FSBPT NPTE-PT Exam Questions

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61.

A physical therapist is performing an evaluation on a patient who has a suspected CN VIII injury. Which of the following abnormal findings is MOST likely?

  • Vertigo

  • Facial paralysis

  • Lateral strabismus

  • Medial strabismus

Correct answer: Vertigo

Each pair of cranial nerves is associated with a set of functions and potential abnormal findings when dysfunction is present. The vestibulocochlear nerve (CN VIII) is primarily involved in vestibular function, eye-head coordination, and cochlear function. When dysfunction of CN VIII is present, vertigo, dysequilibrium, gaze instability, deafness, and conductive loss may occur.

Facial paralysis is more likely with injury to the facial and trigeminal nerves (CN VII, CN V). Lateral and medial strabismus are likely abnormal findings when there is dysfunction of the cranial nerves responsible for eye movement, such as the oculomotor, trochlear, and abducens (CN III, CN IV, CN VI).

62.

A physical therapist determines that a patient needs a spinal orthosis to control spinal movement in order to manage scoliosis.

Which of the following spinal orthoses would the physical therapist MOST LIKELY recommend?

  • Thoracolumbosacral Orthosis (TLSO)

  • Corset

  • Lumbosacral Orthosis (LSO)

  • Rigid-halo orthosis

Correct answer: Thoracolumbosacral Orthosis (TLSO)

A Thoracolumbosacral Orthosis (TLSO) controls thoracic and lumbosacral motions. It is commonly used for postop protection, stable vertebral fracture, and scoliosis. When used for scoliosis, it is used in conjunction with a thoracic pad to counter the spinal curve. The TLSO is typically made from a rigid material with padding on the inside to protect the patient's skin. It is intended to prevent all spinal motions in the thoracic, lumbar, and sacral regions.

A Lumbosacral Orthosis (LSO) controls lumbosacral motion. A corset provides abdominal compression and relieves pain in the lower back. A rigid-halo (four-poster) orthosis is a type of cervical orthosis that controls neck movement.

63.

A physical therapist is providing treatment to a patient in the hospital with an active COVID-19 infection. In order to comply with airborne precautions, which item of face protection equipment is MOST appropriate for the therapist to wear?

  • N95

  • Surgical mask

  • Face shield

  • Cloth mask

Correct answer: N95

Infection control procedures must be followed in order to prevent the spread of infection between patients and healthcare providers. Airborne precautions are necessary for patients with known or suspected infections involving pathogens that may be transmitted through the air, such as COVID-19. To comply with airborne precautions, healthcare providers must wear PPE, including a high-level respirator that is NIOSH-approved and graded N95 or higher.

Cloth masks, surgical masks, and face shields are not considered adequate for airborne precautions.

64.

A physical therapist plans to utilize a Continuous Passive Motion (CPM) unit on a patient's surgical knee. Before setting up the device, the therapist must be aware of the contraindications for the use of a CPM unit. Which of the following is a contraindication?

  • Postoperative management of total knee replacement

  • Fracture repair

  • Ligament repair

  • Tendon repair

Correct answer: Postoperative management of total knee replacement

Continuous Passive Motion (CPM) is strongly contraindicated for the postoperative management of patients following uncomplicated total knee replacement. The therapist must be fully knowledgeable about the patient's current medical condition in order to make safe clinical decisions.

CPM may be used for post-immobilization fracture, tendon, or ligament repair.

65.

A physical therapist is performing an evaluation on a patient who is in a coma. During the evaluation, the therapist observes sustained posturing of the patient's upper limbs in flexion and lower limbs in extension. 

Which of the following BEST describes this observation?

  • Decorticate posturing

  • Decerebrate posturing

  • Opisthotonos

  • Grade 3 spasticity

Correct answer: Decorticate posturing

Decorticate posturing is a form of rigidity seen in comatose patients with brainstem lesions above the superior colliculus. This form of rigidity results in increased tone and sustained posturing of the patient's upper limbs in flexion and lower limbs in extension. 

Decerebrate posturing describes increased tone and sustained posturing with the rigid extension of all four limbs, the trunk, and the neck. Opisthotonos is characterized by prolonged and severe spasms of muscles, causing the head, back, and heels to arch backward while the arms and hands are held in flexion. Grade 3 spasticity is a velocity-dependent symptom that may occur in various body regions.

66.

A physical therapist is performing an evaluation on a 40-year-old male patient who recently experienced a fall on his thigh. The patient experienced a hematoma with calcification of the muscle. 

