National Physical Therapy Examination (NPTE-PT) — Questions and Answers

Question 1: FEV1/FVC ratio below 0.70 is indicative of which type of pulmonary dysfunction?

Obstructive lung disease (Correct answer)
Restrictive lung disease
Normal lung function
Mixed ventilatory defect

Correct answer: Obstructive lung disease

An FEV1/FVC ratio <0.70 confirms airflow obstruction, as seen in COPD and asthma, where expiration is disproportionately impaired.

Question 2: At approximately what age do typical children achieve independent walking?

6–8 months
9–10 months
18–24 months
12–15 months (Correct answer)

Correct answer: 12–15 months

Most children begin walking independently between 12 and 15 months, with a normal range of approximately 9–18 months.

Question 3: Osteokinematics refers to which type of movement?

Movement of one joint surface on another
Muscle fiber recruitment pattern
Gross angular movement of a bone segment (Correct answer)
Nerve conduction along a limb

Correct answer: Gross angular movement of a bone segment

Osteokinematics describes the gross angular motion of a bone, such as flexion, extension, abduction, and rotation, as observed externally.

Question 4: A physical therapist is treating a patient with multiple sclerosis using the Frenkel exercises. What are these exercises designed to address?

Upper extremity strengthening
Spasticity management
Respiratory muscle weakness
Ataxia and coordination deficits (Correct answer)

Correct answer: Ataxia and coordination deficits

Frenkel exercises use slow, controlled, progressive movements to improve coordination and proprioception in patients with ataxia.

Question 5: The slump test is used to assess neural tension in the spine and lower extremities. Which position maximally sensitizes this test?

Cervical flexion, thoracic flexion, knee extension, and ankle dorsiflexion (Correct answer)
Lumbar extension, hip external rotation, and ankle plantarflexion
Cervical neutral, thoracic extension, and hip flexion
Cervical extension with thoracic flexion and hip flexion

Correct answer: Cervical flexion, thoracic flexion, knee extension, and ankle dorsiflexion

The slump test is maximally sensitized by cervical and thoracic flexion (to tension the dura), combined with knee extension and ankle dorsiflexion (to tension the sciatic nerve).

Question 6: Which manual muscle testing grade indicates the patient can move through full ROM against gravity but cannot tolerate any additional resistance?

Grade 2
Grade 4
Grade 5
Grade 3 (Correct answer)

Correct answer: Grade 3

Grade 3 (Fair) indicates the muscle can move the limb through full ROM against gravity only, with no additional external resistance tolerated.

Question 7: Which sign, elicited by stroking the plantar surface of the foot, indicates upper motor neuron lesion?

Hoffmann sign
Clonus
Tinel sign
Babinski sign (Correct answer)

Correct answer: Babinski sign

A positive Babinski sign (great toe extension with fanning of other toes) indicates an upper motor neuron lesion in adults.

Question 8: The anterior talofibular ligament (ATFL) is most taut and most commonly injured in which ankle position?

Plantar flexion and inversion (Correct answer)
Dorsiflexion and eversion
Neutral and eversion
Full dorsiflexion and neutral rotation

Correct answer: Plantar flexion and inversion

The ATFL is most taut in plantar flexion and is the primary restraint against inversion in this position, making it the most commonly injured ligament in lateral ankle sprains.

Question 9: A clinical test has a sensitivity of 90%. This means:

90% of people without the disease will test negative
90% of people who have the disease will test positive (Correct answer)
90% of people who test positive actually have the disease
90% of people who test negative actually have the disease

Correct answer: 90% of people who have the disease will test positive

Sensitivity is the true positive rate — the proportion of people with the condition who correctly test positive; high sensitivity means few false negatives.

Question 10: Which bedside test is used to screen for benign paroxysmal positional vertigo (BPPV) affecting the posterior semicircular canal?

Dynamic visual acuity test
Head impulse test (HIT)
Dix-Hallpike test (Correct answer)
Romberg test

Correct answer: Dix-Hallpike test

The Dix-Hallpike test is the gold standard for diagnosing posterior canal BPPV. A positive result shows geotropic torsional nystagmus with a latency of seconds and fatigability, reproduced by the provoking head position.

Question 11: A patient with a complete C5 spinal cord injury would be expected to have preserved function of which muscle?

Triceps brachii
Wrist extensors
Biceps brachii and deltoid (Correct answer)
Finger flexors

Correct answer: Biceps brachii and deltoid

C5 innervates the biceps brachii and deltoid, so these muscles are preserved in a complete C5 SCI while C6 and below functions are absent.

