FSBPT NPTE-PT Exam Questions

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21.

Use the following scenario to answer this question. 

Based on the patient's presentation, of the following is the BEST action for the therapist to take?

  • Refer the patient for radiographs

  • Perform manual therapy only

  • Perform therapeutic exercise only

  • Perform TENS only

Correct answer: Refer the patient for radiographs

Humeral neck fractures are a type of humeral fracture that typically occur with a fall onto an outstretched upper extremity. This type of fracture is more likely to occur among older women with a history of osteoporosis. Because the patient experienced a fall consistent with this mechanism of injury and has a history of osteoporosis, a fracture is more likely and indicates the need for radiographs.

If a patient with a high likelihood of a fracture is being evaluated by a physical therapist, treatments such as manual therapy, exercise, and modalities are not recommended yet.

22.

A physical therapist is providing treatment to a 52-year-old female patient with chronic low back pain. Based on this information alone, which of the following intervention approaches is MOST appropriate?

  • Strength training and pain neuroscience education

  • Soft tissue mobilization and lumbar spine manipulation

  • Transcutaneous neuromuscular electrical stimulation and heat

  • Education on exercise and the importance of staying active

Correct answer: Strength training and pain neuroscience education

Low back pain is treated differently according to the specific needs of the patient and the chronicity of their condition. Current clinical practice guidelines for the treatment of chronic low back pain are as follows:

  • Physical therapists may use standard educational strategies related to exercise and staying active but not as a stand-alone treatment.
  • Physical therapists should provide pain neuroscience education alongside exercise or manual therapy.
  • Physical therapists should use active treatments, such as stretching and strength training, instead of stand-alone educational interventions.

Because this patient has chronic low back pain, a combination of active treatments and pain neuroscience education is the most appropriate strategy.

Soft tissue mobilization and lumbar spine manipulation may be effective but not in isolation. Transcutaneous neuromuscular electrical stimulation (TENS) and heat are not recommended for the treatment of chronic low back pain. Standard education on education and staying active may be included in treatment.

23.

A physical therapist is performing an evaluation with a patient in an outpatient facility for new-onset left upper extremity symptoms. During the physical exam, the therapist palpates the radial pulse of the patient's left arm, has the patient rotate their head to their left side, and then extends and externally rotates the patient's shoulder while the patient extends their neck.

Which of the following tests is being performed?

  • Adson's test

  • Roos elevated arm test

  • Compression-rotation test

  • Speed's test

Correct answer: Adson's test

Special tests of the upper extremity help identify whether a patient has a particular condition. Thoracic outlet syndrome can be assessed using Adson's test and Roos elevated arm test. Adson's test is performed with the patient sitting. Once the patient's radial pulse of the extremity being tested is palpated, the patient rotates their head toward the extremity being tested, then extends their head while their shoulder is being extended and externally rotated. 

Roos elevated arm test is performed with the patient standing and does not assess the patient's pulse. The compression-rotation test and Speed's test are used to identify superior labrum anterior to posterior (SLAP) lesions and bicipital tendon pathology.

24.

You are a physical therapist performing an evaluation on a patient for left hip weakness in an outpatient facility. During the examination, you have the patient perform resisted left knee extension. Which of the following myotomes is being tested?

  • L3

  • L2

  • L5

  • S1

Correct answer: L3

A myotome is a group of muscles that are innervated by a single spinal segment. Myotome or key muscle testing is performed by assessing the motor function of a muscle that is primarily innervated by a given spinal segment. Testing of resisted knee extension emphasizes the quadriceps muscle and the L3 myotome.

Testing of resisted hip flexion in isolation or in combination with abduction and lateral rotation emphasizes the psoas major or sartorius muscles and the L2 myotome. Testing of great toe MTP extension emphasizes the extensor hallucis longus muscle and the L5 myotome. Testing of foot eversion emphasizes the fibularis muscles and the S1 myotome.

25.

A physical therapist is performing an evaluation on a patient with left shoulder pain. During the physical examination, the therapist observes a taut, palpable band along the patient's upper trapezius muscle that does not cause pain when pressure is applied. 

What is the correct description of this finding?

  • Latent trigger point

  • Active trigger point

  • Tendinopathy

  • Bursitis

Correct answer: Latent trigger point

Myofascial pain syndrome is a condition characterized by a clinical entity known as a trigger point. Trigger points can be active or latent. An active trigger point has a characteristic pattern of pain when palpated, while a latent trigger point is not tender to palpation. 

Active trigger points are painful when provoked by palpation, not latent trigger points. Tendinopathy and bursitis are both common musculoskeletal conditions that a therapist may observe, but neither of these conditions presents as a taut, palpable band within a muscle.

26.

