NBCOT Review 1

Several patients in a cardiovascular unit are referred to occupational therapy for rehabilitation in areas of occupation. Which diagnosis would be inclusive criterion for participation in the home management activity group conducted in the department's simulated apartment? A.) Hypotension B.) Unstable angina C.) Venous thrombosis D.) Uncontrolled atrial arrhythmia

A.) Hypotension Rationale: Persons with hypotension can be included in rehabilitation group that includes IADLs. Engagment in these activities would be contraindication for patients with other conditions

A woman with a complete spinal cord injury at the C5 level has given birth to her first child. The client seeks suggestions on methods to facilitate independent and safe parenting. Which of the following is most beneficial for the OTA to recommend the mother use to help feed her child? A.)A pillow to support the mother's arms during breast feeding B.) Pre-measured formula to simplify the task C.) Bottles that have molded, easy to grip shapes D.) A sling to support the infant's head during breast feeding

A.) A pillow to support the mother's arm during breast feeding Rationale: Providing support of the mother's UE will enable her to independently breast feed her child. The individual with a C5 SCI has sufficient UE function to support the infant's head.

An adolescent with spinal muscle atrophy shows decreased trunk balance and strength during intervention sessions. UE strength and ROM appear unchanged. When discussing these observations with the occupational therapist, which is the best recommendation for the OTA to make? A.) A re-evaluation of the client be completed B.) The client be referred to an orthotist for a soft spinal wheelchair C.) The client be measured for a power wheelchair D.) A trunk strengthening program be initiated with the client.

A.) A re-evaluation of the client be completed. Rationale: The most import action to take after noticing a change in the functional status of a person with a progressive condition is to re-evaluate.

An OTA constructs splint for an individual with a brachial plexus injury with full arm involvement. Which orthosis would be most effective for this condition? A.) An elbow lock splint B.) A flail arm splint C.) A figure-of-eight splint D.) A deltoid spint

A.) An elbow lock splint Rationale: A flail arm splint is recommended for a brachial plexus injury resulting in whole upper extremity involvement. It provides the needed stability at both the shoulder and elbow for functional positioning of the hand. A figure-of-eight splint is used for a combined median ulnar nerve injury and prevent MP hyperextension. A deltoid sling is used for UE muscle weakness.

A client in the descending phase of Guillain-Barre syndrome has bilateral shoulder strength of 2/5. The client fatigues easily. Which equipment should the OTA recommend to enhance the person's performance of ADLs? A.) An overhead suspension sling B.) Long handled utensils and tools C.) Angled/curved handled utensils and tools D.) An environmental control unit

A.) An overhead suspension sling Rationale: The overhead suspension sling is best suited for individual presenting with proximal weakness with muscle grades 1/5-3/5 range. Environmental control units are for individuals who have significant motor deficits, proximally and distally, and who cannot independently perform tasks such as controlling the switches on electronic equipment

An OTA is working with the parents of a 5-year-old child with developmental delay. The child is not self-feeding. The OT's evaluation of the child indicated that the child has the potential to participate in this ADL. When talking to the parents about the possible goal, they indicate this is not a priority for them. Which action is best for the OTA to take in response to the parents' statement A.) Ask the parents about their intervention priorities for their child B.) Work on utensil use with the child without using food items C.) Explain the importance of self-feeding to the child's independence D.) Refer the parents to online sources about the typical development of feeding

A.) Ask the parents about their intervention priorities for their child. Rationale: When differing values occurs between OTP and family members, open-ended questions should be used to help the practitioner understand the family's context

An OTA reviews the positioning protocol for a premature infant with severe spastic CP with the infant's parents. The protocol is in a written format. During the review, there OTA notices that the parents do not seem able to follow along with the protocol's text. Which action is best for the OTA to take initially in response to this observation A.) Ask the parents if they have any concerns about positioning the infant B.) Ask the parents if they can read and understand english C.) Include pictures of proper positioning in the protocol D.) Demonstrate proper positioning techniques

A.) Ask the parents if they have any concerns about positioning their infant Rationale: This is an open-ended question that enables the parents to express any concerns that they may have about positioning their infant. These concerns may be comprehension related and/or task related. The realities of caring for a premature infant with severe physical disabilities can be overwhelming. The parents' perceived difficulties in following the written protocol may be due to emotional stress, not limitations in literacy. The parents may welcome the opportunity to express their concerns.

A carpenter recovering from injuries incurred during a fall from a ladder has decreased strength in the triceps, bilaterally. The most recent MMT indicated that the triceps' muscle strength is 3. The OTA provides the client with a tabletop wood project to complete. To develop triceps' muscle strength, how should the OTA position the tabletop when the person sands the project? A.) At a 45 degree inclined angled so that the individual's hands are above the elbows when the elbows are flexed B.) At the individual's waist height so that the individual's hands and elbows are on the same plane when the elbows flex C.) At a 45 degree incline angled so that the individual's hands are below the elbows when the elbows are flexed

A.) At a 45 degree inclined angled so that the individual's hands are above the elbows when the elbows are flexed Rationale: The position requires the triceps to perform movement against gravity, which is possible at a muscle strength of 3. The sanding activity will provide slight resistance, which is the next level of muscle strength. Sanding wood on a table at was it height, or inclined so that the hand is below the elbow is flexed uses gravity eliminated or gravity assisted positions.

A school-based OTA is providing per diem coverage for an OTA on a disability leave. Upon reviewing the case load, the OTA notes that ten student have had evaluations completed during the past month. Five of these students' individualized education plans (IEPs) have also been completed by the team and approved by their parents. Which is the best initial action for the OTA to take as a contract practitioner? A.) Consult with the OT, team, and students' parents to complete the IEPs for the remaining students. B.) Conduct independent evaluations of each student with the supervision of the school's occupational therapist C.) Implement the IEPs that have been established and approved with the supervision of the school's occupational therapist D.) Report the the supervisor of the contract agency that the school has failed to comply with IEP guidelines

A.) Consult with the OT, team, and students' parents to complete the IEPs for the remaining students Rationale: IDEA mandates that the IEP be written within 30 days of the evaluation. There is no need for additional evaluation or report of the school. Many aspects of the IEP can be implemented by teachers and other school personnel

An older adult with peripheral neuropathy resulting from the effects of diabetes expresses concern over the ability to have a satisfying sexual relationship with a partner. What is the most beneficial recommendation for the OTA to make to a client? A.) Focus on intact senses and areas of intact sensation B.) Experiment with different positions during sexual expression activities C.) Schedule sexual expression during activities after rest periods D.) Advise the client to accept decreased abilities in sexual expression as a normal part of aging

A.) Focus on intact senses and areas of intact sensation Rationale: Peripheral neuropathy result in sensory loss; therefore, focusing on intact senses and intact areas of sensation can help the client and their partner achieve satisfying methods for sexual expression.

A patient had a brain tumor removed one month ago and exhibits residual cognitive-perceptual deficits. The OTA uses a neurofunctional approach to remediate the client's cognitive dysfunction. Which of the following are best for the OTA to include in the intervention program? Select the three BEST responses A.) Functional activities in their real contexts B.) Tabletop activities to practice remediation strategies C.) Computer games to develop performance component skills D.) Routine tasks that have been adapted so that the client can perform them E.) Client education on adaptive approaches to strengthen residual abilities F.) Client education on strategies to remediate deficits and restore deficient abilities

A.) Functional activities in their real contexts D.) Routine tasks that have been adapted so that the client can perform them E.) Client education on adaptive approaches to strengthen residual abilities Rationale: A neurofunctional approach emphasizes functional activity performance in the actual environment. Routine tasks are presented that the person can perform or that have been adapted so that they can perform. A neurofunctional approach places focus on adaptive approaches and strengthening residual abilities. The other options reflect a remedial/restorative/transfer of training approach

A young adult incurred a left CVA, which resulted in left visual field neglect. The OT and the OTA collaborate to develop an intervention plan based on the dynamic interaction approach. Which interventions are best for the OTA to use when working with this person to address this deficit? Select the three BEST responses A.) Grade a series of scanning tasks that decrease in similarity to foster the transfer of learning B.) Ask the client to described anticipated difficulties in finding items in a closet and a strategy to use to find items C.) Teach the person how to use a daily planner to keep track of activities that need to be completed each day D.) Train the person on integrating both sides of the body during the completion of a morning grooming routine E.) Work with the person on integrating both sides of the body during the completion of a morning grooming routine F) Provide the person with written instructions to complete IADLs such as laundry

A.) Grade a series of scanning tasks that decrease in similarity to foster the transfer of learning B.) Ask the client to described anticipated difficulties in finding items in a closet and a strategy to use to find items D.) Train the person on integrating both sides of the body during the completion of a morning grooming routine Rationale: Transfer of learning is facilitated in the dynamic interaction approach by providing a series of graded tasks that decrease in similarity

