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  • 18 augustus 2024
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Geri Exam 1 Questions and Answers
100% Verified
An older adult at risk for falls has undergone a structured home-based exercise program that
consisted of standing balance training and strengthening exercises. The measure that can
BEST show improvement is:
6 minute walk test
Berg balance scale
Timed up and go
Tinetti - ANSWER - Berg balance


The patient is a 71-year-old male. He was recently discharged from an inpatient rehabilitation
facility after suffering a right closed femoral fracture due to a fall. He subsequently had an ORIF
to his right femur. His past medical history is significant for a CVA with right hemiparesis. He
was using an SPC prior to the fall. He currently is using an FWW with a right forearm platform
for all ambulation. His weight-bearing orders are 25% on right lower extremity. He completed a
10-Meter Walk Test in 50 seconds (0.2 m/s). Which of the following would be the best
therapeutic exercise intervention for the patient as part of his home physical therapy plan of
care?
part 1/2


bilat standing hip abduction
marching
mini squats
supine straight leg rises - ANSWER - Supine straight leg raises


This patient's gait speed indicates which of the following?
part 2/2


he is likely independent in his ADLs and IADLs
he is able to cross a street safely due to his normal walking speed
he is likely to be a community ambulatory

,he is less likely to have an adverse event, such as a fall - ANSWER - he is likely independent in
his ADLs and IADLs


A 72-year-old male recently underwent a right total hip arthroplasty with a posterior approach.
His past medical history is significant for hypertension and high cholesterol, which are controlled
with medications. He presents to an outpatient physical therapy clinic for an initial evaluation.
He is no longer using an assistive device for ambulation. During the gait assessment, the
physical therapist notes a significant right trunk lean during stance phases on the right. Based
on the patient's gait assessment, which of the following muscle groups is likely weak?
Hip flexors
Hip extensors
Knee extensors
Hip abductors - ANSWER - Hip abductors


Which of the following interventions is the best exercise to improve his gait deviation?
Sidelying straight leg lifts
Riding a recumbent bicycle
Balance exercises emphasizing a level pelvis
Supine bridge exercises - ANSWER - Balance exercises emphasizing a level pelvis


Reason: This exercise is useful because it is weight-bearing and it mimics the hip abductors'
function of stabilizing the pelvis during single-limb stance of gait. To answer this question
correctly, one has to have a good understanding of the action of the hip abductors during the
stance phases of gait and therapeutic exercise that will closely mimic that. Sidelying straight leg
lifts will target the hip abductors, but it is non-weight-bearing and may not be the best choice to
improve his gait deviation. Supine bridge exercises will target several muscles but do not isolate
the hip abductors and do not necessarily correlate to the hip abductors' function during gait. A
recumbent bicycle will not improve the strength of the hip abductors.


James is 87 years old. He lives at home alone and has recent weight loss, insomnia, increased
confusion, and a fall with UE fracture. He is referred to therapy for gait and balance following his
ground-level fall. Your assessment and plan of care includes:


Limit his care to rehabilitation of the UE fracture to maximize return to function for ADLs.

,Referral to speech therapy for a dysphagia study to address his weight loss.


DGI, FGA, and BESTest to clarify balance and gait factors contributing to his fall and determine
his need for an assistive device


Recognition of his symptoms as geriatric syndrome, which will require a multidisciplinary
approach to address his risk for further functional decline and morbidity in his current living
situation. - ANSWER - Recognition of his symptoms as geriatric syndrome, which will require a
multidisciplinary approach to address his risk for further functional decline and morbidity in his
current living situation.


The benefits of early mobilization in the ICU include all of the following except:
Preserved musculoskeletal and neuromuscular integrity
Enhanced cardiovascular function
Decreased chronic inflammation
Impaired blood sugar homeostasis - ANSWER - Impaired blood sugar homeostasis


For which of the following conditions is use of the Borg Scale appropriate to monitor exercise
intensity?
Use for patients on bronchodilators
Use in self-monitoring of aerobic and/or resistance training
Use if a pacemaker is present
Use when the patient is on a benzodiazepine drug - ANSWER - Use in self-monitoring of
aerobic and/or resistance training


Gait characteristics of low-functioning older adults include:
Increased dual stance time
Decreased dual stance time
Increased DGI scores
Decreased TUG scores - ANSWER - Increased dual stance time
Reason: Low-functioning older adults have gait characteristics that typically increase dual
stance time in order to create increased stability and safety. These characteristics may include
slower gait velocity (walking speed and TUG performance), increased stance-to-swing ratio,
decreased step length, and decreased stability in dynamic balance (DGI tasks).

, Which statement is true regarding fear of falling?
No valid tool exists to effectively measure fear of falling
It is not important; only an actual fall with injury is important in identifying future risk for fall
Fear of falling and avoidance of activity is typically underreported
Patients will typically have fear of falling only if they have experienced an injury from a fall -
ANSWER - Fear of falling and avoidance of activity is typically underreported
term-8Reason: Older adults who fall develop a fear of falling even if they sustain no injury. Fear
of falling causes them to limit their activity, which in turn leads to reduced mobility and fitness
and subsequent increase in fall risk. Fear of falling is strongly associated with future falls. Fear
of falling is well validated with the Activities-Specific Balance Confidence Scale and the Falls
Efficacy Scale. (See rehabmeasures.org)


Functional tests that are appropriate for older adults and provide comparisons to normative data
in assessment of endurance include:
Walking speed, TUG
6-Minute Walk Test, 2-Minute Step Test
DGI, FGA
5 Times Sit-to-Stand Test - ANSWER - Reason: All of the tests listed have good validity and
normative-based references for performance; however, only the 6-Minute Walk Test and the 2-
Minute Step Test are direct measures of endurance. A discussion of interpretation of these tests
and their application to developing a plan of care is found in the article by Whetten and Struder.
[Whetten, B. K., & Struder, M. T. (2011). Physical therapists as the pharmacists of exercise:
Determining the appropriate dosage (intensity) for your patient. GeriNotes, 18(1), 27-30.]
6-Minute Walk Test, 2-Minute Step Test


Serum enzymes are a valuable lab value in initial assessment of critical illness because:


Serum enzymes reflect risk for cardiovascular disease.
Serum enzymes and markers are evidence of tissue breakdown or cellular damage.
Serum enzymes define the coagulation profile of the patient's blood, an important consideration
for patients with atrial fibrillation, mechanical heart valves, or recent trauma.
Serum enzymes are not helpful in understanding the degree of critical illness in older adults -
ANSWER - Serum enzymes and markers are evidence of tissue breakdown or cellular damage.

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