FSBPT NPTE-PT Exam Questions

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81.

A physical therapist is performing an evaluation on a patient with neck pain and stiffness following a recent traumatic injury. During the physical exam, the therapist has the patient long sit on a table and passively flex their head while flexing their hip with an extended knee. In response, the patient reports electrical pain down their spine and into both arms.

What has the physical therapist MOST likely observed?

  • Lhermitte’s sign

  • Compromised vertebrobasilar integrity

  • Atlantoaxial instability

  • Compromised transverse ligament integrity

Correct answer: Lhermitte’s sign

Lhermitte’s sign is a special cervical test that is used to identify spinal cord dysfunction. This test is also used to identify upper motor neuron lesions. The test is performed by positioning the patient in long sitting on a table, then passively flexing their head with one hip while the knee is extended. A positive result is electrical pain down the spine and into the limbs.

The vertebral artery test is used to assess vertebrobasilar integrity. The modified Sharp-Purser test is used to determine the integrity of the transverse ligament/atlantoaxial stability. The transverse ligament test is used to test transverse ligament integrity.

82.

A physical therapist is assessing a patient who was recently in a car accident. They sustained injuries to the thorax and are currently unable to exhibit a gag reflex upon testing. Which of the following cranial nerves is affected?

  • Cranial Nerve X

  • Cranial Nerve I

  • Cranial Nerve VII

  • Cranial Nerve XII

Correct answer: Cranial Nerve X

CN X (vagus) is the only cranial nerve that is not distributed to the neck and the head. CN X is distributed to the abdomen and the thorax and is responsible for the gag reflex.

CN I (olfactory), CN VII (facial), and CN XII (hypoglossal) are all distributed to the neck and the head. CN I is a sensory nerve that carries information about smell. CN VII is a mixed motor nerve that has to do with facial expression. CN XII is a pure motor nerve that controls tongue movements.

83.

A physical therapist is performing an evaluation on a 70-year-old female patient in a skilled nursing facility. During the exam, the patient can maintain balance without hand-hold support but demonstrates some postural sway.

Which of the following functional balance grades is MOST appropriate?

  • Good

  • Normal

  • Fair

  • Poor

Correct answer: Good

Functional balance grades may be used to summarize a patient's static and dynamic balance on a scale of normal to absent. A patient's functional balance is graded as good if they are:

  • Able to maintain balance without hand-hold support and demonstrate limited postural sway (static)
  • Able to accept a moderate challenge to balance while picking up objects from the floor (dynamic)

A grade of normal describes a patient who is able to maintain a steady balance without hand-hold support and no postural sway. A grade of fair describes a patient who is able to maintain balance with hand-hold support and intermittent minimal assistance. A grade of poor describes a patient who requires hand-hold support and moderate to maximal assistance to maintain their position.

84.

Use the following scenario to answer this question. 

Based on the patient's presentation, which of the following pieces of equipment is MOST likely to help manage their symptoms during work activities with their left hand?

  • Counterforce brace

  • Compression sleeve

  • Wrist splint

  • Forearm cast

Correct answer: Counterforce brace

Lateral epicondylalgia is a condition affecting the extensor carpi radialis brevis tendon at its proximal attachment to the lateral epicondyle of the humerus. With lateral epicondylalgia, reproduction of symptoms with resisted wrist extension and tenderness to palpation of the lateral epicondyle are common. For patients with lateral epicondylalgia, counterforce bracing is a technique that can be used to reduce forces along the extensor carpi radialis brevis tendon and assist in relieving symptoms during activities.

Compression sleeves are less likely to provide specific and beneficial pressure compared to a counterforce brace. A wrist splint or forearm case may be used in some cases, although these devices disable the patient from using their left hand and would not allow for relief of symptoms during work activity.

85.

A physical therapist is performing an evaluation on a patient in an outpatient clinic who has wrist pain from repetitive hand use. During the physical exam, the therapist performs Finkelstein's test to assess for de Quervain's tenosynovitis. 

Which of the following procedures is part of this test?

  • The examiner passively pulls the patient's wrist and thumb into ulnar deviation with longitudinal traction

  • The examiner passively moves the patient's wrist into ulnar deviation

  • The patient actively moves their wrist into ulnar deviation

  • The patient actively moves their wrist into radial deviation

Correct answer: The examiner passively pulls the patient's wrist and thumb into ulnar deviation with longitudinal traction

Finkelstein's test is used to identify de Quervain's tenosynovitis (tendonitis of the abductor pollicis longus and/or extensor pollicis brevis). Finkelstein's test is performed by passively pulling the patient's wrist and thumb into ulnar deviation while applying longitudinal traction. A positive test is indicated by pain reproduction in the wrist.

