnar joint is hypomobile

Following the initial evaluation the therapist would like to prescribe an HEP for the patient. Which of the following would be the MOST appropriate exercise to include?

Setting: OP-Neuro

Sex: Male

Age: 70 years

Presenting Problem/Current Problem:

• Patient presents today with increased low back pain, “both legs are feeling heavier, stiffer, and weaker” over the past two months, and increase in fatigue

Past Medical History:

• Parkinson’s Disease
• Increased frequency of UTIs
• Chronic low back pain

Other Information:

• Patient lives in a one story home with wife; wife is the patient’s primary caregiver
• Patient is currently prescribed Levodopa
• Patient receives skilled physical therapy services about every 6-12 months, based on presentation of new limitations
• Patient utilizes a U Step Walker for ambulation 

Physical Therapy Examination(s):

• Sit-to-stand transfer with use of U Step Walker Contact Guard Assist
• Gait: Patient able to ambulate 50 feet with use of U Step Walker and Stand by Assist. Patient demonstrates decreased step length bilaterally, shuffled gait pattern, and decreased gait speed. Patient is able to turn around to face a new direction with U Step Walker with m\Minimal Assist, due to freezing of gait.

Physical Therapy Plan of Care:

• None, this is the patient’s first physical therapy session

Which of the following structures of the brain MOST LIKELY experiences degeneration of dopaminergic neurons?

Setting: OP-Neuro

Sex: Male

Age: 70 years

Presenting Problem/Current Problem:

• Patient presents today with increased low back pain, “both legs are feeling heavier, stiffer, and weaker” over the past two months, and increase in fatigue

Past Medical History:

• Parkinson’s Disease
• Increased frequency of UTIs
• Chronic low back pain

Other Information:

• Patient lives in a one story home with wife; wife is the patient’s primary caregiver
• Patient is currently prescribed Levodopa
• Patient receives skilled physical therapy services about every 6-12 months, based on presentation of new limitations
• Patient utilizes a U Step Walker for ambulation 

Physical Therapy Examination(s):

• Sit-to-stand transfer with use of U Step Walker Contact Guard Assist
• Gait: Patient able to ambulate 50 feet with use of U Step Walker and Stand by Assist. Patient demonstrates decreased step length bilaterally, shuffled gait pattern, and decreased gait speed. Patient is able to turn around to face a new direction with U Step Walker with m\Minimal Assist, due to freezing of gait.

Physical Therapy Plan of Care:

• None, this is the patient’s first physical therapy session

The physical therapist notes that the patient has reduced motions and slowness with all movements during the session. Which of the following terminology BEST describes what the physical therapist is observing?

Setting: OP-Neuro

Sex: Male

Age: 70 years

Presenting Problem/Current Problem:

• Patient presents today with increased low back pain, “both legs are feeling heavier, stiffer, and weaker” over the past two months, and increase in fatigue

Past Medical History:

• Parkinson’s Disease
• Increased frequency of UTIs
• Chronic low back pain

Other Information:

• Patient lives in a one story home with wife; wife is the patient’s primary caregiver
• Patient is currently prescribed Levodopa
• Patient receives skilled physical therapy services about every 6-12 months, based on presentation of new limitations
• Patient utilizes a U Step Walker for ambulation 

Physical Therapy Examination(s):

• Sit-to-stand transfer with use of U Step Walker Contact Guard Assist
• Gait: Patient able to ambulate 50 feet with use of U Step Walker and Stand by Assist. Patient demonstrates decreased step length bilaterally, shuffled gait pattern, and decreased gait speed. Patient is able to turn around to face a new direction with U Step Walker with m\Minimal Assist, due to freezing of gait.

Physical Therapy Plan of Care:

• None, this is the patient’s first physical therapy session

Which of the following statements below LEAST LIKELY pertains to the medication Levodopa/Carbidopa (Sinemet)?

Setting: IP-Acute

Sex: Female

Age: 70 years

Presenting Problem/Current Problem:

• Patient went to emergency room, due to worsening of wound appearance and pain severity on patient’s right ankle

Past Medical History:

• Venous Insufficiency 
• Hypertension
• Varicose Veins
• 5 pregnancies, uncomplicated

Other Information:

• Lives in a one bedroom condominium with husband in assisted living facility
• Requires no assistive device for ambulation around home and community
• Patient reports a heavy feeling in lower extremities with increased activity levels
• Patient reports recent skin changes over the past 6 months including brownish discoloration of legs and flaking of skin
• No reported falls within the past year
• Independent for bed mobility, transfers, ambulation, and all activities of daily living prior to admission 

Physical Therapy Examination(s):

• Supine-to-sit transfer independent
• Sit-to-stand transfer Contact Guard Assist with two wheeled walker
• Transfer from bed to chair with two wheeled walker, Contact Guard Assist, and step through gait pattern
• Gait: Patient ambulated for 10 minutes with two wheeled walker, Contact Guard Assist, and utilized a step through gait pattern 

Physical Therapy Plan of Care:

• Bed Mobility
• Transfers
• Gait

Based on the patient’s past medical history of having Venous Insufficiency, which of the following anatomical locations would MOST LIKELY be the location of the patients’ current wound?

