NBCE PT BOARDS EXAM NEWEST 2026 ACTUAL EXAM TEST
BANK | COMPLETE PRACTICE QUESTIONS & ANSWERS EXAM
with Questions and Answers/Plus a Rationale Updated 2026 A+/Instant
Download PDF
EXAM COVERAGE
1. General Anatomy and Physiology
2. Spinal Anatomy and Biomechanics
3. Chiropractic Technique and Clinical Adjusting
4. Neuromuscular Diagnostics and Clinical Neurology
5. Diagnostic Imaging and Radiology
6. Orthopedic and Physical Examination
7. Clinical Pathology and Internal Disorders
8. Professional Practice, Ethics, and Jurisprudence
1. A 45-year-old male presents to a chiropractic clinic complaining of progressive lower extremity
weakness and numbness following a traumatic lifting injury. During the neurological
examination, the clinician notes diminished patellar reflexes and sensory loss along the medial
aspect of the lower leg and foot. Which specific lumbar nerve root is most likely compromised?
A. L2
B. L3
C. L4
D. S1
CORRECT ANSWER : C
, Rationale: The L4 nerve root contributes significantly to the patellar reflex and provides sensory
innervation to the medial lower leg and medial foot down to the great toe. L2 and L3 affect the
anterior and anterolateral thigh, whereas S1 supplies the Achilles reflex and lateral foot.
Therefore, the clinical presentation points directly to L4 nerve root compression.
2. A chiropractor performs a motion palpation examination on a patient presenting with acute
mechanical neck pain. The practitioner identifies a restriction in right rotation and right lateral
flexion of the mid-cervical spine. According to standard coupled motion mechanics of the
cervical spine (C2-C7), lateral flexion and rotation occur in which direction?
A. Opposite directions (contralateral)
B. The same direction (ipsilateral)
C. Pure extension without rotation
D. Pure translation along the sagittal axis
CORRECT ANSWER : B
Rationale: In the mid-cervical spine (C2 through C7), coupled motion dictates that lateral
flexion and rotation occur in the same (ipsilateral) direction due to the orientation of the
articular facets. Contralateral coupling is characteristic of the thoracic and lumbar spine
segments. Therefore, ipsilateral rotation and lateral flexion represent normal mid-cervical
biomechanics.
3. A 28-year-old female athlete presents with right-sided low back pain that radiates into the
buttock and posterior thigh, stopping short of the knee. Slump test reproduction of symptoms is
positive, but straight leg raise (SLR) is negative for radicular symptoms. Diagnostic imaging is
unremarkable. Which clinical entity is the most probable source of her pain?
A. Acute lumbar disc herniation at L5-S1 with frank nerve root impingement
B. Piriformis syndrome causing localized sciatic nerve irritation across the deep gluteal region
C. Cauda equina syndrome requiring emergency surgical decompression
D. Spondyloptosis of L5 over S1 with complete neural arch lysis
CORRECT ANSWER : B
Rationale: Pain radiating into the posterior thigh that does not cross the knee combined with a
negative straight leg raise points away from true lumbar radiculopathy and toward somatic
referred pain or entrapment neuropathies like piriformis syndrome. Acute disc herniations
typically yield positive traditional SLR and distal radicular signs. Cauda equina and
spondyloptosis present with much more severe progressive neurological deficits.
,4. During a standard radiographic evaluation of the lumbar spine, a 52-year-old male exhibits a
"Scotty dog" appearance on oblique views, but with a clear fracture through the pars
interarticularis characterized by a "collar" or "broken neck" sign. What is the appropriate
diagnostic term for this finding?
A. Spondylosis
B. Spondylolysis
C. Spondylolisthesis
D. Spina bifida occulta
CORRECT ANSWER : B
Rationale: Spondylolysis refers to a structural defect or stress fracture through the pars
interarticularis of the vertebral arch, classically visualized on lumbar oblique radiographs as a
break in the neck of the "Scotty dog." Spondylolisthesis describes the actual anterior slippage of
a vertebral body, whereas spondylosis denotes general degenerative joint disease.
5. A 60-year-old male presents with insidious onset of low back pain and bilateral leg heaviness
that worsens with prolonged standing and walking, and significantly improves with lumbar
flexion (such as sitting or leaning over a shopping cart). What is the most likely diagnosis?
