National Physical Therapy Examination
(NPTE) Practice Examination Questions
And Correct Answers (Verified Answers)
Plus Rationales 2026 Q&A | Instant
Download Pdf
1. A 72-year-old patient with a history of hypertension and type 2 diabetes
presents with a sudden onset of severe left-sided headache, nausea, and
photophobia. Neurological examination reveals a left-sided oculomotor
nerve palsy with a fixed and dilated pupil. Which of the following is the
most likely diagnosis?
A. Cluster headache
B. Intracranial aneurysm of the posterior communicating artery
C. Cavernous sinus thrombosis
D. Migraine with aura
Answer: B
Rationale: A sudden, severe headache accompanied by an oculomotor
nerve palsy with pupillary involvement (fixed and dilated pupil) is a classic
presentation of a posterior communicating artery aneurysm until proven
otherwise. The pupillary fibers run on the superficial aspect of the nerve
and are compressed by the aneurysm. Cluster headaches are typically
unilateral periorbital with autonomic symptoms. Cavernous sinus
thrombosis presents with bilateral or multiple cranial nerve palsies and
systemic signs. Migraine with aura does not typically cause a fixed, dilated
pupil.
2. A physical therapist is examining a patient who sustained a traumatic brain
injury. The patient is unable to sustain attention on a task and is easily
distracted by extraneous stimuli. This patient is displaying a deficit in which
, specific domain of attention?
A. Selective attention
B. Sustained attention
C. Alternating attention
D. Divided attention
Answer: B
Rationale: Sustained attention, also known as vigilance, is the ability to
maintain a consistent behavioral response during continuous and
repetitive activity. The patient's inability to focus over time and
distractibility are hallmark signs of impaired sustained attention. Selective
attention is the ability to focus on a specific stimulus in the presence of
others. Alternating attention is the capacity to shift focus between tasks
with different cognitive requirements. Divided attention is the ability to
respond to multiple tasks simultaneously.
3. Which of the following outcome measures is most appropriate for assessing
functional mobility and fall risk in a community-dwelling older adult with
mild cognitive impairment?
A. Berg Balance Scale
B. Timed Up and Go (TUG) test
C. Dynamic Gait Index (DGI)
D. Functional Reach Test
Answer: B
Rationale: The Timed Up and Go (TUG) test is a quick, reliable, and valid
measure of basic functional mobility, including gait speed and balance. It
has strong predictive validity for falls in community-dwelling older adults
and is feasible for those with mild cognitive impairment. The Berg Balance
Scale is more comprehensive but can be time-consuming. The DGI assesses
gait adaptations, and the Functional Reach Test is a static balance
measure. The TUG is the most efficient and broadly predictive single test
for this population.
4. A patient presents with a flexion contracture of the knee of 20 degrees
following a prolonged period of immobilization. What is the most
, appropriate initial intervention to address this impairment?
A. High-load, long-duration static stretching
B. Low-load, long-duration stretch using a dynamic splint
C. Aggressive passive range of motion exercises
D. Isometric quadriceps strengthening
Answer: B
Rationale: Low-load, long-duration stretch (LLLD) is the most effective
method for improving joint range of motion in a contracted joint because
it promotes tissue creep and remodeling without causing microtrauma. A
dynamic splint applies this principle over hours. High-load, short-duration
static stretching (like aggressive PROM) risks injury and triggers a
protective stretch reflex, potentially increasing contracture. Isometric
strengthening does not directly address the soft tissue contracture.
5. A patient who is 3 days post-stroke is being evaluated for rehabilitation. The
patient has a dense hemiplegia on the right side. The therapist notes that
when the patient's right arm is passively flexed, there is a sudden "catch"
and then a release. This resistance is felt only at the very beginning of the
movement. Which of the following describes this phenomenon?
