NBCOT Prep Questions – Flashcards
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An OTR® is treating a 77-year-old client who requires a resting hand splint. Which splint characteristics are MOST important in addressing the natural aging process of skin and adipose tissue? A. Use colored splints and no moving parts B. Use D rings and mark where straps go C. Use soft straps and thick padding D. Label the splint with client's name and left-right and top-bottom instructions
answer
C
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An OTR® is completing a functional capacity evaluation (FCE) with a client with a history of upper-extremity trauma. During the FCE, the OTR® suspects the client is exaggerating the pain level and is not performing at maximum voluntary effort. Which symptoms would MOST LIKELY lead the OTR® to conclude the client's performance is not at maximum voluntary effort? A. Client reports that significant pain is present with most activities. B. Client reports that pain is radiating throughout the upper extremities. C. Client reports that pain increases with stress. D. Client exhibits increased heart and respiratory rate with exertion.
answer
A
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An OTR® asks a client with impaired balance to dust and polish a bookshelf in standing position without upper-extremity support. The OTR® notes no loss of balance during reaching and bending tasks. How would the OTR® appropriately grade the activity to provide the just-right challenge? A. Add bilateral weights to the client's wrists. B. Reduce the client's base of support. C. Have the client stand on a tilt board. D. Remove the client's assistive device from the work area.
answer
B
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Which recommendation should an OTR® make to the caregiver of a client with dementia who is suffering from caregiver stress? A. Recommend that the caregiver inquire about medication to reduce the caregiver's stress. B. Recommend that the caregiver inquire about additional sleep medication for the client. C. Recommend that the caregiver contact a local adult day care to inquire about its services. D. Recommend that the caregiver find a teenager in the neighborhood who can watch the client.
answer
C
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A 6-year-old child with autism is trying to shoot a ball through a goal 4 feet away. The child has made six attempts already and holds and shoots the ball with correct movements, but he does not seem to be able to calibrate the amount of motor input to approximate the goal. When the child shoots the ball, it always lands 4-5 feet short of the edge of the goal. What skill seems to be impaired for this child? A. Executional praxis B. Upper-extremity coordination C. Feed-forward praxis D. Eye-hand coordination
answer
C
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An OTR® works in an outpatient setting with clients with anxiety disorders. Which skills are MOST essential to the needs of this population? A. Coping skills B. Energy conservation C. Memory retraining D. Creative expression
answer
A
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An older adult client with a history of falls and glaucoma is referred to occupational therapy for evaluation and intervention. Which strategy should the OTR® teach the client to compensate for impaired vision due to glaucoma? A. Use a colorful, patterned tablecloth. B. Place dinner plate to the left of midline. C. Rotate head to choose clothing from a closet. D. Pour coffee into a dark colored mug.
answer
C
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An OTR® is treating a client after surgery for De Quervain's tenosynovitis. The client is employed as a receptionist in a dental office and will participate in a return-to-work program designed by the OTR®. Which option would be CONTRAINDICATED for treatment? A. Application of a resting hand splint at night to stabilize the affected joint B. Progressive AROM of the abductor pollicis longus and extensor pollicis brevis C. Instruction in proper body mechanics to avoid wrist ulnar and radial deviation D. Modifications including use of telephone headset and built-up handled pens
answer
A
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An OTR® is reviewing a chart on an infant who was referred to the developmental follow-up clinic. The OTR® notes that the mother transmitted syphilis to the baby during birth. Which impairments might be seen in the child? A. Poor bladder control B. Poor tolerance of passive range of motion C. Poor balance D. Poor feeding and vomiting
answer
B
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A client who has undergone electroconvulsive therapy (ECT) in the early morning arrives for an evening occupational therapy task group in an inpatient psychiatric unit. What is the OTR®'s BEST choice for working with the client at this time? A. Contact the nursing staff to escort the client back to the client's room. B. Remind the client of the need for 24 hours of bed rest after ECT. C. Invite the client to participate in a different group that focuses on reminiscence. D. Encourage the client to choose one of the available tasks to work on during the group.
answer
D
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An OTR® is adapting the environment to reduce the incidence of repetitive strain injuries among office workers. To maximize the effectiveness of the ergonomic program, what would the OTR® be MOST likely to include? A. Visual reinforcement with signs posted around the office and workstations B. Empowerment of the workers and creation of a positive group-safety culture C. A series of lectures and videos showing bad versus good workstation ergonomics D. Education of supervisors in how to identify noncompliant workers
answer
B
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An OTR® is assisting a client with an incomplete T2 spinal cord injury (SCI). The client is anxious and concerned about being able to live independently. Which response is the MOST accurate for the OTR® to give the client, based on the OTR®'s knowledge of the typical recovery pattern of a client with a T2 SCI? A. Suggest the client make arrangements for a long-term residential facility with support. B. Advise the client not to be concerned with the future and to concentrate on rehabilitation. C. Advise the client that recovery from SCI is often unpredictable, and people with SCI can live fulfilling, active lives. D. Suggest the client move to a supportive apartment when available to increase independence.
answer
C
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An OTR® is conducting an evaluation with a child on the pediatric intensive care unit. While observing the child's heart monitor, the OTR® notes that the child may be experiencing tachydysrhythmia and alerts the nurse immediately. What are the implications of tachydysrhythmia? A. The child's heartbeat is less than 60 beats per minute. B. The child has an atrioventricular block. C. The child's heart beat is between 200 and 300 beats per minute. D. The child has a pacemaker.
answer
C
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An OTR® is working with a high school student with juvenile rheumatoid arthritis (JRA). The OTR® suggests that the student stop using the arms and hands to carry heavy textbooks to class and instead use a backpack. What type of strategy did the OTR® recommend? A. The OTR® recommended an energy conservation strategy. B. The OTR® recommended a joint protection strategy. C. The OTR® recommended a work simplification strategy. D. The OTR® recommended a pacing strategy.
answer
B
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An OTR® working with an adult client with major depression in an inpatient setting assesses the client to determine the impact of occupational and environmental demands on performance of daily occupations. What is most likely to be the OTR®'s PRIMARY theoretical approach to designing an intervention? A. Modifying the environment or the occupation to reduce demands, address personal goals, and use developed skills B. Facilitating age-appropriate occupation through motivation and habit formation C. Exposing underlying conflicts from early childhood relationships that impede current engagement in occupations D. Challenging ineffective adaptive responses and focusing on enhanced occupational adaptation
answer
A
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Which of the following is considered an area of occupation, as described in the Occupational Therapy Practice Framework? A. Space demands B. Hearing functions C. Rest and sleep D. Habits
answer
C
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A client is being treated for an extensor tendon repair in Zone VI of the middle finger proximal to the juncturae tendinum. Which orthosis would be MOST appropriate? A. Hand based, including only the middle finger B. Forearm based, including only the middle finger C. Hand based, including the middle, ring, and index fingers D. Forearm based, including the middle, ring, and index fingers
answer
D
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A 4-year-old client sustained full-thickness burns on the volar surfaces of both wrists and forearms 4 months ago. In spite of using pressure garments and splinting for position, the child has developed thick scars across the wrists. Active and passive wrist flexion and extension are, respectively, as follows: right, 70/25 and 80/40; left, 70/30 and 85/50. Which activity would be MOST EFFECTIVE in improving wrist mobility? A. Finger painting on a vertical surface B. Crawling though a tunnel maze C. Playing an X-Box bowling game D. Throwing bean bags through vertical targets
answer
B
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Parents of children with disabilities often report socioeconomic as well as personal challenges to involving their children in community-based physical activity programs. Which example represents a socioeconomic issue that needs to be considered when planning a community-based physical activity program? A. Some children have disabilities that don't allow them to be physically active. B. Parents of children with disabilities may prefer home-based activities to protect their children from harm. C. Transportation costs or availability can prevent access to community-based programs. D. Some facilities that sponsor physical activity programs may not be accessible to children with disabilities.
