PT BOARDS Exam Prep Test Bank 3
100+ Black Book Questions with Correct Answers and
Detailed Rationales
Physiotherapy NBCE PT Boards Exam Prep | New
Edition
SECTION I: CARDIOVASCULAR & PULMONARY PHYSICAL THERAPY
Questions 1-20
Q1. A 68-year-old male patient with COPD is participating in pulmonary
rehabilitation. Which of the following is the BEST indicator of exercise intensity
during aerobic training?
A) Heart rate reserve (HRR) of 40-60%
B) Borg Scale rating of 15-17
C) Oxygen saturation of 88-92%
D) Respiratory rate of 30 breaths/min
Answer: A) Heart rate reserve (HRR) of 40-60%
Rationale: For patients with COPD, exercise intensity is best prescribed using HRR
(Karvonen method) at 40-60% or Borg Scale 11-14 (somewhat hard). The Borg
Scale of 15-17 (hard-very hard) is too intense for this population and increases
risk of desaturation. Oxygen saturation should be maintained at ≥90% (some
sources say ≥88% but only with close monitoring) .
Q2. A patient is 2 days post-myocardial infarction (MI) and is being monitored in
Phase I cardiac rehabilitation. Which of the following is a CONTRAINDICATION
to initiating mobilization?
,A) Heart rate of 90 bpm
B) Systolic blood pressure of 140 mmHg
C) ST-segment depression of 3 mm
D) Respiratory rate of 20 breaths/min
Answer: C) ST-segment depression of 3 mm
Rationale: ST-segment depression of ≥2 mm is a sign of myocardial ischemia and
is a contraindication to exercise progression. Other contraindications include
chest pain, arrhythmias, hypotension, and uncontrolled tachycardia. The other
options are within acceptable parameters for mobilization, though the target HR
should be based on a percentage of predicted HR and RPE should be monitored .
Q3. A patient with chronic heart failure (HF) presents with decreased exercise
tolerance, dyspnea, and peripheral edema. Which of the following medications
would you expect this patient to be taking?
A) Beta-blockers and ACE inhibitors
B) NSAIDs and corticosteroids
C) Anticholinergics and bronchodilators
D) Anticoagulants and vasodilators
Answer: A) Beta-blockers and ACE inhibitors
Rationale: The standard medical management for chronic HF includes ACE
inhibitors (or ARBs) and beta-blockers. ACE inhibitors reduce afterload and
preload, while beta-blockers reduce heart rate and myocardial oxygen demand.
Diuretics are also commonly prescribed for fluid management. NSAIDs (B) are
contraindicated in HF as they cause fluid retention. Anticholinergics and
bronchodilators (C) are for COPD .
Q4. A patient with COPD has a resting oxygen saturation of 88% on room air.
During exercise, the saturation drops to 82%. What is the MOST appropriate
action?
,A) Discontinue exercise immediately and place patient on 2 L/min O2
B) Continue exercise and monitor for symptoms
C) Increase the speed of the treadmill to improve ventilation
D) Place the patient on 4 L/min O2 and continue exercise
Answer: A) Discontinue exercise immediately and place patient on 2 L/min O2
Rationale: When SpO2 drops below 88% (especially during exercise), the therapist
should stop exercise, place the patient on supplemental oxygen (2 L/min via nasal
cannula), and allow recovery. The patient should be reassessed, and the exercise
prescription should be modified to keep SpO2 ≥90%. The American Thoracic
Society recommends keeping SpO2 >90% during exercise .
Q5. Auscultation of the lungs reveals fine, late-inspiratory crackles that do not
clear with coughing. This finding is MOST consistent with:
A) Chronic bronchitis
B) Pulmonary fibrosis
C) Asthma
D) Atelectasis
Answer: B) Pulmonary fibrosis
Rationale: Fine, late-inspiratory crackles that do not clear with coughing are
characteristic of restrictive lung diseases such as pulmonary fibrosis (Velcro
crackles). Chronic bronchitis and asthma typically present with wheezing and
rhonchi. Atelectasis crackles may clear with coughing and deep breathing .
