NPTE-PTA National Physical Therapy Exam — Questions and Answers

Question 1: Which type of stroke causes deficits on the SAME side as the lesion?

Cortical stroke
Cerebellar stroke (Correct answer)
Basal ganglia lesion
Middle cerebral artery stroke

Correct answer: Cerebellar stroke

Cerebellar lesions cause ipsilateral (same-side) deficits because the cerebellum controls the same side of the body.

Question 2: When fitting axillary crutches, axillary pads should be positioned:

Against the ribs
1–2 inches below the axilla (Correct answer)
Directly in the axilla
At shoulder height

Correct answer: 1–2 inches below the axilla

Axillary crutch tops should be 1–2 inches (2–3 finger widths) below the axilla to prevent axillary nerve and artery compression.

Question 3: Venous stasis ulcers typically occur at which location on the lower extremity?

Tips of toes
Medial malleolus and gaiter area (Correct answer)
Heel
Dorsum of foot

Correct answer: Medial malleolus and gaiter area

Venous ulcers classically occur around the medial malleolus and gaiter area due to venous hypertension from incompetent valves.

Question 4: A pressure injury that presents with partial-thickness skin loss with exposed dermis is classified as:

Stage 2 (Correct answer)
Stage 1
Stage 4
Stage 3

Correct answer: Stage 2

Stage 2 pressure injuries involve partial-thickness skin loss with exposed dermis, appearing as a shallow open ulcer or intact blister.

Question 5: The end-feel for a normal elbow at end-range extension is:

Firm
Empty
Hard (bony) (Correct answer)
Soft

Correct answer: Hard (bony)

Normal elbow extension has a hard (bony) end-feel due to olecranon process contacting the olecranon fossa.

Question 6: When measuring a patient for a manual wheelchair, seat width should be:

Equal to the patient's shoulder width
1-2 inches wider than the widest point of the hips (Correct answer)
Equal to the widest point of the hips
3-4 inches wider than the widest point of the hips

Correct answer: 1-2 inches wider than the widest point of the hips

Seat width should be 1-2 inches wider than the widest part of the hips or thighs, allowing comfortable seating without excessive lateral movement or pressure.

Question 7: Orthostatic hypotension is defined as a drop in systolic BP of at least:

10 mmHg upon standing
5 mmHg upon standing
20 mmHg upon standing (Correct answer)
30 mmHg upon standing

Correct answer: 20 mmHg upon standing

Orthostatic hypotension is a ≥20 mmHg drop in systolic or ≥10 mmHg drop in diastolic BP within 3 minutes of standing.

Question 8: Which muscle is responsible for scapular upward rotation during shoulder elevation?

Serratus anterior (Correct answer)
Middle trapezius
Rhomboids
Levator scapulae

Correct answer: Serratus anterior

The serratus anterior and upper/lower trapezius form the force couple responsible for scapular upward rotation.

Question 9: A patient post-CVA has difficulty recognizing objects by touch with eyes closed. This is called:

Agnosia
Apraxia
Anosognosia
Astereognosis (Correct answer)

Correct answer: Astereognosis

Astereognosis is the inability to identify objects through tactile exploration without visual input.

Question 10: Spasticity in upper motor neuron lesions is characterized by:

Flaccid tone
Velocity-dependent resistance (Correct answer)
Cogwheel rigidity
Velocity-independent resistance

Correct answer: Velocity-dependent resistance

Spasticity is a velocity-dependent increase in tonic stretch reflexes, distinguishing it from rigidity.

Question 11: Informed consent in physical therapy requires the PTA to:

Only obtain consent for surgical procedures
Explain risks, benefits, and alternatives to the patient (Correct answer)
Document consent only for electrical modalities
Perform all procedures without explanation

Correct answer: Explain risks, benefits, and alternatives to the patient

Informed consent requires explaining the procedure, its benefits, potential risks, and alternatives so the patient can make an autonomous decision.

Question 12: Normal hip abduction range of motion is approximately:

30–45° (Correct answer)
60–75°
20–30°
45–60°

Correct answer: 30–45°

Normal hip abduction ranges from approximately 30° to 45° in a typical adult.

Question 13: The rule of nines estimates burn surface area. The entire head and neck accounts for:

9% (Correct answer)
18%
4.5%
36%

Correct answer: 9%

The head and neck together account for 9% of total body surface area in the rule of nines for adults.

Question 14: Which functional mobility task is used to assess fall risk in the elderly: Timed Up and Go (TUG) test?

Stand from floor to standing
Single-leg stance for 30 seconds
Rise from chair, walk 3 meters, turn, return, sit (Correct answer)
Walk 10 meters at comfortable pace

Correct answer: Rise from chair, walk 3 meters, turn, return, sit

The TUG test measures time to stand from a chair, walk 3 meters, turn, return, and sit — scores >12 seconds indicate fall risk.

Question 15: Which wheelchair type is MOST appropriate for a patient with strong upper extremities who prioritizes independent self-propulsion?

Heavy-duty bariatric wheelchair
Ultra-lightweight manual wheelchair (Correct answer)
Transport (attendant-propelled) wheelchair
Standard power wheelchair

Correct answer: Ultra-lightweight manual wheelchair

An ultra-lightweight manual wheelchair requires the least propulsion energy due to its reduced weight, making it ideal for active patients with good upper extremity strength.

Question 16: Which sign indicates arterial insufficiency in the lower extremity?

Dependent rubor with elevation pallor (Correct answer)
Hemosiderin staining
Varicose veins
Brawny edema

Correct answer: Dependent rubor with elevation pallor

Dependent rubor (redness when dependent) and elevation pallor are classic signs of arterial insufficiency from poor perfusion.

Question 17: Which special test is used to assess the anterior cruciate ligament (ACL)?

McMurray test
Lachman test (Correct answer)
Valgus stress test
Apley compression test

Correct answer: Lachman test

The Lachman test is the most sensitive clinical test for ACL integrity, performed with the knee at 20–30° of flexion.

