NBCE PT BOARD EXAMS – QUESTIONS AND ANSWERS |
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1. A 28-year-old patient presents with acute low back pain after lifting a heavy
box. On examination, the clinician notes localized tenderness over the lumbar
paraspinal muscles but no neurological deficits, radicular pain, or signs of disc
herniation. Which of the following is the most appropriate initial management
strategy for this patient?
A. Complete bed rest for 7 to 10 days to allow muscle healing
B. Immediate referral for an MRI of the lumbar spine to rule out occult pathology
C. Prescription of high-dose opioid analgesics and rigid lumbar bracing
D. Modification of activity, education on proper ergonomics, and early
movement
For acute, uncomplicated mechanical low back pain, early mobilization and
activity modification are superior to bed rest, which can prolong disability.
Advanced imaging is not indicated in the absence of red flags or neurological
deficits. Opioids and rigid bracing are not first-line treatments for acute
paraspinal strains.
2. During a routine posture assessment, a chiropractor observes that a patient
exhibits a significant anterior pelvic tilt. Which muscle group is typically
found to be weak or lengthened in this specific presentation?
A. Iliopsoas and rectus femoris
B. Rectus abdominis and gluteus maximus
C. Erector spinae and tensor fasciae latae
D. Hamstrings and adductor longus
According to Janda’s Lower Crossed Syndrome, an anterior pelvic tilt is
characterized by a muscular imbalance where the abdominal muscles (rectus
abdominis) and hip extensors (gluteus maximus) are weak or inhibited, while the
hip flexors and lumbar erector spinae are tight.
,3. A patient is being evaluated for lateral epicondylitis (tennis elbow). To
stress the affected structure and confirm the diagnosis during orthopedic
testing, which passive or active movement should the practitioner perform?
A. Resisted wrist extension with the elbow fully extended
B. Resisted wrist flexion with the elbow fully flexed
C. Passive wrist extension with the elbow fully extended
D. Resisted ulnar deviation with the shoulder abducted
Lateral epicondylitis involves the common extensor tendon, primarily the
extensor carpi radialis brevis. Resisted wrist extension with the elbow in
extension places maximum stress on this tendon, reproducing the patient's
characteristic pain.
4. A chiropractor is adjusting a patient's thoracic spine using a diversified
posterior-to-anterior (P-A) thrust. During the physical examination prior to
the adjustment, which clinical finding would serve as an absolute
contraindication to utilizing a high-velocity, low-amplitude (HVLA)
adjustment at that segment?
A. Mild degenerative joint disease
B. Moderate localized muscle spasm
C. An active osteolytic bone tumor in the target vertebra
D. Controlled primary hypertension
An active osteolytic bone tumor severely compromises the structural integrity of
the vertebra, presenting an absolute risk of pathological fracture during an
HVLA adjustment. Degenerative joint disease and muscle spasms are common
indications, and controlled hypertension is a precaution but not an absolute
contraindication.
5. A 42-year-old female presents with pain and paresthesia affecting the
palmar aspect of the thumb, index, and middle fingers. The symptoms worsen
significantly at night. Phalen’s test reproduces the symptoms within 30
seconds. Compression of which nerve is responsible for this clinical
presentation?
A. Ulnar nerve
B. Radial nerve
C. Median nerve
D. Axillary nerve
, The described presentation matches carpal tunnel syndrome, which involves
compression of the median nerve as it passes beneath the flexor retinaculum.
The median nerve supplies sensory innervation to the palmar surface of the
thumb, index, middle, and lateral half of the ring finger.
6. Which of the following standard orthopedic evaluation procedures is
specifically designed to assess for the presence of a glenoid labrum tear, such
as a SLAP lesion, in a patient presenting with shoulder instability?
A. Hawkins-Kennedy Test
B. O'Brien's Test (Active Compression Test)
C. Speed's Test
D. Neer's Test
O'Brien's test is specifically utilized to differentiate between acromioclavicular
joint pathology and glenoid labrum (SLAP) lesions. Hawkins-Kennedy and
Neer's tests assess for subacromial impingement, while Speed's test primarily
targets biceps tendon pathology.
7. When reviewing a standard lumbar spine radiograph, a clinician notices a
forward displacement of the L4 vertebral body relative to the L5 vertebral
body. The posterior alignment is disrupted, and the forward slippage is
measured at approximately 20% of the vertebral body width. How should this
be classified according to the Myerding grading system?
A. Grade I Spondylolisthesis
B. Grade II Spondylolisthesis
C. Grade III Spondylolisthesis
D. Grade IV Spondylolisthesis
The Myerding system grades spondylolisthesis based on the percentage of
forward slippage: Grade I is 1-25%, Grade II is 26-50%, Grade III is 51-75%,
and Grade IV is 76-100%. A slippage of 20% falls directly into Grade I.
