Npte Clinical Files

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

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 functional capacity?A) Treadmill walking at 60% of maximal heart rate, continuous for 30 minutesB) Walking to the point of moderate pain, resting, and repeating for 30 minutes totalC) Interval walking at high intensity with short rest breaksD) Walking with partial body weight support to reduce claudication painDOWNLOAD THIS EPISODES CHEATSHEET:www.nptecheatsheet.com/PAD1

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 intervention is MOST appropriate to improve the patient’s functional mobility and address her symptoms?A) Aerobic training at moderate intensity with frequent rest breaksB) Strength training with resistance bands targeting lower extremity musclesC) Cooling strategies during physical activity to improve enduranceD) Balance training on a foam surface to reduce fall riskJoin the FREE Facebook Group: www.nptegroup.com

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 testB) Reduced knee flexion range of motionC) Medial joint line tendernessD) Presence of effusionTEXT OUR TEAM:(727) 732-4573

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 initial phase of rehabilitation?A) Daily aggressive stretching to maintain range of motionB) Moisturizing and scar massage to prevent contracture formationC) Gentle range of motion exercises to prevent joint stiffnessD) Compression wrapping to reduce hypertrophic scarringDOWNLOAD THIS EPISODES CHEATSHEET:www.nptecheatsheet.com/burns25

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 aerobic capacity?A) VO2 max test using a treadmill protocolB) 6-minute walk testC) Borg Rating of Perceived Exertion (RPE)D) Step testJoin the FREE Facebook Group: www.nptegroup.com

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 MOST appropriate to initiate during Phase II of cardiac rehabilitation?A) Jogging on a treadmill at 70% maximum heart ratB) Cycling on a stationary bike at 3-5 METsC) Strength training at 50% of 1-rep maxD) Stretching and light walking onlyDOWNLOAD THIS EPISODES CHEATSHEET:www.nptecheatsheet.com/cardiac-rehab1

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) ASIA C (Motor Incomplete)D) ASIA D (Motor Incomplete)TEXT OUR TEAM: (727) 732-4573

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 diagnosis?A) FABER testB) Thomas testC) Scour testD) FADIR testJoin the FREE Facebook Group: www.nptegroup.com

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 testB) Anterior drawer testC) Pivot shift testD) Valgus stress testDOWNLOAD THIS EPISODES CHEATSHEET: www.nptecheatsheet.com/knee-specials

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 IIB) Stage IIIC) Stage IVD) UnstageableTEXT OUR TEAM: (727) 732-4573

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 appropriate to optimize the patient’s function and minimize shoulder strain?A) Reclining backrest to improve postural supportB) Lightweight frame with adjustable axle positionC) High backrest to improve scapular stabilityD) Elevating leg rests to reduce shoulder loadingDOWNLOAD THIS EPISODE'S CHEATSHEET: www.nptecheatsheet.com/wheelchair-prescription

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) Decreased breath sounds in the right lower lobeB) Blood pressure of 142/86 mmHgC) Resting respiratory rate of 22 breaths per minuteD) Oxygen desaturation to 88% with exertionJoin the FREE Facebook Group: www.nptegroup.com

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) Strengthening postural muscles DOWNLOAD THIS EPISODES CHEATSHEET: www.nptecheatsheet.com/parkinsons-overview

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) Pendulum exercises for shoulder mobility D) Isometric strengthening of the supraspinatus TEXT OUR TEAM: (727) 732-4573

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 ankle into plantarflexion D) Skin assessment on the bottom of the heel Join the FREE Facebook Group: www.nptegroup.com

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) Necrotic tissue D) Infection DOWNLOAD THIS EPISODES CHEATSHEET: www.nptecheatsheet.com/pressure-ulcer-staging