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NPTE Cheat Sheet

Practice this exam

Musculoskeletal System

  • 24-30% of exam
  • Special Tests MMT Grading Joint Mobilization Ottawa Rules

Neuromuscular & Nervous

  • 22-27% of exam
  • SCI Levels Stroke Syndromes Balance & Gait Reflex Grading

Cardiovascular & Pulmonary

  • 12-15% of exam
  • Vital Signs MET Levels Breath Sounds O2 Devices

Integumentary System

  • 4-6% of exam
  • Wound Staging Burn Classification Rule of Nines Dressings

Other Body Systems

  • 12-19% of exam
  • Endocrine GI/GU Lymphedema DVT Signs

Equipment & Modalities

  • 5-7% of exam
  • Modalities Assistive Devices Weight-Bearing Orthotics

Safety, Professional & Research

  • 7-9% of exam
  • Documentation Ethics & Legal EBP Statistics Infection Control

Quick Facts

  • Exam NPTE-PT
  • Body FSBPT
  • Items 225 (180 scored)
  • Sections 5 x 45 items
  • Time 5 hours
  • Pass 600/800 scaled
  • Level Entry-level DPT
  • Blueprint Jan 2024 outline

MMT Grading Scale MS

  • 0 is none, 5 is normal
  • 0: no contraction 3: full ROM vs gravity 5: normal resistance

Sprain vs Strain MS

Sprain

  • Ligament injury
  • Joint instability
  • Graded I to III

Strain

  • Muscle or tendon injury
  • Contractile weakness
  • Graded I to III
  • Ligament vs muscle-tendon

Knee & Shoulder Special Tests MS

  • Lachman test ACL laxity, 20-30 degrees
  • McMurray test Meniscus tear
  • Valgus stress test MCL laxity
  • Empty can test Supraspinatus weakness
  • Neer test Subacromial impingement
  • Drop arm test Rotator cuff tear

Ottawa Ankle vs Knee Rule MS

Ottawa Ankle

  • Malleolar zone tenderness
  • No weight-bear 4 steps

Ottawa Knee

  • Age 55+ or patella tenderness
  • Cannot flex to 90 degrees
  • Different anatomic criteria

Hip & Spine Special Tests MS

  • FABER test Hip or SI pathology
  • Thomas test Hip flexor tightness
  • Straight leg raise Nerve root tension
  • Slump test Neural tension sign
  • Trendelenburg sign Glute medius weakness
  • Ober's test IT band tightness

Ankle & Wrist Special Tests MS

  • Ottawa Ankle Rules Bone tenderness or no weight-bear
  • Anterior drawer (ankle) ATFL laxity
  • Talar tilt test CFL laxity
  • Thompson test Achilles tendon rupture
  • Tinel's sign Nerve entrapment site
  • Phalen's test Carpal tunnel syndrome

MMT & Joint Mobilization Grades MS

  • MMT 0 No contraction
  • MMT 2 Full ROM, gravity eliminated
  • MMT 3 Full ROM against gravity
  • MMT 5 Normal, max resistance
  • Mobilization Grade I Small, pain-free range
  • Mobilization Grade III Large, into resistance
  • Mobilization Grade V High-velocity thrust

Diaphragm Innervation NE

  • C3, 4, 5 keep the diaphragm alive
  • C3-C5: phrenic nerve Above C4: ventilator risk C4: partial shoulder shrug

UMN vs LMN Signs NE

UMN

  • Hyperreflexia
  • Spasticity
  • Babinski positive

LMN

  • Hyporeflexia
  • Flaccidity
  • Fasciculations present
  • Increased vs decreased tone

Neuro Outcome Measure Selection NE

  • Fall risk screening → Berg Balance Scale
  • Quick functional mobility check → Timed Up and Go
  • Gait speed measurement → 10-Meter Walk Test
  • Stroke-specific motor recovery → Fugl-Meyer Assessment
  • Endurance, functional capacity → 6-Minute Walk Test