Which of the following is MOST appropriate for this patient?

  • Gentle soft tissue and massage techniques

  • Aggressive soft tissue and massage techniques

  • Deep stretching with overpressure

  • Plyometric training

Correct answer: Gentle soft tissue and massage techniques

Myositis ossificans is abnormal calcification within a muscle belly. This condition is caused by direct trauma that results in a hematoma and subsequent calcification of the muscle. Physical therapy interventions for this condition should focus on soft tissue/massage techniques, joint oscillations, and low-impact flexibility exercises.

Aggressive manual therapy, stretching, and conditioning exercises are not recommended for patients with myositis ossificans because they can worsen the condition.

67.

A physical therapist is providing treatment to a 70-year-old male patient for hand osteoarthritis. During the session, the therapist prepares a paraffin bath for the patient's hand. Which mixture of paraffin wax and mineral oil is MOST appropriate?

  • 6 parts paraffin to 1 part mineral oil

  • 5 parts paraffin to 1 part mineral oil

  • 6 parts paraffin to 2 parts mineral oil

  • 1 part paraffin to 1 part mineral oil

Correct answer: 6 parts paraffin to 1 part mineral oil

A paraffin bath is a therapeutic application of liquid paraffin to a body part to transmit heat. The paraffin bath is composed of a mixture of paraffin wax and mineral oil in a 6:1 or 7:1 ratio. A paraffin bath is indicated for painful joints due to arthritis or other conditions and is most often used on the wrists and hands.

68.

Use the following scenario to answer this question. 

Which of the following is the BEST description of the patient's gait pattern?

  • Trendelenburg sign

  • Radiculopathy

  • Herniated disc

  • Lhermitte's sign

Correct answer: Trendelenburg sign

The Trendelenburg sign is a movement pattern observed during a single-leg stance or gait when a patient's stance hip elevates. This sign indicates weakness of the gluteus medius muscle or instability of the stance limb, which results in the dropping of the contralateral pelvis and relative elevation of the ipsilateral pelvis. 

Radiculopathy refers to weakness or paresthesia due to pathology of a nerve root, which is not identified purely based on observation of gait. Herniated discs may cause radiculopathy or pain but cannot be diagnosed purely on gait analysis. Lhermitte's sign refers to electrical pain down the spine with passive flexion of the cervical spine and hip.

69.

You are a home health physical therapist assessing a geriatric patient with poor balance. The patient has difficulty walking and is at a high fall risk. You decide to use the Berg Balance Scale in your evaluation.

Which of the following statements is true about the Berg Balance Scale?

  •  It examines sitting/standing balance.

  • It has a 0%-100% scale.

  • It is reported as meters/second.

  • Items are scaled using an ordinal scale, with a total possible score of 30.

Correct answer: It examines sitting/standing balance.

The Berg Balance Scale examines sitting/standing balance.

The Activities-Specific Balance Confidence (ABC) Scale has a 0%-100% scale. The 10 Meter Comfortable/Fast Gait Speed test is reported as meters/second. With the Functional Gait Assessment (FGA), items are scaled using an ordinal scale, with a total possible score of 30.

70.

A physical therapist is performing an evaluation on a 30-year-old male patient who is experiencing progressive back pain. The patient began experiencing mid and lower back pain three months ago and their primary complaint is morning stiffness with new-onset sacroiliac pain. During the physical exam, the therapist observes mild kyphotic deformity of the patient's cervical and thoracic spine with decreased lumbar lordosis. 

What is the MOST likely explanation for these findings?

  • Ankylosing spondylitis

  • SIJ dysfunction

  • Osteoarthritis

  • Spondylolisthesis

Correct answer: Ankylosing spondylitis

Ankylosing spondylitis is a progressive inflammatory disorder of unknown etiology that initially affects the axial skeleton. The onset of this condition typically involves mid and lower back pain for three months or longer before age 40, affecting men three times more often than women. Symptoms of this condition may also include morning stiffness and sacroiliitis, and kyphotic deformity of the cervical and thoracic spine are typical. 

SIJ dysfunction may account for the sacral pain this patient is experiencing but not the other symptoms. Osteoarthritis is a possible condition in this scenario, although it is not as likely as ankylosing spondylitis. Spondylolisthesis may result in persistent lower back pain but is not as likely to result in spinal deformity as ankylosing spondylitis does.

71.

Use the following scenario to answer this question.

During the patient's treatment session, which of the following positions is MOST appropriate?

