NPTE-PT General Exam — Questions and Answers

Question 1: A patient presents with weakness of shoulder abduction and external rotation following a traumatic injury to the neck. Which nerve root level is most likely affected?

C4
C5 (Correct answer)
C6
C7

Correct answer: C5

C5 innervates the deltoid (shoulder abduction) and infraspinatus/teres minor (external rotation) via the axillary and suprascapular nerves.

Question 2: During gait assessment, a therapist notices the patient's pelvis drops on the left side during right stance phase. Which muscle is most likely weak?

Right hip adductor
Left hip abductor
Right hip abductor (Correct answer)
Left hip adductor

Correct answer: Right hip abductor

A contralateral pelvic drop (Trendelenburg sign) during stance indicates weakness of the stance-side hip abductors (right gluteus medius).

Question 3: A patient recovering from a stroke demonstrates hypertonicity with elbow flexion, wrist flexion, and finger flexion. This pattern is consistent with which synergy?

Upper extremity extensor synergy
Upper extremity flexor synergy (Correct answer)
Lower extremity flexor synergy
Lower extremity extensor synergy

Correct answer: Upper extremity flexor synergy

Elbow, wrist, and finger flexion are hallmarks of the upper extremity flexor synergy pattern seen post-stroke.

Question 4: Which spirometry value is most useful for differentiating obstructive from restrictive pulmonary disease?

FVC
FEV1/FVC ratio (Correct answer)
TLC
RV

Correct answer: FEV1/FVC ratio

The FEV1/FVC ratio is reduced in obstructive disease (airflow limitation) but normal or elevated in restrictive disease.

Question 5: A physical therapist is treating a patient with a stage III pressure injury. Which of the following best describes this wound?

Intact skin with non-blanchable erythema
Partial-thickness skin loss involving the dermis
Full-thickness skin loss with visible subcutaneous tissue (Correct answer)
Full-thickness tissue loss with exposed bone

Correct answer: Full-thickness skin loss with visible subcutaneous tissue

Stage III pressure injuries involve full-thickness skin loss where subcutaneous fat is visible but bone, tendon, and muscle are not exposed.

Question 6: Which special test is used to assess for a torn acetabular labrum of the hip?

Thomas test
FABER test
FADIR test (Correct answer)
Ober test

Correct answer: FADIR test

The FADIR test (Flexion, ADduction, Internal Rotation) is the most sensitive provocative test for acetabular labral tears and hip impingement.

Question 7: A patient is performing a seated leg press exercise. According to the ACSM guidelines for resistance training, what is the recommended rest interval between sets for muscular strength development?

15–30 seconds
30–60 seconds
2–5 minutes (Correct answer)
8–10 minutes

Correct answer: 2–5 minutes

ACSM recommends 2–5 minutes of rest between sets when training for maximal muscular strength to allow adequate phosphocreatine replenishment.

Question 8: A therapist applies moist heat to a patient's lumbar spine. The primary physiological effect that reduces pain and increases tissue extensibility is:

Decreased nerve conduction velocity
Increased local circulation and collagen extensibility (Correct answer)
Vasoconstriction reducing edema
Increased muscle spindle sensitivity

Correct answer: Increased local circulation and collagen extensibility

Heat increases local blood flow, raises tissue temperature, and decreases collagen stiffness, collectively reducing pain and improving extensibility.

Question 9: Which of the following manual therapy grades (Maitland) is most appropriate for treating pain in an acutely inflamed joint?

Grade I (Correct answer)
Grade III
Grade IV
Grade V

Correct answer: Grade I

Grade I oscillations are small-amplitude movements at the beginning of range, appropriate for acute pain management with minimal stress on inflamed tissue.

Question 10: A patient with Parkinson's disease exhibits a festinating gait. Which characteristic best describes this pattern?

Wide base with lateral trunk sway
Steppage gait with high knee flexion
Involuntary acceleration with short shuffling steps (Correct answer)
Unilateral circumduction of the lower extremity

Correct answer: Involuntary acceleration with short shuffling steps

Festination is an involuntary increase in gait speed with progressively shorter shuffling steps, characteristic of Parkinson's disease.

Question 11: During a patient transfer, the therapist should position their feet in which way to maximize stability and reduce injury risk?

Together and parallel
Shoulder-width apart with a wide base of support (Correct answer)
One foot placed behind the other in a narrow stance
On tiptoe to increase height advantage

Correct answer: Shoulder-width apart with a wide base of support

A shoulder-width stance with a wide base of support lowers the center of gravity and maximizes stability during patient transfers.

