NPTE Test Practice Questions And Answers (Verified
Solution) With Rationale
What conditions are the abnormal heart sounds S3 and S4 associated with,
respectively?
A. S3 = MI or HTN; S4 =CHF
B. S3 = Tracheal Stenosis; S4 = Asthma
C. S3 = closure of Mitral and Tricuspid Valves; S4 = Closure of Pulmonary Valves
D. S3 = CHF; S4 =MI or HTN
Feedback Correct Answer - D
S3 is heard in early diastole (after S2) and is associated with CHF. S4 is heard in late
diastole (before S1) and is associated with an MI or hypertension.
A chronic smoker diagnosed with COPD was tested for an arterial blood gas
(ABG) analysis. After reviewing the patient's chart, the physical therapist is MOST
likely to see which of the following changes in the ABG results?
A. Decreased PaCO2, increased PaO2, and decreased pH.
B. Decreased PaCO2, decreased PaO2, and increased pH.
C. Increased PaCO2, increased PaO2, and increased pH.
D. Increased PaCO2, decreased PaO2, and decreased pH
Feedback Correct Answer - D
COPD causes dilation and destruction of the airspaces and alteration in pulmonary
vasculature resulting in mismatch in ventilation in the alveoli and perfusion in the
capillary membrane. This results in hypoxemia (decreased oxygen in the arterial blood)
in the early stage of COPD and hypercapnea (increased carbon dioxide in the arterial
blood) as the disease progresses.
A geriatric patient recently developed CHF. The patient has symptoms of nausea,
vomiting, and gastrointestinal irritability. The patient also presents with mental
confusion and frustration. Based on these symptoms, what clinical condition
does the therapist suspect?
A. Alzheimer's disease
B. Dementia
C. Digoxin toxicity
D. Age related symptoms
Feedback Correct Answer - C
Signs of digoxin toxicity in patients with CHF : Nausea, vomiting, headache, dizziness,
confusion, abdominal pain, delirium, vision disturbance. With Alzheimer's and dementia,
patient will experience significant memory loss.
A patient has a history of diabetes, hypertension, and chronic heart failure. The
patient's venous filling time is 10 seconds, while Homan's sign and rubor
dependency tests are both negative. These findings support which of the
following diagnoses? Select one:
,A. Chronic venous insufficiency
B. Intermittent claudication
C. Arterial insufficiency
D. Lymphedema Feedback
Correct Answer - A
Venous filling time- The extremity is elevated and then lowered into a dependent
position. The time it takes for the veins on top of the foot to refill is recorded. Normal
filling time is 15 seconds. Greater than 15 seconds indicates arterial disease whereas
less than 15 indicate venous disease. Rubor dependency test is negative indicating no
arterial insufficiency. No signs of intermittent claudication and lymphedema are seen.
While evaluating a 30-year-old male with shoulder pain, the therapist applies
pressure at the end range of shoulder abduction and external rotation. The
patient feels a sudden PARALYZING pain and WEAKNESS in his shoulder. This
finding is MOST LIKELY an indication of:
A. Thoracic outlet syndrome
B. Myotome involvement
C. Anterior instability
D. Cervical spondylosis
Feedback Correct Answer - C
The therapist is performing anterior apprehension test or crank test. This test is primarily
designed to check for traumatic instability problems causing gross or anatomical
instability of the shoulder; positive anterior apprehension test indicates anterior
instability.
A physical therapist is examining a patient with hypomobile talocrural joint and
finds that the range of motion of ankle dorsiflexion is limited. Which of the
following mobilization techniques can be used to increase ankle dorsiflexion?
A. Posterior glide of talus with small amplitude oscillations into tissue resistance
at the limit of available joint motion
B. Anterior glide of talus with small-amplitude rhythmic oscillations performed at
the beginning of the range
C. Posterior glide of talus with small-amplitude rhythmic oscillations performed at
the beginning of the range
D. Anterior glide of talus with small amplitude oscillations into tissue resistance
at the limit of available joint motion
Feedback Correct Answer - A
Posterior glide of talus with small amplitude oscillations into tissue resistance at the limit
of available joint motion At the talocrural joint, convex talus moves over with the
concave mortise made up of the tibia and fibula. So, according to convex-concave rule,
posterior glide of talus can be used to increase ankle dorsiflexion. Grade I, i.e. small-
amplitude rhythmic oscillations performed at the beginning of the range is primarily used
for treating joints limited by pain or muscle guarding. Grade IV, i.e. small-amplitude
rhythmic oscillations performed at the limit of the available motion and stressed into the
tissue resistance is used as stretching maneuver to increase range of motion. So, grade
,4 and posterior glide of talus will be the most appropriate mobilization techniques for the
patient.
