(Test Bank) Fundamental Orthopedic Management for the Physical Therapist Assistant

Manske, 4

Nursing

Test Bank

4th Edition

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Test Bank for Fundamental Orthopedic Management for the Physical Therapist Assistant, The downloadable file consists of 167 pages, and the total size of the file is 1.24 MB. Purchase now only for highly discounted price.

Author(s): Manske

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Fundamental Orthopedic Management for the Physical Therapist Assistant 4th Edition Manske Test Bank Chapter 01: Patient Supervision and Observation During Treatment MULTIPLE CHOICE 1. Who is responsible for carrying out prescribed selected interventions, patient supervision, data collection, and appropriate supervision of a patient during physical therapy? a. Physical therapist (PT) b. Physical therapist assistant (PTA) c. Nursing assistant d. Medical doctor ANS: B The PTA is responsible for carrying out prescribed selected interventions, patient supervision, data collection skills, and appropriate problem -solving and clinical decision making. REF: P. 3 2. Which of the following is NOT a purpose of the clinical patient supervision process? a. To gather relevant information and data b. To establish and enhance rapport, trust, and confidence c. To prescribe interventions the patient requires d. To assist in the management of the patient ANS: C PTAs do not prescribe interventions for the patient. The PTA observes, documents, and discusses patient observations with the PT. REF: P. 4 3. Select the open -ended question. a. What is your pain level today on a scale of 1-10? b. When did the pain begin? c. Tell me about the time that you injured knee. d. When did you take your last pain medication? ANS: C The open -ended question leads the patient to say more than yes or no. Open -ended questions provide much richer details about the incident or experience. REF: P. 6 4. Which of the following statements is true regarding the working environment of PTAs? a. PTAs work in isolation with their patient assignments. b. PTAs work with a team of experts in all areas of a patient’s care. c. PTAs work only with the PT in providing therapy. d. PTAs are the most important people on the rehabilitation team when providing therapy. ANS: B The PTA must be aware of the key members of the rehabilitation team. Occupational therapists, PTs, nurses, respiratory therapists, psychologists, and audiologists are only a few of the important members of the rehabilitation team. The PTA does not work in isolation. REF: P. 4 5. Which of the following statements would be used in a discussion with a patient? a. Your blood pressure is 150/90, which indicates hypertension and could lead to a cerebral vascular accident if you don’t take your medications. b. Your blood pressure is higher than normal today, 150/90. Did you take your blood pressure medication this morning? c. The doctor prescribed a beta -blocker for you a month ago. Has that been helping your blood pressure? d. The combination of your calcium -channel blocker and beta -blocker do not seem to be controlling your blood pressure. Let’s call the doctor. ANS: B The PTA should learn to communicate openly, freely, and in a professional manner. The PTA must employ appropriate and professional medical terminology with professional people —but use familiar (lay) terms to describe the same condition to a patient or a family member. Avoiding the use of medical jargon (hypertension, beta-blocker, calcium -channel blocker) with patients is required by PTAs. REF: P. 4 6. How can a PTA demonstrate accountability in their practice? a. Maintain timely documentation about patient interventions. b. Maintain good rapport with patients. c. Continue their education past their initial degree. d. Report all findings to the supervising PT so that modifications can be made in response to changes in patient status. ANS: D PTAs are responsible for reporting all findings to the supervising PT so that modifications can be made in accordance with changes in patient status. REF: P. 6 7. Which type of questioning would you use to find facts or obtain specific responses from a patient about an injury to a limb or joint? a. Open -ended questions b. Closed -ended questions c. A pause d. Neutral phrase ANS: B Figure 1 -1. Closed -ended questions are used to find out specific details, direct the discussion, or elicit specific responses from the patient. REF: P. 8 8. Which of the following is an example of prompting during a physical therapy session? a. “When you walk up the steps, which foot will you move first?” b. “All right, now pick up your right foot and put it on the next step.” c. Point to the step and touch the patient’s right leg. d. Observe the behavior of the patient to see if they will lift up the correct foot while walking up the steps. ANS: A Prompting a patient to perform a task can be viewed as the presentation of a question. Prompting allows patients to decipher information, solve problems, and provide solutions