exam 2
For which of the following client conditions is the use of superficial thermal agents CONTRAINDICATED? You can select maximum of 3 choices -Acute edema -Wound infection -Thrombophlebitis -Subcutaneous adhesions -Chronic inflammation -Muscular tightness
-Acute edema -Chronic inflammation -Subcutaneous adhesions
A patient was recently admitted to a skilled nursing facility for medical management of peripheral vascular disease and congestive heart failure. The patient is independent with bed mobility, requires supervision during transfers, and is non-ambulatory. When seated in a standard wheelchair, what type of wheelchair accessory for the lower extremities would be MOST BENEFICIAL for this patient? Footplate with heel loop Elevating leg rests Solid cradle footrest
Elevating leg rests
A 2-year-old child has spastic diplegia secondary to cerebral palsy. The child is learning to use a posterior support walker with forearm troughs for ambulation, but tight hip flexors interfere with the child's progress. Which positioning strategy can be incorporated into the intervention for decreasing the influence of the hip flexors on ambulation? -Prone-lying on an incline wedge placed on the floor to play a game -Side-lying with the legs supported in extension by a bolster during story time -Supine-lying on a mat to encourage kicking at a toy dangled in front of the child
Side-lying with the legs supported in extension by a bolster during story time
A COTA is planning a meal preparation session with a client who has early stage 2 Parkinson's disease. Which of the following tasks would present the GREATEST challenge to this client when completed without compensatory motions? -Using kitchen tongs to turn over food on a baking pan -Wiping the surface of a kitchen countertop with a washcloth -Moving a cup partially filled with water from sink to stovetop
Moving a cup partially filled with water from sink to stovetop
An inpatient who sustained a TBI 3 weeks ago is ambulatory and currently functioning at Level VII (Automatic, Appropriate) on the Rancho Los Amigos scale. Visual-perceptual and cognitive deficits interfere with function. One of the overall intervention goals is to optimize the patient's engagement in occupation. Which type of intervention would be MOST EFFECTIVE to include during this phase of the patient's rehabilitation? -Social skills activity groups with several other patients -One-on-one adaptive self-care in the patient's room -Structured community reintegration group activities
One-on-one adaptive self-care in the patient's room
A student in the fourth grade has attention deficit hyperactivity disorder. Symptoms interfere with the student's ability to remember class activity schedules and homework and organize materials for completing assignments. One of the intervention goals is to help the student improve organizational skills. What classroom strategies should the COTA recommend to the teacher for supporting this goal? Select the 3 best choices. -Provide instructions using both verbal and visual cues. -Move the student's desk away from peers. -Have a teacher's aide sit with the student during activities. -Teach the student to use a simple day planner. -Divide larger, more complex projects into manageable sections. -Use a behavioral chart to track frequency of negative behaviors.
-Teach the student to use a simple day planner. -Divide larger, more complex projects into manageable sections. -Provide instructions using both verbal and visual cues.
A patient in a rehabilitation setting has a C6 (ASIA A) spinal cord injury. Which statement represents a realistic long-term outcome for maximizing the patient's independence in self-feeding after setup? -The patient will learn to use a mobile arm support to facilitate hand-to-mouth patterns. -The patient will independently operate a mechanical feeder that is activated by a chin switch. -The patient will use a tenodesis orthosis to hold utensils that have built-up handles.
-The patient will use a tenodesis orthosis to hold utensils that have built-up handles.
A client has an elbow flexion contracture secondary to wearing a long-arm cast for a mid-shaft fracture of the radius. What is the PRIMARY purpose of applying a hot pack to the elbow over the bicep tendon prior to having the client use the affected upper extremity to reach for an item on an overhead shelf? -To facilitate tissue extensibility for increasing elbow extension -To reeducate the muscle after the prolonged immobilization -To decrease soft tissue inflammation and edema at the elbow
-To facilitate tissue extensibility for increasing elbow extension
A client who has fibromyalgia and low back pain wants to independently perform laundry tasks in the home. One of the intervention goals is for the client to demonstrate the use of proper body mechanics while loading and unloading laundry from a front-opening clothes dryer. Which position would provide evidence that the client has made progress toward this learning objective? -Kneeling on one knee facing the dryer to move clothing from a dryer to a laundry basket -Bending forward at the waist to reach for clothing inside the dryer -Standing with both knees slightly bent to transfer wet clothing from the washer to the dryer
-Standing with both knees slightly bent to transfer wet clothing from the washer to the dryer
A client has tendonitis of the wrist and carpal tunnel syndrome. The client is employed as a data entry clerk and uses the keyboard for 6-8 hours each day. Which ergonomic principles would be MOST BENEFICIAL to teach the client to use at work for managing symptoms associated with these conditions? -Take short, frequent rest breaks, and maintain wrists in neutral during work tasks. -Wear anti-vibration gloves, and use ergonomic tools during home and work activities. -Lift heavy objects with weight close to the center of gravity with palm of the hands up.
-Take short, frequent rest breaks, and maintain wrists in neutral during work tasks.
What information is MOST IMPORTANT for a COTA to report during an Individualized Education Program meeting for a student who has juvenile rheumatoid arthritis? -Improvements in ROM and strength measurements -Ability to participate in specific classroom activities -Functional performance during self-care tasks
Ability to participate in specific classroom activities
A resident of a geropsychiatric facility has moderately severe cognitive decline. Staff report the resident is becoming progressively more distracted during meal times resulting in poor nutritional intake. Which recommendation is BEST to use initially for promoting the resident's independence in self-feeding? -Plan for the resident to eat meals at a bedside table in the resident's room. -Recommend dining staff provide frequent verbal cues to the resident during meals. -Arrange for the resident to eat meals in the least distracting area of the dining room.
Arrange for the resident to eat meals in the least distracting area of the dining room.