Question 12: Task-specific training in neurorehabilitation is based on which motor learning principle?

Mental practice is superior to physical practice
Random practice degrades learning
Blocked practice maximizes retention
Skills are best learned by practicing the specific task to be relearned (Correct answer)

Correct answer: Skills are best learned by practicing the specific task to be relearned

Task-specific training applies the specificity of practice principle: motor skills are optimally relearned through repetitive practice of the actual functional task.

Question 13: Duchenne muscular dystrophy (DMD) is caused by a mutation in which gene?

FMR1 gene
CFTR gene
SOD1 gene
Dystrophin gene (Correct answer)

Correct answer: Dystrophin gene

DMD results from mutations in the dystrophin gene on the X chromosome, leading to absent dystrophin protein and progressive muscle degeneration.

Question 14: A patient presents with weakness in wrist extension, finger extension, and thumb extension following a humeral shaft fracture. The nerve most likely damaged is:

Axillary nerve
Radial nerve (posterior interosseous branch) (Correct answer)
Ulnar nerve
Median nerve

Correct answer: Radial nerve (posterior interosseous branch)

Radial nerve palsy (at the mid-humerus) produces weakness of wrist, finger, and thumb extension (posterior interosseous nerve distribution), with wrist drop being the classic presentation.

Question 15: The International Classification of Functioning (ICF) framework in pediatric PT emphasizes:

Participation, activity, and body structure/function in context (Correct answer)
Medical model focused on impairment alone
Pharmacological management
Diagnosis-based treatment protocols only

Correct answer: Participation, activity, and body structure/function in context

The ICF model addresses body functions/structures, activities, participation, and contextual factors, promoting a holistic child-and-family-centered approach.

Question 16: Spasticity is best defined as:

Weakness due to upper motor neuron lesion
Loss of sensation in a limb
Velocity-dependent increase in tonic stretch reflex (Correct answer)
Involuntary writhing movements

Correct answer: Velocity-dependent increase in tonic stretch reflex

Spasticity is a velocity-dependent increase in the tonic stretch reflex (muscle tone) resulting from upper motor neuron lesions.

Question 17: The Alberta Infant Motor Scale (AIMS) is used to assess:

School-age children's athletic performance
Gross motor maturation from birth to independent walking (Correct answer)
Fine motor and hand function
Cognitive development milestones

Correct answer: Gross motor maturation from birth to independent walking

The AIMS is an observational scale assessing gross motor development from birth to 18 months, evaluating weight-bearing, posture, and antigravity movement.

Question 18: Ober test assesses tightness of which structure?

Lateral knee collateral ligament
Piriformis muscle
Hamstring muscle group
Iliotibial band and tensor fasciae latae (Correct answer)

Correct answer: Iliotibial band and tensor fasciae latae

Ober test assesses iliotibial band (ITB) and tensor fasciae latae (TFL) flexibility by testing whether the hip can adduct from a side-lying position with the knee flexed.

Question 19: Which movement assessment tool screens for fundamental movement pattern asymmetry and dysfunction in athletes?

Y Balance Test
Berg Balance Scale
Functional Movement Screen (FMS) (Correct answer)
SEBT

Correct answer: Functional Movement Screen (FMS)

The Functional Movement Screen (FMS) scores 7 fundamental movement patterns on a 0–3 scale to identify asymmetry and dysfunction that may predispose to injury.

Question 20: Which principle guides pediatric physical therapy intervention to maximize motor learning in young children?

Massed practice of isolated muscle exercises
Rote repetition of therapist-directed drills only
Passive stretching as the primary modality
Play-based, task-oriented, and child-motivated activities (Correct answer)

Correct answer: Play-based, task-oriented, and child-motivated activities

Children learn motor skills best through play-based, meaningful, and self-motivated task practice, applying principles of neuroplasticity and motor learning.

Question 21: A patient presents with shoulder pain reproduced by the Hawkins-Kennedy test. This test most specifically assesses for:

Acromioclavicular joint sprain
Subacromial impingement (supraspinatus or subacromial bursa compression) (Correct answer)
Bicipital tendinopathy
Posterior glenohumeral instability

Correct answer: Subacromial impingement (supraspinatus or subacromial bursa compression)

The Hawkins-Kennedy test (shoulder flexion to 90 degrees plus internal rotation) compresses the supraspinatus and subacromial bursa under the coracoacromial arch, reproducing impingement pain.

Question 22: Return to sport after ACL reconstruction is typically guided by which criteria-based milestone?

