Therapeutic Modalities 4th Edition Test Bank

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Chapter 1 The Injury Response Process
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. Which is an accurate statement regarding the effect of modalities and the healing process?
A. Modalities attempt to provide the optimal environment for healing to occur.
B. Most modalities can speed up the healing of an injury.
C. Modality devices are primarily used to alter the body’s psychological status to provide a
good healing environment.
D. The stage of the healing process does not influence which modality is used.
____ 2. According to the physical stress theory, what changes will result from a physical stress that is categorized as
none to low?
A. Cell death
B. Decreased tolerance
C. Increased tolerance
D. Injury
____ 3. What type of tissue is devoid of blood vessels and is able to secrete and absorb various substances?
A. Epithelial
B. Muscle
C. Adipose
D. Connective
____ 4. According to the general adaptation syndrome, what is the correct order of the three stages of stress response?
A. Alarm, resistance, exhaustion
B. Resistance, alarm, excitement
C. Exhaustion, excitement, alarm
D. Resistance, exhaustion, excitement
____ 5. What segment of a neuron is responsible for transmitting impulses toward the nerve body?
A. Dendrites
B. Axons
C. Electrical synapses
D. Chemical synapses
____ 6. What is the longest stage of the general adaptation syndrome?
A. Alarm
B. Resistance
C. Exhaustion
D. Excitement
____ 7. In what tissue order must the different forms of therapeutic energy pass through to affect the target tissues?
A. Epithelial, adipose, muscular, nervous, connective
B. Epithelial, nervous, adipose, muscular, nervous
C. Epithelial, connective, nervous, muscular, adipose
D. Epithelial, adipose, connective, muscular, nervous
____ 8. What type of tissue is the most abundant in the body?
A. Epithelial
B. Muscle

C. Adipose
D. Connective
____ 9. During the healing process, when do you see the formation of granulation tissue and the migration of
phagocytes and fibroblasts to the injured area?
A. Acute inflammatory response
B. Proliferation phase
C. Maturation phase
D. Chronic inflammatory response
____ 10. In order to maximize the effect of gravity on the venous return system, a limb should be placed at a
__________________ to the heart.
A. 0 degree or horizontal angle
B. 90 degree angle above horizontal
C. 30 degree angle above horizontal
D. 60 degree angle above horizontal
____ 11. What type of afferent peripheral nerve is a muscle spindle?
A. Ia
B. Ib
C. II
D. III
____ 12. What neurotransmitter is located in the brainstem and will increase blood pressure and cardiac output?
A. Dopamine
B. Epinephrine
C. Norepinephrine
D. Serotonin
____ 13. There are three potential outcomes of the injury process. What best describes the regeneration outcome?
A. The original tissue is replaced with scar tissue.
B. The structure’s original structure and function is lost.
C. The structure retains some or all of its original structure and function.
D. Dead cells and cellular debris are removed by phagocytosis.
____ 14. What type of exudate is a plasma-rich fluid that is especially high in plasma protein?
A. Fibrinous
B. Serous
C. Purulent
D. Ulcer
____ 15. Application of which modality will result in the greatest rate of femoral vein flow?
A. Passive straight-leg raises
B. Anatomic continuous passive motion
C. Pneumatic sleeve
D. Active ankle dorsiflexion
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
____ 1. In what tissues are labile cells found? Select all that apply.
A. Bone

B. Peripheral nervous system
C. Skin
D. Intestinal tract
E. Central nervous system
____ 2. According to the practical evidence, what are the primary uses for compression wraps? Select all that apply.
A. Increase venous return
B. Reduce acute hemorrhage
C. Prevent venous pooling
D. Reduce secondary cell death
____ 3. Which events occur during the proliferation phase? Select all that apply.
A. Removal of debris and temporary repair tissue
B. Formation of a temporary vascular framework
C. Release of histamine to increase cell permeability
D. Norepinephrine is released, causing vasoconstriction of arterioles
E. Collagen aligns and attempts to adapt to the preinjury orientation
____ 4. Which of the following represents macrotrauma? Select all that apply.
A. Sprain
B. Stress fracture
C. Muscle soreness
D. Fracture
E. Strain
____ 5. Which of the following characteristics describe type 1 muscle fibers? Select all that apply.
A. Fast twitch
B. Slow twitch
C. Low intensity
D. Aerobic
E. Anaerobic

