NPTE-PTA Exam Prep: Study Plan and 30 Free Practice Questions
This free guide is built on FSBPT's current NPTE-PTA content outline (effective January 2024). Start with the priority map and your first 90-minute session. Then follow the 8-week plan and work through 30 original practice questions with full explanations.
Castleport Test Prep Editorial Team · Last verified November 3, 2026
Start here: what to study first
The NPTE-PTA has 180 questions. 140 are scored; the other 40 are unscored pretest items scattered through the exam. FSBPT's outline gives a range of scored items for each area. Three body systems make up 78 to 102 of the 140, so they get most of your hours.
| Content area | Scored items (FSBPT range) | Share of 140* | Priority |
|---|---|---|---|
| Musculoskeletal | 31–40 | 22–29% | Top |
| Neuromuscular & nervous | 27–35 | 19–25% | Top |
| Cardiovascular & pulmonary | 20–27 | 14–19% | Top |
| Equipment, devices & technologies | 8–10 | 6–7% | High |
| Safety & protection | 6–8 | 4–6% | Medium |
| Integumentary | 3–8 | 2–6% | Medium |
| Therapeutic modalities | 5–7 | 4–5% | Medium |
| System interactions | 5–7 | 4–5% | Medium |
| Metabolic & endocrine | 4–6 | 3–4% | Medium |
| Lymphatic | 2–6 | 1–4% | Lower |
| Professional responsibilities | 2–4 | 1–3% | Lower |
| Gastrointestinal | 0–4 | 0–3% | Lower |
| Genitourinary | 0–4 | 0–3% | Lower |
| Research & evidence-based practice | 1–3 | 1–2% | Lower |
*Share is our calculation: FSBPT's item range ÷ 140, rounded. FSBPT publishes only ranges, and each test form lands somewhere inside them. Source: NPTE-PTA Test Content Outline, p. 1.
Two things the table doesn't show:
- Interventions and conditions outweigh data collection. Across the body systems, the outline gives 34–50 items to interventions, 34–53 to diseases and conditions that affect treatment, and 23–34 to data collection.
- "Lower" doesn't mean skip. FSBPT notes that communication, patient teaching, and telehealth are tested across many areas even though they have no line of their own.
Your first study session (90 minutes)
- 15 min: Skim the table above and circle the three areas you feel weakest in.
- 30 min: Answer Questions 1–10 below without notes.
- 30 min: Read every explanation, including the ones you got right. A lucky guess counts as a miss.
- 15 min: Start a miss log (see Review your misses) and write down no more than three topics to fix first.
The rule that separates PTA questions from PT questions
The PT outline tests examination, evaluation, and planning. The PTA outline tests the knowledge needed to carry out the plan of care the PT has already established. That's why so many PTA judgment questions come down to a single decision. Use this three-step check:
- Is the patient safe and stable right now? If not, stop the activity and respond: position the patient, monitor them, and get help.
- Is what you're about to do inside the PT's plan of care? If yes, carry it out, adjusting only within the plan's limits.
- Does the situation call for re-examination, new goals, or a change to the plan? Those decisions belong to the PT. Hold that part and contact your supervising PT.
On PTA questions, the wrong answers often sound clinically reasonable but belong to the PT. Examples are "re-evaluate the patient," "revise the goals," and "advise an MRI." You'll see this pattern in Questions 15, 20, and 28.
Your 8-week NPTE-PTA study plan
This plan assumes you've finished (or nearly finished) your PTA program and can give it 12–15 hours a week. If you start the week of November 9, 2026, it ends right before the January 5–6, 2027 test date. It's an editorial plan, not an FSBPT requirement. Use the outline ranges to decide where your time goes, then shift hours toward what you actually miss.
Daily routine (about 2 hours, 6 days a week, plus one lighter day):
- 60–75 min: content review for the week's area, using class notes or a review text
- 20–30 min: 20–30 practice questions on that area (untimed at first, timed from Week 4)
- 15–20 min: review every miss and log why you missed it
| Week | Focus | By the end of the week |
|---|---|---|
| 1 | Baseline + musculoskeletal foundations. Take FSBPT's free demo exam and all 30 questions on this page. Review MSK anatomy, joint mechanics, and data collection: goniometry, manual muscle testing, posture, gait. | You know your weakest systems, and your miss log has started. |
| 2 | MSK conditions and interventions + equipment. Joint replacements and their precautions, fractures and post-op complications, arthritis, osteoporosis. Assistive devices, gait patterns, stairs, wheelchairs, orthotics, and prosthetics. | You can state common surgical precautions and fit and sequence each assistive device. |
| 3 | Neuro conditions. Stroke; spinal cord injury (levels, autonomic dysreflexia, tenodesis); brain injury; Parkinson disease; multiple sclerosis; peripheral neuropathy; vestibular basics. | You can name the safety red flag for each condition. |
| 4 | Neuro interventions + first timed full-length practice. Motor control and motor learning, balance, transfer training. Then take one timed 180-question practice exam in a single sitting, such as a PEAT form. | You have a score by content area and a miss log sorted by cause. |
| 5 | Cardiovascular and pulmonary. Vital signs, normal and abnormal exercise responses, stop-exercise signs, heart failure, coronary disease, COPD, breathing techniques, oxygen and lines, and cardiac medications (especially beta-blockers). | You can list the stop-exercise signs from memory. |
| 6 | Smaller systems + modalities. Integumentary (wound staging, burns), lymphatic, metabolic and endocrine (diabetes and exercise), GI and GU, and system interactions (cancer, comorbidities, pain, psychological factors). Modalities: indications, contraindications, and precautions. | You have a one-page sheet of contraindications for every modality. |
| 7 | Safety, professional responsibilities, research + second timed practice. Infection control, lines and tubes, falls, emergencies, signs of abuse. PTA scope and supervision, documentation, HIPAA and ADA, billing basics, ethics. Sensitivity and specificity, reliability and validity. Take your second timed full-length exam. | You can compare your second timed score with the first, area by area. |
| 8 | Targeted review + logistics. Work only from your miss log. Keep doing 20–30 timed questions a day, then taper. Use the final-week checklist. | You add no new topics after midweek and go in rested. |
If you have less time
| Time left | What to do |
|---|---|
| 4 weeks (about 20 h/week) | Combine plan weeks in pairs: 1–2, 3–4, 5–6, 7–8. Keep both timed full-length exams. Cut breadth, not timed practice. |
| 2 weeks | Week 1: MSK, neuro, and CV&P only, plus one timed full-length exam. Week 2: safety and equipment, then your miss log. Skip low-range areas unless they're already on your miss log. |
| 1 week | Don't try to relearn the curriculum. Rework your miss log, do two or three timed 45-question blocks to practice pacing, run the demo once, and protect your sleep. |
Studying around clinicals or a full-time job: do 45–60 minutes on weekdays (one content block plus 15 questions), then a longer weekend session with a timed 45-question block and full review. Keep one lighter day. The plan stretches to about 10 weeks this way.