answer
C
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During a commode-to-bed transfer, the client begins to slip from the OTR®'s grasp. What action is best for the OTR® to take? A. Continue with the transfer, and try to get the client to the bed as quickly as possible. B. Have the client return to the commode. C. Ease the client to the floor, then get assistance. D. Call for help, and get the attention of the client's nurse.
answer
C
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An OTR® working at a rehabilitation hospital is given orders for a client who recently underwent a right hip replacement. The OTR® notices a foam wedge between the client's legs. What is the wedge meant to prevent? A. Adduction of the client's lower extremities B. Abduction of the client's lower extremities C. Internal rotation of the client's lower extremities D. External rotation of the client's lower extremities
answer
A
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An OTR® is working with a client with Alzheimer's disease (AD) in a skilled nursing facility. The client's adult child, who is the client's primary caregiver, appears to be stressed and fatigued and has asked the OTR® for advice about how to best manage the parent's progressive decline in function. What would be the BEST approach the OTR® could use? A. Refer the caregiver to a physician for treatment. B. Refer the caregiver to the social worker for community resources. C. Provide the caregiver with education about the progression of AD. D. Suggest that the caregiver use the massage services at the facility.
answer
C
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An OTR® is preparing to perform bedside ADLs with a client with spinal cord injury. As the OTR® assists the client into a sitting position, the client reports dizziness and nausea. What action is the MOST APPROPRIATE for the OTR® to take? A. Assist the client in returning to a reclining position and elevate the client's feet. The OTR® should alert the client's nurse and physician as soon as possible. B. Place the client upright, remove restrictive devices, and check the client's catheter. The OTR® should alert the client's nurse and physician as soon as possible. C. Ensure the client is seated and quickly leave to alert the nurse or physician. D. Encourage the client to remain seated, with assistance, and wait for symptoms to pass. The OTR® should alert the client's nurse and physician as soon as possible.
answer
A
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An OTR® receives a referral to complete a job demand analysis on a client who is a diesel mechanic. At the job site, what should the OTR® do FIRST? A. Assess the design of the workstation. B. Conduct interviews with staff at the work site. C. Assess the client's material handling skills. D. Complete force gauge measurements on all equipment.
answer
B
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A team of OTR®s begins to recognize the need for a program to promote work participation for the young adults with mental illness they serve. Which statement MOST accurately reflects the evidence about developing such a program? A. Prevocational training sufficiently prepares clients with mental illness for work. B. Supported employment programs with a "place-and-train" perspective are more effective than other vocational approaches. C. Transitional employment placement through a clubhouse model is a time-honored method for increasing job placement. D. Sheltered workshops are useful programs for advancing work participation.
answer
B
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Why might a client with early-stage dementia appear rigid in routines? A. The client may be compensating for memory loss. B. The client may be compensating for decreased orientation. C. The client may be compensating for decreased spatial orientation. D. The client may be compensating for decreased temporal organization.
answer
A
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What law allows in-school occupational therapy services to be provided? A. Individuals With Disabilities Education Improvement Act of 2004 (IDEA), Part B B. Medicare Part C C. Health Insurance Portability and Accountability Act of 1996 (HIPAA) D. TRICARE
answer
A
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An OTR® is working with a client in the active phase of C8 spinal cord injury. What is the BEST method of preventing heterotopic ossification in the client? A. Low-load prolonged stretch B. Maintenance of joint ROM C. High-low limited stretch D. Application of leg wraps
answer
B
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An OTR®® in an outpatient psychosocial program sets goals with a client to improve motivation for completing basic ADLs every day, resume daily community activity, and medication management of sertraline (Zoloft). The therapist is MOST likely working with a client with what diagnosis? A. Obsessive-compulsive personality disorder (OCD) B. Schizophrenia C. Major depression D. Substance abuse disorder
answer
C
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Which assessment would an OTR® administer to assess a client's ability to visually scan information using central and peripheral vision and to process that information in a timely fashion? A. Useful Field of View B. Symbol Digit Modalities Test C. Trail Making Test, Parts A and B D. Letter cancellation test
answer
A
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Using the Allen Cognitive Level Screen-5 for screening, followed by use of the Allen Diagnostic Module and the Routine Task Inventory for confirmation of screening results, an OTR® identifies Level 4 as the current level of functioning of a client in an adult day treatment center. What is the MOST appropriate scenario for activity completion for this client? A. The task includes mostly familiar steps but also one step requiring new learning. B. The project and tasks involved are relatively unstructured. The client is given opportunities to find and revise errors. C. A model of the completed project is provided for the client to imitate. Simple instructions are provided. D. The project is designed to encourage relatively independent planning and organizing to complete tasks.
answer
C
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An OTR® is working with a client who has sustained a low ulnar nerve injury to the hand. The client has been instructed in visual protection of the hand. Over the weekend, the client experiences burns to the injured hand. What area of the hand would have been burned? A. Radial side of the hand B. Thumb and index fingers C. Ulnar side of the hand D. Index and middle fingers
answer
C
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An OTR® is using an adaptive approach with a client returning to work after bilateral carpal tunnel release surgery 6 weeks ago. The client works as a supermarket checker. Which job task modification incorporates an adaptive approach? A. Handheld barcode scanner B. Strengthening exercise using 2-pound weight C. Adjustable-height stool at the cash register D. Upper body stretching breaks every hour
answer
A
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An OTR® is performing caregiver training for a client with Stage 3 Parkinson's disease (PD) and family members because of the client's emerging need for increased assistance with ADLs and mobility. Which instruction would MOST appropriately help family members deal with a freezing episode? A. Educate the family to have the client silently count each step while walking. B. Recommend that the family use a rhythmic beat to each step as they walk with the client. C. Advise the family to place vertical strips on the floor where freezing episodes are likely to occur at home. D. Encourage the family to give the client tactile cues to promote weight shifting to resume walking.
answer
B
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An OTR® is working with a 4-year-old on increasing independence with toileting at school. The child's parents indicate that toileting is also a problem at home. Which strategy would help the child to carry over what has been learned at school to home? A. Provide the parents with information about when other children with autism have mastered toileting. B. Provide the parents with the names and phone numbers of other parents of children with autism who have already mastered toileting. C. Provide the parents with an exact copy of the child's toileting picture checklist that is used at school. D. Provide the parents with a description of how the school's bathroom is set up.
