NPTE-PT Review 4 — Questions and Answers
Question 1: A patient demonstrates difficulty walking on heels and foot drop. Which nerve root level is most likely affected?
- L3
- L4
- L5 (Correct answer)
- S1
Correct answer: L5
L5 nerve root innervates the tibialis anterior and extensor hallucis longus; an L5 lesion causes dorsiflexion weakness and foot drop.
Question 2: Which stage of Brunnstrom's Motor Recovery Scale describes the appearance of spasticity and stereotyped limb synergies in a stroke patient?
- Stage 1
- Stage 2 (Correct answer)
- Stage 3
- Stage 4
Correct answer: Stage 2
Stage 2 of Brunnstrom's recovery is characterized by the onset of spasticity and the emergence of limb synergy patterns following a flaccid Stage 1.
Question 3: A patient is referred for vestibular rehabilitation with complaints of position-triggered brief vertigo. The Dix-Hallpike test reproduces symptoms with upbeat-torsional nystagmus. Which canal is most likely involved?
- Horizontal semicircular canal
- Posterior semicircular canal (Correct answer)
- Anterior semicircular canal
- Utricle
Correct answer: Posterior semicircular canal
Upbeat-torsional nystagmus on Dix-Hallpike testing is pathognomonic for posterior semicircular canal BPPV, the most common form.
Question 4: Which pharmacological agent used in the treatment of hypertension can cause exercise-induced hypotension and blunt the heart rate response to exercise?
- ACE inhibitors
- Beta-blockers (Correct answer)
- Calcium channel blockers
- Diuretics
Correct answer: Beta-blockers
Beta-blockers blunt sympathetic-mediated heart rate increase and can cause exertional hypotension, requiring rate of perceived exertion (RPE) rather than heart rate for exercise intensity monitoring.
Question 5: When measuring passive knee extension with a goniometer, the stationary arm of the goniometer should align with which landmark?
- Lateral femoral condyle
- Greater trochanter to lateral femoral condyle (Correct answer)
- Head of the fibula to lateral malleolus
- Tibial tuberosity
Correct answer: Greater trochanter to lateral femoral condyle
For knee extension ROM, the stationary arm aligns along the femur from the greater trochanter to the lateral femoral condyle, with the axis at the lateral femoral condyle.
Question 6: A physical therapist notices a patient's wound has a black, dry, leathery eschar covering its full surface. Which wound classification best describes this?
- Stage II pressure injury
- Stage III pressure injury
- Unstageable pressure injury (Correct answer)
- Deep tissue pressure injury
Correct answer: Unstageable pressure injury
An unstageable pressure injury is one covered by eschar or slough that obscures the true depth, preventing accurate staging.
Question 7: Which principle of therapeutic exercise states that training adaptations are specific to the type, speed, and range of motion used during training?
- Overload principle
- Reversibility principle
- SAID principle (Specific Adaptation to Imposed Demands) (Correct answer)
- Progressive resistance principle
Correct answer: SAID principle (Specific Adaptation to Imposed Demands)
The SAID principle states that the body adapts specifically to the demands placed upon it; training must mimic the target activity's mechanics for optimal transfer.
NPTE-PT Review 4
A patient demonstrates difficulty walking on heels and foot drop.
Which nerve root level is most likely affected?