National Physical Therapy Examination – Physical Therapist Assistant (NPTE-PTA) — Questions and Answers

Question 1: A PTA applies moist heat to reduce muscle spasm. What is the primary physiological effect?

Vasoconstriction and edema reduction
Decreased nerve conduction velocity
Decreased metabolic activity
Increased collagen extensibility and local vasodilation (Correct answer)

Correct answer: Increased collagen extensibility and local vasodilation

Superficial heat application causes local vasodilation and increases collagen extensibility, which reduces muscle spasm and promotes relaxation.

Question 2: A patient has been prescribed forearm crutches. At what height should the forearm cuff be positioned?

1–1.5 inches below the elbow (Correct answer)
2–3 inches above the elbow
At the level of the wrist
At mid-forearm

Correct answer: 1–1.5 inches below the elbow

The forearm cuff of a Lofstrand crutch should be positioned approximately 1–1.5 inches below the elbow to allow free elbow movement while providing secure support.

Question 3: Which frequency would be appropriate for an ultrasound on the achilles tendon for tendonitis?

3MHz because the injury is superficial (Correct answer)
3MHz because the injury is not superficial
1MHz because the injury is superficial
1MHz because the injury is not superficial

Correct answer: 3MHz because the injury is superficial

For deep injuries with therapeutic ultrasounds, a frequency of 1MHz is employed, and for superficial injuries, a frequency of 3MHz. The optimal frequency is 3MHz due to the superficial nature of the achilles tendon.

Question 4: What does an SpO2 reading of 88% in a patient with COPD indicate?

Mild hypoxemia requiring monitoring
Normal oxygen saturation for COPD
Significant hypoxemia that may require supplemental oxygen (Correct answer)
The patient is hyperoxic

Correct answer: Significant hypoxemia that may require supplemental oxygen

An SpO2 of 88% represents significant hypoxemia; supplemental oxygen is generally indicated when SpO2 falls below 88–90% in COPD patients.

Question 5: Which parameter determines the frequency of ultrasound and affects depth of penetration?

Treatment duration (minutes)
Duty cycle (%)
Intensity (W/cm²)
Frequency (MHz) (Correct answer)

Correct answer: Frequency (MHz)

Ultrasound at 1 MHz penetrates deeper (up to 5 cm) and is used for deep tissues, while 3 MHz penetrates more superficially (1–2 cm) due to higher absorption.

Question 6: A patient presents with a positive Lachman test. Which structure is most likely injured?

Anterior cruciate ligament (Correct answer)
Posterior cruciate ligament
Lateral meniscus
Medial collateral ligament

Correct answer: Anterior cruciate ligament

The Lachman test assesses anterior cruciate ligament (ACL) integrity by applying an anterior force to the tibia with the knee at 20–30° of flexion.

Question 7: The therapist goes over typical locations for pressure ulcers while teaching the patient's family about their loved one's spinal cord damage. Which locations should the therapist mention as some of the most vulnerable to pressure sores?

Sacrum, elbows, heels, and forearms
sacrum, coccyx, thighs, plantar aspect of feet
Sacrum, hips, back of cranium, and heels (Correct answer)
Sacrum, coccyx, elbows, and toes

Correct answer: Sacrum, hips, back of cranium, and heels

Bony prominences such as the sacrum, coccyx, hips, heels, scapula, malleoli, elbows, ears, and the back of the skull are among the most prevalent sites for pressure ulcers.

Question 8: What is the primary goal of PNF diagonal patterns in upper extremity rehabilitation?

Isolate individual muscle groups for strengthening
Reduce spasticity through slow, sustained stretching
Facilitate joint mechanoreceptor firing
Improve functional movement through spiral and diagonal mass movement patterns (Correct answer)

Correct answer: Improve functional movement through spiral and diagonal mass movement patterns

PNF diagonal patterns (D1 and D2) use spiral and diagonal movement planes that mimic functional activities and recruit multiple muscle groups simultaneously.

Question 9: When using mechanical lumbar traction, the minimum force required to produce vertebral separation in a typical adult patient is approximately:

25-50% of body weight (Correct answer)
10-15% of body weight
Equal to full body weight
60-75% of body weight

Correct answer: 25-50% of body weight

Approximately 25-50% of body weight is required to overcome friction and produce actual vertebral separation during mechanical lumbar traction.

Question 10: Glenohumeral mobilization is being performed by a therapist to enhance internal rotation. The ideal configuration for using this manual technique is:

Patient in prone, arm at side, anterior glide
Patient in supine, arm at 90 degrees of abduction, posterior glide
Patient in sidelying, arm at 45 degrees abduction, inferior glide.
Patient in supine, arm at 45 degrees abduction, posterior glide (Correct answer)

Correct answer: Patient in supine, arm at 45 degrees abduction, posterior glide

A patient lying on their back with their arm abducted at a 45-degree angle is in the open pack position of the glenohumeral joint. There is a posterior glide used to enhance internal rotation.

Question 11: A patient with C5 ASIA A tetraplegia is being trained in functional activities. Which task is WITHIN the expected functional capacity for this level?

Independent transfers using a sliding board
Independent manual wheelchair propulsion on level surfaces
Feeding using mobile arm supports (Correct answer)
Independent pressure relief by leaning forward

Correct answer: Feeding using mobile arm supports

C5 ASIA A patients retain shoulder flexion and elbow flexion (biceps), allowing feeding with adaptive equipment such as mobile arm supports.

Question 12: During functional task training, which activity is the most appropriate initial task for a patient beginning sit-to-stand practice?

Standing from a standard-height chair using armrests (Correct answer)
Standing from a bed at a 30° incline
Standing from the floor
Standing from a low chair with no armrests

Correct answer: Standing from a standard-height chair using armrests

Starting from a standard-height chair with armrests reduces the demand on hip and knee extensors, making sit-to-stand more achievable early in rehabilitation.

Question 13: A patient is receiving NMES (Neuromuscular Electrical Stimulation) for quadriceps re-education post-ACL repair. The on:off ratio should be set to:

1:5 to allow adequate muscle recovery between contractions (Correct answer)
1:1 for maximum endurance training
3:1 for rapid fatigue training
2:2 for equal work-rest balance

Correct answer: 1:5 to allow adequate muscle recovery between contractions

An on:off ratio of 1:5 (e.g., 10 seconds on, 50 seconds off) allows sufficient recovery time to minimize muscle fatigue during NMES strengthening sessions.

Question 14: A patient with a hip fracture has been placed on 'hip precautions.' Which motion should be avoided following a posterior approach total hip replacement?

Hip flexion beyond 90° (Correct answer)
Hip external rotation beyond 30°
Hip extension
Hip abduction

Correct answer: Hip flexion beyond 90°

After a posterior approach total hip replacement, hip flexion beyond 90° combined with internal rotation and adduction risks posterior dislocation.

Question 15: What is the primary role of the physical therapist assistant during prosthetic training for a patient with a transtibial amputation?

Determine the appropriate prosthetic foot type
Fabricate and adjust the prosthetic socket
Perform the initial prosthetic evaluation and prescription
Implement the gait training program established by the supervising PT (Correct answer)

Correct answer: Implement the gait training program established by the supervising PT

The PTA implements the prosthetic training and gait program as established and supervised by the physical therapist, working within the POC established by the PT.

Question 16: Which type of stroke deficit results in contralateral hemiplegia and ipsilateral facial weakness?

Posterior cerebral artery stroke
Anterior cerebral artery stroke
Lateral medullary (Wallenberg) syndrome (Correct answer)
Middle cerebral artery stroke

Correct answer: Lateral medullary (Wallenberg) syndrome

Lateral medullary (Wallenberg) syndrome causes ipsilateral facial numbness, contralateral body sensory loss, and ipsilateral ataxia due to posterior inferior cerebellar artery infarction.

Question 17: A PTA is treating a patient who underwent split-thickness skin grafting 3 days ago. Which activity must be STRICTLY avoided at the graft site?

Shear forces and mechanical disruption of the graft (Correct answer)
Elevation of the grafted extremity
Gentle visual inspection and assessment
Compression garment application

Correct answer: Shear forces and mechanical disruption of the graft

Shear forces and mechanical disruption in the first 3–5 days post-grafting can dislodge the graft before vascular inosculation (blood supply ingrowth) is established, causing graft failure.

Question 18: A patient performing ADL training is unable to reach overhead due to limited shoulder ROM. Which adaptive strategy is most appropriate?

Perform tasks bilaterally with the unaffected arm only
Use a reacher/grabber device to extend functional reach (Correct answer)
Force full ROM during all tasks to restore normal movement
Avoid all overhead activities permanently

Correct answer: Use a reacher/grabber device to extend functional reach

A reacher/grabber extends the patient's functional reach without requiring full shoulder ROM, promoting independence in ADLs while joint mobility is being restored.

Question 19: A patient has been prescribed a straight cane following a right total hip arthroplasty (posterior approach). In which hand should the cane be held?