A. Acute lumbar disc herniation
B. Lumbar spinal stenosis
C. Ankylosing spondylitis
D. Acute lumbosacral sprain/strain
CORRECT ANSWER : B
Rationale: Lumbar spinal stenosis classically presents with neurogenic claudication, where
symptoms of pain, numbness, or heaviness in the legs are provoked by extension
(standing/walking) and relieved by lumbar flexion which widens the spinal canal. Disc
herniations typically worsen with flexion, and ankylosing spondylitis presents with morning
stiffness and inflammatory markers.
6. Which cranial nerve is primarily responsible for transmitting general sensory information from
the anterior two-thirds of the tongue, as well as innervating the muscles of facial expression?
A. Cranial Nerve V (Trigeminal)
B. Cranial Nerve VII (Facial)
, C. Cranial Nerve IX (Glossopharyngeal)
D. Cranial Nerve XII (Hypoglossal)
CORRECT ANSWER : B
Rationale: Cranial Nerve VII (Facial nerve) controls the muscles of facial expression and
carries taste sensation along with general somatic sensation from parts of the external ear and
anterior tongue (via the chorda tympani for taste). Trigeminal nerve (CN V) supplies general
sensation to the face and anterior tongue. CN IX supplies the posterior third of the tongue.
7. A patient presents with acute onset of severe right shoulder pain following a minor fall. Upon
examination, the clinician notes an inability to actively initiate shoulder abduction, although
passive range of motion remains intact. Which rotator cuff tendon is most likely torn?
A. Subscapularis tendon
B. Infraspinatus tendon
C. Supraspinatus tendon
D. Teres minor tendon
CORRECT ANSWER : C
Rationale: The supraspinatus muscle is the primary initiator of shoulder abduction (first 0 to 15
degrees) and is the most frequently injured rotator cuff tendon. Subscapularis performs internal
rotation, infraspinatus and teres minor perform external rotation.
8. When analyzing a lateral cervical spine radiograph, the practitioner measures the posterior
vertebral body line to evaluate for anterior or posterior displacement of one vertebra on another.
A displacement of greater than 3.5 mm in the cervical spine typically indicates which of the
following?
A. Normal physiological variant without clinical significance
B. Segmental instability or ligamentous disruption
C. Congenital block vertebra fusion
D. Complete osteophytic ankylosis
CORRECT ANSWER : B
BANK | COMPLETE PRACTICE QUESTIONS & ANSWERS EXAM
with Questions and Answers/Plus a Rationale Updated 2026 A+/Instant
Download PDF
EXAM COVERAGE
1. General Anatomy and Physiology
2. Spinal Anatomy and Biomechanics
3. Chiropractic Technique and Clinical Adjusting
4. Neuromuscular Diagnostics and Clinical Neurology
5. Diagnostic Imaging and Radiology
6. Orthopedic and Physical Examination
7. Clinical Pathology and Internal Disorders
8. Professional Practice, Ethics, and Jurisprudence
1. A 45-year-old male presents to a chiropractic clinic complaining of progressive lower extremity
weakness and numbness following a traumatic lifting injury. During the neurological
examination, the clinician notes diminished patellar reflexes and sensory loss along the medial
aspect of the lower leg and foot. Which specific lumbar nerve root is most likely compromised?
A. L2
B. L3
C. L4
D. S1
CORRECT ANSWER : C
, Rationale: The L4 nerve root contributes significantly to the patellar reflex and provides sensory
innervation to the medial lower leg and medial foot down to the great toe. L2 and L3 affect the
anterior and anterolateral thigh, whereas S1 supplies the Achilles reflex and lateral foot.
Therefore, the clinical presentation points directly to L4 nerve root compression.
2. A chiropractor performs a motion palpation examination on a patient presenting with acute
mechanical neck pain. The practitioner identifies a restriction in right rotation and right lateral
flexion of the mid-cervical spine. According to standard coupled motion mechanics of the
cervical spine (C2-C7), lateral flexion and rotation occur in which direction?
A. Opposite directions (contralateral)
B. The same direction (ipsilateral)
C. Pure extension without rotation
D. Pure translation along the sagittal axis
CORRECT ANSWER : B
Rationale: In the mid-cervical spine (C2 through C7), coupled motion dictates that lateral
flexion and rotation occur in the same (ipsilateral) direction due to the orientation of the
articular facets. Contralateral coupling is characteristic of the thoracic and lumbar spine
segments. Therefore, ipsilateral rotation and lateral flexion represent normal mid-cervical
biomechanics.
