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FSBPT (USA) · Last updated November 2026

National Physical Therapy Examination, PT level (NPTE-PT): free practice test

The national licensing exam for physical therapists in the United States, covering examination, evaluation, diagnosis, prognosis and intervention across body systems. It has 225 multiple-choice questions in 5 hours, of which 180 are scored. The current content outline took effect in January 2024.

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About the NPTE-PT exam

The national licensing exam for physical therapists in the United States, covering examination, evaluation, diagnosis, prognosis and intervention across body systems. It has 225 multiple-choice questions in 5 hours, of which 180 are scored. The current content outline took effect in January 2024.

What's on the exam

NPTE-PT
Musculoskeletal System
7 key facts
Neuromuscular and Nervous Systems
7 key facts
Cardiovascular and Pulmonary Systems
6 key facts
Integumentary and Lymphatic Systems
6 key facts
Metabolic, Endocrine, Gastrointestinal and Genitourinary Systems
6 key facts
System Interactions
6 key facts
Equipment, Devices and Therapeutic Modalities
6 key facts
Safety, Professional Responsibilities and Research
6 key facts

Each branch is a topic in the official outline. Members see every key fact on the full mind map. Read the free study guide →

How to pass the NPTE-PT exam

  • Musculoskeletal (44-54 items) and neuromuscular (39-48) make up about half of the 180 scored items, but non-system content adds 21-29 items, so don't skip safety, devices and research.
  • You have about 80 seconds a question and no penalty for guessing. Mark difficult items and finish each section before you end it, because you can't go back.
  • FSBPT limits you to three consecutive attempts in 12 months and six in a lifetime at each level, and two scores below 400 bar further testing. Treat your first sitting as the one that counts.
  • FSBPT has told item writers not to test the theory of NDT or Bobath, and asks that the exam reflect current evidence. Study current guidelines and treat dated techniques with caution.

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Create a free account after the test: your score by topic, a mistakes bank, the complete study notes for the first topic, flashcards and the Clinical Values & Red Flags Sheet.

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What's in the premium NPTE-PT prep

Premium NPTE-PT prep is studied one topic at a time. Each step starts with that topic's key notes and flashcard deck, then its own question sets of 25, so you master one topic before you move to the next. When every topic is strong, the 6 full mock exams show you're ready.

3,000practice questions, every answer explained
6full-length mock exams, 225 questions each, timed
800flashcards with spaced repetition, sorted by topic
60comprehensive key notes across 8 topics

Your step-by-step study path

  1. 1
    Musculoskeletal System8 key notes, 100 flashcards, then 375 practice questions in 15 sets of 25
    Notes free with an account
  2. 2
    Neuromuscular and Nervous Systems8 key notes, 100 flashcards, then 375 practice questions in 15 sets of 25
    Premium
  3. 3
    Cardiovascular and Pulmonary Systems8 key notes, 100 flashcards, then 375 practice questions in 15 sets of 25
    Premium
  4. 4
    Integumentary and Lymphatic Systems8 key notes, 100 flashcards, then 375 practice questions in 15 sets of 25
    Premium
  5. 5
    Metabolic, Endocrine, Gastrointestinal and Genitourinary Systems7 key notes, 100 flashcards, then 375 practice questions in 15 sets of 25
    Premium
  6. 6
    System Interactions7 key notes, 100 flashcards, then 375 practice questions in 15 sets of 25
    Premium
  7. 7
    Equipment, Devices and Therapeutic Modalities7 key notes, 100 flashcards, then 375 practice questions in 15 sets of 25
    Premium
  8. 8
    Safety, Professional Responsibilities and Research7 key notes, 100 flashcards, then 375 practice questions in 15 sets of 25
    Premium
  9. Final step: 6 full mock exams225 questions each, timed like test day. Pass them, then book your exam.
    Premium
Free with an account

Read the complete NPTE-PT study notes for “Musculoskeletal System”

Our first full set of comprehensive notes, about 15 minutes of reading: Examination and special tests · Differential diagnosis · Post-operative precautions · Interventions and prognosis, a worked exam example, the traps examiners use and a one-minute recap. Create a free account to read it and see how premium notes work before you decide.

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Study tools included

3,000 practice questions

3,000 exam-style questions per exam, organized topic by topic in sets of 25. Every answer explained, with the rule it comes from.

6 full mock exams

6 full-length timed mock exams per exam, with real question counts and time limits, so test day feels like practice day.

Exam Readiness Score

One 0 to 100 number that tells you when you're ready to book. Reach 80 and you're covered by our Pass Guarantee.

800 flashcards + spaced repetition

800 flashcards per exam, in a deck for each topic, that come back right before you'd forget them. Five minutes a day keeps every number fresh.

60 comprehensive key notes

60 key notes per exam, split across its topics and each explained in full: the concepts, worked exam examples, the traps examiners use and a quick recap. Your first set is free with an account.

Mind maps

See the whole exam on one screen: every topic and the facts under it.

Sample questions with answers

These are the questions in the free test above, with answers. Try the test first. You'll learn more by getting some wrong.

