NBCE PT BOARDS EXAM NEWEST 2026 ACTUAL
EXAM TEST BANK | COMPLETE PRACTICE
QUESTIONS & ANSWERS
1. A patient is referred for physical therapy following a traumatic brain injury. The patient
presents with ataxia, dysmetria, and intention tremors. Which area of the brain is most likely
affected?
A. Basal ganglia
B. Cerebellum
C. Prefrontal cortex
D. Primary motor cortex
Answer: B
Rationale: Ataxia, dysmetria, and intention tremors are classic signs of cerebellar dysfunction. The basal
ganglia are associated with movement disorders like Parkinson's (rigidity, bradykinesia). The prefrontal
cortex is involved in executive function, not coordination. The primary motor cortex controls voluntary
movement but lesions cause paresis, not ataxia.
2. A patient with chronic obstructive pulmonary disease (COPD) is being treated for an acute
exacerbation. The physical therapist notes that the patient is using accessory muscles and has an
increased anteroposterior chest diameter. Which of the following is the most appropriate
intervention to improve ventilation-perfusion matching?
A. Pursed-lip breathing during exertion
B. Incentive spirometry at maximal inspiration
C. High-frequency chest wall oscillation
D. Postural drainage with percussion
Answer: A
Rationale: Pursed-lip breathing prolongs exhalation, reduces air trapping, and improves
ventilation-perfusion matching in COPD. Incentive spirometry is used postoperatively to prevent
atelectasis. High-frequency chest wall oscillation is for mucus clearance in cystic fibrosis. Postural
drainage is for bronchiectasis or lung abscess, not COPD exacerbation.
3. A physical therapist is evaluating a patient who has been on long-term corticosteroid therapy.
The patient reports sudden onset of severe groin pain and difficulty bearing weight. Which of the
following conditions is most likely?
A. Femoral neck stress fracture
B. Osteoarthritis of the hip
C. Avascular necrosis of the femoral head
D. Iliotibial band syndrome
Page 1
,Answer: C
Rationale: Long-term corticosteroid use is a major risk factor for avascular necrosis (AVN) of the
femoral head, which presents with sudden groin pain and antalgic gait. Stress fractures are related to
repetitive loading, not steroids. Osteoarthritis has insidious onset. IT band syndrome causes lateral knee
pain, not groin pain.
4. A patient with a complete spinal cord injury at T10 is being discharged. Which of the following
is the most important consideration for the physical therapist to address regarding the patient's
ability to perform a wheelchair transfer?
A. The patient will require a sliding board due to lack of hip flexors
B. The patient can perform a stand-pivot transfer with knee-ankle-foot orthoses
C. The patient can transfer independently using a sit-pivot technique without a board
D. The patient will need a mechanical lift for all transfers
Answer: A
Rationale: A T10 spinal cord injury results in complete paraplegia with intact upper extremities but no
voluntary hip or knee control. A sliding board is necessary for safe transfers due to lack of hip flexors
and knee extensors. Stand-pivot transfers require at least partial lower extremity weight-bearing and
motor control (usually T12 or below). Sit-pivot without a board is unsafe without trunk stability. A
mechanical lift is not indicated for a patient with good upper body strength.
5. A patient presents with acute low back pain and a positive crossed straight leg raise test. Which
of the following is the most likely diagnosis?
A. Lumbar strain
B. Lumbar disc herniation
C. Sacroiliac joint dysfunction
D. Spinal stenosis
Answer: B
Rationale: A crossed straight leg raise (pain in the affected leg when lifting the unaffected leg) is highly
specific for lumbar disc herniation causing nerve root compression. Lumbar strain does not produce
radicular signs. Sacroiliac joint dysfunction typically causes pain with asymmetric weight-bearing and
positive provocation tests (e.g., FABER). Spinal stenosis presents with neurogenic claudication, not
unilateral radiculopathy.
6. A patient with a recent anterior cruciate ligament (ACL) reconstruction is four weeks
post-operative. The physical therapist notes that the patient has a positive Lachman test and a 3+
effusion. Which of the following actions is most appropriate?
A. Increase quadriceps strengthening exercises
B. Refer the patient back to the surgeon
C. Apply a knee immobilizer and reduce range of motion
D. Initiate neuromuscular electrical stimulation to the quadriceps
Answer: B
Rationale: A positive Lachman test at four weeks post-ACL reconstruction indicates graft failure or
loosening, and a large effusion suggests hemarthrosis or inflammation. This requires prompt surgical
evaluation. Increasing strengthening or NMES could further stress the graft. Immobilization alone does
Page 2
,not address the graft issue.