During an intervention session, an individual with a spinal cord injury at C7 reports noticing redness on the ischial tuberosity during their morning self exam with a mirror. Which action is most effective for the OTA to recommend to the client in response to their reported observations? A.) Integrate weight shifting into daily activities B.) Consider applying for a tilt-in-space wheelchair C.) Use an angled foam cushion D.) Self-direct caregivers to assist with weight shifting

A.) Integrate weight shifting into daily activities Rationale:During rehabilitation, a person with a SCI must be instructed on the need to relieve pressure on a consistent basis. A person with a spinal cord injury at the level of C7 can perform depression transfers, so the ability to perform weight shifting for pressure relief is intact. Since the person can weight shift independently a tilt-in-space wheelchair and caregivers are unnecessary

An OTA working in a skilled nursing facility conducts an inservice on validation therapy for the recently hired staff of a new psychogeriatric unit. Which fundamental principle of validation therapy is important for the OTA to include in this presentation? A.) Listen to the works the residents use to ascertain each person's underlying message B.) Provide highly structured activities to refocus the residents on reality C.) Provide unstructured activities to facilitate the residents' expression of feelings D.) Listen to the words the residents use and provide reality orientation for invalid statements

A.) Listen to the works the residents use to ascertain each person's underlying message Rationale: Validation therapy is an approach to working with individuals with neurocognitive disorders founded on the principle that the unspoken message an individual conveys in their speech are more important than the actual content of the speech. Individuals with neurocognitive disorders often make statements that are not based in reality.

An OTA is working with an OT to develop a discharge planning group for clients being discharged within the next month for a long-term care facility when implementing this program. A.) Obtain prospective group members' occupational profiles and post-discharge goals and options B.) Identify community resources to develop a community re-integration program and enhance post-discharge participation C.) Develop a self-medication management teaching module to increase post-discharge medication compliance D.) Complete an EBP search to identify best practices in a community-based health occupational therapy

A.) Obtain prospective group members' occupational profile and post-discharge goals and options. Rationale: Occupational profile influence the type, focus, and structure of group. Therapist must know patient's discharge goals before looking into community integration.

An adult who incurred a traumatic brain injury three months ago receives home care OT services. During meal preparation tasks, the client ignores items on the left side of the counter. Which is the best remediation approach for the OTA to sue with this client to enhance performance? A.) Place a brightly colored placemat on the left side of the counter B.) Encourage bilateral activities to promote scanning C.) Place all items on the right side of the counter.

A.) Place a brightly colored placemat on the left side of the counter Rationale: The placemat provides an external cue, which the client can be taught to look for during meal preparation. This anchoring technique is a basic remediation approach. The other interventions would not remediate the performance deficit caused by the client's unilateral neglect

A school based OTA uses behavioral modification techniques to help shape the behavioral responses of students with behavioral disorders. Which action is the most consistent with the intervention approach? A.) Provide frequent positive reinforcement for all desired B.) Reprimand the students every time an undesirable behavior occurs C.) Allow each student enough time to self-correct the undesirable behaviors D.) Encourage the teaching staff to tell the students which behaviors are correct and which are not

A.) Provide frequent positive reenforcement for all desirable behaviors Rationale: Behavioral modification is best achieved through use of positive reinforcements for all desired behaviors. Negative behaviors should be ignored. Self-correction is not a form of behavior modification.

An elementary school student with ASD is referred to OT. One of the student's goals is to self-initiate goal-directed play to decrease the frequency of self-stimulating behaviors of hand waving and rocking. The student's verbal communication is impaired, but the student compensates by using picture cards to let others know what is wanted or needed. Which of the following approaches to initiate self-play in the home environment is best for the OTA to suggest to the student's parents? A.) Provide limited play choices using picture cards, encourage choosing, and give verbal praise when the child chooses an activity B.) Allow the child time to choose a play activity from several options and do not provide guidance to ensure self-directed decision making C.) Provide limited choices using picture cards and only give verbal praise when the child participates in the chosen play activity D.) Include the child in after-school programs to socialize with other children and provide role-modeling opportunities for typical play behaviors

A.) Provide limited play choices using picture cards, encourage choosing, and give verbal praise when the child chooses an activity Rationale: Autism often presents as impaired development of social interactions and communication and a limited repertoire of activities of interest. Using the child's form of communication of picture cards, the parents can provide a choice between a limited number of play activities at home to encourage the self-directed activity of choosing a play activity.

A 17-year-old student with a diagnosis of bipolar disorder and a history of self-abusive behaviors attends a transitional school-to-work program conducted by an OTA and OT. During the vocational skills group, the student expresses feelings of hopelessness about the future and questions the point of participating in the program. The student asks to leave the group due to being too tired to concentrate as a result of sleepless nights. The OT asks the OTA to address the student's concerns while the therapist work with the other group members. Which action is best for the OTA to take in response to the student's statements? A.) Pull the student aside from the group and ask if the student is feeling self-destructive B.) Allow the student to leave the group after reminding the student to relax concerns to the guidance counselor C.) Support the validity of the student's feelings and encourage the student to remain in the group D.) Remind the student that in a work setting the norm is to work, even when fatigued

A.) Pull the student aside from the group and ask if the student is feeling self-destructive Rationale: All statements of hopelessness and lack of a future vision must be taken seriously, as they can indicate suicidal risk.

An individual with schizophrenia begins a partial hospitalization program after a three-day hospitalization. During the initial interview, the client reports that she still experience hallucinations but that they occur less than they have in the past. Which action should the OTA take when the individual begins to actively hallucinate during an OT project/associative group? A.) Redirect the individual's attention back to the project B.) Provide tactile reassurance to the individual C.) Verbally reassure the individual that the hallucination is not real D.) Use humor to divert the individual's attention away from the hallucinations

A.) Redirect the individual's attention back to the project. Rationale: Redirection is the best action to take. Additional effective strategies for responding are to reinforce all misinterpretations of environmental noises and events, use a calm voice, avoid sarcasm, and avoid arguing. The client may not respond favorably to tactile reassurance.

During an intervention session in a school, the OTA observes a young child turn the pages of a book. The OTA identifies this behavior as an example of an in-hand manipulation task. What task should the OTA report to the OT that the child is capable of performing? A.) Shift B.) Simple rotation C.) Translation D.) Translation without stablization

A.) Shift Rationale: Turning the pages of a book involves a linear movement of each page of the finger surface. This allows for repositioning of the page relative to the pads of the fingers while the thumb remains opposed. Simple rotation is not correct as this involves a turning/rolling of an object held at the finger pads with the fingers acting as a unit and thumb in opposition. Translation is incorrect as this involves linear movement of an object from the palm to the fingers or fingers to the palm. The activity of turning pages does not use the palm with stabilization or without stabilization

A person incurred a traumatic above-elbow amputation to the non-dominant UE. The client establishes a goal to be independent in all ADL using the residual limb without a prosthesis. However, the limb is painful and very sensitive. Which should the OTA include in the OT intervention program? Select the three BEST responses A.) Training in compensatory strategies and adaptive equipment to enable the unilateral performance of tasks B.) Instruction in how to use the residual non-dominant UE as a stabilizer during task performance C.) Implementation of an exercise program to focus on strengthening muscles that will enable the effective use of a prosthesis D.) Instruction in how to protectively wrap the residual limb with an elastic bandage in a circular manner to decrease pain and manage hypersensitivity E.) Instruction in how to protectively wrap the residual limb in an figure-of-eight diagonal pattern going from a distal to proximal direction F.) Refer the client to an amputee support group to increase acceptance of the need for a prosthesis to attain ADL independence

A.) Training in compensatory strategies and adaptive equipment to enable the unilateral performance of tasks B.) Instruction in how to use the residual non-dominant UE as a stabilizer during task performance E.) Instruction in how to protectively wrap the residual limb in a figure-of-eight diagonal pattern going from distal to proximal direction

A client with residual hemiplegia in the dominant extremity due to a prior CVA develops carpal tunnel syndrome in the non-dominant hand. The OTA constructs a splint and provides splint training to the client. Which of the following should the OTA ensure the client can do upon completion of the splint training sessions. Select the three BEST responses. A.) Understand the purposes and functions of the splint B.) Don and doff the splint with no physical assistance C.) Accurately state the wearing schedule after one verbal prompt D.) Self-direct the application of pieces of moleskin to areas of the splint that leave red marks E.) Understand that the splint should be worn at night and when performing repetitive activities F.) Self-direct the correct application of the splint to ensure bony prominences are considered

A.) Understand the purposes and functions of the splint E.) Understand that the splint should be worn at night and when performing repetitive activities F.) Self-direct the correct application of the splint to ensure bony prominences are considered Rationale: If the client understand the purposes, functions, and guidelines of the splint protocol they will become a collaborative partner in the intervention program. Since the client is hemiplegic he cannot don and doff without physical assistance

An OTA provides OT services at a homeless shelter that includes residents who are HIV positive. Which procedure should the OTA follow when conducting several therapeutic groups to develop participants ADL and IADl skills? A.) Wash hands before and after each group session B.) Always wear latex gloves during groups C.) Wear latex gloves during meal preparation activities D.) Implement transmission-based precautions

A.) Wash hands before and after each group session Rationale: Health professionals should use standard precautions at all times, regardless of clients' diagnoses. Washing hands is a basic precautionary step all individuals should take to prevent the spread of infections and diseases.