Use the following scenario to answer the question.

Which of the following BEST describes the patient's heart failure?

  • Right ventricular failure

  • Left ventricular failure

  • Biventricular failure

  • Myocardial infarction

Correct answer: Right ventricular failure

Heart failure is a clinical syndrome in which the heart cannot maintain adequate blood circulation to meet the body's metabolic needs. Types include left-sided heart failure (congestive heart failure), right-sided heart failure, and biventricular failure. Possible clinical manifestations of low cardiac output related to right ventricular failure include anorexia, nausea, bloating, cyanosis, right upper quadrant pain, jugular vein distension, right-sided S3 sounds, and murmurs of pulmonary or tricuspid insufficiency. Given the patient's presentation including weight loss, jugular vein distension, and right-sided S3 sounds, right ventricular failure is the most appropriate option provided.

Left ventricular failure may manifest as dyspnea, dry coughing, orthopnea, paroxysmal nocturnal dyspnea, tachycardia, fatigue, and murmurs of mitral or tricuspid regurgitation. Biventricular failure involves severe left ventricular pathology that increases pulmonary artery pressure and ultimately leads to right ventricular signs of heart failure. Myocardial infarction is a separate condition characterized by prolonged ischemia, injury, and death of the myocardium.

27.

A physical therapist is providing treatment to a 12-year-old patient in a hospital with acute flaccid myelitis. During the treatment session, which of the following complications is the GREATEST concern?

  • Respiratory failure

  • Seizures

  • Stroke

  • Encephalitis

Correct answer: Respiratory failure

Acute flaccid myelitis is a rare polio-like condition that affects the motor neurons in the gray matter of the spinal cord, causing the muscles and reflexes to become weak. This condition occurs mainly in children. Symptoms of acute flaccid myelitis include the sudden onset of arm or leg weakness, loss of muscle tone, and loss of reflexes. In some cases, facial drooping, difficulty with speech, and bowel/bladder difficulties may occur. Severe symptoms can include respiratory failure requiring ventilator support.

Seizures and stroke may occur with other conditions such as meningitis but are not typical complications of acute flaccid myelitis. Encephalitis is typically caused by an infection.

28.

You are a physical therapist providing treatment to a 55-year-old female patient in the hospital with stage III liver cancer. The patient wants to improve her physical health, reduce anxiety, and alleviate depression. During the treatment session, what aerobic exercise parameters will be MOST appropriate for this patient?

  • 30-60 minutes at moderate to vigorous intensity

  • 30 minutes at moderate intensity

  • 60-90 minutes at vigorous intensity

  • 15 minutes at low intensity

Correct answer: 30-60 minutes at moderate to vigorous intensity

Aerobic exercise prescriptions should be individualized according to the patient's condition and current status. For patients with a current or past history of cancer, the following aerobic prescription guidelines should be followed:

  • For patients with cancer-related fatigue: 30-minute sessions at moderate intensity, 3 times per week
  • For patients with the goal of improving health-related quality of life: 30- to 60-minute sessions at moderate to vigorous intensity
  • For patients with the goal of improving physical function, anxiety, and depression: 30- to 60-minute sessions at moderate to vigorous activity
  • For patients with the goal of improving sleep: 30- to 40-minute sessions at moderate intensity

29.

You are assessing a patient in the hospital admitted for heart arrhythmias. To treat the arrhythmias, the patient has been put on a medication regimen to adjust their blood ion concentrations. During your assessment, you notice prolonged QT intervals on the patient's ECG. Which of these options is the MOST likely cause?

  • Hypocalcemia

  • Hypercalcemia

  • Hypokalemia

  • Hyperkalemia

Correct answer: Hypocalcemia

Hypocalcemia can cause depressed heart actions. This condition is characterized by a decrease in the blood’s calcium ion concentration. Calcium has a direct effect on the contractile process of the cardiac muscle, so low calcium levels would decrease heart actions. On the ECG, it displays prolonged QT intervals. Given the patient's history, it is possible that their physician is adjusting for increased calcium ion concentrations, which may have caused hypocalcemia.

Hypercalcemia can cause increased heart actions. Hypokalemia, hypermagnesemia, and hypomagnesemia can cause arrhythmias. Hyperkalemia can also produce ECG changes such as widened PR intervals and QRS or, tall T waves.

30.

Use the following scenario to answer this question.

Which of the following is MOST appropriate regarding the patient's ongoing exercise program if a new infection is present?

