NPTE OA PRACTICE EXAM 1 QUESTIONS &
ANSWERS
A physical therapist examines a three-year-old patient diagnosed with a genetic
condition which affects collagen synthesis. The patient bruises easily and has a lifelong
history of pathological fractures. What is the patient's MOST likely diagnosis?
1.Osteomalacia
2.Osteopetrosis
3.Pediatric osteoporosis
4.Osteogenesis imperfecta - Answers - 4. Milder presentations of OI (types I and IV) are
inherited as autosomal dominant traits while more severe forms (types II and III) are
inherited as autosomal recessive traits. The condition is characterized by bone fragility
that is linked to an abnormality in the synthesis of type I collagen. (Campbell p. 333)
A patient diagnosed with rheumatoid arthritis is referred to physical therapy. The
physical therapist observes bilateral thumb deformities characterized by
metacarpophalangeal joint flexion with interphalangeal hyperextension. Which deformity
is MOST consistent with the described presentation?
1.Boutonniere
2.Swan neck
3.Mallet finger
4.Dupuytren - Answers - 1. In the thumb, chronic synovitis eventually forces the
metacarpophalangeal (MCP) joint into a flexed position. The associated palmar
displacement causes tension on the extensor mechanism of the interphalangeal (IP)
joint resulting in hyperextension. In the fingers, this deformity presents with flexion in the
proximal interphalangeal (PIP) joint and extension of the distal interphalangeal (DIP)
joint.
(Goodman - Pathology p. 1267)
A physical therapist works with a patient recovering from surgery on gait activities on a
level surface. Which value represents the MAXIMUM amount of knee flexion required to
complete the described activity?
1.0-90 degrees
2.0-60 degrees
3.0-30 degrees
4.0-20 degrees - Answers - 2.A patient requires 0-60 degrees of knee flexion with gait
on a level surface. The greatest amount of knee flexion is required from the initial swing
to midswing.
,(O'Sullivan p. 257)
A physical therapist completes an initial examination of a patient diagnosed with
complete C7 tetraplegia. As part of the clinical documentation, the therapist classifies
the patient using the American Spinal Injury Association Impairment Scale. Based on
this scale, which degree of impairment would be MOST consistent with this patient's
medical diagnosis?
1.A
2.B
3.C
4.D - Answers - 1.The ASIA degree of impairment "A" is typical of a complete spinal
cord injury. This degree is characterized by a full loss of sensory and motor function
below the neurological level of injury.
(O'Sullivan p. 893)
A patient diagnosed with right rotator cuff tendonitis is referred to physical therapy. As
part of the examination, the physical therapist performs the Hawkins-Kennedy
impingement test. Which shoulder position would be MOST appropriate when
performing this special test?
1.90 degrees of abduction and 30 degrees of horizontal adduction
2.90 degrees of abduction, and 90 degrees of external rotation
3.90 degrees of flexion with 70 degrees of medial rotation
4.Neutral at the patient's side - Answers - 3.To perform the Hawkins-Kennedy
impingement test, the patient is positioned with the arm in 90 degrees of flexion before
being medially rotated. A positive test may be indicative of shoulder impingement
specifically involving the supraspinatus tendon.
(Magee p. 315)
A patient diagnosed with complete L3 paraplegia begins gait training with custom
orthotics in an acute rehabilitation hospital. Which muscle would not contribute to the
fluidity of the patient's gait?
1.Rectus femoris
2.Semitendinosus
3.Iliopsoas
4.Adductor magnus - Answers - 2.The semitendinosus, in conjunction with the other
hamstrings muscles, is primarily responsible for hip extension and knee flexion. This
muscle is essential to the performance of functional activities such as rising from a chair
and stair climbing and derives its primary innervation from the L5-S1 nerve roots and
the tibial nerve.
,(Kendall p. 418)
A patient has ambulated with a prosthesis since undergoing a transtibial amputation six
years ago. During an examination for an unrelated diagnosis, the physical therapist
observes the patient's gait pattern. Which of the following is MOST likely to be observed
in relation to the prosthetic limb?