Either hand based on patient comfort
Right hand, ipsilateral to surgical side
No cane is needed after THR with posterior approach
Left hand, contralateral to surgical side (Correct answer)

Correct answer: Left hand, contralateral to surgical side

The cane is held in the contralateral (left) hand so the cane and operated leg advance together, reducing hip joint reaction force on the surgical side.

Question 20: Which of the following correctly describes the 'two-point' gait pattern with crutches?

Left crutch and right leg advance together, then right crutch and left leg advance together (Correct answer)
Both crutches advance, then both feet follow
One crutch advances, then the opposite foot, alternating separately
Right crutch advances, then left crutch advances, then right leg, then left leg

Correct answer: Left crutch and right leg advance together, then right crutch and left leg advance together

The two-point gait pattern involves simultaneous advancement of the contralateral crutch and leg (e.g., left crutch with right foot), mimicking normal arm-leg reciprocal movement.

Question 21: A patient is ambulating with Lofstrand (forearm) crutches. Elbow flexion during stance should be approximately:

15-30 degrees (Correct answer)
45-60 degrees
0-5 degrees
70-90 degrees

Correct answer: 15-30 degrees

Elbow flexion of 15-30 degrees during stance with forearm crutches allows optimal weight transfer and shock absorption through the upper extremity.

Question 22: Immediately following exercise, these modifications are typically seen:

Decreased systolic and slightly increased diastolic blood pressures
Increased systolic and slightly decreased diastolic blood pressures (Correct answer)
Decrease in systolic and diastolic blood pressures
Rise in systolic and diastolic blood pressures

Correct answer: Increased systolic and slightly decreased diastolic blood pressures

Due to the vasodilation of arteries during activity, it is common to observe an increase in systolic blood pressure and a little fall in systolic blood pressure after exercise.

Question 23: A patient is performing a standing balance exercise on a foam pad with eyes closed. This activity primarily challenges the:

Motor cortex proprioception alone
Cerebellar fine motor coordination
Visual system only
Vestibular system and somatosensory integration (Correct answer)

Correct answer: Vestibular system and somatosensory integration

Eyes closed on an unstable surface removes both visual and somatosensory cues, forcing the vestibular system to take primary responsibility for balance.

Question 24: Which vertebral level corresponds to the C5 dermatome?

Ring and little finger
Lateral arm and shoulder region (Correct answer)
Thumb and index finger
Middle finger

Correct answer: Lateral arm and shoulder region

The C5 dermatome covers the lateral aspect of the arm and the deltoid shoulder region.

Question 25: When measuring the girth of the lower extremity for compression stocking fitting, the PTA should measure the calf at which location?

5 cm below the tibial tuberosity
At the midpoint between knee and ankle
At the point of maximum circumference (Correct answer)
2 cm above the medial malleolus

Correct answer: At the point of maximum circumference

Calf girth for compression stocking fitting is measured at the point of maximum circumference to ensure proper fit.

Question 26: Following the insertion of a colostomy bag, the following exercises might be recommended for a patient during the first week of outpatient therapy:

High planks
Transverse abdominal holds in supine (Correct answer)
Sit ups
Quadruped alternating arm and leg lifts

Correct answer: Transverse abdominal holds in supine

The best exercise for this patient at this point of recovery is supine transverse abdominal holds. The other options are all advanced workouts that would be too demanding for a patient starting their recovery from abdominal surgery.

Question 27: A patient with a right hip replacement is using a cane. In which hand should the cane be held?

No cane is needed after hip replacement
Either hand — it makes no difference
Left hand (contralateral to the affected hip) (Correct answer)
Right hand (ipsilateral to the affected hip)

Correct answer: Left hand (contralateral to the affected hip)

The cane is held in the contralateral (left) hand so it advances with the affected right leg, reducing the load on the hip abductors and the involved joint.

Question 28: A patient demonstrates 'vaulting' during gait. Which compensatory strategy does this describe?

Hiking the pelvis to shorten the functional length of the swing limb
Leaning the trunk toward the weak side
Circumducting the swinging limb in a semicircle
Rising on the toes of the stance limb to clear the contralateral swinging limb (Correct answer)

Correct answer: Rising on the toes of the stance limb to clear the contralateral swinging limb

Vaulting involves exaggerated plantarflexion (rising on tiptoe) of the stance limb to elevate the pelvis and allow a prosthetic or long limb to clear the ground during swing.

Question 29: Which muscle is the primary stabilizer of the glenohumeral joint inferiorly?

Teres minor
Supraspinatus (Correct answer)
Subscapularis
Infraspinatus

Correct answer: Supraspinatus

The supraspinatus is the primary stabilizer against inferior subluxation of the glenohumeral joint due to its superior cuff position and tension.

Question 30: The best technique to help a patient in sub-acute rehabilitation who has had a posterior total hip arthroplasty with mild dementia observe hip precautions is:

Print handouts for the patient on hip precautions.
Print handouts for caregivers and patients as well as verbalizing precautions multiple times throughout the session. (Correct answer)
Have the patient verbalize hip precautions at beginning and end of each session.
Have the patient demonstrate movements to avoid to reinforce memory.

Correct answer: Print handouts for caregivers and patients as well as verbalizing precautions multiple times throughout the session.

The patient and the caregivers receive reinforcement from the response in a number of different ways. It is improper to ask the patient to display hip precautions because you do not want the patient to make movements that violate precaution.

Question 31: A patient is referred for TENS following knee surgery. Which TENS parameter setting is MOST appropriate for acute postoperative pain control?

Low frequency (2-4 Hz), high intensity
Burst mode at 1 Hz
High frequency (80-150 Hz), sensory intensity (Correct answer)
High frequency (80-150 Hz), motor intensity

Correct answer: High frequency (80-150 Hz), sensory intensity

Conventional TENS uses high frequency (80-150 Hz) at sensory (non-painful) intensity and is the first choice for acute postoperative pain.

Question 32: A PTA assesses a diabetic foot ulcer and measures an ankle-brachial index (ABI) of 0.45. This finding MOST likely indicates:

Normal arterial circulation
Primary venous insufficiency
Severe peripheral arterial disease (Correct answer)
Mild peripheral arterial disease

Correct answer: Severe peripheral arterial disease

An ABI below 0.5 indicates severe peripheral arterial disease, which significantly impairs wound healing and is generally a contraindication to full compression therapy.

Question 33: When documenting a patient's progress note using SOAP format, the 'A' (Assessment) section should contain:

The treatment interventions performed during the session
The patient's reported pain level and symptoms
Objective measurements such as ROM and strength grades
The clinician's clinical judgment about progress toward goals (Correct answer)

Correct answer: The clinician's clinical judgment about progress toward goals

The Assessment section contains the clinician's professional judgment about the patient's progress, response to treatment, and likelihood of achieving stated goals.

Question 34: Which manual muscle testing grade indicates movement against gravity with full range of motion but no additional resistance?

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

Correct answer: Grade 3

Grade 3 (Fair) denotes the ability to complete full range of motion against gravity without any added resistance.

Question 35: A patient presents with a venous stasis ulcer on the medial lower leg. ABI is measured at 0.85. The MOST appropriate primary intervention is:

Elevation without any compression
Multilayer compression bandaging (Correct answer)
Unna boot alone without additional compression
Surgical debridement only

Correct answer: Multilayer compression bandaging

Venous stasis ulcers require compression to reduce venous hypertension; an ABI ≥ 0.8 indicates adequate arterial perfusion to safely tolerate full multilayer compression therapy.

Question 36: During gait training, a patient with a right transtibial amputation demonstrates excessive lateral trunk bending to the right during stance. Which prosthetic cause is MOST likely?

Prosthesis is too short (Correct answer)
Prosthetic foot set in too much plantar flexion
Prosthesis is too long
Prosthetic socket is too loose

Correct answer: Prosthesis is too short

A prosthesis that is too short causes the patient to lean toward the prosthetic side (lateral trunk bending) during stance to compensate for leg length discrepancy.

Question 37: What is the normal cadence for adult ambulation?

80–120 steps/minute (Correct answer)
160–180 steps/minute
50–70 steps/minute
130–150 steps/minute

Correct answer: 80–120 steps/minute

Normal adult cadence is approximately 100–120 steps per minute, equating to 50–60 complete gait cycles (stride cycles) per minute.

Question 38: A patient with a complete T10 spinal cord injury retains which function?

Trunk muscle control above the umbilicus (Correct answer)
Voluntary ankle plantarflexion
Voluntary bladder control
Full lower extremity motor function

Correct answer: Trunk muscle control above the umbilicus

A T10 complete SCI preserves motor and sensory function above T10, including upper trunk musculature and sensation above the umbilicus.

Question 39: A PTA is treating a 70-year-old patient with osteoporosis. Which exercise type has the GREATEST evidence for improving bone mineral density?

Progressive resistance and weight-bearing impact exercise (Correct answer)
Swimming three times per week
Aquatic therapy in a warm pool
Low-intensity stationary cycling

Correct answer: Progressive resistance and weight-bearing impact exercise

Progressive resistance training combined with weight-bearing impact activities (such as walking or low-impact aerobics) provides the mechanical loading stimulus needed to increase bone mineral density.

