Practice exam 1

ideational apraxia

"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 sen-sorimotor aspects needed to perform the activity can be intact. "

Utilization review

"Utilization review is a plan to review the use of resources within a facility to determine medical necessity and cost efficiency"

"The family of an individual being admitted to a rehabilitation center offers the occupational therapist a cashgift. The therapist refuses the money but the family continues to insist that the therapist take the cash gift.After thanking the family for their generous gesture, which is the therapist's best response? Answer Choices: A. Donate the money to the hospital. B. Donate the money to charity. C. Use the money to purchase an item for the OT department. D.Decline the gift and explain the setting's no-gift policy"

always decline the gift

"Evaluation results reveal that the patient is deconditioned with deficits in upper body strength, endurance, andbasic ADL. The patient's goals are to return home at the premorbid level, which includes no oxygen use, thesharing of home management tasks, and full-time employment as a home inspector. This job requires climbing on ladders, bending, squatting, and standing for up to 20 minutes at a time. In initiating intervention, which activities are best for the occupational therapist to use? For actions that you think are positive and appropriate to the presented situation, select YES. For actions that you think are not positive and/or not appropriate to the presented situation, select NO. YES or NO must be chosen for each listed action" "1. C5 Incorporate pursed-lip strategies into basic ADL" YES "3. C5 Practice climbs up and down a ladder to simulate work activity." NO "4. C5 Educate in stress management techniques" YES "5. C3 Perform meal preparation in standing without breaks to simulate activity performance in the home" NO "6. C5 Practice the Valsalva maneuver during strengthening activities in order to maximize strength" NO "7. C5 Use free weights and ergometer exercises to improve upper body strength" YES "1. C5 Instruct the patient to engage in hyperventilation strategies when experiencing shortness of breath toincrease oxygen saturation" NO -hyperventilation is bad "2. C8 Provide a wedge cushion for use in bed to elevate the head at night." YES "3. C5 Teach the patient diaphragmatic breathing exercises" YES "4. C5 Demonstrate proper bed positioning, including lying in prone with a pillow under the chest." NO (laying on stomach would compress chest- bad for COPD) ". C5 Instruct the patient to forcefully exhale all air in the lungs when chaotic breathing patterns occur" NO (is this ever a good idea) "6. C5 Provide education in placing elbows on a flat surface when sitting or standing to reduce shortness ofbreath." YES

"A common instructional approach for shortness of breath associated with COPD is toassume a tripod posture/position when sitting or standing. The patient is instructed to lean forward, placing theelbows or forearms on a flat surface to reduce the effort in breathing. In this position, the muscles that assist inbreathing, including muscles of the chest and neck can be prioritized to assist with breathing and less in holding thebody in an upright posture. Selecting YES to this option would result in the awarding of a point"

"An occupational therapist working in a school has been asked to recommend technological devices for a stu-dent with severe spastic quadriplegia and dysarthria. Which action should the therapist take prior to recommending specific equipment? Answer Choices:A. Determine access capabilities in collaboration with the speech-language pathologist. B. Identify funding source(s) in collaboration with the social worker. C. Obtain family support in collaboration with the psychologist. D .Determine intervention goals in collaboration with the student"

"Correct Answer: D. (i got this wrong) Rationale:Establishing the goals of technological interventions in collaboration with the student is essential to ensurethat all equipment recommendations are meaningful and relevant to the student's unique needs and desired goals. For example, technology can facilitate interpersonal communication, functional mobility, engagementin leisure activities, and/or the completion of schoolwork. Determining access capabilities is an importantstep to take after the goal of the device is established. Funding for a device would be provided by the schoolin accordance with the Individuals with Disabilities Education Act (IDEA). While obtaining family support isalways important and is required by IDEA, the occupational therapist must be able to explain the need andrationale for the recommended equipment to effectively obtain this support"

"A child with moderate spastic cerebral palsy works on ambulation with a walker in physical therapy. Theoccupational therapy evaluation reveals problems in lower extremity dressing, transitional skills, self-feeding,and grasp and release skills. To facilitate the attainment of the child's ambulation goal, which activity is bestfor the occupational therapist to include in OT intervention session? Answer Choices: A. Rolling in and out of prone and supine while on a mat, with minimal hands-on facilitation. B. Donning and doffing shoes and socks in bench sitting with one leg externally rotated and placed on the opposite knee. C. Practicing grasp and release of small objects while wearing bilateral soft splints to support a more functional hand position"

**** this question- I got this wrong, its B "Dressing the lower extremities in bench sitting encourages dynamic trunk balance, lower extremity externalrotation, and dissociation. This activity is the best one listed to address the skills needed for ambulationwhile meeting OT goals related to performance in areas of occupation. Practicing the grasp and release ofsmall objects while wearing soft splints might help improve the child's ability to grasp the walker handles butthis activity does not directly address the child's ambulation goal, which is the stated focus of the question"

"An occupational therapist provides consultation services to members of a town chamber of commerce whohave expressed interest in improving their businesses' accessibility. Which is the minimum door width thatthe occupational therapist should recommend to the chamber members as accessible and not requiringmodification?Answer Choices:A. 28 inches.B. 32 inches.C. 30 inches.D.34 inches."

32 inches

"An occupational therapist designs a dynamic splint for an individual recovering from tendon repair. At whichangle should the therapist position the outrigger? Answer Choices:A. 45° to the joint. B. 90° to the joint. C. 60° to the joint. D.110° to the joint"

90 degrees to joint always adjust based on 90 degrees

"A 19-year-old with a diagnosis of persistent depressive disorder attends a vocational rehabilitation program.When the client arrives for the work adjustment group, the therapist notes that the client demonstrates anunsteady gait and slurred speech. The client's breath smells of alcohol. Which is the best action for the thera-pist to take in response to these observations?Answer Choices: A. Follow program procedures to arrange for transportation to bring the client home. B. Introduce the topic of alcohol's effect on work performance as the focus of the scheduled group session. C. Have the client meet with the social worker to discuss treatment options for potential alcohol abuse. D.Contact the client's parents to pick the client up to bring the client home"

A

"A 2-year-old child is placed in foster care due to child abuse and neglect. The child was frequently beaten andlocked in a dark closet. The child is fearful and suffering from sensory deprivation. Which sensory input isbest for the occupational therapist to recommend the foster parents provide for the child?Answer Choices:A. Slow rocking.B. Fast rocking.C. Bright lights.D.Upbeat music"

A

"A child with moderate Klumpke's paralysis on the right side wants to cut meat. The child holds the fork withthe right hand and the knife in the left hand, and practices with therapy putty. To begin cutting, which is thebest way to configure the therapy putty? Answer Choices: A. Flattened and placed directly on the table. B. Rolled and placed on a plate on the table. C. Flattened on a plate that rests on a nonskid mat"

A

"A person recovering from hip replacement surgery wants to begin meal preparation. The client refuses to usethe walker that was ordered by the physician. The physician is unavailable for consultation. Which is the bestinitial action for the occupational therapist to take in response to this situation? Answer Choices:A. Work on meal preparation activities with the client sitting at a table. B. Work on meal preparation activities with the client standing without the walker. C. Delay working on meal preparation activities until the physician can be contacted. D.Tell the client the walker must be used until the physician changes the order"

A

"An entry-level occupational therapist is hired to work on an acute psychiatric unit. The occupational therapysupervisor orients the therapist to hospital policies and procedures. Which are the most important policiesand procedures for the supervisor to include in the initial orientation session? Answer Choices: A. Crisis intervention. B. Reimbursement. C. Employee benefits. D.Group program scheduling"

A

"An occupational therapist working for a psychiatric partial hospital program arranges the seats for a topicalgroup. The room is small and there are eight people in the group. Which is the best arrangement of the roomfor this group composition? Answer Choices: A. Nine chairs placed in a circle with no assigned seats for the patients or the therapist. B. Two semicircles of four chairs with no assigned seats facing the therapist's chair placed at the front of theroom. C. Eight chairs placed around a table with no assigned seats and the therapist at the head of the table."

A

"During an intervention session using a transfer of training approach, the occupational therapist gives theclient a list of items commonly found in a closet and asks the client to separate the items into grooming anddressing items. Which skill is the occupational therapist working on?Answer Choices: A. Categorization. B. Sequencing. C. Problem-solving. D.Memory"

A

"Following medical treatment for a brain tumor, a client is referred to OT home care services for a functionalevaluation. During the initial interview, the client reports difficulty locating desired items. For example, atlunchtime the client could not find a can of soup in the pantry. Based on this self-report, which functionalability should the occupational therapist evaluate? Answer Choices:A. Visual scanning.B. Visual acuity.C. Spatial relations.D.Topographical orientation."

A

"An occupational therapist evaluates a client using the Allen Cognitive Level (ACL) Screen. The client success-fully completes three running stitches. Which step should the therapist take next? Answer Choices: A. Demonstrate the whip stitch and ask the client to imitate this and complete three stitches. B. Demonstrate the single cordovan stitch and ask the client to imitate this and complete three stitches. C. Document that the person demonstrates a cognitive level consistent with Level 3 of the Cognitive Disabili-ties model"

A "According to the Allen Cognitive Level (ACL) Screen, after the completion of three running stitches the per-son should move on to the next step in the screening process, which is the completion of three whip stitches.After the completion of three whip stitches, the therapist then points to the single cordovan stitch and asksthe client if they can do the stitch. If the client is unable to complete the stitch, the therapist provides an ori-enting verbal cue. If the client cannot complete the stitch with this cue, the therapist demonstrates the stitch.A maximum of two demonstrations can be provided. The documentation of a person's cognitive level should be completed after the person has had the opportunity to perform all components of the evaluation"

"An individual with borderline personality disorder is admitted to the hospital following a suicide attempt.After attending an occupational therapy orientation group, the patient tells the occupational therapist, "You are the only therapist who has ever been really helpful." The patient asks to meet with the therapist privately on a regular basis instead of the assigned primary individual therapist. Which action is best for the therapist to take in response to the patient's request? Answer Choices: A. Refer the patient to the assigned primary individual therapist. B. Agree to meet with the patient since a positive therapeutic connection has been expressed. C. Tell the patient that an occupational therapist provides only occupation-based group treatment. D.Explain that this type of manipulative behavior is not acceptable."

A "The patient must be referred to the primary individual therapist assigned to their case. Although the patienthas responded favorably to the initial occupational therapy group session, this does not preclude the patient'sneed for individual therapy. "

"Upon screening, an 8-month-old child demonstrates a positive downward parachute reflex. Which action should the occupational therapist take next in response to this observed behavior?Answer Choices: A. Document that the child exhibits normal reflex development. B. Document that the child exhibits a developmental delay. C. Evaluate the protective extension downward reflex. D.Evaluate the standing tilting reflex"

A "A downward parachute reflex is normal from 4 months and persists throughout one's lifetime unless neuro-logical damage occurs. It is also called the protective extension downward reflex. The onset of the standingtilting reflex is from 12-21 months so an evaluation of this reflex is premature"

"A single parent of two children, a 4-year-old and a 6-year-old, is referred to occupational therapy services in a reha-bilitation center. The client had a brain tumor removed one month ago. The referral states that the client has residualcognitive-perceptual deficits. Screening indicates that the client's sensorimotor abilities are within functional limits." "The occupational therapist uses a neuro-functional approach to remediate the client's cognitive dysfunction.Which is most appropriate for the occupational therapist to include in the intervention program?Answer Choices: A. Functional activities in their real contexts. B. Client education on strategies to compensate for deficits. C. Tabletop activities to practice remediation strategies. D.Computer games to develop performance component skills"

A "A neuro-functional approach emphasizes functional activity performance in the actual environment. Treat-ment is focused on training specific functional skills in true contexts. Client education on strategies tocompensate for deficits is consistent with a compensatory/adaptive/functional approach. Tabletop activitiesto practice remediation strategies and computer games to develop performance component skills reflect atransfer of training approach."

"An occupational therapist reviews the use of the occupational therapy department's resources to determinemedical necessity and cost efficiency. Which service management task is the therapist performing?Answer Choices:A. Utilization review.B. Retrospective peer review.C. Total quality management.D.Risk management"

A (i didn't know this one)

"A37 C1The parents of a 2-year-old child with a unilateral congenital upper extremity amputations express concernto the home-care occupational therapist about their child's complete disinterest in toilet training. At whichpoint should the occupational therapist advise the parents to begin toilet training? Answer Choices:A. When the child indicates discomfort with being wet or soiled. B. Immediately, because toileting is a developmentally appropriate task. C. When the child is 3 years old, as this is the typical developmental age for toilet training"

A and children develop differently! recognition of being soiled or wet is the first toileting skill developed

"An occupational therapist uses behavior modification techniques to help shape the behavioral responses ofstudents with behavioral disorders. Which action is most consistent with this intervention approach? Answer Choices:A. Provide frequent positive reinforcement for all desired behaviors. B. Reprimand the students every time an undesirable behavior occurs. C. Allow each student enough time for self-correction of the behavior. D.Encourage the teaching staff to tell the students which behaviors are correct and incorrect"

A behavior modification rewards positive behavior, ignores negative self-correction is not a behavior modification component

"A child with juvenile rheumatoid arthritis wears bilateral night resting splints with wrists in 0° of extension,MPs and IPs flexed, ulnar deviation of 10°, and thumbs in opposition. The child complains of pain in thewrists upon awakening. No redness is noted upon removing splints. Range of motion (ROM) measurementsshow ulnar deviation of 5°. Which action should the occupational therapist take in response to this com-plaint and these observations? Answer Choices:A. Modify the splints at the wrist.B. Pad the ulnar aspect on the inside of the splints.C. Discontinue the splints and monitor the status of pain for two weeks."

