2024 Version

NPTE PT Practice Test

Take this free physical therapist practice test to get an idea of what is on the National Physical Therapist Exam (NPTE) for physical therapists (PT).

The NPTE for PTs is a standardized exam produced by the Federation of State Boards of Physical Therapy.

The test sections below are based on the NPTE PT test sections: musculoskeletal, neuromuscular, cardiovascular, pulmonary, integumentary, metabolic, endocrine, gastrointestinal, gentitourinary, lymphatic, system interactions, equipment, therapeutic modalities, safety, professional responsibilities and evidenced based practice.

The actual NPTE PT has 250 questions and five hours is given to complete the test.

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Musculoskeletal System

1.	A patient arrives at an initial evaluation with complaints of ankle pain that began with sudden onset after the patient jumped off a couch. The Thompson Test yields a positive result. This is indicative of:
		a. High Ankle Sprain
		b. LCL Sprain
		c. Ruptured Achilles Tendon
		d. Navicular Fracture
The Thompson test is a special test for achilles tendon integrity. Achilles tendon ruptures typically happen with quick movements. Incorrect answer. Please choose another answer.

2.	A true leg length discrepancy may be differentiated from sacroiliac contribution by performing the supine to long sit test. When a patient has a right anterior innominate:
		a. The right leg will appear shorter in supine and the same length in long sitting.
		b. The right leg will appear longer in supine and the same length in long sitting.
		c. The right leg will appear shorter in supine and longer in long sitting.
		d. The right leg will appear longer in supine and shorter in long sitting.
If a leg length discrepancy is due to the SI joint, the supine to long sit test will help indicate the leg length discrepancy. If a patient has an anterior innominate, the leg that looked longer in supine will become shorter in sitting. If the patient has a posterior innominate, the leg that looked shorter in supine will become longer in sitting. Incorrect answer. Please choose another answer.

Neuromuscular System

3.	While working with the upper extremity of a patient who recently had a right hemisphere cerebral vascular accident, the therapist should avoid:
		a. Passive range of motion of the right arm, as the patient is at risk for glenohumeral subluxation.
		b. Passive range of motion of the left arm, as the patient is at risk for glenohumeral dislocation
		c. Placing the right arm in a sling in the acute stage, as it will lead to neglect of the affected arm.
		d.Pulling on the patient's left arm to help them stand with transfers.
Patients who have recently had a CVA that affects the upper extremity are at higher risks for dislocation. Incorrect answer. Please choose another answer.

4.	In the initial evaluation of a patient with back pain, the patient describes symptoms including pain the radiates to the dorsal aspect of the foot accompanied by tingling. On assessment, there is weakness in ankle dorsiflexion. The most likely cause of the patient's back pain is
		a. Nerve root irritation at L4-L5.
		b. Nerve root irritation at L5-S1.
		c. Postural strain.
		d. Compression fracture.
This dermatomal and myotomal pattern is one of L4-L5 distribution. Therefore, irritation of that nerve root would be the most likely cause of these symptoms. Incorrect answer. Please choose another answer.

Cardiopulmonary System

5.	A patient presents to therapy with moderate pain in the bilateral distal lower extremities. He reports that the pain is better when his feet are elevated. During evaluation, the therapist notes that the skin has brown discoloration and is flaky and dry. Pedal pulses are normal and +2 pitting edema is present bilaterally. The most likely cause of the patient's leg pain is:
		a. Arterial insufficiency
		b. Venues insufficiency
		c. Diabetic peripheral neuropathy
		d. Bilateral calf strains
Signs of arterial insufficiency include severe pain, especially at night, ulcers on the lower third of the legs, diminished pedal pulses, decreased skin temperature, shiny skin with hair loss, and leg elevation that increases pain. Venous insufficiency is identified with mild to moderate pain, normal pedal pulses, increased edema, dry and flaky skin, that is at a normal skin temperature, brown discoloration of the skin, and where leg elevation decreases the pain. Incorrect answer. Please choose another answer.

