Practice Test for NBCOT (TMPOT version)

An OT is ordered to evaluate and treat an individual who is 2 days post-op a total hip arthroplasty and expected to be discharged home in 3 days. What areas are most important to address prior to the client discharging home? Cognitive and visual perceptual functioning Vocational, self-care, and leisure performance Upper and lower extremity strength, and ROM Adaptive equipment needs and contextual support

Adaptive equipment needs and contextual support

A 17-year old sustained right transradial amputation in an automobile accident. The OT assessed PROM, AROM, muscle strength, sensory function, and coordination of both UE's. Significant hypersensitivity was noted. The therapist introduced graded stimuli and the patient is now able to tolerate tapping on the residual limb. How should the OT grade the activity to most effectively support the patient's progress? Apply prolonged pressure Introduce rubbing Continue with tapping Introduce light pressure

Apply prolonged pressure (Since we are grading the activity in regards to stimuli presented to the residual limb and they are tolerating tapping, the nextstep would be to apply prolonged pressure to support progress towards desensitization. Typically the progression is light touch, rubbing, tapping then prolonged pressure.)

A client who has severe diabetic retinopathy is referred for low-vision rehabilitation to improve the ability to complete daily activities and occupations. What is the first action the OT should take to help guide the development of intervention strategies and goals based on the client's deficits? Review the report from the optometrist or ophthalmologist Assess the client in different environments and conditions Adapt client's environment by using high-contrast colors

Assess the client in different environments and conditions

An OT is working with a client in the middle stage of Huntington's Disease. During a sink side ADL task, the client is observed to complete the entire task while supporting themselves by using their upper extremities resting on the counter. Which common characteristic of HD would attribute to this pattern of compensation? Balance Fatigue Chorea Pain

Balance (Postural instability is a common characteristic of HD that comes about during the middle stages. Typically those with HD willeventually have to complete self care tasks while seated due to compromised postural control needed to maintain uprightpositioning while standing. During standing tasks, forearm supports can be added to provide additional stability such as adding forearm supports to a walker.)

A roofer experienced a severe traumatic brain injury from a fall while working. Due to significant limitations, the client is unable to return to work as a roofer. Which type of assessment is most beneficial? A functional capacity evaluation A job demand analysis A general vocational evaluation A worksite evaluation

A general vocational evaluation (A general vocational evaluation is a comprehensive assessment that uses work (real or simulated) for vocational assessmentand exploration to help individuals and their vocational development. General looks at the clients potential to do any type ofjob. For individuals who have never worked, cannot return to a previous job, or does not have a job to return to. It looks at aclients interest to explore all options for work.)

A child, with cerebral palsy and poor head and neck control, is in OT to determine a positioning system. The child cannot maintain a righted head in a full prone lying position. What device is best to promote head control and tolerance in the prone position? A prone stander at 45° upright A prone stander at 90° upright A prone stander at 75° upright

A prone stander at 75° upright (The therapist's goal is to challenge the postural system without causing fatigue or associated reactions. Postural demandschange as the stander is tilted forward or backward. Demands on head righting is less in an upright position than in ahorizontal position. The goal is to increase head control and tolerance in the prone position, so our answer needs to provide a'just right challenge'. The prone stander actually may be lowered in increasingly higher horizontal positions as the child develops more head control.)

A client presents to an OT hand clinic with radial nerve palsy secondary to a LUE fracture resulting in axilla compression from daily crutch use. The client is concerned that an orthotic will get in the way and interrupt daily actives. Which orthotic should the OT fabricate based on the clients concern? A wrist immobilization orthosis with the wrist in a functional position of 30° extension A low profile mobilization orthosis that dynamically holds the MP joints in extension A static elbow orthosis with the elbow in 90° flexion and the forearm in neutral

A wrist immobilization orthosis with the wrist in a functional position of 30° extension (With radial nerve palsy the client will need to use a brace to stabilize their wrist. A few option include: A wrist immobilizationorthosis with the wrist in a functional position of 30° extension (wrist cock up orthosis). They are less conspicuous than adynamic orthosis and more comfortable Also, this orthosis is less costly and easy to take on and off. A low profile mobilizationorthosis that dynamically holds the MP joints in extension but allows for full digit flexion can be used to substitute for absentmuscle power and promote functional use. An advantage is that it leaves the palmar surface of the hand free for sensory input.A tenodesis mobilization splint does not immobilize, but rather it moves with the natural tenodesis effect. They are costly andtake time to fabricate.)

An adolescent who is having trouble staying focused has been prescribed psychotropic medications. Symptoms are better controlled but deficits still persist in the home and school environments. Parents report the client is having trouble staying organized and often forgets to complete chores. What should not be included in the intervention plan? Sensory integrative activities and sensory processing education Activities to help the child acquire social interaction skills Structure to compensate for deficient internal controls Teacher education about modifications to the classroom

Activities to help the child acquire social interaction skills

A 39-year old with bilateral dorsal hand burns has just been admitted to the ICU. The medical chart reveals second and thirddegree burns resulting from a torch exploding in hand. The patient is currently receiving intravenous pain medication and is notalert. Approximately 14 hours have passed since admission and orders read 'fabricate bilateral hand splints'. What type of splint isappropriate to fabricate for this client when promoting optimal positioning? Bilateral resting hand splints with the hand in a functional (mid-joint) position Bilateral resting hand splints with the hand in a antideformity (intrinsic plus) position Bilateral wrist cock up splints with 30 degrees of wrist extension and IP's in neutral

Bilateral resting hand splints with the hand in a antideformity (intrinsic plus) position (After a burn we do not place the hand in a functional position, instead we should place the hand in the intrinsic plus orantideformity position to prevent deformity by maintaining the collateral ligaments and volar plates lengthened.)

While engaging in conversation with a client who endured a CVA, the OT notices their speech patterns are slow and difficult to understand. Which type of language function does this best describe? Wernicke's aphasia Broca's aphasia Global aphasia Communication impairment

Broca's aphasia (Broca's aphasia is when the individual is able to comprehend auditory input yet has "slow, labored speech with frequentmisarticulations". Each of these answer choices are some type of communication impairment or disorder (answer D). Wernicke's aphasia is when auditory comprehension is disrupted and global aphasia occurs when there's a loss of all language skills.)

A middle aged adult sustained a wrist laceration as a result of a work injury. The surgeon approved an immediate active flexion approach. At the first rehabilitation session the client demonstrated inability to comply appropriately with the precautions and exercises. What action is most important for the therapist to take next? Provide a handout on exercises and orthotic management Change the rehabilitation approach to an immobilization approach Alter the plan to include an immediate passive flexion approach

Change the rehabilitation approach to an immobilization approach (Active flexion is started right after surgery and if a client is not careful or compliant they are at risk for rupture. We will need tochange the rehabilitation approach to one allowing less motion or a prescribe a cast instead of a removable orthosis in the first3 to 4 weeks postop.)

A patient with index finger stiffness is 2 weeks into active treatment of their home program. At the initial evaluation the left index finger ROM measurements were as follows: DIP joint: 0° extension, 20° flexion, PIP joint: 0° extension, 35° flexion, and MP joint: 0° extension, 25° flexion. At the follow-up appointment the patient demonstrates poor improvement in ROM compared to the initial evaluation. What action should the OT take first based on the findings? Identify how to incorporate therapeutic exercises into their lifestyle Review the literature to learn more about best practices Check with the client to learn their habits, roles, and daily routines A referral back to the referring physician is necessary

Check with the client to learn their habits, roles, and daily routines (When progress is slow after exhaustive treatment, first check with the client to determine if their habits, roles, and dailyroutines are barriers to them performing their HEP. If there are barriers the OT will need to identify how to best incorporatetherapeutic exercises into their lifestyle. Lack of progress can also mean that the therapist has not found the right approachand the current intervention approach may need refinement. Reviewing the literature for best practices and referring to thephysician are both appropriate. On some occasions, not all, the first action is gathering more information related to the problem.)