Question 18: Which of the following assistive devices provides the LEAST amount of stability?

Hemi-walker
Quad cane
Standard straight cane (Correct answer)
Standard walker

Correct answer: Standard straight cane

A standard straight cane has only one point of ground contact, providing the least stability compared to walkers, hemi-walkers, and quad canes.

Question 19: Which muscle is the primary hip flexor tested during the NPTE-PTA examination?

Sartorius
Iliacus
Rectus femoris
Iliopsoas (Correct answer)

Correct answer: Iliopsoas

The iliopsoas (iliacus + psoas major) is the primary hip flexor and is commonly tested on the NPTE-PTA.

Question 20: Standard vital sign monitoring during exercise should include at minimum:

Blood glucose and ECG
Height and weight only
Heart rate, blood pressure, respiratory rate, and perceived exertion (Correct answer)
Temperature and pulse oximetry only

Correct answer: Heart rate, blood pressure, respiratory rate, and perceived exertion

Core vital sign monitoring during exercise includes heart rate, blood pressure, respiratory rate, and RPE to ensure patient safety.

Question 21: Which color wound bed indicates necrotic, non-viable tissue that requires debridement?

Red
Black eschar (Correct answer)
Pink epithelium
Yellow/green slough

Correct answer: Black eschar

Black eschar indicates hard, dried necrotic tissue that must be debrided before wound healing can progress.

Question 22: Which reflex is used to assess the S1 spinal level?

Brachioradialis reflex
Biceps reflex
Achilles reflex (Correct answer)
Patellar reflex

Correct answer: Achilles reflex

The Achilles (ankle jerk) reflex is mediated by the S1 nerve root.

Question 23: When fitting a patient for axillary crutches, the axillary pad should be positioned how far below the axilla?

4-5 inches below
At the level of the shoulder
Flush with the axilla
1-2 inches below (Correct answer)

Correct answer: 1-2 inches below

The axillary pad should rest 1-2 inches (2-3 finger widths) below the axilla to prevent compression of the brachial plexus and axillary nerve.

Question 24: Open kinetic chain (OKC) exercises for the knee are appropriate for:

Early ACL reconstruction rehabilitation to protect the graft
Improving functional gait pattern
Patellofemoral syndrome management
Terminal knee extension strengthening of the quadriceps (Correct answer)

Correct answer: Terminal knee extension strengthening of the quadriceps

OKC terminal knee extension isolates the quadriceps and is used for strengthening in specific ranges without graft stress.

Question 25: The SAID principle in rehabilitation stands for:

Specific Adaptation to Imposed Demands (Correct answer)
Strength and Agility Improvement Design
Systematic Application of Increasing Difficulty
Submaximal Activity for Increased Duration

Correct answer: Specific Adaptation to Imposed Demands

The SAID principle states the body specifically adapts to the type of demands placed upon it during training.

Question 26: Normal blood pressure response to exercise includes:

Equal rise in systolic and diastolic BP
No change in diastolic BP
Increase in systolic BP with stable or slight decrease in diastolic BP (Correct answer)
Decrease in systolic BP

Correct answer: Increase in systolic BP with stable or slight decrease in diastolic BP

During exercise, systolic BP rises with increased cardiac output while diastolic BP remains stable or slightly decreases due to vasodilation.

Question 27: Which medication class used in cardiac patients can blunt the heart rate response to exercise?

Calcium channel blockers
ACE inhibitors
Diuretics
Beta-blockers (Correct answer)

Correct answer: Beta-blockers

Beta-blockers reduce heart rate response to exercise, requiring RPE-based rather than heart rate-based intensity monitoring.

Question 28: Normal active knee extension range of motion is approximately:

15°
10°
0° (Correct answer)
20°

Correct answer: 0°

Normal knee extension is 0° (full extension), with hyperextension beyond 0° considered hypermobile.

Question 29: SOAP notes in physical therapy documentation stand for:

Subjective, Objective, Assessment, Plan (Correct answer)
Summary, Observation, Assessment, Plan
Subjective, Outcomes, Activities, Performance
Situation, Objective, Action, Progress

Correct answer: Subjective, Objective, Assessment, Plan

SOAP notes organize clinical documentation into Subjective (patient reports), Objective (measured findings), Assessment (clinical judgment), and Plan.

Question 30: A full-thickness burn wound is characterized by:

Moist, painful surface
Erythema and pain
Blistering and pain
White or charred appearance, no pain (Correct answer)

Correct answer: White or charred appearance, no pain

Full-thickness (3rd degree) burns destroy all skin layers including nerve endings, resulting in a painless white, brown, or black appearance.

Question 31: A patient post-CABG has a sternal precaution. Which activity should be avoided?

Bilateral shoulder flexion to 90°
Walking on flat surfaces
Lifting objects greater than 5–10 lbs (Correct answer)
Supine to sitting with leg swing

Correct answer: Lifting objects greater than 5–10 lbs

Sternal precautions after CABG restrict lifting >5–10 lbs to protect the healing sternotomy from stress.

Question 32: A patient has a positive Phalen's test. Which condition does this suggest?

Cubital tunnel syndrome
Trigger finger
De Quervain's tenosynovitis
Carpal tunnel syndrome (Correct answer)

Correct answer: Carpal tunnel syndrome

Phalen's test (sustained wrist flexion causing paresthesias) is a clinical screen for carpal tunnel syndrome.

Question 33: Which exercise is most appropriate for a patient in the acute phase of lumbar rehabilitation?

Posterior pelvic tilt in supine (pelvic stabilization) (Correct answer)
Standing long-lever trunk rotations
Deadlifts with full spinal flexion
Full sit-ups with hip flexors anchored

Correct answer: Posterior pelvic tilt in supine (pelvic stabilization)

Posterior pelvic tilts in supine activate the transverse abdominis and reduce lumbar lordosis with minimal spinal load.

