NPTE Clinical Files | Physical Therapy

NPTE Clinical Files | Physical Therapy

NPTE Clinical Files is a podcast from the creator of Dominating the NPTE, hosted by Kyle Rice. NPTE Clinical Files explains a true clinical scenario in the form of a mock NPTE-based question. Each question is followed by a set of answer choices, where Dr. Kyle Rice explains the right answer with a detailed rationale. Each season covers all of the major systems and topics found in physical therapy and likely to be found on an NPTE. NPTE Clinical Files gives the Physical Therapist a weekly opportunity to solve clinical puzzles while learning the latest research related to the topic.

Episodes

April 30, 2025 11 mins

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...

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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 test

B) Reduced knee flexion range of motion

C) Medial joint line tenderness

D) Pres...

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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) Dai...

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April 9, 2025 9 mins

Nivayah presents with a history of myocardial infarction and type 2 diabetes. The patient reports limited endurance and shortness of breath when walking up a flight of stairs. The physical therapist wants to assess her aerobic capacity and guide the exercise prescription while considering safety due to her cardiovascular history. Which outcome measure is MOST appropriate to assess this patient’s aerobic capacity?

A) VO2 max test usi...

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April 2, 2025 9 mins

Jamie is a 62-year-old female who is referred to outpatient cardiac rehabilitation 3 weeks after a myocardial infarction. She reports feeling fatigued with moderate exertion but denies chest pain. Her resting vitals are HR 80 bpm, BP 128/82 mmHg, and SpO₂ 98%. She completed Phase I rehabilitation without complications and is eager to begin exercising to improve her endurance. Which activity is MOST appropriate to initiate during Ph...

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March 26, 2025 7 mins

Teddy sustained a spinal cord injury at the C7 level after a motor vehicle accident. During the ASIA examination, the patient has preserved sensation at S4-S5 but no voluntary anal contraction. Motor function is absent below C7. Reflex activity is present. How should this patient’s spinal cord injury be classified on the ASIA Impairment Scale?

A) ASIA A (Complete)

B) ASIA B (Sensory Incomplete)

C) ASIA C (Motor Incomplete)

D) ASIA D (M...

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March 19, 2025 10 mins

Carlos is a long-distance runner who presents with deep groin pain that worsens with running and prolonged sitting. He also reports occasional clicking and a sensation of instability in the left hip. Examination reveals full strength and range of motion, but pain is elicited during specific hip movements that compress the joint. Which clinical test is MOST appropriate to confirm the suspected diagnosis?

A) FABER test

B) Thomas test

C)...

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March 12, 2025 8 mins

Beniah is a 21-year-old female soccer player who presents with right knee pain and instability after pivoting during a game. She reports hearing a “pop” at the time of injury and is now hesitant to bear weight. Examination reveals mild swelling, limited range of motion, and hamstring guarding. Which special test is MOST sensitive for detecting an ACL tear in this patient?

A) Lachman test

B) Anterior drawer test

C) Pivot shift test

D) V...

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March 5, 2025 8 mins

Heather is a female with diabetes who is referred to physical therapy for evaluation of a right heel wound. The wound measures 4 cm in diameter, shows a dry black eschar covering the entire wound bed, and has no surrounding erythema or drainage. The patient denies pain at the wound site. Which wound stage is MOST consistent with the described findings?

A) Stage II

B) Stage III

C) Stage IV

D) Unstageable

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February 26, 2025 10 mins

Jessica presents with a C6 spinal cord injury and is being fitted for a wheelchair. She has full innervation of the deltoids, biceps, and wrist extensors but lacks active triceps function. The patient requires independence in propulsion and activities of daily living. During assessment, she demonstrates forward shoulder positioning and mild scapular instability. Which wheelchair feature is MOST appropriate to optimize the patient’s...