to activities they must overcome during recovery. Cues are directions. REF: P. 9 9. Who holds the ultimate responsibility for the patient’s physical therapy? a. PTA b. Medical doctor c. Nurse d. PT ANS: D To minimize the confusing array of treatment protocols, the PTA must effectively and efficiently communicate with the supervising PT to clarify differences in patient care, always remembering that the PT has the ultimate responsibility for the interventions provided. REF: P. 10 10. Which of the following actions should you take if you have a disagreement with the PT? a. Refuse to provide the treatment or intervention on the PT’s plan of care. b. Change the treatment for the day and then report to the PT what was done at the end of the day. c. Follow the plan of care no matter what changes are observed in the patient and document later. d. Discuss your findings and rationale with the PT to learn and provide better care. ANS: D A full understanding of the rationale and purpose of PT interventions allows for improved delivery of care and safe and effective care. PTAs cannot change the plan of care by themselves. REF: P. 10 11. What type of behavior is the PTA using in the following example? The PTA quickly agrees to the patient’s reques t to slow down and stop the treatment for the day instead of discussing the purpose and benefits of the treatment. a. Dominance b. Submission c. Hostility d. Warmth ANS: B Figure 1-2. Submission is defined as being passive. People who show submissive behavior are willing to take a back seat and are quick to comply and reluctant to try to exert influence. REF: P. 8 12. What type of behavior is the PTA using in the following example? The PT insists the patient continue treatment for the full time limit even when the tearful patient reports a fear of continuing exercise of a particular joint. a. Dominance b. Submission c. Hostility d. Warmth ANS: C A dominant PTA would try to sway the patient to think or behave in a certain way. In this example, the PTA ignores the patient’s complaints and feelings and continues with the treatment. REF: P. 8 13. In the basic dimensional model, which behaviors would be seen in a warm but submissive person? a. Stubborn, argumentative b. Sincere, open, candid, responsive c. Talks little, doesn’t listen well d. Appeases; compromise leads to lack of focus ANS: D Figure 1-3, B. The submissive -warm person demonstrates a lack of organization, appeasing behavior, and compromises. REF: P. 8 14. In the basic dimensional model, which behaviors would be seen in a dominant -hostile person? a. Stubborn and argumentative b. Sincere, open, candid, responsive c. Talks little and doesn’t listen well d. Appeases; compromise leads to lack of focus ANS: A Figure 1 -3, B. The dominant -hostile person would be stubborn and argumentative, taking fixed positions and sticking to them, talking a lot rather tha n listening, and being pushy and arrogant. REF: P. 8 15. In the basic dimensional model, which behaviors would be seen in a dominant -warm person? a. Stubborn and argumentative b. Sincere, open, candid, responsive c. Talks little and doesn’t listen well d. Appeases; compromise leads to lack of focus ANS: B Figure 1-3, B. The dominant -warm person is sincere, open, and candid; listens; is open - minded and flexible. REF: P. 8 16. In the basic dimensional model, which behaviors would be seen in a submissive -hostile person? a. Talks a lot rather than listens and is belligerent. b. Sincere, open, candid, responsive c. Talks little and doesn’t listen well and avoids issues d. Appeases; compromise leads to lack of focus ANS: C Figure 1-3, B. The submissive -hostile person talks little, doesn’t listen well, avoids or ignores issues, is uninvolved, quiet, and backs down easily. REF: P. 8 17. When can a PTA adjust or modify a program of treatment? a. When the PTA observes certain signs and symptoms in the patient. b. After seeking input and direction from the supervising PT. c. The PTA cannot ever change the plan of care. d. None of the above. ANS: B The PTA, with direction and input from the supervising PT, can adjust or modify the program of treatment. REF: P. 9 18. The PTA’s clinical decision -making process should begin with a. taking orderly and specific steps to notify the supervising PT. b. recognizing that a problem exists. c. adjusting the program according to the patient’s needs. d. asking the PT to assess the patient. ANS: B The clinical decision -making process used by the PTA involves recognizing that a problem exists, then taking orderly and specific steps to notify the supervising PT and adjusting the program accordingly. REF: P. 9 19. Which of the following behaviors exemplifies a well-adapted PTA? a. Constantly asks about the rationale for treatment b. Establishes themselves as an eager learner c. Is open to innovative ways of managing various pathologic conditions d. All of the above ANS: D The well -adapted PTA views any apparent roadblocks as learning opportunities. The PTA is advised to take advantage of the broad knowledge