Question 1
Question
Which of the following definitions best fits pulsatile current (PC)?
Answer
-
It is the continuous biphasic interrupted flow of charged particles ceasing for at least 1 second, which may result in a net charge
-
It is biphasic or monophasic interrupted flow of charged particles ceasing for at least 1 second, which may result in a net charge
-
It is biphasic or monophasic uninterrupted flow of charged particles ceasing for at least 1 second, resulting in a net charge
-
It is the continuous monophasic interrupted flow of charged particles ceasing for at least 1 second, resulting in no net charge
Question 2
Question
You are adjusting the electrical stimulation unit on a patient and she reports that what she is feeling is a thumping sensation but you wanted it to feel smooth and tingling. Which parameter would you need to adjust to make the sensation feel more like a tingling sensation?
Answer
-
The pulse duration
-
The intensity
-
The polarity
-
The frequency
Question 3
Question
Which of the following would represent the greatest potential advantage of a self-adhering
electrode over a carbon impregnated electrode?
Question 4
Question
What can you do to improve the electrode interface to enhance conduction?
Answer
-
Use sandpaper to rough up the patient’s skin
-
Clean the patient’s skin with a lotion-based cleanser
-
Moisten the electrodes with water
-
Replace the electrodes for each application
Question 5
Question
Which of the following would not be part of the process that takes place prior to the
application of various forms of therapeutic electrical stimulation to a patient to maintain patient
safety?
Answer
-
Inspection of the lead wires
-
Inspection of the electrodes
-
Inspection of the power cord
-
Confirm possession of electrical tape
Question 6
Question
Which of the following electrode configurations would be most appropriate for the
accomplishment of a motor response in a specific superficial muscle?
Answer
-
Quadripolar with two bifurcated channels crossing the muscle
-
Monopolar with an active and dispersive electrode that is more than twice the size of the active electrode
-
Monopolar with a dispersive and active electrode that is more than twice the size of the dispersive electrode
-
Bipolar with one electrode over the motor point of the muscle
Question 7
Question
A patient whom you are treating with electrical stimulation has reported that he is
intermittently feeling the sensation from the unit. Which of the following explanations would
most likely be the cause for this if the unit had been set to function continuously without any off
time?
Answer
-
One of the electrodes might have dried out and need to be re-hydrated
-
One of the lead wires might have become disconnected and need to be re-connected
-
One of the electrodes might have become detached from the lead wire and needs to be reconnected
-
One of the lead wires might have a break in its continuity and needs to be replaced
Question 8
Question
Which of the following parameters on an electrical stimulator would be considered essential if
your treatment goal was muscle strengthening?
Answer
-
Frequency
-
Pulse duration
-
Intensity
-
On/off times
Question 9
Question
Which of the following features or parameters on a neuromuscular electrical stimulation
(NMES) unit would be most helpful in differentiating between your ability to use it for range of
motion (ROM), facilitation of muscle function, management of muscle guarding, edema
reduction, or orthotic substitution?
Answer
-
Portability
-
Potential output intensity
-
Flexibility within pulse duration settings
-
Flexibility within on/off time settings
Question 10
Question
Which of the following features or parameters on an NMES unit would differentiate it from
others and make it possible for use with both denervated and fully innervated patients for muscle
reeducation and orthotic substitution?
Answer
-
Potential output intensity
-
Flexibility within pulse duration settings up to continuous
-
Flexibility within on-off time settings
-
A polarity setting that is adjustable
Question 11
Question
While you are working with a patient for the facilitation of muscle function, she complains of
a prickling sensation under the electrode on her vastus medialis oblicus (VMO). Which of the
following is the most likely cause for this type of complaint and appropriate remedy?
Answer
-
She’s fatigued and needs to rest before resuming the activity
-
She’s feeling the effects of the electrode drying out and it needs to be rehydrated to reduce the impedance
-
She’s faking it. If she feels something you wouldn’t be using NMES to facilitate a muscle contraction.
-
The intensity needs to be higher. What she is reporting is the first sensation just before the appropriate level is perceived by the patient.
Question 12
Question
One of the “temps” who is filling in for a clinician who is out on maternity leave has set up a
patient who has been receiving electrical stimulation to assist in the reduction of edema in her
lower leg. You overhear the “temp” instructing the patient what should be felt during the
treatment. Which of the following would be incorrect for this treatment goal?
Answer
-
Let me know when you start to feel something. I’ve supported your leg so that it is elevated above your heart, which is how you should rest it whenever possible.
-
Once you have started to feel something, I will be increasing the intensity a little higher so that we can start to see a muscle contraction. Work with that. It will only be on for a couple of seconds, but it will help pump some of the fluid back out of the area.
-
Let me know when you start to feel something. Once you have started to feel something, I will be decreasing the intensity a little so that it’s not so strong. I’ve supported your leg so that it is elevated above your heart, which is how you should rest it whenever possible.
-
This should feel comfortable, but I also need to see a contraction of the muscle. It will be off and on, and I would like you to work with it.
Question 13
Question
Which of the following forms of electrical stimulation has been used effectively for tissue
repair with human tissues?
Answer
-
Neuromuscular electrical stimulation (NMES)
-
Interferential current therapy (IFC)
-
High volt pulsed current (HVPC)
-
Transcutaneous electrical nerve stimulation (TENS)
Question 14
Question
What is meant by the term “current of injury”?