1.Extended stance time
2.Shortened swing time
3.Longer step length
4.Increased single limb support time - Answers - 3.A longer swing phase will typically
correspond with a longer step length on the prosthetic limb. This further increases
asymmetrical loading forces on the intact limb.
(Cameron - Physical Rehabilitation p. 286)
A patient experiences left lower extremity sciatica secondary to posterior derangement
of the L5 disk. The patient tolerated a prone on elbows position without an increase in
symptoms, however, after performing 10 prone press-ups the patient reports increased
radicular pain in the left lower extremity. What would be the physical therapist's MOST
appropriate response?
1.Instruct the patient to assume a prone position
2.Instruct the patient to assume a prone on elbows position
3.Instruct the patient to assume a standing extension position
4.Discontinue the extension progression - Answers - 2. The prone press-up position
may have been initiated prematurely. Returning to the non-exacerbating prone on
elbows position should assist the therapist to determine how to best proceed with the
patient's care (e.g., more time accommodating to prone on elbows position or
discontinuing the extension progression).
(Brody p. 402)
An individual with declining health due to unhealthy lifestyle choices plans to engage in
an independent exercise program designed to improve their cardiovascular health.
Which form of self-monitoring would be the MOST appropriate for the individual to utilize
when exercising?
1.Metabolic equivalents
2.Systolic blood pressure
3.Rate of perceived exertion
4.Respiration rate - Answers - 3.Patients can utilize a perceived exertion scale, such as
Borg's Rating of Perceived Exertion (RPE) Scale, as a subjective means of self-
monitoring during exercise. The RPE quantifies the subject's overall sense of effort by
quantifying the amount of strain or level of exertion the patient is experiencing during
activity.
(American College of Sports Medicine p. 475)
, A patient diagnosed with temporomandibular joint pain is referred to physical therapy.
During the examination, the patient demonstrates a kyphotic, forward head posture.
What is this position MOST likely to result in?
1.Anterior displacement of the mandible
2.Posterior displacement of the mandible
3.Lateral displacement of the mandible
4.Posterior displacement of the maxilla - Answers - 2.A forward head posture creates
passive tension in selected suprahyoid and infrahyoid muscles which affects the resting
posture of the mandible. The result is a posterior displacement of the mandible.
(Dutton p. 1122)
A physical therapist prepares to administer an iontophoresis treatment to a patient with
myositis ossificans in the right mid-quadriceps region. Which treatment description
would be the MOST appropriate?
1.Driving dexamethasone with a high volt pulsed current unit using the negative pole
2.Driving dexamethasone with a high volt pulsed current unit using the positive pole
3.Driving acetic acid with a direct current unit using the negative pole
4.Driving acetic acid with a direct current unit using the positive pole - Answers - 3.
Acetic acid is a medication which is useful in treating calcific deposits. Since it has a
negative polarity, the negative pole would be used to deliver the medication.
(Cameron p. 274)
After palpating several peripheral pulse sites a physical therapist concludes that a
patient has a strong pulse at the popliteal artery, but a weak pulse at the dorsalis pedis
artery. Which medical finding identified during exercise would be MOST likely based on
the patient's current status?
1.Orthopnea
2.Deep vein thrombophlebitis
3.Intermittent claudication
4.Venous thrombosis - Answers - 3.A strong popliteal artery pulse and weak dorsalis
pedis artery pulse suggests that blood flow between these sites is diminished, perhaps
from atherosclerosis. This patient could be expected to experience intermittent
claudication, or pain in the calf muscles caused by ischemia during exercise.
(Hillegass p. 71)
A physical therapist examines a 37-year-old female referred to physical therapy with an
abdominal strain. The patient reports an insidious onset of pain that is worse after
eating certain foods. The patient describes the pain as a dull ache located slightly to the
right of the center of the back at the level of the inferior border of the scapula. The
dysfunction of which of the following is MOST consistent with the patient's clinical
presentation?
