NPTE Clinical Files | Physical Therapy

Amara presents with mild to moderate Alzheimer’s disease and has impaired gait and balance. She becomes disoriented in new environments and struggles with multi-step instructions.Which intervention is MOST appropriate for this patient?A) High-intensity balance exercises on uneven surfacesB) Dual-task training to improve cognitive functionC) Structured gait training in a familiar environmentD) Community ambulation to enhance adaptabilityTEXT OUR TEAM: (727) 732-4573

Helga is two days post-total knee arthroplasty (TKA) and reports moderate knee pain and stiffness. Her knee range of motion is 0–45 degrees, and her incision is well-approximated with mild edema. Which intervention is MOST appropriate to prioritize during this session?A) Full weight bearing on the surgical legB) Low-intensity range of motion exercises to increase knee flexionC) Ambulation with a rollator walker for at least 200 feetD) Manual lymphatic drainage to reduce swellingDOWNLOAD THIS EPISODE'S CHEATSHEET:www.nptecheatsheet.com/tka

Freda presents with persistent shoulder pain following rotator cuff repair surgery. The therapist considers using electrical stimulation for pain management. The patient has a history of mild hypertension controlled with medication and reports occasional muscle spasms in the surgical area. Which of the following would MOST likely require avoidance of electrical stimulation?A) Metal anchors used during surgical fixationB) Recent use of anti-hypertensive medicationC) Active muscle spasms near the surgical siteD) Impaired sensation over the affected shoulderJoin the FREE Facebook Group: www.nptegroup.com

Mohammad is documenting outcomes for a patient who has been treated for a venous ulcer. Which of the following improvements is the MOST significant to report? A) The patient reports a decrease in pain from 6/10 to 2/10 B) The patient's walking distance has increased from 100 meters to 300 meters C) The wound size has decreased from 6 cm² to 3 cm² D) The patient's lower leg swelling has reduced by 50%TEXT OUR TEAM:(727) 732-4573

Sweeney recently underwent a hysterectomy and requests to sit after ambulating a few feet. The patient reports dizziness and right lower extremity pain. On examination, her resting heart rate is 102 bpm, and she has significant swelling in her right lower leg. Which of the following should be assessed FIRST: A) Walking distance before stopping B) Pulse pressure C) Deep calf tenderness D) Dorsal pedal integrityDOWNLOAD THIS EPISODE'S CHEATSHEET:www.nptecheatsheet.com/dvt-implications

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

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