FINAL

A COTA® is leading a group for clients who have depression and are unable to initiate tasks or make choices about what to do. Which leadership style would be MOST effective with this group? A. Directive B. Facilitative C. Advisory D. Co-leadership

A. Directive

Which of the following elements is an important component of the Recovery Model? A. Peer support and teaching B. Social-emotional learning C. Cognitive-behavioral therapy D. Sensory-motor interventions

A. Peer support and teaching

An OTR® and COTA® team who work with adult clients with mental illness attend an introductory workshop on guided imagery. The OTR® and COTA® want to begin applying the skills obtained from the workshop with clients. With which of the following clients would it be MOST appropriate for the OTR® and COTA® to use guided imagery? A. Clients with generalized stress disorder B. Clients with chronic schizophrenia C. Clients with chronic bipolar disorder with psychotic episodes D. Clients with schizoaffective disorder

A. Clients with generalized stress disorder

A COTA® is providing intervention to a client with an anxiety disorder who hyperventilates when faced with difficult work tasks. The COTA begins to work with the client on physiological responses and the thought processes leading up to the panic attacks and suggests that the client begin journaling. What frame of reference does this intervention suggest? A. Cognitive-behavioral B. Psychodynamic C. Cognitive disability D. Behavioral

A. Cognitive-behavioral

A COTA® 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

A. Coping skills

A COTA® is running a group with clients with schizophrenia in an inpatient psychiatric facility. The group members have low cognitive ability, minimal insight into the condition, and low motivation, and they do not know each other very well. What leadership style would be BEST for the COTA to use? A. Directive B. Facilitative C. Cooperative D. Advisory

A. Directive

A COTA® who works with adult clients with mental illness attends an introductory workshop on guided imagery. The COTA wants to begin applying the skills obtained from the workshop with clients. For which type of disorder is guided imagery an appropriate intervention technique? A. Generalized stress disorder B. Chronic schizophrenia C. Bipolar disorder with psychosis D. Schizoaffective disorder

A. Generalized stress disorder

A COTA® is working with an adult client with severe depression who is able to converse. Which approaches would facilitate engaging in a client-centered process? Select the 3 BEST choices. A. Paying attention to the meaning of nonverbal cues B. Being directive with the client C. Being empathetic with the client D. Asking closed-ended questions E. Asking questions with little time for response F. Using moments of silence to ask questions

A,B,C

A client arrives at the occupational therapy clinic 10 minutes late for an appointment, crying uncontrollably. When the COTA® attempts to engage the client in conversation, the client responds, "I don't want to talk about it. Is that so bad?" What responses from the COTA would be appropriate? Select the 3 BEST choices. A. "It must be very difficult." B. "I understand; would you like to take a few more minutes?" C. "Thank you for being here; take your time and speak when you are ready." D. "Let's have our session later, after you've stopped crying." E. "You are upset. How can I help you?" F. "Come on, now; that's enough of that."

A,B,C

A COTA® working in an outpatient psychiatric setting has been meeting monthly with a closed-membership group of people with depression to promote socialization. Up to this point, the group has been functioning as a parallel group, but the participants are ready to progress to the next level, a cooperative group. Which activities would be appropriate to facilitate this transition? Select the 3 BEST choices. A. Organize making a quilted wall hanging for the reception area to which each participant contributes a square B. Design a music playlist for the next group meeting that includes the music interests expressed by each group member C. Have participants plant seeds in ceramic pots that they decorate themselves D. Distribute journals in which participants write their own poetry collection E. Have participants plan a dinner to which each participant contributes a dish F. Appoint a leader to organize a sale of baked goods that the participants are responsible for promoting

A,B,E

Which occupational therapy groups would benefit from a highly directive and authoritative leadership style? Select the 3 BEST choices. A. A group of young adults who were recently released from incarceration engaging in a court-ordered community reentry program B. A group of adolescents diagnosed with oppositional defiant disorder attending a gang prevention group in an alternative education setting C. A group of middle-aged clients in an outpatient day treatment setting who are learning to manage their depression D. A group of healthy older adults in an apartment complex exploring ways to stay fit and healthy E. A group of older recent stroke survivors engaging in a ROM and exercise group F. A group of preschool children exploring sensory experiences to develop age-appropriate prehension and grasp skills

A,B,E

The spouse caregiver of a client with advanced Alzheimer's disease tells the COTA that the client has become more confused and agitated, is uncooperative when receiving care, and displays inappropriate and sometimes destructive behavior. The caregiver confides that the stress has begun to feel overwhelming. Which occupational therapy interventions are appropriate? Select the 3 BEST choices. A. Training the caregiver to provide simple, one-step directions during caretaking tasks to reduce the client's agitation B. Training the caregiver to avoid distractions from the task at hand when providing care to the client C. Providing assertiveness training with the spouse in how to handle the client's difficult behaviors D. Facilitating conflict resolution sessions between the caregiver and client to remediate differences E. Role-playing with the caregiver and client ways of providing explanations that will clarify the client's confusion F. Providing task simplification training sessions with the caregiver

