NPTE-PTA Integumentary Physical Therapy 2 — Questions and Answers
Question 1: Using the Rule of Nines, what percentage of total body surface area (TBSA) does one entire upper extremity represent in an adult?
- 4.5%
- 9% (Correct answer)
- 13.5%
- 18%
Correct answer: 9%
In the adult Rule of Nines, each upper extremity (including the arm, forearm, and hand) represents 9% of TBSA, making both upper extremities together 18%.
Question 2: A patient presents with a burn wound that is blistered, moist, red, and extremely painful to touch. This burn MOST accurately represents:
- Superficial (first-degree) burn
- Superficial partial-thickness (second-degree) burn (Correct answer)
- Deep partial-thickness (second-degree) burn
- Full-thickness (third-degree) burn
Correct answer: Superficial partial-thickness (second-degree) burn
Superficial partial-thickness burns involve the epidermis and superficial dermis, presenting with blistering, a moist red wound bed, and intense pain because nerve endings remain intact.
Question 3: During the ACUTE phase of burn rehabilitation, a PTA's HIGHEST priority intervention to prevent contracture is:
- Progressive resistive strengthening exercises
- Anti-deformity positioning and splinting (Correct answer)
- Scar massage with emollient cream
- Custom pressure garment fitting
Correct answer: Anti-deformity positioning and splinting
Anti-deformity positioning and splinting is the priority in the acute phase because wounds are not yet healed; it prevents contracture development before scar maturation interventions are appropriate.
Question 4: Which type of skin graft uses donor skin harvested from a deceased human donor (cadaveric skin)?
- Autograft
- Allograft (homograft) (Correct answer)
- Xenograft (heterograft)
- Integra dermal matrix
Correct answer: Allograft (homograft)
An allograft (homograft) uses cadaveric human skin as a temporary biological dressing; it provides wound coverage until autografting with the patient's own skin can be performed.
Question 5: A patient with breast cancer-related lymphedema presents with pitting edema of the upper extremity that resolves significantly with overnight elevation. According to the International Society of Lymphology, this is classified as:
- Stage 0 – subclinical/latent lymphedema
- Stage I – reversible lymphedema (Correct answer)
- Stage II – spontaneously irreversible lymphedema
- Stage III – lymphostatic elephantiasis
Correct answer: Stage I – reversible lymphedema
Stage I lymphedema is characterized by pitting edema that reduces substantially with elevation, distinguishing it from Stage II where fibrotic tissue changes make elevation less effective.
Question 6: Complete Decongestive Therapy (CDT) for lymphedema includes all of the following components EXCEPT:
- Manual lymphatic drainage (MLD)
- Multilayer compression bandaging
- Systemic diuretic therapy (Correct answer)
- Therapeutic exercise and skin care
Correct answer: Systemic diuretic therapy
CDT consists of MLD, multilayer compression bandaging, decongestive exercises, and meticulous skin and nail care; diuretics are not part of CDT and are generally not recommended for lymphedema.
Question 7: When using a whirlpool for wound debridement on a patient with peripheral vascular disease, the MOST appropriate water temperature is:
- 102–104°F (38.9–40°C)
- 98–100°F (36.7–37.8°C)
- 92–96°F (33.3–35.6°C) (Correct answer)
- 80–85°F (26.7–29.4°C)
Correct answer: 92–96°F (33.3–35.6°C)
Patients with peripheral vascular disease have compromised circulation and often reduced sensation, requiring a lower temperature (92–96°F) to minimize the risk of thermal injury.
NPTE-PTA Integumentary Physical Therapy 2
Using the Rule of Nines, what percentage of total body surface area (TBSA) does one entire upper extremity represent in an adult?