6.	While reviewing a chart of a new evaluation for PT in acute care, the therapist finds that the patient currently has the following lab values: pH: 7.41, PaCo2: 33, HCO3: 20. Which of the following is correct regarding this patient?
		a. The patient is in acute respiratory alkalosis.
		b. The patient is in compensated respiratory alkalosis.
		c. The patient is in acute metabolic alkalosis.
		d. The patient is in compensated metabolic alkalosis.
A blood pH level that has returned to normal is indicative that the body has compensated. The PaCo2 is less than 35 and the HCO3 is less than 22 which indicates respiratory alkalosis. Incorrect answer. Please choose another answer.

Integumentary System

7.	A patient has a sloughy wound with moderate exudate. The most appropriate wound dressing for this patient is:
		a. Alginate with secondary foam dressing
		b. Foam dressing with secondary film dressing
		c. Hydrocolloid with secondary film dressing
		d. Hydrogel dressing alone
Film dressings would be inappropriate because the wound has a moderate amount of exudate. Hydrogels increase moisture, so that would not be an appropriate dressing for this wound either. Incorrect answer. Please choose another answer.

8.	You are providing wound care for a recent adult burn unit admission. The patient presents with burns covering the left anterior leg, anterior chest, and left anterior arm. What percent of the patient can you estimate is the burn area?
		a. 50%
		b. 38.5%
		c. 31.5%
		d. 27%
Burn area is determined by the rule of 9s. The left leg would be estimated at 9%, the anterior chest would be 18%, and the left arm would be 4.5% for a total of 31.5%. Incorrect answer. Please choose another answer.

Metabolic and Endocrine Systems

9.	A patient has a diagnosis of Graves disease. Which physiological response to exercise can you expect for this patient in relation to their diagnosis?
		a. Elevated heart rate
		b. Increased respiration rate
		c. Decreased heart rate
		d. Elevated O2 saturation
Patients with Graves disease often have an overactive thyroid. Hyperthyroidism can lead to elevated heart rate. Incorrect answer. Please choose another answer.

10.	A patient you are treating with Addison's disease arrives at therapy in visible distress and reports she has been vomiting and having diarrhea for the last two days. She states that the pain in her back and legs is unbearable now, and that she has been blacking out. You assess the patient's vitals and find her blood pressure to be much lower than previous sessions. The best course of action is to:
		a. Send the patient home to rest instructing her to call her doctor if the vomiting persists due to risk of dehydration.
		b. Assist the patient to make arrangements to get to the nearest emergency room as she is exhibiting signs of acute adrenal failure.
		c. Refer the patient to her primary care physician for an MRI due to the increase in back and leg pain.
		d. Recommend the patient drink some Gatorade and perform seated and supine exercise monitoring vitals throughout.
Addison's disease is an adrenal disorder. This patient is showing signs of an adrenal crisis, so emergency medical care is needed. Incorrect answer. Please choose another answer.

Gastrointestinal System

11.	Pain from gallstones often refers to the:
		a. Chest
		b. Left shoulder and scapular area
		c. Right Shoulder and scapular area
		d. Right lumbar and posterior thigh
The disruption of organs in the body often refers pain to other areas. Gallbladder pain often refers to the right shoulder and scapular area. Incorrect answer. Please choose another answer.

12.	When working with a patient with Chron's disease, the patient should avoid the following when trying to manage their pain:
		a. Ice as patients with Chron's disease are cold-intolerant
		b. NSAIDs due to irritation to GI system
		c. Tylenol as Chron's disease has significant liver involvement
		d. Heat as patients with Chron's disease have decreased sensation
NSAIDs can cause irritation to the intestinal lining. Because Chron's disease already causes significant GI irritation, patient's with Chron's should avoid NSAIDs such as ibuprofen. Incorrect answer. Please choose another answer.

Genitourinary System

13.	You are performing seated exercise with a patient in acute care that has a complete SCI at T5. While performing exercise, he reports a sudden onset of a pounding headache and hisface is flushed. He begins sweating profusely and is nauseated. You suspect autonomic dysreflexia. The BEST next step is to:
		a. Have the patient rest for 2 minutes, then resume exercise if symptoms dissipate.
		b. Call a code
		c. Transfer the patient back to bed and have him rest for 5 minutes. If symptoms do not improve, call the nurse.
		d. Check the catheter bag and tube for kinks, blockages, or fullness.
Autonomic dysreflexia can be caused by backup of urinary flow due to disruption of the catheter, blockages, or a full bag. The therapist should immediately rectify any visible catheter disruptions, then call for the nurse. Incorrect answer. Please choose another answer.