A,B,F

An 18-year-old client is admitted to an inpatient psychiatric hospital. The psychiatrist describes an uninterrupted 18-month period of illness that includes visual and auditory hallucinations. What type of issues would the COTA® expect to see when the client attempts to do a task? A. Aggressive outbursts of behaviors when frustrated with a project B. Overassertive, controlling behaviors during group activities C. Difficulty engaging in problem solving D. Panic over task choices

A. Aggressive outbursts of behaviors when frustrated with a project

A COTA® is using Fidler's task-oriented group as a context for treatment to help participants explore healthy ways to deal with conflict. Which of the following activities would be BEST for this group? A. An activity that is challenging and likely to cause tension among members B. An activity that is highly structured so participants know exactly what is expected of them C. A parallel group activity that enables participants to work alongside one another D. An activity that facilitates participants' success and thus improves their self-esteem

A. An activity that is challenging and likely to cause tension among members

A COTA® is scheduled to lead a discussion group for clients attending an outpatient psychiatric facility. What planning should the COTA® do in advance of the discussion to MOST EFFECTIVELY promote interaction within the group? A. Arrange the chairs so the group and leader sit in a circle B. Place the chairs in rows with the least talkative participants in front C. Sit next to the participants who tend to be most quiet D. Have the most talkative participants directly across from the COTA®

A. Arrange the chairs so the group and leader sit in a circle

A COTA® is working in a nonprofit transitional work program for people who have mental illnesses. Which assessment would be MOST effective for determining goals from the client's perspective? A. Canadian Occupational Performance Measure B. Valpar Component Work Samples C. Minnesota Rate of Manipulation D. Semmes-Weinstein monofilament test

A. Canadian Occupational Performance Measure

A COTA® working with an adult client with major depression in an inpatient setting intervenes with the client to reduce the impact of occupational and environmental demands on performance of daily occupations. What is most likely to be the COTA®'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

A. Modifying the environment or the occupation to reduce demands, address personal goals, and use developed skills

The caregiver of a client with Alzheimer's disease questions the home health COTA® about a recent increase in the client's dosage of donepezil (Aricept) prescribed by the physician. The caregiver is particularly concerned about potential consequences of the increased dosage. What is the COTA®'s most appropriate suggestion for the caregiver? A. Observe the client for signs of dizziness, which increases potential for falls. B. Because the medication can cause photosensitivity, keep the client out of direct sunlight. C. Have the physician monitor the client closely for potential drug toxicity. D. Monitor the client's hydration carefully because the drug can cause dry mouth and constipation.

A. Observe the client for signs of dizziness, which increases potential for falls.

A COTA® working in an outpatient psychiatric setting has been meeting monthly with a closed-membership group of people with depression to promote socialization. Up to this point, the group has been functioning as a parallel group, but the participants are ready to progress to the next level, a cooperative group. Which activities would be MOST appropriate for such a group? A. Organize making a quilted wall hanging for the reception area where each participant contributes a square B. Appoint a leader to organize a sale of baked goods for which the participants are responsible for promoting C. Have participants plant seeds in ceramic pots that they decorate themselves D. Distribute journals in which participants write their own poetry collection

A. Organize making a quilted wall hanging for the reception area where each participant contributes a square

A client diagnosed with dissociative personality disorder is admitted to an inpatient psychiatric hospital as a result of suicidal behavior and impulses, severe anxiety, and periods of violence brought on by the emergence of new personalities. How is the COTA® in this milieu therapy setting likely to intervene? A. Provide a safe, nonthreatening, success-oriented environment to increase the client's sense of control. B. Offer group therapy opportunities for verbalizing experiences and describing other personalities. C. Offer group training in development of coping skills. D. Offer participation in psychodrama groups to encourage catharsis.

A. Provide a safe, nonthreatening, success-oriented environment to increase the client's sense of control.

A client with multiple sclerosis (MS) is displaying symptoms of depressed mood. The client has been referred to occupational therapy by a physician because of increasing feelings of difficulty with life tasks secondary to depression. The COTA® asks how the client feels, and the client responds, "I just don't feel like I can do anything right." Which strategy would be appropriate for the COTA to implement? A. Provide tasks that are graded for successful completion B. Implement energy conservation techniques C. Provide fine motor tasks to improve motor skills D. Discuss areas of life in which the client feels unhappy

A. Provide tasks that are graded for successful completion

client with bipolar disorder in an outpatient setting is having difficulty following a medication routine. The client does not understand the physician's orders for the medication and prefers to take medication with some alcohol because it "helps take the edge off." What approach would be appropriate for the COTA® to take on this visit? A. Provide the client with information about the prescribed medication, dosage and timing, precautions, and side effects. B. Develop a treatment plan that includes activities to enhance occupational balance and leisure. C. Instruct the client in breathing and relaxation activities to decrease the feeling of being on edge. D. Suggest that the client participate in a group facilitated by the COTA titled "Get Your Life Back—NOW!"

A. Provide the client with information about the prescribed medication, dosage and timing, precautions, and side effects.