A COTA witnesses an OT aide using a goniometer to measure a patient's upper extremity ROM. What action should the COTA take in response to this observation? -Determine if the aide has established service competency for this task. -Check to see if the measurements are being recorded according to policies. -Ask the aide to stop the activity and discuss the situation with the supervisor.
Ask the aide to stop the activity and discuss the situation with the supervisor.
A client who has COPD reports shortness of breath and fatigue interfere with the ability to complete daily activities. One of the client's goals is to improve endurance for BADL. Which techniques would be beneficial to teach the client to use for supporting this goal? Select the 3 best choices. -You can select maximum of 3 choices -Chest expansion breathing -Dyspnea control postures -Progressive muscle relaxation -Pursed-lip breathing -Sternal movement precautions -Visualization exercises
Chest expansion breathing Dyspnea control postures Pursed-lip breathing
A kindergarten student has immature prewriting skills secondary to developmental delay. Currently, the student scribbles spontaneously and is able to imitate a vertical line and horizontal line on a blank piece of paper. Based on the typical sequence of prewriting development, which prewriting skill should the student be expected to master NEXT? -Traces simple geometric shapes -Copies two intersecting lines -Colors inside the lines of a circle
Copies two intersecting lines
A young adult client has emotional outbursts and negative self-concept. While waiting to participate in a role-play activity, the client appears disinterested, restless, and angry. When asked about these behaviors, the client denies there is a problem and says, "I don't need therapy; I am fine." What action should the COTA take based on the client's response? -Allow the client to select a different group activity and document the behavioral observations in the client's record. -Provide the option to independently complete workbook exercises and ask the client to stop the negative behaviors. -Encourage participation in the activity and explore the client's insight about their self-limiting behaviors.
Encourage participation in the activity and explore the client's insight about their self-limiting behaviors.
A COTA is collaborating with an OTR in an early intervention (EI) program to plan an intervention for a 2-year-old child who has fetal alcohol syndrome. What information should be considered FIRST when selecting intervention approaches to use with this child? -Family's goals and priorities related to the child's needs -Results of standardized tests administered during the evaluation -Evidenced-based activities available for the EI team to use
Family's goals and priorities related to the child's needs
An inpatient who has lower body extensor hypertonicity secondary to an acquired brain injury requires moderate assistance during transfers. In preparation for a session at bedside, the COTA is assisting the patient to move from side-lying in bed to sitting at the edge of the bed. After moving the lower legs over the side of the bed, what should the COTA do NEXT to ensure a safe transfer? -Stabilize the patient's lower extremities. -Shift the patient's body to an upright sitting position. -Have the patient use one arm to push up from the mattress.
Have the patient use one arm to push up from the mattress.
A patient who had a myocardial infarction is entering phase I of cardiac rehabilitation. What action is MOST IMPORTANT for the COTA to take as part of the intervention during this phase of the patient's rehabilitation? -Monitor the patient's heart rate and blood pressure during self-care. -Determine the energy requirements for the patient's home activities. -Discuss activity pacing and work simplification with the patient.
Monitor the patient's heart rate and blood pressure during self-care
A COTA is working in a classroom with a 6-year-old student who has perceptual motor deficits. During desktop activities, the COTA observes that the student consistently closes one eye to focus on objects. What INITIAL action should the COTA take in response to this observation? -Use behavioral techniques to gradually eliminate these learned behaviors. -Report the observations to the OTR, suggesting a referral for a visual screening. -Recommend visual compensation strategies the student can use in the classroom.
Report the observations to the OTR, suggesting a referral for a visual screening.
A COTA is collaborating with the OTR to fabricate an orthosis for a 5-year-old child who has juvenile rheumatoid arthritis. The child reports pain and stiffness in both hands each morning. Which orthotic device would be MOST BENEFICIAL to fabricate for the child to wear at night time? -Cock-up orthosis -Ulnar deviation orthosis -Resting pan orthosis
Resting pan orthosis
A client has homonymous hemianopsia secondary to a CVA one month ago. The COTA is teaching the client compensatory strategies to use during daily tasks. Which type of activity would be MOST BENEFICIAL to include as part of the intervention for supporting this objective? -Assembling parquetry designs using patterns of contrasting colors and graded difficulty -Searching for familiar objects in a room or during a task using organized search patterns -Completing BADL after placing a patch over the eye contralateral to the side of the lesion
Searching for familiar objects in a room or during a task using organized search patterns
A COTA is scheduled to lead a social skills group for adolescents who have behavioral problems and difficulty maintaining friendships. One of the objectives of the group is for the adolescents to learn skills for cooperation and teamwork with peers. Which type of activity would be MOST BENEFICIAL for supporting this objective? -Structured craft -Guided role-play -Simulated IADL
Structured craft
A client who has a transhumeral amputation of the dominant extremity chooses not to use a prosthetic during personal hygiene and grooming tasks. Which assistive devices would be beneficial for supporting the client's independence during these activities? Select the 3 best choices. -Safety razor -Long-handled sponge -Spray can adapter for deodorant -Suction brush -Universal cuff for toothbrush -Wash mitt
Suction brush Long-handled sponge Wash mitt
A COTA working in an outpatient mental health setting is documenting the progress of a client who has an obsessive-compulsive disorder. When using the SOAP format, which of the following statements meets the guidelines for inclusion in the "O" section of the note? -The client appeared to repeatedly check the written instructions. -The client asked to wash the table four times during the group. -The client hesitated to agree when asked if the project was worthwhile.
The client asked to wash the table four times during the group.
