Nokea
A patient has had reconstructive surgery on her right foot and must be non-weight-bearing for 6 to 8 weeks. She has problems with balance at times. Which device(s) would be most helpful to her during this period?
- A. Knee walker
- B. Crutches
- C. Wheeled walker
- D. Abductor pillow
- E. Splint
Correct Answer: A,C
Rationale: A knee walker or wheeled walker supports non-weight-bearing mobility and balance. Crutches are less stable for patients with balance issues.
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The reason(s) that a limb might have to be amputated include
- A. Severe tissue damage from trauma.
- B. Severely decreased blood flow to the limb.
- C. Failure of skeletal traction to successfully treat a fracture.
- D. Gangrene (death of tissue) in the limb.
- E. Cancerous tumor of the bone.
Correct Answer: A,B,D,E
Rationale: Amputation may be necessary due to severe trauma, poor blood flow (e.g., peripheral vascular disease), gangrene, or bone cancer. Failure of skeletal traction is not a typical reason for amputation.
A patient comes into the clinic where you are working for a follow-up visit after breaking her ankle. She has been using crutches for the past 2 weeks and is complaining of pain and tingling in her forearms and hands. What is the most likely cause of these symptoms?
- A. Poor crutch fit causing nerve compression.
- B. Muscle strain from overuse.
- C. Infection from crutch use.
- D. Poor circulation due to immobility.
Correct Answer: A
Rationale: Pain and tingling in the forearms and hands are likely due to poor crutch fit, causing pressure on nerves (e.g., radial or ulnar nerve compression). Muscle strain, infection, or circulation issues are less likely causes.
You are working in a home health setting. Which of the following assessments would cause you to consider asking your supervisor to arrange for a physical therapy referral for your patient?
- A. The patient is ambulating in the home with a walker.
- B. The patient had surgery recently and is holding on to furniture to ambulate.
- C. The patient uses a wheelchair in the home, which has been remodeled to accommodate it.
- D. The patient is able to transfer with the assistance of one person and has a 24-hour caregiver in the home.
Correct Answer: B
Rationale: Holding onto furniture to ambulate post-surgery indicates unsafe mobility, warranting a physical therapy referral to improve strength and safety. Other options suggest stable mobility or adequate support.
A patient who is 3 days post left total hip replacement with the lateral approach is sitting in a chair and drops a magazine. How should he or she retrieve it?
- A. Bend laterally at the waist to pick it up.
- B. Bend over with the knees flexed to pick it up.
- C. Call for someone else to pick it up.
- D. Use an extension gripper to pick it up.
Correct Answer: C,D
Rationale: Post-hip replacement patients with a lateral approach must avoid bending or twisting to prevent dislocation. Calling for help or using a gripper is safe.
What are the articular surfaces in a total knee replacement?
- A. A metal tibial component that articulates with the plastic surface of the femoral component
- B. A metal femoral component that articulates with the plastic fibula component
- C. The patella is replaced with plastic or similar substance or has plastic affixed to the back to provide a smooth articular surface
- D. The patella, tibia, and femur are replaced with plastic or polyethylene components
Correct Answer: A,C
Rationale: In total knee replacement, the tibial component (metal) articulates with the femoral component (plastic), and the patella may have a plastic surface for smooth movement.