  • It should be reduced from moderate to mild intensity

  • It should be reduced from high to moderate intensity

  • It should remain at the same level of intensity

  • Exercise is contraindicated

Correct answer: It should be reduced from moderate to mild intensity

AIDS is a condition caused by the HIV-1 or HIV-2 virus that weakens the immune system, resulting in a decreased ability to fight infection and progressive neurological complications. An exercise program for patients who have AIDS is recommended to be of moderate intensity focusing on both aerobic and resistance training. When a new opportunistic infection is present, the patient's exercise program should be reduced to mild intensity.

High-intensity exercise is not as recommended for patients with AIDS as moderate-intensity exercise, so reducing a program from moderate to mild is more likely.

31.

While assessing a patient's medical records, the examiner notices that the patient is taking diltiazem, which is a calcium channel blocker. Of the following options, which is the MOST likely scenario for this?

  • A 45-year-old patient with a resting heart rate of 120 beats per minute

  • A 30-year-old patient with an LDL cholesterol reading of 200 mg/dL

  • A 70-year-old patient with a resting heart rate of 90 beats per minute

  • A 45-year-old patient with a resting heart rate of 40 beats per minute

Correct answer: A 45-year-old patient with a resting heart rate of 120 beats per minute

Calcium channel blockers are used to:

  • Decrease heart rate
  • Dilate coronary arteries
  • Reduce blood pressure
  • Inhibit the flow of calcium ions
  • Decrease contractility
  • Control arrhythmias

Because the patient is demonstrating a significantly elevated heart rate at rest, a calcium channel blocker may be used to reduce heart rate.

A 70-year-old patient with a resting heart rate of 90 beats per minute would be considered normal. A patient with a resting heart rate of 40 beats per minute would be considered borderline low, and using medication to lower heart rate would not be indicated. Calcium channel blockers are not used to regulate blood lipids.

32.

Use the following scenario to answer the question.

During the treatment session, the physical therapist decides to perform manual lymphatic drainage of the patient's right lower extremity. Which of the following techniques is MOST appropriate?

  • Proximal segments first

  • Distal segments first

  • Very high pressure

  • Moderate pressure

Correct answer: Proximal segments first

Lymphedema is a chronic disorder characterized by excessive accumulation of lymph fluid due to mechanical insufficiency of the lymphatic system. Lymphedema can be primary (congenital) or secondary (acquired). Manual lymphatic drainage (MDL) is a component of complete decongestive therapy (CDT) where the emphasis is placed on using very low-pressure strokes and decongesting proximal segments first. 

Beginning MDL with distal segments first is not recommended. MDL should be performed with very light pressure, not moderate or very high pressure.

33.

A physical therapist is providing treatment to a patient with left elbow pain. During the session, the physical therapist prepares the patient's left proximal radioulnar joint for mobilization.

Of the following, what is the MOST appropriate position to perform this treatment?

  • 70 degrees of flexion and 35 degrees of supination

  • 10 degrees of supination

  • Five degrees of supination

  • 15 degrees of supination

Correct answer: 70 degrees of flexion and 35 degrees of supination

In order to place the patient’s proximal radioulnar forearm joint in a resting position, the patient’s proximal radioulnar forearm joint will need to be positioned using 70 degrees of flexion and 35 degrees of supination.

The distal radioulnar forearm joint is in a resting position if it is positioned using 10 degrees of supination. The elbow's humeroulnar joint is in a resting position if it is positioned using 70 degrees of flexion and 10 degrees of supination. The proximal and distal radioulnar forearm joints are in a close-packed position if they are positioned using five degrees of supination.

34.

A physical therapist is conducting research to evaluate the relationship between spinal curvature and lower back pain. During the study, the therapist observes radiographs of the research subjects' lumbar spines and analyzes the data alongside the results of pain questionnaires filled out by the subjects. 

In this study, what is MOST likely to be the dependent variable?

  • Pain rating

  • Spinal curvature

  • Both pain rating and spinal curvature

  • Neither pain rating nor spinal curvature

Correct answer: Pain rating

Regarding observations during research, it is typical to have both independent and dependent variables that are assessed to evaluate their relationship. An independent variable stands alone and isn't changed by any other variables being measured. A dependent variable is being studied and measured according to changes in the independent variable. In this example, the independent variable is spinal curvature, and the dependent variable is a subject's pain rating.

Spinal curvature is the independent variable in this example, not the dependent variable. Pain rating is the independent variable, so it must be included in the answer.

35.

While working with a 65-year-old male patient admitted for cardiac rehabilitation, the hospitalist approaches you and expresses that they are concerned about the patient's recent echocardiogram findings because they indicate a compromised ejection fraction. Which of the following test results would be the MOST concerning?

  • 35%

  • 40%

  • 50%

  • 60%

Correct answer: 35%

Ejection fraction is the percentage of blood emptied from the ventricle during systole, which is a clinically useful measure of LV function. Normal ejection fraction is >55% and anything below 40% indicates heart failure.