A kindergarten-age student has poor postural stability and extensor posturing secondary to athetoid cerebral palsy. Currently, the student sits in a wheelchair the majority of the school day. One of the intervention goals is to identify an alternate seating option for the student to use intermittently during the day. Which seating option would MOST EFFECTIVELY promote the student's postural stability for engagement in typical daily activities at school? -Desk chair with a wedge cushion -High back chair with adjustable recline -Corner chair with an abductor wedge
-Corner chair with an abductor wedge
A 5-year-old child with Down syndrome recently mastered dressing skills consistent with those of a 36-month-old child. Which dressing activities should be incorporated into the child's intervention to support the NEXT level of development for independence with self-dressing? Select the 3 best choices. -Unzipping a jacket zipper -Assisting with putting on socks -Identifying the front of clothing -Buttoning a series of four buttons -Donning a pullover garment -Putting on pants with elastic waist
-Buttoning a series of four buttons -Donning a pullover garment -Identifying the front of clothing
A COTA is providing home program instructions to the parents of an infant who has congenital hip dysplasia. The infant's lower extremities were positioned in a spica cast one day ago to promote hip alignment and stability. The legs will be casted for at least 6 weeks. What information would be MOST BENEFICIAL to include as part of the initial home instruction? -Adaptations to support engagement in the family's typical daily routines -Age-related developmental milestones the infant is expected to achieve -Methods for monitoring and recording the infant's response to pain
Adaptations to support engagement in the family's typical daily routines
A COTA is fabricating a thermoplastic orthosis for a 6-year-old child. The child is frightened and cries when the COTA attempts to measure the hand for the orthotic pattern. Which technique would be MOST EFFECTIVE for reducing the child's apprehension during the process of fabricating the orthosis? -Encourage the caregiver to give the child candy for positive behavior. -Allow the child to put a similar orthosis on a favorite stuffed animal. -Ask a colleague to distract the child while the orthosis is being made.
Allow the child to put a similar orthosis on a favorite stuffed animal.
A client who has an olecranon fracture had a long-arm thermoplastic orthosis fabricated 2 days ago. On a follow-up visit, the COTA notes reddened areas over the epicondyles. What action should the COTA take in response to this observation? -Apply several layers of stockinette on the affected arm prior to reapplying the orthosis. -Line the inside surface of the entire orthosis with adhesive-backed moleskin. -Use a heat gun to spot heat and flare the area of the orthosis causing the irritation.
Apply several layers of stockinette on the affected arm prior to reapplying the orthosis.
A client in a home health setting recently had surgery for a laminectomy and fusion at the level of L2 and L3. One of the intervention goals is for the client to learn proper body mechanics to use when getting in and out of bed. Which strategy should the COTA teach the client to support progress toward this goal? -Bend knees, roll into a side-lying position with pelvis and trunk aligned, then push with arms into a sitting position. -Swing legs off the edge of the bed, bend arms across the chest, then engage abdominal muscles to sit up. -Lift buttocks off the bed, scoot to the edge, then use a secure object to pull into an upright position.
Bend knees, roll into a side-lying position with pelvis and trunk aligned, then push with arms into a sitting position.
Which behaviors are TYPICALLY associated with clients who have dementia and are functioning at Allen Cognitive Level 2 (Postural Actions)? -Completes a repetitive task with minimal verbal cues -Is able to attend to a simple tabletop activity for at least 30 minutes -Can imitate a leader during simple gross motor exercises
Can imitate a leader during simple gross motor exercises
A COTA is preparing for a BADL session for a patient who is ventilator-dependent. The COTA plans to transfer the patient from supine to sitting on the edge of the bed at the start of the session. Before initiating the transfer, what medically-related precaution should the COTA take? -Check the tubing that connects the endotracheal tube to the ventilator to ensure adequate length. -Determine which ventilator settings will provide optimal oxygen saturation during the activity. -Complete a tracheal suction using standard procedures to ensure the patient's airway is clear.
Check the tubing that connects the endotracheal tube to the ventilator to ensure adequate length.
An 8-year-old child had skin grafts to the posterior aspect of both shoulders 10 weeks ago. One of the goals is to improve shoulder ROM for functional reach. A reevaluation indicates the child now has 140° of shoulder flexion and 60° of shoulder extension. Which activity BEST promotes the child's progress toward the ROM goal? -Climbing a rope ladder -Pulling a weighted wagon -Playing basketball
Climbing a rope ladder
An inpatient who has relapsing-remitting multiple sclerosis has had a recent decline in function. The patient now requires moderate assistance for bed mobility, transfers, and BADL. The patient is preparing for discharge to home with the spouse as the primary caregiver. What action should the COTA take to MOST EFFECTIVELY facilitate the patient's safe transition to home? -Provide the spouse a handout of proper body mechanics to use when assisting the patient. -Coordinate with the spouse to ensure durable medical equipment is in place at the home. -Arrange for the spouse to actively participate in the patient's intervention sessions.
Coordinate with the spouse to ensure durable medical equipment is in place at the home.
An OTR and COTA are working collaboratively to assess a client who has depression. Which information-gathering tool would provide the MOST comprehensive information about the client's time management skills? -Interest checklist -Leisure history questionnaire -Daily activity log
Daily activity log
A COTA is scheduled to begin transfer training sessions with an inpatient who had a CVA 2 days ago. Which of the following medical conditions would indicate an IMMEDIATE safety risk for proceeding with the session? -Deep vein thrombosis in the calf of the affected leg -Shoulder subluxation of the affected upper extremity -Stage I pressure ulcer on the greater trochanter
Deep vein thrombosis in the calf of the affected leg
A 2-month-old infant has a cleft lip and palate. The infant has poor lip closure but normal swallow patterns. Which adaptation to the infant's bottle would be MOST BENEFICIAL for supporting bottle-feeding? -Elongated nipple with one-way flow regulation valve -Shorter nipple with an enlarged cross-slit at the tip -Standard size nipple with soft tip and wide base
Elongated nipple with one-way flow regulation valve
A COTA is planning an outing for a group of six residents in a long term care setting who have enduring mental illnesses. What INITIAL information should the COTA obtain as part of the planning process for this outing? -Methods for monitoring a resident's suicidal ideation -Emergency contact information in the event of resident elopement -Availability of additional staff to accompany the group
Emergency contact information in the event of resident elopement
A COTA employed at a Medicare-certified hospice program is completing documentation after a session with a client. In addition to including a description of the intervention provided, what information MUST the OT documentation include to meet federal requirements for reimbursement? -Progress related to palliative care -Evidence of client-centered goals -Theoretical approaches used
Evidence of client-centered goals
A COTA is preparing a patient to use a stand-pivot transfer to move from a wheelchair to the bed. The patient currently requires maximum assistance during transfers. As the patient comes to standing, the COTA sees that the patient's feet are behind the center of gravity. What should the COTA do in response to this observation? -Ask the patient to reach forward toward the transfer surface. -Guide the patient back down into the wheelchair seat. -Help the patient to slowly reposition one foot at a time.