3. A 28-year-old female athlete presents with right-sided low back pain that radiates into the
buttock and posterior thigh, stopping short of the knee. Slump test reproduction of symptoms is
positive, but straight leg raise (SLR) is negative for radicular symptoms. Diagnostic imaging is
unremarkable. Which clinical entity is the most probable source of her pain?
A. Acute lumbar disc herniation at L5-S1 with frank nerve root impingement
B. Piriformis syndrome causing localized sciatic nerve irritation across the deep gluteal region
C. Cauda equina syndrome requiring emergency surgical decompression
D. Spondyloptosis of L5 over S1 with complete neural arch lysis
CORRECT ANSWER : B
Rationale: Pain radiating into the posterior thigh that does not cross the knee combined with a
negative straight leg raise points away from true lumbar radiculopathy and toward somatic
referred pain or entrapment neuropathies like piriformis syndrome. Acute disc herniations
typically yield positive traditional SLR and distal radicular signs. Cauda equina and
spondyloptosis present with much more severe progressive neurological deficits.
,4. During a standard radiographic evaluation of the lumbar spine, a 52-year-old male exhibits a
"Scotty dog" appearance on oblique views, but with a clear fracture through the pars
interarticularis characterized by a "collar" or "broken neck" sign. What is the appropriate
diagnostic term for this finding?
A. Spondylosis
B. Spondylolysis
C. Spondylolisthesis
D. Spina bifida occulta
CORRECT ANSWER : B
Rationale: Spondylolysis refers to a structural defect or stress fracture through the pars
interarticularis of the vertebral arch, classically visualized on lumbar oblique radiographs as a
break in the neck of the "Scotty dog." Spondylolisthesis describes the actual anterior slippage of
a vertebral body, whereas spondylosis denotes general degenerative joint disease.
5. A 60-year-old male presents with insidious onset of low back pain and bilateral leg heaviness
that worsens with prolonged standing and walking, and significantly improves with lumbar
flexion (such as sitting or leaning over a shopping cart). What is the most likely diagnosis?
A. Acute lumbar disc herniation
B. Lumbar spinal stenosis
C. Ankylosing spondylitis
D. Acute lumbosacral sprain/strain
CORRECT ANSWER : B
Rationale: Lumbar spinal stenosis classically presents with neurogenic claudication, where
symptoms of pain, numbness, or heaviness in the legs are provoked by extension
(standing/walking) and relieved by lumbar flexion which widens the spinal canal. Disc
herniations typically worsen with flexion, and ankylosing spondylitis presents with morning
stiffness and inflammatory markers.
6. Which cranial nerve is primarily responsible for transmitting general sensory information from
the anterior two-thirds of the tongue, as well as innervating the muscles of facial expression?
A. Cranial Nerve V (Trigeminal)
B. Cranial Nerve VII (Facial)
, C. Cranial Nerve IX (Glossopharyngeal)
D. Cranial Nerve XII (Hypoglossal)
CORRECT ANSWER : B
Rationale: Cranial Nerve VII (Facial nerve) controls the muscles of facial expression and
carries taste sensation along with general somatic sensation from parts of the external ear and
anterior tongue (via the chorda tympani for taste). Trigeminal nerve (CN V) supplies general
sensation to the face and anterior tongue. CN IX supplies the posterior third of the tongue.
7. A patient presents with acute onset of severe right shoulder pain following a minor fall. Upon
examination, the clinician notes an inability to actively initiate shoulder abduction, although
passive range of motion remains intact. Which rotator cuff tendon is most likely torn?
A. Subscapularis tendon
B. Infraspinatus tendon
C. Supraspinatus tendon
D. Teres minor tendon
CORRECT ANSWER : C
Rationale: The supraspinatus muscle is the primary initiator of shoulder abduction (first 0 to 15
degrees) and is the most frequently injured rotator cuff tendon. Subscapularis performs internal
rotation, infraspinatus and teres minor perform external rotation.
8. When analyzing a lateral cervical spine radiograph, the practitioner measures the posterior
vertebral body line to evaluate for anterior or posterior displacement of one vertebra on another.
A displacement of greater than 3.5 mm in the cervical spine typically indicates which of the
following?
A. Normal physiological variant without clinical significance
B. Segmental instability or ligamentous disruption
C. Congenital block vertebra fusion
D. Complete osteophytic ankylosis
CORRECT ANSWER : B