Question 40: A PTA is applying cryotherapy using an ice bag to a patient's acutely sprained ankle. The PTA should place a barrier between the ice and skin primarily to:

Prevent frostbite and ice burn to superficial tissue (Correct answer)
Ensure even distribution of cold over the joint
Maintain the therapeutic temperature for a longer duration
Increase the depth of cold penetration

Correct answer: Prevent frostbite and ice burn to superficial tissue

A moist towel barrier between the ice bag and skin prevents frostbite and ice burn, which can occur with direct ice contact on skin.

Question 41: Which breath sound is associated with fluid in the alveoli and small airways and sounds like crackling or popping?

Rhonchi
Wheezing
Crackles (rales) (Correct answer)
Pleural friction rub

Correct answer: Crackles (rales)

Crackles (rales) are discontinuous, bubbling sounds caused by fluid in the alveoli and small airways, commonly heard in pulmonary edema and pneumonia.

Question 42: During the ACUTE phase of burn rehabilitation, a PTA's HIGHEST priority intervention to prevent contracture is:

Scar massage with emollient cream
Custom pressure garment fitting
Progressive resistive strengthening exercises
Anti-deformity positioning and splinting (Correct answer)

Correct answer: Anti-deformity positioning and splinting

Anti-deformity positioning and splinting is the priority in the acute phase because wounds are not yet healed; it prevents contracture development before scar maturation interventions are appropriate.

Question 43: A patient with Guillain-Barré syndrome is in the acute phase. What is the primary PTA priority?

High-intensity aerobic conditioning
Aggressive gait training
Monitoring for respiratory compromise and positioning to prevent complications (Correct answer)
Progressive resistive strengthening

Correct answer: Monitoring for respiratory compromise and positioning to prevent complications

During the acute ascending phase of GBS, respiratory monitoring is critical as ascending paralysis can compromise breathing; positioning prevents pressure injuries and contractures.

Question 44: A patient with cerebellar ataxia will most likely demonstrate which of the following?

Flaccidity and hyporeflexia
Resting tremor and cogwheel rigidity
Intention tremor and dysdiadochokinesia (Correct answer)
Spasticity and hyperreflexia

Correct answer: Intention tremor and dysdiadochokinesia

Cerebellar lesions produce intention tremor (worsening with purposeful movement), dysdiadochokinesia (inability to perform rapid alternating movements), and ataxic gait.

Question 45: Which type of electrical stimulation has the MOST research evidence supporting its use for wound healing promotion?

Interferential current (IFC)
Neuromuscular electrical stimulation (NMES)
High-voltage pulsed current (HVPC) (Correct answer)
Conventional transcutaneous electrical nerve stimulation (TENS)

Correct answer: High-voltage pulsed current (HVPC)

High-voltage pulsed current (HVPC) has the strongest evidence base for wound healing, demonstrating improvements in tissue perfusion, antimicrobial effects, and granulation tissue formation.

Question 46: A PTA applies a heating agent and notices the patient's skin turns bright red and blistered. What is the most appropriate immediate action?

Continue treatment and note the reaction
Remove the modality, cool the area, and document the adverse event (Correct answer)
Reduce the temperature setting and continue
Apply additional padding and continue for the remainder of the session

Correct answer: Remove the modality, cool the area, and document the adverse event

Blistering indicates a thermal burn; the modality must be removed immediately, the area cooled with room-temperature water, and the adverse event documented and reported.

Question 47: Which ultrasound application technique is required when treating bony or irregular surface areas?

Stationary technique
Water immersion technique (Correct answer)
Moving transducer technique
Air-coupling technique

Correct answer: Water immersion technique

Water immersion ultrasound is used for irregular surfaces (hands, feet, ankles) because water provides a coupling medium and allows the transducer to maintain contact without direct pressure on bony prominences.

Question 48: A patient with a Stage II pressure injury over the right ischial tuberosity is being treated. The PTA should recommend which seating surface modification?

Positioning wedge to increase hip flexion past 90 degrees
Donut-shaped ring cushion to offload the area
Standard foam cushion to maintain positioning
Air-cell cushion to distribute pressure evenly (Correct answer)

Correct answer: Air-cell cushion to distribute pressure evenly

An air-cell or alternating pressure cushion distributes pressure evenly and reduces peak pressure at bony prominences, which is preferred for Stage II injuries.

Question 49: A patient with COPD is receiving pulmonary rehabilitation. The PTA should STOP exercise and notify the supervising PT if the patient's SpO2 drops below what threshold?

88% (Correct answer)
95%
92%
85%

Correct answer: 88%

Exercise should be stopped and the supervising PT notified if SpO2 drops below 88% in a COPD patient, indicating significant oxygen desaturation.

Question 50: The therapist finds an unusual-looking mole on a patient while conducting an ultrasound on them. The criteria for deciding if a mole needs to be examined by a doctor include:

Asymmetry, irregular borders, non-uniform color, diameter larger than 6mm, and evolving size, shape, or color. (Correct answer)
Abnormal size, irregular border, non-uniform color, diameter larger than 6mm, and evolving size, shape, or color
Asymmetry, black in color, coarse, diameter larger than 6mm, and evolving size, shape, or color
Asymmetry, bigger than baseline, non-uniform in color, diameter larger than 6mm, and evolving size, shape, or color

Correct answer: Asymmetry, irregular borders, non-uniform color, diameter larger than 6mm, and evolving size, shape, or color.

Asymmetrical shape, uneven borders, non-uniform color, diameter greater than 6 mm, and changing size, shape, or color are the ABCDEs of moles that are cancer-risk factors.

Question 51: Iontophoresis uses which principle to drive medication through the skin?

High-frequency alternating current
Ultrasonic cavitation
Magnetic resonance
Direct electrical current repelling similarly charged ions (Correct answer)

Correct answer: Direct electrical current repelling similarly charged ions

Iontophoresis uses direct current to drive ionized medication through the skin; like charges repel, so a negatively charged drug is driven from the negative electrode into tissue.

Question 52: The therapist should start from the following while doing lymphatic drainage techniques:

Anterior to posterior
Posterior to anterior
Proximal to distal (Correct answer)
Distal to proximal

Correct answer: Proximal to distal

Proximal to distal lymphatic drainage procedures are used to re-route fluid away from obstructed locations and toward regions that can drain more easily.

Question 53: Using the Rule of Nines, what percentage of total body surface area (TBSA) does one entire upper extremity represent in an adult?

13.5%
4.5%
9% (Correct answer)
18%

Correct answer: 9%

In the adult Rule of Nines, each upper extremity (including the arm, forearm, and hand) represents 9% of TBSA, making both upper extremities together 18%.

Question 54: What is the recommended position for performing low back mobilization to target the L4–L5 segment?

Seated with forward flexion
Side-lying with trunk rotation (Correct answer)
Prone with lumbar extension
Supine with knees to chest

Correct answer: Side-lying with trunk rotation

Side-lying positioning with controlled trunk rotation allows the PTA to target the L4–L5 facet joints effectively with rotational mobilization.

Question 55: A patient with breast cancer-related lymphedema presents with pitting edema of the upper extremity that resolves significantly with overnight elevation. According to the International Society of Lymphology, this is classified as:

Stage I – reversible lymphedema (Correct answer)
Stage III – lymphostatic elephantiasis
Stage II – spontaneously irreversible lymphedema
Stage 0 – subclinical/latent lymphedema

Correct answer: Stage I – reversible lymphedema

Stage I lymphedema is characterized by pitting edema that reduces substantially with elevation, distinguishing it from Stage II where fibrotic tissue changes make elevation less effective.

Question 56: A patient demonstrates a Trendelenburg sign during gait. Which muscle is most likely weak?

Gluteus maximus
Gluteus medius (Correct answer)
Iliotibial band
Tensor fasciae latae

Correct answer: Gluteus medius

A positive Trendelenburg sign (contralateral pelvic drop during single-leg stance) indicates weakness of the hip abductors, primarily the gluteus medius.

Question 57: Which electrical stimulation mode is designed to reduce muscle spasm through reciprocal inhibition?

Alternating agonist-antagonist stimulation (Correct answer)
High-frequency sensory-level TENS
Continuous mode at motor level
Surge (surging) mode at low frequency

Correct answer: Alternating agonist-antagonist stimulation

Alternating stimulation of the agonist and antagonist muscles produces reciprocal inhibition, where contraction of one muscle inhibits the spastic opposing muscle.

Question 58: Which of the following is the best assistive equipment for a patient who was once very active but now has mild hemiplegia as a result of a right hemisphere CVA? The patient has MMT 4+/5 in both the upper and lower extremities on the unaffected side.

Single point cane used in the right hand
Hemi walker used in the right hand (Correct answer)
Rolling walker with platform on the left side.
Hem walker used in the left hand

Correct answer: Hemi walker used in the right hand

A hemi walker is the greatest option because of the patient's prior degree of function and generally good strength on the unaffected side. Hemi walkers ought to be used with caution. Deficits on the left side of the brain will come from CVAs on the right side of the brain.