A. Spasticity
B. Rigidity
C. Clasp-knife phenomenon
D. Cogwheel rigidity
Answer: C
Rationale: The clasp-knife phenomenon is a velocity-dependent resistance
to passive movement that is characterized by an initial high resistance
followed by a sudden "give" or release. It is a hallmark of upper motor
neuron lesions, such as stroke. Spasticity is velocity-dependent resistance
throughout the range. Rigidity is a non-velocity-dependent resistance
(lead-pipe) and is associated with basal ganglia disorders. Cogwheel
rigidity is a type of rigidity with a ratchet-like quality.
6. A physical therapist is assessing the sacroiliac joint. Which of the following
provocation tests has the highest diagnostic accuracy for SIJ dysfunction?
, A. Gaenslen's test
B. Patrick's (FABER) test
C. Thigh thrust test
D. Distraction test
Answer: C
Rationale: The thigh thrust test (also known as the posterior shear test)
has been shown in several studies to have the highest sensitivity and
specificity for sacroiliac joint pain among the commonly used provocation
tests. A cluster of positive tests (including thigh thrust, distraction, and
compression) is considered more diagnostic than a single test, but the
thigh thrust is generally considered the most powerful single test.
7. A patient is 4 weeks status-post anterior cruciate ligament (ACL)
reconstruction using a patellar tendon autograft. The patient is currently in
a rehabilitation program. The therapist notes the patient has a significant
quadriceps lag when performing a straight leg raise. Which of the following
is the MOST likely cause of this lag?
A. Graft failure
B. Patellofemoral pain
C. Quadriceps inhibition due to effusion
D. Hamstring tightness
Answer: C
Rationale: Arthrogenic muscle inhibition (AMI) is a common phenomenon
following knee injury and surgery, particularly after ACL reconstruction.
Joint effusion and inflammation lead to an inhibition of the quadriceps,
specifically the vastus medialis, which is responsible for the terminal
extension necessary to eliminate a quadriceps lag. Graft failure is possible
but less likely at 4 weeks. Patellofemoral pain can be a cause of inhibition
but is secondary to the effusion and surgical trauma.
8. A patient with Parkinson's disease presents with a stooped posture,
shuffling gait, and a tendency to fall backward. This postural instability is
most likely due to a deficit in which of the following?
A. Ankle strategy
(NPTE) Practice Examination Questions
And Correct Answers (Verified Answers)
Plus Rationales 2026 Q&A | Instant
Download Pdf
1. A 72-year-old patient with a history of hypertension and type 2 diabetes
presents with a sudden onset of severe left-sided headache, nausea, and
photophobia. Neurological examination reveals a left-sided oculomotor
nerve palsy with a fixed and dilated pupil. Which of the following is the
most likely diagnosis?
A. Cluster headache
B. Intracranial aneurysm of the posterior communicating artery
C. Cavernous sinus thrombosis
D. Migraine with aura
Answer: B
Rationale: A sudden, severe headache accompanied by an oculomotor
nerve palsy with pupillary involvement (fixed and dilated pupil) is a classic
presentation of a posterior communicating artery aneurysm until proven
otherwise. The pupillary fibers run on the superficial aspect of the nerve
and are compressed by the aneurysm. Cluster headaches are typically
unilateral periorbital with autonomic symptoms. Cavernous sinus
thrombosis presents with bilateral or multiple cranial nerve palsies and
systemic signs. Migraine with aura does not typically cause a fixed, dilated
pupil.
2. A physical therapist is examining a patient who sustained a traumatic brain
injury. The patient is unable to sustain attention on a task and is easily
distracted by extraneous stimuli. This patient is displaying a deficit in which
, specific domain of attention?
A. Selective attention
B. Sustained attention
C. Alternating attention
D. Divided attention
Answer: B
Rationale: Sustained attention, also known as vigilance, is the ability to
maintain a consistent behavioral response during continuous and
repetitive activity. The patient's inability to focus over time and
distractibility are hallmark signs of impaired sustained attention. Selective
attention is the ability to focus on a specific stimulus in the presence of
others. Alternating attention is the capacity to shift focus between tasks
with different cognitive requirements. Divided attention is the ability to
respond to multiple tasks simultaneously.
3. Which of the following outcome measures is most appropriate for assessing
functional mobility and fall risk in a community-dwelling older adult with
mild cognitive impairment?