1.Pancreas
ANSWERS
A physical therapist examines a three-year-old patient diagnosed with a genetic
condition which affects collagen synthesis. The patient bruises easily and has a lifelong
history of pathological fractures. What is the patient's MOST likely diagnosis?
1.Osteomalacia
2.Osteopetrosis
3.Pediatric osteoporosis
4.Osteogenesis imperfecta - Answers - 4. Milder presentations of OI (types I and IV) are
inherited as autosomal dominant traits while more severe forms (types II and III) are
inherited as autosomal recessive traits. The condition is characterized by bone fragility
that is linked to an abnormality in the synthesis of type I collagen. (Campbell p. 333)
A patient diagnosed with rheumatoid arthritis is referred to physical therapy. The
physical therapist observes bilateral thumb deformities characterized by
metacarpophalangeal joint flexion with interphalangeal hyperextension. Which deformity
is MOST consistent with the described presentation?
1.Boutonniere
2.Swan neck
3.Mallet finger
4.Dupuytren - Answers - 1. In the thumb, chronic synovitis eventually forces the
metacarpophalangeal (MCP) joint into a flexed position. The associated palmar
displacement causes tension on the extensor mechanism of the interphalangeal (IP)
joint resulting in hyperextension. In the fingers, this deformity presents with flexion in the
proximal interphalangeal (PIP) joint and extension of the distal interphalangeal (DIP)
joint.
(Goodman - Pathology p. 1267)
A physical therapist works with a patient recovering from surgery on gait activities on a
level surface. Which value represents the MAXIMUM amount of knee flexion required to
complete the described activity?
1.0-90 degrees
2.0-60 degrees
3.0-30 degrees
4.0-20 degrees - Answers - 2.A patient requires 0-60 degrees of knee flexion with gait
on a level surface. The greatest amount of knee flexion is required from the initial swing
to midswing.
,(O'Sullivan p. 257)
A physical therapist completes an initial examination of a patient diagnosed with
complete C7 tetraplegia. As part of the clinical documentation, the therapist classifies
the patient using the American Spinal Injury Association Impairment Scale. Based on
this scale, which degree of impairment would be MOST consistent with this patient's
medical diagnosis?
1.A
2.B
3.C
4.D - Answers - 1.The ASIA degree of impairment "A" is typical of a complete spinal
cord injury. This degree is characterized by a full loss of sensory and motor function
below the neurological level of injury.
(O'Sullivan p. 893)
A patient diagnosed with right rotator cuff tendonitis is referred to physical therapy. As
part of the examination, the physical therapist performs the Hawkins-Kennedy
impingement test. Which shoulder position would be MOST appropriate when
performing this special test?
1.90 degrees of abduction and 30 degrees of horizontal adduction
2.90 degrees of abduction, and 90 degrees of external rotation
3.90 degrees of flexion with 70 degrees of medial rotation
4.Neutral at the patient's side - Answers - 3.To perform the Hawkins-Kennedy
impingement test, the patient is positioned with the arm in 90 degrees of flexion before
being medially rotated. A positive test may be indicative of shoulder impingement
specifically involving the supraspinatus tendon.
(Magee p. 315)
A patient diagnosed with complete L3 paraplegia begins gait training with custom
orthotics in an acute rehabilitation hospital. Which muscle would not contribute to the
fluidity of the patient's gait?
1.Rectus femoris
2.Semitendinosus
3.Iliopsoas
4.Adductor magnus - Answers - 2.The semitendinosus, in conjunction with the other
hamstrings muscles, is primarily responsible for hip extension and knee flexion. This
muscle is essential to the performance of functional activities such as rising from a chair
and stair climbing and derives its primary innervation from the L5-S1 nerve roots and
the tibial nerve.
,(Kendall p. 418)
A patient has ambulated with a prosthesis since undergoing a transtibial amputation six
years ago. During an examination for an unrelated diagnosis, the physical therapist
observes the patient's gait pattern. Which of the following is MOST likely to be observed
in relation to the prosthetic limb?