A shouldn't have more ROM on a splint then they can do!

"A child with tactile defensiveness is receiving intervention from an occupational therapist using a sensoryintegrative approach. Which method is most effective for the therapist to use when introducing tactile stimulito the child? Answer Choices: A. Provide deep touch and firm pressure where the child can see the stimuli. B. Apply the stimuli in the direction opposite of hair growth with vision occluded. C. Apply light touch across the face and abdomen with vision occluded. D.Provide light brushing across the palmar surfaces of the extremities with the child watching"

A tactile defensiveness- proprioception- deep touch!!!

"An occupational therapist provides services to members of a psychosocial clubhouse. Which is the mosteffective approach for the therapist to use when giving directions for a task to an individual with schizophre-nia who is experiencing auditory hallucinations? Answer Choices:A. Written directions for making vanilla pudding. B. Verbal step-by-step directions for making a leather link belt. C. General verbal directions for the completion of a group collage. D.Demonstration of steps during a swing dance class"

A verbal would be hardest unstructured or open ended would be to vague

"An occupational therapist conducts a satisfaction survey to evaluate the quality of OT services in an out-patient program. The questionnaire developed by the therapist asks respondents to rate their responses toquality statements according to a 4-point Likert scale of agreement. Which statement best reflects an adequatemeasure of satisfaction?Answer Choices: A. "The amount of time devoted to stress management was adequate." B. "Setting my own goals was important to me." C. "My experience in occupational therapy helped me." D."The OT staff was respectful and fair to me.""

A (I got this right but why) "The response "The amount of time devoted to stress management was adequate" is the most helpful for thoselisted because it provides concrete information to evaluate service quality and improve service provision.Statements that reflect the personal value of an item to an individual, or that are vague and unmeasurable donot measure satisfaction with the services delivered. As a result, they do not meet the measurement require-ments of a satisfaction survey"

"An occupational therapist provides home-based services to a person recovering from a recent CVA. The indi-vidual lives alone and receives home care Medicare Part A benefits. The therapist arrives at the client's houseat the scheduled session time, but there is no response to the knocking on the door. A neighbor reports seeingthe client leave with a friend. Which is the best action for the therapist to take in response to this situation? Answer Choices:A. Document that no one answered the door and that the appointment will be rescheduled. B. Call the nurse case manager to report the missed appointment and the need to reschedule. C. Document that no one was home and that the appointment will be rescheduled. D.Document that the client is engaged in community mobility activities and should be evaluated for discharge"

A (I got this right- the rational also said they can leave the house under certain circumstances so you don't want to document anything that could hurt there ability to keep receiving home health)

"An individual with advanced Huntington's chorea is newly admitted to a skilled nursing facility. The residentweighs 280 pounds and cannot independently transfer. What is the best recommendation for the occupa-tional therapist to make to the resident's direct care staff to ensure a safe transfer? Answer Choices:A. A mechanical lift transfer.B. A two-person lift transfer.C. An assisted sliding board transfer"

A (I got this wrong) "A mechanical lift transfer is the safest for both the resident and the staff. The other transfers require motor andcognitive abilities that are beyond the capacity of an individual with advanced Huntington's chorea. Huntington'schorea, an autosomal dominant neuromuscular disease, is characterized by choreiform movements, progressiveintellectual deterioration, and psychiatric disturbances. The individual's movement disorder combined withpotential confused and/or agitated behaviors requires the use of a mechanical lift for safe and efficient transfers"

"A young adult with a ten-year history of bulimia nervosa participates in an outpatient vocational explorationgroup and completes a vocational interest inventory. This evaluation identifies four possible areas for a career.Which career choice is best for the occupational therapist to advise the client to explore further? Answer Choices:A. Web designer. B. Dietitian. C. Athletic trainer. D.Fashion designer"

A - duh I should have gotten this right. it is the only one that doesn't deal with food or looking good

"A woman with a complete spinal cord injury at the C5 level has given birth to her first child. The client seekssuggestions on methods to facilitate independent and safe parenting. Which of the following is most benefi-cial for the occupational therapist to recommend the mother use to help her independently feed her child? Answer Choices: A. A pillow to support the mother's arms during breast feeding. B. Bottles with premeasured formula. C. Bottles that have molded easy to grip shapes. D.A sling to support the infant's head during breastfeeding"

A- C5 spinal cord- flexion of elbows. plus it is the only answer that talks about arms.

"An occupational therapist is instructing a patient who had a left CVA on how to lock the brakes on a wheel-chair. The patient is right-handed and the right upper extremity has partial paralysis. Based on motor learningtheory, which is the best intervention approach for the therapist to use when instructing the person to lockthe right brake? Answer Choices: A. Practice with the left hand first and then with the right. B. Show the person how to use an extension brake. C. Practice the locking motions with both hands simultaneously. D.Have the patient use the left hand to assist the right hand"

A- I got it right but why? "Approaches based on motor learning theory acknowledge the importance of practice and repetition. Whenthe patient practices with the left hand first and then the right, transfer of learning is promoted. "

"An occupational therapist receives a referral from a physician that outlines a specific course of treatment. Fol-lowing the evaluation of the person, the therapist believes that a different course of treatment would be morebeneficial. Which course of action is best for the therapist to take? Answer Choices: A. Contact the physician and discuss the alternative treatment. B. Provide the prescribed treatment on a three to four week trial. C. Combine the prescribed treatment with the therapist's preferred treatment. D.Provide the treatment the therapist believes would be more beneficial for the person"

A- I got this right

"An individual receives treatment for a major depressive disorder on an inpatient psychiatric unit. The patienthas received an electroconvulsive treatment (ECT) treatment at 8 a.m. At 2 p.m., the patient walks into theoccupational therapy department stating a desire to participate in the leisure skills group. Which is the occu-pational therapist's best response? Answer Choices: A. Encourage the client to select one of three structured leisure activities to complete. B. Call nursing staff to escort the client back to the client's room so that the client can rest. C. Commend the client's motivation but remind the client that rest is recommended for 24 hours after ECT. D.Have the client complete a leisure history questionnaire to enable individualized treatmen"

A- I got this wrong "Six hours after ECT, the individual is capable of engaging in a structured task. Giving the individual a choiceof activities to complete increases the likelihood that the person will be interested in the task selected. Thereis no need to return the client to their room and 24 hours of rest is not necessary after an ECT. However, thereis some temporary memory loss after an ECT so it would not be appropriate to give the individual an activitythat requires memory to complete"

"An occupational therapist implements intervention in a preschool program for children who are overrespon-sive to touch. In the prior intervention session, the children had responded favorably when the therapisthad rolled a large ball over their bodies as they lay supine on a mat. Which intervention method should thetherapist use next? Answer Choices: A. Roll the large ball with increased pressure across the children's bodies. B. Bounce the ball across the children's bodies. C. Have the children jump into a pool filled with small balls. D.Roll the large ball, as in the prior session, with the children prone"

A- I was right, deep pressure is good for tactile defensiveness

"A child with attention deficit with hyperactivity disorder (ADHD) and conduct disorder attends an after-school program that utilizes sensory-integrative and behavioral management approaches to achieve interven-tion goals. Snacks are provided and occasionally used as rewards. A parent insists that a child not be givenany foods containing sugar because these will increase the child's hyperactive behaviors. Which is the occupa-tional therapist's best response to this request?Answer Choices:A. Discontinue providing sugary snacks but continue their use as rewards in the behavioral management pro-gram.B. Provide the parent with recent research that refutes the link between sugar and hyperactivity.C. Discontinue providing sugary snacks for the child to comply with the parent's request.D.Inform the parent that the therapist will discuss the issue with the program's administrator to determinethe best course of action"

A- always comply with parent requests

"A 6-year-old child with difficulties in figure-ground perception is being discharged from occupational therapyservices. In the discharge plan, which should the therapist recommend for this child? Answer Choices:A. Use a different solid-colored folder to hold materials for each class subject. B. Use a toothbrush and comb that are the same colors as the counter. C. Wear clothing with bold colors and loud patterns. D.Place all school books and handouts on the desk while completing homewor"

A- i got this right

"An occupational therapist is treating an 8-month-old child with mild developmental delay. The child exhibitsnormal cognitive development. The child has developed adequate static sitting balance but has poor dynamicsitting balance. The therapist implements intervention by positioning the child and having the child find atoy that is covered with a cloth. Which positioning and toy placement are most beneficial for the therapist touse with this child? Answer Choices: A. Sit the child between the therapist's extended legs and alternate placing the covered toy to the child's rightand left side .B. Sit the child in a child seat and alternate placing the covered toy to the child's right and left side. C. Lay the child in a prone position and place the covered toy in front of the child. D.Lay the child in on the right side and place the covered toy to the left of the child"

A- i got this right

"uring an occupational therapy session, a veteran recovering from bilateral traumatic lower extremity ampu-tations expresses several concerns about having a changed body and questions its sexual appeal. Whichresponse is best for the therapist to take in response to client's concerns? Answer Choices: A. Refer the client to the primary care physician. B. Ask open-ended questions to explore the concerns further. C. Reassure the client that the concerns are a normal part of the recovery process. D.Explain that positioning can compensate for changes in functional mobility"

A- i got this right

"A patient incurred a traumatic upper extremity amputation. During pre-prosthetic treatment, the occupa-tional therapist molds the contours of the residual limb to shape it in preparation for a prosthesis. Whichmethod is most effective for the occupational therapist to use?Answer Choices: A. Wrapping. B. Percussion. C. Shrinking. D.Massage"

A- i got this right but why? Wrapping is what you do reduce volume and shape for prothesis, shrinking is a result of wrapping. and percussion and massage are used to desensitize residual limb.

"A client exhibits residual difficulties in a variety of perceptual skills. Which procedure should the therapistinclude in the evaluation of the client's proprioception? Answer Choices: A. The therapist positions one extremity with the patient's vision occluded and asks the patient to duplicatethe position with the contralateral extremity. B. The therapist moves one extremity with the patient's vision occluded and asks the patient to duplicate themovement with the contralateral extremity. C. The therapist demonstrates the desired position and asks the person to replicate the position in mirrorfashion. D.The therapist shows the client a picture of a position and asks the client to replicate the position with eachextremity."

A- i got this right don't over think it!

"An elementary-school-aged child is referred to occupational therapy by a pediatrician. The pediatrician hasruled out attention deficit disorder and notes that the child demonstrates poor school performance and unex-plained clumsiness. The occupational therapist screens the child and determines that the child is a candidatefor a sensory processing evaluation. Which skills are most likely to have been observed to be intact during thescreening and needing no further evaluation? Answer Choices: A. Fine motor coordination. B. Sequencing motor tasks. C. Initiation of activities. D.Ocular pursuits"

A- i got this wrong I guess FM coordination is not necessarily effected by sensory processing but the others can be

"An individual with hemiplegia has inadequate ankle dorsiflexion on the affected side. Which of the followingequipment is best for the occupational therapist to recommend the person use to compensate for this deficitand facilitate safe and effective ambulation? Answer Choices: A. An ankle-foot orthosis (AFO). B. A wide-based quad cane (WBQC). C. A narrow-based quad cane (NBQC). D.A knee-ankle-foot orthosis (KAFO)."

AFO the canes are used for poor balance and the knee is not involved so we don't impede movement of unaffected joints

"A non-English-speaking individual with a recent left-sided CVA comes to occupational therapy for the firstevaluation session. The assigned therapist cannot communicate verbally with the person. Which action is bestfor the therapist to take first? Answer Choices: A. Perform a screening to determine the specific areas to evaluate. B. Seek out a translator to assist with the evaluation. C. Communicate with the individual using nonverbal communication. D.Evaluate the individual according to established protocols"

B

"A 15-year-old with asymptomatic HIV attends an outpatient clinic. The occupational therapy protocol forpersons diagnosed with HIV includes presentation of information on safe sex. The adolescent's parents refuseto allow this information to be presented to their child. Which is the best action for the therapist to take inresponse to this situation? Answer Choices:A. Ask the adolescent's opinion and act on their refusal or consent.B. Document that the parents refuse the intervention for their child.C. Refer the family to the social worker for counseling.D.Have the parents sign a waiver that they refused the intervention for their child"

B

"A COTAfi recently attended a two-day splinting workshop. The COTAfi asks the supervising occupationaltherapist for a caseload that includes more clients that require splinting interventions. Which action is bestfor the occupational therapist to take in response to this request? Answer Choices: A. Decline the request because splinting is an advanced practice skill. B. Ask the COTAfi to give a splinting in-service to demonstrate acquired knowledge. C. Establish the COTAfi's service competency in splinting. D.Distribute the department's caseload to meet the COTAfi's request"

B

"A child with myelomeningocele meets the short-term goals of achieving functional gross grasp and lateralpinch. After several additional weeks of occupational therapy, the child does not meet the goals of demon-strating pincer grasp and three jaw chuck. Consequently, the therapist modifies the child's intervention plan.Which intervention is best to include in the revised plan? Answer Choices:A. Increase strength of lateral pinch as a basis to develop pincer grasp and three jaw chuck.B. Teach the child to use gross grasp and lateral pinch for functional activities.C. Teach the child to use ulnar grasp for functional activities"

B

"A private practice composed of five occupational therapists provides home-based services to a variety of adult clientsin a two-county area. They are expanding their practice to include home-based services in another county. This pri-vate practice has also recently been awarded the early intervention service provider contract for all three counties. Thepractitioners plan to hire three entry-level occupational therapists and two certified occupational therapy assistants(COTAfis) to fill the service needs of their growing practice. The COTAfis have extensive experience in home-basedservice provision. The private practitioners plan to provide all of their new employees with a comprehensive orienta-tion program and the shadowing of an experienced therapist for two weeks." "The private practitioners pay for their newly hired occupational therapists' registration for an advanced courseon pediatric assessment. Which is the most important outcome of attending this course for the occupationaltherapists? Answer Choices:A. Networking with other pediatric professionals.B. Improving their professional skills and competence.C. Keeping up-to-date on current trends in occupational therapy"

B

"A teenage girl with juvenile rheumatoid arthritis (JRA) identifies a goal of applying her own makeup. Whichadaptation is most beneficial for the therapist to recommend? Answer Choices: A. Silver ring splints to hold makeup applicators. B. Enlarged soft foam handles on makeup applicators. C. Long thin handles on makeup applicators. D.A universal cuff to hold makeup applicators."

