NPTE Practice Questions (2026) — Free Sample Questions with Answers

Answer: C

First-degree AV block: First-degree block conducts every P wave with a PR interval longer than 0.20 s; here the PR is normal and some P waves are not conducted.

Second-degree AV block, type I (Wenckebach): Type I shows a PR interval that lengthens progressively until a beat is dropped; here the PR is constant.

Second-degree AV block, type II: Correct: P waves are regular, the PR interval is constant on conducted beats, and P waves are intermittently not conducted without prior PR lengthening — the pattern of Mobitz type II, which can progress to complete heart block.

Third-degree (complete) AV block: In complete block no P waves are conducted, so P waves and QRS complexes are dissociated with a varying PR; here most P waves conduct with a fixed PR.

Constant PR with sudden dropped QRS = Mobitz II (potentially dangerous, notify the medical team); progressive PR lengthening before the dropped beat = Wenckebach.

Answer: C

1. 1. Numerator: the higher of the two right ankle pressures = 84 mm Hg (dorsalis pedis).
2. 2. Denominator: the higher of the two brachial pressures = 140 mm Hg (right arm).
3. 3. ABI = 84 ÷ 140 = 0.60.
4. 4. Interpretation: ABI ≤0.90 is abnormal and diagnostic of peripheral artery disease; 1.00–1.40 is normal.

0.50: Divides the lower right ankle pressure (70) by 140; the ankle numerator should be the higher of the two pedal pressures in that leg.

0.53: Uses the lower ankle pressure (70) and the lower brachial pressure (132); both values should be the higher ones.

0.60: Correct: the higher right ankle pressure (84) divided by the higher brachial pressure (140) = 0.60, which is well below 0.90 and confirms peripheral artery disease.

0.64: Divides 84 by the lower brachial pressure (132); the denominator is the higher of the two arm pressures.

ABI = higher ankle systolic pressure of that leg ÷ higher brachial systolic pressure of the two arms; ≤0.90 indicates PAD.

Answer: C

Atrial flutter: Flutter shows regular sawtooth flutter waves and usually a regular ventricular response (e.g., 2:1); this baseline has no organized flutter waves and the R-R intervals vary at random.

Sinus arrhythmia: Sinus arrhythmia has a normal P wave before every QRS, with R-R intervals that lengthen and shorten gradually with breathing.

Atrial fibrillation: Correct: the R-R intervals are irregularly irregular, there are no discrete P waves, and the baseline between complexes is a low-amplitude fibrillatory wave with narrow QRS complexes.

Multifocal premature ventricular contractions: PVCs are wide, bizarre QRS complexes without a preceding P wave; every complex here is narrow and identical.

Atrial fibrillation = irregularly irregular narrow-complex rhythm with no identifiable P waves and a fibrillatory baseline; note the ventricular rate and symptoms before exercise.

Answer: A

Seated knee extension from 90° to 45° with light resistance: Correct. Open-chain extension restricted to 90°–45° produces little ACL graft strain and can begin around 4 weeks, progressing toward full range later (about 12 weeks).

Seated knee extension from 30° to 0° with a 10-lb ankle weight: Open-chain extension near full extension (30°–0°) places the highest anterior shear and strain on the healing graft; resisting it at 5 weeks is unsafe.

Isokinetic knee extension through 90° to 0° at maximal effort: Maximal full-arc loading is a late-stage progression; at 5 weeks it strains the graft in terminal extension.

Full-arc knee extension from 90° to 0° with a 10-repetition maximum: Heavy full-arc loading is premature; the terminal range should stay unresisted until the graft can tolerate it.

After ACL reconstruction, open-chain quadriceps exercise can start early in a restricted 90°–45° arc and be progressed toward full range over the following weeks.

Answer: B

Femoral retroversion: Retroversion would give a smaller Craig angle and increased external rather than internal rotation, with out-toeing.

Excessive femoral anteversion: Correct. A Craig angle of 25° exceeds the normal adult value of about 8°–15°; excess anteversion shifts hip rotation toward internal rotation and produces in-toeing.

Coxa vara: Coxa vara is a reduced neck-shaft angle in the frontal plane; it is not measured by the Craig test and does not explain in-toeing with excess internal rotation.

Coxa valga: Coxa valga is an increased neck-shaft angle in the frontal plane, not a transverse-plane torsion measured by the Craig test.

The Craig test estimates femoral anteversion (normal adult about 8°–15°); excess anteversion causes increased hip internal rotation and in-toeing.

Answer: A

Retear of the rotator cuff repair: Correct: a fall with a pop, then a large active-passive gap and a positive external rotation lag sign with unchanged passive ROM, indicates loss of cuff integrity; the PT should notify the surgeon.

Postoperative adhesive capsulitis: Capsular stiffness would reduce passive ROM, which is unchanged.

