NPTE FINAL

FRONTIER
FINAL REVIEW
JEOPARDY
D R . B HUPINDER S INGH , PT, P H D
APRIL 2023 L EAD I NSTRUCTOR
NPTE F INAL F RONTIER

NPTE Final Frontier: Prep Course

DISCLAIMER

This class will follow strict FSBPT and APTA security and
safety regulations.
Any group members posting questions from previous NPTE
exams or even PEAT will be blocked.
The class, including all audio conversations will be recorded.

NPTE Final Frontier: Prep Course

MY PROFILE
• Lead Instructor NPTE Final Frontier
• Licensed PT in multiple states
• PhD in Physical Therapy and Rehabilitation,
Carver College of Medicine, University of Iowa
• Department Chair, Rehab Sciences Manchester
University
• Associate Professor, DPT Program at California
State University
• President, FACTS for PTs (Non-profit)
• Lucky husband and dad

• Tell us about yourself!

NPTE Final Frontier: Prep Course
FINAL REVIEW JEOPARDY!
Cardio/ Non Systems/
MSK Neuromuscular
Lymphatics Other System

100 100 100 100

200 200 200 200

300 300 300 300

400 400 400 400

500 500 500 500

NPTE Final Frontier: Prep Course
Final Jeopardy!
MUSCULOSKETAL 100- QUESTION 1
A patient presents with chief concerns of knee pain. On
assessing the patient, the PT notes that the patient has some
discomfort while flexing the right knee. Which of the
following is the MOST appropriate direction to give a glide to
increase knee flexion?
A. Distal glide to patella in supine
B. Proximal glide to patella in supine
C. Compression of the patella in supine
D. Anterior glide to tibia on a stable femur in prone.

Answer
NPTE Final Frontier: Prep Course
MUSCULOSKETAL 100- ANSWER 1

• Correct answer is A.
• The patella must have mobility to glide distally on the
femur for normal knee flexion, and glide proximally for
normal knee extension.
• With motions of the tibia while in a non-weight-bearing,
open kinematic chain, the concave plateau of the tibia
slides in the same direction as the bone motion.
• Posterior tibiofemoral glide increases flexion and anterior
glide increases extension.
• Reference: Kisner C, Colby LA. Therapeutic Exercise: Foundations and Techniques. 7th ed. Philadelphia: F.A. Davis
Co; 2018; Pages: 156-158.

Return to Main Menu

NPTE Final Frontier: Prep Course
MUSCULOSKETAL 200- QUESTION 2
A 37-year-old female is admitted to the hospital
with symptoms of low back pain. The PT is
assessing the functioning of the hip muscles.
Passive insufficiency of right iliopsoas will be
caused by?
A. Hip extension and right lateral flexion of the trunk
B. Hip extension and left lateral flexion of the trunk
C. Hip flexion and right lateral flexion of the trunk
D. Hip flexion and left lateral flexion of the trunk

Answer
NPTE Final Frontier: Prep Course
MUSCULOSKETAL 200- ANSWER 2

• Correct Answer is B- Hip extension and left lateral flexion

of the trunk
• Passive Insufficiency is the inability of a two joint muscle
to lengthen sufficiently at both joints during end range of
motion. The function of right iliopsoas is hip flexion and
right lateral flexion
• Rule of 4!

Return to Main Menu

NPTE Final Frontier: Prep Course
ACTIVE AND PASSIVE INSUFFICIENCY

Active and Passive Insufficiency

Step 1: Name of the Muscle
Step 2: Is it a two joint muscle?
Step 3: End Range? Function of the muscle?
Step 4: Active or Passive

Return to Main Menu

NPTE Final Frontier: Prep Course
 DAILY
DOUBLE!
Question
NPTE Final Frontier: Prep Course
MUSCULOSKETAL 300- QUESTION 3
A PT examination reveals posterior superior iliac spine
(PSIS) is low on the left; anterior superior iliac spine (ASIS)
is high on the left. Interventions should MOST likely
include unilateral isometric contraction of the:

A. Left hip flexors to correct left anterior rotated innominate

B. Left hip flexors to correct left posterior rotated innominate
C. Left hip abductors to correct pelvis upslip
D. Right hip adductors to correct iliac inflare on the left

Answer
NPTE Final Frontier: Prep Course
MUSCULOSKETAL 300- ANSWER 3

• The correct answer is B: Strengthen hip flexors to correct

left posterior rotated innominate
• Thumb is PSIS and finger is ASIS
• If the patient had an upslip, both the PSIS and the ASIS on
the left would be elevated.
• If an inflare was present, the left PSIS would appear more
lateral and the ASIS would appear more medial.

Return to Main Menu

NPTE Final Frontier: Prep Course
MUSCULOSKETAL 400- QUESTION 4
A 50-year-old male patient presents to an outpatient clinic
with complains of medial knee pain. The picture represents
the position of the foot during normal quiet standing. What is
the MOST appropriate diagnosis of this condition?

A. Uncompensated forefoot valgus

B. Compensated forefoot valgus
C. Uncompensated forefoot varus
D. Compensated forefoot varus

Answer
NPTE Final Frontier: Prep Course
MUSCULOSKETAL 400- ANSWER 4

• The correct answer is A. Uncompensated forefoot valgus.

• If the heel is neutral and the forefoot is in varus (means the big
toe off the ground and small toe on the ground), then it will be
called Uncompensated forefoot varus.
• The heel is in varus and the forefoot in neutral- the answer
will be Compensated forefoot valgus.

Return to Main Menu

NPTE Final Frontier: Prep Course
MUSCULOSKETAL 400- ANSWER 4

• If the heel is neutral and the forefoot is in valgus (means

the big toe on the ground and small toe off the ground),
then it will be called Uncompensated forefoot valgus.

Return to Main Menu

NPTE Final Frontier: Prep Course
MUSCULOSKETAL 500- QUESTION 5
A 56-year-old patients reports having difficulty in cervical
extension due to a closing restriction. The manual therapy
technique appropriate to correct a bilateral closing restriction
of C5 on C6 is:
A. Central PA glide on the spinous process of C6 while
stabilizing C5.
B. Central PA glide on the spinous process of C5 while stabilizing
C6.
C. Unilateral PA glide on the right transverse process of C5 while
stabilizing C6.
D. Unilateral AP glide on the left transverse process of C6 while
stabilizing C5. Answer
NPTE Final Frontier: Prep Course
MUSCULOSKETAL 500- ANSWER 5

• Correct answer is A.

• PA Glide or AP Glide (Safety)

• To open- Move the top vertebrae
• To close- Move the bottom vertebrae

• Unilateral vs Bilateral (Spinous vs transverse process)

Return to Main Menu

NPTE Final Frontier: Prep Course
NEUROMUSCULAR 100- QUESTION 1
When examining, the PT finds the patient's speech is slow
and hesitant but auditory comprehensions are preserved. The
patient’s MRI scan image is shown in the picture. The patient
is MOST LIKELY to present with symptoms of

A. Global aphasia
B. Non-expressive aphasia
C. Wernicke's aphasia
D. Broca's aphasia

Answer
NPTE Final Frontier: Prep Course
NEUROMUSCULAR 100- ANSWER 1

• Correct answer D- Broca's or expressive aphasia.

• Both Broca's and Wernicke's areas are located in the left
cerebral hemisphere. Broca’s area is located in the left
frontal lobe.
• Auditory comprehension is preserved which rules out
Wernicke's and Non-expressive aphasia.

Return to Main Menu

NPTE Final Frontier: Prep Course
NEUROMUSCULAR 200- QUESTION 2
A patient suffered from a left hemisphere CVA few weeks
ago. The PT instructed patient to pick up an object and
patient did not pick it. The PT stepped away within view
from the patient and noticed him picking up the object.
Which of the following MOST LIKELY describes this
scenario?

