NPTE Clinical Files | Physical Therapy

By Kyle Rice

What's NPTE Clinical Files | Physical Therapy about?

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. Support this podcast: https://podcasters.spotify.com/pod/show/thepthustle/support

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Cardiopulmonary Findings

09.20.2023

Charese presents a history of chronic obstructive pulmonary disease (COPD) performs a six-minute walk test. Which outcome, if observed during the test, would indicate an exacerbation or worsening of the patient's COPD? A. Increased stride length B. Decreased use of ...

NPTE Clinical Files | Physical Therapy episodes:

09.20.2023 Cardiopulmonary Findings Charese presents a history of chronic obstructive pulmonary disease (COPD) performs a six-minute walk test. Which outcome, if observed during the test, would indicate an exacerbation or worsening of the patient's COPD? A. Increased stride length B. Decreased use of ...
09.13.2023 Total Hip Arthoplasty Posterior Approach Vicky is 67-year-old female with advanced osteoarthritis is scheduled for a total hip arthroplasty. The orthopedic surgeon decides on a posterior approach. Which of the following is the PRIMARY reason for utilizing a posterior approach during the procedure? A. Minimize ...
09.06.2023 Low Energy Hip Fracture Jess is working with a patient who has sustained a low-energy hip fracture. These types of fractures are MOST common in which population? A. High-performance athletes during intense training. B. Postmenopausal women with osteoporosis. C. Children between the ages of ...
08.30.2023 Motor Vehicle Accident Kemmie is a 48-year-old female patient, who was recently involved in a motor vehicle accident and presents with a T10 level spinal cord injury. In addition to bladder dysfunction and decreased sensation below the level of injury, she is MOST ...
08.23.2023 Myocardial Infarction 2 Jerry presents with a history of myocardial infarction and reports experiencing chest pain during exercise. Which of the following interventions would be MOST appropriate? A. Discontinue exercise immediately and refer the patient to a physician B. Continue exercise at a ...
08.16.2023 Frequent Falls & Romberg Heather is a 65-year-old patient being evaluated for balance issues and frequent falls. She exhibits a wide-based, unsteady gait and a positive Romberg test but shows no muscle weakness. What system impairment is most likely contributing to her balance problem? ...
08.09.2023 Shoulder Limitations NPTE Favorite Jimare presents with a rotator cuff injury with limitations into internal rotation passively but has full active external range of motion. Which of the following interventions is the MOST likely to be effective: A. Stretching of internal rotators B. Strengthening ...
08.02.2023 O2 Saturation Jaquay is treating a patient with chronic obstructive pulmonary disease (COPD) who complains of dyspnea during daily activities. The patient's SpO2 levels tend to drop below 88% with mild exertion. In addition to continuing with a general exercise program, which ...
07.26.2023 Medications - Baclofen Blane is reviewing a patient's electronic health record and notes that the patient has been prescribed baclofen. The therapist should understand that baclofen is primarily used for which of the following purposes? A. Relief of skeletal muscle spasms B. Increasing ...
07.19.2023 Modified Ashworth Scale Bethany is evaluating a patient with hemiplegia who has increased tone in the upper extremity. The therapist uses the Modified Ashworth Scale (MAS) to grade the patient's muscle spasticity. The therapist describes the patient's resistance to movement as a "more ...
07.12.2023 Neural Function Jesse presents with decreased sensation in the left leg and reports difficulty with dorsiflexion and inversion of the foot. Which of the following nerves is MOST likely affected? A. Femoral nerve B. Tibial nerve C. Common peroneal nerve D. Obturator ...
07.05.2023 Total Hip Arthroplasy Precautions Jess is treating an elderly female in the acute care setting who has just had an uncemented total hip arthroplasty via a posterior approach. Which of the following precautions should be instructed to the patient during the early postoperative period? ...
06.28.2023 Severe Headache Differential Lani is a 15-year-old male who presents with sudden onset of severe headache, neck stiffness, photophobia and a fever. On examination, he has both Kernig's and Brudzinski's signs. Which of the following is the MOST likely diagnosis? A. Meningitis B. ...
06.21.2023 MSK Special Tests Wei presents with severe pain and swelling in her knee after a fall. The therapist performs a diagnostic test for a medial meniscus tear, which results in the patient experiencing pain and clicking. Which of the following tests is MOST ...
06.14.2023 Parkinson's Disease Treatment Madison is treating a patient with Parkinson's disease who is experiencing gait dysfunction. The therapist decides to incorporate rhythmical auditory stimulation (RAS) into the treatment plan. Which of the following is an accurate statement regarding the use of RAS in ...
