Free California Physical Therapy Practice Sample Questions & Answers
Question 1. Lumbar Spine Assessment
A 48-year-old patient reports low back pain extending into the lateral leg. During the examination, repeated lumbar extension decreases the patient’s leg symptoms and produces a more central low-back ache. Which finding is most clinically significant?
A. The symptoms are becoming more distal.
B. The symptoms are centralizing with repeated movement.
C. Lumbar extension should always be avoided.
D. The patient demonstrates a non-mechanical disorder.
Correct Answer. B
Explanation:
Centralization refers to symptoms moving from a more distal location toward the spine in response to a particular movement or position. In this case, repeated lumbar extension decreases the patient’s leg symptoms while increasing discomfort more centrally in the low back. That response can provide useful information during the physical therapy assessment and may help guide subsequent examination and treatment decisions. The finding does not automatically establish a diagnosis, and the therapist should consider the complete history and examination. The important assessment finding is the change in symptom location and intensity with repeated movement, rather than assuming that extension is universally appropriate or inappropriate for patients with low back pain.
Question 2. Shoulder Assessment
A patient reports difficulty reaching overhead after developing shoulder pain. Active shoulder abduction is limited and painful, while passive abduction is substantially greater with less discomfort. Which interpretation is most appropriate?
A. The findings suggest a difference between active and passive movement that warrants further assessment of contractile and neuromuscular factors.
B. The findings prove that the joint capsule is completely normal.
C. The findings establish a full-thickness rotator cuff tear.
D. The therapist should immediately discontinue all shoulder movement.
Correct Answer. A
Explanation:
A substantial difference between active and passive range of motion can provide useful information during a shoulder assessment. When active movement is more limited than passive movement, the therapist should consider factors such as pain inhibition, muscle performance, motor control, and other contractile or neuromuscular contributors. This finding alone does not establish a specific structural diagnosis such as a full-thickness rotator cuff tear. The therapist should integrate the patient’s history with strength testing, movement observation, passive mobility, symptom behavior, and other appropriate examination procedures. A complete assessment is necessary before drawing conclusions about the source of the patient’s functional limitation or determining the most appropriate intervention.
Question 3. Neurological Screening
During an examination for neck pain, a patient reports new difficulty using the hand and demonstrates progressive weakness that was not present at the previous visit. What should the physical therapist do first?
A. Continue the same treatment plan and reassess in one month.
B. Increase resistance exercises for the affected hand.
C. Recognize the change as a potentially significant neurological finding and arrange appropriate medical evaluation.
D. Treat the weakness as expected muscle soreness.
Correct Answer. C
Explanation:
Progressive neurological changes require careful attention during a physical therapy examination. New or worsening weakness, particularly when it represents a meaningful change from the patient’s previous status, may indicate a condition requiring further medical assessment. The therapist should not simply assume that the finding represents ordinary muscle fatigue or soreness. The appropriate response is to recognize the potential significance of the neurological change, complete any appropriate immediate screening, and arrange referral or medical evaluation when indicated. Clinical decision-making should be based on the patient’s complete presentation, including symptom progression, neurological findings, and other relevant examination results. Continuing an unchanged treatment plan without addressing the new deficit would be inappropriate.
Question 4. Gait Assessment
A patient recovering from a stroke walks with reduced stance time on the affected lower extremity and frequently reaches for nearby furniture. Which assessment would provide the most useful additional information about the patient’s functional mobility?
A. Observation of gait only while the patient is seated.
B. Assessment of balance and functional mobility under appropriate supervised conditions.
C. Measurement of upper-extremity circumference only.
D. Passive wrist range of motion as the sole additional examination.
Correct Answer. B
Explanation:
The patient’s reduced stance time and reliance on nearby furniture suggest that balance, weight acceptance, and functional mobility should receive further attention. A comprehensive assessment may include observation of gait, balance testing, transfers, turning, and other functional tasks appropriate to the patient’s condition and safety level. The therapist should select tests that provide information relevant to the patient’s reported activity limitations and observed movement deficits. Because the patient is already demonstrating instability, testing should be performed under appropriate safety precautions and with assistance or guarding when needed. Measuring an unrelated body region would not provide the same information about the functional mobility problem described.
Question 5. Knee Examination
A patient reports knee pain when descending stairs. During the assessment, the therapist observes a controlled ascent but poor eccentric control during step-down activity. Which finding is most directly related to the patient’s reported functional difficulty?
A. Reduced ability to control knee flexion eccentrically during the task.
B. Increased resting heart rate.
C. Reduced elbow extension.
D. Increased cervical rotation.
Correct Answer. A
Explanation:
Descending stairs requires controlled lowering of the body’s center of mass and substantial eccentric control from the lower-extremity musculature, particularly the knee extensors. If a patient demonstrates poor control during a step-down task, that observation may help explain the reported difficulty with stair descent. The therapist should relate the functional finding to additional examination measures such as strength, range of motion, pain behavior, movement mechanics, and other relevant factors. The observation does not by itself establish a specific pathological diagnosis. Functional assessment is valuable because it shows how impairments may affect activities that matter to the patient, rather than relying exclusively on isolated strength or range-of-motion measurements.
