NPTE for PTA Board Exam – FSBPT NPTE-
PTA – 2026/2027 High-Quality Practice
Examination
Question 1
A 72-year-old female patient is 3 days post-right total hip arthroplasty with a
posterior-lateral approach. The supervising PT's plan of care specifies hip
precautions and toe-touch weight-bearing on the right lower extremity.
During gait training with a front-wheeled walker, the patient reports sudden
sharp pain in the right groin and anterior thigh. What is the PTA's MOST
appropriate immediate action?
A) Encourage the patient to continue ambulation to promote mobility
B) Stop ambulation, assist the patient to a seated position, and notify the
supervising PT
C) Reduce the gait speed and continue with close monitoring
D) Change the assistive device to a standard walker for more stability
Answer: B) Stop ambulation, assist the patient to a seated position, and
notify the supervising PT
Rationale: Sudden sharp groin and anterior thigh pain following a posterior-
lateral hip arthroplasty may indicate dislocation or fracture. The PTA must
stop the activity immediately, ensure patient safety, and notify the supervising
PT. Continuing ambulation (A) could worsen injury. Reducing speed (C) does
not address the emergent nature of the symptoms. Changing the device (D) is
not appropriate without PT re-evaluation.
Question 2
A patient with a complete C7 spinal cord injury is participating in wheelchair
mobility training. The PTA observes that the patient has difficulty propelling
,the wheelchair up a ramp. Which muscle group is MOST likely contributing to
this difficulty?
A) Triceps brachii
B) Biceps brachii
C) Deltoid
D) Pectoralis major
Answer: A) Triceps brachii
Rationale: At the C7 level, the triceps (C7) is the key muscle for elbow
extension. During wheelchair propulsion up a ramp, elbow extension is
essential for effective pushing. Biceps (B) is C5-C6 and would be intact.
Deltoid (C) is C5-C6. Pectoralis major (D) is C5-T1 but is not the primary
limiting muscle for this activity.
Question 3
A PTA is implementing a strengthening program for a patient with rotator cuff
tendinopathy. The PT's plan of care includes submaximal isometric exercises.
Which of the following represents the CORRECT application of isometric
exercise for this patient?
A) Full range-of-motion shoulder flexion with a 2-lb weight
B) Shoulder abduction against a wall with sustained contraction for 10
seconds
C) Dynamic shoulder external rotation with a resistance band
D) Overhead press with dumbbells in sitting
Answer: B) Shoulder abduction against a wall with sustained contraction
for 10 seconds
Rationale: Isometric exercise involves muscle contraction without joint
movement. Shoulder abduction against a wall with sustained contraction
meets this definition. Options A, C, and D involve dynamic or isotonic
contractions with joint movement, which may aggravate rotator cuff
tendinopathy and are not isometric.
,Question 4
A 65-year-old male patient with severe knee osteoarthritis presents with
significant quadriceps weakness and a Trendelenburg gait. Which
intervention is MOST appropriate for the PTA to implement first?
A) Quadriceps strengthening with open-chain knee extension
B) Gait training with a cane in the contralateral hand
C) Aquatic therapy for joint unloading
D) Patellar mobilization techniques
Answer: B) Gait training with a cane in the contralateral hand
Rationale: A cane held in the contralateral hand reduces the load on the
affected knee joint and improves gait stability. This is a safe, immediate
intervention that addresses the patient's functional limitation. While
quadriceps strengthening (A) and aquatic therapy (C) are appropriate, they
should be implemented alongside or after establishing safe gait. Patellar
mobilization (D) is not the priority.
Question 5
A PTA is performing manual muscle testing on a patient with L4
radiculopathy. Which muscle would the PTA expect to be MOST affected?
A) Tibialis anterior
B) Gastrocnemius
C) Gluteus maximus
D) Hamstrings
Answer: A) Tibialis anterior
Rationale: The tibialis anterior is innervated by the L4-L5 nerve roots
(primarily L4). L4 radiculopathy would most significantly affect ankle
dorsiflexion strength. Gastrocnemius (B) is S1-S2, gluteus maximus (C) is L5-
, S2, and hamstrings (D) are L5-S2. Tibialis anterior weakness would present as
foot drop.
Question 6
A patient is 2 weeks status post-anterior cruciate ligament (ACL)
reconstruction with a patellar tendon autograft. The PTA notes that the
patient's knee extension is limited to 10 degrees from full extension. What is
the MOST appropriate action?
A) Perform aggressive passive knee extension stretching
B) Apply a prone hang for 5-10 minutes to promote extension
C) Notify the supervising PT of the extension deficit
D) Continue with the current exercise program and reassess next session
Answer: C) Notify the supervising PT of the extension deficit
Rationale: An extension deficit following ACL reconstruction with patellar
tendon autograft is concerning and may indicate cyclops lesion, arthrofibrosis,
or graft impingement. The PTA must communicate this finding to the
supervising PT for re-evaluation. Aggressive stretching (A) could damage the
graft. Prone hang (B) may be appropriate but should be prescribed by the PT.
Continuing without modification (D) is inappropriate given the significance of
the finding.
Question 7
A PTA is implementing gait training for a patient with a left transfemoral
amputation using a prosthetic limb. The patient demonstrates excessive
lateral trunk lean toward the prosthetic side during stance. This gait deviation
is MOST likely due to:
A) Weak hip abductors on the prosthetic side
B) Prosthetic socket discomfort
C) Inadequate knee flexion during swing phase
D) Weak hip flexors on the sound side
PTA – 2026/2027 High-Quality Practice
Examination
Question 1
A 72-year-old female patient is 3 days post-right total hip arthroplasty with a
posterior-lateral approach. The supervising PT's plan of care specifies hip
precautions and toe-touch weight-bearing on the right lower extremity.