  • Sitting upright

  • Sitting at a 45-degree angle

  • Lying supine

  • Lying prone

Correct answer: Sitting upright

Gastroesophageal reflux disease (GERD) is a condition caused by the reflux of gastric contents into the esophagus, which produces heartburn. Symptoms of GERD are often worsened by supine or declined positioning, jumping, and certain foods. A physical therapist can utilize positional changes to minimize symptoms of GERD during treatment, as more upright positions are indicated. Because sitting upright is the least reclined or declined position, it is the correct option.

Sitting at a 45-degree angle, lying supine, and lying prone are more likely to exacerbate symptoms of GERD than sitting upright.

72.

You are evaluating a patient in the intensive care unit and the medical chart states that the patient is recovering from a pneumonectomy. What was done during this procedure?

  • A lung was removed

  • A portion of the lung containing anatomical divisions was removed

  • A segment of a lobe was removed

  • A portion of the lung, which does not contain anatomical divisions, was removed

Correct answer: A lung was removed

A pneumonectomy is a procedure that involves the removal of a lung. If a patient has had a pneumonectomy, then they have had a lung removed.

If a patient has had a lobectomy, then they have had a lobe of the lung removed. If a patient has had a segmental resection, then they have had a segment of a lobe removed. If a patient has had a wedge resection, then they have had a portion of the lung, which does not contain anatomical divisions, removed.

73.

A physical therapist is providing treatment to a patient in a skilled nursing facility who is recovering from a stroke. During the treatment session, the patient demonstrates increasing voluntary control out of synergy, although clear coordination deficits are still present.

 Which stage of recovery do these findings represent?

  • Stage 5

  • Stage 4

  • Stage 3

  • Stage 6

Correct answer: Stage 5

Patients recovering from a stroke may go through sequential recovery stages as follows:

  • Stage 1: Initial flaccidity, no voluntary movement
  • Stage 2: Emergence of spasticity, hyperreflexia, and synergies
  • Stage 3: Voluntary movement possible but only in synergies, spasticity strong
  • Stage 4: Voluntary control in isolated joint movements emerging alongside the decline of spasticity and synergies
  • Stage 5: Increasing voluntary control out of synergy, although coordination deficits are present
  • Stage 6: Control and coordination are near normal

Because the patient demonstrates increasing voluntary control out of synergy with coordination deficits still present, stage 5 is the most likely option provided.

74.

A patient with obesity is recovering from a mild myocardial infarction and is being treated for cardiovascular conditioning in an outpatient setting. This exercise is being coupled with nutritional education at a specialty bariatric clinic. Today is their first session.

What is the MOST appropriate exercise protocol for this patient?

  • Walking over even surfaces at 50% target heart rate

  • Jogging on a treadmill for 15 minutes while monitoring heart rate

  • Walking over uneven surfaces with intensity at 75% target heart rate

  • Exercise no more than twice a week

Correct answer: Walking over even surfaces at 50% target heart rate

Patients with obesity typically have lower levels of physical conditioning and aerobic capacity. The initial exercises should focus on lower-intensity exercise activity with progressing exercise duration.

Higher intensity exercise, at 75% or higher target heart rate, should be avoided initially, especially after myocardial infarction. This patient should perform safe and appropriate exercises five to seven times per week.

75.

A physical therapist is performing an evaluation on a patient who experienced a fall on an outstretched hand two days prior. During the physical examination, the therapist observes a garden spade deformity of the patient's wrist and hand. 

Based on this information, which type of fracture is MOST likely?

  • Smith's fracture

  • Colles' fracture

  • Scaphoid fracture

  • Jones fracture

Correct answer: Smith's fracture

A Smith's fracture happens when the distal fragment of the radius dislocates in a volar direction. This fracture is similar to a Colles' fracture, except the direction of dislocation causes a characteristic "garden spade" deformity. Based on the patient's presentation, this is the most likely type of fracture.

A Colles' fracture is identified by a characteristic "dinner fork" deformity. A scaphoid fracture is not identified through observation of a garden spade deformity. A Jones fracture occurs in the foot, not the wrist or hand.

76.

A physical therapist is performing an evaluation on a patient for right hip pain in an outpatient facility. During the examination, the physical therapist performs manual muscle testing of the patient's right hip abductors. Which of the following muscle substitutions is MOST likely?

