NPTE Clinical Files | Physical Therapy

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...

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 weakness B) Loss of tactile sensation C) Severe gross hip muscle weakness D) Limb contractures DO...

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 pas...

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?...

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-str...

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...

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 feedback B) Distributed practice; concurrent feedback C) Blocked practice; knowledge of results feedb...

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...

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) “Ha...

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...

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 sensation B) Visual inspection f...

Cobert presents with a history of peripheral artery disease and was referred to physical therapy for walking endurance. He reports intermittent claudication in his calves after walking 100 meters and frequently stops to rest. His resting ABI is 0.7 in both legs. The goal is to enhance his functional capacity and quality of life. Which walking program is MOST appropriate to improve this patient’s f...

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 interven...

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...

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 ini...

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 a...

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 MOS...

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)...

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 diag...

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) Anteri...

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) Unsta...

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 ap...

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) D...

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)...

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) Pen...