NBCOT FULL EXAM

Which situation listed below warrants a referral to a driver rehabilitation specialist? a. A client's family member expresses concern about an older adult client's competence to drive a vehicle. b. A client who had a total hip replacement 2 months ago wants to resume driving after not driving since the date of surgery. c. A young adult client who has epilepsy wants to learn how to drive for the first time.

.A client's family member expresses concern about an older adult client's competence to drive a vehicle. Rationale Concerns about an older adult's competence to drive may indicate potential cognitive or physical impairments that could affect driving safety. A driver rehabilitation specialist can assess the older adult's driving abilities, recommend adaptive equipment or strategies if needed, and provide a comprehensive evaluation to ensure the individual's and public safety on the road

A 14-year-old adolescent with a progressive neurological condition has Good (4/5) functional strength of proximal upper extremities and Poor (2/5) strength distally. This interferes with the adolescent's ability to independently self-feed. Which assistive device would be MOST BENEFICIAL for the adolescent to use for maximizing independence while eating? A. Swivel spoon with an extended handle B. Universal cuff with hook-and-loop strap c. Utensil with a large built-up foam grip

A 14-year-old adolescent with a progressive neurological condition has Good (4/5) functional strength of proximal upper extremities and Poor (2/5) strength distally. This interferes with the adolescent's ability to independently self-feed. Which assistive device would be MOST BENEFICIAL for the adolescent to use for maximizing independence while eating? A. Swivel spoon with an extended handle B. Universal cuff with hook-and-loop strap c. Utensil with a large built-up foam grip

A client who has intention tremors of the dominant arm secondary to multiple sclerosis is learning compensatory strategies to use when typing on a computer keyboard. Which of the following strategies should the COTA use FIRST for promoting independence with keyboard tasks? a. Install an on-screen virtual keyboard to access with an alternative pointing system. b. Place a keyguard over the standard keyboard to allow only desired keys to be selected. c. Customize accessibility features that are built into the computer's operating system

A keyguard is an assistive device that helps individuals with tremors or other motor coordination issues by preventing accidental key presses. It ensures that only the intended key is pressed, which is important for someone with intention tremors who may have difficulty accurately hitting the keys. This solution addresses the motor issue directly and is a simple, immediate intervention.

A 6-year-old child has poor lip closure control secondary to hypotonia. The child is able to bring a cup to the mouth and initially provide suction on a straw, but becomes frustrated when liquid in the straw falls back into the cup. One of the intervention goals for the child is to independently drink from a cup with a straw. Which adaptive drinking aid would be MOST EFFECTIVE to support the child's progress toward this goal? a. Cup with sip spout and a clip-on straw holder b. Extra-long, wide diameter drinking straw c. Specialized straw with one-way valve

A specialized straw with a one-way valve allows the child to maintain suction and prevents the liquid from flowing back into the cup. This feature addresses the child's difficulty with lip closure control and prevents the frustration of liquid falling back into the cup. It would help the child to maintain the liquid in the straw while drinking, thus enabling more independent drinking and promoting the goal of drinking from a straw without needing additional assistance.

A resident in a long term care setting has Huntington's Chorea and severe cognitive decline. The nurse reports that the resident sits in a standard wheelchair most of the day Recently, a decrease in the resident's cognition, and an increase in involuntary, non- purposeful dyskinetic movements of the trunk and upper extremity have been hindering the staff's ability to maintain the resident's proper position in the wheelchair. Which seating option would be a beneficial alternative to the resident's current wheelchair? A. Lightweight chair with a custom contour seat cushion B. Reclining high-back power wheelchair C. Tilt-in space manual wheelchair

A tilt-in-space manual wheelchair is the best option for the following reasons: Improved Postural Stability: The tilt-in-space feature allows the entire seating system to tilt backward, which helps to counteract the resident's involuntary dyskinetic movements and reduces the risk of sliding out of the chair. Pressure Redistribution: Frequent repositioning through tilting redistributes pressure, reducing the risk of pressure ulcers, which is a concern for individuals spending extended periods in a wheelchair. Management of Involuntary Movements: The tilt-in-space wheelchair helps to maintain alignment and minimize the impact of excessive trunk and upper extremity movements associated with Huntington's Chorea. Safety and Cognitive Decline: A manual wheelchair allows for caregiver control of positioning and movement, which is critical given the resident's severe cognitive decline and inability to safely operate a power wheelchair.

A patient with secondary progressive multiple sclerosis is learning to use a utensil placed in a universal cuff for self-feeding. The patient requires minimal hand-over-hand assistance to load the utensil, and to bring the food from the plate and place it in the mouth. After swallowing a bite of food during the mealtime session, the patient coughs weakly several times, and speaks with a wet voice quality. What action should the COTA take in response to this observation? A) Consult with the supervising OTR prior to proceeding with the meal. B) Reposition the utensil so food is placed on the posterior part of the tongue. C) Have the patient complete a swallow with the chin tucked toward the chest. NBCOT

A wet voice and weak coughing after swallowing indicate potential dysphagia and difficulty clearing the airway effectively, which can lead to aspiration. The chin-tuck swallowing technique is a compensatory strategy that: Narrows the airway opening. Redirects food or liquid to reduce the risk of aspiration. Helps improve the safety of swallowing by enhancing airway protection.

A 17-month-old child who has fetal alcohol syndrome recently developed skills for maintaining an upright sitting position for several minutes at a time while unsupported. Which intervention activity would support the NEXT level of motor development while sitting? A) Ask the child to lean to one side to reach for a toy while straddling a cylindrical bolster. B) Encourage the child to throw a ball while seated cross-legged on a platform swing. C) Have the child raise both arms above the head in rhythm to music while sitting on the floor. NBCOT

A) Ask the child to lean to one side to reach for a toy while straddling a cylindrical bolster: This activity promotes lateral weight shifting and balance control, which are important for further developing sitting stability and motor skills.

A COTA is using a standard 360∘ goniometer to measure a client's elbow flexion. To obtain the MOST ACCURATE results, which steps should the COTA use as part of this procedure? select maximum of 3 choices A. Position the axis of the goniometer on the medial epicondyle of the humerus. B. Start with the client's arm fully extended at the side of the client's body. C. Align the stable arm of the goniometer with the midline of the humerus. E. Bend the arm at the elbow with the palm down and the forearm pronated. F. Stabilize the goniometer over the muscle belly of the brachioradialis. G. Ensure the moveable arm of the goniometer is parallel to the radius.

A. Position the axis of the goniometer on the medial epicondyle of the humerus. B. Start with the client's arm fully extended at the side of the client's body. C. Align the stable arm of the goniometer with the midline of the humerus.

A patient in a subacute rehabilitation facility who has COPD and coronary artery disease is scheduled to begin ADL sessions. The patient wants to return home and resume independent living. What information should the COTA gather at the start of the INITIAL session with this patient? SELECT 3 CHOICES A. Typical grooming and bathing routines the patient uses at home. B. Length of stay of recent exacerbations requiring inpatient hospital admission. C. Set-up of the patient's home including durable medical equipment. D. Nursing personnel assigned to assist the patient with daily bathing. E. Approximate time of the patient's most recent dosage of pain medication. F. Living situation and support structure available to the patient

A. Typical grooming and bathing routines the patient uses at home. Understanding the patient's current routines will help the COTA identify any challenges or modifications needed in the patient's ADL tasks. Since the patient wants to return to independent living, it is essential to assess their typical home routine to tailor interventions that reflect real-life needs. C. Set-up of the patient's home including durable medical equipment. Knowing the home environment (e.g., the layout of the home, available equipment like a shower chair or grab bars, etc.) is critical for understanding any safety concerns and to design interventions that align with the client's environment. This will also help in determining whether the patient requires any additional adaptive equipment to support independence in ADLs. F. Living situation and support structure available to the patient. Understanding the living situation and support system (family members, caregivers, etc.) will provide insight into the level of assistance the patient may need in the home after discharge. It will also help in determining if home modifications or additional caregiver training is required to facilitate a successful transition back to independent living.

