A 42yo homecare nurse arrives for her initial evaluation at outpatient rehab. The doctor has diagnosed her with a right L4/L5 facet lock, supported by MRI results. Lumbar movement into ___________________ causes or increases neurological symptoms due to foraminal stenosis.

1. Contralateral Sidebending
2. Extension
3. Flexion
4. Ipsilateral Rotation

Answer

As the therapist, you are now conducting special tests to reconfirm the physician’s diagnosis of ‘facet lock’. You will expect which of the following tests to exacerbate your patient’s symptoms:

1. Babinski’s
2. Lachman
3. Ober’s
4. Quadrant

Answer

You are designing a plan of care (POC) for your 47yo patient who has a pathological facet segment. You will incorporate the following to ensure they receive the best quality of care:

1. Extension/Rotation biased exercises to decompress the pathological segment
2. Flexion biased therapeutic exercise combined with grade I/II joint mobilizations to reduce pain by inhibiting muscle guarding and increasing the synovial quality of the joint
3. Flexion biased therapeutic exercise combined with grade IV/V joint mobilizations to reduce pain by inhibiting muscle guarding and increasing the synovial quality of the joint
4. Start by applying a hot pack for 10 minutes to sooth the pain being sure to check for errythema every few minutes, follow that with a couple minutes of U/S, then the big-3 should be performed

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A 37yo construction worker arrives at your outpatient facility for his initial evaluation for low back pain. While taking his history, he mentions to you that he forgot to tell his PCP that there’s a slight pain in his abdomen which radiates to his back. He says it’s probably nothing serious which is why he had forgotten to mention it. Your best course of action would be to:

1. Ask patient to stay tough while you get through the evaluation
2. Call the PCP, leave a message of your findings, and then continue your evaluation and treatment
3. Continue evaluation, but just be aware that there may be secondary complications that may develop, so you must be able to act in case of emergency
4. Stop evaluation immediately and refer him out to see his PCP

Answer

Mrs. Q, a 57yo patient is here to see you for her initial evaluation. She attempts to make a great first impression by bringing a box of pastelitos y café con leche. As you begin the ‘subjective’ portion of your evaluation, she begins telling you about her husband who is a graphic designer, her sister who works in a bank but recently received a promotion, her children who are all married and living out-of-state, as well as nieces and nephews who are still in school. As you begin filtering the irrelevant information, she informs you that her low back has been ‘continuously throbbing’. She then begins to sob, and states that all she wants out of therapy is just to be pain free for once in her life. Your most appropriate course of action would be to:

1. Call 911, because Mrs. Q may be suffering a myocardial infarction.
2. Eat the food and drink the coffee she brought you as you finish your evaluation, then refer the patient back to her PCP, and inform the physician that you suspect a possible aortic aneurysm secondary to the patient’s statement.
3. Educate Mrs. Q on her diagnosis, plan of care at therapy and eventual prognosis. Then ensure her that she will be receiving the highest quality of service possible in order to reduce the pain she’s been continuously experiencing.
4. Refer the patient back to the PCP immediately, as it may be a possible aortic aneurysm.

Answer

An athlete was referred to your outpatient facility with diagnosis of displaced disk. The patient states that he works in a warehouse lifting boxes. What factor must you address first during your intervention _______.

1. Ignore the situation
2. Involve the patient in plyometric activities ASAP
3. Patient’s motivational level may be affected by psychological distress
4. Patient education on proper body mechanics

Answer

Patient comes in to your outpatient physical therapy facility with complains of low back pain for 3 days. Pt states that with activities such as: sitting for long periods, bending forward, coughing and sneezing causes him to have increased pain. During the observation part of the evaluation you noticed the patient is slightly shifted to the right. The physical therapist should rule out __________.

1. Disc displacement
2. Facet Condition
3. Hip bursitis
4. Osteoporosis

Answer

Patient comes in to your outpatient physical therapy facility with L4 disc displacement status-post day 3. The best intervention in the maximum protection phase would include:

1. Involving the patient in rigorous exercise program
2. Lifting weights
3. Modalities (massage, traction as needed)
4. Rotational exercises

Answer

Ms. Jones came in with a diagnosis of L4 disc displacement. During your evaluation special test (s) that would help you confirm diagnosis include:

a. H and I Stability Test
b. Slump test
c. SLR
d. SLR and Slump test

Answer

Ms. Jackson comes in to your clinic with complains of pain that radiates down the right leg. The patient states she’s been feeling the symptom for a couple of months. A possible diagnosis that may be creating this symptom includes:

1. muscle strain
2. disc displacement with nerve root involvement
3. bursitis of the hip
4. ACL sprain

1. 
   
   K
2. 
   
   Na
3. 
   
   Ca
4. 
   
   Cl
5. 
   
   Mg

1. 
   
   
   New military recruit who does 4 mile run, 100 push-ups in 95 degree weather
2. 
   
   
   Otherwise healthy 20 yo male who has influenza A
3. 
   
   
   Construction worker trapped under large plank for 5 hours
4. 
   
   
   25 yo woman who recently had unprotected anal intercourse with HIV positive male
5. 
   
   
   70 yo female with CAD recently started on statin and fibrate

1. 
   
   1.5 L/hr NS
2. 
   
   Acidify urine to pH <4.5
3. 
   
   Dialysis
4. 
   
   Maintain UOP >300 ml/hr
   

1. 
   
   Myoglobin precipitating in renal tubules leading to renal tubular obstruction
2. 
   
   Hypovolemia due to fluid shifting from intravascular space into damaged muscle and interstitum
3. 
   
   Toxic effects of free cheletable iron on tubules
4. 
   
   Obstruction of ureters due to kidney stones

1. 
   
   Hyperkalemia
2. 
   
   Hypokalemia
3. 
   
   Compartment syndrome
4. 
   
   DIC

A patient with tuberculosis develops bright orange-red urine and calls his physician in a panic because he is afraid he is bleeding into the urine. The patient has no other urinary tract symptoms. Which of the following medications is most likely to produce this side effect?

A. Ethambutol
B. Isoniazid
C. Pyridoxine
D. Rifampin
E. Streptomycin

Answer