Deck 16: Examination and Assessment Procedures

Question 1

Orthopnea is defined BEST by which of the following statements?

A)Difficulty breathing in postures other than erect
B)Rapid rate,shallow depth,regular rhythm;associated with accessory muscle activity
C)Slow rate,deep inspiration followed by apnea,irregular rhythm;associated with brainstem disorders
D)Normal rate and rhythm;characterized by abrupt cessation of inspiration when restriction is encountered;associated with pleurisy

Answer 1

A
Orthopnea is defined as difficulty breathing in postures other than erect.

Question 2

When reviewing the medical record of a patient,the date of the event is deemed significant for which of the following reasons?

A)It provides a mechanism to verify the accuracy of patient reported medical history.
B)It determines the acuteness of the patient's medical situation.
C)It is necessary for reimbursement documentation.
D)It determines the onset of an episode of care.

Answer 2

B
The date of the event is significant because it determines the acuteness of the situation.

Question 3

Wheezes are described by which of the following auscultated sounds?

A)Soft,low-pitched sounds heard primarily during inspiration
B)Discontinuous adventitious lung sounds similar to brief bursts of popping bubbles
C)An abnormal sound similar to two pieces of leather or sandpaper rubbing together
D)Continuous adventitious lung sounds with a constant pitch and varying duration

Answer 3

D
Wheezes are continuous adventitious lung sounds with a constant pitch and varying duration.They are most frequently heard on exhalation and are associated with airway obstruction.

Question 4

Which of the following symptoms should be considered a cardiac symptom until cardiac dysfunction is ruled out?

A)Chest tightness or pressure
B)Shortness of breath
C)Burning or indigestion
D)All of the above

Question 5

Which of the following techniques during lung sound auscultation is considered an error in technique?

A)Placing the bell or diaphragm directly against the chest wall
B)Asking an alert patient to sit up or rolling a comatose patient onto the side to auscultate the posterior lobes
C)Auscultating over areas of the chest wall that are accessible and convenient
D)Shutting the door to the patient's room and lowering the volume of the TV

Question 6

The effectiveness of a cough is assessed by using which of the following factors?

A)The strength of the cough
B)The depth of the cough
C)The length of the cough
D)All of the above

Question 7

Which of the following medical tests BEST provides the clinician with information on the status of coronary anatomy?

A)Electrocardiogram (ECG)
B)Cardiac catheterization data
C)Arterial blood gases
D)Chest radiograph

Question 8

When a physical therapist determines the impact of a condition on function at the level of the system and the patient subsequently classifying the patient within a specific practice pattern or cluster of the dysfunctions identified,this is BEST described by which of the following elements of patient management?

A)Examination
B)Evaluation
C)Diagnosis
D)Prognosis

Question 9

The optimal position for auscultation of the lung sounds is which of the following?

A)Supine
B)Side lying
C)Sitting
D)All of the above

Question 10

The completion of a patient history,systems review,and appropriate tests and measures to gather data during a patient's first visit is BEST termed which of the elements of patient management?

A)Examination
B)Evaluation
C)Diagnosis
D)Prognosis

Question 11

Which of the following clinical signs is MOST indicative of early congestive heart failure,specifically right-sided or cor pulmonale?

A)The anteroposterior diameter of the chest wall is equal to the transverse diameter.
B)Presence of hypertrophy or adaptive shortening of the sternocleidomastoid muscles.
C)The rib angles are increased and the intercostal spaces are broader anteriorly.
D)The presence of jugular venous distention in sitting or recumbent positions.

Question 12

Which of the following factors contribute MOST to the poorer quality of a portable anteroposterior (AP)chest radiograph?

A)The patient is generally very sick or unstable.
B)The patient is generally unable to perform a maximal inspiration.
C)The patient is generally in an upright position.
D)The patient's ability to cooperate.

Question 13

Which of the following reasons BEST describes the importance of understanding or having knowledge of specific surgical procedures and chest wall anatomy?

A)Able to identify potential limitations or precautions to therapeutic procedures.
B)Able to identify potential limitations with the musculoskeletal system.
C)Provides insight to activity limitations prior to surgery based on the extent of the surgical intervention completed.
D)All of the above.

Question 14

Which of the following general appearances BEST indicates the presence of low oxygenation and perfusion in the periphery?

A)The patient is leaning forward on the knees or some object to breathe.
B)The patient is using accessory muscles around neck and shoulders to breathe.
C)The patient has noticeable bluish color at the lips and fingernail beds.
D)The patient is resting in a semi-Fowler's position and is not able to tolerate lying flat.

Question 15

Which of the following clinical symptoms is MOST indicative of angina chest discomfort?

A)Muscle soreness and/or joint soreness is evoked by palpation or deep breathing.
B)Minimal additional symptoms present.
C)No evidence of ST-segment depression present.
D)Discomfort is relieved by nitroglycerin within 1 minute.