8. A patient presents with acute neck pain and radiculopathy extending down
the lateral aspect of the right arm into the anatomical snuffbox and thumb.
Deep tendon reflexes reveal a diminished brachioradialis reflex on the right
side. Which nerve root is most likely compromised?
A. C5
B. C6
, C. C7
D. C8
The C6 nerve root provides sensory innervation to the lateral forearm, thumb,
and anatomical snuffbox, and controls the brachioradialis deep tendon reflex. A
deficit in these specific areas points directly to C6 radiculopathy.
9. While evaluating an elderly patient with persistent thoracic pain, a
chiropractor identifies a localized, sharp, step-off deformity along the mid-
thoracic spinous processes following a minor slip-and-fall. The patient has a
known history of severe osteoporosis. What is the most appropriate next step
in clinical management?
A. Perform an immediate high-velocity side-posture lumbar adjustment
B. Order thoracic spinal radiographs to evaluate for a compression fracture
C. Apply deep myofascial release directly over the tender spinous process
D. Initiate a rigorous core stabilization and progressive resistance program
In an elderly patient with osteoporosis and a history of trauma, a step-off
deformity and sharp pain raise high suspicion for a vertebral compression
fracture. Radiographs are essential to confirm diagnosis before executing any
manual therapies to avoid worsening structural damage.
10. During a neurological screening of a 55-year-old male, the clinician
performs the Babinski test by stroking the lateral aspect of the plantar surface
of the foot. The patient responds with extension of the hallux and fanning of
the lesser toes. What does this finding indicate?
A. A normal adult superficial reflex response
B. A lower motor neuron lesion affecting the sciatic nerve
C. An upper motor neuron lesion along the corticospinal tract
D. Malingering or a highly exaggerated psychological response
An upgoing great toe (extension) with fanning of the other toes is a positive
Babinski sign, which indicates an upper motor neuron lesion along the
pyramidal/corticospinal tract in adults. A normal adult response is
plantarflexion of the toes.
11. A 34-year-old male runner presents with sharp, localized heel pain that is
most severe during his very first steps out of bed in the morning. The pain
decreases slightly after walking a short distance but intensifies again after
VERIFIED AND WELL DETAILED ANSWERS PLUS
RATIONALES | GUARANTEED PASS | LATEST EXAM
UPDATE | EXAM PREP | STUDY GUIDE | PRACTICE TEST|
DOWNLOAD INSTANT PDF
1. A 28-year-old patient presents with acute low back pain after lifting a heavy
box. On examination, the clinician notes localized tenderness over the lumbar
paraspinal muscles but no neurological deficits, radicular pain, or signs of disc
herniation. Which of the following is the most appropriate initial management
strategy for this patient?
A. Complete bed rest for 7 to 10 days to allow muscle healing
B. Immediate referral for an MRI of the lumbar spine to rule out occult pathology
C. Prescription of high-dose opioid analgesics and rigid lumbar bracing
D. Modification of activity, education on proper ergonomics, and early
movement
For acute, uncomplicated mechanical low back pain, early mobilization and
activity modification are superior to bed rest, which can prolong disability.
Advanced imaging is not indicated in the absence of red flags or neurological
deficits. Opioids and rigid bracing are not first-line treatments for acute
paraspinal strains.
2. During a routine posture assessment, a chiropractor observes that a patient
exhibits a significant anterior pelvic tilt. Which muscle group is typically
found to be weak or lengthened in this specific presentation?
A. Iliopsoas and rectus femoris
B. Rectus abdominis and gluteus maximus
C. Erector spinae and tensor fasciae latae
D. Hamstrings and adductor longus
According to Janda’s Lower Crossed Syndrome, an anterior pelvic tilt is
characterized by a muscular imbalance where the abdominal muscles (rectus
abdominis) and hip extensors (gluteus maximus) are weak or inhibited, while the
hip flexors and lumbar erector spinae are tight.
,3. A patient is being evaluated for lateral epicondylitis (tennis elbow). To
stress the affected structure and confirm the diagnosis during orthopedic
testing, which passive or active movement should the practitioner perform?
A. Resisted wrist extension with the elbow fully extended
B. Resisted wrist flexion with the elbow fully flexed
C. Passive wrist extension with the elbow fully extended
D. Resisted ulnar deviation with the shoulder abducted
Lateral epicondylitis involves the common extensor tendon, primarily the
extensor carpi radialis brevis. Resisted wrist extension with the elbow in
extension places maximum stress on this tendon, reproducing the patient's
characteristic pain.
