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PEAT EXAM 3: QUESTIONS AND ANSWERS (RATED A+)
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PEAT EXAM 3: QUESTIONS AND ANSWERS (RATED A+)
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PEAT EXAM 3: QUESTIONS AND ANSWERS (RATED A+)A patient reports a 2-day history of a hot, swollen, first metatarsophalangeal joint. This complaint is MOST common in:
1. osteoarthritis.
2. polymyositis.
3. gout.
4. rheumatoid arthritis. Right Ans - 1. Osteoarthritis is typically characterized by dull, achy pain in weight-bearing joints (e.g., hips, knees, etc.)
(pp. 1304-1306).
2. Polymyositis presents as symmetric proximal muscle weakness with malaise and weight loss. There is no joint involvement. (p. 1247)
3. Gout's typical presentation is severe joint pain, occurring at night, typically in the first metatarsophalangeal joint. Signs and symptoms also include erythema, warmth, and extreme tenderness and hypersensitivity of the affected joint. (p. 1345)
4. Rheumatoid arthritis presents with symmetrical joint inflammation and pain with subluxations (pp. 1319-1322).
A patient who sustained an avulsion of the right C5 and C6spinal nerve roots will show functional loss of right:
1. distal thumb flexion.
2. ulnar wrist deviation.
3. elbow extension.
4. shoulder abduction. Right Ans - 1. The C8-T1 nerve roots form the median nerve (anterior interosseus), supplying the flexor pollicis longus muscle. A patient who has an avulsion of the C5 and C6 spinal nerve roots will be able to perform distal thumb (1st digit) flexion. (Dutton, p. 83; O'Sullivan, p.
154)
2. The C7-C8 nerve roots form the ulnar nerve and radial nerve (posterior interosseus), supplying the flexor and extensor carpi ulnaris. Therefore, a patient who has an avulsion of the C5 and C6 spinal nerve roots will be able to perform wrist ulnar deviation. (Dutton, pp. 83, 86; O'Sullivan, p. 154)
3. The C5-C8 and T1 nerve roots form the radial nerve, supplying the triceps brachii. Avulsion of the C5 and C6 nerve roots will result in weakness but not functional loss of elbow extension. (Dutton, pp. 81-82; O'Sullivan, p. 154)
4. The C5-C6 nerve roots form the axillary nerve, supplying the deltoid and teres minor. Avulsion of these nerve roots will result in decreased right shoulder abduction. (Dutton, p. 80; O'Sullivan, p. 154) After a kidney transplant, a patient develops a Stage 3 pressure injury over the
sacrum and is referred to physical therapy for wound care. Which of the following is the MOSTappropriate agent to use initially on this wound?
1. Povidone-iodine solution
2. Sterile normal saline
3. Silver sulfadiazine (Silvadene) cream
4. Zinc oxide cream Right Ans - 1. Povidone-iodine is usually used as a skin preparation to prevent surgical site infection. It can be used in acute traumatic
wounds. A Stage 3 pressure injury is an example of a chronic wound. (Sussman, p. 518)
2. Sterile normal saline is the appropriate initial agent used to clean a wound (Sussman, p. 518).
3. Use of silver sulfadiazine may be indicated if infection is present. However, it is not indicated in the initial treatment. (Sussman, p. 513)
4. Zinc oxide is used in dental fillings and in local surface treatment for various
skin disorders but not for chronic pressure injuries (Mosby's, p. 1913).
When providing patient education in cardiac rehabilitation, which of the following signs and symptoms of exertional intolerance should the physical therapist emphasize?
1. Anginal pain, insomnia, sudden weight gain, leg stiffness
2. Persistent dyspnea, dizziness, anginal pain, sudden weight gain
3. Persistent dyspnea, anginal pain, insomnia, weight loss
4. Anginal pain, confusion, leg numbness, weight loss Right Ans - 1. Leg stiffness is not a sign/symptom associated with exercise intolerance among patients undergoing cardiac rehabilitation.
2. The signs and symptoms listed in this option are associated with exercise intolerance among patients undergoing cardiac rehabilitation.
3. Weight loss is not a sign associated with exercise intolerance among patients undergoing cardiac rehabilitation. However, angina and dyspnea are important signs of exercise intolerance.
4. Leg numbness, confusion, and weight loss are not associated with exercise intolerance. However, angina is important to note in the patient who has cardiac dysfunction.
A patient with no history of trauma has nonradiating low back pain. Lumbar flexion does not reverse the lordosis and is pain-free; lumbar extension increases the symptom. Palpation reveals a step-off in the lower lumbar region. The MOST appropriate treatment for this patient would be:
1. abdominal strengthening.
2. sustained prone positioning on elbows.
3. exaggerated lumbar lordosis in sitting.
4. grade III posteroanterior glide to L5. Right Ans - 1. This patient's signs and symptoms are consistent with spondylolisthesis. Abdominal muscle strengthening and stabilization are key to conservative management.
2. Extension activities are not indicated for a patient with spondylolisthesis.
3. Extension activities are not indicated for a patient with spondylolisthesis.
4. Extension activities are not indicated for a patient with spondylolisthesis.
A patient positioned in prone has difficulty initiating hip extension with the knee bent. Which of the following muscles will MOST likely need strengthening?
1. Hamstrings
2. Gluteus maximus
3. Lumbar erector spinae
4. Gluteus medius Right Ans - 1. Hamstrings are primarily knee flexors. They can be secondary hip extensors but would be tested with the knee extended, not flexed. (p. 242)
2. The gluteus maximus is the primary hip extensor muscle tested in this manner (p. 216).
3. Lumbar erector spinae extend the trunk on the legs. They do not attach on the femur and have no impact on hip extension. (pp. 43-44)
4. Gluteus medius weakness would be assessed by testing hip abduction in sidelying position (p. 223).
A patient presents with moderate pain in the elbow after a fall. The radiograph is negative for a fracture. Which of the following mobilizations is MOST appropriate for decreasing the pain?
1. Small-amplitude oscillations before the onset of tissue resistance
2. Small-amplitude oscillations into tissue resistance
3. Large-amplitude oscillations into tissue resistance 4. Large-amplitude oscillations at the end of tissue resistance Right Ans - 1. Small-amplitude oscillations before the onset of tissue resistance are appropriate for pain modulation.
2. Small-amplitude oscillations into tissue resistance are more appropriate for
joint stiffness, not pain.
3. Large-amplitude oscillations into tissue resistance are more appropriate for
joint stiffness.
4. Large-amplitude oscillations at the end of tissue resistance are for end range joint restrictions and are too aggressive for patients who have pain.
During patellar reflex testing, the patient demonstrates hyperreflexia. What is the MOST likely cause of this finding?
1. A spinal cord tumor at L1
2. A herniated nucleus pulposus at L4
3. Femoral nerve impingement
4. A cauda equina lesion Right Ans - 1. Pressure on the spinal cord at L1 would cause signs of upper motor neuron lesions below this level. A sign of upper motor neuron lesion is hyperreflexia. (p. 1494)
2. A weak or absent patellar reflex is expected with nerve root L4 compression
(p. 1494).
3. Peripheral nerve injuries, such as a femoral nerve impingement, would result in a diminished patellar reflex (pp. 96-97).
4. Peripheral nerve injuries, such as a cauda equina lesion, would result in a diminished patellar reflex (p. 134).
A patient is referred to physical therapy for right shoulder pain. Which of the following findings suggests that physical therapy intervention may not be appropriate?
1. Pain that subsides with right sidelying
2. Tenderness to palpation at the origin of the biceps tendon
3. Trigger points at the right rib 2-3 intercostal space
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