Nokea
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.
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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 see the following orders for a patient with a newly applied cast to the right arm after a surgery to the humerus. Which order would you question as to its accuracy?
- A. May petal cast if necessary.
- B. Support right arm on pillows until the cast is dry.
- C. Keep the right arm elevated at all times.
- D. Do neurovascular checks every 4 hrs ?4, then every 8 hrs ?2.
Correct Answer: C
Rationale: Keeping the arm elevated at all times is impractical and could cause discomfort or complications. Other orders are standard for cast care.
What is the difference in recovery of a patient who has had a direct anterior approach hip arthroplasty and one who has had a lateral approach hip arthroplasty?
- A. Anterior approach has faster recovery due to less muscle disruption.
- B. Lateral approach has faster recovery due to better visualization.
- C. Both approaches have identical recovery times.
- D. Anterior approach requires longer immobilization.
Correct Answer: A
Rationale: The direct anterior approach involves less muscle disruption, leading to faster recovery and fewer movement restrictions compared to the lateral approach, which involves more muscle cutting.
A type of external fixator composed of metal rings on the outside of the limb with rods and wires attached that penetrate through the skin into the bone is a(n)
- A. External immobilizer.
- B. Buck's traction setup.
- C. Skin traction setup.
- D. Ilizarov frame.
Correct Answer: D
Rationale: An Ilizarov frame is an external fixator with metal rings, rods, and wires penetrating the bone to stabilize fractures. Other options describe different devices.
Who is responsible for carrying out ambulation orders for patients?
- A. PT only
- B. Nursing assistants only
- C. All nursing staff and PT staff
- D. PT assistants only
Correct Answer: C
Rationale: Ambulation orders are executed by both nursing staff (including assistants) and physical therapy staff, collaborating to promote mobility.