NPTE Practice Exam 1 – Correct Answers (Physical Therapy Exam Review, Answer
Key & Explanations)
A physical therapist examines a three-year-old patient diagnosed with a genetic condition which
affects collagen synthesis. The patient bruises easily and has a lifelong history of pathological
fractures. What is the patient's MOST likely diagnosis?
1.Osteomalacia
2.Osteopetrosis
3.Pediatric osteoporosis
4.Osteogenesis imperfecta - correct answer ✔✔4.Osteogenesis imperfecta
Pathological fractures associated with milder presentations of osteogenesis imperfecta (OI) may
raise suspicions of child abuse before a formal diagnosis is made. More severe forms of OI are
typically diagnosed early in the child's life with fractures sustained either in utero or during
birth.
Milder presentations of OI (types I and IV) are inherited as autosomal dominant traits while
more severe forms (types II and III) are inherited as autosomal recessive traits. The condition is
characterized by bone fragility that is linked to an abnormality in the synthesis of type I
collagen.
A patient diagnosed with rheumatoid arthritis is referred to physical therapy. The physical
therapist observes bilateral thumb deformities characterized by metacarpophalangeal joint
flexion with interphalangeal hyperextension. Which deformity is MOST consistent with the
described presentation?
1.Boutonniere
2.Swan neck
3.Mallet finger
4.Dupuytren - correct answer ✔✔Boutonniere
,boutonniere deformity may occur in the fingers or thumb as a result of trauma or progressive
arthritic changes. In patients diagnosed with rheumatoid arthritis, boutonniere deformity is the
most commonly occurring thumb deformity.
1.In the thumb, chronic synovitis eventually forces the metacarpophalangeal (MCP) joint into a
flexed position. The associated palmar displacement causes tension on the extensor mechanism
of the interphalangeal (IP) joint resulting in hyperextension. In the fingers, this deformity
presents with flexion in the proximal interphalangeal (PIP) joint and extension of the distal
interphalangeal (DIP) joint.
A physical therapist works with a patient recovering from surgery on gait activities on a level
surface. Which value represents the MAXIMUM amount of knee flexion required to complete
the described activity?
1.0-90 degrees
2.0-60 degrees
3.0-30 degrees
4.0-20 degrees - correct answer ✔✔2.0-60 degrees
The gait cycle is comprised of a stance phase and swing phase. Each phase has anticipated
motion that is expected throughout the cycle for each joint. Stance phase accounts for 60
percent of the gait cycle and swing phase accounts for 40 percent. Many functional activities
(e.g., stair climbing) may require more than 60 degrees of knee flexion.
A patient requires 0-60 degrees of knee flexion with gait on a level surface. The greatest amount
of knee flexion is required from the initial swing to midswing.
A 28-year-old female with low back pain is referred to physical therapy. The patient indicates
that her pain started the previous weekend after painting a ceiling and currently is localized on
the left side of her low back. The patient states the pain is better when sitting in a "slouched"
posture and is worse during periods of prolonged standing. An examination reveals a positive
quadrant test and positive Kemp's test on the left. Based on the presented information, which
structures are MOST likely involved?
1.Right thoracic facets
,2.Left thoracic facets
3.Left lumbar facets
4.Right lumbar facets - correct answer ✔✔Left lumbar facets
The facet joints are likely to be stressed in positions of spinal extension, especially when
combined with a rotation and/or lateral flexion component (e.g., position used when painting
overhead). Flexion (i.e., slouched posture) will relieve the pain since pressure is taken off of the
facet joints. The quadrant test and Kemp's test are tests which are used to indicate pathology of
the facet joints.
During the quadrant test or Kemp's test, the patient extends and laterally flexes or rotates to
the side of pain. This causes maximal narrowing of the intervertebral foramen and stress on the
facet joint. Since the patient had a positive test when moving to the left, the left lumbar facet
joints are likely the source of the pain.
A patient experiences left lower extremity sciatica secondary to posterior derangement of the
L5 disk. The patient tolerated a prone on elbows position without an increase in symptoms,
however, after performing the exercise shown in the video the patient reports increased
radicular pain in the left lower extremity. What would be the physical therapist's MOST
appropriate response?