Question 34: Goniometry measures:

Sensation
Joint range of motion (Correct answer)
Muscle strength
Limb length discrepancy

Correct answer: Joint range of motion

Goniometry is the measurement of joint angles and range of motion using a goniometer.

Question 35: Clubbing of the fingers is associated with:

Peripheral artery disease
Chronic hypoxia from cardiopulmonary disease (Correct answer)
Carpal tunnel syndrome
Raynaud's phenomenon

Correct answer: Chronic hypoxia from cardiopulmonary disease

Digital clubbing is associated with chronic hypoxemia from conditions such as cystic fibrosis, lung cancer, and congenital heart disease.

Question 36: For a standing pivot transfer from wheelchair to mat table, the wheelchair should be positioned at what angle to the surface?

135 degrees
90 degrees (perpendicular)
45 degrees (Correct answer)
Parallel (0 degrees)

Correct answer: 45 degrees

A 45-degree angle minimizes the arc of rotation needed to complete the transfer, reducing physical demands on both the patient and clinician.

Question 37: Which balance system is most relied upon when standing on an unstable surface with eyes closed?

Visual system
Auditory system
Somatosensory system
Vestibular system (Correct answer)

Correct answer: Vestibular system

When both visual and somatosensory inputs are reduced or unreliable, the vestibular system becomes the primary balance reference.

Question 38: Which outcome measure is used to assess functional independence in activities of daily living (ADLs)?

Numeric Pain Rating Scale (NPRS)
Functional Independence Measure (FIM) (Correct answer)
Visual Analog Scale (VAS)
DASH questionnaire

Correct answer: Functional Independence Measure (FIM)

The Functional Independence Measure (FIM) rates 18 ADL items from 1 (total assistance) to 7 (complete independence).

Question 39: A patient's SpO2 drops to 88% during exercise. The PTA should:

Increase exercise intensity
Stop exercise and notify the physical therapist (Correct answer)
Continue exercise at the same intensity
Apply supplemental oxygen and continue

Correct answer: Stop exercise and notify the physical therapist

An SpO2 below 90% is a contraindication to continued exercise; the PTA must stop and report to the supervising PT.

Question 40: A patient progressing from a standard walker to a less supportive device would MOST appropriately transition to:

Quad cane (Correct answer)
Lofstrand crutches
Platform walker
Axillary crutches

Correct answer: Quad cane

A quad cane is the logical next step down in support from a walker, providing more stability than a standard cane while requiring more balance than a walker.

Question 41: Which anatomical structure is most commonly involved in a rotator cuff tear?

Subscapularis
Teres minor
Supraspinatus (Correct answer)
Infraspinatus

Correct answer: Supraspinatus

The supraspinatus tendon is the most frequently torn component of the rotator cuff due to its position under the coracoacromial arch.

Question 42: Which exercise is most appropriate for improving scapular stabilization?

Prone Y, T, W exercises (Correct answer)
Shoulder press with dumbbells
Wrist extension exercises
Biceps curls

Correct answer: Prone Y, T, W exercises

Prone Y, T, W exercises activate lower trapezius and serratus anterior, targeting scapular stabilizers in a gravity-loaded position.

Question 43: Which wheelchair component MOST directly prevents a patient from sliding forward out of the chair?

Anti-tipping devices
Padded armrests
Pressure-relieving seat cushion
Lap/seat belt (Correct answer)

Correct answer: Lap/seat belt

A lap belt is the primary restraint for preventing forward sliding out of the wheelchair, directly securing the patient at the pelvis.

Question 44: A PTA is assessing a patient with a grade 3 muscle strength. What does this indicate?

No contraction
Full ROM against moderate resistance
Full ROM against gravity, no resistance (Correct answer)
Trace contraction only

Correct answer: Full ROM against gravity, no resistance

Grade 3 on the manual muscle testing scale means the patient can complete full ROM against gravity but cannot tolerate added resistance.

Question 45: Which assistive device provides the most stability for ambulation?

Quad cane
Straight cane
Axillary crutches
Standard walker (Correct answer)

Correct answer: Standard walker

A standard walker provides the most stability because it creates a wide, stable base of support on all four legs.

Question 46: A patient presents with lateral epicondylalgia. Which motion will most likely reproduce pain?

Elbow flexion against resistance
Wrist extension with elbow extended (Correct answer)
Wrist flexion with elbow extended
Shoulder internal rotation

Correct answer: Wrist extension with elbow extended

Resisted wrist extension with the elbow extended stresses the extensor carpi radialis brevis tendon, reproducing lateral epicondyle pain.

Question 47: A Lofstrand (forearm) crutch differs from an axillary crutch primarily because it:

Is contraindicated for long-term use
Allows hands-free use via the forearm cuff (Correct answer)
Requires less upper extremity strength to use
Provides greater overall stability than axillary crutches

Correct answer: Allows hands-free use via the forearm cuff

The forearm cuff of a Lofstrand crutch allows the user to release the handgrip while the crutch remains on the arm, enabling hands-free activities during functional tasks.

Question 48: Transcutaneous electrical nerve stimulation (TENS) is MOST appropriate for which patient goal?

Quadriceps strengthening after ACL reconstruction
Decreasing muscle spasticity in hemiplegia
Reduction of chronic low back pain (Correct answer)
Facilitating open wound healing

Correct answer: Reduction of chronic low back pain

TENS is primarily used for pain modulation through gate control or endogenous opioid mechanisms, making pain reduction its most well-supported clinical application.

Question 49: Which type of debridement uses selective enzymatic agents applied to necrotic tissue?

Autolytic debridement
Mechanical debridement
Sharp debridement
Enzymatic debridement (Correct answer)

Correct answer: Enzymatic debridement

Enzymatic debridement uses topical enzymes such as collagenase to selectively break down necrotic tissue.

Question 50: Which of the following is an absolute contraindication to aerobic exercise?

