A 61-year-old male with a transtibial amputation demonstrates excessive knee flexion on the prosthetic side during early stance, from initial contact through loading response, and reports the knee feels as if it is "being pushed into a bend" as he lands. His quadriceps strength is 5/5 and he has no knee flexion contracture. Which of the following prosthetic causes is MOST likely?

The heel cushion or plantar flexion bumper is too stiff, or the foot is set in excessive dorsiflexion

The heel cushion is too soft, or the foot is set in excessive plantar flexion

The socket is aligned in excessive extension

A 55-year-old female with a transfemoral amputation leans her trunk toward the prosthetic side during prosthetic stance. Which of the following lists causes that should ALL be considered for this deviation?

A prosthesis that is too short, weak residual limb hip abductors, an abducted socket, and a painful or sensitive lateral distal femur

A prosthesis that is too long, excessive socket flexion, and a locked knee unit

A heel cushion that is too soft and inadequate suspension

Excessive dorsiflexion of the prosthetic foot and a stiff toe lever

A 63-year-old male with a transfemoral prosthesis swings the prosthetic limb through a wide lateral arc during swing phase. Which of the following prosthetic causes is MOST consistent with this deviation?

The prosthesis is functionally too long, or the knee unit has too much friction or a locked knee limiting flexion in swing

The prosthesis is too short with a soft heel cushion

The medial socket wall is too low

The foot is set in excessive dorsiflexion

A physical therapist is teaching a 58-year-old male with a new transtibial amputation how to wrap his residual limb with an elastic bandage before prosthetic fitting. Which of the following instructions is CORRECT?

Use diagonal figure-of-eight turns with the greatest pressure distally, decreasing proximally, and rewrap several times per day

Apply the bandage in circular turns with even pressure from proximal to distal

Wrap only when the limb appears swollen, leaving it unwrapped otherwise

Anchor the bandage tightly just above the knee to prevent slipping, with light tension below

A 66-year-old male is three days post transtibial amputation. Nursing staff have placed a pillow under his residual limb "for comfort," supporting the knee in flexion while he rests supine, and he spends most of the day sitting in a wheelchair. Which of the following is the MOST important positioning correction?

Remove the pillow from under the knee, keep the knee extended when resting, and add scheduled prone lying

Continue the pillow support to reduce postoperative edema

Position the residual limb in abduction and external rotation for comfort

Keep the hip and knee flexed at all times to protect the suture line

During gait training, a therapist observes that a patient's transtibial socket visibly slides down the residual limb during swing phase and back up during stance, and the patient reports the prosthesis "feels loose" and that skin at the distal end has become red and irritated. Which of the following BEST identifies the problem?

Pistoning due to inadequate suspension or a socket that no longer fits a shrinking residual limb — requiring sock ply adjustment or suspension revision before continued training

Normal early accommodation that resolves as the patient walks more

Excessive suspension requiring the addition of more prosthetic socks

A gait deviation best addressed with verbal cueing for equal step lengths

A 47-year-old female with a transtibial amputation is classified as a K3 functional level ambulator — community ambulation with variable cadence, including uneven terrain. Which of the following prosthetic feet is MOST appropriate for her?

A dynamic response (energy-storing) foot

A SACH (solid ankle cushion heel) foot

A single-axis foot with a locked ankle

No foot component, since K3 patients use running-specific prostheses only

A 52-year-old male has isolated foot drop from a common fibular nerve injury. His ankle has full passive range of motion, normal tone, and good mediolateral stability; his only deficit is absent active dorsiflexion producing toe drag in swing. Which of the following orthoses is MOST appropriate?

A posterior leaf spring ankle-foot orthosis

A solid ankle-foot orthosis holding the ankle rigidly in neutral

A knee-ankle-foot orthosis with a locked knee joint

A rigid floor reaction ankle-foot orthosis

A 9-year-old male with spastic diplegic cerebral palsy walks in a crouch pattern — excessive ankle dorsiflexion, knee flexion, and hip flexion throughout stance — with weak plantar flexors that fail to restrain forward tibial advancement. Which of the following orthoses is MOST appropriate to address the stance-phase crouch?

A floor reaction (ground reaction) AFO that blocks dorsiflexion and directs the ground reaction force to extend the knee

A posterior leaf spring AFO to assist dorsiflexion

A supramalleolar orthosis for mediolateral foot alignment only

Bilateral resting night splints worn during ambulation

A 78-year-old female with osteoporosis has an acute stable T12 vertebral compression fracture. Her physician orders an orthosis to limit the motion MOST responsible for anterior vertebral body loading while the fracture heals. Which of the following orthoses BEST meets this goal?

