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Retired NPTE Form 3.1 exam
questions with answers
A nurse caring for a patient who is 2 days post cerebrovascular accident asks the physical therapist for positioning recommendations when the patient lies on the hemiplegic side. The therapist's recommendations should include positioning the:
- wrist in a flexed position.
- elbow in a flexed position.
- scapula in a protracted position.
- forearm in a pronated position. - CORRECT ANSWERS ✔✔ 3
- When a patient lies on the hemiplegic side, the position of the wrist should be neutral, not flexed.
- When a patient lies on the hemiplegic side, the elbow should be extended, not flexed.
- When a patient lies on the hemiplegic side, the scapula of the hemiplegic arm should be protracted. This is the best choice.
- When a patient lies on the hemiplegic side, the forearm should be supinated, not pronated.
Author: O'Sullivan SB, Schmitz TJ, Fulk GDTitle: Physical RehabilitationEdition: 6Publisher: F.A. DavisYear: 2014Pages: 682 When evaluating the lower extremity muscle strength of a patient, the physical therapist positions the patient prone with the knee flexed. The therapist asks the patient to point the toes upward toward the ceiling. The patient completes the motion, but inverts the foot slightly. This observation indicates:
- tightness of the fibularis (peroneal) muscles.
- substitution by the soleus.
- substitution by the tibialis posterior.
- tightness of the tibialis anterior. - CORRECT ANSWERS ✔✔ 3
- Fibularis (peroneal) muscle tightness can lead to foot eversion, not inversion (p. 631).
- Substitution of the soleus is neutral with respect to foot inversion and eversion (p. 633).
- Substitution of the tibialis posterior may lead to an inverted foot (pp. 634-635).
- Tightness of the tibialis anterior may limit the degree of plantar flexion achieved but would not influence foot inversion or eversion (p. 630).
the motions of hip extension, knee flexion, and lateral (external) rotation of the tibia (p. 977). Author: Dutton MTitle: Dutton's Orthopaedic Examination, Evaluation, and InterventionEdition: 4Publisher: McGraw- HillYear: 2017Pages: 977, 1430, 1452 A physical therapist working with a patient who is borderline hypotensive can minimize orthostatic hypotension by:
- loosening tight legwear and footwear before gait training.
- elevating the head during a hypotensive episode.
- instructing the patient to perform ankle pumps before standing.
- encouraging the patient to consume meals prior to therapy. - CORRECT ANSWERS ✔✔ 3
- Tight stockings can be used to reduce orthostatic hypotension.
- The head of the bed should be lowered during hypotensive episodes.
- Repeatedly dorsiflexing the feet (ankle pumps) can ameliorate symptoms of orthostatic hypotension.
- Consuming meals before therapy will not affect orthostatic hypotension.
Author: Goodman CC, Fuller KSTitle: Pathology: Implications for the Physical TherapistEdition: 4Publisher: Elsevier SaundersYear: 2015Pages: 601 A patient is unable to fully extend the right knee because of a 20° knee flexion contracture. Which of the following compensations during the swing phase of the left lower extremity is expected?
- Hiking of the hip on the left
- Plantar flexion of the left foot
- Lateral trunk lean to the left
- Dropping of the pelvis on the left - CORRECT ANSWERS ✔✔ 1
- A knee flexion contracture on the stance limb would make it more difficult to clear the opposite leg during midswing. Hip hiking on the left may be performed to attempt to "shorten" the swing leg.
- Plantar flexion of the swing leg (left) would effectively lengthen the limb, causing further difficulty in clearing the limb.
- Lateral trunk lean is seen toward the stance side, not the swing side, to reduce abduction demand.
- Dropping of the pelvis to the left would effectively lengthen the swing leg, causing further difficulty in clearing the limb.
application have not been shown to effectively address heterotropic ossification. Author: Umphred DA, Lazaro RT, Roller ML, Burton GUTitle: Umphred's Neurological RehabilitationEdition: 6Publisher: Elsevier MosbyYear: 2013Pages: 478 A physical therapist is setting up an exercise program for a patient who is interested in improving cardiovascular fitness. When performing a submaximal cycle ergometer test the therapist should expect a relatively constant value for:
- oxygen consumption.
- heart rate.
- systolic blood pressure.
- diastolic blood pressure. - CORRECT ANSWERS ✔✔ 4
- An increase in oxygen uptake occurs in response to increased workload (O'Sullivan, p. 531).
- Heart rate increases gradually in response to increased workload (Hillegass, p. 530).
- Systolic blood pressure should increase with increasing workload by approximately 10 mm Hg per 1 metabolic equivalent (MET) increase in workload (Hillegass, pp. 532-533).
- Diastolic blood pressure should remain relatively constant during exercise, remaining within 10 mm Hg of the starting point (Hillegass, p. 533).