and experience of many PTs, constantly inquire about the rationale and scientific basis for a particular program, and establish him - or herself as an eager learning participant who is open to innovative ways of managing various pathologic conditions. REF: P. 10 20. Why do PTAs and PTs use general scales of measurement? a. To standardize assessment and more accurately measure patient progress b. To shorten the amount of time needed to document the patient’s condition c. To demonstrate knowledge of medical terminology d. None of the above ANS: A General scales are used to standardize assessment and more accurately measure patient progress. REF: P. 4 Chapter 02: The Role of the Physical Therapist Assistant in Physical Assessment MULTIPLE CHOICE 1. Which health care provider is defined as “a technically educated health care provider who assists the physical therapist in the provision of select PT interventions?” a. Physical therapist assistant (PTA) b. Physical therapist (PT) c. Nursing assistant d. Medical doctor ANS: A This is the definition of the PTA as defined by the Guide to Physical Therapy Practice (2nd Ed.). REF: P. 14 2. Which of the following is the responsibility of the PT alone? a. Observation b. Assessment c. Examination d. Evaluation ANS: D Evaluation is the specific process reserved solely for the PT, in which clinical judgments are made from this base of data obtained during the examination. REF: P. 14 3. Which of the following statements is NOT included in the Clinical Performance Instrument (CPI) by the American Physical Therapy Association (APTA) related to the PTA’s role? a. Participates in patient status judgments within the clinical environment based on the plan of care established by the PT. b. Obtains accurate information by performing selected data collection consistent with the plan of care established by the PT. c. Discusses the need for modifications to the plan of care established by the PT. d. Makes clinical judgments based on the assessment and examination of the patient. ANS: D It is the role of the PT to make clinical judgments based on the assessment and examination of the patient. REF: P. 14 4. In the Normative Model of PTA Education (2007), which of the following is NOT an expected performance theme? a. Interventions b. Communication c. Diagnosis d. Resource management ANS: C Diagnosis is not one of the five PT performance expectation themes for PTA education. The five include interventions, communication, education, resource management, and career development. REF: P. 15 5. Which of the following contains the cardinal signs of inflammation? a. Swelling, pallor, cool skin temperature b. Swelling, pain, redness, heat c. Fever, pain, redness, and warmth d. Pain, fever, cool skin temperature ANS: B The commonly accepted and normal cardinal signs and symptoms of inflammation are localized heat, redness, swelling, and pain (with a resultant loss of function in the injured area). REF: P. 15 6. How long does acute inflammation last, assuming the precipitating condition, agent, or event is removed? a. 12-24 hours b. 1-2 days c. 3-5 days d. 4-6 days ANS: D Under normal circumstances, signs of acute inflammation persist for 4-6 days, assuming the precipitating condition, agent, or event is removed. REF: P. 16 7. When is pain from acute inflammation felt by the patient during range of motion (ROM) exercises? a. Before tissue resistance (before “end” ROM) b. At the same time end ROM is reached c. After ROM exercises are over d. Never felt by the patient during ROM ANS: A Pain before tissue resistance felt before “end” ROM is an indication of acute inflammation. Pain at the same time end ROM is reached is an indication of a subacute inflammatory state. Pain reported as a stretching sensation at the limit of ROM is a sign of inflammation in the chronic state. REF: P. 16 8. Which of the following reports of pain is indicative of chronic inflammation? a. Pain reported before tissue resistance (before “end” ROM) b. Pain reported as a stretching sensation at the limit of ROM c. Pain reported at the same time ROM is reached d. Pain is not seen with chronic inflammation ANS: B Pain before tissue resistance felt before “end” ROM is an indication of acute inflammation. Pain at the same time end ROM is reached is an indication of a subacute inflammatory state. Pain reported as a “stretching sensation” at the limit of ROM is a sign of inflammation in the chronic state. REF: P. 16 9. Your patient has an oral temperature of 101.6°F. Which other signs and symptoms will you look for in your patient assessment? a. General malaise and increased pulse b. Strong appetite and dry skin c. Decreased pulse and respirations d. Paleness in the affected joint ANS: A The clinical signs and symptoms of fever vary based on the underlying cause and stage; they might include general malaise, headache, increased pulse and respirations, general chills, shivering, piloerection, loss of appetite, pale skin, nausea, irritabilit y, and restlessness. REF: P. 16 10. Which is the most effective