A client who has a C2 (ASIA B) spinal cord injury wants to be able to turn on and off a light using a switch. Which factor is MOST IMPORTANT to consider when selecting a control interface for the client to meet this objective? A) Type of wireless technology available within the client's home B) Ease of the client's ability to physically operate the device C) Frequency of signal interference with other devices within the area

ASIA B - NO motor Only sensory

A 5-year-old child with recent onset of Type III spinal muscular atrophy has been in a children's hospital since the time of diagnosis 2 weeks ago. The child will be discharged home in the next few days to live with the parents and several siblings. Which information is MOST IMPORTANT for the COTA to report to the interprofessional team during the child's discharge planning meeting? a. Adaptive equipment recommendations b. Community-based support services c. IEP recommendations for return to school

Adaptive equipment recommendations Rationale Pt is going home from the hospital and IEP discharge

A 4-year-old child has age-appropriate motor skills, but communication, social play, and ADL skills are at a 2-year-old level. Which technique would be MOST BENEFICIAL to use with the child for promoting cognitive development for self-dressing? A )Allowing the child to play dress-up while offering visual cues as needed B) Having the child use a doll to practice putting on and taking off clothing C) Rewarding the child for each piece of clothing properly donned each morning D) Using a dressing board for training the child to button, zipper, and snap

Allowing the child to play dress-up while offering visual cues as needed Rationale This approach integrates play, which is essential for cognitive development at this age, and allows the child to practice self-dressing in an engaging and developmentally appropriate manner. Visual cues provide the necessary support to help the child learn and succeed, making the activity both fun and educational.

A client in an outpatient mental health clinic has successfully learned strategies to manage symptoms associated with post-traumatic stress disorder and is preparing for discharge from the program. The client lives independently and attends a software training program through vocational rehabilitation services. What action should the OT team take as part of the client's transition planning process? a. Teach the client how to use a desktop computer for use in the home environment. b. Develop a handout for the client listing potential environmental and social stressors. c. Provide the client with information about options and resources for term-78ongoing support.

As part of transition planning, it is critical to ensure the client has access to resources and support systems to maintain the progress made during treatment. Information about ongoing support options—such as peer support groups, community mental health services, or crisis hotlines—helps the client build resilience and confidence in managing potential challenges post-discharge.

A COTA working in a memory care unit is collaborating with an OTR to assess the dressing skills of a client who has severe cognitive decline due to Alzheimer's disease. Which context would be MOST conducive for obtaining information about the client's functional ability? a. Bedside during the typical facility care schedule b In the bathroom immediately after morning self-care routines c. At a time and in a setting most familiar to the client

At a time and in a setting most familiar to the client Rationale Assessing the client's dressing skills at a time and in a setting most familiar to them is likely to yield the most accurate information about their functional ability. Familiarity can help reduce confusion and anxiety, which can otherwise affect performance, especially in clients with severe cognitive decline due to Alzheimer's disease.

A young adult client sustained a C8 (ASIA A) spinal cord injury 8 months ago. Prior to the injury the client participated in a variety of outdoor adventure sports. During a session with the COTA, the client mentions an interest in learning adaptive strategies for resuming these activities. What action should the COTA take in response to learning this information? A) Discuss the influence of current physical limitations on participation in high-risk leisure activities. B) Arrange for the client to meet with an equipment vendor who specializes in sport wheelchairs. C) Provide the client with a list of community resources that support athletes with disabilities.

B) Arrange for the client to meet with an equipment vendor who specializes in sport wheelchairs.

An older adult inpatient in a rehabilitation setting is scheduled to participate in a bathing session. The patient requires assistance with transfers and uses durable medical equipment and adaptive devices. The OT aide is assigned to help the COTA during this session. Based on practice guidelines which task can the OT aide complete? A. Transfer patient to shower bench B. Gather necessary adaptive equipment C. Educate nursing on level of assist needed STOP HERE 11/25

B. Gather necessary adaptive equipment

A young adult client with a mild intellectual disability is participating in a work placement program. The work supervisor reports the client is typically late for work. What strategies should the COTA incorporate into the program to improve the client's on-time arrival at work? Choose the best 3 A. Advise the client to set an alarm watch to sound at the scheduled start time. B. Have the client list tasks that need to be completed each day before going to work. C. Introduce the client to the principles of energy conservation for reducing fatigue. D. Use a daily log to assist the client to prioritize daily tasks and routines. E. Help the client develop a plan for situations that may result in tardiness. F. Give the client a complete list of tasks that need to be performed each day

B. Have the client list tasks that need to be completed each day before going to work. D. Use a daily log to assist the client to prioritize daily tasks and routines. E. Help the client develop a plan for situations that may result in tardiness.

An adult client with quadriplegic cerebral palsy uses a power wheelchair and is planning an international vacation involving air travel. The COTA is assisting the client to plan ahead for the trip. As part of this process, the client has contacted the airlines and made arrangements for advanced boarding and assistance during the boarding process on the airplane. What additional action should the COTA recommend to the client related to traveling with the power wheelchair? Select 3 choices a. Place cushions and other loose accessories on the client's chair for storage during the flight b. Include basic wheelchair maintained tools on a packing list c. Identify a list of vocational vendors at that destination d. Advise airline staff to stow the client's chair in an onboard coat closet e. Request the wheelchair to be available during the flight to allow bathroom access f. Attach illustrated assembly and dissemble

B. Include basic wheelchair maintenance tools on a packing list It's important to have basic tools on hand in case of minor issues with the wheelchair during travel. These tools can help with quick fixes or adjustments, which may be necessary while away from home. A. Place cushions and other loose accessories on the client's chair for storage during the flight Loose accessories and cushions should be removed and stored separately during the flight to prevent damage or loss. This will also help to ensure the wheelchair is securely handled and that the client's comfort and posture needs are addressed upon arrival. F. Attach illustrated assembly and disassembly instructions to the wheelchair This ensures that anyone handling the wheelchair (e.g., airline staff or ground transportation personnel) can easily understand how to properly disassemble and reassemble the wheelchair, if necessary, for storage or transport.

A cota is leading a group at a community wellness center. The group is for individuals require a wheelchair for mobility and who have recently become new parents. What information is most important to include as part of the group? Best ways to position furniture and wall hangings in the infant's room Body mechanics to use when lifting an infant from various surfaces Types of activities to optimize parent infant bonding interaction

Body mechanics to use when lifting an infant from various surfaces. Proper body mechanics when lifting and handling an infant can prevent strain or injury to the parent,

A COTA is fabricating a short thumb spica orthosis for a client who has basal joint osteoarthritis. The primary purpose of the orthosis is to improve hand function while protecting the joint during activity. Which position is OPTIMAL for achieving this objective? A. Maximum palmar abduction of the first CMC joint with the thumb MCP joint in complete extension B. Slight thumb MCP joint flexion with the first CMC joint midway between palmar and radial abduction C. Maximum radial abduction of the first CMC joint with the thumb MCP joint in 25°- 30° of flexion

C. Maximum radial abduction of the first CMC joint with the thumb MCP joint in 25°- 30° of flexion

An OTR and a COTA are developing a plan to monitor intervention outcomes for a 3-year-old child who has a sensory modulation disorder. Observation in multiple contexts indicates the child is frequently preoccupied with sensory items and toys made of soft fabric. One of the intervention goals is to increase the child's participation in developmental play activities with peers. Which option is MOST BENEFICIAL to include as part of the plan for monitoring the child's progress over time? A) Checklist of games and toys that provide the optimal level of sensory arousal B) Method for tracking the frequency of sensory-seeking behaviors C) Schedule for administering a sensory integration screening each week

Checklist of games and toys that provide the optimal level of sensory arousal Rationale implementing a checklist of games and toys that provide the optimal level of sensory arousal allows for focused monitoring and adjustment of interventions to support the child's engagement and progress in developmental play activities with peers.

A 6-year-old child recently sustained a TBI and is preparing to transfer from a pediatric intensive care unit (ICU) to a general acute care unit. Currently, the child is functioning at Level III (Localized Response) on the Rancho Los Amigos scale and has hypertonicity in all four extremities. As part of the child's overall care plan, the COTA developed a positioning program that nursing and family are implementing in the ICU. Which action should the COTA take as part of the intervention planning process to support carry-over of the positioning program for this NEXT level of care? A) Develop a detailed description of the positioning program to place with the child's belongings. B) Ensure the family understands the importance of and purpose for the positioning program. C) Provide a verbal report to OT colleagues that includes the child's current positioning schedule

Develop a detailed description of the positioning program to place with the child's belongings. Rationale By developing a detailed description of the positioning program and ensuring it accompanies the child's belongings, the COTA supports seamless continuity of care and enhances the implementation of the positioning strategies crucial for the child's rehabilitation and comfort in the new care setting.

An inpatient, who is experiencing an acute manic episode, is participating in an activity group. The COTA asks each patient in the group to make a collage to express preferred hobbies and provides the group with supplies and a variety of magazines for pictures. After 15 minutes, the patient begins to wander around the room and does not make progress on the collage. What action should the COTA take to promote the patient's participation in the activity? A) Make sure that all supplies are within reach. B) Limit the number of available magazines. C) Provide a variety of preselected pictures

During an acute manic episode, individuals often exhibit high energy, distractibility, and difficulty sustaining attention. By providing preselected pictures, the COTA reduces the cognitive load required for decision-making and keeps the task manageable. This approach helps maintain focus and encourages participation without overwhelming the patient.