Guide the patient back down into the wheelchair seat.
A client who has moderate cognitive decline lives at home with a spouse. The spouse reports that the client frequently wanders around the house asking, "What should I do?" Which intervention is BEST for reducing the occurrence of this behavior? -Assist the spouse to develop a routine of home activities for the client. -Instruct the client to use a memory book for remembering daily tasks. -Develop a short-term behavioral reinforcement program for the client.
Instruct the client to use a memory book for remembering daily tasks.
A COTA is the only full-time OT staff in a skilled nursing facility. The COTA wants to develop new clinical skills and stay current with practice trends. What is the BEST action for the COTA take in this situation? -Establish an ongoing mentor-mentee relationship through a professional network. -Engage in a multidisciplinary model of practice with speech and physical therapy. -Join an online discussion board with a broad, diverse community of participants.
Join an online discussion board with a broad, diverse community of participants.
A client who has a neurodegenerative disease has been participating in OT for the past several months. During a BADL session, the client becomes frustrated and tearful about the progressive decline in function, despite having just achieved one of the dressing goals. What action should the COTA take INITIALLY in response to the client's behavior? -Continue with the session, recognizing that the lability is related to a medication side effect. -Listen empathetically throughout the session to the client's concerns and feelings. -Divert the client's attention from the negative feelings while proceeding with the session.
Listen empathetically throughout the session to the client's concerns and feelings.
A reevaluation indicates that a patient who has amyotrophic lateral sclerosis now has Fair minus (3-/5) functional muscle strength of bilateral upper extremities. One of the patient's goals is to be independent with self-feeding. Which assistive devices are BEST to recommend for supporting progress toward this goal? -Mobile arm support, universal cuff for utensils, and flexible drinking straw -Scoop dish, utensils with built-up handles, and two-handled cup -Partitioned dish, swivel spoon, and cup with sip spout lid
Mobile arm support, universal cuff for utensils, and flexible drinking straw
A COTA has worked in an acute pediatric hospital for 5 years and will be transitioning to a new job in an outpatient mental health program. Considering this new professional role, what action should the COTA take at the start of this job? -Obtain direct supervision from an OTR until service competency is established. -Arrange for the supervising OTR to sign contact notes for each client on the COTA caseload. -Identify goal-based clinical learning opportunities collaboratively with the supervising OTR.
Obtain direct supervision from an OTR until service competency is established.
Pictured below is an adaptive technique used for pulling up bed sheets to cover the lower body. A patient with which of the following conditions would have to use this technique for optimizing safety while completing this task independently? -Acute phase of Guillain-Barré syndrome -One week after posterolateral hip arthroplasty -Middle stage of amyotrophic lateral sclerosis
One week after posterolateral hip arthroplasty
An older adult client has decreased balance, macular degeneration, and frequent nocturnal urinary urgency. The client lives alone in a single-level home and is concerned about the risk of falling when getting out of bed at night. Which recommendation is MOST IMPORTANT for addressing the client's concern? -Keep a nightlight lit in the main bathroom. -Place a commode chair next to the bed. -Wear incontinence pads when in bed.
Place a commode chair next to the bed.
During a dressing task, a client who had a recent CVA is unable to locate a floral-print shirt that is lying front-side up on a bed covered with a multi-colored bedspread. What INITIAL action should the COTA take to support the client's ability to independently complete this task? -Move the shirt to the left side of the bed. -Guide the client's hands to locate the shirt. -Place the shirt on a solid-colored bed sheet.
Place the shirt on a solid-colored bed sheet.
A COTA is working with a client who has executive dysfunction secondary to a TBI. The client reports wanting to independently prepare meals but has difficulty planning, sequencing, and organizing while cooking. Which method represents the use of the neurofunctional approach for improving the client's ability to prepare meals? -Plan several OT intervention sessions to include having the client make a simple meal. -Assist the client to develop a list of cognitive strategies to be used in multiple contexts. -Suggest environmental modifications to simplify the contextual demands during cooking.
Plan several OT intervention sessions to include having the client make a simple meal.
A COTA is working at a preschool. The director of the preschool asks the COTA to provide suggestions for modifications to increase the playground's physical accessibility for students in the school who use a wheelchair. Which playground modification is BEST to recommend based on this request? -Install table-height water and sand play spaces. -Provide adapted sports equipment and toys. -Install motion sensitive entry and exit doors.
Provide adapted sports equipment and toys.
An inpatient has global aphasia and functional weakness of the dominant hand secondary to a recent CVA. One of the intervention goals is for the patient to learn to self-feed using the utensil holder pictured below. After placing the device on the patient's hand and telling the patient how to use the device, the patient attempts to remove the fork out of the cuff. What action should the COTA take to support the patient's success with this task? -Show the patient how to use the device then provide manual cueing for return demonstration. -Use sequential picture cards to communicate how to complete each step of the eating task. -Provide hand-over-hand assistance to help the patient bring the utensil towards the mouth.
Provide hand-over-hand assistance to help the patient bring the utensil towards the mouth.
