Scorebuilders Q&A

A patient with type 2 diabetes on insulin becomes pale, shaky, and confused during a gait training session. What is the MOST appropriate immediate action for the therapist to take?Option 1- Stop the session, have the patient rest, and resume once symptoms resolveOption 2- Stop the session and provide a fast-acting carbohydrateOption 3- Stop the session immediately and call 911Option 4- Stop the session, document the incident, and reschedule for another dayWatch the video version on our Youtube channel: https://youtu.be/ogdamOUQPh0

During an evaluation, a physical therapist performs the elbow flexion test to reproduce a patient's upper extremity symptoms. Which of the following BEST explains the mechanism behind this test? Option 1- Compression of the ulnar nerve within the cubital tunnel Option 2- Compression of the median nerve as it passes through the pronator teres Option 3- Ischemic compression of the radial artery reducing blood flow to the forearm Option 4- Stretching of the posterior interosseous nerve beneath the supinator Watch the video version on our Youtube channel: https://youtu.be/RK6ELQAI5fM

A physical therapist performs the carpal compression test (Durkan's test) on a patient who complains of pain and paresthesia in their hand. The purpose of this test is to compress which of the following structures?Option 1- Median nerveOption 2- Radial arteryOption 3- Ulnar nerveOption 4- Ulnar arteryWatch the video version on our Youtube channel: https://youtu.be/woiU7Fk8t2g

A physical therapist is performing Tinel's sign to assess for tarsal tunnel syndrome. Where should the therapist tap to provoke symptoms when performing this test?Option 1- Over the anterior ankle joint line between the tibia and talusOption 2- Posterior to the medial malleolusOption 3- Over the dorsum of the foot near the base of the first metatarsalOption 4- Posterior to the lateral malleolusWatch the video version on our Youtube channel: https://youtu.be/SAFvZOQXy84

A physical therapist performs Spurling's test on a patient with right-sided upper extremity neural symptoms. The therapist begins the test by passively placing the patient's neck in right lateral flexion and extension. Before even applying axial compression, the patient reports that their upper extremity symptoms have been reproduced. Which of the following best explains the clinical significance of this test?Option 1- Increased tension of the brachial plexus as it passes through the thoracic outletOption 2- Facet joint irritation from cervical lateral flexion and extensionOption 3- Instability of the upper cervical spine due to ligamentous laxityOption 4- Compression of a cervical nerve root due to foraminal narrowingWatch the video version on our Youtube channel: https://youtu.be/dOvYoGeBqqo

A physical therapist is examining a patient who presents with symptoms consistent with pronator syndrome. Which of the following findings would MOST likely be observed during the examination?Option 1- Weakness of the wrist extensorsOption 2- Sensory loss over the dorsal aspect of the handOption 3- Weakness of the finger flexorsOption 4- Pain over the lateral elbowWatch the video version on our Youtube channel: https://youtu.be/rtisWckWBik

A physical therapist is evaluating a patient with a suspected compression neuropathy of the median nerve. Which of the following findings would help confirm a diagnosis of anterior interosseous nerve syndrome over other median nerve neuropathies?Option 1- Inability to perform an "OK" signOption 2- Sensory loss in the palm of the hand and lateral fingersOption 3- Ape hand deformityOption 4- Positive Tinel's sign at the cubital tunnelWatch the video version on our Youtube channel: https://youtu.be/d6FgCio76mo

A patient presents with weakness isolated to the intrinsic muscles of the hand, specifically the adductor pollicis and the muscles of the hypothenar eminence. The therapist notes that all forearm muscles, the wrist flexors and wrist extensors, have full strength. Which of the following is the MOST likely site of nerve entrapment?Option 1- Carpal tunnelOption 2- Radial tunnelOption 3- Cubital tunnelOption 4- Tunnel of GuyonWatch the video version on our Youtube channel: https://youtu.be/7VjQBzRANU4

A patient is referred to physical therapy with a diagnosis of right thoracic outlet syndrome. The physical therapist identifies that the patient's symptoms are being caused by entrapment at the costoclavicular space. Which of the following activities would MOST likely exacerbate the patient's symptoms?1. Reaching overhead into a high cupboard2. Carrying a heavy bag in the right arm3. Looking over the left shoulder while driving4. Looking upward to shave the neckWatch the video version on our Youtube channel: https://youtu.be/D5p6uO3w9TA