A. Ideomotor apraxia
B. Ideational apraxia
C. Aphasia
D. Ataxia

Answer
NPTE Final Frontier: Prep Course
NEUROMUSCULAR 200- ANSWER 2

Correct answer is A
• For Ideomotor apraxia the patient is unable to produce any
movement on command. However, the patient will be able to
perform habitual tasks without command.
• Ideational Apraxia is the inability to produce movement on
command since the patient cannot formulate the required
motor task.

Return to Main Menu

NPTE Final Frontier: Prep Course
NEUROMUSCULAR 300- QUESTION 3
A patient presented with C6 SCI from a fall causing
hyperflexion of the cervical spine. The PT observed patient
had weak wrist and finger flexion, decreased sense of pain and
temperature. However, patient’s light touch and vibratory
sense were preserved. Which of the following is MOST likely
associated with this scenario?

A. Central Cord Syndrome

B. Anterior Cord Syndrome
C. Brown-Sequard Syndrome
D. Posterior Cord Syndrome

NPTE Final Frontier: Prep Course Answer

NEUROMUSCULAR 300- ANSWER 3

• Correct Ans: B Anterior cord syndrome as patient underwent a fall

causing hyperflexion of the cervical spine by disrupting vascular
supply from anterior spinal artery.
• Central Cord syndrome is most common syndrome as it occurs from
hyperextension to cervical region.
• Brown Sequard syndrome occurs from hemisection of spinal cord
caused by penetrating wounds, gunshot or stab.
• Posterior cord syndrome- Sensory loss.
• Reference: O'Sullivan SB, Schmitz TJ, Fulk GD. Physical
Rehabilitation. Seventh ed. Philadelphia: F.A. Davis Co; 2019;

NPTE Final Frontier: Prep Course Return to Main Menu

NEUROMUSCULAR 400- QUESTION 4
A patient has sudden onset of symptoms of slurred speech,
and unable to pronounce the words properly. The patient has
tongue deviation as shown in the picture below. Which of the
following is the MOST LIKELY cause for this?
A. Right Hypoglossal nerve palsy
B. Left Glossopharyngeal nerve palsy
C. Left Hypoglossal nerve palsy
D. Right Glossopharyngeal nerve palsy

Answer
NPTE Final Frontier: Prep Course
NEUROMUSCULAR 400- ANSWER 4

• Correct answer is Right Hypoglossal nerve palsy

• The hypoglossal nerve innervates the primary muscles
of the tongue. As a result, a lower motor neuron disease
affecting the right hypoglossal nerve will cause
weakness and resultant deviation of the tongue to the
right (toward the side of weakness).
• Glossopharyngeal nerve doesn’t control tongue
movements.

Return to Main Menu

NPTE Final Frontier: Prep Course
NEUROMUSCULAR 500- QUESTION 5

A PT is training a 21-year-old male who has suffered TBI. The

patient is being trained to perform sit-to-stand transfer with
verbal and tactile feedback from the PT. Which of the
following order of practice is MOST appropriate to be
performed in order to achieve early skill acquisition?
A. Distributed practice
B. Blocked order
C. Random order
D. Serial order

Answer
NPTE Final Frontier: Prep Course
NEUROMUSCULAR 500- ANSWER 5

• The correct answer is B

• Blocked order produces improved early acquisition of skills
whereas serial and random order produce better retention and
generalizability of skills.
• Distributed practice is a type of practice not a practice order. It
is a type of practice includes spaced practice intervals in which
the practice time is equal to or less than the rest time

Return to Main Menu

NPTE Final Frontier: Prep Course
MOTOR LEARNING
• Cognitive- what to do stage
• Extrinsic feedback > than intrinsic
• Knowledge of results 1st then knowledge of performance
• Feedback after every trial
• Associative stage- how to do
• Intrinsic feedback
• Feedback- summed, bandwidth, fading
• Variable practice
• Automatic stage- how to succeed
• Use random or serial practice order rather than blocked practice to
improve retention
• Mass vs Distributed practice

Return to Main Menu

NPTE Final Frontier: Prep Course
CARDIOPULMONARY 100

A 40-year-old male patient reports of shortness of breath and

swelling in LE. During the baseline examination, the PT
examines patient’s heart sounds before starting an exercise
program. Which valve is being auscultated in the picture
shown below?

