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Cheat sheet

NPTE Cheat Sheet

Practice QuestionsStudy Guide

Musculoskeletal System

24-30%of exam

Special TestsMMT GradingJoint MobilizationOttawa Rules

Neuromuscular & Nervous

22-27%of exam

SCI LevelsStroke SyndromesBalance & GaitReflex Grading

Cardiovascular & Pulmonary

12-15%of exam

Vital SignsMET LevelsBreath SoundsO2 Devices

Integumentary System

4-6%of exam

Wound StagingBurn ClassificationRule of NinesDressings

Other Body Systems

12-19%of exam

EndocrineGI/GULymphedemaDVT Signs

Equipment & Modalities

5-7%of exam

ModalitiesAssistive DevicesWeight-BearingOrthotics

Safety, Professional & Research

7-9%of exam

DocumentationEthics & LegalEBP StatisticsInfection 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

0 is none, 5 is normal

0: no contraction3: full ROM vs gravity5: normal resistance

Sprain vs Strain

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

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

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

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

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

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

C3, 4, 5 keep the diaphragm alive

C3-C5: phrenic nerveAbove C4: ventilator riskC4: partial shoulder shrug

UMN vs LMN Signs

UMN

  • Hyperreflexia
  • Spasticity
  • Babinski positive

LMN

  • Hyporeflexia
  • Flaccidity
  • Fasciculations present

Increased vs decreased tone

Neuro Outcome Measure Selection

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

Spinal Cord Injury Key Levels

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

0 absent, 2+ normal, 4+ clonus

0: absent reflex2+: normal, average4+: clonus present

Central vs Peripheral Vestibular

Peripheral

  • Fatigable nystagmus
  • Latency present
  • Positional trigger

Central

  • Non-fatigable nystagmus
  • No latency period
  • Other neuro signs

Ear vs brainstem/cerebellum

Stroke Syndromes & Deficits

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

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

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

1-3 rest, 3-5 light, 5-7 moderate, 7+ vigorous

1-3 METs: self-care3-5 METs: light housework5-7 METs: stair climbing7+ METs: jogging, sports

Vital Signs & MET Levels

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

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

Head 9, each arm 9, each leg 18

Head/neck: 9 percentEach arm: 9 percentEach leg: 18 percentTrunk front/back: 18 each

Partial- vs Full-Thickness Burn

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

  1. Heavy exudate wound→Alginate dressing
  2. Dry, minimal exudate wound→Hydrogel dressing
  3. Autolytic debridement goal→Hydrocolloid dressing
  4. Infected, necrotic tissue→Sharp debridement
  5. Clean, granulating wound→Foam dressing

Wound & Burn Staging

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

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

TENS

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

NMES

  • Motor-level stimulation
  • Strength, reeducation
  • Visible contraction

Pain relief vs strength

Modality Selection Logic

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

Therapeutic Modalities Quick Reference

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

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

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

Assistive Devices & Weight-Bearing

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

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. 1.225 items total, 180 scored
  2. 2.45 unscored pretest items hidden
  3. 3.Five sections, 45 items each
  4. 4.5-hour total time limit
  5. 5.Scaled score range: 200-800
  6. 6.Passing scaled score is 600
  7. 7.MSK plus Neuro near 50%
  8. 8.Know special-test positions cold
  9. 9.SCI level equals last intact function
  10. 10.TENS for pain, NMES for strength
  11. 11.Weight-bearing status drives device choice
  12. 12.Wound stage reflects tissue depth

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