These free NPTE practice questions are grouped by content area, so you can drill the systems you're weakest in. Each one is NPTE-style (a single best answer, often built around a patient), written and reviewed by physical therapists, with an explanation of why the right answer is right.
How to use these NPTE practice questions
Pick the content area you want to work on, answer each question before you open the explanation, and read the reasoning even when you're right. There are 62 questions across all 14 FSBPT content areas, weighted toward musculoskeletal and neuro like the real exam. For a mixed, timed set instead, take our 50-question practice test.
- By area: use the links above to jump straight to a system. The scored-item range shown under each heading comes from FSBPT's NPTE-PT content outline.
- As a mixed test: our free NPTE practice test has 50 different questions in exam-like proportions.
- For the most benefit, follow our 4-step review method, and read what your practice score means.
About these questions
These are original NPTE-style questions from the TherapyExams question bank, not real NPTE items, which FSBPT keeps confidential. They were reviewed for this page and don't overlap with our 50-question practice test. If you think an answer or explanation is wrong, tell us and we'll check it against current references.
NPTE musculoskeletal practice questions
10 questions · worth 44–54 of 180 scored items on the NPTE-PT
Which imaging modality is MOST sensitive for detecting a stress fracture in a runner with negative x-rays?
Show answer and explanation
Answer: A. MRI
MRI is the most sensitive imaging for stress fractures, showing bone marrow edema before any change appears on plain films. X-rays are often negative in the first weeks. CT shows fracture lines well but is less sensitive to early stress reaction.
A therapist notes a soft end-feel at end range of elbow flexion. This end-feel is BEST classified as:
Show answer and explanation
Answer: C. Normal — soft tissue approximation
A soft end-feel at end-range elbow flexion is normal soft-tissue approximation, where the forearm meets the upper arm. Capsular stretch gives a firm end-feel. Boggy (edema) and empty (motion stopped by pain before tissue resistance) end-feels are pathological.
The empty can test PRIMARILY assesses which muscle?
Show answer and explanation
Answer: B. Supraspinatus
The empty can (Jobe) test, with the arm elevated in the scapular plane and internally rotated (thumb down), loads the supraspinatus. Pain or weakness suggests supraspinatus pathology. Like most single shoulder tests, it's more useful combined with other findings.
What is the PRIMARY muscle responsible for a positive Trendelenburg sign?
Show answer and explanation
Answer: D. Gluteus medius
A positive Trendelenburg sign, the opposite side of the pelvis dropping in single-leg stance, indicates weakness of the gluteus medius on the stance side. Patients often compensate by leaning the trunk over the stance leg.
The MCL is BEST assessed with which test, and at what knee flexion angle does it isolate the MCL?
Show answer and explanation
Answer: B. Valgus stress at 30°
A valgus stress test at about 30° of knee flexion isolates the MCL. Laxity at 30° but not at full extension suggests an isolated MCL injury. Laxity at 0° as well implicates additional structures, such as the posterior capsule or cruciate ligaments.
A runner has plantar heel pain that is WORST with the FIRST steps in the morning. The MOST likely diagnosis is:
Show answer and explanation
Answer: D. Plantar fasciitis
Heel pain that's worst with the first steps in the morning or after rest, and eases as you walk, is the classic pattern of plantar fasciitis. Tarsal tunnel syndrome causes neural symptoms, a calcaneal stress fracture causes pain that builds with loading, and Achilles tendinopathy hurts at the back of the heel.
A patient has lateral elbow pain reproduced with resisted wrist extension and gripping. This presentation is MOST consistent with:
Show answer and explanation
Answer: C. Lateral epicondylitis
Lateral elbow pain reproduced by resisted wrist extension and gripping is lateral epicondylalgia (tennis elbow), involving the common extensor origin, especially extensor carpi radialis brevis. Medial epicondylalgia involves the flexor-pronator origin.
A patient has numbness in the ulnar 1.5 fingers, weakness of finger abduction, and a positive Froment's sign. Which nerve is MOST likely involved?