Rupture of the long head of the biceps: A biceps rupture causes a pop and a distal bulge but does not abolish active elevation or produce an external rotation lag.

C5 radiculopathy from the fall: Radiculopathy would bring neck or radiating arm symptoms, dermatomal changes and reflex loss, none of which are described.

After cuff repair, a new active-passive ROM gap with a lag sign after a trauma suggests retear, and the surgeon must be notified.

Answer: A

Full-thickness rotator cuff tear: Correct: a large active-passive gap (95° active vs 170° passive) with marked weakness, a positive drop-arm sign and a lifting injury points to a contractile (rotator cuff) defect, not a joint restriction.

Glenohumeral joint osteoarthritis: Osteoarthritis restricts passive motion with crepitus; full passive ROM argues against a joint-surface problem.

Adhesive capsulitis: Adhesive capsulitis limits passive ROM in a capsular pattern; passive abduction here is full at 170°.

Acromioclavicular joint sprain: An AC sprain causes pain at the top of the shoulder and high-arc pain, not marked weakness with an inability to lower the arm.

When active ROM is much less than passive ROM, suspect a contractile or neurological deficit; when both are limited equally, suspect a joint or capsular restriction.

Answer: C

Left posterior canal cupulolithiasis: Cupulolithiasis produces nystagmus that begins with little or no latency and persists beyond 60 seconds while the position is held.

Right posterior canal canalithiasis: The right posterior canal is tested in the right Dix-Hallpike position, which was negative.

Left posterior canal canalithiasis: Correct. Upbeating torsional nystagmus toward the dependent (left) ear with a short latency and duration under 60 seconds is the classic pattern of free-floating otoconia in the left posterior canal.

Left anterior canal canalithiasis: Anterior canal BPPV produces downbeating, not upbeating, torsional nystagmus.

Posterior canal BPPV: upbeating torsional nystagmus toward the down ear. Canalithiasis has a latency and lasts under 60 seconds; cupulolithiasis lasts longer.

Answer: A

C6 radiculopathy: Correct. Denervation in C6 muscles supplied by three different nerves (musculocutaneous, radial, median) plus the paraspinals places the lesion at the root. Normal sensory responses despite numbness mean the lesion is proximal to the dorsal root ganglion.

Upper trunk brachial plexopathy: A plexus lesion is distal to the dorsal root ganglion, so it would lower the lateral antebrachial cutaneous and thumb sensory amplitudes, and it would spare the paraspinals.

Musculocutaneous neuropathy: Would not explain denervation in brachioradialis (radial), pronator teres (median) or the paraspinals, and would reduce the lateral antebrachial cutaneous response.

Median neuropathy at the wrist: Would prolong median distal latencies and spare the elbow flexors and proximal muscles; the median studies are normal.

Paraspinal denervation and normal sensory responses in a numb area point to a root (preganglionic) lesion; a plexus or nerve lesion lowers sensory amplitudes and spares the paraspinals.

Answer: C

Check the urinary catheter tubing for kinks: Looking for the noxious stimulus (bladder first) is essential, but only after the patient is upright to lower BP.

Lower the head of the mat and raise the legs: This is the response to orthostatic hypotension; lying flat with legs raised would further raise BP in autonomic dysreflexia.

Sit him upright with the legs lowered: Correct. Severe hypertension, headache, flushing and sweating above the level, and bradycardia in a lesion at T6 or above signal autonomic dysreflexia. Sitting up with legs lowered pools blood in the legs and lowers BP immediately.

Ask the physician to order an antihypertensive: Medication is considered only if BP stays elevated after positioning and removal of the trigger; it is not the first action.

Autonomic dysreflexia (lesion T6 or above): sit the patient upright with legs dependent, loosen tight clothing, then find and remove the noxious stimulus while monitoring BP.

Answer: C

Positive Hoffmann sign bilaterally: A Hoffmann sign is an UMN sign that occurs in cervical myelopathy as well as ALS, so it does not differentiate them.

Atrophy of the right thenar eminence: Hand-muscle wasting can come from cervical root or anterior horn compression at the spondylotic levels, so it does not differentiate them.

Tongue fasciculations and atrophy: Correct. Tongue fasciculations and atrophy are LMN signs in the bulbar region, above any cervical lesion. Combined UMN and LMN signs in several regions, with sensation spared, fit ALS.

Reduced vibration sense at the ankles: Posterior column sensory loss points toward myelopathy; ALS spares sensation.

ALS shows mixed UMN and LMN signs across several regions with sensation spared; bulbar LMN signs cannot come from a cervical spine lesion.

Answer: D

Pressure injury: Nothing suggests sustained external pressure over the dorsal toe, and the ischemic findings explain the wound.

Venous insufficiency: Venous wounds are shallow, irregular, heavily draining, near the medial malleolus, with edema and hemosiderin staining, and pain eases with elevation.