A COTA® uses cognitive-behavioral interventions in psychosocial practice with clients with stress and anxiety disorders. What intervention is the COTA® MOST likely to use? A. Psychoeducation that provides resources and information about the client's illness and ways to cope with it B. Creative expression using art to free underlying emotions and conflicts C. Psychotherapy that builds trust in the client-therapist relationship and brings unconscious conflicts to a conscious level D. Reminiscence to increase awareness of remote memories and thereby improve the ability to recall and recognize

A. Psychoeducation that provides resources and information about the client's illness and ways to cope with it

Which is an element of social skills training used by COTA®s? A. Role playing B. Psychoeducation C. Rote training D. Authoritative guidance

A. Role playing

Regarding mental health services, of what is the place-and-train approach an example? A. Supported employment B. Transitional employment C. Job matching D. The clubhouse model

A. Supported employment

The spouse of a client with Alzheimer's dementia tells the COTA® that the client has become more agitated, wanders, resists care, and displays inappropriate and sometimes destructive behavior. The spouse confides that feelings of stress have begun to feel overwhelming. Which occupational therapy intervention is most appropriate? A. Training the spouse to provide simple, one-step directions and avoid abstractions B. Role playing with the spouse and the client ways of providing explanations that will clarify the client's confusion. C. Assertiveness training with the spouse D. Conflict resolution sessions between the spouse and client

A. Training the spouse to provide simple, one-step directions and avoid abstractions

A COTA® wants to develop a group activity for clients with personality disorder in an inpatient psychiatric facility. The group has Allen Cognitive Level (ACL) scores ranging from 5.0 to 5.4. What activity would be MOST appropriate to use with these clients in the initial stages of the group? A. Volunteer activities in the community B. Long-term budgeting for house repairs C. Vocational retraining and job seeking D. Role-playing social interactions

D. Role-playing social interactions

A COTA® is conducting a woodworking group in the psychiatric unit of a federal correctional facility. Policies and procedures are established in such facilities to ensure the safety and welfare of inmates and staff. Which statements reflect policies and procedures related to a woodworking group that address the safety and welfare of all inmates at this facility? Select the 3 BEST choices. A. Participants are responsible for putting away tools and cleaning up all work areas. B. No participant may return to the housing units until all tools have been counted. C. Participants are allowed to have coffee and a snack only at the conclusion of the group session. D. The OTR® may not allow a COTA to run groups in federal correctional facilities. E. Woodworking projects are to remain in the workroom at the conclusion of the group session. F. Participants must be prescreened and selected with consideration for safety and risk.

B,E,F

A client arrives for an occupational therapy evaluation upset because of an inability to travel home in time to attend the wedding of a family member. Which response by the COTA® communicates a professional use of empathy? A. "Why don't you come back later when you are feeling better?" B. "You seem upset that you are going to miss the wedding." C. "Life goes on. It will be OK." D. "You need to calm down so we can complete your occupational therapy for today."

B. "You seem upset that you are going to miss the wedding."

A client who presents at an outpatient occupational therapy clinic for an evaluation is crying, because the client will not be able to go home in time to attend the wedding of a family member. Which response BEST communicates empathy? A. "Why don't you come back later when you are feeling better?" B. "You seem upset that you are going to miss the wedding." C. "Life goes on. It will be OK." D. "You need to stop crying so we can complete your occupational therapy session today."

B. "You seem upset that you are going to miss the wedding."

In which of the following groups is group process the MOST important? A. An open-membership group for people with stroke that meets weekly, in which the COTA® demonstrates self-ROM and then participants range their own extremities to demonstrate that they understand the correct procedures B. A closed-membership group for war veterans that meets daily to facilitate coping with the impact of posttraumatic stress disorder by engaging in expressive media, discussion, and reflection C. A diagnosis-specific group for patients with arthritis that meets weekly to measure ROM, monitor pain control, and discuss energy conservation techniques D. A group for adolescent students in an after-school program who are receiving tutoring in math, reading, and fine motor skills

B. A closed-membership group for war veterans that meets daily to facilitate coping with the impact of posttraumatic stress disorder by engaging in expressive media, discussion, and reflection

Which occupational therapy group would benefit MOST from a highly directive and authoritative leadership style? A. A group of preschool children exploring sensory experiences to develop age-appropriate prehension and grasp skills B. A group of adolescents diagnosed with oppositional defiant disorder attending a gang prevention group in an alternative education setting C. A group of middle-aged clients in an outpatient day treatment setting who are learning to manage their depression D. A group of healthy older adults in an apartment complex exploring ways to stay fit and healthy

B. A group of adolescents diagnosed with oppositional defiant disorder attending a gang prevention group in an alternative education setting

Which class of psychopharmaceutical drugs is mood elevating but may increase suicidal tendencies in young adults and carries a small risk of causing hypomania or mania? A. Adrenergic receptor drugs B. Antidepressants C. Anticholinergics D. Antipsychotics

B. Antidepressants

While participating in an occupational therapy activity group, a client becomes highly confrontational with other clients in the group for no apparent reason. During a discussion with the OTR® and COTA®, the client states that if she continues self-mutilating behaviors, her family will no longer allow the client to live at home. Documentation from the psychologist indicates that the client has behaved this way for years. What diagnosis does this client MOST likely have? A. Narcissistic personality disorder B. Borderline personality disorder C. Paranoid personality disorder D. Posttraumatic stress disorder (PTSD)

B. Borderline personality disorder

Which group activity would be the MOST appropriate to engage clients in an expressive activity using the psychodynamic approach? A. Baking chocolate chip cookies B. Constructing a magazine collage C. Hiking in the woods D. Attending a dance performance

B. Constructing a magazine collage

An extremely agitated adult is admitted to an inpatient psychiatric hospital late on a Friday afternoon. Because nursing is short staffed, the nurse on the unit requests that the patient attend an occupational therapy group being led by a COTA® that evening. The COTA® calls the OTR®, who is working at a location far from the unit, for guidance. The OTR® is unable to return to the unit in time to evaluate the client before the session. What is the BEST course of action the OTR® would direct the COTA® to take? A. Allow the patient to attend the group B. Do not allow the patient to attend the group C. Cancel the group and evaluate the client D. Permit the patient to attend the group because the OTR® will complete the evaluation upon returning to the unit.