B

"An older adult with peripheral neuropathy resulting from the chronic effects of diabetes expresses concernover the ability to have a satisfying sexual relationship with a partner. Which is the most beneficial recom-mendation for the occupational therapist to make to the older adult?Answer Choices: A. Experiment with different positions during sexual expression activities.B. Focus on intact senses and areas of intact sensation.C. Schedule sexual expression activities after rest periods.D.Advise the older adult to accept decreased abilities in sexual expression as a normal part of aging"

B

"As the result of a trauma ten months ago, a 13-year-old incurred a unilateral below-elbow amputation. Dueto a recent growth spurt, the adolescent is being reevaluated for a new prosthesis. During the evaluation, theadolescent angrily tells the occupational therapist that a prosthesis is "annoying to have to wear every day."The adolescent reports not liking "the claw" and as a result often takes off the current prosthesis. However,the adolescent acknowledges that the prosthesis is "needed sometimes" to perform desired bilateral activities.Which action is best for the therapist to take in response to this adolescent's statements? Answer Choices:A. Refer the adolescent to the child psychologist to deal with adjustment to disability .B. Work on developing unilateral skills for completion of meaningful activities. C. Refer the adolescent to a prosthetist for a prosthesis with a cosmetic hand. D.Recommend the adolescent attend a teen amputee support group."

B

"During a classroom screening, an 8-year-old is observed holding a pencil with a tight grip. The studentappears to rely heavily on visual cues to assist during both fine and gross motor tasks. During gross motoractivities, the student moves in an uncoordinated manner. The occupational therapist uses a sensory integra-tive frame of reference to interpret evaluation data. Which impairment should the therapist document asneeding further evaluation? Answer Choices: A. Vestibular processing dysfunction. B. Proprioceptive system dysfunction. C. Hyporesponsive tactile system. D.Hyperresponsive tactile system"

B

"The parents of an 8-month-old child bring their child to a free community health developmental screeningprogram. The occupational therapist evaluates the oral motor development of the child and determines thatthe child's development is within normal limits. When documenting this determination, which is most likelyfor the therapist to state the child demonstrates? Answer Choices: A. Rotary chewing. B. Diagonal jaw movements. C. Effective mastication. D.Cup drinking with a firm jaw"

B "Diagonal jaw movements can develop as early as 7 months and would be evident by 8 months. Effectivemastication typically develops at 9 months. Cup drinking with a firm jaw and rotary chewing are typical for achild at 12 month"

"A patient with a complete injury of the spinal cord at the C5 level completed inpatient rehabilitation whichconcentrated on increasing independence in ADL. In the discharge documentation, which is most likely forthe occupational therapist to state the client is able to do?Answer Choices: A. Button buttons using a button hook. B. Use mobile arm supports for feeding. C. Tie shoes using thick shoelaces. D.Brush teeth using a tenodesis splint."

B "Mobile arm supports are likely to be able to be used by a person with a C5 level of injury. The ability to com-plete grooming tasks using a tenodesis splint and buttoning with a button hook are likely skills for a personwith a spinal cord injury (SCI) at the C6 level. A person with a C8 level of SCI would likely be able to tieshoes"

"An individual incurred a spinal cord injury at the C5 level. During an occupational therapy session focusedon developing the ability to feed independently using adaptive equipment, the occupational therapistnotes that the client is flushed and sweating excessively. The client requests that the session end early dueto a pounding headache. Which action is best for the occupational therapist to take first in response to thissituation? Answer Choices: A. End the session and call the transporter to return the client to the client's room. B. Empty the client's filled catheter bag and maintain the client's upright position. C. Return the individual to the unit and report symptoms to the head nurse. D.Stop the session and recline the individual in the wheelchair for a rest break"

B "The client's symptoms are indicative of autonomic dysreflexia. This is an extreme rise in blood pressurecaused by a noxious stimulus. This complication is deemed a medical emergency that must be treated imme-diately by quickly removing the noxious stimulus that caused the problem. Common stimuli are blockedcatheters or sitting on sharp objects. Other symptoms of autonomic dysreflexia include profuse sweating anda pounding headache. "

"A 9-year-old child identifies the assembly of a model as the most desired play activity. The occupational thera-pist determines that the child would have difficulty completing the selected model. Which action is mosteffective for the therapist to take during the next intervention session? Answer Choices:A. Allow the child to work on the model and provide maximum assistance as the child completes the project.B. Explore with the child why completing the model is desired by the child and provide alternative projectchoices.C. Break the project down into accomplishable segments and instruct the child to complete one segment at atime.D.Explain to the child several reasons why the selected model is not the best choice for the child and providealternative project choices"

C

"A child with spastic quadriplegic cerebral palsy has increased tone and flexor synergies in both upperextremities. The child receives Botox injections into both biceps. In designing play activities to use duringintervention, which is most important for the occupational therapist to include as an activity performancecharacteristic?Answer Choices: A. Reaching overhead and to both sides in supine. B. Bilateral upper extremity weightbearing in sitting and in prone. C. Grasp and release of objects in supported sitting. D.Transitions into and out of sitting, supine, and prone"

B "he theory supporting the use of Botox injections is that the Botox lessens spasticity for three to six monthsto allow for strengthening of the opposing nonspastic muscles. In this case, the child has flexor spasticityso relaxation of the biceps to allow strengthening of the triceps is indicated. Therefore, the most importantfocus of intervention is weightbearing of the upper extremities since this can strengthen the triceps muscles."

"Following the performance of a home exercise program prescribed one week ago, an individual with bilateralupper extremity muscle weakness reports experiencing pain in both shoulders and elbows. The pain persistsfor up to five hours. The individual's occupational therapist is on vacation for two weeks, and a recently hiredentry-level therapist has been assigned to cover the vacationing therapist's caseload. In response to thesereported symptoms, which is the best action for the covering therapist to take in response to this individual'sreporting symptoms?" "A. Recommend the person stop exercising completely until the primary therapist returns and can reevaluatethe person's status.B. Reduce the intensity of exercise by 50% and reassess the person during the next intervention session.C. Continue with the current exercise program to develop tolerance.D.Advise the individual to take a pain relief medication 30 min prior to exercising"

B I got this right

"An occupational therapist develops a task group for the newly admitted patients of a psychiatric inpatientunit of a busy city hospital. The therapist considers several activities to use for the group's first session. Whichactivity is best for the therapist to present to the group members?Answer Choices: A. Planning a weekend pizza party for the patients and their visitors. 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 inpaitent in the hospital are short stay. planting a pot and coloring a pot is safe and easy and can be done in one session

"An adult incurred severe lacerations to the extrinsic flexor tendons in Zone V of the hand. The tendons weresurgically repaired and have healed. The surgeon's most recent orders have upgraded the patient to activeROM without restrictions. The occupational therapist is preparing for discharge and performs a final evalua-tion, which reveals limitations in active finger flexion 10°-20° of full active ROM of the MCP, PIP, and DIPjoints of all fingers. The therapist collaborates with the patient to prepare a home program. Which interven-tion is most important for the therapist to include in this program? Answer Choices: A. Use of a resting splint. B. Tendon gliding exercises. C. Weightbearing activities. D.Home management tasks"

B tendon glides are good for tendon injuries! duh. weightbearing is too soon, always start with AROM. Resting splint isn't really talked about. Home management doesn't really go into a HEP

"An occupational therapist works with a patient with diabetes and a below-knee (BK) amputation to learnhow to effectively perform home management tasks while wearing a BK prosthesis. When taking laundryfrom a front-loading washer and placing it into a top-loading dryer, the patient reports feeling weak, dizzy,and somewhat nauseous. The occupational therapist notices that the patient is sweating profusely and isunsteady when standing. Which is the best immediate course of action for the therapist to take in response tothe patient's complaints and these observations? Answer Choices: A. Return the person to the unit of care due to an insulin reaction. B. Administer orange juice for developing hypoglycemia. C. Call a nurse to administer an insulin injection for developing hyperglycemia. D.Have the patient sit down until the orthostatic hypotension resolves."

B think of the hospital "Hypoglycemia, abnormally low blood glucose, results from too much insulin (insulin reaction). It requiresaccurate assessment of symptoms and prompt intervention. Having the patient sit down and ingest an oralsugar (e.g., orange juice) is the best immediate action for the therapist

"A child with mild spastic diplegia wants to participate in neighborhood activities with peers. The family'smain goal for the child is to ride a bicycle. Which bicycle is best for the occupational therapist to recom-mend? Answer Choices: A. A hand-propelled bicycle with hand brakes. B. A foot-propelled bicycle with hand brakes. C. A foot-propelled bicycle with foot brakes"

B- I got this right It is mild, we still want to encourage use of the legs to strengthen them

"A 21-month-old child with severe spastic quadriplegia is evaluated by an occupational therapist. The therapistdetermines that the child is cognitively intact, exhibiting age-appropriate cognitive skills despite major senso-rimotor deficits. The therapist recommends a play activity to enhance these cognitive abilities and provide thechild with a fun and pleasurable experience. Which is the best object for the therapist to recommend? Answer Choices: A. A multicolored mobile of objects of interest placed over the child's stroller. B. A mechanical toy with a chin controlled on/off switch. C. A shape sorter with foam squares, triangles, and circles. D.A battery controlled hammock swing"

B- I got this wrong "At 21 months, a child is cognitively able to operate and control mechanical toys. The chin-controlled switchwill enable this child to self-direct their play despite the spastic quadriplegia. A mobile is cognitively too lowfor this child's ability. It is a passive activity that would not provide active engagement of the child. The abil-ity to identify and sort shapes does occur at 21 months, but the use of a shape sorter requires motor abilities beyond this child's capacity"

"An occupational therapist leads a transitional planning group for high school students with conduct disor-ders. The school fire alarm goes off five minutes before the group's scheduled termination. There have beensix false alarms during the past 3 days at the school. Several of the students laugh and say, "There it goesagain." Which is the occupational therapist's best response to this situation? Answer Choices:A. Call the school's main office to determine the validity of this alarm. B. Immediately escort the students to the nearest fire exit. C. Conclude the group with a discussion about the implications of false alarms. D.Escort the students back to their homeroom classrooms to await directions"

B- duh

"A48 C9An individual who successfully completed an inpatient drug rehabilitation program returns to the setting tothank staff members for their assistance with recovery. The individual offers to share personal insights andexperiences with the members of the OT values clarification group scheduled for the next hour. After thankingthe individual, which is the best response for the occupational therapist to make in response to this offer? Answer Choices: A. Welcome the individual as a guest to the group to share personal perspectives on recovery and inspiregroup members. B. Inform the individual that former clients cannot visit the group due to the need to maintain member confi-dentiality. C. Ask the individual to prepare a presentation on how values clarification aided in recovery for the nextscheduled group session. D.Tell the individual that the therapist will discuss this offer with the group and afterwards inform the indi-vidual regarding the group decision."

B- even if the group members all agreed to the guest, you still shouldn't do it. must maintain confidentiality

"An occupational therapist designs an activity group program for 12 adults with multiple physical disabilitiesand/or illnesses who attend a day hospital family respite program. Which method is most effective for thetherapist to use to determine the members' needs upon which to base the program? Answer Choices: A. Interview family caregivers. B. Interview each member. C. Interview day hospital staff. D.Research the program's population characteristics."

B- i believe I got this right but over thought it. Just think, what is ideal/best practice?

"An occupational therapist conducts a communication skills group in a wellness program for a large account-ing company. In this mature level group, what should the therapist do? Answer Choices: A. Help to develop the group norms. B. Participate as a member. C. Actively resolve group conflicts. D.Maintain a leader role"

B- i got this right

"The occupational therapist wishes to compare the results of an evaluation of lateral pinch to the norms.Which is the best positioning for the therapist to place the individual in when using the pinch meter?Answer Choices: A. Forearm in neutral and the pinch meter placed on the DIP joint. B. Forearm in neutral and the pinch meter placed on the middle phalanx. C. Forearm in pronation and the pinch meter placed on the DIP joint. D.Forearm in pronation and the pinch meter placed on the middle phalanx"

B- i got this right (just visualize or do the position)

"An occupational therapist implements a transitional program for a high school student with a history ofnumerous school-related failures. Which is the most important principle of intervention for the therapist touse with this student? Answer Choices: A. Utilize activities that are typically at the developmental level of a middle school student to ensure success-ful completion. B. Grade an activity of interest into achievable steps to facilitate successful completion. C. Introduce several activities during each session and change them frequently to decrease boredom. D.Terminate the activity during a treatment session when there is difficulty with activity completion to elimi-nate frustration."

