Test A
A85. An OTA works with an acute care rehabilitation patient with diabetes and a below-knee (BK) amputation to learn how to effectively perform home management tasks while wearing a BK prosthesis. When taking laundry from a front-loading washer and placing it into a top-loading dryer, the patient reports feeling weak, dizzy, and somewhat nauseous. The OTA notices that the patient is sweating profusely and is unsteady when standing. Which is the best immediate course of action for the OTA to take in response to the patient's complaints and these observations? a. Return the person to the unit of care due to an insulin reaction. b. Have the patient sit and give them orange juice for developing hypoglycemia. c. Call a nurse to administer an insulin injection for developing hyperglycemia. d. Have the patient sit until the orthostatic hypotension resolves.
b. Have the patient sit and give them orange juice for developing hypoglycemia.
A33. A person blinded in an accident begins an occupational therapy program for persons with vision loss. Before the accident, the person lived independently and worked as an accountant. The occupational therapist and OTA collaborate with the individual to develop an intervention plan. Which activities are best for the therapist and OTA to include in the initial intervention plan? Select the three BEST responses. You must select exactly 3 choices a. Exploring new vocational interests. b. Learning alternative computer access skills. c. Organizing the client's morning personal care routine. d. Learning home safety and emergency procedures. e. Adapting cooking activities to accommodate vision loss. f. Adapting clothing care (e.g., ironing) to accommodate vision loss.
b. Learning alternative computer access skills. c. Organizing the client's morning personal care routine. d. Learning home safety and emergency procedures.
A31. An OTA works with an individual recovering from a traumatic brain injury in a rehabilitation hospital. The OTA uses a transfer of training approach to help the patient develop and carry out a daily schedule of activities upon the patient's return home. Which is the most effective activity for the OTA to use during an intervention session with this client? a. Preparation of a simple meal. b. Organization of a list of daily activities. c. Composition of a shopping list. d. Completion of an interest checklist.
b. Organization of a list of daily activities.
A32. During a therapeutic feeding session, a child with spastic quadriplegic cerebral palsy demonstrates a consistent tonic bite reflex. Which technique should the OTA use to help inhibit this reflex? a. Apply slight upward pressure of the index finger under the child's lip. b. Press a spoon down firmly on the center of the child's tongue. c. Place foods such as soft-cooked vegetables between the gum and teeth. d. Provide sensory input to the inferior faucial arches using a chilled dental exam mirror.
b. Press a spoon down firmly on the center of the child's tongue.
A7. An individual is recovering from lumbar surgery. The patient must remain flat in bed during the initial recovery stages. The patient expresses an interest in reading from a personal collection of classic comics. Which adaptation is best for the OTA to recommend the client use for reading? a. A page magnifier. b. Prism glasses. c. Audiotapes of books of interest. d. Large print books of interest.
b. Prism glasses.
A64. The population of an urban homeless shelter includes individuals with histories of chronic alcohol abuse who are at risk for developing peripheral neuropathy. The OTA consulting at this shelter monitors the residents' status to ensure early detection of this problem. Which is the most important observed status change for the OTA to report to the occupational therapist? a. Progressive deterioration in visual acuity. b. Progressive deterioration of sensorimotor functions of the lower extremities. c. Rapid onset of intention tremors in the upper extremities. d. Rapid loss of sensorimotor functions of the facial and neck muscles.
b. Progressive deterioration of sensorimotor functions of the lower extremities
A47. An individual attends a community day treatment program to assist in recovery from major depression. The client has good eye contact and responds verbally to interactions initiated by others. Cognition is intact. Which group level is best for the OTA to recommend this client attend? a. Parallel. b. Project/associative. c. Cooperative/supportive cooperative. d. Mature.
b. Project/associative.
A17. An OTA works with an 8-year-old with pervasive developmental disabilities in order to improve self-care skills. In teaching the child to brush teeth, the OTA places the toothbrush in the child's hand and guides it to the mouth. To help the child learn to complete the activity the OTA uses the somatosensory system. Which of the following is most effective for the OTA to use next during intervention with this child? a. Tell the child to brush up and down and provide verbal prompts. b. Provide hand-over-hand assistance to brush the child's teeth. c. Touch the child's hand to prompt hand-to-mouth movements. d. Instruct the child to follow a pictorial sequence card depicting toothbrushing.
b. Provide hand-over-hand assistance to brush the child's teeth.
A27. The parents of a 5-year-old with attention deficit with hyperactivity disorder (ADHD) express difficulty managing the child's aggressive behavior toward older siblings. Which is the most effective strategy for the OTA to recommend to the parents? a. Allow the child to vent aggressive feelings on a stuffed animal or doll. b. Redirect the child's energy into acceptable and safe play activities. c. Provide consistent punishment for aggressive behavior.
b. Redirect the child's energy into acceptable and safe play activities.
A28. An employed individual is completing an inpatient program for substance abuse. The OTA consults with the supervising occupational therapist to review the discharge plan. Which would be most beneficial for the OTA and therapist to recommend as part of the individual's discharge plan? a. Assignment to a member of a local Narcotics Anonymous group. b. Regular attendance at one or more Narcotics Anonymous meetings weekly. c. Attendance at the psychosocial clubhouse for leisure skills groups. d. Referral to the state vocational rehabilitation services.
b. Regular attendance at one or more Narcotics Anonymous meetings weekly.
A52. During an intervention session, a client complains of dry mouth due to prescribed medications. What is the most effective strategy for an OTA to suggest to the client to manage this side effect? a. Suck on ice. b. Sip water. c. Drink iced tea. d. Suck on hard candies.
b. Sip water.
A60. 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 theperson 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.