An OT is reviewing sternotomy post surgery precautions with a client using functional tasks. The therapist instructs the client to walk down the hall of the hospital floor while demonstrating a variety of precautions. Which observation represents carryover of sternal precautions? Client observed holding breath to pick up a dropped pen from the floor Using asynchronous movement of the UE while slowly pacing self Client delegating the task of opening the therapy gym door to the OT Placing bilateral UE on the armrests of a chair prior to standing

Client delegating the task of opening the therapy gym door to the OT (Precautions generally last about 8 weeks after surgery and include: do not liftmore than 8 pounds, do not push or pull with arms when getting into and out of bed or up from a chair, do not bring elbowsabove shoulders, avoid twisting and deep bending, hug a pillow when coughing or sneezing, do not drive until cleared bysurgeon, and report clicking or popping noises to your surgeon)

An OT is reviewing sternotomy post surgery precautions with a client using functional tasks. The therapist instructs the client towalk down the hall of the hospital floor while demonstrating a variety of precautions. Which observation represents carryover ofsternal precautions? Client observed holding breath to pick up a dropped pen from the floor Using asynchronous movement of the UE while slowly pacing self Client delegating the task of opening the therapy gym door to the OT Placing bilateral UE on the armrests of a chair prior to standing

Client delegating the task of opening the therapy gym door to the OT (We know that we are using functional tasks to teach the client sternal precautions. Sternal precautions include limiting activities that expand the chest or that pull the sternum apart, no lifting or pushing/pulling more than 5-10 lbs. (for 4-6 weeks). Answer A should be avoided. We should teach client to breathe. Answer B should be avoided because it pulls the two sides ofthe chest. Answer C shows that the client know not to pull or push. Answer D should be avoided because it requires the clientto push up to stand.)

An OTA who has established service competency has completed an evaluation of a client with traumatic brain injury. What action must the OTA take next as part of the OT process? Compile all of the information to form a composite picture of the client Communicate the results of evaluation procedures to the supervising OT Come up with an intervention plan based on the evaluation information

Communicate the results of evaluation procedures to the supervising OT (OTA's are not responsible for the complete evaluation, but may be delegated responsibility for certain procedures and may contribute to an evaluation under an OT's supervision. The OTA communicates the results of all evaluation procedures to the OT. The over-all evaluation, or the process of compiling all of the information to form a composite picture of the client, is the responsibility of an OT)

An OT is completing an assessment for a client with a movement disorder. During the dressing observation the OT notices a blister on the clients buttock. The client does not report any pain but the blister is pink and moist. What action should the OT take based on the observation? Remove the source of pressure Suggest nutrition for wound healing Consult with the wound nurse

Consult with the wound nurse

A heavily sedated patient is referred to OT for orthotic management following a burn injury. Which action would be mostappropriate? Custom fabricated anti-deformity orthosis worn at night Initiate the application of gentle pressure garments Continuous wear of an orthotic in the safe position Pre-fabricated orthosis worn in a position of comfort

Continuous wear of an orthotic in the safe position (The question provides us with specific information about our client. They are heavily sedated following a burn injury.Therefore, we must use that information to select an answer. What do you know about a client who is heavily sedated? Theyare not engaging in functional activities due to lethargy. A patient who cannot follow through with an exercise and positioningprogram because of impaired alertness or poor motivation should wear a splint continuously except for dressing changes andtherapeutic activity to prevent contractures.)

A client in cardiac rehab was transferred from the ICU to the hospital floor 2 days ago. The client has made significantprogress and is functioning at MET level 2.5. The therapist has implemented gentle upper extremity and lower extremity ROM exercises. Which activity should be used with caution? Sitting EOB during ROM exercises Contraction of large or small muscles Fine motor coordination activities

Contraction of large or small muscles (Isometric exercise affects the cardiovascular system. It may cause a rapid and sudden increase in blood pressure, Therefore it should be used with caution)

What type of information should be collected about a 37-year old woman who was hospitalized with a brain aneurysm, which affected speech, right-sided movement, and cognitive abilities when using the Model of Human occupation approach? Daily patterns of behaviors, roles, and everyday routines Early childhood experiences that may influence performance Strategies used to compensate for cognitive impairments

Daily patterns of behaviors, roles, and everyday routines (The MOHO views occupational performance in terms of volition, habituation, performance, and environment.Volition refers to the person's motivation, interests, values, and belief in skill.Habituation refers to one's daily patterns of behaviors, one's roles, and one's everyday routine.Performance refers to the motor, cognitive, and emotional aspects required to act upon the environment.Environment refers to the physical, social, and societal surroundings in which the person is involved.)

A therapist enters a hospital room of a patient with TBI following a motor vehicle accident. The patient appears to be in a deep sleep. The OT also notices that their upper extremities are in a flexed position and their lower extremities are in an extended position turned towards their midline. What common position does this correlate with? Hanging arm syndrome Decorticate rigidity Radial nerve palsy Decerebrate rigidity

Decorticate rigidity (Given the explanation of the positioning of the patient's upper extremities and lower extremities, decorticate rigidity bestexplains the common position TBI patients in the first level of Rancho Los Amigos Levels of Cognitive Functioning presentwith. Hanging arm syndrome is characterized as increased weakness and pain of the UE, radial nerve palsy results in wristdrop, and decerebrate rigidity is when both the UEs and LEs are in an extended position with adduction and internal rotationtowards midline.)

A therapist is fabricating a volar custom-fabricated low-temperature thermoplastic orthosis in the anti-deformity position for aclient with a dorsal hand burn. During application, the client reports that pain increased to 8/10. Which of the following statementsis best regarding the patient's safety? Incorrect application of a splint or improper positioning while in a splint may lead to both joint limitations andtissue damage Do not force joints into the ideal position but position joints as closely as possible to the ideal position and serially revise If edema is present, the splint should be secured by an elastic wrap or gauze wrap to avoid a tourniquet effect from straps

Do not force joints into the ideal position but position joints as closely as possible to the ideal position and serially revise

A client sustained quadriplegia as a teenager and has had multiple pressure injuries. Plastic surgery attempts failed because the cause of pressure injuries was not adequately addressed. While receiving OT, seating changes were made to address the client's Stage 3 pressure injury and now the pressure injury is healed. Based on the report, which is typically associated with these findings? Pressure on the right greater trochanter Dramatically different pressure maps Limited funding for care and equipment

Dramatically different pressure maps

An OT is performing a job analysis to identify WRMD's for a client who has a 2-year history of right dominant wrist pain and diminished ability to perform in-hand manipulation skills. What would be most beneficial for the OT to include in the job analysis documentation? Duration of static hold using a pinch grip is noted in seconds Description of the environment including adjustable equipment Basic description of the client's daily work related task demands

Duration of static hold using a pinch grip is noted in seconds (A job analysis primarily geared to injury prevention, such as WRMDs, should include descriptions of observed risk factors, such as repetitive motions, force, static postures, awkward postures, mechanical compressions, vibration, and the velocity of dynamic motions, noted for each body part and quantified.)

