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NPTE Ultimate Practice Exam 2026–
2027 | 100 Advanced Scenario-Based
Questions with Answers & Detailed
Rationales | National Physical Therapy
Examination (NPTE) Exam Prep, Study
Guide & Full-Length Practice Test
1.
A patient with a complete C6 spinal cord injury is learning wheelchair transfers.
During a transfer from the wheelchair to a level mat, which technique most
effectively compensates for the patient's absent triceps function?
A. Use a posterior pelvic tilt and lift the body vertically
B. Use a lateral scoot with a forward trunk lean and depression through the
shoulders
C. Maintain an upright trunk and pivot primarily through the lower extremities
D. Use active elbow extension against the mat to elevate the pelvis
,Answer: Use a lateral scoot with a forward trunk lean and depression through
the shoulders
Rationale: A person with a C6 injury typically has functional elbow flexion and
wrist extension but limited or absent triceps function. Forward trunk positioning
and shoulder depression allow the patient to generate a transfer through the
available upper-extremity musculature while minimizing dependence on elbow
extension.
2.
A patient 3 days after total knee arthroplasty demonstrates 75° of knee flexion
and a 10° extension deficit. Which intervention is most appropriate to prioritize?
A. High-intensity resisted knee extension
B. Continuous passive motion for several hours daily
C. Active-assisted knee flexion and sustained low-load knee extension
positioning
D. Deep squatting to increase joint mobility
Answer: Active-assisted knee flexion and sustained low-load knee extension
positioning
Rationale: Early after TKA, restoring extension and progressively improving
flexion are important functional priorities. Sustained low-load stretching can
address the extension deficit while active-assisted flexion promotes mobility
without excessive joint stress.
3.
A patient with Parkinson disease freezes when approaching a narrow doorway.
Which strategy is most appropriate?
A. Encourage faster walking
B. Ask the patient to concentrate on moving both legs simultaneously
C. Use an external visual cue placed beyond the doorway
D. Increase resistance during gait training
,Answer: Use an external visual cue placed beyond the doorway
Rationale: External visual cues can bypass impaired internally generated
movement and facilitate initiation and continuation of gait in patients with
Parkinson disease. Lines, stepping targets, and visual markers are commonly
useful for freezing episodes.
4.
A patient with an acute lateral ankle sprain has substantial swelling and pain with
weight bearing. Which intervention is most appropriate during the initial phase?
A. Aggressive grade IV joint mobilization
B. Maximal resisted inversion and eversion
C. Protected weight bearing with progressive active range of motion and edema
control
D. Prolonged immobilization until all pain resolves
Answer: Protected weight bearing with progressive active range of motion and
edema control
Rationale: Early management emphasizes protection while avoiding
unnecessary immobilization. Gentle active motion, appropriate weight bearing,
and edema control help preserve mobility and facilitate recovery.
5.
A patient with chronic obstructive pulmonary disease becomes dyspneic during
therapeutic exercise. Which breathing technique is most appropriate?
A. Rapid shallow breathing
B. Breath holding during exertion
C. Pursed-lip breathing with a prolonged expiratory phase
D. Maximal inspiratory efforts followed by forced expiration
Answer: Pursed-lip breathing with a prolonged expiratory phase
, Rationale: Pursed-lip breathing increases expiratory airway pressure and helps
prevent premature airway closure. A prolonged expiration can decrease air
trapping and improve control of dyspnea.
6.
A patient has weakness of the left gluteus medius following a superior gluteal
nerve injury. Which gait deviation is most likely?
A. Right trunk lean during right stance
B. Left trunk lean during right stance
C. Right trunk lean during left stance
D. Bilateral posterior trunk lean during stance
Answer: Right trunk lean during left stance
Rationale: During left single-limb stance, the left gluteus medius normally
stabilizes the pelvis. Leaning the trunk toward the stance side reduces the
external hip adduction moment and decreases the demand on the weakened
abductor.
7.
A patient with an upper motor neuron lesion demonstrates velocity-dependent
resistance to passive movement. Which finding is most consistent with this
impairment?
A. Lead-pipe rigidity
B. Fasciculations
C. Spasticity
D. Flaccid paralysis
Answer: Spasticity
Rationale: Spasticity is characterized by velocity-dependent increased muscle
tone and is associated with upper motor neuron lesions. Rigidity is generally not
velocity dependent and is more characteristic of basal ganglia disorders.