A. Berg Balance Scale
B. Timed Up and Go (TUG) test
C. Dynamic Gait Index (DGI)
D. Functional Reach Test
Answer: B
Rationale: The Timed Up and Go (TUG) test is a quick, reliable, and valid
measure of basic functional mobility, including gait speed and balance. It
has strong predictive validity for falls in community-dwelling older adults
and is feasible for those with mild cognitive impairment. The Berg Balance
Scale is more comprehensive but can be time-consuming. The DGI assesses
gait adaptations, and the Functional Reach Test is a static balance
measure. The TUG is the most efficient and broadly predictive single test
for this population.
4. A patient presents with a flexion contracture of the knee of 20 degrees
following a prolonged period of immobilization. What is the most
, appropriate initial intervention to address this impairment?
A. High-load, long-duration static stretching
B. Low-load, long-duration stretch using a dynamic splint
C. Aggressive passive range of motion exercises
D. Isometric quadriceps strengthening
Answer: B
Rationale: Low-load, long-duration stretch (LLLD) is the most effective
method for improving joint range of motion in a contracted joint because
it promotes tissue creep and remodeling without causing microtrauma. A
dynamic splint applies this principle over hours. High-load, short-duration
static stretching (like aggressive PROM) risks injury and triggers a
protective stretch reflex, potentially increasing contracture. Isometric
strengthening does not directly address the soft tissue contracture.
5. A patient who is 3 days post-stroke is being evaluated for rehabilitation. The
patient has a dense hemiplegia on the right side. The therapist notes that
when the patient's right arm is passively flexed, there is a sudden "catch"
and then a release. This resistance is felt only at the very beginning of the
movement. Which of the following describes this phenomenon?
A. Spasticity
B. Rigidity
C. Clasp-knife phenomenon
D. Cogwheel rigidity
Answer: C
Rationale: The clasp-knife phenomenon is a velocity-dependent resistance
to passive movement that is characterized by an initial high resistance
followed by a sudden "give" or release. It is a hallmark of upper motor
neuron lesions, such as stroke. Spasticity is velocity-dependent resistance
throughout the range. Rigidity is a non-velocity-dependent resistance
(lead-pipe) and is associated with basal ganglia disorders. Cogwheel
rigidity is a type of rigidity with a ratchet-like quality.
6. A physical therapist is assessing the sacroiliac joint. Which of the following
provocation tests has the highest diagnostic accuracy for SIJ dysfunction?
, A. Gaenslen's test
B. Patrick's (FABER) test
C. Thigh thrust test
D. Distraction test
Answer: C
Rationale: The thigh thrust test (also known as the posterior shear test)
has been shown in several studies to have the highest sensitivity and
specificity for sacroiliac joint pain among the commonly used provocation
tests. A cluster of positive tests (including thigh thrust, distraction, and
compression) is considered more diagnostic than a single test, but the
thigh thrust is generally considered the most powerful single test.
7. A patient is 4 weeks status-post anterior cruciate ligament (ACL)
reconstruction using a patellar tendon autograft. The patient is currently in
a rehabilitation program. The therapist notes the patient has a significant
quadriceps lag when performing a straight leg raise. Which of the following
is the MOST likely cause of this lag?
A. Graft failure
B. Patellofemoral pain
C. Quadriceps inhibition due to effusion
D. Hamstring tightness
Answer: C
Rationale: Arthrogenic muscle inhibition (AMI) is a common phenomenon
following knee injury and surgery, particularly after ACL reconstruction.
Joint effusion and inflammation lead to an inhibition of the quadriceps,
specifically the vastus medialis, which is responsible for the terminal
extension necessary to eliminate a quadriceps lag. Graft failure is possible
but less likely at 4 weeks. Patellofemoral pain can be a cause of inhibition
but is secondary to the effusion and surgical trauma.
8. A patient with Parkinson's disease presents with a stooped posture,
shuffling gait, and a tendency to fall backward. This postural instability is
most likely due to a deficit in which of the following?
A. Ankle strategy