Question 6. Balance Assessment
An older adult reports two recent episodes of losing balance while turning quickly. During examination, the patient demonstrates increased sway when the base of support is narrowed. Which additional assessment would be most relevant?
A. A balance or mobility test that challenges postural control during functional movement.
B. Isolated measurement of hand circumference.
C. Passive shoulder flexion only.
D. Visual inspection of the patient’s shoes without functional testing.
Correct Answer. A
Explanation:
The patient’s history identifies turning and balance as important functional concerns, while the examination reveals increased postural sway when the base of support is narrowed. Additional testing should therefore examine postural control and functional mobility in situations relevant to the patient’s reported difficulty. Depending on the patient’s presentation and safety, an appropriate balance or mobility measure may provide information about stability, turning, anticipatory control, or fall risk. The therapist should select a test that is appropriate for the patient’s abilities and clinical presentation. A single balance finding does not provide a complete assessment, so the results should be interpreted together with the history and other examination findings.
Question 7. Hip Range of Motion
A patient with hip pain demonstrates limited passive hip internal rotation compared with the opposite side and reports pain near the end of the available range. What should the therapist do with this finding?
A. Use it as one component of the overall examination and compare it with the patient’s history and other findings.
B. Diagnose a specific hip disorder solely from the range-of-motion measurement.
C. Ignore the finding because passive motion is not relevant to hip assessment.
D. Immediately begin maximal resistance exercise.
Correct Answer. A
Explanation:
A difference in passive hip internal rotation accompanied by pain can provide meaningful information during the examination, but it should not be interpreted in isolation. The therapist should consider the patient’s age, symptom behavior, functional limitations, mechanism of onset, strength, other hip movements, relevant regional examination findings, and any applicable screening considerations. Comparing sides can help identify asymmetry, but asymmetry alone does not establish a specific diagnosis. The therapist should use the finding to guide additional assessment and clinical reasoning. A complete evaluation combines subjective information with objective findings to determine the patient’s impairments, functional limitations, and appropriate plan of care.
Question 8. Functional Assessment
A patient reports being unable to rise from a standard chair without using both arms. During testing, the patient demonstrates significant forward trunk movement and requires several attempts before standing. What is the best interpretation of this finding?
A. The observation provides functional information that may warrant further assessment of lower-extremity strength, balance, mobility, and movement strategy.
B. The patient has a confirmed neurological disease.
C. Chair-rise performance has no relationship to functional mobility.
D. The therapist should record only the patient’s height and weight.
Correct Answer. A
Explanation:
A sit-to-stand task provides information about functional lower-extremity performance, balance, movement strategy, and the ability to transfer independently. Difficulty rising from a chair and reliance on the upper extremities may indicate limitations that deserve further examination. The therapist could assess lower-extremity strength, range of motion, balance, pain, coordination, and movement mechanics as appropriate. The observation alone does not establish a specific neurological diagnosis. Functional tasks are particularly valuable because they demonstrate how the patient’s impairments affect everyday activities. The therapist should interpret the task performance together with the patient’s history and other examination findings before determining the primary contributors to the limitation.
Question 9. Clinical Measurement
A therapist measures a patient’s shoulder range of motion before and after an intervention. The first measurement is taken with the patient positioned differently from the second measurement. Which issue should the therapist consider when interpreting the change?
A. Differences in measurement position can affect the comparability of the results.
B. Position never affects range-of-motion measurements.
C. Any numerical increase automatically demonstrates clinical improvement.
D. The second measurement should always be discarded.
Correct Answer. A
Explanation:
Reliable comparison of physical therapy measurements requires consistent procedures whenever possible. Changes in patient position, stabilization, measurement technique, equipment placement, or examiner procedure can influence the result. Therefore, if shoulder range of motion is measured using different positions before and after an intervention, the therapist should consider whether the measurements are directly comparable before concluding that a meaningful change occurred. A numerical difference does not automatically represent true clinical improvement. Standardizing the measurement procedure helps improve consistency and makes it easier to interpret changes over time. The therapist should document relevant testing conditions and interpret the result in conjunction with the patient’s symptoms and functional status.
Question 10. Selecting an Assessment Procedure
A patient presents with dizziness during bed mobility and reports symptoms when rolling toward one side. The therapist wants to determine whether the symptom pattern is associated with a positional vestibular disorder. Which approach is most appropriate?
A. Select an appropriate positional assessment based on the patient’s history and clinical presentation.
B. Begin maximal lower-extremity strengthening without further assessment.
C. Perform only a resting blood pressure measurement and end the examination.
D. Ignore the positional relationship because dizziness cannot be assessed by a physical therapist.
Correct Answer. A
Explanation:
When dizziness is consistently associated with a particular movement or position, the therapist should use the history to guide selection of an appropriate vestibular assessment. Positional symptoms can provide important clinical information, but the therapist should first consider the patient’s complete presentation and screen for findings that may require medical referral. An appropriate positional assessment can help determine whether the patient’s symptoms are consistent with a particular vestibular pattern. The therapist should follow established examination procedures and appropriate safety precautions rather than choosing unrelated tests. The result should then be interpreted alongside the patient’s history, symptom behavior, examination findings, and any relevant contraindications or referral considerations.
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