NPTE Test Practice Questions And Answers (Verified Solution) With Rationale

NPTE Test Practice Questions And Answers (Verified Solution) With Rationale What conditions are the abnormal heart sounds S3 and S4 associated with, respectively? A. S3 = MI or HTN; S4 =CHF B. S3 = Tracheal Stenosis; S4 = Asthma C. S3 = closure of Mitral and Tricuspid Valves; S4 = Closure of Pulmonary Valves D. S3 = CHF; S4 =MI or HTN Feedback Correct Answer - D S3 is heard in early diastole (after S2) and is associated with CHF. S4 is heard in late diastole (before S1) and is associated with an MI or hypertension. A chronic smoker diagnosed with COPD was tested for an arterial blood gas (ABG) analysis. After reviewing the patient's chart, the physical therapist is MOST likely to see which of the following changes in the ABG results? A. Decreased PaCO2, increased PaO2, and decreased pH. B. Decreased PaCO2, decreased PaO2, and increased pH. C. Increased PaCO2, increased PaO2, and increased pH. D. Increased PaCO2, decreased PaO2, and decreased pH Feedback Correct Answer - D COPD causes dilation and destruction of the airspaces and alteration in pulmonary vasculature resulting in mismatch in ventilation in the alveoli and perfusion in the capillary membrane. This results in hypoxemia (decreased oxygen in the arterial blood) in the early stage of COPD and hypercapnea (increased carbon dioxide in the arterial blood) as the disease progresses. A geriatric patient recently developed CHF. The patient has symptoms of nausea, vomiting, and gastrointestinal irritability. The patient also presents with mental confusion and frustration. Based on these symptoms, what clinical condition does the therapist suspect? A. Alzheimer's disease B. Dementia C. Digoxin toxicity D. Age related symptoms Feedback Correct Answer - C Signs of digoxin toxicity in patients with CHF : Nausea, vomiting, headache, dizziness, confusion, abdominal pain, delirium, vision disturbance. With Alzheimer's and dementia, patient will experience significant memory loss. A patient has a history of diabetes, hypertension, and chronic heart failure. The patient's venous filling time is 10 seconds, while Homan's sign and rubor dependency tests are both negative. These findings support which of the following diagnoses? Select one: A. Chronic venous insufficiency B. Intermittent claudication C. Arterial insufficiency D. Lymphedema Feedback Correct Answer - A Venous filling time- The extremity is elevated and then lowered into a dependent position. The time it takes for the veins on top of the foot to refill is recorded. Normal filling time is 15 seconds. Greater than 15 seconds indicates arterial disease whereas less than 15 indicate venous disease. Rubor dependency test is negative indicating no arterial insufficiency. No signs of intermittent claudication and lymphedema are seen. While evaluating a 30-year-old male with shoulder pain, the therapist applies pressure at the end range of shoulder abduction and external rotation. The patient feels a sudden PARALYZING pain and WEAKNESS in his shoulder. This finding is MOST LIKELY an indication of: A. Thoracic outlet syndrome B. Myotome involvement C. Anterior instability D. Cervical spondylosis Feedback Correct Answer - C The therapist is performing anterior apprehension test or crank test. This test is primarily designed to check for traumatic instability problems causing gross or anatomical instability of the shoulder; positive anterior apprehension test indicates anterior instability. A physical therapist is examining a patient with hypomobile talocrural joint and finds that the range of motion of ankle dorsiflexion is limited. Which of the following mobilization techniques can be used to increase ankle dorsiflexion? A. Posterior glide of talus with small amplitude oscillations into tissue resistance at the limit of available joint motion B. Anterior glide of talus with small-amplitude rhythmic oscillations performed at the beginning of the range C. Posterior glide of talus with small-amplitude rhythmic oscillations performed at the beginning of the range D. Anterior glide of talus with small amplitude oscillations into tissue resistance at the limit of available joint motion Feedback Correct Answer - A Posterior glide of talus with small amplitude oscillations into tissue resistance at the limit of available joint motion At the talocrural joint, convex talus moves over with the concave mortise made up of the tibia and fibula. So, according to convex-concave rule, posterior glide of talus can be used to increase ankle dorsiflexion. Grade I, i.e. small-amplitude rhythmic oscillations performed at the beginning of the range is primarily used for treating joints limited by pain or muscle guarding. Grade IV, i.e. small-amplitude rhythmic oscillations performed at the limit of the available motion and stressed into the tissue resistance is used as stretching maneuver to increase range of motion. So, grade 4 and