Controlled hypertension
Resting heart rate of 95 bpm
Unstable angina (Correct answer)
Type 2 diabetes mellitus

Correct answer: Unstable angina

Unstable angina is an absolute contraindication to exercise because it signals impending myocardial infarction.

Question 51: According to the physical therapy plan of care, a PTA should consult the supervising PT when:

The patient asks a question
Standard progression milestones are met
The patient refuses one exercise
The patient's condition changes significantly or new symptoms emerge (Correct answer)

Correct answer: The patient's condition changes significantly or new symptoms emerge

PTAs must communicate with and consult the supervising PT when there are significant changes in patient status or unexpected findings.

Question 52: Pitting edema is graded on a 1–4 scale. Grade 3 pitting edema indicates:

6 mm depression, rebounds in 1–2 minutes (Correct answer)
4 mm depression, rebounds in <15 seconds
8 mm depression, rebounds in 2–5 minutes
2 mm depression, rebounds immediately

Correct answer: 6 mm depression, rebounds in 1–2 minutes

Grade 3 pitting edema produces a 6 mm indentation that takes 1–2 minutes to rebound.

Question 53: Which physical agent is contraindicated over a pacemaker?

Cryotherapy
Hot pack
Interferential current (Correct answer)
Ultrasound

Correct answer: Interferential current

Electrical stimulation, including interferential current, is contraindicated near pacemakers as it can interfere with the device's function.

Question 54: The Ober test is used to assess tightness of which structure?

Iliotibial band (Correct answer)
Hip flexor
Hamstring
Piriformis

Correct answer: Iliotibial band

The Ober test assesses tightness of the iliotibial (IT) band and tensor fasciae latae.

Question 55: A tilt-in-space wheelchair differs from a reclining wheelchair because tilt-in-space systems:

Allow the seat-to-back angle to open during recline
Rotate the entire seating system while maintaining the seat-to-back angle (Correct answer)
Are only appropriate for pediatric populations
Provide greater independent mobility than reclining chairs

Correct answer: Rotate the entire seating system while maintaining the seat-to-back angle

Tilt-in-space systems rotate the whole seating unit together, preserving the hip angle and reducing shear forces, unlike reclining systems that open the seat-to-back angle.

Question 56: The Romberg test primarily assesses which sensory system?

Cerebellar coordination
Visual only
Proprioception (Correct answer)
Vestibular only

Correct answer: Proprioception

The Romberg test assesses proprioceptive (somatosensory) function by removing visual input while the patient stands.

Question 57: Paraffin bath treatment temperature is typically set between:

47–54°C (118–130°F) (Correct answer)
40–42°C (104–108°F)
35–38°C (95–100°F)
55–65°C (131–149°F)

Correct answer: 47–54°C (118–130°F)

Paraffin baths are maintained at 47–54°C (118–130°F), providing superficial heat to hands and feet.

Question 58: A patient has non-weight-bearing (NWB) status on the right lower extremity and is using axillary crutches. Which gait pattern is MOST appropriate?

4-point gait
Swing-through gait
3-point gait (Correct answer)
2-point gait

Correct answer: 3-point gait

The 3-point gait pattern is used for NWB on one extremity, where both crutches and the affected limb advance together, followed by the uninvolved leg.

Question 59: Which developmental milestone is typically achieved at 9–10 months of age?

Sitting without support
Independent walking
Rolling
Pulling to stand (Correct answer)

Correct answer: Pulling to stand

Most infants pull themselves to a standing position by 9–10 months as part of normal gross motor development.

Question 60: Which wound dressing maintains a moist environment and is appropriate for a clean, granulating wound?

Hydrocolloid dressing (Correct answer)
Wet-to-dry dressing
Calcium alginate
Dry gauze

Correct answer: Hydrocolloid dressing

Hydrocolloid dressings maintain a moist wound environment that promotes granulation and epithelialization.

Question 61: Which muscle is targeted by terminal knee extensions (TKE) with a resistance band?

Quadriceps (VMO focus) (Correct answer)
Gastrocnemius
Gluteus maximus
Hamstrings

Correct answer: Quadriceps (VMO focus)

TKE specifically targets the quadriceps, particularly the vastus medialis oblique (VMO), in the last degrees of knee extension.

Question 62: The recommended progression of resistance training for a deconditioned patient follows:

High weight, low repetitions first
Power training first to establish baseline
Muscular endurance → hypertrophy → strength → power (Correct answer)
Isometric → isotonic → isokinetic in any order

Correct answer: Muscular endurance → hypertrophy → strength → power

Progressive resistance training typically progresses from endurance (high reps, low load) to hypertrophy to strength to power.

Question 63: Which stretching technique uses alternating contraction and relaxation to increase ROM?

Passive stretching
Static stretching
Ballistic stretching
Contract-relax PNF stretching (Correct answer)

Correct answer: Contract-relax PNF stretching

Contract-relax PNF uses autogenic inhibition (contraction then relaxation of the target muscle) to allow greater ROM.

Question 64: Negative pressure wound therapy (NPWT/VAC) promotes healing by:

Applying subatmospheric pressure to remove exudate and promote granulation (Correct answer)
Delivering antibiotic locally
Keeping the wound dry
Providing heat to the wound bed

Correct answer: Applying subatmospheric pressure to remove exudate and promote granulation

NPWT applies controlled negative pressure to remove exudate, reduce edema, and stimulate granulation tissue formation.

Question 65: A patient with COPD demonstrates barrel chest. This is caused by:

Pulmonary fibrosis
Air trapping from obstructed airways causing hyperinflation (Correct answer)
Decreased lung compliance
Pleural effusion

Correct answer: Air trapping from obstructed airways causing hyperinflation

Chronic air trapping in COPD leads to pulmonary hyperinflation, pushing the diaphragm down and ribs outward, creating barrel chest.

