COTA Exam Example Questions 1 (buy the book)

What is the normal range of motion for the elbow?

0 degrees extension to 135-150 degrees flexion

Accessibility guidelines indicate that for every 1 inch of rise in a ramp there should be how much length?

1 inch rise: 1 foot of length

What is the minimum space required to accommodate the swing of a door for a person using a wheelchair.

26 inches

What is the only true objective assessment tool that OT practitioners utilize? (produces most valid results as it is very difficult for a patient to intentionally skew results and has high inter-rater reliability )

A volumeter/volumetrics

Which of the following is a sign of a swallowing difficulty? A. Coughing while swallowing thin liquids -or- B. Loud noises in the throat during swallowing

A. coughing while swallowing thing liquids

How long after receiving ECT (electroconvulsive therapy) must a client wait before engaging in a structured task?

After 6 hours the client is capable of engaging in structured tasks. There is some temporary memory loss after ECT; therefore, it would not be appropriate to give an individual an activity that requires memory to complete.

The child exhibits the ability to grasp a pencil proximally with crude approximation of the thumb, index, and middle fingers and the ring and little fingers slightly flexed. The grasp pattern described is? A. Digital pronate grasp B. Static tripod posture grasp C. Dynamic tripod grasp D. Palmar supinate grasp

B. Static tripod posture grasp

Child has difficulty letting go of toy upon request. Which developmental level would be most accurate for the OTA to report the child's observed behaviors? A. 11-12 months B. 9-10 months C. 7-8 months D. 3-4 months

D. 3-4 months Rationale: At 3-4 months, children are able to bang toys on a tabletop, but they do not have a voluntary release. At 7-8 months, children begin to be able to give up ojbects with an assisted release, and at 9-10 months there is more efficient release. At 1 year old children have a voluntary release.

Can hospital volunteers perform transfers with patients?

NO. they are not trained health care professionals.

Froment's sign is used to identify?

ulnar nerve dysfunction

A screening of a 8-month-old child found that the child is able to sit independently by propping forward on both arms. Does this indicate the presence of a sensorimotor delay?

yes, Sitting with arms propped forward is typical of a 5- to 6-month-old. At 8 months, a child typically sits without support.

Are compression garments effective in controlling hypertrophic scar formation when treating patients with full thickness burns?

yes, they provide equal pressure over the entire area to prevent scarring. They must be worn 23 hours a day for approximately 12 months (for full thickness burns), or until the scar and wound maturation is complete.

What is emotional lability?

abrupt changes in mood without external precipitants. Often observed in those recovering from CVAs.

which age group is most concerned with separating from parents and developing their own self-identity?

adolescents

If the client is complaining of altered sensation should hot packs be applied?

no, because they might get burned

Does the OTA make the decision to withhold actions because of a DNR order?

no, it is the decision of the facility's medical team that responds to emergency procedures.

If a client states they are concerned about home safety, is it sufficient justification to extend their stay in inpatient services?

no. A request to extend a client's length of stay requires a documented need for inpatient services. Client's stated concerns about home safety are not sufficient justification for a length of stay extension.

Initial action for developing a discharge group?

obtain prospective group members' occupational profile and postdischarge goals and options. Rationale: when developing any therapeutic group, first get any prospective members OT profile.

What is a good initial focus for the OTA for a client with recent vision loss?

organizing the client's morning routine

Diplopia (double vision) can be managed by?

patching one eye. Pts are typically on an eye-patching schedule that alternates the eye that is patched. Loss of depth perception can be expected with eye patching but it is not as disabling as diplopia.

Patient shows an increase in deficits during intervention session that are not immediately life threatening. What should the OTA do?

schedule a reevalution to better treat notably worsened conditioned

Person has a dry mouth. What is the best suggestion for OTA to give?

sip water (cuz they will choke on anything solid like ice or candy)

OTA working in-patient rehab for SCI Patients. Pt sustained complete C5 SCI 2 weeks ago. Pt goal is independent self-feeding. Which pieces of adaptive equipment are best for the OTA to teach the Pt to use during intervention? A. A plate guard and universal cuff. B. One-handed cutting board and rocker knife. C. Sip-n-puff mobile arm support or offset feeder. D. Drinking cup with a drinking spout to prevent spills.

A. A plate guard and universal cuff Rationale: Individuals w/ C5 complete SCI have functional elbow flexion. They can achieve independence in feeding with the help of assistive devices, such as universal cuff and plate guard. Individuals with a complete C1-C4 SCI have little/no movement of UE muscles; therefore a sip-n-puff mobile arm support and/or an offset feeder is needed to assist them in self-feeding. An individual with a C4 SCI can use a long straw to drink from a cup. A one-handed cutting board and a rocker knife are helpful adaptation for meal preparation for individuals who have lost function one side of their body. This outcome is not typical for a person with an SCI. A spill-proof drinking cup is used for individuals with tremors; its use requires the use of an upper extremity.

An adult with schizophrenia has been experiencing negative symptoms of restricted emotion, decreased engagement, and a lack of energy. Which group is the best for the OTA to include in the client's intervention plan? A. An arts and crafts group in which each client works on an individual project. B. A collage group in which each client works collaboratively with others. C. A stress management group that includes biofeedback and visualization. D. A support group for persons with schizophrenia in which all clients share their stories.

A. An arts and crafts group in which each client works on an individual project. Rationale: Experiencing negative symptoms associated with schizophrenia has a devastating impact on a person's ability attain life goals, live independently, maintain a job, and nurture healthy personal and social relationships. Given the person's presenting negative symptoms of restricted emotion, decreased engagement, and a lack of energy, it is best include the person in a group with minimal expectations to share or socialize with others. According to Mosey's developmental groups, this is called a parallel group. The use of Mosey's developmental groups can assist clients in acquiring and developing group interaction skills. An arts and crafts group in which each client works on an individual project meets the criteria of a parallel group. Enabling a client to choose an individual activity to complete will assist the client in developing a comfort level in the presence of others. Providing the client with a choice of activity and a means to express feelings through media is an effective approach to develop group interaction skills. The OTA can structure a parallel group to allow graded expression and interactions with others in a safe environment as the client develops trust and comfort in the presence of others. As the client's comfort level increases in social situations, he or she can work collaboratively on a joint project, share life stories and offer support to others. The concentrated focus that is required to effectively engage in biofeedback and visualization would make these approaches too difficult for a person with negative symptoms.

An OTA constructs a splint for an individual w/ Erb's palsy. Which orthosis would be most effective for this condition? A. An elbow lock splint. B. A flail arm splint. C. A figure-of-eight splint. D. A deltoid sling.

