NPTE Clinical Files | Physical Therapy

Koorin evaluates a 10-month-old infant with delayed gross motor development. The examination reveals a symmetrical tonic neck reflex (STNR) that has not integrated. Which of the following activities will the infant MOST likely have difficulty performing?

A) Rolling from supine to prone while reaching across midline

B) Maintaining quadruped while performing reciprocal crawling movements

C) Maintaining unsupported sitting while reaching outside the base of support

D) Transitioning from supine to sitting through a sidelying position

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Yisari sustained a left middle cerebral artery stroke three weeks ago, resulting in right-sided hemiparesis with a flexor synergy pattern. Which of the following positions is MOST appropriate for the affected upper extremity while resting in supine?

A) Forearm supination

B) Shoulder abduction

C) Scapular retraction

D) Forearm pronation

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Jabari examines a patient who sustained a thermal burn to the anterior forearm 48 hours ago. The affected area has a mottled red-and-white appearance with minimal surface moisture and scattered ruptured blisters. The skin demonstrates sluggish blanching with applied pressure, and the patient reports diminished sensation to light touch but discomfort with firm pressure. Which of the following burn classifications is MOST consistent with these findings?

A) Superficial burn (first-degree)

B) Superficial partial-thickness burn (second-degree)

C) Deep partial-thickness burn (second-degree)

D) Full-thickness burn (third-degree)

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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 assess the suspected injury?

A) Stabilize the lower leg and translate the talus and calcaneus anteriorly.

B) Stabilize the lower leg and externally rotate the foot with the ankle slightly dorsiflexed.

C) Stabilize the foot and externally rotate the tibia while applying an inversion force to the ankle.

D) Stabilize the lower leg and invert the calcaneus to tilt the talus.

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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 on the trapezium

C) Radial glide of the first metacarpal on the trapezoid

D) Ulnar glide of the first metacarpal on the trapezoid

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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 presentation?

A) Graves disease

B) Hashimoto thyroiditis

C) Multiple myeloma

D) Hyperparathyroidism

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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 bilaterally. There is no significant warmth or swelling of the metacarpophalangeal joints.

Which of the following additional findings would be MOST likely in this patient?

A) Ulnar drift of the digits at the metacarpophalangeal joints

B) Swan-neck deformity involving hyperextension of the PIP joints

C) Heberden nodes involving the distal interphalangeal joints

D) Boutonnière deformity involving flexion of the PIP joints

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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 MOST likely prescribed?

A) Lisinopril

B) Metoprolol

C) Furosemide

D) Nitroglycerin

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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 dorsiflexion PROM: 10°

* Right ankle plantar flexor strength: 4/5

* Right quadriceps strength: 3+/5

* Right gluteus maximus strength: 3+/5

Which of the following interventions would be MOST appropriate to address the impairment primarily contributing to the observed gait deviation?

A) Progressive resisted strengthening of the right plantar flexors

B) Progressive resisted strengthening of the right gluteus maximus

C) Joint mobilization to improve extension of the right first metatarsophalangeal joint

D) Progressive resisted strengthening of the right quadriceps

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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 acute pericarditis who reports chest discomfort at rest

C) A patient with suspected acute pulmonary embolism who developed sudden dyspnea earlier in the day

D) A patient with unstable angina who has experienced increasingly frequent chest pain during minimal activity

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