A88. An OTA provides home-based occupational therapy services. An ambulatory older adult with hemiparesis and presbycusis has recently moved in with an adult child. The child requests information from the OTA to help maintain the parent's functional ability in the home. Which is best for the OTA to recommend? a. Remove knobs from the stove when the parent is home alone. b. Speak directly, clearly, and slowly to the parent. c. Add bright color strips to the edge of each stair tread. d. Provide the parent with lists of the sequence of routine tasks.
b. Speak directly, clearly, and slowly to the parent.
A15. A 19-year-old with spastic diplegia and an IQ in the range of 55-69 is graduating from a special education program. The student has been involved in transitional programming since the age of 14. The OTA collaborates with the occupational therapist and the student to complete a discharge plan to meet the student's post-secondary goals. Which of the following should the OTA recommend be included as a postdischarge referral? a. A vocational rehabilitation workshop. b. State vocational rehabilitation services. c. A community college. d. A transitional employment program.
b. State vocational rehabilitation services.
A37. An OTA works with an individual recovering from traumatic brain injury who demonstrates behaviors consistent with Level VII of the Rancho Level of Cognitive Functioning Scale. The client is a resident 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.
A55. An older adult expresses concern about the ability to perform daily tasks. The individual has somatosensory deficits consistent with the normal aging process. The OTA recommends adaptive equipment to assist with task performance. Which adaptive equipment should the OTA recommend the person use during meal preparation and feeding? a. Utensils with narrow, smooth grips. b. Utensils with wide, textured grips. c. A rocker knife.
b. Utensils with wide, textured grips.
A75. 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.
A100. 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. Non-skid mats.
c. A three-in-one commode.
A67. A client has a three-year history of multiple sclerosis. One of the client's presenting symptoms is a persistent and severe diplopia, which leaves the client frequently nauseated and unable to complete desired activities. Which of the following is best for the OTA to recommend the client discuss with an optometrist? a. Magnifying glasses. b. Prism glasses. c. An eye patch.
c. An eye patch.
A19. An individual with advanced Huntington's chorea is admitted to a skilled nursing facility. The resident weighs 280 pounds and cannot independently transfer. What is the best recommendation for the OTA to make to the resident's direct care staff to ensure a safe transfer? a. A mechanical lift transfer. b. A two-person lift transfer. c. A stand pivot transfer. d. An assisted sliding board transfer.
a. A mechanical lift transfer.
A51. An adolescent with spinal muscle atrophy shows decreased trunk balance and strength during intervention sessions. Upper extremity strength and ROM appear unchanged. When discussing these observations with the occupational therapist, which is the best recommendation for the OTA to make? a. A reevaluation of the client be completed. b. The client be referred to an orthotist for a soft spinal support. c. The client be measured for a power wheelchair. d. A trunk strengthening program be initiated with the client.
a. A reevaluation of the client be completed.
A91. An OTA supervises a Level II fieldwork student regarding the evaluation procedures of a work hardening program. The OTA explains that some individuals attending the program magnify their symptoms to retain benefits; therefore, the validity of some evaluation measures may be compromised. Which assessment tool does the OTA identify as providing the most valid results? a. A volumeter. b. A dynamometer using all five positions. c. A standardized pegboard test. d. A total active motion (TAM) evaluation.
a. A volumeter.
A96. A client in the descending phase of Guillain-Barré syndrome has bilateral shoulder strength of 2/5. The client fatigues easily. Which equipment should the OTA recommend to enhance the person's performance of 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.
A81. An OTA is working with the parents of a 5-year-old child with developmental delay. This child is not self-feeding. The occupational therapist's evaluation of the child indicated that the child has potential to participate in this ADL. When talking to the parents about this possible goal, they indicate this is not a priority for them. Which action is best for the OTA to take in response to the parents' statement? a. Ask the parents about their intervention priorities for their child. b. Work on utensil use with the child without using food items. c. Explain the importance of self-feeding to the child's independence. d. Refer the parents to online sources about the typical development of feeding.
a. Ask the parents about their intervention priorities for their child.
A8. A school-based OTA is providing per diem coverage for an OTA on a disability leave. Upon reviewing the caseload, the OTA notes that ten students have had evaluations completed during the past month. Five of these students' individualized education plans (IEPs) have also been completed by the team and approved by their parents. Which is the best initial action for the OTA to take as a contract practitioner? a. Consult with the occupational therapist, team, and students' parents to complete the IEPs for the remaining students. b. Conduct independent evaluations of each student with the supervision of the school's occupational therapist. c. Implement the IEPs that have been established and approved with the supervision of the school's occupational therapist. d. Report to the supervisor of the contract agency that the school has failed to comply with IEP guidelines.
a. Consult with the occupational therapist, team, and students' parents to complete the IEPs for the remaining students.
A48. An OTA is hired to work in the occupational therapy department of an acute psychiatric unit. The OTA requests an orientation to hospital policies and procedures. Which are the most important policies and procedures for the OTA to learn during the initial orientation session? a. Crisis intervention. b. Reimbursement. c. Group program scheduling.
a. Crisis intervention.
A10. An older adult with chronic obstructive pulmonary disease and osteoarthritis is preparing for discharge from a subacute rehabilitation center. During a family training session on how to complete car transfers, a family member expresses concern about the patient's ability to continue driving. The family member explains that the patient has been experiencing episodes of forgetfulness and trouble with focusing on a task. Which action is the best for the OTA to take to address the family member's concern? a. Document and report the family member's concern to the supervising therapist. b. Inform the family member that the episodes are likely due to typical age-related changes. c. Administer the Standardized Mini-Mental State Exam to determine cognition status. d. Provide intervention to optimize the client factors necessary for driving.
a. Document and report the family member's concern to the supervising therapist.
