NPTE-PT Exam Prep: Free Study Plan and 25 Practice Questions
This free NPTE-PT prep guide turns FSBPT's current content outline into a priority map, a six-week study plan, and 25 original practice questions with full explanations. It covers the physical therapist (PT) exam only; the PTA exam uses a different outline.
What to study first
The current PT exam has 225 questions, but only 180 are scored. FSBPT publishes a scored-item range for each content area, so those ranges are a useful starting point for deciding where to spend your study time.
| Content area | Scored items (official range) | Share of 180 scored items | Study priority |
|---|---|---|---|
| Musculoskeletal | 44–54 | 24–30% | Tier 1 |
| Neuromuscular & Nervous | 39–48 | 22–27% | Tier 1 |
| Cardiovascular & Pulmonary | 22–27 | 12–15% | Tier 2 |
| Integumentary | 8–11 | 4–6% | Tier 3 |
| System Interactions | 8–10 | 4–6% | Tier 3 |
| Lymphatic | 4–7 | 2–4% | Tier 3 |
| Metabolic & Endocrine | 4–6 | 2–3% | Tier 3 |
| Gastrointestinal | 3–6 | 2–3% | Tier 3 |
| Genitourinary | 2–5 | 1–3% | Tier 3 |
| Safety & Protection | 5–7 | 3–4% | Tier 3 |
| Equipment, Devices & Technologies | 5–6 | 3% | Tier 3 |
| Therapeutic Modalities | 4–6 | 2–3% | Tier 3 |
| Professional Responsibilities | 4–5 | 2–3% | Tier 3 |
| Research & Evidence-Based Practice | 3–5 | 2–3% | Tier 3 |
Item ranges come from the FSBPT NPTE-PT Test Content Outline, effective January 2024 (page 1). Shares are our calculation (range ÷ 180), and tiers are our editorial grouping. Your exam form will fall somewhere inside each range, not at a fixed number.
Two things the table tells you:
- Musculoskeletal and neuro together account for the largest share of the scored exam. Short on time? Give them the most study time. The smaller systems and nonsystem areas still represent a substantial part of the exam, so they need steady weekly practice rather than a cram at the end.
- Every body system is tested three ways. FSBPT splits system items into Physical Therapy Examination (choosing and interpreting tests, 38–50 items), Foundations for Evaluation, Differential Diagnosis & Prognosis (knowing the condition, its medical management, and what else it could be, 51–66 items), and Interventions (what to do and what can go wrong, 45–58 items). Foundations is the biggest slice. Expect to make decisions, not recite lists.
Your 6-week study plan
Assumptions: about 15 hours a week, six study days, one day off. Questions start in week 1, because the NPTE rewards clinical decisions, not recognition. This is our editorial plan, not an FSBPT requirement, and it can't guarantee a result.
| Week | Focus | Saturday practice block | End-of-week checkpoint |
|---|---|---|---|
| 1 | Baseline. Read the full FSBPT outline once. Musculoskeletal I: examination, special tests, joint biomechanics, imaging rules, red flags | The 25 questions on this page, untimed, then start your miss log | Your three weakest areas from the 25 questions |
| 2 | Musculoskeletal II: post-surgical precautions, regenerative medicine (PRP, stem cells) in the plan of care, connective tissue disease. Neuro I: examination, spinal cord injury classification, vestibular | Timed 45 questions in 60 minutes, mixed | Every MSK miss reworked |
| 3 | Neuro II: stroke, brain injury, progressive disorders, motor control and motor learning. Cardiovascular & pulmonary: vital-sign responses, lines and monitoring, lab values in the plan of care, VTE | Full-length timed practice exam (5 hours) | Misses sorted by area and by cause (see below) |
| 4 | Integumentary, lymphatic, metabolic & endocrine, GI, GU. System Interactions: cancer, multitrauma, pregnancy, comorbidities, polypharmacy, psychological conditions, pain | Timed 45 questions, mixed | Weeks 1–3 misses reworked |
| 5 | Nonsystem areas: equipment, modalities, safety and protection, professional responsibilities, research. Repair your two weakest areas from week 3 | Second full-length timed practice exam | Did your weak areas improve? |
| 6 | Integration: mixed and scenario-style sets, red flags, contraindications, precautions. No big new topics | Light mixed set early in the week; the last two days are logistics and rest | Final-week checklist done |
Your daily template
| Day | Block 1 | Block 2 | Block 3 | Time |
|---|---|---|---|---|
| Monday–Friday | 60 min: content review for the week's focus | 30 min: 20 mixed questions, 60–80 seconds each | 15–30 min: work through misses and log the cause | About 2–2.5 hours |
| Saturday | Timed practice block (see table) | Review every miss and every lucky guess | Update next week's priorities | About 3.5 hours, longer on full-exam weeks |
| Sunday | Off | 0 |
On full-exam weeks (3 and 5), the exam takes most of Saturday. Do the review in Monday's and Tuesday's content blocks instead of starting new material. A full exam you don't review is mostly a stamina drill.