Question 59: What is the primary reason a PTA uses a coupling medium (gel) with therapeutic ultrasound?

To absorb excess ultrasound energy
To increase the temperature of the transducer head
To eliminate the air interface between the transducer and skin, preventing reflection (Correct answer)
To conduct electrical current to the tissue

Correct answer: To eliminate the air interface between the transducer and skin, preventing reflection

Ultrasound waves reflect off air; coupling gel eliminates the air gap between the transducer and skin, ensuring maximal energy transmission into the tissue.

Question 60: Which type of skin graft uses donor skin harvested from a deceased human donor (cadaveric skin)?

Xenograft (heterograft)
Allograft (homograft) (Correct answer)
Integra dermal matrix
Autograft

Correct answer: Allograft (homograft)

An allograft (homograft) uses cadaveric human skin as a temporary biological dressing; it provides wound coverage until autografting with the patient's own skin can be performed.

Question 61: What transfer technique is safest for a dependent patient moving from bed to wheelchair?

Mechanical (hoyer) lift transfer (Correct answer)
Pivot transfer without a gait belt
Two-person lift transfer
Stand-pivot with a gait belt, one-person assist

Correct answer: Mechanical (hoyer) lift transfer

A mechanical (Hoyer) lift is the safest technique for dependent patients who cannot assist in transfers, protecting both the patient and the clinician from injury.

Question 62: A patient presents with a burn wound that is blistered, moist, red, and extremely painful to touch. This burn MOST accurately represents:

Superficial partial-thickness (second-degree) burn (Correct answer)
Full-thickness (third-degree) burn
Superficial (first-degree) burn
Deep partial-thickness (second-degree) burn

Correct answer: Superficial partial-thickness (second-degree) burn

Superficial partial-thickness burns involve the epidermis and superficial dermis, presenting with blistering, a moist red wound bed, and intense pain because nerve endings remain intact.

Question 63: In a patient with foot drop following a common peroneal nerve injury, which orthosis is most appropriate?

Ankle-foot orthosis (AFO) with dorsiflexion assist (Correct answer)
Knee-ankle-foot orthosis (KAFO)
Patellar tendon-bearing orthosis
Supramalleolar orthosis (SMO)

Correct answer: Ankle-foot orthosis (AFO) with dorsiflexion assist

An AFO with a dorsiflexion assist spring mechanism compensates for weak or absent dorsiflexors, preventing toe drag during the swing phase of gait.

Question 64: During normal gait, when does the center of mass reach its lowest point?

During loading response (foot flat) (Correct answer)
At initial contact (heel strike)
During midstance
At terminal stance (heel rise)

Correct answer: During loading response (foot flat)

The center of mass reaches its lowest point during double support (loading response) and its highest point during midstance, producing an inverted pendulum pattern.

Question 65: Which phase of wound healing is primarily characterized by fibroblast proliferation and collagen synthesis?

Maturation and remodeling phase
Inflammatory phase
Hemostasis phase
Proliferative phase (Correct answer)

Correct answer: Proliferative phase

The proliferative phase (approximately days 4–21) is defined by fibroblast migration and activity, collagen synthesis, angiogenesis, and the formation of granulation tissue.

Question 66: What is the primary benefit of diaphragmatic breathing training in patients with COPD?

Increases respiratory rate to improve ventilation
Decreases use of accessory muscles and improves diaphragmatic efficiency (Correct answer)
Strengthens accessory muscles to compensate for diaphragm weakness
Reduces mucus production

Correct answer: Decreases use of accessory muscles and improves diaphragmatic efficiency

Diaphragmatic breathing retraining reduces reliance on inefficient accessory muscles and promotes more effective use of the diaphragm, improving ventilation efficiency in COPD.

Question 67: Which Borg Rating of Perceived Exertion (RPE) scale value corresponds to 'somewhat hard' exertion?

11
13 (Correct answer)
9
17

Correct answer: 13

On the original 6–20 Borg RPE scale, a rating of 13 corresponds to 'somewhat hard,' which is a moderate exercise intensity target.

Question 68: Which gait deviation is most commonly caused by weak ankle dorsiflexors (drop foot)?

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

Correct answer: Steppage gait

Steppage gait is characterized by exaggerated hip and knee flexion during swing to lift the foot and clear the toes when dorsiflexors are weak or paralyzed.

Question 69: Which breathing exercise technique is most appropriate for a patient with COPD to reduce air trapping and dyspnea?

Pursed-lip breathing (Correct answer)
Diaphragmatic breathing only
Incentive spirometry
Forced expiratory technique

Correct answer: Pursed-lip breathing

Pursed-lip breathing creates back-pressure during exhalation that helps keep airways open longer, reducing air trapping and improving gas exchange in COPD.

Question 70: What is the primary purpose of the push-off phase (terminal stance to pre-swing) in the gait cycle?

Forward propulsion of the body (Correct answer)
Shock absorption and weight acceptance
Hip extension and trunk stabilization
Lateral weight transfer

Correct answer: Forward propulsion of the body

The push-off phase generates forward propulsion via ankle plantarflexion, providing the energy needed to advance the limb into swing and propel the body forward.

Question 71: During the swing phase of gait, which muscle group is PRIMARILY responsible for foot clearance?

Plantar flexors
Hip extensors
Ankle dorsiflexors (Correct answer)
Hip adductors

Correct answer: Ankle dorsiflexors

Ankle dorsiflexors (primarily tibialis anterior) contract during swing phase to lift the foot and ensure clearance of the ground.

Question 72: What is the primary physiological effect of cryotherapy in the first 24–48 hours post-injury?

Increased nerve conduction velocity
Increased blood flow and collagen synthesis
Increased tissue extensibility
Vasoconstriction, reduced metabolism, and decreased edema formation (Correct answer)

Correct answer: Vasoconstriction, reduced metabolism, and decreased edema formation

Cryotherapy causes vasoconstriction, slows cellular metabolism, and reduces the release of inflammatory mediators, limiting secondary tissue damage in the acute phase.

Question 73: Which cranial nerve palsy causes an inability to abduct the eye (lateral gaze palsy)?

CN VII
CN III
CN IV
CN VI (Correct answer)

Correct answer: CN VI

Cranial nerve VI (abducens) controls the lateral rectus muscle; palsy causes inability to abduct the eye on the affected side.

Question 74: During stair training with axillary crutches in a non-weight-bearing patient descending stairs, which sequence is correct?

Crutches down first, then affected leg, then unaffected leg
Crutches and affected leg down first, then unaffected leg (Correct answer)
Unaffected leg down first, then crutches and affected leg
Both legs down simultaneously, then crutches

Correct answer: Crutches and affected leg down first, then unaffected leg

Descending stairs: crutches and the affected (non-weight-bearing) leg go down first, then the unaffected leg follows; 'bad goes down' in the mnemonic.

Question 75: What is the Timed Up and Go (TUG) test cutoff score associated with increased fall risk in community-dwelling older adults?

5 seconds
12 seconds (Correct answer)
20 seconds
10 seconds

Correct answer: 12 seconds

A TUG score greater than 12 seconds in community-dwelling older adults is associated with increased fall risk and mobility impairment.

Question 76: Which gait deviation is commonly seen in a patient with weak hip extensors (gluteus maximus)?

Contralateral pelvic drop
Increased hip flexion during swing
Anterior trunk lean during stance
Backward trunk lean at initial contact (Correct answer)

Correct answer: Backward trunk lean at initial contact

Weak gluteus maximus causes the trunk to lean backward over the hip at initial contact to move the ground reaction force anterior to the hip, providing an external extension moment.

Question 77: A PTA inspects a wound and notes all of the following. Which finding is a sign of HEALTHY wound progression rather than infection?

Increased perilesional warmth and erythema
Purulent exudate with foul odor
Pink-red granulation tissue filling the wound bed (Correct answer)
Increasing pain at the wound site

Correct answer: Pink-red granulation tissue filling the wound bed

Pink-red granulation tissue indicates active angiogenesis and new connective tissue formation, which are hallmarks of the proliferative healing phase, not infection.

Question 78: For a patient with right hemiplegia performing wheelchair propulsion, which technique is most efficient?

Using only the unaffected arm and leg to propel and steer
Using a power wheelchair exclusively
Using both arms equally on the hand rims
Using the unaffected arm on the hand rim and the unaffected leg to assist propulsion and steer (Correct answer)

Correct answer: Using the unaffected arm on the hand rim and the unaffected leg to assist propulsion and steer

Hemiplegic patients most efficiently propel a wheelchair using the unaffected arm on the hand rim combined with the unaffected foot on the floor for steering and added propulsion.

Question 79: A patient with congestive heart failure is placed in which position to reduce preload and ease breathing?

Supine flat
Prone
Trendelenburg
High Fowler's (upright sitting) (Correct answer)

Correct answer: High Fowler's (upright sitting)

High Fowler's position (sitting upright at 60–90°) reduces venous return to the heart (preload), decreasing pulmonary congestion and improving breathing ease in CHF.