posterior glide of talus will be the most appropriate mobilization techniques for the patient. A therapist is examining a patient's straight leg raise by taking their leg into hip flexion, knee extension and ankle dorsiflexion with inversion. Which nerve is MOST likely being biased in this position? A. Common peroneal nerve B. Tibial nerve C. Sciatic and Tibial nerve D. Sural nerve Feedback Feedback Correct Answer - D Ankle Dorsiflexion with inversion places tension on the sural nerve. Plantar flexion and inversion places tension on the common peroneal nerve. Dorsiflexion and eversion with toe extension places tension on the tibial nerve. A physical therapist is assessing muscle strength of a 20-year-old male who reports having shoulder pain ever since he started lifting weights at the gym as part of his New Year's resolution. The therapist positions the patient in the supine position with 120° of shoulder abduction and moves the shoulder diagonally down and inward towards the patient's opposite hip. Resistance is given above the wrist in an up and outward direction. Which muscle is being tested? A. Pectoralis major clavicular head B. Pectoralis major both heads C. Pectoralis major sternal head D. Pectoralis minor Feedback Correct Answer - C MMT of Pectoralis major sternal head - the motion begins at 120° of shoulder abduction and moves diagonally down and in toward the patient's opposite hip. Resistance is given above the wrist in an up and outward direction. During a gait training session, a PT notices that the patient is beginning to lose balance in the anterior direction. What IMMEDIATE action should the therapist take? A. Pull the patient backwards B. Allow the patient to re-gain their balance C. Bring the patient to one knee D. Push the patient forward Feedback Correct Answer - A As the patient is beginning to lose the balance forward; pulling the patient backwards will help him to regain balance by performing a posterior weight shift. This is easiest to accomplish when assisted by the therapist. While evaluating the gait of a patient with right hemiplegia, the PT notes foot drop during mid-swing of the right leg. The MOST LIKELY cause of this deviation is: A. Inadequate contraction of the ankle dorsiflexors B. Excessive extensor synergy C. Decreased proprioception of foot-ankle muscles D. Excessive flexor synergy Feedback Correct Answer - A Ankle remains plantar flexed during swing and can be associated with dragging of the toes, typically called drop foot. It is caused by weakness or paralysis of foot dorsiflexors. Excessive extensor synergy causes tight plantar flexors. Excessive flexor synergy causes excessive dorsiflexion. Decreased proprioception does not cause foot drop. It causes sensory ataxia causing foot stomping gait. Which of the following is the MOST appropriate long-term goal for a PT to address in a patient with Down syndrome? A. Accelerate the rate of motor skills development B. Strengthen weak muscles C. Minimize the development of compensatory movement patterns D. Focus on rhythmic stabilization exercises Feedback Correct Answer - C In Down Syndrome, it is important to address the development of compensatory movement pattern, as it can further exacerbate hypotonicity. While rhythmic stabilization exercises do support the above, they are not a viable goal, but rather an activity. When examining a patient with a stroke, a physical therapist finds the patient's speech to be slow and hesitant. The patient is limited to one- or two-word responses but appears to fully comprehend sentences. Which of the following is the BEST description of the patient's ability to communicate? A. Global aphasia B. Non-expressive aphasia C. Wernicke's aphasia D. Broca's aphasia Feedback Correct Answer - D Broca's aphasia (nonfluent) is caused due to lesion involving third frontal convolution of the left hemisphere. The flow of speech is slow and hesitant, vocabulary is limited, and syntax is impaired. Speech production is labored or lost completely whereas comprehension is good. In Wernicke's aphasia speech flows smoothly with a variety of grammatical constructions but auditory comprehension is impaired. Global aphasia is severe aphasia with marked dysfunction across all language modalities and with severely limited residual use of all communication modes for oral-aural interactions. An elderly gentleman was admitted to the hospital with a stroke 2 days ago. The physical therapist has assessed the patient's functional strength, sensation, and bed mobility. With the patient seated at the edge of bed, the therapist instructs the patient to touch his nose with his index finger. The patient first flexes the elbow, and then adjusts the position of the wrist and fingers. The patient then further flexes the elbow, and lastly flexes the shoulder to generate contact between the index finger and the nose. What neurological impairment does the patient MOST likely have? A. Dysdiadochokinesia