An OT is part of the pulmonary rehabilitation team for a patient with COPD. The OT is currently educating the patient on techniques to reduce breathlessness. Independence in IADL's is of high priority for the patient. Which technique is most beneficial for the therapist to recommend to reduce breathlessness during IADL task? During shopping, suggest forward leaning and propping UE's on a shopping cart During shopping, suggest forward leaning and propping UE's on a shopping cart Explain to the patient that IADL tasks should be stopped when breathlessness occurs

During shopping, suggest forward leaning and propping UE's on a shopping cart (Breathlessness can be reduced by having clients adopt dyspnea control postures. When sitting, the patient bends forwardslightly at the waist while supporting the upper body by leaning the forearms on the table or thighs. When standing, leaningforward and propping the body on a counter or shopping cart may relieve the problem. Instructions for purse lip breathingincludes: 1) purse your lips as if you are going to whistle 2) slowly exhale through pursed lips—you should feel someresistance 3) inhale deeply through your nose 4) it should take you twice as long to exhale as it does to inhale. Forcefullybreathing out is not appropriate during PLB. When oxygen saturation drops below 90%, activities should be stopped.)

A therapist is having a client look slightly away from the intended target in order to bring the target into view of the peripheral visual field. Which strategy is the therapist utilizing? Sighted guide technique Scanning strategies Eccentric viewing strategy

Eccentric viewing strategy (Sighted guide is a technique originally developed for people who are blind, but it can also be helpful for people with low vision who are unsure of their bearings in an unfamiliar environment. These techniques will increase the client's safety in crowded or unfamiliar environments and areas that have poor lighting and uneven walking surfaces. Scanning is an effective technique to use with clients with visual field loss who have difficulty finding a landmark, the door to a business, or the edge of a page. The client is instructed to systematically view the environment, starting at the top and scanning right to left, then left to right, until the object of interest comes into the visual field. The same technique can be used by scanning vertically, moving from top to bottom and bottom to top, working across the designated environment until clients find what they are looking for. Eccentric viewing is a strategy used to help clients "look around" the blind spot in their field of view. With eccentric viewing, the client looks slightly away from their intended target, to bring it into view of the peripheral visual field. Once the client has determined the location of the scotoma or blind spot in the central visual field, training in looking around the scotoma is necessary to help develop eccentric viewing skills.)

An OT is collaborating with a 17-year old student diagnosed with down syndrome on developing a plan to reach long term goals. The student reports that the goal is to live in an apartment alone and work with animals. The student fears that their challenges may interfere with their goals. The OT is planning to focus on utilizing supports that will facilitate success in the community. Which activity will best support the students independence in the community? Refer the student to a vocational rehabilitation specialist to assist in discovering vocational interest Educate on the use of a smart phone to set reminders and use of navigation system while traveling Assist the student in planning a field-trip for the class to enhance the ability to complete multi-step tasks

Educate on the use of a smart phone to set reminders and use of navigation system while traveling (The question wants us to find a support that will facilitate success in the community. Smartphones, tablets, and computershave accessible features that improve efficiency and productivity. Additional apps/programs can be added to customizethe device to the client's unique needs. Students with and without disabilities use the same technology so these devices canactually become tools of inclusion.)

An OT working in an acute setting is treating a client who suffered a hip fracture. The client is restricted to non-weight bearing status. Which initial action would be most beneficial for the OT to include in the intervention? Education on hip precautions adaptive equipment to complete lower body dressing Education on sitting during ADL's to conserve energy and increase safety Remind the client not to actively or passively flex the operated hip

Education on sitting during ADL's to conserve energy and increase safety

A 45-year old client diagnosed with chronic schizophrenia is recently fired from work as a delivery courier. The managerreported poor hygiene including clothes that fit badly, unbuttoned pants, hair uncombed, and incessant talking. The clients goal isto return to their former place of employment. Which initial action should the OT promote to support progress toward the client'sgoal? Use role playing to promote conversational skills in simulated job roles Explore the client's social behavior in various situations including groups Encourage participation in a daily grooming and hygiene skills group

Encourage participation in a daily grooming and hygiene skills group

A school occupational therapist is working with a child diagnosed with ASD. The child is reported to have poor behaviors when objects have been moved around the classroom and they demonstrate inflexible adherence to routines. The therapist wants to support positive behaviors in the classroom. Which strategy is best to improve their engagement and reduce problem behaviors? Encourage positive consequences such as earning free play time Promote sensory diets that will be implemented throughout the day Educate the teacher on playful approach to increase compliance Collaborate with the teacher to adapt the environment and routines

Encourage positive consequences such as earning free play time (Therapists help to develop and support implementation of positive behavior programs in the classroom with appropriatereinforcers for the child. One of the best approaches to promote good behavior is a positive behavior plan for the classroomthat provide positive consequences for completion such as earning free play time.)

An OT is hired as an injury prevention specialists for a large corporate company. In order to maintain a successful injury prevention program, what action must the OT take? Ensure that the client company has the knowledge and skills to follow through with the program Avoid teaching corporate clients to be self-sufficient in controlling risk factors in the work environment Direct the corporate client to address the most grievous and resource-draining problems last

Ensure that the client company has the knowledge and skills to follow through with the program

A 70-year old client is 2 weeks post-op right total hip replacement using an posterior approach. The client has met long term goals and is preparing for discharge home. The OT is educating the client and caregiver on safe transfers into the family's car. which option is most appropriate when teaching car transfers? Make sure the caregiver is available to provide maximum assist during the transfers Ensure the passenger seat is pushed back as far as it can go and reclined prior to getting into the car Teach the client to use a walker and to take very small steps when pivoting toward the car

Ensure the passenger seat is pushed back as far as it can go and reclined prior to getting into the car (This client is post-op a right posterior hip replacement. Posterior approach precautions are no internal rotation, hip adductionand hip flexion beyond 90 degrees. Ensuring the seat is pushed back prior to them getting in the car would be mostappropriate to ensure they adhere to these precautions especially their hip flexion precaution.)

An OT is conducting a thorough assessment of the cardiovascular risk factors of a recently admitted patient. Which is considered a non-modifiable risk factors? Hypertension Family history Stress Obesity

Family history

An OT in a skilled nursing facility (SNF) is working with a patient diagnosed with Parkinson's Disease. The OT observes the patient shuffling their lower extremities while walking to the bathroom. Which motor dysfunction is present? Stooped posture Festinating gait Paralysis Micrographia

Festinating gait (Festinating gait is a common characteristic seen with PD when the client is ambulating. It is characterized by increased speed, decreased length of strides and shuffling movements.)

An OT completed research on an innovative technique and the rehabilitation director wants to present the results at the next director's conference. The director asks the OT for permission to submit a conference proposal describing the results of the research with the understanding that the OT will be listed as the principal author. What principle is illustrated in this scenario? Justice Fidelity Veracity Autonomy

Fidelity (The principle of fidelity is being demonstrated by ensuring that both the rehab director's name and the OT's name are on the paper. The director is accurately reporting who has been involved in both gathering the data and reporting the findings.)

During a morning ADL routine, the OT observed a client with difficulty distinguishing a t-shirt from the bed linens. The client is currently recovering from a middle cerebral artery CVA and is expecting to return home alone. What neurobehavioral impairment is the client demonstrating? Ataxia Body neglect Figure-ground Apraxia

Figure-ground

The mother of an infant reports that diapering is becoming a difficult task due to the child's strong extensor tone and adduction patterns in bilateral legs. Which method should the OT teach the mother to incorporate into the diapering routine to decrease extensor patterns? Place the infant prone on a wedge during diapering Flex the hips and slowly rock the hips back and forth Lay the infant in supine across the mother thighs

Flex the hips and slowly rock the hips back and forth (We should teach the mother restorative or remedial methods to decrease extensor patterns before diapering and how toincorporate these methods into the diapering routine. The mother can place a pillow under the child's hips, flex the hips, andslowly rock the hips back and forth before abducting the legs for diapering. Children with extensor tone should be placed inflexion to inhibit extensor pattern.)

