Practical Test 1

B. .Knowledge of the presence of an EVD is important for the therapist to understand the patient's current medical status, any associated precautions or limitations, and potential impacts on the patient's functional abilities and participation in therapy activities.

1. An OTR is scheduled to evaluate a young adult admitted to the neurological unit of an acute care hospital 2 days ago. Medical records indicate the patient has a history of epilepsy and hydrocephalus and was hospitalized after having multiple seizures. severe headaches, high fevers. and alterations in mental status. What additional information would be MOST IMPORTANT for the OTR to obtain from the records prior to beginning the initial evaluation of this patient? A. Activities that prompt the onset of seizures B. Presence of an external ventricular drain C. Guidelines for isolation precautions

C. Having the student look at a posted schedule of daily activities provides a visual representation of the upcoming transition from free play to snack time. This visual cue helps the student anticipate the change in activities, making the transition more predictable and reducing anxiety or resistance. It also promotes independence and self-regulation by empowering the student to understand and follow the routine.

10. A student in kindergarten has a pervasive developmental disorder. The student has difficulty transitioning from free play to snack time during the school day. Which option is a representational transition strategy for the teacher to use at the end of free play activity to increase predictability for the student and minimize behavioral problems associated with imposed transition times? A. Ask the student. "What do we do every day after free play?'' B. Hand the student a cup and say, "Time for a snack" C. Have the student look at a posted schedule of daily activities. D. Physically guide the student to the snack table

C. Self-determination. Self-determination refers to the ability of an individual to make choices and decisions based on their own preferences, values, and goals. In this scenario, the client desires autonomy and the ability to determine their own path in life despite having bipolar disorder. They want to have control over their decisions and actions, reflecting a desire for self-determination. Therefore, option C, self-determination, provides the best description of the client's objective.

100. An OTR is collaborating with an adult client who has bipolar disorder to establish client-centered goals. The client has insight into personal strengths and limitations and wants to independently make decisions about the current and future direction of life plans. Which of the following provides the BEST description of the client's objective? A. Self-management B. Self-actualization C. Self-determination

C.

11. A patient who had a recent total hip replacement is preparing for discharge from a rehabilitation unit to stay at home with a spouse. The patient is independent in all ADLs except for putting socks and shoes on the involved extremity. The OTR has instructed the patient 1n the use of appropriate equipment to assist with this task. but the patient states the equipment is more trouble than 1t 1s worth and refuses to use the device. The patient's spouse is willing to assist the patient each day. How should the OTR respond to this situation? A. Evaluate the spouse's ability to safely put socks and shoes on the patient B. Reemphasize the importance of becoming totally independent with self-care. C. Respect the patient's choice and document the discontinuation of therapy. D. Suggest alternative devices that may be more appealing to the patient

B.

12. A client has dysphagia and is beginning an oral motor feeding program. The OTR observes that the client has reduced lingual control when swallowing. Which food is SAFEST to include as part of the client's diet? A. Chopped meat with gravy B. Cooked paste with melted cheese C. Ory oat cereal with milk D. Toasted bread with butter

A. Given that the client has complex regional pain syndrome and decreased functional use of the dominant upper extremity, the priority should be to address pain management and modulation techniques to enable participation in the work hardening

13. A client had an open reduction internal fixation of a distal radius fracture 3 months ago. The client developed complex regional pain syndrome 2 months after the surgery. Currently. the client has decreased functional use of the dominant upper extremity and Is scheduled to begin an 8-week work hardening program. What should be the INITIAL goal of this intervention? A. Demonstrate pain modulation techniques during work activities B. Improve work behaviors to increase output based on work demands C. Increase upper extremity strength for critical JOb demands. D. Perform critical job tasks within a pre-established reasonable time limit

C.

14. A patient who has Guillain-Barre syndrome is in an acute rehabilitation program. The patient has quadriparesis and currently requires maximum assistance for ADL. The OTR is developing intervention goals for the patient to achieve by the time the patient transitions to the next level of care. Which task would be MOST REALISTIC to include as part of a short-term goal in this treatment plan? A. Patient will be able to self-feed with modified independence using adaptive equipment. B. Patient will use adaptive strategies to complete showering and personal hygiene after set-up. C. Patient will be able to independently complete self-ROM exercises of bilateral upper D. Patient will complete a sliding board transfer with contact guard assistance.

B.

15. As part of the evaluation process. an OTR administers the Hawian Ear1y Learning Profile to an 11-month-old infant who Is at risk for developmental delay. What Is the PRIMARY purpose of using this type of assessment? A. To establish an age-equivalent developmental score to use as a baseline measure B. To determine the infant's level of performance using a defined set of skills C. To measure the infant's participation in developmental tasks relative to a normative group

C.

