Page 1 of 232
NATIONAL PHYSICAL THERAPY
EXAMINATION FOR PHYSICAL THERAPIST
ASSISTANTS (NPTE®-PTA)
COMPREHENSIVE PRACTICE QUESTION
BANK
2026-2027 ACADEMIC YEAR | 250+
QUESTIONS WITH RATIONALES
itsjereguides
## TABLE OF CONTENTS
| Section | Content Area | Exam Weight | Questions |
|---------|--------------|-------------|-----------|
| **I** | **Physical Therapy Data Collection** | 20.7% | Q1-Q52 |
| **II** | **Musculoskeletal System** | 26.0% | Q53-Q120 |
| **III** | **Neuromuscular & Nervous Systems** | 22.0% | Q121-Q175 |
| **IV** | **Cardiovascular/Pulmonary & Lymphatic Systems** | 16.7% | Q176-Q210 |
| **V** | **Integumentary System** | 4.7% | Q211-Q230 |
| **VI** | **Metabolic & Endocrine Systems** | 4.0% | Q231-Q245 |
| **VII** | **Other Systems & System Interactions** | 4.6% | Q246-Q260 |
| **VIII** | **Non-System Domains (Equipment, Modalities, Safety, Professional
Responsibilities)** | 20.7% | Q261-Q285 |
,Page 2 of 232
# SECTION I: PHYSICAL THERAPY DATA COLLECTION
## 20.7% of Total Examination
### Q1. A physical therapist assistant is performing a goniometric measurement of a patient's
right knee flexion. The patient is positioned supine with the hip and knee in extension. The axis
of the goniometer should be placed over which anatomical landmark?
A) Lateral epicondyle of the femur
B) Medial epicondyle of the femur
C) Lateral malleolus
D) Tibial tuberosity
**Correct Answer: A) Lateral epicondyle of the femur**
**Rationale:** For goniometric measurement of knee flexion, the axis of the goniometer is
placed over the lateral epicondyle of the femur. The stationary arm is aligned with the greater
trochanter of the femur, and the moving arm is aligned with the lateral malleolus of the fibula.
The lateral approach is preferred because it avoids the patella and allows for clearer visualization
of the joint axis. This positioning follows standard goniometric procedures for the knee joint.
**Distractor Analysis:**
- **B) Medial epicondyle of the femur:** While anatomically the same joint line, the medial
approach is less commonly used because the moving arm alignment is more difficult to visualize.
- **C) Lateral malleolus:** This is the distal landmark for the moving arm, not the axis
placement.
- **D) Tibial tuberosity:** This is an anterior landmark and is not used as the axis for knee
flexion measurement.
---
,Page 3 of 232
### Q2. A PTA is assessing a patient's muscle strength following a stroke. The patient can move
the right upper extremity through the full range of motion against gravity but cannot resist any
additional resistance applied by the examiner. What manual muscle testing grade should the PTA
assign?
A) 2/5 (Fair)
B) 3/5 (Good)
C) 4/5 (Normal)
D) 5/5 (Normal)
**Correct Answer: B) 3/5 (Good)**
**Rationale:** According to the Oxford Scale (0-5) for manual muscle testing, a grade of 3/5
(Fair) indicates that the patient can move the joint through the full range of motion against
gravity but cannot accept any resistance. Grade 4/5 (Good) indicates the ability to move against
gravity and accept some resistance. Grade 5/5 (Normal) indicates the ability to move against
gravity and accept full resistance. Grade 2/5 (Poor) indicates the ability to move through the full
range of motion with gravity eliminated.
**Distractor Analysis:**
- **A) 2/5 (Poor):** This would indicate movement only with gravity eliminated, not against
gravity.
- **C) 4/5 (Good):** This would indicate the ability to accept some resistance, which is not
present.
- **D) 5/5 (Normal):** This would indicate the ability to accept full resistance, which is not
present.
---
, Page 4 of 232
### Q3. A PTA is measuring a patient's vital signs before initiating an exercise session. The
patient's blood pressure is 148/92 mmHg, heart rate is 88 bpm, and respiratory rate is 16
breaths/min. How should the PTA interpret these findings?
A) Normal vital signs for a patient about to exercise
B) Elevated blood pressure; exercise should be modified or deferred
C) Tachycardia requiring immediate physician notification
D) Hypotension requiring fluid resuscitation
**Correct Answer: B) Elevated blood pressure; exercise should be modified or deferred**
**Rationale:** A blood pressure of 148/92 mmHg is elevated (Stage 1 hypertension according to
ACC/AHA guidelines). The PTA should recognize this as a contraindication or precaution for
exercise and should consult with the supervising PT before proceeding. Resting blood pressure
should ideally be <140/90 mmHg before initiating exercise. The heart rate of 88 bpm is within
normal resting range (60-100 bpm), and the respiratory rate of 16 breaths/min is normal (12-20
breaths/min).
**Distractor Analysis:**
- **A) Normal vital signs:** Blood pressure is elevated, so this is incorrect.
- **C) Tachycardia:** 88 bpm is within normal range (60-100 bpm).
- **D) Hypotension:** Blood pressure is elevated, not low.
---
### Q4. A PTA is performing a sensory assessment on a patient with peripheral neuropathy. The
patient cannot distinguish between the sharp and dull ends of a safety pin when applied to the
dorsum of the foot. This finding indicates impairment in which sensory pathway?
