PrepIQ NPTE Ultimate Exam, Exams of Technology

The National Physical Therapy Examination (NPTE) is the licensing exam for aspiring physical therapists and physical therapist assistants in the United States. Administered by the Federation of State Boards of Physical Therapy (FSBPT), the NPTE assesses knowledge in patient care, interventions, clinical decision-making, and evidence-based practice. Candidates must demonstrate proficiency in treating movement dysfunctions, rehabilitation planning, and ethical clinical behavior.

Typology: Exams

2025/2026

Available from 04/03/2026

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PrepIQ NPTE Ultimate Exam
**Question 228.** Which of the following is the most appropriate method for
assessing thoracic spine mobility in a patient with suspected ankylosing spondylitis?
A) Measuring cervical rotation only
B) Using a dual-inclinometer to measure thoracic flexion and extension between T1
and T12
C) Palpating the scapular spine
D) Assessing lumbar lordosis
**Answer:** B**
**Explanation:** Dual-inclinometry provides quantitative data on thoracic flexion
and extension, which are commonly limited in ankylosing spondylitis.
**Question 229.** A patient with a recent diagnosis of chronic obstructive
pulmonary disease (COPD) is prescribed a home-based breathing exercise program.
Which of the following techniques is specifically aimed at improving diaphragmatic
excursion?
A) Pursed-lip breathing
B) Diaphragmatic breathing with hand placement on the abdomen
C) Rapid shallow breathing
D) Inspiratory muscle training using a threshold device at 50 % of maximal
inspiratory pressure
**Answer:** B**
**Explanation:** Placing hands on the abdomen provides tactile feedback to
promote diaphragmatic movement during inhalation.
**Question 230.** Which of the following laboratory values would be most
concerning for a patient on long-term high-dose corticosteroid therapy?
A) Serum sodium 140 mmol/L
B) Serum potassium 3.8 mmol/L
C) Fasting blood glucose 180 mg/dL
D) Hemoglobin 13 g/dL
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Question 228. Which of the following is the most appropriate method for assessing thoracic spine mobility in a patient with suspected ankylosing spondylitis? A) Measuring cervical rotation only B) Using a dual-inclinometer to measure thoracic flexion and extension between T and T C) Palpating the scapular spine D) Assessing lumbar lordosis Answer: B** Explanation: Dual-inclinometry provides quantitative data on thoracic flexion and extension, which are commonly limited in ankylosing spondylitis. Question 229. A patient with a recent diagnosis of chronic obstructive pulmonary disease (COPD) is prescribed a home-based breathing exercise program. Which of the following techniques is specifically aimed at improving diaphragmatic excursion? A) Pursed-lip breathing B) Diaphragmatic breathing with hand placement on the abdomen C) Rapid shallow breathing D) Inspiratory muscle training using a threshold device at 50 % of maximal inspiratory pressure Answer: B** Explanation: Placing hands on the abdomen provides tactile feedback to promote diaphragmatic movement during inhalation. Question 230. Which of the following laboratory values would be most concerning for a patient on long-term high-dose corticosteroid therapy? A) Serum sodium 140 mmol/L B) Serum potassium 3.8 mmol/L C) Fasting blood glucose 180 mg/dL D) Hemoglobin 13 g/dL

Answer: C** Explanation: Corticosteroids can induce hyperglycemia; a fasting glucose of 180 mg/dL suggests steroid-induced diabetes risk. Question 231. A 70-year-old patient with severe osteoporosis is being fitted for a wheelchair. Which of the following positioning considerations is most important to minimize fracture risk? A) Elevating the footrests to 30 cm B) Providing a high backrest with rigid lumbar support C) Using a seat cushion with a low center of pressure and ensuring the seat depth does not exceed 80 % of thigh length D) Adding a headrest that forces neck flexion Answer: C** Explanation: A properly sized cushion reduces pressure and shear forces, decreasing the likelihood of fractures in osteoporotic bone. Question 232. Which of the following is the primary purpose of the “Timed Up and Go” (TUG) test in clinical practice? A) Measure maximal aerobic capacity B) Assess dynamic balance, gait speed, and functional mobility C) Evaluate lower-extremity strength only D) Determine joint range of motion Answer: B** Explanation: The TUG combines standing, walking, turning, and sitting, providing a quick snapshot of functional mobility and balance. Question 233. A patient with a recent total knee arthroplasty reports anterior knee pain when descending stairs. Which of the following neuromuscular deficits is most likely contributing? A) Weak hip abductors leading to dynamic valgus