16. An initial screening of a 33-month-old child indicates the child has an emerging ability to use objects for solitary pretend play. expresses discomfort by crying. and uses a tripod grasp when copying simple shapes and constructing basic three-dimensional block designs The parents report the child independently uses the bathroom, and helps with dressing. and self feeds but occasionally is a picky eater Which skills appear delayed based on these findings? A. Finemotor B. Sensorimotor C. Social-emotional

B. Conducting focus groups with individuals who have sustained a spinal cord injury in order to develop a theory of adjustment. Qualitative research methodology involves exploring and understanding phenomena in their natural settings, focusing on the meanings people ascribe to them. It is concerned with understanding the complexities of human behavior and the reasons behind it. In the context of the given question, conducting focus groups with individuals who have sustained a spinal cord injury is an example of qualitative research methodology. This approach involves gathering rich, detailed data through interviews, observations, or focus groups to understand the experiences, perspectives, and behaviors of individuals in relation to the phenomenon of interest, in this case, adjustment to spinal cord injury. The aim is not to quantify or measure specific outcomes numerically but to gain insights, develop theories, o

17. Which of the following clinically focused research project topics is an example of qualitative research methodology? A. Assessing the outcomes of a life skills training group to identify the change in Job retention rates for clients who have a substance use disorder B. Conducting focus groups with individuals who have sustained a spinal cord injury in order to develop a theory of adjustment C. Engaging kindergarten-age students who have learning disabilities in a sensory integration program to improve academic performance D. Using gardening activities to improve grip strength outcomes for clients who have mild hemiplegia

A. Given the patient's report of having more energy despite still feeling depressed, it's important for the occupational therapist to ensure that the activity environment provides structure and allows for continuous observation. This precaution helps in monitoring the patient's behavior and mood changes closely, ensuring their safety and well-being during the intervention sessions. Additionally, maintaining a structured environment can help the patient feel supported and engaged in the activities despite their depressive symptoms.

18. A patient who has depression has been taking an antidepressant for 3 weeks. The patient has also been part1c1patmg in a daily OT group. Ounng the most recent group activity. the patient reported having more energy despite still feeling depressed. Based on this report what precautions should the OTR take when preparing intervention sessions'? A. Ensure the activity environment provides structure and allows for continuous observation B. Avoid gross motor activities that may exacerbate medication side effects C. Use sedentary activities to avoid the potential for disruptive hyper-manic outbursts. D. Minimize the use of fine motor activities to avoid frustration due to cogwheel rigidity.

B. A mobile arm support can provide external support and assistance to the patient's weak arm, helping to stabilize and elevate the limb during feeding activities. This can reduce the effort required by the patient to hold the arm in position, allowing for more precise movements and improved control during self-feeding. Additionally, it can help offset weakness and fatigue, enabling the patient to engage in mealtime tasks with greater independence.

19. A patient who has myasthenia gravis and Fair minus (3-/5) strength of the dominant extremity wants to be as independent as possible during meals. The patient is not able to complete self-feeding despite having a universal cuff, plate guard, and an elongated straw. Which intervention would be MOST BENEFICIAL for promoting progress toward the patient's goal? A. Adaptations to the universal cuff and eating utensils B. Instruction in the use of a mobile arm support C. Training on how to facilitate a tenodesis grasp D. Upper extremity strengthening and endurance exercises

B. Patient's endurance for completing activities according to a clinical pathway. Given the recent bilateral total knee arthroplasties, the patient's endurance and tolerance for activities will likely be reduced. It's essential for the OTR to assess the patient's current level of endurance and plan therapy sessions accordingly, gradually increasing activity levels based on the patient's progress and clinical pathway.

2. An OTR who works in an inpatient rehabilitation unit is completing an evaluation of a patient who had bilateral total knee arthroplasties 3 days ago. The patient is in generally good health, and plans to live independently at home. and wants to resume volunteer work in the community. The patient currently requires OT services to increase independence in bathing, dressing, and toileting. What MUST the OTR consider when scheduling the patient for OT? A. Availability of caregivers to participate in daily sessions for education and training B. Patient's endurance for completing activities according to a clinical pathway C. Understand documentation requirements for reimbursement by the third-party payer

B. Five to 10 minutes or until the redness disappears from the skin surface. After ice is applied to an injured area, the analgesic effect typically lasts for about 5 to 10 minutes, or until the skin returns to its normal color and the sensation of cold diminishes. This duration may vary depending on individual tolerance and the severity of the injury. Once the skin begins to warm up again and the sensation of cold diminishes, the analgesic effect of the ice diminishes as well.

20. A client sustained a radial head fracture 2 months ago and 1s part1c1pabng 1n OT. After completing exercise and functional activity. ices applied to the area of 1nJury for 20 minutes. How long after the ice is applied does the client continue to benefit from the analgesic effect of the ice? A. Approximately 30 minutes after the removal of the ice B. Five to 10 minutes or until the redness disappears from the skin surface C. Two times the length of time of the ice application D. Unlit the client feels a burning sensation m the affected area

C. Building Self-Regulation: Teaching coping skills empowers the student to regulate their emotions and behaviors independently, reducing reliance on external cues or direction from adults. As they develop coping strategies, they may become more self-directed in their approach to academic tasks and social interactions, leading to greater autonomy and engagement in classroom activities.

