NPTE-PT Professional Responsibilities and Ethics — Questions and Answers

Question 1: A PT discovers that a colleague is billing for services not rendered. What is the MOST appropriate initial action?

Ignore it to avoid conflict
Report directly to the state licensing board
Confront the colleague and report to the supervisor or compliance officer (Correct answer)
Notify the patient immediately

Correct answer: Confront the colleague and report to the supervisor or compliance officer

The PT should first address the concern internally by confronting the colleague and reporting to a supervisor or compliance officer, which follows proper channels before external reporting.

Question 2: Which of the following BEST describes 'abandonment' in physical therapy practice?

Discharging a patient who has met all goals
Terminating care without adequate notice or arranging for continued care (Correct answer)
Declining to treat a patient before initiating care
Referring a patient to another specialist

Correct answer: Terminating care without adequate notice or arranging for continued care

Abandonment occurs when a PT unilaterally terminates an established therapeutic relationship without proper notice or transition of care.

Question 3: Under HIPAA, which scenario represents a permissible disclosure of PHI without patient authorization?

Sharing records with the patient's employer
Disclosing information to a marketing company
Providing records to a treating physician for continuity of care (Correct answer)
Releasing records to the patient's attorney without a subpoena

Correct answer: Providing records to a treating physician for continuity of care

HIPAA permits disclosure of PHI for treatment purposes, including sharing with other treating healthcare providers without explicit authorization.

Question 4: A PT is treating a patient who reveals plans to harm a specific person. The PT's MOST appropriate response is to:

Maintain confidentiality and continue treatment
Warn the intended victim and appropriate authorities (Correct answer)
Immediately discharge the patient
Consult with the patient's insurance company

Correct answer: Warn the intended victim and appropriate authorities

Under the duty to warn (Tarasoff principle), clinicians must take reasonable steps to protect identifiable third parties from serious credible threats.

Question 5: Which ethical principle is MOST directly violated when a PT provides unnecessary treatments to increase billing?

Justice
Autonomy
Nonmaleficence (Correct answer)
Veracity

Correct answer: Nonmaleficence

Providing unnecessary treatments violates nonmaleficence (do no harm) by exposing patients to risk without therapeutic benefit.

Question 6: A PT working in a school setting suspects a student has been physically abused. The FIRST action should be to:

Contact the parents for clarification
Notify child protective services as required by mandatory reporting laws (Correct answer)
Document findings and wait to see if the situation resolves
Consult with the school principal before any action

Correct answer: Notify child protective services as required by mandatory reporting laws

PTs are mandatory reporters in all U.S. states, requiring immediate reporting of suspected child abuse to the appropriate authorities.

Question 7: Which of the following BEST defines 'informed refusal' in physical therapy?

A patient refusing to sign consent forms
A competent patient declining recommended treatment after being informed of risks and benefits (Correct answer)
A PT refusing to treat a patient
A patient refusing to pay for services

Correct answer: A competent patient declining recommended treatment after being informed of risks and benefits

Informed refusal is a competent patient's right to decline treatment after receiving adequate information about the risks, benefits, and alternatives.

Question 8: A PT is asked by a patient to sign a document stating treatment was provided on a date when the patient was not seen. The PT should:

Sign if the patient insists and it avoids conflict
Refuse and explain that falsifying records is fraud (Correct answer)
Amend the existing records to reflect the requested date
Consult with the billing department first

Correct answer: Refuse and explain that falsifying records is fraud

Falsifying medical records constitutes fraud and a violation of professional ethics; the PT must refuse regardless of pressure.

Question 9: The APTA Code of Ethics principle of 'compassion and caring' is MOST closely aligned with which ethical principle?

Justice
Beneficence (Correct answer)
Autonomy
Veracity

Correct answer: Beneficence

Beneficence — acting in the patient's best interest — aligns most closely with compassion and caring as described in the APTA Code of Ethics.

Question 10: A PT in private practice receives a referral bonus from a specialist for each patient sent for imaging. This MOST likely violates:

The PT Practice Act only
The Stark Law and anti-kickback statutes (Correct answer)
HIPAA privacy regulations
Medicare documentation requirements only

Correct answer: The Stark Law and anti-kickback statutes

Receiving financial incentives for referrals violates the federal Anti-Kickback Statute and potentially Stark Law, which prohibit such arrangements.

Question 11: Which of the following BEST represents an example of a dual relationship that a PT should avoid?

Treating a patient referred by a colleague
Providing PT services to a close friend or family member as a primary therapist (Correct answer)
Consulting with a physician about a patient's progress
Treating patients of different insurance types

Correct answer: Providing PT services to a close friend or family member as a primary therapist

Dual relationships — such as treating close friends or family — compromise professional objectivity and create ethical conflicts of interest.