B. Do not allow the patient to attend the group

A COTA® in an adult day treatment program decides to use a group intervention with clients with schizophrenia who live in a supported living environment with 24-hour supervision. The COTA believes that a sensorimotor approach would help the clients reach their goal to increase independence in overall function and goal-directed activity in the home context. What would be an appropriate group activity that uses the sensorimotor approach? A.Discussing task performance B.Exercising to music C.Using a sensory room D.Baking cookies

B. Exercising to music

A summer picnic has been planned for clients in a day treatment program for people with mental illness. Before leaving, what medication-related precaution should the COTA® review with the clients? A. Effects of combining alcohol use with medications B. Need to protect oneself from direct sun when taking psychotropic medications C. Increased likelihood of temporary ataxia after consuming foods typically contraindicated for monoamine oxidase (MAO) inhibitors D. Need to take medications before leaving for the picnic to avoid losing them

B. Need to protect oneself from direct sun when taking psychotropic medications

A COTA® is conducting a woodworking group in the psychiatric unit of a federal correctional facility. Which statement best reflects the policies and procedures related to this group that involves the safety and welfare of all inmates at this facility? A. All participants must put away tools and clean up all work areas B. No participant may return to the housing units until all tools have been counted. C. Participants are allowed to have coffee and a snack only at the conclusion of the group session. D. The OTR® may not allow a COTA® to run groups in federal corrections facilities.

B. No participant may return to the housing units until all tools have been counted.

A COTA® is conducting a cooking activity in an outpatient occupational therapy group in a community mental health setting. One of the group members is an adult with obsessive-compulsive disorder (OCD). During meal preparation, the client washes hands repetitively and excessively each time the client touches a food item, which delays the group's progress in the activity. What should the therapist do to help the client more efficiently perform the task? A. Assign the client to a role that does not involve touching food. B. Remind the client of triggers for compulsive behavior and recommend use of latex gloves for the activity. C. Encourage the client to use utensils to avoid touching the food. D. Assign the client the role of teaching and managing hygienic cooking behaviors.

B. Remind the client of triggers for compulsive behavior and recommend use of latex gloves for the activity.

A COTA® 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 emotionally. Additionally, this client does not show an interest in returning to work or singing in the choir at church. Which assessment would help identify whether 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

B. Role Checklist

A COTA® 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. Indoor sports activities

B. Skills in performing ADLs and IADLs

An OTR® and COTA® team begin 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.

B. Supported employment programs with a "place-and-train" perspective are more effective than other vocational approaches.

A COTA® is helping a client with Level 1 autism spectrum disorder without intellectual impairment (Asperger syndrome) adjust to the employment demands of a fast-paced office that is noisy and filled with sensory stimulation. Which recommendation would be BEST? A. That the client ask the other workers to be quieter to better be able to concentrate B. That the client use a noise cancellation headset or white noise channeled into ear buds C. That the client's desk be located in the center of a large room with six other desks, providing the support of others D. That the client use a speaker phone to answer calls hands free while using the hands to manipulate a stress ball

B. That the client use a noise cancellation headset or white noise channeled into ear buds

According to the Model of Human Occupation (MOHO), occupational therapy intervention will best benefit adult clients with mental illness through which of the following approaches? A. Understanding the interaction between the client's perceived level of task mastery and the demands of the environment B. Understanding the client's dimensions of occupational participation and performance C. Understanding how the environment can be adapted, modified, and restored to enable effective performance D. Understanding how the client uses sensory information in the environment

B. Understanding the client's dimensions of occupational participation and performance

An OTR® and COTA® team want to develop interventions for homeless adults with mental illness to improve independent living skills. Which of the following roles is MOST appropriate for the team? A. Employment retraining B. Job searching C. Housing procurement D. Room and self-care management

D. Room and self-care management

Which statement BEST describes an important consideration for COTA®s working with clients with dementia and their caregivers? A. Providing a variety of new occupations creates a sense of well-being for the caregiver and care recipient. B. A brief respite from caregiving benefits the caregiver but is detrimental to the care recipient. C. Everyday occupation is central to a caregiver's sense of well-being. D. Psychologically resisting the inevitability of chronic illness improves satisfaction with caregiving.

