1M6-21.

A physical therapist receives a referral

for a two month old infant diagnosed to have
flexible clubfoot. Which of the following is the
proper pattern of correction?

A. Forefoot abduction-> subtalar supination->

talocrural dorsiflexion
B. Forefoot abduction-> subtalar pronation->
talocrural dorsiflexion
C. Forefoot adduction-> subtalar supination->
talocrural plantarflexion
D. Forefoot adduction-> subtalar pronation->
talocrural plantarflexion

2.

A physical therapist is working in an

elementary school system with a child who

demonstrates moderate to severe extensor
spasticity and limited head control. The
MOST appropriate positioning device would
be a:
a.wheelchair with adductor pommel.
b.wheelchair with a back wedge and head
supports.
c.supine stander with abduction wedge.
d.prone stander with abduction wedge.

3M6-27. A physical therapist performs an

examination on a newborn. Which of the
following holds true regarding range of motion
evaluation on a normal infant?

A. Has decreased ROM into flexion but

increased dorsiflexion of ankles
B. Has increased ROM into extension but
increased plantarflexion of ankles
C. Has decreased ROM into extension but
increased dorsiflexion of ankles
D. Has increased ROM into flexion but increased
plantarflexion of ankles

4M6-29. A physical therapist completes a

developmental assessment on a five
month old infant. If the therapist elects to
examine the infants ATNR. If ATNR
becomes obligatory, the following may
result except:
A. Inhibition of grasping
B. Scoliosis
C. Inhibition of crawling
D. Hip dislocation

5M6-31. A physical therapist completes an

examination on a 12-month old child.
Protective extension has been evaluated.
Which of the following time frames is incorrect
regarding their reactions?

A. Downward displacement begins at 2 months

B. Sideward sitting begins at 6 months
C. Forward sitting begins at 7 months
D. Backwad sitting begins at 9 months

6M6-32. A physical therapist is covering a

pediatric unit and is responsible for a 12 year-old

male patient on the floor. The mother of the child
states, I think my son is sexually interested in
girls. The most appropriate course of action of
the physical therapist is to respond by stating:
A: I will talk to the doctor about it.
B: Has this been going on for a while?
C: How do you know this?
D: Teenagers often exhibit signs of sexual
interest in females.

7M6-75. A physical therapist working in a pediatric

clinic observes bruises on the body of a four year-old

boy. The parents report the boy fell riding his bike.
The bruises are located on his posterior chest wall
and gluteal region. The physical therapist should:

A: Suggest a script for counseling for the family to

the doctor on duty.
B: Recommend a warm bath for the boy to decrease
healing time.
C: Notify the case manager in the clinic about
possible child abuse concerns.
D: Recommend ROM to the patients spine to
decrease healing time.

8M6-110. A 14 year-old boy has been admitted to

a mental health unit for observation and

treatment for a broken leg. The boy becomes
agitated and starts yelling at staff members.
What should the physical therapist first response
be?
A. Create an atmosphere of seclusion for the boy
according to procedures.
B. Remove other patients from the area via
wheelchairs for added speed.
C. Ask the patient, What is making you mad?
D. Ask the patient, Why are you doing this, have
you thought about what your parents might say?

9M6-17. A therapist is examining a child with a

BMI of 35. Symptoms include moderate groin
and knee pain. The child s hip is in extension
and adduction during stance but flexes,
abducts and externally rotates during swing.
Which of the following is the most likely
diagnosis of this childs condition?
A. Osgood-Schlatters disease
B. Legg-Calve -Perthes disease
C. Acetabular dysplasia
D. Slipped capital femoral epiphysis

10M6-31. A physical therapist is working in a

pediatric clinic and a mother brings in her 13

month old child who has Down Syndrome. The
mother reports, My childs muscles feel weak
and he isnt moving well. My PT friend check his
reflexes and she said they are diminished.
Which of the following actions should the
physical therapist take first?
A. Contact the physician immediately
B. Have the patient go to X-ray for a c-spine
work-up.
C. Start an IV on the patient
D. Position the childs neck in a neutral position

11M6-76. A therapist wishes to use behavior

modification techniques as part of a plan of
care to help shape the behavioral responses
of a patient recovering from traumatic brain
injury. The BEST form of intervention is to:
a. reprimand the patient every time an
undesirable behavior occurs.
b.use frequent reinforcements for all desired
behaviors.
c.allow the patient enough time for self
correction of the behavior.
d.encourage the staff to tell the patient which
behaviors are correct and which are not.