answer
C
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An OTR® is establishing an occupational therapy group in a state correctional facility for clients with schizophrenia who are the parents of small children. What area of focus would be MOST important for a group in this setting? A. Psychoanalytic intervention B. Skills in performing ADLs and IADLs C. Strength and endurance training D. Visual-motor skill remediation
answer
B
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An OTR® in an inpatient facility is working with an adolescent with major depression who repeatedly expresses feelings of worthlessness and poor self-concept. What therapeutic activities will BEST address this client's self-concept issues? A. Activities that establish normal daily routines B. Activities that engage the client socially C. Activities that do not require too many choices D. Activities that allow for self-expression
answer
D
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An OTR is working with a client who has undergone a carpal tunnel release. The client describes postoperative pain on either side of the carpal tunnel that makes it difficult to grasp objects. What is the term for this type of pain? A. Pillar pain B. Chronic pain C. Phantom pain D. Complex regional pain
answer
A
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An OTR® is evaluating a 4-year-old child with autism. At the gym, the child appeared very guarded with movement and does not want to climb the stairs, try the swing, or use the mini seesaw. When the OTR® encourages the child to jump on the trampoline, the child runs to the mother and cries. What is the MOST likely reason for these behaviors? A. Tactile defensiveness B. Vestibular bilateral integration problems C. Gravitational insecurity D. Dyspraxia
answer
C
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A client had a complete median nerve laceration at the wrist of the dominant hand 3 weeks ago. Which intervention activity should be included as part of the INITIAL phase of the client's sensory reeducation program? A. Instruction in visual compensatory strategies to use during daily tasks B. Application of deep pressure, rubbing, and tapping of the involved digits C. Desensitization by rubbing the fingertips with a variety of textures D. Identification of familiar objects hidden in a bucket of uncooked rice
answer
A
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What strategy might an OTR® appropriately recommend to caregivers of a client with Alzheimer's disease to assist with fall prevention? A. Engage the client in daily, structured activity. B. Provide visual reminders in the home environment. C. Install grab bars in the bathroom. D. Engage the client in an exercise program.
answer
A
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An OTR® is working at an after-school program connected to a women's homeless shelter. The OTR® is engaged in a conversation with the mother of a 10-year-old boy; she says that the child has recently loss quite a bit of weight and is excessively thirsty. To which specialist should the child be referred? A. Pediatrician B. Endocrinologist C. Neurologist D. Audiologist
answer
B
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A client working at a clothing boutique has made progress in completing simulated work tasks but is still unable to resume the prior work status. The OTR® suggests that the client return to work on a light duty schedule. Which consequence is MOST likely to result when a client returns to work on light duty? A. The client learns how to push through the pain. B. The employer has lower workers' compensation costs. C. The client's confidence in his or her abilities to complete job tasks increases. D. The client receives higher ratings on the reevaluation assessment.
answer
C
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An OTR® is ordering a wheelchair for a client with bilateral transfemoral amputations. The client does not have prostheses and has no intention of using prosthetic limbs in the future. Based on this information, which design feature would be MOST BENEFICIAL to include as part of the wheelchair prescription? A. Backrest with vertical zipper B. Anti-tipping attachments C. 5-inch (8-cm) diameter pneumatic front casters D. Adjustable cushioned arm rests
answer
B
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The OTR® wants the client's caregiver to complete a proxy assessment of the client's driving skills. What assessment would be BEST for the caregiver to complete? A. AARP Driver Safety Course B. Driving Habits Questionnaire C. SAFER Driving: The Enhanced Driving Decisions Workbook D. Fitness-to-Drive Screening Measure (previously known as the Safe Driving Behavior Measure)
answer
D
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Recipients of Medicaid may be eligible for subsidized transportation for health care and life maintenance trips. Why is it important for occupational therapy practitioners to be aware of this possibility? A. Most occupational therapy clients are funded by Medicaid. B. People with disabilities are disproportionately represented among Medicaid beneficiaries. C. Public transportation providers do not accept Medicaid vouchers for transportation. D. Medicaid covers transportation only to physician visits and not to therapy appointments.
answer
B
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A client with a recent diagnosis of dementia is receiving occupational therapy. The caregivers are most distressed about significant behavioral changes that have occurred since the client was diagnosed. The client has become increasingly impulsive and difficult to redirect. What type of dementia does this client MOST LIKELY have? A. Frontotemporal dementia B. Alzheimer's dementia C. Vascular dementia D. Dementia with Lewy bodies
answer
A
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An OTR® is working with a driver poststroke who has poor ocular motor skills. Which compensatory approach is MOST APPROPRIATE for this client? A. Awareness training B. Instruction in visual search patterns and efficient scanning techniques C. Adapting side mirrors to deflect bright lights from other vehicles D. Using a voice-activated GPS to compensate for way-finding problems
answer
B
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A client sustained facial burns that required several grafting surgeries. An OTR® is seeing the client in an outpatient setting 6 months post surgery. The client wishes to go out to lunch with a friend but is fearful of participating in this social activity. What treatment intervention would be MOST beneficial for this client? A. Advise the client to wear a facial pressure garment in public and practice putting it on, eating, and taking it off in the clinic B. Have the client participate in activities that can restore confidence and self-esteem, such as applying theater-type full-coverage makeup C. Advise the client to wear a clear facial mask in public and carry a letter from the physician indicating that the client has facial burns D. Have the client participate in stretching activities to improve movement of the facial muscles
answer
B
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An OTR® is working with an 8-year-old client with developmental coordination disorder (DCD) in an outpatient clinic. Which option reflects the difficulty that this child may experience at school as a result of this condition? A. The child may have difficulty with handwriting because of limited fine motor skills. B. The child may have difficulty socializing with peers as a result of limited language skills. C. The child may have difficulty attending to instruction because of limited self-regulation skills. D. The child may have difficulty locating a word in the dictionary because of limited visual-perceptual skills.
answer
A
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An OTR® has received a consult for a client experiencing lower back pain, particularly after waking in the morning. What is the MOST APPROPRIATE recommendation regarding the client's sleeping? A. Sleep on back with pillow under knees B. Purchase a thick, cotton pillow C. Sleep on stomach with pillow under knees D. Purchase a pillowtop mattress
answer
A
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An OTR® has received a referral for a student diagnosed with autism spectrum disorder. The teacher provides information indicating that the student may have tactile defensiveness. On beginning the assessment, the OTR® brushes against the student's arm, and the student pulls away. Which assessment would most effectively enable the OTR® to test the tactile defensiveness hypothesis? A. Occupational Self-Assessment B. Sensory Profile C. Semmes-Weinstein monofilament test D. Kohlman Evaluation of Living Skills
answer
B
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An OTR® working in a neurology unit was referred a client with low back pain. During the interview, the client confides that stressful life events have recently been prominent in the client's life. The client added that the low back pain started after the stressful life events. Malingering and fear of illness do not seem to be a part of this scenario. What is the client's likely diagnosis? A. Low back pain B. Factitious disorder C. Histrionic personality disorder D. Conversion disorder
answer
D
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Back pain injury reports from workers at a bicycle manufacturing company have increased. Management is seeking an OTR®'s recommendations for redesigning the work environment using engineering controls, particularly to reduce awkward postures and repetitions on the assembly line. Which recommendation is the BEST engineering control to redesign the work environment for this organization? A. Place bicycles on a wheeled platform for movement along the assembly line. B. Slow the speed of the assembly line so workers have more time. C. Implement stretch breaks every 45 minutes to improve posture. D. Enforce a work safety policy that requires workers to wear a back support.
answer
A
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An OTR® is working in a pediatric developmental follow-up clinic and learns that a new client has a diagnosis of congenital club hand. When the child and the parent enter the room, the OTR® attempts to gain more information about the client's diagnosis through observation. For what should the OTR® be looking? A. Partial or full absence of the capitates and hamate and muscle hypertrophy B. Dislocation of the humerus and signs of nerve damage C. Bony malformations and underdeveloped musculature D. Partial or full absence of the radius and bowing of the ulnar shaft
answer
D
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The extremities of a client with brain injury in an acute care unit are in a position of spastic extension, adduction, and internal rotation. The client is displaying symptoms of which condition? A. Decorticate rigidity B. Torticollis C. Decerebrate rigidity D. Athetosis
answer
C
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An OTR® in an inpatient facility is conducting a cooking activity to teach effective coping skills to a small group of adolescents. A group member becomes frustrated with a teammate and is angry and verbally threatening. What is the BEST response in this situation? A. "I see that you're becoming upset by your teammate. Let's calm down and breathe for 10 seconds." B. "You seem to be getting upset by your teammate. Verbally threatening is not a good behavior to show others." C. "I need you to stop, pause for a while, and calm down." D. "You seem really upset right now. Would you want to take a minute to calm down or just go back to your room for now?"