If you have more or less than six weeks
| Your situation | How to adapt |
|---|---|
| 3–4 weeks | Merge weeks 1–2 and weeks 3–4. Keep at least one full timed exam and the final-week checklist. Cut reading, not practice questions or sleep. |
| 8–12 weeks | Turn weeks 1–4 into two weeks each. Add a cumulative review day every other week. Keep the second full exam in the second-to-last week. |
| Working or on clinical rotation (8–10 hours a week) | Weekdays become 60–90 minutes (40 minutes of content plus 20 questions). Keep the Saturday block. Stretch the plan to 9–10 weeks. |
| Retaking | Start from your score report and Performance Feedback Report, not week 1 (see "If you're retaking" below). Put your lowest areas in weeks 1–2 and sort every miss by cause. |
25 free NPTE-PT practice questions
These are original, unofficial practice questions written by Castleport Test Prep, not FSBPT questions. Your percentage here is feedback on these 25 items, not a predicted NPTE score. Each question is labeled with the FSBPT content area it targets. Questions 23–25 share one clinical scenario, matching the scenario-set format FSBPT uses at the end of exam sections.
Question 1
NPTEPT-001 · Neuromuscular & Nervous Systems — Interventions
A 34-year-old man with a complete C6 spinal cord injury from 8 months ago is seated in his wheelchair during an outpatient session. He suddenly reports a pounding headache and nasal stuffiness. His face is flushed and sweaty. Blood pressure is 168/100 mm Hg (his usual is about 100/64), heart rate 54 bpm. What should the physical therapist do FIRST?
Show answer for question 1
Answer: D. This is autonomic dysreflexia: an exaggerated sympathetic response to a stimulus below the injury, seen in injuries at or above about T6. A rise of 20–40 mm Hg over a person's (often low) baseline is significant. The first steps in the Consortium for Spinal Cord Medicine guideline are to sit the person upright to use the orthostatic drop in blood pressure, loosen anything constrictive, monitor blood pressure every few minutes, and look for the trigger (a full bladder or kinked catheter is the most common). Supine positioning (A, B) raises blood pressure further. Continuing the session (C) treats an emergency like a headache.
Review next: Common triggers of autonomic dysreflexia and how to check bladder and bowel causes.
Source: PVA/Consortium for Spinal Cord Medicine, Autonomic Dysreflexia CPG; RNOH, Autonomic dysreflexia clinical resource
Question 2
NPTEPT-002 · Neuromuscular & Nervous Systems — Physical Therapy Examination
After a spinal cord injury, an ISNCSCI exam shows light touch preserved at S4–S5, pinprick absent at S4–S5, no voluntary anal contraction, and no motor function more than three levels below the motor level on either side. What is the ASIA Impairment Scale (AIS) grade?
Show answer for question 2
Answer: B. Any sacral sensation (light touch, pinprick, or deep anal pressure at S4–S5) makes the injury incomplete, which rules out A. With no voluntary anal contraction and no motor function more than three levels below the motor level, the injury is motor complete: that's AIS B, sensory incomplete. C and D both require motor incomplete status. They differ by whether at least half of the key muscle functions below the neurological level grade 3 or better (D) or fewer than half do (C).
Review next: ISNCSCI key muscles (C5–T1, L2–S1) and the steps for assigning AIS grades.
Question 3
NPTEPT-003 · System Interactions — Foundations for Evaluation, Differential Diagnosis & Prognosis
A 66-year-old man was treated for prostate cancer 4 years ago. He now has 3 weeks of low back pain that is constant, doesn't change with position or rest, and wakes him at night. He has lost weight without trying. His neurological screen is normal. What is the MOST appropriate action?
Show answer for question 3
Answer: A. A prior history of cancer is one of the most informative red flags for spinal malignancy in a person with low back pain. In this case it appears with persistent nonmechanical pain, night pain, and unexplained weight loss, so medical evaluation is appropriate before routine physical therapy intervention. Starting treatment and waiting (B, C) could delay evaluation of serious pathology, and calling it nonspecific pain (D) ignores the clinical pattern.
Review next: Red flags for serious spinal pathology (malignancy, fracture, infection, cauda equina).
Source: Diagnostic utility of red flags for detecting spinal malignancies in patients with low back pain: a scoping review. PubMed (2025); FSBPT NPTE-PT Test Content Outline (System Interactions)
Question 4
NPTEPT-004 · Neuromuscular & Nervous Systems — Interventions
A 62-year-old reports brief spinning vertigo when rolling over in bed and when looking up to a high shelf. The right Dix-Hallpike test provokes vertigo with upbeating, torsional nystagmus. Which intervention is MOST appropriate?
Show answer for question 4
Answer: D. Upbeating, torsional nystagmus on the Dix-Hallpike points to posterior canal BPPV on the tested (down) side. The AAO-HNS guideline strongly recommends treating it with a canalith repositioning procedure such as the Epley. The same guideline recommends against post-procedure postural restrictions (B) and against routine vestibular suppressants. The log-roll maneuver (C) targets lateral canal BPPV, which is diagnosed with the supine roll test and horizontal nystagmus. Gaze stabilization (A) addresses vestibular hypofunction, not displaced otoconia.