A65. An adult recently diagnosed with scleroderma receives occupational therapy services to deal with the functional changes caused by this disease. Which recommendations are best for the OTA to make to this individual? Select the three BEST responses. You must select exactly 3 choices a. Dress in layers for neutral warmth. b. Wear protective cotton, insulated gloves. c. Dress in lightweight clothing for thermal comfort. d. Use cold packs on hands when pain in hands occurs. e. Modify activities to prevent trauma to fingers and toes. f. Use hand splints to immobilize affected joints and promote rest.
a. Dress in layers for neutral warmth. b. Wear protective cotton, insulated gloves. e. Modify activities to prevent trauma to fingers and toes.
A43. A 2-year-old child receives home care early intervention services. The occupational therapy intervention plan includes a goal to develop the child's pincer grasp. Which is the most appropriate activity for the OTA to work on with the child during an intervention session? a. Finger-feeding of O-shaped cereal. b. Picking up different sized marbles. c. Drawing with jumbo crayons. d. Stacking 1-inch cubes.
a. Finger-feeding of O-shaped cereal.
A34. An older adult with peripheral neuropathy resulting from the effects of diabetes expresses concern over the ability to have a satisfying sexual relationship with a partner. What is the most beneficial recommendation for the OTA to make to the client? a. Focus on intact senses and areas of intact sensation. b. Experiment with different positions during sexual expression activities. c. Schedule sexual expression activities after rest periods. d. Advise the client to accept decreased abilities in sexual expression as a normal part of aging.
a. Focus on intact senses and areas of intact sensation.
A18. An OTA completes a home evaluation for an individual with post-polio syndrome who recently moved into a rent-stabilized studio apartment. When evaluating the accessibility of the client's kitchen, the OTA notes that all appliances are freestanding with no counter space between them. Which action is best for the OTA to take in response to this observation? a. Advise the client to purchase three stationary carts to place next to and between each appliance as a substitute for countertops. b. Advise the client to purchase a stationary cart and a rolling cart and train the client in their safe use. c. Refer the client to a carpenter who has expertise in the construction of accessible kitchen countertops. d. Advise the client to seek a new rent-stabilized apartment with countertops between appliances.
b. Advise the client to purchase a stationary cart and a rolling cart and train the client in their safe use.
A45. A 3-year-old with recurring headaches and decreased gross and fine motor skills is hospitalized for a diagnostic workup. The occupational therapist completed a screening of the child and determined that the OTA should complete a standardized developmental assessment. Just prior to the scheduled OT evaluation, the parents have been told that the child has brain cancer. The parents are upset when they bring the child to OT. The OTA provides support. Which is the next best action for the OTA to take in response to this situation? a. Cancel the evaluation session and refer the parents to their spiritual advisor or the social worker. b. Advise the parents to speak to their spiritual advisor or the social worker after the evaluation session. c. Ask the supervising occupational therapist to participate in the session and spend it addressing the parents' acceptance of the diagnosis. d. Reschedule the evaluation for later in the day so that the parents can speak with their spiritual advisor or the social worker.
b. Advise the parents to speak to their spiritual advisor or the social worker after the evaluation session.
A9. An individual with a C3 spinal cord injury is participating in a community mobility group at a shopping mall. The client expresses the desire to return to the rehabilitation center due to a pounding headache. The OTA notices the 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 rehabilitation 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.
A74. A client with myasthenia gravis shows increasing difficulty with speech and oral-motor control during swallowing. Which behavior is most accurate for the OTA to document as indicative of a swallowing disorder? a. A tendency to spit out foods of mixed textures. b. Coughing while swallowing thin liquids. c. Loud noises in the throat during swallowing.
b. Coughing while swallowing thin liquids.
A35. A person is recovering from a major cardiac infarct. During the initial OT session, the patient loudly and vigorously expresses plans to immediately resume a daily rigorous exercise routine. The OTA reports the individual's plan to the occupational therapist. The OTA explains that the individual appears to be in which stage of adjustment to disability? a. Shock. b. Denial. c. Acting out. d. Acceptance.
b. Denial.
A79. A school-based OTA receives a referral for a student who has illegible handwriting, poor attending behaviors, questionable visual skills, and problems with pencil management. After speaking with the teacher, reviewing classroom work samples, and collaborating with the occupational therapist, which action should the OTA take next? a. Provide pencil grips and specialized paper as a trial to determine interventions. b. Directly observe the student during a naturally occurring writing time. c. Administer a standardized visual perceptual and visual motor assessment. d. Administer a standardized handwriting assessment.
b. Directly observe the student during a naturally occurring writing time.
A99. An OTA is scheduled to give a 1-hour presentation to a support group of parents of infants with a diversity of developmental disabilities. Which of the following is the most important focus for the OTA's presentation? a. Demonstration of infant positioning techniques. b. Discussion of typical areas of concern addressed by OT practitioners. c. Demonstration of different types of developmental assessments. d. Discussion of the Individual Family Service Plan (IFSP).
b. Discussion of typical areas of concern addressed by OT practitioners.
A86. An OTA is working in an in-patient rehabilitation facility for persons with SCI. A patient sustained a C5 complete SCI following an automobile accident two weeks ago. The OTA is working with the patient to attain the patient's goal to independently self-feed. Which pieces of adaptive equipment are best for the OTA to teach the patient to use during intervention? Select the three BEST responses. You must select exactly 3 choices a. A rocker knife. b. Dycem to place under plates. c. A plate guard or scoop dish. d. A sip-n-puff mobile arm support. e. A dorsal wrist splint with universal cuff. f. A drinking cup with a drinking spout.
b. Dycem to place under plates. c. A plate guard or scoop dish. e. A dorsal wrist splint with universal cuff.