answer
D
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A client with advanced amyotrophic lateral sclerosis (ALS) is new to a computerized communication device. On what would the OTR® treating this patient focus? A. Positioning, to ensure proximal support on a lap tray B. ROM exercises, to enable the patient to adequately reach the device C. Trunk strengthening, to enable upright sitting during use of the device D. Adapting the device with larger buttons and controls, to enable independent use
answer
A
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A newly certified OTR® wants to provide occupational therapy coverage on an "as-needed basis" at a medical center burn unit. What should the OTR® expect the facility to provide in order to promote continuity of care for these services based on best practice standards? A. Funds to attend professional development classes to learn about evidence-based burn care B. Availability of burn-care protocols currently used for patients with thermal injuries C. Options for establishing service competence for completing clinically based processes and procedures on the unit D. Written communication from the primary therapist in advance of the coverage date outlining patient care routines
answer
C
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During the OTR®'s initial interview, a client with Stage 2 Parkinson's disease (PD) explains the importance of the client's role as head of household and expresses a fear of being dependent on his or her children. The client's chief complaints are tremors and fatigue, which are starting to affect the client's performance of higher level ADL and IADL tasks. Which intervention should be the OTR®'s focus? A. Energy conservation education, such as delegating tasks to family members to reduce fatigue B. Stress management skills, because stress tends to exacerbate symptoms such as tremors C. Activity and environmental modifications for home management skills to successfully maintain the client's role D. Therapeutic exercise to improve balance, which will enhance the client's participation in higher level tasks
answer
C
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An OTR® in an inpatient setting is inviting an adolescent with major depression to participate in an individual treatment session. The adolescent has refused to participate for 3 days, claiming not to feel well. How should the OTR® BEST respond? A. "I think that participating in occupational therapy will make you feel a lot better." B. "I noticed you've been feeling like this for 3 days straight now, and it might be helpful for you to participate in occupational therapy." C. "I can see that you aren't feeling well. Let's try doing something you like that will not take too long and see what happens." D. "I can see that you aren't feeling well, and I'm sorry for this. Can we try again tomorrow?"
answer
C
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A cabinetmaker is referred to occupational therapy with a recent onset of stenosing tenosynovitis of the right middle and ring fingers. The client has a history of rheumatoid arthritis. As part of the ergonomic education, what will the OTR® MOST likely include? A. Prevent static wrist positioning, hold tools close to the fulcrum, and use a thick protective glove. B. Reduce use of excessive gripping force, prevent contact stress, and implement task rotation. C. Stenosing tenosynovitis is common in rheumatoid arthritis; no ergonomic education is needed D. Switch to manual tools to reduce vibration from power tools and conduct a regular tool check for wear and tear.
answer
B
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A client did not attend the occupational therapy session because of an illness. According to the Guidelines for Documentation of Occupational Therapy, what is the BEST type of documentation to note nonattendance in a timely manner? A. Reassessment report B. Service contact C. Plan of care D. Monthly progress report
answer
B
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An OTR® is conducting a group for older adult clients on preparation for driving cessation. Several group members express a fear of using public transportation because they have never done so. Which action would BEST address these clients' stated needs? A. Referrals to a psychologist to address issues of fear and anxiety regarding public transportation B. Driving evaluations to ensure that the clients can continue to drive for as long as possible C. Travel training to practice use of public transportation with the clients until they feel comfortable on their own D. Simulation of public transportation by driving the clients along the same routes used by the transit system
answer
C
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An OTR® is working with an adult client with sensory processing difficulties who finds it uncomfortable to commute to a job via train because of the noise of the train and of other passengers talking. Which environmental modification would allow the client to continue to commute and maintain employment? A. Encourage the client to obtain a driver's license and avoid train travel B. Petition the train system to allow the client to occupy a compartment alone and ask others to sit elsewhere C. Recommend the use of noise-cancelling headphones with a device that plays music or books the client enjoys D. Assist the client in seeking employment closer to home to avoid train travel
answer
C
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An OTR® needs to categorize the driving behaviors of a client with Parkinson's disease. Using Michon's (1985) Hierarchy of Driving, in which three categories will the OTR® review the client's driving behaviors? A. Motor skills, cognitive skills, and visual skills B. Concentration, attention, executive function C. Strategy, tactic, and operation D. Person, vehicle, environment
answer
C
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Older adults who are familiar with using public transportation and enjoy it as an affordable and accessible alternative to driving may have concerns about their personal safety while traveling, particularly if their functional abilities are changing. How might an OTR® collaborate with well elders to address personal safety concerns at the level of community? A. Refer the older adults for individual therapy sessions to improve their functional abilities B. Partner with older adults to advocate for strategies to improve the safety of waiting areas and vehicles C. Write a letter on behalf of the older adults to the transportation authority stating the concerns the older adults reported D. Encourage the older adults not to use the public transportation system and instead to ask for rides from friends and family
answer
B
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An OTR® is working in a lower socioeconomic status school district that offers developmental screenings to all 3-year-olds whose parents can prove residency. As part of the process, the OTR® screens for Duchenne's muscular dystrophy (DMD). Which activity would alert the OTR® to the need to refer the child to a specialist? A. A positive Gower's sign B. Abdominal distention C. Excessive bruising D. A positive Trendelenburg's sign
answer
A
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What is the first course of action an occupational therapy practitioner should take to begin to resolve an ethical dilemma? A. Formulate possible resolutions to remediate the dilemma. B. Identify the resources available to resolve the dilemma. C. Report the ethical dilemma to the state regulatory board. D. Determine whether an ethical violation has occurred.
answer
D
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An OTR® is establishing reasonable accommodations for a client diagnosed with osteoarthritis in the left shoulder. The client is employed as a plumber. Essential job functions include reaching, bending, crawling, lifting, pushing and pulling, using tools, and lifting materials weighing 25-50 lb. Which accommodation is MOST appropriate for the OTR® to recommend? A. Provide the client with modified-handle tools to reduce torque on the shoulder joint. B. Allow the client a flexible work schedule and use of leave time as needed. C. Ensure materials and equipment are within functional reach. D. Recommend use of wheeled cart to transport tools.
answer
B
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An OTR® is working with an infant on learning how to transition from sitting to kneeling. Which activity would be the most appropriate to achieve this outcome? A. Place a toy on the kitchen table. B. Place a toy on the caregiver's lap. C. Place a toy on a low coffee table on the other side of the room from the child. D. Place a toy on a surface that cannot be reached in sitting.
answer
D
question
An entry-level OTR® working in an outpatient rehabilitation clinic is evaluating a client who was recently hospitalized for dehydration and subsequently diagnosed with mild cognitive impairment. The client lives alone in an independent living facility. Before admission, the client was independent in ADLs and light homemaking and active in community and social activities, including driving independently. The client reports no crash record and no violations or citations but avoids night driving, highway driving, and driving in rush-hour traffic or heavy rain. After the initial evaluation, the OTR® determines that the client requires a complete clinical and road evaluation to determine the client's driving skills. To whom should the OTR® refer the client? A. Case manager, for discharge planning and reintegration into the independent living facility B. Certified driving rehabilitation specialist, for a comprehensive driving evaluation C. Department of Motor Vehicles, for license retesting D. Neuropsychologist, for cognitive testing
answer
B
question
Which option can be viewed as a critical comprehensive priority for an OTR® who seeks to optimize community mobility for a client? A. Stay abreast of legislation and policy that influence independence in societal participation, community mobility and alternative transportation options. B. Attend continuing education seminars, and conferences on transportation to ensure up to date knowledge of community mobility practices. C. Include community mobility in the initial evaluation and intervention planning; and include actual or simulated practice in using community mobility options. D. Consult with the driver rehabilitation specialist, transportation providers, and volunteer driver organizations on a regular basis.
