A physical therapist assistant is checking the fit of a standard manual wheelchair for a 70-year-old man who will use it full time after a bilateral transtibial amputation. The supervising PT's plan of care includes wheelchair fitting and propulsion training. Which of the following findings indicates the chair needs adjustment?

The seat is of standard depth and the rear axle is in the standard position, and the patient tips backward when he pushes up a ramp

There is about two inches of clearance between the front edge of the seat and the back of the knees

The patient's elbows are flexed about 30 degrees when his hands rest on the top of the push rims

There are about two inches of clearance between the seat width and each hip

A physical therapist assistant is conducting gait training with a 58-year-old man who received a transfemoral prosthesis four weeks ago, per the supervising PT's plan of care. During ambulation the PTA observes that the prosthetic knee buckles during the early stance phase. Which of the following is the MOST likely cause?

The prosthetic knee is aligned too far anterior to the trochanter-knee-ankle line, or the patient's hip extensors are weak

The prosthetic foot is set in too much plantarflexion

The socket is too loose, allowing the limb to piston

The pylon is too short on the prosthetic side

A physical therapist assistant is setting up neuromuscular electrical stimulation to the quadriceps for a 45-year-old woman after an anterior cruciate ligament reconstruction, per the supervising PT's plan of care. While reviewing the chart before applying the electrodes the PTA notes that the patient has a cardiac pacemaker. Which of the following is the MOST appropriate action?

Hold the modality, document the finding, and contact the supervising PT, because an implanted pacemaker is a contraindication or precaution that requires the PT's decision

Apply the stimulation as planned, since the electrodes are on the thigh and far from the chest

Reduce the intensity to a sensory level so the current cannot reach the pacemaker

Replace the electrical stimulation with therapeutic ultrasound over the quadriceps at the same parameters

A physical therapist assistant is applying continuous therapeutic ultrasound to the posterior shoulder of a 50-year-old man with adhesive capsulitis before stretching, per the supervising PT's plan of care, which calls for thermal effects to deep tissue. The PTA selects a 1 MHz frequency at 1.5 W/cm2 for 8 minutes over an area about twice the size of the sound head. Which of the following statements about this setup is CORRECT?

The 1 MHz frequency is appropriate for deep tissue heating, and the sound head should be kept moving throughout the treatment

A 3 MHz frequency should be used instead, because higher frequency penetrates deeper

The sound head should be held stationary over the most painful point to concentrate the heat

A pulsed duty cycle of 20 percent should be used to produce the thermal effect

A physical therapist assistant is scheduled to treat a 66-year-old woman in an acute care unit whose door sign indicates contact precautions for a methicillin-resistant Staphylococcus aureus wound infection. The plan of care includes transfer training and ambulation in the hallway. Which of the following is the MOST appropriate infection control approach?

Perform hand hygiene, don a gown and gloves before entering the room, use dedicated or disinfected equipment, remove the gown and gloves and perform hand hygiene before leaving, and confirm with nursing whether hallway ambulation is permitted and under what conditions

Wear gloves only, since the infection is in a wound and not airborne

Wear an N95 respirator, gown, and gloves, and keep the door closed at all times

Skip the session until the infection has resolved, since contact precautions prohibit physical therapy

A physical therapist assistant is ambulating an 84-year-old man with a gait belt and a front-wheeled walker in a skilled nursing facility hallway when his knees buckle and he begins to fall. Which of the following is the MOST appropriate response?

Use the gait belt to control his descent, lower him to the floor while protecting his head, call for help, and assess him before any attempt to get up

Grab the patient under both arms and lift him back to standing

Step back so the patient does not pull the PTA down with him, then call for help

Hold the patient upright by the gait belt until another staff member arrives to help lift him

A physical therapist assistant is treating a 48-year-old woman for low back pain in an outpatient clinic. The patient reports that she has been doing much better and asks whether she can be discharged today, since she has a long drive. The supervising physical therapist is at another clinic site and reachable by phone. Which of the following is the MOST appropriate action?

Explain that discharge decisions and the discharge evaluation are the physical therapist's responsibility, collect and document the patient's current status and progress, and contact the supervising PT to arrange the discharge

Discharge the patient, since the PTA can see she has met her goals

Perform a reassessment, update the goals, and document the discharge in the PT's name

Continue treatment indefinitely, since the PTA cannot stop care without a written order from the physician

A physical therapist assistant is writing a daily treatment note after a gait training session with a 72-year-old woman recovering from a stroke. The patient walked 150 feet with a hemi-walker and minimal assistance, compared with 100 feet with moderate assistance at the previous session, and reported fatigue at the end. Which of the following entries is the MOST appropriate way to document the session in the objective section of a SOAP note?