  • Tensor fascia latae

  • Quadriceps

  • Quadratus lumborum

  • Lower obliques

Correct answer: Tensor fascia latae

Muscle substitutions occur when muscles have become shortened, lengthened, or weakened; lost endurance; developed impaired coordination; or become paralyzed. As a result of muscle impairment, stronger muscles compensate for loss of motion. When the hip abductors are weak, the tensor fascia latae (TFL) muscle or lateral trunk muscles will substitute for hip abduction.

The lower obliques and quadriceps muscles (specifically the rectus femoris muscle) are involved in the substitution of hip flexion, not hip abduction. The quadratus lumborum muscle is involved in the substitution of hip extension when the hip extensors are weak.

77.

A physical therapist is performing an evaluation on a 60-year-old patient who is experiencing knee pain following a fall directly onto their left knee two days prior. The patient does not have isolated patellar tenderness or tenderness of the fibular head and was able to bear weight immediately after the injury.

Based on this information, what is the MOST appropriate course of action for the therapist to take?

  • Refer the patient for a knee X-ray series

  • Refer the patient for a knee MRI

  • Imaging is not required; continue treatment as usual

  • Arrange more tests to determine if imaging is required

Correct answer: Refer the patient for a knee X-ray series

The Ottawa knee rules are a series of guidelines used to determine whether a patient requires a knee X-ray series following a knee injury. A knee X-ray series is required if a patient with a knee injury also has any of the following:

  • Age 55 years or older
  • Isolated patellar tenderness without other bone tenderness
  • Tenderness of the fibular head
  • Inability to flex the knee to 90 degrees
  • Inability to bear weight immediately after injury

Since this patient is older than age 55, a knee X-ray series is required.

A knee MRI is not recommended based on this patient's presentation and the Ottawa knee rules. More special tests may be used but would not change the fact that imaging is required.

78.

A physical therapist is performing an evaluation on a patient who was recently involved in a high-speed MVA. During the physical examination, the therapist observes a reversal of lower cervical lordosis and a decrease in upper cervical kyphosis. 

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

  • Whiplash-associated disorder

  • Facet entrapment

  • Central posterior disc bulge

  • Degenerative joint disease

Correct answer: Whiplash-associated disorder

Whiplash-associated disorder (WAD) occurs when excess shear and tensile forces are exerted on cervical structures such as facets, capsules, ligaments, muscles, and discs. Early signs and symptoms of WAD include headaches, neck pain, limited flexibility, reversal of lower cervical lordosis and decreased upper cervical kyphosis, vertigo, change in vision and hearing, irritability to noise and light, dysesthesias, nausea, difficulty swallowing, and emotional lability. 

Facet entrapment is characterized by flexion preference due to capsule distension. A central posterior disc bulge is characterized by loss of strength, radicular pain, and paresthesia of the extremities. Degenerative joint disease is characterized by a progressive reduction in mobility of the spine and is not typically associated with an acute injury.

79.

You are preparing to see a 54-year-old male patient in the hospital who has recently been admitted for the progression of chronic kidney disease. During chart review, you note new test results indicating dysfunction of the glomeruli in the patient's kidneys. Of the following, which function will be MOST compromised?

  • Filtration of blood

  • Drainage of the kidney into the ureter

  • Drainage of waste products from the nephron

  • Elimination of urine

Correct answer: Filtration of blood

The glomerulus is responsible for the filtration of blood. Each kidney is multi-lobular and each lobe is composed of over one million nephrons; each nephron consists of a glomerulus and nephron tubules. Nephron tubules are responsible for the reabsorption of materials and removal of waste.

The renal pelvis is responsible for the drainage of the kidney into the ureter. Waste products are secreted into nephron tubules to be eliminated. The urethra is responsible for the elimination of urine.

80.

A physical therapist is performing an evaluation on a patient in an outpatient facility for left-hand weakness. During the physical exam, the therapist plans to test for entrapment of the patient's anterior interosseous nerve. 

Which of the following instructions is correct for the patient?

  • Pinch the tips of the index finger and thumb

  • Pinch the tips of the middle finger and thumb

  • Pinch the tips of the pinky finger and thumb

  • Clench the fingers into a fist and hold firmly

Correct answer: Pinch the tips of the index finger and thumb

The pinch grip test is used to identify entrapment of the anterior interosseous nerve. The pinch grip test is performed by asking the patient to pinch the tips of their index finger and thumb together. A positive test is observed if the patient is unable to pinch tip-to-tip and instead demonstrates pulp-to-pulp pinching.

The pinch grip test is performed by pinching the tips of the index finger and thumb together, not the middle or pinky fingers. Clenching the fingers into a fist may be used as a general strength test for the hand, not for a specific peripheral nerve.