An outpatient PTA is collecting knee flexion ROM data in supine for a patient 5 weeks after open reduction and internal fixation of a tibial plateau fracture. Which goniometer alignment is correct?

Axis at the lateral femoral epicondyle, stationary arm toward the greater trochanter, moving arm toward the lateral malleolus

Axis at the fibular head, stationary arm toward the lateral femoral condyle, moving arm toward the fifth metatarsal head

Axis at the center of the patella, stationary arm toward the ASIS, moving arm toward the midpoint of the ankle

Axis at the medial joint line, stationary arm toward the ASIS, moving arm toward the medial malleolus of the same limb

A 72-year-old with osteoporosis (T-score of -3.0) brings her home exercise sheet from a fitness class to outpatient therapy. Which exercise should the PTA recommend she replace, consistent with the plan of care?

Curl-ups (sit-ups) performed on the floor

Tandem stance with a hand near a counter

Prone thoracic extension lifts on a mat

Standing heel raises holding a counter

The PT asks the PTA to screen outpatients with chronic stroke for a constraint-induced movement therapy program. Which finding in the involved upper extremity MOST supports eligibility under typical CIMT criteria?

Active wrist extension of 20 degrees and finger extension of 10

Active shoulder flexion of 45 degrees with no wrist or finger movement

Full passive ROM of the wrist and fingers with flaccid tone throughout

Mass finger flexion with no active extension of the wrist or fingers

A patient recovering from pneumonia on an acute medical unit has this order: oxygen 2 L/min by nasal cannula, keep SpO2 at 90% or higher; no titration parameters are written. The PTA records these values during gait training. Time point HR SpO2 Dyspnea Rest, seated 92 94% mild Walking 3 min 112 86% moderate-severe The patient is short of breath but alert and oriented. What is the MOST appropriate action by the PTA?

Seat the patient, cue pursed-lip breathing, monitor recovery, and report to nurse and PT

Remove the nasal cannula and switch the patient to a non-rebreather mask for the walk

Increase the oxygen flow to 4 L/min and continue walking while watching the oximeter

Continue walking at a slower pace because a brief drop below 90% is expected with pneumonia

A PTA is measuring shoulder external rotation with the patient supine, the shoulder abducted 90 deg, and the elbow flexed 90 deg. Which goniometer alignment is correct?

Axis at the olecranon, stationary arm perpendicular to the floor, moving arm along the ulna to the ulnar styloid

Axis at the acromion, stationary arm along the midaxillary line, moving arm along the humerus to the lateral epicondyle

Axis at the olecranon, stationary arm parallel to the floor, moving arm along the radius toward the thumb

Axis at the lateral epicondyle, stationary arm along the humerus, moving arm along the radius to the radial styloid

The plan of care for a 50-year-old with thoracic stiffness includes thoracic joint mobilization. The patient asks the PTA to "crack my back like a chiropractor would." Which intervention is within PTA scope?

Thoracic non-thrust oscillations at the grade the POC specifies

Adding lumbar mobilization because the low back now feels stiff

Changing the plan to manipulation because the patient prefers it

A high-velocity, low-amplitude thrust to the stiff thoracic segment

A patient with pusher syndrome after a right hemisphere stroke leans and pushes toward his left side in sitting. Which intervention is MOST appropriate within the POC?

Use a door frame as a vertical cue and have him reach to the right

Have him close his eyes to train his internal sense of upright posture

Push him back to midline with firm, steady force against his resistance

Have him press down through his right hand on the mat to sit straighter

A PTA is seeing a patient with pulmonary hypertension at home. Which group of findings is MOST consistent with right-sided heart failure?

Jugular venous distension, bilateral ankle edema and abdominal swelling

Intermittent calf pain with walking and absent pedal pulses

Orthopnea, inspiratory crackles at both lung bases and a frothy, pink-tinged cough

Sudden unilateral calf swelling with warmth and tenderness

NPTAE

Free NPTAE Practice Questions

10 sample questions for the NPTAE, with the correct answer and an explanation for each. No account needed. Try each one before you open the answer.

Sections covered on the exam: Musculoskeletal System: Anatomy, Data Collection and Conditions, Musculoskeletal Interventions, Cardiovascular and Pulmonary Systems, Metabolic, Endocrine, Gastrointestinal and Genitourinary Systems, Neuromuscular and Nervous Systems: Data Collection and Conditions, Therapeutic Modalities, Equipment, Devices and Technologies, Professional Responsibilities, Ethics and Evidence-Based Practice.

