NPTE PTA Exam Prep 2026: Updated Practice Questions,
Comprehensive Physical Therapist Assistant
Examination Review, Detailed Explanations, Verified
Answers, Complete Success Workbook
SECTION 1: MUSCULOSKELETAL SYSTEM
Question 1
During a goniometric measurement of elbow flexion, which anatomical
landmarks should the PTA use for accurate placement of the goniometer?
A. Lateral epicondyle, radial styloid, and acromion process
B. Lateral epicondyle, midline of the humerus, and midline of the radius
C. Medial epicondyle, ulnar styloid, and acromion process
D. Olecranon process, midline of the ulna, and midline of the humerus
Rationale: For elbow flexion goniometry, the axis (fulcrum) is placed over the
lateral epicondyle of the humerus. The stationary arm is aligned with the
midline of the humerus (pointing toward the acromion process), and the
moving arm is aligned with the midline of the radius (pointing toward the
radial styloid). The other options include incorrect landmarks for this specific
measurement.
Question 2
A patient who is 3 days post-total knee arthroplasty (TKA) has a hemovac
drain in place. Which of the following interventions is MOST appropriate for
the PTA to perform?
A. Assisted range of motion exercises within the surgeon's protocol
B. Aggressive passive range of motion to end range
C. Resistance training with ankle weights
D. Deep squatting exercises
Rationale: In the acute post-operative phase (3 days post-TKA), the focus is
on protected range of motion, edema control, and early mobilization. Assisted
,ROM within the surgeon's protocol is appropriate. Aggressive ROM, resistance
training, and deep squatting are contraindicated at this stage due to risk of
damage to the surgical site and prosthesis.
Question 3
During manual muscle testing of the quadriceps, a patient is able to complete
full range of motion against gravity but cannot tolerate any added resistance.
What grade should the PTA document?
A. 2/5
B. 3−/5
C. 3/5
D. 4/5
Rationale: A muscle grade of 3/5 indicates the patient can complete full range
of motion against gravity but cannot tolerate any added resistance. Grade 2/5
indicates full ROM with gravity eliminated, grade 3−/5 indicates partial ROM
against gravity, and grade 4/5 indicates full ROM against gravity with
moderate resistance.
Question 4
A patient with a diagnosis of adhesive capsulitis of the shoulder is referred to
physical therapy. Which of the following is the MOST appropriate initial
intervention?
A. Aggressive shoulder mobilization to end range
B. Gentle range of motion exercises within pain-free limits
C. Overhead pulleys for forced range of motion
D. Resistive exercises with Theraband
Rationale: Adhesive capsulitis (frozen shoulder) is characterized by painful
restriction of shoulder motion. In the early (painful) phase, treatment focuses
on gentle ROM within pain-free limits, modality use for pain control, and
patient education. Aggressive mobilization, forced ROM, and resistance
exercises are contraindicated during the acute phase.
,Question 5
A patient is recovering from a distal radius fracture and has been placed in a
short arm cast. Which of the following should the PTA monitor for as a
potential complication?
A. Compartment syndrome
B. Deep vein thrombosis
C. Pulmonary embolism
D. Autonomic dysreflexia
Rationale: Compartment syndrome is a potential complication of fractures,
particularly those treated with casts that may restrict swelling. Signs include
severe pain, pallor, paresthesia, paralysis, and pulselessness. DVT and PE are
more associated with lower extremity surgery and immobility. Autonomic
dysreflexia is associated with spinal cord injury above T6.
Question 6
Which of the following exercises BEST targets the gluteus medius during gait
training for a patient with Trendelenburg gait?
A. Straight leg raises
B. Side-lying hip abduction
C. Quadriceps sets
D. Ankle pumps
Rationale: The gluteus medius is a hip abductor. Side-lying hip abduction
directly targets this muscle. Straight leg raises target the hip flexors and
quadriceps, quadriceps sets target the quadriceps, and ankle pumps target the
calf musculature.
Question 7
A patient with a below-knee amputation is being fitted for a prosthesis. Which
of the following is the MOST important factor in determining prosthetic
candidacy?
, A. The patient's functional goals and rehabilitation potential
B. The patient's age alone
C. The patient's insurance coverage
D. The patient's dominant hand
Rationale: Prosthetic candidacy is determined primarily by the patient's
functional goals, rehabilitation potential, cognitive status, cardiovascular
status, and residual limb condition. While age and insurance are
considerations, they are not the primary determinants. Hand dominance is not
a primary factor.
Question 8
Which of the following is a contraindication to joint mobilization?
A. Joint hypermobility
B. Joint hypomobility
C. Muscle weakness
D. Decreased range of motion
Rationale: Joint hypermobility is an absolute contraindication to joint
mobilization, as it can further destabilize the joint. Joint hypomobility, muscle
weakness, and decreased ROM are indications for mobilization, not
contraindications.
Question 9
A patient with a total hip arthroplasty (posterior approach) should be
educated to avoid which of the following movements?
