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TrueLearn Full Solution Pack 2023-2024 All Questions and Answers are hereWhich of the following lists of equipment is required to perform the Berg balance scale with a patient accurately?
a) stopwatch, armchair, measured walkway, foam pad
b) foam pad, 6-inch step, stopwatch, armchair
c) chairs with and without arms, stopwatch, ruler, 6 inch step
d) measured walkway, ruler, chair without arms, foam pad - correct answer: C
Answer A:The Berg balance scale does not include a measured walkway because it does not test gait, and it does not require a foam pad because all standing activities are tested on a stable surface in the Berg balance test.
Answer B:The Berg balance scale does not require a foam pad because all standing is done on a stable surface. The sit-stand tests need a chair without arms, although the transfer testing requires a chair with and without arms.
Answer D:The Berg balance scale does not test gait, so no measured walkway is required. The Berg balance scale does all standing tests on a stable surface, so it does not require a foam pad.
Bottom Line:The Berg balance scale requires minimal equipment to perform accurately. There must be two types of chairs, one with and one without arms for the transfer testing, and then the one without arms is used for the sit-stand. A stopwatch, 6" step and ruler are also needed.
In a diabetic patient with poorly controlled hyperglycemia, all of the following can occur in the body EXCEPT which of these?
a) kidneys excrete increased amounts of glucose
b) kidneys excrete increased amounts of water
c) liver increases glucose production
d) liver produces more insulin - Correct answer: D
The liver does not produce insulin. It is produced in the pancreas. In addition, in patients
with diabetes and hyperglycemia, they may not be able to produce more insulin, or the insulin they do produce is ineffective because there is insulin resistance. The body tries to remove the glucose through the urine.
Answer A: Since insulin is not doing the job of moving glucose out of the blood and into the cells, the kidneys attempt to excrete it in the urine. That is why patients with diabetes will test positive for glucose in their urine. Answer B: The excess sugar in the urine sets up an osmotic pressure gradient where water is not reabsorbed by the renal tubules and is instead excreted in theurine. This causes a patient to urinate frequently, called polyuria.
Answer C: The liver usually absorbs glucose after a meal. If the glucose is not mobilized
to the liver, such as when there is insufficient insulin or insulin resistance, the glucose remains in the blood. The liver, sensing it did not absorb new glucose, perceives this as a glucose deficit and produces more glucose and sends it into the circulation. This is meant to help, but it only exacerbates the hyperglycemia.
Bottom Line: The liver does not produce insulin. When the body has too much glucose in the blood that is not sent to the cells, many other compensatory processes occur. The
excess sugar is excreted through the urine, which also sets up an osmotic pressure gradient, causing water to not be absorbed in the renal tubules and also to be excreted through the urine. This causes patients with hyperglycemia to urinate frequently, called polyuria.
A physical therapist is planning a research study investigating the effect of a lower extremity strengthening program on gait speed in community-dwelling older adults. Subjects will be assessed at three different time points: baseline (assessment 1), after 6
weeks of training (assessment 2), and after 12 weeks of training (assessment 3). Gait speed will be calculated for each participant using distance in meters and time in seconds. What type of statistical test would be used to determine if the intervention was able to significantly improve gait speed?
a) chi square
b) independent t test
c) pearson r correlation
d) repeated measures analysis of variance - A repeated measures analysis of variance
(ANOVA) is used to compare three or more measures of interval or ratio level data collected from the same research subject over time. Since the design of this study measured the same group of individuals over a period of three assessments, repeated measures analysis of variance would be an appropriate statistic for this data.
Answer A: A Chi square is used to analyze nominal level data to determine if the proportion of categories of data differ from what you would expect to find by chance. Since the design of this study measured the same group of individuals over a period of three assessments and gait speed is ratio level data, a Chi square would be an incorrect statistic for this data.
Answer B: An independent t test is used to compare the means of interval or ratio data from two independent groups of individuals. Since the design of this study measured the
same group of individuals over a period of three assessments, an independent t test would be the incorrect statistic for this data.
Answer C: A Pearson r correlation is used to determine the relationship between two dependent variables, which are interval or ratio level data. The design of this study was not correlational since it was attempting to determine the effect of an intervention.
Bottom Line: Analysis of variance is used to compare three or more measures of interval or ratio level data. A physical therapist needs to understand why a particular statistical analysis was completed so that they can determine the validity of study findings.
