Deck 17: Integration of Physical Agents: Clinical Decision-Making

Question 1

Which of the following definitions best fits the phrase "evidence-based practice?"

A)Treating patients based upon research
B)Judicious use of research findings to make decisions about patient treatment interventions
C)Treating patients as individuals based upon experience
D)Using previous experience to evaluate research to make decisions about treatment interventions

Answer 1

B

Question 2

A treatment intervention for a patient who has been referred to physical therapy for lower extremity edema reduction would be considered inappropriate if all but which of the following statements was true?

A)If the edema was the result of an insect bite that had been identified during the PT evaluation that revealed a "target type" bite with rings that surrounded the center and the area distal to it was warm and edematous
B)If the edema is the result of congestive heart failure, because treating the edema can cause undesirable responses
C)If the patient has been examined and there are no pedal pulses present, which would be indicative of circulatory complications that need to be evaluated further and treated by a physician
D)Treatment interventions for lower extremity edema would be appropriate as long as the lower extremity has been evaluated, is elevated during treatment, and the patient is educated regarding what to do when not in therapy.

Answer 2

D

Question 3

A patient has been in the physical therapy department for the past 20 minutes and has received electrical stimulation to the upper trapezius bilaterally while lying prone on a treatment table. There were hot packs placed on top of the electrodes, and the patient felt a mild but comfortable tingling sensation during the application of the electrical stimulation. After removing the electrodes and hot packs, the area has a mild hyperemia. How should this be explained to the patient?

A)"This is a normal response."
B)"This is a normal response, which is an increase in circulation that should last for approximately an hour or possibly longer."
C)"Your neck is red, and it will go away soon."
D)You don't need to explain it to a patient; he or she can't see his or her own neck.

Answer 3

B

Question 4

Of what potential significance is the patient's ability to understand the purpose of the therapeutic intervention, and why?

A)The patient should know what to expect from therapy.
B)There should be carry-over through the time that the patient is not in therapy so that activities during that time are not counter-productive to the therapeutic intervention.
C)The patient should understand what sensations are inappropriate, what sensations are to be expected, and what should be reported to the clinician.
D)The patient's ability to understand the purpose of the intervention has no significance.

Question 5

Of what clinical significance is the imposition of the FDA's safety and efficacy standard on the introduction of new devices into the physical therapy marketplace?

A)This standard ensures that the manufacturer has paid the necessary fees to the FDA to market and label the device.
B)This standard ensures that the device, when marketed, is safe for use on human subjects.
C)This standard ensures that when a device is labeled for a specific indication, it has been proven in clinical studies to treat that indication.
D)Both B and C

Question 6

You are about to select a piece of equipment to use for a therapeutic intervention with a patient. Which of the following questions must be considered, and why?

A)What are the primary and secondary benefits of selecting this physical agent? It may be contraindicated for this patient.
B)Is it indicated for this patient? If not, why would you select it?
C)Is it safe? When was the last time it was inspected?
D)All of the above, to ensure optimal patient safety and effective treatment outcome

Question 7

Of what clinical significance would the presence of osteoporosis be for a patient who had been involved in an automobile accident in which the patient had been driving the car and had been hit from behind? This patient has been complaining of decreased cervical mobility, paresthesia in the left upper extremity, and severe headaches.

A)This would have no clinical significance for this patient.
B)This would mean that cervical traction would be contraindicated as a treatment option for this patient.
C)This might impact the types of treatment approaches that are considered for this patient.
D)There is no clinical significance.

Question 8

Which of the following descriptions would best fit a "shotgun" approach?

A)The use of all physical agents available that could possibly be used to treat a patient's reported symptom
B)The use of at least two manual techniques and one physical agent to treat a patient's reported symptom
C)The use of one manual technique and one physical agent to treat a patient's reported symptom of pain if both were indicated for pain separately
D)The use of a therapeutic treatment intervention appropriate to treat a patient's reported symptom as indicated

Question 9

What is the one of the greatest differences between treating a patient with a chronic condition and treating a patient with an acute injury?

A)Patients with chronic conditions are easily able to identify exactly where their discomfort is located and patients with acute discomfort are not able to do this.
B)Patients with chronic conditions are eager to return to daily activities and patients with acute conditions are unmotivated.
C)Although pain may or may not be a complaint with chronic conditions, patients with chronic conditions usually experience a loss of function.
D)There is no difference between treating a patient with a chronic condition and treating a patient with an acute condition.

