Equipment Application & Safety - National Physical Therapy Examination NPTE

Which electrotherapy precaution is required before using NMES or TENS in a patient with an implanted pacemaker?

Avoid use unless physician clearance; do not place electrodes near device. Clearance ensures no interference with pacemaker function, and distance minimizes electrical risks.
Which gait aid is indicated for a patient who must keep weight off one lower extremity?

Axillary or forearm crutches (non-weight-bearing gait). Crutches support body weight through upper extremities, enabling non-weight-bearing on the affected leg during gait.
Identify the correct sequence for a 2-point gait pattern with bilateral involvement using crutches.

Right crutch + left leg, then left crutch + right leg. This reciprocal pattern supports bilateral weakness by mimicking natural gait mechanics.
What elbow flexion angle should be present when a cane is properly fitted?

$20^\circ$ to $30^\circ$ elbow flexion. This angle optimizes shock absorption and force distribution during weight-bearing phases of gait.
Which modality is contraindicated over a pregnant uterus due to potential fetal risk?

Therapeutic ultrasound (over pregnant uterus). Ultrasound may induce thermal or mechanical effects potentially harmful to fetal tissues.
Which wheelchair component should be adjusted to reduce posterior pelvic tilt and sacral sitting?

Seat-to-back angle and proper seat depth (avoid excessive depth). These adjustments promote neutral pelvic alignment and prevent forward sliding.
What key precaution prevents neurovascular injury when using axillary crutches?

Do not bear weight through the axilla; weight through hands. Weight through hands avoids brachial plexus compression, reducing risk of nerve palsy.
What is the correct action if a patient reports burning or sharp pain during superficial heat application?

Stop treatment immediately and inspect skin. Prompt cessation prevents thermal injury, with inspection to assess for burns or irritation.
Which orthosis is indicated to prevent genu recurvatum by limiting knee hyperextension in stance?

Knee orthosis with extension stop (or ground-reaction AFO if appropriate). Extension stops block hyperextension, enhancing knee stability during weight-bearing.
Which assistive device is indicated to reduce load on a painful hip by shifting trunk support to the upper extremities?

Cane held contralaterally to decrease hip joint reaction force. Contralateral use offloads the hip by transferring forces through the arm and reducing joint compression.
What is the correct initial height setting for axillary crutches relative to the axilla?

Crutch pad $2$ to $3$ finger widths below axilla. This gap prevents axillary neurovascular compression while allowing proper arm support.
What is the correct sequence for ascending stairs with crutches when one leg is involved?

Up with the good: uninvolved leg first, then crutches + involved leg. Leading with the strong leg ensures stability, with crutches providing support for the weak leg.
Identify the correct sequence for a 3-point gait pattern using crutches (NWB on one leg).

Crutches forward, involved leg held NWB, then uninvolved leg through. This pattern maintains stability while ensuring no weight on the involved leg during progression.
What is the primary indication for a platform walker attachment?

Inability to bear weight through the hands/wrists (forearm weight-bearing needed). Platforms allow weight distribution through forearms, bypassing compromised hand or wrist structures.
Which side should a cane be held on for a patient with unilateral lower-extremity pain or weakness?

Contralateral side (opposite the involved lower extremity). This positioning offloads the affected side by shifting weight and widening the base of support.
What elbow flexion angle should be present when axillary crutches are properly fitted?

$20^\circ$ to $30^\circ$ elbow flexion at handgrip. This flexion allows comfortable weight-bearing and minimizes fatigue in the upper extremities.
What is the safest direction for a patient to push a walker during gait training?

Lift or roll walker a short distance forward; do not push far ahead. Short forward movements keep the walker within the base of support, minimizing forward fall risk.
Identify the safest initial skin-check schedule after issuing a new lower-extremity orthosis.

Inspect skin after $30$ minutes of wear, then at least daily thereafter. Early and regular checks identify pressure points promptly to prevent skin irritation or ulcers.
Which gait aid is most appropriate for a patient with poor balance who needs maximal stability?

Standard walker. Standard walkers provide four points of ground contact, maximizing base of support for balance-compromised patients.
Which orthosis is indicated to control foot drop during swing phase and assist toe clearance?

Ankle-foot orthosis (AFO). AFOs provide dorsiflexion assist to maintain toe clearance and prevent tripping in swing phase.
What is the correct initial setting for wheelchair footrest height to protect skin and alignment?

Thighs supported; feet fully on footplates without pressure at popliteal fossa. This positioning ensures proper thigh support and avoids pressure behind the knees to prevent skin breakdown.
What is the primary safety check before transferring a patient into or out of a wheelchair?

Lock brakes and remove/position footrests appropriately. These actions stabilize the wheelchair and clear obstacles to prevent falls during transfer.
What is the correct initial height setting for a single-point cane relative to bony landmarks?

Top of cane at greater trochanter (or wrist crease in standing). This positioning ensures optimal elbow flexion for efficient weight transfer and reduced upper extremity strain.
What is the correct sequence for descending stairs with crutches when one leg is involved?

Down with the bad: crutches + involved leg first, then uninvolved leg. Descending with the weak leg first allows controlled lowering using the strong leg for support.

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