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NPTE Clinical Files is a podcast from the creator of Dominating the NPTE, hosted by Kyle Rice. NPTE Clinical Files explains a true clinical scenario in the form of a mock NPTE-based question. Each question is followed by a set of answer choices, where Dr. Kyle Rice explains the right answer with a detailed rationale. Each season covers all of the major systems and topics found in physical therapy and likely to be found on an NPTE. NPTE Clinical Files gives the Physical Therapist a weekly opp ...
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Richard is a 75-year-old male patient being treated by physical therapy. In educating a patient with chronic obstructive pulmonary disease (COPD) about managing exacerbations at home, what advice should the physical therapist emphasize as MOST important? A. Use of an incentive spirometer every 2 hours while awake. B. Maintenance of a high-protein, …
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Vivek is being seen by physical therapy after recovering well from a stroke. The patient is refining gait during the autonomous stage of motor learning. Which activity is BEST to challenge their gait adaptability? A. Walking backwards on a treadmill B. Navigating a cluttered hallway C. Stepping over obstacles at 6 inch heights D. Reciprocal pedalin…
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Henry presents with right-sided congestive heart failure and reports slight limitations in physical activity. The patient is comfortable at rest; however, ordinary physical activity results in fatigue, palpitation, or dyspnea. Based on this description, which of the following activities is the patient MOST likely able to do without exacerbating the…
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Andrea is a 45-year-old patient presents to physical therapy with complaints of fluctuating muscle weakness, notably worsening toward the evening. The patient reports difficulty maintaining upward gaze and a history of transient diplopia. No sensory deficits were reported. Which of the following conditions is MOST likely?A) Multiple Sclerosis (MS)B…
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A physical therapy clinic is planning to install a new wheelchair ramp that incorporates a switchback for space efficiency. According to ADA guidelines, what is the MINIMUM required landing size at the switchback to ensure compliance and safety? A) 36 inches by 36 inches B) 48 inches by 48 inches C) 60 inches by 60 inches D) 72 inches by 72 inches …
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Jessie is a 12-year-old male patient who presents with an onset of groin pain. The patient has a BMI of 28 and a recent growth spurt. The physical therapist notes the patient has a limp with external rotation of the affected leg during ambulation. Which of the following diagnoses is MOST likely? A) Legg-Calvé-Perthes Disease B) Slipped Capital Femo…
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Joscelin receives a referral for a patient with a diagnosis that the therapist is unfamiliar with. What is the INITIAL course of action? A. Decline the referral, citing lack of expertise B. Accept the patient and start treatment C. Research the condition D. Refer the patient to another therapist LINKS MENTIONED: Did you get this question wrong?! If…
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Henry is treating a patient with severe complications after right total knee arthroplasty. The therapist is preparing a new total knee arthroplasty presentation for his healthcare team and wants to remain HIPAA compliant. Which of the following is NOT a form of protected health information covered under HIPAA? A. Patient alias B. Medical record num…
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Tamia presents with an unspecified work-related injury to her right upper extremity. Upon examination, the patient demonstrates weakness in wrist flexion and loss of forearm pronation. The patient also exhibits a diminished brachial reflex and a positive Froment's sign. Which nerve is LEAST likely to be affected? A. Median nerve B. Ulnar nerve C. M…
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Charlie is a patient with chronic anemia who is participating in a physical therapy program. Which of the following signs should the physical therapist monitor for during exercise? A. Sudden increase in blood pressure B. Excessive sweating C. Tachycardia and dyspnea on exertion D. Hyperactivity LINKS MENTIONED: Did you get this question wrong?! If …
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Sahar is educating her student about surgical protocols of the foot and ankle. A patient who presents two weeks post-surgery for an Achilles tendon repair, should avoid which of the following? A. Passive dorsiflexion to mild discomfort B. Seated toe extensions C. Gentle isometric plantarflexion exercises D. Active ankle inversion and eversion LINKS…
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In this podcast episode, Dr. Kyle Rice, also known as Coach K, focuses on the mission of the PT Hustle and 3 tips for helping any physical therapist PASS the NPTE, who struggles with standardized tests. He uncovers the three major mistakes people make when preparing for the exam and how to resolve them. Join us on this enlightening podcast episode!…
