NPTE-PTA National Physical Therapist Assistant 4 — Questions and Answers
Question 1: A PTA is treating a 70-year-old patient with osteoporosis. Which exercise type has the GREATEST evidence for improving bone mineral density?
- Swimming three times per week
- Progressive resistance and weight-bearing impact exercise (Correct answer)
- Low-intensity stationary cycling
- Aquatic therapy in a warm pool
Correct answer: Progressive resistance and weight-bearing impact exercise
Progressive resistance training combined with weight-bearing impact activities (such as walking or low-impact aerobics) provides the mechanical loading stimulus needed to increase bone mineral density.
Question 2: A patient receiving outpatient PT tells the PTA they were recently diagnosed with HIV. The PTA's FIRST response should be to:
- Inform the supervising PT so the patient can be reassigned
- Apply transmission-based precautions in addition to standard precautions
- Continue treatment using standard precautions only (Correct answer)
- Consult the facility infection control officer before continuing
Correct answer: Continue treatment using standard precautions only
HIV is transmitted through blood and body fluids, not casual contact; standard precautions are sufficient for routine PT treatment of a patient with HIV.
Question 3: When using mechanical lumbar traction, the minimum force required to produce vertebral separation in a typical adult patient is approximately:
- 10-15% of body weight
- 25-50% of body weight (Correct answer)
- 60-75% of body weight
- Equal to full body weight
Correct answer: 25-50% of body weight
Approximately 25-50% of body weight is required to overcome friction and produce actual vertebral separation during mechanical lumbar traction.
Question 4: A patient is performing a standing balance exercise on a foam pad with eyes closed. This activity primarily challenges the:
- Visual system only
- Vestibular system and somatosensory integration (Correct answer)
- Motor cortex proprioception alone
- Cerebellar fine motor coordination
Correct answer: Vestibular system and somatosensory integration
Eyes closed on an unstable surface removes both visual and somatosensory cues, forcing the vestibular system to take primary responsibility for balance.
Question 5: A patient with a flaccid neurogenic bladder following a cauda equina injury asks the PTA about bladder management. The MOST appropriate response is to:
- Teach the patient Kegel exercises to restore sphincter tone
- Explain the condition and refer to the PT and physician for bladder management planning (Correct answer)
- Instruct the patient to use a timed voiding schedule every 2 hours
- Advise the patient to limit fluid intake to reduce bladder volume
Correct answer: Explain the condition and refer to the PT and physician for bladder management planning
Bladder management for neurogenic dysfunction requires physician and PT coordination; the PTA should educate the patient and facilitate the appropriate referral.
Question 6: During manual muscle testing of the gluteus medius, the therapist positions the patient in sidelying with the tested limb on top. A grade of 3/5 (fair) would be indicated if the patient:
- Holds the position against maximum resistance
- Completes full range of motion against gravity with moderate resistance
- Completes full range of motion against gravity with no resistance (Correct answer)
- Completes partial range of motion with gravity eliminated
Correct answer: Completes full range of motion against gravity with no resistance
Grade 3/5 (Fair) is defined as the ability to move through full range of motion against gravity but with no additional resistance.
Question 7: A PTA notices that a patient's chart contains a physician's order for 'ultrasound to left shoulder.' Before beginning treatment, the PTA should:
- Proceed with standard ultrasound parameters for shoulder pathology
- Contact the physician to clarify the specific parameters
- Consult the supervising PT for a complete plan of care before treating (Correct answer)
- Request a new order specifying exact frequency and intensity
Correct answer: Consult the supervising PT for a complete plan of care before treating
PTAs must work within a PT-established plan of care; if no PT plan of care exists, the PTA must consult the supervising PT before initiating treatment.
NPTE-PTA National Physical Therapist Assistant 4
A PTA is treating a 70-year-old patient with osteoporosis.
Which exercise type has the GREATEST evidence for improving bone mineral density?