A90. An individual receives treatment for major depression on an inpatient psychiatric unit. The patient has received an electroconvulsive treatment (ECT) treatment at 8 am. At 2 pm, the patient walks into the occupational therapy department stating a desire to participate in the leisure skills group. Which is the OTA's best response? a. Call nursing staff to escort the client back to the client's room. b. Encourage the client to select one of three structured leisure activities to complete. c. Provide the client with a leisure history questionnaire to complete. d. Commend the client's motivation but remind the client that rest is recommended for 24 hours after ECT.
b. Encourage the client to select one of three structured leisure activities to complete.
A97. Several adolescents with behavior problems attend a school-based after-school program. They work at an egocentric-cooperative/basic cooperative level in a group which is focused on developing the skills needed to enable successful school performance and respond effectively to peer pressure. Which of the following should the OTA focus on helping the group members do in the group to facilitate the attainment of group goals? a. Actively take on roles such as energizer, coordinator, or opinion giver. b. Focus on the group tasks related to the completion of a long- range activity. c. Make decisions with minimal to no input or guidance from the group leader. d. Perform group skills consistent with the developmental level of adolescents.
b. Focus on the group tasks related to the completion of a long- range activity.
A83. 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. Explain and reinforce the importance of active range-of-motion exercises for remediation of dysfunction. b. Provide interventions to improve time management skills and temporal adaptation. c. Incorporate the parent's engagement in a diversity of role activities into the home program. d. Increase the frequency of OT sessions to compensate for lack of follow-through on the home program.
c. Incorporate the parent's engagement in a diversity of role activities into the home program.
A56. An OTA is working with a patient to develop their ability to complete dressing tasks. The patient requires assistance to pull the shirt down over the body and verbal cues to orient the shirt correctly. In documenting the patient's performance, which most accurately represents the patient's performance in upper body dressing? a. Modified independence. b. Stand- by supervision. c. Minimal assistance. d. Moderate assistance.
c. Minimal assistance.
A76. An OTA employed in a pediatric clinic for children with cerebral palsy participates in a performance appraisal. The OTA's supervisor identifies handling skills as an area needing improvement. Which is the most effective way for the OTA to improve handling skills? a. Observe an experienced 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 video 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.
A69. An individual receives OT services at a subacute rehabilitation facility. The patient's personal goal is to be independent in dressing. The patient demonstrates decreased memory, poor sequencing skills, and ideational apraxia. Which of the following is most effective for the OTA to provide when teaching one-handed dressing techniques to this patient? a. Step-by-step verbal instructions. b. Sequenced photographs of the steps in dressing. c. Physical prompts to initiate the steps in dressing. d. A full-length mirror for the client to observe self-dressing performance.
c. Physical prompts to initiate the steps in dressing.
A11. An elementary school-aged child holds a pencil with a tightly held static tripod grasp and forms letters at an average rate of speed. The child demonstrates the ability to write all class and homework assignments. Which is best for the OTA to recommend this child do to improve their grasp? a. Perform all written work with a larger pencil and jumbo crayons on a horizontal surface. b. Take a break every 15 minutes while writing to open and close the hand several times. c. Practice moving coins from the fingertips to the palm and then from the palm to the fingertips. d. Write all written work on a vertical surface, such as an easel or classroom wall board.
c. Practice moving coins from the fingertips to the palm and then from the palm to the fingertips.
A80. 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.
A29. An individual with a spinal cord injury at the level of T1 is practicing a stand-pivot transfer in the OT department of a rehabilitation center. The patient complains of dizziness and nausea. Which action is most important for the OTA to take first? a. Call for help according to facility procedures. b. Return the patient to the wheelchair for a 5-minute rest break. c. Return the person to the wheelchair and immediately recline it. d. Return the patient to the wheelchair and transport the patient back to rest in bed.
c. Return the person to the wheelchair and immediately recline it.
A53. An OTA works with the new foster parent of a 2-year-old child diagnosed with major developmental delays and severe hypotonia. The OTA advises the foster parent to position the head in midline during feeding. Which additional positioning recommendations for feeding are best for this child? a. Sitting with hips and knees at 90 degrees of flexion, neck in neutral. b. Sitting with hips and knees at 90 degrees of flexion, neck in extension. c. Semi-reclined with neck in neutral. d. Semi-reclined with neck in extension.
c. Semi-reclined with neck in neutral.
A66. A parent recovering from brain cancer receives home-based occupational therapy services. The client has residual problem solving deficits. Sensorimotor abilities are within functional limits. The client identifies a desire to resume the role of home maintainer. To develop the requisite problem-solving skills needed forthese roles, which is best for the OTA to work on with the client during OT intervention? a. Performing routine morning self- care. b. Dusting the home's living room. c. Washing the family's laundry.
c. Washing the family's laundry.
A38. The transition plan for an 18-year-old with developmental delay includes employment in a vocational rehabilitation workshop job setting. The student has set a goal to live independent of family. Which is the best living environment for the OTA to recommend for this student? a. An apartment in a subsidized housing project. b. A group home with case managers available on-call. c. A supported apartment with a roommate. d. A group home with daily on-site supervision.
d. A group home with daily on-site supervision.
A30. An adolescent with myelomeningocele (spina bifida) at the C8 level wants to access a new computerized play system. Which is the best adaptation for the OTA to recommend the adolescent use to access this system? a. A chin switch. b. A tenodesis splint. c. A dorsal wrist splint with a universal cuff. d. A joystick control.
d. A joystick control.
