
NPTE Clinical Files | Physical Therapy
By Kyle Rice


Foot Ulcers / Key Assessments
Betty presents with type 2 diabetes and a non-healing ulcer on the lateral ankle. The ulcer is dry, and the patient reports discomfort in her posterior lower leg with walking. On examination, the affected foot has a capillary refill that is prolonged. Which assessment is MOST important to include during the initial evaluation?
A) Monofilament testing for protective sensation
B) Visual inspection for signs of infection
C) ABI to evaluate vascular supply
D) Toe pressure measurement for microvascular assessment
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- (727) 732-4573

Peripheral Artery Disease & Walking Programs

Multiple Sclerosis - Symptoms & Interventions

Knee OA Examination
Rachel presents with knee pain that worsens with activity and improves with rest. She describes stiffness lasting about 30 minutes in the morning and difficulty with stairs. On examination, there is mild joint swelling and crepitus with knee flexion and extension. Which examination finding is MOST indicative of knee osteoarthritis?
A) Positive McMurray test
B) Reduced knee flexion range of motion
C) Medial joint line tenderness
D) Presence of effusion
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- (727) 732-4573

Burns - Classification & PT Interventions

Exercise Physiology

Cardiac Rehab Phases

Spinal Cord Injuries / ASIA Scale
Teddy sustained a spinal cord injury at the C7 level after a motor vehicle accident. During the ASIA examination, the patient has preserved sensation at S4-S5 but no voluntary anal contraction. Motor function is absent below C7. Reflex activity is present. How should this patient’s spinal cord injury be classified on the ASIA Impairment Scale?
A) ASIA A (Complete)
B) ASIA B (Sensory Incomplete)
C) ASIA C (Motor Incomplete)
D) ASIA D (Motor Incomplete)
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- (727) 732-4573

Hip Special Tests / Key Signs

Knee Special Tests
Beniah is a 21-year-old female soccer player who presents with right knee pain and instability after pivoting during a game. She reports hearing a “pop” at the time of injury and is now hesitant to bear weight. Examination reveals mild swelling, limited range of motion, and hamstring guarding. Which special test is MOST sensitive for detecting an ACL tear in this patient?
A) Lachman test
B) Anterior drawer test
C) Pivot shift test
D) Valgus stress test
DOWNLOAD THIS EPISODES CHEATSHEET:
- www.nptecheatsheet.com/knee-specials

Wound Healing Stages
Heather is a female with diabetes who is referred to physical therapy for evaluation of a right heel wound. The wound measures 4 cm in diameter, shows a dry black eschar covering the entire wound bed, and has no surrounding erythema or drainage. The patient denies pain at the wound site. Which wound stage is MOST consistent with the described findings?
A) Stage II
B) Stage III
C) Stage IV
D) Unstageable
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- (727) 732-4573

Wheelchair Prescription & Positioning

Medical Team Communication

Parkinson’s Disease: Stages & Treatments

Rotator Cuff Tear Rehab Protocols
Travasia is 4 weeks post-supraspinatus repair. She reports mild soreness but no significant pain. Examination reveals limited passive shoulder elevation beyond 90° due to stiffness and marked restriction in active range of motion. Which intervention is MOST appropriate at this stage?
A) Resisted external rotation with a resistance band
B) Active-assisted range of motion for shoulder flexion
C) Pendulum exercises for shoulder mobility
D) Isometric strengthening of the supraspinatus
TEXT OUR TEAM:
- (727) 732-4573

Gait Dysfunction Assessment

Pressure Ulcer Examination
Talar is a diabetic patient that presents with a chronic foot ulcer that has not healed despite standard care. The ulcer is clean, but the tissue around the wound is swollen and warm, and there is noticeable erythema. What is the MOST likely underlying cause of this condition?
A) Poor wound dressing technique
B) Venous insufficiency Infection
C) Necrotic tissue
D) Infection
DOWNLOAD THIS EPISODES CHEATSHEET: www.nptecheatsheet.com/pressure-ulcer-staging

ECG Evaluation
Jamie is a 68 year old male with a history of hypertension presents with dizziness, palpitations, and shortness of breath. An ECG reveals a regular rhythm at 110 bpm with narrow QRS complexes and absent P waves. What is the MOST likely diagnosis?
A) Atrial fibrillation
B) Paroxysmal supraventricular tachycardia (PSVT)
C) Ventricular tachycardia
D) Sinus tachycardia
TEXT OUR TEAM:
- (727) 732-4573