Setting: IP-Acute

Sex: Female

Age: 70 years

Presenting Problem/Current Problem:

• Patient went to emergency room, due to worsening of wound appearance and pain severity on patient’s right ankle

Past Medical History:

• Venous Insufficiency 
• Hypertension
• Varicose Veins
• 5 pregnancies, uncomplicated

Other Information:

• Lives in a one bedroom condominium with husband in assisted living facility
• Requires no assistive device for ambulation around home and community
• Patient reports a heavy feeling in lower extremities with increased activity levels
• Patient reports recent skin changes over the past 6 months including brownish discoloration of legs and flaking of skin
• No reported falls within the past year
• Independent for bed mobility, transfers, ambulation, and all activities of daily living prior to admission 

Physical Therapy Examination(s):

• Supine-to-sit transfer independent
• Sit-to-stand transfer Contact Guard Assist with two wheeled walker
• Transfer from bed to chair with two wheeled walker, Contact Guard Assist, and step through gait pattern
• Gait: Patient ambulated for 10 minutes with two wheeled walker, Contact Guard Assist, and utilized a step through gait pattern 

Physical Therapy Plan of Care:

• Bed Mobility
• Transfers
• Gait

The physical therapist begins to observe the patient’s wound bed and periwound area. Which of the following characteristics of the wound would LEAST LIKELY be present?

Setting: IP-Acute

Sex: Female

Age: 70 years

Presenting Problem/Current Problem:

• Patient went to emergency room, due to worsening of wound appearance and pain severity on patient’s right ankle

Past Medical History:

• Venous Insufficiency 
• Hypertension
• Varicose Veins
• 5 pregnancies, uncomplicated

Other Information:

• Lives in a one bedroom condominium with husband in assisted living facility
• Requires no assistive device for ambulation around home and community
• Patient reports a heavy feeling in lower extremities with increased activity levels
• Patient reports recent skin changes over the past 6 months including brownish discoloration of legs and flaking of skin
• No reported falls within the past year
• Independent for bed mobility, transfers, ambulation, and all activities of daily living prior to admission 

Physical Therapy Examination(s):

• Supine-to-sit transfer independent
• Sit-to-stand transfer Contact Guard Assist with two wheeled walker
• Transfer from bed to chair with two wheeled walker, Contact Guard Assist, and step through gait pattern
• Gait: Patient ambulated for 10 minutes with two wheeled walker, Contact Guard Assist, and utilized a step through gait pattern 

Physical Therapy Plan of Care:

• Bed Mobility
• Transfers
• Gait

Which of the following special tests would MOST LIKELY be used to identify the presence of a DVT?

Setting: OP-Orthopedics

Sex: Female

Age: 21 years

Presenting Problem/Current Problem:

• Onset of neck pain after studying at desk and using laptop for greater than 1 hour

Past Medical History:

• Wisdom teeth removal

Other Information:

• Patient is a full time college student who lives in an apartment complex on the sixth floor with three roommates, no elevator access
• Patient expresses that they get headaches on the right side only if they study for periods greater than 1 hour
• Patient reports the only way to decrease pain is by stopping computer use and/or taking a Tylenol
• Patient reports that they are taking a new class for computer science, which requires computer use for greater than 3 hours
• Patient reports always having tight muscles around the neck throughout high school and the beginning of college, but now the tightness has reached a “higher level of pain”

Physical Therapy Examination(s):

• Posture: Forward head, rounded shoulders
• Pain Location with Palpation: Right upper trapezius, right levator scapulae, and right rhomboids
• Pain Location (Headache): Right occipital region, which spreads to frontal region
• Pain Ranking: Current 0/10, worst 5/10, best 0/10
• AROM: All cervical motions within normal limits, but extension, left side bending, and right rotation are painful

Physical Therapy Plan of Care:

• None, this is the first physical therapy session

Based on the patient presentation in the scenario, which type of headache is the patient MOST LIKELY experiencing?

