3 NPTE questions DPT students struggle with

Many students have the burden of trying to figure out where to start when it comes to tackling the NPTE. There are many schools of thought and study guides available, but, regardless of which you choose, it’s always best to start by understanding the question formatting and complexity. Below you will find 3 sample NPTE questions from Modern Learning. Can you get them all correct?

QUESTION 1

A physical therapist examines a 32-year-old female complaining of right-sided neck pain and headaches following a rear end motor vehicle accident three days ago. The headaches are precipitated by neck movements. She denies any neurologic symptoms or visual disturbance. The examination reveals deep neck flexor muscle endurance deficits. The cervical flexion – rotation test is positive for asymmetry of cervical rotation. The patient has 80 degrees of rotation left, but only 40 degrees of rotation right. Which of the following diagnoses and actions is the MOST appropriate?

A) Cervicogenic headaches. Perform an atlanto-axial joint mobilization.
B) Cervical Facet Syndrome. Perform supine chin tucks.
C) Cervical radiculopathy. Perform suboccipital soft tissue mobilization and stretching.
D) Cervical neck pain and headaches. Refer to primary care physician.

ANSWER 1

We have a 32-year-old female with neck pain and headaches due to a motor vehicle accident. Her headaches are precipitated by neck movements and she has deficits in deep neck flexor strength and cervical rotation right. The signs and symptoms are consistent with cervicogenic headaches, however, there is a more important finding that often gets overlooked. Follow the flow chart below.

This is the Canadian C-Spine Rules. The patient had a simple rear end motor vehicle collision and is unable to rotate 45 degrees right. Therefore, a referral to her primary care physician for a radiograph is warranted prior to physical therapy intervention. The correct answer is D. One of the primary reasons the National Physical Therapy Exam exists is to protect the public by ensuring every Doctor of Physical Therapy graduate is able to Safely & Competently practice. Knowing when it’s appropriate to start treatment or refer is a MUST!

QUESTION 2

A 45-year-old male presents to physical therapy with right ankle pain. He reports rolling his ankle yesterday while playing basketball. He enters the clinic with an antalgic gait pattern, but, no assistive device or brace. He has noticeable swelling on the lateral aspect of the ankle. Examination reveals tenderness along the anterior aspect of the lateral malleoli. Medial talar tilt testing is positive. Which of the following diagnoses and actions is the BEST?

A) Grade I lateral ankle sprain. Advise non-weight bearing, ice, compression, elevation.
B) Grade I lateral ankle sprain. Apply an external ankle support and advise progressive weight bearing.
C) Grade II lateral ankle sprain. Perform balance and proprioceptive exercises.
D) Malleolar fracture. Refer to primary care physician.

ANSWER 2

According to the Ottawa Ankle Rules, there is no indication for a radiograph. Answer B is correct. The patient’s signs and symptoms are most consistent with a grade I ankle sprain. He has swelling, a (+) medial talar tilt test, but minimal loss of function, as he’s able to ambulate into the clinic with no assistive device or brace. Usually, a grade II sprain presents with greater loss of function. At any rate, even if it was a grade II sprain, we would not start treatment with balance and proprioceptive exercises during the acute inflammatory/protective phase of healing. Take into account the patient’s age and tissue healing times when analyzing NPTE questions.

QUESTION 3

A physical therapist measures leg length on a patient with low back pain. While supine, the patient’s right leg is 2 cm shorter than the left. Upon moving into long sitting the right leg becomes longer than the left. Which of the following interventions is the MOST appropriate?

A) Muscle energy technique to facilitate right innominate posterior rotation
B) Muscle energy technique to facilitate right innominate anterior rotation
C) Muscle energy technique to facilitate left innominate anterior rotation
D) Backwards lunge stepping posterior with left lower extremity

ANSWER 3

Did you read the answer options first? If not, you should. Read this article for more information on question analyzation. At any rate, let’s get into this question. This is a classic example of the multiple step complexity of board exam questions. Requiring the test-taker to make in inference based on the stem to correctly select an answer is the hallmark of a quality NPTE question. Expect this formatting on the National Physical Therapy Exam!!! Ultimately, this question style minimizes the likelihood of the test-taker “guessing” the correct answer. He or she must know in order to get it correct.

The question describes the supine to long sit test, in which the patient’s right leg moves from short in supine to long in long sitting. A simple Mnemonic we use to remember the interpretation of the supine to long sit test is acknowledging our speech language pathologist friends, otherwise known as SLP (Short to Long is Posterior). When the leg moves from short to long with the long sit test it indicates a posteriorly rotated innominate. To correct a posteriorly rotated innominate we would facilitate anterior rotation on the right. Answer B is correct.

SUMMARY

Did you get all three questions correct? Only 1% of D.P.T. graduates were able to. If you did congratulations! Simply send us an email with subject line: MLCBLOG30 to receive $30 off. Click here to send email.