Fundamental Orthopedic Management for the Physical Therapist Assistant 4th Edition By Robert Manske – Test Bank A+

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1. Which body systems are involved in endurance training?

a.	Endocrine
b.	Cardiovascular
c.	Muscular
d.	B and C

ANS: D

Endurance training (exercise) involves the muscular and cardiovascular systems.

REF: P. 116

1. What are the benefits of participating in an aerobic fitness program?

a.	Reduced risk of developing a chronic disease
b.	Reduced obesity and diabetes
c.	Decreased severity of symptoms associated with some diseases
d.	All of the above

ANS: D

All of the above are correct.

REF: P. 117

1. What are the cardiovascular changes associated with regular endurance training?

a.	Decrease in adipose (fat) tissue
b.	Increased heart weight and size
c.	Increased myoglobin content
d.	Improved oxygen extraction rates from the blood

ANS: B

Of all the listed items, increased heart weight and size is the only one that pertains to the cardiovascular system.

REF: P. 117

1. What is the minimum Centers for Disease Control and Prevention (CDC)-recommended moderate-intensity aerobic exercise for adults, older adults, and pregnant women?

a.	1 hour, 3 times a week
b.	2 hours, 3 times a week
c.	2 hours and 30 minutes a week, spread out across the 7-day period
d.	3 hours and 30 minutes a week, spread out across the 7-day period

ANS: C

See Table 6-1 for minimum weekly aerobic exercise guidelines for adults.

REF: P. 117

1. Which of the following is an example of a moderate-intensity aerobic activity?

a.	Walking briskly, water aerobics, doubles tennis
b.	Singles tennis, running, swimming laps
c.	Rowing, cycling at a rate of 10 mph
d.	None of the above

ANS: A

Examples of moderate-intensity exercises include walking briskly, water aerobics, and doubles tennis.

REF: P. 118

1. What is the CDC-recommended moderate-intensity daily exercise for children?

a.	30 minutes
b.	45 minutes
c.	60 minutes
d.	180 minutes

ANS: C

CDC recommends that children perform at least 60 minutes of moderate-intensity exercise each day in addition to vigorous-intensity exercises at least three times per week.

REF: P. 118

1. Calculate the maximum heart rate (MHR) in moderate-intensity exercise for a 180-pound man who is 60 years old.

a.	120
b.	160
c.	180
d.	220

ANS: B

220 minus 60 = 160 (MHR)

REF: P. 118

1. Calculate the MHR in moderate-intensity exercise for a 180-pound man who is 60 years old using a desired intensity of 70%.

a.	102
b.	112
c.	125
d.	160

ANS: B

Target heart rate = MHR ´ Desired intensity: 160 ´ 0.70 = 112 beats per minute

REF: P. 118

1. A patient is walking on the treadmill in the therapy department. The patient points to the number 6 on the Borg scale. What does a rating of 6 mean?

a.	The patient is at maximum exertion on the treadmill
b.	The patient is midway toward achieving maximum exertion on the treadmill
c.	The patient is experiencing no exertion at all
d.	The patient is almost at maximum exertion

ANS: C

A 6 on the Borg scale means that the patient is experiencing no exertion at all. The scores on the Borg scale range from 6 to 20.

REF: P. 119

1. Which aerobic conditioning program would most likely be prescribed for patients with limited exercise tolerance?

a.	Continuous
b.	Discontinuous
c.	None required
d.	Slow, walking program that progresses over an 8-week period

ANS: B

Discontinuous aerobic activities are also called interval training activities.

REF: P. 119

1. Which of the following aerobic exercises could be used by a patient whose back cannot tolerate land-based aerobic exercises?

a.	Stationary bicycle
b.	Recumbent bicycle
c.	Underwater treadmill
d.	Walking on a treadmill

ANS: C

Immersion in water can provide enough buoyancy during walking, unloading the spine, allowing the patient to exercise without exacerbating symptoms.