A COTA is planning an intervention session for an inpatient who has COPD. The COTA learns that the patient only speaks in a language that is unfamiliar to the COTA. What action would be MOST BENEFICIAL for the COTA to take in response to learning this information? -Communicate with the patient using non-verbal techniques. -Reschedule the session when an interpreter is available to assist. -Provide the patient with an illustrated brochure on energy conservation.
Provide the patient with an illustrated brochure on energy conservation.
A COTA is recommending home modifications for a client who has stage 1 Parkinson's disease. The client lives with family members in a single-level home. Which adaptations should be included as part of the recommendations? -Place safety reminders in a clearly visible location in the kitchen. -Remove loose rugs and clutter in commonly used living areas. -Teach the client to use a pill crusher for prescription medication.
Remove loose rugs and clutter in commonly used living areas.
An injury prevention team is providing consultative services at an industrial warehouse setting. What is the PRIMARY role of a COTA on this type of interprofessional team? -To design individual treatment plans for workers who are considered at-risk -To evaluate each worker initially during job-specific lifting and carrying tasks -To instruct workers how to reduce ergonomic risk factors based on specific job tasks
To instruct workers how to reduce ergonomic risk factors based on specific job tasks
What is the PRIMARY biomechanical purpose for recommending an antispasticity hand orthosis for a client who has severe upper extremity hypertonicity? -To retain the integrity of the transverse palmar arch -To maintain the length of the MCP joint collateral ligaments -To preserve the relative balance between flexors and extensors
To maintain the length of the MCP joint collateral ligaments
A COTA is fabricating an anti-deformity wrist, hand, finger immobilization orthosis for a client. The primary purpose of the orthosis is to maximize the length of the MCP joint collateral ligaments of the fingers. Which position is MOST BENEFICIAL for achieving this goal? -Full extension of the MCP joints and 10°- 30° flexion of the IP joints -70°- 90° flexion of the MCP joints and full extension of the IP joints -Resting hand position with MCP and PIP joints in 5°-15° of flexion
-70°- 90° flexion of the MCP joints and full extension of the IP joints
A COTA is using a 180° standard goniometer to measure a client's wrist ulnar deviation. To obtain the MOST ACCURATE results, which steps should the COTA use as part of this procedure? Select the 3 best choices. -Align the stationary arm of the goniometer with the midline of the forearm. -Ensure the moveable arm of the goniometer is parallel to the third metacarpal. -Hold the stable arm of the goniometer in line with the second metacarpal. -Place the client's hand and forearm in a pronated position on a tabletop. -Position the client's elbow in 90° flexion with the forearm in midposition. -Stabilize the goniometer along the border of the forearm and fifth metacarpal.
-Align the stationary arm of the goniometer with the midline of the forearm. -Position the client's elbow in 90° flexion with the forearm in mid-position. ...Ensure the moveable arm of the goniometer is parallel to the third metacarpal.
A student in the first grade has moderate developmental delay and hypotonia. The student has difficulty maintaining an upright position when seated at a classroom desk. Which technique would be MOST EFFECTIVE for facilitating the student's muscle tone several minutes prior to engaging the student in a writing activity? -Gently wrapping the student's body in a blanket -Rhythmically rocking the student in a rocking chair -Briskly bouncing the student on a large therapy ball
-Briskly bouncing the student on a large therapy ball
A COTA is planning a behavioral treatment program for a student in kindergarten who has autism. The student frequently engages in potentially injurious self-stimulation behaviors during periods of high anxiety in the classroom. After collaborating with the teacher to identify a realistic positive behavior to work toward, what is the NEXT step of this process? -Identify a schedule for implementing the program. -Determine a list of alternative activities to provide distraction. -Select a method of counting and recording positive behaviors.
-Determine a list of alternative activities to provide distraction.
A COTA and an OTR are collaborating on a quality improvement initiative. The goal of the initiative is to review outcomes to determine the success of interventions. Which investigative question would be BEST to use as the focus of this initiative? -Did intervention foster a positive change in a client's engagement in occupation? -Were intervention activities occupation-based using the most current evidence? -Was an occupational profile consistently developed using a client-centered approach?
-Did intervention foster a positive change in a client's engagement in occupation?
A client had an open reduction, external fixation of a wrist fracture 5 days ago. The OTR completed an assessment and developed an intervention plan for the COTA to follow. During the next session, the COTA observes that the client's hand has 3+ pitting edema, is hypersensitive to touch, and the fingertips appear somewhat cyanotic. What action should the COTA take in response to this observation? -Proceed with the planned intervention and monitor the client's response. -Elevate the affected arm on a pillow and begin retrograde massage. -Document the observation and inform the supervising OTR.
-Document the observation and inform the supervising OTR.
A COTA is selecting interventions to control upper extremity edema for a client who had a stroke 6 months ago and has flaccid hemiplegia. Which intervention methods would be MOST EFFECTIVE to reduce edema in the affected upper extremity? You can select maximum of 3 choices -Elevation above the level of the heart -Application of compression wrap -Instruction in self-PROM exercises -Prescription of a sling to wear during self-care -Deep tissue massage in a circular pattern -Application of warm compresses before activity
-Elevation above the level of the heart -Application of compression wrap -Instruction in self-PROM exercises
A COTA is selecting assistive devices for a 5-year-old child who has arthrogryposis multiplex congenita. The child has full functional use of both hands, but decreased elbow flexion and forearm supination limit the child's ability to self-feed. Which features would be MOST BENEFICIAL for the child's eating utensils to have for supporting independence with feeding tasks? Select the 3 best choices. -Flexible wrap-around handle -Rocker component -Extended handle -Swivel component -Textured soft grip -Adjustable angle handle
-Extended handle -Swivel component -Adjustable angle handle
A COTA is starting a mealtime session at the bedside of an inpatient who has generalized debilitation and diabetes mellitus. At the start of the session, the COTA notes that the patient's skin is very flushed, breathing is deep and labored, and there is a fruity odor to the patient's breath. The patient reports feeling unusually fatigued and asks the COTA for several glasses of water due to a dry mouth. What IMMEDIATE action should the COTA take in this situation? -Position the patient in supine with both feet elevated. -Give the patient several sips of orange juice from the food tray. -Report the symptoms to the patient's charge nurse.