A student in the second grade has decreased strength and poor postural control that interferes with the student's handwriting skills. Which strategy would be MOST BENEFICIAL for supporting the student's handwriting development? • Arrange a desk area for the student to use away from other students. • Encourage whole-body movement activities prior to writing. • Have the student practice tracing enlarged letters of the alphabet. • Provide the student with letter formation worksheets for homework.

Encourage whole-body movement activities prior to writing. Encouraging whole-body movement activities prior to writing helps to improve overall postural control and core strength, which are essential for maintaining proper posture and stability during handwriting task

A school-based COTA is using a health promotion approach to support the school's anti-bullying initiatives. Which option would be MOST BENEFICIAL to implement for supporting this initiative when using this approach? a. Establish an after-school group for fostering friendship development and social participation. b. Initiate a play-based club to offer developmentally appropriate activities for interested students. c. Provide the classroom teacher with adaptive strategies to help deal with bullying behaviors

Establish an after-school group for fostering friendship development and social participation. Rationale This option directly addresses the social aspects of bullying by promoting positive interactions, friendship development, and social participation. It creates a supportive environment where students can build relationships and develop social skills, which can help reduce bullying behaviors and improve overall school climate

Pictured below are two children playing at a sand table. What type of play environment does this represent. a. constructive b. Pretend c. Exploratory

Exploratory Rationale Playing at a sand table typically involves exploring textures, experimenting with pouring and scooping sand, and discovering how objects interact with the sand. This type of play encourages sensory exploration and learning through hands-on experience.

An 8-year-old child has generalized dystonia and is depended on power wheelchair for all mobility. The child's parents recently purchased a modified wheelchair accessible van with automatic lift and lowered floor. The child remains seated in the wheelchair when traveling in a van. What action is contradicted when preparing the child to ride as a passenger in this vehicle? A. Fastening a standard seat belt across the child shoulder and lap. B. Positioning the wheelchair in the front facing position behind the front passenger seat. C. Using a wheelchair tie down to secure the wheelchair to the van floor.

Fastening a standard seat belt across the child shoulder and lap.

A COTA working in a hospital setting wants to search current evidence about intervention methods that can be incorporated into intervention sessions with patients. Which search method would be MOST BENEFICIAL to use for this purpose? Access information through an online social media platform. Read single-subject case studies written by clinical experts. Find studies based on systematic randomized control trials.

Find studies based on systematic randomized control trials.

An outpatient client who is a professional violinist has stopped playing the violin secondary to focal hand dystonia of the dominant upper extremity. The client wants to resume playing the violin but symptoms associated with the condition make it difficult. Which intervention would be MOST BENEFICIAL to support progress toward the client's goal? A. Attach an oversized rubber hand grip to the violin and to the bow. B. Place the violin in a vertical stand and learn to play the instrument in an upright position. C. Recommend the client purchase an extra-long bow and add an extension, if needed

Focal hand dystonia: This condition causes involuntary muscle contractions in the hand, making precise movements difficult. Hand grip modification: By adding an oversized rubber grip to both the violin and bow, the client can maintain a more relaxed hand position, reducing the strain that triggers dystonia symptoms

A COTA working in an acute pediatric hospital uses a variety of toys during developmental play therapy sessions. Which preventive measure is MOST IMPORTANT for the COTA to take after a child finishes using a toy? Follow facility policies and procedures for cleaning and disinfecting the toys. Wipe each toy with a cloth soaked in a diluted bleach and hot water solution. Place each toy in a separate plastic bag and follow procedures for sterilization.

Follow facility policies and procedures for cleaning and disinfecting the toys. In a hospital setting, infection control is paramount to prevent the spread of pathogens among vulnerable pediatric patient

A client who has incoordination of the dominant upper extremity secondary to Parkinson's disease is learning compensatory strategies to use when dialing on a smartphone. Which strategy would support the client's independence when using the phone? a. Increase the volume control to maximum level. b. Customize the screen settings to full brightness. c. Install an application to enlarge the size of the numeric buttons

For a client with Parkinson's disease and upper extremity incoordination, larger buttons on the smartphone will make it easier to select the correct number with less precision, reducing the impact of motor difficulties. This modification supports the client's ability to independently and accurately dial numbers.

A 15-year-old student in high school has autism spectrum disorder. The transition plan recently was updated to include the student's long-term independent living objective. After completion of high school, the student wants to move out of the parents' home and live alone in an apartment. Which intervention would be MOST BENEFICIAL to promote progress toward this objective? a. Assist the student in advocating for personal care supports. B. Encourage the student to identify a meal preparation goal. c. Help the student develop routines for daily living.

Help the student develop routines for daily living. Rationale Help the student develop routines for daily living.

A client who has an ulnar nerve injury works as an office clerk. Which manual task would be MOST DIFFICULT for this client to complete without using compensatory techniques? A) Holding several pieces of paper between the thumb and the index finger. B) Pressing down firmly with the palm of the hand on the top of a stapler. C) Pushing the drawer of a file cabinet closed using the proximal portion of the palm.

Holding several pieces of paper between the thumb and the index finger. Rationale An ulnar nerve injury typically affects the intrinsic muscles of the hand, leading to weakness in the interossei and the ulnar two lumbricals, which are essential for the fine motor control needed to hold items between the thumb and the index finger. This injury often results in difficulty with tasks that require precise grip and manipulation, making this task particularly challenging.

A client who has dementia attends an adult daycare program. The client has been participating in a daily current events group. The COTA notes that the client's frequency of interacting during the group has decreased over the past few sessions, and the client now has intermittent verbal outbursts that disrupt the group's discussion. What action should the COTA take based on this observation? a. Identify possible triggers for the change in level of interaction with others in the group. b. Ask the client direct questions to facilitate appropriate communication within the group. c. Provide immediate feedback during the group when the client demonstrates signs of agitation.

Identify possible triggers for the change in level of interaction with others in the group. Rationale This approach helps understand the underlying causes of the client's decreased interaction and verbal outbursts, allowing for more targeted and effective interventions. Identifying triggers can lead to better management strategies, helping the client participate more comfortably in the group

A patient was admitted to an intensive care unit 3 days ago with acute respiratory failure. Medical history is significant for severe rheumatoid arthritis diagnosed 3 years ago. The OTR and COTA are collaborating to develop a restorative program that a nursing aid will use with the patient to support functional mobility until the patient is medically able to participate in ADL sessions. What information should be included as part of this program? a. Active assistive ROM prior to the scheduled Moring self-care routines b. Active ROM of bilateral upper extremities using a series of progressive activities c. Gentle passive ROM of the involved joint several times a day

In patients with severe rheumatoid arthritis, especially in an acute setting, joint inflammation and pain can limit the ability to perform active range of motion exercises. Gentle passive range of motion (ROM) is appropriate for maintaining joint mobility and preventing further stiffness or contractures while avoiding strain on the joints. This technique should be performed slowly and carefully, ensuring that the patient is not overstressed during the process.

What is the PRIMARY purpose for teaching a client who has subacute rheumatoid arthritis to use the assistive device picture below? a. To protect the hand from slipping onto the blade b. To increase leverage for slicing hard to cut foods. c. To reduce deformities forces on the MCP joints

In subacute rheumatoid arthritis, joint protection is a key principle to minimize stress on inflamed or weakened joints. An adaptive knife handle, like the one described, is designed to reduce deforming forces on the MCP joints by enabling a more neutral grip and reducing the strain placed on these joints during tasks such as cutting. This helps prevent exacerbation of joint deformities commonly seen in rheumatoid arthritis.

A 5-year-old child recently underwent treatment for a severe gastrointestinal illness. Despite a full recovery, the child refuses to eat. The parents report that prior to the illness, the child was not a picky eater. One of the intervention goals is for the child to resume eating a Varity of food types. Which behavioral management technique would be MOST EFFECTIVE for promoting incremental improvements for supporting progress toward this goal? a. Have the child select several foods to taste from a list of preferred foods. b. Introduce one type of nutritious food at a time until acceptance is achieved c. Provide motivating reinforcements to the child during mealtime sessions.