Retaking? Start from your NPTE Performance Feedback Report (available from FSBPT) instead of the Week 1 baseline. Give your two weakest body systems a full week each, and switch to a different study method if your last cycle was mostly rereading.
30 free NPTE-PTA practice questions
Original, unofficial practice written by Castleport Test Prep. These are not FSBPT questions and not recalled exam items. Your score here is feedback on these 30 questions only. It doesn't predict an NPTE score.
The set samples both major and smaller outline areas; with only 30 questions, it is not a miniature version of the official blueprint. It has 21 stand-alone questions, then three case sets of 3 questions each. On the real exam, case (scenario) questions come at the end of each section, and each one can be answered on its own.
Question 1 · Cardiovascular & pulmonary (data collection)
A 68-year-old patient is 2 days after a lumbar fusion. Supine, BP is 132/78 mm Hg and HR is 76 bpm. After 2 minutes of standing, BP is 108/70 mm Hg and HR is 92 bpm, and the patient feels lightheaded. What should the PTA do?
Show answer and explanation
Answer: C
Why: Systolic pressure fell 24 mm Hg within 3 minutes of standing, and the patient has symptoms. That meets the standard definition of orthostatic hypotension: a sustained drop of at least 20 mm Hg systolic or 10 mm Hg diastolic within 3 minutes of standing. The safe response is to lower the patient, monitor, and report it so the team can act.
- A is wrong: this is not a normal response.
- B is wrong: it keeps a symptomatic patient upright.
- D is wrong: documenting without reporting leaves the team uninformed.
Review next: vital-sign responses to position changes. Source: StatPearls, Orthostatic Hypotension (Introduction; cites the 2011 consensus definition)
Question 2 · Cardiovascular & pulmonary (interventions)
A patient in outpatient cardiac rehabilitation takes metoprolol, a beta-blocker. The PT's plan calls for moderate-intensity aerobic training. What is the most appropriate way for the PTA to gauge exercise intensity?
Show answer and explanation
Answer: A
Why: Beta-blockers blunt the heart-rate rise during exercise and lower peak heart rate. A target based on age-predicted maximum can push the patient too hard while the heart rate never reaches the number. The AHA exercise standards describe the 6–20 Borg scale as a useful complement to heart rate for judging intensity. Heart-rate monitoring still belongs in the picture; it just isn't enough on its own here. Neither oxygen saturation nor breathing rate alone tells you how hard the patient is working.
Review next: how cardiac medications change exercise responses. Source: Fletcher et al., AHA Exercise Standards for Testing and Training, Circulation 2013 (Heart Rate Response; Perceived Exertion)
Question 3 · Cardiovascular & pulmonary (interventions)
A patient with COPD gets short of breath climbing a flight of stairs during a session. Which breathing technique should the PTA cue first?
Show answer and explanation
Answer: D
Why: Pursed-lip breathing lengthens exhalation. That can reduce air trapping and ease shortness of breath in COPD.
- A is wrong: forcing air out can worsen airway collapse and air trapping. Even pursed-lip breathing backfires if it's forced.
- B and C are wrong: breath-holding and fast, shallow breathing make the problem worse.
Review next: breathing techniques and positions that ease dyspnea. Source: StatPearls, Pursed-lip Breathing
Question 4 · Musculoskeletal (interventions)
A 72-year-old woman has osteoporosis and a previous vertebral compression fracture. She is reviewing her home exercise program with the PTA. Which exercise should be replaced?
Show answer and explanation
Answer: C
Why: Loaded or end-range spinal flexion raises the risk of vertebral fracture. Osteoporosis guidance says to avoid sit-ups and toe touches and to train the trunk with the spine in neutral instead. Options A, B, and D all keep the spine neutral and are reasonable. The PTA can suggest a neutral-spine alternative that fits the plan, or flag the exercise to the PT.