Question 10

What legislative requirement was passed in 1976 and had a significant impact on the use of medical devices in physical therapy?

A)Manufacturers were required to prove that a device is safe and effective for human use before marketing it.
B)Physical therapy equipment started to become tested on human subjects.
C)The Food and Drug Administration required regulation of physical therapy equipment.
D)The Centers for Medicare and Medicaid Services started to reimburse for physical therapy services if they were prescribed by a physician.

Question 11

What is the difference between a subscription online resource and a free online resource?

A)One is free and the other has a fee associated with it.
B)The free resource is sponsored by advertisers and is unfiltered.
C)The subscription resource is sponsored only by subscribers and is screened to fit certain reviewer criteria.
D)All of the above

Question 12

A mother is escorting her daughter, who has been diagnosed with scoliosis, to the clinic. You have been instructing the mother and daughter in a treatment regimen with electrical stimulation to assist in the reduction of the lateral curvature of the daughter's scoliosis. The stimulation is to be applied to the concave side of the curvature to fatigue the musculature at night while the daughter sleeps. The daughter is going to spend the weekend at her father's house. What should happen with the electrical stimulation, and why?

A)The stimulation could stop for the weekend because it is just a weekend.
B)It should continue in the same manner as it has under the mother's instruction to continue to fatigue the musculature and reduce the lateral curvature. Optimally, the father should attend a physical therapy session to learn how to apply the stimulation to ensure that there will be effective application of the stimulation.
C)It should continue, but only if the daughter feels comfortable with it.
D)The daughter should not stay at the father's home until he is trained in the use of the electrical stimulation.

Question 13

Why is it important for patients to understand the difference between expected and unexpected responses to treatment interventions?

A)Patients need to know what they should be feeling so that they will recognize when they are feeling it.
B)All the patient needs to understand is the concept of "no pain, no gain."
C)Clinicians know what responses are considered normal and what response would be considered inappropriate, but patients don't know this and may become injured.
D)It is not important for the patient to know about these responses; it is important for the clinician to know about them.

Question 14

A patient has been in the physical therapy department for the past 20 minutes and has received electrical stimulation to the upper trapezius bilaterally while lying prone on a treatment table. There were hot packs placed on top of the electrodes, and the patient felt a mild but comfortable tingling sensation during the application of the electrical stimulation. She had initially complained of pain and muscle tightness in her neck that limited her mobility in cervical rotation. After removing the electrodes and hot packs, she now reports that her discomfort is a "2/10 from the 9/10 that it was" and she can "freely move her neck." Where and how should the treatment intervention be documented?

A)Patient comments should be placed in quotes in black ink in the patient's chart.
B)The intervention should be documented in a flow sheet in the patient's chart and then signed by the treating therapist.
C)Treatment interventions or "what was done" should be documented in the objective portion of the note and the outcome should be documented in the assessment portion of the note.
D)"Patient tolerated treatment well" should be documented in the assessment portion of the treatment notes.

Question 15

Which of the following is NOT interrelated to other symptoms and does not fit into the pain triangle?

A)Pain
B)Muscle guarding
C)Dysfunction
D)None of the above

Question 16

What is the difference between treating a patient with an acute injury and treating a patient with a chronic condition?

A)The emphasis for patients with an acute injury is often to maintain mobility and prevent further injury.
B)The emphasis for patients with an acute injury is often on pain reduction.
C)The emphasis for patients with an acute injury is often to medicate the patient to remove all sensations of pain.
D)The emphasis for patients with an acute injury is not any different from treating patients with a chronic condition.

Question 17

What is the difference between a treatment approach that treats the symptom and one that treats the patient and the cause for the symptom?

A)The approach that treats the symptom will be less frustrating to the patient.
B)The approach that deals with the symptom will have a longer period of relief than the approach that treats the cause.
C)The approach that deals with the patient and cause for the symptom will have a greater potential for preventing the problem from recurring.
D)There is no difference between the two approaches.

Question 18

Which of the following statements is most accurate regarding the potential significance of the available treatment time to the outcome of the treatment intervention?

A)It is inconsequential if a goal can be accomplished in 5 minutes because that's all the time it takes.
B)It is an important consideration if additional time would cause the patient to experience more muscle guarding.
C)The available treatment time that the patient allows can make or break the outcome of the treatment if it is insufficient to produce results.
D)The available treatment time that the patient allows can make or break a practice if it is insufficient for billing purposes.