A physical therapist assistant is performing a skin check before a positioning session with a 79-year-old woman who is bed-bound after a hip fracture. Over the sacrum the PTA finds a shallow open wound with a red-pink wound bed, no slough, and no visible fat or deeper tissue. Which of the following BEST describes this finding, and what is the MOST appropriate action?

Stage 2 pressure injury; document the finding, relieve pressure from the sacrum, and report it to the supervising physical therapist and nursing staff

Stage 1 pressure injury; continue the positioning program as planned

Stage 3 pressure injury; apply a dry gauze dressing and continue the session

Deep tissue pressure injury; perform sharp debridement of the wound bed

A physical therapist assistant is treating a 32-year-old man with deep partial-thickness burns across the anterior neck and chest, now in the rehabilitation phase. The supervising PT's plan of care includes positioning to prevent contracture and range of motion. Which of the following positioning strategies is MOST appropriate?

Position the neck in extension with no pillow, or a small roll under the shoulders, and the shoulders abducted, to counteract the contracture pattern the burn will pull toward

Position the neck in flexion with a pillow behind the head, which is the most comfortable position for the patient

Keep the neck and shoulders in a neutral, relaxed position and avoid any stretch until the wounds have fully closed

Position the patient side-lying with the arms adducted across the chest to protect the healing skin

A physical therapist assistant is about to begin an aerobic conditioning session with a 58-year-old man with type 2 diabetes managed with insulin. Before the session the patient checks his blood glucose and it reads 285 mg/dL. He reports feeling fine. According to the supervising PT's plan of care, exercise is held outside the stated glucose range. Which of the following is the MOST appropriate action?

Hold the aerobic session, check for ketones per the plan if the facility provides it, and report the reading to the supervising physical therapist

Proceed with the session, since exercise lowers blood glucose

Give the patient a snack with fast-acting carbohydrate and proceed

Have the patient take an extra dose of insulin and begin the session in fifteen minutes

A physical therapist assistant is treating a 76-year-old woman with severe osteoporosis and a history of a vertebral compression fracture. The supervising PT's plan of care includes spinal extensor strengthening, weight-bearing exercise, and fall prevention. The patient asks to add the abdominal crunches she sees others doing in the gym. Which of the following is the MOST appropriate response?

Explain that repeated or loaded trunk flexion is avoided with osteoporosis because it increases the risk of vertebral compression fracture, continue the extension-based program, and note the request for the supervising PT

Add the crunches, since core strengthening protects the spine

Substitute toe-touch stretches, which are gentler than crunches

Replace all exercise with non-weight-bearing aquatic activity to protect the bones

A physical therapist assistant is treating a 67-year-old man in a skilled nursing facility whose plan of care includes bed mobility and supine exercises. He has a documented history of gastroesophageal reflux disease and a gastrostomy tube through which he receives continuous feeding. Which of the following is the MOST appropriate modification to the session?

Keep the head of the bed elevated at least 30 degrees during and after the feeding, modify the supine exercises to a semi-reclined position, and avoid pressure or traction on the tube site

Perform the supine exercises as written, since the feeding tube bypasses the esophagus

Clamp the feeding tube for the session so the patient can lie flat

Place the patient prone for the exercises to protect the tube

A physical therapist assistant is working with a 34-year-old woman with a T5 complete spinal cord injury who manages her bladder with intermittent catheterization on a schedule. During a wheelchair skills session she mentions she skipped her last catheterization because she was running late, and a few minutes later she develops a pounding headache and flushed skin. Which of the following is the MOST appropriate action?

Recognize the signs of autonomic dysreflexia, keep her upright, check her blood pressure, and assist her to empty the bladder or get nursing help immediately

Lay her flat and elevate her legs to treat what is probably low blood pressure

Continue the session and remind her to catheterize when she gets home

Give her acetaminophen for the headache and continue the session

A physical therapist assistant is treating a 62-year-old woman with stage 2 lymphedema of the left arm after a mastectomy with axillary lymph node dissection. The supervising PT's plan of care includes compression bandaging, remedial exercise, and skin care education. Which of the following instructions is MOST appropriate to include in the education?

Protect the left arm from cuts, burns, insect bites, and constriction, avoid blood pressure cuffs and needle sticks on that arm, and wear the compression garment during exercise

Have blood pressure taken and blood drawn on the left arm, since the right arm should be rested

Apply heat to the left arm before exercise to improve circulation

Perform vigorous resistance exercise with the left arm to pump the fluid out as quickly as possible

A physical therapist assistant is treating a 54-year-old man receiving chemotherapy for lymphoma, with a plan of care for deconditioning that includes aerobic and resistance exercise. Before today's session the PTA reviews the chart and finds this morning's lab values: hemoglobin 7.8 g/dL, platelets 18,000 per microliter, and an absolute neutrophil count of 400 per microliter. Which of the following is the MOST appropriate action?