7. A patient with a transtibial amputation is fitted with a new prosthetic socket. The patient
complains of pain over the distal anterior tibia. Which of the following is the most likely cause?
A. Inadequate suspension
B. Excessive socket flexion
C. Insufficient distal padding
D. Pistoning of the residual limb
Answer: C
Rationale: Pain over the distal anterior tibia is often due to insufficient padding or a socket that is too
tight over the bony prominence. Inadequate suspension causes pistoning, which can lead to skin
irritation but not specifically anterior tibial pain. Excessive socket flexion causes pain over the patellar
tendon or proximal tibia. Pistoning is a vertical movement, not a focal pressure point.
8. A patient with Parkinson's disease is being treated for gait dysfunction. Which of the following
interventions is most likely to improve freezing of gait?
A. Backward walking training
B. Visual cues (e.g., transverse lines on the floor)
C. Resisted treadmill walking
D. Balance exercises on foam surfaces
Answer: B
Rationale: Visual cues, such as transverse lines or laser lights, help bypass the defective basal ganglia
and improve step initiation in Parkinson's disease. Backward walking may increase fall risk. Resisted
treadmill walking improves cardiovascular fitness but not specifically freezing. Balance exercises on
foam address postural instability but not freezing.
9. A patient with a history of atrial fibrillation presents with sudden onset of severe left lower
extremity pain, pallor, and pulselessness. The physical therapist suspects an embolic event. Which
of the following is the most appropriate immediate action?
A. Elevate the leg and apply warm packs
B. Perform passive range of motion to maintain joint mobility
C. Notify the medical team immediately
D. Administer aspirin and monitor for compartment syndrome
Answer: C
Rationale: Acute limb ischemia due to embolic occlusion is a medical emergency requiring immediate
revascularization. Elevation and warmth are contraindicated as they increase metabolic demand.
Passive range of motion could dislodge additional emboli. Aspirin is insufficient; the patient needs
urgent surgical or interventional evaluation.
10. A patient with a diagnosis of adhesive capsulitis of the shoulder has been in physical therapy
for 8 weeks without improvement. The patient continues to have significant pain and stiffness.
Which of the following is the most appropriate next step?
Page 3
, A. Continue the current program for another 4 weeks
B. Refer for a corticosteroid injection
C. Initiate a high-intensity strengthening program
D. Perform a capsular stretch with low load and long duration
Answer: B
Rationale: Adhesive capsulitis often responds to corticosteroid injections in the early stages, especially
when conservative PT fails. Continuing the same program without change is not warranted.
High-intensity strengthening is contraindicated in the painful phase. Low-load long-duration stretch is
appropriate but if no improvement after 8 weeks, injection is indicated to reduce inflammation.
11. In a patient with chronic obstructive pulmonary disease (COPD), which combination of
ventilatory muscle training parameters has been shown to most effectively improve inspiratory
muscle strength and endurance, based on a 2025 systematic review and meta-analysis?
A. High-intensity (60% maximal inspiratory pressure), low-repetition (10 breaths per set) training
B. Low-intensity (30% maximal inspiratory pressure), high-repetition (30 breaths per set) training
C. Threshold loading at 50% of maximal inspiratory pressure, 15 breaths per set, 3 sets per day
D. Normocapnic hyperpnea training at 70% of maximal voluntary ventilation
Answer: A
Rationale: High-intensity ("e60% PImax) low-repetition training has been shown to produce superior
gains in inspiratory muscle strength and endurance in COPD patients. Low-intensity or
moderate-intensity protocols yield smaller improvements. Normocapnic hyperpnea is more specific to
endurance but not strength.
12. A physical therapist is treating a patient with chronic low back pain who demonstrates
impaired motor control and delayed activation of the transversus abdominis during rapid arm
movements. Which of the following interventions is most likely to address the underlying
impairment based on current evidence?
A. Strengthening the erector spinae with progressive resistance exercises
B. Training the patient to voluntarily contract the transversus abdominis prior to limb movement
C. Passive stretching of the hip flexors and lumbar paraspinals
D. Application of transcutaneous electrical nerve stimulation (TENS) over the lumbar spine
Answer: B
Rationale: Impaired feed-forward activation of the transversus abdominis is a key motor control deficit in
chronic low back pain. Training voluntary pre-contraction before limb movement has been shown to
improve activation timing. Strengthening erector spinae or passive stretching do not directly address
feed-forward control.
13. Which of the following electrodiagnostic findings is most consistent with a diagnosis of chronic
inflammatory demyelinating polyneuropathy (CIDP) in a patient presenting with symmetric
proximal and distal weakness?