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Upper Extremity Neurological Signs and Symptoms
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Jeremy is a 55 year old male who presents with numbness and tingling in both hands, loss of pain and temperature sensation in a glove-like distribution, and decreased grip strength. This patient MOST likely suffers from: A. Cervical radiculopathy B. Thoracic outlet syndrome C. Peripheral neuropathy D. Carpal tunnel syndrome LINKS MENTIONED: Did you…
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Blake wants to reduce the risk of orthostatic hypotension in a patient with low blood pressure. The physical therapist should: A. Encourage slow transitions from sitting to standing B. Have the patient perform deep breathing exercises before standing C. Recommend wearing compression stockings during sessions D. Check the chart for blood pressure re…
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Copeland is evaluating a 55-year-old patient who presents with a mild case of unilateral vestibular hypofunction and associated hearing loss on the left side. The therapist performs the caloric test by instilling warm water into the affected ear. What is the MOST likely direction of the patient's nystagmus during this test? A. Towards the opposite …
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Peter is a physical therapist who is working with a 3-year-old child who has Down syndrome. The therapist observes increased flexibility and hypermobility. These findings is primarily due to: A. Poor muscle tone B. Ligamentous laxity C. Delayed bone age D. Spastic muscle contractions LINKS MENTIONED: Did you get this question wrong?! If you were st…
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Kayla is a physical therapist who is evaluating a patient with shoulder pain via telehealth. The patient is unable to accurately palpate the area of maximal tenderness. What alternative method should the therapist use to localize the pain? A. Guide the patient through a series of active range of motion exercises to identify the painful location B. …
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Frankie is a physical therapist who, during a home health visit, notices that the patient's home has several potential safety hazards. What is the FIRST step the therapist should take? A. Ignore the hazards as addressing them is not within the therapist’s scope of practice. B. Report the hazards to the patient’s primary care physician. C. Discuss a…
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Setting: Sports Clinic Gender: Female Age: 28 years Presenting Problem/Current Condition: Pain in the right elbow after increasing the frequency of her tennis games. Medical History: No significant medical issues Other Information: Recreational tennis player, recently started competing Physical Therapy Examination(s): Tenderness over the lateral ep…
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Wendy presents with a recent diagnosis of Addison's disease and has. been referred to physical therapy. During exercise, the therapist should expectant of which of the following symptoms? A. Hypertension and tachycardia B. Hyperglycemia and diaphoresis C. Hypotension and fatigue D. Hypoglycemia and hyperreflexia LINKS MENTIONED: Did you get this qu…
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Burton is a 45-year-old male patient with a long-standing history of hypothyroidism who presents with complaints of increasing fatigue, cold intolerance, and muscle stiffness. Physical therapy examination reveals slowed reflexes and generalized muscle weakness. Which intervention should be prioritized in this patient's treatment plan? A. High-inten…
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Question 1: Given the patient's medication and medical history, which complication is he at an increased risk for during mobility training A) Orthostatic hypotension B) Fractures C) Respiratory distress D) HyperkalemiaQuestion 2: The patient is exhibiting difficulty following multi-step commands. Which approach would be MOST appropriate when giving…
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June presents with complaints of pain during the midstance to terminal stance phase of gait. Upon examination, there's excessive pronation of the subtalar joint and pes planus deformity. What muscle is MOST likely weakened? A) Flexor digitorum brevis B) Tibialis posterior C) Abductor hallucis D) Extensor digitorum longus LINKS MENTIONED: Did you ge…
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Belinda is a 46-year-old patient with a history of diabetes presents with a non-healing ulcer on the plantar surface of the foot. Upon examination, the therapist notes a well-defined ulcer with a punched-out appearance surrounded by callused skin. Which type of ulcer is this most indicative of? A) Venous stasis ulcer B) Arterial insufficiency ulcer…
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Kelly is a 60-year-old patient who is post-stroke and exhibits a steppage gait pattern. What is the MOST likely underlying neuromuscular deficit contributing to this gait deviation? A) Weak hip flexors B) Weak ankle dorsiflexors C) Spastic quadriceps D) Spastic hip adductors LINKS MENTIONED: Did you get this question wrong?! If you were stuck betwe…
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