Review next: exercise precautions for osteoporosis. Sources: Osteoporosis Canada, Too Fit To Fracture patient handout; Mayo Clinic, Exercising with osteoporosis (Movements to avoid)
Question 5 · Musculoskeletal (data collection)
While collecting strength data, the PTA sees that the patient moves the elbow through full flexion against gravity but can't hold against any added resistance. Which manual muscle test grade fits?
Show answer and explanation
Answer: B
Why: Grade 3 means full range of motion against gravity, with no added resistance.
- A is wrong: grade 2 is full range only with gravity eliminated.
- C and D are wrong: grades 4 and 5 require holding against some resistance or full resistance.
Review next: MMT grades and gravity-eliminated positions. Source: StatPearls, Muscle Strength Grading (Function)
Question 6 · Musculoskeletal (conditions that impact treatment)
The PTA arrives for gait training with a patient 1 day after open reduction and internal fixation (ORIF) of a tibial shaft fracture. The patient reports severe lower-leg pain that keeps getting worse despite pain medication. The pain spikes sharply when the PTA gently moves the toes passively. The leg looks swollen and feels tight. A pedal pulse is present. What should the PTA do?
Show answer and explanation
Answer: A
Why: Pain out of proportion to the injury, and pain with passive stretch, are the early warning signs of acute compartment syndrome, a surgical emergency. A pulse can still be present when the compartment is in serious trouble; pulselessness is a late sign. That makes B a dangerous trap.
- C is wrong: compression adds pressure to the compartment.
- D is wrong: waiting until tomorrow loses critical time.
Review next: post-op complications (DVT, compartment syndrome, infection) and what each looks like. Source: StatPearls, Acute Compartment Syndrome (History and Physical; Treatment)
Question 7 · Musculoskeletal (conditions that impact treatment)
A 45-year-old woman has swelling in both wrists and in the knuckles (MCP joints) of both hands. Her morning stiffness lasts about 90 minutes. The joints at her fingertips (DIP joints) are not affected. These findings are most consistent with which condition?
Show answer and explanation
Answer: B
Why: Rheumatoid arthritis typically involves joints on both sides of the body, most often the wrists and MCP joints. Its morning stiffness lasts more than 60 minutes, and it doesn't affect the DIP joints.
- A is wrong: osteoarthritis stiffness usually lasts under 30 minutes, and in the hands it favors the DIP and PIP joints (Heberden and Bouchard nodes).
- C and D are wrong: neither explains swelling in several joints on both sides plus long morning stiffness.
Knowing which arthritis you're treating changes how you plan joint protection and how you dose activity during a flare.
Review next: inflammatory vs degenerative joint disease. Sources: Merck Manual Professional, Rheumatoid Arthritis; Merck Manual Professional, Osteoarthritis
Question 8 · Neuromuscular (interventions)
A patient with Parkinson disease freezes when walking through doorways. The PT's plan includes cueing strategies for gait. Which is the most appropriate strategy?
Show answer and explanation
Answer: D
Why: The APTA Parkinson disease guideline strongly recommends external cueing to reduce freezing of gait. A rhythmic beat or a visual target gives the patient an outside trigger for the next step.
- A is wrong: pulling the patient risks a fall.
- B is wrong: "try harder" isn't a cue.
- C is wrong: it abandons gait goals that are already in the plan.
Review next: freezing of gait and the different types of cues. Source: Osborne et al., Physical Therapist Management of Parkinson Disease (APTA CPG), Phys Ther 2022 (Summary of action statements)
Question 9 · Neuromuscular (motor learning)
A patient is practicing three transfers before going home: bed to chair, chair to toilet, and into a car simulator. The goal is to keep these skills after discharge. Which practice schedule best supports that?
Show answer and explanation
Answer: B
Why: Blocked practice usually looks better during the session. But random practice (high "contextual interference") tends to produce better retention afterward, which makes A the classic trap.
- C is wrong: mental practice can supplement physical practice but can't replace it.
- D is wrong: it ignores two of the three goals.
Review next: types of practice and feedback schedules. Source: Czyż, Wójcik & Solarská, systematic review and meta-analysis of contextual interference, 2024 (retention and transfer findings; applied effects vary)
Question 10 · Neuromuscular (interventions)
A patient with multiple sclerosis says her leg weakness gets worse during long hot showers and after exercising on warm days, then improves once she cools down. Which change fits the plan of care?
Show answer and explanation
Answer: A
Why: Heat sensitivity is common in MS. A small rise in core temperature can temporarily block nerve conduction and worsen symptoms, and the effect reverses with cooling. Exercise still helps, so the goal is to manage heat, not avoid activity. B gives up that benefit; C and D add heat.
Review next: managing fatigue and heat in MS. Source: Davis et al., Thermoregulation in multiple sclerosis, J Appl Physiol 2010 (Heat Sensitivity in MS; Countermeasures)
Question 11 · Integumentary (data collection)
Over a patient's sacrum, the PTA sees a shallow open wound with a moist, pink-red wound bed. There is no slough, and no fat is visible. Which pressure injury stage matches these findings?
Show answer and explanation
Answer: B
Why: Stage 2 is partial-thickness skin loss with exposed dermis. The wound bed is pink or red and moist, and fat is not visible.
- A is wrong: Stage 1 is intact skin.
- C is wrong: Stage 3 is full-thickness loss with fat visible.
- D is wrong: unstageable means slough or eschar hides the wound base.
The PTA records accurate findings and reports them to the PT.
Review next: all NPIAP stages, including deep tissue pressure injury. Source: NPIAP, Pressure Injury Stages
Question 12 · Lymphatic (interventions)
A patient receiving decongestive therapy for arm lymphedema after breast cancer treatment arrives with that arm red, hot, and tender. She says she feels flu-like. What should the PTA do?