A. Conduction block in at least one nerve, reduced motor amplitudes, and normal sensory nerve action
potentials
Page 4
EXAM TEST BANK | COMPLETE PRACTICE
QUESTIONS & ANSWERS
1. A patient is referred for physical therapy following a traumatic brain injury. The patient
presents with ataxia, dysmetria, and intention tremors. Which area of the brain is most likely
affected?
A. Basal ganglia
B. Cerebellum
C. Prefrontal cortex
D. Primary motor cortex
Answer: B
Rationale: Ataxia, dysmetria, and intention tremors are classic signs of cerebellar dysfunction. The basal
ganglia are associated with movement disorders like Parkinson's (rigidity, bradykinesia). The prefrontal
cortex is involved in executive function, not coordination. The primary motor cortex controls voluntary
movement but lesions cause paresis, not ataxia.
2. A patient with chronic obstructive pulmonary disease (COPD) is being treated for an acute
exacerbation. The physical therapist notes that the patient is using accessory muscles and has an
increased anteroposterior chest diameter. Which of the following is the most appropriate
intervention to improve ventilation-perfusion matching?
A. Pursed-lip breathing during exertion
B. Incentive spirometry at maximal inspiration
C. High-frequency chest wall oscillation
D. Postural drainage with percussion
Answer: A
Rationale: Pursed-lip breathing prolongs exhalation, reduces air trapping, and improves
ventilation-perfusion matching in COPD. Incentive spirometry is used postoperatively to prevent
atelectasis. High-frequency chest wall oscillation is for mucus clearance in cystic fibrosis. Postural
drainage is for bronchiectasis or lung abscess, not COPD exacerbation.
3. A physical therapist is evaluating a patient who has been on long-term corticosteroid therapy.
The patient reports sudden onset of severe groin pain and difficulty bearing weight. Which of the
following conditions is most likely?
A. Femoral neck stress fracture
B. Osteoarthritis of the hip
C. Avascular necrosis of the femoral head
D. Iliotibial band syndrome
Page 1
,Answer: C
Rationale: Long-term corticosteroid use is a major risk factor for avascular necrosis (AVN) of the
femoral head, which presents with sudden groin pain and antalgic gait. Stress fractures are related to
repetitive loading, not steroids. Osteoarthritis has insidious onset. IT band syndrome causes lateral knee
pain, not groin pain.
4. A patient with a complete spinal cord injury at T10 is being discharged. Which of the following
is the most important consideration for the physical therapist to address regarding the patient's
ability to perform a wheelchair transfer?
A. The patient will require a sliding board due to lack of hip flexors
B. The patient can perform a stand-pivot transfer with knee-ankle-foot orthoses
C. The patient can transfer independently using a sit-pivot technique without a board
D. The patient will need a mechanical lift for all transfers
Answer: A
Rationale: A T10 spinal cord injury results in complete paraplegia with intact upper extremities but no
voluntary hip or knee control. A sliding board is necessary for safe transfers due to lack of hip flexors
and knee extensors. Stand-pivot transfers require at least partial lower extremity weight-bearing and
motor control (usually T12 or below). Sit-pivot without a board is unsafe without trunk stability. A
mechanical lift is not indicated for a patient with good upper body strength.
5. A patient presents with acute low back pain and a positive crossed straight leg raise test. Which
of the following is the most likely diagnosis?
A. Lumbar strain
B. Lumbar disc herniation
C. Sacroiliac joint dysfunction
D. Spinal stenosis
Answer: B
Rationale: A crossed straight leg raise (pain in the affected leg when lifting the unaffected leg) is highly
specific for lumbar disc herniation causing nerve root compression. Lumbar strain does not produce
radicular signs. Sacroiliac joint dysfunction typically causes pain with asymmetric weight-bearing and
positive provocation tests (e.g., FABER). Spinal stenosis presents with neurogenic claudication, not
unilateral radiculopathy.
6. A patient with a recent anterior cruciate ligament (ACL) reconstruction is four weeks
post-operative. The physical therapist notes that the patient has a positive Lachman test and a 3+
effusion. Which of the following actions is most appropriate?
A. Increase quadriceps strengthening exercises
B. Refer the patient back to the surgeon
C. Apply a knee immobilizer and reduce range of motion
D. Initiate neuromuscular electrical stimulation to the quadriceps
Answer: B
Rationale: A positive Lachman test at four weeks post-ACL reconstruction indicates graft failure or
loosening, and a large effusion suggests hemarthrosis or inflammation. This requires prompt surgical
evaluation. Increasing strengthening or NMES could further stress the graft. Immobilization alone does
Page 2
,not address the graft issue.
7. A patient with a transtibial amputation is fitted with a new prosthetic socket. The patient
complains of pain over the distal anterior tibia. Which of the following is the most likely cause?