A. An elbow lock splint. Rationale: Erb's palsy results from injury to the 5th and 6th cervical roots of the brachial plexus. The resulting clinical picture is that the arm hangs limp with the shoulder rotated inward due to atrophy and paralysis in the biceps, deltoid, brachialis, and brachioradialis muscles. This significantly limits functional movement. The elbow lock splint stabilizes the elbow to enable the individual to position the hand closer to or away from his/her body for functional use. A flail arm splint is recommended for a brachial plexus injury of C5-T1, resulting in whole upper extremity involvement. It provides the needed stability at both the shoulder and elbow for functional positioning of the hand. A figure-of-eight splint is used for a combined median ulnar nerve injury and to prevent MP hyperextension. A deltoid sling is used for upper extremity muscle weakness.

An individual has relocated to a new area and begins treatment at an outpatient OT clinic for follow-up after rotator cuff surgery. It is 6 weeks' postoperation. Which is the most effective intervention for the OTA to implement at this time? A. An isometric strengthening program. B. Passive range of motion. C. Active assistive ROM. D. An isotonic strengthening program.

A. An isometric strengthening program. Rationale: Strengthening should begin with isometrics at 6 weeks and then progress to isotonics. PROM progressing to active assistive ROM (AA/AROM) is the intervention for 0-6 weeks' postoperation.

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

A. An overhead suspension sling Rationale: Overhead suspension sling is best suited for individuals presenting with proximal weakness with muscle grades in the 1/5-3/5 range. Long-handled and curved utensils and tools are useful for individuals with range of motion limitations. Environmental control units are used for individuals who have significant motor deficits, proximally and distally, and who cannot independently perform tasks such as controlling the switches on electronic equipment.

While reviewing a written protocol on the positioning of their infant, the OTA notices the parents do not seem to be following along with the protocol's text. Which action is best for the OTA to take initially in response to this observation? A. Ask the parents if they have any concerns about positioning their infant. B. Ask the parents if they can read and understand english. C. Include pictures of proper positioning in the protocol. D. Demonstrate proper positioning techniques.

A. Ask the parents if they have any concerns about positioning their infant. Rationale: This is an open-ended question that enables the parents to express any concerns that they have about positioning their infant. These concerns may be comprehension related and/or task related. Caring for a child with sever physical disabilities can be overwhelming, and the parents' perceived difficulties in following the written protocol may be due to emotional stress, not limitations in literacy. The parents may welcome the opportunity to express their concerns. The other choices are close-ended and do not facilitate an open dialogue. If the parents have difficulty understanding English or if they could benefit from pictures and/or demonstrated positions, they can express this in response to the OTA's open invitation to express concerns.

A patient had a brain tumor removed 1 month ago and exhibits residual cognitive-perceptual deficits. The OTA uses a neurofunctional approach to remediate the client's cognitive dysfunction. Which of the following is best for the OTA to include in the intervention program? A. Functional activities in their real contexts. B. Client education on strategies to remediate deficits. C. Tabletop activities to practice remediation strategies. D. Computer games to develop performance component skills.

A. Functional activities in their real contexts. Rationale: A neurofunctional approach emphasizes functional activity performance in the *actual environment*. The other options reflect a transfer of training approach.

Hospitilized adult with COPD discharge planning session. Pt says they want to exercise regularly you should recommend? A. Hospital wellness program's yoga group B. Low-impact aerobics at local gym C. Weight-lifting under direction of personal trainer D. Jogging with friends at local park

A. Hospital wellness program's yoga group Rationale: yoga places least amount of stress on pulmonary and cardiac systems and the hospital program will likely be overseen by trained professionals.

A single parent with rheumatoid arthritis and two school-aged children reports difficulty completing a home exercise program. The parent states that multiple familial, work, and home management responsibilities fill the day and additional activities cannot fit into the day. Which is the best action for the OTA to take in response to these realities? A. Incorporate the parent's engagement in a diversity of role activities into the home program. B. Provide intervention for time management and temporal adaptation. C. Explain and reinforce the importance of AROM exercises for remediation of dysfunction.

A. Incorporate the parent's engagement in a diversity of role activities into the home program. Rationale: The performance of role activities requires the individual to actively range joints, which is the purpose of an exercise program. Incorporating AROM into one's daily routines can be more easily implemented than adding a specific exercise regimen. Some people fin pure rote exercise uninteresting. In addition, since activity and the pursuit of occupational roles is the foundation of OT, this choice provides the most theoretically consistent action. Reminding the individual of the importance of AROM, providing time management intervention, and/or increasing the frequency of the OT sessions ignore the reality of a single parent's busy life. The person has reported nothing to indicate a lack of understanding of the importance of AROM, poor time management skills, or temporal dysfunction. Increasing the frequency of OT sessions would just add further demands to the parent's already busy schedule and is not indicated.

Which environmental approach should the OTA recommend to help a client complaining of irregular sleeping patterns? A. Install room-darkening shades and wear earplugs. B. Meditate for 30 minutes prior to bedtime. C. Do not eat for 2 hours prior to bedtime. D. If unable to sleep, get up and do a boring chore.

A. Install room-darkening shades and wear earplugs. Rationale: it was the only choice listed that was an environmental approach.

An individual with C-7 spinal cord injury reports noticeable redness on the ischial tuberosity during self-exam with a mirror. Which action is most effective for the OTA to recommend in response to the client's observations? A. Integrate weight shifting into daily activities. B. Use a tilt-in-space wheelchair. C. Use an angled foam cushion. D. Self-direct caregiver to assist with weight shifting.

A. Integrate weight shifting into daily activities. Rationale: During rehabilitation, a person with a spinal cord injury must be instructed on the need to relieve pressure on a consistent basis. A person with a spinal cord injury at the level of C7 can perform depression transfers so the ability to perform weight shifting for pressure relief is intact. The person is reporting the early signs of skin breakdown, so it is vital that the person integrates weight shifting into daily activities. This is a very effective way to prevent decubitus ulcers. Since the person is able to weight shift independently, a tilt-in-space wheelchair and self-directing caregivers to assist with weight shifting are two modifications that are at too low a lever for this scenario. An angled foam cushion would position the person in a manner that would increase weight on the ischial tuberosity. This would be contraindicated.

An individual recovering from hepatitis, type C has decreased upper and lower extremity muscle strength and hypertension. Six months ago the client had an angioplasty and is very fearful of having a heart attack. Which should the OTA advise the client to perform in increase muscle strength? A. Isotonics. B. Isometrics. C. Contract-relax exercise. D. Muscle contractions and holds.

A. Isotonics. Rationale: Isotonics are the only exercises listed that are not contraindicated for a person with hypertension or heart disease.