Show answer and explanation
Answer: D
Why: These are signs of cellulitis, an infection that needs prompt medical treatment, usually antibiotics. Guidance for people with lymphedema is to pause manual lymphatic drainage and exercise, and remove compression from the affected limb, until the infection is treated. A, B, and C all push ahead with treatment that should stop.
Review next: contraindications to compression and manual lymphatic drainage. Source: HSE Ireland, Cellulitis & Lymphoedema (original leaflet unavailable)
Source note: the original HSE leaflet cited above is no longer available at its published address. Supporting reference (not an HSE document or a current guideline): Wrightington, Wigan and Leigh NHS, cellulitis and lymphoedema patient leaflet (2022; review date 2024), which advises contacting a GP immediately, avoiding compression during an acute attack, and stopping exercise and lymphatic drainage until it resolves.
Question 13 · Metabolic & endocrine (interventions)
During a session, a patient with type 1 diabetes becomes shaky and sweaty. His glucometer reads 62 mg/dL. He is alert and able to swallow. What should the PTA do first?
Show answer and explanation
Answer: C
Why: A glucose level below 70 mg/dL is hypoglycemia. The ADA Standards of Care say to give glucose to a conscious person (most people need about 15 g), recheck after 15 minutes, and repeat if it's still low. Follow your facility's protocol and report the event.
- A and B are wrong: they delay treatment.
- D is wrong: insulin would lower his glucose further.
Review next: exercise precautions in diabetes, including high glucose. Source: ADA, Standards of Care in Diabetes—2026, Section 6 (Hypoglycemia Treatment; Recommendation 6.15)
Question 14 · Gastrointestinal (interventions)
A patient with GERD reports heartburn during supine exercises that are scheduled right after lunch. Which change is most appropriate?
Show answer and explanation
Answer: A
Why: Lying flat soon after eating encourages reflux. The ACG GERD guideline advises avoiding meals in the 2–3 hours before lying down for bed and raising the head of the bed for nighttime symptoms. The same reasoning applies to when you schedule the session and how you position the patient.
- B is wrong: head-down positions make reflux worse.
- C and D are wrong: neither changes the position or timing causing the problem.
Review next: positioning precautions for GI and GU conditions. Source: Katz et al., ACG Clinical Guideline for GERD, Am J Gastroenterol 2022 (Recommendations 2 and 5)
Question 15 · System interactions
A 58-year-old patient with a history of prostate cancer is being treated for low back pain under the PT's plan. Today he says the pain wakes him at night and doesn't ease in any position. He has also lost weight over the past 2 months without trying. What should the PTA do?
Show answer and explanation
Answer: B
Why: A history of cancer, night pain that doesn't change with position, and unexplained weight loss together raise concern for spinal malignancy. Prostate cancer is one of the cancers that tends to spread to bone. The PT decides on re-examination and referral.
- A is wrong: it ignores the red flags.
- C is wrong: it reassures him without basis.
- D is wrong: recommending an MRI is a referral decision that belongs to the PT.
Review next: red flags that should stop treatment. Sources: NICE, Spinal metastases and metastatic spinal cord compression (2023) (1.3, recognising spinal metastases); ACR Appropriateness Criteria: Low Back Pain (red flags for cancer)
Question 16 · Equipment & devices
A patient who must not bear weight on his left leg is going up stairs with axillary crutches. What sequence should the PTA teach?
Show answer and explanation
Answer: A
Why: Going up, the strong (uninvolved) leg leads, and the crutches and injured leg follow. Going down, the crutches lead with the injured leg held forward. People remember it as "up with the good, down with the bad."
- B and D are wrong: leading with the crutches on the way up forces the arms to lift the body instead of the strong leg.
- C is wrong: the left leg can't bear weight.
Review next: stair and curb patterns with canes and walkers. Source: AAOS OrthoInfo, How To Use Crutches, Canes, and Walkers (Crutches: stairs)
Question 17 · Therapeutic modalities
The plan of care includes therapeutic ultrasound to the lumbar muscles. Before treatment, the patient mentions she is 10 weeks pregnant. What should the PTA do?
Show answer and explanation
Answer: C
Why: The evidence-based contraindication review in Physiotherapy Canada says neither continuous nor pulsed ultrasound should be applied over the low back, abdomen, or uterus during pregnancy. A, B, and D all still apply ultrasound over a contraindicated area. Picking a substitute intervention changes the plan, so that decision goes to the PT.
Review next: contraindications for electrical stimulation and heat. Source: Houghton, Nussbaum & Hoens, Electrophysical Agents: Contraindications and Precautions, Physiother Can 2010 (Section 3-1, Pregnancy)
Question 18 · Therapeutic modalities
The plan includes ice massage for lateral elbow pain. Before starting, the patient says her fingers turn white and then blue in the cold. What should the PTA do?
Show answer and explanation
Answer: D
Why: These are signs of Raynaud's phenomenon, a form of cold hypersensitivity. The same evidence-based review lists it as a contraindication to cold. A, B, and C are all still cold therapy. Choosing an alternative changes the plan, so it goes to the PT.
Review next: contraindications for heat and cold. Source: Houghton, Nussbaum & Hoens, Physiother Can 2010 (Tables 1–2, cryotherapy)
Question 19 · Safety & protection
During a facility outbreak of Clostridioides difficile (C. diff), the PTA removes gloves after treating a patient on contact precautions. What hand-hygiene step is the best answer?
