NPTE-PT Test Physical Therapist Review 1 — Questions and Answers
Question 1: A physical therapist assigns a manual muscle test (MMT) grade of 3/5 to the hip abductors. Which description best matches this grade?
- Full range of motion in a gravity-eliminated position with moderate resistance
- Full range of motion against gravity without additional resistance (Correct answer)
- Full range of motion against gravity with minimal resistance
- Partial range of motion in a gravity-eliminated position
Correct answer: Full range of motion against gravity without additional resistance
An MMT grade of 3/5 (Fair) indicates the muscle can move the limb through its full range of motion against gravity but cannot tolerate any additional external resistance. Grade 3+ adds minimal resistance, and grade 4 tolerates moderate resistance.
Question 2: A patient presents with a positive Hawkins-Kennedy test. This finding is most consistent with which condition?
- Glenohumeral anterior instability
- Biceps tendon rupture
- Subacromial impingement syndrome (Correct answer)
- Acromioclavicular joint sprain
Correct answer: Subacromial impingement syndrome
The Hawkins-Kennedy test internally rotates the shoulder at 90° of flexion, compressing the supraspinatus tendon under the coracoacromial ligament. A positive test — pain with this maneuver — strongly implicates subacromial impingement syndrome.
Question 3: Which nerve root is primarily responsible for the patellar tendon (knee jerk) reflex?
- L2
- L3
- L4 (Correct answer)
- L5
Correct answer: L4
The patellar tendon reflex is primarily mediated by the L4 nerve root (with L3 contribution). Diminution or absence of this reflex is a key clinical indicator of L4 nerve root pathology, such as from an L3–L4 disc herniation.
Question 4: A patient with moderate COPD is experiencing dyspnea during an exercise session. Which position would best optimize ventilation and reduce the work of breathing?
- Supine with lower extremities elevated
- Prone with a pillow under the chest
- High Fowler's position (sitting upright at 90°) (Correct answer)
- Left lateral decubitus
Correct answer: High Fowler's position (sitting upright at 90°)
High Fowler's position allows the diaphragm to descend fully without abdominal compression, maximizes lung expansion, and reduces the work of breathing. It is the preferred position for patients with obstructive lung disease experiencing dyspnea.
Question 5: According to Maitland's joint mobilization classification, a Grade IV technique is best described as:
- Small-amplitude oscillations at the beginning of the available range
- Large-amplitude oscillations through the full available range
- Small-amplitude oscillations at the end of the available range (Correct answer)
- A single high-velocity thrust at the end of range
Correct answer: Small-amplitude oscillations at the end of the available range
Maitland Grade IV consists of small-amplitude rhythmic oscillations performed at the end of the available range of motion, used to address stiffness and restricted joint mobility. Grade III is large amplitude reaching the end of range, while Grade V is the manipulation thrust.
Question 6: A physical therapist is performing a sensory evaluation and finds that a patient has lost light-touch sensation along the medial aspect of the lower leg and the great toe. Which nerve root level is most likely compromised?
- L3
- L4 (Correct answer)
- L5
- S1
Correct answer: L4
The L4 dermatome covers the medial lower leg and the medial aspect of the foot including the great toe. Loss of light-touch sensation in this distribution, combined with potential weakness of the tibialis anterior and diminished patellar reflex, indicates L4 nerve root involvement.
NPTE-PT Test Physical Therapist Review 1
A physical therapist assigns a manual muscle test (MMT) grade of 3/5 to the hip abductors.
Which description best matches this grade?