A client with progressive multiple sclerosis has progressed to using a power chair with power seat functions including tilt-in space, recline, and elevating leg rest. During a seating assessment, the client assumed sacral sitting with kyphosis when upright. The therapist opened the seat to back angle to 105 degrees and noticed a considerable improvement in upright. Based on this information, which limitation is typically associated with the reported symptoms? Hamstring tightness Poor midline orientation Pelvic obliquity

Hamstring tightness (We notice that posture improves when the chair is reclined indicating hamstring tightness. Hamstrings run across both hipsand knees, and when shortened or tight, it is difficult for individuals to combine hip flexion with knee extension because thehamstrings cannot elongate muscles over both joints simultaneously. Hip joints will be pulled into some extension, forcing thetrunk backward resulting in the posterior pelvic tilt. To relax hamstrings you can increase hip extension by recline the wheelchair or by raising the hips/buttocks about 1 inch using a cushion that is higher at the back of the wheelchair.)

An OT is conducting an activity analysis for a group of clients who are hearing impaired and participating in a game of bingo. The therapist has clearly explained the game and has assured that the activity demands match the cognitive capacity of the group. What modification can then be made in the activity to suit the client's abilities? Provide bingo cards with larger letters and numbers Add more challenging requirements such as markers in an 'H' shape Have the calls written on a blackboard or flashed on a screen Initially explain the activity as directly and simply as possible

Have the calls written on a blackboard or flashed on a screen (The clients are hearing impaired and our job is to find a modifications to suit the client's abilities. Therefore, we know our answer will compensate for hearing deficits. Answer C provides visual cues for individuals who are hearing impaired. Answer A addresses visual deficits. Answer B increases the challenge for higher-functioning individuals. Answer D is a general first step when introducing an activity.)

An adolescent with a developmental disability is having a difficult time developing friendships and has limited interaction with peers. The client's goal is to "participate in peer groups." During an OT session, the client is engaging in a group game then abruptly leaves the group, stating "I am not as good as the other kids, I can't do it" Which intervention strategy would be most beneficial for promoting the patient's emotional and social needs during tasks? Identify the child's strengths in order to develop basic life skills and emotional resources Partner the child with a classroom peer while engaging them in a simple competitive game Have the child play a simple game in a small group of two to three peers with similar skill levels Provide one-on-one assistance to help the child successfully learn the steps of the game

Have the child play a simple game in a small group of two to three peers with similar skill levels (The first thing to identify is if the group is the problem or the task. The child states that "I can't do it" indicating the task is toochallenging. Therefore, the task should be simplified. When promoting emotional and social needs we should provide opportunities for expanded and enriched natural learning with typically developing peers.)

An eye report from an ophthalmologist indicates that a scotoma in the central visual field is making reading and fine motor activities difficult to complete for a client with macular degeneration. Which compensatory technique should the OT recommend to promote the client's ability to find objects in a room? Provide demonstration and verbal explanation Administer an assessment of reading skills Help the client develop eccentric viewing skills

Help the client develop eccentric viewing skills (A person with central field loss can learn to use their peripheral vision rather than central vision to view objects. Answer A does not provide a visual strategy and answer B is not relevant to the question.)

A recline wheelchair is contraindicated for an adult client who presents with which of these findings? Hip extensor pattern Spinal cord injury Spine asymmetries EU joint contracture

Hip extensor pattern (When a client presents with extensor pattern, we need to promote hip flexion to inhibit tone. A position of hip extension suchas when using a reclining chair will result in increased tone. Contraindicated means that something should not be used based on the situation)

An OT is working with a client in the intermediate phase following a flexor tendon repair. How should the OT position the wrist when assessing composite finger extension? Have the wrist extended Place the wrist in neutral Hold the wrist in flexion

Hold the wrist in flexion (In the intermediate phase following a flexor tendon repair assess composite finger extension with the wrist flexed. 1 to 2 weekslater, assess with the wrist in neutral. Do not assess composite extension until the intermediate phase of flexor tendon healing,because this could cause tendon rupture.)

An adolescent who sustained a C8 spinal cord injury 5 weeks ago is learning adaptive dressing techniques. The adolescent wants to be able to put on a pair of full-length pants independently while supine in bed. Which adaptive technique should the OT teach the adolescent to use as a preparatory step for completing this dressing task? Hook the right hand under the right knee to passively pull the leg into flexion Lift the buttocks off the surface of the bed by bridging at the hips and knees Log-roll to one side followed by flexing the hip and knee to approximately 90°

Hook the right hand under the right knee to passively pull the leg into flexion (We are told the patient sustained a C8 level SCI and to find a preparatory step technique to assist them with LB dressing. All ofthese answers are preparatory steps therefore it is important to understand the capabilities of someone at C8. C8 have goodUE strength and would be able to use their hands to passively flex their leg. They do not have the core or LB strength neededto bridge or log roll.)

A client diagnosed with congestive heart failure and type 2 diabetes lives in a one-bedroom apartment and uses a rollator walker for all mobility. The client fatigues easily and is unable to attend church or grocery shop due to shortness of breath. The client is able to easily sit on the treatment mat and move to the edge. The clients goal is to be able to attend church and grocery shop without depending on others. What type of evaluation will the client benefit from? Seating assessment Mobility assessment Positioning assessment

Mobility assessment

A student diagnosed with ADHD presents with motor skills deficits. How should the school OT begin the evaluation process? Conduct observations of the student in the natural context Identify participation concerns by interviewing stakeholders Understand the students strengths and resources available Administer a suitable participation-based evaluation tool

Identify participation concerns by interviewing stakeholders (The beginning of the OT process begins with a referral, then we develop the occupational profile, followed by observation in the natural context, and administration of an assessment or evaluation tool.)

An OT is consulting with the teacher of a high school senior diagnosed with ASD. The student is non verbal and uses an I-pad for communication. The student spends most of the day in a special education classroom with one science class in a general education environment. The student is able to successfully complete all assignments independently but there is limited participation in the science class. When using a peer mediated approach, what is the first step when developing a peer support program? Identify peers who may be willing to participate in peer modeling Orient the students on how to support peers with social challenges Identify peers with similar performance capabilities to pair in groups

Identify peers who may be willing to participate in peer modeling

An OT is conducting a sensory test of the UE. Which is a prerequisite for stereognosis testing? Strength Motor Function Vision Endurance

Motor Function (Motor function is a prerequisite. Stereognosis is the use of proprioceptive information and touch information to identify an object with vision occluded. The other options are not required.)

A patient sustained full thickness burns on the volar surface of both wrists and forearms two months ago resulting in scarring across the wrist. The client wears custom pressure garments but wrist mobility continues to be limited. Which activity can be graded to most effectively increase wrist motion? Throw darts at varying distances from the client Incorporating all-fours yoga poses while on hands and knees Simulating making a bed by moving sheets up and down Bouncing various sized basketballs from hand to hand

Incorporating all-fours yoga poses while on hands and knees (Answer B places the wrist in extension with weight-bearing (prolonged stretch). Answer A promotes slight extension and ulnar deviation. Answer C promotes radial and wrist deviation. Answer D promotes wrist flexion and slight extension.)

A therapist working in the ICU is treating a client who recently underwent heart surgery. The OT's focus is to improve functional capacity and endurance in order for the client to discharge at PLOF. Which is the most important component when educating the client? Educating relevant family members and caregivers on ECT Incorporating the client's active involvement in planning the day Prescribing how the client should sequence their typical day

Incorporating the client's active involvement in planning the day

An OT is working with a client with Guillain-Barré Syndrome (GBS). The client is demonstrating progress and improving their physical abilities. Which option would be best to incorporate into the next intervention session? Daily PROM, positioning, and splinting Introduce electronic aids for daily living (EADLs) Instruct on ECT and work simplification

Instruct on ECT and work simplification (During the recovery phase the client's strength is improving and the activities we choose to include should be graded for theclient's success and should also guard against fatigue. "Adaptive equipment, frequent rest breaks, and creative strategies aretypically necessary during this phase". Answers A and B would be done during the initial or plateau phases.)

