NPTE Clinical Files | Physical Therapy

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 jointsB) Swan-neck deformity involving hyperextension of the PIP jointsC) Heberden nodes involving the distal interphalangeal jointsD) Boutonnière deformity involving flexion of the PIP joints- Join the FREE NPTE Facebook Group: www.nptegroup.com- Download My Hand Deformities Cheatsheet: https://www.nptecheatsheet.com/hand-deformities

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) LisinoprilB) MetoprololC) FurosemideD) Nitroglycerin- Text our team the word COACH for a free diagnostic: (727) 732-4573- Download My Top 10 Meds Cheatsheet: https://www.nptecheatsheet.com/meds-npte

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+/5Which 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 flexorsB) Progressive resisted strengthening of the right gluteus maximusC) Joint mobilization to improve extension of the right first metatarsophalangeal jointD) Progressive resisted strengthening of the right quadricepsDownload 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 walkingB) A patient with acute pericarditis who reports chest discomfort at restC) A patient with suspected acute pulmonary embolism who developed sudden dyspnea earlier in the dayD) A patient with unstable angina who has experienced increasingly frequent chest pain during minimal activityDownload 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 contactB) Wear gloves only when contact with blood or other potentially infectious body fluids is anticipatedC) 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 roomText our team the word COACH for a free diagnostic: (727) 732-4573