Question 66: The primary difference between a PTA and a PT according to the APTA is:

PTAs can diagnose conditions; PTs cannot
PTAs work independently after 5 years
PTs only treat surgical patients
PTs examine, evaluate, and establish the plan of care; PTAs implement selected interventions under supervision (Correct answer)

Correct answer: PTs examine, evaluate, and establish the plan of care; PTAs implement selected interventions under supervision

PTs examine, evaluate, diagnose, and establish the plan of care; PTAs implement selected interventions under PT supervision.

Question 67: The 6-Minute Walk Test (6MWT) primarily measures:

Maximal aerobic capacity (VO2 max)
Balance and coordination
Muscle strength
Functional exercise capacity and endurance (Correct answer)

Correct answer: Functional exercise capacity and endurance

The 6MWT measures the maximum distance a patient can walk in 6 minutes, reflecting submaximal functional exercise capacity.

Question 68: A patient with diabetes has a neuropathic ulcer on the plantar surface of the foot. The wound bed typically appears:

Well-granulated with minimal exudate (Correct answer)
Boggy with excessive exudate
Necrotic with eschar
Pale and poorly perfused

Correct answer: Well-granulated with minimal exudate

Neuropathic (diabetic) ulcers typically have a well-granulated or callused wound bed because perfusion is often intact, unlike arterial ulcers.

Question 69: Which breathing pattern is characteristic of Cheyne-Stokes respiration?

Rapid shallow breaths
Cyclic crescendo-decrescendo with apneic pauses (Correct answer)
Slow regular deep breaths
Deep labored breaths

Correct answer: Cyclic crescendo-decrescendo with apneic pauses

Cheyne-Stokes respiration is a cyclical pattern of increasing then decreasing tidal volume followed by apnea.

Question 70: Which TENS parameter setting is associated with the gate control theory of pain modulation?

High frequency (80-150 Hz) at low intensity producing paresthesia (Correct answer)
Burst mode at high intensity for endorphin release
Continuous mode at medium intensity for muscle re-education
Low frequency (2-4 Hz) at high intensity to elicit muscle twitch

Correct answer: High frequency (80-150 Hz) at low intensity producing paresthesia

Conventional (high-frequency, low-intensity) TENS activates large-diameter Aβ sensory fibers that inhibit nociceptive transmission in the dorsal horn via gate control.

Question 71: Moist heat packs are applied for a typical duration of:

5 minutes
60 minutes
30–45 minutes
10–20 minutes (Correct answer)

Correct answer: 10–20 minutes

Moist heat packs are typically applied for 10–20 minutes to promote superficial tissue heating and pain relief.

Question 72: Coxa vara refers to a hip angle of inclination that is:

Greater than 150°
Less than 120° (Correct answer)
Exactly 125°
Greater than 135°

Correct answer: Less than 120°

Coxa vara is defined as a neck-shaft angle less than 120°, causing relative limb shortening.

Question 73: A patient with a transtibial (below-knee) amputation demonstrates lateral trunk lean toward the prosthetic side during stance. This is MOST likely caused by a prosthetic foot set in:

Neutral alignment
Excessive inversion
Excessive plantarflexion (Correct answer)
Excessive dorsiflexion

Correct answer: Excessive plantarflexion

Excessive plantarflexion of the prosthetic foot creates a functionally shorter limb during stance, causing the patient to lean toward the prosthesis to maintain balance.

Question 74: During isokinetic exercise, which variable is held constant?

Muscle length
Joint angle
Resistance force
Velocity of movement (Correct answer)

Correct answer: Velocity of movement

Isokinetic exercise maintains a constant angular velocity regardless of applied force, with resistance accommodating to effort.

Question 75: Which spinal cord level is responsible for the knee jerk (patellar) reflex?

L2–L3
L1–L2
L4–L5
L3–L4 (Correct answer)

Correct answer: L3–L4

The patellar (knee jerk) reflex is mediated through the L3–L4 spinal cord segments.

Question 76: A PTA is treating a patient post-total knee arthroplasty. Which motion is typically most restricted early post-op?

Extension
Internal rotation
External rotation
Flexion (Correct answer)

Correct answer: Flexion

Knee flexion is typically most restricted early after total knee arthroplasty due to swelling, pain, and surgical healing.

Question 77: During gait, which phase requires the most hip extensor muscle activity?

Midstance
Loading response (Correct answer)
Terminal swing
Initial swing

Correct answer: Loading response

During loading response (early stance), the hip extensors eccentrically control forward trunk lean.

Question 78: The numeric pain rating scale (NPRS) asks patients to rate pain from:

1 to 5
1 to 10
0 to 100
0 to 10 (Correct answer)

Correct answer: 0 to 10

The NPRS uses a 0–10 scale where 0 = no pain and 10 = worst imaginable pain.

Question 79: Before initiating a mechanical lift transfer, the PTA's FIRST action should be to:

Lower the bed to its lowest position
Remove all IV lines and monitoring leads
Position the sling under the patient
Verify the lift's weight capacity rating (Correct answer)

Correct answer: Verify the lift's weight capacity rating

Verifying the mechanical lift's weight capacity before use is a mandatory safety check to ensure the equipment can safely support the patient's body weight.

Question 80: Which gait pattern is used with non-weight-bearing (NWB) status on the right leg using crutches?

2-point gait
4-point gait
Swing-through gait
3-point gait (Correct answer)

Correct answer: 3-point gait

Three-point gait is used for NWB status: both crutches advance together with the affected leg, then the unaffected leg swings through.

Question 81: Proprioceptive neuromuscular facilitation (PNF) techniques are based on which principle?

Wolff's law
Davis's law
Sherrington's law of successive induction (Correct answer)
Hilton's law

Correct answer: Sherrington's law of successive induction

PNF is based on Sherrington's neurophysiological principles including successive induction and reciprocal inhibition.

Question 82: Which incentive spirometry technique encourages maximum inspiration?