12M6-83. A physical therapist attempts to

assess the Babinski reflex as part of an initial
examination. However, the therapist has
elicited the Piotrowskis sign. This can be
triggered by:

A. Stroking the lateral aspect of the foot

beneath the lateral malleolus
B. Stroking the anteromedial tibial surface
C. Percussing the tibialis anterior muscle
D. Firmly squeezing the calf or the Achilles
tendon

13M6-97. A physical therapist working in a

pediatric clinic and observes the following

situations. Which of the following may indicate
a delayed child to the physical therapist?

A. A 10-month old that does not cruise.

B. A 8-month old that can sit upright
unsupported.
C. A 6-month old that is rolling prone to
supine.
D. A 3-month old that does not roll supine to
prone.

14M6-131.

A physical therapy functional goal for a 5

year-old child with a very high lumbar
lesion myelomeningocele and minimal
cognitive involvement would be:
a.community ambulation with HKAFOs and
Lofstrand crutches.
b.household ambulation with a reciprocating
gait orthosis (RGO) and Lofstrand crutches.
c.community ambulation with a reciprocating
gait orthosis (RGO) and Lofstrand crutches.
d.household ambulation with KAFOs and
rollator walker.

15M6-170. While walking home from your

hospital one day, you meet an old friend who

begins to tell you about her 8-y/o son who
has been diagnosed with chronic brain
syndrome. She asks you about your
experience treating these types of patient.
You tell her that all of the following conditions
are commonly seen with this affliction except:
A. impairment in speech
B. memory loss
C. impairment in judgment
D. bradycognition

16M6-26. A physical therapist completes a

developmental assessment on an infant. At
what age should an infant begin to sit with
hand support for an extended period of time?
A. 6-7 months
B. 8-9 months
C. 10-11 months
D. 12 months

17M6-65. A physical therapist identifies that a

child is unable to promote efficient grasp.
Which reflex could interfere with the childs
ability to grasp efficiently?
A. Asymmetrical tonic neck reflex
B. Moro reflex
C. Palmar grasp
D. Tonic Labyrinthine reflex

18M6-103. A physical therapy completes an

examination on an infant with Erbs palsy.
Functional limitations in scapulohumeral
rhythm has been observed. Approximately
what ratio of the scapulohumeral rhythm is
being manifested during movement:
A.1:2
B.2:1
C.1:3
D.1:1

19M6-2. The intermittent use of tone reducing

lower extremity bivalve casting for children
with cerebral palsy hypothesizes that casting
may:

A. Increase compensatory stabilizing efforts

B. Cause flexion of the toes which inhibits the
plantar grasp response
C. Facilitate trunk stability by reducing
contractures of the foot
D. Inhibit the use of extensor thrust by
preventing plantar flexion

20M6-43. A child with dyskinetic cerebral palsy is

referred to physical therapy. Which of the
following characteristics would a physical
therapist typically identify when examining the
child?

A. Disorganized movements with fluctuating

muscle tone from proximal to distal
B. Continuous low tone and intermittent tonic
spasms from distal to proximal
C. Small range of writhing movements with full
control within the range from distal to proximal
D. Abnormal repetitive twisting movements of the
body form proximal to distal

21M6-47. A child stands then holds on the

backrest of the chair. He starts to bend his

knees then lunges side to side. Which
sequence of motor development explains
this?
a.Mobility
b.Stability
c.Controlled mobility
d.Skill

22M6-140. A physical therapist reviews an

examination of a 14-month old child in the
pediatric ward. The examination documented the
existence of Babinski reflex at 12 months. The
normal Babinski response is characterized by:

A. Flexion of the great toe and flexion of the

smaller toes
B. Extension of the great toe and extension of the
smaller toes
C. Flexion of the great toe and fanning of the
smaller toes
D. Extension of the great toe and fanning of the
smaller toes

23M6-171. A developmental examination is

performed of an infant. The infant is able to
play on extended arms and attempts to reach
for the objects. The infant can maintain good
alignment of the head and trunk when pulled to
a sitting position. The infant bears weight when
placed in supportive standing. The physical
therapist would expect the infant age to be:

A. 3 months
B. 5 months
C. 7 months
D. 9months

24M6-99. Which of the following is the

mechanism for the use of Benzodiazepine as a
pharmacological intervention for cerebral
palsy?
A. Post synaptic inhibition of Ach release
B.
Presynaptic excitation of Ach release
C. Postsynaptic excitation of Ach release
D. Presynaptic inhibition of Ach release

25M6-24.