Diabetic neuropathy: Neuropathic wounds occur at plantar pressure points, are usually painless and are surrounded by callus.

Arterial insufficiency: Correct: a punched-out, pale, dry wound on the toes with trophic skin changes, rest pain relieved by dependency and an ABI of 0.48 indicate arterial insufficiency.

Arterial wounds: distal toes or lateral malleolus, pale base, little drainage, rest pain relieved by dependency and a low ABI.

Answer: C

Gallbladder: Gallbladder pain is typically right upper quadrant with referral to the right shoulder or scapula, and is not relieved by leaning forward.

Kidney: Renal pain is felt at the costovertebral angle and flank, often radiating to the groin, and is not related to meals.

Pancreas: Correct: epigastric pain radiating to the mid-back, worse after meals and supine and relieved by leaning forward, in a person with heavy alcohol use, suggests pancreatitis; refer for medical evaluation.

Appendix: Appendicitis starts around the umbilicus and moves to the right lower quadrant; it does not refer to the mid-back.

Pancreatic pain is epigastric, refers to the mid-back and is eased by sitting forward or curling up; mechanical thoracic tests do not change it.

Answer: B

Elastic-band resistance and stationary cycling at moderate intensity: Resistance and moderate-intensity exercise are inappropriate with platelets of 18,000/µL and hemoglobin of 7.8 g/dL.

Active ROM and short-distance gait with no added resistance: Correct: with platelets between 10,000 and 20,000/µL and hemoglobin below 8 g/dL, light activity such as AROM, transfers and short walks is appropriate while monitoring symptoms; resisted exercise is avoided because of bleeding risk.

Strict bed rest until the platelet count exceeds 50,000/µL: Overly restrictive: light functional activity is permitted at this platelet level and prevents further deconditioning.

Progressive resisted exercise with free weights at 60% of 1RM: Heavy resistance raises the risk of muscle and joint bleeding with severe thrombocytopenia.

Severe thrombocytopenia (platelets under 20,000/µL) limits activity to light AROM and functional mobility without resistance; low hemoglobin calls for symptom and vital-sign monitoring.

Answer: A

Shorten the cane to greater trochanter height: Correct. The handle sits above the greater trochanter and the elbow is flexed 40°. Lowering it to trochanter (wrist crease) height gives the recommended 20–30° of elbow flexion for effective push-off through the arm.

Move the cane to the left hand on the painful side: The cane belongs in the hand opposite the painful hip, which is the right hand, as already used.

Replace the cane with a standard pick-up walker: The problem is cane height, not the device; nothing suggests she needs the extra support of a walker.

Lengthen the cane to increase upper extremity support: The cane is already too high; lengthening it would increase elbow flexion further and weaken the push through the arm.

Fit a cane with the handle at the greater trochanter or wrist crease and 20–30° of elbow flexion, held in the hand opposite the involved hip.

Answer: A

1 MHz, continuous, 1.5 W/cm²: Correct. A frequency of 1 MHz reaches tissue about 2–5 cm deep, and continuous output at about 1.5–2.0 W/cm² produces vigorous heating before stretching.

1 MHz, 20% pulsed, 0.5 W/cm²: Penetrates to the right depth, but a 20% duty cycle at low intensity is a nonthermal dose; it will not raise tissue temperature enough to increase extensibility.

3 MHz, 20% pulsed, 1.0 W/cm²: Both the depth (3 MHz) and the dose (pulsed, nonthermal) are wrong for heating deep tissue.

3 MHz, continuous, 0.5 W/cm²: A frequency of 3 MHz is absorbed in superficial tissue (about 1–2 cm); it will not effectively heat tissue 3–5 cm deep.

Choose ultrasound frequency by depth (1 MHz deep, 3 MHz superficial) and duty cycle by goal (continuous for heating, pulsed for nonthermal effects).

Answer: D

1. Sensitivity = true positives ÷ all with the condition = 40 ÷ 50 = 0.80.
2. Specificity = true negatives ÷ all without the condition = 85 ÷ 100 = 0.85.
3. LR+ = sensitivity ÷ (1 − specificity) = 0.80 ÷ 0.15 ≈ 5.3.
4. An LR+ of about 5 produces a moderate increase in the post-test probability.

0.24: This is the negative likelihood ratio: (1 − 0.80) ÷ 0.85 ≈ 0.24.

0.73: This is the positive predictive value (40/55), which depends on prevalence.

2.7: This divides true positives by false positives (40/15), which is not a likelihood ratio.

5.3: Correct: sensitivity = 40/50 = 0.80 and specificity = 85/100 = 0.85, so LR+ = 0.80 ÷ (1 − 0.85) = 0.80 ÷ 0.15 ≈ 5.3.

LR+ = sensitivity ÷ (1 − specificity); LR− = (1 − sensitivity) ÷ specificity. Values of 5–10 or 0.1–0.2 shift probability moderately.