Chapter 1 The Injury Response Process
Answer Section
MULTIPLE CHOICE
1. ANS: A PTS: 1
2. ANS: C PTS: 1
3. ANS: A PTS: 1
4. ANS: A PTS: 1
5. ANS: A PTS: 1
6. ANS: B PTS: 1
7. ANS: A PTS: 1
8. ANS: D PTS: 1
9. ANS: A PTS: 1
10. ANS: B PTS: 1
11. ANS: A PTS: 1
12. ANS: A PTS: 1
13. ANS: B PTS: 1
14. ANS: A PTS: 1
15. ANS: A PTS: 1
MULTIPLE RESPONSE
1. ANS: C, D PTS: 1
2. ANS: B, C PTS: 1
3. ANS: A, B PTS: 1
4. ANS: A, D, E PTS: 1
5. ANS: B, C, D PTS: 1

Chapter 2 The Physiology and Psychology of Pain
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. Which statement best describes nociception?
A. Nociception must be interpreted as pain by higher brain centers.
B. Nociception is a neuropsychological process that must be interpreted as pain.
C. Nociception describes an unpleasant sensation.
D. Nociception is the neural process of encoding and processing noxious stimuli.
____ 2. Which of the following dimensions of pain perception localize the source and type of pain?
A. Effective-terminal
B. Sensory-discriminative
C. Cognitive-evaluative
D. Affective-motivational
____ 3. Pain threshold is often based on the recruitment of _______________ fibers.
A. A-delta
B. A-beta
C. C
D. COX-1
____ 4. Memories of past experiences are a component that creates one’s “pain filter.” Where do these memories
come from?
A. Limbic system
B. Cerebral cortex
C. Somatosensory system
D. Thalamus
____ 5. What best defines pain that is produced from a normally nonpainful stimulus?
A. Hyperesthesia
B. Hyperalgesia
C. Primary hyperalgesia
D. Primary hyperesthesia
____ 6. In pain control theory, which is considered a secondary pain control approach?
A. Target the perception of pain
B. Resolve physiological pain triggers
C. Decrease mechanical irritation
D. Decrease chemical irritation
____ 7. Which scenario will result in a closing of the gate, thus inhibiting the pain signal from getting to the
second-order neuron?
A. Large-diameter afferent traffic is greater than small diameter.
B. Small-diameter afferent traffic is greater than large diameter.
C. Increase speed of small-diameter afferent transmission.
D. Increase speed of large-diameter afferent transmission.
____ 8. Damage to the diaphragm can result in referred pain to the skin and muscles of the ___________________.
A. neck and shoulder
B. lower back

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C. thigh and knee
D. anterior thorax
____ 9. Which therapeutic modality has the ability to alter cell membrane permeability and thus alter the rate of nerve
depolarization?
A. Cold packs
B. Therapeutic ultrasound
C. Electrical stimulation
D. Intermittent compression
____ 10. Which inflammatory pain mediator is released by mast cells to directly stimulate nociceptors?
A. Bradykinins
B. Prostaglandin
C. Substance P
D. Histamine
____ 11. What mechanoreceptor is located deeper in the skin and reacts to higher levels of mechanical pressure?
A. Merkel’s disks
B. Meissner’s corpuscles
C. Pacinian corpuscles
D. Ruffini corpuscles
____ 12. What does the verbal rating scale use to represent the current pain intensity of a patient?
A. 10-cm line
B. Different faces
C. Numbers 1 through 10
D. Descriptive terms
____ 13. Regarding pain control, the primary action of NSAIDS is to block the action of what inflammatory pain
mediator?
A. Bradykinins
B. Prostaglandin
C. Substance P
D. Histamine
____ 14. What substance is released by the body and reduces the perception of pain by bonding to pain receptor sites?
A. Serotonin
B. Enkephalin
C. Mast cells
D. Tract cells
____ 15. What pain-decreasing medication temporarily blocks nerve conduction, thus resulting in the loss of sensation?
A. Aspirin
B. Lidocaine
C. Endorphin
D. Propoxyphene
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
____ 1. Which therapeutic modalities can provide mechanical pain reduction by removing swelling, restoring joint
motion, decreasing pressure on nerve endings, and restoring blood flow? Select all that apply.

