NPTE Clinical Files | Physical Therapy

Jermaine is a 22-year-old collegiate soccer player who injured his ankle when another player landed on his leg while his foot was planted. The ankle was forced into dorsiflexion and external rotation. Three days later, he has pain and tenderness over the anterolateral distal tibiofibular region, especially during push-off. Which of the following examination procedures would be MOST appropriate to...

Yessica has a history of thumb carpometacarpal osteoarthritis and recently wore a functional hand splint for several weeks following a burn to the hand. After the burn has healed, she demonstrates limited thumb CMC adduction. Which joint mobilization technique is MOST appropriate to improve this motion? A) Dorsal glide of the first metacarpal on the trapezium B) Volar glide of the first metacarpal...

Olivia reports progressive lower-extremity weakness and decreased exercise tolerance. Examination reveals a resting heart rate of 104 bpm, a fine hand tremor, brisk deep tendon reflexes, and mild proximal muscle weakness. She also reports recent unintentional weight loss despite no change in diet or activity level. Which of the following conditions is MOST likely responsible for Olivia’s presentat...

Jason is referred to physical therapy for gradually progressive bilateral hand pain and stiffness. The patient reports that the hands feel stiff for approximately 15 minutes after waking and becomes increasingly painful after prolonged gripping and household activities. Examination reveals firm enlargement of several interphalangeal joints and decreased motion of the first carpometacarpal joints b...

Brian presents with chronic heart failure and is referred to physical therapy for aerobic conditioning. The patient has a history of hypertension and has a resting heart rate of 102 bpm. The medical record indicates that the patient takes a medication that decreases cardiac workload by reducing preload through increased renal excretion of sodium and water. Which of the following medications is MOS...

Priyanshi is a 68-year-old female referred to physical therapy for gradually increasing right forefoot pain and difficulty walking longer distances. During gait assessment, the physical therapist observes decreased push-off on the right during terminal stance and pre-swing. Examination reveals the following findings: * Right first metatarsophalangeal joint extension PROM: 40° * Right ankle dorsifl...

Ashley is preparing to perform a symptom-limited graded exercise test to determine functional exercise capacity and help develop an aerobic exercise prescription. Which of the following patients is the MOST appropriate candidate for this type of testing? A) A patient with stable coronary artery disease who reports predictable substernal discomfort during prolonged uphill walking B) A patient with...

Zoe is preparing to ambulate a patient hospitalized with hepatitis B. The patient is medically stable and has no open wounds, active bleeding, or uncontrolled drainage. Which of the following precautions is MOST appropriate during gait training? A) Wear gloves and a gown throughout the treatment session because the infection can be transmitted through direct contact B) Wear gloves only when contac...

Getsemani examines a patient with a Stage 4 pressure injury over the sacrum. The therapist inserts a sterile cotton-tipped applicator beneath the intact wound edge. The applicator advances 2.4 cm toward the patient’s head while remaining immediately beneath the skin. Which of the following is the MOST appropriate documentation of this finding? A) Tunneling of 2.4 cm at 12 o’clock B) Undermining of...

Stassi is administering neuromuscular electrical stimulation (NMES) to improve quadriceps strength following knee surgery. The patient reports that the stimulation feels uncomfortable as the current is delivered. Stassi would like to maintain a strong therapeutic muscle contraction while making the treatment more comfortable for the patient. Which of the following stimulation parameters should be...

Inez is receiving physical therapy in the acute cardiac unit following an acute coronary event. During treatment, the physical therapist observes a new telemetry change characterized by progressive PR interval lengthening followed by a dropped QRS complex. The patient denies any new symptoms. What is the MOST appropriate action by the physical therapist? A) Continue treatment because this is an ex...

Anisa is being treated in an inpatient rehabilitation facility following a traumatic brain injury (TBI). The physical therapist has been training the patient to ambulate using a two-point gait pattern with a single-point cane. Anisa consistently performs the gait pattern correctly in a quiet hallway without verbal cueing. Which of the following is the BEST strategy to improve long-term retention a...

Tasnuva is referred to physical therapy for progressively worsening right knee pain. The patient reports symptoms that have gradually increased over the past year and are aggravated by prolonged walking. Observation reveals right coxa vara and significant genu valgum during standing. Which of the following structures is MOST likely contributing to the patient’s symptoms? A) Anterior cruciate ligam...