Patient ambulated 150 ft with hemi-walker and min assist of 1, up from 100 ft with mod assist of 1 on the previous visit; patient reported fatigue at the end of the walk

Patient is doing great and is much stronger than last time

Patient seems to have improved motor control and is probably ready to discontinue the hemi-walker

Patient walked further today and was tired afterward

A physical therapist assistant is treating a 90-year-old man in a long-term care facility. During a session he says clearly that he does not want to continue with the exercises today and would like to return to his room. His daughter, who holds his health care power of attorney and is present, insists that the PTA continue because he needs the therapy. The patient is alert and oriented and has not been deemed incapable of making his own decisions. Which of the following is the MOST appropriate action?

Respect the patient's refusal, document it along with the education provided about the consequences of refusing, and report it to the supervising PT

Continue the session, since the daughter holds power of attorney and has authorized it

Tell the patient that he has no choice because the physician ordered the therapy

Call the facility administrator to resolve the disagreement before doing anything else

A physical therapist assistant is reviewing a study the supervising PT shared to support a new balance protocol in the clinic. The study randomly assigned 120 older adults to the balance protocol or to usual care, with assessors who did not know the group assignment, and found a significant reduction in falls over 12 months. Which of the following BEST describes this study design and its position in the hierarchy of evidence?

A randomized controlled trial with blinded assessors, which sits near the top of the evidence hierarchy for questions about the effectiveness of an intervention, below systematic reviews and meta-analyses

A case series, which is the strongest form of evidence because it describes real patients

A cross-sectional survey, which can prove that the protocol causes fewer falls

An expert opinion, since the supervising PT selected the study

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

About This Content Area

NPTE-PTA Non-Systems Content Breakdown

The non-systems domains are everything on the NPTE-PTA that is not organized by body system. Per the official FSBPT content outline for the NPTE-PTA, effective January 2024, equipment, devices, and technologies carry 8 to 10 scored items, therapeutic modalities 5 to 7, safety and protection 6 to 8, professional responsibilities 2 to 4, and research and evidence-based practice 1 to 3, for a combined 22 to 32 of the 140 scored items. That is more than the cardiopulmonary system and close to the neuromuscular system, which is why the Federation of State Boards of Physical Therapy outline is worth reading in full before you decide these are minor topics. Try our free 20-question NPTE-PTA practice test, Other Systems practice questions, or the 10 general NPTE-PTA practice questions to see how this content sits alongside the rest of the exam.

What the PTA non-systems section covers

→Equipment, devices, and technologies: wheelchair measurement and fitting, assistive devices and gait patterns (axillary crutches, single point cane, walkers, and the partial weight bearing sequences for each), orthotics (AFO, KAFO, spinal orthoses) and prosthetics (transtibial and transfemoral components, gait deviations, residual limb care), adaptive equipment, and the devices and lines in acute care

→Therapeutic modalities: electrical stimulation (NMES, TENS, interferential current, iontophoresis), therapeutic ultrasound, superficial heat and cold, traction, compression (including intermittent pneumatic compression for lymphedema), hydrotherapy, biofeedback, and the indications, parameters, precautions, and contraindications for each

→Safety and protection: infection control with standard precautions and transmission-based precautions, fall prevention, body mechanics and patient handling, emergency response, environmental safety, restraints, and lines, tubes, and monitors

→Professional responsibilities: the PT-PTA relationship and supervision, scope of practice and practice acts, documentation, informed consent and patient rights, confidentiality, ethics and the APTA standards, cultural competence, and communication with the health care team

→Research and evidence-based practice: study designs and the hierarchy of evidence, reliability and validity, basic statistics, and applying evidence within the plan of care

The PTA frame separates this page from the NPTE-PT non-systems questions. The PT exam asks you to select the device, choose the modality, design the research, and make the supervision decision. The PTA exam asks whether you can fit and check the device the PT selected, set up and deliver the modality within safe parameters, recognize the contraindication the PT may have missed, stay inside the PTA’s role when a patient or a family member asks you to step outside it, and document in a way that tells the PT what happened. See our full NPTE-PTA exam format breakdown for how these items fit into the 180-question structure, and note that the passing standard is the same for both exams: a scaled score of 600 on the 200 to 800 scale that FSBPT reports.