C. Everyday occupation is central to a caregiver's sense of well-being.

A COTA® is facilitating a task-oriented group with five group members and observes that the group is in the storming phase of group development. Which characteristics are typical of the storming phase of group development? Select the 3 BEST choices. A. The group is now running smoothly and handles problems efficiently after two participants worked out their differences early on. B. The group is meeting for the first time, and participants are asking the group leader for help because they do not understand the task at hand. C. A participant who has recently joined the group disagrees with everything another participant says, and a third participant questions whether accomplishing the task is even possible. D. The group leader is exhausted by all the questions about the details of the finished product. No one seems to want to work together, and the participants seem to expect the leader to solve this problem. E. Two group members disagree and begin to argue while a third group member adds uninvited comments. F. A group member questions the group leader as to why the group is meeting and appears uninterested in the process.

C,E,F

A client served 18 months in a forensic facility and was released to a halfway house; the client is now participating in a community reentry program. Which areas would be the focus for an occupational therapy program? Select the 3 BEST choices. A. Dressing and bathing skills B. Decision-making skills C. Budgeting and shopping skills D. School readiness skills E. Prioritization and time management skills F. Home management and homemaking skills

C,E,F

When working with a client with chronic pain, the OTA® needs to set a tone that will facilitate a therapeutic relationship with the client. Which statement sets an open and appropriate tone when working with a client who has chronic pain? A. "Your pain is all in your head. All you have to do is ignore it." B. "I have pain when I wake up in the morning. I have arthritis. It usually takes a while before it gets any better. Maybe you should try to exercise in the morning to get things moving, like I do." C. "I realize that you are in pain. Let's try this activity and see what happens. If you need to stop, let me know, but I would like to see you push yourself." D. "I think we should slowly increase the time you are spending at work-related tasks so that you can get back to work as soon as possible."

C. "I realize that you are in pain. Let's try this activity and see what happens. If you need to stop, let me know, but I would like to see you push yourself."

A COTA® is approached by a client with Alzheimer's dementia who asks, "Do I finish high school next year, or am I already finished? I don't want to go back." What is the BEST response for the COTA® to make? A. "Try to remember that you completed high school 60 years ago. Would you like to see your graduation picture?" B. "I'll have to find out if you finished high school. Could you ask me again at a later time?" C. "It sounds like you're a little worried about that. You're already finished with high school. You don't have to go back." D. "Didn't you go to college?"

C. "It sounds like you're a little worried about that. You're already finished with high school. You don't have to go back."

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, the supervising 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.

C. A model of the completed project is provided for the client to imitate. Simple instructions are provided.

Which statement BEST describes a task-oriented group in the "storming" phase of group development? A. The group is now running smoothly and handles problems efficiently because two participants were able to work out their differences early on B. The group is meeting for the first time, and participants are asking the group leader for help because they do not understand the task at hand. C. A participant who has recently joined the group sets up a roadblock to everything another participant says, and a third participant questions whether accomplishing the task is even possible. D. The group leader is exhausted by all the questions about the details of the finished product. No one seems to want to work together, and the participants seem to expect the leader to solve this problem.

C. A participant who has recently joined the group sets up a roadblock to everything another participant says, and a third participant questions whether accomplishing the task is even possible.

A client scores an Allen Cognitive Level (ACL) of 4.0 with the Allen Cognitive Disability Framework. A COTA® is working with the client in an adult day treatment center. A. Any project with mostly familiar steps; no more than two steps of the task should require new learning. B. A project that is unstructured; the client should be given opportunities to find and revise errors. C. A project that is set up with a model final product; simple instructions should be provided, along with supervision. D. A project that encourages relatively independent planning and organizing to complete; none of the steps should require new learning.

C. A project that is set up with a model final product; simple instructions should be provided, along with supervision.

A COTA® is using groups in a residential rehabilitation facility for people with substance abuse. The COTA has identified a group of clients who have difficulty with assertiveness during encounters with significant others. The COTA decides to use role playing with the group members to help them improve their response in such events. What frame of reference does this intervention choice suggest? A. Psychodynamic B. Sensorimotor C. Behavioral D. Developmental

C. Behavioral

A client served 18 months in a forensic facility and was released to a halfway house; the client is now participating in a community reentry program. Which of the following areas of occupation would be the best focus for an occupational therapy program? A. Dressing and bathing skills B. Decision-making skills C. Budgeting and shopping skills D. School readiness skills

C. Budgeting and shopping skills

A young adult client with anorexia nervosa is referred to occupational therapy after an episode of depression for which the client was briefly hospitalized. The client presents with concerns about using time meaningfully to reduce both depression and urges to binge and purge. What is the MOST appropriate initial plan for the OTR® and COTA® team to develop with this client? A. Client will enroll in a master swimming program to encourage continuation of a sport in which the client was previously active. B. Client will choose a different restaurant each day and eat lunch or dinner alone there. C. Client will explore volunteer options and allow the OTR® or COTA® to accompany the client to the first volunteer meetings. D. The OTR® or COTA® will enroll the client in a support group for people with anorexia nervosa.

C. Client will explore volunteer options and allow the OTR® or COTA® to accompany the client to the first volunteer meetings.