-Give the patient several sips of orange juice from the food tray.
A 10-year-old child in an acute setting is undergoing treatment for third-degree burns in the antecubital space of the non-dominant elbow. The child has 90° elbow flexion and -30° elbow extension and is starting to spontaneously use the affected upper extremity during ADL. The child will be discharged home in 2 days. Which action should the COTA take to MOST EFFECTIVELY support carry-over of the ROM exercises in the home environment? -Ask the caregiver to learn proper hand placement on the child's arm by observing the COTA several times. -Have the caregiver and child demonstrate the stretching regimen after watching the COTA. -Provide the caregiver with written instructions for each step of the stretching routine.
-Have the caregiver and child demonstrate the stretching regimen after watching the COTA.
A COTA working in an outpatient pain clinic is gathering information about an older adult client who has fibromyalgia. Which method would be MOST BENEFICIAL for obtaining information about the influence of the client's pain on everyday activities? -Have the client complete a pain diary throughout each day for one week. -Administer a numeric pain rating scale at the beginning of each session. -Review the client's medication management habits and routines.
-Have the client complete a pain diary throughout each day for one week.
A COTA is completing a self-feeding session with a resident in the dining room of a skilled nursing setting. During the session, the COTA observes that another resident who has hemiplegia and is not on the COTA caseload seems to be pocketing food between the cheek and gums and frequently coughs when swallowing. What action should the COTA take INITIALLY in response to this observation? -Tell the dining room aide to have the resident sip water between bites. -Inform the charge nurse and recommend a swallowing evaluation. -Document the findings in the resident's chart and request a referral to OT.
-Inform the charge nurse and recommend a swallowing evaluation.
A COTA working in an outpatient setting wants to search current evidence about interventions that can be incorporated into daily sessions with clients. Which search method would be MOST BENEFICIAL to use for this purpose? -Locate diagnostic-specific studies based on systematic randomized control trials. -Review level II evidence with studies having a minimum of two groups. -Read subjective reports on single-subject case studies written by clinical experts.
-Locate diagnostic-specific studies based on systematic randomized control trials.
Which technique is CONTRAINDICATED to use as part of the intervention for a client who has type 1 complex regional pain syndrome? -Stress-loading -Desensitization -Passive ROM
-Passive ROM
A client has complete loss of function of the dominant arm secondary to a recent brachial plexus avulsion injury. The client is learning compensatory strategies to use when preparing meals. Which strategies would support the client's independence with meal preparation tasks? Select the 3 best choices. -Slice meats and cut foods using a rocker knife. -Use a reacher to get cooking items from above counter shelves. -Stabilize pots and mixing bowls on a non-skid mat. -Cut raw vegetables on a cutting board with stainless steel nails. -Adhere tactile cues to operating knobs of kitchen appliances. -Hang an angled mirror over the cooking surface.
-Slice meats and cut foods using a rocker knife. -Stabilize pots and mixing bowls on a non-skid mat. -Cut raw vegetables on a cutting board with stainless steel nails.
For which of the following conditions is manual muscle testing considered an effective tool for establishing an initial baseline measurement of muscle strength? Select the 3 best choices. -Hemiplegia -Cerebral palsy -Spinal cord injury -Acquired brain injury -Peripheral nerve injury -Guillain-Barré syndrome
-Spinal cord injury Peripheral nerve injury -Guillain-Barré syndrome
A COTA is providing recommendations to the caregiver for a 3-year-old child who has autism spectrum disorder. The child frequently has a temper tantrum while teeth are being brushed and refuses to participate in the activity. Which techniques are beneficial for the COTA to include in the recommendations to the caregiver to improve the child's engagement in teeth brushing? -Experiment with various types of toothpaste. -Encourage the child to try an electric toothbrush. -Use a visual schedule of the self-care task. -Schedule teeth brushing at a different time each day. -Offer flavored oral rinse as positive reinforcement. -Decorate the bathroom so that it is appealing to children.
-Use a visual schedule of the self-care task. -Experiment with various types of toothpaste. -Offer flavored oral rinse as positive reinforcement.
An 18-month-old child has mild hypertonicity secondary to cerebral palsy. When sitting in a standard high chair, the child is initially able to maintain upright sitting but slides forward in the seat after several minutes. Which adaptation would be MOST BENEFICIAL to add to the high chair for supporting the child's ability to maintain upright sitting while in the chair? Abductor wedge Lateral trunk supports Lumbar support
...Abductor wedge
A 13-month-old child has gross motor delays secondary to Down syndrome. One of the Individualized Family Service Plan goals is for the child to walk independently. Currently, the child stands upright without support for several seconds and can cruise while holding on to furniture, but delayed equilibrium reactions inhibit the ability to ambulate without support. Which activity is MOST EFFECTIVE to include as part of the intervention for eliciting equilibrium reactions for walking? -Having the child maintain cross-legged sitting on a scooter board being pulled slowly across the room -Moving the child in prone back and forth on a therapy ball while the child attempts to reach for a toy -Providing the child firm hand-in-hand assistance while guiding the child to walk forward several steps
Having the child maintain cross-legged sitting on a scooter board being pulled slowly across the room
An older adult client has mild cognitive decline secondary to dementia. The client's daily routine includes taking a walk each morning on a familiar route in the neighborhood. The client reports recently experiencing anxiety about the possibility of getting lost during these walks, but wants to continue this daily routine. When provided options, the client is not willing to learn how to use smart phone technology. Which alternate option would be MOST BENEFICIAL for supporting the client's engagement in this preferred activity? -Highlight the walking route on a laminated map of the neighborhood for the client to use. -Secure a tracking device to the client's ankle for the caregiver to monitor the client's location. -Create a picture book containing landmarks for the client to look for during the walk.