B- just a basic grading question

"An individual has intention tremors, dysmetria, decreased equilibrium and nystagmus caused by a cerebel-lar lesion. The person expresses difficulty with routine tasks. Which intervention is best for the occupationaltherapist to provide?" "Answer Choices: A. A cone and pegboard activity with wrist weights to control tremors. B. Upper extremity weightbearing during self-care activities at a sink. C. Quick stretch to lateral trunk muscles during a dressing activity.

B. Rationale:The treatment goals for persons with cerebellar dysfunction are focused on strengthening proximal muscles, improving postural responses, and increasing stability. Weightbearing of the upper extremities can increase shoul-der girdle stability. A cone and pegboard activity is not a functional activity and would not generalize to activitiesof daily living. This activity is also very difficult to complete with dysmetria and intention tremor. Quick stretch isnot an intervention method. It is a method to assess spasticity. It is applied in a direction opposite the pull of themuscle group being tested and then graded utilizing a "minimal/moderate/severe" rating scale."

"A client with a diagnosis of schizophrenia is participating in an initial evaluation session at a psychiatric daytreatment program. Halfway through the completion of an activities configuration, the client states the refer-ral to this day program is inappropriate and unnecessary because it was made by an incompetent psychiatrist.The client becomes visibly upset and loud when talking about the unfounded referral and the psychiatrist'sincompetence. Which is the best initial action for the occupational therapist to take in response to the client'sstatements?Answer Choices: A. End the evaluation session and tell the client to call to reschedule when feeling better. B. Assure the client of the referring psychiatrist's competence and advise the client to discuss concerns withthe doctor. C. Acknowledge that the client appears upset and ask if the client is able to focus on the remaining evalua-tion. D.Contact the day program's chief psychiatrist to report the client's stated concerns about the referring psy-chiatrist's competence"

C

"A single parent is hospitalized for an exacerbation of schizophrenia. Actively psychotic upon admission, theclient has been stabilized on medication. The client is currently not demonstrating hallucinations or delusions.Residual deficits include several negative symptoms and decreased cognitive skills. At the team meeting, thepsychiatrist decides to discharge the client within 48 hours The client lives with their elementary-school-agedchildren. Which is the best recommendation for the occupational therapist to make during this team meeting?" "A. An extension of hospitalization to further evaluate cognitive skills. B. A family meeting to discuss the need for the children to assume home management tasks. C. A home visit to assess the client's safety skills within the home environment. D.A referral to social services to explore foster care for the children"

C

"An occupational therapist works with adolescents who are survivors of child abuse. Treatment can be carriedout in groups or on an individual basis. Which of the following would indicate to the therapist that interven-tion should be provided to an adolescent on an individual basis rather than in a group? Answer Choices: A. The adolescent wants more socialization experiences. B. The adolescent could benefit from feedback from peers. C. The adolescent desires greater control over the environment. D.The adolescent needs an opportunity to gain situational perspective"

C

"An individual with post-polio syndrome receives an occupational therapy reevaluation of functional status.How should the therapist initiate sensory testing with this client? Answer Choices: 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 "Sensory testing must begin with a demonstration of the test with the client being able to visually observe thedemonstration. If the client's vision is impaired, the therapist must verbally explain each step of the demonstra-tion to ensure that the individual understands the testing process. After this demonstration is complete, thetesting proceeds with vision occluded. Sensory testing for individuals with spinal cord injuries proceeds fromproximal to distal. Sensory testing for individuals with peripheral nerve injuries proceed from distal to proximal"

"The occupational therapist administers the Allen Cognitive Level (ACL) Screen to an individual. During thisevaluation, the most complex behavior the individual can perform is to do the three running stitches, imitat-ing the therapist's example. Based on these results, the therapist selects an activity to use for intervention thatis consistent with the individual's functional level. According to the Cognitive Disabilities model, which activ-ity is best for the therapist to use when implementing intervention with this patient? Answer Choices: A. Exercises that require the imitation of another's posture. B. Sorting laundry by matching the colors of clothing items. C. Sanding wooden bookends. D.Planning a three-course meal."

C "According to the rating criteria of the ACL, the ability to imitate the running stitch indicates Level 3 of cogni-tive performance. According to Allen's Cognitive Disability model, people at Level 3 can use their hands tomanipulate objects and they are able to perform a limited number of simple tasks that are repetitive. Sandingwood is an activity that is consistent with Level 3 of the Allen Cognitive Levels. In addition, sanding book-ends will result in the completion of a tangible object that has functional use which can facilitate the person'sfeelings of self-efficacy. According to the Cognitive Disabilities model, the imitation of postures is a Level2 skill, so exercises that require postural imitation would be too low for this individual. Sorting laundry bymatching clothing colors is a Level 4 skill. Planning a three-course meal would require the Level 5 skills ofproblem-solving. This is too high of a level for this perso"

"A toddler with spastic quadriplegic cerebral palsy demonstrates a consistent tonic bite reflex. Which techniqueshould the occupational therapist use to help inhibit this reflex? Answer Choices: A. Move a spoon from side to side on the tongue. B. Walk a spoon down the tongue, going from proximal to distal. C. Press a spoon down firmly on the center of the tongue. D.Stroke the tongue in a circular motion with a firm object."

C "The best approach to decrease a tonic bite reflex is to press down firmly on the center of the tongue and toapply pressure from distal to proximal. Lateral and circular movements can facilitate the gag reflex so theyshould be avoided"

"An individual who has Parkinson's disease presents with poor trunk rotation during ambulation and whileperforming ADL. According to neurophysiologic approaches, which is the most effective therapeutic interven-tion for the occupational therapist to use with this person?Answer Choices:A. Facilitation of trunk rotation using neurodevelopmental handling techniques.B. Slow rolling with the person supine with knees and hips flexed.C. Engagement in ADL using diagonal patterns.D.Provision of a rolling walker to compensate for limited rotation and enhance mobility"

C many ADLs can be performed at diagonals (loading dishwasher/washer) "This is typical in indi-viduals with Parkinson's disease. According to neurophysiologic approaches, the most appropriate approachis to use a technique to facilitate rotation during activity performance. Proprioceptive neuromuscular facili-tation (PNF) diagonals are the best choice because many activities (e.g., loading/unloading the dishwasher,putting away groceries) can be performed using diagonal patterns. Neurodevelopmental treatment techniquesand the Rood technique of slow rolling may facilitate rotation; however, they do not incorporate func-tional activities. Therefore, they are not the best choice. The provision of a rolling walker is a compensatoryapproach and does not directly address the effects of poor rotation on the person's performance of activitiesof daily living"

"An individual with an incomplete C6 spinal cord injury has a secondary diagnosis of thromboangiitis oblit-erans. The occupational therapist conducts a predischarge home evaluation of the client's rented apartment.Which is the most important area for the therapist to assess?Answer Choices: A. The apartment's electrical capacity for an environmental control unit. B. The apartment's electrical capacity for an emergency call system. C. The apartment's water temperature. D.The landlord's willingness to modify the bathroom."

C thromboangiitis obliterans- tempurature sense

"An occupational therapist provides recommendations for play activities that a parent with a complete spinalcord injury at the C7 level can do with children, aged 8 and 10 years. Which is the best adapted activity forthe therapist to recommend? Answer Choices: A. An arts and crafts project using a mouthstick brush to paint. B. A woodworking project using a universal cuff to hold tools. C. A board game using a tenodesis grasp to move game pieces. D.A computer game using a typing stick to keyboard."

C! I got this right after the podcast!

"An occupational therapist providing home-based occupational therapy services implements a bed positioningplan for a person recovering from a cerebral vascular accident. The person is receiving care from family mem-bers and personal care assistants employed by a home care agency. Which action should the therapist take toensure the accurate implementation of this plan by the client's caregivers? Answer Choices: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 positions on the wall by the client's bed. C. Post pictures of the desired positions next to the headboard of the client's bed. D.Require each caregiver to demonstrate the replication of the desired positions"

C- I got this right

"An individual with degenerative joint disease (DJD) incurred an injury to the right hand. The client is referred tooccupational therapy due to complaints of severe pain, stiffness, and extreme temperature changes in the hand. Theoccupational therapy referral states that the person has pitting edema and blotchy, shiny skin. Based on a screening,the occupational therapist determines that the client's presenting symptoms are consistent with the diagnosis ofcomplex regional pain syndrome (CRPS) Type I" "A64 C3The occupational therapist completes the pain evaluation. What additional evaluation methods should thetherapist use to assess this client? Answer Choices: A. Vigormeter. B. Dynamometer. C. Volumeter. D.Sphygmomanometer"

C- edma is the key here

"A clubhouse program hires an occupational therapist as a consultant. The clubhouse board of directorsrequests that the OT consultant focus on the development of evening and weekend leisure activities. Whichrecommendations should the therapist make for the selection and completion of the group activities? Answer Choices:A. Activities to be selected and completed by clubhouse members according to guidelines provided by thetherapist. B. Activities to be selected by the therapist with written instructions provided to the group attendees for activ-ity completion. C. Activities to be selected by clubhouse members with activity completion led by the clubhouse members"

C- i got it right but why? "Rationale:Clubhouse programs utilize recovery and consumer empowerment models that emphasize the active involve-ment of all participants in the decision-making and implementation processes of the clubhouse. The otherchoices are too directive"

"A client with a major depressive disorder and a spouse attend a discharge meeting with the occupationaltherapist following the client's two-week hospitalization for a major depressive episode. They state that theyhave few activities in common and spend little time together. The client retired two months ago, and thespouse continues to work full time. Which of the following should the therapist encourage this couple to dofirst to address this concern? Answer Choices: A. Immediately participate in one activity together. B. Become involved in their own individualized activities during the day. C. Explore activities enjoyed together and alone. D.Delay planning activities until the depression is totally resolved"

C- i got this right

"An occupational therapist and a COTAfi co-lead a work adjustment group. One member has become progres-sively more dependent on the COTAfi for directions, praise, and input throughout the group activities. Whichaction should the group leaders initially take in response to these behaviors? Answer Choices: A. Schedule several individual sessions with the COTAfi and group member to examine the issues of depend-ency and transference. B. Inform the attending psychiatrist that the group member is exhibiting signs of dependency andtransference. C. Have the COTAfi work with the person during group sessions to develop independence in task completion. D.Have another therapist co-lead the group with the occupational therapist and reassign the COTAfi toanother group"

C- i got this right

"An occupational therapist assesses a retired carpenter and war veteran who was recently admitted to an acutepsychiatric unit due to an exacerbation of post-traumatic stress disorder. The individual is observed to initiateinteractions with others during structured tasks but is withdrawn when not engaged in a task. Which activityis best for the therapist to recommend to the individual? Answer Choices: A. Writing thoughts and feelings in a daily journal. B. Engaging in meditation when alone in a hospital room. C. Assisting another patient with a woodworking project. D.Writing about personal experiences in the unit's newspaper"

C- i got this right

"Two months ago, a person received full-thickness circumferential burns of both upper extremities. The personshows progressively decreasing ROM of the right elbow with a 25° loss to date with a stiff endpoint. Theperson complains of increased pain in the elbow. Which action should the occupational therapist take first inresponse to this change in status? Answer Choices: A. Begin use of a continuous passive motion device. B. Apply heat prior to active ROM. C. Contact the person's physician. D.Splint the person's elbows in static splints."

C- i got this wrong "The person shows probable symptoms of heterotopic ossification, a calcium deposit that may occur in or neara joint after burns. Circumferential burns are most susceptible to this condition. Symptoms include decreasedjoint excursion, a stiff endpoint, and increased pain. The best action is to call the physician. Aggressive pas-sive ROM, especially to increase range, is contraindicated in treatment of this condition. The physician mustdetermine the intervention. Heat may be contraindicated at this time. Splinting may be contraindicated in thetreatment of heterotopic ossification."

"An occupational therapist works with the new foster parent of a 2-year-old child diagnosed with major devel-opmental delays and severe hypotonia. The therapist advises the foster parent to position the head in midlineduring feeding. Which additional positioning recommendations for feeding are best for this child? Answer Choices:A. Sitting with hips and knees at 90° flexion, neck in neutral. B. Sitting with hips and knees at 90° flexion, neck in extension. C. Semi-reclined with neck in neutral. D.Semi-reclined with neck in extension"

C- key worde "severe" needs adaptive seating, although 90 is ideal they can maintain it

"When performing a chart audit for an on-site accreditation visit, an occupational therapist realizes that a dateof service was documented wrong. Which actions are best for the therapist to take? Answer Choices:A. Use whiteout to remove the incorrect date, write the correct date of service, and then initial and date thecorrection. B. Write the correct date over the incorrect date and then write the rehabilitation department director's ini-tials. C. Put a single line through the incorrect date, write the correct date of service, and then initial and date thecorrection. D.Meet with the rehabilitation department director to discuss the need to correct this documentation."

C- single line, you must initial and date the correction because you found it

"A child with spinal muscle atrophy can no longer reach beyond 90° of shoulder abduction and 90° of shoul-der flexion. The parents state that the child can no longer don or doff a T-shirt. Which is the best approach forthe occupational therapist to recommend the child use for dressing?Answer Choices: 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 learn to don and doff front-opening shirts instead of T-shirts. C. Have the child support the elbows on a table at chest height to don the T-shirt over arms, and then over thehead. D.Have the child sit with the trunk well-supported, lean to the right and don the right arm, repeat to the left,and then don the head of the T-shirt."