A. Hip flexion beyond 90 degrees, adduction past midline, and internal
rotation
B. Hip extension and abduction
C. Knee flexion and ankle dorsiflexion
D. Shoulder flexion and abduction
Rationale: Following total hip arthroplasty via the posterior approach,
patients must avoid hip flexion beyond 90 degrees, adduction past midline,
Comprehensive Physical Therapist Assistant
Examination Review, Detailed Explanations, Verified
Answers, Complete Success Workbook
SECTION 1: MUSCULOSKELETAL SYSTEM
Question 1
During a goniometric measurement of elbow flexion, which anatomical
landmarks should the PTA use for accurate placement of the goniometer?
A. Lateral epicondyle, radial styloid, and acromion process
B. Lateral epicondyle, midline of the humerus, and midline of the radius
C. Medial epicondyle, ulnar styloid, and acromion process
D. Olecranon process, midline of the ulna, and midline of the humerus
Rationale: For elbow flexion goniometry, the axis (fulcrum) is placed over the
lateral epicondyle of the humerus. The stationary arm is aligned with the
midline of the humerus (pointing toward the acromion process), and the
moving arm is aligned with the midline of the radius (pointing toward the
radial styloid). The other options include incorrect landmarks for this specific
measurement.
Question 2
A patient who is 3 days post-total knee arthroplasty (TKA) has a hemovac
drain in place. Which of the following interventions is MOST appropriate for
the PTA to perform?
A. Assisted range of motion exercises within the surgeon's protocol
B. Aggressive passive range of motion to end range
C. Resistance training with ankle weights
D. Deep squatting exercises
Rationale: In the acute post-operative phase (3 days post-TKA), the focus is
on protected range of motion, edema control, and early mobilization. Assisted
,ROM within the surgeon's protocol is appropriate. Aggressive ROM, resistance
training, and deep squatting are contraindicated at this stage due to risk of
damage to the surgical site and prosthesis.
Question 3
During manual muscle testing of the quadriceps, a patient is able to complete
full range of motion against gravity but cannot tolerate any added resistance.
What grade should the PTA document?
A. 2/5
B. 3−/5
C. 3/5
D. 4/5
Rationale: A muscle grade of 3/5 indicates the patient can complete full range
of motion against gravity but cannot tolerate any added resistance. Grade 2/5
indicates full ROM with gravity eliminated, grade 3−/5 indicates partial ROM
against gravity, and grade 4/5 indicates full ROM against gravity with
moderate resistance.
Question 4
A patient with a diagnosis of adhesive capsulitis of the shoulder is referred to
physical therapy. Which of the following is the MOST appropriate initial
intervention?
A. Aggressive shoulder mobilization to end range
B. Gentle range of motion exercises within pain-free limits
C. Overhead pulleys for forced range of motion
D. Resistive exercises with Theraband
Rationale: Adhesive capsulitis (frozen shoulder) is characterized by painful
restriction of shoulder motion. In the early (painful) phase, treatment focuses
on gentle ROM within pain-free limits, modality use for pain control, and
patient education. Aggressive mobilization, forced ROM, and resistance
exercises are contraindicated during the acute phase.
,Question 5
A patient is recovering from a distal radius fracture and has been placed in a
short arm cast. Which of the following should the PTA monitor for as a
potential complication?
A. Compartment syndrome
B. Deep vein thrombosis
C. Pulmonary embolism
D. Autonomic dysreflexia
Rationale: Compartment syndrome is a potential complication of fractures,
particularly those treated with casts that may restrict swelling. Signs include
severe pain, pallor, paresthesia, paralysis, and pulselessness. DVT and PE are
more associated with lower extremity surgery and immobility. Autonomic
dysreflexia is associated with spinal cord injury above T6.
Question 6
Which of the following exercises BEST targets the gluteus medius during gait
training for a patient with Trendelenburg gait?
A. Straight leg raises
B. Side-lying hip abduction
C. Quadriceps sets
D. Ankle pumps
Rationale: The gluteus medius is a hip abductor. Side-lying hip abduction
directly targets this muscle. Straight leg raises target the hip flexors and
quadriceps, quadriceps sets target the quadriceps, and ankle pumps target the
calf musculature.
Question 7
A patient with a below-knee amputation is being fitted for a prosthesis. Which
of the following is the MOST important factor in determining prosthetic
candidacy?
, A. The patient's functional goals and rehabilitation potential
B. The patient's age alone
C. The patient's insurance coverage
D. The patient's dominant hand
Rationale: Prosthetic candidacy is determined primarily by the patient's
functional goals, rehabilitation potential, cognitive status, cardiovascular
status, and residual limb condition. While age and insurance are
considerations, they are not the primary determinants. Hand dominance is not
a primary factor.
Question 8
Which of the following is a contraindication to joint mobilization?
A. Joint hypermobility
B. Joint hypomobility
C. Muscle weakness
D. Decreased range of motion
Rationale: Joint hypermobility is an absolute contraindication to joint
mobilization, as it can further destabilize the joint. Joint hypomobility, muscle
weakness, and decreased ROM are indications for mobilization, not
contraindications.
Question 9
A patient with a total hip arthroplasty (posterior approach) should be
educated to avoid which of the following movements?
A. Hip flexion beyond 90 degrees, adduction past midline, and internal
rotation
B. Hip extension and abduction
C. Knee flexion and ankle dorsiflexion
D. Shoulder flexion and abduction
Rationale: Following total hip arthroplasty via the posterior approach,
patients must avoid hip flexion beyond 90 degrees, adduction past midline,