answer
C
question
An OTR is working with a client who has been in a motor vehicle accident. The client has sustained flexor tendon injuries to the index and middle fingers and also presents with a median nerve injury. Which flexor tendon zone corresponds to this client's injuries? A. Zone I B. Zone II C. Zone III D. Zones IV and V
answer
D
question
A 4-year-old child with attention deficit hyperactivity disorder is using a tire swing for vestibular input to feel more organized. After a few minutes, the child appears to have some autonomic reactions to the fast swinging. Which course of action for the OTR® is BEST? A. Immediately ask the child to stop and sit in a corner to relax B. Ask the child to slow down the swinging by pulling a trapeze bar for proprioceptive input C. Ask the child to slow down while doing slow, deep breathing D. Let the child continue because the vestibular stimulation ceases with autonomic activation
answer
B
question
An OTR® completes a job demand analysis for the job requirements of a printer position. The OTR® determines that the job requires 95% of time spent in standing; the pacing of the job is predetermined by the printing rate of the machine, and the worker lifted as much as 30 pounds occasionally and 15 pounds frequently. According to the definitions of overall level of work, what type of work is the printer position? A. Sedentary B. Light C. Medium D. Heavy
answer
C
question
An OTR® is working with a client diagnosed with depression who does not seem to care about fulfilling the roles as a parent to teenage children and friend to a person who also is struggling. Additionally, this client does not show an interest in returning to work or singing in the choir at church. Which assessment would help the OTR® explore a hypothesis that the client is devaluing these roles? A. Work Environment Impact Scale B. Role Checklist C. Comprehensive Occupational Therapy Evaluation D. Performance Assessment of Self-Care Skills
answer
B
question
A sales associate for a pharmaceutical company developed bilateral carpal tunnel syndrome 3 months ago. During an occupational interview, the OTR® finds out that the associate has recently switched from a sedentary office job to a job that requires frequent traveling. On average, the sales associate visits five to seven medical offices per day, using a rolling briefcase that weighs about 15 pounds. The sales associate uses a laptop computer in different environments, often including countertops at medical offices. The associate also uses the laptop at home several hours per day on the kitchen counter. What work-related factor would the OTR® MOST likely describe as the main contributor to the sales associate's carpal tunnel syndrome? A. Inappropriate height for the laptop computer on different countertops B. Lifting the rolling briefcase in and out of the car C. Lifting the laptop computer in and out of the briefcase D. Excessive and sustained gripping on the steering wheel of the car
answer
A
question
Six weeks after a wrist sprain, a client was diagnosed with complex regional pain syndrome (CRPS), Type 1. The client is employed as an electromechanical equipment assembler. The client is able to perform all ADLs and light meal preparation. The client reports previously enjoying baking and being unable to bake since the injury. The client's pain increases to 6 or higher on a 0-10 scale while using the hand. The skin presents with mild discoloration of the dorsal surface of the wrist. What should the OTR® FIRST include when establishing the client's work conditioning program? A. Kneading bread dough B. Upper-extremity PROM exercises C. Stress-loading tasks D. Progressive resistive exercises
answer
C
question
A client is receiving occupational therapy after a right total hip arthroplasty. How would an OTR® using fading techniques to BEST address lower-body dressing tasks? A. Educate the client on the benefits of using a reacher to assist in donning pants and then allow the client to learn from his or her mistakes. B. Demonstrate the use of adaptive equipment and elastic shoelaces to don sneakers, then count the needed verbal cues the client requires to complete the task. C. Instruct the client to dress the right leg first and undress the right leg last, and observe for carryover. D. Offer a visual demonstration of how to use a sock donner, verbally cue the client on first attempts, and lessen cues with additional trials.
answer
D
question
The OTR®'s next client has macular degeneration in both eyes. To prepare the treatment environment for this client, which course of action should the OTR® take? A. Close the blinds and the curtains. B. Sit directly in front of the client. C. Increase lighting and avoid glare. D. Place dark objects on a black table.
answer
C
question
An OTR® is performing a presurgical intervention with a client who will undergo hip replacement surgery in a few days. Which recommendation regarding sleep positioning is MOST appropriate? A. The client should sleep in the most comfortable position that is pain free. B. The client should sleep in supine position with a wedge or pillow in place. C. The client should sleep in prone position with a wedge or pillow in place. D. The client should sleep in side-lying position.
answer
B
question
An OTR® is completing a wheelchair assessment for an adult client who has progressive cerebellar degeneration and requires the use of a power wheelchair for mobility. What type of control switch would be MOST BENEFICIAL for enabling this client to independently operate the wheelchair? A. Sip and puff B. Joystick C. Chin-activated toggle D. Proximity-sensing microswitch
answer
A
question
An OTR® is working in a preschool with a child who has a developmental delay in toileting. The child is beginning to show interest in toileting and can stay dry for more than 2 hours at a time. What is the next "just-right" challenge for this child? A. Moving the bowels regularly B. Wiping independently after having a bowel movement C. Managing clothing during toileting D. Telling someone when he or she has to go to the bathroom
answer
D
question
An OTR® is working with a client with a transtibial lower limb amputation to develop a prosthetic wearing schedule. The client has been gradually increasing wear time from 15 minutes to 1 hour in 15-minute increments. However, after 1 hour of wear, they notice a reddened area on the residual limb that remains for 45 minutes after removing the device. What is the BEST course of action to take? A. Cut the wear time back to 30 minutes and gradually increase it, using 10-minute increments. B. Add additional socks to better pad the prosthetic device. C. Contact the prosthetist to adjust the device to improve the fit. D. Educate the client on proper residual limb care to prevent skin breakdown.
answer
C
question
An OTR® is working with a client diagnosed with fibromyalgia who is experiencing disturbed sleep patterns. Which cognitive areas of functioning are disturbed sleep patterns MOST likely to interfere with? A. Arousal and orientation B. Sequencing and categorization C. Initiation of movement and language D. Attention span and short-term memory
answer
D
question
Which of the following goals would be appropriate for an client with mild dementia? A. Client will improve money management skills to independent as evidenced by paying five of five bills on time in 30 days. B. Client will verbalize with 100% accuracy the names of at least four family members once cued when looking at family photos. C. Client will maintain good safety during independent light meal preparation while using visual cues for sequencing as needed. D. Client will improve bathing to independent while using adaptive equipment for safety.
answer
C
question
An OTR® is working on life skills with a teenager who has achondroplasia. Which of the following tasks might pose a challenge for the client? A. Reaching an upper cupboard to obtain a box of cereal B. Transporting silverware from the dishwasher to the silverware drawer C. Sweeping the kitchen floor after a meal D. Making toast using a toaster
answer
A
question
An OTR® is working with a client 8 weeks after a unilateral traumatic transtibial amputation. The client's residual limb is well healed, and the team has identified prosthetic fitting and training as the next step. The client wants to use a prosthesis but indicates that the residual limb is not healed enough and is fearful about wearing it. The client's mother currently performs all limb care, including washing, dressing, and wrapping. What is the BEST strategy to progress the client to prosthetic training? A. Have the prosthetist make the client a prosthesis and implement a wearing schedule. B. Recommend that the client wait another month and then return for prosthetic fitting and training. C. Have the client talk with other clients who have similar amputations. D. Refer the client for psychiatric evaluation and treatment.