C- use table I got this right, and remember muscle atrophy is progressive

"An occupational therapist receives a referral to construct a splint for an individual with a brachial plexusinjury with full arm involvement. Which orthosis would be most effective for this condition? Answer Choices:A. A flail arm splint.B. A figure-of-eight splint.C. A deltoid sling.

Correct Answer: A. Rationale:A flail arm splint is recommended for a brachial plexus injury resulting in whole upper extremity involve-ment. 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 to prevent MP hyperextension.A deltoid sling is used for upper extremity muscle weakness."

"During an intervention session focused on developing home management skills, a client made a grocery list.The client grouped needed items together to make shopping easier and listed eggs separately from all of theother items. When explaining how the list was composed, the client stated, "Eggs break, they should be ontop." Which of the following is the most accurate for the occupational therapist to report that the client'sapproach to this task represents? Answer Choices: A. Diminished insight. B. Concreteness. C. Anosognosia. D.Poor sequencing.

Correct Answer: B. Rationale:The statement reflects concrete thinking which is concerned with the actual properties of things and therealities of situations, rather than abstract properties or situational potentialities. In this situation, it is afunctional strength. Insight is an awareness and understanding of oneself and behavior. Anosognosia is una-wareness or denial of deficits. Sequencing is the ability to determine the proper ordering of steps in a task."

"Upon evaluating a client for a wheelchair, the occupational therapist determines that a standard narrow adultchair would be suitable for the individual. Which dimensions most accurately identify this chair? Answer Choices: A. 18′′ wide × 18′′ deep × 20′′ high. B. 16′′ wide × 16′′ deep × 20′′ high. C. 16′′ wide × 16′′ deep × 18.5′′ high. D. 14′′ wide × 16′′ deep × 18.5′′ high.

Correct Answer: B. Rationale:These are the standard dimensions for a narrow adult chair. The other choices do not identify measurementsconsistent with standard adult wheelchairs. These measurements would reflect a customized chair. A regular adult chair has dimensions of 18′′ wide × 16′′ deep × 20′′ high. A slim adult standard chair has dimensions of14′′ wide × 16′′ deep × 20′′ high and a junior standard chair has dimensions of 16′′ wide by 16′′ deep by 18.5′′high"

"A 14-year-old with spastic quadriplegia cerebral palsy and mild intellectual disability begins highschool. The occupational therapist determines that the adolescent's academic needs are being adequatelyaddressed by the use of the equipment and strategies that the adolescent had acquired during the middleschool years. Which recommendation is best for the therapist to make to the individualized educationplanning team? Answer Choices: A. Adaptation of the middle school strategies and equipment to the adolescent's high school classes. B. The development of a transition plan with the adolescent for a desired post-secondary education life. C. The development of peer relationships through engagement in extracurricular activities. D.A referral to the local center for independent living for community-based activities.

Correct Answer: B. (I got this wrong) Rationale:The IEP must include transitional planning to help a student identify desired post-secondary education goalsand develop a plan for achieving these goals for adult life. This plan must begin at 14 (or younger if indi-cated) with transition services implemented at 16 (or younger if indicated). In the exam item scenario, itstates that the strategies and equipment acquired during middle school are effective. There is no indicationthat adaptations are needed. Having used these strategies and equipment during middle school, an adoles-cent with mild intellectual disability would be able to use these in high school without additional interven-tion. There is no information in the scenario to indicate that the adolescent requires intervention to developpeer relationships or engage in community-based activities"

"An occupational therapist is evaluating a child with developmental delay characterized by hypotonicity.According to the Rood approach, which is the first stability pattern that the therapist should facilitate duringintervention? Answer Choices: A. Roll over. B. Quadruped. C. Neck co-contraction. D.Prone on elbows.

Correct Answer: C. Rationale:According to Rood, motor development follows a sequence termed "ontogenic motor patterns" that includeseight different patterns in sequence (i.e., supine withdrawal, rollover, prone extension, neck co-contraction,prone on elbows, quadruped, standing, and walking). In this model, neck co-contraction is the first stabil-ity pattern because it requires simultaneous activation or contraction of the neck flexors and extensors. Neckco-contraction is essential for head control. Roll over is an early mobility pattern and occurs when the armand leg on the same side of the body flex as the trunk rotates. It is utilized to elicit lateral trunk responses. Thepositions of prone on elbows and quadruped are stability patterns that develop after neck co-contraction. Theprone on elbows position provides trunk and proximal limb stability. The quadruped position develops limband trunk co-contraction"

"A house painter is referred to occupational therapy after a reoccurrence of rotator cuff tendinitis. The physi-cian prescribes a conservative intervention approach. Which recommendation is best for the occupational therapist to make to the individual? Answer Choices: A. Continue performing above shoulder activities to build rotator cuff strength. B. Use an extension handle in the paint roller when painting ceilings. C. Sleep with the shoulder extended and adducted. D.Sleep with the shoulder fully flexed and adducted.

Correct Answer: C. (I got this wrong) Rationale:Sleeping with the shoulder extended and adducted is an acceptable position for this condition. Above shoul-der activities and positions are contraindicated for persons with rotator cuff injuries. Even with an extendedroller handle the individual would still be performing above shoulder activities while painting"

"A patient has been discharged from a rehabilitation facility six months ago. A staff therapist who works atthe facility sees the former patient and the senior therapist who treated the patient in a dating situation. Thesenior therapist confirms involvement in a personal relationship with the former patient. Which is the stafftherapist's best response to this situation? Answer Choices:A. Report the therapist to the NBCOTfi. B. Advise the facility director. C. Do nothing. D.Report the therapist to the OT supervisor.

Correct Answer: C.Rationale:A health-care practitioner can date a former but not a current patient. This is no evidence that they datedwhile the person was a patient. The therapist is doing nothing wrong and there is no need to take any action"

"An elementary-school-aged child incurred burns, lacerations, and a femur fracture in a motor vehicle accidentand was hospitalized for 3 weeks. During outpatient occupational therapy sessions, the parent expresses con-cern that the child has begun wetting the bed daily. Which professional is most relevant for the occupationaltherapist to advise the parent to contact? Answer Choices: A. A rehabilitation nurse to develop a bladder control program. B. A child life therapist for intervention for developmental delays. C. A psychiatric occupational therapist for behavior management strategies. D.A clinical social worker to explore potential regression issues.

Correct Answer: D. Rationale:The child has no reported developmental delay and the injuries they incurred would not have likely affectedthe renal-genitourinary system. If there had been internal organ complications as a result of the accident,these would have been treated in the hospital prior to discharge. Therefore, the development of bedwettingis likely a symptom of regression. Regression is a common reaction to trauma. A social worker can providesupportive counseling for the regressive behaviors. Behavior management is typically indicated for acting-outand aggressive behaviors and there is nothing in the provided scenario to indicate that the child's bedwettingis intentional"

"A person recovering from skin grafting due to full-thickness burns is prescribed splints to immobilize thegrafted areas in antideformity positions. Which splint wearing schedule is best to include in the splintingprotocol for the first 72 hours post-surgery?Answer Choices: A. One hour on, with 10 min off. B. Four hours on, with 20 min off. C. Eight hours on, with 30 min off. D.On at all times, except for dressing changes"

D

"An individual with myasthenia gravis is being discharged home after a hospitalization for the treatment ofpneumonia. The person's spouse has expressed concern about caregiving responsibilities and the client's abil-ity to function in the home. Which is the most beneficial recommendation for the occupational therapist tomake to address the spouse's concerns and the client's needs? Answer Choices: 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. D.A referral to a home care agency for a functional evaluation and home assessment."

D

"An occupational therapist conducts an after-school transition skills group with adolescents with a diversity ofdisabilities. One of the student's behaviors is very different than in prior groups (e.g., difficulty focusing whentypically serving as the group initiator, making statements that are irrelevant to the topic at hand). The thera-pist smells a strong alcohol scent on the student's breath. Which action should the therapist take in responseto this situation? Answer Choices:A. Directly ask the student if the student has been drinking. B. Initiate a group discussion about the effects of substance abuse on occupational performance. C. Proceed with the group and report suspicions of alcohol use at the next transition planning team meeting. D.Call for a school aide to escort the student to the school's on-site health-care facility"

D

"An occupational therapist receives a referral to evaluate an individual's executive functioning following a mildcerebral vascular accident. Which are the most relevant foci for this evaluation? Answer Choices: A. The person's attention and memory. B. The person's job interests and efficacy. C. The person's spatial relations and praxis. D.The person's initiation and planning"

D

"The director of an occupational therapy driver rehabilitation program must determine if the program is meet-ing its objectives. Which of the following is most important for the director to measure during the evaluation of the program outcomes? Answer Choices: A. Participants' satisfaction with program services. B. Family members' satisfaction with program services. C. The effect of program participation on participants' automobile insurance premiums. D.The percentage of participants who successfully return to driving."

D

"The staff of an acute inpatient medical unit consists of an occupational therapist and an entry-level COTAfi.The admission rate has increased and the occupational therapist is having difficulty completing evaluations ina timely manner. Which is the best action for the therapist to take in response to these practice realities? Answer Choices:A. Evaluate patients screened by nursing staff as appropriate for occupational therapy. B. Plan intervention based on the physical therapy evaluation. C. Train the COTAfi to independently complete the evaluation process. D.Redesign the program to allow more time for evaluation"

D

"An individual recently lost significant functional abilities due to post-polio syndrome. The occupationaltherapist works with the individual to develop compensation skills for performing daily tasks. During a mealpreparation session, the person angrily throws all of the adaptive equipment onto the floor. At the next teammeeting, which defense mechanism should the therapist report the individual appears to be demonstrating? Answer Choices: A. Acting out. B. Passive-aggressive behavior. C. Reaction formation D. Displacement"

D "Displacement occurs when an individual redirects an emotion from one "object" (in this case, the anger overthe progression of the disease) to another "object" (i.e., the adaptive equipment). Acting out is a term used todescribe behaviors that violate societal norms (e.g., sexually provocative behavior, physically assaultive behav-ior). Passive-aggressive behavior is characterized by indirect or unassertive aggression (e.g., being chronicallylate when meeting someone you had an argument with years ago). Reaction formation is the switching of anunacceptable impulse into its opposite (e.g., hugging someone you would like to hit)"

"An adult is hospitalized in the recovery phase of Guillain-Barré syndrome. The patient complains of tingling,aching, and weakness in both hands, causing difficulty in grasping grooming supplies. The patient requests relieffrom the hand symptoms. Which action should the occupational therapist take to address the patient's concerns? Answer Choices: A. Provide soft tissue massage to both hands prior to grooming activities. B. Apply hot packs to both hands and complete stretching exercises prior to grooming activities. C. Refer the client to a neurologist for follow-up of possible condition regression. D.Educate the patient about sensory deficits and related adaptive ADL strategies."

D "Guillain-Barré (GBS) is characterized by ascending motor weakness in the limbs, usually beginning in thehands and feet. Paresthesias and pain are also a common occurrence. The best approach to this patient is toeducate the patient about the sensory deficits that are common to the condition and provide adaptive strate-gies for ADL so the patient is successful. Soft tissue massage will not remedy the aching in the hands as theinflammation of the peripheral nerves must decrease for this to resolve. Hot packs are contraindicated in thissituation due to the potential for burns from altered sensation. Referral to a neurologist is not needed as thesymptoms are typical of the syndrome"

"A large general hospital in an urban area initiates several quality improvement committees that include occu-pational therapists. Which of the following does participation in these committees provide to the occupational therapists? Answer Choices: A. The ability to develop personal performance skills. B. The capability to enhance leadership skills. C. The power to promote occupational therapy services. D. The opportunity to improve overall service delivery

D "Quality improvement (QI) involves a prospective analysis of specific services to improve service quality andmeet the needs of a population. The QI approach is designed to use a team effort to empower employees toimprove service quality. Participants may develop skills while working on the committee, but personal per-formance and leadership development are not the goals of QI. Participating in a QI committee can provideopportunities for the occupational therapists to informally promote occupational therapy services, but this isnot the purpose of a QI committee"

"The transition plan for a high school senior with developmental delay includes a referral to a vocational reha-bilitation workshop job setting. The student has set a goal to live independent of family. Which is the bestliving environment for the occupational therapist to recommend for this student? Answer Choices: 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 person with developmental disabilities who meets the referral criteria for a vocational rehabilitation (for-merly called sheltered) workshop will typically have cognitive deficits that require structure and supervisionto successfully and safely complete tasks"

"An individual recovering from a traumatic brain injury is assessed to be at Level VI of the Rancho Los AmigosLevels of Cognitive Functioning Scale. Which should the occupational therapist use to implement treatment? Answer Choices:A. Sensory stimulation activities such as moving to music. B. Repetitive self-care tasks such as brushing hair. C. Community reentry activities such as taking a bus. D.Simple meal preparation tasks such as making a sandwich"

D "At Level VI, the individual is appropriate and goal-directed but can become confused. Cues are required.Community reentry activities are too high-level for an individual at Level VI. They are more appropriate forLevels VII and VIII. Sensory stimulation activities such as moving to music would be appropriate for Level III.Repetitive self-care tasks would be appropriate for Level V"

"A single parent of two children, a 4-year-old and a 6-year-old, is referred to occupational therapy services in a reha-bilitation center. The client had a brain tumor removed one month ago. The referral states that the client has residualcognitive-perceptual deficits. Screening indicates that the client's sensorimotor abilities are within functional limits." "During the evaluation, the occupational therapist observes that the client has difficulty dealing with increas-ing amounts of stimuli. This is observed in all modalities. Based on this observation, which cognitive percep-tual dysfunction does the therapist record as present when reporting the client's evaluation results? Answer Choices: A. Inability to abstract. B. Poor organizational skills. C. Poor semantic memory. D.Generalized attention deficit"

D "Attention requires the ability to focus on a specific stimulus without being distracted by external or internalstimuli. The other options describe deficits with different manifestations. The ability to abstract requiresthe person to see relationships between concepts, ideas, and events. Organization is the ability to structurethoughts and actions. Semantic memory is the general knowledge shared by groups of people, such as socialnorms"

"An older adult who is recovering from a cerebral vascular accident attends occupational therapy two times perday. The intervention environment is highly structured and not overstimulating, yet the occupational thera-pist observes that the client's mood often changes abruptly. Within one session, the client will laugh and thenbecome tearful with no apparent precipitant. Which is most accurate for the occupational therapist to docu-ment the client may be exhibiting in the client's daily progress note? Answer Choices: A. Early onset of a neurocognitive disorder. B. Anhedonia. C. A response to auditory hallucinations. D.Emotional lability."