Q6. A 55-year-old patient with a 40-pack-year smoking history presents with a
chronic cough, sputum production, and barrel chest. Which of the following is
the MOST appropriate intervention for this patient?
A) Pursed-lip breathing and diaphragmatic breathing training
B) Incentive spirometry and chest percussion
C) Oxygen therapy only
D) High-intensity interval training
, Answer: A) Pursed-lip breathing and diaphragmatic breathing training
Rationale: Patients with COPD (barrel chest, hyperinflation) benefit from pursed-
lip breathing (prolongs expiration, prevents airway collapse) and diaphragmatic
breathing (improves ventilation). Incentive spirometry is used for atelectasis
prevention post-surgery. High-intensity training may be too intense for this
population. Pursed-lip breathing increases expiratory airway pressure and
reduces air trapping .
Q7. During a graded exercise test on a patient post-MI, the patient reports chest
pain, lightheadedness, and nausea. What is the FIRST action?
A) Administer nitroglycerin
B) Stop the test and place the patient in a supine position
C) Reduce the workload and monitor vital signs
D) Increase the workload to improve cardiac output
Answer: B) Stop the test and place the patient in a supine position
Rationale: Angina, lightheadedness, and nausea are signs of myocardial ischemia
and are absolute indications to stop the test. The patient should be placed in a
comfortable position (often supine with legs elevated if hypotensive), oxygen
should be administered, and emergency protocols should be initiated. The
physician should be notified immediately .
Q8. A patient with COPD has an FEV1/FVC ratio of 55%. Which of the following
is TRUE regarding this patient?
A) The patient has a restrictive lung disease
B) The patient has an obstructive lung disease
C) The patient has a normal lung function
D) The patient has a combined restrictive and obstructive disease
Answer: B) The patient has an obstructive lung disease
Rationale: An FEV1/FVC ratio <70% (or <0.70) is diagnostic of obstructive lung
disease (COPD, asthma). This indicates that the patient cannot exhale air as
100+ Black Book Questions with Correct Answers and
Detailed Rationales
Physiotherapy NBCE PT Boards Exam Prep | New
Edition
SECTION I: CARDIOVASCULAR & PULMONARY PHYSICAL THERAPY
Questions 1-20
Q1. A 68-year-old male patient with COPD is participating in pulmonary
rehabilitation. Which of the following is the BEST indicator of exercise intensity
during aerobic training?
A) Heart rate reserve (HRR) of 40-60%
B) Borg Scale rating of 15-17
C) Oxygen saturation of 88-92%
D) Respiratory rate of 30 breaths/min
Answer: A) Heart rate reserve (HRR) of 40-60%
Rationale: For patients with COPD, exercise intensity is best prescribed using HRR
(Karvonen method) at 40-60% or Borg Scale 11-14 (somewhat hard). The Borg
Scale of 15-17 (hard-very hard) is too intense for this population and increases
risk of desaturation. Oxygen saturation should be maintained at ≥90% (some
sources say ≥88% but only with close monitoring) .
Q2. A patient is 2 days post-myocardial infarction (MI) and is being monitored in
Phase I cardiac rehabilitation. Which of the following is a CONTRAINDICATION
to initiating mobilization?
,A) Heart rate of 90 bpm
B) Systolic blood pressure of 140 mmHg
C) ST-segment depression of 3 mm
D) Respiratory rate of 20 breaths/min
Answer: C) ST-segment depression of 3 mm
Rationale: ST-segment depression of ≥2 mm is a sign of myocardial ischemia and
is a contraindication to exercise progression. Other contraindications include
chest pain, arrhythmias, hypotension, and uncontrolled tachycardia. The other
options are within acceptable parameters for mobilization, though the target HR
should be based on a percentage of predicted HR and RPE should be monitored .
Q3. A patient with chronic heart failure (HF) presents with decreased exercise
tolerance, dyspnea, and peripheral edema. Which of the following medications
would you expect this patient to be taking?