Spinal Cord Injury Key Levels NE

  • C4 level Diaphragm; may need ventilator
  • C5 level Shoulder/elbow flexion (deltoid, biceps)
  • C6 level Wrist extension, tenodesis grasp
  • C7 level Elbow extension (triceps active)
  • C8-T1 level Hand intrinsics, fine motor
  • T1-T9 level Trunk control, hands intact
  • L2-S1 level Knee, ankle, hip extension

Deep Tendon Reflex Grades NE

  • 0 absent, 2+ normal, 4+ clonus
  • 0: absent reflex 2+: normal, average 4+: clonus present

Central vs Peripheral Vestibular NE

Peripheral

  • Fatigable nystagmus
  • Latency present
  • Positional trigger

Central

  • Non-fatigable nystagmus
  • No latency period
  • Other neuro signs
  • Ear vs brainstem/cerebellum

Stroke Syndromes & Deficits NE

  • MCA stroke Contralateral face/arm weakness
  • ACA stroke Contralateral leg weakness
  • PCA stroke Contralateral visual field loss
  • Broca's aphasia Nonfluent, comprehension intact
  • Wernicke's aphasia Fluent, poor comprehension
  • Wallenberg syndrome Lateral medullary deficits

Balance & Gait Outcome Measures NE

  • Berg Balance Scale Fall risk, 0-56 scale
  • Timed Up and Go Mobility, cutoff 13.5 sec
  • Dynamic Gait Index Fall risk, gait tasks
  • 10-Meter Walk Test Gait speed, meters/sec
  • Tinetti POMA Balance plus gait score
  • 6-Minute Walk Test Endurance, functional capacity

Reflex & Tone Grading NE

  • DTR 0 Absent reflex
  • DTR 2+ Normal reflex
  • DTR 4+ Clonus present
  • Modified Ashworth 0 No tone increase
  • Modified Ashworth 4 Rigid flexion/extension
  • Babinski sign Upper motor neuron lesion

MET Level Ladder CA

  • 1-3 rest, 3-5 light, 5-7 moderate, 7+ vigorous
  • 1-3 METs: self-care 3-5 METs: light housework 5-7 METs: stair climbing 7+ METs: jogging, sports

Vital Signs & MET Levels CA

  • Normal resting HR 60-100 bpm
  • Normal BP Under 120/80 mmHg
  • Normal SpO2 95% or higher
  • 1-3 METs Self-care, slow walking
  • 3-5 METs Light housework, cycling
  • 5-7 METs Stair climbing, moderate exercise
  • 7+ METs Jogging, competitive sports

Cardiopulmonary Signs & O2 Devices CA

  • Crackles Fluid in alveoli
  • Wheezes Narrowed airway, bronchospasm
  • Nasal cannula FiO2 about 24-44%
  • Non-rebreather mask FiO2 about 60-90%
  • Borg RPE scale Perceived exertion, 6-20
  • Cardiac rehab Phase I Inpatient, early mobility

Burn Rule of Nines IN

  • Head 9, each arm 9, each leg 18
  • Head/neck: 9 percent Each arm: 9 percent Each leg: 18 percent Trunk front/back: 18 each

Partial- vs Full-Thickness Burn IN

Partial-thickness

  • Blisters, moist surface
  • Painful
  • Heals without graft

Full-thickness

  • Leathery, dry surface
  • Painless, nerve damage
  • Needs skin graft
  • Sensation present vs absent

Wound Dressing Selection IN

  • Heavy exudate wound → Alginate dressing
  • Dry, minimal exudate wound → Hydrogel dressing
  • Autolytic debridement goal → Hydrocolloid dressing
  • Infected, necrotic tissue → Sharp debridement
  • Clean, granulating wound → Foam dressing

Wound & Burn Staging IN

  • Pressure injury Stage 1 Nonblanchable erythema, intact skin
  • Pressure injury Stage 2 Partial-thickness, open wound
  • Pressure injury Stage 3 Full-thickness, fat visible
  • Pressure injury Stage 4 Exposed bone, muscle, tendon
  • Superficial partial burn Blisters, moist, painful
  • Full-thickness burn Leathery, painless, needs graft
  • Rule of Nines Estimates burn surface area

