NPTE-PT Review 3 — Questions and Answers
Question 1: A patient with T6 complete spinal cord injury is performing wheelchair propulsion and suddenly develops pounding headache, diaphoresis above the lesion, and hypertension. What is the most appropriate immediate action?
- Administer oxygen and monitor vitals
- Sit the patient upright and identify the noxious stimulus (Correct answer)
- Place the patient supine and call emergency services
- Apply a cold pack to the forehead
Correct answer: Sit the patient upright and identify the noxious stimulus
Autonomic dysreflexia management begins with sitting the patient upright to lower BP reflexively and immediately identifying and removing the offending noxious stimulus below the level of injury.
Question 2: Which manual therapy technique is classified as a Grade V mobilization according to the Maitland grading system?
- Large amplitude movement at the beginning of range
- Small amplitude movement at end range
- High-velocity low-amplitude thrust (Correct answer)
- Sustained end-range stretch
Correct answer: High-velocity low-amplitude thrust
Grade V in the Maitland system is a high-velocity low-amplitude (HVLA) thrust technique performed at the end of available range.
Question 3: A patient demonstrates a positive Finkelstein test. Which condition does this finding indicate?
- Carpal tunnel syndrome
- De Quervain's tenosynovitis (Correct answer)
- Trigger finger
- Cubital tunnel syndrome
Correct answer: De Quervain's tenosynovitis
A positive Finkelstein test—pain along the radial wrist with thumb adduction and ulnar deviation—indicates De Quervain's tenosynovitis of the APL and EPB tendons.
Question 4: Which type of muscle contraction produces the greatest amount of force for a given level of muscle activation?
- Concentric
- Isometric
- Eccentric (Correct answer)
- Isokinetic concentric
Correct answer: Eccentric
Eccentric contractions allow muscles to produce greater force than isometric or concentric contractions due to passive elastic component contributions and cross-bridge mechanics.
Question 5: A patient with chronic obstructive pulmonary disease (COPD) reports improved breathing with which position?
- Supine with legs elevated
- Sitting forward leaning on forearms (forward lean sitting) (Correct answer)
- Standing with arms crossed at chest
- Lying on uninvolved side
Correct answer: Sitting forward leaning on forearms (forward lean sitting)
Forward lean sitting fixes the shoulder girdle, allowing accessory breathing muscles to act on the thorax rather than the shoulder, reducing dyspnea in COPD patients.
Question 6: Which nerve is tested by assessing sensation over the dorsal web space between the first and second toes?
- Sural nerve
- Deep peroneal nerve (Correct answer)
- Superficial peroneal nerve
- Saphenous nerve
Correct answer: Deep peroneal nerve
The deep peroneal nerve (deep fibular nerve) provides sensory innervation to the dorsal web space between the first and second toes.
Question 7: According to the APTA Guide to Physical Therapist Practice, which term best describes the process of determining who will benefit from physical therapy?
- Prognosis
- Diagnosis
- Screening (Correct answer)
- Evaluation
Correct answer: Screening
Screening determines whether an individual's condition warrants physical therapy services or requires referral to another healthcare provider.
NPTE-PT Review 3
A patient with T6 complete spinal cord injury is performing wheelchair propulsion and suddenly develops pounding headache, diaphoresis above the lesion, and hypertension.
What is the most appropriate immediate action?