A62. An individual cannot independently get from a supine position to a sitting position. The client has good scapular, shoulder, and elbow muscle strength. Which of the following should the OTA recommend as the most effective for the client to use to improve bed mobility? a. A leg lifter. b. A bed rail assist. c. A log roll technique. d. A rope ladder.
d. A rope ladder.
A6. An OTA provides occupational therapy services in an assisted living facility. The OTA meets with a new resident who expresses concern that their poor vision has made it very difficult to complete their favorite activity of embroidering tablecloths and napkins. The OTA determines that the person's low vision is age-related and not due to any pathological disorder. Which adaptation is best for the OTA to recommend to this resident to use to enable engagement in these activities? a. Concave lenses. b. Large print instructions. c. A handheld magnifier. d. A stand magnifier.
d. A stand magnifier.
A54. An individual admitted to a psychosocial day treatment program has a diagnosis of a major depressive disorder. The client reports having difficulty performing home management tasks and caring for two young children. The occupational therapist determines that the recently hired, entry-level OTA can contribute to the evaluation process. Which evaluation is best for the OTA to complete with this client? a. A cognitive evaluation. b. A mental status exam. c. An occupational history interview. d. An activities of daily living evaluation.
d. An activities of daily living evaluation.
A73. An individual with developmental disabilities scores a Level 4 on Allen's Cognitive Level Test. The OTA collaborates with the occupational therapist to plan intervention. Which activities should the OTA and occupational therapist include in the intervention plan to help meet the client's functional needs? Select the three BEST responses. You must select exactly 3 choices a. Self-care activities such as brushing teeth. b. Home management activities such as folding socks. c. Home management activities such as food shopping using a prepared list. d. Leisure activities such as matching picture cards. e. Leisure activities such as completing a 50-piece puzzle. f. Community mobility training to develop the ability to take public transit using a map.
c. Home management activities such as food shopping using a prepared list. e. Leisure activities such as completing a 50-piece puzzle. f. Community mobility training to develop the ability to take public transit using a map.
A71. An OTA works in a school setting with adolescents with autism spectrum disorder (ASD). The need for a social skills training group is identified. One activity that the OTA plans to use in the group is role playing. Which is the most effective way for the OTA to determine relevant scenarios for the role-play activities? a. Survey the teachers on social difficulties displayed in class. b. Survey parents on social difficulties they have observed in the adolescents. c. Review literature on adolescent social skill development. d. Ask the group members about their social concerns.
d. Ask the group members about their social concerns.
A44. An older adult has lost significant functional vision over the last 4 years and complains of blurred vision and difficulty reading. The person frequently mistakes images directly in front, especially in bright light. When walking across a room, the person is able to locate items in the environment using peripheral vision when items are located to both sides. Based on these findings, which visual deficit should the OTA report the client is most likely exhibiting? a. Glaucoma. b. Presbyopia. c. Hemianopsia. d. Cataracts.
d. Cataracts.
A16. An OTA working on an acute psychiatric inpatient unit conducts a series of groups for clients newly admitted to the unit. Which group leadership style is most effective for the OTA to assume when leading these groups? a. Advisory. b. Facilitative. c. Laissez faire. d. Directive.
d. Directive.
A57. An individual is status post carpal tunnel release. When the OTA conducts a sensory test for sharp/dull (pain), the person reports dull as sharp on the palmar surface of the thumb and index finger. All other responses are correct. Which is accurate for the OTA to document about the individual'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.
A61. A 3-year-old with severe congenital anomalies and irreparable cleft palate has a do not resuscitate (DNR) order. While being fitted for a molded seat for a wheelchair, the child stops breathing and turns blue. The OTA determines that the child has a brachial pulse. Which of the following is the first action the OTA should take in response to this situation? a. Inform the physician about the situation and the child's DNR order. b. Call the supervising occupational therapist to discuss the best response. c. Implement the facility's emergency procedure. d. Perform obstructed airway maneuver and monitor heart rate for 5 minutes.
c. Implement the facility's emergency procedure.
A78. 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 action 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.
A93. A graduate student with an anxiety disorder reports feeling confused about the future. During the OT evaluation, the 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 educational services. d. Establish short-term goals with high potential for attainment.
d. Establish short-term goals with high potential for attainment.
A26. An older adult with a mild neurocognitive disorder consistent with Reisberg's Level 3 has been told to stop driving by their primary care physician. The client and spouse seek services from an OTA who has attained service competency in driver rehabilitation. The client and spouse are upset about the physician's advice because the spouse does not drive. Which response is best for the OTA to provide to this client and spouse? a. Advise the client and spouse to seek a second opinion from a physician who specializes in neurocognitive disorders. b. Train the spouse to use a navigation system to provide verbal directional prompts to the client. c. Schedule the client for a full evaluation of performance skills and client factors. d. Explore available driving alternatives to maintain community mobility and participation.
d. Explore available driving alternatives to maintain community mobility and participation.
A98. The parent of two elementary school-aged children receives home care hospice services due to metastasized bone cancer. The client has pain, poor endurance, and decreased muscle strength. The client requires moderate assistance with 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.
A49. An adult who incurred a CVA has difficulty dealing with increasing amounts of stimuli. This is noted in all modalities. The OTA documents these observations. Which cognitive perceptual dysfunction should the OTA report the client is exhibiting? a. Inability to abstract. b. Poor organizational skills. c. Poor semantic memory. d. Generalized attention deficit.
d. Generalized attention deficit.