A cruciform anterior spinal hyperextension (CASH) or Jewett-type orthosis that restricts trunk flexion at the thoracolumbar junction

A soft lumbosacral corset for abdominal compression

A cervicothoracic orthosis such as a Minerva brace

A Milwaukee orthosis with a cervical superstructure

10 Free NPTE Prosthetics & Orthotics Practice Questions (2026) - Practitionr

About This Topic

How Prosthetics & Orthotics Are Tested on the NPTE

Prosthetics and orthotics content lives in the equipment, devices, and technologies thread of the FSBPT content outline, scored alongside the musculoskeletal and neuromuscular systems whose deficits the devices manage. Try our free 20-question timed NPTE practice test, Gait Analysis practice questions, or Musculoskeletal practice questions to see the adjacent content this topic builds on.

The P&O pairings the exam tests

→Stiff heel / dorsiflexed foot — early-stance knee flexion; soft heel / plantar flexed foot — knee extension

→Lateral trunk lean — short prosthesis, abducted socket, weak abductors, painful lateral femur

→Circumduction — long prosthesis, poor suspension, knee that won’t flex

→Wrapping — figure-of-eight, distal-to-proximal gradient, no circular turns

→Contracture prevention — transtibial: knee extension, no pillows; transfemoral: prone lying, no abduction

→Pistoning — suspension failure or limb shrinkage; socks first, then the prosthetist

→K-levels — K1 SACH; K3 dynamic response; componentry follows function

→AFOs — leaf spring for foot drop; solid for spasticity/instability; floor reaction for weak quads and crouch

→Spinal orthoses — region first, motion second: hyperextension designs block flexion after compression fracture

Two framing habits pay for themselves across all of it. For prosthetic deviations, build every answer as two columns — device causes and patient causes — because the exam’s distractors are almost always real causes filed in the wrong column. For orthotics, prescribe by minimum effective control: identify exactly which motions at which joints need managing, and choose the least device that manages them, since over-bracing costs energy, muscle activity, and adherence. See our full NPTE exam format breakdown for how these items fit into the 225-question structure.

The pattern to recognize

P&O vignettes tell you which column the answer lives in by what they rule OUT. When the stem certifies the patient — full strength, no contracture, normal tone — the cause is the device, and vice versa. And orthotic questions signal the answer through the deficit’s plane and phase: a swing-phase sagittal problem points to a flexible assist, a stance-phase collapse points to rigid control or ground-reaction geometry, and frontal-plane instability points to a solid design. Read the deficit before reading the device list.

Cross-Content Reasoning

Where P&O Connects Across the Exam

P&O is applied gait analysis, and our Gait Analysis practice questions are its prerequisite: the same ground-reaction-force reasoning that explains a quadriceps-weak patient’s forward lean explains the floor reaction AFO, and prosthetic deviations reuse the able-bodied cause-and-compensation logic with alignment and componentry as the new causes. The amputation population itself connects to the Other Systems and Wound Care threads — most lower-limb amputations are dysvascular and diabetic, so residual limb skin inspection, contralateral foot protection, and healing-capacity thinking all carry over directly.

The orthotic side spans the neurologic pages: AFO selection is a core management question in stroke (tone-appropriate designs for the hemiplegic ankle), KAFO candidacy and orthotic ambulation energy cost belong to the spinal cord injury thread, and the crouch-gait orthoses tested here manage the cerebral palsy patterns from the pediatric page.

And the phantom limb thread ties into pain science and the psychosocial content of the non-systems section: distinguishing phantom sensation (normal, near-universal) from phantom pain (a treatment target, with mirror therapy and graded motor imagery as the tested interventions) from residual limb pain (a fit or neuroma problem) is a three-way differential the exam draws from this same well.

Study tip

Build three tables and drill them as pairs. Table one: prosthetic deviation → device causes → patient causes (the two-column habit). Table two: K-level → functional description → foot and knee components. Table three: deficit → orthosis (foot drop → leaf spring; spasticity or instability → solid AFO; weak quads or crouch → floor reaction; compression fracture → hyperextension orthosis; scoliosis → Boston or Milwaukee by curve level). Add the two positioning rules for contracture prevention, and our complete NPTE study guide covers how to fold it all into a full study plan.

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