A physical therapist performs the standing lumbar quadrant test (Kemp's test) on a patient with low back pain. The patient reports that their pain is intermittent and mostly isolated to the lumbar region, though can occasionally radiate to the buttock. During the test, the patient notes that only their lumbar pain is reproduced. Which structure is MOST directly loaded during this test?1. Intervertebral disc and corresponding nerve root2. Erector spinae muscle group3. Lumbar facet joints4. Iliolumbar ligamentWatch the video version on our Youtube channel: https://youtu.be/eCxN1-MgKtQ

A physical therapist is preparing to perform the slump test on a patient with suspected lumbar radiculopathy. When correctly performing the slump test, which movement should be completed FIRST?1. Cervical flexion2. Ankle dorsiflexion3. Trunk flexion4. Knee extensionWatch the video version on our Youtube channel: https://youtu.be/wTjtrJ8daSM

A patient reports persistent burning and tingling along the medial aspects of the knee, lower leg, and ankle. The physical therapist suspects saphenous nerve involvement. Which of the following nerves would MOST closely mimic the sensory symptoms of saphenous nerve entrapment?1. Obturator2. Posterior tibial3. Femoral4. SciaticWatch the video version on our Youtube channel: https://youtu.be/ubTtbdIOt_w

A physical therapist performs Tinel's sign by tapping over the cubital tunnel. The patient reports tingling sensations consistent with a positive finding. Which region of the hand would MOST likely be affected?1. Dorsal-lateral aspect of the hand and first web space2. Palmar aspect of all five digits3. Hypothenar eminence and fifth digit4. Thenar eminence and lateral three digitsWatch the video version on our Youtube channel: https://youtu.be/0WCucozv6jA

A physical therapist performs a slump test on a patient with complaints of intermittent posterior leg pain and numbness. The patient reports increased symptoms when the neck is flexed during the test, but symptoms decrease when the neck is extended while maintaining knee extension and ankle dorsiflexion. What is the MOST accurate interpretation of this finding?1. The symptoms are likely due to hamstring tightness2. The test result is negative because pain improved with neck extension3. The response suggests adverse neural tension involving the spinal cord or nerve roots4. The findings are consistent with mechanical low back pain from a lumbar paraspinal strainWatch the video version on our Youtube channel: https://youtu.be/yAFcauqnAEQ

A physical therapist is evaluating a patient with low back pain radiating into the left posterior thigh and calf. A straight leg raise on the left side reproduces the patient's familiar symptoms. When the therapist performs a crossed straight leg raise on the right leg, the patient again experiences pain radiating down the left leg. What is the MOST appropriate interpretation of these findings?1. The patient has bilateral hamstring tightness2. The patient has non-specific low back pain unrelated to nerve root involvement3. The symptoms are due to sacroiliac joint dysfunction on the left side4. The findings suggest a large central disc herniation compressing a nerve rootWatch the video version on our Youtube channel: https://youtu.be/yickD2jz3DU

A physical therapist plans to perform all four upper limb tension tests on a patient. However, they find it difficult to complete ULTT 1 (median nerve bias) and ULTT 4 (ulnar nerve bias) due to the patient's limited mobility. Which of the following joint motions is MOST likely restricted and interfering with these tests?1. Shoulder abduction2. Elbow extension3. Forearm pronation4. Wrist flexionWatch the video version on our Youtube channel: https://youtu.be/JsC0dFjirUs

A patient presents with hypersensitivity in the distal forearm following a recent peripheral nerve injury. The physical therapist initiates a desensitization program involving gradual exposure to various tactile stimuli. What is the primary mechanism through which desensitization training aids in reducing hypersensitivity?1. Inhibition of nociceptor activity2. Enhancement of neuroplasticity and cortical reorganization3. Reduction of peripheral nerve inflammation4. Stimulation of axonal growthWatch the video version on our Youtube channel:  https://youtu.be/TmoLHI_OPto

A physical therapist is evaluating a 38-year-old patient who reports an electric shock-like sensation radiating down the spine and into both arms when flexing the neck. The therapist suspects a positive Lhermitte's sign. Which of the following conditions is MOST likely associated with this clinical finding?1. Thoracic outlet syndrome2. Multiple sclerosis3. Cervical radiculopathy4. Cervical paraspinal spasmWatch the video version on our Youtube channel: https://youtu.be/hrgrnOA0Hfs

A physical therapist performs Tinel's sign by gently tapping over the posterior tibial nerve at the medial malleolus, looking for reproduction of paresthesia. In a patient with tarsal tunnel syndrome, the expected tingling symptoms would MOST likely radiate to which of the following locations?1. The dorsal web space between the first and second toes2. The plantar surface of the foot3. The medial ankle and shin4. The dorsum of the footWatch the video version on our Youtube channel: https://youtu.be/-MBDhocmNSg