1. A 68-year-old reports bilateral buttock and leg pain after walking about 5 minutes, relieved by sitting or leaning on a shopping cart. Stationary cycling is well tolerated and pedal pulses are normal. Which condition is MOST likely?
Answer: Lumbar spinal stenosis. Neurogenic claudication improves with lumbar flexion, which opens the canal, so sitting, leaning forward and cycling are tolerated. Vascular claudication is relieved by standing still and worsens with cycling because it depends on leg work and blood flow, and pulses are often reduced. Position dependence is the key distinction.
2. During right single-limb stance, the left side of the patient's pelvis drops and the trunk leans to the right. Which muscle weakness BEST explains this gait pattern?
Answer: Right gluteus medius. The stance-side hip abductors hold the pelvis level, so a contralateral pelvic drop during right stance indicates right gluteus medius weakness. Leaning toward the stance side shortens the moment arm of body weight, which is a compensated Trendelenburg pattern. Gluteus maximus weakness produces a backward trunk lean at initial contact.
3. A patient is 6 weeks after a reverse total shoulder arthroplasty. Which activity should the physical therapist instruct the patient to avoid because of dislocation risk?
Answer: Reaching the hand behind the back to tuck in a shirt. The reverse prosthesis is most prone to dislocation in combined internal rotation, adduction and extension, the position used to reach behind the back or to tuck in a shirt. Supine elevation in the scapular plane and elbow exercises with the arm at the side are typical during this phase. Early rehabilitation also limits weight-bearing through the arm.
4. A 38-year-old runner has 4 months of pain and morning stiffness in a thickened Achilles tendon about 4 cm above the insertion. Which intervention has the BEST support as first-line treatment?
Answer: A progressive heavy calf-loading program, continued for at least 12 weeks. Midportion Achilles tendinopathy responds best to progressive tendon loading, using eccentric or heavy slow resistance programs, as recommended in the APTA Orthopedics clinical practice guideline. Rest and passive treatments do not build tendon capacity, and stretching alone is insufficient. Pain during loading can be acceptable if it settles by the next morning.
5. After a fall with neck hyperextension, a 74-year-old with cervical spondylosis has greater weakness in the hands and arms than in the legs, along with patchy sensory loss. Which syndrome is MOST likely?
Answer: Central cord syndrome. Central cord syndrome often follows hyperextension in older adults with spondylosis, and weakness is greater in the upper limbs than the lower limbs. Anterior cord syndrome causes loss of motor function, pain and temperature below the lesion with dorsal columns spared. Brown-Sequard causes ipsilateral motor loss and contralateral loss of pain and temperature.
6. A patient has weakness of the left leg much greater than the left arm, with urinary incontinence and abulia. Occlusion of which artery BEST explains these findings?
Answer: Right anterior cerebral artery. The anterior cerebral artery supplies the medial frontal lobe and the leg area of the motor cortex, so the deficit is contralateral and the leg is worse than the arm. Incontinence and abulia reflect medial frontal involvement. Middle cerebral occlusion affects the arm and face more than the leg.
7. A patient with Guillain-Barre syndrome has passed the peak of weakness and is beginning to recover strength. Which exercise approach is MOST appropriate?
Answer: Low-intensity sessions with rest to avoid overwork. Reinnervating muscle is vulnerable to overwork, which can delay recovery, so exercise should be low intensity and short, with rest and fatigue monitoring. Progress gradually as strength returns. Prolonged bed rest adds deconditioning, contracture and thrombosis risk, while exhaustive or soreness-producing loading is unsafe at this stage.
8. A 72-year-old has fatigue, orthopnea, bibasilar crackles and an S3 heart sound on examination. Which condition is MOST likely?
Answer: Left ventricular heart failure. Orthopnea, pulmonary crackles and an S3 reflect elevated left-sided filling pressures and pulmonary congestion, typical of left ventricular failure. Isolated right-sided failure presents mainly with peripheral edema, jugular venous distension and hepatic congestion. COPD exacerbation typically causes wheeze and prolonged expiration.
9. A 66-year-old has calf claudication, an ankle-brachial index of 0.72 and no rest pain or wounds. Which exercise plan is MOST appropriate as primary rehabilitation?
Answer: Walking until moderate claudication pain, resting, then repeating, for 30-45 minutes three times weekly. Supervised walking to moderate or greater claudication pain, alternating with rest, in 30-45 minute sessions at least three times weekly for at least 12 weeks has the strongest evidence for improving walking distance (ACC/AHA peripheral artery disease guideline). Stopping at the first symptom gives too little stimulus. An ABI of 0.72 confirms disease but is not a contraindication to exercise.
10. A patient has a shallow, irregular wound near the medial malleolus with surrounding hemosiderin staining and edema. Ankle-brachial index is 1.0. Which intervention is the MOST appropriate priority?
Answer: Multilayer compression with leg elevation. A medial gaiter location, irregular edges, hemosiderin staining and edema indicate a venous ulcer, and a normal ABI means compression is safe. Compression and elevation address the venous hypertension driving the wound. A total contact cast suits neuropathic plantar ulcers, and dependency worsens venous pooling.
11. A 52-year-old has right shoulder pain that does not change with shoulder movement but worsens after fatty meals, and is tender in the right upper abdominal quadrant. What is the MOST appropriate next step?
Answer: Refer the patient for medical evaluation. Shoulder pain unaffected by movement and linked to meals suggests referred visceral pain, and gallbladder disease commonly refers to the right shoulder region. This pattern falls outside the scope of musculoskeletal care until it has been medically evaluated. Screening for non-mechanical pain behavior is a key part of differential diagnosis.
12. A patient receiving chemotherapy has a platelet count of 18,000/µL and reports fatigue. What is the MOST appropriate physical therapy plan today?
Answer: Light self-care mobility only, after coordinating with the medical team. A platelet count below about 20,000/µL carries significant bleeding risk, so acute care lab guidance limits activity to light functional mobility and calls for coordination with the medical team. Resistance training, vigorous exercise and deep manual techniques raise bleeding risk. Always check the day's labs before treating an oncology patient.
13. During early stance on a transtibial prosthesis, a patient's knee moves into excessive flexion. Which alignment problem is MOST likely?
Answer: Excessive dorsiflexion of the prosthetic foot. Excessive dorsiflexion moves the tibial progression forward, pushing the knee into early flexion. Excessive plantar flexion and a foot set too far anterior instead create a knee extension moment. A very soft heel cushion reduces the flexion moment at loading, so it does not explain this finding.
14. In a study of fall prevention, 30% of older adults in usual care fell within one year compared with 18% in an exercise program. How many people need to be treated to prevent one person from falling?
Answer: 9 patients. Absolute risk reduction is 30% - 18% = 12%, or 0.12. Number needed to treat is 1 divided by 0.12, which is 8.3, rounded up to 9. The value 12 confuses the risk difference with the NNT, and 40 is the relative risk reduction expressed as a percentage.
15. During a home visit, a physical therapist notes unexplained patterned bruises on an 82-year-old's upper arms. The patient appears afraid, and the caregiver answers all questions. What should the therapist do?
Answer: Document the findings and report concerns as state law requires. Patterned bruising, fear and a controlling caregiver are warning signs of elder abuse. Health professionals have reporting duties set by state law, and a report is based on reasonable suspicion rather than proof. Document objective findings and follow the agency's protocol, without confronting the caregiver or abandoning the patient.

