NPTE Clinical Files | Physical Therapy

Mackenzie presents to physical therapy following a stroke affecting the basal ganglia. The patient exhibits bradykinesia and difficulty initiating movements. Which of the following interventions would be MOST effective in addressing these impairments?A) Rhythmic auditory stimulationB) High-resistance strength trainingC) Visual cueing during gait trainingD) Balance exercises using an unstable surfaceJoin the FREE Facebook Group: www.nptegroup.com

Bellie presents with persistent bilateral lower extremity swelling that worsens throughout the day. The therapist is selecting an intervention to assist with fluid return. Which of the following interventions would MOST effectively assist with this goal?A) Maintaining the lower extremities in a gravity-dependent positionB) Diaphragmatic breathingC) Sustained isometric contraction of the upper extremitiesD) Passive trunk rotation in supineJoin the FREE Facebook Group: www.nptegroup.com

Dr. Rice evaluates a patient with a chief complaint of mid-thoracic pain radiating around the left lateral rib cage. The patient reports symptoms worsen with deep breathing and coughing, but are not reproduced with spinal movement, rib mobilization, or palpation. Neurological screening is unremarkable. Which of the following structures is MOST likely referring pain to this region?A) Thoracic facet joint dysfunctionB) Intercostal muscle strainC) The pleuraD) The pancreashttp://www.nptecheatsheets.com

Carmen is performing a special test on her patient. The test has a sensitivity of 95% and a specificity of 30%. The patient tests negative. What is the BEST interpretation?A) The condition is unlikely presentB) The condition is likely presentC) The test confirms the diagnosisD) The test has low false negativesJoin the FREE Facebook Group: www.nptegroup.com

Elena presents with significant muscle atrophy in the lower extremities, fasciculations of the gastrocnemius, and a 1+ Achilles tendon reflex. During gait, the patient demonstrates a "slapping" foot strike. These signs are MOST indicative of: A) A lesion in the corticospinal tractB) An injury to the cerebellumC) Compression of the posterior columns D) A lesion in the anterior horn cellsJoin the FREE Facebook Group: www.nptegroup.com

Yesenia is a 37-year-old patient with lumbar disc herniation who reports pain radiating to the posterior thigh. During treatment, repeated lumbar extension causes leg pain to resolve but increases central low back discomfort. Which intervention is MOST appropriate to continue?A) Discontinue extension due to increased lumbar painB) Progress lumbar flexion exercises to reduce spinal compressionC) Continue repeated lumbar extension within toleranceD) Introduce hamstring stretching to reduce neural tensionJoin the FREE Facebook Group: www.nptegroup.comDownload my lumbar spine intervention cheatsheet: www.nptecheatsheet.com/lumbar-treat

Benito, a patient with a right transfemoral amputation, demonstrates circumduction of the prosthetic limb during the swing phase. Which of the following prosthetic causes is MOST likely contributing to this deviation?A) Insufficient socket flexionB) Socket is excessively abductedC) Knee friction is too lowD) Foot is set too posteriorlyJoin the FREE Facebook Group: www.nptegroup.com

Victor is a 12-year-old male who presents with a limp and groin pain. The hip rests in external rotation, and hip flexion produces obligatory external rotation. Which of the following should the physical therapist initiate FIRST?A) Begin hip strengthening and gait trainingB) Stretch hip internal rotators and adductorsC) Make the patient non–weight bearing and refer urgentlyD) Initiate aquatic therapy for pain-free ROMJoin the FREE Facebook Group: www.nptegroup.com

Belsnickel is a 63-year-old male who presents with right-sided facial paralysis, inability to abduct the right eye, and an absent corneal blink reflex on the right. Sensation to the face is intact. These findings are MOST consistent with a lesion affecting which of the following cranial nerves?A) Cranial nerve V, VIB) Cranial nerve VIC) Cranial nerve VI, VIID) Cranial nerve II, VIJoin the FREE Facebook Group: www.nptegroup.com