A physical therapist is beginning desensitization treatment for a patient with significant tactile hypersensitivity in the palm following carpal tunnel surgery. The patient describes light touch as irritating and has started avoiding hand use. Which of the following textures would be the MOST appropriate to use when initiating treatment?1. A soft cotton T-shirt2. A silk scarf3. A bath towel4. A paper towelWatch the video version on our Youtube channel: https://youtu.be/V53vv7zOrs0

A physical therapist is preparing to perform all upper limb tension tests (ULTTs) on a patient with upper extremity paresthesia. The patient's medical history includes osteoarthritis of the elbow and their passive range of motion is 0 to 95 degrees. Which test would be the MOST difficult to perform given the patient's elbow mobility restriction?1. ULTT 1 (median nerve bias)2. ULTT 2 (median, musculocutaneous, axillary nerve bias)3. ULTT 3 (radial nerve bias)4. ULTT 4 (ulnar nerve bias)Watch the video version on our Youtube channel: https://youtu.be/_xRwXVhseLg

A physical therapist examines a 74-year-old female patient who reports aching and stiffness affecting the upper arms, lower back, and thighs. Laboratory testing reveals an elevated erythrocyte sedimentation rate. Which medical condition is MOST consistent with the described clinical presentation?1. Duchenne muscular dystrophy2. Hodgkin’s lymphoma3. Systemic lupus erythematosus4. Polymyalgia rheumaticaWatch the video version on our Youtube channel: https://youtu.be/c-WWkGukeu0

A physical therapist treats a patient with a full-thickness wound that is intentionally left open to heal. This approach was necessary due to significant tissue loss and jagged wound edges that could not be approximated? What type of healing is best described by this description?1. Primary intention 2. Delayed primary intention 3. Secondary intention 4. Tertiary intention Watch the video version on our Youtube channel: https://www.youtube.com/watch?v=bQpRXRCSI7o

A physical therapist positions a patient in supine in preparation for goniometric measurements. When measuring lateral rotation of the shoulder, where should the stationary arm of the goniometer be aligned?1. On the lateral midline of the humerus using the lateral epicondyle as a reference 2. Perpendicular to the floor 3. Along the midaxillary line of the thorax 4. Over the olecranon processWatch the video version on our Youtube channel: https://youtu.be/8V3BfZZYpc8?si=Wd9C0hFSQZlpT_ez

A patient is asked to complete a pain questionnaire. The patient selects words such as diffuse, throbbing, and aching to describe the pain and indicates that it is difficult to localize the pain. What structure is MOST often associated with this type of pain description? 1. Nerve root 2. Muscle 3. Bone 4. Vascular Watch the video version on our Youtube channel: https://youtu.be/xAp05B3kEWw

A patient presents with marked weakness during resisted testing of right shoulder extension and medial rotation. Which of the following nerve lesions would MOST likely produce the described impairments?1.    Thoracodorsal nerve2.    Suprascapular nerve3.    Spinal accessory nerve4.    Axillary nerveWatch the video version on our Youtube channel: https://youtu.be/9ADpLtq21rI

A physical therapist works with a patient with a transfemoral amputation on controlled fall training. The patient ambulates with a single axillary crutch. What controlled falling technique is the MOST appropriate to teach the patient in an anterior loss of balance?1.    Pull the crutch close to the body to absorb the impact2.    Discard the crutch and land on slightly flexed arms3.    Turn the body to absorb the fall on the back of the trunk and legs4.    Land on the elbows and prosthesis to absorb the impactWatch the video version on our Youtube channel: https://youtu.be/oD5tqC2t4H4

A physical therapist checks the water temperature of the hot pack machine after several patients report the heat being very strong. Which of the following temperatures would be acceptable? 1.      64 degrees Celsius (147 degrees Fahrenheit)2.      71 degrees Celsius (160 degrees Fahrenheit)3.      83 degrees Celsius (181 degrees Fahrenheit)4.      94 degrees Celsius (201 degrees Fahrenheit)Watch the video version on our Youtube channel: https://youtu.be/qx5XLJvR-M8

A skilled nursing facility plans to expand a hallway to accommodate two wheelchairs passing simultaneously. In order to comply with the Americans with Disabilities Act standards, what is the required minimum width of the hallway? 1.      36 inches2.      48 inches3.      60 inches4.      108 inchesWatch the video version on our Youtube channel: https://youtu.be/KuihzgXgSE8