answer
C
question
A student in the third grade with a learning disability has attended school-based occupational therapy for several years to improve visual-perceptual skills for completing curriculum-based school work. The latest update report to the parents indicates the student is not making progress toward the stated Individualized Education Program (IEP) goals. This report is similar to the previous two reports. What action should the OTR® take NEXT to address the lack of progress? A. Continue occupational therapy intervention knowing that developmental progress due to maturity is still possible. B. Discuss alternative classroom modifications and adaptations with the student's teacher. C. Request the special education team schedule an interim meeting to modify the student's IEP. D. Send a letter to the student's parents informing them that occupational therapy is no longer beneficial to their child.
answer
B
question
According to the Standards of Practice for Occupational Therapy, which task can the COTA® can complete in the evaluation process? A. Respond to the initial referral request. B. Interpret and document the evaluation results. C. Perform delegated assessments using current tools. D. Make recommendations to other professionals.
answer
C
question
rticipating in outpatient occupational therapy and is able to complete activities in the 1-3 metabolic equivalent (MET) range. Dyspnea and angina limit physical activity above 5 METs. Which activity is safe to include as part of the initial intervention for this client? A. Completing self-care tasks including dressing, bathing, grooming, and hygiene for 5-minute intervals each with 1-2 minutes rest between activities B. Participating in very light stationary biking for 5 minutes with a short rest of 1 minute and then standing to pack moderate weight items into boxes for 5 minutes C. Pedaling a stationary bicycle for several 5-minute intervals followed by a 1- to 2-minute rest between interval and continuing with 5-minute intervals until fatigued D. Walking on a treadmill at 10 miles per hour (16 km per hour) for 5 minutes followed by a 1- to 2-minute rest, then walking on treadmill at 5 miles per hour (8 km per hour)
answer
B
question
A client sustained a peripheral nerve injury 6 months ago and has regained initial perception of moving and constant touch stimulation at the fingertips. The OTR® is selecting activities for a graded tactilekinesthetic training program for the client. Which type of activity would be MOST BENEFICIAL to include as part of this program at this phase of the client's recovery? A. Manipulating common objects with eyes open then with eyes closed B. Locating small objects hidden in containers of contact particles C. Identifying shapes and textures of common objects with vision occluded D. Rubbing a variety of textures in succession across the fingertips
answer
A
question
An OTR® is working with a child with hemiplegia on the playground. On the basis of this condition, with which playground activity might the child have difficulty? A. Watching classmates play kickball. B. Inviting a friend to play on the swings. C. Lining up to go in from recess. D. Playing catch with a ball.
answer
D
question
The Safe, Accountable, Flexible, Efficient Transportation Equity Act (Pub. L. 109-59) was signed into law in 2005. What is the basic premise of this law? A. This law includes providing transportation benefits to optimize access to the workplace and assumes that lack of transportation is a major barrier and challenge in sustainable employment. B. That people who can access fixed-route public transportation may travel more successfully compared with those who do not have such access. C. That state and local transportation decision makers play a role in bringing attention to safety concerns related to individual users of different transportation modes D. That people who can access public transportation in a sustainable fashion, are more likely to be successful in welfare-to-work initiatives.
answer
C
question
An OTR® receives a referral to evaluate a client with Alzheimer's disease. The client is difficult to redirect while performing the assessment. What would be the BEST approach for the OTR® to use to gather appropriate information to complete the assessment and guide intervention planning? A. Decide that it is not the appropriate time to complete the assessment; plan to return later in the day. B. Talk to the physician about the client's inability to maintain attention to the assessment. C. Explain to the family members that they should contact the OTR® when the client is able to participate more fully in the assessment. D. Observe the client's behavior and reactions to environmental stimuli to gather information for the assessment.
answer
D
question
According to AOTA and the Occupational Therapy Practice Framework: Domain and Process, which clinical occupational engagement treatment session would be considered to include an inappropriate use of physical agent modalities? A. Application of a hot pack to the hand followed by an activity that involves making a cord bracelet B. Use of fluidotherapy for the upper extremity followed by passive stretch C. Use of a transcutaneous electrical nerve stimulation unit for the back during homemaking activities D. Use of a cold pack to the elbow after a game of checkers
answer
B
question
An OTR® is providing a back injury prevention program for workers at a food manufacturing plant. The OTR® has provided education in proper body mechanics and on proper equipment use to decrease effort with tasks. Which component should the OTR® also include in the program? A. Support group B. Functional capacity evaluation C. Instruction in the use of physical agents D. Training in symptom identification
answer
D
question
Many occupational therapy clients who can no longer drive are referred to public transportation programs. Clients from rural areas, however, may not be served by public transportation of any form. Approximately what percentage of the U.S. rural population does NOT have access to public transportation? A. 5% B. 25% C. 50% D. 75%
answer
D
question
An OTR® is working with a client with chronic obstructive pulmonary disease on therapeutic exercise and how to measure exercise tolerance. The client is performing seated bilateral shoulder flexion with 3-lb weights and rates this activity as "very, very easy." How would the OTR® appropriately grade this activity? A. Change the muscle groups used by switching to shoulder abduction. B. Advise the client to perform the task in a standing position. C. Switch the client to a resistance band. D. Increase the number of repetitions and have the client perform the exercises while standing.
answer
B
question
An OTR® is working with a client who works on an assembly line. The client presents with symptoms of cubital tunnel syndrome. In educating the client, what position does the OTR® advise the client to avoid? A. Sustained elbow extension B. Sustained elbow flexion C. Sustained wrist extension while making a fist D. Sustained wrist flexion while making a fist
answer
B
question
An OTR® is assessing a client for safety in community mobility. The client is using a front-wheeled walker (FWW) and had a left total knee replacement 10 days ago. What client ability is the MOST important area to address in the assessment? A. Carrying a grocery bag safely while using the FWW B. Checking for traffic before crossing any intersection C. Handling the FWW while going up and down the curb in front of the building D. Crossing the crosswalk in a timely manner before the light changes
answer
D
question
A person with Level 1 autism spectrum disorder without intellectual impairment (Asperger syndrome) is having difficulty in the transition to a new adult foster care home, and an OTR® is contracted to make four home visits to assess the client and provide appropriate intervention. When the OTR® arrives for the first visit and attempts to interview the client, the client angrily refuses to speak with the OTR®. Which option is BEST in response? A. Stay long enough to convince the client to cooperate so that the placement can be successful B. Engage the client in a favorite game and convince the client to work together C. Leave the home, allowing the client to refuse occupational therapy services D. Tell the client that the OTR® will stop hassling the client after four visits
answer
C
question
Which strategy should the occupational therapy practitioner keep in mind when preparing a handout for an older adult with low vision? A. Print the handout in regular-size type on light-colored paper. B. Use a large, dark font on white paper. C. Make sentences short and use a vocabulary appropriate for 8th graders. D. Keep the handout to only one page and place it in a notebook.
