When prescribing physical therapy for a patient with bony metastases, it is prudent to avoid which of the following?

Correct Answer: A

Rationale: The correct answer is A: Resistive exercises in that limb. Bony metastases can weaken bones and increase the risk of fractures. Resistive exercises can put excessive stress on the bones, potentially leading to fractures. It is important to focus on gentle, low-impact exercises to maintain mobility without risking further damage. Active range of motion exercises (choice B) can help maintain flexibility without stressing the bones. Bracing (choice C) can provide support and stability. Cold therapy (choice D) can help with pain and inflammation management but does not directly impact bone strength.

Correct Answer: B

Rationale: The correct answer is B: Decreased muscle spasm. Ultraviolet radiation does not directly affect muscle spasms. Increased vascularization (A) can occur as a response to UV exposure, cell protein changes (C) can be induced by UV radiation, and UV radiation can have a bactericidal (D) effect by damaging microbial DNA. Therefore, choice B is the correct answer as it does not align with the known effects of UV radiation.

Correct Answer: D

Rationale: The correct answer is D because in an outpatient setting for cold and flu symptoms, a focused or problem-centered history is appropriate to quickly assess the current issue. Step 1: Identify the presenting problem - cold and flu symptoms. Step 2: Gather specific information related to the issue. Step 3: Focus on relevant history questions to determine the cause and appropriate intervention. Other choices are incorrect because they may require a comprehensive history for long-term care (A), immediate intervention for severe shortness of breath (B), or pre-operative assessment for surgery (C).

Correct Answer: A

Rationale: The correct answer is A: Otosclerosis of the left ear. In otosclerosis, there is abnormal bone growth in the middle ear that affects sound conduction. In this case, bone conduction being greater than air on the left indicates a conductive hearing loss, which is consistent with otosclerosis. The Weber test showing the sound better on the left ear suggests a lateralization towards the affected ear, supporting the diagnosis. Incorrect choices: B: Exposure to chronic loud noise of the right ear would likely result in sensorineural hearing loss, not a conductive hearing loss as seen in this case. C: Otitis media of the right ear would also lead to conductive hearing loss, but the abnormal findings are consistent with left ear involvement, making this choice incorrect. D: Perforation of the right eardrum would result in a conductive hearing loss in the right ear, not the left ear as observed in this patient.

Correct Answer: D

Rationale: The correct answer is D because ascites is fluid accumulation in the peritoneal cavity, causing a shifting dullness or fluid wave. Tympany that changes location with patient position (shifting dullness) is a classic finding in ascites, indicating the presence of fluid. Choices A, B, and C do not specifically indicate ascites. Bilateral flank tympany (choice A) is associated with bowel sounds, dullness that remains despite position change (choice B) may suggest a solid mass, and dullness centrally when supine (choice C) could be due to other abdominal organ enlargement.