REF: P. 119

1. While recovering from a total knee replacement 1 week ago, the patient is engaged in aerobic activities for his upper body. Which of the following pieces of equipment would a PTA use?

a.	Upper body ergometer (UBE)
b.	Underwater treadmill
c.	Recumbent bicycle
d.	Stationary bicycle

ANS: A

Sitting on bicycles and walking underwater are contraindicated for patients in the immediate postoperative period. However, the UBE is ideal for an individual who cannot bear weight or perform full range of motion on an involved lower extremity and therefore can facilitate initial aerobic training.

REF: P. 119

1. Which person would be a candidate for using a stair climber exercise machine?

a.	A patient who experienced a stroke 6 weeks ago and has right-sided weakness
b.	A patient who had a total knee replacement 3 weeks ago
c.	A 70-year-old who had a total hip replacement 2 weeks ago
d.	A 65-year-old who had a total hip replacement 12 weeks ago

ANS: D

Patients who should not use stair climbers are those in the acute stage of immediate postorthopedic surgery period and those with unstable balance. The patient who should use the stair climber is the 65-year-old who had a total hip replacement 12 weeks (3 months) ago and is ready for increased aerobic activity at this point in the recovery and healing process.

REF: P. 120

1. What would you recommend to increase muscular endurance?

a.	10 repetitions per set with a 3-minute rest period between each set
b.	25 repetitions per set with a 5-minute rest period between each set
c.	15 repetitions per set with a 1- to 2-minute rest period between each set
d.	5 repetitions per set with no rest period between each set

ANS: C

The key variables that define how a muscle is being trained are (1) the number of repetitions during a set, (2) the amount of weight lifted during the set, and (3) the period of rest between sets. To increase muscular endurance, sets of high repetitions should be performed—at least 15 per set with a period of 1-2 minutes allowed for rest between each set.

REF: P. 121

1. Which type of endurance requires training to maintain or improve capacity, reduces the risk of developing acute or chronic conditions, and helps restore function after injury?

a.	Muscular endurance
b.	Cardiovascular endurance
c.	Both A and B
d.	Neither A nor B

ANS: C

Both muscular and cardiovascular endurance require training, improve one’s fitness level, reduce the risk of acute and chronic conditions, and help restore function after injury.

REF: P. 116

1. What is the main energy source for muscular function?

a.	Oxygen (O2)
b.	Adenosine triphosphate (ATP)
c.	Fat
d.	Vitamins and minerals

ANS: B

Micronutrients such as carbohydrates, proteins, and fats are converted into adenosine triphosphate, which is the main energy source for muscular function.

REF: P. 116

1. What percentage of adults in the United States are considered overweight or obese?

a.	10%
b.	25%
c.	50%
d.	60% or higher

ANS: D

Over 60% of adults in the United States are considered overweight or obese.

REF: P. 117

1. Running, swimming laps, singles tennis, and intense cycling are examples of what level of exercise?

a.	Minimal-intensity
b.	Moderate-intensity
c.	Vigorous-intensity
d.	Extreme-intensity

ANS: C

Running, swimming laps, singles tennis, and intense cycling are examples of vigorous-intensity exercise.

REF: P. 118

1. If a client shows an ability to talk during exercise, the exercise would be considered as what level of intensity?

a.	Moderate
b.	Vigorous
c.	Extreme
d.	Ability to talk has no relevance to exercise intensity

ANS: A

The talk test is an effective method to assess clinically the relative intensity of an exercise. The ability to talk during exercise suggests that the exercise is of moderate intensity, whereas the inability to talk without having to pause for breath suggests that the exercise is of vigorous intensity.

REF: P. 117

1. An exercise intensity rating system that uses the client’s perception of exertion is the:

a.	Karvonen Rating Scale
b.	Borg Rating of Perceived Exertion Scale
c.	APTA Exercise Rating Scale
d.	THR/MHR Perception Rating Scale

ANS: B

The Borg Rating of Perceived Exertion Scale may be used to assess exercise intensity based on a client’s perception of exertion. It uses a 6-20 point scale, 6 meaning no exertion and 20 corresponding to maximal exertion.

