NPTE-PT Therapeutic Modalities Application 4 — Questions and Answers
Question 1: A PT uses pulsed shortwave diathermy (PSWD) over a patient's lumbar region. Which tissue type is MOST effectively heated by the inductive coil method?
- Subcutaneous adipose tissue
- Highly hydrated tissues with high water content such as muscle (Correct answer)
- Bone cortex
- Dry skin
Correct answer: Highly hydrated tissues with high water content such as muscle
Inductive coil PSWD generates eddy currents most effectively in tissues with high water and electrolyte content, such as muscle.
Question 2: Which electrode placement during TENS application over the cervical spine region is CONTRAINDICATED due to risk of adverse physiological response?
- Bilateral paraspinal muscles at C5-C6
- Over the anterior neck across the carotid sinus (Correct answer)
- Ipsilateral upper trapezius and rhomboid
- Between the scapulae bilaterally
Correct answer: Over the anterior neck across the carotid sinus
Electrode placement over the carotid sinus can trigger a vasovagal response, causing bradycardia and hypotension.
Question 3: A patient with a skin sensitivity complaint after treatment states the skin feels hot and looks red after cryotherapy. Which term describes this paradoxical hunting response?
- Vasoconstriction rebound
- Lewis hunting reaction (Correct answer)
- Raynaud's phenomenon
- Reactive hyperemia
Correct answer: Lewis hunting reaction
The Lewis hunting reaction is a cyclical vasoconstriction and vasodilation that prevents tissue freezing during prolonged cold application.
Question 4: When using high-volt pulsed current (HVPC) for wound healing, which polarity is typically used in the proliferative phase to promote fibroblast activity?
- Negative polarity
- Positive polarity (Correct answer)
- Alternating polarity every session
- Polarity has no effect in wound healing
Correct answer: Positive polarity
Positive polarity HVPC attracts fibroblasts and promotes collagen synthesis during the proliferative phase of wound healing.
Question 5: A PT is selecting ultrasound parameters for treating a superficial trigger point at 1 cm depth in the upper trapezius. Which frequency is MOST appropriate?
- 1 MHz
- 3 MHz (Correct answer)
- 0.5 MHz
- 5 MHz
Correct answer: 3 MHz
3 MHz ultrasound has a shallower depth of penetration (1–2 cm), making it ideal for superficial structures like trigger points near the surface.
Question 6: Which modality uses high-frequency alternating current (>100,000 Hz) and produces NO neuromuscular stimulation because it is above the threshold for nerve depolarization?
- TENS
- NMES
- Diathermy (shortwave) (Correct answer)
- Interferential current
Correct answer: Diathermy (shortwave)
Shortwave diathermy operates at frequencies (27.12 MHz) far above the neuromuscular excitation threshold, so it heats tissue without stimulating nerves or muscles.
Question 7: A PT applies paraffin bath treatment to a patient's arthritic hand. Compared to a moist heat pack, paraffin bath provides superior superficial heating because:
- Paraffin reaches higher temperatures than a standard heat pack
- The low thermal conductivity of paraffin retains heat longer on the skin surface (Correct answer)
- Paraffin penetrates deeper into joint structures
- Paraffin generates convective heat currents
Correct answer: The low thermal conductivity of paraffin retains heat longer on the skin surface
Paraffin's low thermal conductivity allows it to maintain contact heat on the skin surface longer than water-based modalities without burning.
NPTE-PT Therapeutic Modalities Application 4
A PT uses pulsed shortwave diathermy (PSWD) over a patient's lumbar region.
Which tissue type is MOST effectively heated by the inductive coil method?