An OTA provides home-based services to a child with developmental delays. The child picks up and puts away toys when reminded by the parents and mimics the parents when they dry dishes and fold clothes. The family has identified a goal of including the child in home management activities. Which activity should the OTA introduce next during intervention. A.) Wiping tabletops B.) Sorting laundry C.) Making a bed D.) Taking out trash

A.) Wiping tabletops Rationale: Picking up and putting away toys when reminded and copying the parents when they do domestic chores are home management task skills that are typical of a 2 year old children. According to developmental frame of reference, wiping spills is the ability of a 3 year old child.

A local pharmacy hires an OTA to consult on the redesign of the pharmacy's customer service area. Which heigh should the OTA recommend for an accessible service counter? A.) 32 inches B.) 36 inches C.) 34 inches

B.) 36 inches Rationale: According to established accessibility standards, the recommended maximal height for accessible service countertops is 36 inches.

A high school senior with Friedrich's ataxia is working on developing keyboarding skills in a school-to-work transition program. During the initial session, the OTA observers signs of dysmetria. Which is the most appropriate adaptation for the OTA to recommend to increase the effectiveness of the student's keyboarding. A.) An eye-gaze input system B.) A key guard overlay C.) A voice-activated input system D.) A reduced size key board

B.) A key guard overlay Rationale: Dysmetria is the overshooting or the undershooting of a target. It would be observed in keyboarding activity as frequent misses of the desired key. A key guard overlay provides raised separations between each key. This enables the individual to place their finger into the desired key space and prevents the person's finger from jumping to key above, below, or next of the targeted key.

A client is being discharged after recovery from hip replacement surgery to live at home alone. Which is the most important equipment for the OTA to review with the client prior to discharge to enable safe occupational performance in the home A.) A rolling walker B.) A long handled reacher C.) A bedside commode D.) An emergency call system

B.) A long-handled reacher Rationale: Client will need to observe hip precautions for several weeks. Including not flexing the hip past 90 degrees.

An OTA conducts a standardized sensory assessment of an individual recovering from a left CVA. The individual has right hemiplegia and expressive aphasia. During the assessment of stereognosis which should the OTA have the client use to identify responses to the testing stimuli? A.) Pictures of the objects B.) A set of identical objects C.) Cards with "1" and "2" printed on them D.) Cards with "yes" and "no" printed on them.

B.) A set of identical objects Rationale: Stereognosis is the ability to identify objects through touch and cognition. Having an identical set of objects from which the individual can select an object that matches the test stimulus will enable a person with expressive aphasia to participate in the assessment.

An individual with RA is currently in a stage of remission. During the inactive chronic phase of the disease, the OTA works with the client to maintain ROM and muscle strength. Which of the following is most effective for the OTA to recommend the client include in a daily home exercise program? A.) Passive ROM B.) Active ROM C.) Isotonics D.) Progressive Resistance

B.) Active ROM Rationale: Activities that use active ROM are indicated for the treatment of RA both in its acute and chronic phases. Passive ROM and progressive resistance is contraindicated for persons with RA.

A 3-year-old with recurring headaches and decreased gross and fine motor skills is hospitalized for diagnostic workup. The OT completed a screening of the child and determined that the OTA should complete a standardized developmental assessment. Just prior to the scheduled OT evaluation, the parents have been told that the child has brain cancer. The parents are upset when they bring the child to OT. The OTA provides support. Which is the next best action for the OTA to take in response to this situation A.) Cancel the evaluation session and refer the parents to their spiritual advisor or the social worker B.) Advise the parents to speak to their spiritual advisor or the social worker after the evaluation session C.) Ask the supervision OT to participate in the session and spend it addressing the parents' acceptance of the diagnosis D.) Reschedule the evaluation for later in the day so that the parents can speak with their spiritual advisor or the social worker

B.) Advise the parents to speak to their spiritual advisor after the evaluation session Rationale: Best actions are to advise the family to seek a source of help and comfort and proceed with the evaluation session. OTA can provide the advice in supportive and empathetic manner and then complete the scheduled assessment

During an intervention session focused on the development go grasp and shoulder mobility, an OTA asks a client to move numerous identical one-fund cans of vegetables from the countertop to the cabinet shelf above the counter. According to contemporary motor learning approaches, what type of practice has the OTA implemented for this client? A.) Random practice B.) Blocked practice C.) Planned practice

B.) Blocked practice Rationale: Blocked practice involves repeated performance of the same motor skill. Since the cans are identical and weigh the same, lifting each can request the same motor skill. If the cans were of different sizes, shapes, or weights, then different motor skills would be required for task performance. This would be an example of random practice, which involves the performance of several tasks in random order to encourage the reformulation of the solution to the present motor problems. Planned practice is a contrived term.

An OTA collaborates with an OT to develop an after-school program for adolescents with obesity who also have diabetes or who are at risk for developing diabetes. Which program development action should the therapist and the OTA take first? A.) Obtain statistical data about adolescent obesity to support the need for the program to the school administrators B.) Collaborate with the OT to survey the adolescents about their occupational performance C.) Collaborate with the OT to survey OTPs about services they provide to obese adolescents D.) Review the professional literature about programs for obese adolescents to obtain ideas for the program's activities

B.) Collaborate with the OT to survey the adolescents about their occupational performance Rationale: The development of new services would require a needs assessment to determine the necessity and the focus of services. The information obtained from surveying potential participants is an excellent way to ensure that the program developed will meet a real unmet need.

An OTA works with a person who incurred full-thickness burns to both arms. Which intervention approach would be most effective for the OTA to provide to control hypertrophic scar formation? A.) Axillary splints applied in the airplane position B.) Compression garments C.) Wound grafting D.) Elevation of the areas just above the heart level

B.) Compression garments Rationale: Custom-made compression garments provide equal pressure over the entire area to prevent scarring. They must be work 23 hours per day for approximately 12 months, or until the scar and wound maturation is complete.

At a home care intervention planning meeting, the team discusses a client with a right CVA. The physical therapist states the individual's ambulatory status is now within functional limits. PT services will be discontinued because the person is no longer homebound. The OTA reports that the individual is frequently confused during home management task performance and becomes extremely anxious when community activities are proposed. Prior to this meeting, the OTA has discussed these concerns the OT. During the meeting, which recommendation is best for the OTA to make? A.) Refer the individual to a psychiatrist for a mental status evaluation to help inform the discharge planning B.) Continue OT services as the person should continue to be considered homebound C.) Discontinue OT services as they are non-reimbursable because the person is no longer considered homebound D.) Contact the physician to discuss the need for OT services on an outpatient basis and for psychosocial counseling.

B.) Continue OT services as the person should continue to be considered homebound Rationale: The individual can be considered homebound for cognitive and psychosocial deficits. Discontinuing services can place the individual at risk because the person will not receive evaluation or intervention for their demonstrated cognitive and psychosocial deficits. There is no need for a consultation with a physician at this point. OTPs can continue to provide services in this scenario without physician input.

A client with myasthenia graves shows increasing difficulty with speech and oral-motor control during swallowing. Which behavior is most accurate for the OTA to document as indicative of a swallowing disorder A.) A tendency to spit out foods of mixed liquids B..) Coughing while swallowing thin liquids C.) Loud noises in the throat during swallowing

B.) Coughing while swallowing thin liquids Rationale: Coughing and choking are signs of swallowing difficulties. It is important to determine the type and viscosity of foods that cause chocking and coughing

An OTA develops a task skills group for the patients of a psychiatric inpatient unit. The OTA considers several activities to use for the group's first session. Which activity is best for the OTA to present to the group members? A.) Planning a pizza party for a weekend evening B.) Decorating styrofoam cups and planting cuttings in them C.) Publishing a weekly newsletter about city attractions for patients on the unit D.) Painting a large mural to cover one wall of the day room

B.) Decorating styrofoam cups and planting cuttings in them Rationale: Decorating cups and planting cuttings is a simple concrete task, which can be structured to ensure successful completion by individuals with acute psychiatric disorders. Because the length of stay on an acute unit is short, activities that can be completed in one session are typically best for initial treatment sessions. Other options will take multiple session to complete.