D "Emotional lability describes abrupt changes in mood without external precipitants. It is often observed inpersons recovering from CVAs. Anhedonia is the inability to experience pleasure. There is no information inthe case that would substantiate a conclusion that the individual is developing a neurocognitive disorder or isresponding to the internal stimulation of hallucinations"

"After evaluating a client with right-sided weakness and decreased motor control an occupational therapistdecides to use interventions based on the PNF approach. When applying PNF principles, which of the follow-ing actions should the therapist have the client do during an intervention session to increase use of the rightupper extremity and hand? Answer Choices: A. Reach overhead with the right hand to retrieve a dish out of a higher cabinet and set it down on the coun-tertop 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 toset 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 cabi-net on the opposite side"

D "PNF (proprioceptive neuromuscular facilitation) is a technique that involves use of diagonal patterns ofmovement and involves rotational trunk movement."

"A newly hired COTAfi is instructed by the director of rehabilitation to supervise two hospital volunteers asthey learn how to assist patients in safely completing bed to wheelchair transfers. The COTAfi informs thesupervising occupational therapist of the director's request. Which is the first action the occupational thera-pist should take in response to this request? Answer Choices:A. Advise the COTAfi to comply with the request. B. Advise the COTAfi to refuse the request. C. Observe the COTAfi to assess service competence in transfer training. D.Explain to the director of rehabilitation why the request is inappropriate"

D "Volunteers are not trained health-care professionals, and they cannot perform transfers with patients. "

"Which is the most appropriate activity for the occupational therapist to recommend for the person to com-plete at home? Answer Choices:A. Doing light craft work.B. Playing a tabletop game.C. Performing relaxation exercises.D.Manually washing a car"

D- CPRS is fluid and stress manually washing a car is a stress loading activity

"An occupational therapist is working with a preschool student who was born with congenital cytomegalovi-rus (CMV) infection. As a result, the child has difficulty seeing. The child enjoys playing with classmates buthas difficulty when the play activity is highly dependent on vision. Which of the following actions is best forthe therapist to recommend for improving the child's play experiences with classmates? Answer Choices: A. Train a personal assistant to provide verbal cues during play activities. B. Have the child read books in Braille aloud to the classmates .C. Train a classmate to guide the child during play activities. D.Incorporate three-dimensional objects into play activities."

D- I go this right

An occupational therapist works with an individual with chest and upper extremity burns. During the inter-vention session, the client expresses vague fears about personal safety at home and asks the therapist to advo-cate for an extension in the discharge date. According to the medical record, the client had incurred the burnsduring a cooking accident. Which is the therapist's best initial response to the client's stated concerns? Answer Choices: A. Encourage the client to speak to the social worker 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- I got this right

"During a home visit, a client who had incurred a CVA reports difficulty finding objects during BADL andIADL. The client reports that the directions family members provide (e.g., look on the refrigerator's door, lookin the medicine cabinet) are not helpful. Which cognitive perceptual ability should the occupational therapistfurther evaluate?Answer Choices: A. Stereognosis. B. Organization. C. Spatial relations. D.Visual closure."

D- I got this wrong "This behavior may be evidence of difficulties with visual closure since the person may not be able to find anitem if it is in its incomplete form (i.e., covered partially by other objects in the refrigerator or cabinet). Theother options describe cognitive-perceptual deficits with different manifestations. Stereognosis is the abil-ity to recognize objects by touch alone. Organization is the ability to structure thoughts and actions. Spatialrelations are the ability to relate objects in relationship to each other or the self (e.g., up/down, front/back,under/over)"

"An occupational therapist is working with a child presenting with sensory-seeking behaviors and under reactivityto touch and movement. The child has an unusually high activity level, inability to self-calm, motor impulsiv-ity, and frequent touching and handling of items in the environment. Using Ayres classic sensory integrative (SI)approach which would be most effective for the therapist to use with this child to facilitate an adaptive response? Answer Choices:A. A predetermined schedule of sensory activities designed by the occupational therapist. B. The child's passive participation in a variety of vestibular and proprioceptive experiences. C. Use of a sensory void environment to promote self-regulation. D.Individualized therapeutic activities based on the interests of the child"

D- I got this wrong, why? "Classic Ayres SI treatment is based on the principles of inner drive and active involvement of the child.Individualizing the activities used in therapy based on the child's interests is consistent with these principles;the use of a predetermined schedule of activities designed by the occupational therapist is not. " passive doesn't allow for child engagement

"An older adult has lost significant functional vision over the last four years and complains of blurred visionand difficulty reading. The patient frequently mistakes images directly in front, especially in bright light.When walking across a room, the patient is able to locate items in the environment using peripheral visionwhen items are located on both sides. Based on these findings, which visual deficit should the occupationalreport the client is exhibiting? Answer Choices: A. Glaucoma. B. Presbyopia C. Hemianopsia. D.Cataracts"

D- cataracts "Cataracts are a clouding of the lens which results in a gradual loss of vision. Central vision is lost first, thenperipheral. There are increased problems with glare and a general darkening of vision with loss of acuity anddistortion. Glaucoma produces the reverse symptoms: loss of peripheral vision is first (tunnel vision), thencentral, progressing to total blindness. Presbyopia is a visual loss in middle and older ages that is character-ized by an inability to focus properly and blurred images. Hemianopsia is field defect in both eyes that oftenoccurs following CVA"

"A skilled nursing facility (SNF) wants to provide an activities program to meet the needs of each resident.The occupational therapy supervisor has been asked to write a job description for the position of an activitiesprogram director and delineate the qualifications needed for that position. Which should the occupationaltherapist recommend for this position? Answer Choices:A. A COTAfi who receives general supervision from an occupational therapist. B. A COTAfi who receives close supervision from an occupational therapist. C. A COTAfi who receives routine supervision from an occupational therapist. D.A COTAfi who does not require the supervision of an occupational therapist.

D- different job I guess, but idk why this is a question-stupid. Correct Answer: D.Rationale:According to AOTA standards of practice and Medicare guidelines, a COTAfi who works strictly as an activitiesprogram director is not providing occupational therapy. While COTAfis who work as activities program direc-tors likely use their OT knowledge (e.g., the impact of client factors on activity performance) and skills (e.g.,activity analysis, adaptation, and gradation) in this position; they are not providing OT services. Rather theyare providing directorship to the SNF's activity program. Therefore, they do not require the supervision of anoccupational therapist."

"A 7-year-old with complete spina bifida at the T10 level attends outpatient OT weekly. The child's parentreports that the child is losing bladder control. Upon reevaluating the child, the occupational therapist notesthat the child shows a minimal decrease in strength of bilateral lower and upper extremities and an increasein the equinovarus position of the feet. The therapist contacts the physician to report that the child's changein status may indicate which of the following? Answer Choices: A. Shunt malformation. B. A recent growth spurt. C. Arnold-Chiari formation. D.Tethered cord"

D- i didn't know this "Tethered cord is noted by all of the symptoms listed. The spinal cord of the child with spina bifida is some-times attached to the spinal column and becomes taut as the child grows. The child requires a surgicalrelease of the tethered cord. Shunt malformation is marked by intermittent headaches, shortened attentionspan, increased paralysis, decreased upper extremity strength, noticeable decrease in school performance,and increased irritability. Young children often demonstrate increased head size, nausea, and vomiting. Thetethered cord presents whether the child has an even rate of growth or goes through a recent growth spurt.Arnold-Chiari formation occurs in the process of development and involves the part of the lower portion ofthe brain slipping or being pushed through the foramen ovale"

"A client expresses an interest in playing a computer game with another group member during a leisure skillsgroup. The occupational therapist reviews the client's cognitive evaluation and agrees that the game is a goodchoice for the client's cognitive level. After 15 min of engaging in the computer game, the client rubs botheyes, looks around, and reports trouble focusing. Which should the therapist do in response to these observa-tions and client statements? Answer Choices:A. Provide verbal encouragement for the client to complete the game before taking a break. B. Suggest the client and the other member play a different video game that is easier for the client. C. Discontinue the session and advise the client to select a different leisure activity to do with the other member. D.Suggest the client and the other member pause the game to talk about the game's progress after significantplays"

D- take visual breaks from screen

"An adolescent student with Duchenne muscular dystrophy and depression is being evaluated for a powerwheelchair. Which is the most important area to be considered during the occupational therapy evaluation ofthe student to determine the student's readiness for the wheelchair? Answer Choices: A. Fine motor skills. B. Cognitive skills. C. Postural control

Got this wrong but I shouldn't have. Answer is B "Cognitive skills include alertness, spatial operations, judgment, decision-making and problem-solving, whichcan be affected by depression. Since these abilities are needed for the safe operation of a power wheelchair, itis essential that the occupational therapist assesses the student's cognitive level."

"An occupational therapist interviews a COTAfi for a position at a high school for gay and lesbian youth. Theposition involves the provision of transitional vocational programming and life skills training. The COTAfiuses a wheelchair for mobility and has dysarthric speech. Which of the following is most relevant for theoccupational therapist to ask the COTAfi about during the interview? Answer Choices: A. Verbal group leadership skills. B. Sexual orientation. C. Personal beliefs about homosexuality. D.Accommodations needed due to the evident disabilities."

I got this wrong! the answer is A! it is up to the individual to ask for accommodations- we can't ask

"The private practitioners meet with their accountant to plan fiscally for their expanded practice. How wouldthe accountant classify the fees that the practice receives from their early intervention contract? Answer Choices:A. Accounts payable.B. Capital assets.C. Productivity standards.D.Accounts receivable"

I did not know this one! answer is D accounts receivable "Accounts receivable are the payments received by a program, setting, or institution for services rendered. Theyare the assets in a budget. Accounts payable are the payments that are due for purchases by or services ren-dered to a program, setting, or institution. They are the debts in a budget. Capital assets are improvements orpurchases that cost more than a set amount (often $500 or $1,000) and that are expected to last more thana year (e.g., a new ADL kitchen, computer equipment). Productivity standards establish the amount of directcare and reimbursable services each therapist must provide each day"

"A private practice composed of five occupational therapists provides home-based services to a variety of adult clientsin a two-county area. They are expanding their practice to include home-based services in another county. This pri-vate practice has also recently been awarded the early intervention service provider contract for all three counties. Thepractitioners plan to hire three entry-level occupational therapists and two certified occupational therapy assistants(COTAfis) to fill the service needs of their growing practice. The COTAfis have extensive experience in home-basedservice provision. The private practitioners plan to provide all of their new employees with a comprehensive orienta-tion program and the shadowing of an experienced therapist for two weeks." "To ensure the provision of best practice, the new entry-level occupational therapists will be provided withsupervision of their caseloads. At what level should this supervision be provided? Answer Choices:A. Routine.B. General.C. Close.D. Minimal"

I didn't know this one! answer: close "It is recommended that entry-level occupational therapists receive close supervision, that is, daily, direct con-tact for patient care" intermediate- routine advanced- minimal

"During an occupational therapy intervention session, a client with a left CVA demonstrates extinction to theright and a tendency to ignore items on the right side. When documenting this behavior what should thetherapist report? Answer Choices: A. Agnosia. B. Unilateral inattention. C. Poor right/left discrimination. D.Poor visual scanning"

I go this right- B agnosia- identifying body parts

"An occupational therapist advises the parent of an 18-month-old with developmental delays on techniquesto facilitate feeding. The child has a reflexive bite. Which utensil is most beneficial for the therapist to recom-mend the parent use when feeding the child?Answer Choices:A. A deep-bowled soup spoon.B. A narrow shallow coated spoon.C. A traditional teaspoon.D.A plastic spork"

I got it right- B but why? it will make food slide off easier

"An occupational therapist working on an acute psychiatric inpatient unit conducts a series of groups forclients newly admitted to the unit. Which group leadership style is most effective for the therapist to assumewhen leading these groups?" "Answer Choices: A. Advisory. B. Facilitative. C. Laissez-faire. D.Directive.