06.07.2023 Rotator Cuff Tear Interventions Kofi is a physical therapist treating a patient with an acute rotator cuff tear. Which of the following interventions is MOST appropriate for improving the range of motion in this patient? A) Eccentric strengthening exercises B) Passive range of motion ...
05.31.2023 Neural Symptoms Jackson presents with complaints of numbness and tingling throughout their right hand. The therapist performs a neural tension test on the patient, which reproduces the patient's symptoms. Which of the following is MOST likely involved? A) Median nerve B) Ulnar ...
05.24.2023 Medication Polarity Niamh is a 22-year-old patient with a previous forearm laceration presenting with a raised scar that is tender to touch. The therapist would like to use iontophoresis with the appropriate parameters. Which of the following is the MOST recommended for ...
05.17.2023 TENS Parameters Sajan presents with lower back pain and reports that the pain has been persistent without lasting relief. The treating therapist would like to use low-rate TENS with 2 Hz and 200 microseconds parameters. Which of the following is the MOST ...
05.10.2023 Visceral Evaluation Kaida patient presents with severe epigastric pain that radiates to her back, accompanied by nausea and vomiting. She reports a history of heavy alcohol use and a recent episode of gallbladder stones. Upon examination, there is tenderness in the upper ...
05.03.2023 Bone Mineral Density & Exercise Hadiya is a 60-year-old female who presents to physical therapy with a diagnosis of generalized weakness and a bone Mineral Density T-Score of -1.5. Which of the following interventions is the MOST recommended: A. Marching in 5ft of water B. ...
04.26.2023 Exercise Response Freyja presents with a history of myocardial infarction and reports experiencing chest pain during exercise. Which of the following interventions would be MOST appropriate? A. Discontinue exercise immediately and refer the patient to a physician B. Continue exercise at a ...
04.19.2023 Thomas Test Efe presents to physical therapy with hip pain. During a routine examination, the patient lacks hip extension, has a positive Thomas test, and has excessive anterior pelvic tilt. Which of the following tissues is the MOST likely shortened? A. Rectus ...
04.12.2023 Cardiovascular Interventions Dariana is a 70-year-old patient who presents to physical therapy with a history of congestive heart failure. Upon examination, the patient has significant edema in the lower extremities. Which of the following is the MOST appropriate intervention for this patient? ...
04.05.2023 Physical Therapy Ethics 2 Aiko is treating an uninsured patient who cannot afford the cost of treatment. The patient's condition is chronic and requires specialized ongoing care to manage symptoms and prevent complications. What is the MOST appropriate action for the physical therapist to ...
03.29.2023 THR Complications Laird is treating a patient who has recently undergone a posterolateral total hip replacement surgery. Which of the following postoperative complications should the therapist be MOST concerned about observing during the examination? A. Hematoma B. Neuroborreliosis C. Infection D. Anterior ...
03.22.2023 Pediatric Musculoskeletal Examination Janese is a young child who presents to physical therapy with a medical diagnosis of clubfoot. Which of the following is the correct description: A. Plantarflexion, eversion, adduction B. Dorsiflexion, inversion, adduction C. Plantarflexion, inversion, adduction D. Dorsiflexion, eversion, abduction ...
03.15.2023 Subacromial Impingement Lizzie is performing a routine examination on a patient with a suspected subacromial impingement. Which of the following should be assessed FIRST? A. Shoulder abduction active range of motion B. External rotation manual muscle testing C. Gross shoulder joint mobility ...
03.08.2023 Patient Tardiness India is treating a patient who is frequently late or misses appointments. The patient has a history of poor time management and has apologized for their behavior. What is the MOST appropriate action for the physical therapist to take in ...
03.01.2023 Physical Therapy Ethics Hannah is treating a patient who discloses that they are currently experiencing depression and anxiety. The patient expresses concern that these conditions may interfere with their ability to adhere to their rehabilitation program. What is the MOST appropriate action for ...
02.22.2023 Chronic Low Back Pain Janie is a 50-year-old female who presents with a complaint of chronic low back pain. On examination, the patient reports that she spends most of her day sitting at a desk for work and has limited physical activity. Which of ...
02.15.2023 Referred Pain Hal is researching common referral sites for pathologies and conditions that affect his patient population. Which of the following is MOST likely associated with substernal chest pain that does not have a referral pain pattern? A. Neurological B. Gastrointestinal C. ...