Show answer and explanation
Answer: B
Why: During a C. diff outbreak, CDC encourages soap-and-water handwashing after caring for patients with known or suspected infection as an added precaution. Gloves and a gown remain the key barriers, and hand hygiene is still required after glove removal.
- A is wrong in this outbreak-specific stem: CDC specifically encourages soap and water as the additional precaution.
- C is wrong: removing gloves does not eliminate the need for hand hygiene.
- D is wrong: gloves are not reused between patients.
Outside an outbreak, current CDC guidance says alcohol-based hand sanitizer remains preferred in most clinical situations when hands are not visibly soiled, including routine care of patients with C. diff.
Review next: standard, contact, droplet, and airborne precautions. Sources: CDC, Hand Hygiene for Healthcare Workers; CDC, C. diff: Facts for Clinicians
Question 20 · Professional responsibilities
A PTA is treating a patient after a knee replacement. Which task is outside the PTA's role?
Show answer and explanation
Answer: C
Why: APTA's position on PTA direction and supervision reserves several tasks for the PT: examination and re-examination, evaluation, and developing or changing the plan of care. It also calls for a PT supervisory visit when the PTA requests a re-examination or when the patient's medical status changes. A, B, and D are all PTA tasks. State practice acts can add stricter rules.
Review next: supervision rules and documentation standards. Source: APTA, Direction and Supervision of the Physical Therapist Assistant (HOD P06-18-28-35)
Question 21 · Research & evidence-based practice
A special test for ACL tear has very high sensitivity. In a patient with knee pain, the test is negative. How should the result be interpreted?
Show answer and explanation
Answer: A
Why: The rule is "SnNout": a highly sensitive test, when negative, helps rule out the condition. Its partner is "SpPin": a highly specific test, when positive, helps rule in.
- B is wrong: a negative result can't confirm a tear.
- C and D are wrong: the result is valid, and low specificity has nothing to do with ruling a condition out.
The shortcut is only a screening heuristic; likelihood ratios and the clinical context still matter. In this item, the unusually high sensitivity plus a negative result makes A the best answer.
Review next: reliability vs validity. Source: Baeyens et al., Questioning the "SPIN and SNOUT" rule in clinical testing, Arch Physiother 2019
Case set 1: Questions 22–24
Setting: Inpatient rehabilitation
Patient: 24-year-old man
Current condition: Complete spinal cord injury at C6, 6 weeks after a motor vehicle crash
Other information: Indwelling urinary catheter; usual BP about 100/60 mm Hg
Physical therapy plan of care: Mat mobility and transfer training, upper-extremity strengthening, passive range of motion to the hands that preserves tenodesis, wheelchair skills
Question 22 · Neuromuscular (safety in interventions)
During mat work in supine, he suddenly reports a pounding headache and is sweating and flushed above the level of his injury. His BP is 168/98 mm Hg. What should the PTA do first?
Show answer and explanation
Answer: A
Why: This is autonomic dysreflexia, a medical emergency in injuries at T6 and above. The clinical practice guideline's first steps are:
- sit the person up and lower the legs
- loosen clothing and constrictive devices
- check BP every 1–2 minutes
- look for the trigger, starting with the urinary system, because bladder distention is the most common cause; here, a kinked or blocked catheter is the first thing to check
Why the other options are wrong:
- B raises BP further.
- C and D delay treatment of a dangerous BP spike.
Review next: autonomic dysreflexia vs orthostatic hypotension in SCI. Source: Consortium for Spinal Cord Medicine/PVA, Autonomic Dysreflexia CPG (Recommendations 2.6–2.10)
Question 23 · Neuromuscular (interventions)
View case: Case set 1 (Questions 22–24)
Setting: Inpatient rehabilitation
Patient: 24-year-old man
Current condition: Complete spinal cord injury at C6, 6 weeks after a motor vehicle crash
Other information: Indwelling urinary catheter; usual BP about 100/60 mm Hg
Physical therapy plan of care: Mat mobility and transfer training, upper-extremity strengthening, passive range of motion to the hands that preserves tenodesis, wheelchair skills
The plan says to preserve his tenodesis grasp. During passive range of motion to his hand, which movement should the PTA avoid?
Show answer and explanation
Answer: C
Why: Tenodesis works because the long finger flexors are slightly tight: when he extends his wrist, his fingers curl into a passive grasp. Stretching the wrist and fingers into full extension together overstretches those tendons and weakens the grasp.
- A and B are wrong: those are the ways to range the hand that protect the grasp, moving the wrist and fingers separately.
- D is wrong: flexing the wrist and fingers together doesn't stretch the finger flexors.
Review next: key muscles and functional outcomes by SCI level. Source: University of Sydney Physiotherapy eSkills, C6/7 passive movements (Key points)
Question 24 · Safety & protection (lines and tubes)
View case: Case set 1 (Questions 22–24)
Setting: Inpatient rehabilitation
Patient: 24-year-old man
Current condition: Complete spinal cord injury at C6, 6 weeks after a motor vehicle crash
Other information: Indwelling urinary catheter; usual BP about 100/60 mm Hg
Physical therapy plan of care: Mat mobility and transfer training, upper-extremity strengthening, passive range of motion to the hands that preserves tenodesis, wheelchair skills
The PTA is transferring him from the mat to his wheelchair. How should the catheter drainage bag be handled?
Show answer and explanation
Answer: D
Why: CDC's guideline on catheter-associated urinary tract infections says to keep the bag below the bladder at all times, never resting on the floor; to keep the system closed; and to keep urine flowing freely. This matters even more for him, because a blocked or kinked tube is a common trigger for autonomic dysreflexia.