Highlight the walking route on a laminated map of the neighborhood for the client to use.
A client recently diagnosed with rheumatoid arthritis reports independence with dressing, but is frustrated that it takes more than an hour to complete this task. The client asks the COTA for suggestions for reducing the time it takes to get dressed each day. What action should the COTA take as an INITIAL response to the client's request? -Teach the client joint protection techniques for minimizing pain that slows dressing. -Identify factors influencing the client's ability to dress at an acceptable pace. -Provide the client with assistive devices to help decrease the time it takes to dress.
Identify factors influencing the client's ability to dress at an acceptable pace.
A young adult client who is legally blind recently enrolled to attend classes at a community college. One of the client's goals is to independently negotiate the campus environment. What INITIAL action should the COTA take for supporting progress toward this goal? -Teach the client to use a text reader to learn the class schedule. -Identify physical barriers the client may encounter on the campus. -Pair the client with a sighted guide when in crowded spaces.
Identify physical barriers the client may encounter on the campus.
An inpatient had a TBI 4 weeks ago and is functioning at Level VI (Confused, Appropriate) on the Rancho Los Amigos scale. The patient will be discharged in 2 days to live at home with the spouse as the primary caregiver. What information is MOST IMPORTANT for the COTA to give to the spouse prior to the patient's discharge? -Contact information of durable equipment vendors -Illustrated checklists to post throughout the home -Strategies to use for reducing caregiver burnout
Illustrated checklists to post throughout the home
A 16-year-old student in high school has a moderate intellectual disability. The transition plan was recently updated to include the student's long-term employment goal. After completion of high school, the student wants to work in a grocery store bagging groceries. In addition to reviewing the job description, what action should the COTA take NEXT to support the student's successful transition to work? -Implement individual sessions to teach the student skills for sorting items. -Provide the life skills teacher essential functions of the job to practice in class. -Assist the student to create visual cues for each step of the job tasks.
Implement individual sessions to teach the student skills for sorting items.
An inpatient had surgery for a coronary artery bypass graft 3 days ago. The patient is preparing for discharge to live at home with a spouse. Which information is MOST IMPORTANT to provide to the spouse prior to the patient's discharge home? -Brochures about outpatient OT service availability -Informational booklets about durable medical equipment -Instructions about activity guidelines and sternal precautions
Instructions about activity guidelines and sternal precautions
A COTA who works in an acute psychiatric setting is selecting activities for a coping skills group. The group has an open membership format and, on average, each patient attends the group twice during the admission. The objective of the group is to help the patient select positive lifestyle options to use while in the hospital, and suggest ways the patients can continue using these options after discharge. What types of activities would be BEST to consider for this group? -Stress management techniques based on participant needs and abilities -Leisure tasks that address the individual interests of the patients in the group -Protocol-driven activities based on an established clinical pathway
Leisure tasks that address the individual interests of the patients in the group
A resident of a skilled nursing facility who has mild dementia and a moderate age-related hearing impairment is participating in OT. What action should the COTA take when providing instructions to the resident during a session? -Stand next to the resident and write task steps on a communication board. -Maintain direct eye contact whenever speaking with the resident. -Supplement verbal communication with hand gestures as much as possible.
Maintain direct eye contact whenever speaking with the resident.
A COTA working in an acute care setting is scheduling sessions for an inpatient recently diagnosed with Guillain-Barré syndrome. Which factor is MOST IMPORTANT to consider when determining the frequency and duration of these sessions? -Therapy minutes required based on the Resource Utilization Group -Patient's current level of physical tolerance -Staffing available to assist as needed with this patient
Patient's current level of physical tolerance
An inpatient who has Parkinson's disease is preparing for discharge to live alone at home. The patient is independent in ADL but frequently loses balance and is at-risk for falls. What information is MOST IMPORTANT for the COTA to report during the patient's interprofessional discharge planning meeting? -Patient's understanding of environmental barriers within the home -Cost of environmental modifications needed in the patient's home -Social services available to assist the patient after discharge home
Patient's understanding of environmental barriers within the home
An inpatient who has hemiplegia secondary to a CVA is learning adaptive strategies to use when putting on a pair of pants from a seated position. What modifications to the typical dressing technique should the COTA teach the patient to use when starting to put on pants? -Position the unaffected leg in midline with the knee flexed to 90°. -Lift the unaffected leg over the affected leg into a crossed position. -Place the unaffected foot into the pant leg pulling the pants up to the level of the knee.
Position the unaffected leg in midline with the knee flexed to 90°.
A COTA is preparing a group activity for residents of a skilled nursing facility who have dementia and are functioning at Allen Cognitive Level 4 (Goal-Directed Actions). The purpose of the activity is to increase the resident's engagement in a structured task. Which activity would be MOST BENEFICIAL to use for this purpose? -Assembling a wooden birdhouse from a kit -Preparing a familiar stovetop meal -Reviewing current events in the newspaper
Preparing a familiar stovetop meal
An adolescent in an inpatient setting recently underwent surgery for bilateral transfemoral amputations. The COTA is teaching the patient how to use a sliding board to transfer from the bed to the bedside commode in preparation for toileting. Which instructions should the COTA use when teaching this type of transfer? -Push down with both arms to lift or slide the buttocks along the board. -Shift upper body weight forward from the buttocks while sliding. -Scoot hips forward and back on the board to facilitate movement.
Push down with both arms to lift or slide the buttocks along the board.
A client who has low back pain is participating in a pain management program. One of the intervention goals is for the client to learn proper body mechanics to use when lifting bags of groceries out of the car. Which strategy should the COTA teach the client to use for supporting progress toward this goal? -Rotate the torso when picking up heavy bags. -Bend forward at the waist to pick up grocery bags. -Reach for one bag of groceries at a time.