Show answer and explanation
Answer: B. Ulnar nerve
Sensory loss in the ulnar one and a half digits, weak finger abduction (interossei), and a positive Froment sign point to the ulnar nerve. In Froment sign, a weak adductor pollicis makes the patient flex the thumb IP joint (flexor pollicis longus, median nerve) to hold a pinch.
A femoral neck fracture with the HIGHEST risk for avascular necrosis (AVN) is classified as:
Show answer and explanation
Answer: C. Subcapital (intracapsular) fracture
Subcapital, intracapsular femoral neck fractures carry the highest risk of avascular necrosis, because they disrupt the retinacular vessels, chiefly from the medial femoral circumflex artery, that supply the femoral head. Intertrochanteric and subtrochanteric fractures are extracapsular.
Which ligament is MOST commonly sprained in a lateral ankle injury?
Show answer and explanation
Answer: D. Anterior talofibular ligament (ATFL)
The anterior talofibular ligament is the most commonly sprained ankle ligament. It's taut in plantarflexion and inversion, the usual sprain mechanism. The calcaneofibular ligament is next most often injured; the deltoid ligament is injured by eversion.
NPTE neuromuscular and nervous system practice questions
10 questions · worth 39–48 of 180 scored items on the NPTE-PT
A cerebellar lesion would MOST likely produce which findings?
Show answer and explanation
Answer: B. Intention tremor, dysmetria, and dysdiadochokinesia
Cerebellar lesions cause intention tremor, dysmetria (over- or undershooting a target) and dysdiadochokinesia (impaired rapid alternating movements). Spasticity and a Babinski sign are upper motor neuron signs, rigidity and resting tremor are basal ganglia signs, and fasciculations with areflexia are lower motor neuron signs.
A patient has a positive Romberg test — stable with eyes open but loses balance with eyes closed. This finding MOST likely indicates a deficit in which system?
Show answer and explanation
Answer: D. Dorsal column (proprioceptive)
Standing steadily with eyes open but losing balance when they close (positive Romberg) means the patient was relying on vision to make up for lost proprioception, a dorsal column (sensory) deficit. Cerebellar ataxia is present with eyes open and closed.
A patient cannot abduct the right eye (lateral gaze). Which cranial nerve is MOST likely injured?
Show answer and explanation
Answer: A. CN VI (Abducens)
The abducens nerve (CN VI) supplies the lateral rectus, which abducts the eye. A CN VI palsy leaves the eye unable to look laterally. CN III palsy causes ptosis and a 'down and out' eye with a dilated pupil, and CN IV affects the superior oblique.
A patient has absent DTRs, ascending weakness starting in the feet, and CSF showing elevated protein with normal cell count (albuminocytologic dissociation). Which condition is MOST likely?
Show answer and explanation
Answer: B. Guillain-Barré syndrome
Ascending weakness from the feet, absent reflexes and albuminocytologic dissociation (raised CSF protein with a normal cell count) are the hallmarks of Guillain-Barré syndrome, an acute peripheral demyelinating polyneuropathy. Monitor respiratory function closely.
A patient post-MCA stroke has contralateral hemiplegia with arm weaker than leg, and fluent but incomprehensible speech. The lesion is MOST likely in which hemisphere?
Show answer and explanation
Answer: C. Left (dominant) hemisphere
Fluent speech that makes little sense, with poor comprehension, is Wernicke (receptive) aphasia. Aphasia follows lesions of the language-dominant hemisphere, the left in most people, and arm-greater-than-leg weakness fits the middle cerebral artery territory.
Which ASIA Impairment Scale classification indicates that motor function is preserved below the level of injury with ≥50% of key muscles grading ≥3/5?
Show answer and explanation
Answer: D. ASIA D (Motor Incomplete)
On the ASIA Impairment Scale, D is motor incomplete with at least half of the key muscle functions below the neurological level graded 3 or more. C is motor incomplete with fewer than half at grade 3, B is sensory incomplete, and A is complete.