A. Mitral valve
B. Pulmonary valve
C. Tricuspid valve
D. Aortic valve

Answer
NPTE Final Frontier: Prep Course
CARDIOPULMONARY 100- ANSWER 1

• The correct answer is C. The Tricuspid valve is auscultated

at the left edge of the sternum in the 4th intercostal space.
• The address: "APT M. 2245" stands for:
Aorta (2nd R sternal), Pulmonic (2nd L sternal),
Tricuspid (4th L sternal), Mitral (5th L mid-clavicular)

Return to Main Menu

NPTE Final Frontier: Prep Course
AUSCULTATION

NPTE Final Frontier: Prep Course Return to Main Menu

INTEGUMENTARY 200- QUESTION 2

A 60-year-old male suffered a left sided CVA that caused

weakness of the right-side of the body. His ankle brachial
index is measured to be 0.94. The PT assesses his wound on
the lower back as shown in the picture. Which of the
following is MOST appropriate regarding the ulcer?
A. Unstageable pressure ulcer
B. Stage I pressure ulcer
C. Stage III pressure ulcer
D. Stage II pressure ulcer

NPTE Final Frontier: Prep Course

Answer
INTEGUMENTARY 200- ANSWER 2
Ans: D
Stage II pressure ulcer is defined as partial-thickness skin loss
of dermis presenting as a shallow open ulcer with a red pink
wound bed, without slough.
Stage I pressure ulcer is defined as intact skin with non-
blanchable redness of a localized area usually over a bony
prominence.

Reference: O'Sullivan SB, Schmitz TJ, Fulk GD. Physical

Rehabilitation. Sixth ed. Philadelphia: F.A. Davis Co; 2014;
Pages: 586, 599 Return to Main Menu

NPTE Final Frontier: Prep Course

LYMPHATICS 300- QUESTION 3

A 55-year patient is being seen by a PT 6 months post

mastectomy. The PT is assessing the patient's lymph nodes.
When assessing the lymph nodes, which presentations LEAST
likely require referral to physician?
A. Fixed lymph nodes
B. Rubbery lymph nodes
C. Soft lymph nodes
D. Firm lymph nodes

Answer
NPTE Final Frontier: Prep Course
LYMPHATICS 300- ANSWER 3
The correct answer is C.
Normal:
• Soft, non tender, moveable
Abnormal: Report to physician
• Tender
• Inflammation with or without infection
• Hard, immobile
• Metastatic tumour

NPTE Final Frontier: Prep Course

Return to Main Menu
PULMONARY 400- QUESTION 4
A PT instructed a patient in home postural drainage
positioning. The PT finds the patient siting in a recliner and
leaning forward trying to perform drainage for the superior
segments of the lower lobes. What is the best way for the PT
to correct the position?
A. Change the position to prone lying on a bed with two pillows
under the pelvis
B. Keep sitting in the recliner, leaning forward over a folded
pillow
C. Change the position to supine on a bed with pillows under the
knees
D. Keep sitting in a recliner, leaning slightly backward
NPTE Final Frontier: Prep Course Answer
PULMONARY 400- ANSWER 4
• The correct answer is A
• Prone lying on a bed with two pillows under the pelvis-
Superior segments of the lower lobes
• Sitting on a chair, leaning forward over a folded pillow
Posterior apical segments of the upper lobes
• Supine lying on a bed with pillows under the knees-
Anterior segments of the upper lobes
• Sitting in a recliner, leaning slightly backward- Anterior
Apical segments of the upper lobes