Author: O'Sullivan SB, Schmitz TJ, Fulk GDTitle: Physical RehabilitationEdition: 6Publisher: F.A. DavisYear: 2014Pages: 531 Author: Hillegass ETitle: Essentials of Cardiopulmonary Physical TherapyEdition: 4Publisher: ElsevierYear: 2017Pages: 530, 532- 533 During a physical therapy examination, a patient reports numbness, burning, and paresthesias in both feet. A neurological examination reveals bilateral loss of pain and temperature sensation in a stocking-and-glove distribution, diminished ankle reflexes, normal knee-jerk reflexes, and decreased strength in the feet and ankles bilaterally. The patient MOST likely has:
- L4-L5 nerve root compression.
- intermittent claudication.
- peripheral vascular disease.
- peripheral neuropathy. - CORRECT ANSWERS ✔✔ 4
- L4-L5 nerve root compression would cause sensory impairments in a dermatomal pattern (p. 125).
- Intermittent claudication is a vascular problem that causes pain, but no sensory or motor loss (p. 244).
- Peripheral vascular disease would not cause sensory changes or altered reflexes (p. 569).
Author: Myers BATitle: Wound Management: Principles and PracticeEdition: 3Publisher: PearsonYear: 2012Pages: 141 A patient underwent surgical decompression and repair of a large rotator cuff tear 2 weeks ago. Which of the following interventions is LEAST appropriate at this time?
- Maximal elbow isometric exercises
- Active elbow flexion and extension through full range
- Pendulum exercise
- Passive shoulder flexion to 90° - CORRECT ANSWERS ✔✔ 1
- Maximal exercises are not indicated at this stage of recovery at the elbow. They are indicated at week 4.
- Active range motion at the hand, wrist, and elbow is part of the rehabilitation protocol in the early stage of healing.
- Pendulum exercises are a form of passive range of motion permitted at the shoulder in the early stage of healing.
- Limited passive range of motion of the shoulder is permitted during the early stage of healing. Author: Reider BC, Davies GJ, Provencher MTTitle: Orthopaedic Rehabilitation of the Athlete: Getting Back in the GameEdition: 1Publisher: Elsevier SaundersYear: 2015Pages: 232-
A patient with C3 spinal cord injury is working with a physical therapist to select an appropriate power wheelchair. The wheelchair that the patient is trying out has the following features: power-elevating leg rests, power recline, and chest strap. When the patient performs pressure relief by reclining the wheelchair, spasticity increases in the patient's lower extremities. The patient should try a wheelchair with:
- lateral hip guides.
- non-elevating leg rests.
- foot straps.
- power tilt. - CORRECT ANSWERS ✔✔ 4
- Lateral hip guides will not provide pressure relief.
- Non-elevating leg rests will not provide pressure relief or address the patient's spasticity.
- Foot straps would fixate the feet and could cause injury to the patient if the patient reclined and spasticity increased.
- A wheelchair with power tilt provides pressure relief and is less likely to elicit spasticity than a wheelchair with power recline. Author: Umphred DA, Lazaro RT, Roller ML, Burton GUTitle: Umphred's Neurological RehabilitationEdition: 6Publisher: Elsevier MosbyYear: 2013Pages: 505 The joint mobilization technique seen in the illustration is designed to improve hip:
A patient reports a deep, localized pain in the low back and posterior hip region with intermittent tingling that radiates along the posterior thigh. The pain increases when the hip is passively moved into medial (internal) rotation. This finding is MOST likely related to:
- piriformis syndrome.
- tension on the posterior joint capsule of the hip.
- trochanteric bursitis.
- a sacroiliac joint dysfunction. - CORRECT ANSWERS ✔✔ 1
- Symptoms described in the scenario are consistent with piriformis syndrome.
- Tension on the posterior joint capsule of the hip would result in limited motion but not the symptoms described.
- Trochanteric bursitis produces pain laterally, over the greater trochanter, which is not consistent with the symptoms described in the scenario.
- Although sacroiliac joint dysfunction can produce back and leg pain, the description is more consistent with piriformis syndrome. Author: Dutton MTitle: Dutton's Orthopaedic Examination, Evaluation, and InterventionEdition: 4Publisher: McGraw- HillYear: 2017Pages: 249-250, 950 A physical therapist is examining an older adult who has a history of falls. The therapist notes that the patient stops walking when
engaging in conversation, but resumes walking at a brisk pace as soon as the conversation ends. The MOST appropriate interpretation of this behavior is that the patient has:
- inadequate cardiopulmonary function to control breathing while walking.
- high attention requirements for performance of the walking task.
- difficulty dealing with the small balance perturbations associated with speech production.
- a long-standing habit of interrupting ongoing activity and standing still to talk. - CORRECT ANSWERS ✔✔ 2
- Breathlessness is more likely a symptom of cardiopulmonary dysfunction associated with walking and talking. If breathing were difficult when walking at a brisk pace, the patient would more likely slow down to have enough breath for both talking and walking.