A therapist is examining a patient's straight leg raise by taking their leg into hip
flexion, knee extension and ankle dorsiflexion with inversion. Which nerve is
MOST likely being biased in this position?
A. Common peroneal nerve
B. Tibial nerve
C. Sciatic and Tibial nerve
D. Sural nerve Feedback
Feedback Correct Answer - D
Ankle Dorsiflexion with inversion places tension on the sural nerve. Plantar flexion and
inversion places tension on the common peroneal nerve. Dorsiflexion and eversion with
toe extension places tension on the tibial nerve.
A physical therapist is assessing muscle strength of a 20-year-old male who
reports having shoulder pain ever since he started lifting weights at the gym as
part of his New Year's resolution. The therapist positions the patient in the supine
position with 120° of shoulder abduction and moves the shoulder diagonally
down and inward towards the patient's opposite hip. Resistance is given above
the wrist in an up and outward direction. Which muscle is being tested?
A. Pectoralis major clavicular head
B. Pectoralis major both heads
C. Pectoralis major sternal head
D. Pectoralis minor
Feedback Correct Answer - C
MMT of Pectoralis major sternal head - the motion begins at 120° of shoulder abduction
and moves diagonally down and in toward the patient's opposite hip. Resistance is
given above the wrist in an up and outward direction.
During a gait training session, a PT notices that the patient is beginning to lose
balance in the anterior direction. What IMMEDIATE action should the therapist
take?
A. Pull the patient backwards
B. Allow the patient to re-gain their balance
C. Bring the patient to one knee
D. Push the patient forward
Feedback Correct Answer - A
As the patient is beginning to lose the balance forward; pulling the patient backwards
will help him to regain balance by performing a posterior weight shift. This is easiest to
accomplish when assisted by the therapist.
While evaluating the gait of a patient with right hemiplegia, the PT notes foot drop
during mid-swing of the right leg. The MOST LIKELY cause of this deviation is:
A. Inadequate contraction of the ankle dorsiflexors
B. Excessive extensor synergy
, C. Decreased proprioception of foot-ankle muscles
D. Excessive flexor synergy
Feedback Correct Answer - A
Ankle remains plantar flexed during swing and can be associated with dragging of the
toes, typically called drop foot. It is caused by weakness or paralysis of foot dorsiflexors.
Excessive extensor synergy causes tight plantar flexors. Excessive flexor synergy
causes excessive dorsiflexion. Decreased proprioception does not cause foot drop. It
causes sensory ataxia causing foot stomping gait.
Which of the following is the MOST appropriate long-term goal for a PT to
address in a patient with Down syndrome?
A. Accelerate the rate of motor skills development
B. Strengthen weak muscles
C. Minimize the development of compensatory movement patterns
D. Focus on rhythmic stabilization exercises
Feedback Correct Answer - C
In Down Syndrome, it is important to address the development of compensatory
movement pattern, as it can further exacerbate hypotonicity. While rhythmic stabilization
exercises do support the above, they are not a viable goal, but rather an activity.
When examining a patient with a stroke, a physical therapist finds the patient's
speech to be slow and hesitant. The patient is limited to one- or two-word
responses but appears to fully comprehend sentences. Which of the following is
the BEST description of the patient's ability to communicate?
A. Global aphasia
B. Non-expressive aphasia
C. Wernicke's aphasia
D. Broca's aphasia
Feedback Correct Answer - D
Broca's aphasia (nonfluent) is caused due to lesion involving third frontal convolution of
the left hemisphere. The flow of speech is slow and hesitant, vocabulary is limited, and
syntax is impaired. Speech production is labored or lost completely whereas
comprehension is good. In Wernicke's aphasia speech flows smoothly with a variety of
grammatical constructions but auditory comprehension is impaired. Global aphasia is
severe aphasia with marked dysfunction across all language modalities and with
severely limited residual use of all communication modes for oral-aural interactions.
An elderly gentleman was admitted to the hospital with a stroke 2 days ago. The
physical therapist has assessed the patient's functional strength, sensation, and
bed mobility. With the patient seated at the edge of bed, the therapist instructs
the patient to touch his nose with his index finger. The patient first flexes the
elbow, and then adjusts the position of the wrist and fingers. The patient then
further flexes the elbow, and lastly flexes the shoulder to generate contact
between the index finger and the nose. What neurological impairment does the
patient MOST likely have?