Hold the exercise session, document the values, and contact the supervising physical therapist, because the platelet count and neutrophil count fall below the commonly used thresholds for exercise and the hemoglobin is low

Proceed with the session as planned, since lab values are the physician's concern

Proceed with resistance exercise but skip the aerobic portion to avoid fatigue

Perform the session in a crowded gym so the patient benefits from social support

A physical therapist assistant is treating a 29-year-old woman in her third trimester of pregnancy for low back pain, per the supervising PT's plan of care. During a supine exercise she becomes lightheaded, pale, and nauseated. Which of the following is the MOST appropriate action?

Roll her onto her left side, allow her symptoms to resolve, and modify the remaining supine exercises to side-lying or semi-reclined positions, reporting the response to the supervising PT

Continue the exercise, since lightheadedness is a normal part of pregnancy

Have her sit up quickly and perform deep breathing

Place her prone to take the weight off her back

A physical therapist assistant is seeing an 81-year-old woman for gait training two weeks after a hip fracture repair. Her chart lists type 2 diabetes with peripheral neuropathy, hypertension managed with a diuretic and a beta-blocker, and early dementia. Which of the following considerations is MOST important when the PTA carries out the gait training session?

Her neuropathy reduces foot sensation and balance, her medications blunt heart rate and predispose her to orthostatic drops, and her dementia limits carryover, so the PTA checks her feet and footwear, monitors blood pressure with position changes, uses simple repeated cues, and guards closely

Her diabetes is irrelevant to gait training, since the session targets the hip

Her dementia means the session should be skipped until her cognition improves

Her beta-blocker will raise her heart rate, so the PTA should keep the session short

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

About This Content Area

NPTE-PTA Other Systems Content Breakdown

“Other systems” is the grouping students use for the smaller body systems on the NPTE-PTA, the physical therapist assistant version of the National Physical Therapy Exam. Per the official FSBPT NPTE-PTA content outline, effective January 2024, the integumentary system carries 3 to 8 scored items, metabolic and endocrine 4 to 6, gastrointestinal 0 to 4, genitourinary 0 to 4, lymphatic 2 to 6, and system interactions 5 to 7, for a combined 14 to 35 of the 140 scored items. The Federation of State Boards of Physical Therapy (FSBPT) tests the integumentary system and the lymphatic system across data collection, conditions, and interventions, while the metabolic and endocrine systems, the gastrointestinal system, and the genitourinary system are tested through conditions and interventions only. Together with the musculoskeletal system, the neuromuscular and nervous systems, and the cardiovascular and pulmonary systems, these make up the body system portion of the exam; the remaining items are the non-systems domains (equipment, devices, and technologies; therapeutic modalities; safety and protection; professional responsibilities; research and evidence-based practice). Try our free 20-question NPTE-PTA practice test, Cardiopulmonary 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 other systems section covers

→Integumentary system: skin inspection, pressure injury (pressure ulcers) staging and prevention, burn depth classification from superficial to partial-thickness burn to full-thickness and anti-contracture positioning, wound dressings and moist wound healing, scar management, friction and shear

→Metabolic and endocrine systems: diabetes and blood glucose thresholds for exercise, hypoglycemia and hyperglycemia signs, osteoporosis precautions, hyperthyroidism (elevated resting heart rate, heat intolerance, fatigue) and hypothyroidism (low exercise tolerance, cold intolerance, weight gain), and adrenal conditions that change the session

→Gastrointestinal system: reflux and aspiration precautions, positioning with feeding tubes, head-down postural drainage positions modified or avoided with reflux, bowel programs, visceral referral patterns to recognize and report

→Genitourinary system: bladder programs and catheter care, urinary incontinence types (stress incontinence, urge, overflow, functional) and pelvic floor retraining, renal referral patterns, autonomic dysreflexia triggers

→Lymphatic system: lymphedema staging and precautions, compression and remedial exercise, complete decongestive therapy, infection risk

→System interactions: cancer and lab values, pregnancy, polypharmacy, comorbidities such as diabetes with hypertension, congestive heart failure with COPD, or dementia with hip fracture, psychological conditions and pain that change the session

The PTA frame is what separates this page from the NPTE-PT other systems questions. The PT version of the NPTE practice questions asks you to screen for visceral disease and decide whether a referral is needed. The PTA exam gives you a patient whose chart already lists the diagnosis and asks whether you recognize the precaution it imposes, carry out the intervention the PT selected, and report the finding (a glucose reading, a wound change, a swollen limb, a lab value) that changes the plan. See our full NPTE-PTA exam format breakdown for how these items fit into the 180-question structure.