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A. Intermittent compression
B. Continuous passive motion
C. Shortwave diathermy
D. Electrical stimulation
E. Cervical/lumbar traction
____ 2. Which statements are true regarding the afferents responsible for transmitting pain? Select all that apply.
A. The fibers that transmit pain are A-beta and C fibers.
B. The fibers are heavily myelinated.
C. A-delta fibers give ability to localize pain to a specific spot.
D. Both types of fibers respond to mechanical pressure and temperature extremes.
E. Pain originating from C fibers is referred to as “fast” pain.
____ 3. Which of the following are examples of mechanical stimuli that can trigger peripheral nociceptors? Select all
that apply.
A. Thermal changes associated with the inflammatory response
B. Direct-force trauma
C. Release of prostaglandins from trauma
D. Pressure from swelling
____ 4. Which of the following are associated with pain tolerance? Select all that apply.
A. Limbic system
B. C fibers
C. Cortex
D. A-delta fibers
E. Thalamus
____ 5. Which statements are true regarding the definition of pain? Select all that apply.
A. Pain is an unpleasant sensory and emotional experience.
B. Pain is associated only with actual tissue damage and not potential damage.
C. Pain is always an emotional experience.
D. Acute pain has an identifiable cause and extended duration.
E. Pain is just a simple sensation and not a process.

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Chapter 2 The Physiology and Psychology of Pain
Answer Section
MULTIPLE CHOICE
1. ANS: D PTS: 1
2. ANS: B PTS: 1
3. ANS: A PTS: 1
4. ANS: A PTS: 1
5. ANS: A PTS: 1
6. ANS: A PTS: 1
7. ANS: A PTS: 1
8. ANS: A PTS: 1
9. ANS: B PTS: 1
10. ANS: D PTS: 1
11. ANS: C PTS: 1
12. ANS: D PTS: 1
13. ANS: A PTS: 1
14. ANS: B PTS: 1
15. ANS: B PTS: 1
MULTIPLE RESPONSE
1. ANS: A, B, E PTS: 1
2. ANS: C, D PTS: 1
3. ANS: B, D PTS: 1
4. ANS: A, B, C PTS: 1
5. ANS: A, C PTS: 1

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Chapter 3 Development and Delivery of Intervention Strategies
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. Which is most useful when determining the efficacy of an intervention?
A. Minimum detectable change
B. Minimally clinically important change
C. Maximum detectable change
D. Maximally clinically important change
____ 2. PICO is a mnemonic that provides structure for developing clinical questions. When developing a clinical
question, what part of the mnemonic represents the therapy being considered?
A. Patient
B. Intervention
C. Comparison
D. Outcomes
____ 3. Which component of evidence-based practice carries the least weight when making decisions?
A. Personal experience
B. Best available evidence
C. Patient values and preferences
D. Personal experience, best available evidence, and patient values all carry the same weight.
____ 4. What are the first three steps of the problem-solving approach?
A. Obtain a medical history, identify patient limitations and restrictions, and prioritize
problems
B. Obtain a medical history, review the evidence, and set treatment goals
C. Identify patient limitations and restrictions, prioritize problems, and set treatment goals
D. Identify patient limitations and restrictions, set treatment goals, and review the evidence
____ 5. In which component of the problem-solving approach would you identify the stage of the healing process?
A. Medical history
B. Recognition of the problem
C. Goal setting
D. Treatment planning
____ 6. In order to develop a logical treatment sequence in the problem-solving approach, problems should be
prioritized based on what?
A. Cause-and-effect relationship to the patient’s functional limitations
B. Importance of the treatment to the patient
C. Importance of the treatment to the clinician
D. Cost of the proposed intervention
____ 7. When based on ______________, treatment goals can be used as the basis for research on treatment efficacy.
A. outcome measures
B. patient preference
C. cost effectiveness
D. short-term goals
____ 8. Which of the following goals is quantifiable and measures function?
A. Increase passive dorsiflexion by 2 degrees

