Understanding the Anatomy of an NPTE Question

What makes up the components of a multiple choice question on the NPTE? We understand there is a question with four answers. However, if you miss a question, do you know what part of the question or answers steered you in a different direction away from the correct choice? It’s pretty broad as to what part of the question misled you and it is usually assumed that it’s just the question part. But there are different areas in which a person can miss a multiple choice question. So, let’s break down the question components:

  • Question – mainly clinically based, ranges from easy to difficult
  • 4 Answers – range from simple to complex

Question Sample Format:

The NPTE question usually focuses on more of the clinical aspects by integrating different components of what you have learned. There will be information that is relevant as well as some facts that are nice to know, but they may throw you off if you focus on them. The questions are not meant to trick you, but rather to test how well you are able to identify pertinent information without overanalyzing. The last sentence in the question is called the STEM. You’ll then see a list of 4 options in a similar format below to choose from to pick an answer to the question.

  1. The answer may be simple, usually one word
  2. Some answers can have multiple components
  3. Other answers may be longer in length for you to interpret
  4. There’s only 1 correct answer

We are pretty familiar with the multiple choice question format, however, don’t make the mistake of thinking the question is just testing your content knowledge. The question is also testing your test-taking skills as well as your mental and physical endurance. As you continue to answer questions over a period of time, it’s a test of how well you can still focus to pick out the correct answer.


There’s an assumption that all of the NPTE questions are rather the same; however, there are different aspects to the question itself. The following are components of the question part:

  • Length – ranges from 1 to 5 sentences
  • Descriptive words – specific to goal
  • Difficulty level – ranges beyond the academics to fully clinical integration
  • What is being asked – ranges from needing more information to providing enough information to answer right away


While most multiple choice answers are single word answers, multiple answers within an answer could throw you off.

  • Answer length – 1 to many words
  • Number of answers within an answer – ranges from 2 to 4
  • Number of correct answers – only 1
  • Answer focus – ranges from facts to being able to recognize clinical examples
  • Answer difficulty – ranges from concrete to less concrete (but not abstract) information

What are the Reasons Questions or Answers are Missed?

There are many reasons why NPTE questions or answers are missed and a lot of it can be how you view the questions themselves. Ever notice you may get some harder questions right and the easy questions wrong? The reason may lie in the amount of focus you are putting on that particular question at that time. What you may perceive as a hard or unfamiliar topic question, you may find you spend more time to understand what the question is asking. While you may find an easier question to be less stress on the brain, you may unintentionally skip over crucial keywords that can make the difference on how you answer that question. At times, it seems as if our brains shut off and ignore when we approach a question we feel is easy but only to find that we missed it and start kicking ourselves for it. This is where many silly mistakes are made and the scores are lower. When we see a lower score than expected, it may put a damper on our mind when preparing for this exam and make it harder to see the questions without a clear mindset.

How You Perceive Length

A longer question or multiple answers within an answer can seem daunting and psychologically, you may be dreading these types; however, it’s not always as hard as you may think. While there are differences in length or number of answers, you can learn to be systematic in your approach. This is where having good test-taking strategies are helpful to break both the questions or answers down.

Notice how your mind thinks or what happens physiologically when your body reacts to the different questions and answers.

Lengthy Question:

The components of a question contain both relevant and not as important information. It’s testing how well you can pick up the keywords from your academic knowledge and recognize that clinical integration may be needed. Longer types of questions tend to list information separated by commas or provide detailed information. By the end of the question, you’ll be asked what would be essentially the MOST appropriate facts.

Lengthy NPTE Question Example:

A patient who is a smoker for more than 10 years comes with a persistent productive cough with minimal white mucus for 2 years. The patient also complains of dyspnea while exercising. The pulmonary function test report of this patient shows FEV1/ FVC ratio 52%, FEV1 – 62%, FEV1 after bronchodilator – 70%, TLC – 85%, RV – 75%, SVC – 90%, FRC – 85%, DLCO – 90%. What is the MOST likely diagnosis for this patient?

Take away:

Break the lengthy question down into parts and ask yourself what is important to know. In this particular question, this is where that separate laminated sheet that is given at the Prometric center to write down the numbers to help visualize or understand what’s going on. When practicing on your own, use a separate sheet of paper to help you solve the questions.