Juvelyn shows an impaired corneal reflex, loss of facial sensation, and difficulty chewing on the right side. Which of the following is MOST likely impaired?A) Difficulty chewing on the leftB) Vertebrobasilar insufficiency (VBI) test on the rightC) Jaw jerk testD) SwallowingUse PTH020 to get 20% off the 90-day Truelearn Subscription: www.truelearn.comDownload my quick cranial nerves cheatsheet: www.nptecheatsheet.com/cranial

Hallie presents with bilateral anterior knee pain and an in-toeing gait. Craig’s test reveals 10° of femoral anteversion on both sides. Which of the following special tests is MOST appropriate to further assess the cause of the in-toeing?A) FABER testB) Tibial torsion testC) Q-angle measurementD) Thomas testJoin the FREE Facebook Group: www.nptegroup.com

Lionel has a past medical history of hypertension and has been referred to physical therapy for generalized fatigue and reduced exercise tolerance. During the session, the therapist notes mild bilateral lower extremity edema. Which of the following medications is MOST likely contributing to these findings?A) LisinoprilB) FurosemideC) AmlodipineD) MetoprololJoin the FREE Facebook Group: www.nptegroup.com

Faith is a 65-year-old female recovering from hip replacement surgery and presents with mild calf swelling and tenderness. Based on Virchow’s Triad, which of the following is the LEAST likely contributing factor to her symptoms?A) Endothelial injuryB) Stasis of blood flowC) HypercoagulabilityD) Arterial insufficiencyJoin the FREE Facebook Group: www.nptegroup.comDownload my unfamiliar terms cheatsheet: www.nptecheatsheet.com/unfamiliar-terms

Skye is a soccer player who reports intermittent knee locking and joint line pain following a twisting injury 2 weeks ago. The McMurray test reproduces pain with a click. Which additional clinical finding would MOST support the suspected diagnosis?A) Positive Pivot shift test B) Negative Clarke’s testC) Positive Thessaly test at 20° flexionD) Pain with valgus stress testingJoin the FREE Facebook Group: www.nptegroup.com

Brittinie presents with difficulty pushing up from a chair, weakness with shoulder extension and adduction, and no significant sensory deficits. She recently underwent axillary lymph node dissection following surgery for breast cancer. Which of the following peripheral nerves is MOST likely injured?A) Axillary nerveB) Thoracodorsal nerveC) Long thoracic nerveD) Radial nerveJoin the FREE Facebook Group: www.nptegroup.com

Betty is a 45-year-old female who presents to physical therapy with complaints of pelvic pain, urinary frequency, and urgency without signs of infection. She reports symptoms worsening after prolonged sitting and during high-impact exercises. Which intervention is MOST appropriate to address her condition?A) Pelvic floor muscle strengthening with biofeedbackB) Bladder retraining and dietary modificationC) Myofascial release for the pelvic floorD) Core strengthening exercises to improve pelvic stabilityJoin the FREE Facebook Group: www.nptegroup.com

Josue recommends a prolonged warm-up for a patient with hypertrophic cardiomyopathy before initiating aerobic exercise. Which of the following is the MOST likely rationale for this recommendation?A) To increase left ventricular filling timeB) To prevent sudden increases in heart rateC) To increase myocardial oxygen consumptionD) To enhance stroke volume during exerciseDOWNLOAD THIS EPISODE'S CHEATSHEET:www.nptecheatsheet.com/hyper-heart

Bill presents with early-stage amyotrophic lateral sclerosis (ALS) and reports mild lower extremity weakness and occasional tripping when walking on uneven surfaces. Which intervention is MOST appropriate to address his current functional mobility?A) Prescribe a wheelchair for energy conservationB) Provide ankle-foot orthoses (AFOs) to prevent foot dropC) Initiate high-intensity strength training for lower extremitiesD) Recommend a walker to improve stabilityJoin the FREE Facebook Group: www.nptegroup.com