Answer
-
Injured tissue produces an electrical current that is different from the surrounding current potentials
-
Tissues become injured when electrical stimulation is applied and produce a current of injury that can be measured
-
Matching the action potential of the current of injured tissues can balance and heal that tissue
-
Using the opposite action potential of the current of injury for an injured area will promote tissue healing
Question 15
Question
What is the rationale behind promoting mobility during the various stages of wound healing?
Answer
-
There is none; the tissue will not heal unless it is immobilized
-
Alignment of the collagen fibers will be based upon function if mobility is permitted during the remodeling phase
-
Tissue repair will be enhanced as a result of constant re-injury and repair that will be caused by motions taking place throughout the injured area
-
Angiogenesis will not occur unless motion accompanies healing
Question 16
Question
What would be the appropriate application of electrical stimulation to promote autolytic
débridement for tissue repair?
Answer
-
Placement of the negative electrode over the wound to attract the positively charged neutrophils and macrophages to promote autolysis
-
Placement of the negative electrode over the wound to attract the negatively charged neutrophils and macrophages to promote autolysis
-
Placement of the positive electrode over the wound to attract the positively charged neutrophils and macrophages to promote autolysis
-
Placement of the positive electrode over the wound to attract the negatively charged neutrophils and macrophages to promote autolysis
Question 17
Question
Which of the following techniques is most accurate regarding the application of HVPC for
wound healing?
Answer
-
Use a periwound technique with electrodes placed adjacent to the wound bed on intact skin
-
Use a direct technique with electrodes placed adjacent to the wound bed on intact skin
-
Use a periwound technique with the active electrode placed on the wound bed, with dispersive electrode located 15 to 20 cm distant to the wound
-
Use a direct technique with the active electrode placed on the wound bed, with dispersive electrode located 15 to 20 cm distant to the wound
Question 18
Question
What is the difference between pain management and pain relief?
Answer
-
There is no difference
-
Pain management is what medications do and pain relief is what occurs through the use of physical therapy
-
Both pain relief and pain management can be accomplished with physical agents but one is managed by the patient with a portable device
-
Pain management is temporary and pain relief is constant
Question 19
Question
What would the rationale be for using a clinical versus portable option for pain management
with electrical stimulation?
Answer
-
Clinical electrical stimulation can be used in combination with manual techniques so that the patient feels no discomfort during therapy
-
Clinical electrical stimulation units are battery operated and offer more power output potential than portable units for sustained benefit
-
Clinical electrical stimulation units are more expensive than portable units, which means that the reimbursement from insurance carriers would be higher for the same service billed to the patient
-
Portable electrical stimulators are the most convenient form of electrical stimulation for use in the clinic and would save clinicians money because they would not need to purchase clinical models
Question 20
Question
Electrode placement site selection guidelines for pain management involve the selection of
which of the following considerations?
Answer
-
Sites that exhibit an increased resistance to the flow of electrical current
-
Acupuncture points in the area surrounding the treatment area and referral area of pain
-
Motor points in the treatment area so that a strong muscle contraction can easily be generated in the painful region
-
Trigger points in the treatment area
Question 21
Question
Which of the following parameters would not be important to document for the use of
electrical stimulation to promote analgesia?
Answer
-
The name of the electrical stimulator
-
The location of the electrodes and general setup
-
The treatment goal and amount of time for the application
-
The patient’s pre- and post-treatment pain ratings
Question 22
Question
Which of the following descriptions of the application of electrical stimulation most accurately
represents IFC?
Answer
-
Two channels from one stimulator are crossed over the treatment area and the intensity is adjusted to the patient’s tolerance
-
Two channels from separate generators within one stimulator that produces high frequencies in the thousands are crossed over the treatment area and the intensity is adjusted to the patient’s tolerance
-
Two channels from a TENS unit are crossed over the treatment area and the intensity is adjusted to the patient’s tolerance
-
Two channels from one stimulator are crossed over the treatment area and the intensity is adjusted to just above the patient’s tolerance
Question 23
Question
What is the main advantage of IFC over other forms of electrical stimulation?
Answer
-
There is no advantage to IFC
-
IFC is billable at a higher rate than other forms of electrical stimulation
-
IFC is purported to have a greater depth of penetration than other forms of electrical stimulation
-
IFC is less comfortable than other forms of electrical stimulation
Question 24
Question
Which of the following treatment goals is inappropriate for IFC due to the crossing of the
channels of electrodes that is required?
Question 25
Question
The importance of appropriate electrode placement sites has been discussed in several
different chapters. Since IFC relies on the crossing of current pathways within the tissue, which
of the following statements is most accurate regarding the type of electrode placement sites that
should be considered?
Answer
-
Where the electrodes are placed is irrelevant as long as the channels are crossed over the tissue
-
As long as areas that have decreased skin resistance are used as electrode placement sites and the channels are crossed, that’s all that matters
-
The electrode placement sites must be motor points for the IFC to be effective
-
Each channel must be placed over segmentally related electrode placement sites for the stimulation to be effective
Question 26
Question
What does “premodulation” mean when the term is listed on an electrical stimulation unit that
is capable of producing IFC?
Answer
-
It means that one channel can be used but there will be no greater depth of the current
-
It means that two channels are still needed but they do not need to be crossed
-
It means that the stimulator is an IFC device and nothing more
-
It means that Wedensky Inhibition can be caused with the selection of a pre-modulated channel