REF: P. 119

Chapter 07: Balance and Coordination

MULTIPLE CHOICE

1. Select the term that is defined as the ability to maintain the center of mass over the base of support.

a.	Coordination
b.	Neuromuscular control
c.	Proprioception
d.	Balance

ANS: D

Balance is often defined as the ability to maintain the center of mass over the base of support.

REF: P. 125

1. Select the term that is defined as the ability to produce patterns of body and limb motions in the context of environmental objects and events.

a.	Coordination
b.	Neuromuscular control
c.	Proprioception
d.	Balance

ANS: A

Coordination is the ability to produce patterns of body and limb motions in the context of environmental objects and events.

REF: P. 126

1. What term is defined as the perception of knowing joint position, movement, and movement resistance?

a.	Coordination
b.	Neuromuscular control
c.	Proprioception
d.	Balance

ANS: C

Essential to joint positions is sufficient sensory (afferent) information regarding joint position, movement (kinesthesia), and movement resistance, or tension. The afferent information contributing to these three elements is called proprioception. Proprioception is vital for neuromuscular control.

REF: P. 126

1. Where are mechanoreceptors located?

a.	Muscle
b.	Tendon
c.	Ligament
d.	All of the above

ANS: D

Mechanoreceptors are the sensory receptors that are responsible for converting mechanical events (movement or tension) into neural signals that can be conveyed to the central nervous system.

REF: P. 127

1. Muscle spindles convey information regarding:

a.	nutrients delivered to the muscle.
b.	muscle length and rate of length change.
c.	muscle tension.
d.	the balance of the body.

ANS: B

Muscle spindles are responsible for conveying information regarding muscle length and rate of length changes.

REF: P. 127

1. Which of the following mechanoreceptors is responsible for conveying information regarding muscle tension?

a.	Golgi tendon organs
b.	Ruffini receptors
c.	Pacinian corpuscles
d.	Free nerve endings

ANS: A

Golgi tendon organs, located across a musculotendinous junction, are responsible for conveying information regarding muscle tension.

REF: P. 127

1. Balance tests and balance treatment activities use the same movements. How does the physical therapist assistant challenge the patient and test different aspects of the postural control system?

a.	By counting the number of repetitions within a given time frame
b.	By counting the time the patient can maintain a certain balance activity
c.	By manipulating the conditions in which the balance tasks are conducted
d.	There is no way to change balance tests; they are designed to measure all aspects of the postural control system

ANS: C

Different aspects of the postural control system may be more selectively challenged by manipulating the conditions in which balance tasks are conducted. For example, having a patient stand with the eyes closed heightens his or her reliance on somatosensory and vestibular information.

REF: P. 127

1. Which of the following are included in a comprehensive balance assessment and training?

a.	Progressive tasks of incremental difficulty
b.	Static stance with varying bases of support
c.	Progressive tasks with unexpected perturbations
d.	All of the above

ANS: D

Comprehensive balance assessment and training frequently call for a progressive battery of specific tasks of incremental difficulty and should include not only static stances with varying bases of support and support-surface characteristics, but also tasks that involve voluntary movement and unexpected perturbations with task completion.

REF: P. 128

1. Which of the following descriptions of coordination tests applies to the finger-to-nose test?

a.	A static position test in which the arms are held horizontal or the knees extended
b.	A reciprocal motion test in which the patient is asked to receive and deliver a ball
c.	A reciprocal motion test in which the patient alternately touches the tip of each finger with the tip of the thumb
d.	A reciprocal motion test in which the patient touches the tip of the index finger to the tip of the nose

ANS: D

The finger-to-nose coordination test involves having the patient touch the tip of the index finger to the tip of the nose.

REF: P. 127

1. Which of the following is involved in coordination?

a.	Sensory organs
b.	Muscle function
c.	Central nervous system centers
d.	All of the above

ANS: D

Coordination involves multiple elements, including sensory organs, muscle function, and central nervous system centers.