Full passive range of motion restoration
Time alone (6 months)
Pain-free walking only
Limb symmetry index ≥90% on strength and hop tests plus psychological readiness (Correct answer)

Correct answer: Limb symmetry index ≥90% on strength and hop tests plus psychological readiness

Criteria-based ACL return to sport requires ≥90% limb symmetry on quadriceps strength and functional hop tests, plus psychological readiness assessment.

Question 23: Gowers' sign, seen in children with DMD, describes:

Waddling gait pattern
Inability to raise arms above shoulder height
Using hands to 'walk up' the legs when rising from the floor (Correct answer)
Calf pseudohypertrophy

Correct answer: Using hands to 'walk up' the legs when rising from the floor

Gowers' sign is the characteristic maneuver where a child pushes off their own legs with their hands to stand, compensating for weak hip and knee extensors.

Question 24: Which gait deviation is most commonly associated with weak hip abductors?

Steppage gait
Antalgic gait
Trendelenburg gait (Correct answer)
Scissor gait

Correct answer: Trendelenburg gait

Weakness of the hip abductors (gluteus medius) causes a Trendelenburg gait, where the pelvis drops on the contralateral side during single-leg stance.

Question 25: Iontophoresis using dexamethasone (negative pole/cathode) is most commonly used to treat which condition?

Chronic venous insufficiency
Open wounds for antimicrobial effect
Inflammatory conditions such as lateral epicondylitis, plantar fasciitis, and bursitis (Correct answer)
Muscle spasm via motor nerve stimulation

Correct answer: Inflammatory conditions such as lateral epicondylitis, plantar fasciitis, and bursitis

Dexamethasone is negatively charged and is repelled by the cathode (negative pole), driving the anti-inflammatory medication into superficial inflammatory conditions like tendinopathies and bursitis.

Question 26: The Timed Up and Go (TUG) test measures:

Grip strength
Functional mobility and fall risk (Correct answer)
Aerobic capacity
Upper extremity coordination only

Correct answer: Functional mobility and fall risk

The TUG test times a patient rising from a chair, walking 3 meters, turning, returning, and sitting, providing a measure of functional mobility and fall risk.

Question 27: The MRC (Medical Research Council) Dyspnea Scale grades breathlessness on a scale of:

6–20
0–4 or 1–5 (modified) (Correct answer)
1–5
0–10

Correct answer: 0–4 or 1–5 (modified)

The MRC Dyspnea Scale uses grades 0–4 (original) or 1–5 (modified) to classify breathlessness from none to breathlessness while dressing.

Question 28: Which medication class used in COPD management causes bronchodilation by blocking muscarinic receptors?

Phosphodiesterase inhibitors
Inhaled corticosteroids
Beta-2 agonists
Long-acting anticholinergics (LAMA) (Correct answer)

Correct answer: Long-acting anticholinergics (LAMA)

Long-acting muscarinic antagonists (LAMA) such as tiotropium block M3 receptors in bronchial smooth muscle, reducing bronchoconstriction and secretion.

Question 29: The 6-Minute Walk Test (6MWT) is used to assess:

Cardiac output at rest
Pulmonary function volumes
Submaximal functional exercise capacity (Correct answer)
Maximum aerobic capacity (VO2 max)

Correct answer: Submaximal functional exercise capacity

The 6MWT measures the distance walked in 6 minutes, reflecting submaximal functional aerobic capacity relevant to daily activities.

Question 30: Diaphragmatic breathing exercises are prescribed primarily to:

Improve efficiency of ventilation by maximizing diaphragm use (Correct answer)
Increase expiratory reserve volume
Decrease functional residual capacity
Strengthen accessory neck muscles

Correct answer: Improve efficiency of ventilation by maximizing diaphragm use

Diaphragmatic breathing reduces the use of accessory muscles, improves ventilatory efficiency, and reduces the work of breathing.

Question 31: Which parameter of NMES most directly determines the depth of muscle recruitment?

Frequency (pulse rate)
Waveform shape
Intensity (amplitude) (Correct answer)
Pulse duration (pulse width)

Correct answer: Intensity (amplitude)

Intensity (amplitude) most directly determines the depth and breadth of motor unit recruitment. Increasing amplitude depolarizes more deeply located motor nerve fibers, recruiting deeper motor units.

National Physical Therapy Examination (NPTE-PT)

The NPTE-PT is the national licensing exam for physical therapists in the United States, administered by FSBPT. It tests clinical knowledge and decision-making across body systems and non-systems domains required for entry-level PT practice.

Questions

35 min

Time Limit

75%

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