Question 80: The Thomas test is used to assess tightness of which muscle group?

Hip flexors (Correct answer)
Ankle plantar flexors
Hamstrings
Hip abductors

Correct answer: Hip flexors

The Thomas test assesses hip flexor tightness, particularly the iliopsoas and rectus femoris, by observing if the opposite leg rises off the table when the hip is brought to full flexion.

Question 81: Which method of wound debridement is considered the MOST selective, removing only necrotic tissue while preserving viable tissue?

Sharp or surgical debridement
Autolytic debridement (Correct answer)
Pulsed lavage debridement
Wet-to-dry mechanical debridement

Correct answer: Autolytic debridement

Autolytic debridement uses the body's own phagocytic cells and proteolytic enzymes under a moisture-retentive dressing to selectively liquefy necrotic tissue without harming healthy tissue.

Question 82: Which technique is used to mobilize secretions from the peripheral airways toward the larger airways?

Pursed-lip breathing
Incentive spirometry
Diaphragmatic strengthening
Active Cycle of Breathing Technique (ACBT) (Correct answer)

Correct answer: Active Cycle of Breathing Technique (ACBT)

The Active Cycle of Breathing Technique combines breathing control, thoracic expansion exercises, and the forced expiration technique to clear peripheral airway secretions.

Question 83: Which wound characteristic represents a PRIMARY contraindication to pulsed lavage wound irrigation?

Wound with healthy granulation tissue present
Heavily contaminated traumatic wound with debris
Exposed vasculature or tendons without protective paratenon (Correct answer)
Large wound with undermining or tunneling

Correct answer: Exposed vasculature or tendons without protective paratenon

Exposed vasculature or tendons without the protective paratenon are primary contraindications to pulsed lavage because pressurized irrigation can cause mechanical damage to these delicate structures.

Question 84: Which vital sign parameter should prompt a PTA to stop exercise in a patient with hypertension?

Diastolic BP rises above 110 mmHg during exercise (Correct answer)
Systolic BP rises to 150 mmHg
Heart rate reaches 120 bpm
SpO2 is 96%

Correct answer: Diastolic BP rises above 110 mmHg during exercise

Exercise should be stopped if diastolic BP exceeds 110 mmHg, as this indicates excessive cardiovascular stress and a risk for adverse events.

Question 85: What is the therapeutic depth of penetration for a hot pack (hydrocollator)?

0–0.5 cm (superficial skin only)
5–7 cm (joint capsule)
1–2 cm (superficial tissues) (Correct answer)
3–5 cm (deep muscle)

Correct answer: 1–2 cm (superficial tissues)

Hot packs heat superficial tissues to a depth of approximately 1–2 cm; deeper muscles are not significantly heated by this modality.

Question 86: In Brunnstrom's stages of stroke recovery, what characterizes Stage 3?

Spasticity beginning to appear
Peak spasticity with voluntary synergy patterns (Correct answer)
Spasticity decreasing and more isolated movements
No movement

Correct answer: Peak spasticity with voluntary synergy patterns

Brunnstrom's Stage 3 is characterized by peak spasticity and voluntary control of limb synergy patterns.

Question 87: Which electrical stimulation waveform is most commonly used for muscle strengthening in a normally innervated muscle?

Interferential current
Direct current (galvanic)
High-voltage pulsed current
Russian current (medium-frequency AC) (Correct answer)

Correct answer: Russian current (medium-frequency AC)

Russian current (2500 Hz sinusoidal AC delivered in 50 bursts/sec) is widely used for muscle strengthening because it produces strong, comfortable muscle contractions.

Question 88: What does a 20% duty cycle in pulsed ultrasound indicate?

The frequency is 20% of 1 MHz
Ultrasound intensity is set to 20% of maximum
Ultrasound is on 20% of the time and off 80% of the time (Correct answer)
The treatment lasts 20 minutes

Correct answer: Ultrasound is on 20% of the time and off 80% of the time

Duty cycle is the ratio of on-time to total cycle time; a 20% duty cycle means the ultrasound is active for 20% of each pulse cycle, reducing thermal effects.

Question 89: What is the primary purpose of CIMT (Constraint-Induced Movement Therapy)?

Strengthen the unaffected limb for compensation
Provide biofeedback during bilateral tasks
Force use of the affected limb by restraining the unaffected limb (Correct answer)
Reduce spasticity through inhibitory techniques

Correct answer: Force use of the affected limb by restraining the unaffected limb

CIMT restrains the unaffected upper extremity to force intensive use of the hemiparetic limb, promoting cortical reorganization and functional recovery.

Question 90: A patient has weakness of the peroneals (fibularis muscles). Which motion will be most impaired?

Inversion
Plantarflexion
Eversion (Correct answer)
Dorsiflexion

Correct answer: Eversion

The peroneus longus and brevis are the primary evertors of the foot and ankle.

Question 91: A PTA is treating a patient using ultrasound over scar tissue on the dorsum of the hand. Which duty cycle should be used to maximize collagen extensibility without heating superficial tissue excessively?

50% pulsed (Correct answer)
10% pulsed
100% continuous
20% pulsed

Correct answer: 50% pulsed

A 50% pulsed duty cycle provides thermal effects sufficient to increase collagen extensibility while reducing the risk of superficial tissue overheating.

Question 92: Due to the discomfort she has and the time it takes her to get out of bed and go down the hall, a patient with severe arthritis has trouble getting to the bathroom in time. This kind of incontinence is categorized as follows:

Urge incontinence
Overflow incontinence
Stress incontinence
Functional incontinence (Correct answer)

Correct answer: Functional incontinence

Functional incontinence occurs when a person can't reach the bathroom quickly due to a physical obstruction. Because it takes so long to get to the bathroom in this situation, the patient experiences incontinence.

Question 93: Which sensory system is primarily affected when a patient fails the Romberg test with eyes closed but passes with eyes open?

Proprioception (Correct answer)
Vision
Auditory system
Vestibular system

Correct answer: Proprioception

Failing the Romberg test only with eyes closed indicates proprioceptive dysfunction, as the patient can compensate with vision but not without it.

Question 94: Which phase of cardiac rehabilitation focuses on monitored in-hospital ambulation and low-level activity immediately after a cardiac event?

Phase II (outpatient supervised)
Phase I (inpatient) (Correct answer)
Phase IV (independent maintenance)
Phase III (community-based)

Correct answer: Phase I (inpatient)

Phase I cardiac rehab begins in the hospital immediately after a cardiac event, focusing on low-level ambulation, education, and monitored activity to prevent deconditioning.

Question 95: Which parameter in electrical stimulation determines the duration of each individual pulse?

Ramp time
Pulse duration (width) (Correct answer)
Frequency (Hz)
Amplitude (intensity)

Correct answer: Pulse duration (width)

Pulse duration (width), measured in microseconds, determines how long each individual electrical pulse lasts and influences which nerve fibers are recruited.

Question 96: Which treatment approach uses sensory stimulation (tapping, brushing, icing) to facilitate muscle activation?

Bobath/Neurodevelopmental Treatment
Feldenkrais method
Rood approach (Correct answer)
Proprioceptive Neuromuscular Facilitation (PNF)

Correct answer: Rood approach

The Rood approach uses cutaneous sensory stimulation such as brushing, icing, and tapping over muscles to facilitate or inhibit motor responses.

Question 97: A patient taking beta-blockers will have which response during exercise testing?

Blunted heart rate response to exercise (Correct answer)
Elevated resting heart rate and exaggerated HR response
Elevated blood pressure throughout exercise
Increased cardiac output at submaximal levels

Correct answer: Blunted heart rate response to exercise

Beta-blockers blunt the chronotropic (heart rate) response to exercise by blocking sympathetic stimulation, making HR an unreliable exercise intensity measure.

Question 98: Which assistive device provides the most stability for a patient who is non-weight-bearing on the right lower extremity?

Single-point cane
Forearm (Lofstrand) crutches
Standard walker (Correct answer)
Axillary crutches

Correct answer: Standard walker

A standard walker provides the greatest base of support and stability for a non-weight-bearing patient, particularly for those with balance and strength limitations.

Question 99: A patient presents with weakness of intrinsic foot muscles and sensory loss on the plantar surface. These findings are MOST consistent with injury to which nerve?

Saphenous nerve
Common peroneal nerve
Tibial nerve (Correct answer)
Sural nerve

Correct answer: Tibial nerve

The tibial nerve innervates the intrinsic foot muscles and provides plantar sensation; injury produces weakness and plantar sensory loss.

Question 100: Which plane of motion is used when performing hip abduction exercises?

Sagittal plane
Oblique plane
Transverse plane
Frontal (coronal) plane (Correct answer)

Correct answer: Frontal (coronal) plane

Hip abduction occurs in the frontal (coronal) plane, moving the limb laterally away from the midline.

Question 101: Which position best facilitates drainage of the right middle lobe of the lung?