- A and B are wrong: both put the bag above the bladder.
- C is wrong: disconnecting opens the closed system.
Review next: precautions for IV lines, oxygen tubing, and chest tubes. Source: CDC/HICPAC, Guideline for Prevention of Catheter-Associated Urinary Tract Infections (Recommendations III.A–B)
Case set 2: Questions 25–27
Setting: Home health
Patient: 68-year-old man
Current condition: 10 days after right total hip arthroplasty through a posterior approach; weight bearing as tolerated; standard posterior hip precautions ordered by the surgeon
Other information: Two-story home; uses a single-point cane
Physical therapy plan of care: Gait training with a cane on level surfaces and stairs, hip strengthening within precautions, ADL training with adaptive equipment
Question 25 · Musculoskeletal (interventions)
Which of his daily activities needs to change?
Show answer and explanation
Answer: B
Why: Standard posterior precautions are no hip flexion past 90°, no crossing the legs (adduction past midline), and no internal rotation. Leaning forward from a low seat pushes hip flexion well past 90°. A sock aid or reacher solves it.
- A is wrong: a raised seat is how you keep flexion under 90°.
- C is wrong: a pillow between the legs prevents adduction.
- D is wrong: cane gait at his ordered weight-bearing status is appropriate.
Precautions vary by surgeon, so always follow the specific orders.
Review next: anterior vs posterior hip precautions. Source: StatPearls, Hip Precautions (Posterior Approach THA Precautions)
Question 26 · Equipment & devices
View case: Case set 2 (Questions 25–27)
Setting: Home health
Patient: 68-year-old man
Current condition: 10 days after right total hip arthroplasty through a posterior approach; weight bearing as tolerated; standard posterior hip precautions ordered by the surgeon
Other information: Two-story home; uses a single-point cane
Physical therapy plan of care: Gait training with a cane on level surfaces and stairs, hip strengthening within precautions, ADL training with adaptive equipment
How should his cane be fitted and held?
Show answer and explanation
Answer: D
Why: The cane goes in the hand opposite the surgical side, so it moves with the right leg and shares the load. With his arm hanging relaxed, the handle sits at the wrist crease, which leaves the elbow bent about 15–30°.
- A and B are wrong: they put the cane on the surgical side.
- C is wrong: the armpit is far too high.
Review next: fitting walkers and crutches. Source: Bradley & Hernandez, Geriatric Assistive Devices, Am Fam Physician 2011 (Correct Height and Fit; Proper Use)
Question 27 · Equipment & devices
View case: Case set 2 (Questions 25–27)
Setting: Home health
Patient: 68-year-old man
Current condition: 10 days after right total hip arthroplasty through a posterior approach; weight bearing as tolerated; standard posterior hip precautions ordered by the surgeon
Other information: Two-story home; uses a single-point cane
Physical therapy plan of care: Gait training with a cane on level surfaces and stairs, hip strengthening within precautions, ADL training with adaptive equipment
He needs to go down the stairs to his kitchen with the cane. Which sequence should the PTA teach?
Show answer and explanation
Answer: C
Why: Going down, the cane goes first, then the surgical (right) leg, then the strong (left) leg. That way the strong leg holds his weight while the cane and the weaker leg step down. Going up is the reverse: the strong leg leads.
- A and B are wrong: stepping the strong leg down first leaves him lowering himself on the healing hip.
- D is wrong: both legs step down before the cane is there for support.
Review next: curb and ramp technique with each device. Source: AAOS OrthoInfo, How To Use Crutches, Canes, and Walkers (Canes: stairs)
Case set 3: Questions 28–30
Setting: Skilled nursing facility
Patient: 81-year-old woman
Current condition: 6 days after ORIF of a left hip fracture; weight bearing as tolerated on the left
Medical history: Heart failure, type 2 diabetes, hypertension
Medications: Includes furosemide (a diuretic) and metoprolol (a beta-blocker)
Other information: Nursing records her weight every morning
Physical therapy plan of care: Gait training with a front-wheeled walker and progressing distance, lower-extremity strengthening, vital-sign monitoring each session
Question 28 · Cardiovascular & pulmonary
This morning's weight log shows she is 3.5 lb heavier than yesterday. She says she needed an extra pillow to breathe last night, and her ankles look more swollen. What should the PTA do?
Show answer and explanation
Answer: B
Why: The American Heart Association tells people with heart failure to report a weight gain of more than 2–3 lb in a day. Her new breathlessness when lying flat and her extra swelling add to the concern. The medical team needs to know before she exercises. A, C, and D all carry on with the session before anyone has assessed a possible heart failure flare.
Review next: heart failure warning signs and how they change exercise. Source: American Heart Association, Managing Heart Failure Symptoms
Question 29 · Equipment & devices
View case: Case set 3 (Questions 28–30)
Setting: Skilled nursing facility
Patient: 81-year-old woman
Current condition: 6 days after ORIF of a left hip fracture; weight bearing as tolerated on the left
Medical history: Heart failure, type 2 diabetes, hypertension
Medications: Includes furosemide (a diuretic) and metoprolol (a beta-blocker)
Other information: Nursing records her weight every morning
Physical therapy plan of care: Gait training with a front-wheeled walker and progressing distance, lower-extremity strengthening, vital-sign monitoring each session
The next day she is cleared to continue. With the front-wheeled walker and weight bearing as tolerated on the left, which gait sequence should the PTA teach?