A) Spinothalamic tract
NATIONAL PHYSICAL THERAPY
EXAMINATION FOR PHYSICAL THERAPIST
ASSISTANTS (NPTE®-PTA)
COMPREHENSIVE PRACTICE QUESTION
BANK
2026-2027 ACADEMIC YEAR | 250+
QUESTIONS WITH RATIONALES
itsjereguides
## TABLE OF CONTENTS
| Section | Content Area | Exam Weight | Questions |
|---------|--------------|-------------|-----------|
| **I** | **Physical Therapy Data Collection** | 20.7% | Q1-Q52 |
| **II** | **Musculoskeletal System** | 26.0% | Q53-Q120 |
| **III** | **Neuromuscular & Nervous Systems** | 22.0% | Q121-Q175 |
| **IV** | **Cardiovascular/Pulmonary & Lymphatic Systems** | 16.7% | Q176-Q210 |
| **V** | **Integumentary System** | 4.7% | Q211-Q230 |
| **VI** | **Metabolic & Endocrine Systems** | 4.0% | Q231-Q245 |
| **VII** | **Other Systems & System Interactions** | 4.6% | Q246-Q260 |
| **VIII** | **Non-System Domains (Equipment, Modalities, Safety, Professional
Responsibilities)** | 20.7% | Q261-Q285 |
,Page 2 of 232
# SECTION I: PHYSICAL THERAPY DATA COLLECTION
## 20.7% of Total Examination
### Q1. A physical therapist assistant is performing a goniometric measurement of a patient's
right knee flexion. The patient is positioned supine with the hip and knee in extension. The axis
of the goniometer should be placed over which anatomical landmark?
A) Lateral epicondyle of the femur
B) Medial epicondyle of the femur
C) Lateral malleolus
D) Tibial tuberosity
**Correct Answer: A) Lateral epicondyle of the femur**
**Rationale:** For goniometric measurement of knee flexion, the axis of the goniometer is
placed over the lateral epicondyle of the femur. The stationary arm is aligned with the greater
trochanter of the femur, and the moving arm is aligned with the lateral malleolus of the fibula.
The lateral approach is preferred because it avoids the patella and allows for clearer visualization
of the joint axis. This positioning follows standard goniometric procedures for the knee joint.
**Distractor Analysis:**
- **B) Medial epicondyle of the femur:** While anatomically the same joint line, the medial
approach is less commonly used because the moving arm alignment is more difficult to visualize.
- **C) Lateral malleolus:** This is the distal landmark for the moving arm, not the axis
placement.
- **D) Tibial tuberosity:** This is an anterior landmark and is not used as the axis for knee
flexion measurement.
---
,Page 3 of 232
### Q2. A PTA is assessing a patient's muscle strength following a stroke. The patient can move
the right upper extremity through the full range of motion against gravity but cannot resist any
additional resistance applied by the examiner. What manual muscle testing grade should the PTA
assign?
A) 2/5 (Fair)
B) 3/5 (Good)
C) 4/5 (Normal)
D) 5/5 (Normal)
**Correct Answer: B) 3/5 (Good)**
**Rationale:** According to the Oxford Scale (0-5) for manual muscle testing, a grade of 3/5
(Fair) indicates that the patient can move the joint through the full range of motion against
gravity but cannot accept any resistance. Grade 4/5 (Good) indicates the ability to move against
gravity and accept some resistance. Grade 5/5 (Normal) indicates the ability to move against
gravity and accept full resistance. Grade 2/5 (Poor) indicates the ability to move through the full
range of motion with gravity eliminated.
**Distractor Analysis:**
- **A) 2/5 (Poor):** This would indicate movement only with gravity eliminated, not against
gravity.
- **C) 4/5 (Good):** This would indicate the ability to accept some resistance, which is not
present.
- **D) 5/5 (Normal):** This would indicate the ability to accept full resistance, which is not
present.
---
, Page 4 of 232
### Q3. A PTA is measuring a patient's vital signs before initiating an exercise session. The
patient's blood pressure is 148/92 mmHg, heart rate is 88 bpm, and respiratory rate is 16
breaths/min. How should the PTA interpret these findings?
A) Normal vital signs for a patient about to exercise
B) Elevated blood pressure; exercise should be modified or deferred
C) Tachycardia requiring immediate physician notification
D) Hypotension requiring fluid resuscitation
**Correct Answer: B) Elevated blood pressure; exercise should be modified or deferred**
**Rationale:** A blood pressure of 148/92 mmHg is elevated (Stage 1 hypertension according to
ACC/AHA guidelines). The PTA should recognize this as a contraindication or precaution for
exercise and should consult with the supervising PT before proceeding. Resting blood pressure
should ideally be <140/90 mmHg before initiating exercise. The heart rate of 88 bpm is within
normal resting range (60-100 bpm), and the respiratory rate of 16 breaths/min is normal (12-20
breaths/min).
**Distractor Analysis:**
- **A) Normal vital signs:** Blood pressure is elevated, so this is incorrect.
- **C) Tachycardia:** 88 bpm is within normal range (60-100 bpm).
- **D) Hypotension:** Blood pressure is elevated, not low.
---
### Q4. A PTA is performing a sensory assessment on a patient with peripheral neuropathy. The
patient cannot distinguish between the sharp and dull ends of a safety pin when applied to the
dorsum of the foot. This finding indicates impairment in which sensory pathway?
A) Spinothalamic tract