14.	You are treating a new mother for lower back pain. She reveals during the session that she is having urinary incontinence frequently, especially when she coughs or sneezes. The best intervention to begin for her is:
		a. Refer her back to her OBGYN
		b. Core strengthening exercise
		c. Implementing a bathroom schedule
		d. Begin Kegel exercises
New mothers can experience stress incontinence due to weakened pelvic floor muscles. Kegel exercises strengthen the pelvic floor and can help with stress incontinence. Incorrect answer. Please choose another answer.

Lymphatic System

15.	While performing an evaluation, the therapist palpates a hard, non-movable, lump in the patient's right axillary. The best action to take next is:
		a. Monitor the lump over the next few therapy sessions.
		b. Ask the patient if they have ever noticed it or had a physician check it.
		c. Contact the referring provider to order a biopsy.
		d. Recommend the patient go to the nearest emergency room.
Hard, non-movable lymph nodes can be a cause for concern. While the patient does not need emergency medical treatment, they will need to have it checked by a physician if they have not already done so. Incorrect answer. Please choose another answer.

16.	When determining therapeutic exercises for patients in phase 1 management of lymphedema, which of the following is appropriate:
		a. Passive range and bed exercise only
		b. Jogging
		c. Seated activity only
		d. Light exercises such as walking and light resistance training
While exercise is beneficial for patients undergoing lymphedema treatment, high intensity activity should be avoided. Incorrect answer. Please choose another answer.

System Interactions

17.	An elderly patient reports bouts of dizziness regularly throughout the day. The patient has multiple comorbitiies she is being treated for. Her blood pressure is normal and positional vertigo is ruled out. The most likely cause for dizziness in this patient is:
		a. CVA
		b. A normal part of the aging process
		c. Side effects of polypharmacy
		d. Increased cranial pressure
Often, in the elderly population, there can be overlap of medications that may interact with each other due to seeing multiple providers. Incorrect answer. Please choose another answer.

18.	In a patient with poorly managed diabetes, which of the following is a precaution that should be taken in their plan of care?
		a. Using caution during balance activities as diabetics can have decreased proprioception due to neuropathy.
		b. Checking blood glucose before and after treatment to ensure normal levels for safe exercise.
		c. Monitoring blood pressure as diabetics are often hypotensive.
		d. Using heat before exercise to promote blood flow.
Poorly managed diabetes can cause damage to the peripheral nervous system beginning distally. People with chronic, unmanaged diabetes can experience balance issues due to decreased proprioception as a result of this damage. Incorrect answer. Please choose another answer.

Equipment, Devices, and Technologies

19.	A four year old child with spina bifida occulta, at the L5 level, is beginning to ambulate. Which orthotic would be the best option to address this child's gait deficits?
		a. Knee ankle foot orththosis (KAFO)
		b. Dynamic ankle foot orthosis (DAFO)
		c. Rigid ankle foot orthosis (AFO)
		d. Supra-malleolar orthosis (SMO)
Based upon the child's level of the occulta, lack of dorsiflexion should be the biggest deficit. KAFO would be excessive, an SMO would be too little support, and the child would need the rigidity of the AFO. Incorrect answer. Please choose another answer.

20.	A therapist is working with new spinal cord injury (complete T4) patient on getting a wheelchair for discharge. The best features for this chair are:
		a. Power wheelchair with tilt in space for pressure relief
		b. Power wheelchair for community use with a light weight manual chair for household and short distances.
		c. Manual wheelchair for community use. Lofstrand crutches and orthotics for household ambulation.
		d. Manual wheelchair with pressure relief cushion.
A patient with a T4 SCI should be able to perform manual propulsion even for community use, so a power wheelchair is not appropriate. The patient will be unable to ambulate any significant distance, therefore C is not a good choice. Incorrect answer. Please choose another answer.

Therapeutic Modalities

21.	Which of the following patients are appropriate for phonophoresis treatment?
		a. A 12 year old male patient on an acute knee injury
		b. A 67 year old female patient with lower back pain following fractures from metastasized cancer.
		c. A 72 year old male patient with COPD and history of MI with a rotator cuff injury
		d. A 18 year old female patient with severe road rash following a motorcycle accident.
Phonophoresis is contraindicated for use over non-fused growth plates, therefore making it inappropriate for the 12 year old male patient. It is also contraindicated for recent tumors in the area, and over areas of skin breakdown and infection. Incorrect answer. Please choose another answer.