Review next: Posterior vs. lateral canal BPPV: tests, nystagmus patterns, and matching maneuvers.
Source: Bhattacharyya N, et al. Clinical Practice Guideline: BPPV (Update). Otolaryngol Head Neck Surg 2017
Question 5
NPTEPT-005 · Neuromuscular & Nervous Systems — Interventions
A 38-year-old with relapsing-remitting multiple sclerosis says her leg weakness and blurred vision get worse in the second half of her aerobic sessions in a warm gym, then return to baseline about 30 minutes after she cools down. Which change is MOST appropriate?
Show answer for question 5
Answer: B. Temporary, heat-related worsening that resolves with cooling is Uhthoff's phenomenon: heat slows conduction in demyelinated nerve fibers. An estimated 60–80% of people with MS experience it. Cooling and pre-cooling strategies help people keep exercising. Exercise has clear benefits in MS, so stopping it (A) is the wrong trade. Higher intensity (C) raises core temperature faster. Symptoms that fully reverse with cooling don't describe a relapse (D), though new symptoms, or symptoms that persist after cooling, should be reported to her physician.
Review next: Exercise prescription and symptom monitoring in multiple sclerosis.
Source: Davis SL, et al. Thermoregulation in multiple sclerosis. J Appl Physiol 2010
Question 6
NPTEPT-006 · Musculoskeletal System — Physical Therapy Examination
A 24-year-old rolled his ankle playing basketball an hour ago. He has pain around the lateral malleolus and tenderness over the anterior talofibular ligament. There is no bone tenderness along the posterior edge or tip of either malleolus, no midfoot pain, and he walked four steps unassisted both right after the injury and in the clinic. Under the Ottawa Ankle Rules, which is correct?
Show answer for question 6
Answer: C. An ankle series is indicated only when there's malleolar-zone pain plus one of: bone tenderness at the posterior edge or tip of the distal 6 cm of the lateral or medial malleolus, or inability to bear weight for four steps both immediately and at evaluation. A foot series needs midfoot pain plus tenderness at the navicular or base of the fifth metatarsal (or the same weight-bearing failure). Pain alone (A) isn't enough, there's no midfoot pain (B), and ligament tenderness (D) isn't one of the criteria. The most common misapplication is palpating soft tissue in front of the malleolus instead of the posterior bony edge.
Review next: Clinical decision rules for imaging: Ottawa ankle and knee rules.
Source: NSW Agency for Clinical Innovation, Ottawa ankle rules (adapted from Stiell et al., JAMA 1994)
Question 7
NPTEPT-007 · Musculoskeletal System — Physical Therapy Examination
Which test is performed with the knee in about 20–30° of flexion to assess anterior cruciate ligament (ACL) integrity?
Show answer for question 7
Answer: B. The Lachman test (B) assesses anterior translation of the tibia relative to the femur with the knee in slight flexion and is a standard clinical test for ACL injury. The anterior drawer (A) also assesses the ACL but is performed near 90° of knee flexion. McMurray (C) is primarily a meniscal test, and valgus stress at 30° (D) assesses medial collateral ligament laxity. Newer meta-analyses show that the diagnostic accuracy of ACL tests varies by test and presentation, so no single bedside test should be described as universally superior.
Review next: Knee special tests: what each one stresses and its diagnostic accuracy.
Source: Sokal PA, et al. Diagnostic accuracy of clinical tests for ACL tears: systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2022; Tanaka S, et al. Diagnostic Accuracy of Physical Examination Tests for Suspected Acute ACL Injury. Int J Sports Phys Ther. 2022
Question 8
NPTEPT-008 · Musculoskeletal System — Foundations for Evaluation, Differential Diagnosis & Prognosis
A 45-year-old with 3 days of low back pain and pain into both posterior thighs reports new numbness in her buttocks and inner thighs and trouble starting urination since this morning. What should the physical therapist do?
Show answer for question 8
Answer: D. Saddle sensory disturbance, bladder dysfunction, and symptoms in both legs are red flags for cauda equina syndrome. Outcomes worsen the longer the nerve roots stay compressed, so suspected cauda equina is an emergency referral, not a wait-and-see problem. A, B, and C all delay definitive diagnosis.
Review next: Cauda equina red flags and the difference between urgent and emergency referral.
Question 9
NPTEPT-009 · Cardiovascular & Pulmonary Systems — Physical Therapy Examination
A 68-year-old with calf pain that comes on with walking and eases with rest has a right ankle systolic pressure of 84 mm Hg. The higher brachial systolic pressure is 136 mm Hg. Which interpretation is correct?
Show answer for question 9
Answer: C. ABI = ankle systolic ÷ brachial systolic = 84 ÷ 136 ≈ 0.62. The ACC/AHA categories are abnormal ≤0.90, borderline 0.91–0.99, normal 1.00–1.40, and noncompressible >1.40. D inverts the ratio. Exertional calf pain relieved by rest plus an abnormal ABI fits intermittent claudication.
