Patient Safety & Clinical Decision-Making Flashcards
7 cards from real CVT practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Patient Safety & Clinical Decision-Making flashcards as text
A patient completes the Dix-Hallpike test with no nystagmus but reports intense subjective vertigo. What is the MOST appropriate clinical interpretation?
Answer: Subjective BPPV or incomplete cupulolithiasis may be present
Subjective BPPV (without observable nystagmus but with positional vertigo) can occur and should not be dismissed; further assessment and clinical correlation are warranted.
Which patient population requires MODIFIED positioning angles during canalith repositioning procedures primarily for safety reasons?
Answer: Patients with severe cervical spine stenosis or instability
Cervical spine stenosis or instability limits safe neck range of motion, requiring modified head positions or alternative approaches during canalith repositioning to prevent neurological injury.
A vestibular therapist suspects a patient may have perilymph fistula. Which activity should be CONTRAINDICATED until further evaluation?
Answer: Valsalva maneuver and high-impact balance activities
Valsalva maneuver and high-impact activities increase intracranial and middle ear pressure, which can enlarge a perilymph fistula and worsen the condition.
During a balance assessment, a patient with known acoustic neuroma resection consistently falls toward which side on the Fukuda stepping test?
Answer: Ipsilateral to the lesion due to reduced vestibular input on that side
In the Fukuda stepping test, patients with unilateral vestibular hypofunction rotate and deviate toward the affected (ipsilateral) side due to reduced tonic vestibular input.
A therapist uses the Sensory Organization Test (SOT) to evaluate a vestibular patient. Which SOT condition most isolates vestibular function?
Answer: Condition 5: Eyes closed, sway-referenced surface
SOT Condition 5 eliminates visual input (eyes closed) and destabilizes somatosensory input (sway-referenced surface), making the vestibular system the only reliable sensory source for balance.
When is it MOST appropriate to refer a vestibular patient back to their physician without initiating rehabilitation?
Answer: Patient presents with new-onset unilateral hearing loss and ear fullness at initial evaluation
New-onset unilateral hearing loss with ear fullness at initial evaluation may indicate an active pathology such as Meniere's disease or sudden sensorineural hearing loss requiring medical management before rehabilitation.
Which behavior BEST demonstrates appropriate professional boundaries and patient safety in vestibular rehabilitation?
Answer: Documenting all adverse reactions and communicating them to the referring physician
Thorough documentation of adverse events and communication with the referring physician maintains patient safety, supports care coordination, and fulfills professional and legal obligations.