22.	When using dexamethasone in iontophoresis, it should be:
		a. Placed on the cathode as dexamethasone is positively charged.
		b. Placed on the anode as dexamethasone is negatively charged.
		c. Placed on the anode as dexamethasone is positively charged.
		d. Placed on the cathode as dexamethasone is negatively charged.
Like charges repel. In iontophoresis, it is desired for the medication to flow towards the area of concern. Therefore, a negatively charged medications such as dexamethasone should be placed on the negative (cathode) in order to flow towards the positive electrode. Incorrect answer. Please choose another answer.

Safety and Protection

23.	What are the appropriate precautions to use with a patient with disseminated herpes zoster virus in acute care?
		a. Gloves
		b. Gloves and gown
		c. Gloves, gown, and mask
		d. Isolation in negative pressure room
This patient would require droplet precautions which includes gloves, gown and mask in the room at all times. Incorrect answer. Please choose another answer.

24.	In a skilled nursing facility, a patient who is a high fall risk is finishing up with therapy. The patient's medical history includes dementia, impulsive behavior, and that she rarely remembers to use her assistive device. What measures should the therapist take when leaving to ensure patient safety?
		a. Bed alarm, non-skid socks, and walker close to bedside
		b. Bed alarm, non-skid socks, nurse call light in reach, and walker close to bedside
		c. Bed alarm is unnecessary because patient is MOD I with functional mobility
		d. Nurse call light in reach and non-skid socks
Due to the patient's impulsive behavior and cognitive impairment, it is crucial to place the bed alarm on. Putting other measures in place will also help with patient compliance to follow correct procedure to call the nurse and use AD. Incorrect answer. Please choose another answer.

Professional Responsibilities

25.	While working in a busy outpatient clinic, a therapist is treating two medicare patients scheduled within the same hour. According to medicare law and guidelines, billed services for the patient can include:
		a. Only time spent that the therapist was directly treating that patient
		b. Therapeutic exercise that a tech assisted the patient with while the therapist performed manual techniques on another patient
		c. Therapeutic exercise that the patients performed while the therapist supervised both of them.
		d. Any exercise or modality that was performed in line of sight of the therapist.
Medicare rules indicate that a therapist can only bill for 1 on 1 direct treatment. Incorrect answer. Please choose another answer.

26.	In an outpatient setting, a therapist notices an elderly patient who lives with family has atypical bruising on the arms. When the patient's daughter goes to the restroom, the patient confides in you that she is often without food or personal care items at home. What is the best course of action for the therapist?
		a. Confer with the daughter to get her story since you suspect the patient may have dementia.
		b. Call the patient's primary care provider to discuss possible elderly abuse.
		c. Call in a tip to the police that you suspect elder abuse.
		d. Nothing. It is against HIPPA to tell anyone about the patient.
There are signs that highly indicate elder care abuse. As a mandatory reporter, the therapist should call in an anonymous tip to have it investigated. Incorrect answer. Please choose another answer.

Research and Evidence Based Practice

27.	Which statistical analysis is best used to compare outcomes of a group of individuals with small (less than 1 cm) rotator cuff tears split into three treatment groups: Surgical with post-operative rehabilitation, Conservative non-surgical rehab protocol and Non-surgical with home exercise program?
		a. ANOVA
		b. Independent T test
		c. Chi squared
		d. Wilcoxon rank-sum Test
The best test to use to compare groups with only one variable is the analysis of variance. The independent T test would not be appropriate as there are three treatment groups. Incorrect answer. Please choose another answer.

28.	A new special test to predict integrity of the ACL was found to have a test-retest correlation of .95 and an inter-rater reliability of .75. Using this information, it can be said that:
		a. The test is reliable between tests with the same therapist and between therapists.
		b. The test is not reliable between tests with the same therapist and between therapists.
		c. The test is not reliable with the same therapist but is reliable between therapists.
		d. The test is reliable with the same therapist but is not reliable between therapists.
The reliability value indicates the percentage of people who will be correctly identified using that measure. 95% is considered good reliability while 75% does not. Incorrect answer. Please choose another answer.

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