answer
B
question
An occupational therapist is working with a child with dysgraphia on school work. Which intervention strategy might the OTR® use? A. Provide the child with a magazine that is of high interest and at his reading level B. Provide the child with a copy of partially completed notes so that he only has to fill in key words C. Provide the child with a lab partner during science experiments D. Provide the child with a calculator
answer
B
question
An adolescent referred for occupational therapy has oppositional defiant disorder. During the initial interview, the parent reports that the youth never listens to requests, become angry several times a day, blames mistakes on an older sibling, and deliberately annoys a younger sibling. The youth also fails to respect others' space and complete assigned chores and is often disruptive and argumentative at the dinner table. Which area of occupation is MOST affected? A. Activities of daily living B. Rest and sleep C. Leisure D. Social participation
answer
D
question
An OTR is evaluating a client for an injury to the right middle finger. On assessment, the OTR notices that the client is unable to extend the distal interphalangeal (DIP) joint but can move it into extension passively (mallet finger). What treatment plan would the OTR recommend for this injury? A. Electrical stimulation and ultrasound to facilitate extensor tendon gliding B. A hand strengthening program C. Resting of the joint D. A static orthosis holding the DIP joint in slight hyperextension
answer
D
question
A client is being evaluated for a new wheelchair cushion because a Stage I pressure ulcer developed on the skin over the right ischial tuberosity. The OTR® is using pressure mapping to determine which cushion best redistributes pressure for the client and determines that one type of cushion best redistributes the pressure. However, the client refuses it because it feels unstable. Which cushion type would MOST likely elicit this response? A. Foam B. Foam molded C. Hybrid foam and gel D. Air filled
answer
D
question
A recent hip replacement client has been referred to an OTR® for a wheelchair evaluation. What type of wheelchair is the MOST appropriate to maintain hip precautions and preserve mobility? A. A reclining manual wheelchair B. A standard manual wheelchair C. A power wheelchair with hand control D. A lightweight folding wheelchair
answer
A
question
With which situation would a child with autism spectrum disorder (ASD) likely have difficulty? A. Remembering a parent's work telephone number B. Copying homework assignments into a daily planner C. Being able to pick up on a peer's nonverbal cues during a conversation D. Giving a speech on preferred topic
answer
C
question
An OTR® is working on the playground with a child who has sensory integration dysfunction. The OTR® is trying to foster an adaptive response, which is best described by which statement? A. The behavioral manifestation of optimal sensory organization that results in an efficient goal-directed action B. Engagement in rough-and-tumble play and other activities that provide the child with muscle resistance C. A reflection on primitive neural functions in children with sensory processing problems D. An individualized plan that provides a specific child with optimal sensory experiences
answer
A
question
An occupational therapy Level II fieldwork student gives an in-service to the occupational therapy staff at the fieldwork site. The following month, the occupational therapy student attends a continuing education session one of the OTR®s at the site is conducting for the physician assistants. The occupational therapy student recognizes most of the slides as being from the student's previous presentation. No credit is given to the student or the sources the student used. Which ethical principle did the OTR® violate? A. Veracity B. Prudence C. Social Justice D. Freedom
answer
A
question
In preparation for an upcoming orchestral performance, an adolescent student has been practicing playing a string musical instrument 5 to 6 hours per day. The student reports hand pain that is causing illegible handwriting and an inability to complete written classwork in a timely manner. What INITIAL action should the OTR® take in this situation? A. Advise the student to take a break from music practice until the pain subsides. B. Arrange for the student to use a computer for written assignments for school. C. Collaborate with the music teacher to determine an appropriate rest/practice schedule. D. Schedule a time to observe the student during a rehearsal set-up and practice.
answer
D
question
An OTR® evaluating a client listens as the client says, "My pain is really bad, forcing me to stay in bed 24/7, and I am not able to take care of myself at all." Which clarifying response is BEST? A. "It appears that your pain is really bad, forcing you to stay in bed." B. "I feel badly that you are experiencing pain 24/7, forcing you to stay in bed." C. "You poor thing. That's awful! Where is the pain?" D. "It seems that your pain is so bad you can't get up to go to the bathroom or get yourself food from the kitchen."
answer
D
question
The private automobile is the dominant form of transportation for most adults in the United States and is closely tied to occupational routines. Older adults who can no longer drive need viable options for other types of transportation to remain engaged in valued occupations. How do the majority of older adult nondrivers in the United States travel in the community? A. As riders on public transportation vehicles B. As passengers in private automobiles driven by someone else C. As operators of nonmotorized or small-scale vehicles such as bicycles and golf carts D. As pedestrians during daylight hours and not at all at night
answer
B
question
The Beverly Foundation, a nonprofit group that promotes new ideas and options for older adult transportation, evaluates transportation programs using the Five As of Senior-Friendly Transportation. Which characteristic of a transportation system is categorized in the Acceptability category? A. Availability of transportation on evenings or weekends B. Affordability of the cost of travel C. Accessibility of the vehicles used for travel D. Cleanliness of the vehicles used for transportation
answer
D
question
Under what circumstances is a COTA® allowed to administer the Kohlman Evaluation of Living Skills to a new patient in an inpatient acute psychiatric hospital? A. After an OTR® has directed the COTA® to initiate the evaluation process B. When the OTR® is unavailable to administer the assessment C. When the OTR® is in the room while the COTA® administers the assessment D. When the COTA® has demonstrated competence in administering the assessment to the OTR®
answer
D
question
A client is being discharged from a rehab facility. During the discharge interview, the OTR® asks questions such as, "Who is available to assist the client in each physical context the client needs to be in?" "When are they available?" "Who will check the Roho cushion and reinflate it as needed?" "Who will clean the cushion cover?" Under which assessment category do these questions fall? A. Physical context B. Social context C. Physical skills context D. Equipment context
answer
B
question
A COTA® is shifting roles within a skilled nursing facility to become the manager of the therapeutic recreation department. In which way does supervision from the OTR® change? A. Supervision is no longer needed. B. Supervision is on an as-needed basis. C. The OTR® and COTA® meet monthly to discuss clients. D. The OTR® and COTA® meet quarterly to discuss clients.
answer
A
question
An OTR® working at an outpatient clinic receives a physician's order for occupational therapy evaluation and intervention for a new client. After the OTR® completes the evaluation, which billing codes for services are appropriate to put into the documentation system? A. International Classification of Diseases (ICD) B. CPT™ C. Children's Health Insurance Program (CHIP) D. The Diagnostic and Statistical Manual of Mental Disorders (DSM)
answer
B
question
An OTR® is working in outpatient rehabilitation with a client with a spinal cord injury who is interested in using public transportation to engage in part-time work but is unable to used regular fixed-route services. The OTR® assists the client in finding out about the eligibility process for paratransit services, and the OTR® and client discuss the advantages and disadvantages of using such services. What is one possible disadvantage of using paratransit services from the client's perspective? A. Paratransit systems typically offer more flexible travel time options than do fixed transit routes. B. Paratransit operators are trained to assist riders with functional limitations in boarding vehicles. C. Paratransit systems use smaller and more accessible vehicles than fixed transit routes. D. Paratransit systems require that reservations be made in advance to use the service
answer
D
question
An OTR is working with a client who has a flexor tendon injury. The referring physician prefers patients to follow the flexor tendon protocol using controlled passive motion. Which movement is indicated? A. Active movement of the metacarpal joint only B. Passive extension of the distal interphalangeal joint if the metacarpal and proximal phalangeal joints are flexed C. Active movement of the distal interphalangeal joint only D. Passive flexion of the distal interphalangeal joint if the metacarpal and proximal phalangeal joints are extended
answer
B- The distal interphalangeal joint and proximal interphalangeal joint can be passively extended if the other joints of the digit are flexed to initiate tendon glide and prevent scarring of the tendon.
