Npte Clinical Files

Azaria is a 22-year-old swimmer with intermittent right shoulder pain who complains of a slipping sensation during overhead activities. Which of the following tests should be performed FIRST?A) Apprehension test B) Speed's test C) Drop arm test D) Load and shift test Join the FREE Facebook Group: www.nptegroup.com

John reports dizziness and unsteadiness when walking, especially in busy environments or when turning his head quickly. He denies positional dizziness but struggles to read signs while walking. Examination reveals normal balance in static postures and no spontaneous nystagmus. Which test is MOST appropriate to assess the suspected deficit?A) Dix-Hallpike maneuverB) Head thrust testC) Snellen Chart Reading while walkingD) Romberg testDOWNLOAD THIS EPISODE'S CHEATSHEET:www.nptecheatsheet.com/vestibular-patho

Before an evaluation, Arial is reviewing the patient's MRI report that describes sequestration at the L4 – L5 level. The intake form reveals sensory changes along the lateral calf, and dorsum of the foot. Which clinical finding is the most consistent with the medical record? A) Impaired heel walking B) Gastrocnemius and soleus atrophy C) Extensor hallicus longus weakness D) Saddle paraesthesiaTEXT OUR TEAM:(727) 732-4573

Samantha is an office worker who presents with pain and numbness in the right hand, particularly at night. On examination, there is decreased sensation along the palmar aspect of the thumb, index, and middle fingers. Which the of the following is the LEAST likely impaired: A) Abductor pollicus brevisB) Flexor pollicus longusC) Opponens pollicus D) 2nd LumbricalDOWNLOAD THIS EPISODE'S CHEATSHEET:www.nptecheatsheet.com/hand-wrist

Denise is six days post-abdominal surgery with a midline incision. The incision is well-approximated with slight redness but no drainage or dehiscence. She is concerned about safely participating in physical therapy. Which recommendation is MOST appropriate for this patient?A) Avoid core exercises until 6 weeks post-opB) Continue light activities and monitor for redness, swelling, or drainageC) Apply heat to the incision before exercise to promote healingD) Use high-compression abdominal binders during therapyJoin the FREE Facebook Group: www.nptegroup.com

Kelly is referred to physical therapy six days after coronary artery bypass graft (CABG) surgery. She reports mild fatigue but denies chest pain or shortness of breath. Her resting heart rate is 85 bpm, and her blood pressure is 125/80 mmHg. The therapist plans to begin light aerobic exercise as part of her cardiac rehabilitation. Which of the following is the MOST appropriate guideline to follow during this session?A) Monitor for a target heart rate of 70–80% of her age-predicted maximumB) Avoid upper extremity exercises to minimize sternal stressC) Limit aerobic exercise to a maximum of 1–2 METs during this phaseD) Emphasize light aerobic exercise with an intensity below 13 on the Borg RPE scaleTEXT OUR TEAM:(727) 732-4573

Ollie reports progressive weakness in his legs and tingling sensations in his hands and feet after a recent upper respiratory infection. On examination, he has moderate dorsiflexor weakness, and mild gait instability. Which of the following is the MOST anticipated finding? A) Hyperreflexia with distal weaknessB) Loss of tactile sensationC) Severe gross hip muscle weaknessD) Limb contracturesDOWNLOAD THIS EPISODE'S CHEATSHEET:www.nptecheatsheet.com/gbs25

Rella presents with a diagnosis of adhesive capsulitis in the freezing phase. She reports persistent, deep shoulder pain at rest and significant discomfort with attempted movement. Passive range of motion reveals capsular end-feel in all directions, particularly with external rotation. Which intervention is MOST appropriate to address the patient’s symptoms at this stage?A) Low-load prolonged passive stretching with gradual increases in intensityB) Submaximal isometric exercises to reduce pain and maintain muscle activationC) Low-grade joint mobilizations to minimize discomfort and maintain joint mechanicsD) Dynamic strengthening exercises to improve shoulder functionJoin the FREE Facebook Group: www.nptegroup.com

Bailey presents with a history of osteoarthritis and hypertension and is referred to physical therapy for knee pain management. She reports taking over-the-counter medication daily for pain relief. During the session, she mentions experiencing mild stomach discomfort and occasional dizziness. Her blood pressure is 138/86 mmHg. Which medication is MOST likely contributing to the patient’s symptoms?A) AcetaminophenB) IbuprofenC) Calcium-channel blockerD) Glucosamine supplementDOWNLOAD THIS EPISODE'S CHEATSHEET:www.nptecheatsheet.com/common-med

Pouria presents with secondary lymphedema following breast cancer treatment. The patient reports heaviness in the arm and mild discomfort but denies significant pain. The affected arm shows a circumference 3 cm greater than the contralateral arm. She has no open wounds or signs of infection. Which compression and therapy strategy is MOST appropriate to manage this patient’s lymphedema?A) High-stretch bandages to provide consistent pressure during rest and activityB) Intermittent pneumatic compression at 60 mmHg pressure, followed by elastic sleeve applicationC) Short-stretch bandages with manual lymphatic drainage techniquesD) Compression garments with 40-50 mmHg pressure for daily useTEXT OUR TEAM: (727) 732-4573