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February 19, 2025 9 mins

Teniah was admitted to the acute care hospital with community-acquired pneumonia. She reports shortness of breath and fatigue. Auscultation reveals decreased breath sounds in the right lower lobe, and SpO₂ drops from 95% to 88% with exertion. Resting vital signs: HR 92 bpm, BP 142/86 mmHg, RR 22 breaths per minute. Which finding requires the MOST immediate communication with the medical team?

A) Decreased breath sounds in the right ...

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February 12, 2025 10 mins

Jamie presents with stage 3 Parkinson’s disease and marked presbycusis and reports frequent freezing episodes during ambulation. She demonstrates a reduced step length and minimal arm swing. Her goal is to improve safety and mobility. Which intervention is MOST appropriate to address the patient’s freezing episodes?

A) Dynamic balance training

B) Rhythmic auditory cueing

C) External visual cues

D) Strengthening postural muscles

DOW...

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February 5, 2025 11 mins

Travasia is 4 weeks post-supraspinatus repair. She reports mild soreness but no significant pain. Examination reveals limited passive shoulder elevation beyond 90° due to stiffness and marked restriction in active range of motion. Which intervention is MOST appropriate at this stage?

A) Resisted external rotation with a resistance band

B) Active-assisted range of motion for shoulder flexion

C) Pendulum exercises for shoulder mobi...

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January 29, 2025 8 mins

Narek reports progressive gait difficulties, including frequent tripping and reduced foot clearance during swing phase. Which examination is MOST appropriate to evaluate the primary cause of his impairments?

A) Neurological assessment of the deep common peroneal nerve

B) Assessment of proprioception in the lower extremities

C) Passive motion of the ankle into plantarflexion

D) Skin assessment on the bottom of the heel

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January 22, 2025 8 mins

Talar is a diabetic patient that presents with a chronic foot ulcer that has not healed despite standard care. The ulcer is clean, but the tissue around the wound is swollen and warm, and there is noticeable erythema. What is the MOST likely underlying cause of this condition?

A) Poor wound dressing technique

B) Venous insufficiency Infection

C) Necrotic tissue

D) Infection

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January 15, 2025 11 mins

Jamie is a 68 year old male with a history of hypertension presents with dizziness, palpitations, and shortness of breath. An ECG reveals a regular rhythm at 110 bpm with narrow QRS complexes and absent P waves. What is the MOST likely diagnosis?

A) Atrial fibrillation

B) Paroxysmal supraventricular tachycardia (PSVT)

C) Ventricular tachycardia

D) Sinus tachycardia

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January 8, 2025 10 mins

Hamza is 3 weeks post-stroke and presents with right-sided hemiparesis. He is able to sit unsupported but struggles to stand and has difficulty walking without assistance. His Brunnstrom stage is III for the right upper extremity and II for the right lower extremity. Which of the following interventions would be most appropriate for this patient to improve his functional mobility and independence?

A) Facilitate weight-bearing on th...

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January 1, 2025 10 mins

Milani presents with anterior shoulder pain and reports difficulty with overhead activities. The patient describes intermittent clicking and discomfort with forward reaching. On examination, the therapist observes a positive Speed’s test, normal strength in external rotation, and no pain with passive shoulder elevation. Which of the following is the MOST likely diagnosis?

A. Bankart lesion

B. Subacromial bursitis

C. Biceps tendinop...

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September 25, 2024 11 mins

Jeremy is performing a neurological evaluation. The therapist notes repeated falls in quiet standing with a suspected forward anticipatory balance impairment. Which of the following tests is MOST likely to reveal this specific impairment?

A) Functional Reach Test

B) Romberg Test

C) Sensory Organization Test

D) Standing in tandem with eyes closed

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September 18, 2024 11 mins

A 45-year-old female presents to physical therapy with complaints of persistent fatigue, and unexplained weight loss. Upon examination, the therapist notes tachycardia, low blood pressure episodes, and excessive sweating. Which of the following is the MOST likely diagnosis?

A) Graves Disease

B) Cor Pulmonale

C) Hypoglycemia

D) Adrenocortical hyperplasia

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