Which principle of validation therapy is important for an OTA to include in a presentation during an in-service at the new psychogeriatric unit of a skilled nursing facility? A. Listen to the words an individual uses to ascertain the person's underlying message. B. Provide highly structured activities to refocus the individual on reality. C. Provide unstructured activities to facilitate the expression of feelings. D. Listen to the words an individual uses and provide reality orientation for invalid statements.

A. Listen to the words an individual uses to ascertain the person's underlying message. Rationale: Validation therapy is an approach to working with individuals with dementia founded on the principle that the unspoken messages an individual conveys in his/her speech are more important that the actual content of the speech. Individuals with dementia often make statements that are not based in reality. For example, an individual introduces a daughter as his/her mother. In validation therapy, the factual aspects of this familial relationship are irrelevant and do not need to be addressed at all. However, the underlying message that this relationship is valued and important is worthy of comment. The use of structured or unstructured activities is not a component of validation therapy. The focus of validation therapy is to facilitate communication with persons with dementia in a caring, respectful, and empathetic manner.

An adult who incurred a traumatic brain injury 3 months ago receives home care OT services. During meal preparation tasks, the client ignores items on the left side of the counter. Which is the best remediation approach for the OTA to use with this client to enhance performance? A. Place a brightly colored placemat on the left side of the counter. B. Encourage bilateral activities. C. Place all items on the right side of the counter. D. Practice scanning activities.

A. Place a brightly colored placemat on the left side of the counter. Rationale: The placemat provides an external cue which is an anchoring technique. Anchoring technique is a basic remediation approach. Answer C doesn't make sense and answer B isn't the best answer. Letter D isn't the right answer according to the book.. it is not well explained why A was picked instead of D.

A person incurred a traumatic above-elbow amputation to the nondominant upper extremity. The client establishes a goal to be independent in all ADL, using the residual limb without a prosthesis. However, the limb is painful and very sensitive. Which should the OTA include in the OT intervention program? A. Train the client in the use of adaptive strategies and/or equipment to perform ADL. B. Refer the client to an amputee support group to facilitate acceptance of the need for a prosthesis to attain ADL independence. C. Implement an exercise program to focus on strengthening muscles that will enable the effective use of a prosthesis. D. Teach the client to protectively wrap the residual limb with an elastic bandage in a circular manner to decrease pain and manage hypersensitivity.

A. Train the client in the use of adaptive strategies and/or equipment to perform ADL. Rationale: it looks like a good answer. -and- -Wrapping a residual limb with an elastic bandage in a circular manner is a major contraindication in amputee care. The wrapping of a residual limb should be performed in a figure-of-eight diagonal pattern going from a distal to proximal direction, with greater pressure applied at the distal end of the limb.

OTA collaborates w/ OT to review use of OT department's resources to determine medical necessity and cost efficiency. Which service management task is the OTA working on with the OT? A. Utilization review. B. Retrospective peer review. C. Total quality management. D. Risk management.

A. Utilization review. Rationale: Utilization review is a plan to review the use of resources within a facility to determine the medical necessity and cost efficiency. It is often a component of a continuous quality improvement (CQI) or a performance assessment and improvement (PAI) system. Total quality management is the creation of an organizational culture that enables all employees to contribute to an environment of continuous improvement. Risk management is a process that identifies, evaluates, and takes corrective action against risk and plans, organizes, and controls the activities and resources of OT services to decrease actual or potential losses. Retrospective review involves the auditing of medical records by third-party payers to ensure appropriate care was rendered. Peer review is a system in which the quality of work of a group of health professionals is reviewed by peers.

An OTA provides service to a homeless shelter that includes residents who are HIV positive. The OTA conducts several activity groups. Which should the OTA do while working with this population? 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.

A. Wash hands before and after each group session. Rationale: the diagnosis is irrelevant. Wash your hands before and after ya little nasty.

An OTA uses behavior modification techniques to help shape the behavioral responses of students with behavioral disorders. Which action is most consistent with this intervention approach? 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 to self-correct the undesirable behaviors. D. Encourage the teaching staff to tell the students which behaviors are correct and which are not.

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

Restaurant employee with left humeral fracture. After cast removal Pt received OT. Pt has 3/5 tricep strength and full elbow rom. To increase elbow function in work-tasks, which activity is most effective for the OTA to next include during intervention. A. storing plates and glasses on shelves at chest height. B. Wiping off a table while standing. C. Carrying a tray of dishes from the table to the sink. D. Wiping off a counter at chest height.

A. storing plates and glasses on shelves at chest height. Rationale: Storing plates at chest height is a resistive activity against gravity. This is one of the best ways to increase strength in a muscle to attain full elbow ROM. Wiping tables at stomach level is gravity assisted so its wrong. Wiping counter at chest height is gravity eliminated so yep thats wrong. carrying dishes is an isometric activity. Welcome to the cota exam.

An OTA implements intervention for individuals on an inpatient cardiopulmonary rehabilitation unit. The OTA assesses a patient's heart rate during intervention sessions by palpating a peripheral pulse. Which most accurately describes the time the OTA should use to complete this assessment? A. 30 seconds prior to, during, and at cessation of the activity. B. 1-2 minutes prior to, during, and at cessation of the activity and 5 minutes' post activity C. 1-2 minutes prior to, during, and at cessation of the activity. D. 30 seconds prior to, during, and at cessation of the activity and 5 minutes' post activity.

B. 1-2 minutes prior to, during, and at cessation of the activity and 5 minutes' post activity Rationale: On an inpatient cardiopulmonary rehab unit, the OTA must monitor a Pt's HR before, during and immediately after an activity and a few minutes (example: 5 minutes) post activity. HR should be assessed using palpation of peripheral pulses (most commonly radial pulses). Individuals receiving treatment in an inpatient cardiopulmonary rehab unit may likely have irregular heart rhythms which require 1-2 minutes of palpation.

A school-based OTA is working with a child who has poor sitting posture, inefficient grasp, and excessive writing pressure into the paper. The OTA collaborates with the OT and determines that the best intervention approach requires integration of more than one intervention model. Which approaches will most effectively address all the child's deficits? A. A combination of biomechanical and psychosocial approaches. B. A combination of biomechanical and sensory integration approaches. C. A combination of acquisitional and motor learning approaches. D. A combination of psychosocial and neurodevelopmental approaches.

B. A combination of biomechanical and sensory integration approaches. Rationale: The task of writing is a complex process that requires sensorimotor, cognitive, language, and visual processing abilities. OT intervention for handwriting problems often requires the integration of multiple models and frames of reference. In this case, the biomechanical frame of reference is best suited to address the areas of posture, pencil grasp, and possible compensatory strategies, including environmental and tool adaptations. The child's reported behaviors can be indicative of a sensory-processing deficit. For example, a proprioceptive-processing disorder can be evident in clumsiness, motor planning difficulties, and the use of too much force (e.g., pressing too hard on paper). Therefore, sensory integration approaches are also indicated.