Review next: Arterial vs. venous insufficiency: signs, ABI interpretation, and exercise and compression implications.
Source: 2024 ACC/AHA Guideline for the Management of Lower Extremity Peripheral Artery Disease
Question 10
NPTEPT-010 · Integumentary System — Physical Therapy Examination
A sacral pressure injury shows full-thickness skin loss with visible subcutaneous fat, granulation tissue, and rolled wound edges. No fascia, muscle, tendon, or bone is visible, and slough doesn't obscure the base. What stage is it?
Show answer for question 10
Answer: A. Under the NPIAP system, Stage 3 is full-thickness skin loss where fat may be visible, often with granulation tissue and rolled edges (epibole), but no exposed fascia, muscle, tendon, ligament, cartilage, or bone. Stage 2 (B) is partial thickness with no visible fat. Stage 4 (C) requires exposed or directly palpable deeper structures. Unstageable (D) means slough or eschar hides the base, which it doesn't here.
Review next: All NPIAP stages, including deep tissue pressure injury and unstageable.
Source: National Pressure Injury Advisory Panel (NPIAP), Pressure Injury Stages
Question 11
NPTEPT-011 · Integumentary System — Foundations for Evaluation, Differential Diagnosis & Prognosis
An adult has burns covering the entire anterior trunk and the entire right upper extremity, front and back. Using the rule of nines, what is the estimated total body surface area burned?
Show answer for question 11
Answer: C. In the adult rule of nines, the anterior trunk is 18% and each entire upper extremity is 9% (4.5% front, 4.5% back): 18 + 9 = 27%. B counts only the front of the arm. D counts the whole trunk. The rule of nines is an adult estimate. Children's proportions differ, and charts such as Lund-Browder are more precise.
Review next: Burn depth classification and positioning to prevent contracture.
Source: American Burn Association, Burn Patient Referral Guidelines — Rule of Nines
Question 12
NPTEPT-012 · Lymphatic System — Physical Therapy Examination
Two years after inguinal lymph node dissection, a 58-year-old has swelling of the left foot and leg. The therapist can't pinch and lift a skin fold at the base of the left second toe but can on the right. How should this finding be interpreted?
Show answer for question 12
Answer: B. A positive Stemmer sign is an inability to pinch and lift a skin fold at the base of a toe or finger. It supports lymphedema, which fits this patient's unilateral swelling after lymph-node dissection. The sign is useful but not perfectly specific, so it should be interpreted with the rest of the examination rather than treated as a stand-alone diagnosis. A (negative sign) describes the opposite finding. It is not a DVT test (C) and does not confirm chronic venous insufficiency (D).
Review next: Lymphedema staging and the components of complete decongestive therapy.
Question 13
NPTEPT-013 · Metabolic & Endocrine Systems — Interventions
A 52-year-old with type 1 diabetes on insulin checks her blood glucose before a planned 40-minute moderate aerobic session. It's 78 mg/dL, and she has no symptoms. What is the MOST appropriate action?
Show answer for question 13
Answer: D. Below 90 mg/dL before exercise, published strategies for exercise in type 1 diabetes recommend 15–30 g of fast-acting carbohydrate before starting, followed by extra carbohydrate during prolonged activity. Having no symptoms (A) doesn't protect against exercise-induced hypoglycemia. Cancelling (C) is unnecessary when the low reading can be corrected. Extra insulin (B) would drive glucose lower.
Review next: Pre-exercise glucose ranges, hypoglycemia signs, and when to hold exercise for high glucose and ketones.
Source: Exercise and type 1 diabetes: carbohydrate intake by pre-exercise glucose (Table 1)
Question 14
NPTEPT-014 · Gastrointestinal System — Physical Therapy Examination
A 50-year-old referred for right-sided mid-back pain has no change in symptoms with any spinal movement. She reports right upper abdominal discomfort after fatty meals and some nausea. When the therapist presses under the right costal margin and asks her to breathe in, she stops inhaling mid-breath because of pain. What is the BEST interpretation and action?
Show answer for question 14
Answer: D. Pain that arrests inspiration during right upper-quadrant palpation is a positive Murphy sign and raises concern for acute cholecystitis in the right clinical context. The combination here—postprandial right upper abdominal symptoms, nausea, and pain not reproduced by spinal movement—warrants medical evaluation rather than routine mechanical thoracic treatment. Murphy sign alone does not prove cholecystitis, so D appropriately says it suggests gallbladder inflammation and calls for referral. McBurney and Rovsing signs (A, C) relate to appendiceal irritation.
Review next: Visceral screening: GI tests named in the outline (Murphy, Rovsing, McBurney point).
Source: History, Physical Examination, Laboratory Testing, and ED Ultrasonography for Acute Cholecystitis: systematic review. PubMed (2017); FSBPT NPTE-PT Test Content Outline (GI tests/measures)
Question 15
NPTEPT-015 · Genitourinary System — Interventions
A 41-year-old leaks urine when she coughs, sneezes, or jumps. She has no urgency. Which intervention is the recommended first-line treatment?