During an OT session, the OTA observes that the child bands objects on a tabletop but has difficulty letting of of a toy upon request. The OTA documents these behaviors. Which developmental level would be most accurate for the OTA to report the child's observed behaviors indicate? A.) 9-10 months B.) 7-8 months C.) 3-4 months

C.) 3-4 months. Rationale: At 3-4 months, children are able to bang toys on a tabletop but do not have voluntary release. At 7-8 months, children have voluntary release. At 9-10 months, children can release an object into a container with a straight wrist

An OTA is scheduled to give a 1 hour presentation to a support group of parents of infants with a diversity of developmental disabilities. Which of the following is the most important focus for the OTA's presentation? A.) Demonstration of infant positioning techniques B.) Discussion of typical areas of concern addressed by OT practitioners C.) Demonstration of different types of developmental assessments D.) Discussion of the Individualized Family Service Plan (IFSP)

B.) Discussion of typical areas of concern addressed by OT practitioners Rationale: An overview of the domain of concern addressed by the OT for infants with developmental disabilities is the most appropriate topic for 1-hour presentation to an audience with diverse needs.

An individual receives treatment for major depression on an inpatient psychiatric unit. The patient has received an ECT treatment at 8 am. At 2pm, the patient walks into the OT department stating a desire to participate in the leisure skills group. Which is the OTA's best response? A.) Call nursing staff to escort the client back to the client's room B.) Encourage the client to select one of three structured leisure activities to complete C.) Provide the client with a leisure history questionnaire to complete D.) Commend the client's motivation but remind the client that the rest is recommended for 24 hours after ECT

B.) Encourage the client to select one of three structured leisure activities to complete Rationale: Sex hours after the ECT, the individual is capable of engaging in a structured task. Giving the individual a choice of structured activities to complete can increase the likelihood that the person will be interested in the selected task.

The residents of a halfway house plan a community leisure activity for a Saturday. Two residents state that they cannot participate in Saturday activities due to religious observances. The other residents express strong interest in the activity. Which is the OTA's best response to this situation? A.) Schedule an in-house Saturday leisure activity for two residents B.) Explore with the group an alternative schedule for a community leisure activity C.) Schedule an in house Saturday leisure activity for all residents D.) Recommend the two members seek approval from their religious leadership to attend the Saturday activity

B.) Explore with the group an alternative schedule for a community leisure activity Rationale: All residents should be provided with the opportunity to engage in community leisure activity. Facilitating the group's exploration of alternative schedule can result in all residents' statement that they could not participate in activities on Saturday

Several adolescents with behavior problems attend a school-based after-school program. They work at an egocentric-cooperative/basic cooperative level in a group which is focused on developing the skills needed to enable successful school performance and respond effectively to peer pressure. Which of the following should the OTA focus on helping the group members do in the group to facilitate the attainment of group goals? A.) Actively take on roles such as energizer, coordinator, or opinion giver B.) Focus on the group tasks related to the completion of a long-range activity C.) Make decisions with minimal to no input or guidance from the group leader D.) Perform group skills consistent with the developmental level of adolescents

B.) Focus on the group tasks related to the completion of a long-range activity Rationale: The goals of an egocentric-cooperative/basic cooperative group are to enable members to select and implement a long-range activity, develop an unerstanding go group goals and group interaction norms, and enable members to identify and meet the needs of themselves and others. At this level, members do not actively assume diverse group roles and they are not able to make decision without the group leader's input or guidance.

A developmental evaluation has determined that an 8-month-old child with myelomeningocele at L1 level has no developmental delays. To foster the child's continued gross motor development, which of the following activities would be best for the OTA focus on with this child during intervention A.) Rolling from prone to supine without assistance B.) Increasing dynamic trunk balance when sitting without support C.) Transitioning from sitting to supine and from supine to sitting

B.) Increasing dynamic trunk balance when sitting without sitting Rationale: The development of gross motor skills in an 8-month-old child with myelomeningocele at the L1 level with no developmental delay will parallel that of a child with no disability. Working on dynamic trunk balance while sitting without support is relevant for an 8-month-old. At this age, children develop the ability to sit unsupported and rotate the upper body while the lower body remains stationary. They are also able to play with toys in sitting position which often will require dynamic balance.

A school-based OTA implements an intervention plan for an elementary school student who has Cystic Fibrosis. The IEP was developed during a meeting with the child's parents, teachers, and OT. The school nurse and dietitian also contributed to this plan. Which is the best primary focus for OT services for this student? A.) Ensuring that the student's school lunches and snacks provide adequate nutrition and hydration B.) Instructing the student and teacher in the use of energy conservation techniques during activities C.) Monitoring the student for signs of fatigue, which may lead to cardiac and respiratory problems D.) Assessing the student for the developmental delays, medical complication, and psychological status

B.) Instructing the student and teacher in the use of energy conservation techniques during activities Rationale: Cystic fibrosis is a chronic, progressive lung disease that reduces life expectancy and limits participation. Instruction in the use of energy conservation techniques during activities is the intervention that a school-based OTPs can uniquely provide

A person blinded in an accident begins an OT program for personals with vision loss. Before the accident, the person lived independent and worked as an accountant. The OT and OTA collaborate with the individual to develop and intervention plan. Which activities are best for the therapist and OTA to include in the initial intervention plan? Select the three Best responses. A.) Exploring new vocational interests B.) Learning alternative computer access skills C.) Organizing the client's morning personal care routine D.) Learning home safety and emergency procedures E.) Adapting cooking activities to accommodate vision loss F.) Adapting clothing care to accommodate vision loss

B.) Learning alternative computer access skills C.) Organizing the client's personal care routine D.) Learning home safety and emergency procedures Rationale: No need to explore new vocational interests

An individual recovering from a head trauma exhibits a motor pattern indicative of being influenced by the symmetrical tonic neck reflex. Which is most likely for the OTA to observe the client having difficulty with functional mobility? A.) Moving both arms to midline when supine B.) Moving from lying to supine to sitting C.) Flexing the head from the supine position D.) Extending the head from the prone position

B.) Moving from lying to supine to sitting Rationale: Moving from lying to sitting is ignited by flexion of the neck. The presence of symmetrical tonic neck reflex will cause this flexion to result in increased hip extension, making it difficult to assume a sitting position.

During a therapeutic feeding session, a child with spastic quadriplegic cerebral palsy demonstrates a consistent tonic bite reflex. Which technique should the OTA use to inhibit this reflex? A.) Apply a slight upward pressure of the index finger under the child's lip B.) Press a spoon down firmly on the center of the child's tongue C.) Place foods such as soft-cooked vegetables between the gum and teeth D.) Provide sensory input to the inferior faucial arches using a chilled dental mirror

B.) Press a spoon down firmly on the center of the child's tongue Rationale: Best approach to decrease tonic bite reflex is to press down firmly on the center of the tongue. Other options are techniques used for oral motor dysfunction but not effective for decreasing a tonic bite reflex

An individual attends a community day treatment program to assist in recovery from major depression. The client has good eye contact and responds verbally to interactions initiated by others. Cognition is intact. Which group level is best for the OTA to recommend this client attend? A.) Parallel B.) Project/associative C.) Cooperative/ supportive cooperative D.) Mature

B.) Project/associative Rationale: A project/associative group utilizes short-term activities that require the participation of two or more people. Tasks are shared, and the focus is on interaction rather than task completion

An OTA works with an 8-year-old with pervasive developmental disabilities in tower to improve self-care skills. In teaching the child to brush teeth, the OTA places the toothbrush in the child's hand and guides it to the mouth. To help the child learn to complete the activity the OTA uses the somatosensory system. Which of the following is most effective for the OTA to use next during intervention with this child. A.) Tell the child to brush up and down and provide verbal prompts. B.) Provide hand-over-hand assistance to brush the child's teeth C.) Touch the child's hand to prompt hand-to-mouth movements D.) Instruct the child to follow a pictorial sequence card depicting toothbrushing

B.) Provide hand-over-hand assistance to brush the child's teeth Rationale: In providing hand-over-hand assistance the OTA is using tactile, proprioceptive, and movement stimuli to cue the child. The somatosensory system is inclusive of the sensory systems. Providing auditory, tactile, to visual input does not provide sufficient input for the child to learn the task.

An OTA accepts a position at an adult day care and respite program for older adults with a variety of physical and cognitive disabilities. The OTA has only clinical experience in school-based practice. Which is the most effective way for the OTA to prepare for the professional responsibilities this new position will entail? A.) Attend support group meeting for caregivers of older adults B.) Review current literature on occupation-based and evidence-based care of older adults C.) Review area demographic information on older adults with disabilities D.) Confer with the program's administrative director

B.) Review current literature on occupation-based and evidence-based care of older adults Rationale: The OTA must update their knowledge base about current occupation-based and evidence-based practices in the care of older adults with an emphasis on physical and cognitive disabilities. A review of the professional literature can provide relevant information about effective equation and intervention approaches for the setting's population.

