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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 opp ...
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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 McMu…
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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. Whi…
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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 meas…
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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 exercisi…
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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) A…
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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…
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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 A…
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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 findi…
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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 scapula…
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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 i…
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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) R…
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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-as…
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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…
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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) Ne…
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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) …
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