National Physical Therapy Examination for Physical Therapists (NPTE-PT) Study Guide

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A patient reports exertional breathlessness after years of smoking. Identify spirometry as the investigation of forced exhaled volume and airflow, and distinguish it from oxygen-saturation monitoring.

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A medically stable patient completes the prescribed walking duration with acceptable effort and no concerning symptoms. Increase walking time while initially keeping speed constant, then reassess tolerance before another progression.

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A patient develops rapid, shallow breathing during repeated transfers despite stable saturation. Modify the task and recovery periods, reassess the full response, and investigate persistent or disproportionate symptoms.

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A report shows pH 7.30 and PaCO2 55 mm Hg. Recognize acidemia with elevated carbon dioxide rather than concluding that an acceptable saturation excludes impaired ventilation.

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A patient taking a beta blocker reports moderate effort while walking, although the pulse remains below an old training target. Review how that target was established before increasing workload solely to reach the previous number.

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A stable patient tolerates several shorter walking bouts but cannot yet complete the same total time continuously. Use planned recovery periods and document accumulated walking time, then reassess before extending the bouts.

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After a period of postoperative immobility, a patient develops new calf swelling, tenderness, and warmth on one side. Pause the planned session and arrange prompt medical evaluation rather than proceeding with calf strengthening or massage.

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During rehabilitation after lower-limb surgery, a patient suddenly becomes breathless and reports sharp chest pain with inspiration. Stop treatment and activate emergency assistance immediately, even if the earlier limb examination did not show obvious swelling.

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A patient develops progressive shoulder stiffness without a recent injury. Both self-directed elevation and therapist-assisted elevation are limited. Relate the shared restriction to capsular involvement and investigate the overall pattern before selecting a mobility intervention.

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Two patients cannot actively elevate the arm fully. One also has marked passive restriction; the other has nearly full passive elevation. Use that difference to prioritize capsular assessment in the first and investigate active-force limitations in the second.

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A later shoulder measurement appears larger, but the patient now extends the trunk during elevation. Repeat the measurement with consistent trunk stabilization before attributing the difference to increased shoulder mobility.

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A patient with diagnosed hip osteoarthritis has difficulty walking to nearby shops and putting on shoes. Connect these limitations to painful loading and restricted movement, then select functional goals that exercise and activity adjustment can realistically address.

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A patient cannot rise from a low chair but succeeds from a higher surface. Use the response to select an achievable starting task, then examine the strength, motion, pain, and balance factors that could explain the difficulty.

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A patient has sufficient passive range for a transfer but cannot generate the force to complete it. Emphasize force production and transfer practice rather than adding stretching solely because the transfer remains difficult.

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A patient develops prolonged hip pain after running but tolerates stationary cycling. Discuss replacing some running sessions with cycling and tracking symptoms and daily function, while continuing an individualized strength and mobility program suited to the examination findings.

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A patient feels comfortable shortly after rotator cuff repair and wants to lift a heavy bag. Explain that low pain does not establish tendon healing and select activities consistent with the stated protection requirements for the repair.

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During a permitted shoulder exercise, compare the same external load held closer to versus farther from the shoulder. Identify the larger perpendicular moment arm as the greater external torque demand.

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A patient is prohibited from resisted shoulder activity after repair. Recognize that pushing against an immovable surface still produces muscular force and may violate that restriction despite no visible shoulder motion.

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An athlete reports a pop behind the ankle, impaired push-off, and an absent expected calf-squeeze response. Arrange prompt assessment for rupture even though slight active plantarflexion remains.

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A patient produces adequate initial force but loses movement quality during repeated transfers. Examine sustained or repeated task capacity in addition to peak force before selecting the exercise emphasis.

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A patient's goal is a controlled chair transfer. Use a suitable weight-bearing task to practise coordinated hip, knee, and ankle movement, while adding isolated exercise when a specific force deficit also needs attention.

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A postmenopausal patient's report gives a T-score of −2.7. Identify the osteoporosis category and incorporate the documented bone-health findings into rehabilitation planning rather than describing the result as a 2.7 percent reduction in bone density.

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A 35-year-old man's Z-score is −2.1. Describe it as below the expected range for age; do not assign a T-score osteoporosis category or diagnose osteoporosis from bone density alone.

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A patient has brief position-triggered spinning and compatible Dix–Hallpike findings. Provide or refer for canalith repositioning, review safety and recurrence, and arrange reassessment if symptoms persist.

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A patient stands steadily with eyes open but sways markedly when the eyes close. Guard against a fall, document the condition-dependent change, and examine other contributors before assigning a lesion or diagnosis.

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A patient has brief position-triggered vertigo, but Dix–Hallpike testing produces horizontal rather than torsional upbeating nystagmus. Perform or arrange appropriate supine roll testing to assess lateral-canal involvement before selecting the next repositioning procedure for this patient.

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A patient turns safely with continuous verbal guidance. At a later session, test the turn with less guidance and then in the relevant room layout to examine retention and transfer.

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A person with Parkinson disease takes short steps in a hallway. Trial appropriately spaced visual markers, compare step length and walking performance with uncued walking, and retain the strategy only if it improves the task safely and meaningfully.

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A patient covers a timed 10-meter segment in 20 seconds, giving a speed of 0.5 m/s. Also examine a longer-duration walking outcome when the goal concerns sustained community mobility.

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A patient gains seated leg strength but still struggles to negotiate a turn and sit in a chair. Include appropriately supervised turning and sitting practice, then measure performance of that activity.

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If a patient's established program uses that progression rule, meeting its repetition and form criteria supports considering a small load increase.

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Select a tolerable mode and build duration and intensity progressively toward an individualized conditioning dose.