A patient is currently having a

petit mal seizure in the clinic on the floor.
Which of the following criteria has the highest
priority in this situation?

A: Provide a safe environment free of

obstructions in the immediate area
B: Call a code
C: Contact the patients physician
D: Prevent excessive movement of the
extremities

26M6-82. You are testing the tonic labyrinthine

reflex of a patient. You have positioned the
patient in 60 degrees inclined supine. Which of
the following would you consider to be a
positive response to this position?
A. Increased extensor tone in upper and lower
extremities
B.
Increased flexor tone in upper and lower
extremities
C. Increased extensor tone in upper extremities
and flexor tone in the lower extremities
D. Increased flexor tone in upper extremities and
extensor tone in lower extremities

27M6-83. You are testing a patient for the

negative supporting reaction. The integration
level for this reaction is the brainstem. You
bounce the patient several times on the soles
of the feet but you do not allow her to bear
weight. Which of the following would you
anticipate as the patients response?
A. Increased extensor tone in lower extremities
B.
Increased extensor tone in upper
extremities
C. Increased flexor tone in lower extremities
D. Increased extensor tone in upper extremities

28M6-84. You have a patient referred to

physical therapy with cerebral palsy. Which of
the following inappropriately describe what
you would typically observe in a cerebral
palsy child?
A. The child may be passive during motion
B.
The child cannot adjust the body position
C. The child can promote head co-contraction
D. The child can assume supine with tonic
extension

29M6-156.

A physical therapist is returning

phone calls in a pediatric clinic. Which of the
following reports most requires the physical
therapists immediate attention and phone call?
A: A 8 year-old boy has been vomiting and
appears to have slower movements and has a
history of hydrocephalus.
B: A 10 year-old girl feels a dull pain in her
abdomen after doing sit-ups in gym class.
C: A 7 year-old boy has been having a low fever
and headache for the past 3 days that has history
of an anterior knee wound.
D: A 7 year-old girl that had a cast on her right
ankle is complaining of burning pain.

30M6-161. A new physician on staff refers a

patient to physical therapy with a diagnosis of
Down's syndrome. Which of the following
treatments should be implemented in this
patient's physical therapy program?
A. Calisthenic exercises
B . Hydrotherapy sessions
C. Specific therapy is unnecessary
D. Treadmill ambulation

31M6-192. You are preparing to perform

vibration on a neonate. Which of the following
would be a contraindication to performing
vibration?
A. Persisted fetal cardiovascular circulation
B. Hypocapnea resulting to hyper-irritability
during treatment
C. Restlessness during treatment
D. Intermittent sinus bradycardia

32M6-200. You are performing a pediatric

assessment for growth and development in a
9-month-old patient. Which of the following
should this patient be able to perform?
A. The patient should be able to stand and walk
holding onto furniture
B.
The patient should be able to sit alone
and crawl
C. The patient should be able to stand and walk
unaided
D. The patient should be able to sit on a small
chair

33 A 4 year old patient has been diagnosed

with Trisomy 21. Epicanthal folds, Simian
palmar creases, slanted eyes, and jaw
hanging were manifested. Atlanto axial
subluxation was significant. The following
are typical features that could be
manifested except for :
A. Decreased strength
B. Decreased ROM
C. Hyperactive MSRs
D. Paresthesia

A therapist is involved in pediatric

rehabilitation. Which of the following
adaptive devices can best promote prone
stability?
A.
Wedges
B. Swings
C. Bolsters
D. Scooter boards
34

35 A therapist wishes to use operant conditioning as

A.
B.
C.
D.

part of her treatment to help shape the

behavior of children with problems associated
with cerebral palsy. All of these approaches
would be appropriate using operant conditioning
except for:
Complementing the child with a prize for a correct
response or attitude
Reacting to inappropriate behaviors or attitudes to
rectify bad habits
Praise the child or a pat on the back to strengthen
desired responses
Do not verbally reinforce correct responses and
pointing out and explaining incorrect behaviors

36 A therapist is evaluating a childs developmental

A.
B.
C.
D.

milestones. Which of the following milestones

most consistently show tonic stability on a
child?
Sitting unsupported without head lag
Lifts head up while prone
Reaches forward while standing
Maintains prone extension posture

37 A therapist applies quick stretching force on the

gastrocnemius and soleus muscles. What is the

effect of this maneuver on the muscles if theres
exetensor thrust based on the Rood technique?
A. Facilitating the agonist and antagonist
B. Inhibiting the agonist and antagonist
C. Facilitating the agonist and inhibiting the antagonist
D. Inhibiting the agonist and facilitating the antagonist

38 Which adaptive device is often used CP patients

because it helps the child maintain upright
position and arm position helps to decrease
extensor tone?