During an intervention session, a client complains of dry mouth due to prescribed medications. What is the most effective strategy for an OTA to suggest to the client to manage this side effect? A.) Suck on ice B.) Sip water C.) Drink iced tea D.) Suck on hard candies

B.) Sip water Rationale: Sipping water is the best choice to relieve dry mouth. Suck ice or hard candies presents a possible choking hazards. Iced tea contains caffeine, which can increase dehydration.

A 19-year-old with spastic diplegia and an IQ in the range of 55-69 is grading from a special education program. The student has been involved in transitional programming since the age of 14. The OTA collaborates with the OT and the student to complete a discharge plan to meet the student's post-secondary goals. Which of the following should the OTA recommend be included as a post-discharge referral? A.) A vocational rehabilitation workshop B.) State vocational rehabilitation services C.) A community college D.) A transitional employment program

B.) State vocational rehabilitation services Rationale: Purpose of a state vocational rehabilitation services is to provide a 'one stop' access to a multitude of vocational and educational evaluation and training programs. A transitional employment program may be appropriate for the student, but a complete evaluation is needed to determine the desired intervention program.

An individual with an incomplete C6 SCI has a secondary diagnosis of thromboangiitis obliterates. The OTA conducts a pre-discharge home assessment of the patient's rented apartment. Which is the most important area for the OTA to focus on A.) The apartment's electrical capacity for an environmental control unit B.) The apartment's water temperature C.) The apartment's electrical capacity for an emergency system D.) The landlord's willingness to modify the bathroom

B.) The apartment's water temperature Rationale: Thromboangiitis obliterates, also known as Buerger's disease, results in diminished temperature sense, paresenthesia, pain, and cold extremities

Occupational therapy services are provided to the clients of a psychogeriatric unit in a skilled nursing facility. An OTA presents an inservice on restraint reduction to the unit's direct care staff. Which of the following would the OTA identify as a permissible use of restraint? A.) A bed guardrail to prevent a confused resident from wondering in the evening B.) Prescribed medication to control a resident's agitated behavior C.) A lapboard to enhance a resident's self-directed functional behavior D.) A wheelchair with a lap belt to prevent a person with ataxic gate from falling

C.) A lapboard to enhance a resident's self-directed functional behavior Rationale: A restraint is defined as anything that prevents access to the environment or to oneself. A restraint such as a lapboard can enhance functional performance and is permissible with the resident's informed consent

An OTA provides early intervention services to a 3-year-old child with left spastic hemiplegia due to CP. During a session, the OTA observes behaviors that seem to indicate the presence of visual deficits. In discussing these observations with the OT, which recommendation should the OTA make? A.) The completion of motor-free visual perceptual assessment B.) The completion of a developmental vision assessment C.) A referral of the child to an optometrist D.) A referral of the child to an optician

C.) A referral of the child to an optometrist Rationale: Prior to conducting a visual perceptual assessment, an anatomical visual assessment to determine visual acuity is required. Optometrists are the professionals who are qualified to perform eye exams to determine visual acuity , level of visual impairment, and damage to or disease in their visual system

A child with a tactile defensive sensory modulation disorder attends a private early intervention clinic. The OTA collaborates with the OT and child's parents to develop strategies and guidelines to help the child handle the symptoms of this disorder at home. Which are the best recommendations for the OTA and therapist to make the parents? Select the three BEST responses. A.) Avoid the use of swings and other moving equipment during play activities B.) Encourage the use of swings and other moving equipment during play activities C.) Adjust stimuli that seem to influence the child's modulation of sensation D.) During bathing, teach the child to use firm pressure and a soft cloth to wash self E.) Soften the child's clothing by repeated laundering and remove clothing tags F.) Provide a variety of textures in the clothing the child wears

C.) Adjust stimuli that seem to influence the child's modulation of sensation D.) During bathing, teach the child to use firm pressure and a soft cloth to wash self E.) Soften the child's clothing by repeated laundering and remove clothing tags Rationale: Intervention for a child with sensory modulation disorder should follow the general principles of Ayres Sensory Integration Approach. A fundamental intervention approach in this model is the monitoring and adjustment of stimuli that seem to influence the child's modulation of sensation. Children with tactile defensiveness typically find self-applied stimuli more tolerable that the application of tactile stimuli by others. Deep touch and firm pressure are also more tolerable than light tight

A young adolescent with right hemiplegic CP demonstrates a strong flexor synergy of the hand. The adolescent does not use the hand for grasp, pinch, or release, and often maintains the thumb flexed in the palm. The orthopedic hand surgeon recommends a flexor tendon release followed by several weeks of hand therapy and splinting. The parents are very anxious about the surgery and they ask the OTA what to do. What is the OTA's best response? A.) Recommend that the parents follow the surgical recommendations presented by the doctor B.) Suggest the parents talk to the OT about a pre-operative course of therapy C.) Advise the family to review all the information to make an educated decision D.) Encourage the parents to get a second opinion from another orthopedic hand surgeon

C.) Advise the family to review all the information to make an educated decision Rationale: The OTA should offer unbiased, objective support and not give medical or other advice.

An individual hospitalized for the first time due to a brief psychotic episode attends an OT group. During task performance, the OTA notices that the person is restless with hand rumors and shaking legs. Which of the following should the OTA document that the person seems to be exhibiting? A.) Akinesia B.) Pseudo-parkinsonism C.) Akathisia D.) Tardive Dyskinesia

C.) Akathisia Rationale: Akathisia is a side effect of antipsychotic medications that is exhibited by restlessness, hand rumors, and shaky legs. Akinesua us also a potential side effect, but this is evident by the lack of movement. Akinesia is also a negative symptom of schizophrenia. Pseudo-parkinsonism is also a side effect that appears as behaviors similar to the symptoms of advanced Parkinson's disease; that is, rigidity, pill-rolling tremors, masked face, and a shuffling gait. Tardive dyskinesia is an irreversible neurological condition caused by years of taking neuroleptic medications.

A patient on an acute medical unit has right homonymous hemianopsia. The OTA provides recommendations to modify the patient's room to enhance independence. What are the most effective recommendations for the OTA to make for the placement of the patient's call button and cell phone? A.) Call button on the left side and the cell phone on the left side B.) Call button on the right side and the cell phone on the right side C.) Call button on the right side and the cell phone on the left side D.) Call button on the left side and cell phone on the right side

C.) Call button on the left side and cell phone on the right side Rationale: the call button must be placed within the person's intact visual field, so the person can readily access it in case of emergencies. However the cell phone can be placed outside of the person's visual field to encourage the person to scan the environment

A person fell and sustained bilateral Colles' fractures. The client wore bilateral short-arm casts for 6 weeks. After cast removal, the client began OT sessions to increase endurance and strength prior to returning to work. The client tend to work hard when performing resistive exercises with both wrists. The OTA monitors the client for overexertion. Which behavior indicates overexertion. A.) Decreased respiration rate during resistive wrist flexion B.) Increased ability to achieve full ROM of the wrist C.) Complaints of pain in the wrist extensors D.) Consistent strength in wrist extension activities

C.) Complaints of pain in the wrist extensors Rationale: Complaints of pain can be a sign of overexertion. The others are signs of adequate performance, not overexertion

An OTA leads a community integration group for individuals with mild intellectual disabilities who reside in a group home. During a travel training session a member of the group slips while going up the stairs of a bus. The client quickly gets up, pays the fare, sits down, and jokingly states "Good thing I bounce well." Which action should the OTA take after assessing that the person is not injured? A.) Cancel the planned activity and return the group to file an occurrence report B.) Ask the bus driver to radio for an ambulance to obtain a medical assessment of the client C.) Continue with the planned activity and full an occurrence report upon the return to the group home. D.) Continue with the activity and ask the client to report the development of any symptoms related to the fall

C.) Continue with the planned activity to rule an occurrence report upon return to the group home Rationale: Standard policy to file report about any incidents that involve the clients, but minor events do not have to be done immediately. Asking the client to report any symptoms related to the fall is appropriate, but it is not the most important action for the OTA to take.

A 5-year-old is referred to OT. Upon the completion of a standardized test assessment, the OTA determines that the child demonstrate age-appropriate cognitive and fine motor skills. Which activity would the child be able to complete at this developmental level? A.) Cutting long thin strips with scissors B.) Holding and snipping with scissors C.) Cutting simple figure shapes with scissors

C.) Cutting simple figure shapes with scissors Rationale: Cutting simple shapes: 4-6 year old cognitive skills Cutting strips: 3-4 year old skill Holding and snipping with scissors: 2-3 year old skill

An individual with post-polio syndrome receives an OT re-evaluation. The OTA collaborates with the OT to determine assessments to be administered during the re-evaluation process. They determine that the outcomes of an assessment of the person's sensation would help inform the development of an intervention plan. How should the OTA initiate sensory testing with this client? A.) Demonstrate the test with the individual's vision occluded B.) Proceed proximal to distal C.) Demonstrate the test with the client's vision not occluded D.) Proceed distal to proximal

C.) Demonstrate the test with the client's vision not occluded Rationale: Sensory testing must begin with a demonstration of the test with the client being able to visually observe the demonstration. If the client's vision is impaired, the OTA must verbal explain each stop of the demonstration to ensure with the individual understands the testing process.