Left side-lying with the bed in a head-down position (Correct answer)
Supine with a pillow under the knees
Prone with the right side elevated
Right side-lying in a flat position

Correct answer: Left side-lying with the bed in a head-down position

Right middle lobe drainage is achieved with the patient in left side-lying with a slight head-down (Trendelenburg) tilt, allowing gravity to drain secretions from that lobe.

Question 102: Phonophoresis differs from standard ultrasound in that it:

Uses pulsed ultrasound exclusively to avoid heating
Applies ultrasound in water to irregular surfaces
Uses a higher frequency for deeper penetration
Drives topical medication into deeper tissues using ultrasound energy (Correct answer)

Correct answer: Drives topical medication into deeper tissues using ultrasound energy

Phonophoresis uses ultrasound energy to enhance the transdermal delivery of topical medications such as hydrocortisone or diclofenac into deeper tissues.

Question 103: An urgent care patient is receiving treatment for a pituitary tumor. What impact would this tumor likely have on the patient's recovery, according to the therapist?

Hypotension
Lower susceptibility to fracture
Increased energy
Hypertension (Correct answer)

Correct answer: Hypertension

In addition to producing hormones including growth hormone, the pituitary gland also controls metabolism. A pituitary tumor may make a patient more susceptible to hypertension.

Question 104: A PTA notices that a patient's chart contains a physician's order for 'ultrasound to left shoulder.' Before beginning treatment, the PTA should:

Consult the supervising PT for a complete plan of care before treating (Correct answer)
Proceed with standard ultrasound parameters for shoulder pathology
Contact the physician to clarify the specific parameters
Request a new order specifying exact frequency and intensity

Correct answer: Consult the supervising PT for a complete plan of care before treating

PTAs must work within a PT-established plan of care; if no PT plan of care exists, the PTA must consult the supervising PT before initiating treatment.

Question 105: Which of the following is a contraindication for the use of electrical stimulation?

Delayed-onset muscle soreness
Chronic muscle atrophy
Active malignancy in the treatment area (Correct answer)
Mild peripheral edema

Correct answer: Active malignancy in the treatment area

Electrical stimulation is contraindicated over areas of active malignancy because it may stimulate tumor cell proliferation or spread through increased blood flow.

Question 106: Which nerve is compressed in carpal tunnel syndrome?

Ulnar nerve
Musculocutaneous nerve
Median nerve (Correct answer)
Radial nerve

Correct answer: Median nerve

Carpal tunnel syndrome results from compression of the median nerve within the carpal tunnel at the wrist.

Question 107: Which proprioceptive neuromuscular facilitation (PNF) technique involves alternating contraction of agonist and antagonist muscles without relaxation?

Hold-relax
Rhythmic initiation
Rhythmic stabilization (Correct answer)
Contract-relax

Correct answer: Rhythmic stabilization

Rhythmic stabilization involves alternating isometric contractions of agonists and antagonists to improve joint stability and proprioception.

Question 108: What is the close-packed position of the knee joint?

Full extension with tibial external rotation (Correct answer)
45° flexion with tibial internal rotation
90° flexion
30° flexion

Correct answer: Full extension with tibial external rotation

The close-packed (maximally congruent) position of the knee is full extension with slight external tibial rotation, creating the screw-home mechanism.

Question 109: A patient recovering from a stroke demonstrates pusher syndrome. Which intervention is MOST effective for retraining postural alignment?

Strengthening the non-paretic side to correct lean
Applying manual pressure to reinforce the pushing pattern
Passive stretching of the paretic trunk musculature
Using a mirror for visual feedback to correct vertical orientation (Correct answer)

Correct answer: Using a mirror for visual feedback to correct vertical orientation

Visual feedback using a mirror helps patients with pusher syndrome recalibrate their perception of midline and vertical orientation.

Question 110: When using a whirlpool for wound debridement on a patient with peripheral vascular disease, the MOST appropriate water temperature is:

102–104°F (38.9–40°C)
92–96°F (33.3–35.6°C) (Correct answer)
98–100°F (36.7–37.8°C)
80–85°F (26.7–29.4°C)

Correct answer: 92–96°F (33.3–35.6°C)

Patients with peripheral vascular disease have compromised circulation and often reduced sensation, requiring a lower temperature (92–96°F) to minimize the risk of thermal injury.

Question 111: A patient receiving outpatient PT tells the PTA they were recently diagnosed with HIV. The PTA's FIRST response should be to:

Inform the supervising PT so the patient can be reassigned
Continue treatment using standard precautions only (Correct answer)
Consult the facility infection control officer before continuing
Apply transmission-based precautions in addition to standard precautions

Correct answer: Continue treatment using standard precautions only

HIV is transmitted through blood and body fluids, not casual contact; standard precautions are sufficient for routine PT treatment of a patient with HIV.

Question 112: A patient with lower back discomfort is being treated by a PTA in an outpatient clinic. The patient has severe GERD, according to the PT's initial assessment. Which posture for this patient should be avoided?

Side lying
Prolonged sitting
Prolonged standing
Supine (Correct answer)

Correct answer: Supine

In contrast to gravity's ability to keep gastric acid in the stomach, lying supine allows acid reflux to remain in the esophagus. Therefore, those who have GERD should refrain from spending a lot of time flat out.

Question 113: A PTA notices a patient's blood pressure drops 20 mmHg systolic upon standing. This is called:

Hypertensive crisis
Orthostatic (postural) hypotension (Correct answer)
White coat syndrome
Essential hypertension

Correct answer: Orthostatic (postural) hypotension

Orthostatic hypotension is defined as a drop of ≥20 mmHg systolic or ≥10 mmHg diastolic upon moving from supine to standing.

Question 114: A patient with asthma presents with an FEV1/FVC ratio of 0.65 pre-bronchodilator. This indicates:

A normal spirometry result
A restrictive lung defect
A mixed restrictive-obstructive defect
An obstructive lung defect (Correct answer)

Correct answer: An obstructive lung defect

An FEV1/FVC ratio below 0.70 indicates an obstructive lung defect, as airflow is limited during forced expiration relative to total lung capacity.

Question 115: Which spinal cord injury classification indicates motor incomplete with more than half of key muscles below neurological level graded less than 3/5?

ASIA C (Correct answer)
ASIA A
ASIA D
ASIA B

Correct answer: ASIA C

ASIA C (motor incomplete) means some motor function is preserved below the neurological level, but more than half of key muscles have a grade less than 3.

Question 116: Which rotator cuff muscle is responsible for internal rotation of the shoulder?

Teres minor
Supraspinatus
Subscapularis (Correct answer)
Infraspinatus

Correct answer: Subscapularis

The subscapularis is the only rotator cuff muscle that internally rotates the glenohumeral joint.

Question 117: Negative pressure wound therapy (NPWT) promotes wound healing PRIMARILY by:

Delivering topical antibiotic solution continuously to the wound
Applying subatmospheric pressure to remove exudate and stimulate granulation tissue (Correct answer)
Supplying supplemental oxygen directly to the wound bed
Elevating wound bed temperature to accelerate cellular metabolism

Correct answer: Applying subatmospheric pressure to remove exudate and stimulate granulation tissue

NPWT applies controlled subatmospheric pressure through a foam dressing to remove excess exudate, reduce wound edema, and mechanically stimulate granulation tissue formation.

Question 118: Which ligament is tested by the valgus stress test of the knee?

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

Correct answer: Medial collateral ligament

The valgus stress test applies a medially directed force to the knee, stressing the medial collateral ligament (MCL).

Question 119: A patient with a T6 complete spinal cord injury is performing wheelchair pushups for pressure relief. What is the MINIMUM recommended frequency for this activity?

Every 15 minutes (Correct answer)
Every 2 hours
Every 30 minutes
Every 60 minutes

Correct answer: Every 15 minutes

Patients with complete SCI at T6 should perform pressure relief every 15 minutes to prevent pressure injuries.

Question 120: Complete Decongestive Therapy (CDT) for lymphedema includes all of the following components EXCEPT:

Manual lymphatic drainage (MLD)
Multilayer compression bandaging
Therapeutic exercise and skin care
Systemic diuretic therapy (Correct answer)

Correct answer: Systemic diuretic therapy

CDT consists of MLD, multilayer compression bandaging, decongestive exercises, and meticulous skin and nail care; diuretics are not part of CDT and are generally not recommended for lymphedema.

Question 121: Shortwave diathermy is most useful for heating which tissue type?

Superficial skin and subcutaneous fat
Thin peripheral nerves only
Bone cortex
Deep musculature and joint structures (Correct answer)

Correct answer: Deep musculature and joint structures

Shortwave diathermy uses high-frequency electromagnetic energy to heat deep muscle and periarticular tissues to a depth of 3–5 cm.

Question 122: A PTA uses therapeutic ultrasound on a deep wound cavity (approximately 4 cm depth). Which frequency is MOST appropriate?

10 MHz
5 MHz
3 MHz
1 MHz (Correct answer)

Correct answer: 1 MHz

1 MHz ultrasound penetrates to depths of 3–5 cm, making it appropriate for deep wounds, while 3 MHz is used for superficial structures within 1–2 cm of the skin surface.