Setting: OP-Orthopedics

Sex: Female

Age: 21 years

Presenting Problem/Current Problem:

• Onset of neck pain after studying at desk and using laptop for greater than 1 hour

Past Medical History:

• Wisdom teeth removal

Other Information:

• Patient is a full time college student who lives in an apartment complex on the sixth floor with three roommates, no elevator access
• Patient expresses that they get headaches on the right side only if they study for periods greater than 1 hour
• Patient reports the only way to decrease pain is by stopping computer use and/or taking a Tylenol
• Patient reports that they are taking a new class for computer science, which requires computer use for greater than 3 hours
• Patient reports always having tight muscles around the neck throughout high school and the beginning of college, but now the tightness has reached a “higher level of pain”

Physical Therapy Examination(s):

• Posture: Forward head, rounded shoulders
• Pain Location with Palpation: Right upper trapezius, right levator scapulae, and right rhomboids
• Pain Location (Headache): Right occipital region, which spreads to frontal region
• Pain Ranking: Current 0/10, worst 5/10, best 0/10
• AROM: All cervical motions within normal limits, but extension, left side bending, and right rotation are painful

Physical Therapy Plan of Care:

• None, this is the first physical therapy session

The physical therapist wants to test the patient’s Cranial Nerve XI. Which of the following muscles will the physical therapist MOST LIKELY assess in order to conduct the test?

Setting: OP-Orthopedics

Sex: Female

Age: 21 years

Presenting Problem/Current Problem:

• Onset of neck pain after studying at desk and using laptop for greater than 1 hour

Past Medical History:

• Wisdom teeth removal

Other Information:

• Patient is a full time college student who lives in an apartment complex on the sixth floor with three roommates, no elevator access
• Patient expresses that they get headaches on the right side only if they study for periods greater than 1 hour
• Patient reports the only way to decrease pain is by stopping computer use and/or taking a Tylenol
• Patient reports that they are taking a new class for computer science, which requires computer use for greater than 3 hours
• Patient reports always having tight muscles around the neck throughout high school and the beginning of college, but now the tightness has reached a “higher level of pain”

Physical Therapy Examination(s):

• Posture: Forward head, rounded shoulders
• Pain Location with Palpation: Right upper trapezius, right levator scapulae, and right rhomboids
• Pain Location (Headache): Right occipital region, which spreads to frontal region
• Pain Ranking: Current 0/10, worst 5/10, best 0/10
• AROM: All cervical motions within normal limits, but extension, left side bending, and right rotation are painful

Physical Therapy Plan of Care:

• None, this is the first physical therapy session

The physical therapist noted that the patient’s posture is indicative of Upper Crossed Syndrome. Which of the following muscle changes are MOST LIKELY observed by the therapist?

Setting: Outpatient Orthopedic

Sex: Female

Age: 67 years old

Presenting Problem / Current Condition

•         Patient referred for falls risk assessment due to unsteadiness with standing and walking
•         Reports two falls in the last month after standing up from a chair to go to the bathroom and while standing up to leave a restaurant
•         After the second fall, patient developed some bruises
•         Patient is fearful of walking in the community

Medical History

•         Diagnosed with Parkinson’s disease five years ago

Other Information

•         Retired lawyer
•         Enjoys walking her dog around the community
•         Lives in a single-story home with husband and dog, three steps to enter the home
•         Patient performs most of her self-care activities except for those that require precise finger and wrist functions

 Physical Therapy Examination(s)

•         ROM: impaired elbow flexion, wrist flexion/extension; knee flexion/extension, and ankle PF/DF
•         Strength: weakness in bilateral lower extremities
•         Balance: Romberg eyes open 30 sec; eyes closed 8 sec
•         Forward reach test: 8 cm
•         Gait: small, shuffling steps with increased concentration; lacks coordinated movement

Which outcome measure would be MOST appropriate for this patient?

Setting: Outpatient Orthopedic

Sex: Female

Age: 67 years old

Presenting Problem / Current Condition

•         Patient referred for falls risk assessment due to unsteadiness with standing and walking
•         Reports two falls in the last month after standing up from a chair to go to the bathroom and while standing up to leave a restaurant
•         After the second fall, patient developed some bruises 
•         Patient is fearful of walking in the community

Medical History

•         Diagnosed with Parkinson’s disease five years ago

Other Information

•         Retired lawyer
•         Enjoys walking her dog around the community
•         Lives in a single-story home with husband and dog, three steps to enter the home
•         Patient performs most of her self-care activities except for those that require precise finger and wrist functions

 Physical Therapy Examination(s)

•         ROM: impaired elbow flexion, wrist flexion/extension; knee flexion/extension, and ankle PF/DF
•         Strength: weakness in bilateral lower extremities 
•         Balance: Romberg eyes open 30 sec; eyes closed 8 sec
•         Forward reach test: 8 cm
•         Gait: small, shuffling steps with increased concentration; lacks coordinated movement

When you are planning her next PT session, which of the following interventions would be MOST appropriate for this patient?