Eichoff's test is performed by passively moving the patient's wrist into ulnar deviation without applying longitudinal traction, not Finkelstein's test. Neither Finkelstein's test nor Eichoff's test are performed with active wrist motion from the patient.

86.

During an initial evaluation in the outpatient setting, the patient that you are working with mentions that they have had a mitral valve repair in the past. You decide to auscultate the patient's heart before initiating treatment. Where would be the MOST appropriate place to position the stethoscope?

  • Over the patient's fifth left intercostal space at the midclavicular area

  • Over the patient's second left intercostal space at the sternal border

  • Over the patient's fourth left intercostal space at the sternal border

  • Over the patient's second right intercostal space at the sternal border

Correct answer: Over the patient's fifth left intercostal space at the midclavicular area

The examiner is using this landmark to listen to the mitral valve, also known as the bicuspid valve. This is done by placing the stethoscope over the patient's fifth left intercostal space at the midclavicular area.

The auscultation landmark for the pulmonic valve is located at the second left intercostal space at the sternal border. The auscultation landmark for the tricuspid valve is located at the fourth left intercostal space at the sternal border. The auscultation landmark for the aortic valve is located at the second right intercostal space at the sternal border. There is no dicuspid valve in the heart.

87.

A patient with Parkinson's disease demonstrates deficits relating to the basal ganglia. Which of the following circuits would MOST LIKELY be affected if this patient demonstrates difficulty with saccadic eye movements?

  • Caudate loop

  • Putamen loop

  • Limbic circuit

  • Associative auditory cortex

Correct answer: Caudate loop

The oculomotor circuit is also known as the caudate loop. It originates in the frontal and supplementary eye motor eye fields and projects to the caudate. It functions with saccadic eye movements. A Parkinson's patient with the caudate loop affected will likely present with impaired inhibition of reflexive saccades, reduced accuracy, or increased latency.

The motor loop is also known as the putamen loop. It functions to scale the amplitude and velocity of movements, reinforces a selected pattern, suppresses conflicting patterns, and anticipates movements. The limbic circuit functions to organize behaviors and for procedural learning. The associative auditory cortex is part of the temporal lobe.

88.

A physical therapist is conducting an evaluation on a patient with new onset of left thigh pain. During the physical exam, the therapist positions the patient supine and supports their hip and knee at 90 degrees of flexion, then passively extends the patient's knee. The therapist is assessing hamstring mobility.

What is the MOST likely indication of a negative finding?

  • 5 degrees of knee flexion

  • 10 degrees of knee flexion

  • Knee pain

  • Hip pain

Correct answer: 5 degrees of knee flexion

The 90-90 hamstring test is a special hip test that is used to identify hamstring tightness. The 90-90 hamstring test is deemed positive when the patient’s knee is not able to reach 10 degrees from its neutral position, which may also be described as 10 degrees or more of knee flexion. If the patient's knee reaches 5 degrees of knee flexion, the test is considered negative.

Knee pain and hip pain may occur while performing this test. However, neither are indicative of a positive finding for the 90-90 hamstring test.

89.

Use the following scenario to answer this question.

Which of the following stages BEST describes the patient's condition?

  • Stage IV

  • Stage V

  • Stage VI

  • Stage III

Correct answer: Stage IV

Amyotrophic lateral sclerosis (ALS) is a degenerative disease affecting both upper motor neurons and lower motor neurons with degeneration of anterior horn cells and descending corticobulbar and corticospinal tracts. ALS progresses in 5 stages that span from mild focal weakness to complete loss of mobility and independence. Stage IV is characterized by severe weakness and wasting of the lower extremities, mild weakness of the upper extremities, and wheelchair use with moderate assistance for functional mobility. 

Stage V is characterized by loss of head control and maximal assistance needs. Stage VI is characterized by dependency with ADLs and progressive respiratory distress. Stage III is characterized by severe weakness in select muscle groups with ambulation intact.

90.

A physical therapist is performing an evaluation on a 40-year-old female patient in a subacute facility. During the evaluation, the therapist observes that the patient is obese, has abnormal hair loss, and demonstrates bradycardia. The patient also reports an intermittent history of fibromyalgia.

Which of the following is the MOST likely explanation for these findings?

  • Hypothyroidism

  • Hyperthyroidism

  • Hypoparathyroidism

  • Hypercortisolism

Correct answer: Hypothyroidism

Hypothyroidism describes the decreased secretion of thyroid hormones. It is most common in females aged 30-60 and involves symptoms such as weight gain, hair loss, fatigue, bradycardia, constipation, fibromyalgia, and depression. Based on the patient's presentation, this is the most likely explanation provided.