Shorter Question:

These can be image type of questions as well as being more concise as to what is being asked of you. The questions could be more direct and seem too easy; where some candidates might end up rushing through or want to make it harder than necessary when it really doesn’t need to be.

Shorter NPTE Question Example:

A physical therapy order is received to evaluate a patient on the acute unit. A review of the computerized tomography scan in the chart confirms that the patient had an ischemic infarct in the right cerebellum. What signs and symptoms are MOST likely to be present?

Take away:

The shorter questions should be approached as if they are giving you the bottom line. They are meant to be answered relatively quickly but don’t make the mistake of making the question harder than necessary by adding things.

Lengthy Answers:

Just because answers may be long in length and almost nearly sentences, don’t allow your brain to freak out. These answers tend to give candidates the most amount of trouble and cause anxiety. It doesn’t have to be stressful when breaking it down into its components.

Lengthy NPTE Answer Example

  1. The patient rises from the floor through assuming a bear crawl position and pushing up from the floor
  2. The patient rises from the floor through half kneeling and not using any upper extremity support
  3. The patient rises from the floor through walking their hands up their own body from a squatting position
  4. The patient rises from the floor through pulling to stand with both hands supported on an elevated surface

Take away:

Tackle the lengthy answers by breaking them down into smaller parts. Start with the first answer and focus on whether it answers the question. If not, then move on.

Multiple Components Within an Answer:

This type of answer can contain 2 to 4 answers within an answer which tends to trip up candidates. A lot of time is spent after narrowing down to only 2 multiple choice answers.
Just like the lengthy answers, it’s easier to break this type of answer down to one at a time.
A common mistake candidates make is trying to make an answer work by rationalizing it by changing part of the answer that is not fully true to be true.

Multiple Components Within an NPTE Answer Example

  1. Vertigo, leaning to left side, decreased pain and temperature sensation on the left side
  2. Vertigo, leaning to right side, decreased pain and temperature sensation on the right side
  3. Vertigo, leaning to left side, decreased pain sensation on the right and decreased temperature sensation on the left
  4. Vertigo, leaning to right side, decreased pain and temperature sensation on the left side

Take away:

Tackle the answer by breaking it down to focusing on what’s in between the commas. Take each part at face value and decide whether it helps or doesn’t help to answer the question. The correct answer will be the one where all of the parts of the answer are true.

Short Answers:

These short answers are to the point. This answer choice tends to be 1 to 2 words in length and focuses on conditions, terminology, clinical examples, specific treatments and lab values or tests. They can be easier to eliminate wrong answers, however, they can also be harder when testing your knowledge of terminology.

Short NPTE Answers

  1. Anterior Drawer test
  2. McMurray test
  3. Lachman test
  4. Valgus stress test

Take away:

Be confident that you can tackle them easily and view the answers at face value. Just like short questions, don’t overanalyze by second-guessing yourself – choose from your gut and move on.

Unfamiliar Terminology Answers

When you come across unfamiliar terminology in the answer choice, the easiest strategy is to break the word down into its parts, i.e., prefix or suffix, when possible. This helps to reduce the tripping up on unknown answers that can take your mind off what the question is specifically asking you. If breaking down the parts isn’t possible (like conditions), then some part of the word may help you get some idea. If you can’t figure it out, then let it be and don’t let it get to you.

Unfamiliar NPTE Terminology Answers:

  1. Allodynia
  2. Hyperalgesia
  3. Hypoalgesia
  4. Psychogenic

Take away:

Don’t freak out at unknown answers. Take a moment to dissect each unknown answer into parts that you know for a better understanding of what the word may mean. The goal is to get a general sense of the meaning of the terminology to help you be able to answer the question. If unsure after this, go with an answer that may make sense.

Overall, you want to approach the question and answers at face value by not adding any prior experience or changing any wording. Many questions are missed when overanalyzing. By keeping the mindset that you can approach any question or answer length, that will help you to gain the confidence to tackle any question that is presented to you. Now you have more of an understanding of about the breakdown of a question and can become comfortable approaching them.
Remember that to succeed on the NPTE, you’ll want to know “What to Aim For” for your score on the practice exams. Practice makes perfect and you can simulate the actual day by practicing NPTE format questions with Therapy Exam Prep’s Practice Exam Simulation.