NPTE PRACTICE QUESTIONS AND ANSWERS
Which of the following monofilament grades indicates that only protective sensation is
intact?
1. 3.61
2. 4.37
3. 5.07
4. 6.65 - Answers - 3. 5.07
The 5.07 monofilament supplies the least amount of force that can be sensed by
patients with only protective sensation intact. Ability to sense only the 6.65
monofilament indicates a loss of protective sensation. Ability to sense the 3.61 and 4.37
monofilaments indicates fully normal sensation.
Which of the following afferent fiber types transmits information regarding aching pain?
1. Large unmyelinated fibers
2. Small unmyelinated fibers
3. Small myelinated fibers
4. Large myelinated fibers - Answers - 2. Aching pain is transmitted on small,
unmyelinated Type C fibers
Which of the following examination findings would MOST likely be positive in a patient
with cauda equina syndrome?
1. Ankle clonus
2. Babinski sign
3. Urinary retention
4. Positive prone knee flexion test - Answers - 3. Urinary retention
Cauda equina causes lower motor neuron dysfunction, including urinary retention and
incontinence. Positive Babinski and clonus responses indicate upper motor neuron
dysfunction. A positive prone knee flexion test is more likely with upper lumbar nerve
root impairment
A physical therapist is evaluating a patient with low back pain and associated
symptoms. Which of the following findings should cause the therapist to refer the patient
back to the physician?
1. Good (4/5) strength of the hamstrings
2. Pain radiating down the back of the thigh into the calf
3. Positive straight-leg test at 60° of hip flexion
4. Saddle anesthesia around the perineum - Answers - 4. Saddle anesthesia around the
perineum
, Options 1, 2, and 3 are typical with low back pain, and none alone requires immediate
referral. Saddle anesthesia around the perineum is a sign of cauda equine syndrome
and usually requires immediate treatment by someone other than a physical therapist
Which of the following lower extremity proprioceptive neuromuscular facilitation patterns
is MOST appropriate for a patient who needs strengthening of the tibialis posterior?
1. Hip extension, abduction, and medial (internal) rotation, with ankle plantar flexion and
eversion
2. Hip flexion, adduction, and lateral (external) rotation, with ankle dorsiflexion and
inversion
3. Hip extension, adduction, and lateral (external) rotation, with ankle plantar flexion and
inversion
4. Hip flexion, abduction, and medial (internal) rotation, with ankle dorsiflexion and
eversion - Answers - 3. Hip extension, adduction, and lateral (external) rotation, with
ankle plantar flexion and inversion
A patient who had a C6 traumatic spinal cord injury 1 month ago reports a severe,
pounding headache and restlessness while standing in a standing frame. The patient's
vital signs indicate hypertension and bradycardia. The MOST appropriate immediate
response of the physical therapist is to:
1. instruct the patient in deep breathing techniques.
2. apply a cervical cold pack.
3. remove the abdominal gait belt.
4. assess for catheter blockage. - Answers - 4. assess for catheter blockage.
Neither deep breathing techniques nor a cervical cold pack would be an effective
response to this emergency situation. Although the abdominal gait belt might be a
contributing factor, it is not the most likely primary cause. This patient scenario is
indicative of autonomic dysreflexia, a pathological reflex. The most common cause is
bladder distention or urinary retention, which is likely to be caused by a urinary catheter
blockage
During examination of a patient, a physical therapist notes bradycardia. The patient
reports constipation and cold intolerance. Which of the following conditions is the MOST
likely cause of this sign and symptoms?
1. Hypothyroidism
2. Hyperthyroidism
3. Hyperparathyroidsim
4. Hypoparathyroidsim - Answers - 1. Hypothyroidism
Hypothyroidism would most likely cause the signs and symptoms. Hyperthyroidism
causes diarrhea, rather than constipation. Hyperparathyroidism is not associated with
Which of the following monofilament grades indicates that only protective sensation is
intact?
1. 3.61
2. 4.37
3. 5.07
4. 6.65 - Answers - 3. 5.07
The 5.07 monofilament supplies the least amount of force that can be sensed by
patients with only protective sensation intact. Ability to sense only the 6.65
monofilament indicates a loss of protective sensation. Ability to sense the 3.61 and 4.37
monofilaments indicates fully normal sensation.
Which of the following afferent fiber types transmits information regarding aching pain?
1. Large unmyelinated fibers
2. Small unmyelinated fibers
3. Small myelinated fibers
4. Large myelinated fibers - Answers - 2. Aching pain is transmitted on small,
unmyelinated Type C fibers
Which of the following examination findings would MOST likely be positive in a patient
with cauda equina syndrome?
1. Ankle clonus
2. Babinski sign
3. Urinary retention
4. Positive prone knee flexion test - Answers - 3. Urinary retention
Cauda equina causes lower motor neuron dysfunction, including urinary retention and
incontinence. Positive Babinski and clonus responses indicate upper motor neuron
dysfunction. A positive prone knee flexion test is more likely with upper lumbar nerve
root impairment
A physical therapist is evaluating a patient with low back pain and associated
symptoms. Which of the following findings should cause the therapist to refer the patient
back to the physician?
1. Good (4/5) strength of the hamstrings
2. Pain radiating down the back of the thigh into the calf
3. Positive straight-leg test at 60° of hip flexion
4. Saddle anesthesia around the perineum - Answers - 4. Saddle anesthesia around the
perineum
, Options 1, 2, and 3 are typical with low back pain, and none alone requires immediate
referral. Saddle anesthesia around the perineum is a sign of cauda equine syndrome
and usually requires immediate treatment by someone other than a physical therapist
Which of the following lower extremity proprioceptive neuromuscular facilitation patterns
is MOST appropriate for a patient who needs strengthening of the tibialis posterior?
1. Hip extension, abduction, and medial (internal) rotation, with ankle plantar flexion and
eversion
2. Hip flexion, adduction, and lateral (external) rotation, with ankle dorsiflexion and
inversion
3. Hip extension, adduction, and lateral (external) rotation, with ankle plantar flexion and
inversion
4. Hip flexion, abduction, and medial (internal) rotation, with ankle dorsiflexion and
eversion - Answers - 3. Hip extension, adduction, and lateral (external) rotation, with
ankle plantar flexion and inversion
A patient who had a C6 traumatic spinal cord injury 1 month ago reports a severe,
pounding headache and restlessness while standing in a standing frame. The patient's
vital signs indicate hypertension and bradycardia. The MOST appropriate immediate
response of the physical therapist is to:
1. instruct the patient in deep breathing techniques.
2. apply a cervical cold pack.
3. remove the abdominal gait belt.
4. assess for catheter blockage. - Answers - 4. assess for catheter blockage.
Neither deep breathing techniques nor a cervical cold pack would be an effective
response to this emergency situation. Although the abdominal gait belt might be a
contributing factor, it is not the most likely primary cause. This patient scenario is
indicative of autonomic dysreflexia, a pathological reflex. The most common cause is
bladder distention or urinary retention, which is likely to be caused by a urinary catheter
blockage
During examination of a patient, a physical therapist notes bradycardia. The patient
reports constipation and cold intolerance. Which of the following conditions is the MOST
likely cause of this sign and symptoms?
1. Hypothyroidism
2. Hyperthyroidism
3. Hyperparathyroidsim
4. Hypoparathyroidsim - Answers - 1. Hypothyroidism
Hypothyroidism would most likely cause the signs and symptoms. Hyperthyroidism
causes diarrhea, rather than constipation. Hyperparathyroidism is not associated with