Aiyana is an office worker with chronic low back pain who is referred to physical therapy. During a core stability assessment, the patient demonstrates difficulty maintaining a neutral pelvis while lifting one leg in a hook-lying position. Which muscle is MOST likely underperforming?A) IliopsoasB) Erector SpinaeC) Quadratus lumborumD) Rectus abdominisTEXT OUR TEAM:(727) 732-4573

Leilani is an athlete who reports muscle cramps, fasciculations in the legs, and fatigue during prolonged training sessions. Which of the following is the MOST likely cause of her symptoms?A) Steroid abuseB) Inadequate caloric intakeC) HypervolemiaD) HyponatremiaDOWNLOAD THIS EPISODE'S CHEATSHEET:www.nptecheatsheet.com/electrolyte

Zayden presents with well-defined, raised plaques on the extensor surfaces of his elbows and knees. The lesions are covered with silvery scales, and he reports occasional itching and no systemic symptoms. What is the MOST likely diagnosis?A) Atopic dermatitisB) Psoriasis vulgarisC) Tinea corporisD) Lichen planusJoin the FREE Facebook Group: www.nptegroup.com

Miraide is recovering from a total hip arthroplasty and reports mild calf discomfort on the second day post-surgery. On examination, there is no significant swelling or redness, but the patient has a resting heart rate of 105 bpm. Which of the following interventions is MOST appropriate to reduce the risk of deep vein thrombosis?A) Initiate ambulation with a walkerB) Apply ice packs to the calfC) Administer ankle pumps and quad setsD) Perform a Homan’s test to confirm DVTDOWNLOAD THIS EPISODES CHEATSHEET:www.nptecheatsheet.com/dvt-implications

Orion is a 12-year-old with spastic diplegic cerebral palsy and is evaluated for gait abnormalities. The therapist observes excessive hip flexion, knee flexion, and ankle dorsiflexion throughout the gait cycle. Which of the following gait patterns BEST describes these findings?A) Crouch gaitB) Scissoring gaitC) Ataxic gaitD) Steppage gaitTEXT OUR TEAM:(727) 732-4573

Kai is a 65-year-old male who presents with deep groin pain, morning stiffness lasting 30 minutes, and a positive scour test. Which gait deviation is MOST likely to be observed?A) Uneven cadenceB) Decreased step length on the unaffected limbC) Lateral trunk lean toward the unaffected limbD) Marked hip internal rotation on the affected sideDOWNLOAD THIS EPISODE'S CHEATSHEET:www.nptecheatsheet.com/osteo-arthritis

Harper presents with neck pain and tingling radiating into the right hand. Symptoms worsen with overhead activities and improve with the arm at rest. Examination reveals weakness in elbow flexion, diminished biceps reflex, and reduced sensation over the lateral forearm. Which of the following tests is the MOST effective to assess this condition? A) Spurling’s testB) Cervical distraction testC) Upper limb tension test (ULTT) for the median nerveD) Adson’s testJoin the FREE Facebook Group: www.nptegroup.com

DeShawn is assessing a 12-month-old child during a developmental screening. The child can pull to stand, cruise along furniture, and grasp small objects using a pincer grip, but has not yet started walking independently. Which of the following findings is MOST concerning?A) Inability to walk independentlyB) Absence of babbling or single wordsC) Persistence of the Moro reflexD) Lack of interest in grasping toysTEXT OUR TEAM: (727) 732-4573

Diego is six weeks post-rotator cuff repair and reports stiffness and a pulling sensation near the surgical incision during overhead movement. Examination reveals restricted shoulder range of motion and palpable adhesions. Which technique is MOST appropriate to address the patient’s symptoms?A) EffleurageB) Transverse friction massageC) Myofascial releaseD) Joint mobilizationDOWNLOAD THIS EPISODE'S CHEATSHEET:www.nptecheatsheet.com/soft-tissue