A middle school student presents with emotional and behavioral challenges demonstrated by difficulty coping with situations that require problem solving skills and patience. During a group activity, the student becomes angry and pushes over tables during episodes of frustration. In addition to providing sensory regulating activities, which activity is best for the OT to introduce during the next session? Engage the student in classroom group games and board activities Have the student create a rap song by taking turns writing lyrics Instruct the class to write a letter about a difficult situation

Instruct the class to write a letter about a difficult situation (What are you pulling out? Emotional and behavioral challenges, pushing over tables during episodes of frustration, difficultycoping with situations that require problem solving skills and patience. There is a lot of information but the underlying problemis difficulty coping when challenged. Therefore, the answer needs to be a 'just right challenge', not requiring problem solvingskills or patience. It is important for us to tailor activities to maintain the experience of challenge without going beyond theclient's limits to the point of failure or frustration. Answer A requires problem solving skills and patience. Answer B requirespatience. Answer C is a task that can be completed individually and works on self awareness.)

A patient presents to the hospital with symptoms of dyspnea secondary to lung disease. The patient is admitted several times a year. Symptoms severely limit participation in BADL's. One of the intervention priorities is for the patient to increase activity tolerance during self-care tasks in order to support the self-management of the disease. Which action would be most beneficial for the OT to include in the intervention for this client? Increase the patient's understanding of their disease and the disease process Instructing the patient to prop elbows on countertop during morning grooming Have the patient stand to don pants, sit to rest, followed by donning underwear Suggest using hot water during showers to facilitate muscle relaxation

Instructing the patient to prop elbows on countertop during morning grooming (Positioning and breathing are the most important ways therapists can helprelieve dyspnea symptoms. Answer A does not provide a strategy. Also considering multiple hospitalizations the client mayhave some awareness into their condition. Answer B places the client in mechanically advantageous position. At rest or duringactivity, leaning forward slightly as if slouching or supporting arms on a table/counter with shoulder internally rotated andadducted helps. Avoid moderate to maximal trunk flexion. Answer C is not using ECT, they client should don pant andunderwear at the same time. Answer D is inappropriate because warm water should be used to reduce humidity. Keeping thedoor open helps as well.)

An OT working in a home health setting is developing educational handouts for clients who have low vision. Which guidelines are most beneficial for the OT to use when making print more readable for clients with low vision? Large-print type at a minimum 16 point with wide spacing between letters Bold dark colored 18 point font with single spacing between lines of text Glossy-finish paper with all capital and different colors of lettering for the header

Large-print type at a minimum 16 point with wide spacing between letters

An OT working in an outpatient clinic is making wheelchair recommendations for a 4-year old with severe spastic quadriparesis. The child exhibits poor postural alignment and inability to maintain symmetrical posture during functional activities. Which adapted features should the OT include in the recommendations to promote the highest level of hand function? Lateral support Wheelchair tray Pelvic strap Back support

Lateral support (Back support through the scapula area can enhance shoulder stability for distal (hand) function. Pelvic strap holds thepelvis in a neutral position which supports an upright trunk. Lateral support guides the trunk but do not support or hold the trunk. A lap tray can improve shoulder and trunk position and provides a surface to support arms and hands.)

A patient with borderline personality disorder was admitted to an inpatient facility one week ago due to suicidal and self mutilating behavior. The patient is now considered stable but continues to display extreme fluctuations in mood and difficulty dealing with daily life challenges. Which intervention would be most beneficial when addressing problems and performance patterns? Life skills group with a variety of ways of adapting to problems Simple graded tasks that facilitates increased self esteem Refer the client to a supported employment program Task that build and maintain collaborative relationships

Life skills group with a variety of ways of adapting to problems

A student with CP who demonstrates a weak grasp and low vision needs modifications for school. The child wants to be able to participate in classroom activities independently. Which modification would be beneficial to include to support the child's goal? Built up colored pencils and spring opening scissors during art class A wrist-thumb orthosis for accuracy of movement during writing tasks Loop of ribbon in contrasting colors tied to the zipper of a lunch box

Loop of ribbon in contrasting colors tied to the zipper of a lunch box (What are we focusing on? Weak grasp and low vision and we need to identify a modification that would be beneficial. Our modification will need to address the client's deficits in order for the student to function in school. Answer C the loop of ribbon in contrasting colors (addresses the visual deficit) tied to the zipper of a lunch box (addresses the fine motor deficit). Answer A addresses the weak grasp. Answer B can also address a weak grasp but they do not address the visual deficit.)

A client is in OT to address a newly healed scar. The goal is the achieve a flat, smooth, cosmetically acceptable scar. The OTprovided the client with pressure garments that are tolerable and worn continually. When beginning a program of gentle massage,what must the OT consider first? Slowly progress to using 70 mmHg of pressure on the scar Massage in circular motions to work the scar in all directions Lubricate the scar prior to massage to precondition the tissue

Lubricate the scar prior to massage to precondition the tissue (The therapist must lubricate the scar before massage to precondition the tissue. Then you begin with gentle massage ofnewly healed skin to avoid blisters and skin breakdown. As the scar gets stronger (tensile strength improves) progress togreater pressure causing scar blanching and massage in circular motions to work the scar in all directions. Pressure shouldbegan at 35 mm Hg. Lymphatics began to collapse at a pressure of 60 mm Hg. To give a better idea, light massage isranges from 10 to 20 mm Hg. Pneumatic pumps to soften lymph is set at 40 mm Hg or less.)

Which clinical observation instrument is based upon Sensory Integration principles? Barthel Index for Activities of Daily Living Miller Assessment for Preschoolers Occupational Self-Assessment

Miller Assessment for Preschoolers (The Miller Assessment for Preschoolers looks at the sensory and motor abilities in children age 2.9 to 5.8 years old. Theother listed assessments do not examine sensory skills.)

An OT is working with a client post right MCA stroke presenting with hemiplegia of the LUE. The OT plans to implement anevidenced based intervention that requires the client to utilize visual feedback of their non-affected upper extremity. Whichtechnique does this most accurately describe? NMES Robot assisted therapy Mirror therapy

Mirror therapy

An OT is preparing to initiate a self-feeding program for a client who suffered a stroke resulting in right-side hemiparesis. The client has grade 2 shoulder flexion and shoulder abduction muscles. Which adaptation is best for the OT to recommend when assisting this client with drinking from a cup? Mobile arm supports with elevation assist Use of a coffee cup with enlarged-handled Teach the client one-handed techniques

Mobile arm supports with elevation assist

An OT is working on a client's motor skills by inhibiting abnormal muscle tone and facilitating normal movement patterns. Which frame of reference is the therapist using? Neurodevelopmental Motor control Biomechanical Sensorimotor

Neurodevelopmental (NDT helps clients with functional limitations perform quality, skilled movements more efficiently in order to carry out daily, lifeskills. Occupational therapist using a NDT approach/FOR provide a hands on approach for individuals who experienceposture and movement impairments using handling and positioning techniques.)