Introduce one type of nutritious food at a time until acceptance is achieved Rationale This approach allows for systematic exposure to new foods while focusing on acceptance and gradual adjustment to different flavors and textures. I

A 2-year-old child with Down syndrome has an oral-motor deficit resulting in ineffective chewing skills. The child is not eating solid food but is able to safely swallow liquids from a bottle with a standard nipple. One of the intervention goals is to improve the child's oral-motor control for chewing solid food. Which type of solid food texture should be introduced to the child at the start of a feeding program? a. Finely chopped fork mashed c. Smooth pureed

Introducing smooth pureed foods is typically the first step in transitioning a child from liquids to solid foods when they have oral-motor difficulties

Several students in a preschool class are having difficulty tracing lines and forming the letters of their own names using the correct direction and sequence. The teacher asks the COTA for activity suggestions to help improve the students' pre-writing skills. The COTA observes the students during classroom activities and determines they are kinesthetic learners. Which activity is MOST EFFECTIVE for the COTA to recommend when supporting the students' learning style? a. Have the students use their fingers to draw letter shapes in the air with hand-over-hand assistance as needed. kinetics b. Provide each student with a colorful worksheet to connect dots that form the shape of the letters in their name. -visual c. Teach the students a descriptive story about letter formation that they can recite each time they form a letter. -audio

Kinesthetic learners benefit most from hands-on, movement-based activities that engage their physical senses. Air tracing allows students to use large motor movements, which can help reinforce the correct direction and sequence for forming letters. Hand-over-hand assistance provides additional tactile and proprioceptive feedback, further supporting their learning style.

A -4 year old child with spastic diplegia had level 2 motor performance for gross motor and manual abilities. The child attends Preschool and wants to be able to play independently in the gym and on the school based playground with peers. Which adaptive equipment would be MOST BENEFICAL for the COTA to recommend to promote progress toward this goal. a. Lightweight self-propel mobile stander b. Modified tricyle with build up pedals c. Riding a toy with a parent-guided handle

Lightweight self-propel mobile stander Rationale Promotes independence: A lightweight self-propel mobile stander allows the child to move around independently in different environments, including the gym and playground. Supports standing and mobility: This equipment helps in weight-bearing and facilitates mobility, which is beneficial for gross motor skill development in children with spastic diplegia. Versatility: It can be used in various settings, providing the child with opportunities to engage in play activities with peers while standing, which is crucial for social interaction and participation.

An adolescent with a mild intellectual disability wants to be able to prepare meals independently. One of the short-term goals is for the adolescent to learn how to use a microwave oven to heat a prepared frozen meal. Which contextual strategy would be MOST BENEFICIAL for supporting the adolescent's success with this task? Mask unnecessary microwave oven operation buttons and adhere pertinent pictures to the exposed buttons. Provide a checklist for the adolescent to refer to when using the microwave oven for meal preparation. Teach the adolescent to use a thermometer to ensure the food has reached the appropriate internal temperature.

Mask unnecessary microwave oven operation buttons and adhere pertinent pictures to the exposed buttons.

Which symptoms typically present the GREATEST barrier to full participation in daily habits and routines for an adolescent who has a diagnosis of cyclothymic disorder? a. Multiple depressive and hypomanic episodes b. Persistent low mood and restless behavior c. Pervasive mistrust and auditory hallucinations

Multiple depressive and hypomanic episodes. Rationale Cyclothymic disorder is characterized by fluctuations between periods of hypomanic symptoms (elevated mood, increased energy) and depressive symptoms (low mood, decreased energy).

A student in kindergarten has myelomeningocele at the T4-T6 level. One of the intervention goals is to increase the student's peer interactions on the school playground during recess. Which mobility option would be MOST CONSISTENT with the student's expected level of function? a. Ambulate on poured-in synthetic surfaces while wearing a thoracic-hip-knee-ankle orthosis. b. Operate a power wheelchair that has a joystick control and lateral trunk supports. c. Walk with platform crutches on a flat surface on uneven terrain while wearing an ankle and foot orthosis.

Operate a power wheelchair that has a joystick control and lateral trunk supports. Rationale This option provides the student with the most practical and supportive means of mobility, allowing independent movement on the playground without the physical strain of ambulation. The joystick control and lateral trunk supports ensure safe and comfortable operation, enabling the student to focus on social interactions and play activities with peers during recess. myelomeningocele s a birth defect that occurs when the spinal cord and spinal canal don't close properly before birth. It's the most severe form of spina bifida.

A client has joint stiffness of both hands secondary to osteoarthritis. The COTA, who is service competent in using physical agent modalities, is applying paraffin as an adjunct to activity with this client. What is the recommended time frame for the application of the paraffin modality? a. 5-10 min b. 15-20 min c. 25-30 min

Paraffin baths are commonly used for joint stiffness, particularly in conditions like osteoarthritis, as they provide heat and help increase tissue flexibility. The typical duration for paraffin application is 15-20 minutes, which is enough time to achieve therapeutic effects like improved blood circulation, reduced joint stiffness, and enhanced flexibility without risking burns or tissue damage.

An OTR and a COTA are collaborating to complete the initial assessment of a student in kindergarten who recently diagnosed with autism spectrum disorder. Which information would be MOST BENEFICAL to obtain the parents as a part of this process.? A. Frequency at which stereotypical behaviors associated with this diagnosis occurs at home B. Performance patterns the student typically uses during routine daily activities at home C. Techniques the parents find effective to use at home for managing the student's behavior

Performance patterns the student typically uses during routine daily activities at home Rationale Understanding how the student engages in daily activities at home can provide crucial information about their functional abilities, preferences, challenges, and routines. This information helps occupational therapists and certified occupational therapy assistants (COTAs) tailor interventions and strategies that support the student's participation and independence in school settings and daily life.

A 5-year-old child with mild developmental delay has poor in-hand manipulation skills. During a drawing activity, the child picks up a crayon with the right hand and then uses the left hand to reposition the crayon in the right hand before starting to draw. Based on this observation, which activity would be MOST BENEFICIAL to include as part of the intervention for supporting age-appropriate in-hand manipulation skill development? Cutting paper into strips for a craft project using blunt-tip scissors Picking up a puzzle piece and placing it into the jigsaw puzzle Turning the pages of a picture book and searching for key items

Picking up a puzzle piece and placing it into the jigsaw puzzle

A 2-year-old child has hypotonia resulting in developmental delay. Currently, the child has good head control, can roll from supine to prone, and shifts weight from side to side in prone. One of the intervention goals is for the child to master movement in a quadruped position. Which facilitation activity is MOST BENEFICIAL to include as part of the initial intervention for progressing toward this goal? Have the child reach for a toy with alternating hands while lying in prone over a therapy ball that is 31 inches (78.74 cm) in diameter. Place the child in a hands-and-knees position on the floor while providing stabilization at the pelvis. Position the child in prone on a wedge cushion on the floor to provide joint approximation on propped arms.

Place the child in a hands-and-knees position on the floor while providing stabilization at the pelvis. Placing the child in a hands-and-knees position on the floor with pelvic stabilization helps promote the development of weight-bearing through the arms and shoulders, which is essential for transitioning to a quadruped position

A 4-year-old child has poor motor coordination and limited trunk control secondary to Dandy-Walker syndrome. In preparation for a play session, the COTA positions the child in a standing frame that has a contoured head support, an attached tray table, and an adjustable foot support. When the child is in a full upright position, the child's head falls into forward flexion. Which action should the COTA take to facilitate the child's ability to participate in the play session? a. Place the stander in a slightly recline position b. Remove the head support from the stander c. Tilt the tray table to a 45 degree incline in relation to the torso

Placing the stander in a slightly reclined position can help to support the child's head and maintain a more neutral alignment of the spine and neck.

What is the most important action for the COTA to take FIRST when molding heated thermoplastic material during fabrication of a hand-based orthotic? a. Let the material cool so that it can be placed on the skin and tolerated by the client b. Position the client's forearm in supination to allow gravity to help mold the material c. Ensure that the material is properly aligned with the palmar arches for the hand and creases

Position the client's forearm in supination to allow gravity to help mold the material Rationale Positioning the forearm in supination helps achieve a neutral wrist position, which is crucial for ensuring the orthotic fits correctly and provides effective support and function for the client's hand and wrist. This step ensures that the orthotic molding process starts with the proper alignment and positioning, setting the stage for a successful outcome

A client who has Parkinson's disease, hypertension, coronary artery disease, and diabetes mellitus is participating in home health OT. The client is independently able to complete functional transfers, but has fallen several times without sustaining significant injury. Which factor is MOST IMPORTANT for the COTA to consider when gathering information about the client's fall risk? A) Availability of funding to purchase durable medical equipment B) possibility of medication side effects due to polypharmacy C) Client's ability to select and put on well-fitted footwear

Possibility of medication side effects due to polypharmacy Rationale Clients with multiple chronic conditions like Parkinson's disease, hypertension, coronary artery disease, and diabetes mellitus often take multiple medications, which increases the risk of side effects such as dizziness, hypotension, and balance issues, all of which can contribute significantly to fall risk. Assessing the impact of polypharmacy is crucial in understanding and mitigating the client's fall risk.