Pursed lip breathing
Sustained maximal inspiration (SMI) (Correct answer)
Forced expiratory technique
Diaphragmatic breathing

Correct answer: Sustained maximal inspiration (SMI)

Incentive spirometry uses sustained maximal inspiration (SMI) to prevent atelectasis by maximally inflating the lungs.

Question 83: The RICE protocol for acute musculoskeletal injuries stands for:

Rest, Immobilize, Cold, Exercise
Rest, Ice, Compression, Elevation (Correct answer)
Resistance, Ice, Compression, Elevation
Rehabilitation, Ice, Circulation, Endurance

Correct answer: Rest, Ice, Compression, Elevation

RICE (Rest, Ice, Compression, Elevation) is the standard initial management for acute soft tissue injuries.

Question 84: Proprioceptive training on an unstable surface (wobble board) primarily improves:

Cardiovascular fitness
Neuromuscular control and joint position sense (Correct answer)
Strength
Flexibility

Correct answer: Neuromuscular control and joint position sense

Unstable surface training challenges proprioceptors, improving neuromuscular control and joint position sense for injury prevention.

Question 85: Iontophoresis is used to deliver medication transdermally using:

Infrared radiation
Direct electrical current (Correct answer)
Ultrasound waves
Phonophoresis gel

Correct answer: Direct electrical current

Iontophoresis uses direct (galvanic) current to drive ionized drug molecules through the skin into underlying tissue.

Question 86: When applying a hydrocollator (moist heat) pack, how many layers of dry toweling are recommended between the pack and the patient's skin?

No toweling; direct contact is safe
6-8 layers (Correct answer)
3-4 layers
1-2 layers

Correct answer: 6-8 layers

Six to eight layers of dry toweling (or a commercial hydrocollator cover equivalent) are required to insulate the patient's skin from the high temperature of the pack and prevent thermal burns.

Question 87: An ankle-foot orthosis (AFO) that prevents plantarflexion while permitting dorsiflexion is MOST beneficial for a patient with:

Plantar fasciitis
Achilles tendon rupture requiring immobilization
Foot drop during the swing phase of gait (Correct answer)
Chronic lateral ankle instability

Correct answer: Foot drop during the swing phase of gait

A dorsiflexion-assist or solid AFO set in neutral prevents foot drop during swing phase by keeping the foot from plantarflexing and catching the ground.

Question 88: A 1-repetition maximum (1RM) is defined as:

50% of the maximum weight lifted
Maximum repetitions with a given weight
The maximum load lifted once with proper form (Correct answer)
Weight lifted 10 times to fatigue

Correct answer: The maximum load lifted once with proper form

1RM is the heaviest weight a person can lift once through a full range of motion with correct technique.

Question 89: In a patient with a lower motor neuron lesion, which finding is expected?

Flaccid paralysis (Correct answer)
Positive Babinski sign
Clonus
Hyperreflexia

Correct answer: Flaccid paralysis

Lower motor neuron lesions cause flaccid paralysis, hyporeflexia, and muscle atrophy due to loss of direct muscle innervation.

Question 90: Ankle-brachial index (ABI) below 0.5 indicates:

Mild arterial insufficiency
Severe arterial insufficiency with rest pain risk (Correct answer)
Normal circulation
Moderate arterial insufficiency

Correct answer: Severe arterial insufficiency with rest pain risk

An ABI below 0.5 indicates severe peripheral arterial disease with critical limb ischemia and high amputation risk.

Question 91: Ultrasound at 1 MHz frequency penetrates to a depth of approximately:

1–2 cm
0.5–1 cm
8–10 cm
3–5 cm (Correct answer)

Correct answer: 3–5 cm

1 MHz ultrasound penetrates 3–5 cm, making it suitable for deep tissue heating of muscles and tendons.

Question 92: The Wagner classification system grades:

Burns
Venous ulcers
Diabetic foot ulcers (Correct answer)
Pressure injuries

Correct answer: Diabetic foot ulcers

The Wagner grading system (0–5) classifies diabetic foot ulcers by depth and presence of infection or gangrene.

Question 93: The two-point discrimination test assesses which sensory modality?

Temperature sensation
Fine touch and tactile discrimination (Correct answer)
Proprioception
Pain sensation

Correct answer: Fine touch and tactile discrimination

Two-point discrimination tests the ability to detect two distinct tactile points, assessing the density of cutaneous mechanoreceptors.

Question 94: Compression stockings for venous insufficiency should provide what level of pressure at the ankle?

10–20 mmHg
5–10 mmHg
20–30 mmHg (Correct answer)
40–50 mmHg

Correct answer: 20–30 mmHg

Standard therapeutic compression stockings for venous insufficiency provide 20–30 mmHg of pressure at the ankle.

Question 95: The primary purpose of offloading a diabetic foot ulcer is to:

Reduce edema
Improve blood flow
Reduce repetitive mechanical stress to allow healing (Correct answer)
Prevent infection

Correct answer: Reduce repetitive mechanical stress to allow healing

Offloading redistributes pressure away from the wound site, eliminating the repetitive mechanical trauma that prevents healing.

Question 96: Target heart rate for moderate-intensity exercise in a healthy 40-year-old is approximately:

126–144 bpm
144–162 bpm
90–108 bpm
108–126 bpm (Correct answer)

Correct answer: 108–126 bpm

Using the 220-minus-age formula: max HR = 180 bpm; 60–70% of 180 = 108–126 bpm for moderate intensity.

Question 97: Which vitamin deficiency is most associated with impaired wound healing?

Vitamin C (Correct answer)
Vitamin B12
Vitamin K
Vitamin D

Correct answer: Vitamin C

Vitamin C is essential for collagen synthesis; deficiency impairs wound healing and can cause scurvy.

Question 98: A PTA notes bilateral crackles at lung bases on auscultation. This finding most likely indicates:

Pulmonary edema or heart failure (Correct answer)
Normal breath sounds
Pneumothorax
Pulmonary fibrosis exacerbation

Correct answer: Pulmonary edema or heart failure

Bilateral basilar crackles are a classic sign of fluid accumulation from pulmonary edema or congestive heart failure.