Question 12: When a PT disagrees with a physician's order that appears clinically inappropriate, the BEST course of action is to:

Follow the order without question to avoid conflict
Refuse the order and document the refusal
Contact the physician to discuss clinical concerns before proceeding (Correct answer)
Immediately report the physician to the licensing board

Correct answer: Contact the physician to discuss clinical concerns before proceeding

Professional responsibility requires the PT to communicate concerns directly with the physician before taking further action, respecting collaborative care.

Question 13: Under the APTA Standards of Practice, supervision of a PTA by a PT requires that the PT:

Be physically present in the same room at all times
Be available for consultation and conduct regular supervision per state law (Correct answer)
Cosign every treatment note written by the PTA
Review and revise the PTA's plan of care independently

Correct answer: Be available for consultation and conduct regular supervision per state law

PT supervision of PTAs requires availability for consultation and regular supervisory contact, with specific requirements varying by state law.

Question 14: A patient requests that their PT not document a specific treatment technique in the record. The PT should:

Honor the request to maintain therapeutic rapport
Omit the documentation to avoid upsetting the patient
Explain that accurate documentation is required and cannot be omitted (Correct answer)
Ask the patient to sign a waiver before omitting the entry

Correct answer: Explain that accurate documentation is required and cannot be omitted

Complete and accurate documentation is both a legal requirement and an ethical obligation; omitting clinical information at a patient's request is not permissible.

Question 15: A PT notices signs of elder abuse in a patient receiving home health services. According to professional standards, the PT MUST:

Discuss findings with the family before reporting
Report suspicions to adult protective services as a mandatory reporter (Correct answer)
Document observations and wait for the patient to disclose
Consult the referring physician before any action

Correct answer: Report suspicions to adult protective services as a mandatory reporter

PTs are mandatory reporters of suspected elder abuse and must report to adult protective services regardless of family cooperation.

Question 16: Which of the following BEST describes 'clinical competence' as an ethical obligation for PTs?

Passing the NPTE once and maintaining licensure
Continuously updating knowledge and skills to provide current, evidence-based care (Correct answer)
Treating only conditions covered by one's employer
Limiting practice to conditions treated during internships

Correct answer: Continuously updating knowledge and skills to provide current, evidence-based care

Ethical competence requires ongoing professional development and lifelong learning to maintain current evidence-based practice.

Question 17: A PT treating a patient for low back pain discovers the patient is using opioids prescribed by another provider without disclosing this. The MOST appropriate action is to:

Stop treatment immediately and report the patient
Incorporate this information into the treatment plan and communicate with the prescribing provider (Correct answer)
Ignore the information as it is outside the PT's scope
Notify the patient's employer

Correct answer: Incorporate this information into the treatment plan and communicate with the prescribing provider

Knowledge of opioid use is clinically relevant and must be integrated into care planning with appropriate interprofessional communication.

Question 18: The ethical principle of 'justice' in physical therapy practice is BEST exemplified by:

Providing the same treatment to every patient regardless of need
Ensuring equitable access to services regardless of ability to pay or demographic factors (Correct answer)
Charging the same fee for all services
Treating all diagnoses with identical protocols

Correct answer: Ensuring equitable access to services regardless of ability to pay or demographic factors

Justice requires fair and equitable distribution of resources and services, ensuring access regardless of socioeconomic or demographic factors.

Question 19: A PT is approached by a pharmaceutical company offering compensation to use their product exclusively with patients. This arrangement MOST directly raises concerns about:

Scope of practice violations
Conflict of interest and undue industry influence (Correct answer)
HIPAA violations
Supervision requirements

Correct answer: Conflict of interest and undue industry influence

Financial arrangements with industry that influence clinical decisions create conflicts of interest that compromise patient-centered care.

Question 20: When providing care in a state where a PT is not licensed, the PT is:

Permitted if the treatment is temporary emergency care only
Potentially in violation of the state practice act and subject to disciplinary action (Correct answer)
Covered under their home state license via reciprocity
Permitted if supervised by a licensed provider in that state

Correct answer: Potentially in violation of the state practice act and subject to disciplinary action

Providing PT services without licensure in that state violates state practice acts, except for very specific emergency or compact-covered situations.

Question 21: A PT student observes their clinical instructor performing a technique that appears to cause unnecessary patient discomfort. The student's BEST action is to:

Remain silent to avoid jeopardizing the clinical placement
Immediately file a complaint with the state board
Discuss observations with the clinical instructor or program coordinator (Correct answer)
Refuse to participate in future similar treatments

Correct answer: Discuss observations with the clinical instructor or program coordinator

Students should address clinical concerns through appropriate professional channels, starting with the clinical instructor or academic program coordinator.

NPTE-PT Professional Responsibilities and Ethics

A PT discovers that a colleague is billing for services not rendered.
What is the MOST appropriate initial action?

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