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…
Stassi is administering neuromuscular electrical stimulation (NMES) to improve quadriceps strength following knee surgery. The patient reports that the stimulation feels uncomfortable as the current is delivered. Stassi would like to maintain a strong therapeutic muscle contraction while making the treatment more comfortable for the patient. Which of the following stimulation parameters should be…
Inez is receiving physical therapy in the acute cardiac unit following an acute coronary event. During treatment, the physical therapist observes a new telemetry change characterized by progressive PR interval lengthening followed by a dropped QRS complex. The patient denies any new symptoms. What is the MOST appropriate action by the physical therapist? A) Continue treatment because this is an…
Anisa is being treated in an inpatient rehabilitation facility following a traumatic brain injury (TBI). The physical therapist has been training the patient to ambulate using a two-point gait pattern with a single-point cane. Anisa consistently performs the gait pattern correctly in a quiet hallway without verbal cueing. Which of the following is the BEST strategy to improve long-term retention…
Tasnuva is referred to physical therapy for progressively worsening right knee pain. The patient reports symptoms that have gradually increased over the past year and are aggravated by prolonged walking. Observation reveals right coxa vara and significant genu valgum during standing. Which of the following structures is MOST likely contributing to the patient’s symptoms? A) Anterior cruciate…
Stephanie is evaluating a patient 8 weeks after sustaining a displaced radial head fracture following a fall onto an outstretched hand. The patient reports persistent lateral elbow pain, difficulty actively extending the wrist and fingers, and weakness when gripping objects. Which of the following examination findings is LEAST likely? A) 5/5 elbow extension manual muscle test B) Limited forearm…
Jeff is a 78-year-old patient recovering from a right CVA. The patient requires moderate assistance for transfers and bed mobility. During therapy, frequent vital sign monitoring is necessary due to ongoing cardiac instability. The patient is now able to tolerate approximately 75 minutes of therapy each day; however, they live alone in a two-story home. Which of the following is the MOST…
Chimezie is performing an initial examination of a patient with type 2 diabetes mellitus. The patient’s most recent hemoglobin A1C is 6.7%. During inspection of the right foot, the therapist observes a small ulcer on the plantar surface beneath the fifth metatarsal head. The patient reports progressively limiting walking activities because of discomfort in the involved foot. Which of the following…
Sando is a 4-month-old infant receiving physical therapy for right congenital muscular torticollis. The physical therapist notes improved cervical alignment, increased tolerance to prone positioning, and improved active midline head control. Which of the following goals would be MOST appropriate to include in the patient's plan of care? A) Restore left cervical rotation passive ROM B) Restore…
LeMarcus is a 42-year-old recreational runner who reports progressive anterior hip discomfort after increasing mileage over the past 2 months. Examination reveals: * Hip flexion ROM: 125° * Hip extension ROM is limited compared to the uninvolved side * Positive Thomas test * Negative Ely’s test * Hip flexor strength: 5/5 * Hip extensor strength: 5/5 * Negative FABER test Which of the following…
Garret is a 30-year-old patient who was hospitalized 3 days ago after being diagnosed with Guillain-Barré syndrome. During examination, the patient is able to perform repeated seated marches without difficulty. However, the therapist notes impaired sensation in a glove-and-stocking distribution and difficulty with heel- and toe-walking. The therapist decides to assess the hip flexor deep tendon…