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NPTE-PT exam FAQ

How many questions are on the NPTE-PT exam?

225 multiple-choice questions in 5 sections of 45: 180 scored and 45 unscored pretest items, mixed together. Some questions use a graphic or video, and shared-scenario sets of 2 to 5 questions come at the end of each section, with a time limit of 5 hours of testing (about 80 seconds a question) within a 5 hour 30 minute appointment, with a scheduled 15-minute break after section 2. Format: closed book, computer-based, one correct answer per question, no penalty for wrong answers. an erasable note board is provided. once you end a section you cannot return to it.

What is the passing score for NPTE-PT?

Scaled score of 600 on a 200-800 scale, a criterion-referenced standard used by all US jurisdictions. The number of correct answers needed changes slightly from form to form.

How much does the NPTE-PT exam cost?

US$485 FSBPT exam fee plus US$112 Prometric sitting fee; FSBPT adds a 1.6% processing fee, rounded up to the nearest dollar. State license fees are separate. CAPR sets the fee per exam date and charges for rescheduling, so confirm the current fee on the CAPR website before you apply.

Which languages is the NPTE-PT exam offered in?

FSBPT's Candidate Handbook does not list a language option; materials are in English. Confirm with FSBPT.

Where do I take the NPTE-PT exam?

Prometric test centers in the United States, on fixed dates in January, April, July and October.

Is this NPTE-PT practice test free?

Yes. The 15-question practice test on this page is free, with an explanation for every answer and no signup. A free account also unlocks the complete study notes for the first topic. The full NPTE-PT prep is Premium at C$207 a month for this exam.

What's in the premium NPTE-PT prep?

3,000 practice questions organized topic by topic (Musculoskeletal System: 375; Neuromuscular and Nervous Systems: 375; Cardiovascular and Pulmonary Systems: 375; Integumentary and Lymphatic Systems: 375; Metabolic, Endocrine, Gastrointestinal and Genitourinary Systems: 375; System Interactions: 375; Equipment, Devices and Therapeutic Modalities: 375; Safety, Professional Responsibilities and Research: 375), 6 full-length timed mock exams of 225 questions, 800 flashcards and 60 comprehensive key notes split across all 8 topics, plus a mistakes bank and the Readiness Score.

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National Physical Therapy Examination, PTA level (NPTE-PTA)

The national exam for physical therapist assistants in the United States, testing the knowledge needed to carry out care under a physical therapist's supervision.

15 free questions3,000 premium Qs · 6 mocks · 800 flashcards · 60 key notes
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Exam details are summarized from the official candidate information available in November 2026. the Canadian Alliance of Physiotherapy Regulators changes formats and fees, so confirm with Federation of State Boards of Physical Therapy (FSBPT) before you book. CPTEExamPrep is not affiliated with the Canadian Alliance of Physiotherapy Regulators.

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