NPTE Scorebuilders OA Practice Exam 1 (Physical Therapy Board Review, Clinical Reasoning &
Answer Explanations)
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 - ANS ✔✔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 - ANS ✔✔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 - ANS ✔✔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 - ANS ✔✔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 - ANS ✔✔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 - ANS ✔✔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 - ANS ✔✔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 - ANS ✔✔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
Answer Explanations)
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 - ANS ✔✔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 - ANS ✔✔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 - ANS ✔✔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 - ANS ✔✔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 - ANS ✔✔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 - ANS ✔✔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 - ANS ✔✔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 - ANS ✔✔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