A. Inadequate suspension
B. Excessive socket flexion
C. Insufficient distal padding
D. Pistoning of the residual limb
Answer: C
Rationale: Pain over the distal anterior tibia is often due to insufficient padding or a socket that is too
tight over the bony prominence. Inadequate suspension causes pistoning, which can lead to skin
irritation but not specifically anterior tibial pain. Excessive socket flexion causes pain over the patellar
tendon or proximal tibia. Pistoning is a vertical movement, not a focal pressure point.
8. A patient with Parkinson's disease is being treated for gait dysfunction. Which of the following
interventions is most likely to improve freezing of gait?
A. Backward walking training
B. Visual cues (e.g., transverse lines on the floor)
C. Resisted treadmill walking
D. Balance exercises on foam surfaces
Answer: B
Rationale: Visual cues, such as transverse lines or laser lights, help bypass the defective basal ganglia
and improve step initiation in Parkinson's disease. Backward walking may increase fall risk. Resisted
treadmill walking improves cardiovascular fitness but not specifically freezing. Balance exercises on
foam address postural instability but not freezing.
9. A patient with a history of atrial fibrillation presents with sudden onset of severe left lower
extremity pain, pallor, and pulselessness. The physical therapist suspects an embolic event. Which
of the following is the most appropriate immediate action?
A. Elevate the leg and apply warm packs
B. Perform passive range of motion to maintain joint mobility
C. Notify the medical team immediately
D. Administer aspirin and monitor for compartment syndrome
Answer: C
Rationale: Acute limb ischemia due to embolic occlusion is a medical emergency requiring immediate
revascularization. Elevation and warmth are contraindicated as they increase metabolic demand.
Passive range of motion could dislodge additional emboli. Aspirin is insufficient; the patient needs
urgent surgical or interventional evaluation.
10. A patient with a diagnosis of adhesive capsulitis of the shoulder has been in physical therapy
for 8 weeks without improvement. The patient continues to have significant pain and stiffness.
Which of the following is the most appropriate next step?
Page 3
, A. Continue the current program for another 4 weeks
B. Refer for a corticosteroid injection
C. Initiate a high-intensity strengthening program
D. Perform a capsular stretch with low load and long duration
Answer: B
Rationale: Adhesive capsulitis often responds to corticosteroid injections in the early stages, especially
when conservative PT fails. Continuing the same program without change is not warranted.
High-intensity strengthening is contraindicated in the painful phase. Low-load long-duration stretch is
appropriate but if no improvement after 8 weeks, injection is indicated to reduce inflammation.
11. In a patient with chronic obstructive pulmonary disease (COPD), which combination of
ventilatory muscle training parameters has been shown to most effectively improve inspiratory
muscle strength and endurance, based on a 2025 systematic review and meta-analysis?
A. High-intensity (60% maximal inspiratory pressure), low-repetition (10 breaths per set) training
B. Low-intensity (30% maximal inspiratory pressure), high-repetition (30 breaths per set) training
C. Threshold loading at 50% of maximal inspiratory pressure, 15 breaths per set, 3 sets per day
D. Normocapnic hyperpnea training at 70% of maximal voluntary ventilation
Answer: A
Rationale: High-intensity ("e60% PImax) low-repetition training has been shown to produce superior
gains in inspiratory muscle strength and endurance in COPD patients. Low-intensity or
moderate-intensity protocols yield smaller improvements. Normocapnic hyperpnea is more specific to
endurance but not strength.
12. A physical therapist is treating a patient with chronic low back pain who demonstrates
impaired motor control and delayed activation of the transversus abdominis during rapid arm
movements. Which of the following interventions is most likely to address the underlying
impairment based on current evidence?
A. Strengthening the erector spinae with progressive resistance exercises
B. Training the patient to voluntarily contract the transversus abdominis prior to limb movement
C. Passive stretching of the hip flexors and lumbar paraspinals
D. Application of transcutaneous electrical nerve stimulation (TENS) over the lumbar spine
Answer: B
Rationale: Impaired feed-forward activation of the transversus abdominis is a key motor control deficit in
chronic low back pain. Training voluntary pre-contraction before limb movement has been shown to
improve activation timing. Strengthening erector spinae or passive stretching do not directly address
feed-forward control.
13. Which of the following electrodiagnostic findings is most consistent with a diagnosis of chronic
inflammatory demyelinating polyneuropathy (CIDP) in a patient presenting with symmetric
proximal and distal weakness?
A. Conduction block in at least one nerve, reduced motor amplitudes, and normal sensory nerve action
potentials
Page 4