An OT working in an outpatient setting is scheduled to begin sessions with a middle aged adult with blurred vision. Several months ago, the patient sustained a traumatic brain injury and is no longer participating in certain activities. Since the injury, the patient has had to give up valued occupations leading to depression. One of the intervention goals is to improve daily participation. Which action should the OT take during the initial session with the patient? Observe and interview the patient to identify the occupations that cause visual stress Add contrast, increase size, reduce clutter, and find sources of comfortable lighting Assist the patient in establishing habits and routines to reduce visual stress

Observe and interview the patient to identify the occupations that cause visual stress

An OT is screening a young child with cognitive impairments for auditory processing problems. The OT gathers noisy objects such as a bell and squeaky toy. What action should the OT take next when screening for auditory processing problems? Refer the child to a an audiologist or neuropsychologist Provide visual cues when providing verbal directions Ask the caregivers how distractible the child is Observe the child's ability to orient towards sound

Observe the child's ability to orient towards sound

A client who was hospitalized with a brain aneurysm is unable to remain standing for long periods of time, and needs frequent breaks during seated activities. Evaluation results indicate that the client enjoys socializing with others and spending time with family. The OT practitioner changes the demands of the occupation of socializing, by allowing the client to sit in a chair and visit with family members for short periods of time. The OT practitioner also provides the client with short projects in which they can participate with their grandchildren when they visit. Which model of practice is reflected in the scenario? Spatiotemporal Adaptation Occupational Adaptation Canadian Model of Occupational Performance

Occupational Adaptation

A patient with T11 paraplegia could benefit from a job specific Functional Capacity Evaluation to determine whether they can meet the physical demands of the job as a laundry attendant. What will the main focus of the FCE be? Transfer skills to and from the front desk chair to the power wheelchair Social communication skills used to interact with patrons and co-workers Physical demands of the job that can be performed from a wheelchair

Physical demands of the job that can be performed from a wheelchair

A 3-year-old boy is admitted to the ICU following a MVA (motor vehicle accident) resulting in a T-12 SCI and 30% total bodysurface area full thickness burn to the neck and right shoulder. The child is in a pharmacologically induced coma. Followingautografting of the burn areas, the child begins to demonstrate decreased shoulder and neck ROM. The therapist positioned theshoulder in abduction using a thermoplastic orthosis. How should the OT position the child's neck? Place the neck in extension over a rolled towel when in bed Alternate positions of flexion and neutral using small pillows Promote flexion of the neck by placing a pillow under the head

Place the neck in extension over a rolled towel when in bed (The anti-deformity position for the neck is neutral to slight extension. Do not use pillows, but a soft collar, towel, or neck splintcan be used.)

An OT is treating a client who is in stable condition following burns on the dorsal aspect of the hand. Analgesics and antianxietymedication was recently given to the patient by nursing to reduce pain in preparation for dressing changes and hydrotherapy. TheOT is educating the client on their wound care and dressing program prescribed by the physician. Which is most appropriate touse when cleansing the client's wound? Plain dove soap Hydrogen peroxide Bleach Betadine

Plain dove soap (It should be noted that the literature is conflicting. Pedretti's states using plain white soap (Ivory or Dove) and water is appropriate. And Cooper states to avoid using solutions such as hydrogen peroxide, Dakin's solution, povidoneiodine/Betadine, soap, or bleach on clean wounds. Because these solutions contain chemicals that are toxic to granulation tissue, and will slow wound healing.)

A patient recently experienced a mild CVA resulting in weakness, postural instability, and poor problem solving skills. The patient was previously employed at a grocery store and was responsible for stocking shelves. The employer has agreed to allow the client to return to their position as a stocker upon completion of the rehabilitation program. During the initial evaluation the OT determined that the client is unable to move body parts independent of each other. What should the OT assess next? Postural control during sitting and standing Upper extremity strength and sensation Activity tolerance during a simulated work task Sequencing and problem solving during ADL's

Postural control during sitting and standing

A client is in the later stages of carpal tunnel syndrome and has loss the ability to functionally grasp and pinch. Which orthotic design is indicated for this client? Fabricated orthosis with the wrist in 30 degrees extension An orthosis that places the MCP in flexion and IP in extension Prefabricated orthosis that positions the thumb in opposition

Prefabricated orthosis that positions the thumb in opposition (A person with a median nerve injury with thumb involvement may benefit from a hand based thumb spica orthosis or anorthosis that places the thumb in opposition. The C-bar will help maintain the thumb web space and prevent muscularshortening of the adductor pollicis)

A occupational therapy assistant (OTA) starting at a new facility reads the employer's policies and procedures manual regarding facility records and becomes acquainted with the department's style of record-keeping. Which principle is demonstrated in this scenario? Procedural Justice Practicing Legally Social Justice

Procedural Justice (Procedural Justice states that OT practitioners are obligated to comply with the laws and regulations that guide the profession. The OTA is in compliance with the documentation policies delineated by the facility.)

An OT is determining a mobility device for a 6-year old child with spastic diplegia that provides access for participating in play activities and allows exploration of the environment. Which mobility device is recommended? Prone scooter Posterior walker Handheld walker Power chair

Prone scooter (The question provides us with information about our client. They have spastic diplegia, which is the only function we know,and that they are 6-years old. When determining a mobility device we must consider the clients functional ability and deficits.What do we know about spastic diplegia? Their lower extremities are affected. Therefore, the mobility device needs to usetheir upper extremities in order to explore.)

The OT is collaborating with the parents of a child with visual impairment who exhibits hypersensitivity to touch. Deficits are interfering with daily bathing routines. Which strategy will be most beneficial to help the child modulate their reactions during selfcare routines? Have parents provide a verbal cue prior to tactile stimulation Have the child rub different textured cloths on their arms Provide a nubby towel for the child to dry oneself after a bath

Provide a nubby towel for the child to dry oneself after a bath (When collaborating with families, tactile experiences should be provided in the context of real-life self-care activities. This will promote tactile experiences with actions and events versus providing passive tactile experiences such as rubbing different textures on their arms.)

A client who sustained a TBI two months ago is in OT to improve functional living skills.The client's goal is to be able to independently prepare a meal once discharged home. The client can successfully prepare a simple cold snack with minimal physical assist. Which activity would present a 'just right' challenge to progress toward the clients goal? Provide hand over hand as the client is preparing a peanut butter sandwich Have a written checklist available as the client prepares a simple salad Provide maximum verbal cues while the client prepares microwave chili Make a checklist of all the needed items in order to plan a 3-step meal

Provide maximum verbal cues while the client prepares microwave chili (The client can prepare a simple cold snack with minimal physical assist and wants to independently prepare a meal once discharged home. Remember, when a question tells you what your client 'can do' use the information to identify your answer. When grading we can provide more or less direction and since we know the client can prepare a simple cold snack with minimal physical assist we can grade up to verbal guidance. When grading the activity make sure your answer is going from A to B and not A to Z.)

A client is in the ICU following a kitchen-related injury resulting in a dorsal hand burn. Which ROM technique is safest for a client in the ICU? Instruct the client on slowly making a fist and then slowly extend the hand Provide passive range of motion to each digit individually one at a time Fabricate a resting hand immobilization orthosis to be worn continuously Passively provide gentle range of motion to digits 2-5 at the same time

Provide passive range of motion to each digit individually one at a time (Following a dorsal hand burn gentle, isolated ROM exercises at the IP joints should be performed be performed. Compositeflexion is harmful and can cause tendon rupture in fragile tissue. A resting hand immobilization orthosis can lead to poor positioning.)

A 10-month old child recovering from brachial plexus palsy is receiving OT at a pediatric clinic. The intervention priority is to strengthen the affected UE. Which activity is most beneficial to support the objective? Picking up one-inch sized blocks Incorporate energy conservation techniques Reaching to place a ball into a container Isometric exercises without resistance

Reaching to place a ball into a container (Play-based activities or exercises involving holding sustained positions may be the most effective to improve strengthening foryoung children. Make sure to focus on what the answer is promoting. If the answer is promoting fine motor skills, it is not thebest option. If the answer is working on exercises without incorporating play, it is not the best answer for a 10-month old child.)