Hyperthyroidism describes the increased secretion of thyroid hormones. It is most common in females aged 20-40 and involves symptoms such as weight loss, excessive sweating, diarrhea, and tremors. Hypoparathyroidism describes the decreased secretion of parathyroid hormone. Hypercortisolism describes increased cortisol production by the adrenal glands or excess of corticosteroid medication.

91.

You are a physical therapist performing a gait analysis of a patient four weeks s/p right total knee arthroplasty. She has a full range of motion for knee extension and knee flexion. During the stance phase, your patient displays excessive knee flexion.

Which of the following options causes excessive knee flexion?

  • Weakened quadriceps

  • Weakened dorsiflexors

  • Weakened plantar flexors

  • Tightened hip flexors

Correct answer: Weakened quadriceps

Excessive knee flexion is a common gait deviation that occurs during the stance phase as a result of weakened quadriceps or knee flexor contracture.

Foot flat is a common gait deviation that occurs during the stance phase as a result of weakened dorsiflexors. Inadequate push-off with an uncontrolled forward motion of the tibia is a common gait deviation that occurs during the stance phase as a result of weakened plantar flexors. Limited hip extension is a common gait deviation that occurs during the stance phase as a result of tightened hip flexors.

92.

A physical therapist is evaluating a patient in an outpatient clinic for right shoulder pain. During the interview, the patient explains that they are currently experiencing increased symptoms of irritable bowel syndrome. What information from this interview is the LEAST likely to contribute to the patient's condition?

  • Low intake of roughage

  • Emotional stress

  • Depression

  • High intake of dietary fat

Correct answer: Low intake of roughage

Irritable Bowel Syndrome (IBS) is a gastrointestinal condition characterized by abnormally increased motility of the small and large intestines. It is associated with emotional stress, anxiety, and depression. It is also triggered by the consumption of certain foods, including roughage, foods with a high fat content, and sometimes dairy.

93.

You are preparing to see a patient in the cardiovascular unit for a physical therapy evaluation. During your chart review, you read that the outermost layer of the patient's heart is damaged. Which of the following tissues is MOST likely affected?

  • The pericardium

  • The epicardium

  • The endocardium

  • The myocardium

Correct answer: The pericardium

The pericardium is the protective sac enclosing the heart. It is made of fibrous tissue and is the outermost layer.

The epicardium is the inner layer of the pericardium. The endocardium lines the heart's cavities. Myocardium is the heart tissue that forms the heart muscle and composes the majority of the heart.

94.

A physical therapist is monitoring a patient who has just begun dialysis after being monitored for diabetes-related renal failure for several years. During the session, the patient begins to complain of nausea, drowsiness, and headache. Which of the following is the MOST likely reason for the patient's new symptoms?

  • Dialysis disequilibrium

  • Dialysis dementia

  • Dialysis failure

  • Uremia

Correct answer: Dialysis disequilibrium

Dialysis disequilibrium may occur in patients who are beginning dialysis due to the rapid changes in urea levels in the blood. It typically occurs within the first few sessions. Symptoms can include vomiting, nausea, headache, drowsiness, and seizures. These symptoms should be relayed to the overseeing urologist.

Dialysis dementia is the result of long-duration dialysis treatment and involves signs of cerebral dysfunction. This can include trouble with speech, confusion, seizures, and eventual death. Uremia is an end-stage toxic condition resulting from renal insufficiency; this diagnosis is a reason for patients to begin dialysis and is not caused by dialysis.

95.

You are a physical therapist performing an intake assessment of a new patient. The patient is a 58-year-old female and presents with lower back pain. You learn that she has a prescription for Evista.

What is the MOST LIKELY reason for this?

  • Osteoporosis

  • Cardiovascular disease

  • Muscle spasms

  • Osteoarthritis

Correct answer: Osteoporosis

Raloxifene (Estiva) is commonly prescribed to treat osteoporosis.

ACE Inhibitors are commonly prescribed to treat cardiovascular disease. Flexeril is commonly prescribed to treat muscle spasms. Corticosteroids are commonly prescribed to treat a wide variety of musculoskeletal conditions, including osteoarthritis (degenerative arthritis).

96.

A physical therapist is performing an evaluation on a patient who experienced a right-sided stroke. During the physical exam, the patient demonstrates left-sided sensory loss, choreoathetosis, and homonymous hemianopsia.

Based on this information, what syndrome is MOST likely present?