A COTA® believes that changing clients' negative beliefs ultimately reduces negative emotional statements and leads to a change in behavior. What is the COTA's main theoretical perspective? A. Cognitive disability B. Developmental C. Cognitive D. Sensorimotor

C. Cognitive

A COTA® is providing intervention to a client with an anxiety disorder who hyperventilates when faced with difficult work tasks. The COTA (with the client's permission) works with the employer to identify work tasks in which the client can be successful. What frame of reference does this intervention suggest? A. Cognitive-behavioral B. Psychodynamic C. Cognitive disability D. Behavioral

C. Cognitive disability

A COTA®'s guiding framework about improving the lives of clients with mental illness is that changing clients' negative beliefs about experiences and situations ultimately reduces negative emotional states and behaviors. What is the COTA®'s main theoretical perspective? A. Psychoanalytic B. Developmental C. Cognitive-behavioral D. Occupational

C. Cognitive-behavioral

A COTA® is intervening with a client who is in an active state of mania. The client has difficulty concentrating on the assessment procedure and displays disruptive behavior, saying the COTA is "stupid" and "asking dumb questions." The COTA tells the client, "I would like to help you, but I will not tolerate this behavior. You are not being nice to me right now, and I deserve to be treated better than this." Which interpersonal strategy does the COTA's statement exemplify? A. Validation B. Limit setting C. Confrontation D. Reframing

C. Confrontation

A COTA® works with elderly clients with low vision. A client with macular degeneration is referred after substantial symptom progression and loss of vision. The client's spouse states that for the past 3 months, the client has uncharacteristically refused to participate in social activities, is frequently irritable and uncommunicative, and is unwilling to perform personal care or routine tasks. What should the COTA® advise the spouse to do? A. Consider exploring assisted living alternatives. B. Insist that the client resume accompanying the spouse to bridge club and prepare a snack to share with the club. C. Encourage the client to consult a mental health provider. D. Advise the client and spouse to seek professional counseling to adjust to the inevitable changes in the marriage.

C. Encourage the client to consult a mental health provider.

An adult client is receiving home health occupational therapy services from a COTA®. At the initial intervention session, an adult child of the client informs the COTA® that the client's spouse passed away 2 months ago. The adult child states that the client has never been so down, that the client has to be encouraged to go to restaurants or movies, and that the client often cries. How should the COTA® respond? A. Tell the client's adult child that the client is experiencing depression and the COTA® will discuss with the OTR® the need for the client to seek psychiatric care. B. Describe the difference between grief and depression to the client's adult child. C. Further explore with the client's adult child the extent of the client's sadness and negative moods before discussing the situation with the supervising OTR®. D. Ask the client's adult child about any potential physical or psychological abuse the client may have experienced in his or her lifetime.

C. Further explore with the client's adult child the extent of the client's sadness and negative moods before discussing the situation with the supervising OTR®.

A COTA® working in an inpatient mental health forensic facility is leading a group of clients who have histories of emotional outbursts and causing harm to themselves or others. Which group design element would have the highest priority? A. Cognitive and educational level of the participants B. Age and gender of the participants C. Location of the meeting room and exits D. Climate and temperature of the meeting room

C. Location of the meeting room and exits

A COTA® working in an inpatient mental health forensic facility is establishing a group for clients who have a history of emotional outbursts and causing harm to themselves or others. What elements should the COTA consider when deciding on the group design? Select the 3 BEST choices. A. Cognitive and educational level of the participants B. Age and gender of the participants C. Location of the meeting room and exits D. Temperature and comfort of the meeting room E. Objects and materials to be used in group activities F. Presence of kitchen utensils, scissors, or sharp objects in the meeting room

C. Location of the meeting room and exits E. Objects and materials to be used in group activities F. Presence of kitchen utensils, scissors, or sharp objects in the meeting room

A COTA® 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

C. Major depression

Through what type of interventions is the field of occupational therapy MOST likely to be successful in demonstrating a population impact on the problem of cocaine and amphetamine abuse disorder? A. Restorative B. Adaptive C. Preventive D. Consultative

C. Preventive

A COTA® is working with a client with bulimia. The client has become preoccupied with hiding purging behaviors from friends and family. While developing an occupational profile with the client, the COTA notices that as the client's bulimia has evolved, the client has replaced many valued activities with the bulimia. The client has severe occupational imbalance, with no participation in anything but binging and purging behaviors. Which strategy would be MOST successful with this client? A. Teach the client relaxation strategies to provide relief from the stress caused by the bulimia. B. Recommend social activities to encourage the client to interact with friends and family in a more positive way. C. Provide the client with leisure activities that will create more balance and offer the client more control over the client's life. D. Assign the client small-group activities with other clients to provide the client with information about the health impact of bulimia.

C. Provide the client with leisure activities that will create more balance and offer the client more control over the client's life.