Show answer for question 15
Answer: A. This presentation is stress urinary incontinence. NICE recommends a supervised pelvic floor muscle training program of at least 3 months as first-line treatment for women with stress or mixed urinary incontinence. Bladder training (B) is first-line for urgency or mixed incontinence rather than isolated stress leakage. Systemic medication (C) and abdominal crunches (D) are not the first-line treatment described here.
Review next: Stress vs. urgency vs. mixed incontinence and the first-line intervention for each.
Source: NICE NG123, Urinary incontinence and pelvic organ prolapse in women — recommendation 1.4.4
Question 16
NPTEPT-016 · Equipment, Devices & Technologies — Nonsystem
A patient with painful right knee osteoarthritis is learning to use a single-point cane. Which instruction is correct?
Show answer for question 16
Answer: D. Standard cane instruction for a painful right lower extremity is to use the cane in the left hand and advance it with the right leg. A common fit is the wrist crease or greater trochanter with the arm relaxed, leaving slight elbow flexion. Contralateral cane use can reduce medial knee loading in knee osteoarthritis. A and B use the cane on the involved side, while C specifies a straight elbow and an imprecise waist-height fit.
Review next: Fitting and gait patterns for canes, crutches, and walkers.
Source: Simic M, et al. Contralateral cane use and knee joint load in medial knee osteoarthritis. Osteoarthritis Cartilage. 2011; Lower extremity ambulatory assistive devices review. Foot & Ankle International. 2023
Question 17
NPTEPT-017 · Therapeutic Modalities — Nonsystem
Which electrode placement for electrical stimulation should be avoided?
Show answer for question 17
Answer: A. Evidence-based electrophysical-agent guidance advises against direct surface electrical stimulation over the anterior neck and carotid sinus because of the risk of adverse cardiovascular or airway-related responses. The other placements can be used in appropriate patients when no separate contraindication or precaution applies.
Review next: Contraindications and precautions for electrical stimulation, ultrasound, and thermal agents.
Question 18
NPTEPT-018 · Safety & Protection — Nonsystem
During a C. difficile outbreak on an inpatient unit, a therapist finishes treating a patient on contact precautions and removes her gown and gloves. What is the BEST hand hygiene?
Show answer for question 18
Answer: B. B is best because the stem explicitly says the unit is experiencing a C. difficile outbreak. CDC generally prefers alcohol-based hand sanitizer for most clinical situations, including routine C. difficile care when hands are not visibly soiled, but during C. difficile outbreaks it encourages soap-and-water handwashing after caring for patients with known or suspected infection. Gloves and gowns remain essential, and equipment disinfectant wipes are not for skin.
Review next: Standard, contact, droplet, and airborne precautions and which organisms need each.
Source: CDC, Clinical Safety: Hand Hygiene for Healthcare Workers — C. difficile outbreak guidance
Question 19
NPTEPT-019 · Professional Responsibilities — Nonsystem
A clinic is behind schedule. A physical therapist assistant offers to complete a new patient's initial evaluation so the physical therapist can "review and sign it later." What is the appropriate response?
Show answer for question 19
Answer: C. C is the appropriate response. In APTA's patient-management model, the physical therapist must conduct the initial examination and is responsible for the evaluation and plan of care. A PTA may assist with delegated data collection where allowed, but co-signing later, years of PTA experience, or patient consent do not transfer the PT's responsibility for the initial examination and evaluation. Legal delegation and supervision details still depend on the applicable jurisdiction.
Review next: PT vs. PTA roles, levels of supervision, and when a PTA must stop and contact the PT.
Source: APTA, Documentation: Initial Examination and Evaluation
Question 20
NPTEPT-020 · Research & Evidence-Based Practice — Nonsystem
A test has a sensitivity of 0.85 and a specificity of 0.94. What is its positive likelihood ratio (LR+)?
Show answer for question 20
Answer: C. LR+ = sensitivity ÷ (1 − specificity) = 0.85 ÷ 0.06 ≈ 14.2. A is the negative likelihood ratio: (1 − 0.85) ÷ 0.94 ≈ 0.16. B divides specificity by (1 − sensitivity), which is not the LR+ formula (0.94 ÷ 0.15 ≈ 6.3). D simply averages the two inputs. The sensitivity and specificity values in this question are supplied for calculation practice; they are not intended as the current accuracy estimate for a named clinical test.
Review next: Sensitivity, specificity, predictive values, and likelihood ratios from a 2×2 table.
Source: Centre for Evidence-Based Medicine, SpPin and SnNout (LR formulas)
Question 21
NPTEPT-021 · Research & Evidence-Based Practice — Nonsystem
A screening test has a sensitivity of 0.98 and a specificity of 0.60. A patient tests negative. Which interpretation is MOST accurate?