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B. Increase active dorsiflexion
C. Increase active dorsiflexion to allow patient to climb stairs unassisted
D. Increase active assistive dorsiflexion
____ 9. Which statement accurately describes long-term goals?
A. Long-term goals are revised more often than short-term goals.
B. There are typically more long-term goals than short-term goals.
C. Long-term goals focus on restoring participation.
D. Long-term goals tend to address specific pathologies.
____ 10. When treatment planning, what largely determines the types of modalities that will resolve a pathology?
A. Stage of the healing process
B. Length of application
C. Amplitude at which the modality is applied
D. Type of insurance carried by the patient
____ 11. When determining the best method for heat application, which surface would best be served with a whirlpool
over a moist heat pack?
A. Thigh
B. Lower leg
C. Ankle
D. Upper arm
____ 12. Which common tool used in the examination of orthopedic injuries can be measured with a handheld
dynamometer?
A. Active range of motion
B. Muscle function assessment
C. Hypertrophy
D. Sensation
____ 13. Which common tool used in the examination of orthopedic injuries is contraindicated when the patient suffers
from dementia or disorientation?
A. Weight-bearing status
B. Pain
C. Sensation
D. Flexibility
____ 14. According to the World Health Organization, which is an environmental contextual factor that can help
determine a patient’s level of function/disability?
A. A person’s gender
B. A person’s profession
C. A person’s life experiences
D. Social attitudes where a person works
____ 15. What is the purpose of “Condition” in the ABCD goal-writing structure?
A. To identify the person performing the task
B. To describe the task using action terms
C. To define the tools or techniques used in obtaining the goal
D. To identify the quality with which the task will be performed
Multiple Response
Identify one or more choices that best complete the statement or answer the question.

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____ 1. Which of the following are considered external factors that affect the development of a treatment plan? Select
all that apply.
A. Expertise of the staff
B. Financial constraints
C. Type of available equipment
D. Patient’s motivation
E. Support the patient receives from friends and family
____ 2. Which databases are designed to answer clinical questions through the incorporation of publications from
multiple databases? Select all that apply.
A. PEDro
B. Cochrane
C. PubMed
D. SPORTDiscus
E. Google
____ 3. Which factors should be considered when determining if a therapeutic modality would be effective in treating
a specific condition? Select all that apply.
A. What is the cost of the therapeutic modality?
B. Does the modality produce the physiological response to promote healing?
C. Can the modality affect the target tissue?
D. Does the device improve patient outcomes?
E. What is the ease of applying the modality?
____ 4. Planning a treatment and rehabilitation program requires the integration of what complex skills? Select all
that apply.
A. Clinical examination skills
B. Knowledge of pathology
C. Identification of the patient’s level of function
D. Identification of the patient’s participation restrictions
E. Knowledge of the current costs associated with common modalities
____ 5. The problem-solving approach to developing an intervention strategy is a logic-based technique that uses
what components? Select all that apply.
A. Clinical examination findings
B. Patient’s long-term goals
C. Best available evidence
D. Cost of the interventions
E. Supplies of the facility

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Chapter 3 Development and Delivery of Intervention Strategies
Answer Section
MULTIPLE CHOICE
1. ANS: A PTS: 1
2. ANS: B PTS: 1
3. ANS: A PTS: 1
4. ANS: A PTS: 1
5. ANS: B PTS: 1
6. ANS: A PTS: 1
7. ANS: A PTS: 1
8. ANS: C PTS: 1
9. ANS: C PTS: 1
10. ANS: A PTS: 1
11. ANS: C PTS: 1
12. ANS: B PTS: 1
13. ANS: C PTS: 1
14. ANS: D PTS: 1
15. ANS: C PTS: 1
MULTIPLE RESPONSE
1. ANS: A, D, E PTS: 1
2. ANS: A, B PTS: 1
3. ANS: B, C, D PTS: 1
4. ANS: A, B, C, D PTS: 1
5. ANS: A, B, C PTS: 1