means of controlling the transmission of infectious agents? a. Isolating infected patients b. Hand washing by the caregiver and patient c. Disinfecting treatment areas routinely d. B and C ANS: D The importance of hand washing by the caregiver and patient cannot be overstated as an effective means of controlling the transmission of infectious agents. In addition, treatment areas should be properly cleaned and disinfected as a routine procedure. REF: P. 16 11. Which of the following actions would be considered discretionary caution by the PTA when performing pool ROM exercises with a patient experiencing a fever of 102.8°F? a. Notify the PT and ask to omit the exercises until the fever resolves. b. Continue with the prescribed walking activities. c. Omit therapy during times the patient has a fever. d. Increase the walking exercises to help break or resolve the fever. ANS: A Discretionary caution is a pplied with any patient with a fever, because of stresses on the cardiopulmonary and immune systems and the possible further complications related to dehydration. The PTA should be familiar with specific exercise techniques contraindicated in the presence of diseases transmitted via water or air. REF: P. 17 12. Which type of redness indicates acute inflammation caused by a bacterial infection? a. Superficial tenderness or hardness of the area b. Red streaks c. Flushed cheeks d. None of the above ANS: B Red streaks might indicate an acute inflammation caused by a bacterial infection (strep, staph, or both). Superficial tenderness or hardness in an area may be a sign of superficial thrombophlebitis. REF: P. 18 13. What technique would you use to assess deep vein thrombosis (DVT)? a. Patient sits in a comfortable position and lifts knee to chest. b. Patient points toes toward the floor and reports any pain in the thigh area. c. Patient points toes upward (dorsiflex) for assessment of pain in the calf. d. Patient holds foot in neutral position and you squeeze the calf. ANS: C A commonly used quick assessment technique to rule out the presence of a DVT is the Homan sign. It is performed by gentle passive stretching of the ankle into full dorsiflexion and assessing for pain in the calf. REF: P. 18 14. What are the risk factors for DVT? a. Prolonged bed rest or prolonged air travel b. Varicose veins, fractures, and age under 60 c. Oral contraceptive use and high cholesterol level d. Obesity and falling ANS: A Box 2-1. Risk factors for DVT. Prolonged bed rest and air travel are risk factors. Items listed that are not risk factors are age under 60, high cholesterol level, and falling. REF: P. 18 15. Which term is defined as the excessive pooling of fluid in the spaces between tissues (interstitial spaces)? a. Fracture b. Infection c. Edema d. Hemorrhage ANS: C Edema refers to excessive pooling of fluid in the spaces between tissues (interstitial spaces). The main consideration for the PTA is measurement of the edematous part or extremity. REF: P. 19 16. Which signs and symptoms would be seen with congestive heart failure (CHF)? a. Swelling in one ankle without a change in breathing or muscle strength b. Swelling in both ankles with fatigue and shortness of breath c. No swelling in either ankle, but fatigue and normal respirations d. Weakness without a change in respirations ANS: B Bilateral pitting edema in the distal lower extremities is a common manifestation in CHF. Other signs include a decrease in tolerance to exercise (fatigue, shortness of breath, and muscle weakness). These symptoms need prompt consultation with the supervising PT. REF: P. 19 17. Which of the following is the PTA’s best response to a patient reporting new pain since the last therapy session? a. “Well, some pain is to be expected after our therapy sessions” b. “Really? I didn’t think the last session was that difficult for you” c. “That pain is normal and should be expected. Take your pain medication before and after our therapy sessions and you should feel better” d. “Tell me about the pain, is it sharp or burning? When do you have the pain?” ANS: D The PTA’s role in assessing pain is to gather data that present a clear picture of any change i n pain since the last visit, and to elicit responses of the patient in terms of how interventions to date have affected pain, patterns of pain, and the characteristics of pain. All pain is considered “real” by the PTA and should be investigated and reported to the PT. REF: P. 23 18. Which of the following are the signs and symptoms of a heart attack? a. Pain or pressure under the breastbone, neck or jaw with pain in the left arm and shoulder b. Indigestion and pain in the lower abdomen after exercise c. Pain between the shoulder blades and the inside of the left or right arms d. A and C ANS: D Figure 2-6. Early warning signs of a heart attack. Indigestion and pain in the lower abdomen are not warning signs of a heart attack. REF: P. 24 19. What should a PTA do when a patient experiences “red flag” pain symptoms during therapy? a. Call the doctor immediately and report the pain