NPTE-PT study guide · 2026

The 8 NPTE-PT domains, explained

8 domains and 28 official content areas. Musculoskeletal System carries the most weight at 24-30%. Each guide explains what the domain covers, how its questions are framed and where candidates lose marks.

Start with Domain 2 See all domains
Questions
225 multiple-choice items (180 scored, 45 unscored pretest items)
Time
5 hours of testing time across 5 sections of 45 items (5 hours 30 minutes total appointment)
Passing score
Scaled score of 600 (score scale 200-800)
Outline
NPTE-PT Test Content Outline, effective January 2024 (Version 1.1, 8/25/2023) (current)

Exam blueprint

Bar widths follow the official weights. Weight ranges are drawn at their midpoint.

  1. 1 12-15%
  2. 2 24-30%
  3. 3 22-27%
  4. 4 4-6%
  5. 5 7-13%
  6. 6 4-6%
  7. 7 5-7%
  8. 8 7-9%
  1. 1 Cardiovascular & Pulmonary Systems
  2. 2 Musculoskeletal System
  3. 3 Neuromuscular & Nervous Systems
  4. 4 Integumentary System
  5. 5 Metabolic & Endocrine, Gastrointestinal, Genitourinary & Lymphatic Systems
  6. 6 System Interactions
  7. 7 Equipment, Devices, Technologies & Therapeutic Modalities
  8. 8 Safety, Professional Responsibilities & Research

All 8 domains

28 official content areas 201–267 hrs suggested study

  1. Domain 01 12-15%

    Cardiovascular & Pulmonary Systems

    Cardiopulmonary items test how you examine heart and lung function, interpret vital signs, ECGs and lab values, and choose safe exercise, airway clearance and breathing interventions for patients across acute, rehab and outpatient settings.

    Inside this domain

    • Physical Therapy Examination (cardiovascular & pulmonary)
    • Foundations for Evaluation, Differential Diagnosis, & Prognosis (cardiovascular & pulmonary)
    • Interventions (cardiovascular & pulmonary)

    Watch for Push through falling BP

    Content areas
    3
    Questions est.
    ~25 scored
    Study time est.
    30–40 hrs
  2. Domain 02 24-30%

    Musculoskeletal System

    Musculoskeletal is the largest content area on the NPTE-PT. It covers orthopedic examination and special tests, joint mechanics, fractures, arthritis and connective tissue disease, imaging and medication effects, and post-operative and manual therapy interventions.

    Inside this domain

    • Physical Therapy Examination (musculoskeletal)
    • Foundations for Evaluation, Differential Diagnosis, & Prognosis (musculoskeletal)
    • Interventions (musculoskeletal)

    Watch for Aggressive early loading

    Content areas
    3
    Questions est.
    ~49 scored
    Study time est.
    50–65 hrs
  3. Domain 03 22-27%

    Neuromuscular & Nervous Systems

    Neuromuscular & Nervous Systems covers examination of the central, peripheral and autonomic nervous systems, conditions from stroke to Guillain-Barre syndrome, medication and regenerative medicine effects, and interventions grounded in motor control and motor learning.

    Inside this domain

    • Physical Therapy Examination (neuromuscular & nervous)
    • Foundations for Evaluation, Differential Diagnosis, & Prognosis (neuromuscular & nervous)
    • Interventions (neuromuscular & nervous)

    Watch for Lay flat for dysreflexia

    Content areas
    3
    Questions est.
    ~44 scored
    Study time est.
    45–60 hrs
  4. Domain 04 4-6%

    Integumentary System

    Integumentary items test wound and burn examination, staging and classification, the causes behind arterial, venous, neuropathic and pressure wounds, and choices about debridement, dressings, offloading, compression, scar management and burn positioning.

    Inside this domain

    • Physical Therapy Examination (integumentary)
    • Foundations for Evaluation, Differential Diagnosis, & Prognosis (integumentary)
    • Interventions (integumentary)

    Watch for Compression for every leg wound

    Content areas
    3
    Questions est.
    ~10 scored
    Study time est.
    12–16 hrs
  5. Domain 05 7-13%

    Metabolic & Endocrine, Gastrointestinal, Genitourinary & Lymphatic Systems

    This domain groups four smaller FSBPT body systems: metabolic and endocrine, gastrointestinal, genitourinary and lymphatic. It covers diabetes and thyroid disease, visceral referred pain, bowel and bladder programs, pelvic floor rehabilitation and lymphedema management.

    Inside this domain

    • Metabolic & Endocrine Systems
    • Gastrointestinal System
    • Genitourinary System
    • Lymphatic System

    Watch for Exercise through low glucose

    Content areas
    4
    Questions est.
    ~17 scored
    Study time est.
    20–28 hrs
  6. Domain 06 4-6%

    System Interactions

    System Interactions tests reasoning when a condition, drug list or patient affects several body systems at once: cancer, pregnancy, multitrauma, autoimmune disease, polypharmacy, coexisting conditions, psychological factors and the dimensions of acute and persistent pain.

