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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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Matt, a 17-year-old athlete, experiences chronic muscle weakness, foot deformities (high arches and hammer toes), and sensory deficits in his legs and feet. These symptoms have been progressively worsening over the past few years, without any associated swelling or inflammation. Which condition is MOST likely present? A) Osteomyelitis B) Juvenile r…
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Suely a 40-year-old female with multiple sclerosis (MS) presents with ataxic gait, characterized by wide base of support, irregular steps, and difficulty maintaining balance. Which of the following interventions is MOST appropriate to address her gait abnormalities? A. High-intensity plyometric exercises B. Treadmill training with body-weight suppo…
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Blakely is a 65-year-old female with a history of type 2 diabetes mellitus presents with a non-healing wound on her left foot. The wound has been present for six weeks and shows no signs of improvement. Which of the following interventions is MOST appropriate to promote wound healing? A. Hydrotherapy with whirlpool B. Application of a moist wound d…
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Raj presents with anterior knee pain that worsens during prolonged cycling. Which of the following adjustments to the bike setup would be MOST beneficial in alleviating the cyclist's symptoms? A. Lowering the saddle height B. Raising the saddle height C. Moving the saddle forward D. Moving the saddle backward LINKS MENTIONED: NPTE Tips & Tricks: ww…
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Caden is a physical therapist who notes that a patient with a recent ACL reconstruction is reluctant to perform weight-bearing exercises. The patient expresses fear of re-injury. The MOST appropriate response to facilitate rehabilitation progress would involve: A. Encouraging the patient to ignore the fear and push through discomfort. B. Implementi…
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Xavier is a patient who recently underwent hip replacement surgery and is now at a rehabilitation facility with a weight-bearing as tolerated (WBAT) status. The patient is 75 years old with mild Parkinson’s disease, affecting his balance and coordination. Given these considerations, which assistive device would be MOST appropriate for this patient …
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Gerard arrives at physical therapy reporting acute lower back pain following an attempt to lift a heavy box. The pain radiates into both lower extremities constantly. During examination, all lumbar motions exacerbate the pain, and the patient prefers to stand and sit with increased lumbar flexion. Which pathology is MOST likely present? A) Lumbar H…
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Margot, a 53-year-old woman, presents to physical therapy with bilateral, symmetrical enlargement of her legs extending from her hips to her ankles, sparing the feet. She reports the condition is painful and has worsened over several years. Skin texture is normal, and there is no pitting edema. Which condition is MOST consistent with these findings…
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Jerry, a patient with type 2 diabetes, has been prescribed metformin to manage his blood glucose levels. The physical therapist understands that metformin’s primary function is to: A) Stimulate the pancreas to produce more insulin. B) Decrease the liver's production of glucose. C) Increase the sensitivity of insulin receptors on cells. D) Slow the …
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Julian, a 59-year-old patient with a longstanding history of type 2 diabetes, presents with a chronic, non-healing wound on his foot. The wound is located on the lateral aspect of the foot, characterized by a sharply demarcated, circular margin, and a pale, dry base with minimal exudate. His medical history includes poorly controlled hypertension a…
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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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