A) Beta-blockers and ACE inhibitors
B) NSAIDs and corticosteroids
C) Anticholinergics and bronchodilators
D) Anticoagulants and vasodilators
Answer: A) Beta-blockers and ACE inhibitors
Rationale: The standard medical management for chronic HF includes ACE
inhibitors (or ARBs) and beta-blockers. ACE inhibitors reduce afterload and
preload, while beta-blockers reduce heart rate and myocardial oxygen demand.
Diuretics are also commonly prescribed for fluid management. NSAIDs (B) are
contraindicated in HF as they cause fluid retention. Anticholinergics and
bronchodilators (C) are for COPD .
Q4. A patient with COPD has a resting oxygen saturation of 88% on room air.
During exercise, the saturation drops to 82%. What is the MOST appropriate
action?
,A) Discontinue exercise immediately and place patient on 2 L/min O2
B) Continue exercise and monitor for symptoms
C) Increase the speed of the treadmill to improve ventilation
D) Place the patient on 4 L/min O2 and continue exercise
Answer: A) Discontinue exercise immediately and place patient on 2 L/min O2
Rationale: When SpO2 drops below 88% (especially during exercise), the therapist
should stop exercise, place the patient on supplemental oxygen (2 L/min via nasal
cannula), and allow recovery. The patient should be reassessed, and the exercise
prescription should be modified to keep SpO2 ≥90%. The American Thoracic
Society recommends keeping SpO2 >90% during exercise .
Q5. Auscultation of the lungs reveals fine, late-inspiratory crackles that do not
clear with coughing. This finding is MOST consistent with:
A) Chronic bronchitis
B) Pulmonary fibrosis
C) Asthma
D) Atelectasis
Answer: B) Pulmonary fibrosis
Rationale: Fine, late-inspiratory crackles that do not clear with coughing are
characteristic of restrictive lung diseases such as pulmonary fibrosis (Velcro
crackles). Chronic bronchitis and asthma typically present with wheezing and
rhonchi. Atelectasis crackles may clear with coughing and deep breathing .
Q6. A 55-year-old patient with a 40-pack-year smoking history presents with a
chronic cough, sputum production, and barrel chest. Which of the following is
the MOST appropriate intervention for this patient?
A) Pursed-lip breathing and diaphragmatic breathing training
B) Incentive spirometry and chest percussion
C) Oxygen therapy only
D) High-intensity interval training
, Answer: A) Pursed-lip breathing and diaphragmatic breathing training
Rationale: Patients with COPD (barrel chest, hyperinflation) benefit from pursed-
lip breathing (prolongs expiration, prevents airway collapse) and diaphragmatic
breathing (improves ventilation). Incentive spirometry is used for atelectasis
prevention post-surgery. High-intensity training may be too intense for this
population. Pursed-lip breathing increases expiratory airway pressure and
reduces air trapping .
Q7. During a graded exercise test on a patient post-MI, the patient reports chest
pain, lightheadedness, and nausea. What is the FIRST action?
A) Administer nitroglycerin
B) Stop the test and place the patient in a supine position
C) Reduce the workload and monitor vital signs
D) Increase the workload to improve cardiac output
Answer: B) Stop the test and place the patient in a supine position
Rationale: Angina, lightheadedness, and nausea are signs of myocardial ischemia
and are absolute indications to stop the test. The patient should be placed in a
comfortable position (often supine with legs elevated if hypotensive), oxygen
should be administered, and emergency protocols should be initiated. The
physician should be notified immediately .
Q8. A patient with COPD has an FEV1/FVC ratio of 55%. Which of the following
is TRUE regarding this patient?
A) The patient has a restrictive lung disease
B) The patient has an obstructive lung disease
C) The patient has a normal lung function
D) The patient has a combined restrictive and obstructive disease
Answer: B) The patient has an obstructive lung disease
Rationale: An FEV1/FVC ratio <70% (or <0.70) is diagnostic of obstructive lung
disease (COPD, asthma). This indicates that the patient cannot exhale air as
