PHYSICAL THERAPY – NPTE
PRACTICE EXAMINATION
QUESTIONS WITH CORRECT
ANSWERS PLUS RATIONALES
2026/2027 EDITION WITH INSTANT
PDF DOWNLOAD
Question 1
A patient with a complete spinal cord injury at the C6 level is
participating in rehabilitation. Which functional activity would the
patient most likely be able to perform independently?
A. Ambulate without an assistive device
B. Perform a tenodesis grasp to assist with feeding
C. Independently transfer from the floor to standing
D. Perform active finger flexion and extension
Correct Answer: B. Perform a tenodesis grasp to assist with
feeding
Rationale: A patient with a C6-level complete spinal cord injury
typically retains wrist extension but has limited or absent
voluntary finger flexion. Wrist extension can passively flex the
fingers through the tenodesis effect, allowing functional grasp and
release. Independent ambulation and active finger movements
would not generally be expected with a complete C6 injury.
Question 2
,A physical therapist evaluates a patient with a suspected upper
motor neuron lesion. Which finding is most consistent with an
upper motor neuron lesion?
A. Flaccid paralysis and muscle atrophy
B. Fasciculations and decreased reflexes
C. Spasticity and hyperreflexia
D. Loss of muscle tone and absent reflexes
Correct Answer: C. Spasticity and hyperreflexia
Rationale: Upper motor neuron lesions commonly produce
increased muscle tone, spasticity, hyperreflexia, abnormal
reflexes, and a positive Babinski sign. Lower motor neuron lesions
are more commonly associated with flaccidity, muscle atrophy,
fasciculations, and hyporeflexia.
Question 3
A patient is prescribed a cane following a unilateral lower-
extremity injury. On which side should the cane generally be held
to improve mechanical support during gait?
A. Same side as the involved limb
B. Opposite side of the involved limb
C. Dominant side regardless of injury
D. Side with greater hip strength
Correct Answer: B. Opposite side of the involved limb
Rationale: Holding the cane in the hand opposite the involved
lower extremity allows the cane and involved limb to share the
load while reducing the external hip adduction moment. This
,generally improves stability and decreases stress on the involved
limb.
Question 4
A patient with congestive heart failure is beginning an exercise
program. Which finding should prompt the therapist to stop
exercise immediately?
A. Mild increase in respiratory rate
B. Rating of perceived exertion of 11/20
C. New onset of chest pain
D. Mild increase in systolic blood pressure
Correct Answer: C. New onset of chest pain
Rationale: New chest pain during exercise is a potentially serious
sign of myocardial ischemia and requires immediate cessation of
activity and appropriate medical assessment. Mild increases in
respiratory rate, blood pressure, and perceived exertion can be
normal physiological responses to exercise.
Question 5
A patient demonstrates a Trendelenburg gait during right single-
limb stance. Which muscle is most likely weak?
A. Right gluteus medius
B. Left gluteus medius
C. Right adductor magnus
D. Left quadriceps
Correct Answer: A. Right gluteus medius
, Rationale: During right single-limb stance, the right hip abductors
stabilize the pelvis and prevent the left side of the pelvis from
dropping. Weakness of the right gluteus medius can therefore
produce a contralateral pelvic drop, known as a Trendelenburg
sign.
Question 6
Which intervention is most appropriate for a patient with acute
inflammation immediately following an ankle sprain?
A. Aggressive resisted exercise
B. Prolonged deep tissue massage
C. Protection, relative rest, and edema control
D. High-intensity plyometric exercise
Correct Answer: C. Protection, relative rest, and edema
control
Rationale: During the acute inflammatory stage following an ankle
sprain, treatment should emphasize protection of the injured
tissue, appropriate relative rest, pain control, and management of
swelling. Aggressive loading or deep tissue techniques may
aggravate the injury during this phase.
Question 7
A patient has a peripheral median nerve injury at the wrist. Which
sensory distribution is most likely affected?