Luca is a 68 year old male with moderate COPD who is referred for physical therapy to improve exercise tolerance. He reports dyspnea with minimal exertion and has a 6-minute walk test distance of 250 meters. His resting oxygen saturation is 92% on room air. Which of the following is the MOST appropriate initial exercise approach?A) Interval training with short work and rest periods at moderate intensityB) Continuous training at 75% of peak work rate to build enduranceC) Resisted walking with a weighted vest to strengthen lower extremitiesD) Breathing retraining combined with unsupported upper extremity exercisesJoin the FREE Facebook Group: www.nptegroup.com

Amara presents with mild to moderate Alzheimer’s disease and has impaired gait and balance. She becomes disoriented in new environments and struggles with multi-step instructions.Which intervention is MOST appropriate for this patient?A) High-intensity balance exercises on uneven surfacesB) Dual-task training to improve cognitive functionC) Structured gait training in a familiar environmentD) Community ambulation to enhance adaptabilityTEXT OUR TEAM: (727) 732-4573

Helga is two days post-total knee arthroplasty (TKA) and reports moderate knee pain and stiffness. Her knee range of motion is 0–45 degrees, and her incision is well-approximated with mild edema. Which intervention is MOST appropriate to prioritize during this session?A) Full weight bearing on the surgical legB) Low-intensity range of motion exercises to increase knee flexionC) Ambulation with a rollator walker for at least 200 feetD) Manual lymphatic drainage to reduce swellingDOWNLOAD THIS EPISODE'S CHEATSHEET:www.nptecheatsheet.com/tka

Freda presents with persistent shoulder pain following rotator cuff repair surgery. The therapist considers using electrical stimulation for pain management. The patient has a history of mild hypertension controlled with medication and reports occasional muscle spasms in the surgical area. Which of the following would MOST likely require avoidance of electrical stimulation?A) Metal anchors used during surgical fixationB) Recent use of anti-hypertensive medicationC) Active muscle spasms near the surgical siteD) Impaired sensation over the affected shoulderJoin the FREE Facebook Group: www.nptegroup.com

Mohammad is documenting outcomes for a patient who has been treated for a venous ulcer. Which of the following improvements is the MOST significant to report? A) The patient reports a decrease in pain from 6/10 to 2/10 B) The patient's walking distance has increased from 100 meters to 300 meters C) The wound size has decreased from 6 cm² to 3 cm² D) The patient's lower leg swelling has reduced by 50%TEXT OUR TEAM:(727) 732-4573

Sweeney recently underwent a hysterectomy and requests to sit after ambulating a few feet. The patient reports dizziness and right lower extremity pain. On examination, her resting heart rate is 102 bpm, and she has significant swelling in her right lower leg. Which of the following should be assessed FIRST: A) Walking distance before stopping B) Pulse pressure C) Deep calf tenderness D) Dorsal pedal integrityDOWNLOAD THIS EPISODE'S CHEATSHEET:www.nptecheatsheet.com/dvt-implications

Azaria is a 22-year-old swimmer with intermittent right shoulder pain who complains of a slipping sensation during overhead activities. Which of the following tests should be performed FIRST?A) Apprehension test B) Speed's test C) Drop arm test D) Load and shift test Join the FREE Facebook Group: www.nptegroup.com

John reports dizziness and unsteadiness when walking, especially in busy environments or when turning his head quickly. He denies positional dizziness but struggles to read signs while walking. Examination reveals normal balance in static postures and no spontaneous nystagmus. Which test is MOST appropriate to assess the suspected deficit?A) Dix-Hallpike maneuverB) Head thrust testC) Snellen Chart Reading while walkingD) Romberg testDOWNLOAD THIS EPISODE'S CHEATSHEET:www.nptecheatsheet.com/vestibular-patho