An adult incurred a traumatic brain injury (TBI), which resulted in sensory and perceptual deficits that make completion of basic activities of daily living difficult. During an intervention session focused on dressing, which will the OTA most likely observe the person have difficulty with when donning shoes? A.) Grasping and manipulating the shoelaces B.) Sequencing the steps of tying the shoelaces C.) Discriminating between the right and left shoe

C.) Discriminating between the right and left shoe Rationale: Sense of vision and visual perceptual skills are required to discriminate between the right and left shoes.

An intervention plan for a person with a complete lesion of the spinal cord at the C6 level has been developed by the client, OT, and OTA. Which activity should be included in this plan as a goal for the client to independently perform? A.) Typing with a mouth stick B.) Transferring from bed to wheelchair using depression transfers C.) Donning pants while in bed D.) Feeding using a suspension sling or mobile arm support

C.) Donning pants while in bed Rationale: A person with a C6 SCI can independently don underwear and pants while in bed. Therefore, intervention would focus on developing the ability to don pants while lying in bed. A person with a C6 SCI uses a sliding board to transfer; depression transfers are not possible at the C7 levels. The client with a complete C7 SCI does not need a mouth stick or mobile arm support.

An OTA works in a school system with a child with developmental delays. One of the goals of treatment is to develop prewriting skills. The child exhibits the ability to grasp a pencil proximally with crude approximation of the thumb, index and middle fingers and the ring and little fingers slightly flexed. The OTA collaborates with the OT to develop an intervention plan. Which grasp should be the focus for the implementation of intervention? A.) Digital pronate grasp B.) Static tripod posture grasp C.) Dynamic tripod grasp D.) Palmar supinate grasp

C.) Dynamic tripod grasp Rationale: The grasp pattern described in the case is static tripod posture grasp. The next grasp pattern to be mastered after this grasp is the dynamic tripod grasp. The other grasp patterns are precursors to the static tripod grasp.

A child with spinal muscle atrophy can no longer reach beyond 90 degrees of shoulder abduction and 90 degrees of shoulder flexion. The parents state that the child can no longer independently don or doff a t-shirt. Which is the beset approach for the OTA to recommend the child use to don a T-shirt? A.) Place the t-shirt directly on the child's lap, have the child don the arms first, then don the head of the t-shirt B.) Have the child wear front-opening shirts instead of t-shirts to eliminate the need to don shirts over the head C.) Have the child support the elbows on a table at chest height to don the t-shirt over the arms, then don over the head D.) Have the child lean to the right and don the right arm, repeat with the left arm, and then don the head of the t-shirt

C.) Have the child support the elbows on a table at chest height to don the t-shirt over the arms, then don over the head Rationale: Spinal muscle atrophy is a progressive disorder and the OTA needs to prepare the child and family for progressive loss of skills. The best technique, as should ROM decreases, is to use a table for support to don the arms then use elbow and neck flexion to don the t-shirt over the head.

An individual with developmental disabilities scores a level 4 on Allen's Cognitive Level Test. The OTA collaborates with the OT to plan intervention. Which activities should the OTA and OT include in the intervention plan to help meet the client's functional needs? Select three BEST responses A.) Self-care activities such as brushing teeth B.) Home management activities such as folding socks C.) Home management activities such as food shopping using a prepared list D.) Leisure activities such as matching picture cards E.) Leisure activities such as completing a 50-piece puzzle F.) Community mobility training to develop the ability to take public transit using a map

C.) Home management activities such as food shopping using a prepared list E.) Leisure activities such as completing a 50 piece puzzle F.) Community mobility training to develop the ability to take public transport using a map Rationale: An individual who scores a Level 4 on Allen's Cognitive can perform goal-directed actions. Level 4 is characterized by the ability to carry out structured tasks through to completion. Individual relies on visual cues and can perform established routines.

A 3-year-old with severe congenital anomalies and irreparable cleft palate has a do not resuscitate (DNR) order. While being fitted for a molded seat for a wheelchair, the child stops breathing and turns blue. The OTA determines that the child has a brachial pulse. Which of the following is the first action the OTA should take in response to this situation. A.) Inform the physician about the situation and the child's DNR order B.) Call the supervising OT to discuss the best response C.) Implement the facilities emergency response systems D.) Perform obstructed airway maneuver and monitor heart rate for 5 minutes

C.) Implement the facilities and emergency response system Rationale: It is not the decision of the OTA to withhold actions because of the DNR order. The medical team that responds to emergency procedures must make the decision

An OTA employed in a pediatric clinic for children with CP participates in a performance appraisal. The OTA's supervisor identifies handling skills as an area needing improvement. Which is the most effective way for the OTA to improve handling skills. A.) Observe an experienced OT using handling techniques with a diversity of children with CP B.) Complete an extensive literature review of EBP for children with CP C.) Participate in a beginner-level experiential course on handling skills with children with CP D.) Attend a video teleconference on handling skills for the child with CP

C.) Participate in a beginner-level experiential course on handling skills with child with CP Rationale: Participating in a experiential handling skills course provides opportunities to interact with other OTPs and benefit from visual and kinesthetic learning.

An individual receives OT services at a subacute rehabilitation facility. The patient's personal goal is to be independent in dressing. The patient demonstrates decreased memory, poor sequencing skills, and ideational apraxia. Which of the following is most effective for the OTA to provide when teaching one-handed dressing techniques to this patient? A.) Step-by-step verbal instructions B.) Sequenced photographs of the steps in dressing C.) Physical prompts to inmate the steps in dressing D.) A full-length mirror for the client to observe self-dressing performance

C.) Physical prompts to inmate the steps in dressing. Rationale: Ideational apraxia is the breakdown in the knowledge of what is to be done and how to perform specific activities. This means that one cannot perform a task either spontaneously or upon request. However, the sensorimotor aspects needed to perform the activity can be intact. Providing physical prompts to initiate dressing may be a sufficient cue for the individual to begin and then complete the task.

An OTA working in an outpatient clinic observes the clinic's administrative assistant leaving patient records open on the clinic's reception counter. The assistant has left the clinic to go for lunch. Which action is best for the OTA to take in response to this observation? A.) Remind the administrative assistant of the need to keep patient records private when the assistant returns from lunch B.) Contact the administrative assistant's direct supervisor to report this observation C.) Pick up the records and place them in a location out of public view D.) Discuss the issue with the OT during their next scheduled supervision session

C.) Pick up the records and place them in a location out of public view Rationale: The OTA must immediately act to protect patient privacy. The HIPPA privacy rule requires that all providers protect their patient confidentiality in all forms.

An OTA providing home-based OT services implements a bed positioning plan for a person recovering from a CVA. The person is receiving care from family members and personal care assistants employed by a home care agency. Which action should the OTA take to ensure the accurate implementation of this plan by the client's caregivers. A.) Provide verbal step-by-step directions of the desired positions to the client's caregivers B.) Post written step-by-step directions of the desired position on the wall by the client's bed C.) Post pictures of the desired positions next to the bed's headboard D.) Require each caregiver to demonstrate the replication of the desired positions

C.) Post pictures of the desired positions next to the bed's headboard Rationale: A visual representation of the exact positions desired can decrease any misinterpretation of a written description. Placing this picture by the bed's headboard will ensure that it is visible to all caregivers. It is the most effective method provided to ensure compliance.

An elementary school-aged child holds a pencil with a tightly static tripod grasp and forms letters at an average rate of speed. The child demonstrates the ability to write all class and homework assignments. Which is best for the OTA to recommend this child do to improve their grasp? A.) Perform all written work with a larger pencil and jumbo crayons on a horizontal surface B.) Take a break every 15 minutes while writing to open and close the hand several times C.) Practice moving coins from the fingertips to the palm and then from the palm to the fingertips D.) Write all written work on a vertical surface, such as an easel or classroom wall board

C.) Practice moving coins from the fingertips to the palm and then from the palm to the fingertips Rationale: Incorporation of the finger-to-palm translation and vice versa are in-hand manipulation skills that address the dynamic use of the fingers.

