PCE REE PCE Clinical Practice and Patient Management 2 — Questions and Answers
Question 1: A patient post-total knee arthroplasty reports pain of 8/10 during ambulation on day 2. Which intervention is the MOST appropriate first step?
- Discontinue ambulation and return to bed rest
- Coordinate with the medical team regarding pain management before continuing mobility (Correct answer)
- Continue ambulation as post-surgical pain is expected
- Apply ice and defer therapy until pain resolves
Correct answer: Coordinate with the medical team regarding pain management before continuing mobility
Addressing uncontrolled pain through interprofessional collaboration is essential before advancing mobility to ensure patient safety and cooperation.
Question 2: Which outcome measure is MOST appropriate to assess functional mobility in a patient with Parkinson's disease in a clinical setting?
- Berg Balance Scale
- Timed Up and Go (TUG) test (Correct answer)
- Six-Minute Walk Test
- Dynamic Gait Index
Correct answer: Timed Up and Go (TUG) test
The TUG test is widely validated for assessing functional mobility and fall risk in individuals with Parkinson's disease.
Question 3: A physiotherapist suspects a patient has cervical arterial dysfunction before performing cervical manipulation. What is the MOST appropriate next step?
- Proceed with manipulation at reduced force
- Perform the cervical arterial dysfunction screening protocol (Correct answer)
- Refer immediately to a vascular surgeon
- Apply cervical traction instead
Correct answer: Perform the cervical arterial dysfunction screening protocol
Completing a cervical arterial dysfunction screening is mandatory before any cervical manipulation to identify contraindications and ensure patient safety.
Question 4: During the PCE, which component of the ICF model refers to a patient's difficulty walking on uneven terrain due to lower limb weakness?
- Health condition
- Body function and structure
- Activity limitation (Correct answer)
- Participation restriction
Correct answer: Activity limitation
Difficulty performing a specific task such as walking on uneven terrain is classified as an activity limitation within the ICF model.
Question 5: A patient with COPD presents with oxygen saturation dropping to 87% during a 6-Minute Walk Test. The MOST appropriate action is to:
- Continue the test and document the drop
- Stop the test and administer supplemental oxygen if available (Correct answer)
- Slow the walking pace and monitor for 1 minute
- Complete the test as desaturation is expected in COPD
Correct answer: Stop the test and administer supplemental oxygen if available
SpO2 below 88% is a standard stopping criterion for exercise testing; the physiotherapist must halt the test and address oxygen saturation immediately.
Question 6: Which manual therapy technique is MOST appropriate for a patient with a hypomobile glenohumeral joint in a posterior capsule pattern?
- Anterior glide of the humeral head (Correct answer)
- Inferior glide of the humeral head
- Posterior glide of the humeral head
- Superior glide of the humeral head
Correct answer: Anterior glide of the humeral head
A posterior capsule restriction limits internal rotation and horizontal adduction; an anterior glide restores posterior capsule mobility using convex-on-concave rules.
Question 7: A physiotherapist is treating a patient with a suspected L4-L5 disc herniation. Which clinical finding MOST strongly supports nerve root involvement at L4?
- Weak ankle plantar flexion and absent Achilles reflex
- Weak knee extension and diminished patellar reflex (Correct answer)
- Weak great toe extension and normal reflexes
- Weak ankle dorsiflexion and absent Achilles reflex
Correct answer: Weak knee extension and diminished patellar reflex
The L4 nerve root supplies the quadriceps (knee extension) and contributes to the patellar reflex; deficits here indicate L4 involvement.
PCE REE PCE Clinical Practice and Patient Management 2
A patient post-total knee arthroplasty reports pain of 8/10 during ambulation on day 2.
Which intervention is the MOST appropriate first step?