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A person presents to physical therapy for evaluation after sustaining a mild stroke of the right middle cerebral artery. Their spouse is present for the session and insists that they must sign all paperwork because they are the health care agent. The physical therapist checks the medical record and does not see any paperwork on file for a completed power of attorney for health care or an incapacitation form? What is the best action to take this visit?

A physical therapist in a hospital is scheduled to treat a 70-year-old male that was admitted for COPD exacerbation and placed on 4 L/min of oxygen. At evaluation yesterday afternoon, the patient was alert and oriented, could follow directions, and required contact guard assistance during mobility within the room. This morning, the patient has been assigned a 1:1 patient sitter and bed/chair alarms applied for safety due to progressive disorientation, agitation, and hallucinations that developed overnight. The nurse notes that the patient was started on antibiotics this morning for suspected pneumonia. What is the most likely cause of the patient’s change in cognitive status?

A physical therapist in a hospital is scheduled to treat a 70-year-old male that was admitted for COPD exacerbation and placed on 4 L/min of oxygen. At evaluation yesterday afternoon, the patient was alert and oriented, could follow directions, and required contact guard assistance during mobility within the room. This morning, the patient has been assigned a 1:1 patient sitter and bed/chair alarms applied for safety due to progressive disorientation, agitation, and hallucinations that developed overnight. The nurse notes that the patient was started on antibiotics this morning for suspected pneumonia. What is the most likely cause of the patient’s change in cognitive status?

A patient was referred to physical therapy due to recent changes in gait and falls. Based on the history and examination, the physical therapist suspects that the patient may have normal pressure hydrocephalus. What is the characteristic triad of symptoms that is associated with this condition?

A physical therapist is working with a patient with dementia at an assisted living facility who has been having increased falls and has become much more sedentary. The patient no longer wants to go to the dining room for meals or go to group exercise class with the activity director because they don’t like to exercise. The therapist learns that the patient used to enjoy gardening and likes to work on puzzles. There are lots of potted plants around the facility (both indoors and outdoors) and there are puzzles available in the common area of the facility. Describe how you could incorporate Montessori-based programming into an intervention to improve the patient’s willingness to work on walking endurance, balance, and/or general activity tolerance. (I.e., Choose a “PT” task and add in a motivating activity based on Montessori principles). 

A physical therapist performs the St. Louis University Mental Status Examination (SLUMS) with a person that only completed schooling through the 8th grade. Which of the following scores indicates that this person has dementia?

A physical therapist establishes a plan of care that focuses on exercises to improve range of motion and strength. Their treatment notes over the past 3 sessions indicate that the same exercises have been completed each time, but with small increases in repetitions from one session to the next. Documentation also indicates that the patient is independently performing a home program consisting of those exercises at home daily. Which type of care does this scenario best describe?

A patient with Parkinson’s disease has Medicare B insurance and is seeking physical therapy services at an outpatient physical therapy clinic. What is the expected coverage (in percent) that insurance will cover for each visit?

A physical therapist evaluates a patient with 76-year-old patient with Alzheimer’s disease. Pertinent Subjective Information: The patient is able to state their name correctly but not their birthdate and they correctly state the name of their spouse The patient is able to speak and provides answers to the therapist’s questions, but their responses are not accurate The patient’s spouse reports that their memory is very limited and they are demonstrating increased agitation and some outbursts of profanity. The spouse also notes they need to help the patient with bathing, dressing, and toileting, and the patient is having increased episodes of incontinence. Objective Information: BIMS score 2/15 MoCA score 4/30 Transfer ability: Sit to stand transfers and bed mobility completed with supervision Gait: Patient ambulates with a front-wheeled walker with stand-by assistance for safety due to some impulsivity and mild unsteadiness. Based on this information, which stage of dementia based on the Global Disability Scale and/or Functional Assessment Staging Tool?

A patient is referred to physical therapy following a myocardial infarction. They also have a history of a cerebrovascular accident on the right with mild hemiplegia. Family notes that the patient had some memory changes after their stroke but that the loss was fairly stable and they could still manage their own medications and finances. Since this recent myocardial infarction, they have had significant decline in their memory and are now needing help with all IADLs. This presentation is MOST consistent with which type of dementia?