Chapter 1 Clinical Decisions Neuro Rehab Exam Questions

Chapter 1: Foundations for Making Clinical Decisions in Neuromuscular Rehabilitation

Dennis W. Fell, PT, MD

Multiple Choice

1. Regarding the clinical decisions to be made regarding the interventions the therapist will provide:

A. Intervention decisions throughout the plan of care are based on data from the initial examination.

B. Decisions regarding intervention are made at the time the plan of care is established.

C. The therapist should always consider how to adjust the intervention exercises/activities to optimally challenge the patient.

D. The primary and ultimate focus is on interventions for underlying impairments.

2. Which one best represents the ultimate goal of PT and OT intervention?

A. Optimal recovery of function and participation

B. Remediation of underlying impairments

C. Correction of the underlying disease process

D. Teach the patient to compensate for any underlying deficits

3. Based on the examination, the Physical Therapist must determine a Physical Therapy Diagnosis, to include:

A. The ICD-9 or ICD-10 code

B. A label that clearly specifies the movement-related problem(s) for which the therapist will provide intervention

C. A label that clearly specifies the patient’s underlying medical diagnosis

D. A descriptive label determined at the completion of the episode of care

4. Which set of actions could a new graduate intentionally incorporate to move more quickly toward expert practice?

A. Listens intently to patient and pays attention to clues; forms tentative hypothesis after reexamination; patient-centered approach.

B. Infrequent clinical reasoning; intentionally revising the plan of care; more aware of own mistakes and uses reflection.

C. Listens intently to patient and pays attention to clues; collaboration with the patient; central focus on underlying impairments.

D. Patient-centered approach; intentionally revising the plan of care; performs skill with greater efficiency

5. Which statement has ICF dimensions correctly matched?

A. Spasticity is a body system impairment of the motor system that can result from a cerebrovascular accident.

B. Short step-length in gait is a body system impairment of the motor system that can occur following cerebrovascular accident.

C. Slow-velocity ambulation that requires moderate assistance is a participation limitation.

D. Lack of isolated motor control in right elbow flexion is a functional activity limitation.

6. Which of the following is an example of a primary impairment related to a neurological disorder?

A. Decubitus ulcer at the heel following complete paralysis from SCI

B. Spasticity in L plantar flexors following R CVA with L hemiplegia

C. Decreased cardiorespiratory endurance following a CVA with hemiplegia

D. R plantar flexor contracture following L CVA with R hemiplegia

7. Which is the best example of use of appropriate people-first language?

A. “Mr. Jones is a stroke.”

B. “Your 3:00 Spinal Cord Injury is here now for the examination.”

C. “Johnny was diagnosed with CP 2 months ago.

D. “The stroke patient will be here at 1:15.”

8. Regarding neuroplasticity, which statement is most accurate?

A. Use-dependent changes in the nervous system can result in long-term improvement of function in conditions such as Parkinson Disease.

B. In patients with stroke, brain injury, or the nonprogressive form of multiple sclerosis, the therapist expects some degree of CNS reorganization, especially with a challenging intensity and repetition of practice.

C. Neuroplasticity is most optimal with usual intensity of practice to avoid overuse.

D. The therapist should expect greater degrees of neural plasticity in the more mature brain.

9. Which characteristic is most valued when writing a functional goal, considering measurement of outcomes?

A. Prognosis of the individual

B. Environmental context

C. Age of the patient

D. Objective measures

10. What is a reason that the home exercise/activity program could be as important as the direct therapeutic intervention?

A. Within a day, the patient has time and opportunities for more repetitions of movement at home than during the typical intervention session.

B. Detailed instructions for a home activity allow for the therapist to direct the specifics of the activity.

C. Feedback from the therapist assures proper performance of the activity.

D. The patient may require supervision or motivation from the therapist.