An OTA instructs the direct care staff of a rehabilitation unit on proper positioning techniques for a patient following the occurrence of a left CVA. In which of the following positions should the OTA recommend the patient's right affected arm be placed when the patient is sleeping in side-lying on the unaffected side? A.)In 90 degrees of humeral abduction and 15 degrees of internal rotation B.) On the person's side, adducted and internally rotated C.) Protracted with arm forward on a pillow and the elbow extended or slightly flexed D.) In 90 degrees of abduction of the humerus with neutral rotation

C.) Protracted with arm forward on a pillow and the elbow extended or slightly flexed. Rationale: The best position of the UE for sleeping or bed rest is to place the affected arm on a pillow in a comfortable position. Excess abduction can cause the joint capsule to loose and reduce the stability of the humeral head in the glenoid fossa. It is important to avoid traction of the affected arm to ensure adequate positioning of the humerus with the scapula and to prevent subluxation. Correct positioning means putting the involved arm in slight abduction. 90 degrees of abduction is excessive

An elementary school-aged child with Duchenne's MD receives OT services. The family established a goal of maintaining the child's leisure and social participation. Which is the best activity for the OTA to recommend the family pursue with this child? A.) Electronic sports (Wii bowling) B.) Adapted little league baseball C.) Wheelchair basketball D.) Recreational swimming

D.) Recreational swimming Rationale: Recreational swimming is a social and leisure activity that the child can participate in with family members and friends. It can also be helpful in maintaining the child's functional level as long as possible.

A toddler attends an early intervention program as a result of developmental delay. Over the past two weeks the toddler has successfully completed the activities the OTA has provided in order to develop a palmar grasp. Which action should the OTA take next in response to the child's progress? A.) Continue providing the child with activities to refine palmar grasp B.) Review the initial evaluation with the OT to determine new goals C.) Provide activities to develop a radial palmar grasp D.) Provide activities to develop an ulnar palmar grasp

C.) Provide activities to develop a radial palmar grasp Rationale: The child has exhibited mastery of the palmar grip. The next developmental level of grasp after a palmar grasp is a radial palmar grasp. Ulnar palmar grasp is the developmental precursor to palmar grasp.

An older teenager with a congenital right, BE amputatation had never wanted a prosthesis. Now the teen wants a prosthesis "to look good at prom and for going on dates." Which action would be most beneficial to meet the client's expressed need? A.) Recommend a prosthesis with a cosmetic passive hand B.) Recommend a prothesis with a voluntary opening hand C.) Recommend a prothesis with a myoelectrically controlled hand D.) Recommend counseling to explore the client's sudden preoccupation with body image

C.) Recommend a prosthesis with a myoelectrically controlled hand

An OTA leads an outpatient wellness program. An individual with OCD asks for suggestions to manage symptoms that are interfering with life satisfaction. Which is the best recommendation for the OTA to make to the individual? A.) Approach activities in a nonchalant manner without high expectations B.) Engage in concrete activities that can be broken down into simple steps C.) Redirect thoughts and energies into meaningful activities D.) Set limits on the number of activities done in a day

C.) Redirect thoughts and energies into meaningful activities Rationale: The focus of OT in a wellness program is to help individuals attain and maintain life satisfaction through the engagement in meaningful activities. Individuals with OCD. Individuals with OCD have recurring and persistent thoughts and the need to engage in ritualistic behaviors that interfere with functional activities. Therefore, redirecting thoughts and energy into meaningful activities can be effective behavior management strategy

An OTA working in a school system incorporated the Individuals with Disabilities Education Act (IDEA) into their daily service provision. In which location should the OTA provide intervention? A.) Regular classroom while general education classes are not in session B.) Special education classroom specifically designed for children with disabilities C.) Regular classroom while general education classes are in session D.) Private occupational therapy room specifically designed for children with disabilities

C.) Regular classroom while general education classes are in session Rationale: The guidelines from IDEA emphasize that children with disabilities receive services in an inclusive manner that enables each child to have full access to the general education curriculum, and full participation in a general education classroom. The other options are too restrictive and do not facilitate inclusion in general education

An individual with spinal cord injury at the level of T1 is practicing a stand-pivot transfer in the OT department for rehabilitation center. The patient complains of dizziness and nausea. Which action is most important for the OTA to take first? A.) Call for help according to facility procedures B.) Return the patient to the wheelchair for a 5 minute break C.) Return the person to the wheelchair and immediately recline it D.) Return the patient to the wheelchair and transport the patient back to rest in bed

C.) Return the person to the wheelchair and immediately recline it Rationale: Individuals with SCIs are at risk for orthostatic hypotension. Complaints of dizziness and nausea are indications of orth-station hypotension and require an immediate response. Reclining the individual in their wheel chair will retune blood pressure to normal range

An OTA works with the new foster parent of a 2-year-old diagnosed with major developmental delays and severe hypotonia. The OTA advises the foster parent to position the head in midline during feeding. Which additional positioning recommendations for feed are best for this child? A.) Sitting with hips and knees at 90 degrees of flexion, neck in neutral B.) Sitting with hips and knees at 90 degrees of flexion, neck in extension C.) Semi-reclined with neck in neutral D.) Semi-reclined with neck in extension

C.) Semi-reclined with neck in neutral Rationale: Semi-reclined position can be easily maintained with the use of a commercially available child seat, and allows for correct postural alignment during feeding. Feeding with neck in extension is a choking hazard

An OTA works at a community-based vocational program. Right before a discussion group about effective work habits is scheduled to begin, the OTA is asked to assist another OTA with this group. Which is the best action for the OTA to take? A.) Split the group in two and have each OTA work with their own group B.) Participate as a member of the group and model desired responses C.) Support the leader with comments and questions that keep the group on focus D.) Act as an observer and take notes for documentation

C.) Support the leader with comments and questions that keep the group on focus Rationale: The role of assisting a group leader is to facilitate participation of the members and the achievement of the goals of the group. Splitting members into two groups would result in the assisting OTA having no knowledge of the group's history, process, or goals. In addition the existing leader would receive no input from a co-leader. The benefit of receiving feed from a co-leader is likely the precipitant for the group leader asking the OTA to participate

An individual with Lyme disease receives outpatient OT services. Upon evaluation, the OT and the OTA determine that the person's Lyme disease had resulted in a number of nervous system abnormalities including numbness in the hand and toes, bladder control impairments and Bell's palsy. The person is upset that they Lyme disease is preventing them from doing things like ' a normal person'. Which intervention is best for the OTA to implement during the first intervention session? A.) Teach the person to perform kegal exercises to improve bladder control B.) The application of thermal heat modalities to address numbness in the hands C.) Train person to use their fingers to prevent spillage of a bolus through the lips

C.) Train person to use their fingers to prevent spillage of bolus through the lips Rationale: While numbers and bladder control impairments are import to address, the first intervention session should address the person's Bell's palsy. Bell's palsy is condition in which the muscles on one side of the face becomes weak or paralyzed, causing it to droop or become stiff on that side. This makes eating very difficult as the person cannot fully close their mouth or keep food in their mouth.

An OTA measures a person for a wheelchair. The widest point across the person's hips and thighs is 16 inches, and the greatest length from the person's posterior portion of the buttocks to the popliteal fossa is 18 inches. Which wheelchair seat dimensions should the OTA recommend? A.) 18 inches wide by 20 inches deep B.) 18 inches wide by 18 inches deep C.) 16 inches wide by 18 inches deep D.) 18 inches wide by 16 inches deep

D.) 18 inches wide by 16 inches deep Rationale: to determine the width of a wheelchair seat, two inches are added to the measurement of the widest point across the hips and thighs. Allows for clearance on the sides to precent rubbing. The determination of wheelchair depth seat, two inches are subtracted from the length to prevent rubbing and potential decubitus formation in the posterior knee region.

The transition plan for an 18-year-old with developmental delay includes employment in a vocational rehabilitation workshop job setting. The student has set a goal to live independent of family. Which is the best living environment for the OTA to recommend for this student? A.) An apartment in a subsidized housing project B.) A group home with case managers available on-call C.) A supported apartment with a roommate D.) A group home with daily on-site supervision

D.) A group home with daily on-site supervision Rationale: A group home with on-site staff would be able to provide structure and supervision to successfully and safely complete tasks for clients with cognitive deficits.

An individual with myasthenia graves is being discharged home after a hospitalization for the treatment of pneumonia. The person's spouse has expressed concern about caregiving responsibilities and the client's ability to function in the home. The OTA collaborates with the OT to address the spouse's concern and the client's needs. Which is the most beneficial recommendation for the OTA and OT to make? A.) The extension of client's length of stay to allow for caregiver training B.) The extension of client's length of stay to provide intervention to develop ADL skills C.) A referral for the client to an adult day care program to relieve caregiver stress and develop functional skills D.) A referral to a home care agency for a functional evaluation and home assessment

D.) A referral to a home care agency for a functional evaluation and home assessment Rationale: A functional evaluation in the client's nome and an assessment of the home environment is the most beneficial choice listed to provide accurate information about the client's functional status and caregiver needs.

An individual cannot independently get from a supine position to a sitting position. The client has good scapular, shoulder, and elbow muscle strength. Which of the following should the OTA recommend as the most effective for the client to use to improve bed mobility. A.) A leg lifter B.) A bed rail assist C.) A log roll technique D.) A rope ladder

D.) A rope ladder Rationale: A rope ladder enables the individual to loop the arm into the first loop and then the next until they achieve a sitting position. Other options do not assist with independently moving from supine to sitting.