Show answer and explanation
Answer: C
Why: Move the walker first, then step the involved (left) leg into it, then bring the uninvolved (right) leg up even with it. This way the walker is already in place to share the load whenever the healing hip takes weight.
- A and B are wrong: both put the left leg's step last, after the right leg has already moved, which defeats the sequence.
- D is wrong: it steps out before the walker is placed.
Review next: gait patterns for each weight-bearing status. Source: AAOS OrthoInfo, How To Use Crutches, Canes, and Walkers (Walkers)
Question 30 · Cardiovascular & pulmonary
View case: Case set 3 (Questions 28–30)
Setting: Skilled nursing facility
Patient: 81-year-old woman
Current condition: 6 days after ORIF of a left hip fracture; weight bearing as tolerated on the left
Medical history: Heart failure, type 2 diabetes, hypertension
Medications: Includes furosemide (a diuretic) and metoprolol (a beta-blocker)
Other information: Nursing records her weight every morning
Physical therapy plan of care: Gait training with a front-wheeled walker and progressing distance, lower-extremity strengthening, vital-sign monitoring each session
During gait training, her resting BP is 128/74 mm Hg. She walks 40 feet at a steady pace, then picks up speed. Her BP is now 116/70 mm Hg, she reports increasing fatigue, and her HR is 88 bpm. What should the PTA do?
Show answer and explanation
Answer: D
Why: Systolic pressure should rise as the workload increases. Hers fell 12 mm Hg while the workload went up, and she is getting more tired. The AHA exercise standards list a systolic drop of more than 10 mm Hg despite increasing workload as an indication to stop exercise.
- A is wrong: on metoprolol, a "normal" heart rate isn't reassuring.
- B and C are wrong: both keep her exercising.
Review next: normal and abnormal BP and HR responses to exercise. Source: Fletcher et al., AHA Exercise Standards for Testing and Training, Circulation 2013 (Indications for Termination of Exercise Testing)
After the 30 questions
| Content area | Questions |
|---|---|
| Cardiovascular & pulmonary | 1, 2, 3, 28, 30 |
| Musculoskeletal | 4, 5, 6, 7, 25 |
| Neuromuscular & nervous | 8, 9, 10, 22, 23 |
| Equipment & devices | 16, 26, 27, 29 |
| Therapeutic modalities | 17, 18 |
| Safety & protection | 19, 24 |
| Integumentary · Lymphatic · Metabolic · GI · System interactions | 11 · 12 · 13 · 14 · 15 |
| Professional responsibilities · Research | 20 · 21 |
Mark every question you missed or guessed. If two or more fall in one body system, move that system's week earlier in your plan. With only a few questions per area, treat the tally as a hint about where to look, not a measure of your ability.
Review your misses the right way
For each miss, answer three questions:
- What clue in the stem mattered most?
- Why was my choice tempting?
- What would have to change in the stem for my choice to be right?
Then log the miss as one of these four types, because each one has a different fix:
| Why you missed it | What it looks like | Fix |
|---|---|---|
| Knowledge gap | You didn't know the fact (for example, the MMT grade definitions). | Restudy the topic, then do 10 new questions on it within 2–4 days. |
| Role or order error | You knew the content but picked an action that belongs to the PT, or did the right thing in the wrong order. | Rework the question with the three-step PTA check. |
| Missed cue | You skipped a detail like "C6," "posterior approach," or "metoprolol." | Underline the condition, setting, and medications before you read the options. |
| Pacing | You rushed or changed a correct answer. | Practice timed 45-question blocks in about 60 minutes. |
Worked example (Question 2): Choosing B, the age-predicted heart-rate target, is rarely a knowledge gap. Most candidates know the formula. The miss is overlooking "metoprolol" in the stem. Log it as a missed cue, add "beta-blocker → don't rely on HR targets alone" to your one-page review sheet, and re-answer a beta-blocker question three days later.
How the NPTE-PTA works
| Exam feature | NPTE-PTA |
|---|---|
| Questions | 180 multiple-choice questions, in 4 sections of 45 |
| Scored | 140 scored. The other 40 are pretest questions scattered across sections, so treat every question as if it counts. |
| Question types | Stand-alone questions (some with a graphic or video), plus case (scenario) sets of 2–5 questions at the end of each section. Up to 35 questions can be scenario-based, and each can be answered independently. |
| Time | 4 hours of testing. The full appointment is 4 hours 30 minutes, including the tutorial, scheduled break, and survey. |
| Pacing | Sections aren't timed separately. On average you have about 1 minute 20 seconds per question (240 min ÷ 180, our calculation), or about an hour per section. Once you end a section, you can't go back to it. |
| Break | A 15-minute scheduled break after section 2. Unscheduled breaks after other sections come out of your exam time. |
| Scoring | Scaled from 200 to 800; 600 passes. The result is pass/fail. Wrong answers carry no penalty, so answer every question. |
| Raw score needed | It varies by test form, usually within a 1–2 question range. FSBPT doesn't publish a fixed number. |
| Lab values | Normal reference ranges generally aren't provided. Know the common ones and what they mean for treatment. |
| Fees | $485 to FSBPT + $92 to Prometric = $577 in base fees, plus FSBPT's 1.6% processing fee rounded up to the next dollar: $8 on a $485 registration ($7.76 rounded up). Total: $585 before jurisdiction fees. FSBPT registration and processing fees. |
| Where | Prometric test centers. You can test at any center that offers the NPTE, regardless of the jurisdiction you chose. |
| Content outline | NPTE-PTA Test Content Outline, effective January 2024 |
Sources: Understanding the NPTE; NPTE Candidate Handbook (PDF), Section 4; NPTE Content; Exam Registration and Scheduling.