An individual with RA is currently in remission. OTA is working to maintain ROM and strength. Which of the following is most effective for OTA to recommend the client include in a daily home exercise program? A. Passive ROM. B. Active ROM. C. Isotonics. D. Progressive Resistance.

B. Active ROM Rationale: AROM is indicated for treatment of RA in both acute and chronic stages. PROM is contraindicated unless person is unable to perform AROM, and must be used with caution. Progressive resistance is contraindicated and the use of isotonic exercise for RA patients is controversial. Joints must be stable and Pt must be able to benefit from isotonics without jeopardizing other joints. RA Pt must be monitored for isotonic exercise therefore it is not appropriate for an unmonitored home exercise program.

When working with below knee amputation and diabetic Pt in acute rehab setting, the Pt reports feeling weak, dizzy, and somewhat nauseous. You notice Pt is sweating profusely and is unsteady when standing. What is the best immediate course of action as an OTA? 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. Administer orange juice for developing hypoglycemia. Rationale: Pt is showing signs of hypoglycemia and therefore does not need insulin as that lowers blood glucose. Profuse sweating and nausea do not usually accompany orthostatic hypotension.

An OT's evaluation indicates that a 5 year old with developmental delay has the potential to participate in self-feeding. The parents indicate that achieving the goal of self-feeding for their child is not a priority. You should? A. Explain the importance of self-feeding to the child's independence. -or- B. Ask the parents about their priorities for their child.

B. Ask the parents about their priorities for their child. Rationale: OTA must respect family preferences and cultural differences. By asking the parents about their priorities for their child we can better understand the family's context and collaborate with the OT to come up with a treatment plan.

During an intervention session focused on the development of grasp and shoulder mobility, an OTA asks a client to move numerous identical 1# cans of vegetables from the countertop to the cabinet shelf above the counter. According to contemporary motor learning approaches, what type of practice has the OTA implemented for this client? A. Random practice. B. Blocked practice. C. Planned practice. D. Contextual practice.

B. Blocked practice Rationale: Blocked practice involves repeated motor skill. Cans were identical and were lifted using identical motor skills. Random practice involves use of different motor skills (i.e. different size/weight cans being moved with different motor skills) Planned practice and contextual practice are some bogus A** terms created for your amusement.

Pt with C3 spinal cord injury is participating in a community mobility group at a shopping mall. Client expresses desire to return to rehab center due to a pounding headache. OTA notices client is sweating profusely. Which should the OTA do first in response to this observation and request? A. Escort the client to outside of the mall to cool off in the fresh air. B. Check the client's urinary catheter and collecting bag. C. Call the rehab center's transportation department to relay the client's request. D. Immediately activate the recline feature of the patient's tilt-in-space wheelchair.

B. Check the client's urinary catheter and collecting bag. Rationale: Profuse sweating and headaches are signs of autonomic dysreflexia. This is an extreme rise in BP caused by a noxious stimuli, which must be treated immediately by removing the stimulus. A blocked catheter and overfilled urine bag are common precipitants to this complication and could results in a medical emergency in persons with a spinal cord injury. The patient should also be kept upright to help manage the rise in blood pressure.

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

B. Decorating styrofoam cups and planting cuttings in them. Rationale: Decorating cups and planting cuttings is a simple concrete tasks, which can be structured to ensure successful completion by individuals with acute psychiatric disorders. Because the length of stay on acute units is short, activities that can be completed in one session are typically best for intitial treatment sessions. Publishing a weekly newsletter and painting a large mural will require multiple sessions to complete. The outcome of planning a pizza party for a weekend evening may not be implemented for several days. Given that some group members may be discharged before the weekend, this is not the best option for working on current goals.

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

B. Explore with the group an alternative schedule for a community leisure activity. Rationale: All residents should be provided with the opportunity to engage in the community leisure activity. Facilitating the group's exploration of alternative scheduling can result in all residents' needs being met.

8 month old child w/ myelomeningocele at L1 with normal cognitive function. Which activity would OTA most likely focus on? A. Doffing sleeves of overhead shirts with assistance. B. Increasing trunk balance when placed in sitting. C. Transferring objects from one hand to the other. D. Transitioning from sitting to supine and from supine to sitting.

B. Increasing trunk balance when placed in sitting. Rationale: This is normal for 8 month old. Gross motor skills development in childs with myelomeningocele parallel those of a typical child. The difference is that upright mobility at the 12 to 18 month level concentrates on use of assistive devices. & -Doffing sleeves overhead is a skill consistent at the 10 to 12 month level. -Transferring objects from one hand to another is found at the 6 to 8 month level -Transition from sitting to supine comes after working on trunk balance after being placed in sitting, from 9 to 11 months.

Pt recovering from lumbar surgery and must remain flat in bed during initial recovery. Pt wants to read comic books. Which is the best adaptation for OTA to recommend? A. page magnifier B. Prism Glasses C. Audiotapes of books of interest. D. Large print books of interest.

B. Prism Glasses Rationale: Prism glasses bend light 90 degrees which enables a person to lay flat and read anything resting on his/her lap. This way Pt can read their comics.

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

B. Review current literature on occupation-based and evidence-based elder care.

An adult diagnosed with multiple sclerosis over 10 years ago experiences an exacerbation of symptoms. The individual's principle complaint is decreased strength and endurance. The person can ambulate short distances with a cane in the home and uses a wheelchair outside of the home. The client asks for suggestions to enable independent home maintenance. Which is the best positioning recommendation for the OTA to suggest the person use during meal preparation? A. sitting in the wheelchair with a tray table. B. Sitting at the kitchen table C. leaning against the counter while standing D. Leaning against a tall stool while standing

B. Sitting at the kitchen table Rationale: Multiple Sclerosis is characterized by fluctuations in abilities. The best choice for an activity that will be performed frequently is to perform the activity in an adequately supported position. The avoidance of fatigue is important in the management of MS. Doing meal preparation while sitting at the kitchen table achieves these aims and uses the person's natural context. There is no need indicated in this scenario for the use of a wheelchair and a tray. The client can do meal preparation activities with readily available supports. Standing might require using too much energy and does not provide good support or stability for performing the fine motor aspects of meal preparation. Leaning against the counter or a stool requires more energy, does not provide good support or stability for performing the fine motor aspects of meal preparation, and may not be safe.