A physical therapist evaluates a 4-year-old boy who uses his hands to "walk up" his thighs when rising from the floor. This sign is MOST characteristic of which condition?
Show answer and explanation
Answer: C. Duchenne muscular dystrophy
Using the hands to 'walk up' the thighs to stand is the Gowers sign, which reflects proximal hip and knee extensor weakness and is characteristic of Duchenne muscular dystrophy. Exercise should avoid overwork and heavy eccentric loading.
A post-stroke patient has nonfluent, effortful speech but intact comprehension. This BEST describes which type of aphasia?
Show answer and explanation
Answer: D. Broca's (expressive)
Nonfluent, effortful speech with relatively intact comprehension is Broca (expressive) aphasia, from a lesion in the dominant frontal lobe. Because comprehension is preserved, short, simple verbal instructions usually work well.
Which type of practice produces BETTER long-term retention and transfer despite WORSE performance during practice?
Show answer and explanation
Answer: A. Random practice
Random practice, mixing tasks in an unpredictable order, creates contextual interference. Performance during practice is worse, but long-term retention and transfer are better than with blocked practice. That's the contextual interference effect.
Knowledge of Results (KR) provides feedback about the _____ of a movement, while Knowledge of Performance (KP) provides feedback about the _____.
Show answer and explanation
Answer: D. Outcome; movement pattern
Knowledge of results is feedback about the outcome of a movement ('you reached the cup'). Knowledge of performance is feedback about the movement pattern itself ('your elbow dropped'). KP is especially useful early in learning, when technique is being shaped.
NPTE cardiovascular and pulmonary practice questions
8 questions · worth 22–27 of 180 scored items on the NPTE-PT
During auscultation of the heart, a physical therapist hears a low-pitched sound immediately after S2 in an elderly patient with heart failure. This sound is MOST likely:
Show answer and explanation
Answer: C. S3 heart sound
An S3 is a low-pitched sound just after S2, during rapid ventricular filling. In an older adult with heart failure it suggests ventricular dysfunction or volume overload. An S4 comes just before S1 and reflects a stiff ventricle.
A physical therapist auscultates a patient's lungs and hears fine, discontinuous crackling sounds at the bases bilaterally during inspiration. These adventitious lung sounds are MOST consistent with:
Show answer and explanation
Answer: A. Crackles (rales)
Fine, discontinuous inspiratory sounds are crackles (rales), from fluid in the alveoli or small airways snapping open. At both bases they fit pulmonary edema or pneumonia. Wheezes are continuous and musical, rhonchi are coarse and continuous, and stridor is a high-pitched upper-airway sound.
A patient presents with substernal chest pressure during exercise that occurs at a predictable heart rate and is relieved within 3 minutes by rest. This description is MOST consistent with:
Show answer and explanation
Answer: A. Stable angina
Chest pressure that comes on at a predictable level of exertion and eases within minutes of rest is stable angina. Unstable angina is new, worsening or at rest. MI pain persists, and vasospastic (Prinzmetal) angina typically occurs at rest.
The rate-pressure product (RPP) is calculated as HR × SBP. This value is MOST useful as an index of:
Show answer and explanation
Answer: A. Myocardial oxygen demand
The rate-pressure product (heart rate × systolic BP) is an index of myocardial oxygen demand. In stable angina, symptoms tend to appear at a reproducible RPP, which makes it useful for setting safe exercise limits.
A physical therapist reviews a patient's ECG and notes peaked T waves, wide QRS complexes, and absent P waves. This pattern is MOST consistent with:
Show answer and explanation
Answer: D. Hyperkalemia
Peaked T waves, a widening QRS and flattened or absent P waves are the ECG pattern of hyperkalemia, which can progress to life-threatening arrhythmia and needs urgent medical attention. Hypokalemia flattens T waves and produces U waves.