Question 12: Which of the following is the correct sequence for donning a sterile gown in an isolation room?

Hand hygiene → gloves → gown → mask
Hand hygiene → gown → mask → gloves (Correct answer)
Mask → gown → hand hygiene → gloves
Gown → hand hygiene → mask → gloves

Correct answer: Hand hygiene → gown → mask → gloves

The correct PPE donning sequence is hand hygiene, then gown, then mask/respirator, then gloves (gloves last to avoid contaminating them).

Question 13: A patient presents with a positive Phalen's test and tingling in the thumb, index, and middle fingers. Which condition is most likely?

Cubital tunnel syndrome
Carpal tunnel syndrome (Correct answer)
Guyon's canal syndrome
Thoracic outlet syndrome

Correct answer: Carpal tunnel syndrome

Phalen's test reproduces symptoms of carpal tunnel syndrome by compressing the median nerve at the wrist during sustained wrist flexion.

Question 14: When using crutches, the non-weight-bearing (NWB) three-point gait pattern requires the patient to advance the crutches and affected limb simultaneously, then swing:

Both legs through simultaneously
The uninvolved leg forward to a point even with or past the crutches (Correct answer)
The involved leg first, then the uninvolved
The uninvolved leg first, then bring crutches forward

Correct answer: The uninvolved leg forward to a point even with or past the crutches

In three-point gait for NWB, crutches and affected limb advance together, then the uninvolved leg swings forward to or past the crutch tips.

Question 15: A physical therapist reviews an ECG rhythm strip and notes a heart rate of 150 bpm with no identifiable P waves and an irregular R-R interval. This finding is most consistent with:

Sinus tachycardia
Atrial fibrillation (Correct answer)
Ventricular tachycardia
First-degree AV block

Correct answer: Atrial fibrillation

Atrial fibrillation is characterized by the absence of organized P waves, an irregularly irregular R-R interval, and often a rapid ventricular rate.

Question 16: A patient with T6 complete spinal cord injury is being repositioned from supine to sitting. The therapist observes the patient develop a pounding headache, blurred vision, and profuse sweating above the level of injury. The most appropriate immediate action is:

Lay the patient supine and elevate the legs
Sit the patient upright and identify the noxious stimulus (Correct answer)
Administer oxygen at 6 L/min via nasal cannula
Call for an emergency code team immediately

Correct answer: Sit the patient upright and identify the noxious stimulus

These are signs of autonomic dysreflexia; the first step is to sit the patient upright (to drop blood pressure) and quickly identify and remove the triggering noxious stimulus.

Question 17: Which muscle is the primary restraint to anterior translation of the tibia on the femur?

Posterior cruciate ligament
Anterior cruciate ligament (Correct answer)
Medial collateral ligament
Popliteus

Correct answer: Anterior cruciate ligament

The ACL is the primary restraint to anterior tibial translation, which is why the Lachman and anterior drawer tests assess ACL integrity.

Question 18: A patient presents with insidious onset of cervical pain and numbness radiating into the ring and little fingers with weakness of grip. Which cervical level is most likely involved?

C5
C6
C7
C8 (Correct answer)

Correct answer: C8

C8 radiculopathy produces sensory changes in the ring and little fingers (ulnar two digits) and weakness in hand intrinsics and grip.

Question 19: Which pharmacological class is most commonly associated with increased fall risk in older adults due to orthostatic hypotension?

NSAIDs
Antihypertensives and diuretics (Correct answer)
Proton pump inhibitors
Statins

Correct answer: Antihypertensives and diuretics

Antihypertensives and diuretics reduce blood pressure and can cause orthostatic hypotension, significantly increasing fall risk in the elderly.

Question 20: According to the Guide to Physical Therapist Practice, which term describes the anticipated level of improvement and time to achieve it, documented at the start of an episode of care?

Diagnosis
Prognosis (Correct answer)
Plan of care
Outcomes

Correct answer: Prognosis

The prognosis is the determination of the predicted optimal level of improvement in function and the time needed to reach that level.

Question 21: A therapist performs joint mobilization at the glenohumeral joint. To increase shoulder abduction, which mobilization direction should be applied to the humeral head?

Superior glide
Inferior glide (Correct answer)
Anterior glide
Posterior glide

Correct answer: Inferior glide

According to the concave-convex rule, the convex humeral head glides inferiorly when the humerus is abducted, so inferior mobilization restores this motion.

NPTE-PT General Exam

A patient presents with weakness of shoulder abduction and external rotation following a traumatic injury to the neck.
Which nerve root level is most likely affected?

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