NPTE Exam Questions With 100%
Correct Answers
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, NPTE Exam Questions With 100%
Correct Answers
During the initial screening of a patient, the physical therapist notes contusions in
various states of healing on the chest, back, and face, as well as multiple scars. The
patient reports falling often. Which of the following courses of action should the
therapist take FIRST?
1. Take the patient's dietary history to assess for mineral deficiency.
2. Ask the patient if bruising was caused by being hit, kicked, or abused.
3. Instruct the patient in safe movement patterns to avoid falls.
4. Report the patient's caregivers to the appropriate authorities.
2. Ask the patient if bruising was caused by being hit, kicked, or abused.
Multiple lesions in various stages of healing in a broad number of areas is a sign of
possible abuse. In the interest of patient protection, the issue should be pursued,
because the patient may not be forthcoming with an admission that abuse has taken
place.
A patient has the deformity shown in the photograph. Which of the following shoe
modifications is MOST likely to be beneficial for this patient?
1. High toe box
2. Metatarsal pad
3. Rocker bar
4. Metatarsal bar
1. High toe box
Rationale
1. The photograph depicts a hammer toe (p. 1003). A high toe box would allow
space for the hammer toe and would decrease irritation (pp. 1289, 1292).
2. A metatarsal pad transfers stress from the metatarsal heads to the metatarsal
shafts, reducing plantar pressure (p. 1290). The photograph shows pressure on the
dorsum of the hammer toe, which would not be relieved by a metatarsal pad.
3. Rocker bars affix to the sole of the shoe proximal to the metatarsal heads to
reduce the distance the patient travels during stance phase and to shift the load from
the metatarsophalangeal joints to the metatarsal shaft (pp. 1291-1292). The
photograph shows pressure on the dorsum of the hammer toe, which would not be
relieved by a rocker bar.
4. A metatarsal bar is placed posterior to the metatarsal heads on the sole of a shoe
to assist in transferring stress from the metatarsophalangeal joints to the metatarsal
shafts during late stance (p. 1292). The photograph shows pressure on the dorsum
of the hammer toe, which would not be relieved by a metatarsal bar.
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A patient reports significant hypersensitivity to light touch in the left foot and ankle
region following minor trauma. A physical therapist notes warmth, swelling, and
redness over the entire foot and ankle. Which of the following interventions
is MOST appropriate?
1. Continuous ultrasound
2. Gait training, non-weight-bearing on the left
3. Deep friction massage
4. Progressive weight-bearing activities
4. Progressive weight-bearing activities
Rationale
1. The apparent diagnosis is complex regional pain syndrome type I, or reflex
sympathetic dystrophy (p. 410). Patients who have complex regional pain syndrome
often have hypersensitivity to heat and/or cold and, therefore, would not likely
tolerate use of thermal modalities such as continuous ultrasound (p. 412).
2. The apparent diagnosis is complex regional pain syndrome type I, or reflex
sympathetic dystrophy (p. 410). Non-weight-bearing gait would promote more
swelling due to disuse of the muscle pump (p. 412).
3. The apparent diagnosis is complex regional pain syndrome type I, or reflex
sympathetic dystrophy (p. 410). Retrograde massage is recommended in complex
regional pain syndrome; deep friction massage may increase edema (p. 412).
4. The apparent diagnosis is complex regional pain syndrome type I, or reflex
sympathetic dystrophy (p. 410). Range of motion and therapeutic exercises
(including weight-bearing exercises) may encourage a decrease in sympathetic tone,
enhance circulation, help to maintain range of motion and strength, and increase
functional use of the extremity (p. 412).
A patient reports an insidious onset of swelling of 1 month's duration on the dorsum
of the left foot. Which of the following conditions is the MOST likely cause?
1. Heart failure
2. Chronic venous insufficiency
3. Lymphedema
4. Lipedema
3. Lymphedema
1. Dependent edema is one of the early signs of right-sided heart failure. The edema
is usually symmetric and occurs in the feet and ankles (Goodman, Differential
Diagnosis; Goodman, Pathology, pp. 591-592).
2. Edema associated with chronic venous insufficiency usually presents in a gaiter
distribution creating the appearance of an inverted bottle at the calf. Acute onset of
swelling at the dorsum of the foot, as described in the stem, is not typical of chronic
venous changes. (Goodman, Pathology, pp. 655-656)
, 3. Lymphedema is usually unilateral with typical presentation distally on the extremity
(dorsum of the foot or hand) (Goodman, Differential Diagnosis; Goodman,
Pathology, pp. 680-682).
4. Lipedema is a symmetrical swelling of both legs, extending from hips to ankles.
Lipedema onset is primarily proximal to distal. (Goodman, Pathology, pp. 702-704).
A patient maintains the posture shown in the photograph throughout the gait cycle
and reports a sense of numbness in both legs when walking. The MOST probable
explanation for this posture is that the patient is:
1. using the trunk position to advance the lower extremity.
2. unable to disassociate trunk movements from pelvic or limb movement.
3. attempting to decrease the demand on the hip extensors.
4. substituting visual input for impaired proprioception in the lower extremities.
4. substituting visual input for impaired proprioception in the lower extremities.
1. A backward trunk lean, not forward, is associated with compensations to advance
the lower extremity (pp. 1008-1009).
2. Walking in a forward leaning posture does not require disassociation of trunk
movements from the pelvis or lower extremities (p. 1007).
3. Hip extensors are less in demand when leaning backward, not forward. With weak
hip extensors, the trunk would be displaced posteriorly relative to the lower
extremities. (pp. 1008-1009)
4. The patient leans forward to improve stability in the forward progression in gait. In
addition, the head is flexed and held with a downward gaze because the patient is
relying on visual input due to decreased sensory input. (pp. 1006-1007)
Changes in the level of which hormone are MOST likely to contribute to development
of chondromalacia patella in a pregnant woman?
1. Calcitonin
2. Progesterone
3. Relaxin
4. Insulin
3. Relaxin
1. The role of calcitonin is to decrease plasma calcium concentration. There are no
receptors on tendons that would alter their function in any way in response to
changes in calcitonin levels. Calcitonin should not alter the way muscles and bones
interact in a way that would cause chondromalacia, because any calcium changes in
the muscle will occur in every muscle, so no imbalance should occur. (pp. 1012-
1013)
2. The hormone progesterone is secreted by the placenta during pregnancy and has
no known action on tendon laxity. It would not alter the way muscles and bones