Incomplete C6 SCI w/ secondary d/x of thromboangiitis obliterans. The OTA conducts a predischarge home evaluation of Pt's rented apartment. Which is most important area for OTA to assess? A. Apartments electrical capacity for an environmental control unit. B. Apartments water temperature C. Aparments electrical capacity for an emergency call system D. Landlord's willingness to modify the bathroom.

B. The Apartment's water temperature. Rationale: Thromboaniitis obliterans, also known as Buerger's disease, results in diminished temperature sense, paresthesias, pain, and cold extremities. It is most common in young men who smoke. Poor/absent temperature sense can results in serious risk of scalding burns. If apartment's water temp is higher than 102 degrees fahrenheit, an antiscalding faucet and/or valve must be installed. An individual with a C6 SCI is independent in many tasks and does not require an ECU and is able to independently dial 911 w/ minimal modifications (large push buttons and/or speaker phone) Structural bathroom modifications are not needed. A person with a C6 SCI can bathe with minimal assistance using a tub bench, a sliding board transfer, and a handheld shower. None of these modifications would require a landlord's permission.

An OTA works with an individual recovering from TBI demonstrates behavior consistent with Level VII of the Rancho Level of Cognitive Functioning Scale. The client is in a transitional living program. Which is the most important focus for the OTA to include in the client's intervention plan? A. The provision of a high degree of environmental structure to decrease confusion and ensure safety. B. The development of strategies to accurately and safely complete IADL with minimal assistance. C. The development of adaptive techniques to accurately and safely complete BADL with moderate assistance. D. The provision of maximum assistance to accurately and safely complete IADL.

B. The development of strategies to accurately and safely complete IADL with minimal assistance. Rationale: A person at Level VII of the Rancho Level of Cognitive Functioning Scale is able to appropriately complete highly familiar tasks such as BADL with minimal assistance. At this level, the person can learn to use strategies to accurately and safely complete IADL with minimal assistance.

which intervention would better help a toddler with a hyperactive gag reflex to decrease the gag reflex? A. having child suck through straws of progressively longer lengths -or- B. Walking a tongue depressor from the front of the tongue to its back

B. Walking tongue depressor from front of the tongue to its back Rationale: sucking through straw increases the sucking reflex but does not decrease a hyperactive gag reflex (Welcome to the COTA exam)

High school senior has Friedreich's ataxia. The senior is trying to develop keyboarding skills in a school-to-work transition program. During the initial session, the OTA observes signs of dysmetria. Which is the most appropriate adaptation for the OTA to recommend to increase the effectiveness of the student's keyboarding skills? A. An eye-gaze input system. B. A key guard overlay. C. A voice-activated input system. D. A reduced size keyboard.

B. a key guard overlay. Rationale: Dysmetria is the overshooting (hypermetria) or the undershooting (hypometria) of a target. It would be observed during a keyboarding activity as frequent misses of the desired key. A key guard overlay provides raised separation between each key which enable the Pt to place their finger on the desired key. One with Friedrich's ataxia has poor coordination of all muscles, including ocular muscles, rendering an eye-gaze input system ineffective. Dysarthria is also characteristic of Friedrich's ataxia which limits the efficacy of voice-activated system. A reduced size keyboard is contraindicated.

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

B. a set of identical objects Rationale: Stereognosis is the ability to identify objects through touch and cognition. Having an identical set of objects from which the individual can selet an object that matches the test stimulus will enable a person with expressive aphasia to participate in the evaluation. The person can point to the object to indicate his/her response. Cards with "1" and "2" printed on them would be relevant to assist for the evaluation of two-point discrimination. Cards with "yes" and "no" printed on them would be relevant assists for evaluation of light touch. Presenting the person with pictures to indicate a response requires the ability to generalize the object to its symbolic representation. This ability may be compromised in an individual with a CVA. It is more accurate to have exact matches of the objects used during the evaluation for this will not require the interpretation of pictures. (FAH Q 2 NBCOT)

An individual with left hemiplegia who is right-hand dominant receives training to resume independent driving. Which adaptation is best for the OTA to recommend the client use? A. 'Palming' the steering wheel. B. Hand Controls for brake and gas pedals. C. A spinner knob on the steering wheel. D. Left-sided Accelerator pedal.

C. A spinner knob on the steering wheel Rationale: Spinner knob allows for one handed driving. Palming the wheel is not recommended for one handed driving. There is no functional need to rearrange existing pedal arrangements.

An individual recovering from a total hip replacement is being discharged home. The individual is insured only by Medicare. For safety and independence in the bathroom, which adaptive equipment is best for the OTA to recommend? A. A raised toilet seat. B. Grab bars. C. A three-in-one commode. D. Nonskid mats.

C. A three-in-one commode Rationale: 3-in-1 commode provides additional height needed by Pt to maintain hip precautions. It is also the only item identified that is reimbursable by Medicare. Medicare does not cover any equipment that can be useful to individuals without a disability. Self-help items such as grab bars, raised toilet seats, and nonskid mats are not considered medically necessary and are not reimbursable since other people can use them.

The family is very anxious about surgery, and they ask the OTA what to do. Which is the OTA's best response? A. Recommend the family follow surgical recommendations from the doctor. B. Suggest preoperative course of intensive therapy, and static/dynamic splinting C. Advice the family to review all of the information to make an educated decision. D. Encourage the family to get a second opinion from another surgeon.

C. Advice the family to review all of the information to make an educated decision.

Individual hospitalized for first time for brief psychotic episode, is exhibiting restlessness, hand tremors, and shaking legs. Which of the following is the person exhibiting? A. Akinesia. B. Pseudo-parkinsonism C. Akathisia. D. Tardive dyskinesia.

C. Akathisia. Rationale: Akathisia is a side effect of antipsychotic medications that is exhibited by restlessness, hand tremors, and shaky legs. Akinesia is lack of movement. Pseudo-parkinsonism is also a side effect that appears as behaviors similar to the symptoms of advanced Parkinson's disease; that is, rigidity, pill-rolling tremors, masked face, and a shuffling gate. Tardive dyskinesia is an irreversible neurological condition caused by years of taking neuroleptic medications. It would not be evident in someone being treated for a first break with neuroleptic medications.

A 5 year-old demonstrates age-appropriate cognitive and fine motor skills. Which activity would the child be able to complete at this developmental level? A. Cutting long thin strips with scissors. B. Holding and snipping with scissors. C. Cutting simple figure shapes with scissors. D. Opening and closing scissors in a controlled fashion.

C. Cutting simple figure shapes with scissors. Rationale: According to established developmental milestones, cutting simple figure shapes is a 4- to 6-year-old cognitive and fine motor skill. Cutting strips is a 3- to 4-year-old skill. Holding and snipping with scissors and opening and closing scissors in a controlled fashion are 2- to 3-year-old skills.