An OTA working in a school has been asked to recommend technological devices for a student with severe spastic quadriplegia and dysarthria. Which action should the OTA take prior to recommending specific equipment? A.) Determine access capabilities in collaboration with the SLP B.) Identify funding source in collaboration with a social worker C.) Obtain family support in collaboration with the psychologist D.) Determine intervention goals in collaboration with the OT

D.) Determine intervention goals in collaboration with the OT Rationale: Establishing the goals of technological interventions is essential to ensure that all equipment recommendations are meaningful and relevant to the student's needs.

An OTA working on an acute psychiatric inpatient unit conducts a series of groups for clients newly admitted to the unit. Which group leadership style is most effective for the OTA to assume when leading these groups? A.) Advisory B.) Facilitative C.) Laissez faire D.) Directive

D.) Directive Rationale: Directive leadership involves the provision of structure, clear directions, and immediate and consistent feedback. These qualities are needed in a group whose members are acutely ill with psychiatric disorders whose symptoms often include decreased attention span, distractibility, poor social skills, and or thought disorders

An older adult who is recovering from a CVA attends OT two times per day. The intervention environment is highly structured and not overstimulating, yet the client's mood often changes abruptly. Within one session, the client will laugh and then become tearful with no apparent precipitant. What should the OTA document these behaviors as potential signs of in the client's daily progress notes A.) A neurocognitive disorder B.) Anhedonia C.) A response to auditory hallucinations D.) Emotional lability

D.) Emotional lability Rationale: Emotional lability describes abrupt changes in mood without external precipitants. It is often observed in persons recovering CVAs. Anhedonia is the inability to experience pleasure. There is no information in the case that would substantiate a conclusion that the individual is developing a neurocognititve disorder or responding to the internal stimulation of hallucinations

A newly hired OTA is instructed by the director of rehabilitation to supervise two hospital volunteers as they learn how to assist patients in safely completing bed to wheelchair transfers. Which is the first action the OTA should take in response to the request? A.) Recommend the hospital develop a transfer training program for volunteers B.) Inform the OT supervisor of the director's request C.) Supervise the volunteers during the transfers to ensure patient safety D.) Explain to the director of rehabilitation why the request is inappropriate

D.) Explain to the director of rehabilitation why the request is inappropriate Rationale: Volunteers are not trained health care professionals and they cannot perform transfers with patients. Therefore the OTA cannot comply with the director's request.

An adult who incurred a CVA has difficulty dealing with increasing amounts of stimuli. This is noted in all modalities. The OTA documents these observations. Which cognitive-perceptual dysfunction should the OTA report the client is exhibiting? A.) Inability to abstract B.) Poor organizational skills C.) Poor semantic memory D.) Generalized attention deficit

D.) Generalized attention deficit Rationale: Attention requires the ability to focus on specific stimulus without being distracted by external or internal stimuli. The other options describe deficits with different manifestations.

An OTA conducts an intervention session with a client recovering from a CVA to develop transfer skills. The client has a comorbidity of epilepsy with primary generalized seizures. As the client stands to complete a transfer from the wheelchair to the bed, the client reports feeling sensations that are indicative of an aura. Which is the best immediate action for the OTA to take in response to the situation? A.) Provide reassurance and ask for guidance from the occupational therapist B.) Return the client to a seated position in the wheelchair until the sensations pass C.) End the session to the client can rest and inform the OT D.) Guide the person into side-lying position on the bed

D.) Guide the person into a side-lying position on the bed Rationale: Since the person could fall and harm themselves during a seizure the OTA must immediately ensure the client's safety

An OTA works with an individual with chest and UE burns. During the intervention session, the client expresses vague fears about personal safety at home and asks the OTA to advocate for an extension in the discharge fate. According to the medical record, the client had incurred the burns during a cooking accident. Which is the OTA's best initial response to the client's stated concerns? A.) Encourage the client to speak to the OT about discharge plans B.) Assure the client that pre-discharge fears are normal and expected C.) Document the client's concerns and recommend an extension of the length of stay D.) Invite the client to expand upon the nature of these concerns

D.) Invite the client to expand upon the nature of these concerns Rationale: The OTA needs more information to determine the basis for the client's fears and an appropriate response. Referring the client to the OT can be helpful, but it will not address their concerns at this moment. A delay may result in the client deciding that their concerns are not worth mentioning.

The supervisor of an acute inpatient medical unit requests that a recently hired entry-level OTA write summaries for several assessment sessions that were completed by another OTA. The evaluating OTA had to leave work unexpectedly due to a medical emergency and is not expected to return to work. Which is the best response for the OTA to make in response to this request? A.) Comply with the supervisor's request to ask for the supervisor to cosign the notes B.) Request time to complete an independent assessment of each individual previously evaluated C.) Report the supervisors request to the faculty's administration D.) Suggest that the OTA's assessment results be documented by the supervisor

D.) Suggest that the OTA's assessment result be documented by the supervisor Rationale: It is not appropriate for a peer to document results of an assessment session in which they did not participate. It is unacceptable for the supervisor to provide documentation based upon staff members' input, as long as the documentation reports that it is based upon the work of a given staff member. In acute inpatient medical setting there is insufficient time to complete another assessment. There is nothing to report to the administration at this time.

An OTA working in a skilled nursing facility observes a resident with cognitive disabilities don slippers by putting them on the wrong feet. The resident plans to go visit a friend on another floor and does not seem aware that the slippers are on the wrong feet. Which is the best action for the OTA to take in response to this situation? A.) Say nothing because this error may embarrass the resident B.) Say nothing but follow the resident to the friend's room to ensure a safe arrival C.) Ask the resident to look at the slippers if the error is noted D.) Supportively inform the resident of the need to reverse the slippers

D.) Supportively inform the resident of the need to reverse the slippers Rationale: The slippers must be immediately reversed to ensure safety and prevent a fall. Since resident has cognitive deficits they may not be able to notice the error and self correct.

A client has right-sided weakness and decreased motor control. The OTA uses the proprioceptive neuromuscular facilitation (PNF) approach to help the client increase use of the right UE and hand. Which of the following actions should the OTA have the client do during an intervention session to apply PNF principles? A.) Reach overhead with the right hand to retrieve a dish out of a higher cabinet and set it down on the countertop in front B.) Reach to the right side to retrieve an item out of refrigerator at hip height and place it into the left hand to set it on the countertop to the left C.) Use both hands together to pour juice out of a heavy pitcher into a glass on a countertop D.) Take items out of a dishwasher on the right side and reach across the body to place them in the upper cabinet on the opposite side

D.) Take items out of a dishwasher on the right side and reach across the body to place them in the upper cabinet on the opposite side Rationale: PNF is a technique that involves use of diagonal patterns of movement and involves rotational trunk movement. Using the right UE to reach down to the side to take items out of a dishwasher and reaching across one's body to place these items into a higher cabinet on the opposite side creates this diagonal pattern and encourages use of affected side to increase motor control.

An individual attend an outpatient partnering skills group. The person has major depressive disorder and is taking Nardil. The client complains of recurrent headaches and difficulty focusing during the day. Which action is best for the OTA to make in response to the client's expressed concerns? A.) Instructs the client in stress reduction techniques A.) Ask the group for suggestions on how to deal with the parenting stress of homework C.) Suggest that the individual consult with a nurse practitioner for headache relief strategies D.) Tell the client you will be notifying the psychiatrist of these complaints

D.) Tell the client you will be notifying the psychiatric of these complaints Rationale: Nardil is a MAOI. It has serious side effects when a person eats food that contain the amino acid tyramine. Tyramine increased BP and may lead to stroke or other cardiovascular reach actions. Headache and heart palpitations are the first sign of a problem.The individual needs to collaborate with a psychiatrist to determine if an MAOI is the best medication, given its restrictions.

An OTA works with a person who is recovering from the removal of a brain tumor from the cerebellum. The client has established a goal to resume the role of home maintainer. Which is most relevant for the OTA to focus on during intervention sessions focused on the development of home management skills? A.) Sensory precautions to observe when cooking and ironing B.) Compensatory techniques from finding items in the supermarket C.) Organizational strategies for managing the household budget D.) The use of a wheeled cart to assist with balance while doing laundry

D.) The use of a wheeled cart to assist with balance while doing laundry Rationale: The use of mobility aids such as a wheeled cart would be a helpful intervention for a person who incurred damage to the cerebellum, which would result in balance and coordination concerns. The observation of sensory precautions when cooking and ironing would be indicated for a person who has sensory loss due to parietal lobe damage. Training in compensatory techniques for finding items in the supermarket would be indicated for a person who has visual deficits resulting from occipital lobe damage. A person who has cognitive deficits from frontal lobe damage would benefit from interventions focus on the use of organizational strategies.