A39. An OTA conducts an intervention session with a client recovering from a CVA to develop transfer skills. The client has a comorbidity of epilepsy with primary generalized seizures. As the client stands to complete a transfer from the wheelchair to the bed, the client reports feeling sensations that are indicative of an aura. Which is the best immediate action for the OTA to take in response to this situation? a. Provide reassurance and ask for guidance from the occupational therapist. b. Return the client to a seated position in the wheelchair until the sensations pass. c. End the session so the client can rest and inform the occupational therapist. d. Guide the person into a side-lying position on the bed.
d. Guide the person into a side-lying position on the bed.
A3. A middle school student with moderate intellectual disability does not eat lunch during the school's lunch hour. Instead the student spends the lunch period socializing with peers. A 1:1 aide is not assigned to the student. Which is the first intervention the school-based OTA should use to promote the activity of eating lunch? a. Schedule the student's lunch to be in the classroom to limit distractions. b. Provide positive feedback for attending to eating at 10-minute intervals. c. Practice role playing lunch conversations in the classroom. d. Have the student share a lunchroom table with one peer.
d. Have the student share a lunchroom table with one peer.
A92. A patient with fibromyalgia is receiving occupational therapy to reduce pain and promote flexibility during ADL tasks. The patient expresses the intent to discontinue treatment based on information obtained during an online search that questioned the value of therapy for fibromyalgia. Which of the following actions should the OTA do first in response to the patient's statements? a. Confront the inaccuracy of these statements and provide current evidence-based research about the benefits of therapy for persons with fibromyalgia. b. Reassure the patient that the physician has ordered therapy; therefore, it will be beneficial. c. Respect the patient's wishes and advise the occupational therapist that services should be discontinued. d. Inform the patient that online information can be inaccurate and provide literature about the benefits of therapy for fibromyalgia.
d. Inform the patient that online information can be inaccurate and provide literature about the benefits of therapy for fibromyalgia.
A95. In measuring the ROM of a client's elbow, the OTA records a flexion measurement of 145 degrees. Which is most accurate for the OTA to document based on this measurement? a. Hypomobility. b. Dysfunctional elbow ROM. c. Hypermobility. d. Normal elbow ROM.
d. Normal elbow ROM.
A77. 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 the person may need an audiological evaluation.
A14. An OTA provides occupational therapy services in a program for survivors of domestic violence. The OTA uses a client-centered approach. Which should the OTA do during intervention sessions? a. Offer specific suggestions for more effectively dealing with confrontations. b. Respond to self-deprecating comments with positive feedback on personal characteristics. c. Reinforce only the consumers' neutral comments about themselves and their skills. d. Paraphrase the consumers' statements to help clarify expressed feelings and plans.
d. Paraphrase the consumers' statements to help clarify expressed feelings and plans.
A42. An individual with obsessive-compulsive personality disorder participates in a vocational program. The client asks the OTA to speak to the supervisor of the transitional employment program (TEP). The client is concerned that compulsive behaviors are interfering with job performance and may result in the loss of a new TEP placement. Which is the OTA's best response to these expressed concerns? a. Instruct the client to speak to the TEP supervisor about the right to receive reasonable accommodations. b. Schedule a reevaluation of the client's work behaviors and skills. c. Assure the client that it is natural to have initial difficulties at a new job. d. Schedule an appointment with the client and the TEP supervisor.
d. Schedule an appointment with the client and the TEP supervisor.
A68. An OTA working in a skilled nursing facility observes a resident with cognitive disabilities don slippers by putting them on the wrong feet. The resident plans to go visit a friend on another floor and does not seem aware that the slippers are on the wrong feet. Which is the best action for the OTA to take in response to this situation? a. Say nothing because this error may embarrass the resident. b. Say nothing but follow the resident to the friend's room to ensure a safe arrival. c. Ask the resident to look at the slippers to see if the error is noticed. d. Supportively inform the resident of the need to reverse the slippers.
d. Supportively inform the resident of the need to reverse the slippers.
A82. The family of an individual being discharged from a long-term care facility offers the OTA a substantial cash gift. The OTA refuses the money but the family insists that the OTA take the cash gift. Which is the OTA's best response? a. Donate the money to the hospital. b. Thank the family and donate the money to charity. c. Use the money to purchase an item on the OT department's 'wish list.' d. Thank the family for their thoughtfulness and decline the gift.
d. Thank the family for their thoughtfulness and decline the gift.
A46. A child with autism receives home care OT intervention services. The parent identifies a primary goal of developing the child's independent toileting skills. The child is completely dependent, and the parent reports not attempting toilet training for several years. The OTA collaborates with the occupational therapist to establish the first intervention goal for the child. Which behavior should this goal address? a. The child's ability to sit on the toilet with supervision. b. The child's ability to verbally tell someone of the need to go to the bathroom. c. The child's ability to nonverbally indicate the need to go to the bathroom. d. The child's ability to indicate when the diaper is wet or soiled.
d. The child's ability to indicate when the diaper is wet or soiled.
A41. A young adult incurred a left CVA, which has resulted in left visual field neglect. The occupational therapist and the OTA collaborate to develop an intervention plan based on the dynamic interaction approach. Which interventions are best for the OTA to use when working with this person to address this deficit? Select the three BEST responses. You must select exactly 3 choices a. Grade a series of scanning tasks that decrease in similarity to foster the transfer of learning. b. Ask the client to describe anticipated difficulties in finding items in a closet and a strategy to use to find items. c. Teach the person how to use a daily planner to keep track of activities that need to be completed each day. d. Train the person in scanning strategies to locate a desired condiment in the refrigerator to put on a sandwich. e. Work with the person on integrating both sides of the body during the completion of a morning grooming routine. f. Provide the person with written instructions to complete instrumental activities of daily living such as laundry.
a. Grade a series of scanning tasks that decrease in similarity to foster the transfer of learning. b. Ask the client to describe anticipated difficulties in finding items in a closet and a strategy to use to find items. d. Train the person in scanning strategies to locate a desired condiment in the refrigerator to put on a sandwich.