Over the last several months, an adolescent with autism has made a significant progress independently performing grooming routine. The adolescent is motivated by these successes but continues to become frustrated with facial shaving. Despite watching videos of the tasks and trying to imitate others, the adolescent has not mastered the skill. Which technique would be MOST EFFECTIVE to include as a part of the intervention to support progress toward the adolescent independence with facial shaving? a. Offer step-by step verbal instructions until the adolescent able to routinely shave in a daily basis b. Post sequential picture cards illustrating each step of shaving task on the adolescent bathroom mirror c. Provide assistance with the initial steps of shaving and support the adolescent to perform the last step

Post sequential picture cards illustrating each step of shaving task on the adolescent bathroom mirror Rationale By having the picture cards on the bathroom mirror, the adolescent can easily follow each step in sequence, promoting independence and confidence in mastering the skill of facial shaving over time.

A young adult client has progressive limb girdle muscular dystrophy. The client has had a recent decline in function resulting in poor head and neck control and has developed a chronic pressure ulcer on the sacrum from sitting in a poorly fitted standard wheelchair. When selecting a new wheelchair for this client, what feature is MOST IMPORTANT to include as a part of the wheelchair design? A. Reclining back with a seatback angle that opens to 170 degrees B. Lightweight frame with fixed 90 degrees hip, knee and ankle sitting position C. Tilt-in-Space seat with tilt ranges from 45 to 65 degrees

Pressure Redistribution: The tilt-in-space feature allows the entire seating system to tilt backward while maintaining the same hip, knee, and ankle angles. This redistributes pressure away from the sacrum to reduce the risk of worsening or developing additional pressure ulcers.

A patient in a hospital setting has pneumonia and is participating in an ADL session while seated in a recliner at the bedside. During a grooming activity, the patient becomes short of breath. In addition to calling for the patient's nurse, what IMMEDIATE action should the COTA take? A: Provide the patient with maximal assistance to transfer to the bed and position the head of the bed at a 30° angle B: Have the patient bend forward slightly at the waist and lean through the forearms on an overbed table .C: Administer oxygen through a nasal cannula and monitor oxygen saturation levels using a pulse oximeter

Priority is airway management: When a patient experiences shortness of breath, the primary concern is to optimize their breathing by positioning them in a way that facilitates lung expansion. Elevating the head of the bed helps achieve this. Immediate action needed: Transferring the patient to the bed and adjusting the head of the bed can be done quickly, which is crucial in a situation where the patient is having difficulty breathing.

A 5-year-old child has hypersensitivity to clothing textures secondary to tactile defensiveness and is only willing to wear the same shirt and pair of pants each day. The child has verbal outbursts, cries, and becomes physically aggressive when the parent attempts to dress the child in any other clothing. One of the intervention goals is for the child to dress without triggering these behaviors. Which strategy is MOST EFFECTIVE for supporting this goal? A) Help the child self-select daily outfits from similar clothing texture options. B) Problem solve clothing options that meet the child's sensory based needs. C) Recommend the parent launder the child's pants and shirt each evening.

Problem solve clothing options that meet the child's sensory based needs Rationale By identifying and selecting clothing options that align with the child's sensory preferences and needs, you can help reduce the discomfort and distress associated with tactile defensiveness. This approach involves understanding the child's specific sensory triggers and finding clothing that is more acceptable to them, which can ultimately support the child in expanding their wardrobe choices in a way that feels safe and comfortable.

A hospital-wide interprofessional continuous quality improvement (CQI) committee has identified customer satisfaction as an opportunity for improvement. As part of this team, the COTA is responsible for contributing customer satisfaction information specifically related to OT services. After discussing the initiative with the OTR manager, what should the COTA do NEXT to contribute to this process? A. Understand the current level of satisfaction with OT service delivery and outcomes. B. Develop a customer satisfaction survey to send to patients recently discharged from OT. C. Initiate a process improvement plan for the OT clinic designed to reduce customer dissatisfaction NBCOT

Rationale Before designing a customer satisfaction survey, the COTA needs to gather baseline data to identify areas where improvements can be made. This involves reviewing existing feedback mechanisms, analyzing patient charts, and potentially conducting preliminary interviews to gain insights into current patient perceptions of OT services

A client in an outpatient setting has generalized debilitation with Fair minus (3/5) functional muscle strength in both upper extremities following a prolonged hospital stay for pneumonia. One of the client's goals is to complete personal grooming tasks such as brushing and styling hair independently. Which activity would be MOST EFFECTIVE to include as part of a strengthening program for supporting progress toward this goal? a. Ask the client to repetitively reach for an object positioned overhead while providing assistance to guide the arm through the full ROM. b. Have the client complete isometric contractions of the upper arm for 10 second intervals intermittently throughout the day. c. Provide the client with a structured program of light resistance therapy band exercises for the elbow and shoulder.

Rationale Since the client has Fair minus (3/5) muscle strength, they have some strength but are not yet able to perform tasks requiring more strength or endurance. A structured resistance program is essential for building muscle strength and endurance in the upper extremities. Using light resistance therapy bands will provide progressive resistance to the elbow and shoulder muscles, which are critical for performing grooming tasks. This approach helps to gradually increase muscle strength and improve functional performance in daily activities like brushing and styling hair..

An inpatient was admitted to a psychiatric facility 3 days ago for treatment of depression. The patient has low self-esteem and difficulty making decisions. Which type of activity would be MOST BENEFICIAL for this patient during the initial phases of recovery? A. Physically challenging tasks B. Routine, familiar tasks C. Socially engaging tasks D. Timed, multi-step tasks

Routine and familiar tasks can provide a sense of stability, comfort, and accomplishment. These types of activities can help build confidence and gradually improve the patient's ability to make decisions without overwhelming them, which is particularly important for someone with low self-esteem and difficulty making decisions.

A COTA is fabricating an orthosis to increase wrist ROM of a 9-year-old child who has a 20° flexion contracture of the wrist secondary to arthrogryposis. Which type of orthosis would be OPTIMAL to use as an adjunct to a home stretching program for achieving this objective? Dynamic mobilization orthosis Nonarticular orthosis Serial static immobilization orthosis

Serial static immobilization orthosis

An adolescent patient in a rehabilitation setting recently sustained a C6 (ASIA B) spinal cord injury. The patient is learning to transfer from the bed to the wheelchair. Which transfer method is MOST BENEFICIAL to teach this patient to use based on the expected functional outcome for this injury? A) Bent pivot B) Sliding board C) Stand pivot

Sliding board Rationale For a patient with a C6 spinal cord injury, the sliding board transfer is typically the most appropriate method. This injury level usually allows for some shoulder, elbow, and wrist movement, but limited hand function, making a sliding board an effective tool to bridge the gap between surfaces and facilitate a safe transfer

A COTA is helping a kindergarten student who has autism spectrum disorder establish routines for following classroom expectations. Each morning, the teacher expects each student to hang up his or her coat and backpack on a hook in the closet before proceeding to a designated play area of the classroom. Instead of following this routine, the student typically walks directly to the play area after entering the classroom. Which strategy would be MOST EFFECTIVE to include as part of the intervention for helping the student follow the morning routine? A) Advise the caregiver to bring the student to the classroom 15 minutes early each morning for additional assistance. B) Help the student create a social story about following the rules that the teacher establishes for the classroom. C) Use the student's favorite superhero to decorate a specific hanging space close to the classroom door.

Social stories are a well-established intervention for children with autism spectrum disorder (ASD) that can effectively teach and reinforce appropriate behaviors in specific situations. By creating a social story tailored to the child, the COTA can provide a clear, visual, and structured explanation of the morning routine. This approach helps the student understand expectations and reduces anxiety by clarifying what they need to do.