A. Dysdiadochokinesia
Solution) With Rationale
What conditions are the abnormal heart sounds S3 and S4 associated with,
respectively?
A. S3 = MI or HTN; S4 =CHF
B. S3 = Tracheal Stenosis; S4 = Asthma
C. S3 = closure of Mitral and Tricuspid Valves; S4 = Closure of Pulmonary Valves
D. S3 = CHF; S4 =MI or HTN
Feedback Correct Answer - D
S3 is heard in early diastole (after S2) and is associated with CHF. S4 is heard in late
diastole (before S1) and is associated with an MI or hypertension.
A chronic smoker diagnosed with COPD was tested for an arterial blood gas
(ABG) analysis. After reviewing the patient's chart, the physical therapist is MOST
likely to see which of the following changes in the ABG results?
A. Decreased PaCO2, increased PaO2, and decreased pH.
B. Decreased PaCO2, decreased PaO2, and increased pH.
C. Increased PaCO2, increased PaO2, and increased pH.
D. Increased PaCO2, decreased PaO2, and decreased pH
Feedback Correct Answer - D
COPD causes dilation and destruction of the airspaces and alteration in pulmonary
vasculature resulting in mismatch in ventilation in the alveoli and perfusion in the
capillary membrane. This results in hypoxemia (decreased oxygen in the arterial blood)
in the early stage of COPD and hypercapnea (increased carbon dioxide in the arterial
blood) as the disease progresses.
A geriatric patient recently developed CHF. The patient has symptoms of nausea,
vomiting, and gastrointestinal irritability. The patient also presents with mental
confusion and frustration. Based on these symptoms, what clinical condition
does the therapist suspect?
A. Alzheimer's disease
B. Dementia
C. Digoxin toxicity
D. Age related symptoms
Feedback Correct Answer - C
Signs of digoxin toxicity in patients with CHF : Nausea, vomiting, headache, dizziness,
confusion, abdominal pain, delirium, vision disturbance. With Alzheimer's and dementia,
patient will experience significant memory loss.
A patient has a history of diabetes, hypertension, and chronic heart failure. The
patient's venous filling time is 10 seconds, while Homan's sign and rubor
dependency tests are both negative. These findings support which of the
following diagnoses? Select one:
,A. Chronic venous insufficiency
B. Intermittent claudication
C. Arterial insufficiency
D. Lymphedema Feedback
Correct Answer - A
Venous filling time- The extremity is elevated and then lowered into a dependent
position. The time it takes for the veins on top of the foot to refill is recorded. Normal
filling time is 15 seconds. Greater than 15 seconds indicates arterial disease whereas
less than 15 indicate venous disease. Rubor dependency test is negative indicating no
arterial insufficiency. No signs of intermittent claudication and lymphedema are seen.
While evaluating a 30-year-old male with shoulder pain, the therapist applies
pressure at the end range of shoulder abduction and external rotation. The
patient feels a sudden PARALYZING pain and WEAKNESS in his shoulder. This
finding is MOST LIKELY an indication of:
A. Thoracic outlet syndrome
B. Myotome involvement
C. Anterior instability
D. Cervical spondylosis
Feedback Correct Answer - C
The therapist is performing anterior apprehension test or crank test. This test is primarily
designed to check for traumatic instability problems causing gross or anatomical
instability of the shoulder; positive anterior apprehension test indicates anterior
instability.
A physical therapist is examining a patient with hypomobile talocrural joint and
finds that the range of motion of ankle dorsiflexion is limited. Which of the
following mobilization techniques can be used to increase ankle dorsiflexion?
A. Posterior glide of talus with small amplitude oscillations into tissue resistance
at the limit of available joint motion
B. Anterior glide of talus with small-amplitude rhythmic oscillations performed at
the beginning of the range
C. Posterior glide of talus with small-amplitude rhythmic oscillations performed at
the beginning of the range
D. Anterior glide of talus with small amplitude oscillations into tissue resistance
at the limit of available joint motion
Feedback Correct Answer - A
Posterior glide of talus with small amplitude oscillations into tissue resistance at the limit
of available joint motion At the talocrural joint, convex talus moves over with the
concave mortise made up of the tibia and fibula. So, according to convex-concave rule,
posterior glide of talus can be used to increase ankle dorsiflexion. Grade I, i.e. small-
amplitude rhythmic oscillations performed at the beginning of the range is primarily used
for treating joints limited by pain or muscle guarding. Grade IV, i.e. small-amplitude
rhythmic oscillations performed at the limit of the available motion and stressed into the
tissue resistance is used as stretching maneuver to increase range of motion. So, grade
,4 and posterior glide of talus will be the most appropriate mobilization techniques for the
patient.