Question 99: Which ligament is primarily stressed with a valgus force at the knee?

Medial collateral ligament (Correct answer)
Anterior cruciate ligament
Lateral collateral ligament
Posterior cruciate ligament

Correct answer: Medial collateral ligament

A valgus (medially directed) force stresses the medial collateral ligament on the inside of the knee.

Question 100: Normal resting respiratory rate for an adult is:

30–35 breaths/min
12–20 breaths/min (Correct answer)
6–10 breaths/min
22–28 breaths/min

Correct answer: 12–20 breaths/min

Normal adult resting respiratory rate is 12–20 breaths per minute.

Question 101: A knee-ankle-foot orthosis (KAFO) is MOST commonly indicated for patients with:

Quadriceps weakness insufficient for independent knee control during stance (Correct answer)
Mild hip abductor weakness causing Trendelenburg gait
Isolated ankle dorsiflexion weakness
Plantar fasciitis with secondary arch collapse

Correct answer: Quadriceps weakness insufficient for independent knee control during stance

KAFOs control both the knee and ankle and are indicated when patients lack adequate quadriceps strength to stabilize the knee during the stance phase of gait.

Question 102: In peripheral nerve regeneration, the approximate rate of axon regrowth is:

5 mm/day
1–3 mm/day (Correct answer)
0.5 mm/day
10 mm/day

Correct answer: 1–3 mm/day

Peripheral nerve axons regenerate at approximately 1–3 mm per day after injury.

Question 103: A patient's ECG shows a heart rate of 150 bpm with narrow QRS complexes. This is most consistent with:

Ventricular tachycardia
Third-degree heart block
Atrial fibrillation
Supraventricular tachycardia (SVT) (Correct answer)

Correct answer: Supraventricular tachycardia (SVT)

Narrow-complex tachycardia at 150 bpm is characteristic of supraventricular tachycardia (SVT).

Question 104: Which joint mobilization technique is used to improve flexion at the glenohumeral joint?

Anterior glide
Superior glide
Inferior glide (Correct answer)
Posterior glide

Correct answer: Inferior glide

An inferior glide of the humeral head is used to increase glenohumeral flexion and abduction.

Question 105: Ultrasound at 1 MHz frequency is used instead of 3 MHz when the treatment goal is to reach tissue at a depth of approximately:

3-5 cm (Correct answer)
1-2 cm
8-10 cm
0.5-1 cm

Correct answer: 3-5 cm

1 MHz ultrasound penetrates to 3-5 cm depth and is selected for treating deeper structures, while 3 MHz penetrates only 1-2 cm and is used for superficial tissues.

Question 106: A patient with a 2-point crutch gait moves:

Both crutches first, then both legs swing through
One crutch first, then the opposite crutch
Both crutches together, then both legs together
One crutch and the contralateral lower extremity simultaneously (Correct answer)

Correct answer: One crutch and the contralateral lower extremity simultaneously

The 2-point pattern simultaneously advances one crutch with the contralateral lower extremity, mimicking normal reciprocal gait and requiring good balance.

Question 107: The Thomas test is used to identify tightness in which muscle group?

Hip extensors
Hip abductors
Hip flexors (Correct answer)
Hamstrings

Correct answer: Hip flexors

The Thomas test assesses hip flexor tightness by observing if the non-tested leg rises off the table during the test.

Question 108: Hydrotherapy (whirlpool) is contraindicated for which wound type?

Infected wounds
All of the above
Arterial ulcers
Granulating wounds (Correct answer)

Correct answer: Granulating wounds

Whirlpool is contraindicated for granulating wounds because the turbulence and maceration can damage new tissue.

Question 109: Plyometric training is primarily designed to improve:

Cardiovascular endurance
Muscle hypertrophy
Flexibility
Power and stretch-shortening cycle efficiency (Correct answer)

Correct answer: Power and stretch-shortening cycle efficiency

Plyometrics utilize the stretch-shortening cycle to improve power output and neuromuscular efficiency.

Question 110: DOMS (delayed onset muscle soreness) typically peaks:

24–72 hours after exercise (Correct answer)
Immediately after exercise
1 week after exercise
Only during the exercise session

Correct answer: 24–72 hours after exercise

DOMS peaks at 24–72 hours post-exercise, particularly after eccentric exercise, due to micro-tears and inflammatory response.

Question 111: Which gait deviation is most characteristic of a patient with foot drop?

Antalgic gait
Steppage gait (Correct answer)
Scissor gait
Trendelenburg gait

Correct answer: Steppage gait

Steppage gait (exaggerated hip and knee flexion to clear the foot) is the compensatory pattern for foot drop.

Question 112: Which position best facilitates drainage of the right lower lobe posterior basal segment?

Supine with head elevated
Left side-lying with foot of bed elevated
Prone with foot of bed elevated (Correct answer)
Sitting upright

Correct answer: Prone with foot of bed elevated

The prone position with the foot of the bed elevated drains the posterior basal segments via gravity-assisted postural drainage.

Question 113: Pressure-relieving wheelchair cushions are MOST critical for patients with:

Lower extremity spasticity
Impaired trunk stability
Sensory deficits and impaired self-repositioning ability (Correct answer)
Upper extremity weakness only

Correct answer: Sensory deficits and impaired self-repositioning ability

Patients with sensory deficits cannot detect pressure discomfort and impaired mobility prevents self-repositioning, placing them at the highest risk for pressure injuries.

Question 114: When measuring cane height for a patient, the handle should be level with the:

Greater trochanter
Wrist crease with arm relaxed at side (Correct answer)
Mid-thigh level
Anterior superior iliac spine

Correct answer: Wrist crease with arm relaxed at side

The cane handle at wrist crease height (arm relaxed at side) results in approximately 20-30° of elbow flexion during use, which is the optimal functional position.