Stroke Rehabilitation Strategies

Shoulder Differential Diagnosis

Neurological Outcome Measures
Jeremy is performing a neurological evaluation. The therapist notes repeated falls in quiet standing with a suspected forward anticipatory balance impairment. Which of the following tests is MOST likely to reveal this specific impairment?
A) Functional Reach Test
B) Romberg Test
C) Sensory Organization Test
D) Standing in tandem with eyes closed
LINKS MENTIONED:
- NPTE Tips & Tricks: www.nptegroup.com
- Practice Question Club: www.npteclub.com

Other Systems Differential Diagnosis
A 45-year-old female presents to physical therapy with complaints of persistent fatigue, and unexplained weight loss. Upon examination, the therapist notes tachycardia, low blood pressure episodes, and excessive sweating. Which of the following is the MOST likely diagnosis?
A) Graves Disease
B) Cor Pulmonale
C) Hypoglycemia
D) Adrenocortical hyperplasia
Links Mentioned:
- NPTE Tips & Tricks: www.nptegroup.com
- Truelearn: USE CODE: PTH020

What Would I Do Different After Passing The NPTE W/ Greg Todd
Are you a PT wondering where you'll find the money to pay off your student loan debt?
In this exclusive episode, Coach K and his long-term mentor and best friend Greg Todd discuss what they'd do differently after Passing the NPTE to build financial freedom.
Check out Greg's Exclusive Resources for Clinical Files Listeners Only!
- Side Hustle Checklist - https://smartsuccesshealthcare.com/sidehustlekr
- How to Prep for Job Interviews - https://smartsuccesshealthcare.com/interviewkr
- How to Build Your First Digital Product as a New Grad - https://smartsuccesshealthcare.com/digitalkr

Cardio Exercise Prescription
Lina presents with a history of chronic heart failure, increased dyspnea and fatigue during daily activities. The physical therapist plans to implement an aerobic exercise program. Which of the following exercise protocols is MOST appropriate for this patient?
A) 70-85% of HRmax, 5 times per week, for 45-60 minutes
B) 50-60% of HRR, 3 times per week, for 20-40 minutes
C) 30-40% of HRmax, daily, for 10-15 minutes
D) 80-90% of HRR, 4 times per week, for 60 minutes
LINKS MENTIONED:
- NPTE Tips & Tricks: www.nptegroup.com
- Truelearn: USE CODE: PTH020
- Free Cheatsheets: www.nptecheatsheets.com

Burn Interventions 2
Bronny presents to the hospital with burns to the anterior neck, chest, axillas, and cubital fossa regions. Which of the following positions is the BEST for this patient?
A. Cervical slight extension, arm abduction with elbow extension
B. Neutral cervical spine, shoulder external rotation with wrist extension
C. Cervical slight flexion, arm elevated and elbow extended
D. Cervical extension with arm abduction and elbow flexion
LINKS MENTIONED:
- Practice Question Club: www.npteclub.com
- NPTE Tips & Tricks: www.nptegroup.com

Pediatric Hypotonia
Cory is a 3 year old child presents with severe hypotonia. The child has difficulty maintaining an upright posture and frequently collapses when attempting to sit or stand. Which of the following interventions would be MOST appropriate?
A. Sitting balance exercises on an unstable surface such as a wobble cushion
B. Passive stretching of the hamstrings to improve flexibility
C. Practicing squats with support to encourage leg strength
D. Rhythmic stabilization exercises in a seated position on a therapy ball
LINKS MENTIONED:
- NPTE Tips & Tricks: www.nptegroup.co
- Free Cheatsheets: www.nptecheatsheets.com


MSK Joint Mobility Intervention
Calen presents to physical therapy with difficulty grasping a glass. Upon examination, the patient has diminished joint mobility at the 2nd MCP and difficulty performing abduction of the digit. Which of the following glides is the MOST effective?
A. Volar glide
B. Dorsal glide
C. Radial glide
D. Medial glide
LINKS MENTIONED:
- NPTE Tips & Tricks: www.nptegroup.com
- Free Cheatsheets: www.nptecheatsheets.com

MSK Postural Examination
During a clinical evaluation, Aiyinde notices that a patient exhibits pronounced anterior pelvic tilt while standing but this posture significantly improves when the patient engages in a squat. This observation is MOST likely due to tightness in which of the following muscles?
A. Iliopsoas
B. Gluteus maximus
C. Rectus abdominis
D. Biceps femoris (long head)
LINKS MENTIONED:
- Practice Question Club: www.npteclub.com
- NPTE Tips & Tricks: www.nptegroup.com