A therapist is examining a patient's straight leg raise by taking their leg into hip
flexion, knee extension and ankle dorsiflexion with inversion. Which nerve is
MOST likely being biased in this position?
A. Common peroneal nerve
B. Tibial nerve
C. Sciatic and Tibial nerve
D. Sural nerve Feedback
Feedback Correct Answer - D
Ankle Dorsiflexion with inversion places tension on the sural nerve. Plantar flexion and
inversion places tension on the common peroneal nerve. Dorsiflexion and eversion with
toe extension places tension on the tibial nerve.
A physical therapist is assessing muscle strength of a 20-year-old male who
reports having shoulder pain ever since he started lifting weights at the gym as
part of his New Year's resolution. The therapist positions the patient in the supine
position with 120° of shoulder abduction and moves the shoulder diagonally
down and inward towards the patient's opposite hip. Resistance is given above
the wrist in an up and outward direction. Which muscle is being tested?
A. Pectoralis major clavicular head
B. Pectoralis major both heads
C. Pectoralis major sternal head
D. Pectoralis minor
Feedback Correct Answer - C
MMT of Pectoralis major sternal head - the motion begins at 120° of shoulder abduction
and moves diagonally down and in toward the patient's opposite hip. Resistance is
given above the wrist in an up and outward direction.
During a gait training session, a PT notices that the patient is beginning to lose
balance in the anterior direction. What IMMEDIATE action should the therapist
take?
A. Pull the patient backwards
B. Allow the patient to re-gain their balance
C. Bring the patient to one knee
D. Push the patient forward
Feedback Correct Answer - A
As the patient is beginning to lose the balance forward; pulling the patient backwards
will help him to regain balance by performing a posterior weight shift. This is easiest to
accomplish when assisted by the therapist.
While evaluating the gait of a patient with right hemiplegia, the PT notes foot drop
during mid-swing of the right leg. The MOST LIKELY cause of this deviation is:
A. Inadequate contraction of the ankle dorsiflexors
B. Excessive extensor synergy
, C. Decreased proprioception of foot-ankle muscles
D. Excessive flexor synergy
Feedback Correct Answer - A
Ankle remains plantar flexed during swing and can be associated with dragging of the
toes, typically called drop foot. It is caused by weakness or paralysis of foot dorsiflexors.
Excessive extensor synergy causes tight plantar flexors. Excessive flexor synergy
causes excessive dorsiflexion. Decreased proprioception does not cause foot drop. It
causes sensory ataxia causing foot stomping gait.
Which of the following is the MOST appropriate long-term goal for a PT to
address in a patient with Down syndrome?
A. Accelerate the rate of motor skills development
B. Strengthen weak muscles
C. Minimize the development of compensatory movement patterns
D. Focus on rhythmic stabilization exercises
Feedback Correct Answer - C
In Down Syndrome, it is important to address the development of compensatory
movement pattern, as it can further exacerbate hypotonicity. While rhythmic stabilization
exercises do support the above, they are not a viable goal, but rather an activity.
When examining a patient with a stroke, a physical therapist finds the patient's
speech to be slow and hesitant. The patient is limited to one- or two-word
responses but appears to fully comprehend sentences. Which of the following is
the BEST description of the patient's ability to communicate?
A. Global aphasia
B. Non-expressive aphasia
C. Wernicke's aphasia
D. Broca's aphasia
Feedback Correct Answer - D
Broca's aphasia (nonfluent) is caused due to lesion involving third frontal convolution of
the left hemisphere. The flow of speech is slow and hesitant, vocabulary is limited, and
syntax is impaired. Speech production is labored or lost completely whereas
comprehension is good. In Wernicke's aphasia speech flows smoothly with a variety of
grammatical constructions but auditory comprehension is impaired. Global aphasia is
severe aphasia with marked dysfunction across all language modalities and with
severely limited residual use of all communication modes for oral-aural interactions.
An elderly gentleman was admitted to the hospital with a stroke 2 days ago. The
physical therapist has assessed the patient's functional strength, sensation, and
bed mobility. With the patient seated at the edge of bed, the therapist instructs
the patient to touch his nose with his index finger. The patient first flexes the
elbow, and then adjusts the position of the wrist and fingers. The patient then
further flexes the elbow, and lastly flexes the shoulder to generate contact
between the index finger and the nose. What neurological impairment does the
patient MOST likely have?
A. Dysdiadochokinesia