A23. Several patients in a cardiovascular unit are referred to occupational therapy for rehabilitation in areas of occupation. Which diagnosis would be an inclusive criterion for participation in the home management activity group conducted in the department's simulated apartment? a. Hypotension. b. Unstable angina. c. Venous thrombosis. d. Uncontrolled atrial arrhythmia.
a. Hypotension.
An OTA is working with an occupational therapist to develop a discharge planning group for clients being discharged within the next month from a long-term facility for adults with serious mental illness. Which initial action is best for the OTA and therapist to take when implementing this program? a. Obtain prospective group members' occupational profile and post-discharge goals and options. b. Identify community resources to develop a community re-integration program and enhance post-discharge participation. c. Develop a self-medication management teaching module to increase post-discharge medication compliance. d. Complete an evidence-based search to identify best practices in community-based mental health occupational therapy.
a. Obtain prospective group members' occupational profile and post-discharge goals and options.
A89. An adult who incurred a traumatic brain injury three months ago receives home care OT services. During meal preparation tasks, the client ignores items on the left side of the counter. Which is the best remediation approach for the OTA to use with this client to enhance performance? a. Place a brightly colored placemat on the left side of the counter. b. Encourage bilateral activities to promote scanning. c. Place all items on the right side of the counter.
a. Place a brightly colored placemat on the left side of the counter.
A72. A school-based 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.
A63. A 17-year-old student with a diagnosis of bipolar disorder and a history of self-abusive behaviors attends a transitional school-to-work program conducted by an OTA and an occupational therapist. During the vocational skills group, the student expresses feelings of hopelessness about the future and questions the point of participating in the program. The student asks to leave the group due to being too tired to concentrate as a result of sleepless nights. The occupational therapist asks the OTA to address the student's concerns while the therapist works with the other group members. Which action is best for the OTA to take in response to the student's statements? a. Pull the student aside from the group and ask if the student is feeling self-destructive. b. Allow the student to leave the group after reminding the student to relay concerns to the guidancecounselor. c. Support the validity of the student's feelings and encourage the student to remain in group. d. Remind the student that in a work setting the norm is to work even if fatigued.
a. Pull the student aside from the group and ask if the student is feeling self-destructive.
A58. An individual with schizophrenia begins a partial hospitalization program after a three- day hospitalization. During the initial interview, the client reports that they still experience hallucinations but that they occur less than they have in the past. Which action should the OTA take when the individual begins to actively hallucinate during an OT project/associative group? a. Redirect the individual's attention back to the project. b. Provide tactile reassurance to the individual. c. Verbally reassure the individual that the hallucination is not real. d. Use humor to divert the individual's attention away from the hallucination.
a. Redirect the individual's attention back to the project.
A5. A restaurant employee incurred a fracture to the left humerus. After cast removal, the patient received occupational therapy and now demonstrates 3/5 strength of the left triceps and full ROM of the left elbow. To increase elbow function in order to perform work-related tasks, which activity is most effective for the OTA to next include during intervention? a. Storing 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 glasses on shelves at chest height.
A12. An adult is hospitalized and diagnosed with mild chronic obstructive pulmonary disease (COPD). During the discharge planning session, the person identifies a desire to exercise regularly. Which of the following should the OTA recommend the client pursue? a. The hospital wellness program's yoga group. b. Low-impact aerobics at a local gym. c. Weight-lifting under the direction of a personal trainer. d. Jogging with friends in a local park.
a. The hospital wellness program's yoga group.
A22. A client with residual hemiplegia in the dominant extremity due to a prior CVA develops carpal tunnel syndrome in the non-dominant hand. The OTA constructs a splint and provides splint training to the client. Which of the following should the OTA ensure the client can do upon completion of the splint training sessions? Select the three BEST responses. You must select exactly 3 choices a. Understand the purposes and functions of the splint. b. Don and doff the splint with no physical assistance. c. Accurately state the wearing schedule after one verbal prompt. d. Self-direct the application of pieces of moleskin to areas of the splint that leave red marks. e. Understand that the splint should be worn at night and when performing repetitive activities. f. Self-direct the correct application of the splint to ensure bony prominences are considered.
a. Understand the purposes and functions of the splint. e. Understand that the splint should be worn at night and when performing repetitive activities. f. Self-direct the correct application of the splint to ensure bony prominences are considered.
A24. An elementary school student is referred to occupational therapy to develop handwriting skills. The student complains that the dominant hand hurts when writing. The student often tears the paper because of how hard they press. The student's teacher reports that the student is frequently observed playing 'rough' with peers despite being asked to calm down. When implementing the intervention plan developed in collaboration with the occupational therapist, which activity is best for the OTA to use prior to handwriting? a. Walking like an animal. b. Playing hop-scotch. c. Jumping rope. d. Performing somersaults.
a. Walking like an animal.
A36. An OTA provides home-based services to a child with developmental delays. The child picks up and puts away toys when reminded by the parents and mimics the parents when they dry dishes and fold clothes. The family has identified a goal of including the child in home management activities. Which activity should the OTA introduce next during intervention? a. Wiping tabletops. b. Sorting laundry. c. Making a bed. d. Taking out trash.
a. Wiping tabletops.
A94. 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 timing 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.