Question 1 · Musculoskeletal System: Anatomy, Data Collection and Conditions
An outpatient PTA is collecting knee flexion ROM data in supine for a patient 5 weeks after open reduction and internal fixation of a tibial plateau fracture. Which goniometer alignment is correct?
- A.Axis at the lateral femoral epicondyle, stationary arm toward the greater trochanter, moving arm toward the lateral malleolus
- B.Axis at the fibular head, stationary arm toward the lateral femoral condyle, moving arm toward the fifth metatarsal head
- C.Axis at the center of the patella, stationary arm toward the ASIS, moving arm toward the midpoint of the ankle
- D.Axis at the medial joint line, stationary arm toward the ASIS, moving arm toward the medial malleolus of the same limb
Show answer and explanation
Answer: A. Axis at the lateral femoral epicondyle, stationary arm toward the greater trochanter, moving arm toward the lateral malleolus
Knee flexion is measured with the axis over the lateral femoral epicondyle, the stationary arm along the femur toward the greater trochanter, and the moving arm along the fibula toward the lateral malleolus. A patella-centered axis does not sit over the knee's axis of rotation (the patella moves with the quadriceps tendon), and the fibular-head setup uses the wrong joint axis and the wrong proximal and distal landmarks.
Question 2 · Musculoskeletal Interventions
A 72-year-old with osteoporosis (T-score of -3.0) brings her home exercise sheet from a fitness class to outpatient therapy. Which exercise should the PTA recommend she replace, consistent with the plan of care?
- A.Tandem stance with a hand near a counter
- B.Curl-ups (sit-ups) performed on the floor
- C.Prone thoracic extension lifts on a mat
- D.Standing heel raises holding a counter
Show answer and explanation
Answer: B. Curl-ups (sit-ups) performed on the floor
Loaded spinal flexion such as curl-ups increases anterior vertebral compression and the risk of vertebral compression fractures in osteoporosis. Thoracic extension, weight bearing heel raises, and balance training are all recommended for this population.
Question 3 · Musculoskeletal Interventions
The PT asks the PTA to screen outpatients with chronic stroke for a constraint-induced movement therapy program. Which finding in the involved upper extremity MOST supports eligibility under typical CIMT criteria?
- A.Active shoulder flexion of 45 degrees with no wrist or finger movement
- B.Full passive ROM of the wrist and fingers with flaccid tone throughout
- C.Mass finger flexion with no active extension of the wrist or fingers
- D.Active wrist extension of 20 degrees and finger extension of 10
Show answer and explanation
Answer: D. Active wrist extension of 20 degrees and finger extension of 10
Typical CIMT criteria require at least about 20 degrees of active wrist extension and 10 degrees of active finger extension so the patient can practice functional grasp and release. Shoulder motion alone, mass flexion without extension or flaccid tone do not provide enough distal control for intensive task practice.
Question 4 · Cardiovascular and Pulmonary Systems
A patient recovering from pneumonia on an acute medical unit has this order: oxygen 2 L/min by nasal cannula, keep SpO2 at 90% or higher; no titration parameters are written. The PTA records these values during gait training.
Time point HR SpO2 Dyspnea
Rest, seated 92 94% mild
Walking 3 min 112 86% moderate-severe
The patient is short of breath but alert and oriented. What is the MOST appropriate action by the PTA?
- A.Remove the nasal cannula and switch the patient to a non-rebreather mask for the walk
- B.Seat the patient, cue pursed-lip breathing, monitor recovery, and report to nurse and PT
- C.Increase the oxygen flow to 4 L/min and continue walking while watching the oximeter
- D.Continue walking at a slower pace because a brief drop below 90% is expected with pneumonia
Show answer and explanation
Answer: B. Seat the patient, cue pursed-lip breathing, monitor recovery, and report to nurse and PT
SpO2 fell below the ordered target with significant dyspnea, so activity should stop and the patient should rest with breathing strategies while saturation is monitored; the nurse and PT need to know the response. Oxygen flow and delivery device are changed only by order, so raising the flow or switching to a mask without parameters oversteps scope. Continuing to walk below target ignores the order.
Question 5 · Therapeutic Modalities
The POC for a patient with chronic posterior hip capsule tightness calls for continuous ultrasound to heat the capsule, estimated at 4 cm deep, before stretching. Which parameter set is MOST appropriate?
- A.1 MHz, pulsed 20%, 0.5 W/cm2
- B.3 MHz, pulsed 20%, 0.8 W/cm2
- C.1 MHz, continuous, 1.5 W/cm2
- D.3 MHz, continuous, 1.5 W/cm2
Show answer and explanation
Answer: C. 1 MHz, continuous, 1.5 W/cm2