Dizziness Evaluation
Wajiha presents with a chief complaint of dizziness upon waking and difficulty washing hair secondary to the onset of dizziness. The patient is currently unable to reach down to pick up objects from the floor. The patient denies heart palpitations and states that she has frequent nausea but does not vomit. What condition is the MOST likely present?
A. Meniere’s Disease
B. Canalithiasis
C. Optic neuritis
D. Vestibulo-Ocular Reflex impairment
LINKS MENTIONED:
- Practice Question Club: www.npteclub.com
- NPTE Tips & Tricks: www.nptegroup.com
- NPTE Cheat Sheets: www.nptecheatsheets.com

Complete Decongestive Therapy
Kyle is treating a patient in stage 1 of complete decongestive therapy (CDT). Which of the following is NOT a primary focus in this phase:
A. Manual lymphatic drainage and short stretch bandages
B. Use of a customized compression garment
C. Education on keeping the skin clean and dry
D. Exercising the trunk before affected extremities
LINKS MENTIONED:
- NPTE Tips & Tricks: www.nptegroup.com
- Free Cheatsheets: www.nptecheatsheets.com

Balance & Falls
Jared presents with a history of cataracts and has been experiencing repeated falls at home. Six months ago, his home was remodeled, and new carpets were installed, coinciding with the onset of the falls. Which sensory system is the patient MOST dependent on for balance?
A. Vision, somatosensory, and vestibular
B. Vision and somatosensory
C. Somatosensory
D. Vestibular
LINKS MENTIONED:
- Practice Question Club: www.npteclub.com
- NPTE Tips & Tricks: www.nptegroup.com

Forefoot Pain Evaluation
Kelly a 30-year-old marathon runner presents with a gradual onset of persistent pain at the base of the first metatarsal, which intensifies during long runs and eases with rest. Examination reveals localized swelling, tenderness on palpation, and pain during passive extension of the big toe. Radiographs show no fractures but a slight increase in the space between the first and second metatarsal bones. What is the MOST likely diagnosis?
A) Turf toe
B) Sesamoiditis
C) Hallux valgus
D) Metatarsalgia
LINKS MENTIONED:
- NPTE Tips & Tricks: www.nptegroup.com
- Practice Question Club: www.npteclub.com

Cardiac Immediate Action
Jane has a history of coronary artery disease (CAD) and is performing marching and lunges during an in-home visit. The patient suddenly reports chest pain, shortness of breath, and dizziness. The physical therapist's IMMEDIATE action should be:
A. Stop the exercise and have the patient sit down
B. Administer nitroglycerin and continue the exercise at a lower intensity
C. Call emergency medical services (EMS) immediately
D. Measure the patient's blood pressure and heart rate
LINKS MENTIONED:
- NPTE Tips & Tricks: www.nptegroup.com
- Practice Question Club: www.npteclub.com

Pediatric Lower Extremity Evaluation
Matt, a 17-year-old athlete, experiences chronic muscle weakness, foot deformities (high arches and hammer toes), and sensory deficits in his legs and feet. These symptoms have been progressively worsening over the past few years, without any associated swelling or inflammation. Which condition is MOST likely present?
A) Osteomyelitis
B) Juvenile rheumatoid arthritis
C) Sever's disease
D) Hereditary Motor & Sensory Neuropathy (HMSN)
LINKS MENTIONED:
- NPTE Tips & Tricks: www.nptegroup.com
- Truelearn: USE CODE: PTH020
- Free Cheatsheets: www.nptecheatsheets.com

Multiple Sclerosis Interventions
Suely a 40-year-old female with multiple sclerosis (MS) presents with ataxic gait, characterized by wide base of support, irregular steps, and difficulty maintaining balance. Which of the following interventions is MOST appropriate to address her gait abnormalities?
A. High-intensity plyometric exercises
B. Treadmill training with body-weight support
C. Functional electrical stimulation (FES) of the quadriceps
D. Static stretching of the lower extremities
LINKS MENTIONED:
- NPTE Tips & Tricks: www.nptegroup.com
- PT Hustle Phone Number: (727) 732-4573
- Free Cheatsheets: www.nptecheatsheets.com

Diabetes & Wound Care
Blakely is a 65-year-old female with a history of type 2 diabetes mellitus presents with a non-healing wound on her left foot. The wound has been present for six weeks and shows no signs of improvement. Which of the following interventions is MOST appropriate to promote wound healing?
A. Hydrotherapy with whirlpool
B. Application of a moist wound dressing
C. Daily debridement with a dry gauze
D. Use of systemic antibiotics only
LINKS MENTIONED:
- NPTE Tips & Tricks
- PT Hustle Phone Number: (727) 732-4573
- PT Hustle Practice Question Bootcamp