I got this right, but why? Correct Answer: D. Rationale:Directive leadership involves the provision of structure, clear directions, and immediate and consistentfeedback. These qualities are needed in a group whose members are acutely ill with psychiatric disorders. "

"A client with a right below-elbow amputation begins prosthetic training with a body-powered myoelectricprosthesis. The occupational therapist collaborates with the client to begin training in the use of the terminaldevice to grasp and release objects. Which elbow position is best for the therapist to place the client's elbowin during grasp and release activities? Answer Choices:A. Flexed at 90° with neutral degrees of pronation/supination. B. Flexed at 90° and pronated 60°. C. Flexed at 120° and with neutral degrees of pronation/supination. D.Flexed at 90° and supinated 60"

I got this right- A most functional/natural position

"A 2-year-old child receives home care early intervention services. The occupational therapy intervention planincludes a goal to develop the child's pincer grasp. Which is the most appropriate activity for the occupationaltherapist to work on with the child during an intervention session? Answer Choices:A. Finger-feeding of O-shaped cereal. B. Picking up marbles. C. Drawing with jumbo crayons. D.Stacking 1-inch cubes"

I got this right- A (marbles would be a choking hazard)

"A school-aged child who is right-hand dominant complains of numbness and tingling after writing for morethan 15 minutes. A neurological exam shows no reason for the numbness and tingling. Which action wouldbe most beneficial for the occupational therapist to recommend to the child? Answer Choices: A. Use a pencil held in a universal cuff to complete writing activities.B . Elevate the right upper extremity at night and whenever possible during the day. C. Stretch the right upper extremity every 15-20 minutes during writing activities. D.Use a custom-molded pencil grip made of splinting material when writing."

I got this righti it is C also side note, remember elevation is for edema. and a universal cuff/pencil grip wouldn't relieve numbness/tingling necessarily

"The occupational therapist employed at a day treatment center for clients with psychiatric disorders is con-ducting a leisure planning group. The members of the group decide to take a day trip to the local sculpturegarden. Which side effect of psychotropic medications is most important for the therapist to discuss preventa-tive precautions for with the group? Answer Choices: A. Orthostatic hypotension. B. Akathisia. C. Photosensitivity"

I got this wrong C-photosensitivity

"A nine-year-old girl with the diagnosis of cystic fibrosis is hospitalized in a small rural hospital. Currently,there are no other children in the hospital and the hospital does not have a pediatric play area. The headnurse asks the occupational therapist to suggest appropriate play activities that hospital volunteers can pro-vide for the child. Which is the most age-appropriate activity for the therapist to suggest? Answer Choices: A. Dressing paper dolls. B. Coloring in coloring books. C. Playing card games. D.Cutting and pasting pictures onto cards"

I got this wrong answer is C (coloring isn't social and kids her age can play games with rules)

"An individual recovering from a CVA has received extensive motor learning intervention. The client can nowtransfer a learned motor skill to different contexts. The client also demonstrates the ability to successfullyproblem-solve during motor activities in different contexts. In documenting the client's progress, which stageof motor learning is most accurate for the occupational therapist to document the individual has achieved? Answer Choices:A. Skill acquisition. B. Skill transfer stage C. Skill retention"

I got this wrong, I said c its B "During the skill transfer stage of motor learning, the individual can successfully demonstrate the motor skilland transfer its application and use to a diversity of contexts. In these different settings and situations, theperson must modify their timing, sequencing, posture, and many other neuromotor component skills. Thesemodifications and adjustments reflect successful motor problem-solving abilities. During the skill acquisitionstage (cognitive stage) of motor learning, the person receives initial instruction and practices the skill. Duringthis stage, the individual will make errors, and motor performance is inconsistent and inefficient. In the skillretention stage (associated stage) the person can "carry over" a skill and demonstrate their newly acquiredskill after initial practice"

"The accountant asks the private practitioners to present their budget for anticipated direct expenses of theirgrowing practice. Which is the most appropriate item to include in this budget request? Answer Choices:A. The rent and utilities of the practice's primary office.B. An integrated computer system for paperless documentation by all staff.C. Staff vacation and sick time.D.Supplies of items used in in-home therapy sessions.

I got this wrong, I said d Correct Answer: C.Rationale:Direct expenses include costs related to OT service provision such as salaries and benefits. Vacation and sick timeare benefits that must be budgeted. An integrated computer system will cost a substantial amount of money whichrenders it a capital expense. As previously noted, capital expenses are any item above a fixed amount. Capital itemsare separated from other expenses due to their depreciation in value and potential tax credits that may be avail-able for purchases and/or investments. Supplies are considered a variable expense since this expense will change indirect proportion to the amount of services provided. Rent is a fixed expense. Utilities are indirect expenses."

"A client with a traumatic below-elbow amputation of the dominant right arm has participated in occupa-tional therapy for prosthetic training. The therapist prepares a discharge plan that incorporates recommenda-tions to facilitate independence in meal preparation and feeding. Which method is best for the therapist torecommend the client use to cut meat? Answer Choices: A. Hold a regular knife in the terminal device and hold a regular fork in the left hand. B. Hold a knife with a built-up handle in the terminal device and hold the plate with the left hand. C. Use a one-handed technique with a rocker knife in the left hand and hold the plate with the terminaldevice. D.Hold a regular fork in the terminal device and hold a regular knife in the left hand"

I got this wrong, it is d "Holding a regular fork in the terminal device and the knife in the hand is the best and safest option for usingthe prosthesis to cut meat. It is also the method most people use to cut food so it will facilitate the person'sresumption of typical activities"

"The parent of a newborn infant has bilateral shoulder weakness and is referred to occupational therapy fortraining in energy conservation techniques for the performance of parenting and home management tasks.Which adaptation(s) is/are most effective for the occupational therapist to recommend the parent use? Answer Choices: A. A top-loading washer and dryer for clothing care. B. A steamer, steamer basket, and/or slow cooker for meal preparation. C. A front-pack carrier for holding the infant. D.Cloth diapers and the use of a weekly diaper care service"

I got this wrong, the asnwer is B (these will elminate the need to lift heavy objects, while the front-pack carrier would put weight on the shoulders.

"An occupational therapist becomes aware of the practice of a colleague who conducts an outpatient energyconservation class for persons with arthritis. This colleague has been sending the names of class participantsto a vendor who sells adaptive equipment. Which action is best for the occupational therapist to take inresponse to the situation?Answer Choices: A. Ignore the situation for it does not harm anyone. B. Speak to the therapist privately and tell them this action is unethical. C. Advise the therapist to disclose this practice, and if they refuse, report the therapist to the outpatient pro-gram director. D.Report the therapist's unethical behavior to the state regulatory board."

I got this wrong- C first let the person self-correct State is not needed at this time

"During a wheelchair evaluation, an individual with limited functional mobility expresses concern about theability to continue volunteer work at a local church. The church's doorways are 31 inches wide. The clientknows (from a recent home remodeling project) that 32 inches is the minimum width recommended forwheelchair access. Which recommendation should the occupational therapist make to the client to mosteffectively address their concerns and functional mobility needs?Answer Choices: A. Have the church widen its doorways to comply with ADA requirements. B. Order a wheelchair with wraparound armrests. C. Have the client explore alternative volunteer activities in accessible locations. D.Order a customized narrow adult wheelchair"

I got this wrong- I chose C so religions organizations do not have to follow ADA and wrap around armrests decrease width by 1-inch!

"The parent of two elementary-school-aged children receives home care hospice services due to metastasizedbone cancer. The client is in pain and has poor endurance and decreased muscle strength. The client requiresmoderate assistance with self-care and dressing. Which is the best intervention for the occupational therapistto incorporate into sessions with this parent? Answer Choices: A. Training in energy conservation techniques for self-care and dressing. B. Training in joint protection techniques for self-care and dressing. C. Using biofeedback to reduce the client's pain. D.Exploring play activities for the parent to do with the children."

I missed a key word- HOSPICE!!! The answer is D b/c she will want to do meaningful activities while in hospice its likely she's getting help with other stuff

"An occupational therapist provides services to a homeless shelter that includes residents who are HIV posi-tive. The therapist conducts several activity groups. Which should the therapist do while working with thispopulation? Answer Choices: A. Wash hands before and after each group session. B. Always wear latex gloves during groups. C. Wear latex gloves when handling food. D.Implement transmission-based precautions"

I got this wrong- It is A "Health professionals should use standard precautions at all times, regardless of peoples' diagnoses.Washing hands is a basic precautionary step all individuals should take to prevent the spread of infec-tions and diseases (even in their own homes). The diagnosis of HIV is irrelevant to the question's correctanswer for HIV is transmitted only through the exchange of body fluids. See Chapter 9. Wearing gloveswhile handling food is a health department regulation but it only addresses sessions involving food.One must still wash one's hands before and after glove use. In addition, due to potential latex allergies,health-care environments must be latex-free. Transmission-based precautions are used when the route(s)of transmission is (are) not completely interrupted using standard precautions alone. For some dis-eases that have multiple routes of transmission (e.g., severe acute respiratory syndrome), more than onetransmission-based precaution category may be used. Transmission-based precautions have three catego-ries: contact precautions, droplet precautions, and airborne precautions. None of these are indicated forHIV. See Appendix 3A and Appendix 3B in Chapter 3 for comprehensive information about standard andtransmission-based precautions"

"An occupational therapist leads a work group at a vocational rehabilitation program for persons with trau-matic brain injuries. One member begins to make sexually suggestive comments to other group members.The therapist redirects the client to the work in progress but the member continues to make sexually sugges-tive statements. Which is the therapist's best initial response to this situation? Answer Choices: A. Explain to the client that such statements are not tolerated at work and call security to have the client removed from the group. B. Explain to the client that such statements are not tolerated at work and the client must stop or leave the group. C. End the group before the situation escalates and reschedule the group to meet without the disruptiveclient. D.Set the client up at a different work station so the client is not in contact with other group members andcannot disrupt the group's work"

I got this wrong- it is B "This response reinforces the norms of a work environment and gives the individual the opportunity to prac-tice making a decision about the most appropriate course of action. An important aspect of vocational reha-bilitation for persons with traumatic brain injuries is the development of appropriate social interaction skills"

"An individual with degenerative joint disease (DJD) incurred an injury to the right hand. The client is referred tooccupational therapy due to complaints of severe pain, stiffness, and extreme temperature changes in the hand. Theoccupational therapy referral states that the person has pitting edema and blotchy, shiny skin. Based on a screening,the occupational therapist determines that the client's presenting symptoms are consistent with the diagnosis ofcomplex regional pain syndrome (CRPS) Type I" "The occupational therapist plans intervention to address the client's goals to engage in meaningful occupa-tions. Which physical agent modality (PAM) should the occupational therapist use in preparation for func-tional activity? Answer Choices:A. Transcutaneous electrical nerve stimulator (TENS). B. Contrast baths. C. Whirlpool. D.None; PAMs are contraindicated for this diagnosis."

I got this wrong- it is C I guess those are good for Edma/CRPS

"An individual is evaluated for a repetitive stress disorder. The individual complains of numbness and tinglingof the thumb, index, middle, and radial half of the ring finger and aching pain in the proximal forearm. Theclient states that these symptoms are not evident at night. The occupational therapist notes a positive Tinel'ssign. Which site should the therapist document as the location of this sign for this client? Answer Choices:A. The wrist. B. The Guyon's canal. C. The elbow .D.The forearm"

I got this wrong--- its not the wrist (carpal tunnel) it is the median nerve but the answer in D, b/c it stated the proximal forearm (pronator)

"During an early intervention planning meeting, an occupational therapist explains the results of a play assess-ment to the parents of an 18-month-old toddler with multiple developmental disabilities. The child has beenassessed as delayed by 6-8 months in all developmental parameters. Which intervention approach is mosteffective for the therapist to recommend using first to develop the toddler's play skills?Answer Choices: A. The use of toys that encourage creative and imaginative play. B. The use of toys that are visually and auditorily stimulating. C. Participation in a small parallel play group with other toddlers. D.Engagement in activities that use sensorimotor skills prerequisite to play"

I got this wrong. the answer is B "Providing toys that are visually and auditorily stimulating will help engage the child in the intervention pro-cess. As the child explores the sensory properties and characteristics of these toys, they will engage in activitiesthat will facilitate developmentally appropriate play. Through this process, the child will develop sensorimo-tor and cognitive skills."

"The occupational therapist reevaluates the client prior to discharge from the rehabilitation center. The clientexhibits residual cognitive deficits in problem-solving. To develop requisite problem-solving skills for inde-pendent functioning at home, which ability should the occupational therapist work on with the client duringOT intervention?Answer Choices: A. Performing routine morning self-care. B. Making a shopping list of grocery staples. C. Washing the family's laundry. D.Reading a bedtime story to the client's children"

I guess the asnwer is C the book said washing the laundry has alot of problems (stains, colors, ect) but I disagree... I still feel like making a shopping list requires it. But i guess you just look to see what you need... not really problem sovling

"An individual attends an outpatient parenting skills group. The person has a history of serious recurrentdepression and is taking Nardil. The client complains of recurrent headaches and difficulty focusing duringthe day (e.g., when helping children with their homework). Which action is best for the occupational thera-pist to make in response to the client's expressed concerns?" "A. Instruct the client in stress reduction techniques.B. 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"

I originally said A answer is D due to medication- is can have serious side effects and we cannot just assume the headaches are due to stress! basically if you see a specific medication and a symptom- tell physician

"An individual who incurred a cerebrovascular accident (CVA) six months ago is receiving outpatient occu-pational therapy to address residual cognitive-perceptual deficits (i.e., unilateral inattention and spatialrelations impairments). The individual drives daily despite strong suggestions from family members todiscontinue this activity. The family members share their concerns about the person's capabilities to drivesafely with the occupational therapist. Which is the best action for the therapist to take in response to theseexpressed concerns?" "Answer Choices:A. Report the individual to the department of motor vehicles.B. Suggest that the individual attend a driver training program.C. Report the information to the physician.D.Validate the family members' concerns about the individual's driving risk"

I originally said D answer is C b/c it is up to the physician to determine someone's ability to drive

"Following a left CVA, an individual receives OT services at a subacute rehabilitation facility. The patient'spersonal goal is to be independent in dressing. The patient demonstrates decreased memory, poor sequencingskills, and ideational apraxia. Which of the following is most effective for the therapist to provide when teach-ing one-handed dressing techniques to this patient? Answer Choices:A. Step-by-step verbal instructions.B. Sequenced photographs of the steps in dressing.C. Physical prompts to initiate the steps in dressing.D.A full-length mirror for the client to observe self-dressing performance"

I said B (photos) answer is C (physical prompts because ideational apraxia deals with execution/initiation of tasks

"A young adult with a diagnosis of schizophrenia is scheduled to be discharged from an inpatient setting to ahalfway house and psychosocial clubhouse. The occupational therapist is assisting the team with the dischargeplan. Which is the most important information for the therapist to provide to the team about this person? Answer Choices:A. The person's instrumental ADL skills.B. The person's vocational potential.C. The person's social interaction skills."

