NPTE Clinical Files | Physical Therapy

Cobert presents with a history of peripheral artery disease and was referred to physical therapy for walking endurance. He reports intermittent claudication in his calves after walking 100 meters and frequently stops to rest. His resting ABI is 0.7 in both legs. The goal is to enhance his functional capacity and quality of life. Which walking program is MOST appropriate to improve this patient’s functional capacity?

A) Treadmill walking at 60% of maximal heart rate, continuous for 30 minutes

B) Walking to the point of moderate pain, resting, and repeating for 30 minutes total

C) Interval walking at high intensity with short rest breaks

D) Walking with partial body weight support to reduce claudication pain

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Liara presents with relapsing-remitting multiple sclerosis with complaints of fatigue and difficulty walking. She reports worsening symptoms in the afternoon but denies any new relapses. Examination reveals mild spasticity in the lower limbs, decreased endurance, and poor postural control. The patient works as a teacher and finds it challenging to maintain energy throughout the day. Which intervention is MOST appropriate to improve the patient’s functional mobility and address her symptoms?

A) Aerobic training at moderate intensity with frequent rest breaks

B) Strength training with resistance bands targeting lower extremity muscles

C) Cooling strategies during physical activity to improve endurance

D) Balance training on a foam surface to reduce fall risk

Lorren sustained burns to his right forearm and hand while working with hot oil. The burn area is red with blistering, and the patient reports significant pain. On examination, capillary refill is intact, and the wound blanches with pressure. The patient is referred to physical therapy to prevent complications during the early phase of healing. Which intervention is MOST appropriate during the initial phase of rehabilitation?

A) Daily aggressive stretching to maintain range of motion

B) Moisturizing and scar massage to prevent contracture formation

C) Gentle range of motion exercises to prevent joint stiffness

D) Compression wrapping to reduce hypertrophic scarring

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Nivayah presents with a history of myocardial infarction and type 2 diabetes. The patient reports limited endurance and shortness of breath when walking up a flight of stairs. The physical therapist wants to assess her aerobic capacity and guide the exercise prescription while considering safety due to her cardiovascular history. Which outcome measure is MOST appropriate to assess this patient’s aerobic capacity?

A) VO2 max test using a treadmill protocol

B) 6-minute walk test

C) Borg Rating of Perceived Exertion (RPE)

D) Step test

Jamie is a 62-year-old female who is referred to outpatient cardiac rehabilitation 3 weeks after a myocardial infarction. She reports feeling fatigued with moderate exertion but denies chest pain. Her resting vitals are HR 80 bpm, BP 128/82 mmHg, and SpO₂ 98%. She completed Phase I rehabilitation without complications and is eager to begin exercising to improve her endurance. Which activity is MOST appropriate to initiate during Phase II of cardiac rehabilitation?

A) Jogging on a treadmill at 70% maximum heart rat

B) Cycling on a stationary bike at 3-5 METs

C) Strength training at 50% of 1-rep max

D) Stretching and light walking only

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Carlos is a long-distance runner who presents with deep groin pain that worsens with running and prolonged sitting. He also reports occasional clicking and a sensation of instability in the left hip. Examination reveals full strength and range of motion, but pain is elicited during specific hip movements that compress the joint. Which clinical test is MOST appropriate to confirm the suspected diagnosis?

A) FABER test

B) Thomas test

C) Scour test

D) FADIR test

Jessica presents with a C6 spinal cord injury and is being fitted for a wheelchair. She has full innervation of the deltoids, biceps, and wrist extensors but lacks active triceps function. The patient requires independence in propulsion and activities of daily living. During assessment, she demonstrates forward shoulder positioning and mild scapular instability. Which wheelchair feature is MOST appropriate to optimize the patient’s function and minimize shoulder strain?

A) Reclining backrest to improve postural support

B) Lightweight frame with adjustable axle position

C) High backrest to improve scapular stability

D) Elevating leg rests to reduce shoulder loading

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Teniah was admitted to the acute care hospital with community-acquired pneumonia. She reports shortness of breath and fatigue. Auscultation reveals decreased breath sounds in the right lower lobe, and SpO₂ drops from 95% to 88% with exertion. Resting vital signs: HR 92 bpm, BP 142/86 mmHg, RR 22 breaths per minute. Which finding requires the MOST immediate communication with the medical team?

A) Decreased breath sounds in the right lower lobe

B) Blood pressure of 142/86 mmHg

C) Resting respiratory rate of 22 breaths per minute

D) Oxygen desaturation to 88% with exertion

Jamie presents with stage 3 Parkinson’s disease and marked presbycusis and reports frequent freezing episodes during ambulation. She demonstrates a reduced step length and minimal arm swing. Her goal is to improve safety and mobility. Which intervention is MOST appropriate to address the patient’s freezing episodes?

A) Dynamic balance training

B) Rhythmic auditory cueing

C) External visual cues

D) Strengthening postural muscles

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Narek reports progressive gait difficulties, including frequent tripping and reduced foot clearance during swing phase. Which examination is MOST appropriate to evaluate the primary cause of his impairments?

A) Neurological assessment of the deep common peroneal nerve

B) Assessment of proprioception in the lower extremities

C) Passive motion of the ankle into plantarflexion

D) Skin assessment on the bottom of the heel

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

Hamza is 3 weeks post-stroke and presents with right-sided hemiparesis. He is able to sit unsupported but struggles to stand and has difficulty walking without assistance. His Brunnstrom stage is III for the right upper extremity and II for the right lower extremity. Which of the following interventions would be most appropriate for this patient to improve his functional mobility and independence?

A) Facilitate weight-bearing on the right lower extremity using assistive devices

B) Move the patient's right lower extremity through PNF patterns

C) Use body-weight-supported treadmill training (BWSTT)

D) Initiate fine motor activities for the right hand to improve hand dexterity

Milani presents with anterior shoulder pain and reports difficulty with overhead activities. The patient describes intermittent clicking and discomfort with forward reaching. On examination, the therapist observes a positive Speed’s test, normal strength in external rotation, and no pain with passive shoulder elevation. Which of the following is the MOST likely diagnosis?

A. Bankart lesion

B. Subacromial bursitis

C. Biceps tendinopathy

D. Rotator cuff tendinopathy

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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

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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

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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

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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

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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

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Everett presents with right groin pain. Which of the following conditions must be ruled out FIRST?

A) Diverticulitis

B) L2 nerve root compression

C) Appendicitis

D) Psoas abscess

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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

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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)

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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

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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

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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

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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

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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

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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)

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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

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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

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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

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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.

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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

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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

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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

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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.

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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

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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.

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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

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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

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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)

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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

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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

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