question
Public transportation systems might benefit in the long term from investing in greater accessibility and user training opportunities for young people with disabilities. Which statement BEST supports this argument? A. Public transportation providers will avoid financial penalties if they provide high-quality travel training for young people with disabilities. B. Better relationships between public schools and public transportation providers will result from more attention to the needs of young people with disabilities. C. Public transportation systems will have a larger pool of potential employees if they respond to the access and travel training needs of young people with disabilities. D. People who are taught early to use transportation systems that are accessible to their needs often become lifelong users of the system.
answer
D
question
What is the first course of action the AOTA Ethics Commission takes when it receives an ethics complaint? A. It conducts a full investigation. B. It imposes a sanction or discipline. C. It starts a preliminary assessment. D. It writes an educative letter.
answer
C
question
An OTR® has determined that a visually impaired client can no longer drive. What should the therapist include in the occupational therapy intervention to help this client be independent in the use of community mobility? A. Familiarize the client with the procedures for using paratransit. B. Obtain a bus schedule and start training the client to use the bus for fixed-route travel. C. Select, test, adopt, and train the client and the client's family or support system in the use of the most appropriate transportation options. D. Educate the client on the need for driving cessation and the importance of maintaining independence in the community mobility.
answer
C
question
A client was provided with an ultra lightweight wheelchair. Because the client is at risk for falls, the drop seat was tilted posteriorly to help prevent the client from getting out of the chair; also, because of the client's short stature, the axle was moved forward to make it easier for the client to propel the chair. What two accessories would the OTR® recommend to improve the client's safety while using the wheelchair? A. Solid rubber casters, antitippers B. Antitippers, brake lever extenders C. Brake lever extenders, flip-up footrests D. Flip-up footrests, antitippers
answer
B
question
How does the Occupational Therapy Practice Framework: Domain and Process (2nd ed.; AOTA, 2008) define community mobility? A. As a variety of ways to move about the world and the fit between these means and the client's abilities B. As moving around in the community or using public or private transportation, such as driving, walking, bicycling, and using buses, taxicabs, or other transportation systems C. As selecting, testing, or adopting with the client and the client's family or support system the most appropriate transportation options D. As opportunities for occupational therapists to be involved in broader dialogue with transportation providers, health and human service agencies, and policymakers
answer
B
question
An OTR has been working with a client diagnosed with carpal tunnel syndrome. The client's symptoms have diminished, but now the client reports more pain at the elbow in the median nerve area. When a client reports dual sites of impingement of a single nerve without a history of trauma, what condition is MOST likely the cause? A. Thoracic outlet syndrome B. Double crush syndrome C. Ulnar tunnel syndrome D. Cubital tunnel syndrome
answer
B
question
An OTR is teaching discriminative sensory reeducation techniques to a client who has had a median nerve surgical repair. Which method is BEST for reeducation of discriminative sensibility? A. Educate the client to avoid working around machinery. B. Advise the client to use vision to compensate for sensory loss. C. Educate the client to identify items by touch both with and without vision on a daily basis. D. Educate the client to avoid temperatures below 60°.
answer
C
question
An OTR® has been working on an oncology unit of a hospital for several years and has begun to acknowledge signs of risk for burnout. How can the OTR® MOST effectively prevent burnout? A. Take notes home at the end of the day to finish after work hours B. Engage in personally meaningful activities to promote life balance C. Attend an oncology conference at least once a year D. Meet once a month with other OTR®s who work in oncology
answer
B
question
Which strategy is MOST appropriate strategy for resolving conflicts in the workplace? A. Listening effectively when others are speaking B. Using emotions during the conversation C. Commenting on staff's strengths and weaknesses D. Describing how the conflict will be resolved
answer
A
question
Which type of payer provides health coverage for the military? A. Children's Health Insurance Program B. TRICARE C. Medicare D. Federal Employees Health Benefit Program
answer
B
question
An occupational therapy student on Level II fieldwork came to the fieldwork site drunk and attempted to treat clients. The student was reported by the supervisor and found in violation of the NBCOT® Code of Conduct. What is the most severe sanction the student could receive? A. Public censure B. Ineligibility for certification C. Failed fieldwork D. Letter of reprimand
answer
B
question
An order came in for a hand splint for a new client. A newly graduated OTR® evaluated the client for the splint. The new OTR® had not made a splint on a client before and requested an experienced OTR® hand therapist's assistance. In doing so, the OTR® abided by the ethical principle that involves taking "responsibility for maintaining high standards and continuing competence?" Which principle is that? A. Nonmaleficence B. Procedural Justice C. Prudence D. Veracity
answer
B
question
A 76-year-old client will be using a wheelchair after discharge from an acute rehabilitation facility. The client has achieved independence in wheelchair mobility on level surfaces but still requires minimal assistance for transfer. The client is planning to move into a daughter's home, which was not the client's previous residence. The OTR® conducts an onsite home evaluation with the client and the client's daughter. During the home evaluation, it is obvious that the hallway to the bathroom is too narrow for the client to turn the wheelchair without assistance. What would be the MOST APPROPRIATE transitional recommendation to include in the report? A. Referral to homecare occupational therapy for wheelchair mobility training B. Training in a 3-point wheelchair-turning technique in a narrow hallway C. Wearing an adult diaper and refraining from using the bathroom D. Securely placing a bedside commode between the bed and the side wall
answer
D
question
As an occupational therapy practitioner, you have accepted an assignment to go overseas to work with victims of a disaster in a culture that is new to you. In preparation for your trip and in consideration of the Occupational Therapy Practice Framework: Domain and Process, which of the following elements is part of the context in which activity occurs that you will need to consider when planning occupational therapy intervention? A. The process used to carry out the activity B. The tools used to complete the activity C. The cultural beliefs held by the person engaging in the activity D. The praxis skills required to complete the activity
answer
C
question
An OTR® is seeking to understand how a client perceives an impending change from driving to use of other forms of transportation. Which assessment would BEST assist the OTR® in understanding the client's perception of this change? A. Canadian Occupational Performance Measure B. Motor-Free Visual Perception Test C. Rivermead Behavioral Memory Test D. Assessment of Readiness for Mobility Transitions
answer
D
question
Community mobility has been described in the occupational therapy literature as a conduit for participation in valued occupations. In addition to being a means to move from one place to another, what is the relationship of community mobility to participation? A. An occupational performance skill B. An occupation aid C. An occupation enabler D. An occupational profile
answer
C
question
An OTR® is working with a community organization to address child passenger safety and injury prevention, including car seat safety and pedestrian and bicycle safety. Which organization would be MOST appropriate for the OTR® contact? A. National Center for Senior Transportation B. SafeKids USA C. AARP D. National Mobility Equipment Dealers Association
answer
B
question
A physician has referred a client to an outpatient setting for an occupational therapy evaluation and intervention. The client has late effects from a stroke that occurred approximately 10 years ago. The OTR® is performing a screening before initiating the evaluation. Which is the MOST likely reason for completing the screening? A. To complete the occupational profile and become acquainted with the client B. To meet the client and conduct a standardized interview before the evaluation C. To complete the assessments to save time during the evaluation process D. To identify whether the client may benefit from occupational therapy services
answer
D
question
The director of occupational therapy services for a large metropolitan home health agency is conducting a supervisory visit and notices that the OTR® is writing progress notes on a personal electronic tablet. The OTR® is excited about using this new technology and shares with the director that it saves a great deal of time. Which response by the director is MOST appropriate? A. Applaud the OTR® for using technology efficiently B. Develop a policy prohibiting the use of personal electronic tablets for note writing C. Ask the OTR® to describe the use of electronic recording to the other OTR®s at the agency D. Ask home health clients for their opinions regarding electronic record keeping
answer
B