02.08.2023 Cardiorespiratory Conditions April is examining a patient with cardiorespiratory dysfunction. The patient denies any co-existing respiratory disorder however reports a recent trauma to chest. Upon examination, the patient has chest pain that is intensified with inspiration and a non-productive cough. Which of ...
02.01.2023 Types of Pain Jessica, 15-year-old female patient sustained an injury while rollerblading, landing on her right arm. She describes the pain as “deep, nagging, & dull.” Based on the pain description, which of the following structures is MOST likely affected? A. Muscle B. ...
01.25.2023 Cardiac Conditions Blake is a 45-year-old male patient with chest pain at rest, pallor, palpitations, hypertension, and an elevated blood serum cholesterol level of 242 mg/dL. All of these clinical signs and symptoms are MOST likely red flags indicative of which of ...
01.18.2023 Lower Leg Differential Diagnosis Ryan presents with anterolateral leg pain and reports progressive worsening since an increase in his training regimen over the past two weeks. Symptoms appear in the later stages of running and last 2-3 hours after the run. The anterior tibialis ...
01.11.2023 Wound Classification Kemp is treating a patient with lymphedema who presents to physical therapy with a script for wound care. The patient’s chart describes the wound bed as shallow and irregular on the anteromedial lower leg. In addition, the peri-wound area is ...
01.04.2023 Pulse Assessment Rosa presents with a history of CAD and has complaints of pale cool skin on the right lower extremity. The therapist suspects a femoral artery dysfunction. Which of the following pulses is BEST to indicate an impaired flow or blockage ...
12.28.2022 Gait Interventions Estephania is treating a patient with a transfemoral amputation who presents with excessive right hip flexion during routine gait analysis. Upon examination, the patient has 4/5 gross MMT and decreased right hip extension range of motion. Which of the following ...
12.21.2022 Cardiac Rehabilitation Bhava is a physical therapist who is educating a group of practitioners on indications for cardiac rehabilitation. Which of the following diagnoses is the LEAST appropriate for a formal cardiac rehabilitation program? A. Coronary artery bypass graft (CABG) B. Acute ...
12.14.2022 Diastasis Recti Heather is a 32-year-old who presents two weeks postpartum with low back pain. She has a referral to evaluate and treat her 2.25cm diastasis recti. Which of the following interventions would be the MOST appropriate to treat this condition? A. ...
12.07.2022 Neurological Assessement & Sensory Function Blherim performs a routine examination of a patient's neurological function of their hand. Using calipers with a fine tip, the patient can perceive two points when the distance between the points is 11mm or greater. This finding is MOST consistent ...
11.23.2022 Musculoskeletal Origin Jenny presents with an idiopathic onset of anterior shoulder pain. Which of the following is NOT consistent with a musculoskeletal origin: A. Night pain while lying on the affected side B. Intractable pain C. Positive Hornblower's sign D. No change ...
11.16.2022 Overpronation Jesse presents with complaints of right lateral knee pain. Upon gait assessment, the patient has significant overpronation on the right. Which of the following examination findings would BEST explain the observed overpronation? A. Forefoot valgus B. Femoral anteversion C. Genu ...
11.09.2022 Cryotherapy Sohaila is a clinical instructor testing her student on the physiological effects of cryotherapy. Which of the following is NOT an effect of cryotherapy? A. Pain reduction B. Decrease in spasticity C. Reduction in joint stiffness D. Decrease in nerve ...
11.02.2022 Pusher's Syndrome Roger is status post cerebrovascular accident and is being evaluated by physical therapy. The patient seems to disregard safety and repeatedly falls onto their weak side. Which of the following is a diagnostic factor of Pusher Syndrome: A. Contralateral loss ...
10.26.2022 Wound Functional Outcomes Jenny is assessing an immobilized patient with a sacral pressure wound. During the assessment, the therapist examines the change in wound and surrounding skin attributes, reduction in wound depth, change in exudate characteristics, and wound closure. These performance indicators are ...
10.19.2022 Diabetes Symptoms Hasim is educating a patient on the negative effects of diabetes on the body. Which of the following is NOT a sign or symptom of untreated or uncontrolled diabetes mellitus? A. Polyuria B. Polydipsia C. Polyphagia D. Weight gain LINKS ...
10.12.2022 Manual Muscle Testing Juri is performing elbow flexion manual muscle testing on a 16-year-old male athlete. Elbow flexion was graded a 4 out of 5, and the motion was strong but painful. Based on the findings, the therapist should reasonably conclude which of ...
09.28.2022 Sensitivity & Specificity Mariah finds in the literature that the Homans’ sign to screen for DVT is no longer advocated because the test lacks sensitivity and specificity. Which of the following is a consequence of a false-negative test? A. Receiving treatment when it ...

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