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Chapter 4 Administrative Considerations
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. An institution’s or facility’s policies and procedures manual:
A. should reflect the state practice acts.
B. should reflect the professional standards of practice.
C. should reflect the state practice acts and professional standards of practice.
D. is independent of the state practice acts and professional standards of practice.
____ 2. What term best identifies defamation of character through printed or electronic media?
A. Libel
B. Liability
C. Slander
D. Negligence
____ 3. Identify the most accurate statement regarding the Health Insurance Portability and Accountability Act
(HIPAA).
A. HIPAA regulations affect present and future medical records but not past records.
B. State regulation can override HIPAA requirements.
C. HIPAA ensures patient confidentiality but does not control the security of protected health
information (PHI).
D. HIPAA was created by the Food and Drug Administration (FDA).
____ 4. What best defines negligent behavior when a person acts on a situation but does so at a level different than a
reasonable and prudent person would?
A. Act of omission
B. Act of commission
C. Tort
D. Fraud
____ 5. All therapeutic equipment must be inspected and calibrated by a qualified technician at least _____________.
A. yearly
B. weekly
C. monthly
D. twice a year
____ 6. According to the Food and Drug Administration’s medical device classification system, what classification
would a device get if it presented a great risk to the patient?
A. Class I
B. Class II
C. Class III
D. Class IV
____ 7. Which develops safety standards and regulations to prevent work-related injuries and illnesses?
A. Food and Drug Administration (FDA)
B. Health Insurance Portability and Accountability Act (HIPAA)
C. American Hospital Association (AHA)
D. Occupational Safety & Health Administration (OSHA)
____ 8. A failure to maintain accurate, legible medical records may result in what charge?

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A. Ordinary negligence
B. Professional negligence
C. Ordinary and professional negligence
D. Neither ordinary nor professional negligence
____ 9. Current Procedural Terminology (CPT) codes were established by what organization?
A. Health Care Finance Administration (HCFA)
B. National Center for Health Statistics
C. American Hospital Association (AHA)
D. American Medical Association (AMA)
____ 10. As a general rule, treatment tables should be _______ high and _______ apart.
A. 30 inches; 30 inches
B. 30 inches; 4 feet
C. 2 feet; 4 feet
D. 2 feet; 30 inches
____ 11. Where is the ideal location for the ON-OFF switch to a whirlpool motor?
A. Within reach of the patient in the tub
B. Out of reach of the patient in the tub
C. Mounted on top of the tub’s motor
D. It does not matter where the ON-OFF switch is located.
____ 12. In order to decrease the potential growth of fungi, bacteria, and viruses, what should the humidity of the
hydrotherapy area be?
A. 40 to 50 percent
B. 50 to 60 percent
C. 60 to 70 percent
D. 70 to 80 percent
____ 13. What is the highest form of state regulation?
A. Licensure
B. Certification
C. Registration
D. Exemption
____ 14. What part of the FDA’s minimal requirements for device labeling describes conditions where the risk of use
outweighs the anticipated benefits?
A. Contraindications
B. Warnings
C. Boxed warning
D. Precautions
____ 15. What medical record document provides an ongoing record of the patient’s intervention plan?
A. Treatment record
B. Prescription record
C. Injury report
D. Medical history
____ 16. What term best describes the tort when there is a duty to act but a failure to perform the act?
A. Malfeasance
B. Misfeasance
C. Nonfeasance

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D. Malpractice
____ 17. Which statement is accurate in its description of direct access?
A. Third-party reimburses will always reimburse in a state that is granted direct access.
B. Professions granted direct access typically do not require a physician’s referral.
C. Cold packs, moist heat packs, and whirlpools typically require a prescription in states
without direct access.
D. Phonophoresis and iontophoresis do not require a prescription if the profession is granted
direct access.
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
____ 1. What can you be charged with if you provide care without consent in a nonemergent situation? Select all that
apply.
A. Tort
B. Professional negligence
C. Battery
D. Slander
E. Mischief
____ 2. When assessing for the possibility of professional negligence, what forms the benchmark for determining if
care provided was standard or substandard? Select all that apply.
A. Professional standards of practice
B. Facility policies and procedures manual
C. State practice acts
D. Best practice standards
E. Patient opinion
____ 3. Which statements are true concerning third-party reimbursement? Select all that apply.
A. Other insurance companies use Medicare but not Medicaid standards when establishing
their own guidelines.
B. Individuals rendering treatment must be state licensed to be eligible for reimbursement.
C. As long as all standards are met, a reimbursement is guaranteed by insurance companies.
D. Reimbursement requires documentation of the treatment services but not the condition
being treated.
E. The rate of reimbursement is frequently based on the usual, customary, and reasonable
(UCR) system.

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