Question 123: A patient's resting heart rate is 92 bpm and maximum predicted heart rate is 180 bpm. Using the Karvonen formula with a 60% intensity target, what is the target heart rate?

148 bpm (Correct answer)
152 bpm
140 bpm
160 bpm

Correct answer: 148 bpm

Karvonen formula: Target HR = ((HRmax – HRrest) × intensity%) + HRrest = ((180 – 92) × 0.60) + 92 = 52.8 + 92 = 144.8, approximately 148 bpm at 60%.

Question 124: The O2 saturation of a patient who is receiving acute care for a COPD exacerbation falls to 82% while the patient is being moved around. The PTA's best plan of action is to:

Try to get the patient to finish the walk as they need to build endurance
Have the patient lie down immediately.
Stop ambulation and rest, coaching the patient through purse lip breathing. Then notify the nurse. (Correct answer)
Turn the patient's supplemental oxygen up 0.5L to allow them to finish the walk.

Correct answer: Stop ambulation and rest, coaching the patient through purse lip breathing. Then notify the nurse.

It is not recommended to continue exercising at an oxygen saturation level of 82%. Coaching through pursed lip breathing while pausing to rest should raise levels to a safe level. It is crucial to let the nurse know about this severe desaturation.

Question 125: A PTA is treating a patient with lateral epicondylitis. Which structure is most commonly involved?

Extensor carpi radialis brevis (Correct answer)
Flexor carpi radialis
Supinator
Pronator teres

Correct answer: Extensor carpi radialis brevis

Lateral epicondylitis (tennis elbow) most commonly involves the extensor carpi radialis brevis tendon at its origin on the lateral epicondyle.

Question 126: An injury to the: is likely present in a patient who is unable to imitate facial expressions and has diminished taste in the anterior two thirds of the tongue.

Cranial Nerve V
Cranial Nerve VIII
Cranial Nerve VI
Cranial Nerve VII (Correct answer)

Correct answer: Cranial Nerve VII

The facial expression and diminished taste on the tongue's anterior two thirds are controlled by the motor and sensory functions of cranial nerve VII. Deficits in these regions would occur from a damage to it.

Question 127: A third-trimester pregnant lady being treated by a therapist for sciatic nerve discomfort claims that today's swelling in her feet is worse. The therapist applies pressure to the distal, anterior lower extremity before releasing it. A 2 mm indentation is caused by the pressure before it instantly recovers. This fits into the category of:

Non-pitting edema
Grade 2 Pitting Edema
Grade 1 Pitting Edema (Correct answer)
Grade 3 Pitting Edema

Correct answer: Grade 1 Pitting Edema

The characteristics of grade 1 pitting edema include pitting of 2mm or less, little discernible deformation, and swift rebound.

Question 128: Which balance assessment tool uses a 14-item ordinal scale and is commonly used to predict fall risk in older adults?

Berg Balance Scale (Correct answer)
Functional Reach Test
Dynamic Gait Index
Timed Up and Go Test

Correct answer: Berg Balance Scale

The Berg Balance Scale is a 14-item, 0–4 ordinal scale with a maximum of 56 points; scores below 45 indicate increased fall risk.

Question 129: Which wound dressing is MOST appropriate for managing a large wound with heavy exudate output?

Transparent film dressing
Hydrogel sheet dressing
Calcium alginate dressing (Correct answer)
Hydrocolloid dressing

Correct answer: Calcium alginate dressing

Calcium alginate dressings are highly absorbent, forming a gel on contact with exudate that maintains a moist healing environment, making them optimal for heavily draining wounds.

Question 130: A 17-year-old female patient has completed her treatment for lower back pain after regularly making progress and experiencing no pain for the last seven days. She described a sudden return of back discomfort that persisted for almost three days before going away. She disputes a shift in her behavior. What among the following is most likely to be the reason?

Newly bulging disc
Metastatic bone disease
Referred pain as a part of the menstrual cycle (Correct answer)
Gallstones

Correct answer: Referred pain as a part of the menstrual cycle

Ovarian pain occasionally refers to the lower back and can be a result of the menstrual cycle. This is the most likely reason of those listed given the patient's brief start and ease of symptoms.

Question 131: Which modality is contraindicated over a cardiac pacemaker?

Manual stretching
Moist heat pack
Cold pack application
Interferential current (IFC) (Correct answer)

Correct answer: Interferential current (IFC)

Electrical stimulation modalities including interferential current are contraindicated over or near cardiac pacemakers as they can interfere with pacemaker function.

Question 132: Which gait pattern is safest for a patient who is touch-down weight-bearing (TDWB) using axillary crutches on a staircase going up?

Go up with both legs simultaneously
Lead with the affected leg up, then bring the unaffected leg
Use a swing-through pattern on stairs
Lead with the unaffected leg up, then bring crutches and affected leg (Correct answer)

Correct answer: Lead with the unaffected leg up, then bring crutches and affected leg

The mnemonic 'good goes up, bad goes down' applies: the unaffected leg leads going up stairs, and the affected leg leads going down stairs.

Question 133: A patient with a flaccid neurogenic bladder following a cauda equina injury asks the PTA about bladder management. The MOST appropriate response is to:

Advise the patient to limit fluid intake to reduce bladder volume
Explain the condition and refer to the PT and physician for bladder management planning (Correct answer)
Teach the patient Kegel exercises to restore sphincter tone
Instruct the patient to use a timed voiding schedule every 2 hours

Correct answer: Explain the condition and refer to the PT and physician for bladder management planning

Bladder management for neurogenic dysfunction requires physician and PT coordination; the PTA should educate the patient and facilitate the appropriate referral.

Question 134: A patient with Parkinson's disease exhibits a festinating gait. Which description best fits this gait pattern?

Short shuffling steps with increasing speed (Correct answer)
Scissor gait with hip adduction
Wide-based gait with lateral trunk sway
Steppage gait with high knee lift

Correct answer: Short shuffling steps with increasing speed

Festinating gait in Parkinson's disease is characterized by progressively shorter and faster shuffling steps as the patient leans forward to catch their center of gravity.

Question 135: TENS (Transcutaneous Electrical Nerve Stimulation) in conventional mode works primarily through which pain mechanism?

Endorphin release
Tissue heating
Alpha motor neuron inhibition
Gate control theory (Correct answer)

Correct answer: Gate control theory

Conventional TENS uses high-frequency, low-intensity current to activate large-diameter A-beta sensory fibers, which inhibit pain signal transmission via the gate control mechanism.

Question 136: It's critical that treatment for an 8-year-old with a newly diagnosed case of Duchenne's muscular dystrophy concentrate on:

Cardiovascular endurance exercises to preserve pulmonary function
Light strengthening exercises careful to not reach point of fatigue (Correct answer)
Gentle passive range of motion to prevent contracture and preserve joint mobility
Plyometric and balance activities

Correct answer: Light strengthening exercises careful to not reach point of fatigue

DMD is a neuromuscular condition that causes muscle atrophy. While working to maintain strength for as long as you can, it's crucial to avoid overworking the muscles.

Question 137: Which workout intensity monitoring device is the most precise when working with a patient who is taking beta blockers?

Borg rate of perceived exertion (Correct answer)
Heart rate
Blood Pressure
Berg dyspnea scale

Correct answer: Borg rate of perceived exertion

The heart rate of a patient is slowed by beta blockers. Heart rate is therefore not a reliable indicator of exercise intensity for these people. The best method for gauging exercise intensity is the Borg rate of perceived exertion scale.

Question 138: A patient with multiple sclerosis reports symptoms worsening with heat. This is known as:

Lhermitte's sign
Devic's phenomenon
Uhthoff's phenomenon (Correct answer)
Lhermitte–McAlpine syndrome

Correct answer: Uhthoff's phenomenon

Uhthoff's phenomenon describes the temporary worsening of MS symptoms with increased body temperature, such as during exercise or hot baths.

Question 139: A PTA is working with a patient who has a diagnosis of adhesive capsulitis (frozen shoulder) in the freezing stage. The PRIMARY treatment goal during this stage should be:

Strengthening the rotator cuff to stabilize the joint
Modalities only — no manual therapy during freezing stage
Aggressive joint mobilization to restore full ROM
Pain management and gentle ROM to slow progression (Correct answer)

Correct answer: Pain management and gentle ROM to slow progression

During the freezing stage, pain is the dominant symptom and aggressive stretching worsens pain; gentle ROM and pain management are the appropriate primary goals.

Question 140: Which drug from the list below would be applied to the anode during iontophoresis?

Dexamethasone
Calcium Chloride
Acetic Acid
Lidocaine (Correct answer)

Correct answer: Lidocaine

Iontophoresis requires pulling the medicine in the desired direction. The negatively charged electrode (anode) needs a positively charged substance applied to it because opposing charges attract and like charges repel. The only positively charged option is lidocaine.

Question 141: Which of the following is a sign of autonomic dysreflexia in a patient with a spinal cord injury at C6?