A.
B.
C.
D.

Prone stander
Supine stander
Four-wheeled walker
Posterior rollator walker

39 Which of the following positions of the lower

A.
B.
C.
D.

extremities would best describe the standing

position of a child for the first 24 months after
birth with no corresponding deformities?
Femoral anteversion, hip internal rotation, subtalar
supination
Femoral retroversion, hip external rotation, subtalar
pronation
Femoral anteversion, hip external rotation, subtalar
pronation
Femoral retroversion, hip internal rotation, subtalar
supination

40 A PT is working as a school therapist. Which of the

following is the most appropriate school physical

therapy intervention that should be used on a
child with decreased sitting balance but with
normal tone?
A. Prone stander to improve upper extremity activities
B. Use of wheelchair with adaptive desk
C. Use of vestibular ball to improve sitting balance
D. Use of a corner seat for sitting stability

41.
A child with brain damage shows evidence of

mental retardation, tactile defensiveness and

proximal joint instability. Activities that the
physical therapist can best utilize in this case
include:
A. neutral warmth and rhythmic stabilization.
B. repetitive brushing and joint traction.
C. very light touch and weight bearing.
D. firm pressure and joint approximation.

42.
The therapist is on a home visit, scheduled at
lunchtime, visiting an 18 month-old child with moderate
developmental delay. The therapist notices the child
and mother are experiencing difficulties with feeding.
The child is slumped down in the highchair and is
unsuccessfully attempting to use a raking grasp to lift
cereal pieces to her mouth. Both the child and mother
are frustrated. The FIRST intervention should be to:
a.work on desensitizing the gag reflex.
b.recommend the mother return to breast feeding for a
few more months.
c. recommend the mother feed the child baby food
instead of cereal for a few more months.
d.reposition the child in a proper sitting position using
postural supports.

43.
A 14 month-old child with spastic

diplegia is up on the tiptoes with the toes

curled when held in supported standing.
This position is characteristic of a:
A. Proprioceptive placing reaction
B. Marie Foix reflexes
C. Plantar grasp reflex
D. Primitive walking response

44.
An infant demonstrates that the ATNR is NOT

obligatory when he/she can turn the head:

A. to either side and open the hand.
B. to one side and look at the extended arm

on that side.
C. to one side and bring the opposite hand
to mouth.
D. to one side and bring the hand to mouth
on the same side.

45.
The therapist is treating a child with mild

developmental delay secondary to 7 weeks

prematurity at birth. The child is now 8
months old and is just learning to sit. The
BEST choice for training activity is:
a.standing tilting reactions.
b.sideward protective extension in sitting.
c.prone tilting reactions.
d.supine tilting reactions.

46.
An infant has just begun to pull-to-stand

through kneeling, still demonstrates plantar

grasp in standing, and is independent in sitting
including all protective extension reactions.
This infant's chronological age is
approximately:
a.5-6 months.
b.7-8 months.
c.12-14 months.
d.9-10 months.

47.
You are working with a 12 month-old with

a developmental delay of 3 months.

Appropriate intervention at this time
would incorporate:
A. Pivot prone positioning
B. Rolling from prone to supine
C. Rolling from supine to prone
D. Training in supported sitting

48.
A physical therapist is examining a 9 month-

old child who was born at 28 weeks

gestational age. Which of the following
activities should this child be able to
perform?
A. Walking independently
B. Standing independently
C. Creeping on hands and knees
D. Rolling supine to prone

49.
An appropriate fine motor behavior

that should be established by 9

months of age would be the ability to:
a.pick up a raisin with a scissor grasp.
b.build a tower of 4 blocks.
c.hold a cup by the handle while
drinking.
d.transfer objects from one hand to
another.

50M6-10. A physical therapist attempts to

reduce a childs knee buckling using an
ankle-foot orthosis. Which ankle setting
would be the most effective to achieve the
therapists objective?
A. Anterior shell with 5-10 degrees of
dorsiflexion
B. Posterior shell with 5-10 degrees of
dorsiflexion
C. Anterior shell with 5-10 degrees of plantar
flexion
D. Posterior shell with 5-10 degrees of plantar
flexion