Before an evaluation, Arial is reviewing the patient's MRI report that describes sequestration at the L4 – L5 level. The intake form reveals sensory changes along the lateral calf, and dorsum of the foot. Which clinical finding is the most consistent with the medical record? A) Impaired heel walking B) Gastrocnemius and soleus atrophy C) Extensor hallicus longus weakness D) Saddle paraesthesiaTEXT OUR TEAM:(727) 732-4573

Samantha is an office worker who presents with pain and numbness in the right hand, particularly at night. On examination, there is decreased sensation along the palmar aspect of the thumb, index, and middle fingers. Which the of the following is the LEAST likely impaired: A) Abductor pollicus brevisB) Flexor pollicus longusC) Opponens pollicus D) 2nd LumbricalDOWNLOAD THIS EPISODE'S CHEATSHEET:www.nptecheatsheet.com/hand-wrist

Denise is six days post-abdominal surgery with a midline incision. The incision is well-approximated with slight redness but no drainage or dehiscence. She is concerned about safely participating in physical therapy. Which recommendation is MOST appropriate for this patient?A) Avoid core exercises until 6 weeks post-opB) Continue light activities and monitor for redness, swelling, or drainageC) Apply heat to the incision before exercise to promote healingD) Use high-compression abdominal binders during therapyJoin the FREE Facebook Group: www.nptegroup.com

Kelly is referred to physical therapy six days after coronary artery bypass graft (CABG) surgery. She reports mild fatigue but denies chest pain or shortness of breath. Her resting heart rate is 85 bpm, and her blood pressure is 125/80 mmHg. The therapist plans to begin light aerobic exercise as part of her cardiac rehabilitation. Which of the following is the MOST appropriate guideline to follow during this session?A) Monitor for a target heart rate of 70–80% of her age-predicted maximumB) Avoid upper extremity exercises to minimize sternal stressC) Limit aerobic exercise to a maximum of 1–2 METs during this phaseD) Emphasize light aerobic exercise with an intensity below 13 on the Borg RPE scaleTEXT OUR TEAM:(727) 732-4573

Ollie reports progressive weakness in his legs and tingling sensations in his hands and feet after a recent upper respiratory infection. On examination, he has moderate dorsiflexor weakness, and mild gait instability. Which of the following is the MOST anticipated finding? A) Hyperreflexia with distal weaknessB) Loss of tactile sensationC) Severe gross hip muscle weaknessD) Limb contracturesDOWNLOAD THIS EPISODE'S CHEATSHEET:www.nptecheatsheet.com/gbs25

Rella presents with a diagnosis of adhesive capsulitis in the freezing phase. She reports persistent, deep shoulder pain at rest and significant discomfort with attempted movement. Passive range of motion reveals capsular end-feel in all directions, particularly with external rotation. Which intervention is MOST appropriate to address the patient’s symptoms at this stage?A) Low-load prolonged passive stretching with gradual increases in intensityB) Submaximal isometric exercises to reduce pain and maintain muscle activationC) Low-grade joint mobilizations to minimize discomfort and maintain joint mechanicsD) Dynamic strengthening exercises to improve shoulder functionJoin the FREE Facebook Group: www.nptegroup.com

Bailey presents with a history of osteoarthritis and hypertension and is referred to physical therapy for knee pain management. She reports taking over-the-counter medication daily for pain relief. During the session, she mentions experiencing mild stomach discomfort and occasional dizziness. Her blood pressure is 138/86 mmHg. Which medication is MOST likely contributing to the patient’s symptoms?A) AcetaminophenB) IbuprofenC) Calcium-channel blockerD) Glucosamine supplementDOWNLOAD THIS EPISODE'S CHEATSHEET:www.nptecheatsheet.com/common-med