A. Little finger and medial half of ring finger
B. Dorsal surface of the entire hand
C. Palmar surface of the thumb, index, middle, and radial half of
PRACTICE EXAMINATION
QUESTIONS WITH CORRECT
ANSWERS PLUS RATIONALES
2026/2027 EDITION WITH INSTANT
PDF DOWNLOAD
Question 1
A patient with a complete spinal cord injury at the C6 level is
participating in rehabilitation. Which functional activity would the
patient most likely be able to perform independently?
A. Ambulate without an assistive device
B. Perform a tenodesis grasp to assist with feeding
C. Independently transfer from the floor to standing
D. Perform active finger flexion and extension
Correct Answer: B. Perform a tenodesis grasp to assist with
feeding
Rationale: A patient with a C6-level complete spinal cord injury
typically retains wrist extension but has limited or absent
voluntary finger flexion. Wrist extension can passively flex the
fingers through the tenodesis effect, allowing functional grasp and
release. Independent ambulation and active finger movements
would not generally be expected with a complete C6 injury.
Question 2
,A physical therapist evaluates a patient with a suspected upper
motor neuron lesion. Which finding is most consistent with an
upper motor neuron lesion?
A. Flaccid paralysis and muscle atrophy
B. Fasciculations and decreased reflexes
C. Spasticity and hyperreflexia
D. Loss of muscle tone and absent reflexes
Correct Answer: C. Spasticity and hyperreflexia
Rationale: Upper motor neuron lesions commonly produce
increased muscle tone, spasticity, hyperreflexia, abnormal
reflexes, and a positive Babinski sign. Lower motor neuron lesions
are more commonly associated with flaccidity, muscle atrophy,
fasciculations, and hyporeflexia.
Question 3
A patient is prescribed a cane following a unilateral lower-
extremity injury. On which side should the cane generally be held
to improve mechanical support during gait?
A. Same side as the involved limb
B. Opposite side of the involved limb
C. Dominant side regardless of injury
D. Side with greater hip strength
Correct Answer: B. Opposite side of the involved limb
Rationale: Holding the cane in the hand opposite the involved
lower extremity allows the cane and involved limb to share the
load while reducing the external hip adduction moment. This
,generally improves stability and decreases stress on the involved
limb.
Question 4
A patient with congestive heart failure is beginning an exercise
program. Which finding should prompt the therapist to stop
exercise immediately?
A. Mild increase in respiratory rate
B. Rating of perceived exertion of 11/20
C. New onset of chest pain
D. Mild increase in systolic blood pressure
Correct Answer: C. New onset of chest pain
Rationale: New chest pain during exercise is a potentially serious
sign of myocardial ischemia and requires immediate cessation of
activity and appropriate medical assessment. Mild increases in
respiratory rate, blood pressure, and perceived exertion can be
normal physiological responses to exercise.
Question 5
A patient demonstrates a Trendelenburg gait during right single-
limb stance. Which muscle is most likely weak?
A. Right gluteus medius
B. Left gluteus medius
C. Right adductor magnus
D. Left quadriceps
Correct Answer: A. Right gluteus medius
, Rationale: During right single-limb stance, the right hip abductors
stabilize the pelvis and prevent the left side of the pelvis from
dropping. Weakness of the right gluteus medius can therefore
produce a contralateral pelvic drop, known as a Trendelenburg
sign.
Question 6
Which intervention is most appropriate for a patient with acute
inflammation immediately following an ankle sprain?
A. Aggressive resisted exercise
B. Prolonged deep tissue massage
C. Protection, relative rest, and edema control
D. High-intensity plyometric exercise
Correct Answer: C. Protection, relative rest, and edema
control
Rationale: During the acute inflammatory stage following an ankle
sprain, treatment should emphasize protection of the injured
tissue, appropriate relative rest, pain control, and management of
swelling. Aggressive loading or deep tissue techniques may
aggravate the injury during this phase.
Question 7
A patient has a peripheral median nerve injury at the wrist. Which
sensory distribution is most likely affected?
A. Little finger and medial half of ring finger
B. Dorsal surface of the entire hand
C. Palmar surface of the thumb, index, middle, and radial half of