An OT is working with a young adult client following a head injury. An initial screening identified visual closure deficits have an impact on IADL safety. What action will highlight the underlying neurobehavioral problem associated with the findings? Recognizing a sign that is partially occluded by a tree branch Identifying a signal light blinking on the car in the next lane Seeing objects during low-light conditions such as fog or dawn

Recognizing a sign that is partially occluded by a tree branch (Visual closure means that the individual is unable to decipher the whole picture from looking at a portion of it therefore answerA highlights the underlying neurobehavioral problem.)

An OT is working with a client with MS who expressed feelings of sadness and difficulty engaging in previously enjoyed activities. The plan is to promote interpersonal interactions and work on coping strategies during the OT treatment session. Which would be the best action to support the plan? Talking to another client at the clinic Recommend a CBT group Acknowledge the clients feelings Suggest a support animal

Recommend a CBT group

A patient is referred to an OT hand clinic due to new onset of aching pain radiating proximally to distally. The patient recently started a new job that involved constant leaning on a hard surface. The evaluation results are positive for ulnar nerve compression at the elbow. During the initial session the OT fabricated an elbow orthosis at 70 degrees flexion to be worn at night for 3 week. The client returned 2 weeks later with complaints of continuous symptoms. What action should the therapist take next? Adjust the elbow orthosis between 90 and 100 degrees of flexion Recommend the patient to increase wearing time to all day Incorporate the wrist at neutral to 20 degrees into the orthotic design

Recommend the patient to increase wearing time to all day (When a patient continues to present with symptoms the therapist can recommend the orthotic be worn throughout the day orthe therapist can educate the client on avoiding positions that flex the elbow and avoid resting the elbow on hard surfaces.The elbow should be positioned in 30 to 70 degrees flexion. Ulnar nerve pressure increases when the elbow is flexed greater than 100.)

An OT working in a rehabilitation hospital is gathering information about the visual abilities of an inpatient who recently had a stroke. The OT suspects that the stroke caused left visual field cut. What action should the OT take next? Perform peripheral field testing with dynamic activities Refer the client to an ophthalmologist or optometrist Evaluate the client's occupational performance

Refer the client to an ophthalmologist or optometrist (It is important for OT professionals to screen their clients for low-vision conditions and then refer to an ophthalmologist or optometrist as needed. The eye report information is helpful in the assessment process. Answers A and C would occur after the referral.)

A patient recently diagnosed with Huntington's Disease is noted to have twitching of the hands while trying to perform lower body dressing. Which option is best to support the client's ability to engage in the dressing tasks? Encourage the use of a dressing stick Replaced buttons with Velcro closures Educate on how to use an easy-pull sock aid

Replaced buttons with Velcro closures (During the early stages of HD fine motor disturbances are most prevalent. This can be attributed to chorea. We are told wesee the client twitching during dressing therefore our intervention should directly correlate with that task. Providing Velcroclosures is a modification that can decrease the effect of their FM disturbance during dressing.)

An OT in a hospital setting is treating a client one day after elective total joint replacement secondary to degenerative jointdisease. The client states that they have thought through how they will manage at home and do not need to actually practicecertain skills. How should the OT respond? Respect the client's decision and prepare discharge recommendations Educate the client on the role and importance of OT following surgery Refer to physical therapy to increase knee ROM and lower extremity strength Request that the client show you their plan for dressing and IADL tasks

Request that the client show you their plan for dressing and IADL tasks

An adult sustained a deep partial-thickness burn to the dorsal aspect of the forearm and wrist 3 months ago. The wound did notrequire skin grafting and is now fully healed. Which scar management technique is most beneficial to include as part of the overallintervention at this stage of the healing process? Scar massage for 3-5 minutes with enough pressure to blanch the skin Aggressive range of motion held to terminal end range and held for 1-2 minutes Customized pressure garments to maintain 45-50 mmHg of pressure on the scar

Scar massage for 3-5 minutes with enough pressure to blanch the skin (Once scars have healed and tensile strength improves, progress to greater pressure causing scar blanching isappropriate. Scar tissue that is restricting motion responds best to sustained, low-load stretching to the point of scarblanching. Answer B, aggressive ROM is not appropriate.*Note* Different resources state different parameters of pressure. I will list them all. 1) Custom-made compression garmentsare constructed to provide gradient pressure starting at 35 mm Hg. 2) Pressure wraps or garments should be fit to achievepressure near capillary pressure (20 to 30 mmHg). 3) Light massage is from 20 to 30 mm Hg . 4) Compression not exceed 40mm Hg. In summary, pressure should not exceed 40 mm Hg.)

A patient admitted to the hospital following a C5 spinal cord injury is working with OT on an out-of-bed sitting schedule. Blood pressure dropped the first several times the patient was in an upright position. Currently, the patient can tolerate sitting in bed with the head of the bed at 45 degrees with hemodynamic stability. The patient wants to be able to sit up when family members visit. What position is the safest for the patient to be placed in during the family visit? High-back wheelchair upright with feet on leg rest Semi-reclined in a manual wheelchair with legs elevated Sitting edge of bed with abdominal binder and ted hose

Semi-reclined in a manual wheelchair with legs elevated

An OT is working with an adolescent with camptodactyly. Which type of orthotic is indicated? Serial static PIP extension orthosis Neoprene thumb opposition orthosis Radial or ulnar digit based orthosis

Serial static PIP extension orthosis (Camptodactaly is a congenital hand disorder which causes a flexion contracture of the PIP joint of the little finger. Thereforethe orthosis will promote extension of the PIP joint.)

A patient suffered an acute MI two weeks ago. The patient will be discharged from the inpatient rehabilitation unit to live at home with family. One of the patient's goals is to resume painting. The cardiologist is allowing the patient to resume an activity level of no more than 1.5 metabolic equivalent (METs) units. Which activity represents the maximum allowable MET-level for this patient? Shopping for arts and crafts materials from a computer Organizing the materials and furniture in the craft room Carrying delivered craft materials up a flight of stairs Directing family members on the set up of materials

Shopping for arts and crafts materials from a computer (Resting quietly in bed requires the least amount of oxygen per kilogram of body weight (1 MET).)

What are the clinical findings following a superficial burn? Significant pain Short-term moderate pain Severe pain to light touch

Short-term moderate pain (A superficial burn (first-degree burn) involves only the upper layers of the epidermis. The healing time is 3-7 days. There is nopotential for scarring or contractures. Clinical findings include erythema, dry, no blisters, and short-term pain)

A patient is diagnosed with stage IV Alzheimer's disease. Caregivers report that the patient communicates through grunting, is unable to walk, and is often unable to eat. What would be the most important to educate the caregivers on in regards to the patient's status? Assisted ambulation methods Passive and active ROM program Skin inspection and positioning Suggest a nursing home placement

Skin inspection and positioning

An OT is selecting adaptations to address fine motor and visual-motor difficulties for a student in the 4th grade. Which adaptation would be most beneficial to include as part of the recommendation? Vertical or semi-vertical surface Wide-barreled pencil Slant board at 20 to 30 degrees Rubber band sling

Slant board at 20 to 30 degrees (Biomechanically, slant positions the hand in wrist extension and into some supination. A wrist-extended position facilitatesfinger flexion and grasp. Also a slanted surface is positioned closer to the eyes, which can facilitate the eyes' tracking of thehand's movement. Use of a vertical or semi-vertical surface promotes a more upright posture. A wide-barreled pencilreduces muscle tension and fatigue. A rubber band sling promotes a slanted, relaxed pencil position.)