Question 115: The sit-and-reach test primarily measures:

Quadriceps flexibility
Hip flexor strength
Hamstring and lower back flexibility (Correct answer)
Hip abductor range of motion

Correct answer: Hamstring and lower back flexibility

The sit-and-reach test assesses flexibility of the hamstrings and lumbar extensors in the posterior chain.

Question 116: A patient with multiple sclerosis has fatigue that worsens with increased body temperature. This phenomenon is called:

Uhthoff's phenomenon (Correct answer)
Borg fatigue response
Lhermitte's sign
Central sensitization

Correct answer: Uhthoff's phenomenon

Uhthoff's phenomenon describes the temporary worsening of MS symptoms with increased body temperature.

Question 117: Which type of muscle contraction produces the greatest force?

Isokinetic
Concentric
Eccentric (Correct answer)
Isometric

Correct answer: Eccentric

Eccentric contractions produce the greatest force because cross-bridge cycling and passive elastic elements combine to resist lengthening.

Question 118: Electrotherapeutic modality TENS (transcutaneous electrical nerve stimulation) primarily works by:

Heating deep tissue
Stimulating the spinal cord for motor re-education
Activating pain gate control and endogenous opioid mechanisms (Correct answer)
Reducing edema through osmosis

Correct answer: Activating pain gate control and endogenous opioid mechanisms

TENS reduces pain via the gate control theory (large fiber stimulation inhibits pain signals) and endogenous opioid release.

Question 119: The overload principle states that for strength gains to occur:

Training must be maximal intensity every session
The load must exceed what the tissue is accustomed to (Correct answer)
Only bodyweight exercises should be used
Exercise must be performed daily

Correct answer: The load must exceed what the tissue is accustomed to

The overload principle requires that the training stimulus exceed the body's current capacity to drive physiological adaptation.

Question 120: Berg Balance Scale scores of 0–20 indicate:

Supervision required
Minimal fall risk
High fall risk requiring wheelchair (Correct answer)
Independent community ambulator

Correct answer: High fall risk requiring wheelchair

A Berg Balance Scale score of 0–20 indicates high fall risk, and the patient is likely wheelchair dependent.

Question 121: A patient with a complete C6 spinal cord injury would retain which muscle function?

Wrist extensors (Correct answer)
Wrist flexors
Elbow extensors
Finger extensors

Correct answer: Wrist extensors

C6 innervates the extensor carpi radialis, so wrist extension is preserved in a complete C6 injury.

Question 122: Which phase of cardiac rehabilitation focuses on supervised inpatient exercise after a cardiac event?

Phase II
Phase III
Phase IV
Phase I (Correct answer)

Correct answer: Phase I

Phase I cardiac rehabilitation is the acute inpatient phase, beginning while the patient is still hospitalized.

Question 123: A patient with Parkinson's disease demonstrates micrographia and bradykinesia. Which brain structure is primarily affected?

Hippocampus
Prefrontal cortex
Cerebellum
Basal ganglia (substantia nigra) (Correct answer)

Correct answer: Basal ganglia (substantia nigra)

Parkinson's disease involves degeneration of dopaminergic neurons in the substantia nigra of the basal ganglia.

Question 124: Lymphedema is best managed with which PT intervention?

Complete decongestive therapy (CDT) (Correct answer)
Ice massage
Ultrasound
Compression-free elevation only

Correct answer: Complete decongestive therapy (CDT)

Complete decongestive therapy (CDT) combines manual lymphatic drainage, compression bandaging, exercise, and skin care.

Question 125: Which cranial nerve is tested by the gag reflex?

CN XI and XII
CN III and IV
CN IX and X (Correct answer)
CN V and VII

Correct answer: CN IX and X

The gag reflex involves the glossopharyngeal (CN IX) as the afferent limb and vagus (CN X) as the efferent limb.

Question 126: The Borg Rating of Perceived Exertion (RPE) scale ranges from:

6–20 (Correct answer)
1–10
0–20
0–100

Correct answer: 6–20

The original Borg RPE scale ranges from 6 to 20, designed to correlate with heart rate (multiply by 10).

Question 127: Aquatic therapy reduces joint compressive forces because:

Water resistance strengthens muscles
Water increases muscle temperature
Buoyancy reduces effective body weight (Correct answer)
Hydrostatic pressure increases blood flow

Correct answer: Buoyancy reduces effective body weight

Archimedes' principle: buoyancy provides an upward force that reduces the effective weight of the body, decreasing joint loading.

Question 128: Fluidotherapy is a thermal modality that uses:

Dry finely divided cellulose particles suspended in warm air (Correct answer)
Paraffin wax
Heated water
Infrared light

Correct answer: Dry finely divided cellulose particles suspended in warm air

Fluidotherapy uses dry cellulose particles heated by air to provide superficial heat and desensitization of hypersensitive extremities.

Question 129: Which fracture pattern is most common in osteoporotic vertebral compression fractures?

Jefferson fracture
Burst fracture
Chance fracture
Wedge compression fracture (Correct answer)

Correct answer: Wedge compression fracture

Wedge compression fractures are most common in osteoporosis, occurring at the anterior vertebral body.

NPTE-PTA National Physical Therapy Exam

The NPTE-PTA (National Physical Therapy Examination for Physical Therapist Assistants) is administered by the Federation of State Boards of Physical Therapy (FSBPT). Effective January 2024, the exam consists of 180 multiple-choice questions (140 scored, 40 unscored pretest items) with a 4-hour time limit, split into four 40-question sections. A scaled passing score of 600 out of 800 is required. Content is organized into Body Systems (cardiovascular/pulmonary, musculoskeletal, neuromuscular/nervous, integumentary, lymphatic) and Non-Systems (data collection, therapeutic interventions, equipment, professional roles).

180

Questions

240 min

Time Limit

75%

To Pass

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