  • PCA syndrome

  • MCA syndrome

  • ACA syndrome

  • LCA syndrome

Correct answer: PCA syndrome

The posterior cerebral artery (PCA) and posterior communicating arteries supply the midbrain, temporal lobe, diencephalon, and posterior third of the cortex. PCA syndrome is primarily characterized by contralateral sensory loss, involuntary movements such as choreoathetosis and tremor, transient contralateral hemiparesis, and homonymous hemianopsia. 

MCA syndrome is primarily characterized by contralateral hemiplegia of the face and extremities, contralateral hemisensory loss of the extremities, and homonymous hemianopsia. ACA syndrome is primarily characterized by contralateral hemiplegia of the extremities, contralateral hemisensory loss of the extremities, urinary incontinence, problems with bimanual tasks, and apraxia. LCA syndrome is not a term used to describe the symptoms of a stroke.

97.

Use the following scenario to answer this question.

Based on the patient's presentation, which of the following is the BEST treatment approach for their injury?

  • Progressive weight-bearing and balance training

  • Therapeutic ultrasound

  • Exercise in the clinic only

  • Ankle immobilization for 14 days

Correct answer: Progressive weight-bearing and balance training

Ligament sprains of the ankle are a common injury among athletes, and 95% of all ankle sprains involve the lateral ligaments of the ankle. Lateral ankle sprains most often occur during an inversion mechanism where the foot turns inward, overstretching the lateral ligaments of the ankle. Clinical practice guidelines for acute lateral ankle sprains suggest advising patients on external support, progressive weight-bearing, and the use of proprioception/balance training for recovery and secondary prevention.

Therapeutic ultrasound is not recommended for the treatment of acute lateral ankle sprains. Exercise is recommended both in the clinic and at home for patients recovering from acute lateral ankle sprains. Ankle immobilization for up to 10 days is recommended for severe injuries only.

98.

A patient has recently had a myocardial infarction and will be spending four days in the hospital. Which of the following activities is MOST appropriate for the patient prior to discharge?

  • Short exercise sessions, 2-3 times a day

  • Short exercise sessions, once a day

  • 20-30 minutes of ambulation, 1-2 times per day

  • The use of elastic bands in a gentle exercise routine

Correct answer: Short exercise sessions, 2-3 times a day

Following an uncomplicated Myocardial Infarction (MI), the patient will spend 3-5 days in the hospital. It is appropriate for the patient to participate in short exercise sessions 2-3 times a day (not only once a day) during their hospital stay.

The patient should gradually increase ambulation time with the goal of 20-30 minutes per day, 1-2 times per week, by 4-6 weeks post-MI. This goal should not be attempted during the initial four days post-MI. The use of elastic bands during exercise routines should begin approximately five weeks post-MI.

99.

While preparing to perform an evaluation with a patient recently admitted for poor activity tolerance and chest pain, you receive new results from their recent echocardiogram. The results indicate right backflow of blood into the right ventricle during diastole. Which of the following is the MOST likely structure affected?

  • Pulmonary valve

  • Aortic valve

  • Tricuspid valve

  • Ventricular valve

Correct answer: Pulmonary valve

The pulmonary valve is a semilunar valve that prevents right backflow of blood into the right ventricle during diastole. Because the results of the echocardiogram indicate problems with right backflow during diastole, this is the most likely structure that could be affected.

The aortic valve is a semilunar valve that prevents left backflow of blood into the left ventricle during diastole. The tricuspid valve and the bicuspid valve are both atrioventricular valves that prevent the backflow of blood into the atria during ventricular systole. "Ventricular valve" is not a commonly used term.

100.

Use the following scenario to answer this question. 

Based on the patient's presentation, which of the following muscles is MOST likely to demonstrate additional atrophy?

  • Lumbricals I and II

  • Abductor digiti minimi

  • Extensor carpi radialis brevis

  • Supinator

Correct answer: Lumbricals I and II

Carpal tunnel syndrome is a condition where compression of the median nerve at the carpal tunnel, usually due to inflammation of the flexor tendons and/or median nerve, causes neurological symptoms along the distribution of the median nerve. Clinical findings of carpal tunnel syndrome most often include burning, tingling, pins and needles, and numbness along the median never distribution which are worse at night and associated with repetitive wrist motions such as gripping and typing. With prolonged carpal tunnel syndrome, atrophy and weakness of the thenar muscles and lateral two lumbricals are common.

The abductor digiti minimi, extensor carpi radialis brevis, and supinator muscles typically do not demonstrate atrophy with carpal tunnel syndrome.