While a COTA® is working with a client on vocational training in a community-based setting, the client becomes frustrated with a computer task and states, "I am too slow at the computer; I can't do this." The COTA responds, "I notice that you take your time to be very careful not to make mistakes while you are working. I am sure that employers would think that is a positive quality in a job candidate." Which interpersonal strategy does the COTA's statement exemplify? A. Interpretation B. Metaphor C. Reframing D. Encouragement

C. Reframing

An adult with posttraumatic stress disorder (PTSD) is admitted to an inpatient psychiatric unit after a suicide attempt. What would be the BEST initial intervention for a COTA® to attempt with this client? A. Individualized assertiveness training B. Reality-orientation group C. Relaxation-focused group D. Daily routine group

C. Relaxation-focused group

A client who has been a participant in a community integration program for adults with mental illness arrives at an occupational therapy group after not being seen for several weeks. The client's mood is noticeably elevated. The client switches from one topic to another in rapid succession and claims to have not slept for 3 days. The psychiatrist describes the client as having manic episodes. What is the BEST course of action for the COTA® to take? A. Recommend individual sessions to catch up on missed goals during the client's absence. B. Allow the client to rest, and then resume therapy. C. Resume group therapy sessions as soon as possible and apply cognitive-behavioral methods. D. Discuss with psychiatrist the possible need for the client to receive medication to improve behaviors.

C. Resume group therapy sessions as soon as possible and apply cognitive-behavioral methods.

During an initial interview with a young adult who has Level 1 autism spectrum disorder without intellectual impairment (Asperger syndrome), the COTA® becomes aware that the client lives alone and is isolated, does not go out much, does not value family relationships, and does not seem to have any friends. Additionally, the client is not gainfully employed and does not take care of the apartment. The client spends most of the day surfing the Web and watching TV. Using the Model of Human Occupation, which of the following assessments would be the MOST appropriate? A. A projective test such as House-Tree-Person B. Worker Role Interview C. Role Checklist D. Canadian Occupational Performance Measure

C. Role Checklist

A COTA® is working with a client who has major depression and works for a service-based business that opens at 9:00 a.m. and closes at 5:00 p.m. The client finds work meaningful but is unable to keep up with a full-time schedule because of the depression. The COTA would like to advocate for workplace accommodations. According to the Americans With Disabilities Act of 1990 (ADA), what is a reasonable accommodation for this client? A. The client should be allowed to work 3 hours per day. B. The client should be given a flexible start time. C. The client could job share with a coworker. D. The client can break for 3 hours in the middle of the day.

C. The client could job share with a coworker.

During a journal reading activity led by the COTA®, a client becomes very emotional when disclosing sensitive personal feelings on how the client's family perceives the client's admission to the mental health facility. Several other clients recognize that they share the same feelings and perceptions, which makes the client feel better. According to Yalom's therapeutic factors in groups, what curative factor is this? A. Altruism B. Catharsis C. Universality D. Cohesion

C. Universality

A client with depression enjoyed exercising in the past because it helped the client experience more positive feelings. The client now has difficulty finding the motivation to participate in exercise. Which strategy would be BEST for the COTA® to use to encourage this client to resume exercise? A. Use motivational interviewing to encourage exploration of desirable leisure activities. B. Provide opportunities for the client to explore new leisure pursuits. C. Use the remotivation approach to determine the appropriate motivational stage for intervention related to exercise. D. Provide the client with useful feedback about performance in occupational therapy interventions related to exercise and why the client should resume it.

C. Use the remotivation approach to determine the appropriate motivational stage for intervention related to exercise.

A client has two children, a 3½-year-old and a 2-year-old. Because of postpartum depression, she has been unable to return to work since the birth of the younger child. What home- and community-based occupational therapy services would BEST help the client improve her worker role? A. Job simulation and work retraining in the home B. Facilitation of employer-client meetings to negotiate bringing the children to work C. Weekly goal setting, time management activities, and use of a positive-events diary to build self-confidence D. Facilitation of employer-client meetings to negotiate work- at-home options Submit Answer

C. Weekly goal setting, time management activities, and use of a positive-events diary to build self-confidence

A client arrives at the occupational therapy clinic 10 minutes late for a session crying uncontrollably. When the COTA® attempts to engage the client in conversation, the client responds, "I don't want to talk about it. Is that so bad?" Which response would be MOST effective? A. "Let's have our session later, after you've stopped crying." B. "You are upset. How can I help you?" C. "Come on, now; that's enough of that." D. "It must be very difficult."

D. "It must be very difficult."

A client has bipolar disorder. Under supervision of an OTR®, a COTA® focuses, with the client's permission, on the client's work environment because the employer appears to be resistant to providing accommodations and the intervention plan includes goals for work. Consequently, the COTA provides educational information to the client's boss about bipolar disorder. What approach does this intervention strategy take? A. Delay deterioration in performance skills B. Maintain performance of component skills C. Prevent secondary disability and anticipatory action D. Reduce behaviors and environmental barriers

D. Reduce behaviors and environmental barriers

A COTA® is working in an inpatient psychiatric setting where the average length of stay is 5 days. Which group activities would be appropriate for patients with depression? Select the 3 BEST choices. A. A parallel group in which participants work on a free-form clay project of their choice B. A cooperative group in which participants plant a garden C. A project group in which participants paint a watercolor picture on a blank canvas D. A parallel group in which each participant completes his or her own solid-color ceramic tile trivet E. A parallel group in which participants paint simple, preconstructed birdhouses using only two or three colors F. A parallel group in which each participant is involved in a simple activity that requires little decision making and interaction with others

D,E,F

A COTA® working in an outpatient mental health setting meets with a client with depression 3 weeks after the client's discharge from the hospital. The client expresses concern about phenelzine (Nardil), a monoamine oxidase inhibitor (MAOI) the client has been prescribed, saying that the drug's negative side effects deplete the client's ability to function. The client plans to stop taking the medication. What is the COTA®'s MOST appropriate response? A. "Discontinue use of the medication until you see your doctor." B. "Remember the dietary restrictions related to MAOIs." C. "Side effects are present in all medications. You just have to get used to them." D. "Let's get your psychiatrist or a nurse on the phone now so you can discuss your concerns."