Pouria presents with secondary lymphedema following breast cancer treatment. The patient reports heaviness in the arm and mild discomfort but denies significant pain. The affected arm shows a circumference 3 cm greater than the contralateral arm. She has no open wounds or signs of infection. Which compression and therapy strategy is MOST appropriate to manage this patient’s lymphedema?A) High-stretch bandages to provide consistent pressure during rest and activityB) Intermittent pneumatic compression at 60 mmHg pressure, followed by elastic sleeve applicationC) Short-stretch bandages with manual lymphatic drainage techniquesD) Compression garments with 40-50 mmHg pressure for daily useTEXT OUR TEAM: (727) 732-4573

Jafar has a history of atrial fibrillation and reports occasional fatigue and palpitations. His resting heart rate is 96 bpm and irregular, and he takes a beta-blocker. During a six-minute walk test, he experiences mild shortness of breath but completes the test without difficulty. Which consideration is MOST important when developing this patient’s exercise program?A) Monitor for a target heart rate based on age-predicted max heart rateB) Use a perceived exertion scale to guide exercise intensityC) Avoid aerobic exercise due to the risk of arrhythmiasD) Encourage high-intensity intervals to improve cardiovascular functionDOWNLOAD THIS EPISODE'S CHEATSHEET:www.nptecheatsheet.com/atrial-fib

Taylor presents with a TBI and is recently learning to transfer from a wheelchair to a bed independently. The therapist aims to facilitate the learning process while minimizing cognitive load. Which training strategy is MOST effective for this stage of motor learning?A) Massed practice; intrinsic feedbackB) Distributed practice; concurrent feedbackC) Blocked practice; knowledge of results feedbackD) Random practice; knowledge of performance feedbackJoin the FREE Facebook Group: www.nptegroup.com

Kyle reports sudden posterior ankle pain after jumping, describing it as feeling “kicked.” Examination reveals mild swelling, a palpable gap above the calcaneus, limited active plantarflexion, and inability to perform a single-leg heel raise. Passive range of motion is full and pain-free. Which finding BEST explains the patient’s inability to perform a single-leg heel raise?A) Tear of the medial ankle stabilizer leading to decreased propulsion strengthB) Inflammation of the plantar aponeurosis causing mechanical restrictionC) Disruption of the calcaneal attachment of the posterior compartment tendonD) Strain of the posterior compartment musculature limiting force generationTEXT OUR TEAM:(727) 732-4573

Martha presents with six weeks of dull, intermittent low back pain. The pain worsens with standing but improves slightly with rest. Examination reveals mild lumbar tenderness and restricted motion. Which line of questioning is MOST important to uncover a potential red flag?A) “Have you noticed changes in bowel or bladder habits?” B) “What activities seem to aggravate or relieve your pain?”C) “Have you experienced an increased heart rate and dizziness upon standing? "D) “Do you have electric-like shocks extending down part of one leg? DOWNLOAD THIS EPISODE'S CHEATSHEET:www.nptecheatsheet.com/lumbar-flags

Gertrude presents with right knee osteoarthritis and is being trained to use a cane. She demonstrates unsteady steps when initiating gait and turning, occasionally placing the cane too far ahead of her. She reports feeling unsure about how to use the cane properly in crowded environments. Which intervention is MOST important to improve the patient’s safety and confidence during cane use?A) Adjust cane height to ensure proper weight distributionB) Train safe gait initiation and turning techniquesC) Instruct on cane use in crowded environmentsD) Recommend a walker for greater stabilityJoin the FREE Facebook Group: www.nptegroup.com

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 sensationB) Visual inspection for signs of infectionC) ABI to evaluate vascular supplyD) Toe pressure measurement for microvascular assessmentTEXT OUR TEAM:(727) 732-4573

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 minutesB) Walking to the point of moderate pain, resting, and repeating for 30 minutes totalC) Interval walking at high intensity with short rest breaksD) Walking with partial body weight support to reduce claudication painDOWNLOAD THIS EPISODES CHEATSHEET:www.nptecheatsheet.com/PAD1