NPTE Ultimate Practice Exam 2026–
2027 | 100 Advanced Scenario-Based
Questions with Answers & Detailed
Rationales | National Physical Therapy
Examination (NPTE) Exam Prep, Study
Guide & Full-Length Practice Test
1.
A patient with a complete C6 spinal cord injury is learning wheelchair transfers.
During a transfer from the wheelchair to a level mat, which technique most
effectively compensates for the patient's absent triceps function?
A. Use a posterior pelvic tilt and lift the body vertically
B. Use a lateral scoot with a forward trunk lean and depression through the
shoulders
C. Maintain an upright trunk and pivot primarily through the lower extremities
D. Use active elbow extension against the mat to elevate the pelvis
,Answer: Use a lateral scoot with a forward trunk lean and depression through
the shoulders
Rationale: A person with a C6 injury typically has functional elbow flexion and
wrist extension but limited or absent triceps function. Forward trunk positioning
and shoulder depression allow the patient to generate a transfer through the
available upper-extremity musculature while minimizing dependence on elbow
extension.
2.
A patient 3 days after total knee arthroplasty demonstrates 75° of knee flexion
and a 10° extension deficit. Which intervention is most appropriate to prioritize?
A. High-intensity resisted knee extension
B. Continuous passive motion for several hours daily
C. Active-assisted knee flexion and sustained low-load knee extension
positioning
D. Deep squatting to increase joint mobility
Answer: Active-assisted knee flexion and sustained low-load knee extension
positioning
Rationale: Early after TKA, restoring extension and progressively improving
flexion are important functional priorities. Sustained low-load stretching can
address the extension deficit while active-assisted flexion promotes mobility
without excessive joint stress.
3.
A patient with Parkinson disease freezes when approaching a narrow doorway.
Which strategy is most appropriate?
A. Encourage faster walking
B. Ask the patient to concentrate on moving both legs simultaneously
C. Use an external visual cue placed beyond the doorway
D. Increase resistance during gait training
,Answer: Use an external visual cue placed beyond the doorway
Rationale: External visual cues can bypass impaired internally generated
movement and facilitate initiation and continuation of gait in patients with
Parkinson disease. Lines, stepping targets, and visual markers are commonly
useful for freezing episodes.
4.
A patient with an acute lateral ankle sprain has substantial swelling and pain with
weight bearing. Which intervention is most appropriate during the initial phase?
A. Aggressive grade IV joint mobilization
B. Maximal resisted inversion and eversion
C. Protected weight bearing with progressive active range of motion and edema
control
D. Prolonged immobilization until all pain resolves
Answer: Protected weight bearing with progressive active range of motion and
edema control
Rationale: Early management emphasizes protection while avoiding
unnecessary immobilization. Gentle active motion, appropriate weight bearing,
and edema control help preserve mobility and facilitate recovery.
5.
A patient with chronic obstructive pulmonary disease becomes dyspneic during
therapeutic exercise. Which breathing technique is most appropriate?
A. Rapid shallow breathing
B. Breath holding during exertion
C. Pursed-lip breathing with a prolonged expiratory phase
D. Maximal inspiratory efforts followed by forced expiration
Answer: Pursed-lip breathing with a prolonged expiratory phase
, Rationale: Pursed-lip breathing increases expiratory airway pressure and helps
prevent premature airway closure. A prolonged expiration can decrease air
trapping and improve control of dyspnea.
6.
A patient has weakness of the left gluteus medius following a superior gluteal
nerve injury. Which gait deviation is most likely?
A. Right trunk lean during right stance
B. Left trunk lean during right stance
C. Right trunk lean during left stance
D. Bilateral posterior trunk lean during stance
Answer: Right trunk lean during left stance
Rationale: During left single-limb stance, the left gluteus medius normally
stabilizes the pelvis. Leaning the trunk toward the stance side reduces the
external hip adduction moment and decreases the demand on the weakened
abductor.
7.
A patient with an upper motor neuron lesion demonstrates velocity-dependent
resistance to passive movement. Which finding is most consistent with this
impairment?
A. Lead-pipe rigidity
B. Fasciculations
C. Spasticity
D. Flaccid paralysis
Answer: Spasticity
Rationale: Spasticity is characterized by velocity-dependent increased muscle
tone and is associated with upper motor neuron lesions. Rigidity is generally not
velocity dependent and is more characteristic of basal ganglia disorders.