Setting: Outpatient Orthopedic

Sex: Female

Age: 67 years old

Presenting Problem / Current Condition

•         Patient referred for falls risk assessment due to unsteadiness with standing and walking
•         Reports two falls in the last month after standing up from a chair to go to the bathroom and while standing up to leave a restaurant
•         After the second fall, patient developed some bruises 
•         Patient is fearful of walking in the community

Medical History

•         Diagnosed with Parkinson’s disease five years ago

Other Information

•         Retired lawyer
•         Enjoys walking her dog around the community
•         Lives in a single-story home with husband and dog, three steps to enter the home
•         Patient performs most of her self-care activities except for those that require precise finger and wrist functions

 Physical Therapy Examination(s)

•         ROM: impaired elbow flexion, wrist flexion/extension; knee flexion/extension, and ankle PF/DF
•         Strength: weakness in bilateral lower extremities 
•         Balance: Romberg eyes open 30 sec; eyes closed 8 sec
•         Forward reach test: 8 cm
•         Gait: small, shuffling steps with increased concentration; lacks coordinated movement

Upon further examination, you determine that the patient would be safer with an assistive device. Which device would you MOST LIKELY recommend?

Setting: OP – Ortho

Sex: Female

Age: 23 years

Presenting Problem/Current Problem:

• Onset of right lateral hip pain with clicking sound began 3 weeks ago
• Pain is described as achy and snapping
• Increase in pain occurs with running, swimming, and biking

Past Medical History:

• Tonsillectomy 

Other Information:

• Lives in third floor apartment with significant other and 1 dog, elevator available for use as needed, in unit washer and dryer
• Recreational runner, although patient expresses recent increase in running recently to train for local 5K

Physical Therapy Examination(s):

• Pain: Currently 3/10, worst 6/10, best 1/10
• Palpation: Moderately tender to palpation over the right greater trochanter
• AROM: Painful hip flexion, abduction, and external rotation
• PROM: No pain with all movements
• Special Tests: FADIR Test (-)

Physical Therapy Plan of Care:

None, this is the first physical therapy session

Which of the following diagnoses listed below is MOST CONSISTENT with this patient presentation?

Setting: OP – Ortho

Sex: Female

Age: 23 years

Presenting Problem/Current Problem:

• Onset of right lateral hip pain with clicking sound began 3 weeks ago
• Pain is described as achy and snapping
• Increase in pain occurs with running, swimming, and biking

Past Medical History:

• Tonsillectomy 

Other Information:

• Lives in third floor apartment with significant other and 1 dog, elevator available for use as needed, in unit washer and dryer
• Recreational runner, although patient expresses recent increase in running recently to train for local 5K

Physical Therapy Examination(s):

• Pain: Currently 3/10, worst 6/10, best 1/10
• Palpation: Moderately tender to palpation over the right greater trochanter
• AROM: Painful hip flexion, abduction, and external rotation
• PROM: No pain with all movements
• Special Tests: FADIR Test (-)

Physical Therapy Plan of Care:

None, this is the first physical therapy session

What is the MOST LIKELY normal active range of motion for hip flexion?

Setting: OP – Ortho

Sex: Female

Age: 23 years

Presenting Problem/Current Problem:

• Onset of right lateral hip pain with clicking sound began 3 weeks ago
• Pain is described as achy and snapping
• Increase in pain occurs with running, swimming, and biking

Past Medical History:

• Tonsillectomy 

Other Information:

• Lives in third floor apartment with significant other and 1 dog, elevator available for use as needed, in unit washer and dryer
• Recreational runner, although patient expresses recent increase in running recently to train for local 5K

Physical Therapy Examination(s):

• Pain: Currently 3/10, worst 6/10, best 1/10
• Palpation: Moderately tender to palpation over the right greater trochanter
• AROM: Painful hip flexion, abduction, and external rotation
• PROM: No pain with all movements
• Special Tests: FADIR Test (-)

Physical Therapy Plan of Care:

None, this is the first physical therapy session

The therapist performs a manual muscle test for the right hip abductors. With the patient in left sidelying, the right leg is abducted and the patient moves through full range of motion and can hold the position against moderate resistance. Which of the below descriptions is MOST CONSISTENT with this finding?