A physical therapist examines a patient with a history of recurrent lateral ankle sprains. Which special test would BEST assess ligamentous integrity?

Correct Answer: A

Rationale: The correct answer is A: Anterior drawer test. This test assesses the integrity of the anterior talofibular ligament in the lateral ankle. Step 1: Stabilize the lower leg and move the ankle into slight dorsiflexion. Step 2: Grasp the calcaneus and apply an anterior force. Step 3: Positive test indicates excessive anterior translation, suggesting ligamentous laxity. Incorrect choices: B: Thompson test assesses Achilles tendon integrity, not ligamentous integrity. C: Talar tilt test assesses calcaneofibular and deltoid ligament integrity, not specifically lateral ligament. D: Kleiger test assesses syndesmotic ligament integrity, not lateral ligament.

Correct Answer: C

Rationale: The primary purpose of assessing for rebound tenderness during an abdominal examination is to evaluate for peritoneal inflammation. Rebound tenderness indicates irritation of the peritoneum, a membrane lining the abdominal cavity. This can be a sign of serious conditions like peritonitis. Organ enlargement (Choice A) may not necessarily cause rebound tenderness. Ascites (Choice B) is the accumulation of fluid in the peritoneal cavity, which may not directly cause rebound tenderness. Identifying abdominal masses (Choice D) is important but may not be the primary purpose of assessing for rebound tenderness.

Correct Answer: B

Rationale: The primary purpose of performing percussion over the costovertebral angle is to assess kidney tenderness. This technique, known as CVA tenderness, helps identify potential kidney issues such as infections or kidney stones. By tapping over this area, any tenderness or pain indicates underlying kidney pathology. This is crucial in diagnosing conditions like pyelonephritis or renal stones. The other choices are incorrect because: A: Liver enlargement is typically detected through palpation and imaging studies, not percussion over the costovertebral angle. C: Evaluating diaphragmatic excursion involves assessing the movement of the diaphragm during respiration, which is not related to percussion in the CVA region. D: Detecting fluid in the lungs is usually done through auscultation and imaging studies, not percussion over the costovertebral angle.

Correct Answer: C

Rationale: The correct answer is C: Absent dorsalis pedis pulse. This finding is most concerning as it indicates a significant impairment in arterial blood flow to the foot, potentially leading to severe complications such as tissue necrosis or limb ischemia. Absence of the dorsalis pedis pulse suggests a severe blockage or narrowing in the arteries supplying the foot, which requires immediate medical attention to prevent further complications. Capillary refill of 2 seconds (choice A) is within the normal range and indicates adequate peripheral circulation. Bilateral pitting edema (choice B) can be a sign of venous insufficiency but is not as urgent as an absent dorsalis pedis pulse. Warm and pink extremities (choice D) indicate good tissue perfusion and are positive findings in a vascular assessment.

Correct Answer: A

Rationale: The correct answer is A: Osteoarthritis. In a 60-year-old woman with joint pain worsened with activity, improved with rest, decreased range of motion, and crepitus, osteoarthritis is the most likely diagnosis due to its characteristic presentation in weight-bearing joints. Osteoarthritis is a degenerative joint disease characterized by cartilage breakdown, leading to pain and stiffness. Rheumatoid arthritis (B) typically presents with symmetric joint involvement, morning stiffness, and systemic symptoms. Gout (C) manifests as sudden onset of severe joint pain, redness, and swelling, commonly affecting the big toe. Psoriatic arthritis (D) is associated with skin psoriasis and may involve asymmetric joint inflammation.