Anterior Knee Pain & Cycling
Raj presents with anterior knee pain that worsens during prolonged cycling. Which of the following adjustments to the bike setup would be MOST beneficial in alleviating the cyclist's symptoms?
A. Lowering the saddle height
B. Raising the saddle height
C. Moving the saddle forward
D. Moving the saddle backward
LINKS MENTIONED:
- NPTE Tips & Tricks: www.nptegroup.com
- PT Hustle Phone Number: (727) 732-4573
- Free Cheatsheets: www.nptecheatsheets.com

ACL Reconstruction Rehabilitation
Caden is a physical therapist who notes that a patient with a recent ACL reconstruction is reluctant to perform weight-bearing exercises. The patient expresses fear of re-injury. The MOST appropriate response to facilitate rehabilitation progress would involve:
A. Encouraging the patient to ignore the fear and push through discomfort.
B. Implementing graded exposure therapy and psychological support to address fear-avoidance behaviors.
C. Focusing exclusively on non-weight-bearing exercises until the fear subsides.
D. Increasing the intensity of weight-bearing exercises to quickly regain strength.
LINKS MENTIONED:
- NPTE Tips & Tricks: www.nptegroup.com
- PT Hustle Phone Number: (727) 732-4573
- Free Cheatsheets: www.nptecheatsheets.com

Assistive Device Prescription 2
Xavier is a patient who recently underwent hip replacement surgery and is now at a rehabilitation facility with a weight-bearing as tolerated (WBAT) status. The patient is 75 years old with mild Parkinson’s disease, affecting his balance and coordination. Given these considerations, which assistive device would be MOST appropriate for this patient during the initial phase of recovery?
A) Standard cane
B) Quad cane
C) Front-wheeled walker
D) Rollator walker
LINKS MENTIONED:
- Truelearn: USE CODE: PTH020
- Get Your Episode Cheatsheet here: https://www.nptecheatsheet.com/assistive-ad
- NPTE Tips & Tricks: www.nptegroup.com

Acute Low Back Pain
Gerard arrives at physical therapy reporting acute lower back pain following an attempt to lift a heavy box. The pain radiates into both lower extremities constantly. During examination, all lumbar motions exacerbate the pain, and the patient prefers to stand and sit with increased lumbar flexion. Which pathology is MOST likely present?
A) Lumbar Herniated Disc
B) Facet Joint Syndrome
C) Sacroiliac Joint Dysfunction
D) Ankylosing Spondylitis
LINKS MENTIONED:
- NPTE Tips & Tricks: www.nptegroup.com
- Truelearn: USE CODE: PTH020
- PT Hustle Phone Number: (727) 732-4573

Lower Extremity Lymphedema
Margot, a 53-year-old woman, presents to physical therapy with bilateral, symmetrical enlargement of her legs extending from her hips to her ankles, sparing the feet. She reports the condition is painful and has worsened over several years. Skin texture is normal, and there is no pitting edema. Which condition is MOST consistent with these findings?
A) Chronic venous insufficiency
B) Obesity-related lymphedema
C) Primary lymphedema
D) Lipedema
LINKS MENTIONED:
- PT Hustle Phone Number: (727) 732-4573
- Get Your Episode Cheatsheet HERE
- NPTE Tips & Tricks: www.nptegroup.com
- Truelearn: USE CODE: PTH020

Drug Interactions
Jerry, a patient with type 2 diabetes, has been prescribed metformin to manage his blood glucose levels. The physical therapist understands that metformin’s primary function is to:
A) Stimulate the pancreas to produce more insulin.
B) Decrease the liver's production of glucose.
C) Increase the sensitivity of insulin receptors on cells.
D) Slow the absorption of sugar from the intestines.
LINKS MENTIONED:
- NPTE Tips & Tricks: www.nptegroup.com
- Get Your Episode Cheatsheet here: https://www.nptecheatsheet.com/meds
- Truelearn: USE CODE: PTH020
- PT Hustle Phone Number: (727) 732-4573