b. Continue the therapy session using caution c. Stop any intervention that could be contraindicated and report the findings to the PT d. Ask the patient when he had his last pain medication and contact the nurse to deliver a pain medication ANS: C The PTA must be keenly aware of pain that sends a “red flag” signal. The PTA should not proceed with any interventions or data collection techniques that are potentially contraindicated and should immediately report the findings to the supervising PT. REF: P. 23 20. Which symptoms are exhibited during intermittent claudication? a. Bilateral pain in the calves or thighs described as cramping that goes away with rest b. Unilateral pain in one calf described as cramping that goes away after walking c. Bilateral pain in calves or thighs that goes away with walking d. Unilateral pain in buttocks or thighs that worsens when the patient rests ANS: A It is typically described as aching or cramping that is localized in the region affected by the impaired circulation (calves, thighs, buttocks bilaterally) and is rapidly improved after the aggravating activity is discontinued (such as after resting). REF: P. 23 Chapter 03: Differential Diagnosis and Emergent Conditions MULTIPLE CHOICE 1. The process of providing a label that correlates specific signs and symptoms to an identifiable disease or disorder is: a. evaluation. b. diagnosis. c. consideration. d. prognosis. ANS: B Multiple sources have used this definition of diagnosis. REF: P. 38 2. The process of comparing and contrasting patient data points with the goal of appropriate exclusion and inclusion that terminate with the development of intervention strategies is: a. examination. b. prognosis. c. intervention. d. differential diagnosis. ANS: D Examination is the use of tests and measures to screen the patient. Prognosis is the prediction of outcomes. Intervention is the action taken by the physical therapist (PT) or physical therapist assistant (PTA) to resolve the patient’s problem. Differentia l diagnosis is the process of using patient data to develop intervention strategies. REF: P. 39 3. What is the term for a comprehensive screening of the patient that includes specific tests and measures? a. Examination b. Prognosis c. Intervention d. Differential diagnosis ANS: A Examination is the use of tests and measures to screen the patient. Prognosis is the prediction of outcomes. Intervention is the action taken by the PT or PTA to resolve the patient’s problem. Differential diagnosis is the process of using patient data to develop intervention strategies. REF: P. 39 4. What is the term for a prediction of the outcome of the physical therapy episode of care with the establishment of a plan of care (POC)? a. Examination b. Prognosis c. Intervention d. Differential diagnosis ANS: B Examination is the use of tests and measures to screen the patient. Prognosis is the prediction of outcomes. Intervention is the action taken by the PT or PTA to resolve the patient’s problem. Differential diagnosis is the process of using patient data to develop intervention strategies. REF: P. 41 5. Which of the following is not a minimum skill for a PTA? a. Collect data on patient’s current condition and compare results to previously collected data b. Communicate to the PT when there are significant changes in patient status c. Develop the POC d. Use clinical problem solving skills to determine if the patient is safe and comfortable with the intervention ANS: C The PT is responsible for the development of the POC. The PTA is expected to have all of the other skills listed (see Table 3-1). REF: P. 42 6. The PTA is expected to have which of the following basic assessment skills? a. Assessment of range of motion b. Ability to do manual muscle testing c. Proficiency in anthropometric measurement d. All of the above ANS: D The PTA is expected to be competent in all of the above skills. REF: P. 43 7. Which type of diagnosis emphasizes the influence of a disease or disorder on the patient’s functional status at the system level and on the interrelationship betw een the system and the patient as a whole? a. Physical therapy diagnosis b. Medical diagnosis c. Nursing diagnosis d. Functional diagnosis ANS: A A medical diagnosis labels a disease or disorder on a cellular, tissue, or organ level. A physical therapy diagnosis emphasizes the impact of the disorder on the patient’s functional status. REF: P. 41 8. Which of the following is not true about vital signs? a. They provide an objective overview of the patient’s cardiopulmonary function b. They may be influenced by exercise, disease, stress, and age c. Baseline vital signs data should be obtained prior to initiation of a POC d. During an episode of care, vital signs are no longer measured or useful ANS: D Vital signs should be measured periodically during care. Altered vital signs may indicate an adverse response to care and must be evaluated. REF: P. 48 9. What percentage of patients undergoing orthopedic surgery develops an infection? a. 1% b. 2-5% c. 10% d. 12-15% ANS: B Two to five percent of patients undergoing orthopedic surgery develop an infection. REF: P. 48 10. The signs and symptoms of redness, edema, pain, and increased skin temperature may indicate: a. inflammation or infection. b. infection only. c. inflammation only. d. a prognosis. ANS: A Both inflammation and infection may be indicated by redness, edema, pain, and increased skin temperature. The health care team needs to evaluate these signs and symptoms to determine if infection is present. REF: P. 48 11. An abnormal response to musculoskeletal trauma that involves the excessive collection of red and white blood cells and fibrin resulting in a partial or complete occlusion of a vessel is: a. inflammation. b. tumor. c. venous thrombosis. d. tachycardia. ANS: C Venous thrombosis is caused when an excessive collection of white and red blood cells and fibrin occlude a blood vessel. If a deep vessel is involved, the thrombosis is referred to as a deep vein thrombosis (DVT). REF: P. 48 12. DVT usually occurs in which location? a. Upper extremities b. Lower extremities c. Head and neck region d. Lungs ANS: B Approximately 90% of DVTs occur in the lower extremities. REF: P. 48 13. What is a chronic swelling of an area that leads to the involvement of an entire extremity? a. Thrombosis b. Myocardial infarction c. Orthostatic hypertension d. Lymphedema ANS: D A chronic swelling of an area that leads to the involvement of the entire extremity is a lymphedema. A common type of lymphedema is secondary lymphedema, which is a direct result of obstruction or damage to the lymphatic system. REF: P. 51 14. A fall in blood pressure associated with position changes from lying to sitting or sitting to standing is: a. syncope. b. orthostatic hypotension. c. orthostatic hypertension. d. lymphedema. ANS: B Orthostatic hypotension is defined as a fall in systolic blood pressur e of 20 mm Hg or more and a 10 mm Hg decrease in diastolic blood pressure when the patient moves from a lying position to a sitting or standing position or from sitting to standing. REF: P. 51 15. What is a dysfunction that is a result of a reduction in the quality or quantity of erythrocytes and results in oxygen deficiency? a. Anemia b. Syncope c. Pulmonary embolism d. Hypertension ANS: A Anemia is a dysfunction that is a direct result of a reduction in the quality or quantity of erythrocytes. The resultant oxygen deficiency can lead to multi -tissue and organ disturbances that further impair the individuals healing capacity and overall functional capabilities. REF: P. 52 16. A common problem, especially among elderly patients, to the pulmonary system that is an inflammation of lung tissue that creates excessive fluids resulting in difficulty breathing is: a. pulmonary embolism. b. lymphedema. c. pneumonia. d. lung cancer. ANS: C The elderly are particularly susceptible to pulmonary dysfunction or disease, such as pneumonia. Pneumonia is an inflammation of lung tissue that results in excessive fluid accumulation. This then creates breathing difficulties. REF: P. 52 17. Which of the following statements is not true about asthma? a. Asthma primarily inflames the bronchial blood vessels b. Asthma is associated with response to allergens, infectious agents, or pollution c. Asthma may be triggered by exercise d. Asthma may cause a “panting” breathing pattern with a nonproductive, hacking cough ANS: A Asthma affects the bronchial airways, not the bronchial blood vessels. All of the other statements are true about asthma. REF: P. 52 18. When evaluating a patient with low -back pain, who also has experienced unexplained recent weight loss, night pain, and inability to obtain a comfortable position, the health care team should investigate for: a. spinal muscle spasm. b. spinal tumor or cancer. c. pulmonary embolism. d. osteomyelitis. ANS: B Recent weight loss, night pain, and inability to obtain a comfortable position are possible indications of tumor or cancer. None of the other answers are associated with these three signs or symptoms. REF: P. 53 19. Spinal compression fractures are not associated with which of the following? a. Trauma b. Osteoporosis c. Steroid use d. Infection ANS: D Spinal fractures are usually caused by trauma. Both osteoporosis and steroid use can weaken bone and inert tissue that may contribute to spinal fracture. Infection is not normally associated with spinal fracture. REF: P. 53 20. Obesity, eating red meat, cigarette smoking, and alcohol consumption are risk factors for: a. pulmonary embolism. b. colon cancer. c. spinal fracture. d. asthma. ANS: B Risk factors for colon cancer include obesity, eating red mean, cigarette smoking, and alcohol consumption. REF: P. 54 Chapter 04: Muscle Flexibility and Range of Motion MULTIPLE CHOICE 1. Which of the following is NOT a benefit to having a more flexible body? a. Injury prevention and quicker recoveries after workouts b. Faulty postural alignment that leads to injuries c. Reduced postexercise soreness d. Facilitation of relaxation ANS: B Muscle imbalance leads