Question 16

A history gathered by a physical therapist should include the determination of major risk factors for heart disease.Which of the following statements identifies the importance of determining these risk factors?

A)Develop realistic goals for long-term treatment.
B)Identify a need for referral to other rehabilitation members.
C)Decide on precautions to and monitoring of increased activity.
D)All of the above.

Question 17

Which of the following activities completed by a physical therapist is considered a test/measure beyond a systems review?

A)Collection of vital signs (respiratory rate,heart rate,blood pressure)
B)Examining for the presence of edema
C)Palpation of the chest wall
D)Observing skin color and integrity

Question 18

A breathing pattern characterized by increasing then decreasing depth with a period of apnea interspersed that is a somewhat regular rhythm typically in critically ill patients is BEST termed which of the following breathing patterns?

A)Bradypnea
B)Cheyne-Stokes
C)Apneustic
D)Biot's

Question 19

A patient is determined to have a low PaO₂,but >60 mm Hg on room air at the beginning of a physical therapy session.Which of the following actions should be implemented by the physical therapist regarding exercise during that same session?

A)Exercise is contraindicated with this patient.
B)If the patient tolerates,encourage low-intensity exercise and monitor symptoms.
C)Call the physician to discuss the patient's need for supplemental oxygen during exercise.
D)The patient should be referred back to the physician and resume when cleared.

Question 20

Which of the following actions done by the physical therapists enhances trust and rapport with that patient during the initial evaluation session?

A)Knowledge of the patient's medical history after a thorough review of the medical chart
B)Completing a highly structured interview of questions
C)Joking around with the patient prior to the interview
D)Having the patient complete a questionnaire prior to the physical therapy visit

Question 21

Which of the following heart sounds when heard early in diastole is a diagnostic sign of congestive heart failure?

A)S1
B)S2
C)S3
D)S4

Question 22

Auscultation at the lower left sternal border,approximately the fourth to fifth intercostal spaces,describes the area where which of the following heart sounds is heard?

A)Aortic area
B)Pulmonary area
C)Tricuspid area
D)Mitral area

Question 23

Which of the following is considered an abnormal blood pressure response to an exercise activity in which the workload is gradually being increased?

A)Systolic blood pressure increases with increasing levels of exertion.
B)In a trained athlete,diastolic blood pressure decreases during exercise.
C)In a person taking beta-adrenergic antagonists medication,a slight increase in systolic blood pressure initially with no progressive rise with increasing workloads.
D)Systolic blood pressure rise at submaximal levels with a progressive decrease on increasing workload.

Question 24

A 68-year-old female patient reports shortness of breath during the activity evaluation at her first visit in the physical therapy clinic.She has a history of obesity,diabetes,and hypertension.Which of the following clinical signs or symptoms MOST likely indicates an angina equivalent?

A)The patient's recovery from the shortness of breath takes a while,but eases with a cool down walk.
B)The patient's shortness of breath goes away with rest sitting in a chair.
C)The patient commented that she has not exercised in a long time.
D)The patient commented that she has esophageal reflux and has a history of asthma.

Question 25

When measuring blood pressure on a patient who is performing an activity such as walking,using an automatic blood pressure cuff is easier but does not provide the same accuracy as manual blood pressure measurement.

Question 26

Egophony is BEST described by which of the following in a patient with emphysema?

A)The said phrase "99" is heard more loudly than normal.
B)The said phrase "E" is heard much softer than normal as "A."
C)Whispered words are heard more loudly than normal.
D)The said phase "E" is heard more loudly than normal as "A."

Question 27

A patient with chronic obstructive lung disease who appears to have a barrel chest will have which of the following signs on examination of the chest area?

A)Rib angles of <90 degrees
B)A diminished diaphragm excursion measured by percussion
C)The presence of stronger,louder sounds heard during auscultation
D)The presence of normal muscle activity of the respiratory accessory muscles

Question 28

Which of the palpation techniques assists in the confirmation of consolidation in an area of the lung?

A)Palpation of the mediastinum for tracheal shift
B)Palpation of chest wall movement or asymmetry
C)Palpation of fremitus (vibration)when the patient says "99"
D)Palpation of the anterior chest wall with the thumb tips meeting at the xiphoid

Question 29

Which of the following conditions would transmission of lung sound increase?

A)An increase in lung tissue density such as consolidation.
B)A decrease in lung tissue density.
C)Shallow breaths are taken.
D)The distance between the airway and the stethoscope is increased such as obesity.

Question 30

Lung sounds auscultated in the latter half of inspiration that are commonly associated with pulmonary edema are BEST described as which of the following?

A)Wheezes
B)Crackles
C)Bronchovesicular
D)Pleural rub