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For a medically stable person nine months after stroke who walks with a cane without substantial physical assistance, consider monitored walking practice that combines the target task with a sufficient cardiovascular challenge.

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A chronic stroke patient walking independently with a device more closely matches the strongest evidence than a chronic traumatic brain injury patient or someone requiring substantial physical assistance.

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A person with T4 spinal cord injury usually has systolic pressure near 95 mm Hg. During treatment it reaches 130 mm Hg with a pounding headache. Recognize the 35 mm Hg rise as concerning despite the absolute value.

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A patient with high spinal cord injury develops headache and a marked pressure rise. Position upright, start one-to-two-minute monitoring, summon help, and check for an obvious catheter obstruction. If systolic pressure reaches 150 mm Hg, alert the clinician to the medication threshold before catheter manipulation.

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After five minutes supine, pressure is 136/78 mm Hg. At one minute standing it is 112/70 with dizziness. Recognize an abnormal response from the systolic decrease and symptoms, and protect the patient from falling during assessment.

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A heel lesion caused by pressure has a shallow, moist pink bed with exposed dermis and no visible fat or slough. Identify the findings as compatible with Stage 2 rather than classifying depth from wound diameter alone.

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One pressure wound has visible adipose, an assessable depth, and no exposed or directly palpable fascia, muscle, tendon, ligament, cartilage, or bone: classify it as Stage 3. Another is covered by thick eschar that prevents confirmation of depth: classify it as unstageable. Directly palpable tendon would establish Stage 4 even without visible tendon.

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After prolonged heel loading, a patient has intact skin with a persistent maroon area. Recognize possible deep tissue pressure injury and address pressure exposure rather than waiting for an open wound before acknowledging clinically important tissue damage.

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During exercise, an adult patient becomes shaky and has glucose of 62 mg/dL but remains alert and can swallow. Stop activity, provide 15 grams of rapid carbohydrate, and recheck after 15 minutes. Repeat treatment and reassessment if glucose remains below 70 mg/dL.

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A patient using insulin completes a longer-than-usual afternoon exercise session with no symptoms. Review the possibility of later low glucose and the patient's monitoring and treatment plan instead of limiting education to what happened during the supervised session.

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A patient scheduled for back therapy reports several hours of upper-right abdominal pain with fever and yellowing eyes. Defer the planned exercises and arrange prompt medical assessment rather than testing whether stretching reduces the reported discomfort.

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A patient leaks during coughing and also sometimes leaks while rushing to the toilet after a sudden urge. Identify a mixed symptom pattern and investigate both components rather than documenting the problem solely as exercise-related stress leakage.

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A patient with stage II breast cancer-related arm lymphedema is entering a volume-reduction phase. Plan compression bandaging and exercise within comprehensive care, then reassess volume stability before transitioning to a maintenance garment and self-management approach.

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A patient with stable arm lymphedema arrives with new painful redness and fever. Pause the usual session and arrange prompt medical assessment for possible infection rather than increasing massage or compression solely because the arm appears more swollen.

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A patient with diabetes and elevated HbA1c develops progressive loss of active and passive shoulder motion. Assess for adhesive capsulitis, begin appropriate shoulder care, and coordinate glucose-control review with the medical clinician alongside the rehabilitation plan.

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A patient receiving long-term systemic glucocorticoids begins rehabilitation for reduced mobility. Review fracture history and available bone-health information, incorporate relevant findings into activity planning, and communicate unresolved bone-risk concerns to the clinician managing the underlying medical condition.

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A patient taking a beta blocker and insulin reports shakiness during walking despite a pulse below the old target. Stop and assess the possible low-glucose episode rather than increasing speed because the heart-rate goal has not been reached.

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A patient with painful right hip osteoarthritis holds a cane in the right hand. Trial the cane in the left hand, teach coordinated advancement with the right leg, and assess comfort and stability during the walking task.

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A patient pulls on a walker to rise and later rests body weight on crutch pads during training. Teach chair-supported rising and hand-supported crutch loading, then observe repeated performance to confirm safe technique before independent use of either device.

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A patient with a Micra transcatheter pacemaker is referred for shortwave diathermy to the hip. Identify the device warning and select another appropriate intervention rather than attempting treatment because the target area is distant from the heart.

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A patient with a Guardian system asks about home TENS. Explain the damage warning and involve the responsible physician and device team rather than providing an electrode-placement workaround for unsupervised use.

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After removing gloves used for wound care, a therapist plans to assist a different patient with gait training. Perform hand hygiene before the next contact rather than assuming that wearing gloves kept the hands clean throughout the prior task.

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During a home visit, a patient catches a walker near a loose rug and an electrical cord crossing the route to the bathroom. Address the route hazards and observe the walking task again after the environment is improved.

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A patient who previously agreed to treatment declines a newly proposed intervention after discussion. Respect the decision, clarify remaining questions without coercion, discuss acceptable alternatives, and document the conversation and resulting plan rather than proceeding from the earlier signature.

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A hypothetical outcome measure has a minimal detectable change of 5 points. A 3-point improvement does not exceed that error threshold, although the patient may still report benefit. Examine both measurement uncertainty and clinical importance.

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Over one year, falls occur in 30 of 100 comparator participants and 20 of 100 intervention participants. Calculate an absolute risk reduction of 0.10, or 10 percentage points, for that outcome and follow-up period.

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An intervention reduces an undesirable outcome from 18 percent to 12 percent over six months. The absolute reduction is 0.06, giving 16.67; report an NNT of 17 people over six months after rounding upward.

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For experiencing a fall, a study reports a risk ratio of 0.82 with a 95 percent confidence interval from 0.60 to 1.12. The point estimate favors fewer falls, but the interval includes equal risk and a possible increase in fall risk.