A 1 MHz frequency penetrates to about 5 cm, and continuous output at 1.0-2.5 W/cm2 produces the thermal effect needed to increase tissue extensibility before stretching. Three MHz is absorbed in the superficial 1-2 cm, and 20% pulsed output is non-thermal, used for acute inflammation and tissue healing.
Question 6 · Musculoskeletal System: Anatomy, Data Collection and Conditions
A PTA is measuring shoulder external rotation with the patient supine, the shoulder abducted 90 deg, and the elbow flexed 90 deg. Which goniometer alignment is correct?
- A.Axis at the acromion, stationary arm along the midaxillary line, moving arm along the humerus to the lateral epicondyle
- B.Axis at the olecranon, stationary arm parallel to the floor, moving arm along the radius toward the thumb
- C.Axis at the lateral epicondyle, stationary arm along the humerus, moving arm along the radius to the radial styloid
- D.Axis at the olecranon, stationary arm perpendicular to the floor, moving arm along the ulna to the ulnar styloid
Show answer and explanation
Answer: D. Axis at the olecranon, stationary arm perpendicular to the floor, moving arm along the ulna to the ulnar styloid
For shoulder rotation in 90 deg of abduction, the axis is the olecranon, the stationary arm is perpendicular to the floor, and the moving arm follows the ulna to the ulnar styloid. Acromion alignment along the midaxillary line measures abduction, and lateral epicondyle alignment measures elbow flexion.
Question 7 · Musculoskeletal Interventions
The plan of care for a 50-year-old with thoracic stiffness includes thoracic joint mobilization. The patient asks the PTA to "crack my back like a chiropractor would." Which intervention is within PTA scope?
- A.Adding lumbar mobilization because the low back now feels stiff
- B.Thoracic non-thrust oscillations at the grade the POC specifies
- C.Changing the plan to manipulation because the patient prefers it
- D.A high-velocity, low-amplitude thrust to the stiff thoracic segment
Show answer and explanation
Answer: B. Thoracic non-thrust oscillations at the grade the POC specifies
A PTA may perform non-thrust joint mobilization within the plan of care where state law allows, but high-velocity thrust manipulation is a PT-only procedure. Adding a new region or changing the intervention would change the plan of care, which only the PT can do.
Question 8 · Musculoskeletal Interventions
A patient with pusher syndrome after a right hemisphere stroke leans and pushes toward his left side in sitting. Which intervention is MOST appropriate within the POC?
- A.Have him close his eyes to train his internal sense of upright posture
- B.Push him back to midline with firm, steady force against his resistance
- C.Have him press down through his right hand on the mat to sit straighter
- D.Use a door frame as a vertical cue and have him reach to the right
Show answer and explanation
Answer: D. Use a door frame as a vertical cue and have him reach to the right
Patients with pusher syndrome have an altered sense of vertical, so visual vertical references and reaching toward the stronger side shift weight away from the hemiplegic side. Forcing the patient back increases pushing, pressing through the stronger hand is the pushing behavior itself, and removing vision takes away the most useful cue.
Question 9 · Cardiovascular and Pulmonary Systems
A PTA is seeing a patient with pulmonary hypertension at home. Which group of findings is MOST consistent with right-sided heart failure?
- A.Jugular venous distension, bilateral ankle edema and abdominal swelling
- B.Intermittent calf pain with walking and absent pedal pulses
- C.Orthopnea, inspiratory crackles at both lung bases and a frothy, pink-tinged cough
- D.Sudden unilateral calf swelling with warmth and tenderness
Show answer and explanation
Answer: A. Jugular venous distension, bilateral ankle edema and abdominal swelling
Right ventricular failure backs blood up into the systemic veins, producing jugular venous distension, dependent edema and abdominal congestion. Orthopnea and basilar crackles reflect pulmonary congestion from left-sided failure. Claudication with absent pulses suggests PAD, and unilateral calf swelling with warmth suggests DVT.
Question 10 · Therapeutic Modalities
The POC for a patient 3 days after a lateral ankle sprain calls for non-thermal pulsed ultrasound. The unit displays a pulse on time of 1 ms and an off time of 4 ms. Which duty cycle is being delivered?
- A.40%
- B.25%
- C.80%
- D.20%
Show answer and explanation
Answer: D. 20%
Duty cycle is on time divided by the total pulse period: 1 ms / (1 ms + 4 ms) = 0.20, or 20%, the common non-thermal setting for acute tissue healing. Dividing on time by off time gives 25%, a common error, and 80% is the off portion of the cycle.

Time point	HR	SpO2	Dyspnea
Rest, seated	92	94%	mild
Walking 3 min	112	86%	moderate-severe

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