A physical therapist is examining a patient with shoulder pain. After completing a full examination with all special tests completed, the following special tests were positive: Hawkins-Kennedy test, infraspinatus resisted test, and painful arc sign. Which of the following disorders is MOST likely present?
a) glenohumeral instability
b) labral tear
c) rotator cuff tear
d) subacromial impingement - Pain in the subacromial space can be caused by a number of disorders. Clinical prediction rules (CPR) combine certain findings to improve
the likelihood of predicting the source of the dysfunction. Positive findings for subacromial impingement include a painful arc sign and positive Hawkins-Kennedy and infraspinatous resisted tests.The pain generator stems from a structure being compressed within the subacromial space. The Hawkins-Kennedy test creates a gradual compression to the subacromial space and is compression provocative. The infraspinatus resisted test emphasizes the external rotators as a source of tissue not stabilizing correctly, thus allowing the humeral head to move more freely, creating compression within the subacromial space. Lastly, a painful arc occurs in the range in which the structures in subacromial space are most compressed.
Answer A: Glenohumeral instability can lead to a subacromial impingement, but there are other causes as well. This answer is not the best choice because the tests listed do not directly test for instability; they test for subacromial compression of the structures within the subacromial space.
Answer B: These special tests do not stress the labrum.
Answer C: The CPR for a rotator cuff tear has some similarity to the CPR for subacromial impingement since the location of the supraspinatous in the subacromial space makes it susceptible to injury and tearing. However, the CPR for a rotator cuff tear includes a positive drop arm test. The CPR for an incomplete rotator cuff tear is painful arc sign, drop arm sign, and infraspinatus resisted test. In this scenario, rotator cuff tear is not the best option.
A physical therapist is working with a patient who has had a stroke. The patient reports difficulty engaging the brakes on the wheelchair because of motor control and strength impairments on the more involved upper extremity. Which of the following is the wheelchair option that would maximize the patient's ability to engage the brakes?
a) push-to-lock brake
b) brake lever extension
c) pull-to-lock brake
d) scissor brake - Correct answer: B
Abrake lever extensionwill increase the patient's leverage and thus make it easier for them to engage the brakes. Answer A:A push-to-lock brake does not make it easier or harder to engage the brake compared to other brake types.
Answer C:A pull-to-lock brake does not make it easier or harder to engage the brake compared to other brake types.
Answer D:A scissor brake positions the brakes under the seat, which may make propulsion easier since the brakes are not in the way of the wheels. However, it may be harder for a patient to reach a scissor brake, so they may be more difficult to engage compared to other brake types.
If the treatment approach for a non-infected wound is to liquefy the necrotic tissue in the
wound, which of the following is the MOST appropriate type of debridement?
a) maggots
b) autolytic
c) wet-to-dry dressings
d) soft abrasion - Correct answer: B
Autolytic debridement uses moisture-retentive dressings to seal the wound closed and allow the body's own endogenous enzymes to break down and liquefy the necrotic tissue. It takes longer than other methods but is less invasive and requires less skill. Dressings include hydrogels, hydrocolloids, transparent films, and semipermeable foams.
Answer A:Maggots ingest necrotic tissue and spare viable tissue.
Answer C:Wet-to-dry dressings are applied to a wound. When the necrotic tissue adheres to the most gauze and the gauze is dry, the gauze is pulled away. This method is not recommended for wounds that have greater than 50% granulation tissue as the gauze removes the healthy granulation tissue as well.
Answer D:Soft abrasion is a type of mechanical debridement that uses a piece of gauze
or swab to remove non-adherent, moist necrotic tissue.
A physical therapist observes that a patient who is performing moderate exercise is beginning to show signs of hypoglycemia. The therapist most likely observes all of the following signs EXCEPT which sign?
a) bradycardia
b) confusion
c) complaint of headache
d) perspiration - Correct answer: A
Acute hypoglycemia causes a number of physiological responses in order to maintain the supply of glucose to the brain and help the liver add more glucose to the circulation. The autonomic nervous system is activated, and epinephrine is released to help this activation, and that creates tachycardia, not bradycardia. People report a rapid heart rate, dizziness and shakiness, perspiration, and headache. They also begin to act confused as they become more hypoglycemic.
Answers B & C & D:This is a common sign of hypoglycemia.
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