REF: P. 127

1. When planning a progressive balance training plan for your postoperative patient, where would you begin with activities?

a.	The tasks and drills begin and progress according to the abilities of the patient
b.	The tasks and drills are established two levels above what the patient can perform to challenge his balance and coordination
c.	The tasks and drills are initiated a level below what the patient can perform and progress as the patient progresses
d.	The tasks and drills are established based on the diagnosis and followed on a set time schedule

ANS: A

Tasks and drills are initiated and progress according to the abilities and desired goals of the patient.

REF: P. 128

1. Which of the following exercises is NOT a closed kinetic chain (CKC) exercise?

a.	Double- and single-leg squats on stable and unstable surfaces
b.	Forward and backward gait
c.	Sidestepping and heel-to-toe walking
d.	Reaching for an object placed outside of the patient’s reach

ANS: D

Progressively challenging tasks and CKC exercises stimulate a patient’s ability to safely and accurately negotiate obstacles. Such exercises include the double- and single-leg squats, forward and backward gait, sidestepping, and heel-to-toe walking.

REF: P. 131

1. For which training tasks would a wobble board be used?

a.	Balance training for the lower extremities
b.	Coordination training for the upper extremities
c.	Proprioceptive training for the upper extremities
d.	Flexibility training for the lower extremities

ANS: A

The wobble board, or balance board, is a portable and affordable device. It is used in balance training for lower extremities.

REF: P. 131

1. Which training exercise would be most appropriate for the glenohumeral joint of a gymnast?

a.	Double- and single-leg squats on stable and unstable surfaces
b.	Forward and backward gait walking
c.	Medicine balls and physioballs
d.	Stretching exercises that emphasize the spine and hips

ANS: C

Global stability of the glenohumeral joint can be enhanced effectively with the use of medicine balls and physioballs (Fig. 7-10, B1 and B2).

REF: P. 132

1. A critical safety component in all balance and proprioception activities is the patient’s ability to demonstrate which of the following?

a.	Increased range of motion (ROM)
b.	Improved strength
c.	Steady gait
d.	Protective reactions

ANS: D

Close observation of the patient’s protective reactions during loss of balance is a critical component of all balance tests and training activities.

REF: P. 128

1. Which of the following factors does NOT contribute to balance dysfunction?

a.	ROM
b.	Coordination
c.	Perception
d.	CKC exercises

ANS: D

Duncan identified several factors that may significantly contribute to balance dysfunction: perception, behavior, ROM, biomechanical alignment, weakness, synergistic organization strategy, coordination, and adaptability.

REF: P. 130

1. Which of the following is not a sensory source that a patient relies on for balance?

a.	Vision
b.	Proprioceptive
c.	Somatosensory
d.	Vestibular

ANS: B

A patient relies on visual, somatosensory, and vestibular senses. By observing changes in the amount of sway or using a forceplate to quantify sway, the clinician can determine which of these sensory sources a patient relies on for balance as well as the degree to which the patient can adapt reliance on the remaining senses during situations of intersensory conflict.

REF: P. 129

1. Why is balance training and proprioceptive training needed for upper extremities?

a.	Many household chores involve the repetitive use of arms and shoulders to lift, pull, and carry
b.	Surgery, injury, and immobilization lead to significant alterations in proprioception
c.	Many workers use their arms and shoulders in their jobs with vigorous weight bearing
d.	All of the above

ANS: D

All of the listed items are reasons why balance training and proprioceptive training are needed for the upper extremities.

REF: P. 132

1. In progressive balancing exercises, which of the following exercises would come first?

a.	Seated: eyes open, then eyes closed
b.	Single-leg standing: eyes open, then eyes closed
c.	Minitrampoline: double-leg standing
d.	Balance board

ANS: A

Progressive balancing exercises are in Box 7-2. Seated: eyes open, then eyes closed comes first.

REF: P. 128

1. In progressive balancing exercises, which of the following exercises would come last?

a.	Seated: eyes open, then eyes closed
b.	Single-leg standing: eyes open, then eyes closed
c.	Minitrampoline: double-leg standing
d.	Balance board

ANS: D

Progressive balancing exercises are in Box 7-2. The balance board activities would come last in this list.

REF: P. 128