A patient presents with sudden absence of breath sounds on the right side, tracheal deviation to the left, and acute dyspnea. This presentation is MOST consistent with:
Show answer and explanation
Answer: C. Right-sided tension pneumothorax
Absent breath sounds on one side with the trachea shifted away from that side and acute distress indicate a tension pneumothorax, an emergency. Atelectasis tends to pull the trachea toward the affected side.
A patient with C6 complete spinal cord injury cannot generate an effective cough. Which coughing technique is MOST appropriate to assist this patient with airway clearance?
Show answer and explanation
Answer: A. Quad (manually-assisted) cough
At C6 the diaphragm (C3–C5) works, but the abdominal and intercostal muscles needed for a forceful cough are paralyzed. A manually assisted ('quad') cough, with upward-inward pressure below the ribs timed to the patient's cough, substitutes for the abdominals.
A therapist is performing chest physiotherapy on a patient. During which phase of the respiratory cycle should vibration be applied?
Show answer and explanation
Answer: C. Exhalation only
Vibration is applied during exhalation, to augment expiratory flow and move secretions toward larger airways. Percussion is applied rhythmically through the breathing cycle over the segment being drained.
NPTE integumentary and lymphatic practice questions
7 questions · worth 12–18 of 180 scored items on the NPTE-PT
A physical therapist is evaluating protective sensation in a patient with diabetes mellitus. The patient cannot detect the 5.07 Semmes-Weinstein monofilament on the plantar surface of the foot. This finding MOST likely indicates:
Show answer and explanation
Answer: D. Loss of protective sensation with high ulcer risk
The 5.07 Semmes-Weinstein monofilament exerts 10 g of force, the accepted threshold for protective sensation. Failing to feel it on the plantar foot means loss of protective sensation and a high risk of neuropathic ulcers, so footwear, offloading and daily foot checks matter.
A patient presents with a lower extremity wound at the medial malleolus with marked edema, stasis dermatitis, brown skin pigmentation, and large amounts of serous exudate. Pedal pulses are present. Pain is minimal and relieved with leg elevation. These findings are MOST consistent with which type of ulcer?
Show answer and explanation
Answer: B. Venous insufficiency ulcer
A medial malleolar wound with edema, hemosiderin staining, heavy exudate, palpable pulses and pain eased by elevation is a venous ulcer. Arterial ulcers are painful, worse with elevation, with poor pulses. Neuropathic ulcers are painless and plantar.
A wound assessment reveals a deep crater extending into subcutaneous tissue. Undermining is present, but fascia is intact and no muscle or bone is exposed. This pressure injury is MOST accurately staged as:
Show answer and explanation
Answer: B. Stage 3 pressure injury
Full-thickness skin loss into subcutaneous fat, with no fascia, muscle, tendon or bone exposed, is a Stage 3 pressure injury (NPIAP). Undermining and tunneling can occur. Stage 4 exposes deeper structures; Stage 2 is partial thickness; unstageable means slough or eschar hides the depth.
A patient has a venous ulcer at the medial malleolus with large amounts of serous exudate. The wound bed shows healthy red granulation tissue. Which dressing is the MOST appropriate PRIMARY choice?
Show answer and explanation
Answer: A. Alginate dressing
Alginates are highly absorbent and suit moderate-to-heavy exudate, such as a draining venous ulcer with healthy granulation. They need a secondary dressing. Transparent films don't absorb, hydrogels add moisture to dry wounds, and wet-to-dry gauze would strip healthy tissue.
A physical therapist is treating a 55-year-old female who underwent axillary lymph node dissection and radiation therapy for breast cancer 14 months ago. She now presents with progressive right upper extremity swelling. The PRIMARY cause of secondary lymphedema in the United States is:
Show answer and explanation
Answer: A. Axillary lymph node dissection for breast cancer
In the United States, the most common cause of secondary lymphedema is cancer treatment, particularly axillary lymph node dissection (often with radiation) for breast cancer. Worldwide, filariasis is the leading cause.
A patient with lymphedema presents with pitting edema of the right arm that reduces significantly after overnight limb elevation. This clinical finding is MOST LIKELY consistent with which ISL stage?