    Inside this domain

    • Diseases/conditions that primarily affect more than one system (e.g., cancer, multitrauma, sarcoidosis, autoimmune disorders, pregnancy) and their impact on the plan of care and prognosis
    • Nonpharmacological medical management of multiple systems (e.g., diagnostic imaging, other medical tests, surgical procedures)
    • Impact of pharmacology used to treat multiple systems, including polypharmacy, on physical therapy management
    • Differential diagnoses related to diseases/conditions that primarily affect more than one system
    • and 3 more content areas

    Watch for Resistance with low counts

    Content areas
    7
    Questions est.
    ~9 scored
    Study time est.
    12–16 hrs
  7. Domain 07 5-7%

    Equipment, Devices, Technologies & Therapeutic Modalities

    This domain combines two FSBPT nonsystem areas: equipment, devices and technologies, covering assistive devices, wheelchairs, prostheses and orthoses, and therapeutic modalities, covering heat, cold, ultrasound, electrotherapy, iontophoresis, traction, biofeedback and compression.

    Inside this domain

    • Equipment, Devices, & Technologies
    • Therapeutic Modalities

    Watch for Same-side cane

    Content areas
    2
    Questions est.
    ~11 scored
    Study time est.
    14–18 hrs
  8. Domain 08 7-9%

    Safety, Professional Responsibilities & Research

    This domain combines three FSBPT nonsystem areas: safety and protection, professional responsibilities, and research and evidence-based practice. It covers infection control, lines and tubes, emergencies, abuse, documentation, ethics, law, reimbursement, telehealth, study design and statistics.

    Inside this domain

    • Safety & Protection
    • Professional Responsibilities
    • Research & Evidence-Based Practice

    Watch for Lift the chest tube unit

    Content areas
    3
    Questions est.
    ~15 scored
    Study time est.
    18–24 hrs

Study the heaviest domains first

Marks follow weight. This order puts the most marks behind you first, across about 201–267 hrs of study.

  1. 2 Musculoskeletal System 24-30% · 50–65 hrs
  2. 3 Neuromuscular & Nervous Systems 22-27% · 45–60 hrs
  3. 1 Cardiovascular & Pulmonary Systems 12-15% · 30–40 hrs
  4. 5 Metabolic & Endocrine, Gastrointestinal, Genitourinary & Lymphatic Systems 7-13% · 20–28 hrs
  5. 8 Safety, Professional Responsibilities & Research 7-9% · 18–24 hrs
  6. 7 Equipment, Devices, Technologies & Therapeutic Modalities 5-7% · 14–18 hrs
  7. 4 Integumentary System 4-6% · 12–16 hrs
  8. 6 System Interactions 4-6% · 12–16 hrs

Try one

Practice questionDomain 2: Musculoskeletal System

A patient is three weeks after a posterior approach total hip arthroplasty and plans to return home alone. Which instruction should the physical therapist give for daily activities at home?

One trap from every domain

The answer that looks right, and the clue that gives it away.

  • Domain 1

    Push through falling BP

    Clue Systolic lower at higher workload.

  • Domain 2

    Aggressive early loading

    Clue Early post-operative timeline in the stem.

  • Domain 3

    Lay flat for dysreflexia

    Clue Pounding headache and high BP in cord injury above T6.

  • Domain 4

    Compression for every leg wound

    Clue Painful distal wound, weak pulses, pallor on elevation.

  • Domain 5

    Exercise through low glucose

    Clue Pre-exercise glucose below about 100 mg/dL in an insulin user.

  • Domain 6

    Resistance with low counts

    Clue Platelet value in the stem.

  • Domain 7

    Same-side cane

    Clue Unilateral hip or knee pain.

  • Domain 8

    Lift the chest tube unit

    Clue Chest tube in an acute care mobility scenario.

Practise what you read

NPTE-PT domains: common questions

How many domains are in the NPTE-PT exam?

NPTE-PT has 8 domains with 28 official content areas between them: Cardiovascular & Pulmonary Systems, Musculoskeletal System, Neuromuscular & Nervous Systems, Integumentary System, Metabolic & Endocrine, Gastrointestinal, Genitourinary & Lymphatic Systems, System Interactions, Equipment, Devices, Technologies & Therapeutic Modalities and Safety, Professional Responsibilities & Research.

Which NPTE-PT domain carries the most weight?

Musculoskeletal System is the heaviest at 24-30%, followed by Neuromuscular & Nervous Systems (22-27%). The lightest is System Interactions (4-6%). Weights come from FSBPT's official outline.

What is the NPTE-PT exam format?

Questions: 225 multiple-choice items (180 scored, 45 unscored pretest items). Time allowed: 5 hours of testing time across 5 sections of 45 items (5 hours 30 minutes total appointment). Passing score: Scaled score of 600 (score scale 200-800).

How long should I study for NPTE-PT?

Our planning estimate is 201–267 hrs across all domains, split by weight. It is an editorial estimate, not an official figure, so adjust it to your experience and to how you score on practice questions.

Where should I start?

Start with Musculoskeletal System, because it carries the most marks, then work down by weight. Use the checklist on each domain page to confirm you can do what the domain asks before moving on.

Which outline is this guide based on?

This guide follows NPTE-PT Test Content Outline, effective January 2024 (Version 1.1, 8/25/2023) (current), published by FSBPT. It was last reviewed in October 2026.

Domain names, weights and content areas come from FSBPT's official outline (NPTE-PT Test Content Outline, effective January 2024 (Version 1.1, 8/25/2023) (current)). Question counts and study hours are editorial planning estimates, not official figures. Last reviewed October 2026.