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

C. Donning pants while in bed. Rationale: C6 spinal cord injury can independently don underwear and pants lying in bed. Minimal assistance is needed to don socks and shoes. Therefore, intervention would focus on developing the ability to don pants while lying in bed. A person with a C6 spinal cord injury uses a sliding board to transfer; depression transfers are possible at the C7 level. The client with a complete spinal cord injury at the C6 level does not need a mouth stick to type or a suspension sling/mobile arm support to feed. Therefore, intervention is not needed to develop these abilities.

An individual with complex regional pain syndrome (CRPS), type 1 presents with sever pain and pitting edema in the right hand. The individual has a secondary diagnosis of degenerative joint disease (DJD). Which should the OTA initially recommend to the person to address these concerns? A. Passive ROM of wrist and fingers B. Retrograde massage from distal to proximal. C. Elevation of the affected hand above the heart. D. Retrograde massage from proximal to distal.

C. Elevation of the affected hand above the heart. Rationale: Elevation of the affected hand above the heart will promote venous and lymphatic drainage and decrease the hydrostatic pressure in the blood vessels. Retrograde massage is performed in centripetal direction. It is not the initial treatment when severe pain is present. PROM is not advisable for persons with DJD.

School-based OTA consults a teacher regarding a nonspeaking student who uses a wheelchair and an augmentative communication device. The teacher reports that the student is making many errors on the communication device but that no difficulties had been observed when the student used the device in the past. Which is the most effective initial action for the OTA to take in response to the teacher's report? A. Advice the teacher to contact the student's parents and recommend that they bring the child to a physician for an exam. B. Recommend a reassessment of the student's motor and communication abilities. C. Evaluate the position of the student in the wheelchair and the device on the wheelchair. D. Reposition the communication device.

C. Evaluate the position of the student in the wheelchair and the device on the wheelchair. Rationale: Minor changes in position can greatly affect performance, therefore the initial action is for the OTA to evaluate the position of the student and the device. OTA may then provide recommendations on positioning/placement. Everything else is not indicated at this time.

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

C. Have the child support the elbows on a table at chest height to don the T-shirt over the arms, then don over the head. Rationale: Spinal muscle atrophy is a progressive disorder and the OTA needs to prepare the child/family for progressive skill loss. The best technique, as shoulder ROM decreases, is to use a table for support to don the arms then use elbow and neck flexion to don the T-shirt over the head. Wearing front-opening shirts instead of T-shirts is an effective compensatory technique to eliminate the need to don shirts over the head. However, the exam item specifically asked for an approach to help the child don a T-shirt. When the child can no longer don a T-shirt using adaptive strategies, the use of front-opening shirts can effectively maintain the child's independence in dressing.

Pt reports dull stimulus as sharp on palmar surface of thumb and index finger. All other responses are normal. Which is accurate for the OTA to document about the Pt's sensation? A. Impaired for pain along C5 and C6 dermatomes. B. Hypersensitive along the ulnar nerve distribution of the palmar surface of the hand. C. Hypersensitive along the median nerve distribution of the thumb and index fingers. D. Absent for pain along the median nerve distribution.

C. Hypersensitive along the median nerve distribution of the thumb and index fingers. Rationale: it's not C5 or C6 dermatomes because then additional loss of sensation would be present in upper forearm and arm. no other answer makes sense

An OTA employed at pediatric clinic for children with cerebral palsy participates in performance appraisal. OTA's supervisor identifies handling skills as an area needing improvement. Which is the most effect way for the OTA to improve handling skills? A. Observe an experienced occupational therapist using handling techniques with a diversity of children with cerebral palsy. B. Complete an extensive literature review of evidence-based practice for children with cerebral palsy C. Participate in a beginning level experiential course on handling skills with children with cerebral palsy. D. Attend a teleconference on handling skills for the child with cerebral palsy.

C. Participate in a beginning level experiential course on handling skills with children with cerebral palsy. Rationale: Participating in an experiential handling skills course provides opportunities to interact with other occupational therapy practitioners and benefit from visual and kinesthetic learning. Observing a skill is helpful but does not offer opportunity to develop hands-on skills and obtain feedback on the application of learned techniques. A literature review and a teleconference can cover a variety of information about best practices and handling techniques for children with cerebral palsy, However, these offer little opportunity to learn *handling skills, which is a hands-on competence* rather than knowledge-based.

An OTA employed at a day treatment center for clients with psychiatric disorders is conducting a leisure-planning group. The members of the group decide to take a day trip to the local sculpture garden. Which side effect of psychotropic medications is most important for the OTA to discuss preventative precautions with the group? A. Orthostatic hypotension. B. Akathisia. C. Photosensitivity. D. Tremors.

C. Photosensitivity. Rationale: Photosensitivity results in severe sunburn which can occur during an outdoor trip. The other options are potential side effects of medications, but they are not exacerbated by being outside.

9 y/o girl hospitalized w/ cystic fibrosis. Hospital does not have play area and has no other children. Which age-appropriate activity should OTA suggest for hospital volunteers to do with child? A. Dressing paper dolls. B. Coloring in coloring books. C. Playing card games. D. Cutting and pasting pictures on cards.

C. Playing card games. Rationale: Children aged 7-12 are developmentally able to participate in games with rules, competition, and social interaction. The other activities reflect creative play that is developed between ages 4 and 7. In addition, they are solitary activities and do not afford opportunities for competitive fun and socialization. Hospitalization can be lonely and frightening, so having volunteers play with the child can be psychologically beneficial, as well as developmentally appropriate.

OTA implements bed-positioning plan for Pt recovering from CVA. Pt is receiving care from family/personal care assistants employed by a home care agency. Which action should the OTA take to ensure the accurate implementation of this plan by the client's caregivers? A. Verbal step-by-step directions of the desired positions to the client's caregivers. B. Written step-by-step directions of the desired position on the wall by the client's bed. C. Post pictures of the desired positions next to the bed's headboard. D. Require each caregiver to demonstrate the replication of the desired positions.

C. Post pictures of the desired postions next to the bed's headboard. Rationale: A visual presentation of the exact positions desired can decrease any misinterpretations of a written description. Placing this picture next to the bed's headboard will ensure that it is visible to all caregivers. It is the most effective method provided to ensure compliance. Requiring demonstration would require OTA to access every care assistant which is unlikely.

An elementary age kid holds pencil with tightly held static tripod grasp. Which is the best approach to improve his grasp? A. perform all written work with a larger pencil and jumbo crayons on a horizontal surface. B. Take a break every 15 minutes while writing to open and close the hand several times. C. Practice moving coins from the fingertips to the palm and then from the palm to the fingertips. D. Write all written work on a vertical surface, such as an easel or classroom wall board.

