A 72-year-old male with chronic cervical pain requests transcutaneous electrical nerve stimulation (TENS), which he states helped him in a previous episode of care. His medical history includes hypertension and a demand-type cardiac pacemaker implanted 2 years ago. Which of the following is the MOST appropriate course of action?

Select an alternative intervention such as moist heat and therapeutic exercise

Apply TENS to the cervical region using a low pulse rate to minimize interference

Apply TENS with electrodes positioned at least 2 inches from the pacemaker site

Use interferential current instead of TENS to reduce risk of pacemaker interference

A physical therapist is scheduled to treat a hospitalized patient with confirmed Clostridioides difficile (C. diff) infection. Which of the following infection control measures is MOST important for the therapist to implement after completing the treatment session?

Perform hand hygiene using an alcohol-based hand sanitizer

Don a new pair of gloves before leaving the room

Wipe down equipment with a standard low-level disinfectant

A physical therapist is reviewing the diagnostic accuracy of a clinical special test that has a reported sensitivity of 0.97 and a specificity of 0.55. Based on these values, this test is MOST useful for which of the following purposes?

Ruling out the condition when the test is negative

Ruling in the condition when the test is positive

Confirming the diagnosis regardless of test result

Establishing the prevalence of the condition in the clinic population

A 58-year-old female recovering from a total knee arthroplasty declines to participate in her scheduled physical therapy session, stating she is exhausted and in too much pain today. The therapist explains the risks of missing early post-operative mobility, including stiffness and delayed recovery, but the patient still declines. Which of the following is the MOST appropriate action?

Respect the patient's decision, document the refusal and the education provided, and communicate with the care team

Proceed with a modified bedside session, since post-operative protocols require daily mobility

Inform the patient that refusing therapy may result in discharge from the plan of care

Contact the surgeon to obtain an order compelling the patient to participate

A physical therapist plans to use therapeutic ultrasound to heat the piriformis muscle in a patient with deep buttock pain. Which of the following parameter selections is MOST appropriate to reach the target tissue depth?

1 MHz frequency, 100% duty cycle

3 MHz frequency, 100% duty cycle

3 MHz frequency, 20% duty cycle

1 MHz frequency, 20% duty cycle

A physical therapist is fitting axillary crutches for a patient who is non-weight-bearing on the left lower extremity following an ankle fracture. With the patient standing and the crutch tips positioned approximately 6 inches lateral and 6 inches anterior to the feet, which of the following BEST describes correct crutch fit?

Two to three finger widths between the axilla and the axillary pad, with 20 to 25 degrees of elbow flexion at the handgrip

The axillary pad rests firmly in the axilla with the elbow fully extended

Four to five finger widths between the axilla and the axillary pad, with the handgrip at the level of the wrist crease when the arm hangs relaxed

The axillary pad level with the top of the shoulder, with 45 degrees of elbow flexion at the handgrip

A 49-year-old male with type 1 diabetes is 20 minutes into an outpatient exercise session when he becomes pale, diaphoretic, and tremulous, and begins responding slowly to questions. Which of the following is the MOST appropriate immediate action?

Stop the session and administer a fast-acting carbohydrate source

Have the patient sit, continue the session at a lower intensity, and monitor symptoms

Stop the session and have the patient self-administer insulin per his sliding scale

Position the patient supine with legs elevated and take blood pressure

During a home health visit, a physical therapist notes multiple bruises in various stages of healing on the forearms and trunk of an 84-year-old female patient. When asked, the patient becomes withdrawn and states her adult son, who is her caregiver, "gets frustrated sometimes." Which of the following is the MOST appropriate action for the therapist to take?

Report the suspected abuse to adult protective services as required by law

Document the findings and reassess for new bruising at the next scheduled visit

Confront the son directly about the findings before taking further action

Advise the patient to contact adult protective services if the situation worsens

10 Free NPTE Non-Systems Practice Questions (2026) - Practitionr

About This Content Area

NPTE Non-Systems Content Breakdown

Non-systems is the content on the NPTE-PT that does not belong to any single body system — 36 to 45 scored items per the official FSBPT blueprint, which makes it larger than cardiopulmonary and second only to musculoskeletal and neuromuscular. It is also the content students most consistently skip during preparation, because it never had its own clinical rotation and it feels like miscellaneous material. On exam day, that neglect shows. Try our free 20-question timed NPTE practice test, Musculoskeletal practice questions, or Neuromuscular practice questions to see where your preparation actually stands.

What the non-systems section covers

→Equipment, devices, and technologies — wheelchairs, assistive devices, orthotic and prosthetic fit

→Therapeutic modalities — parameters, indications, contraindications

→Safety and protection — infection control, emergency response, fall prevention

→Professional responsibilities — ethics, consent, documentation, mandatory reporting

→Research and evidence-based practice — study design, statistics, diagnostic accuracy

→Standard precautions and sterile technique

→Roles, supervision, and delegation within the PT/PTA team

→Legal and regulatory obligations in patient care

Non-systems questions differ from body-system questions in an important way: many of them have precisely correct answers. A wheelchair seat width is the hip measurement plus 2 inches. C. diff requires soap and water. 1 MHz ultrasound reaches deep tissue. A sensitive test rules out. These are not judgment calls — they are learnable facts, which makes non-systems the highest return-on-study-time content area on the exam. See our full NPTE exam format breakdown for how these items fit into the 225-question structure.

The pattern to recognize

Non-systems questions love the almost-right answer that would be correct in the more common situation. Alcohol sanitizer is correct hand hygiene — except for C. diff. TENS is a reasonable pain modality — except with a demand pacemaker. Continuing a session at lower intensity is reasonable — except when the symptoms are a medical emergency. When a non-systems question includes a specific detail in the vignette (the pacemaker, the diagnosis, the diabetes), that detail is almost always the reason the standard answer is wrong. Read every rationale above and note which vignette detail changed the answer.

Cross-Content Reasoning

How Non-Systems Shows Up Inside Every Other Content Area

Non-systems knowledge is unusual because it is tested twice: once in dedicated non-systems items, and again woven into body-system questions. A musculoskeletal question about post-surgical rehabilitation may hinge on the weight-bearing restriction and the correct assistive device. A cardiopulmonary question may turn on recognizing when vital signs require stopping the session — a safety decision, not a cardiopulmonary one. A neuromuscular question about a patient with a stroke may actually be testing wheelchair prescription or caregiver education.

The same is true in reverse: dedicated non-systems items borrow clinical context from every system. The modality question includes a cardiac history. The infection-control question specifies the pathogen. The ethics question involves a post-surgical patient. You cannot fully separate non-systems preparation from the rest of the exam — which is exactly why students who skip it lose points everywhere, not just in one section.

The professional responsibilities and research domains also carry the questions students find hardest to guess: mandated reporting thresholds, supervision and delegation rules for the PT/PTA team, informed consent and refusal, sensitivity versus specificity, and levels of evidence. These reward direct study in a way clinical intuition cannot replace. PTA candidates face a parallel non-systems section on the NPTE-PTA with additional emphasis on the scope of the PTA role.

Study tip

Build a one-page reference sheet for the pure-recall non-systems facts: modality parameters and contraindications, wheelchair and assistive device measurements, isolation precautions by pathogen, and the SnNout/SpPin rules. Review it daily during your final two weeks — these are the only NPTE points you can secure through memorization alone, and our complete NPTE study guide covers how to fit this into a full study plan.

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