Stephanie is evaluating a patient 8 weeks after sustaining a displaced radial head fracture following a fall onto an outstretched hand. The patient reports persistent lateral elbow pain, difficulty actively extending the wrist and fingers, and weakness when gripping objects. Which of the following examination findings is LEAST likely? A) 5/5 elbow extension manual muscle test B) Limited forearm su...

Jeff is a 78-year-old patient recovering from a right CVA. The patient requires moderate assistance for transfers and bed mobility. During therapy, frequent vital sign monitoring is necessary due to ongoing cardiac instability. The patient is now able to tolerate approximately 75 minutes of therapy each day; however, they live alone in a two-story home. Which of the following is the MOST appropria...

Chimezie is performing an initial examination of a patient with type 2 diabetes mellitus. The patient’s most recent hemoglobin A1C is 6.7%. During inspection of the right foot, the therapist observes a small ulcer on the plantar surface beneath the fifth metatarsal head. The patient reports progressively limiting walking activities because of discomfort in the involved foot. Which of the following...

Sando is a 4-month-old infant receiving physical therapy for right congenital muscular torticollis. The physical therapist notes improved cervical alignment, increased tolerance to prone positioning, and improved active midline head control. Which of the following goals would be MOST appropriate to include in the patient's plan of care? A) Restore left cervical rotation passive ROM B) Restore...

LeMarcus is a 42-year-old recreational runner who reports progressive anterior hip discomfort after increasing mileage over the past 2 months. Examination reveals: * Hip flexion ROM: 125° * Hip extension ROM is limited compared to the uninvolved side * Positive Thomas test * Negative Ely’s test * Hip flexor strength: 5/5 * Hip extensor strength: 5/5 * Negative FABER test Which of the following act...

Garret is a 30-year-old patient who was hospitalized 3 days ago after being diagnosed with Guillain-Barré syndrome. During examination, the patient is able to perform repeated seated marches without difficulty. However, the therapist notes impaired sensation in a glove-and-stocking distribution and difficulty with heel- and toe-walking. The therapist decides to assess the hip flexor deep tendon re...

Ulises presents with intermittent upper extremity paresthesia reproduced with overhead activity. Examination reveals an elevated first rib on the involved side without reports of soft tissue tenderness. Which of the following mobilization techniques is MOST appropriate? A) Large-amplitude oscillations performed into tissue resistance B) Small-amplitude oscillations performed into tissue resistance...

Brendaisha is a physical therapist who becomes concerned about a colleague who previously completed rehabilitation for substance abuse. Over the past several weeks, the colleague has demonstrated increasing tardiness, reduced attention during patient care, and episodes of excessive drowsiness while completing documentation. No direct evidence of substance use has been observed, and no adverse pati...

A physical therapist is mentoring a student physical therapist during an outpatient orthopedic clinical rotation. The therapist plans to administer therapeutic ultrasound using the following parameters: * 3 MHz frequency * 20% pulsed duty cycle * 0.5 W/cm² intensity * 6-minute treatment duration Which of the following patients should NOT receive this treatment? A) A 14-year-old basketball player w...

Harry presents with a right-sided posterolateral disc herniation at L5-S1 and demonstrates weakness associated with the involved nerve root. Which of the following gait deviations is MOST likely? A) Diminished propulsion during terminal stance B) Increased plantarflexion following initial contact C) Contralateral pelvic drop during stance D) Genu recurvatum during stance Join the FREE Facebook Gro...

Jason is a patient with peripheral vascular disease who presents with a lower leg wound containing dry, adherent slough and minimal exudate. The wound bed appears desiccated, and the surrounding skin is fragile but intact. Which of the following interventions is MOST appropriate? A) Transparent film B) Hydrocolloid C) Impregnated gauze D) Amorphous hydrogel Join the FREE Facebook Group: www.nptegr...

Petey is 4 weeks status post ACL reconstruction with a semitendinosus autograft and partial meniscectomy. Which of the following interventions is LEAST appropriate at this time? A) Quad sets held in knee extension B) Mini squats to 45 degrees C) Resisted knee flexion with a 3-lb ankle weight in prone D) Sidelying straight leg raises Join the FREE Facebook Group: www.nptegroup.com Use PTH020 to get...