A COTA wants to use current evidence to learn more about the benefits of using assistive technology for pediatric clients who have a progressive neurological condition. The COTA found very few randomized controlled trials in the literature related to assistive technology and this pediatric population. Based on this finding, which level of evidence would provide the BEST information to meet the COTA's needs? A. Expert opinions of board-certified pediatric clinicians B. Practice guidelines for the pediatric population C. Systematic scoping review from a variety of source

Systematic scoping review from a variety of source

A student in kindergarten has hypotonia and poor trunk control secondary to Down syndrome. When sitting on the floor, the student typically positions the legs in a W-sitting pattern. One of the intervention goals is for the student to begin using a more developmentally appropriate position when sitting on the floor to minimize potential problems associated with the student's current preferred position. Which floor-sitting position is BEST for meeting this objective? a. Long-sitting b. Side-sitting c. Tailor-sitting NBCOT

Tailor sitting Rationale Criss cross apple sauce / Indian style

A hospital-based OTR and COTA are collaborating to reevaluate a patient who has Parkinson's disease. Which task can the COTA complete as part of the information gathering process? a. Analyze the findings of a quality of life inventory b. Interpret the results of an ADL assessment c. Administer a standardized test of cognitive function

The COTA can administer standardized assessments as part of the reevaluation process, provided they have demonstrated competency in using the specific assessment tool. Administering tests and gathering objective data fall within the scope of a COTA's practice, though the interpretation of results is the responsibility of the OTR.

A COTA working in an outpatient behavioral health program is using the Model of Human Occupation (MOHO) to guide activity selection for a young adult client has borderline personality disorder. The client engages in self-cutting behaviors several times when alone at home. One of the client's goals is to develop strategies to decrease the frequency of these behaviors. Which activity represents the MOHO approach for supporting this goal? A. Assist the client to identify leisure activities that can be integrated into daily and weekly routines B. Instruct the client in the benefits of changing preconceived attitudes and perspective on self-image C. Provide the client with a list of positive affirmation to use intermittently throughout the day

The Model of Human Occupation emphasizes the importance of meaningful activities ("occupations") in a person's life and how they can be used to address challenges and improve well-being.

A COTA employed in private practice is providing home-based services for a child who has attention deficit hyperactivity disorder (ADHD). One of the intervention goals is to develop strategies for completing homework assignments. When documenting the child's progress toward this goal, which information is BEST to include in the "O" section of the SOAP note? a. The child frequently looks around the room and requires verbal redirection to complete homework. b. The child is able to attend to worksheet assignments for 5 minutes without getting distracted. c. The child often drops the pencil on the floor or desk during writing assignments

The child is able to attend to worksheet assignments for 5 minutes without getting distracted. Rationale which is essential for the "O" section of a SOAP note. It directly relates to the intervention goal of developing strategies for completing homework assignments.

A 10-year-old child has spastic quadriplegia and is non-verbal. The child is learning to use an augmentative and alternative communication (AAC) word completion system for the first time. This requires the child to use head-turning to activate the control interface. During the initial trial, the child is able to activate the device, but the voice-output message produced is not understandable. Which activity should the COTA have the child practice FIRST to refine the skills needed to operate the AAC? a. Providing time-dependent choices using symbols instead of words b. Playing with a switch activated toy master point and click options c. Using the head switch to express simple messages and intentions

The child is already able to activate the device, but the voice-output message is not understandable. This suggests that the primary focus should be on refining the child's ability to accurately use the head-turning motion to select the intended options. Practicing with simple messages or intentions will help the child become more comfortable and precise in using the head-switch to communicate clearly, gradually improving the accuracy of the message output.

A 10-year-old child has poor motor control and incoordination of the dominant upper extremity secondary to a cerebellar brain tumor. One of the goals is to help the child independently complete a grooming routine. Which assistive device would be MOST BENEFICIAL for the child to use for supporting this goal? a. Hairbrush with an extended handle b. Nail clippers with a suction cup base c. Toothbrush with a contoured grip

The child's cerebellar brain tumor has resulted in poor motor control and incoordination, which can make grooming tasks such as brushing hair challenging. A hairbrush with an extended handle would provide the child with additional leverage and stability, making it easier to hold and manipulate the brush, which can help improve the child's ability to independently complete the grooming task.

An OTR and COTA are establishing a long term goal to be achieved in 8 weeks time for a home health client who had a total hip replacement 7 days ago. The client is having an uncomplicated post-operative recovery, is on partial weight-bearing status, and is following prescribed total hip precautions. Currently, the client ambulates with a walker, avoids bearing any weight on the affected leg due to fear of pain, and requires moderate assistance with transfers. Which statement represents an achievable long-term goal to include as part of the intervention plan for this client? The client will demonstrate full weight bearing through the affected lower extremity during all functional transfers. The client will complete toilet transfers at modified independent level 100% of the time with a standard walker. The client will be able to verbalize 3-4 pain management strategies typically used during the toileting routine.

The client will demonstrate full weight bearing through the affected lower extremity during all functional transfers.

A client who has schizophrenia is attending a community-based program that operates using a clubhouse model. Which type of intervention would BEST support the client's engagement in occupation when using this model? Independent living skills activities developed jointly by program members and OT staff ? Work skills classes that follow a step-wise protocol and workbook of activity assignments Interpersonal skill development guided by outcomes of standardized assessments

The clubhouse model emphasizes collaboration, empowerment, and community involvement, making it distinct from more structured or prescriptive models. In this model, members of the program (clients) actively participate in the design and execution of their activities, fostering a sense of ownership, engagement, and meaningful participation in daily life. By jointly developing independent living skills with the OT staff, the client can gain practical skills while being supported in a way that emphasizes autonomy and active participation, both of which are key principles in the clubhouse model.

A 10-year-old child who sustained a TBI 3 weeks ago has made significant progress in an inpatient pediatric rehabilitation setting, but mild cognitive and physical deficits persist. The child will be discharged home to live with family in several days and will be transitioning back to school as soon as possible. What role does the inpatient OT team have in supporting the child's transition back to school? a. Communicate with the special education team regarding the child's needs. b. Complete the initial paperwork for services under section 504 of the IDEA. c. Provide the IEP team with unmet goals to carry over in the school environment.

The inpatient occupational therapy (OT) team plays an important role in facilitating a smooth transition for a child with a traumatic brain injury (TBI) returning to school. While the OT team does not directly manage or initiate school-based services, they can provide critical information to the school team about the child's current abilities, challenges, and strategies that have been effective during rehabilitation. This communication supports the school in developing an appropriate plan for accommodations and interventions.

A high school student who has a mild cognitive impairment participates in a transition preparation group as part of an Individualized Education Program (IEP). During the past several sessions, the student has refused to participate in the planned activities. Which action would be MOST BENEFICIAL for the COTA to take in response to the student's refusal? a. Advise the student that participation in the program activities is legal requirement b. Recommend the student be discharged from services during the next IEP meeting c. Provide the student with a list of alternative activities related to the intervention goals

This approach respects the student's autonomy while still encouraging engagement in activities related to their transition preparation

During a meal preparation session in a geropsychiatric facility, a resident who has chronic schizophrenia is preparing cupcakes from a box mix. While stirring the batter, the resident steps away from the kitchen counter and exclaims that there are spiders in the batter. What action should the COTA take to redirect the resident? Reassure the resident that the lumps in the batter are from the dry mix. Ask the resident to begin placing cupcake liners in the baking pan. Tell the resident to continue the baking task because the vision is not real.

This response acknowledges the resident's experience while providing reassurance and grounding in reality.

A COTA employed in an industrial rehabilitation setting is reviewing the results of a functional capacity evaluation (FCE) of a client who is scheduled to participate in a work hardening program. What is the PRIMARY purpose for reviewing the FCE prior to the start of the program? a. To learn the client's physical abilities based on expected job duties and demands. b. To provide the client's physician a recommendation for the duration of medical leave. c. To understand the workers' compensation laws that impact the client's plan of care.

To learn the client's physical abilities based on expected job duties and demands

A 4-year-old child has spastic quadriplegic cerebral palsy and is dependent on caregivers for all aspects of bathing. The child's parents indicate that it is becoming difficult to wash the child in the home bathtub and ask the COTA about available equipment options that would make this task more manageable. Which equipment should the COTA recommend placing in the tub to support safe bathing? A) Bath transfer bench with a nonskid seating surface B) Hammock chair with suction feet and head support C) Trunk support ring with a molded back and adjustable legs

Trunk support ring with a molded back and adjustable legs Rationale Trunk support ring: This type of equipment provides essential support around the child's trunk, which can help maintain proper sitting posture and prevent slumping during bathing. Molded back: A molded backrest offers stability and comfort, crucial for a child with limited muscle control and spasticity. Adjustable legs: These allow for customization to fit the child's height and the bathtub's dimensions, ensuring optimal positioning and safety.