Return to Main Menu

NPTE Final Frontier: Prep Course
ABNORMAL BLOOD GASES
NORMAL BLOOD GASES
PaCO2 35–45 mm H
pH 7.35–7.45
HCO3 22–26 mEq/L
Acid Normal Alkaline
pH <7.35 7.35-7.45 >7.45
PaCO2 >45 35-45 mmHg <35
HCO3 <22 22-26 mEq/l >26

NPTE Final Frontier: Prep Course

Return to Main Menu
CARDIOPULMONARY 500- QUESTION 5

A patient has been diagnosed with uncompensated metabolic

acidosis. Which of the following findings are MOST likely
expected to be seen in the lab report?

A. pH= 7.4, HCO3= 26mEq/L, PaCO2= 30 mm Hg

B. pH= 7.3, HCO3= 26mEq/L, PaCO2= 55 mm Hg
C. pH= 7.3, HCO3= 20mEq/L, PaCO2= 35 mm Hg
D. pH= 7.5, HCO3= 19 mEq/L, PaCO2= 46 mm Hg

NPTE Final Frontier: Prep Course

Answer
CARDIOPULMONARY 500- ANSWER 5

• The correct answer is C.

1. Look at pH
Normal 7.35-7.45- Answer is Compensated
2. Look at PaCO2
Normal 35-45- Answer is Metabolic
3. Look at HCO3
Normal 22-26 – Answer is Respiratory
4. None of the three are normal
Answer is Partially Compensated
Return to Main Menu
NPTE Final Frontier: Prep Course
NON-SYSTEMS 100- QUESTION 1

Two PTs are asked to perform a test on the same group of

patients using the Berg Balance test. The results of both sets
of measurements reveal differences in the PTs' scores, but not
in the repeat measurements. This is indicative of a problem
in:
A. Concurrent validity
B. Intrarater reliability
C. Interrater reliability
D. Construct validity
Answer
NPTE Final Frontier: Prep Course
NON-SYSTEMS 100- ANSWER 1

C is correct
Two PTs are asked to perform a test on the same group
of patients.
A. Concurrent validity.
B. Intrarater reliability.
C. Interrater reliability.
D. Construct validity.

Return to Main Menu

NPTE Final Frontier: Prep Course
TYPES OF VALIDITY
• Concurrent validity:
• Test performed and compared to the gold standard test
and results are matched.
• Eg- Heart rate measured by peripheral pulses and
compared with ECG readings

• Construct validity:
• Test should measure what its supposed to measure
• Eg- Gonio should measure ROM nothing else

Return to Main Menu

NPTE Final Frontier: Prep Course
NON-SYSTEMS 200- QUESTION 2

A patient with a right transfemoral amputation is referred to

a clinic. During gait analysis, the PT observes that patient’s
trunk is bending laterally on the right side during right
stance phase. Which of the following would be the MOST
likely cause of this gait abnormality?
A. Right socket is too small
B. Right medial wall too low
C. Right lateral wall too low
D. Right prosthetic limb is too long

NPTE Final Frontier: Prep Course

Answer
NON-SYSTEMS 200- ANSWER 2
• The correct answer is C.

• The patient would lean toward the affected side due to a

low lateral wall or a high medial wall.
• Low walls
• Similar to weak muscles
• E.g. Low anterior thigh wall= weak quadriceps
• High walls
• Similar to tight muscles
• E.g. High anterior thigh wall= tight hip flexors which pull
pelvis anteriorly

NPTE Final Frontier: Prep Course

Return to Main Menu
NON-SYSTEMS 300- QUESTION 3
A physical therapist is administering iontophoresis for
the management of musculoskeletal inflammation. To
administer this treatment, which ion and polarity should
be used?
A. Zinc, positive pole.
B. Acetate, negative pole.
C. Copper, positive pole.
D. Dexamethasone, negative pole.