Attempt limits:
- No more than 3 attempts in any 12-month period. After 3 consecutive attempts, you must skip the next test date. See FSBPT's Retaking the Examination guidance.
- No more than 6 attempts per exam level, lifetime.
- No further testing after two scores at or below 400, including a score of exactly 400. See FSBPT's NPTE appeal form (PDF). Check with FSBPT and your licensing authority before registering.
Upcoming PTA test dates
All deadlines are 11:59 p.m. Eastern Time. Some states set earlier application deadlines, so check with your licensing board.
| Test date | Register & pay by | Jurisdiction approval by | Scores to jurisdictions | Free score report |
|---|---|---|---|---|
| January 5–6, 2027 | December 1, 2026 | December 8, 2026 | January 13, 2027 | January 20, 2027 |
| April 6–7, 2027 | March 2, 2027 | March 9, 2027 | April 14, 2027 | April 21, 2027 |
| July 7–8, 2027 | June 2, 2027 | June 9, 2027 | July 15, 2027 | July 22, 2027 |
| October 5–6, 2027 | August 31, 2027 | September 7, 2027 | October 14, 2027 | October 21, 2027 |
Source: FSBPT Future Test Dates.
If your jurisdiction doesn't approve you by its deadline, FSBPT closes your registration and refunds the exam fee minus $50. Students in CAPTE-accredited programs can sit up to 90 days before graduation, though some jurisdictions are stricter.
For the step-by-step registration process, see our NPTE exam registration guide. After test day, see NPTE exam results and, if you need it, the NPTE retake policy.
Official practice tools: what each one is for
| Resource | Cost | Best use |
|---|---|---|
| NPTE-PTA Test Content Outline | Free | Defines what's in scope. Read the descriptions for your weakest systems. |
| NPTE Demo Exam | Free | Shows the real interface and case-box layout, with sample PTA questions. Use it in Week 1 so nothing looks new on test day. It's not a readiness score. |
| PEAT for PTAs | $99 + 1.6% processing fee | FSBPT's own timed practice: two 180-question, 4-hour exams (a practice test and a retired NPTE form), with explanations and a report by content area. Access lasts 90 days from when you start your first exam, so don't start it until Week 4. |
| FifthTheory Test Mastery | Free | Checks your test-taking skills, not your content knowledge. |
| Third-party question banks | Varies | More repetition and more misses to learn from. Prefer banks that explain every answer and cite sources, and don't treat their percentages as a predicted NPTE score. |
Final-week checklist
- Confirm your test date, Prometric center, and travel time. Make sure the name on your Authorization to Test exactly matches your ID.
- Stop adding new books or question banks.
- Work only from your miss log and your one-page review sheet.
- Run the FSBPT demo once more so the interface feels familiar.
- Plan your pacing: about an hour per section, plus the scheduled break after section 2.
- Sleep matters more than one last chapter the night before.
See FSBPT's Test Day page for current ID and check-in rules.
FAQ
How long should I study for the NPTE-PTA? FSBPT doesn't set a number. The 8-week plan above (12–15 hours a week) is an editorial starting point for a recent graduate who can sustain that schedule. If your first timed practice exam shows big gaps in MSK or neuro, add time rather than cramming.
How is the PTA exam different from the PT exam? It's shorter: 180 questions over 4 hours, versus 225 over 5. It also uses its own content outline, built around carrying out the PT's plan of care and collecting data rather than examining and evaluating patients. Make sure your practice questions are written for the PTA level. If you're preparing for the PT exam instead, see NPTE-PT exam prep.
How many questions can I miss and still pass? There's no fixed number. The raw score needed for 600 shifts slightly from form to form, and 40 of the 180 questions are unscored. You can't count your way to a pass during the exam, so answer everything and move on.
Can I take the NPTE-PTA online? No. It's given only at Prometric test centers, on four fixed test-date windows a year.
Does passing make me licensed? No. Your state licensing board issues the license, and many states add steps such as a jurisprudence exam. Check your board's full requirements through FSBPT's licensing authorities directory.
How many times can I retake it? Up to 6 times in a lifetime at the PTA level, with no more than 3 attempts in any 12-month period. After 3 consecutive attempts, you must skip the next test date. No further testing is permitted after two scores at or below 400, including a score of exactly 400. FSBPT's own data show that candidates who fail twice or more rarely pass later without substantial remediation, so start any retake from your Performance Feedback Report. See FSBPT's Important Retake Information.
Sources
Last verified November 3, 2026. We checked the exam format, scoring, fees, attempt limits, 2027 test dates, PEAT details, and the content outline against FSBPT's current pages and Candidate Handbook (Version 2025.02). Each practice question's underlying fact was checked against the clinical or professional source listed beneath it. That's a source check, not a clinical review.
FSBPT
- NPTE-PTA Test Content Outline, effective January 2024 (Version 1.1, 8/25/2023)
- NPTE Candidate Handbook, Version 2025.02 (PDF)
- NPTE Content (including FAQs on the 2024 changes)
- Candidate Handbook web pages: Understanding the NPTE, Exam Registration and Scheduling, Eligibility Requirements
- Future Test Dates
- Practice Exam & Assessment Tool (PEAT)
- Important Retake Information
Clinical and professional sources are linked under each practice question.
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. They are not actual or recalled 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.