Jafar has a history of atrial fibrillation and reports occasional fatigue and palpitations. His resting heart rate is 96 bpm and irregular, and he takes a beta-blocker. During a six-minute walk test, he experiences mild shortness of breath but completes the test without difficulty. Which consideration is MOST important when developing this patient’s exercise program?A) Monitor for a target heart rate based on age-predicted max heart rateB) Use a perceived exertion scale to guide exercise intensityC) Avoid aerobic exercise due to the risk of arrhythmiasD) Encourage high-intensity intervals to improve cardiovascular functionDOWNLOAD THIS EPISODE'S CHEATSHEET:www.nptecheatsheet.com/atrial-fib

Taylor presents with a TBI and is recently learning to transfer from a wheelchair to a bed independently. The therapist aims to facilitate the learning process while minimizing cognitive load. Which training strategy is MOST effective for this stage of motor learning?A) Massed practice; intrinsic feedbackB) Distributed practice; concurrent feedbackC) Blocked practice; knowledge of results feedbackD) Random practice; knowledge of performance feedbackJoin the FREE Facebook Group: www.nptegroup.com

Kyle reports sudden posterior ankle pain after jumping, describing it as feeling “kicked.” Examination reveals mild swelling, a palpable gap above the calcaneus, limited active plantarflexion, and inability to perform a single-leg heel raise. Passive range of motion is full and pain-free. Which finding BEST explains the patient’s inability to perform a single-leg heel raise?A) Tear of the medial ankle stabilizer leading to decreased propulsion strengthB) Inflammation of the plantar aponeurosis causing mechanical restrictionC) Disruption of the calcaneal attachment of the posterior compartment tendonD) Strain of the posterior compartment musculature limiting force generationTEXT OUR TEAM:(727) 732-4573

Martha presents with six weeks of dull, intermittent low back pain. The pain worsens with standing but improves slightly with rest. Examination reveals mild lumbar tenderness and restricted motion. Which line of questioning is MOST important to uncover a potential red flag?A) “Have you noticed changes in bowel or bladder habits?” B) “What activities seem to aggravate or relieve your pain?”C) “Have you experienced an increased heart rate and dizziness upon standing? "D) “Do you have electric-like shocks extending down part of one leg? DOWNLOAD THIS EPISODE'S CHEATSHEET:www.nptecheatsheet.com/lumbar-flags

Gertrude presents with right knee osteoarthritis and is being trained to use a cane. She demonstrates unsteady steps when initiating gait and turning, occasionally placing the cane too far ahead of her. She reports feeling unsure about how to use the cane properly in crowded environments. Which intervention is MOST important to improve the patient’s safety and confidence during cane use?A) Adjust cane height to ensure proper weight distributionB) Train safe gait initiation and turning techniquesC) Instruct on cane use in crowded environmentsD) Recommend a walker for greater stabilityJoin the FREE Facebook Group: www.nptegroup.com

Betty presents with type 2 diabetes and a non-healing ulcer on the lateral ankle. The ulcer is dry, and the patient reports discomfort in her posterior lower leg with walking. On examination, the affected foot has a capillary refill that is prolonged. Which assessment is MOST important to include during the initial evaluation?A) Monofilament testing for protective sensationB) Visual inspection for signs of infectionC) ABI to evaluate vascular supplyD) Toe pressure measurement for microvascular assessmentTEXT OUR TEAM:(727) 732-4573

Cobert presents with a history of peripheral artery disease and was referred to physical therapy for walking endurance. He reports intermittent claudication in his calves after walking 100 meters and frequently stops to rest. His resting ABI is 0.7 in both legs. The goal is to enhance his functional capacity and quality of life. Which walking program is MOST appropriate to improve this patient’s functional capacity?A) Treadmill walking at 60% of maximal heart rate, continuous for 30 minutesB) Walking to the point of moderate pain, resting, and repeating for 30 minutes totalC) Interval walking at high intensity with short rest breaksD) Walking with partial body weight support to reduce claudication painDOWNLOAD THIS EPISODES CHEATSHEET:www.nptecheatsheet.com/PAD1

Liara presents with relapsing-remitting multiple sclerosis with complaints of fatigue and difficulty walking. She reports worsening symptoms in the afternoon but denies any new relapses. Examination reveals mild spasticity in the lower limbs, decreased endurance, and poor postural control. The patient works as a teacher and finds it challenging to maintain energy throughout the day. Which intervention is MOST appropriate to improve the patient’s functional mobility and address her symptoms?A) Aerobic training at moderate intensity with frequent rest breaksB) Strength training with resistance bands targeting lower extremity musclesC) Cooling strategies during physical activity to improve enduranceD) Balance training on a foam surface to reduce fall riskJoin the FREE Facebook Group: www.nptegroup.com

Rachel presents with knee pain that worsens with activity and improves with rest. She describes stiffness lasting about 30 minutes in the morning and difficulty with stairs. On examination, there is mild joint swelling and crepitus with knee flexion and extension. Which examination finding is MOST indicative of knee osteoarthritis?A) Positive McMurray testB) Reduced knee flexion range of motionC) Medial joint line tendernessD) Presence of effusionTEXT OUR TEAM:(727) 732-4573

Lorren sustained burns to his right forearm and hand while working with hot oil. The burn area is red with blistering, and the patient reports significant pain. On examination, capillary refill is intact, and the wound blanches with pressure. The patient is referred to physical therapy to prevent complications during the early phase of healing. Which intervention is MOST appropriate during the initial phase of rehabilitation?A) Daily aggressive stretching to maintain range of motionB) Moisturizing and scar massage to prevent contracture formationC) Gentle range of motion exercises to prevent joint stiffnessD) Compression wrapping to reduce hypertrophic scarringDOWNLOAD THIS EPISODES CHEATSHEET:www.nptecheatsheet.com/burns25