During gait training with a front-wheeled walker, the patient reports sudden
sharp pain in the right groin and anterior thigh. What is the PTA's MOST
appropriate immediate action?
A) Encourage the patient to continue ambulation to promote mobility
B) Stop ambulation, assist the patient to a seated position, and notify the
supervising PT
C) Reduce the gait speed and continue with close monitoring
D) Change the assistive device to a standard walker for more stability
Answer: B) Stop ambulation, assist the patient to a seated position, and
notify the supervising PT
Rationale: Sudden sharp groin and anterior thigh pain following a posterior-
lateral hip arthroplasty may indicate dislocation or fracture. The PTA must
stop the activity immediately, ensure patient safety, and notify the supervising
PT. Continuing ambulation (A) could worsen injury. Reducing speed (C) does
not address the emergent nature of the symptoms. Changing the device (D) is
not appropriate without PT re-evaluation.
Question 2
A patient with a complete C7 spinal cord injury is participating in wheelchair
mobility training. The PTA observes that the patient has difficulty propelling
,the wheelchair up a ramp. Which muscle group is MOST likely contributing to
this difficulty?
A) Triceps brachii
B) Biceps brachii
C) Deltoid
D) Pectoralis major
Answer: A) Triceps brachii
Rationale: At the C7 level, the triceps (C7) is the key muscle for elbow
extension. During wheelchair propulsion up a ramp, elbow extension is
essential for effective pushing. Biceps (B) is C5-C6 and would be intact.
Deltoid (C) is C5-C6. Pectoralis major (D) is C5-T1 but is not the primary
limiting muscle for this activity.
Question 3
A PTA is implementing a strengthening program for a patient with rotator cuff
tendinopathy. The PT's plan of care includes submaximal isometric exercises.
Which of the following represents the CORRECT application of isometric
exercise for this patient?
A) Full range-of-motion shoulder flexion with a 2-lb weight
B) Shoulder abduction against a wall with sustained contraction for 10
seconds
C) Dynamic shoulder external rotation with a resistance band
D) Overhead press with dumbbells in sitting
Answer: B) Shoulder abduction against a wall with sustained contraction
for 10 seconds
Rationale: Isometric exercise involves muscle contraction without joint
movement. Shoulder abduction against a wall with sustained contraction
meets this definition. Options A, C, and D involve dynamic or isotonic
contractions with joint movement, which may aggravate rotator cuff
tendinopathy and are not isometric.
,Question 4
A 65-year-old male patient with severe knee osteoarthritis presents with
significant quadriceps weakness and a Trendelenburg gait. Which
intervention is MOST appropriate for the PTA to implement first?
A) Quadriceps strengthening with open-chain knee extension
B) Gait training with a cane in the contralateral hand
C) Aquatic therapy for joint unloading
D) Patellar mobilization techniques
Answer: B) Gait training with a cane in the contralateral hand
Rationale: A cane held in the contralateral hand reduces the load on the
affected knee joint and improves gait stability. This is a safe, immediate
intervention that addresses the patient's functional limitation. While
quadriceps strengthening (A) and aquatic therapy (C) are appropriate, they
should be implemented alongside or after establishing safe gait. Patellar
mobilization (D) is not the priority.
Question 5
A PTA is performing manual muscle testing on a patient with L4
radiculopathy. Which muscle would the PTA expect to be MOST affected?
A) Tibialis anterior
B) Gastrocnemius
C) Gluteus maximus
D) Hamstrings
Answer: A) Tibialis anterior
Rationale: The tibialis anterior is innervated by the L4-L5 nerve roots
(primarily L4). L4 radiculopathy would most significantly affect ankle
dorsiflexion strength. Gastrocnemius (B) is S1-S2, gluteus maximus (C) is L5-
, S2, and hamstrings (D) are L5-S2. Tibialis anterior weakness would present as
foot drop.
Question 6
A patient is 2 weeks status post-anterior cruciate ligament (ACL)
reconstruction with a patellar tendon autograft. The PTA notes that the
patient's knee extension is limited to 10 degrees from full extension. What is
the MOST appropriate action?
A) Perform aggressive passive knee extension stretching
B) Apply a prone hang for 5-10 minutes to promote extension
C) Notify the supervising PT of the extension deficit
D) Continue with the current exercise program and reassess next session
Answer: C) Notify the supervising PT of the extension deficit
Rationale: An extension deficit following ACL reconstruction with patellar
tendon autograft is concerning and may indicate cyclops lesion, arthrofibrosis,
or graft impingement. The PTA must communicate this finding to the
supervising PT for re-evaluation. Aggressive stretching (A) could damage the
graft. Prone hang (B) may be appropriate but should be prescribed by the PT.
Continuing without modification (D) is inappropriate given the significance of
the finding.
Question 7
A PTA is implementing gait training for a patient with a left transfemoral
amputation using a prosthetic limb. The patient demonstrates excessive
lateral trunk lean toward the prosthetic side during stance. This gait deviation
is MOST likely due to:
A) Weak hip abductors on the prosthetic side
B) Prosthetic socket discomfort
C) Inadequate knee flexion during swing phase
D) Weak hip flexors on the sound side