A client in an outpatient setting has amyotrophic lateral sclerosis. The client has spasticity of the dominant upper extremity with Grade 3 tone as measured by the Modified Ashworth Scale. The client is learning inhibitory strategies to use as part of an upper body dressing program. Which technique would be MOST EFFECTIVE to teach the patient to use at the start of a dressing task to support independence with putting on front-opening clothing? A) Sustained stretch of the elbow, hand, and finger flexors for 8 - 10 minutes B ) Vibration and manual tapping on primary agonists for 5 - 10 seconds C) Rapidly alternating flexion and extension movements for 10 - 15 repetitions

Vibration and manual tapping are both well-documented inhibitory techniques that work quickly to reduce muscle tone and promote relaxation. These techniques help to prepare the agonist muscles for functional tasks like dressing, making them the most suitable choice for preparing the upper extremities to perform tasks like putting on front-opening clothing.

A 10-year-old child sustained a TBI several days ago and is functioning at Level VI (Confused, Appropriate) on the Rancho Los Amigos scale. One of the inpatient rehabilitation goals is for the child to bathe independently. Which approach is MOST EFFECTIVE for facilitating success with bathing tasks based on the child's current cognitive level? Have the child follow sequential picture cards for each bathing task. Provide intermittent verbal instructions throughout the bathing activity. Use hand-over-hand assistance for each step of the bathing routine.

Visual Support: Children at Rancho Level VI benefit from visual cues and structured routines. Sequential picture cards provide clear visual guidance, which helps the child understand and follow each step of the bathing routine.

A resident of a skilled nursing facility had a resection of a brain tumor of the left parietal lobe. During ADL sessions, the COTA observes that the resident is unable to find toiletry items on the bathroom sink counter, despite using adequate scanning techniques. The COTA suspects that the resident has visual agnosia and plans to incorporate strategies into the intervention to compensate for this deficit. Which strategy would be MOST BENEFICIAL to use for this purpose? a. Position typically used toiletry items in the resident's right visual field. b. Adhere large print labels to the toiletry items the resident typically uses. c. Teach the resident to use other senses such as touch to locate toiletry items

Visual agnosia is a condition in which a person has difficulty recognizing objects despite having intact vision. Since the resident is already using adequate scanning techniques but is still unable to identify items, relying on touch to identify the shape, texture, or position of toiletry items can be an effective compensatory strategy. This approach can help the resident navigate the environment without solely relying on visual input, particularly when visual recognition is impaired.

An OTR and a COTA are developing a discharge plan for an inpatient who was recently diagnosed with schizophrenia. Prior to this admission, the patient was independent in all ADL and lived alone, but now requires 24-hour supervision. The patient will be discharged to live with a parent who will be the primary caregiver. What questions would be beneficial to ask the caregiver when gathering information to contribute to the discharge plan? A) What is included in your typical daily routines? B) Will this change in living arrangement influence your current lifestyle? C) How do you plan to manage household responsibilities? D) Will you become frustrated with this living arrangement? E) What concerns do you have about the transition to this new living arrangement? F) Do you feel you have enough knowledge about the symptoms of this disease?

What is included in your typical daily routines? Will this change in living arrangement influence your current lifestyle? How do you plan to manage household responsibilities?

An outpatient client who has breast cancer had a total mastectomy 4 week ago and recently started radiation treatment. Which ROM exercises would be most effective for the COTA to teach the client during this phase of treatment? a. Wrist flexion and extension, and hand ROM b. Elbow flexion and extension, and forearm supination c. Shoulder flexion, extension, and rotation -specific

Why? After a mastectomy, especially with radiation therapy, the client may experience restrictions in the range of motion (ROM) in the shoulder due to surgical changes, scarring, and the effects of radiation. The shoulder's mobility is crucial for regaining upper body function, and exercises to improve shoulder flexion, extension, and rotation can help to: Prevent adhesions or tightness in the soft tissues around the surgical site. Restore functional shoulder movement, which is essential for daily activities such as dressing, reaching, and lifting.

A client who has ataxia of the dominant arm secondary to a cerebellar tumor is learning compensatory strategies to use when self-feeding. Which strategies would be MOST BENEFICAL to support the client's independence when eating? A. Stabilize the plate on a non-skid mat and wear a weighted cuff on the wrist. B. Apply a brightly colored piece of tape to the right of the plate and use visual scanning. C. Use the clock technique for positioning food on the plate and lightweight utensils

Why? Stabilizing the plate on a non-skid mat helps to prevent sliding or shifting during the meal, making it easier for the client to manage the food without additional effort or frustration. The weighted cuff on the wrist provides proprioceptive input that can help improve control and reduce tremors or involuntary movements, allowing for more stable movements when bringing food to the mouth. This strategy addresses both sensory and motor coordination challenges.

What information MUST be documented in the Individualized Family Service Plan for children who meet eligibility criteria for OT services? a. Child-centered objectives that are prioritized by the primary care-givers b. Specific recommendations for active technology and adaptive devices c. Subjective statements from the children wants and needs

a. Child-centered objectives that are prioritized by the primary care-givers Rationale The IFSP is a family-focused document that outlines the services and supports needed to help the child achieve developmental milestones. It includes child-centered objectives that are prioritized by the primary caregivers, ensuring that the goals are relevant and meaningful to the family's needs and priorities

A patient with a mild intellectual disability recently had transabdominal surgery for an intestinal fistula repair. The COTA is planning intervention to provide the patient with strategies to complete BADL while following post-operative precautions. What principles should the COTA incorporate into the session to improve the client's understanding of the information? CHOOSE 3 ANSWERS a. Determine the patient's ability to understand the information presented b. Use verbal directions as a primary mode of giving information c. Explain the meaning of occupational therapy terminology d. Give detailed directions on each step of the activity e. Use appropriate cultural references and therapeutic use of self f. Share the information in an environment conducive to learning

a. Determine the patient's ability to understand the information presented Why? Assessing the patient's cognitive level is crucial to tailoring the information to their comprehension abilities. This helps ensure the patient receives instructions and information in a way that they can understand and apply safely, especially after surgery. e. Use appropriate cultural references and therapeutic use of self Why? Cultural sensitivity and a personalized approach improve engagement. By using references and communication styles that resonate with the patient's background, the COTA can create a more comfortable and effective learning environment. Therapeutic use of self also involves building rapport and trust, which enhances the patient's willingness to follow the intervention plan. f. Share the information in an environment conducive to learning Why? Providing information in a distraction-free environment supports concentration and understanding. A calm, focused environment is essential for helping the patient absorb and remember the instructions related to post-operative precautions and BADLs.

A 10-year-old child is undergoing treatment in a pediatric hospital after having an open reduction and internal fixation of bilateral femur fractures. The discharge planning team indicates the child will be discharged home in 3 days. Although the child has made progress, several of the intervention goals have not been achieved. Which action should the COTA take to maximize the child's progress prior to discharge? a. Have the child parents attend remaining sessions so they can assist with goal achievement after discharge. b. Identify the child's current level or participation and barriers influencing the expected outcome through each goal. c. Increase the frequency and duration of OT sessions to enable more opportunities to work toward unmet goals.

a. Have the child parents attend remaining sessions so they can assist with goal achievement after discharge.

An inpatient who has sustained a TBI several days ago has limited hemiparesis and is functioning at level VI (Confused and appropriate) on the Ranchos los Amigo's scale. Currently, the patient requires moderate assistance during dressing tasks and avoids using the affected hand during bimanual tasks such as buttoning. As a part of a dressing session, the COTA uses blocked practice techniques to initially teach the patient how to fasten the buttons on the front of the shirt. What is the PRIMARY benefit for using these techniques for supporting the patient's independence? a. Repetitive practice of the same movements establishes motor patterns of similar tasks b. Massed practice of the same motor skill efficiently generalizes to other similar activities c. Variability of movements help the client to learn ways to adapt for motor deficits NBCOT

a. Repetitive practice of the same movements establishes motor patterns of similar tasks Blocked practice involves repetitive practice of the same task without variation. This technique is effective for individuals with cognitive or motor deficits, such as those with a traumatic brain injury (TBI), because it helps establish and reinforce motor patterns for specific tasks. By focusing on repetition of the same movements, the patient can build consistency in their motor skills, which is crucial in early stages of motor learning.

A high school student had surgical reconstruction of the ulnar collateral ligament of the dominant elbow 4 weeks ago. Due to movement precautions associated with this stage of healing, the student is not able to position a backpack filled with school books and supplies over both shoulders. Which option would be MOST BENEFICIAL for the student to use for carrying school supplies at this time? a. Rolling soft-sided backpack with adjustable-height handle b. Single-strap sling backpack worn over the unaffected shoulder c. Standard backpack modified to carry the load across the chest

a. Rolling soft-sided backpack with adjustable-height handle Rationale This option eliminates the need to bear weight on the shoulders and arms, thus reducing the risk of straining the healing elbow. The adjustable-height handle allows the student to pull the backpack comfortably without stressing the affected area.