Reach for one bag of groceries at a time.
A COTA wants to use current evidence to learn more about the benefits of using assistive technology for older adult clients who have low vision. The COTA found practice guidelines in the OT department related to assistive technology and this older adult population. Which level of evidence would the COTA search for NEXT to meet the COTA's needs? -Expert opinions of board-certified pediatric clinicians -Randomized control trials found in the literature -Systematic scoping review from a variety of sources
Systematic scoping review from a variety of sources
A COTA and OTR want to develop a community-based program for individuals who have an enduring mental illness. The purpose of the program would be to help the individuals obtain and maintain meaningful work experiences. What is the FIRST stage of this process? -Talk to social agencies to identify funding sources for the program. -Identify resources currently available for meeting specific needs. -Survey employers to determine their willingness to provide jobs.
Talk to social agencies to identify funding sources for the program.
A client has relapsing-remitting multiple sclerosis. Tremors and incoordination interfere with the client's ability to handwrite brief reminder notes to family members regarding schedules and activities. The client wants to be able to continue using this form of communication with the family. Which adaptive technique would be MOST EFFECTIVE for supporting the client's ability to write these notes? -Advise the client to write with a wide-barrel pen that has a foam cushion grip. -Provide the client with lightweight writing aids to provide stability for the fingers. -Teach the client to stabilize elbow, forearm, and wrist on a flat surface when writing.
Teach the client to stabilize elbow, forearm, and wrist on a flat surface when writing.
A client who has mild cognitive decline secondary to Alzheimer's disease resides in an independent living facility. The client routinely attends a facility-sponsored exercise class in the gymnasium located on the opposite side of the facility from the client's apartment. The activity staff report that the client has arrived late for the past several sessions. When asked about the tardiness the client states, "The maze of hallways is so confusing in this place." What action should the COTA take INITIALLY to help the client navigate the route from the apartment to the gymnasium? -Teach the client to use the wayfinding signs posted in the hallways on the route. -Have the client draw a map of the facility and highlight the hallway routes to take. -Provide the client with written instructions to use when walking in the hallways.
Teach the client to use the wayfinding signs posted in the hallways on the route.
A patient was admitted to an acute care setting 7 days ago for treatment of severe depression. OT intervention throughout the week focused on identifying meaningful roles, habits, and routines, and using positive self-talk to complete BADL. What additional intervention activities would support carry-over of this intervention after discharge? -Assist the patient to establish a daily schedule of activities for resuming previous roles. -Teach the patient ways to integrate relaxation exercises into typical daily routines. -Provide the patient with handouts that include guidelines for establishing healthy habits
Teach the patient ways to integrate relaxation exercises into typical daily routines.
An OTR and a COTA are gathering information to update the occupational profile of a student who has a sensory processing deficit. As part of this process, the COTA will ask the student's parents to complete a sensory profile. What is the PRIMARY reason for using this tool for this purpose? -To determine the student's developmental level as compared to a normative group -To provide objective data to the pediatrician about the student's sensory deficits -To understand how the student responds to a variety of experiences during a typical day
To understand how the student responds to a variety of experiences during a typical day
An 8-year-old child has Normal (5/5) functional strength of proximal upper extremities and Good (4/5) strength distally resulting in a weak cylindrical grasp. This interferes with the child's ability to brush teeth independently. Which assistive device would be MOST BENEFICIAL for the child to use for maximizing independence while brushing teeth? -Toothbrush with a built-up handle -Extended handle toothbrush -Universal cuff with hook and loop strap
Toothbrush with a built-up handle
A 5-year-old student who has autism and is non-verbal is learning to communicate using the Picture Exchange Communication System (PECS). The Individualized Education Program (IEP) team is reinforcing learning based on the established protocol. Currently, the student is able to present a picture of a desired item to both the classroom teacher and others who are not part of the IEP team in exchange for the actual item. What method should the COTA use during OT as the student progresses to the NEXT phase of the PECS protocol? -Support the student to select from many picture options within similar categories such as clothing. -Ask the student to comment about the classroom environment responding with words such as "I see." -Use a sentence strip to combine simple printed phrases such as "I want" with a familiar picture.
Use a sentence strip to combine simple printed phrases such as "I want" with a familiar picture.
A 4-year-old child has a seizure disorder and a strong bite reflex associated with objects being placed in the mouth. The child requires full assistance from a caregiver for brushing teeth and is observed to bite down on the toothbrush when it is placed in the mouth. Which technique is BEST for the COTA to teach the caregiver to use with the child in order to promote proper oral hygiene? -Firmly rub the child's teeth and gums with a moist textured cloth. -Apply toothpaste to a finger and rub the finger along the child's teeth. -Use a water pick external to the child's mouth instead of a toothbrush.
Use a water pick external to the child's mouth instead of a toothbrush.
A patient who had a total hip replacement, posterolateral approach 3 days ago is learning to get into a car. The caregiver opens the front car door on the passenger side and slides the car seat back. The patient ambulates toward the car using a walker. How should the COTA instruct the patient to proceed with the NEXT step of the transfer? -Use the walker to slowly turn around and back up to the front passenger seat. -Place both feet close together before bending forward to sit in the front passenger seat. -Extend the unaffected leg in preparation for sitting in the front passenger seat.
Use the walker to slowly turn around and back up to the front passenger seat.
An inpatient who had a right CVA reports consistently having difficulty locating items on the meal tray. The COTA suspects that the patient has visual neglect. In which situation during a mealtime self-feeding session would this deficit be MOST EVIDENT? -When food items are placed on a tray with contrasting background -When eating utensils are located to the right of the patient's midline -When the plate is placed within the patient's left visual field
When the plate is placed within the patient's left visual field