The rules and ranges the non-systems section expects you to know

→Assistive device sequences: partial weight bearing with axillary crutches uses a three-point pattern, a single point cane is held on the side opposite the involved leg and advances with it, and stairs go up with the stronger leg and down with the weaker leg and the device

→Wheelchair fit: seat width equals hip width plus 2 inches, seat depth equals thigh length minus 2 inches, armrest height equals seated elbow height plus 1 inch, footrests 2 inches off the floor, elbows at about 30 degrees of flexion on the push rims

→Ultrasound: 1 MHz for deep tissue (3 to 5 cm), 3 MHz for superficial (1 to 2 cm), continuous duty cycle for thermal effects, pulsed for non-thermal, sound head kept moving over an area two to three times its size

→Electrical stimulation contraindications: implanted cardiac devices, carotid sinus, pregnant trunk, active thrombosis, malignancy, impaired sensation at motor intensities

→Transmission-based precautions add to standard precautions: contact adds gown and gloves, droplet adds a surgical mask, airborne adds an N95 and a negative-pressure room; soap and water for C. difficile

→Supervision: the PT evaluates, establishes and modifies the plan of care, and discharges; the PTA implements, collects data, adjusts within the plan, and reports; supervision level varies by state and setting

→Documentation: measurable objective language, correct errors with a single line, initials, and date, no blank lines, co-signature per state and setting, and anything not documented is treated as not done

→Patient rights: a patient with capacity may refuse treatment, a health care proxy acts only when the patient cannot, and informed consent precedes every intervention

→Evidence hierarchy: systematic reviews and meta-analyses, then randomized controlled trials, cohort studies, case-control studies, case series, expert opinion; p less than 0.05 is statistically significant

The pattern to recognize

Non-systems vignettes rarely ask what is wrong with the patient. They hand you a device, a modality setting, a precaution sign, a request, or a study, and ask whether what is about to happen is safe, inside the PTA’s role, and documented correctly. The wrong answers are a parameter outside the range, a contraindication ignored, a decision that belongs to the PT, or a shortcut that would not survive a chart review. The right answer checks the rule, protects the patient, stays in role, and reports.

Cross-Content Reasoning

Where Non-Systems Content Connects Across the NPTE-PTA

Non-systems content is the delivery layer for every other section. The orthotics, prosthetics, and assistive device items are the practical side of the musculoskeletal section and the neuromuscular section, where the AFO for the foot drop after a CVA and the wheelchair for a spinal cord injury are the intervention. The modality parameters and contraindications apply to the same patients, and the pacemaker that stops an electrical stimulation session is a cardiopulmonary fact with a modality consequence.

Safety and protection overlaps with the other systems section through infection control for the neutropenic patient, the compression garments and pumps used for lymphedema, the lines and tubes that come with feeding and bladder management, and the skin inspection that prevents pressure injuries under a device. Fall prevention draws on the orthostatic hypotension, neuropathy, and medication effects tested elsewhere, and the emergency response items (a fall, a cardiac event, a seizure, hypoglycemia) are the same stop-and-act judgments every system section rewards.

Professional responsibilities run under all of it. Every vignette on this site ends with the PTA reporting to the PT, and the supervision, scope, and documentation rules are what make that reporting meaningful. The research items are small in number, but the evidence hierarchy and the reliability-versus-validity distinction show up as the hidden detail in data collection questions across the exam.

Study tip

Build three cards: a parameters card (ultrasound frequency and duty cycle, electrical stimulation settings, wheelchair measurements, heat and cold times), a contraindications card (one line per modality), and a role card (what the PT does, what the PTA does, what supervision each setting requires). Then add the SOAP sections and the evidence hierarchy at the bottom. These are the most recallable points on the exam. Then test the cards against mixed multiple-choice questions rather than a single-domain question bank, because the exam buries non-systems rules inside clinical vignettes: our 20-question NPTE practice test for PTA candidates does exactly that, and the full-length practice exams in the Practitionr app track each domain separately. Our complete NPTE-PTA study guide shows how to fit the cards into a full PTA exam prep plan, and if you are preparing for the PT version, start with our NPTE practice questions.

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