The numbers and rules the other systems expect you to know

→Pressure injury stages: 1 intact non-blanchable redness, 2 partial-thickness with exposed dermis, 3 full-thickness with visible fat, 4 exposed muscle or bone, plus unstageable and deep tissue injury

→Blood glucose: hold exercise below about 70 mg/dL (treat with 15 grams of carbohydrate and recheck in 15 minutes) and above about 250 to 300 mg/dL per the plan; recheck before resuming

→Oncology labs: platelets below about 20,000 hold resistance and impact exercise, absolute neutrophil count below 500 means infection precautions, hemoglobin below about 8 g/dL limits exercise to light activity

→Lymphedema: no blood pressure cuffs or needle sticks on the affected limb, compression during exercise, protect the skin, treat any sign of infection promptly

→Burns: rule of nines for surface area, anti-contracture positioning opposite the position of comfort, early range of motion, immobilize fresh grafts for the first several days

→Pregnancy: avoid prolonged supine after the first trimester, no Valsalva, no overheating, respect relaxin-related laxity, stop and refer for bleeding, contractions, or fluid leakage

→Thyroid: hyperthyroidism raises resting heart rate and lowers heat tolerance, so intensity is guided by perceived exertion and the session is cooled; hypothyroidism lowers exercise tolerance and slows recovery, so progression is gradual

→Stress incontinence: leakage with coughing, sneezing, or lifting; the intervention is pelvic floor muscle training and the PTA cues the contraction without Valsalva and reports progress

The pattern to recognize

Other-systems vignettes hand you a number or an observation that the rest of the question depends on: a glucose value, a platelet count, a wound bed, a swollen limb, a skipped catheterization, a position that triggers symptoms. The wrong answers either ignore the finding and proceed, or treat it with something the PTA cannot do (medication, debridement, a changed medical order). The right answer compares the finding with the threshold in the plan, modifies or holds the session, protects the patient, and reports. Once you see the pattern in these NPTE practice questions, it shows up in every set of practice exams you take afterward.

Cross-Content Reasoning

Where the Other Systems Connect Across the NPTE-PTA

These systems rarely appear alone. The pressure injury, burn, and lymphedema items connect to the positioning and range of motion work tested under the musculoskeletal system in the musculoskeletal section, the osteoporosis precautions are musculoskeletal rules with a metabolic cause, and the diabetic foot and neuropathy items sit on the border with the neuromuscular and nervous systems in the neuromuscular section, where the same sensory loss changes balance and gait training.

The cardiopulmonary section supplies the vital-sign layer again: the blood pressure spike of autonomic dysreflexia from a full bladder, the orthostatic drop in a pregnant or dehydrated patient, the fluid overload of congestive heart failure in a patient whose kidneys are failing, and the anemia that limits exercise tolerance in a cancer patient are all cardiovascular responses with a cause in another system. The postural drainage positions in pulmonary care are modified for reflux and feeding tubes, which is a gastrointestinal precaution applied to a pulmonary technique. The lab values and lines-and-tubes precautions overlap with the safety and protection category in the non-systems section, and infection control for the neutropenic patient is tested there too, alongside the equipment, devices, and technologies (feeding pumps, catheters, compression garments), the therapeutic modalities that are contraindicated over a malignancy or a lymphedematous limb, the professional responsibilities that govern reporting, and the research and evidence-based practice items that underpin the thresholds on this page.

And the pharmacology thread is heaviest here: insulin and oral hypoglycemics set the glucose rules, corticosteroids cause secondary osteoporosis and thin the skin, chemotherapy drives the lab values, diuretics shift fluid and potassium, and polypharmacy in an older adult is itself a system-interaction item. The exam expects a PTA to know how each drug changes the session, not to prescribe or adjust it.

Study tip

Make a one-page threshold sheet: the pressure injury stages, the glucose rules at both ends, the three oncology lab cutoffs, the lymphedema do-not list, and the pregnancy positioning and red-flag rules. These are pure recall and cost points only when they are skipped, and they also appear as the hidden detail in musculoskeletal and neuromuscular vignettes. Then drill them with mixed practice exams rather than a single-system question bank, because the exam hides these facts inside other vignettes. Our complete NPTE-PTA study guide shows how to fold the sheet into a full study plan, and the NPTE practice test for PTA candidates mixes all of these systems the way the real exam does. If you are studying for the PT version instead, start with our NPTE practice questions.

Want to Know Which Thresholds You Would Miss?

10 questions give you a snapshot. Practitionr’s adaptive question bank tracks your accuracy across the integumentary, metabolic, GI, GU, and lymphatic systems and the system-interaction vignettes on every set of NPTE practice questions you take, then rebuilds your NPTE-PTA study plan around exactly where you need more work. No credit card required.

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