Pathology, Contraindications, Areas of Caution, Special Populations practice questions

Answer: B) Crusted, oozing impetigo sores on the face and arms

Contagious skin infections such as impetigo mean postponing the whole session. Non-contagious conditions such as psoriasis, eczema, and seborrheic keratoses are local cautions that the therapist works around.

• AIncorrect. Psoriasis is not contagious. The plaques are a local caution: avoid irritating them and massage elsewhere.
• BCorrect. Impetigo is a contagious bacterial skin infection that spreads through contact with fluid from the sores, so the session should be postponed until it has been treated and has resolved.
• CIncorrect. Eczema is not contagious. Avoid the affected areas, especially if the skin is broken, and check the client's tolerance of the lubricant.
• DIncorrect. Seborrheic keratoses are benign, non-contagious growths. Work around them gently to avoid irritation.

Answer: D) Gentle work around the neck, avoiding deep pressure

• AIncorrect. That aggravates it.
• BIncorrect. That aggravates acute injury.
• CIncorrect. They can worsen injury.
• DCorrect. Inflammation is present.

Answer: D) Avoided

• AIncorrect. Avoid the area.
• BIncorrect. Avoid the area.
• CIncorrect. Avoid the area.
• DCorrect. Pressure can worsen tissue damage.

Answer: A) Reduced sensation

• ACorrect. Use moderate pressure and check in often.
• BIncorrect. Sensation is often reduced.
• CIncorrect. Sensation may be reduced.
• DIncorrect. Sensation may be reduced.

Answer: C) Deep abdominal work

• AIncorrect. That's generally fine.
• BIncorrect. That's generally fine.
• CCorrect. Avoid pressure on the hernia.
• DIncorrect. Draping is still used.

Answer: B) Avoid the incision and nearby tissue, and work other areas until it heals and she is cleared

A recent surgical incision is a local contraindication. Work elsewhere, and save direct or scar work for after the tissue has healed and the client has medical clearance.

• AIncorrect. Scar mobilization is only appropriate after the tissue has fully healed and the client has medical clearance. Friction on a fresh incision can disrupt healing and raise the risk of infection.
• BCorrect. A recent incision is a local contraindication. The therapist can address the back while staying off the surgical site until it has healed and the surgeon or physician approves.
• CIncorrect. Heat over or near a healing wound can increase inflammation and irritate fragile tissue. The area should be avoided, not treated.
• DIncorrect. A lack of pain does not mean the tissue has healed. Deep work over a recent surgical site risks tissue damage, and after surgery it raises concern about dislodging a clot.

Answer: B) Use lighter, shorter sessions and avoid inflamed areas

• AIncorrect. That can worsen a flare.
• BCorrect. Flares cause pain and fatigue.
• CIncorrect. That can aggravate inflammation.
• DIncorrect. Adapt to it.

Answer: A) Help the client on and off the table and allow extra time for position changes

Parkinson's disease causes tremor, stiffness, slow movement and poor balance. The therapist should help with getting on and off the table and allow extra time, not use forceful or vigorous techniques.

• ACorrect. Parkinson's causes stiffness, slow movement and poor balance and coordination. Helping with transfers and not rushing position changes lowers the risk of a fall.
• BIncorrect. Parkinson's tremor comes from the nervous system, and vigorous percussion won't stop it. A calm, steady pace suits these clients better.
• CIncorrect. Rigidity from Parkinson's doesn't go away with forceful stretching. Pushing past end range risks injury, so movement should stay gentle and within the client's comfort.
• DIncorrect. Poor balance and slow movement make getting up alone a fall risk. Respecting the client's autonomy still means offering help with getting off the table.

Answer: A) Have the client sit on the edge of the table for a moment before standing up slowly

Clients prone to low blood pressure should get up slowly in stages, sitting first and then standing, to prevent orthostatic dizziness. Offering water also helps, since extra fluids are recommended.

• ACorrect. Blood pressure can drop when a person moves from lying to standing. Rising in stages and getting up slowly gives circulation time to adjust.
• BIncorrect. Standing up quickly from lying down is the change in position that sets off orthostatic hypotension and can cause dizziness or fainting.
• CIncorrect. Going straight from lying to standing skips the sitting stage. That is exactly the sudden change in position that should be avoided.
• DIncorrect. Stimulating strokes at the end of a session do not replace a gradual transition. Standing right away still risks a drop in blood pressure.

Answer: A) Follow the surgeon's positioning and movement precautions

• ACorrect. Avoid dislocation-risk positions.
• BIncorrect. That can dislocate the joint.
• CIncorrect. Avoid the incision early.
• DIncorrect. Follow the precautions.