Preparing for the NPTE (National Physical Therapy Examination) exam? Diagnostics is one of the areas our deck drills hardest: 30 of its 1010 flashcards focus on diagnostics, covering topics like PVCs, Premature Ventricular Contractions, AFib, Atrial Fibrillation. Try the sample questions below — every card is a real question-and-answer pair from the full deck.
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A patient performing a treadmill stress test exhibits 2 mm of horizontal ST-segment depression in leads V4-V6. The patient is asymptomatic but reports mild fatigue. What is the most appropriate immediate action for the physical therapist?
Show answer →Stop exercise and monitor the patient. Horizontal or downsloping ST-segment depression ≥ 1 mm is indicative of myocardial ischemia. According to ACSM and FSBPT guidelines, ST depression > 2 mm during exercise is a relative contraindication to continue. Since the depression is exactly 2 mm and horizontal, the PT must stop the session, assess vitals, and notify the physician. **Exam Tip:** Differentiate between upsloping (often normal/benign) and horizontal/downsloping (ischemic). Upsloping depression is less predictive of CAD than horizontal or downsloping patterns.
During an inpatient PT session, a patient’s ECG monitor shows 7 unifocal Premature Ventricular Contractions (PVCs) within one minute. The patient is stable and denies chest pain. What is the clinical significance and required PT action?
Show answer →Stop exercise and notify the medical team. While isolated PVCs can be benign, the frequency of > 6 PVCs per minute is a standard criterion for terminating exercise. **Clinical Pearl:** PVCs indicate ventricular irritability. PTs must monitor for R-on-T phenomenon, multifocal PVCs, or couplets/triplets, which increase the risk of Ventricular Tachycardia. **NPTE Strategy:** FSBPT often tests the Rule of 6 (more than 6 in a minute) or a sudden increase in frequency as reasons to pause and consult.
A patient's ECG shows a constant PR interval followed by a non-conducted P wave (dropped QRS). The patient feels slightly lightheaded during gait training. Which arrhythmia is most likely present and what is the PT's priority?
Show answer →Type II Second-Degree AV Block (Mobitz II). In Mobitz II, the PR interval remains constant before the drop, indicating a block below the AV node (Bundle of His). This is an unstable rhythm and a medical emergency because it frequently progresses to Third-Degree Heart Block. **Action:** Stop all activity, stabilize the patient, and activate emergency medical services/notify the physician immediately. Unlike Mobitz I (Wenckebach), which has a progressively lengthening PR interval, Mobitz II is never considered a normal variant and carries a high risk of sudden cardiac arrest.
A patient with chronic, rate-controlled Atrial Fibrillation (AFib) is referred for cardiac rehab. Their resting HR is 88 bpm. During exercise, the HR reaches 145 bpm and the rhythm remains irregularly irregular. What is the appropriate PT management?
Show answer →Continue exercise if the patient remains hemodynamically stable and the HR stays below the target threshold (usually <150 bpm). In chronic AFib, the goal is rate control. PTs must monitor for signs of reduced cardiac output (dizziness, pallor, hypotension). **NPTE Distractor:** Don't confuse chronic AFib with NEW onset AFib. New onset requires immediate medical consultation. Also, remember that pulse oximetry may be inaccurate in AFib due to the irregular pulse; manual palpation for one full minute is the gold standard for heart rate assessment.
A patient in an outpatient clinic reports sudden substernal pressure. The 12-lead ECG reveals 1.5 mm ST-segment elevation in leads II, III, and aVF. Which coronary artery is likely occluded, and what is the immediate PT response?
Show answer →Right Coronary Artery (RCA); Activate EMS (911). ST elevation (STEMI) in leads II, III, and aVF indicates an Inferior Wall Myocardial Infarction. This is a medical emergency. **Clinical Reasoning:** Inferior MI is associated with the RCA and can affect the SA/AV nodes, leading to bradyarrhythmias. **Exam Tip:** Memorize lead groupings: V1-V2 (Septal/LAD), V3-V4 (Anterior/LAD), I, aVL, V5-V6 (Lateral/LCx), II, III, aVF (Inferior/RCA). Any ST elevation > 1 mm is an absolute contraindication to exercise in the PT setting.
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Try 30 free NPTE cards firstThe full NPTE deck contains 1010 flashcards, and 30 of them focus on diagnostics. This page shows 5 free samples.
Our NPTE deck dedicates 30 of 1010 cards (3%) to diagnostics — always cross-check the official FSBPT exam outline for the current blueprint weighting.
Yes — the samples on this page are free, and the NPTE preview page has 30 more free cards. Full access to all 1010 cards is a one-time $7.
Assessment
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40 cards
Management
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Pathology
330 cards
Physiology
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140 cards
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