4. A chiropractor is adjusting a patient's thoracic spine using a diversified
posterior-to-anterior (P-A) thrust. During the physical examination prior to
the adjustment, which clinical finding would serve as an absolute
contraindication to utilizing a high-velocity, low-amplitude (HVLA)
adjustment at that segment?
A. Mild degenerative joint disease
B. Moderate localized muscle spasm
C. An active osteolytic bone tumor in the target vertebra
D. Controlled primary hypertension
An active osteolytic bone tumor severely compromises the structural integrity of
the vertebra, presenting an absolute risk of pathological fracture during an
HVLA adjustment. Degenerative joint disease and muscle spasms are common
indications, and controlled hypertension is a precaution but not an absolute
contraindication.
5. A 42-year-old female presents with pain and paresthesia affecting the
palmar aspect of the thumb, index, and middle fingers. The symptoms worsen
significantly at night. Phalen’s test reproduces the symptoms within 30
seconds. Compression of which nerve is responsible for this clinical
presentation?
A. Ulnar nerve
B. Radial nerve
C. Median nerve
D. Axillary nerve
, The described presentation matches carpal tunnel syndrome, which involves
compression of the median nerve as it passes beneath the flexor retinaculum.
The median nerve supplies sensory innervation to the palmar surface of the
thumb, index, middle, and lateral half of the ring finger.
6. Which of the following standard orthopedic evaluation procedures is
specifically designed to assess for the presence of a glenoid labrum tear, such
as a SLAP lesion, in a patient presenting with shoulder instability?
A. Hawkins-Kennedy Test
B. O'Brien's Test (Active Compression Test)
C. Speed's Test
D. Neer's Test
O'Brien's test is specifically utilized to differentiate between acromioclavicular
joint pathology and glenoid labrum (SLAP) lesions. Hawkins-Kennedy and
Neer's tests assess for subacromial impingement, while Speed's test primarily
targets biceps tendon pathology.
7. When reviewing a standard lumbar spine radiograph, a clinician notices a
forward displacement of the L4 vertebral body relative to the L5 vertebral
body. The posterior alignment is disrupted, and the forward slippage is
measured at approximately 20% of the vertebral body width. How should this
be classified according to the Myerding grading system?
A. Grade I Spondylolisthesis
B. Grade II Spondylolisthesis
C. Grade III Spondylolisthesis
D. Grade IV Spondylolisthesis
The Myerding system grades spondylolisthesis based on the percentage of
forward slippage: Grade I is 1-25%, Grade II is 26-50%, Grade III is 51-75%,
and Grade IV is 76-100%. A slippage of 20% falls directly into Grade I.
8. A patient presents with acute neck pain and radiculopathy extending down
the lateral aspect of the right arm into the anatomical snuffbox and thumb.
Deep tendon reflexes reveal a diminished brachioradialis reflex on the right
side. Which nerve root is most likely compromised?
A. C5
B. C6
, C. C7
D. C8
The C6 nerve root provides sensory innervation to the lateral forearm, thumb,
and anatomical snuffbox, and controls the brachioradialis deep tendon reflex. A
deficit in these specific areas points directly to C6 radiculopathy.
9. While evaluating an elderly patient with persistent thoracic pain, a
chiropractor identifies a localized, sharp, step-off deformity along the mid-
thoracic spinous processes following a minor slip-and-fall. The patient has a
known history of severe osteoporosis. What is the most appropriate next step
in clinical management?
A. Perform an immediate high-velocity side-posture lumbar adjustment
B. Order thoracic spinal radiographs to evaluate for a compression fracture
C. Apply deep myofascial release directly over the tender spinous process
D. Initiate a rigorous core stabilization and progressive resistance program
In an elderly patient with osteoporosis and a history of trauma, a step-off
deformity and sharp pain raise high suspicion for a vertebral compression
fracture. Radiographs are essential to confirm diagnosis before executing any
manual therapies to avoid worsening structural damage.
10. During a neurological screening of a 55-year-old male, the clinician
performs the Babinski test by stroking the lateral aspect of the plantar surface
of the foot. The patient responds with extension of the hallux and fanning of
the lesser toes. What does this finding indicate?
A. A normal adult superficial reflex response
B. A lower motor neuron lesion affecting the sciatic nerve
C. An upper motor neuron lesion along the corticospinal tract
D. Malingering or a highly exaggerated psychological response
An upgoing great toe (extension) with fanning of the other toes is a positive
Babinski sign, which indicates an upper motor neuron lesion along the
pyramidal/corticospinal tract in adults. A normal adult response is
plantarflexion of the toes.
11. A 34-year-old male runner presents with sharp, localized heel pain that is
most severe during his very first steps out of bed in the morning. The pain
decreases slightly after walking a short distance but intensifies again after