to faulty postural alignment, which affects flexibility. REF: P. 65 2. Which type of collagen is most abundant in the body, is a thick fiber, and has little elongation when placed under tension? a. Type I b. Type II c. Type III d. Tropocollagen ANS: A Type I collagen is made of short fibrils (bundles) found in all different types of connective tissues. The majority of the collagen in the body is type I. REF: P. 66 3. Which type of collagen would you expect to find in the arteries, liver, and lungs? a. Type I b. Type II c. Type III d. None of the above ANS: C Type III collagen serves mainly in a structural support capacity and is found in expansible organs (e.g., arteries, liver, lungs). It also helps out in the early stages of wound repair. REF: P. 66 4. Which term is defined in force/area (pounds per square inch) and is directly related to the magnitude of force? a. Stress (load) b. Strain c. Deformation d. Viscoelasticity ANS: A Stress or load is defined as force/area (i.e., pounds per square inch). It is directly related to the magnitude of force and inversely related to the unit area, but it is independent of the amount of a material. Deformation is a complementary measure related to stress and is also called strain . REF: P. 66 5. Which of the following terms is defined as a gradual increase in tissue length that occurs when maintaining a constant stress (force)? a. Stress (load) b. Creep c. Deformation d. Viscoelasticity ANS: B Creep phenomenon means the gradual increase in tissue length that occurs when maintaining a constant stress or force. The deformation of the tissue will continue until a state of equilibrium is reached when the load is balanced. The longer the duration of the applied force, the greater the deformation or stretching. REF: P. 68 6. What is increased in ligaments and tendons that experience increasing levels of stress? a. Collagen b. Creep c. Strain d. None of the above ANS: A The ability of tissues to recover after stress is extremely important in relation to flexibility. Increasing the levels of stress produces an increase in collagen within ligaments and tendons. REF: P. 69 7. What effect does heat have on the viscoelastic properties of connective tissue? a. No effect b. Greater elongation with stress before tissue failure c. More microscopic damage under stress d. Thermal damage to the connective tissues below 45°C ANS: B Viscoelastic and plastic changes occur at higher temperatures with less microscopic damage under stress. A temperature of 45°C is needed to reduce tissue damage during strains. REF: P. 69 8. What happens to flexibility over time in a damaged or unused muscle? a. The muscle shortens and loses its ability to stretch b. The muscle is unchanged c. The muscle remains flexible but weaker d. The range of motion (ROM) of the joint that the muscle serves remains normal ANS: A Flexibility refers to the degree of normal ROM available. If a muscle becomes damaged by trauma or disease or becomes shortened because of immobility, its ability to stretch and allow freedom of joint motion is affected. Flexibility will diminish over time if tissues are not stretched or exercised using regular and proper stretching regimens. REF: P. 69 9. What is the name of the instrument that looks like a protractor with degree measurements and is used to measure ROM for almost all joints in the body? a. Scale b. Flexibility test c. Goniometer d. ROM meter ANS: C Measuring joint ROM is accomplished by using standard goniometric instruments. The measuring device most commonly used is a goniometer, which looks like a protractor with degree measurements. REF: P. 70 10. What are the benefits of a warm -up before strenuous activities? a. Blood flow to working muscles is increased b. Temperature in working muscles is increased c. Cardiovascular response to sudden; dynamic exercise is improved d. All of the above ANS: D Warm -up is necessary to help prepare the tissue for activity. Stretching alone is not enough. All of the listed items are benefits of a warm -up before strenuous activities. REF: P. 73 11. Which term is defined as a common form of stretching that allows one to sustain a controlled stretch by placing a muscle in a fully elongated position and holding that position for a period of time? a. Static stretching b. Ballistic stretching c. Dynamic stretching d. Proprioceptive neuromuscular facilitation (PNF) ANS: A Static stretching is the most common form and allows one to sustain a controlled stretch by placing a muscle in a fully elongated position and holding that position for a period of time (Fig. 4-11). REF: P. 74 12. Which term is defined as using a muscle contraction to stretch a muscle to increase or decrease the joint angle thereby elongating the musculotendinous unit at the end of ROM exercise? a. Static stretching b. Ballistic stretching c. Dynamic stretching d. PNF ANS: C Dynamic stretching is defined as using a muscle contraction to stretch it to increase or decrease the joint angle thereby elongating the musculotendinous unit at the end of ROM