An 8-year-old student has a moderate congenital hearing impairment and wears bilateral hearing aids. The student does not like wearing the aids at school and tells the COTA, "Most of the time, I can't hear what people are saying anyway." A recent audiology report indicates the hearing aids are in good working order. Which strategies should the COTA implement in the school environment based on the student's report? select 3 choices a. Adhere tactile markings that help the student identify frequently used items. b. Advise the teacher to use a circular seating arrangement for class discussions. c. Determine ways to reduce ambient background noises in the classroom. d. Provide the teacher with basic sign language words to use with the student. e. Recommend the teacher limit visual distractions in the classroom. f. Teach the student to use an augmentative communication board.

b. Advise the teacher to use a circular seating arrangement for class discussions:A circular seating arrangement allows the student to see the faces of all participants, which can improve understanding through visual cues like lip-reading and facial expressions. This arrangement can also help the student better access sound if they are facing the teacher or peers. c. Determine ways to reduce ambient background noises in the classroom:Reducing background noise can improve the student's ability to focus on conversations, as excessive noise can make it harder for them to hear even with hearing aids. Using strategies like sound-absorbing materials, turning off fans or other noisy equipment, and using directional microphones for the teacher can help the student hear more clearly. e. Recommend the teacher limit visual distractions in the classroom:Minimizing visual distractions can help the student focus better on the primary stimuli they need to process, such as the teacher's face, visual aids, or other students' movements. Less visual clutter will allow the student to concentrate on lip-reading and other non-hearing cues, improving their overall understanding of the lesson.

An older adult client with COPD has recently started using home oxygen 24 hours per day but continues to have dyspnea with basic daily tasks. Currently, the client lived alone and wants to remain as independent as possible with ADL and leisure activities. What strategies should the COTA advise this client to use to support progress toward this goal? Select 3 choices a. Identify a maximum number of activities that can be completed each day. b. Plan to take rest breaks intermittently throughout the day. c. Problem solve-alternate ways to conserve energy during tasks. d. Ask friends or neighbors to assist with strenuous household activities. e. Hire a chore worker to assist with routine home management. f. Store typically used supplies for an activity within reach.

b. Plan to take rest breaks intermittently throughout the day. d. Ask friends or neighbors to assist with strenuous household activities. f. Store typically used supplies for an activity within reach.

A client who has adiadochokinesia of the dominant arm secondary to Friedreich's ataxia is learning compensatory strategies to use when washing the exterior of a car. Which strategies would be MOST BENEFICIAL support the client's independence with this cleaning task? a. Use a telescoping extension on the hose and a bucket on wheels. b. Put cleaning supplies in a carrying caddy and place the caddy near the car. c. Support torso on the side of the car and wear a wash mitt.

b. Put cleaning supplies in a carrying caddy and place the caddy near the car.

A COTA working in an outpatient setting has collaborated with an OTR to fabricate a wrist-hand-thumb immobilization orthosis for a client. What information should the COTA provide to the client prior to the client leaving the clinic with the orthosis? CHOOSE 3 ANSWERS a. Ways to pad the orthosis if minor irritation occurs b. Wearing schedule of the orthosis c. Tips for making minor modifications to the orthosis at home d. Estimated timeframe for recovery based on orthotic use. e. Signs of adverse reactions to the orthosis f. Primary purpose of the orthosis

b. Wearing schedule of the orthosis The client needs to understand how long and when to wear the orthosis to ensure its effectiveness. This will guide the client in using it consistently to promote healing or reduce symptoms. e. Signs of adverse reactions to the orthosis It is important to educate the client on potential adverse reactions such as skin irritation, swelling, numbness, or pain. The client should know when to seek further assistance if any of these issues occur. f. Primary purpose of the orthosis The client should understand the primary purpose of the orthosis, such as protecting the joint, immobilizing the wrist, and improving function. This helps ensure that the client understands the role of the orthosis in their rehabilitation and follows instructions appropriately.

A COTA is completing an initial interview with the spouse of an older adult client who has end-stage Alzheimer's disease. The client resides at home with the spouse who is the primary caregiver. Which option represents an open-ended question the COTA should ask during the interview? a. How much assistance do you provide for bathing activities? b. What activities do you want to work on during these sessions? c. Do you receive help from family or friends on a regular basis?

b. What activities do you want to work on during these sessions? Rationale This question encourages the spouse to freely express their priorities and concerns regarding the therapy sessions and their caregiving role.

A patient was admitted to a locked mental health unit 5 days ago with paranoid delusions and combative tendencies associated with an exacerbation of schizophrenia. The patient is currently considered an elopement risk, but is permitted to leave the unit to attend OT clinic sessions when escorted by a mental health technician. What risk management actions should the COTA take during the patient's scheduled sessions? Select 3 best choices a. Make certain there are physical restraints available to use if combative behaviors occur b. Lock the clinic exit doors for the duration of the patient's session. c. Ensure there are no other patients in the immediate clinic area during the patient's session. d. Conduct session activities away from the main doorways of the clinic. e. Inventory supplies prior to the start of the session and before patient leaves the session. F. Avoid having supplies available that could be

c. Ensure there are no other patients in the immediate clinic area during the patient's session. d. Conduct session activities away from the main doorways of the clinic. e. Inventory supplies prior to the start of the session and before patient leaves the session.

A student in the fifth grade has a pervasive developmental delay. During a pull-out session with the COTA, the student draws a self-portrait that depicts self-harm. When questioned about this picture, the student says, "Everyone would be better off if I didn't exist." After obtaining more information from the student about these feelings, which course of action should the COTA take in response to this situation? a. Accompany the student to the classroom after the session, and inform the teacher about the comment.. b. Document the details of the concerning behaviors, and contact the student's parents by telephone. b. Escort the student to a supervised environment, and inform the school principal

c. Escort the student to a supervised environment, and inform the school principal. Rationale This ensures the student's immediate safety and involves the appropriate school authorities who can take further action, including contacting the student's parents and arranging for additional support or intervention as needed. Prioritizing the student's safety and well-being is critical in this situation.

A patient on an acute oncology unit recently underwent surgery for a radial neck dissection. During a self-care session at the bathroom sink, the patient states, "I am afraid to look at myself in the mirror." What action should the COTA take in response to the patient's comment? a. Ask questions to gain insight into the patient's perspective on their body image. b. Encourage the patient to participate after covering the mirror at the sink with a towel. c. Initiate a conversation on adapting to the change in physical appearance

c. Initiate a conversation on adapting to the change in physical appearance

Which variable listed below can be graded to MOST EFFECTITIVELY increase physical endurance? a. Amount to resistance needed during an activity b. Coordination required for controlled movement c. Speed in which the activity is completed d. Total amount of time spent on an activity

d. Total amount of time spent on an activity Rationale By gradually increasing the duration or time spent on physical activities, individuals can improve their endurance capacity. This gradual progression allows for physiological adaptations that enhance cardiovascular fitness and muscular endurance, contributing to overall improved physical endurance.

A 9-year-old child has autism and is non-verbal. The child has no sense of danger and is at risk for wandering away from the home and away from a caregiver during outings in the community. The caregiver is concerned for the child's safety and asks for suggestions to reduce these wandering behaviors. Which strategies represent the LEAST RESTRICTIVE options for supporting the child's independence in the home and community? Select 3 choices a. Advise residents in the surrounding neighborhood about the child's tendencies. b. Have the child carry a mobile phone with an enabled electronic tracking device. c. Implement a token economy to reward the child for days without wandering d. Install locks on the doorways in the home at a height that is out of the child's reach. e. Register the child's identifying information with emergency response providers. f. Secure a medical alert identification bracelet on the child's

e. Register the child's identifying information with emergency response providers. f. Secure a medical alert identification bracelet on the child's wrist. c. Implement a token economy to reward the child for days without wandering

A COTA working in an outpatient rehabilitation setting is interviewing a young adult client. The client was recently diagnosed with post-traumatic stress disorder and depression secondary to sustaining an amputation of the dominant upper extremity 3 months ago. What questions would be beneficial to ask about the client's leisure and social participation when gathering information to contribute to the occupational profile? CHOOSE 3 ANSWERS a. How anxious do you feel about doing things with your non-dominant arm? b. Do family and friends seem to interact differently with you now? c. What things do you choose to do, rather than things you have to do? d. Is there an activity that you particularly enjoy watching or participating in? e. Which of your preferred activities are you unable to do since the accident? f. What activities do you like to do with family and friends in your spare time?

f. What activities do you like to do with family and friends in your spare time? d. Is there an activity that you particularly enjoy watching or participating in? b. Do family and friends seem to interact differently with you now?