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

Question 1: A patient with cerebellar ataxia will most likely demonstrate which of the following?

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

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 2: Which modality is contraindicated over a cardiac pacemaker?

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

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

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

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 4: 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
Teach the patient Kegel exercises to restore sphincter tone
Explain the condition and refer to the PT and physician for bladder management planning (Correct answer)
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 5: 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 the unaffected arm on the hand rim and the unaffected leg to assist propulsion and steer (Correct answer)
Using both arms equally on the hand rims
Using a power wheelchair exclusively

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 6: 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
The treatment lasts 20 minutes
Ultrasound is on 20% of the time and off 80% of the time (Correct answer)

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

Compression (Correct answer)
Cold
Circulation
Core stability

Correct answer: Compression

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

Question 8: A PTA is treating a patient with lateral epicondylitis. Which structure is most commonly involved?

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

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

Score of 13
Score of 23
Score of 9 (Correct answer)
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 10: Which type of stroke deficit results in contralateral hemiplegia and ipsilateral facial weakness?

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

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

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

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

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

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 13: 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?

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

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 14: 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 high-resistance, low-repetition strengthening
Avoid all resistive exercise during flares
Use light resistance and avoid positions that stress joint surfaces (Correct answer)

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

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

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

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

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

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 18: 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 19: A patient presents with a positive Lachman test. Which structure is most likely injured?

Anterior cruciate ligament (Correct answer)
Medial collateral ligament
Lateral meniscus
Posterior cruciate 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 20: In Brunnstrom's stages of stroke recovery, what characterizes Stage 3?

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

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

Both legs down simultaneously, then crutches
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

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

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

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 23: 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?

Increased energy
Hypotension
Lower susceptibility to fracture
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 24: Which type of contraction occurs when a muscle produces force while lengthening?

Concentric
Isometric
Eccentric (Correct answer)
Isokinetic

Correct answer: Eccentric

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

Question 25: Which manual muscle testing grade indicates movement against gravity with full range of motion but no additional resistance?

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

Correct answer: Grade 3

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

Question 26: 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)
140 bpm
160 bpm
152 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 27: A PTA notices a patient's blood pressure drops 20 mmHg systolic upon standing. This is called:

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

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 28: Which nerve is compressed in carpal tunnel syndrome?

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

Correct answer: Median nerve

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

Question 29: A patient with a right hip replacement is using a cane. In which hand should the cane be held?

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

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 30: 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.

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.

Questions

40 min

Time Limit

70%

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These practice questions were written with AI tools. They are not real exam questions. Exam facts are checked against the official sources listed below. Not reviewed by a subject-matter expert. Editorial policy

Sources & references

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fsbpt.org — Eligibility, fees, late registration, retake policy, retake fee, score release, test delivery, passing score, test dates, exam format · verified Oct 2026