A) Lumbar disc herniation with nerve root irritation B) Primary facet joint arthropathy C) Sacroiliac joint dysfunction D) Hip flexor tightness Answer: A** Explanation: The slump test stretches the neural tissues; a positive result indicates neural tension, often from disc herniation or nerve root involvement. Question 237. Which of the following is the most appropriate progression for a patient performing seated heel raises after a plantar fasciitis flare-up? A) Increase repetitions to 200 per session immediately B) Add ankle weights once the patient can complete 2 sets of 15 pain-free repetitions with proper form C) Transition to single-leg hopping within one week D) Discontinue the exercise entirely Answer: B** Explanation: Gradual resistance progression after mastering pain-free repetitions ensures safe strengthening without exacerbating symptoms. Question 238. Which of the following best describes the mechanism of action of transcutaneous electrical nerve stimulation (TENS) for pain relief? A) Directly stimulating muscle contraction to increase strength B) Activating large-diameter A-β fibers to inhibit nociceptive transmission via the gate control theory C) Increasing local tissue temperature to promote circulation D) Blocking all nerve conduction Answer: B** Explanation: TENS preferentially stimulates A-β fibers, which can “close” the pain gate in the dorsal horn, reducing pain perception.

Question 239. A patient with a recent diagnosis of type 2 diabetes mellitus is being educated on foot care. Which of the following recommendations is most important to prevent ulceration? A) Soak feet in hot water for 20 minutes daily B) Inspect feet daily for cuts, blisters, or redness and keep nails trimmed straight across C) Walk barefoot at home to improve proprioception D) Apply lotion between the toes Answer: B** Explanation: Daily inspection and proper nail care are essential to detect early lesions and prevent diabetic foot ulcers; applying lotion between toes can increase moisture and risk of maceration. Question 240. Which of the following imaging findings is most indicative of a rotator cuff tear on MRI? A) Hyperintense signal within the supraspinatus tendon on T2-weighted images extending to the humeral head B) Joint space narrowing in the glenohumeral joint C) Subchondral sclerosis of the acromion D) Calcific deposit within the deltoid muscle Answer: A** Explanation: A high-intensity fluid signal within the tendon on T2 images that extends to the humeral head is characteristic of a full-thickness rotator cuff tear. Question 241. A patient with a recent total hip arthroplasty is experiencing a “leg length discrepancy” sensation. Which of the following interventions is most appropriate? A) Immediate surgical revision B) Use of a shoe lift on the contralateral limb and gait training to promote symmetry C) Restrict weight-bearing on the operative limb indefinitely

Question 244. Which of the following best describes the principle of “specificity” when designing a balance training program for a patient with vestibular dysfunction? A) Use only static standing exercises B) Incorporate tasks that mimic daily activities such as turning the head while walking on uneven surfaces C) Perform high-intensity cardio only D) Focus solely on upper-extremity strength Answer: B** Explanation: Specificity dictates that training should replicate functional challenges the patient will encounter, enhancing transfer to real-world tasks. Question 245. A patient with a recent diagnosis of chronic heart failure is being educated about the “talk test” for monitoring exercise intensity. Which statement correctly describes its use? A) The patient should be unable to speak more than one word during exercise B) The patient should be able to speak comfortably in full sentences, indicating moderate intensity C) The patient should be gasping for air and unable to talk at all D) The test is not applicable to heart failure patients Answer: B** Explanation: The talk test correlates with moderate intensity; being able to converse comfortably suggests the exercise is within safe limits for heart failure patients. Question 246. Which of the following is the most appropriate precaution when applying a hot pack to a patient with reduced skin sensation due to peripheral neuropathy? A) Apply the hot pack for 30 minutes continuously B) Use a low temperature setting, limit application to 10- 15 minutes, and place a protective barrier between the pack and skin while monitoring temperature frequently

C) Apply the hot pack directly to the affected area without a barrier D) Use the hottest setting available to ensure deep heating Answer: B** Explanation: Reduced sensation increases burn risk; low temperature, short duration, a barrier, and frequent checks are essential for safety. Question 247. A patient with a recent diagnosis of chronic low-back pain demonstrates poor trunk control during functional tasks. Which of the following core stabilization exercises is most appropriate as an initial prescription? A) Full sit-ups with hands behind the head B) Supine abdominal drawing-in maneuver (abdominal bracing) combined with diaphragmatic breathing C) Heavy deadlifts at 80 % 1RM D) Static lumbar extension against a wall Answer: B** Explanation: The drawing-in maneuver activates deep core stabilizers (transversus abdominis) safely, making it ideal for early core training. Question 248. Which of the following is a key component of “patient-centered care” when managing chronic disease? A) Ignoring the patient’s personal goals and focusing solely on clinician-driven outcomes B) Involving the patient in goal setting, respecting cultural values, and tailoring interventions to the individual’s lifestyle C) Providing a one-size-fits-all exercise program D) Limiting education to printed handouts only Answer: B** Explanation: Patient-centered care emphasizes shared decision-making, cultural competence, and individualized treatment planning.