C. Practice moving coins from the fingertips to the palm and then from the palm to the fingertips. Rationale: incorporation of finger-to-palm and palm-to-finger translations are in-hand manipulation skills that address the dynamic use of the fingers. Everything else does not address the issue or involves use of wrist elbow and shoulder movements rather than the needed finger movements to improve the static tripod grasp to a dynamic tripod grasp.

Left CVA patient with right arm affected. In which of the following positions should the OTA recommend the Pt's right affected arm be placed when the Pt is sleeping in side-lying on the unaffected side? A. In 90 degrees of humeral abduction and 15 degrees of internal rotation. B. On the person's side, adducted and internally rotated. C. Protracted with arm forward on a pillow and the elbow extended or slightly flexed. D. In 90 degrees of abduction of the humerus with neutral rotation.

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

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

C. Recommend a prosthesis with a myoelectrically controlled hand. Rationale: The best choice is a prosthesis that meets the teen's expressed need for a cosmetically appealing device which can also be used to perform functional age-appropriate bilateral fine motor activities, such as text messaging, or playing video games. A prosthesis with a myoelectrically controlled hand meets these goals. A prosthesis can be used for purely cosmetic reasons; however, it would be best to provide the teen with a device that he/she could use to increase functional performance. A passive cosmetic hand can be used for grasping large objects like a beach ball or to hold an object on a table, but has no moving parts for grasp and release; thus it would not be the most functional choice. Although a voluntary opening hook would enable the teen to perform functional activities, recommending this would not respect the teen's expressed desire for a cosmetically appealing device. Recommending counseling based on an interpretation of the teen's request as a preoccupation with body image is judgmental. This action also violates the person's rights of autonomy.

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

C. Redirect thoughts and energies into meaningful activities. Rationale: The focus of OT in a wellness program is to help individuals attain and maintain life satisfaction through the engagement in meaningful activities. Acting nonchalant, having low expectations, and setting limits on daily activities do not address the problem. Engaging in activities that can be broken down into simple steps is helpful for people with cognitive deficits. However, people with OCD typically do not have cognitive deficits. Therefore, the best choice is to redirect their thoughts and energies into meaningful activities as a behavior management strategy.

A child w/ a tactile defensive sensory modulation disorder attends a private early intervention clinic. The OTA collaborates with the child's parents to develop strategies and guidelines to help the child handle the symptoms of this disorder at home. Which is the best recommendation for the OTA to make to the parents? A. Avoid the use of swings and other moving equipment during play activities. B. Encourage the use of swings and other moving equipment during play activities. C. Soften the child's clothing by repeated laundering and remove clothing tags. D. Provide a variety of textures in the clothing the child wears.

C. Soften the child's clothing by repeated laundering and remove clothing tags. Rationale: Children w/ tactile defensive sensory modulation disorder find stiff clothing, textured clothing, and clothing tags aversive. The use or avoidance of swings and other moving play equipment is indicated for vestibular processing disorder.

On a bus at community integration group a member falls gets up and laughs says "good thing I bounce well". you should? A. cancel and go file an occurrence report B. Ask the bus driver to radio an ambulance C. continue activity and file report up return to group home D. Continue activities and ask client if they are having symptoms

C. continue and file the report later upon return to group home. Rationale: client is not injured and occurrence reports about minor events do not have to be filed immediately. Reporting symptoms are important but documentation is more important than the client's symptoms.

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

D. 18 inches wide by 16 inches deep. Rationale: To determine the width of a wheelchair seat, add 2 inches to the measurement of the widest point across hips and thighs. This allows for clearance on the sides to prevent rubbing and to allow the individual to wear heavier clothing without it being restrictive. To determine the depth of a wheelchair seat, 2 inches are substracted from the measurement of the length from the posterior portion of the buttocks to the popliteal fossa. This prevents rubbing and potential decubit formation in the posterior knee region, while also allowing maximum swing length. In the case, the person's measurements were 16"W x 18"L; therefore, the resulting seat measurement is 18"W x 16"D. +2 inches to width, -2 inches from length

A local pharmacy hires an OTA to consult on the redesign of the pharmacy's customer service area. Which height should the OTA recommend the pharmacy counter be no higher than? A. 29 inches B. 33 inches C. 35 inches D. 31 inches

D. 31 inches Rationale: The recommended maximal height for countertops is 31 inches, according to the American National Standards Institute (ANSI) guidelines for building and facilities. The other choices do no meet these criteria.

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

D. A rope ladder. Rationale: A rope ladder or bed loops enable the individual to loop the arm(s) into the first 'rung'/loop, and then into the next 'rung'/loop, and so on until he/she has achieved a sitting position. The bed rail assist is incorrect because it is used to get from sitting to standing and a log roll technique would require the assistance of another person.

An OTA provides bed mobility training for an individual recovering from a left CVA. The OTA notes that the person's right calf is swollen and warm. The person complains that it is painful. Which action should the OTA take initially? A. Elevate the leg and provide retrograde massage. B. Advise the person to tell the physician about the symptoms during the physician's next bedside visit. C. Continue with the training and inform the supervising occupational therapist about the symptoms after the session. D. Contact the charge nurse immediately to report symptoms.

D. Contact the charge nurse immediately to report symptoms. Rationale: The signs and symptoms in this scenario are indicative of a DVT. DVT, an inflammation of a vein in association with the formation of a thrombus, is often a complication of CVAs or the result of prolonged bed rest. DVT is a medical emergency that must be handled immediately by medical staff. While it would be appropriate to elevate the legs, massage is contraindicated. The other answers are inappropriate because they delay the acquisition of needed medical care.

most effective group leadership style for OTA working acute psychiatric inpatient for clients newly admitted to the unit? A. Advisory. B. Facilitative. C. Laissez faire. D. Directive.

D. Directive Rationale: Directive leadership involves the provision of structure, clear directions, and immediate and consistent feedback. These qualities are needed in a group whose members are acutely ill with psychiatric disorders.

A tool and die designer develops bilateral carpal tunnel syndrome. The local work hardening program does not have the exact equipment that the designer uses in the job setting. Which actions is best for the OTA to take in response to this situation? A. Refer the client to another work hardening program that has the equipment. B. Inform the occupational therapist about the need for equipment to duplicate the work setting. C. Perform some necessary aspects of rehabilitation in the client's work setting. D. Duplicate the job task components as closely as possible.