NPTE Final Frontier: Prep Course

Answer
NON-SYSTEMS 300- ANSWER 3
Correct answer is D.
Indications Ions from Medicine Polarity of Medical Ions Commonly used
Medicinal Sources
Hyperhidrosis Water +/- Tap water
Analgesic Salicylate - Sodium salicylate
Calcium deposits Acetate - Acetic Acid
Musculoskeletal Dexamethasone - Dexamethasone Phosphate
inflammation
Sclerotic scars Iodine - Iodine
Dermal ulcers Zinc + Zinc oxide
Analgesic Lidocaine + Lidocaine
Xylocaine + Xylocaine
Fungal infections Copper + Copper sulfate
Edema reduction Hyaluronidase + Wydase
Muscle Spasm Calcium + Calcium chloride
Magnesium + Magnesium sulfate

NPTE Final Frontier: Prep Course Return to Main Menu

NON-SYSTEMS 400- QUESTION 4
A 20-year-old patient working at a grocery store complains of
anterior hip pain. During treatment, the patient starts flirting
with the male PT. The PT acts professionally but the patient
persists and makes the PT uncomfortable. What would be
MOST appropriate response?

A. Refuse to treat the patient and refer to another male PT

B. Ignore the flirting and continue to treat
C. Notify patient’s supervisor
D. Joke along to keep open the possibility of dating in the future

Answer
NPTE Final Frontier: Prep Course
NON-SYSTEMS 400- ANSWER 4

• The correct answer is A. Refuse to treat the patient and

refer to another male PT
• PT has full rights to refuse treatment
• Referring to another PT doesn’t mean the patient will
make racial remarks to them too.
• Notifying the patients family is not required

Return to Main Menu

NPTE Final Frontier: Prep Course
SAFETY AND PROFESSIONAL QUESTIONS
• Don’t get Sued
• Be a GOLD
• Follow Protocol
• Think Expensive!

Return to Main Menu

NPTE Final Frontier: Prep Course
NON-SYSTEMS 500- QUESTION 5
A PT is developing a treatment plan for a patient who has a 10 deg of
extension lag. The PT decides to use electrical stimulation to improve the
strength of the quadriceps. Which of the following parameters is the
MOST APPROPRIATE for this patient?

A. Pulse duration- 270 microsec; 8 seconds on, 40 seconds off; Pulse

frequency- 60-70 pps
B. Pulse duration- 150 microsec; 8 seconds on, 16 seconds off; Pulse
frequency- 60-70 pps
C. Pulse duration- 250 microsec; 8 seconds on, 16 seconds off; Pulse
frequency- 60-70 pps
D. Pulse duration- 150 microsec; 8 seconds on, 40 seconds off; Pulse
frequency- 60-70 pps

Answer
NPTE Final Frontier: Prep Course
NON-SYSTEMS 500- QUESTION 5
Ans: A
Rationale: For muscle strengthening:
Pulse duration- 250-300 microsec for large muscle group
and 150-200 msec for small muscle group. On: Off
time::1:5 and may be reduced gradually; Pulse
frequency- 35-80pps;

Reference: Cameron MH. Physical Agents in

Rehabilitation: From Research to Practice. 2nd ed. St.
Louis: Saunders; 2003; 247

Return to Main Menu

NPTE Final Frontier: Prep Course
FINAL THOUGHTS
Integrity, Excellence, Attention
What do we offer?
• Free Facebook/Instagram content
• Free NPTE Final Frontier Podcast
• Group and 1-1 Coaching
• Independent Study Bundle
• 3 Full practice exams
• Careerff.com
• Good luck if you are taking the January 2023 exam
• Feel free to contact at [email protected] if you have
any last-minute questions
• If you are interested in joining our regular coaching program, visit
https://npteff.com/enroll/
• Consider leaving a review on
https://www.facebook.com/groups/NPTEFF/ or on Instagram
https://www.instagram.com/npteff/

NPTE Final Frontier: Prep Course

QUESTIONS

NPTE Final Frontier: Prep Course