Show answer and explanation
Answer: B. ISL Stage I — mild/reversible
Pitting edema that reduces with elevation is International Society of Lymphology Stage I. Stage 0 has impaired lymph transport without visible swelling, Stage II doesn't resolve with elevation and develops fibrosis, and Stage III involves skin changes (lymphostatic elephantiasis).
In a patient with chronic lower extremity lymphedema, the MOST common portal of entry for bacterial cellulitis is:
Show answer and explanation
Answer: C. Tinea pedis (athlete's foot)
In lower-limb lymphedema, cracked skin between the toes from tinea pedis is a well-recognized entry point for the bacteria that cause cellulitis. Each infection can further damage lymphatics, so skin and foot care are a core part of management.
NPTE metabolic, GI and GU practice questions
9 questions · worth 9–17 of 180 scored items on the NPTE-PT
A patient referred to physical therapy for generalized fatigue and muscle weakness presents with cold intolerance, constipation, weight gain, bradycardia, and delayed deep tendon reflexes. These findings are MOST consistent with:
Show answer and explanation
Answer: C. Hypothyroidism
Cold intolerance, constipation, weight gain, bradycardia, fatigue and slow-relaxing reflexes point to hypothyroidism. Hyperthyroidism is the mirror image: heat intolerance, weight loss, tachycardia, tremor and brisk reflexes.
A physical therapist is reviewing laboratory results for a patient with Type 2 diabetes. The HbA1c result is 9.2%. This value indicates:
Show answer and explanation
Answer: D. Poorly controlled blood glucose over the past 2–3 months
HbA1c reflects average glucose over about 2–3 months. By American Diabetes Association criteria, 6.5% or higher is diabetic range, and many adults with diabetes aim for below 7%. A value of 9.2% means sustained poor glycemic control, not a single high reading.
A physical therapist is prescribing an exercise program for a 68-year-old female with a DEXA T-score of −2.8 at the lumbar spine. Which exercise is MOST important to AVOID in this patient?
Show answer and explanation
Answer: B. Seated trunk flexion with resistance
A T-score of −2.5 or lower is osteoporosis. Loaded or resisted spinal flexion raises the risk of vertebral compression fracture and is avoided. Weight-bearing exercise, hip extensor strengthening and spinal extension exercises are appropriate.
A physical therapist is evaluating a 48-year-old patient who presents with severe right upper quadrant pain that increases with deep inspiration. The therapist places a hand at the right costal margin and asks the patient to take a deep breath; the patient abruptly halts inspiration and grimaces in pain. This positive finding is MOST consistent with:
Show answer and explanation
Answer: D. Acute cholecystitis
Pain that stops a deep breath while the examiner presses under the right costal margin is a positive Murphy sign, pointing to acute cholecystitis. Appendicitis causes right lower quadrant pain (McBurney point), and pancreatitis typically causes epigastric pain radiating to the back.
A physical therapist is reviewing the medical history of a patient diagnosed with inflammatory bowel disease. The gastroenterologist's notes describe transmural inflammation, skip lesions throughout the GI tract, and fistula formation. This description is MOST consistent with:
Show answer and explanation
Answer: C. Crohn disease
Transmural inflammation, skip lesions anywhere in the GI tract, and fistulas are features of Crohn disease. Ulcerative colitis is continuous and limited to the mucosa of the colon and rectum.
A physical therapist is modifying treatment positioning for a patient with gastroesophageal reflux disease (GERD) who requires a rest period during the session. Which position is MOST appropriate?
Show answer and explanation
Answer: A. Semi-Fowler's at 30–45 degrees
Keeping the head and trunk elevated about 30–45° (semi-Fowler) uses gravity to limit reflux. Lying flat or head-down (Trendelenburg) makes reflux more likely, and lying on the right side has been associated with more reflux than lying on the left.