exercise. REF: P. 75 13. Which stretching technique is completed by performing the following steps? The patient is instructed to relax the affected muscle as the therapist passively moves the limb to the limit of motion. Then the patient actively contracts the restricted muscle against manual resistance for 5 -8 seconds. Then the patient relaxes while the therapist passively moves the limb to the new limits of motion and holds the stretch for 10 seconds. a. Static stretching b. Ballistic stretching c. Dynamic stretching d. PNF ANS: D PNF has several techniques. The one described in this question is the contract -relax with agonist contraction technique (Fig. 4 -18). REF: P. 77 14. What is the generally recommended length of time (in seconds) that a static stretch should be held? a. 0-10 b. 15-30 c. 60-120 d. 120-240 ANS: B Generally, most research recommends stretches be held between 15 and 30 seconds. Current American College of Sports Medicine guidelines recommend 2 -5 repetitions for each stretching exercise. REF: P. 78 15. How many weeks of stretching are needed to demonstrate significant increases in muscular flexibility? a. 0-2 b. 2-3 c. 4-5 d. 6 ANS: D Approximately 6 weeks of stretching are necessary to demonstrate significant increases in muscular flexibility. A person must stretch at least three times per week to improve flexibility and at least 1 day per week to maintain the flexibility gai ned during the program. REF: P. 78 16. Based on the research evidence presented in the text about when to perform stretching exercises, which of the following best describes the state of research? a. It is best to stretch before exercise b. It is best to stretch during exercise c. It is best to stretch after exercise d. The research supports stretching before, during, and after exercise ANS: D The evidence presented in the text section “When to Stretch” supports all three times for stretching —before, during, and after exercise. REF: P. 81 17. How long does it take for an immature adaptable scar to mature and reach its maximum strength? a. 5 days b. 40 days c. 60 days d. 12 months ANS: D At 12 months, a new scar is approximately 100% of its maximum strength. REF: P. 82 18. Which stretching exercises are effective in stretching joint contractures in combination with thermal agents such as moist heat? a. Static stretching b. Ballistic stretching c. Low-load, long-duration stretching d. PNF ANS: C Low-load, long -duration (20 -60 minutes) stretching of joint contractures in combination with thermal agents to preheat extensible connective tissue has proved effective in the treatment of soft tissue contracture. REF: P. 83 19. Which of the following terms is defined as a process that alters the structure of connective tissue in response to stress? a. Stretching b. Deformation c. Viscoelasticity d. Remodeling ANS: D Remodeling is defined as a process that alters the structure of connective tissue in response to stress. REF: P. 81 20. Which term is defined as a limitation of function that results from the formation of scar tissue? a. Adhesion b. Contracture c. Strain d. Sprain ANS: A An adhesion is a limitation of function that results from the formation of scar tissue. A contracture is a permanent or transient limitation of movement or shortening of muscle or other soft tissue. REF: P. 81 Chapter 05: Muscle Strength MULTIPLE CHOICE 1. A muscle’s strength or tension generating capacity is determined by a number of diverse but interrelated factors. Select the best explanation of how muscle length affects strength. a. The rate at which the motor neurons fire affects strength b. Muscle produces the greatest strength when it is at or near the physiologic resting position at the time of contraction c. The type of fibers (type I, type IIA, and type IIB) in the muscle determines strength d. How the muscle fibers are aligned in relation to an imaginary line between the muscle’s origin and insertion affects strength ANS: B The best description of how muscle length affects strength is the length tension ratio; muscle produces the greatest strength when it is at or near the physiologic resting position at the time of contraction. REF: P. 92 2. What is the noncontractile connect ive tissue that surrounds the muscle? a. Epimysium b. Fasciculi c. Perimysium d. Endomysium ANS: A The body of an individual muscle is surrounded by noncontractile connective tissue called the epimysium . REF: P. 92 3. Actin and myosin are the two predominant proteins in which part of the muscle? a. Perimysium b. Fasciculi c. Myofilaments d. Epimysium ANS: C The structural components of the myofibrils are called myofilaments and they comprise two predominant proteins, actin and myosin. Myosin is a thick protein and actin is a thin protein. Both are actively involved with the mechanics of muscle contraction. REF: P. 92 4. What are the primary differences between the slow twitch (ST) muscle fibers and the fast twitch (FT) muscle fibers? a. ST fibers are designed for endurance; FT fibers are designed for speed, strength, and power