1.Extended stance time
2.Shortened swing time
3.Longer step length
4.Increased single limb support time - Answers - 3.A longer swing phase will typically
correspond with a longer step length on the prosthetic limb. This further increases
asymmetrical loading forces on the intact limb.
(Cameron - Physical Rehabilitation p. 286)
A patient experiences left lower extremity sciatica secondary to posterior derangement
of the L5 disk. The patient tolerated a prone on elbows position without an increase in
symptoms, however, after performing 10 prone press-ups the patient reports increased
radicular pain in the left lower extremity. What would be the physical therapist's MOST
appropriate response?
1.Instruct the patient to assume a prone position
2.Instruct the patient to assume a prone on elbows position
3.Instruct the patient to assume a standing extension position
4.Discontinue the extension progression - Answers - 2. The prone press-up position
may have been initiated prematurely. Returning to the non-exacerbating prone on
elbows position should assist the therapist to determine how to best proceed with the
patient's care (e.g., more time accommodating to prone on elbows position or
discontinuing the extension progression).
(Brody p. 402)
An individual with declining health due to unhealthy lifestyle choices plans to engage in
an independent exercise program designed to improve their cardiovascular health.
Which form of self-monitoring would be the MOST appropriate for the individual to utilize
when exercising?
1.Metabolic equivalents
2.Systolic blood pressure
3.Rate of perceived exertion
4.Respiration rate - Answers - 3.Patients can utilize a perceived exertion scale, such as
Borg's Rating of Perceived Exertion (RPE) Scale, as a subjective means of self-
monitoring during exercise. The RPE quantifies the subject's overall sense of effort by
quantifying the amount of strain or level of exertion the patient is experiencing during
activity.
(American College of Sports Medicine p. 475)
, A patient diagnosed with temporomandibular joint pain is referred to physical therapy.
During the examination, the patient demonstrates a kyphotic, forward head posture.
What is this position MOST likely to result in?
1.Anterior displacement of the mandible
2.Posterior displacement of the mandible
3.Lateral displacement of the mandible
4.Posterior displacement of the maxilla - Answers - 2.A forward head posture creates
passive tension in selected suprahyoid and infrahyoid muscles which affects the resting
posture of the mandible. The result is a posterior displacement of the mandible.
(Dutton p. 1122)
A physical therapist prepares to administer an iontophoresis treatment to a patient with
myositis ossificans in the right mid-quadriceps region. Which treatment description
would be the MOST appropriate?
1.Driving dexamethasone with a high volt pulsed current unit using the negative pole
2.Driving dexamethasone with a high volt pulsed current unit using the positive pole
3.Driving acetic acid with a direct current unit using the negative pole
4.Driving acetic acid with a direct current unit using the positive pole - Answers - 3.
Acetic acid is a medication which is useful in treating calcific deposits. Since it has a
negative polarity, the negative pole would be used to deliver the medication.
(Cameron p. 274)
After palpating several peripheral pulse sites a physical therapist concludes that a
patient has a strong pulse at the popliteal artery, but a weak pulse at the dorsalis pedis
artery. Which medical finding identified during exercise would be MOST likely based on
the patient's current status?
1.Orthopnea
2.Deep vein thrombophlebitis
3.Intermittent claudication
4.Venous thrombosis - Answers - 3.A strong popliteal artery pulse and weak dorsalis
pedis artery pulse suggests that blood flow between these sites is diminished, perhaps
from atherosclerosis. This patient could be expected to experience intermittent
claudication, or pain in the calf muscles caused by ischemia during exercise.
(Hillegass p. 71)
A physical therapist examines a 37-year-old female referred to physical therapy with an
abdominal strain. The patient reports an insidious onset of pain that is worse after
eating certain foods. The patient describes the pain as a dull ache located slightly to the
right of the center of the back at the level of the inferior border of the scapula. The
dysfunction of which of the following is MOST consistent with the patient's clinical
presentation?
1.Pancreas