A 72-year-old male patient with a 20-year history of diabetes mellitus reports constant urinary dribbling without awareness of bladder fullness. He denies any urgency or leakage associated with coughing or physical exertion. Post-void residual volume measured by bladder ultrasound is 280 mL. Which type of urinary incontinence does this presentation MOST LIKELY indicate?
Show answer and explanation
Answer: D. Overflow incontinence
Constant dribbling without urgency, reduced awareness of bladder fullness, and a large post-void residual (280 mL) indicate overflow incontinence, here consistent with diabetic bladder dysfunction. Stress incontinence is triggered by exertion or coughing, and urge incontinence by sudden urgency.
A physical therapist is educating a 72-year-old female patient with urge urinary incontinence on the proper technique for managing sudden urgency episodes. Which instruction represents the MOST appropriate urge suppression strategy?
Show answer and explanation
Answer: B. Stop moving, perform 3–5 rapid pelvic floor contractions, wait for the urge to pass, then walk calmly to the toilet
For urge incontinence, teach urge suppression: stop, stay still, do several quick pelvic floor contractions until the urge settles, then walk calmly to the toilet. Rushing tends to make leakage more likely.
A physical therapist is developing a care plan for an 84-year-old nursing home resident with moderate dementia who has urinary incontinence. The patient's bladder function is intact on urodynamic testing, but the patient is unable to recognize the urge to void or navigate to the bathroom independently. Which intervention strategy is MOST appropriate?
Show answer and explanation
Answer: B. Prompted voiding by caregivers every 2–3 hours
When bladder function is intact but dementia prevents someone from recognizing the urge or getting to the toilet, the problem is functional incontinence. Prompted voiding by caregivers on a regular schedule is the appropriate strategy; bladder retraining and pelvic floor training depend on the patient's own participation.
NPTE system interactions practice questions
4 questions · worth 8–10 of 180 scored items on the NPTE-PT
A 42-year-old patient presents with bilateral hand and wrist stiffness. Morning stiffness lasts approximately 90 minutes and improves with gentle movement throughout the day. The MCP and PIP joints are symmetrically involved with warm, boggy swelling. This presentation is MOST consistent with which condition?
Show answer and explanation
Answer: B. Rheumatoid arthritis
Symmetric MCP and PIP involvement, warm boggy swelling, and morning stiffness lasting over an hour that eases with activity indicate rheumatoid arthritis. Osteoarthritis causes briefer morning stiffness and typically affects the DIP joints and weight-bearing joints.
During a physical therapy session, a patient with chronic low back pain reports new-onset numbness in the perineal and saddle region, difficulty initiating urination since the previous evening, and bilateral lower extremity weakness that was previously unilateral. What is the MOST appropriate IMMEDIATE action?
Show answer and explanation
Answer: A. Immediately stop treatment and refer for emergency medical evaluation
New saddle numbness, urinary retention and progressing bilateral leg weakness suggest cauda equina syndrome, a surgical emergency. Stop treatment and arrange emergency medical evaluation immediately. Don't keep examining or treating.
A physical therapist is about to begin an exercise session with a patient who has Type 1 diabetes mellitus. The patient's pre-exercise blood glucose reading is 268 mg/dL and a urine ketone test is positive. What is the MOST appropriate action?
Show answer and explanation
Answer: A. Do NOT exercise and refer the patient for medical management
In type 1 diabetes, glucose above about 250 mg/dL with positive ketones means exercise should be avoided, because it can worsen hyperglycemia and ketosis toward diabetic ketoacidosis. Refer for medical management. Carbohydrate would only make things worse.
A 70-year-old male is POD 4 following coronary artery bypass graft (CABG) surgery. He was extubated on POD 2 and has been in the ICU for 6 days total. The patient demonstrates bilateral proximal weakness with hip flexors and deltoids graded 3/5 that developed during the ICU stay. This finding is MOST consistent with which diagnosis?
Show answer and explanation
Answer: D. ICU-acquired weakness
New, symmetric proximal weakness developing during a critical-care stay is typical of ICU-acquired weakness, which includes critical illness polyneuropathy and myopathy. Immobility, systemic inflammation and some medications contribute. Early mobilization is part of the treatment.