A patient with ALS is beginning to demonstrate increased fatigue and increased respiratory effort while engaging in self care tasks. What stage does this most likely correlate with? Stage I Stage III Stage VI Stage V

Stage III (Stage III is when we see further increase in weakness, decreased independence in ADL completion and increased exhaustionalong with increased respiratory effort. During this stage an intervention should focus on providing wheelchairs, prioritizingtasks, work simplification, and AE. We should try to keep the client as independent as possible and also encourage deep breathing exercises.)

An OT is planning to review kitchen activities with a client who underwent a total hip replacement and plans to return home tomorrow. The chart says that the client is toe-touch weight-bearing, how will the weight-bearing restriction impact participation in kitchen-related activities? The client should perform all kitchen activities from a sitting position due to not being able to place any weight on theaffected leg Standing kitchen activities can be performed by placing about 50%of the person's body weight on the affected leg Standing kitchen activities can be performed by placing the majority of weight through both arms, using toes for balance (10% of weight)

Standing kitchen activities can be performed by placing the majority of weight through both arms, using toes for balance (10% of weight)

The rotator cuff is made up of the tendons of which structures? Subscapularis, Infraspinatus, Teres Minor, and Supraspinatus Subscapularis, Infraspinatus, and Teres Minor Subscapularis, Infraspinatus, Teres Major, and Supraspinatus

Subscapularis, Infraspinatus, Teres Minor, and Supraspinatus

An older adult client experiences debilitating headaches. Over the past few months, the client reports significant visual stress that triggers a headache when shopping for groceries, and asks the OT for suggestions on how to reduce the occurrence of the headaches. Which strategy would be most beneficial to include as part of the recommendations for supporting this objective? Shop when there are more people at the grocery store Instruct the client in online grocery shopping and takeout Suggest that the client shops for just a few items at a time Create a structured and predictable environment at the store

Suggest that the client shops for just a few items at a time (We must teach clients practical ways to manage their visual stress and continue to participate in daily occupations. Taking more trips to the grocery store will reduce the amount of time spent in the stress-provoking environment, which may reduce the incidence of headache. The client may also shop at a different time of day, perhaps in the early morning, when the client is more rested and the grocery store is less crowded. Answer A will increase visual stress. Answer B does not give the client an opportunity to learn how to manage their visual stress. Answer D is not realistic as we are unable to control the grocery store environment.)

An OT is instructing a patient on diaphragmatic breathing to relieve symptoms of dyspnea during self-care. Which technique is most appropriate to relieve symptoms of dyspnea? Maximal forward bending of the trunk while slowly engaging in self-care When engaging in self-care, move slowly, do not rush, and limit rest breaks Support arms on a table with shoulders internally rotated and adducted

Support arms on a table with shoulders internally rotated and adducted (To relieve symptoms of dyspnea, when sitting, the patient bends forward slightly at the waist while supporting the upper bodyby leaning the forearms on the table or thighs. When standing, leaning forward and propping the body on a counter or shopping cart may relieve the problem. Rest breaks need to be increased during task, not limited.)

An adult client who is functioning at Allen's Cognitive Level 3 (Manual Actions) lives in a group home. The client is instructed to set the dining table following a visual model. Which statement best represents how the task will be completed based on the client's level of functioning? Each place setting will include a plate, cup, napkin, and silverware The client will place items on the table in random, non-organized order The client will copy the demonstration with poor spacing between settings

The client will place items on the table in random, non-organized order (At level 3 client's are more aware of surroundings (objects that can be seen and touched). They enjoy hand movements thatare repeated and will participate in activities where the same action is repeated over and over but they fail to comprehend theend product or goal. Therefore, they will place the items on the table but will fail to comprehend the goal of setting the table.Items will only be placed on the table until they no longer have any items left.)

n OT is planning to evaluate a client with Schizophrenia. Which action is best when determining an assessment method? Observe how clients' sequence the steps of an activity Set goals based on diagnosis and ideas of outcome Include the family and significant others in the interview Use a top-down practical assessment within the home

Use a top-down practical assessment within the home (Answer A is a component skill. Answer B is not apart of theevaluation process. It is highly desirable to also include the family and significant others if we have consent or if the client isuncapable of self reporting)

What is the best action an OT can make when attempting to prevent a flexion pattern in the neck and trunk of a 14-year old with cerebral palsy? Place a small wedge on seat back to bring the scapulae forward Adjust the child's pelvis position in the chair to 85 degrees flexion Use adjustable hardware to tilt a removable lap tray like an easel

Use adjustable hardware to tilt a removable lap tray like an easel

An OT is planning an intervention session for an 8-year old child Ehlers Danlos syndrome (EDS). The child has difficulty with playing their favorite musical instrument due to joint fatigue and hypermobility. The OT has initiated a program of proprioception retraining to limit positions that strain the joints. Which strategy should the OT use as an initial intervention to most effectively support the child's ability to engage in the task? Collaborate with the child to identify alternative musical instruments that do not cause discomfort Increase joint stability by providing external supports such as orthoses or therapeutic taping Use theraputty exercises to gently pinch while keeping joints in flexion versus hyperextension

Use theraputty exercises to gently pinch while keeping joints in flexion versus hyperextension (First, identify what the function (or problem) is, then identify what the questions wants you to do about it. The problemis difficulty with playing due to joint fatigue and hypermobility. Next, what does the question want you to do with the problem;the OT has initiated a program of proprioception re-training. Therefore, the answer will need to include proprioception retraining to support the child's ability to engage in the task.Ehlers Danlos syndrome (EDS) is a condition characterized by a collagen deficiency causing increased soft tissue elasticityand global joint hypermobility. They are more likely to have pain with sustained repetitive use of their upper extremities (writingor playing a musical instrument). We use activity modifications and joint protection strategies to decrease joint strain and pain.They also have altered proprioceptive registration and benefit from proprioceptive training exercises to learn the feel of thejoint end range without going into hyperextension.)

A therapist opening a private practice advertises that the private practice center will "cure" client conditions and makes promises of creating a "new life". Which aspect of professional behavior is the private practice practitioner not following? Fidelity Veracity Beneficence

Veracity (Veracity is the duty to tell the truth. Clinicians must assure that advertisements and promotion of services are truthful.)

A therapist is working with a client on a cancellation worksheet. During the task the client reads a line of letters and misses all of the letter C's in a random order. What condition is reflected in the observation? Visual inattention Right neglect Left neglect

Visual inattention (One way to differentiate between left hemianopia and hemi inattention is to observe the search strategies the client uses tocomplete a cancellation test. Typical adults use an organized, sequential search pattern. Adults with deficits in visual attentionfrom brain injury demonstrate disorganized, random, and often abbreviated search strategies, frequently missing numbers onone side of the board. Neglect is demonstrated by missing one side of the board.)

An OT is working with a client who sustained a back injury while at work. The therapist is providing general ergonomic considerations to reduce the risk of re-injury. The client works at a shipping store where duties include handling packages over 50lbs and placing them on a carrier belt. Which recommendation is best to reduce re-injury? Pick up heavy boxes using a wide base of support, then twist toward the conveyor belt to lower the package. When lifting packages over 35lbs use a device (i.e. lift table) and slide the package onto the conveyor belt. When lifting from the floor ensure that packages are arms reach away from the body with have a narrow base of support.

When lifting packages over 35lbs use a device (i.e. lift table) and slide the package onto the conveyor belt. (When lifting heavy items (>35lbs) consider using a mechanical assistive device. If there is no mechanical device then propertraining in lifting techniques and proper body mechanics are important.)