Although 40% and 50% would also be clinically significant test results, they do not indicate the potential of heart failure as significantly as 35%. An ejection fraction of 60% would be considered normal in this case.

36.

A physical therapist is providing exercise treatment for a 60-year-old male patient in a skilled nursing facility who has limited exercise endurance. The patient has a relatively low VO2 max, and the therapist is planning to focus on training the patient's heart rate. 

Which of the following exercises will be MOST appropriate for the patient?

  • Arm ergometry

  • Leg ergometry

  • Swimming

  • Outdoor cycling

Correct answer: Arm ergometry

Various exercise types have different implications for the patient performing them. Dynamic arm exercise (arm ergometry) uses a smaller muscle mass and therefore results in a 60-70% lower VO2 max compared to leg ergometry. Because this patient has a lower VO2 max but the therapist is focusing on heart rate, this method of exercise will be the most appropriate.

Leg ergometry requires a higher VO2 max for the same heart rate training compared to arm ergometry. Swimming would not be a practical or accessible form of exercise in this setting. Outdoor cycling would not be a practical or accessible form of exercise in this setting and would also require a higher VO2 max.

37.

A physical therapist is preparing to see a patient in a subacute rehabilitation facility who has a history of stage I hypertension but is not at a high risk for heart attack or stroke. What is the MOST accurate advice to give the patient regarding managing their blood pressure through lifestyle changes?

  • Limit alcohol

  • Use antihypertensive medication

  • Stop exercising

  • Use antiarrhythmic medication

Correct answer: Limit alcohol

Individuals without high risk are advised to improve their lifestyles through weight loss, eating healthily, exercising more, limiting alcohol, and avoiding smoking.

Medications are prescribed for stage I hypertension if a patient has already had a heart attack or stroke or is at a high risk of heart attack or stroke in the presence of diabetes, chronic kidney disease, or atherosclerotic risk. Stopping exercise would not be recommended for a patient with stage I hypertension who is not at high risk for heart attack or stroke.

38.

You have been monitoring your patient's blood pressure at each treatment visit and you are concerned they may be classified as having Hypertension Stage 1, so you refer them to their physician. Of the following options, which reading would MOST likely give you this impression?

  • 130/75 mmHg

  • 125/70 mmHg

  • 135/95 mmHg

  • 115/120 mmHg

Correct answer: 130/75 mmHg

The American Heart Association suggests that an individual's blood pressure is categorized as Hypertension Stage 1 when the individual's systolic reading is between 130-139 OR their diastolic reading is between 80-89.

Blood Pressure CategorySystolic BP mmHg Diastolic BP mmHg
Normal<120AND<80
Elevated120-129AND<80
Hypertension Stage 1130-139OR80-89
Hypertension Stage 2≥140OR≥90
Hypertensive Crisis≥180AND/OR≥120

39.

A physical therapist is performing an evaluation on a patient with new-onset left leg pain and paresthesia. During the physical exam, the therapist observes reduced sensation in the patient's left dorsum of the foot, just proximal to the patient's third and fourth digits.

Based on this information, which of the following dermatomes is MOST likely involved?

  • L5

  • L4

  • S1

  • L3

Correct answer: L5

The term dermatome refers to a specific segmental skin area innervated by spinal sensory axons. The L5 dermatome covers the lateral and posterior thigh, anterior leg, and dorsum of the foot. 

The L4 dermatome covers much of the lateral and distal anterior thigh, medial leg, and medial foot. The L3 dermatome covers the proximal and anterior thigh, medial thigh, and proximal medial leg. The S1 dermatome covers the posterior lateral thigh and leg, as well as the lateral foot.

40.

Physical therapy has been ordered for a patient recently admitted to the inpatient unit for symptoms of a restrictive lung disorder. Without knowing the patient's specific symptoms, which of the following is the patient's MOST likely diagnosis?

  • Idiopathic pulmonary fibrosis

  • Bronchiectasis

  • Bronchopulmonary dysplasia

  • Respiratory distress syndrome

Correct answer: Idiopathic pulmonary fibrosis

Idiopathic pulmonary fibrosis is a type of interstitial lung disease and is classified as a restrictive disorder. This condition is characterized by chronic, progressive, fibrotic pneumonia that causes irreversible scarring of lung tissue.

All of the remaining options are obstructive disorders. Bronchiectasis is a chronic congenital or acquired disease, characterized by abnormal dilation of the bronchi and the excessive production of sputum. Bronchopulmonary dysplasia results from high pressures of mechanical ventilation, high fractions of inspired oxygen, and/or infection. Respiratory distress syndrome is an alveolar collapse in a premature infant resulting from lung immaturity.