Show answer for question 21
Answer: A. A highly sensitive test misses few true cases, so a negative result helps rule the condition out ("SnNout"). Here LR− = (1 − 0.98) ÷ 0.60 ≈ 0.03, a strong shift away from the diagnosis. A negative result can't rule a condition in (B). Low specificity (C) limits what a positive result means, not a negative one. With LR+ = 0.98 ÷ 0.40 ≈ 2.5, a positive result (D) would be far less informative.
Review next: Reliability vs. validity, and choosing tests to rule in vs. rule out.
Source: Centre for Evidence-Based Medicine, SpPin and SnNout
Question 22
NPTEPT-022 · Cardiovascular & Pulmonary Systems — Interventions
A 60-year-old starting outpatient cardiac rehabilitation takes a beta-blocker and hasn't had an exercise test on his current dose. How should the therapist set aerobic exercise intensity?
Show answer for question 22
Answer: D. Beta-blockers blunt the heart-rate response to exercise, so age-predicted maximal-heart-rate targets can misjudge intensity. Without an exercise test performed on the current medication dose, perceived exertion and the talk test are practical intensity guides while heart rate, blood pressure, symptoms, and overall response are monitored. Stopping a prescribed beta-blocker (B) is not appropriate, and A/C depend on an age-predicted maximum that does not account for the medication effect.
Review next: How common cardiac medications change vital-sign responses to exercise.
Source: American Heart Association, How Do Beta Blocker Drugs Affect Exercise?
Scenario set: Questions 23–25
Setting: Acute care hospital
Sex: Female
Age: 71
Presenting problem/current condition: Postoperative day 1 after a right total hip arthroplasty through a posterior approach
Medical history: Hypertension, osteoarthritis
Other information: Weight-bearing as tolerated; surgeon's order for standard posterior hip precautions
Physical therapy plan of care: Bed mobility, transfers, and gait training with a walker
Question 23
NPTEPT-023 · Musculoskeletal System — Interventions
Which activity violates her hip precautions?
Show answer for question 23
Answer: B. Because the scenario explicitly says the surgeon ordered standard posterior hip precautions, B violates that order: reaching forward toward the foot from a standard chair can take the hip beyond 90° of flexion and may add rotation. A raised chair, keeping the legs from crossing, and turning with small steps are common ways to stay within traditional posterior precautions. Posterior precautions are not prescribed identically after every total hip arthroplasty, so the patient's actual surgeon and facility orders control.
Review next: Posterior vs. anterior hip precautions and adaptive equipment for dressing.
Source: StatPearls, Hip Precautions — posterior approach precautions
Question 24
Shared scenario for Questions 23–25
NPTEPT-024 · Cardiovascular & Pulmonary Systems — Physical Therapy Examination
Supine blood pressure is 128/76 mm Hg. One minute after she stands with the walker, it's 104/70 mm Hg, and she says she feels lightheaded. What does this indicate?
Show answer for question 24
Answer: A. Orthostatic hypotension is a sustained fall in systolic pressure of at least 20 mm Hg or diastolic pressure of at least 10 mm Hg within 3 minutes of standing. Her systolic dropped 24 mm Hg, with symptoms. Return her to sitting or reclining, monitor vital signs, and progress upright tolerance gradually. Her pressure fell rather than rose (C). Autonomic dysreflexia (D) is a spinal cord injury complication with a sharp rise in blood pressure.
Review next: Normal and abnormal blood pressure and heart rate responses to position change and exercise.
Question 25
Shared scenario for Questions 23–25
NPTEPT-025 · Cardiovascular & Pulmonary Systems — Foundations for Evaluation, Differential Diagnosis & Prognosis
On postoperative day 3, she reports a new aching pain in her right calf. The calf is swollen and warm compared with the left. What should the therapist do?
Show answer for question 25
Answer: C. New unilateral calf pain, swelling, and warmth after major lower-extremity surgery raise concern for DVT. The therapist should stop routine mobility, assess DVT likelihood using an accepted clinical decision tool such as the Wells criteria, and promptly communicate with the medical team so appropriate diagnostic testing can be arranged. Continuing routine gait training (A), vigorous ankle pumping (B), or local heat (D) is not appropriate while a new DVT is being evaluated.
Review next: VTE risk factors, the Wells criteria for DVT, and when mobility can resume after a DVT diagnosis.
Source: APTA / Physical Therapy, VTE Clinical Practice Guideline 2022; Hillegass E, et al. VTE CPG — Action Statement 6: recommend further testing after Wells criteria. Phys Ther. 2016 After you finish: count misses by content area and by cause, but don't overread a 25-question sample. The set is not blueprint-proportional and is too small to measure readiness. Use it to identify topics and reasoning patterns to review next.
