Nokea
A physical therapist evaluates a patient following a transtibial amputation. Which factor is MOST likely to contribute to knee instability during gait?
- A. Weak hip abductors
- B. Prosthesis aligned in excessive dorsiflexion
- C. Prosthesis too short
- D. Socket too tight
Correct Answer: B
Rationale: The correct answer is B: Prosthesis aligned in excessive dorsiflexion. Excessive dorsiflexion can lead to increased knee flexion during stance phase of gait, causing knee instability. Weak hip abductors (A) may contribute to Trendelenburg gait but not knee instability. A prosthesis that is too short (C) may result in decreased step length but not necessarily knee instability. A socket too tight (D) can cause discomfort and skin breakdown but is unlikely to directly lead to knee instability.
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Mark each of the following statements as therapeutic or nontherapeutic. c. "Dr. Daniels knows what he is talking about. Just follow his recommendations."
- A. Therapeutic
- B. Nontherapeutic
Correct Answer: B
Rationale: The correct answer is B: Nontherapeutic. This statement is nontherapeutic because it implies a lack of autonomy and empowerment for the individual seeking help. It suggests blindly following advice without considering personal preferences or values. This can hinder the therapeutic process by diminishing the client's ability to actively participate in decision-making and problem-solving. Therapeutic communication focuses on collaboration, empowerment, and respect for the client's autonomy. Choices A, C, and D are left blank as they do not provide a suitable rationale for the given question.
Which test is the most specific test to diagnose an ACL tear?
- A. Pivot shift
- B. Lachman test
- C. Anterior drawer sign
- D. Ege's test
Correct Answer: A
Rationale: The correct answer is A: Pivot shift. This test is the most specific for diagnosing an ACL tear because it assesses the rotational instability of the knee joint, which is a key characteristic of an ACL injury. During the test, the examiner applies a valgus force and internal rotation to the knee while extending it, causing the tibia to subluxate anteriorly. If there is an ACL tear, the tibia will suddenly reduce back into place, producing a characteristic "pivot shift" movement.
Summary of other choices:
B: Lachman test - While also used to assess ACL integrity, it primarily evaluates anterior translation of the tibia and is not as specific for rotational instability.
C: Anterior drawer sign - This test is primarily used to assess anterior translation of the tibia and is not specific to diagnosing an ACL tear.
D: Ege's test - This test is not commonly used in clinical practice for diagnosing ACL tears.
During which phase of throwing is the elbow joint placed under the most valgus stress?
- A. Follow-through
- B. Wind-up
- C. Early cocking
- D. Late cocking
Correct Answer: D
Rationale: The correct answer is D: Late cocking. During late cocking phase of throwing, the arm is maximally externally rotated which places the elbow joint under the most valgus stress. This is due to the extreme abduction and extension of the arm at this stage, leading to increased valgus force on the elbow joint. In contrast, in the early cocking phase (choice C), the arm is in a more neutral position with less valgus stress. The wind-up phase (choice B) involves more shoulder and trunk movements rather than stressing the elbow joint. Follow-through phase (choice A) comes after the release of the ball and does not involve significant valgus stress on the elbow.
If a patient presents with a burn with damage to the epidermis but only partial damage to the dermis and has blistering, how is the burn classified?
- A. First degree or superficial
- B. Second degree or partial thickness
- C. Third degree or full thickness
- D. Unstageable
Correct Answer: B
Rationale: The correct answer is B: Second degree or partial thickness. This type of burn involves damage to both the epidermis and the dermis, resulting in blistering. First-degree burns (A) only affect the epidermis. Third-degree burns (C) extend through the dermis into deeper tissues. Unstageable burns (D) are typically associated with pressure ulcers, not burns. In this case, the presence of blistering indicates partial damage to the dermis, making the burn a second-degree or partial thickness burn.
In a patient with acromegaly, the nurse will expect to discover which assessment findings?
- A. Heavy, flattened facial features
- B. Growth retardation and a delayed onset of puberty
- C. Overgrowth of bone in the face, head, hands, and feet
- D. Increased height and weight and delayed sexual development
Correct Answer: C
Rationale: Rationale: Acromegaly is a condition caused by excessive growth hormone production, leading to overgrowth of bones in the face, head, hands, and feet. This results in characteristic features such as enlarged facial bones, hands, and feet. The correct answer is C because it aligns with the typical assessment findings in acromegaly.
Summary of other choices:
A (Heavy, flattened facial features): This is not consistent with acromegaly, as the condition is characterized by overgrowth of bone rather than flattened features.
B (Growth retardation and a delayed onset of puberty): These findings are more indicative of growth hormone deficiency rather than excess, which is seen in acromegaly.
D (Increased height and weight and delayed sexual development): While increased height and weight may occur, delayed sexual development is not a common feature of acromegaly.