Ulcer Examination
Julian, a 59-year-old patient with a longstanding history of type 2 diabetes, presents with a chronic, non-healing wound on his foot. The wound is located on the lateral aspect of the foot, characterized by a sharply demarcated, circular margin, and a pale, dry base with minimal exudate. His medical history includes poorly controlled hypertension and intermittent claudication. What is the most likely classification of this ulcer?
A) Venous ulcer
B) Mixed arterial-venous ulcer
C) Pure arterial ulcer
D) Neuropathic ulcer
LINKS MENTIONED:
- NPTE Tips & Tricks: www.nptegroup.com
- Get Your Episode Cheatsheet here: https://www.nptecheatsheet.com/ulcerclass

Respiratory Interventions
Richard is a 75-year-old male patient being treated by physical therapy. In educating a patient with chronic obstructive pulmonary disease (COPD) about managing exacerbations at home, what advice should the physical therapist emphasize as MOST important?
A. Use of an incentive spirometer every 2 hours while awake.
B. Maintenance of a high-protein, low-carbohydrate diet.
C. Participation in daily, moderate-intensity aerobic exercise.
D. Keeping the home environment well-ventilated and free of irritants.
LINKS MENTIONED:
- NPTE Tips & Tricks: www.nptegroup.com
- Get Your Episode Cheatsheet here: https://www.nptecheatsheet.com/pulmonaryinterventions

Stroke & Motor Learning
Vivek is being seen by physical therapy after recovering well from a stroke. The patient is refining gait during the autonomous stage of motor learning. Which activity is BEST to challenge their gait adaptability?
A. Walking backwards on a treadmill
B. Navigating a cluttered hallway
C. Stepping over obstacles at 6 inch heights
D. Reciprocal pedaling on a stationary bike
LINKS MENTIONED:
- NPTE Tips & Tricks: www.nptegroup.com
- Get Your Episode Cheatsheet here: https://www.nptecheatsheet.com/motor

Right Congestive Heart Failure
Henry presents with right-sided congestive heart failure and reports slight limitations in physical activity. The patient is comfortable at rest; however, ordinary physical activity results in fatigue, palpitation, or dyspnea. Based on this description, which of the following activities is the patient MOST likely able to do without exacerbating their symptoms? A) Climbing two flights of stairs without stopping B) Walking 3mph on a treadmill C) Laying flat in Trendelenburg position D) Running a short distance
LINKS MENTIONED:
- Did you get this question wrong?! If you were stuck between two answers and selected the wrong one, then you need to visit www.NPTEPASS.com, to learn about the #1 solution to STOP getting stuck.
- NPTE Tips & Tricks: www.nptegroup.com
- Get Your Episode Cheatsheet here: https://www.nptecheatsheet.com/CHF

Neurological Differential Diagnosis
Andrea is a 45-year-old patient presents to physical therapy with complaints of fluctuating muscle weakness, notably worsening toward the evening. The patient reports difficulty maintaining upward gaze and a history of transient diplopia. No sensory deficits were reported. Which of the following conditions is MOST likely? A) Multiple Sclerosis (MS) B) Amyotrophic Lateral Sclerosis (ALS) C) Guillain-Barré Syndrome (GBS) D) Myasthenia Gravis (MG)
LINKS MENTIONED:
- Get Your Episode Cheatsheet here: https://www.nptecheatsheet.com/mg
- Check out our Instagram account: www.nptegroup.com

Ramp Specifications & ADA Requirements
A physical therapy clinic is planning to install a new wheelchair ramp that incorporates a switchback for space efficiency. According to ADA guidelines, what is the MINIMUM required landing size at the switchback to ensure compliance and safety?
A) 36 inches by 36 inches
B) 48 inches by 48 inches
C) 60 inches by 60 inches
D) 72 inches by 72 inches
LINKS MENTIONED:
- Did you get this question wrong?! If you were stuck between two answers and selected the wrong one, then you need to visit www.NPTEPASS.com, to learn about the #1 solution to STOP getting stuck.
- Get Your Episode Cheatsheet here: https://www.nptecheatsheet.com/wheelchairs
- Check out our Instagram account: www.nptegroup.com

Pediatric Evaluation
Jessie is a 12-year-old male patient who presents with an onset of groin pain. The patient has a BMI of 28 and a recent growth spurt. The physical therapist notes the patient has a limp with external rotation of the affected leg during ambulation. Which of the following diagnoses is MOST likely?
A) Legg-Calvé-Perthes Disease
B) Slipped Capital Femoral Epiphysis
C) Osgood-Schlatter Disease
D) Septic Arthritis
LINKS MENTIONED:
- Get Your Episode Cheatsheet here: https://www.nptecheatsheet.com/pediatriceval
- Check out our Instagram account: www.instagram.com/thepthustle