NPTE non-system practice questions: equipment, modalities, safety, professional and research
14 questions · worth 21–29 of 180 scored items on the NPTE-PT
A patient who underwent open reduction internal fixation (ORIF) of a tibial plateau fracture 3 days ago is restricted to non-weight-bearing status on the left lower extremity. The patient has adequate bilateral upper-extremity strength (MMT 4+/5). Which crutch gait pattern is MOST appropriate?
Show answer and explanation
Answer: B. Three-point gait pattern
A non-weight-bearing restriction on one leg with good arm strength calls for a three-point gait: both crutches and the involved leg advance together, then the uninvolved leg steps through. Four- and two-point patterns require weight-bearing on both legs.
A physical therapist is fitting axillary crutches for a patient. Which measurement describes the correct position of the axillary pad relative to the axilla?
Show answer and explanation
Answer: C. 2–3 finger-widths (approximately 1.5–2 inches) below the axilla
The axillary pad should sit about 2–3 finger-widths (roughly 1.5–2 inches) below the axilla, with weight taken through the hands. Pressure in the axilla can compress the brachial plexus. The radial nerve is the classic 'crutch palsy' nerve.
A physical therapist is recommending forearm (Lofstrand) crutches for a 35-year-old patient with an incomplete spinal cord injury who requires long-term ambulatory assistance. Which characteristic of Lofstrand crutches BEST supports this recommendation over axillary crutches?
Show answer and explanation
Answer: B. They allow use of hands without dropping the crutch
The forearm cuff of a Lofstrand crutch stays on when the user lets go of the handgrip, freeing the hand to open a door or reach, which matters for long-term users. Axillary crutches are usually for short-term use.
A physical therapist applies a cold pack to a patient's acute ankle sprain. The patient reports an initial sensation sequence of cold, then burning, then aching and numbness. This progression is MOST accurately described by which acronym?
Show answer and explanation
Answer: C. CBAN
The expected sequence of sensations with cold is Cold, Burning, Aching, Numbness (CBAN). PRICE and RICE are acute injury management acronyms, and SAID is the principle of specific adaptation to imposed demands.
A physical therapist is applying therapeutic ultrasound to treat a patient's chronic Achilles tendinopathy. The device's beam non-uniformity ratio (BNR) is listed as 6:1. What does this value indicate about the ultrasound beam quality?
Show answer and explanation
Answer: B. The beam has significant intensity variation with potential hot spots
The beam non-uniformity ratio compares the peak intensity in the ultrasound beam with the average intensity. Lower is more uniform. A BNR of 6:1 means the peak is six times the average, raising the risk of hot spots, so keep the sound head moving.
A physical therapist is reviewing the medical history of a patient referred for therapeutic ultrasound to the left shoulder. The chart indicates the patient has a demand-type cardiac pacemaker. Which of the following is the MOST appropriate action?
Show answer and explanation
Answer: A. Do NOT apply ultrasound near the pacemaker; consider alternative modalities
Therapeutic ultrasound shouldn't be applied over or near a cardiac pacemaker, and the left shoulder is close to a typical pacemaker site. Choose an alternative treatment for that area.
A patient reports diffuse, dull aching in the quadriceps muscles that began approximately 36 hours after an unfamiliar stair-descent training session. The pain is not present at rest but increases with active knee extension. This presentation is MOST consistent with:
Show answer and explanation
Answer: D. Delayed onset muscle soreness (DOMS)
Diffuse aching that starts a day or more after unaccustomed exercise, especially eccentric work such as stair descent, is delayed onset muscle soreness. It typically peaks within 1–3 days and resolves on its own; a strain causes sudden, localized pain at the time of injury.
A physical therapist applies a hot pack to a patient's lower back. At what time point during the application should the therapist FIRST inspect the patient's skin?