1.Instruct the patient to assume a prone position
2.Instruct the patient to assume a prone on elbows position
3.Instruct the patient to assume a standing extension position
4.Discontinue the extension progression - correct answer ✔✔2.Instruct the patient to assume a
prone on elbows position
Centralized pain is often considered to be a positive outcome during an extension progression.
Patients may experience discomfort during positioning, however, an increase in radiating
symptoms warrants reassessment of the appropriateness of the intervention.
, The prone press-up position may have been initiated prematurely. Returning to the non-
exacerbating prone on elbows position should assist the therapist to determine how to best
proceed with the patient's care (e.g., more time accommodating to prone on elbows position or
discontinuing the extension progression).
An individual with declining health due to unhealthy lifestyle choices plans to engage in an
independent exercise program designed to improve their cardiovascular health. Which form of
self-monitoring would be the MOST appropriate for the individual to utilize when exercising?
1.Metabolic equivalents
2.Systolic blood pressure
3.Rate of perceived exertion
4.Respiration rate - correct answer ✔✔There are a variety of subjective and objective methods
available to monitor exercise intensity. The most appropriate method for a given clinical
scenario is influenced by a number of variables including measurement purpose, medical status,
patient's abilities, setting, and equipment available.
Patients can utilize a perceived exertion scale, such as Borg's Rating of Perceived Exertion (RPE)
Scale, as a subjective means of self-monitoring during exercise. The RPE quantifies the subject's
overall sense of effort by quantifying the amount of strain or level of exertion the patient is
experiencing during activity.
After palpating several peripheral pulse sites a physical therapist concludes that a patient has a
strong pulse at the popliteal artery, but a weak pulse at the dorsalis pedis artery. Which medical
finding identified during exercise would be MOST likely based on the patient's current status?
1.Orthopnea
2.Deep vein thrombophlebitis
3.Intermittent claudication
4.Venous thrombosis - correct answer ✔✔Intermittent claudication
Palpation of peripheral arteries is used to assess perfusion of the extremities in addition to
pulse rate. Patients with diabetes or peripheral vascular disease often have diminished blood
Key & Explanations)
A physical therapist examines a three-year-old patient diagnosed with a genetic condition which
affects collagen synthesis. The patient bruises easily and has a lifelong history of pathological
fractures. What is the patient's MOST likely diagnosis?
1.Osteomalacia
2.Osteopetrosis
3.Pediatric osteoporosis
4.Osteogenesis imperfecta - correct answer ✔✔4.Osteogenesis imperfecta
Pathological fractures associated with milder presentations of osteogenesis imperfecta (OI) may
raise suspicions of child abuse before a formal diagnosis is made. More severe forms of OI are
typically diagnosed early in the child's life with fractures sustained either in utero or during
birth.
Milder presentations of OI (types I and IV) are inherited as autosomal dominant traits while
more severe forms (types II and III) are inherited as autosomal recessive traits. The condition is
characterized by bone fragility that is linked to an abnormality in the synthesis of type I
collagen.
A patient diagnosed with rheumatoid arthritis is referred to physical therapy. The physical
therapist observes bilateral thumb deformities characterized by metacarpophalangeal joint
flexion with interphalangeal hyperextension. Which deformity is MOST consistent with the
described presentation?
1.Boutonniere
2.Swan neck
3.Mallet finger
4.Dupuytren - correct answer ✔✔Boutonniere
,boutonniere deformity may occur in the fingers or thumb as a result of trauma or progressive
arthritic changes. In patients diagnosed with rheumatoid arthritis, boutonniere deformity is the
most commonly occurring thumb deformity.
1.In the thumb, chronic synovitis eventually forces the metacarpophalangeal (MCP) joint into a
flexed position. The associated palmar displacement causes tension on the extensor mechanism
of the interphalangeal (IP) joint resulting in hyperextension. In the fingers, this deformity
presents with flexion in the proximal interphalangeal (PIP) joint and extension of the distal
interphalangeal (DIP) joint.
A physical therapist works with a patient recovering from surgery on gait activities on a level
surface. Which value represents the MAXIMUM amount of knee flexion required to complete
the described activity?