D. "Let's get your psychiatrist or a nurse on the phone now so you can discuss your concerns."

An OTR® supervises a COTA® who works with a group of adults who are continuing their recovery from alcohol and drug addiction by living in a halfway house. The OTR® suggests that the COTA® become familiar with a particular group intervention in working with these clients. What type of intervention would the OTR® MOST likely suggest? A. An occupational deprivation group B. Project MAINSTREAM C. A heavy work activity group D. A 12-step self-help group

D. A 12-step self-help group

A COTA® is working in an inpatient psychiatric setting where the average length of stay is 5 days. Which group activity would be MOST appropriate for patients with depression? A. A parallel group in which participants work on a free-form clay project of their choice B. A cooperative group in which participants plant a garden C. A project group in which participants paint a watercolor on a blank canvas D. A parallel group in which each participant completes his or her own solid-color ceramic tile trivet

D. A parallel group in which each participant completes his or her own solid-color ceramic tile trivet

A COTA® is working in a clubhouse with a group of clients who have mental health issues. Which leadership style would be MOST effective for the COTA® to use? A. Director B. Authority figure C. Facilitator D. Advisor

D. Advisor

A COTA® is running a group in an innovative preventive program for parolees. The goal of the program is to assist parolees with establishing or restoring occupational balance and productive occupations. The current group has been meeting regularly for 6 months. The members have good insight, and they understand the goals of the program. What leadership style should the COTA use in this setting? A. Directive B. Facilitative C. Cooperative D. Advisory

D. Advisory

During an occupational therapy intervention session, which approach would pose the biggest barrier to engaging in a client-centered process with an adult client who is able to converse? A. Paying attention to the meaning of nonverbal cues B. Being directive with the client C. Being too empathetic with the client D. Asking too many closed-ended questions

D. Asking too many closed-ended questions

A client recovering from substance abuse disorder is referred for occupational therapy services. What intervention is the COTA® MOST likely to provide? A. Group psychotherapy B. Medication management C. Assistance with locating a new apartment D. Assistance with finding meaningful ways to spend free time

D. Assistance with finding meaningful ways to spend free time

A COTA® is providing intervention to a client with an anxiety disorder who hyperventilates when faced with difficult work tasks. The COTA suggests that the client use breathing techniques and relaxation breaks during the work day to minimize the client's response to stressful events at work. What frame of reference does this intervention suggest? A. Cognitive-behavioral B. Psychodynamic C. Cognitive disability D. Behavioral

D. Behavioral

A COTA® work in an interdisciplinary adult day program for clients with chronic mental illness. Other professionals working in the program include a recreational specialist, an art therapist, and a social worker. For what area is the COTA® MOST likely to assume leadership? A. Creative expression B. Crisis management C. Sports activities D. Community integration

D. Community integration

A COTA® 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

D. Conversion disorder

According to Allen's Cognitive Disabilities Model, to what type of group will clients with active acute symptoms of schizophrenia respond best? A. Free-choice task and activities group B. Assertiveness training group C. Psychoeducational group D. Directive task and activities group

D. Directive task and activities group

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 COTA®'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.

D. Encourage the client to choose one of the available tasks to work on during the group.

What is the FIRST step in the process of designing a group protocol for clients with mental illness? A. Find appropriate dates and times for conducting the group. B. Identify the appropriate outcomes of the group and methods for tracking and recording them. C. Develop group goals and determine the size of the group. D. Identify a problem and the factors that will motivate the people in the group to change.

D. Identify a problem and the factors that will motivate the people in the group to change.

A COTA® has been leading a developmental group that is in charge of planning a staff party at an inpatient facility. After a few sessions, the COTA® observes that the group has now bonded with one another and appears united and emotionally supportive of one another. According to Tuckman's theory of group development, at what stage is this group? A. Forming B. Storming C. Norming D. Performing

D. Performing

A client scores a Allen Cognitive Level (ACL) of 4.0 with the Allen Cognitive Disability Framework. Given this score, what discharge arrangement would the COTA®, in consultation with the OTR®, likely recommend for this client? A. This client could be discharged home alone with weekly checks for novel safety issues and health maintenance needs and reminders. B. This client could be discharged home with family for support in all areas of IADLs and personal care, including bathing, dressing, and hygiene. C. This client should remain in the psychiatric facility under close 24-hour supervision for safety and personal care needs. D. This client could be discharged to a supported living arrangement with the expectation that the client can independently complete the morning self-care routine.

D. This client could be discharged to a supported living arrangement with the expectation that the client can independently complete the morning self-care routine.

Which of the following is an open-ended question that can be used when interviewing a client who has a substance-related disorder? A. What type of work do you do? B. How many times per week do you go out with friends? C. Do you have any hobbies or leisure skills? D. What do you do during a typical 24-hour day?

D. What do you do during a typical 24-hour day?