I said c answer is A because IADLs will tell the halfway house how much structure this person will need while living there

"The supervising occupational therapists meet to plan the workload of the recently hired COTAfis. Which taskis best for them to assign to the COTAfis? Answer Choices:A. The in-home evaluation of the adult clients' instrumental activities of daily living.B. The determination of long-term goals to include in the adult clients' OT home care intervention plan.C. The design of home-based sensory integration protocols for infants and toddlers with sensory processingdisorders.D.The administration and interpretation of the Hawaii Early Learning Profile (HELP) to infants and toddlers."

I said c- the design answer is A "A COTAfi can complete IADL evaluations with the supervision of an occupational therapist. The interpretationof the evaluation results and the determination of goals are the responsibility of the occupational therapist.The design of sensory integration protocols and the completion and interpretation of evaluations cannot becompleted by a COTAfi. A COTAfi can contribute to these processes but cannot independently complete them" I cota can contribute to design but not do it independetly

"An occupational therapist constructs a splint for a person who incurred full-thickness facial and anterior neckburns. In which position should the therapist splint the neck?Answer Choices:A. Extension.B. 15° flexion.C. 15° lateral flexion.D.15° hyperextension"

I said d thinking of towel under the neck it is A (just extension) you want opposite of flexion so its extension.

"A 6-year-old has thumb weakness that is most evident in the child's poor ability to perform thumb oppo-sition. During evaluation, which activity will the therapist most likely observe the child having difficultyperforming? Answer Choices:A. Rolling a piece of clay into a ball.B. Turning a pencil over to erase.C. Picking up coins.D.Separating two pieces of paper"

I said picking up coins answer is B "Turning a pencil over to erase is an example of complex rotation, which involves the rotation of an object360°. This is the activity that a child with poor thumb opposition will experience the most difficulty perform-ing. Rolling a piece of clay into a ball and separating two pieces of paper are examples of shift, which is a lin-ear movement of an object on the finger surfaces to allow for repositioning of the object relative to the fingerpads. Picking up coins is an example of finger-to-palm translation, which is a linear movement of an objectfrom the fingers to the palm of the hand."

"An occupational therapist develops a protocol for a topical group to be implemented on an acute inpatientunit for individuals recovering from substance abuse. Which intervention focus is best for the occupationaltherapist to identify for this topical group? Answer Choices: A. The improvement of self-esteem. B. The development of coping skills. C. The identification of leisure pursuits. D.The practice of assertive behaviors"

I straight up didn't know this. it is C "A topical group is a verbal discussion group focused on a specific activity engaged in outside of the group.Identifying leisure activities that can be pursued in a substance-free environment is a relevant focus forindividuals on an inpatient unit who need to plan concretely for discharge. Recovery from substance abuse islong-term. Having non-substance-related leisure activity ideas to pursue upon discharge can aid in this recov-ery process. Improving self-esteem, developing coping skills, and practicing assertive behaviors are very broadand not related to a specific activity. Topical groups are activity focused"

"An individual with degenerative joint disease (DJD) incurred an injury to the right hand. The client is referred tooccupational therapy due to complaints of severe pain, stiffness, and extreme temperature changes in the hand. Theoccupational therapy referral states that the person has pitting edema and blotchy, shiny skin. Based on a screening,the occupational therapist determines that the client's presenting symptoms are consistent with the diagnosis ofcomplex regional pain syndrome (CRPS) Type I" "The occupational therapist evaluates the client's pain by asking the client which movements or activities elicitpain. Which of the following is the therapist assessing Answer Choices: A. The quality of pain. B. The location of pain. C. The intensity of pain. D.The triggers of pain"

Pain triggers "Pain triggers are those activities and/or movements that result in pain. The quality of pain is determined byasking the person to describe the pain; common descriptors are sharp, throbbing, burning, tender, and shoot-ing. The intensity of pain is measured by pain scales; a 0-10 scale is most commonly used. The location ofpain is determined by having the person describe or point to the location"

"A carpenter recovering from injuries incurred during a fall from a ladder has decreased strength in the triceps,bilaterally. The most recent manual muscle test indicated that the triceps muscle strength is 3. The occupa-tional therapist provides the individual with a tabletop wood project to complete. To develop triceps musclestrength, how should the therapist position the tabletop when the person sands the project? Answer Choices: A. At a 45° incline 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 theelbows flex. C. At the individual's chest height so that the individual's hands and elbows are on the same plane when theelbows flex. D.At a 45° incline angled so that the individual's hands are below the elbows when the elbows are flexed"

This one was a thinker- A so remember 3/5- they can still lift against gravity. So you want to give them a position that still slightly works against gravity. at hips/chest or angled so hands are below gives them extra support with gravity.

"An occupational therapist measures the active range of motion of an individual's index finger. The measure-ments are MCP 0-45, PIP 10-60, and DIP 10-40. Which is most accurate for the therapist to document as thefinger's total active motion (TAM)" "Answer Choices: A. 62.5°. B. 125.0°. C. 72.5°. D. 145.0°.

To obtain the TAM measurement, the extension deficits are added and then subtracted from the flexion measurement total. In this scenario, the extension deficits total 20°. The flexion measurements total 145°. 145minus 20 equals 125.0°." B

"An individual with amyotrophic lateral sclerosis requires the use of an environmental control unit (ECU) toaccess electrical devices and a personal emergency response system. The individual lives alone and self-directspersonal care attendants to perform personal activities of daily living. During instruction to the individual onthe capabilities and use of the ECU, which is most important for the occupational therapist to discuss withthe client? Answer Choices:A. The ECU's backup power source and charging instructions.B. Additional assistive technology available.C. Augmentative alternative communication options.D.Funding for the ECU and assistive technology."

a

"An occupational therapist conducts an initial home visit to a family with a premature infant who, at4 months and 5 lb, has just been discharged from the hospital. The child has multiple developmentaldisabilities. Which is most important for the therapist to do during this first session with the family? Answer Choices:A. Communicate effectively to develop a therapeutic relationship with the family.B. Teach the family proper body mechanics for lifting the child.C. Teach the family assertiveness training to develop advocacy skills.D.Determine whether adaptive aids or positioning equipment is needed"

a

"An individual recovering from hip replacement surgery prepares for discharge home. The client has a second-ary diagnosis of gastric esophageal reflux disease (GERD). Which is the best bed position for the occupationaltherapist to recommend to this client? Answer Choices:A. Supine with elevation of the shoulders and head. B. Sidelying with the neck in neutral. C. Sidelying with elevation of the shoulders and head. D.Supine with elevation of the hips"

a other positions are contraindicated for hip

"An older adult diagnosed with a major neurocognitive disorder was recently admitted to a skilled nursingfacility (SNF). The COTAfi working with the resident reports to the occupational therapist that during themorning care session, the COTAfi observed bruises on the resident's back and upper arms. Which action isbest for the occupational therapist to initially take? Answer Choices: A. Talk to the resident to obtain more information. B. Follow facility procedures for investigating resident safety. C. Contact the resident's family to obtain more information. D.Contact the state office for adult protective services"

b

"An occupational therapist provides home-based early intervention evaluations. A referral for an 18-month-old child notes that the child is able to finger feed effectively but is not able to use a spoon or suck from astraw. The occupational therapist puts together supplies to bring to the child's home and plans activities touse during the developmental evaluation. Which developmental age is most important for the therapist toconsider when selecting objects and activities to bring to the evaluation session? Answer Choices: A. 6-9 months. B. 9-12 months. C. 12-18 months. D.18-20 months"

b- "The referral notes abilities that are typical of the age of 9-12 months. Therefore, the therapist would beginthe assessment by using activities that are at the child's developmental age as reflected in the referral. If thechild's performance in certain parameters is more or less advanced than this developmental age, the therapistcan adjust the evaluation accordingly. However, initially the therapist would begin evaluation at the develop-mental age consistent with the referral. Since the child cannot use a spoon or a straw, activities that are typicalof the developmental ages of 12-18 months and 18-20 months may be too difficult for the child. Spoon usetypically develops at 12-18 months. Straw use typically develops at about 18 months. Since the child's fingerfeeding is noted to be effective, activities that are typical at 6-9 months would be too low developmentallyfor the child"

"A religious congregation obtained private funding to build a ramp so that members with disabilities canattend services. The entrance to the congregation's building has six steps with a rise of 7 inches each. Which isbest for the occupational therapist hired by the congregation to recommend for construction of this ramp? Answer Choices:A. 42 feet long with a 3′ × 3′ landing at the ramp's midpoint.B. 48 feet long with a 3′ × 3′ landing at the ramp's midpoint.C. 42 feet long with a 5′ × 5′ landing at the ramp's midpoint.D.48 feet long with a 5′ × 5′ landing at the ramp's midpoint"

c

"An adult is referred to occupational and physical therapy for treatment of chronic back pain that hinders thesatisfactory performance of home maintenance tasks. The occupational therapists in the department havelittle experience with back pain, while the physical therapists in the rehabilitation department have extensiveexperience in this area. Which action is the best choice for the occupational therapist to take in response to this situation?" "A. Refer the patient to physical therapy. B. Co-treat the person with a physical therapist. C. Give the patient the option to work in occupational or physical therapy. D.Review a continuing education video on treatment of back pain"

c- i got this right

"A 5-year-old is referred to occupational therapy. Upon the completion of a standardized test evaluation, theoccupational therapist determines that the child demonstrates age-appropriate cognitive and fine motorskills. Which activity would the child be able to complete at this developmental level? Answer Choices: A. Cutting long thin strips with scissors. B. Holding and snipping with scissors. C. Cutting simple figure shapes with scissors. D.Opening and closing scissors in a controlled fashion."

c- i got this right review the cutting progression

"A middle-school-aged child with osteogenesis imperfecta reports feelings of low self-esteem, social isola-tion, boredom, and lethargy. The occupational therapist collaborates with the child to identify resources forafter-school leisure activities to promote socialization and community participation. Which of the followingactivities is best for the therapist to explore with the child? Answer Choices:A. Team sports. B. Therapeutic horseback riding. C. Scouting programs. D.Computer clubs"

computer programs osteogenesis imperfecta= brittle bones!

"An elementary school teacher has been recently diagnosed with multiple sclerosis (MS). Which adaptationis best for the occupational therapist to recommend the teacher use to accommodate for the effects of MS onclassroom teaching? Answer Choices:A. The use of anchoring techniques to compensate for scanning deficits.B. A daily list of tasks to compensate for cognitive deficits.C. A motorized scooter to compensate for decreased endurance.D.A high stool to compensate for lower extremity weakness"

d

"A co-worker in the therapy department complains excessively during working hours of personal problems.The co-worker does not respond to colleagues' statements that this is disruptive to their work. Which action isbest for the occupational therapist to take in response to this situation? Answer Choices: A. Call the employee assistance program for the co-worker. B. Talk with the co-worker using a client-centered approach. C. Tactfully and firmly redirect the co-worker to work issues. D.Inform the department supervisor of the situation"

d no personal problems in the work place

"A 3-year-old child with left spastic hemiplegia due to cerebral palsy is evaluated for early intervention ser-vices. During the evaluation the occupational therapist observes behaviors that seem to indicate the presenceof visual deficits. Based on these observations, which action should the occupational therapist take? Answer Choices:A. Completion of a motor-free visual perceptual assessment.B. Completion of a developmental vision assessment.C. Refer the child to an optician.D.Refer the child to an optometrist"

d prior to a visual Evalution, they need to have a visual test done by an optometrist

"A single parent of two children, a 4-year-old and a 6-year-old, is referred to occupational therapy services in a reha-bilitation center. The client had a brain tumor removed one month ago. The referral states that the client has residualcognitive-perceptual deficits. Screening indicates that the client's sensorimotor abilities are within functional limits." "The occupational therapist administers a standardized cognitive-perceptual assessment to the client. Theclient demonstrates difficulty performing the first two tasks of the evaluation. Which is the most appropriateaction for the therapist to take?" "Answer Choices: A. Continue the evaluation and provide verbal cues during task performance. B. Continue the evaluation and model each evaluation task. C. Continue the evaluation according to the established administration protocol. D.Discontinue the evaluation to avoid frustrating the client."

this is one of those by the book or real life questions always follow standardized protocol- C