A patient diagnosed with schizophrenia has been taking haloperidol (Haldol) following an acute psychotic episode. The physical therapist should be alert for which of the following side effects MOST commonly associated with this medication?1. Facial grimacing and involuntary extremity movements2. Significant weight gain and elevated serum lipids3. Constipation and urinary retention4. Respiratory depression and orthostatic hypotensionWatch the video version on our Youtube channel: https://youtu.be/yu48aNiGCn4

A physical therapist analyzes the gait of a child with spastic diplegia cerebral palsy in the school setting. Based on this diagnosis, which muscle group is MOST likely to be shortened?1. Hip adductors2. Knee extensors3. Hip abductors4. Ankle dorsiflexorsWatch the video version of this Q&A episode on YouTube - https://youtu.be/MW_zSbc8ajw

A physical therapist treats a patient admitted to an acute care hospital with congestive heart failure. Which medication would MOST likely be prescribed for this patient?1. Lanoxin (digoxin)2. Coumadin (warfarin)3. Zocor (simvastatin)4. Nitrostat (nitroglycerin)Watch the video version on our Youtube channel: https://youtu.be/y5rUok5x13E

A patient with a genetically inherited neuromuscular disorder reports weakness in their hands and feet with normal strength elsewhere. The patient experiences difficulty with grasping objects and demonstrates a steppage gait pattern. This clinical presentation is MOST consistent with which of the following medical conditions?1. Guillain-Barre syndrome2. Charcot-Marie-Tooth disease3. Post-polio syndrome4. Huntington’s diseaseWatch the video version on our Youtube channel: https://youtu.be/7gNx_RmYqQw

A physical therapist evaluates a pediatric patient using the Modified Ashworth Scale. Which condition would LEAST benefit from the use of this tool?1. Hypotonia2. Hyperreflexia3. Spasticity4. RigidityWatch the video version on our Youtube channel: https://youtu.be/GFUWGUI9XyI

A physical therapist reviews the current pain management protocol of a patient three days post total hip arthroplasty. Which of the following medications would the patient MOST likely have been prescribed for breakthrough pain as needed?1. Acetaminophen (1,000 milligrams)2. Meloxicam (15 milligrams)3. Oxycodone (5 milligrams)4. Tramadol (100 milligrams)Watch the video version on our Youtube channel: https://youtu.be/lVAl8HJ5qCI

A patient is evaluated in physical therapy three days following a lateral ankle reconstruction. Which of the following weight bearing limitations would be MOST typical for this patient?1.    Non-weight bearing with bilateral axillary crutches2.    Partial weight bearing with a single axillary crutch3.    Weight bearing as tolerated with bilateral axillary crutches4.    Weight bearing as tolerated with a single axillary crutchWatch the video version on our Youtube channel: https://youtu.be/5uaYZngN5Mo

A 55-year-old patient presents with sudden onset of shortness of breath and pleuritic chest pain. As part of the clinical decision making process, a physical therapist considers the Wells Score to assess the probability of pulmonary embolism. Which of the following findings would increase the Wells Score, indicating a higher clinical suspicion for pulmonary embolism?1. Wheezing during physical activity2. Bilateral lower extremity swelling3. Heart rate of 115 beats per minute4. Productive cough with green sputumWatch the video version of this episode on YouTube - https://youtu.be/53BOagVCoOQ

A patient with cubital tunnel syndrome is being fitted for a night brace. Which of the following braces would be the MOST appropriate to help minimize the patient’s symptoms?1. Elbow brace, positioned in 40 degrees of flexion2. Elbow brace, positioned in 100 degrees of flexion3. Wrist brace, positioned in 20 degrees of extension4. Wrist brace, positioned in neutralWatch the video version of this episode on YouTube - https://youtu.be/SgJNDqJtiQs

A patient presents with weakness extending the fingers and thumb and weakness with supination. The patient reports pain in the lateral elbow, but denies pain or sensory changes in the hand or forearm. Which of the following entrapment syndromes BEST explains these findings?1. Radial tunnel syndrome2. Anterior interosseous nerve syndrome3. Posterior interosseous nerve syndrome4. Carpal tunnel syndromeWatch the video version of this episode on YouTube - https://youtu.be/c0zQaRMI-sU

A physical therapist uses the Ottawa Knee Rules to assess a patient with acute knee trauma. Which of the following findings would indicate a possible knee fracture and justify the need for radiographic imaging? 1. A 15 degree loss of passive knee extension2. Isolated tenderness of the patella3. Tenderness along the medial and lateral joint lines4. Active knee flexion limited to 105 degreesWatch the video version of this episode on YouTube - https://youtu.be/0eZiwNEO3hY