1.0-90 degrees
2.0-60 degrees
3.0-30 degrees
4.0-20 degrees - correct answer ✔✔2.0-60 degrees
The gait cycle is comprised of a stance phase and swing phase. Each phase has anticipated
motion that is expected throughout the cycle for each joint. Stance phase accounts for 60
percent of the gait cycle and swing phase accounts for 40 percent. Many functional activities
(e.g., stair climbing) may require more than 60 degrees of knee flexion.
A patient requires 0-60 degrees of knee flexion with gait on a level surface. The greatest amount
of knee flexion is required from the initial swing to midswing.
A 28-year-old female with low back pain is referred to physical therapy. The patient indicates
that her pain started the previous weekend after painting a ceiling and currently is localized on
the left side of her low back. The patient states the pain is better when sitting in a "slouched"
posture and is worse during periods of prolonged standing. An examination reveals a positive
quadrant test and positive Kemp's test on the left. Based on the presented information, which
structures are MOST likely involved?
1.Right thoracic facets
,2.Left thoracic facets
3.Left lumbar facets
4.Right lumbar facets - correct answer ✔✔Left lumbar facets
The facet joints are likely to be stressed in positions of spinal extension, especially when
combined with a rotation and/or lateral flexion component (e.g., position used when painting
overhead). Flexion (i.e., slouched posture) will relieve the pain since pressure is taken off of the
facet joints. The quadrant test and Kemp's test are tests which are used to indicate pathology of
the facet joints.
During the quadrant test or Kemp's test, the patient extends and laterally flexes or rotates to
the side of pain. This causes maximal narrowing of the intervertebral foramen and stress on the
facet joint. Since the patient had a positive test when moving to the left, the left lumbar facet
joints are likely the source of the pain.
A patient experiences left lower extremity sciatica secondary to posterior derangement of the
L5 disk. The patient tolerated a prone on elbows position without an increase in symptoms,
however, after performing the exercise shown in the video the patient reports increased
radicular pain in the left lower extremity. What would be the physical therapist's MOST
appropriate response?
1.Instruct the patient to assume a prone position
2.Instruct the patient to assume a prone on elbows position
3.Instruct the patient to assume a standing extension position
4.Discontinue the extension progression - correct answer ✔✔2.Instruct the patient to assume a
prone on elbows position
Centralized pain is often considered to be a positive outcome during an extension progression.
Patients may experience discomfort during positioning, however, an increase in radiating
symptoms warrants reassessment of the appropriateness of the intervention.
, The prone press-up position may have been initiated prematurely. Returning to the non-
exacerbating prone on elbows position should assist the therapist to determine how to best
proceed with the patient's care (e.g., more time accommodating to prone on elbows position or
discontinuing the extension progression).
An individual with declining health due to unhealthy lifestyle choices plans to engage in an
independent exercise program designed to improve their cardiovascular health. Which form of
self-monitoring would be the MOST appropriate for the individual to utilize when exercising?
1.Metabolic equivalents
2.Systolic blood pressure
3.Rate of perceived exertion
4.Respiration rate - correct answer ✔✔There are a variety of subjective and objective methods
available to monitor exercise intensity. The most appropriate method for a given clinical
scenario is influenced by a number of variables including measurement purpose, medical status,
patient's abilities, setting, and equipment available.
Patients can utilize a perceived exertion scale, such as Borg's Rating of Perceived Exertion (RPE)
Scale, as a subjective means of self-monitoring during exercise. The RPE quantifies the subject's
overall sense of effort by quantifying the amount of strain or level of exertion the patient is
experiencing during activity.
After palpating several peripheral pulse sites a physical therapist concludes that a patient has a
strong pulse at the popliteal artery, but a weak pulse at the dorsalis pedis artery. Which medical
finding identified during exercise would be MOST likely based on the patient's current status?
1.Orthopnea
2.Deep vein thrombophlebitis
3.Intermittent claudication
4.Venous thrombosis - correct answer ✔✔Intermittent claudication
Palpation of peripheral arteries is used to assess perfusion of the extremities in addition to
pulse rate. Patients with diabetes or peripheral vascular disease often have diminished blood
