Deck 11: Joint, Connective Tissue, and Bone Disorders and Management

Question 1

A 43-year-old patient with a diagnosis of FM has been referred to you for an exercise program.As you take her history, she tells you that she rarely exercises.Which of the following types of exercise has been shown to be most appropriate at the beginning of an exercise program for patients with FM?

A)Circuit weight training at 60% to 70% of the maximum repetition for each exercise at five or six stations
B)Stretching program of trunk and large muscles of the extremities
C)Aerobic exercise started at a low intensity that is adjusted based on the individual's response
D)Relaxation and meditation exercises

Answer 1

C

Question 2

Which of the following are risk factors for secondary osteoporosis?

A)Low body weight
B)Family history of osteoporosis
C)Caucasian or Asian descent
D)Long-term use of corticosteroids

Answer 2

D

Question 3

You are treating a patient with osteoarthritis of the left knee.The morning after performing the exercise program you prescribed for him, he reports experiencing stiffness of the involved knee and joint pain during weight bearing lasting about 30 minutes.What should you do?

A)Refer the patient to his physician
B)Reassure the patient that this is an expected and desired response
C)Decrease the intensity of the exercise program
D)Add early morning jogging to his exercise program

Answer 3

C

Question 4

A patient with a diagnosis of osteoporosis wishes to participate in a fitness program at her local community center.All of the following describe precautions that she should adhere to during exercise except:

A)Avoid sitting abdominal machines and supine curl-ups and sit-ups to strengthen the abdominals.
B)Avoid high-velocity movements of the spine and extremities.
C)Avoid strength training with free weights or the use of a weighted vest during walking or jogging.
D)Avoid end-range resisted movements of the spine combining flexion and rotation.

Question 5

At what point in the healing process after reduction of a fracture is immobilization usually discontinued and exercise of related areas permissible so long as stress is not placed across or distal to the fracture site?

A)When callus formation begins to develop
B)When the site is radiographically healed
C)When delayed union has been achieved
D)At the stage of clinical union

Question 6

Which of the following interventions would be appropriate for myofascial pain syndrome but not for fibromyalgia, based on the etiology of the two conditions?

A)Providing education with a focus on activity modification
B)Eliminating trigger points with techniques such as muscle elongation with contract-relax procedures, spray and stretch techniques, and dry needling
C)Reducing postural stresses and improving posture
D)Treating muscular pain with low-intensity strengthening and aerobic exercise

Question 7

All of the following are recommendations of the National Osteoporosis Foundation for ways to prevent osteoporosis except:

A)Maintain a diet rich in calcium and vitaminD.
B)Routinely participate in weight bearing and aerobic exercises.
C)Strengthen the core and protect the spine with flexion exercises (curls and sit-ups).
D)Stop smoking and decrease excessive alcohol consumption.

Question 8

Each of the following signs or symptoms is a characteristic of rheumatoid arthritis except:

A)Inflammatory synovitis.
B)Recurring periods of active disease (flare) followed by remission.
C)Usually asymmetrical joint involvement.
D)Fatigue, general malaise, and possibly fever.

Question 9

The articular cartilage of a synovial joint is most susceptible to damage from stress:

A)During low-impact exercise performed on a regular basis.
B)During early weight-bearing exercises after soft tissue surgery.
C)During passive stretching procedures.
D)Immediately following a period of prolonged joint immobilization.

Question 10

Each of the following is a characteristic of osteoarthritis except:

A)It typically affects only a few joints.
B)Onset typically is sudden in patients older than 40 years of age.
C)There is no evidence of systemic symptoms.
D)It can affect the spine or small or large joints of the extremities.

Question 11

You are treating a patient with a 5-year history of rheumatoid arthritis who is experiencing an exacerbation of symptoms.Which of the following is an appropriate intervention at this time?

A)A low-impact, aerobic exercise program to improve endurance and reduce fatigue
B)Grade II oscillation techniques to decrease the pain
C)Grade III joint mobilization techniques to increase mobility of involved joints
D)Progressive resistance exercise at an intensity of 60% of the maximum voluntary contraction to improve muscle strength

Question 12

A person can usually resume normal activity with no limitations when a fracture shows:

A)Radiographic union.
B)Clinical union.
C)Delayed union.
D)Callus formation.

Question 13

Your patient has osteoarthritis of the left hip and states he experiences hip and thigh pain after walking for more than 20 to 30 minutes.As a therapist, which of the following is the most appropriate intervention for you to recommend?

A)A period of complete rest or immobility
B)Application of heat and massage after periods of walking
C)Measures to decrease the mechanical stresses on the hip joint, such as use of a cane when walking over an extended period of time
D)Use of anti-inflammatory medication

Question 14

Each of the following is true regarding principles of joint protection and energy conservation for a patient with rheumatoid arthritis experiencing a flare of the disease except:

A)Stop activities for a period of time when pain or fatigue begins to develop.
B)Perform stretching exercises once a day to help maintain joint alignment.
C)Use adaptive equipment to avoid deforming forces during functional activities.
D)Maintain inflamed joints in positions opposite the positions of deformity during periods of rest.

Question 15

Each of the following is characteristic of fibromyalgia (FM) except:

A)Chronic muscle pain experienced in referred patterns.
B)Decreased ROM.
C)Chronic fatigue and decreased exercise tolerance.
D)Eleven of eighteen tender points at specific sites throughout the body.

Question 16

A balance of bone resorption that equals bone replacement occurs normally during growth and development until peak bone mass is reached.This typically occurs:

A)At about age 18 for females and 21 for males.
B)During the third decade of life.
C)At puberty.
D)During the sixth decade of life.

Question 17

Your 80-year-old patient fractured his distal radius and ulna 6 weeks ago.He wore a cast during this period, extending from the mid-humerus to, but not including, the metacarpophalangeal joints.His cast was removed yesterday because of evidence of clinical union, and he has been cleared to begin exercise.ROM is limited (wrist flexion and extension, thumb flexion, forearm supination, and elbow extension).Which type of exercise is contraindicated at this time?

A)Grade II distraction of the humeroulnar joint
B)Active ROM of all limited joints
C)Passive stretching to increase wrist, forearm, and elbow ROM
D)Grade III joint mobilization (gliding technique) to increase flexion of the thumb

Question 18

A therapist's role in diagnosing arthritic conditions is to:

A)Identify the underlying pathological process and inform the physician.
B)Order laboratory tests or radiological imaging that may confirm or rule out the diagnosis.
C)Determine the type of arthritis that is causing the patient's symptoms.
D)Identify impairments, such as the pattern and extent of range of motion (ROM) and joint mobility limitations, contributing to a patient's activity limitations and participation restrictions.