How to review a missed question
Most wasted study time comes from treating every miss the same way. Before you look anything up, decide why you missed it:
| Cause | What it looks like | What to do next |
|---|---|---|
| Knowledge gap | You didn't know the fact, sign, test, or precaution | Learn the concept, then answer two new questions on it within a few days |
| Application gap | You knew the rule but didn't apply it to this patient | Write down which detail in the stem should have changed your decision |
| Cue-reading gap | You missed a deciding word: timeline, setting, a contraindication, "FIRST," "MOST" | Before reading the options, underline the cue that decides the question |
| Pacing or guessing error | You rushed, ran long, or changed a supported answer without a reason | Do timed blocks at 60–80 seconds per question; only change an answer when you can name the fact that changed your mind |
Worked example: Question 6 (Ottawa Ankle Rules). Say you picked A, "ankle radiograph because he has malleolar-zone pain."
- If you didn't know the rule needs pain plus posterior-edge bone tenderness or failed weight bearing, that's a knowledge gap. Learn both the ankle and foot criteria, then try a knee decision-rule question.
- If you knew the rule but read "tenderness over the anterior talofibular ligament" as bone tenderness, that's a cue-reading gap. The fix is slowing down on the exact location in the stem, not more reading.
Same wrong letter, two different fixes. Your miss log should record the cause, the content area, and the one-line rule you'll remember.
How the NPTE-PT works
| Exam feature | NPTE-PT |
|---|---|
| Exam owner | Federation of State Boards of Physical Therapy (FSBPT) |
| Where | Prometric test centers, on fixed dates four times a year |
| Questions | 225 multiple-choice in 5 sections of 45; 180 scored and 45 unscored pretest items mixed in |
| Question types | Stand-alone questions (some with a graphic or video) and scenario sets of 2–5 questions at the end of each section |
| Testing time | 5 hours as one overall block; sections aren't separately timed |
| Appointment | 5 hours 30 minutes, including a scheduled 15-minute break after section 2, a tutorial, and a survey |
| Scoring | Raw score converted to a 200–800 scale; 600 passes. No penalty for wrong answers |
| Fees | $485 to FSBPT when you register, plus $112 to Prometric when you schedule ($597 total) |
Fee clarification: The $597 above is the sum of the two base fees. FSBPT also charges a 1.6% processing fee rounded up to the next dollar: $8 on a $485 registration. That makes the PT total $605 before jurisdiction fees. FSBPT registration and processing fees.
Sources: Understanding the NPTE, NPTE Content FAQ, Exam Registration and Scheduling.
Pacing: 225 questions in 300 minutes is 80 seconds per question, or about 60 minutes per section. Unscheduled breaks after sections other than section 2 come out of your testing time.
What 600 means. It's a scaled score, not 60% and not a fixed number of correct answers. Forms differ slightly in difficulty, so FSBPT converts raw scores to a 200–800 scale and holds every form to the same standard. The number correct needed for 600 shifts from form to form, generally within one or two questions (Examination Results and Scoring). Any "you can miss X questions" number online is someone's estimate. Since wrong answers cost nothing, answer every question.
Attempt limits. FSBPT allows no more than three NPTE attempts in any 12-month period and no more than six lifetime attempts at the PT level. Its low-score rule also bars further testing after two scores of 400 or below. Jurisdictions can impose additional retake rules (Retaking the Examination).
Getting to test day. You register and pay through your FSBPT account. Then your jurisdiction approves you, or FSBPT does if you're a CAPTE graduate in an Alternate Approval Pathway state. Approval triggers your Authorization to Test (ATT) letter. Schedule your Prometric seat right away, because seats fill, and make sure the name on your ATT matches your ID exactly. FSBPT lets CAPTE-program candidates test up to 90 days before graduation, but some states are stricter (Exam Registration and Scheduling).
What changed in the current outline
The outline in effect since January 2024 came from FSBPT's June 2022 practice analysis. If a book, app, or article doesn't match these points, check its date:
- 225 questions, 180 scored. Many older guides still say 250 questions with 200 scored. That was the previous format.
- Scenario sets end every section. Scenarios usually use headings like setting, sex, age, presenting problem, medical history, other information, PT examination, and plan of care (the format of Questions 23–25).
- Regenerative medicine is in scope for musculoskeletal and neuro: conditions treated with PRP or stem cells, expected prognosis, and PT precautions afterward.
- System Interactions has its own 8–10 items, covering conditions that affect more than one system, comorbidities, polypharmacy, psychological conditions, and dimensions of pain.
- NDT and Bobath step sequences are no longer item targets. FSBPT told item writers not to test their theory or use them as answers, and trimmed neuro intervention items to 13–16.
- Lab values usually come without reference ranges. Know normal ranges, and especially what an abnormal value means for your plan of care.
- Telehealth sits under Professional Responsibilities.
Sources: FSBPT NPTE Content and 2024 FAQ; PT Test Content Outline.