A physical therapist examines a patient who complains of forearm pain and weakness in the hand. During the examination, the therapist identifies weakness with wrist flexion, finger flexion, and thumb adduction. Froment’s sign is positive. Which of the following nerves is MOST likely affected?1. Ulnar2. Radial3. Median4. MusculocutaneousWatch the video version of this episode on YouTube - https://youtu.be/1hbFq_Q3tP0

A physical therapist evaluates a patient who sustained an ankle injury during a recreational soccer game. To determine whether imaging is necessary, the therapist applies the Ottawa Foot and Ankle Rules. According to this screening tool, which of the following factors would meet the criteria to refer the patient for an x-ray?1. Pain near the medial malleolus and an inability to bear weight2. Pain near the lateral malleolus and passive dorsiflexion limited to five degrees3. Pain near the posterior calcaneus and a positive talar tilt test4. Pain near the cuboid and swelling of the ankle jointWatch the video version of this episode on YouTube - https://youtu.be/zf1X0BkrgYI 

A physical therapist evaluates a patient who presents with leg swelling and discomfort. The patient has a history of recent surgery and prolonged immobility. Based on the Wells Criteria for deep vein thrombosis, which of the following would be the MOST relevant factor in assessing the patient's risk for deep vein thrombosis? Body mass index greater than 282. Previous history of deep vein thrombosis 10 years ago3. Previous history of prostate cancer 5 years ago4. Current diagnosis of cellulitisWatch the video version of this episode on YouTube - https://youtu.be/6lLt4Rv-MvY

A physical therapist works on various balance tasks with a patient who has known balance deficits. The patient has intact visual and vestibular systems, though has deficits with somatosensory inputs. Which of the following activities would be MOST useful in improving utilization of the somatosensory system to maintain balance?1. Standing on a firm surface with eyes open2. Standing on a firm surface with eyes closed3. Standing on a foam pad with eyes open4. Standing on one leg with eyes openWatch the video version of this episode on YouTube - https://youtu.be/UTd0A9CycF8

A patient status post right transfemoral amputation is prescribed a standard wheelchair with recommendation for posterior rear wheel axle placement. What is the result of this positioning? 1. Decreased wheelchair rear stability2. Decreased wheelchair rolling resistance3. Decreased turning radius4. Decreased ease of performing wheeliesWatch the video version of this episode on YouTube - https://youtu.be/FfRviGBbeD4

A physical therapist orders a wheelchair with anti-tip tubes for a patient in preparation for discharge from a rehabilitation hospital. A patient with which of the following conditions would benefit the MOST from this option?1. Guillain-Barre syndrome2. C5 tetraplegia 3. Stroke with hemiparesis4. Amyotrophic lateral sclerosisWatch the video version of this episode on YouTube - https://youtu.be/M4lVSR6bwC8

A physical therapist prepares to assist a patient with a sliding board transfer from a wheelchair to a bed. Which of the following directions would be MOST appropriate when directing the patient to perform the sliding board transfer?1. Adjust the bed height so it is four inches lower than the wheelchair seat2. Position the wheelchair so that it is at a slight angle to the bed 3. Remove both armrests from the wheelchair before positioning the transfer board4. Leave the elbows bent slightly as you move the body laterally on the transfer boardWatch the video version of this episode here - https://youtu.be/XTdca0QK6Ug

A patient with atrial flutter suddenly becomes extremely lightheaded while exercising and appears to lose consciousness. Which of the following physiologic responses BEST explains the change in the patient’s status? 1. Increased filling of the ventricles2. Increased system congestion3. Decreased atrial depolarization4. Decreased blood traveling to the brainWatch the video version of this episode on YouTube - https://youtu.be/eXsure_4i_I

A patient is treated for low back pain with unilateral lower extremity radiculopathy. The MRI report indicates the patient’s condition is caused by a moderate L3 disk herniation. Which of the following special tests would be MOST likely to recreate the patient’s symptoms?1. Straight leg raise test2. Prone knee bending test3. Slump test4. Crossed straight leg raise testWatch the video version of this episode on YouTube - https://youtu.be/8OJwWPY7CZY

A physical therapist working in a high school setting has an athlete come into the treatment room complaining of a headache, fever, and a painful neck. The therapist positions the athlete in supine and flexes the hip to 90 degrees. When the therapist attempts to extend the knee in this position, the patient complains of significant pain. Which finding is MOST consistent with this scenario? 1. Positive Kernig’s sign2. Negative Kernig’s sign3. Positive Brudzinski’s sign4. Negative Brudzinski’s signWatch the video version of this episode on YouTube - https://youtu.be/oVobgOqAKiA