DPT Geriatric Rehabilitation 4 — Questions and Answers
Question 1: Which cognitive screening tool is MOST commonly used by physical therapists to identify cognitive impairment that may affect rehabilitation participation?
- Beck Depression Inventory
- Mini-Cog (Correct answer)
- Hamilton Anxiety Scale
- PHQ-9
Correct answer: Mini-Cog
The Mini-Cog is a brief, validated screening tool combining a 3-word recall and clock drawing test that can be administered quickly in clinical settings.
Question 2: A 79-year-old male with Parkinson's disease exhibits festinating gait. Which cueing strategy is MOST effective for improving gait in this patient?
- Tactile cueing using resistance bands
- Auditory rhythmic cueing using a metronome (Correct answer)
- Cognitive dual-task exercises
- Visual cliff training
Correct answer: Auditory rhythmic cueing using a metronome
Auditory rhythmic cueing (e.g., metronome) bypasses defective basal ganglia timing circuits by providing an external rhythm that improves stride length and cadence in Parkinson's disease.
Question 3: An 88-year-old nursing home resident has stage 3 pressure injury on the sacrum. Which positioning strategy BEST reduces further tissue breakdown?
- Elevate head of bed to 90 degrees for all meals and activities
- Reposition every 2 hours and use a pressure-redistribution mattress (Correct answer)
- Apply heat packs to promote circulation
- Encourage prolonged sitting in a standard wheelchair
Correct answer: Reposition every 2 hours and use a pressure-redistribution mattress
Repositioning every 2 hours combined with a pressure-redistribution mattress reduces sustained mechanical load on vulnerable tissues to prevent further injury.
Question 4: Which factor is the STRONGEST independent predictor of functional decline following hospitalization in older adults?
- Length of stay greater than 3 days
- Pre-hospital functional status (Correct answer)
- Age above 80
- Number of medications at admission
Correct answer: Pre-hospital functional status
Pre-hospital functional status is the strongest independent predictor of post-hospitalization functional outcomes, superseding age and diagnosis severity.
Question 5: A 73-year-old woman with diabetic peripheral neuropathy demonstrates impaired protective sensation in both feet. Which intervention is HIGHEST priority?
- High-intensity proprioceptive training on unstable surfaces
- Foot inspection education, appropriate footwear, and supervised balance training (Correct answer)
- Vibration therapy applied directly to plantar surfaces daily
- Strengthening of hip extensors only
Correct answer: Foot inspection education, appropriate footwear, and supervised balance training
Patients with impaired protective sensation are at high risk for unrecognized foot injury; education on foot inspection and appropriate footwear combined with supervised balance training is the safest, highest-priority approach.
Question 6: Which exercise prescription principle is MOST important when prescribing resistance training for an 85-year-old with mild hypertension?
- Use maximum load with minimal repetitions to maximize strength gains quickly
- Use moderate loads (40–60% 1RM) with controlled breathing to avoid Valsalva maneuver (Correct answer)
- Avoid all resistance training due to cardiovascular risk
- Prescribe resistance training without any warm-up to conserve energy
Correct answer: Use moderate loads (40–60% 1RM) with controlled breathing to avoid Valsalva maneuver
Moderate loads with controlled breathing prevent the Valsalva maneuver, which can cause dangerous blood pressure spikes in older adults with hypertension.
Question 7: A PT is designing a home exercise program for a 77-year-old with moderate osteoarthritis of both knees. Which exercise is MOST appropriate to include?
- Deep squat to 120 degrees of knee flexion
- Stationary cycling with low resistance (Correct answer)
- High-impact jumping exercises
- Prolonged kneeling exercises
Correct answer: Stationary cycling with low resistance
Low-resistance stationary cycling provides cardiovascular conditioning and maintains knee range of motion with minimal joint impact forces, making it ideal for knee osteoarthritis.
DPT Geriatric Rehabilitation 4
Which cognitive screening tool is MOST commonly used by physical therapists to identify cognitive impairment that may affect rehabilitation participation?