A physical therapist is mentoring a student physical therapist during an outpatient orthopedic clinical rotation. The therapist plans to administer therapeutic ultrasound using the following parameters:

* 3 MHz frequency
* 20% pulsed duty cycle
* 0.5 W/cm² intensity
* 6-minute treatment duration

Which of the following patients should NOT receive this treatment?

A) A 14-year-old basketball player with Osgood-Schlatter disease over an open tibial epiphyseal plate

B) A 72-year-old patient status post cemented total knee arthroplasty 8 months ago

C) A 68-year-old male with benign prostatic hyperplasia receiving treatment to the lumbar paraspinals

D) A 59-year-old patient with diabetic neuropathy and absent protective sensation over the treatment region

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Harry presents with a right-sided posterolateral disc herniation at L5-S1 and demonstrates weakness associated with the involved nerve root. Which of the following gait deviations is MOST likely?

A) Diminished propulsion during terminal stance

B) Increased plantarflexion following initial contact

C) Contralateral pelvic drop during stance

D) Genu recurvatum during stance

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Jason is a patient with peripheral vascular disease who presents with a lower leg wound containing dry, adherent slough and minimal exudate. The wound bed appears desiccated, and the surrounding skin is fragile but intact. Which of the following interventions is MOST appropriate?

A) Transparent film

B) Hydrocolloid

C) Impregnated gauze

D) Amorphous hydrogel

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Petey is 4 weeks status post ACL reconstruction with a semitendinosus autograft and partial meniscectomy. Which of the following interventions is LEAST appropriate at this time?

A) Quad sets held in knee extension

B) Mini squats to 45 degrees

C) Resisted knee flexion with a 3-lb ankle weight in prone

D) Sidelying straight leg raises

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Alynne is a woman who reports fatigue, intermittent joint pain, and a recurrent facial rash that becomes worse after spending time in the sun. Examination reveals a rash over the bridge of the nose and cheeks that spares the nasolabial folds. Which of the following conditions is MOST likely?

A) Psoriasis

B) Systemic lupus erythematosus

C) Eczema

D) Rosacea

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Mila reports a sudden, intense urge to urinate followed by leakage before reaching the bathroom. The patient voids frequently throughout the day and wakes multiple times at night to urinate. Pelvic floor strength is 4/5, and there is no leakage with coughing or sneezing. Which of the following interventions is MOST appropriate for the treatment of this patient?

A) Pelvic floor strengthening with maximal sustained holds

B) Bladder retraining with scheduled voiding intervals

C) Abdominal strengthening to increase intra-abdominal support

D) Fluid restriction throughout the day to reduce urgency

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Mackenzie presents to physical therapy following a stroke affecting the basal ganglia. The patient exhibits bradykinesia and difficulty initiating movements. Which of the following interventions would be MOST effective in addressing these impairments?

A) Rhythmic auditory stimulation
B) High-resistance strength training
C) Visual cueing during gait training
D) Balance exercises using an unstable surface

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Bellie presents with persistent bilateral lower extremity swelling that worsens throughout the day. The therapist is selecting an intervention to assist with fluid return. Which of the following interventions would MOST effectively assist with this goal?

A) Maintaining the lower extremities in a gravity-dependent position

B) Diaphragmatic breathing

C) Sustained isometric contraction of the upper extremities

D) Passive trunk rotation in supine

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Dr. Rice evaluates a patient with a chief complaint of mid-thoracic pain radiating around the left lateral rib cage. The patient reports symptoms worsen with deep breathing and coughing, but are not reproduced with spinal movement, rib mobilization, or palpation. Neurological screening is unremarkable. Which of the following structures is MOST likely referring pain to this region?
A) Thoracic facet joint dysfunction

B) Intercostal muscle strain

C) The pleura

D) The pancreas

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Carmen is performing a special test on her patient. The test has a sensitivity of 95% and a specificity of 30%. The patient tests negative. What is the BEST interpretation?

A) The condition is unlikely present

B) The condition is likely present

C) The test confirms the diagnosis

D) The test has low false negatives

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Elena presents with significant muscle atrophy in the lower extremities, fasciculations of the gastrocnemius, and a 1+ Achilles tendon reflex. During gait, the patient demonstrates a "slapping" foot strike. These signs are MOST indicative of:

A) A lesion in the corticospinal tract
B) An injury to the cerebellum
C) Compression of the posterior columns
D) A lesion in the anterior horn cells

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