A84. A local pharmacy hires an OTA to consult on the redesign of the pharmacy's customer service area. Which height should the OTA recommend for an accessible service counter? a. 32 inches. b. 36 inches. c. 34 inches.
b. 36 inches.
A13. A client is being discharged after recovery from hip replacement surgery to live at home alone. Which is the most important equipment for the OTA to review with the client prior to discharge to enable safe occupational performance in the home? a. A rolling walker. b. A long-handled reacher. c. A bedside commode. d. An emergency call system.
b. A long-handled reacher.
A59. An OTA conducts a standardized sensory assessment of an individual recovering from a left cerebral vascular accident. The individual has right hemiplegia and expressive aphasia. During the assessment of stereognosis, which should the OTA have the client use to identify responses to the testing stimuli? a. Pictures of the objects. b. A set of identical objects. c. Cards with "1" and "2" printed on them. d. Cards with "yes" and "no" printed on them.
b. A set of identical objects.
A87. An OTA is working with a teenager who is recovering from surgery to remove a brain tumor. The teen has been hospitalized for two months and exhibits a decline in cognitive functioning and muscle weakness. The client is receiving occupational therapy services to develop the skills needed to complete ADL and other desired activities. Upon evaluation, the occupational therapist determined that the client is experiencing symptoms of depression, including anhedonia, social isolation, and poor sleeping patterns. During an intervention session, the OTA learns that the client is feeling socially isolated and missing friends and family members. Which activity is best for the OTA to integrate into intervention sessions to help the client communicate with and remain connected to friends and family? a. An online social networking service that enables users to send and read short messages of 140 characters or less. b. An online service that allows users to post interests and explore new ones by browsing what others have posted. c. An online networking service that enables one to call, see, and message with others in real-time by using a webcam. d. A business-based networking service for which o
c. An online networking service that enables one to call, see, and message with others in real-time by using a webcam.
A70. A person fell and sustained bilateral Colles' fractures. The client wore bilateral short-arm casts for 6 weeks. After cast removal, the client began OT sessions to increase endurance and strength prior to returning to work. The client tends to work hard when performing resistive exercises with both wrists. The OTA monitors the client for overexertion. Which behavior indicates overexertion? a. Decreased respiration rate during resistive wrist flexion. b. Increased ability to achieve full ROM of the wrist. c. Complaints of pain in the wrist extensors. d. Consistent strength in wrist extension activities.
c. Complaints of pain in the wrist extensors.
A40. An OTA administers a standardized cognitive-perceptual assessment to a client. The client demonstrates difficulty performing the first two tasks included in this assessment tool. Which is the next best action for the OTA to take? a. Continue the assessment and provide additional verbal cues during task performance. b. Continue the assessment and demonstrate each task for the client. c. Continue the assessment according to the established administration protocol. d. Discontinue the assessment to avoid frustrating the client.
c. Continue the assessment according to the established administration protocol.
A4. An OTA leads a community integration group for individuals with mild intellectual disabilities who reside in a group home. During a travel training session, a member of the group slips while going up the stairs of a bus. The client quickly gets up, pays the fare, sits down, and jokingly states, "Good thing I bounce well." Which action should the OTA take after assessing that the person is not injured? a. Cancel the planned activity and return to the group home to file an occurrence report. b. Ask the bus driver to radio for an ambulance to obtain a medical assessment of the client. c. Continue with the planned activity and file an occurrence report upon return to the group home. d. Continue with the activity and ask the client to report the development of any symptoms related to the fall.
c. Continue with the planned activity and file an occurrence report upon return to the group home.
A25. An OTA is implementing a community mobility group with individuals attending a traumatic brain injury day-treatment program in an urban area. Which activity should the OTA plan for the group members to complete during the first group session? a. Reading bus and subway maps. b. Take a subway or a bus as a group. c. Determining a desired destination. d. Purchasing a public mass transportation fare card.
c. Determining a desired destination.
A50. During a clubhouse vocational support group, a client reports difficulty keeping track of the job tasks that need to be completed each day. What is the most effective recommendation for the OTA to make to the client? a. Write down directions for each task that needs to be completed. b. Keep a daily log of completed tasks. c. Develop and use a checklist of tasks to be completed each day. d. Ask the work supervisor to provide verbal cues through the workday.
c. Develop and use a checklist of tasks to be completed each day.
A2. An adult incurred a traumatic brain injury (TBI) which resulted in sensory and perceptual deficits that make the completion of basic activities of daily living difficult. During an intervention session focused on dressing, which will the OTA most likely observe the person have difficulty with when donning shoes? a. Grasping and manipulating the shoelaces. b. Sequencing the steps of tying the shoelaces. c. Discriminating between the right and left shoe.
c. Discriminating between the right and left shoe.
A21. The members of a clubhouse attain a level of cohesion that enables them to perform at a cooperative/supportive cooperative level. Two members disagree with the others on the details of a group project. How should the OTA leading this group respond to this conflict? a. Listen to all viewpoints and suggest that members vote to determine the project details. b. Mediate only when the members have reached a deadlocked situation. c. Encourage the members to explore alternative methods to resolve the conflict.
c. Encourage the members to explore alternative methods to resolve the conflict.
A20. A client with a persistent depressive disorder and their spouse attend a discharge meeting with the OTA following the client's four day hospitalization for a major depressive episode. They express concern that they have few shared activity interests and spend little time together. The client retired four months ago. The spouse continues to work full time. Which of the following should the OTA encourage this couple to do first to address this concern? a. Immediately participate in one activity together. b. Engage in their individualized activities of interest during the week. c. Explore activities they have enjoyed together and alone. d. Delay planning activities until the depression is totally resolved.
c. Explore activities they have enjoyed together and alone.