Severe hypertension with pounding headache and diaphoresis above the lesion (Correct answer)
Muscle spasticity below the level of injury
Hyperthermia and tachycardia throughout the body
Hypotension and bradycardia below the lesion

Correct answer: Severe hypertension with pounding headache and diaphoresis above the lesion

Autonomic dysreflexia presents with severe hypertension, pounding headache, profuse sweating, and flushing above the SCI level, triggered by a noxious stimulus below.

Question 142: In the RICE protocol for acute musculoskeletal injury, what does the 'C' stand for?

Cold
Core stability
Compression (Correct answer)
Circulation

Correct answer: Compression

In the RICE acronym (Rest, Ice, Compression, Elevation), 'C' stands for Compression, which helps limit swelling.

Question 143: A patient with Type 1 diabetes reports feeling dizzy and sweaty during a PT session. Blood glucose is checked and reads 58 mg/dL. The PTA should FIRST:

Administer insulin to correct the glucose imbalance
Call 911 immediately as this is a diabetic emergency
Administer 15 grams of fast-acting carbohydrate and recheck glucose in 15 minutes (Correct answer)
Have the patient rest supine and continue the session when symptoms resolve

Correct answer: Administer 15 grams of fast-acting carbohydrate and recheck glucose in 15 minutes

A blood glucose of 58 mg/dL with symptoms indicates hypoglycemia; the standard intervention is 15 grams of fast-acting carbohydrate followed by recheck in 15 minutes.

Question 144: A PTA is performing iontophoresis with dexamethasone to treat plantar fasciitis. The dexamethasone should be placed under which electrode?

Cathode (negative) (Correct answer)
Dispersive electrode only
Anode (positive)
Either electrode

Correct answer: Cathode (negative)

Dexamethasone carries a negative charge and must be placed under the cathode (negative electrode) to be driven into tissue by iontophoresis.

Question 145: Which type of contraction occurs when a muscle produces force while lengthening?

Concentric
Isometric
Isokinetic
Eccentric (Correct answer)

Correct answer: Eccentric

An eccentric contraction occurs when the muscle generates tension while it is lengthening, such as when lowering a weight slowly.

Question 146: On the Braden Scale for pressure injury risk prediction, which score indicates the HIGHEST risk for pressure injury development?

Score of 9 (Correct answer)
Score of 13
Score of 23
Score of 19

Correct answer: Score of 9

The Braden Scale ranges from 6 (highest risk) to 23 (lowest risk); a score of ≤9 indicates very high risk because lower scores reflect severe impairment across sensory perception, moisture, activity, mobility, nutrition, and friction/shear.

Question 147: A patient is 7 weeks in to rehabilitation following a right medial meniscectomy. The patient reports feeling excellent overall but continues to suffer weakness and difficulties going down slopes or down stairs. The most appropriate activity to address this deficit is:

Standing hip abduction
Eccentric quadricep step downs (Correct answer)
Terminal knee extension with theraband
Hamstring curls

Correct answer: Eccentric quadricep step downs

Controlling descent needs the quadriceps to operate eccentrically. Therefore, eccentric steps-downs are the best exercise to tackle this shortfall.

Question 148: Which percussion finding over the lung fields indicates pneumothorax?

Flatness
Dullness
Hyperresonance (tympany) (Correct answer)
Resonance

Correct answer: Hyperresonance (tympany)

A pneumothorax produces hyperresonance (tympany) on percussion because air trapped in the pleural space creates an abnormally hollow sound.

Question 149: What does the 6-Minute Walk Test (6MWT) primarily assess?

Maximal aerobic capacity (VO2 max)
Anaerobic threshold only
Submaximal functional exercise capacity (Correct answer)
Single-leg balance and coordination

Correct answer: Submaximal functional exercise capacity

The 6MWT measures the distance a patient can walk in 6 minutes and reflects submaximal functional exercise capacity in cardiopulmonary and musculoskeletal conditions.

Question 150: Which adaptive equipment modification helps a patient with severe bilateral grip weakness to perform self-feeding?

Long-handled spoon
Universal cuff (utensil holder) (Correct answer)
Built-up handle utensils
Rocker knife

Correct answer: Universal cuff (utensil holder)

A universal cuff attaches a utensil to the hand without requiring grip, enabling self-feeding for patients with severe grip weakness or paralysis.

Question 151: A PTA is treating a patient with rheumatoid arthritis of the hands. Which exercise principle is MOST important to protect joint integrity?

Focus exclusively on passive range of motion
Use light resistance and avoid positions that stress joint surfaces (Correct answer)
Use high-resistance, low-repetition strengthening
Avoid all resistive exercise during flares

Correct answer: Use light resistance and avoid positions that stress joint surfaces

Joint protection during RA hand exercise requires light resistance and avoiding positions (such as ulnar deviation under load) that stress already compromised joint surfaces.

Question 152: When applying a hot pack to a patient's lumbar region, the PTA places 6 layers of toweling. After 5 minutes, the patient reports the heat feels very comfortable. What should the PTA do?

Check the skin and reduce to 4 layers if no redness
Remove the hot pack immediately as the patient may lack sensation
Remove one layer of toweling to increase heat transmission
Continue treatment and reassess at 10 minutes (Correct answer)

Correct answer: Continue treatment and reassess at 10 minutes

A comfortable sensation with appropriate insulation after 5 minutes is expected; the PTA should continue and reassess the skin at regular intervals.

Question 153: During manual muscle testing of the gluteus medius, the therapist positions the patient in sidelying with the tested limb on top. A grade of 3/5 (fair) would be indicated if the patient:

Completes full range of motion against gravity with moderate resistance
Completes full range of motion against gravity with no resistance (Correct answer)
Holds the position against maximum resistance
Completes partial range of motion with gravity eliminated

Correct answer: Completes full range of motion against gravity with no resistance

Grade 3/5 (Fair) is defined as the ability to move through full range of motion against gravity but with no additional resistance.

Question 154: Which of the following is an absolute contraindication to exercise in a cardiac rehabilitation patient?

Unstable angina (Correct answer)
Recent minor joint pain
Resting systolic BP of 160 mmHg
Resting heart rate of 85 bpm

Correct answer: Unstable angina

Unstable angina is an absolute contraindication to exercise because it indicates myocardial ischemia at rest or minimal exertion, posing a risk of MI.

Question 155: A patient with elevated TSH and low free T3 and T4 most likely has:

Grave Disease
Low Testosterone
Hyperthyroidism
Hypothyroidism (Correct answer)

Correct answer: Hypothyroidism

The quantities of thyroid hormone that are present in the body are T3 and T4. These hormones may circulate at lower levels when the thyroid is underactive. The body is continually signaling for additional thyroid hormones, therefore this can also lead to greater levels of thyroid stimulating hormone (TSH).

Question 156: Which reflex, if present in an adult, indicates an upper motor neuron lesion?

Patellar reflex
Achilles reflex
Biceps reflex
Babinski sign (Correct answer)

Correct answer: Babinski sign

The Babinski sign (plantar extension of the great toe with fanning of lesser toes upon plantar stimulation) indicates an upper motor neuron lesion in adults.

Question 157: According to the National Pressure Injury Advisory Panel (NPIAP), a Stage II pressure injury is characterized by which finding?

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

Correct answer: Partial-thickness skin loss with exposed dermis

Stage II pressure injuries involve partial-thickness skin loss exposing the dermis, presenting as a shallow open wound with a pink or red wound bed without slough or bruising.

Question 158: Which laser safety classification is typically used in therapeutic photobiomodulation (low-level laser therapy)?

Class 2 (low power visible)
Class 3B (medium power) (Correct answer)
Class 1 (exempt)
Class 4 (high power)

Correct answer: Class 3B (medium power)

Therapeutic low-level laser therapy typically uses Class 3B lasers (5–500 mW), which require safety eyewear to prevent eye damage but are non-thermal for tissue.

Question 159: A patient has rales (crackles) at the base of the lungs and pitting edema in the ankles. Which cardiac condition is most consistent with these findings?

Pericarditis
Right-sided heart failure with pulmonary edema (Correct answer)
Mitral valve stenosis only
Left-sided heart failure

Correct answer: Right-sided heart failure with pulmonary edema

Right-sided heart failure leads to systemic venous congestion causing peripheral edema; if combined with left-sided failure, pulmonary edema produces basal crackles.

Question 160: The standard clinical method for measuring wound dimensions requires length to be measured along which axis?

Along the longest diagonal of the wound
Along the head-to-toe (craniocaudal) axis of the body (Correct answer)
At the widest point regardless of body orientation
Perpendicular to the largest scar border

Correct answer: Along the head-to-toe (craniocaudal) axis of the body

Standard wound measurement defines length along the head-to-toe (craniocaudal) body axis and width perpendicular to it (side to side), ensuring consistent serial measurements across clinicians.

National Physical Therapy Examination – Physical Therapist Assistant (NPTE-PTA)

The NPTE-PTA is the national licensure examination for physical therapist assistants, administered by the FSBPT, testing entry-level knowledge across body systems, interventions, data collection, and non-system professional competencies.

180

Questions

240 min

Time Limit

70%

To Pass

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