Metabolic, GI, GU & Lymphatic OT

  • Hypoglycemia signs Shaky, sweaty, confused
  • Lymphedema Stage 2 Non-pitting, fibrotic tissue
  • Complete decongestive therapy Lymphedema gold standard
  • Stress incontinence Leakage with cough/sneeze
  • Urge incontinence Sudden strong urge, leakage
  • DVT signs Calf pain, swelling, warmth

TENS vs NMES EQ

TENS

  • Sensory-level stimulation
  • Pain modulation
  • No motor recruitment

NMES

  • Motor-level stimulation
  • Strength, reeducation
  • Visible contraction
  • Pain relief vs strength

Modality Selection Logic EQ

  • Acute inflammation, swelling → Cryotherapy ( Vasoconstrict, limit swelling )
  • Chronic stiffness, tightness → Thermotherapy ( Vasodilate, extensibility )
  • Pain gate control needed → TENS
  • Muscle strength, reeducation → NMES
  • Deep tissue heating goal → Continuous ultrasound

Therapeutic Modalities Quick Reference EQ

  • TENS Pain gate control
  • NMES Muscle strengthening, reeducation
  • FES Functional movement (e.g., foot drop)
  • Continuous ultrasound Deep heating, thermal
  • Pulsed ultrasound Non-thermal, tissue healing
  • Cryotherapy Acute inflammation, vasoconstriction

Cane vs Walker EQ

Cane

  • Mild instability
  • Contralateral hand use
  • Faster gait speed

Walker

  • Moderate-severe instability
  • Both hands needed
  • Maximum stability
  • Mild vs significant deficit

Assistive Device Selection EQ

  • Non-weight-bearing status → Walker or crutches ( No limb loading )
  • Mild balance deficit → Single-point cane
  • Moderate instability → Front-wheeled walker
  • Bilateral LE weakness → Axillary crutches
  • Max stability, min speed → Standard walker

Assistive Devices & Weight-Bearing EQ

  • NWB Zero weight on limb
  • TDWB/TTWB Toe-touch only, under 20%
  • PWB Specified partial percentage
  • WBAT Weight as tolerated
  • Standard walker Max stability, slower gait
  • Single-point cane Mild balance deficit
  • Axillary crutches Bilateral LE involvement

EBP, Legal & Documentation SA

  • Systematic review Highest level of evidence
  • RCT Strong single-study evidence
  • Sensitivity True positive rate
  • Specificity True negative rate
  • HIPAA Patient privacy law
  • Informed consent Right to refuse treatment
  • Mandatory reporting Suspected abuse or neglect

Common Traps

Numbness Is Not Weakness

  • Numbness: sensory deficit ≠ Weakness: motor deficit

AROM Is Not PROM

  • AROM: patient effort ≠ PROM: examiner moves joint

Contracture Is Not Spasticity

  • Contracture: fixed shortening ≠ Spasticity: velocity-dependent tone

High Pass Rate Is Not Easy

  • 89% first-time US grads ≠ Clinically rigorous scenarios tested

Scaled Score Is Not Percent Correct

  • 600 is not 75 percent ≠ Difficulty-adjusted per test form

Pretest Items Are Not Identifiable

  • 45 unscored items hidden ≠ Answer every item fully

Cryotherapy Is Not Always Safe

  • Contraindicated in Raynaud's ≠ Avoid over impaired sensation

Last Minute

  • 1. 225 items total, 180 scored
  • 2. 45 unscored pretest items hidden
  • 3. Five sections, 45 items each
  • 4. 5-hour total time limit
  • 5. Scaled score range: 200-800
  • 6. Passing scaled score is 600
  • 7. MSK plus Neuro near 50%
  • 8. Know special-test positions cold
  • 9. SCI level equals last intact function
  • 10. TENS for pain, NMES for strength
  • 11. Weight-bearing status drives device choice
  • 12. Wound stage reflects tissue depth

NPTE Physical Therapist

  • Practice Questions 224 questions Study Guide 22 topics Cheat Sheet 96 facts Flashcards 50 cards Shorts 3 short s Videos 3 videos Blogs 4 blogs Free CE Podcast