NPTE Musculoskeletal Practice Questions

10 Free NPTE Musculoskeletal Practice Questions (2026)

10 NPTE-style musculoskeletal practice questions covering the single largest content area on the exam — 44 to 54 items per the official FSBPT blueprint. Shoulder, hip, knee, spine, pediatric orthopedics, and inflammatory conditions. Written and reviewed by a licensed Doctor of Physical Therapy.

Why musculoskeletal matters most

Musculoskeletal is the highest-weighted content area on the NPTE with 44 to 54 scored items per the FSBPT blueprint — roughly 25 to 30 percent of the entire exam. Students who are weak in MSK cannot pass the NPTE by compensating in other areas. Strong MSK preparation is not optional.

0 of 10 answered
Shoulder Examination
Question 1 of 10
A 68-year-old male presents to physical therapy with a chief complaint of right shoulder pain that has progressively worsened over the past 3 months. He reports difficulty reaching overhead and behind his back, impacting his ability to dress and perform household chores. During the initial examination, which of the following is the MOST appropriate next step, focusing on musculoskeletal system considerations?
Pediatric Orthopedics
Question 2 of 10
A 14-year-old male presents with insidious onset of left hip and knee pain, accompanied by a limp. Examination reveals limited hip internal rotation and abduction. Radiographs show widening of the physis of the left femoral head. Which of the following is the MOST likely diagnosis?
Hip — Osteoarthritis
Question 3 of 10
A 70-year-old female presents to physical therapy with a diagnosis of osteoarthritis in the right hip. Examination reveals limited hip extension and external rotation, moderate pain with ambulation, and decreased step length on the right. Radiographic findings show moderate joint space narrowing. Which of the following interventions is MOST appropriate to address her hip mobility limitations?
Differential Diagnosis
Question 4 of 10
A 62-year-old male presents to physical therapy with a 6-month history of insidious onset of bilateral hip pain and stiffness. He reports morning stiffness lasting approximately 45 minutes, which improves with light activity. He denies any history of trauma or systemic illness. During the physical examination, which of the following findings would be MOST indicative of inflammatory joint pain rather than mechanical joint pain?
Connective Tissue / Rheumatology
Question 5 of 10
A 35-year-old female presents with insidious onset of bilateral wrist pain, stiffness lasting 60 minutes in the morning, and fatigue. Examination reveals swelling and tenderness to palpation at the MCP and PIP joints of both hands. Grip strength is significantly reduced bilaterally. Which of the following is the MOST likely primary source of this patient’s symptoms?
Knee — Osteoarthritis
Question 6 of 10
A 75-year-old female presents with a 2-year history of bilateral knee osteoarthritis. She reports increased pain and stiffness in the mornings lasting approximately 45 minutes. Radiographs reveal moderate joint space narrowing bilaterally. Examination reveals quadriceps weakness (4/5 MMT) and limited knee extension bilaterally (-10 degrees). She has difficulty rising from a chair and walking for more than 10 minutes. Which of the following interventions is MOST appropriate to address her morning stiffness and improve function?
Shoulder — Differential Diagnosis
Question 7 of 10
A 68-year-old male reports progressive difficulty reaching overhead to retrieve items from a kitchen cabinet. He denies any specific injury. During the examination, which of the following tests would BEST help differentiate between adhesive capsulitis and rotator cuff pathology as the primary source of his reaching limitation?
Pediatric Orthopedics
Question 8 of 10
A 14-year-old male presents with anterior knee pain that increases with activity, specifically after playing basketball. Physical examination reveals tenderness to palpation at the tibial tuberosity and pain with resisted knee extension. Radiographs are negative for fracture. Which of the following is the MOST likely diagnosis?
Shoulder — Intervention
Question 9 of 10
A 70-year-old female presents with a 3-month history of right shoulder pain and limited range of motion following a fall. Examination reveals adhesive capsulitis with significant restriction in external rotation and abduction. Initial pain levels are 6/10. Which of the following interventions is MOST appropriate to initiate during the acute phase?
Shoulder — Examination Findings
Question 10 of 10
A 62-year-old male reports insidious onset of right shoulder pain and progressive difficulty reaching overhead. He denies any trauma. During the examination, which of the following findings would be MOST indicative of adhesive capsulitis?
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Musculoskeletal is 25–30% of the NPTE — strong MSK preparation is essential
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About This Content Area

NPTE Musculoskeletal Content Breakdown

Musculoskeletal is the most heavily weighted content area on the NPTE-PT with 44 to 54 scored items per the official FSBPT blueprint. It is also the content area most students feel most comfortable with coming out of DPT programs — which can be a dangerous false sense of security. The NPTE tests musculoskeletal knowledge at a clinical reasoning level, not a recall level. Knowing the anatomy is not enough.

What the MSK section covers
→Orthopedic conditions and post-surgical rehabilitation
→Joint biomechanics and movement analysis
→Special tests and clinical significance
→Manual therapy principles and applications
→Connective tissue diseases and rheumatology
→Pediatric orthopedic conditions
→Regenerative medicine impact on prognosis
→Pharmacology effects on PT management

The question format on the NPTE is almost universally scenario-based. A patient presents with specific history and examination findings. Multiple answer choices are plausible. Only one is the single best clinical decision. Students who have memorized facts but have not practiced applying them in scenario format consistently underperform on MSK questions despite knowing the content.

The pattern to recognize

NPTE MSK questions almost always include answer choices that are technically correct in a different context — just not the one in the scenario. Learning to identify why the wrong answers are wrong in each specific scenario is the skill the exam is actually testing. Read every rationale above carefully, not just the correct answer.

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10 questions give you a snapshot. Practitionr’s AI gives you a full diagnostic across every MSK subtopic — shoulder, hip, knee, spine, pediatric, inflammatory — then rebuilds your study plan around exactly where you need more work. No credit card required.

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