Upcoming PT test dates
| Test date | Register and pay by | Jurisdiction approval by | Scores to jurisdictions | Free score report online |
|---|---|---|---|---|
| January 26–27, 2027 | December 22, 2026 | January 5, 2027 | February 3, 2027 | February 10, 2027 |
| April 27–28, 2027 | March 23, 2027 | March 30, 2027 | May 5, 2027 | May 12, 2027 |
| July 27–28, 2027 | June 22, 2027 | June 29, 2027 | August 4, 2027 | August 11, 2027 |
| October 26–27, 2027 | September 21, 2027 | September 28, 2027 | November 3, 2027 | November 10, 2027 |
All deadlines are 11:59 p.m. Eastern. Miss the registration deadline and you wait for the next date. If your jurisdiction doesn't approve you in time, your registration closes and you get the fee back minus $50. Some states set earlier application deadlines, so check with your board. Your free score report stays viewable for 30 days. Source: FSBPT future test dates.
When to take PEAT and the demo exam
PEAT (Practice Exam and Assessment Tool) is FSBPT's own practice product. For $99 plus a 1.6% processing fee, you get two timed, 225-question PT exams: one retired NPTE form and one practice form. Each comes with rationales, references, timing data, and a performance report by content area, body system, and section. Access lasts 90 days from when you start your first exam, or until you pass (FSBPT PEAT).
How we'd use it with the six-week plan:
- Don't start it too early. The 90-day clock begins with your first exam, so start no more than about 12 weeks out.
- Take one form around week 3 to find weak areas and check your pacing.
- Take the other around week 5 to see whether your repair work moved those areas.
- Spend at least as long reviewing each form as taking it. The report tells you where; your miss log tells you why.
The NPTE Demonstration Exam is free. It shows the real interface, the tutorial, and sample PT questions. Go through it once before test day so nothing on screen is new.
Your final week
- Do mixed review and your miss log. Don't open a new textbook.
- Finish any last full practice early in the week, with time left to review it.
- Rehearse scenario sets and your pacing: about 60 minutes per section.
- Walk through the free FSBPT demo exam.
- Check your ATT letter, your ID name match, your Prometric location, and your travel time.
- Plan what you'll eat at the scheduled break after section 2.
- Protect your sleep. Don't try to memorize every low-frequency fact in the last 48 hours.
If you're retaking
Don't repeat the same study plan. Start with data:
- Get your Performance Feedback Report. For $100 plus a 1.6% processing fee, FSBPT shows your items correct by work activity, body system, and section, an "On Track to Pass" target for each area, and how candidates with similar scores did on their next try. FSBPT notes that individual areas can't be passed or failed on their own (NPTE Performance Feedback Report).
- Split content problems from reasoning problems. Run your practice misses through the four causes above. A candidate with mostly cue-reading and pacing misses needs a different plan than one with knowledge gaps.
- Move your study hours. Put your two or three lowest areas into the first weeks of the plan and keep mixed practice going for everything else.
- Take substantial remediation seriously after more than one unsuccessful attempt. FSBPT's retake page says that, based on scores since 2008, candidates who have failed twice or more are unlikely to pass a later attempt, and those who did pass usually completed substantial remediation and PT education. FSBPT lists options including its feedback report, PEAT, the demo exam, and its free FifthTheory test-taking tool (Important Retake Information).
Quick answers
How long should I study for the NPTE-PT? FSBPT doesn't set a study length. The plan above runs six weeks at about 15 hours a week. Stretch it to 8–12 weeks if you're working, on rotation, or your first timed practice shows big gaps in musculoskeletal or neuro.
Is the NPTE-PT the same as the NPTE-PTA? No. The PTA exam has 180 questions in 4 sections over 4 hours and its own content outline (Understanding the NPTE). Make sure every resource you use is for the PT level.
Can I take the NPTE online? No. FSBPT delivers the NPTE at Prometric test centers. Use your Authorization to Test and the Prometric scheduling process to select an eligible available center.
Does passing the NPTE make me licensed? No. Your jurisdiction's licensing authority issues the license, and it may require steps beyond passing the NPTE. Check the authority for your jurisdiction through FSBPT's licensing authorities directory.
Sources
Last verified November 3, 2026: exam format, scoring, fees, attempt limits, test dates, PEAT and Performance Feedback Report details, and the current FSBPT content outline were rechecked against official FSBPT pages. Practice-item teaching claims were rechecked against the linked clinical or professional sources above.
Official FSBPT sources
- NPTE-PT Test Content Outline, effective January 2024 (v1.1, 8/25/2023)
- NPTE Content and FAQs on the 2024 changes
- Candidate Handbook: Understanding the NPTE, Examination Results and Scoring, Eligibility Requirements, Exam Registration and Scheduling, Preparing for the NPTE
- Future test dates and deadlines
- Practice Exam & Assessment Tool (PEAT)
- NPTE Performance Feedback Report
- Retaking the Examination
- Important Retake Information
Castleport Test Prep is an independent exam prep publisher. We are not affiliated with, endorsed by, or approved by the Federation of State Boards of Physical Therapy (FSBPT). NPTE and other exam and credential names are used to identify the subject of this page; trademarks belong to their respective owners. Our practice questions are original and unofficial, not recalled or actual NPTE items. Clinical content is for exam study, not patient care decisions, and this resource doesn't guarantee a passing score or licensure. Prepared by the Castleport Test Prep Editorial Team.