Show answer and explanation
Answer: D. At 5 minutes
Check the skin after about the first 5 minutes of a hot pack, then periodically. The pack is hottest early, so burns are most likely then. Add towel layers or stop if you see excessive redness, blotching or blistering.
A physical therapist is obtaining informed consent from a patient before initiating a new treatment intervention. Which three elements are ALL required for informed consent to be legally valid?
Show answer and explanation
Answer: D. Disclosure of information, patient capacity, and voluntariness
Valid informed consent needs three things: disclosure of the relevant information (treatment, risks, benefits, alternatives), a patient with the capacity to decide, and a decision made voluntarily. A signature documents consent but isn't what makes it valid.
A physical therapist receives a phone call from a patient's employer requesting the patient's diagnosis and treatment records. The patient has not signed a written authorization for this disclosure. Which action is MOST appropriate?
Show answer and explanation
Answer: C. Decline to release any information without written patient authorization
Under HIPAA, an employer isn't entitled to a patient's protected health information without the patient's written authorization, even if the employer pays for care. Decline and explain that authorization is needed.
A physical therapist provides a home exercise program (HEP) to a patient with suspected low health literacy. The patient nods in agreement when the therapist explains the exercises but appears uncertain when shown the written handout. Which strategy is MOST effective for confirming the patient's comprehension?
Show answer and explanation
Answer: C. Ask the patient to demonstrate each exercise and explain it in their own words
Teach-back, asking the patient to demonstrate and explain each exercise in their own words, confirms understanding rather than assuming it from a nod. It's especially important when health literacy may be limited.
A researcher collects hospital length-of-stay data for 200 patients following total knee arthroplasty. The distribution is positively skewed due to several patients with extended stays of 25–40 days. Which measure of central tendency BEST represents the typical patient's length of stay?
Show answer and explanation
Answer: A. Median
With positively skewed data, a few long stays pull the mean upward, so the median better represents the typical patient. In a positive skew the usual order is mode < median < mean.
A research team conducts a randomized controlled trial comparing two exercise protocols for knee osteoarthritis. The study reports no significant difference between groups (p = 0.22), but the sample size was only 12 participants per group. A post-hoc power analysis reveals the study had only 40% power. Which type of error is MOST likely to have occurred?
Show answer and explanation
Answer: B. Type II error (beta error, false negative)
Failing to find a real difference is a type II error (false negative). With only 40% power, the study had a 60% chance of missing a true effect, most likely because of its small sample. Type I error is a false positive.
A highly specific diagnostic test (specificity = 98%) is applied in a population where the disease prevalence is only 1%. The positive predictive value (PPV) for this test will MOST LIKELY be:
Show answer and explanation
Answer: B. Low (well below 50%)
Positive predictive value depends on prevalence. At 1% prevalence, even with 98% specificity, about 2% of the 99% without the disease test positive, which is more than the 1% who truly have it. So most positive results are false, and PPV is well below 50%.
Where to go from here
- Note which sections cost you the most points, and check how many items each is worth on the content outline.
- Test those areas again in a timed, mixed set: try the 50-question practice test.
- Lock in the facts you missed with our free NPTE flashcards and mnemonics, sorted by the same content areas.
- Build them into a plan with our NPTE study plan.
Frequently asked questions
Are these real NPTE questions?
No. Real NPTE items are confidential. These are original NPTE-style questions written by physical therapists and organized by FSBPT's published content outline.
How many NPTE practice questions should I do?
There's no official number. What matters most is reviewing each question thoroughly. Many 12-week plans add up to 2,000–3,000 questions plus two or three full-length exams.
Where can I find more free NPTE practice questions?
Our 50-question practice test has different questions from this page. FSBPT also offers a free NPTE Demonstration Examination with sample questions and the exam interface.
Which NPTE content area has the most questions?
Musculoskeletal, with 44–54 of the 180 scored questions, followed by neuromuscular and nervous systems with 39–48.
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Every figure on this page comes from the primary sources below, checked on September 30, 2026. If an official source changes, it overrides this page.