NPTE Clinical Files | Physical Therapy

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
Download My Top 3 Gait Cheatsheets: www.thepthustle.com/gait-sheets

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
Download My Top 5 Cardiopulmonary Cheatsheets: www.thepthustle.com/cardiopulmonary-sheets

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 contact with blood or other potentially infectious body fluids is anticipated
C) Wear a surgical mask when treating the patient within 3 feet (0.9 m)
D) Wear an N95 respirator and perform treatment in a negative-pressure room
Text our team the word COACH for a free diagnostic: (727) 732-4573

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 2.4 cm at 12 o’clock
C) Maceration extending 2.4 cm at 12 o’clock
D) Induration extending 2.4 cm at 12 o’clock
Text our team the word COACH for a free diagnostic: (727) 732-4573

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 adjusted?
A) Amplitude
B) Pulse rate (frequency)
C) Pulse duration
D) Ramp down time
Text our team the word COACH for a free diagnostic: (727) 732-4573