- This finding suggests the individual is struggling with the introduction of a secondary task (conversation), which may interfere with performance of a primary task (walking). Individuals who must devote extra attention to walking are unable to perform the two tasks simultaneously.
- Speech should not typically create balance perturbations.
- It is more likely that the person stops walking when talking to concentrate on the task of walking, for which talking is a distraction.
Author: Hillegass ETitle: Essentials of Cardiopulmonary Physical TherapyEdition: 4Publisher: ElsevierYear: 2017Pages: 558, 582 Author: Kraemer WJ, Fleck SJ, Deschenes MRTitle: Exercise Physiology: Integrating Theory and ApplicationEdition: 1Publisher: Lippincott, Williams & WilkinsYear: 2012Pages: 56 A patient had an arthroscopic patellar debridement and lateral retinacular release of the knee 8 weeks ago. The patient works as a computer programmer, has two small children, and lives in a three-story home. Which of the following information is MOST important for determining whether the patient is appropriate for discharge from outpatient therapy?
- Single leg hop for distance
- Isokinetic strength comparison of the quadriceps and hamstrings
- Passive knee flexion range of motion
- Unilateral step down from an 8-inch (20.3-cm) stair - CORRECT ANSWERS ✔✔ 4
- Single leg hop for distance doesn't determine how well the patient can negotiate stairs or squat, which might be required for attending to small children.
- Although isokinetic strength may also be of interest, it may not provide answers about functional tolerances. Simply because the patient may test strong with isokinetic testing does not mean the patient will be able to resume previous activities such as stair climbing.
- Passive knee motion would be expected to be normal in a patient 8 weeks after arthroscopic patellar debridement and lateral retinacular release. Range of motion is not sufficient to determine discharge; functional outcomes would be better.
- The patient would need to be proficient with stair climbing due to the living situation, and stair climbing likely was problematic due to the nature of the surgery. Unilateral step downs most closely match home activities/activities of daily living (ADLs) and is a meaningful activity for the patient. Author: Kisner C, Colby LATitle: Therapeutic Exercise: Foundations and TechniquesEdition: 6Publisher: F.A. DavisYear: 2012Pages: 772-773, 791 The parent of a child with myelomeningocele at L2 asks a physical therapist to provide information regarding the child's prognosis for walking. The therapist should respond by telling the parent that the child will MOSTlikely be able to:
- walk with ankle-foot orthoses throughout the home and school.
- walk with knee-ankle-foot orthoses throughout the home and school.
- walk with knee-ankle-foot orthoses within the home.
- stand using a parapodium; walking will not be possible. - CORRECT ANSWERS ✔✔ 3
- Patient will need to use a wheelchair at home to avoid falls.
- Patient should be transferred to a skilled nursing facility for safety. - CORRECT ANSWERS ✔✔ 1
- A prognosis is the predicted optimal level of improvement in function reached in a certain time period. For some patients, a prognosis may be difficult to establish initially because of complex new problems. In these patients, the prognosis may be established after some treatment and evidence of improvement has occurred. For other patients, like the one in the question, the issues are not complex. The patient has not developed a new illness and will most likely wish to go home. The patient has common illnesses of older persons and will benefit by gait and balance training while in the hospital, with the anticipation of going home to resume normal activities.
- There is no mention of a gait dysfunction in the question; therefore, assuming the patient needs a walker is inappropriate.
- The patient should be given an opportunity to ambulate safely before turning to a wheelchair.
- The patient's workup is negative, the patient was active before admission and the comorbidities are clearly identified. With gait and balance retraining while in the hospital, the patient should be able to resume normal activity. Author: O'Sullivan SB, Schmitz TJ, Fulk GDTitle: Physical RehabilitationEdition: 6Publisher: F.A. DavisYear: 2014Pages: 9
A physical therapist is performing passive range of motion of all extremities with a patient in the intensive care unit who is in a coma. The therapist notes the electrocardiogram in the photograph. The physical therapist's INITIALresponse should be to:
- continue with present treatment.
- continue passive range of motion of lower extremities only.
- stop the treatment and monitor electrocardiogram for 5 minutes.
- activate the emergency system. ventricular fibrillation - CORRECT ANSWERS ✔✔ 4
- The electrocardiogram shows ventricular fibrillation, which is a medical emergency. Continuing treatment is inappropriate.
- The electrocardiogram shows ventricular fibrillation, which is a medical emergency. Continuing treatment is inappropriate
- The electrocardiogram shows ventricular fibrillation, which is a medical emergency. Medical attention should be sought immediately, not delayed for 5 minutes.
- The electrocardiogram shows ventricular fibrillation, which is a medical emergency. Author: Frownfelter D, Dean ETitle: Cardiovascular and Pulmonary Physical Therapy: Evidence to PracticeEdition: 5Publisher: Elsevier MosbyYear: 2012Pages: 169