D. Duplicate the job task components as closely as possible. Rationale: Work hardening programs can use real or simulated tasks that duplicate, as closely as possible, the components of each client's job tasks. It is not realistic for all programs to have every possible piece of equipment related to client's job tasks. Consequently, OT practitioners become skilled at activity analysis and adept at simulating job tasks with the equipment that they have available. An OTA who is experienced in work hardening can provide effective intervention without equipment that exactly matches the client's work. Therefore, there is no reason to refer the client to another facility. A reason to refer the client to another facility is the therapy staff's lack of experience and inability to provide effective intervention. It may be helpful to perform some aspects of rehabilitation during a site visit, but the logistics of this can be difficult. The OTA's ability to provide intensive therapy in a work environment would likely be limited. Therefore, the best answer is to duplicate the job tasks in the clinic.

Graduate student with anxiety disorder reports feeling confused about the future. During eval client relates decreased feelings of competence for a chosen field of study and overall poor personal causation. Which is the best initial action for the OTA to take in response to the client's stated concerns? A. Administer a vocational interest inventory. B. Provide activities related to the client's chosen field of study. C. Refer the client to the state office of vocational and education services. D. Establish short-term goals with high potential for attainment.

D. Establish short-term goals with high potential for attainment. Rationale: Decreased personal causation and feelings of incompetence are common symptoms of anxiety disorders. Establishment of short-term goals with high potential for attainment can provide the individual with the success experiences needed to develop a sense of competence and improve personal causation. Once these skills are developed, the need for further vocational exploration and/or services can be determined.

Parent of 2 elementary school-aged children receives home car hospice services due to metastasized bone cancer. Pt has pain, poor endurance, and decreased strength. Requires mod assistance w/ self-care and dressing. Which is the best intervention for the OTA to incorporate into sessions with this parent? 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.

D. Exploring play activities for the parent to do with the children. Rationale: A major focus of hospice care is to maintain the individual's control over his/her life while enabling engagement in meaningful activities that are related to the person's valued roles. Although the person is dying, he/she is still a parent and will likely enjoy playing with his/her children when they're not in school. There are many play activities suitable for elementary school-aged children that can be completed by a person with decreased endurance/strength. Research has found that diversional activities can decrease intensity of one's pain experience. There is no indication of a need to train the client in techniques for self-care or dressing. The client is in pain and requires mod assist due to functional deficits. It is likely that the client will continue to need this assistance due to the fact that his/her cancer is at the terminal stage. Even w/ training in energy conservation or joint protection, the individual would still need assistance with these tasks due to the effects of advanced cancer. Biofeedback is not effective in managing pain that results from metastasized bone cancer.

Several newly homeless veterans w/ PTSD attend an OT community reentry group in a shelter. Which is the best primary focus of the initial group session? A. Development of home management skills such as meal preparation. B. Determination of financial assets and money management skills. C. Exploration of vocational interests and employment possibilities. D. Identification of local resources such as soup kitchens and thrift stores.

D. Identification of local resources such as soup kitchens and thrift stores. Rationale: Locating basic resources is the most essential survival skill listed. Initial sessions at a homeless shelter would likely focus on basic survival and personal self-care skills prior to focusing on vocational interests, employment opportunities, or instrumental activities of daily living (IADL), such as meal preparation and money management skills. Subsequent sessions may focus on the development of IADL and vocational skills.

An OTA applies for the position of activities program director in a SNF. During the job interview, the OTA discussess supervisory requirements for this position with the SNF administrator. Which amount of supervision should the OTA expect from an Occupational Therapist? A. Daily. B. Weekly. C. Monthly. D. None.

D. None. Rationale: According to AOTA standards of practice and Medicare guidelines, an OTA who works strictly as an activities program director is not providing OT. While OTAs who work as activities program directors 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, they are providing directorship to the SNF's activity program. Therefore, they do not require the supervision of an occupational therapist.

During a group session an older adult complains that everyone is mumbling. Which action should the OTA take after the group in response to these statements? A. Notify the client's physician that the person exhibited evidence of paranoia. B. Collaborate with the occupational therapist to remove groups from the client's intervention plan. C. Document objective data about the complaints in the person's charts. D. Notify the occupational therapist that the person may need an audiological evaluation.

D. Notify the occupational therapist that thep erson may need an audiological evaluation. Rationale: Hearing loss is common for old people. Complaints of mumbling are indicative of potential hearing loss that warrants further evaluation. Modifying the person's intervention plan to not include groups and documenting the individual's complaints does not deal directly with the issue (eat Sh*t)

Elementary aged child has Duchenne's muscular dystrophy. The family has goal of maintaining the child's leisure and social participation. Which is the best activity for the OTA to recommend the family pursue with this child? A. Electronic sports (e.g., Wii bowling). B. Adapted little league baseball. C. Wheelchair basketball. D. Recreational swimming.

D. Recreation swimming. Rationale: Recreational swimming is a social and leisure activity that the child can participate in with family members and friends. It can also be helpful in maintaining the child's functional level as long as possible. Even when the child's Duchenne's progresses, swimming can remain an activity that can be successfully pursued. The eye-hand coordination to play electronic sports game will likely be too difficult for the child with Duchenne's. Baseball and basketball also have mobility and coordination requirements that would be difficult for this child. Wheelchair use is typically not indicated for an elementary school-aged child with Duchenne's.

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

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

Pt of outpatient parenting skills group has history of serious recurrent depression and is taking Nardil. Pt complains of recurrent headaches and difficulty focusing during the day. (example: when helping children w/ homework)Which action is best for the OTA to make in response to the client's expressed concerns? A. Instruct client in stress reduction techniques. B. Ask group for suggestions on how to deal w/ parenting stress of homework. C. Suggest that individual consult w/ a nurse practitioner for headache relief strategies. D. Tell the client you will be notifying the psychiatrist of these complaints.

D. Tell the client you will be notifying the psychiatrist of these complaints. Rationale: Nardil is a monoamine oxidase inhibitor (MAOI). It has serious side effects when a person eats foods that contain the amino acid tyramine. Tyramine increases BP and may lead to stroke or other cardiovascular reaction. Headache and heart palpitations are the first sign of a problem. This must be considered a serious medical situation and the physician must be contacted. TO assume that the headaches are stress-related is dangerous. Suggesting that the person contact a nurse practitioner does not guarantee follow through. The individual needs to collaborate with the psychiatrist to determine if an MAOI is the best medication, given its restrictions. Chapter 10 in this text provides these restrictions.

Student w/ down syndrome and moderate intellectual disability does not each lunch during lunch hour due to distractions. You should? A. Schedule lunch to be in classroom to limit distractions B. Provide positive feedback for attending to eating at 10-minute intervals C. Practice role playing lunching conversations in the classroom D. Seat the student at a lunchroom table with one peer?

D. seat at table with one peer Rationale: allows for socialization without too many distractors.