21. A student in elementary school has experienced significant childhood trauma and lives in a foster home. The student becomes frustrated when asked to complete cognitively and physically challenging tasks and does not participate in classroom activities unless directed to do so by an adult. Which method would be MOST BENEFICIAL to include as part of the intervention for promoting the student's academic success and social interaction within the school environment? A. Engaging the student in interactive curriculum-based competitive games B. Having the teacher use a behavior modification program with the student C. Including the student in a coping skills and stress management class D. Involving the student in a structured goal-oriented activity group

B. While other activities such as free-style painting, scooping food with a spoon, or stacking blocks may also be incorporated into the toddler's training program later on, pushing a large therapy ball toward a target is a suitable introductory activity during the first phase, focusing on gross motor skill development and prosthetic adaptation.

22. A 2-year-old toddler has a congenital absence of bilateral upper extremities at the proximal forearm level. The toddler Is transitioning from using passive prosthetic devices to using body-powered voluntary opening prostheses. Which activity should the OTR introduce during the FIRST phase of the toddler's prosthetic training program? A. Free-sty1e painting on an upright easel B. Pushing a large therapy ball toward a target C. Scooping food with a spoon D. Stacking l in (2.54 cm) blocks

C.

23. An OTR is using manual muscle testing to evaluate the wrist strength of a client who has peripheral neuropathy. When the client Is seated upright with the forearm supported In neutral. the client has 30° of active wnst extension. The client has full passive ROM of the wrist. When the forearm Is placed in midposition on its ulnar border. the client Is able to actively extend the wrist to 70° and maintain the position against slight resistance. What muscle grade for wrist extension should the OTR record in the client's chart? A. Poor plus (2+/5) B. Fair C. Good minus (4-/5) D. Good(4/5)

B. Given the child's developmental delay in upper body motor development, the most appropriate action for the OTR to take is to initiate a referral to an early intervention program in the family's community. Early intervention programs are designed to provide support and services to children with developmental delays or disabilities, helping them reach their full potential through therapeutic interventions and family support. Referring the child to an early intervention program ensures that they receive timely and targeted interventions to address their developmental needs. These programs typically offer a range of services, including occupational therapy, physical therapy, speech therapy, and developmental education, tailored to the individual child's needs and delivered in their natural environment, such as their home or daycare. By initiating a referral to an early intervention program in the family's community,

24. An OTR works as part of a multidisciplinary team in support of a spina bifida clinic at a university-based orthopedic children's hospital. A 2-year-old child who lives In a rural community 90 miles (144 km) from the clinic has a routine appointment with the clinic team every 2 months. During one of the clinic appointments, the OTR completes a developmental screening and the results 1nd1cate a 2-3 month delay in upper body motor development. What action should the OTR take based on the screening outcomes? A. Advise the child's parents to schedule an appointment with a developmental pediatrician B. Initiate a referral to an early intervention program in the family's community C. Schedule the child for a comprehensive developmental assessment during the next clinic visit

C. Pouring pre-measured liquid ingredients into the mixing bowl involves fine motor coordination and judgment of quantity, which can be challenging for individuals with mild cognitive decline. Environmental adaptations, such as using measuring cups with clear markings, a stable surface, or a funnel, can help optimize independence and accuracy in this task. Answer D. states, "Responding appropriately to the sound of the oven timer." While this step is important for completing the baking process, it does not involve the actual baking activity of preparing the cake. Additionally, environmental adaptations may not directly apply to this step, as it primarily requires auditory perception and cognitive processing rather than physical manipulation or coordination. Therefore, it is not the most appropriate step for the use of environmental adaptations to optimize independence.

25. A resident of a skilled nursing facility who has mild cognitive decline secondary to Alzheimer's disease wants to bake a cake for a teenage grandchild's birthday. an Activity the resident has done every year since the grandchild was born. Ounng which step of the activity would the resident benefit from using environmental adaptations to optimize independence with this task? A. Accurately, reading the recipe 1ogredients from the box of mix B. Cracking the eggs and add them into the bowl of cake mix C. Pouring pre-measured liquid ingredients into the mixing bowl D. Responding appropriately to the sound of the oven timer

C. After removing electrodes from a client who has received iontophoresis, it is important to take care of the skin surface that came in contact with the electrodes. Applying a lotion with a neutral pH can help soothe the skin and restore its natural balance. This step helps minimize any potential irritation or discomfort that may occur as a result of the iontophoresis treatment. Additionally, a lotion with a neutral pH is less likely to cause further irritation to the skin, making it a suitable choice for post-treatment care. Option A suggests wiping the area with an alcohol pad. Alcohol pads can be harsh on the skin and may further irritate the skin that has already been sensitized by the iontophoresis treatment. Using alcohol immediately after the treatment could exacerbate any discomfort or irritation, making it an inappropriate choice for post-iontophoresis care.

26. An OTR is removing electrodes from a client who has just received iontophoresIs. Within several minutes of removing the electrodes, what should the OTR do to the skin surface that came In contact with the electrodes? A. Wipe the area with an alcohol pad B. Vigorously massage the area C. Apply a lotion with a neutral PH C. Rub an analgesic lotion into the area

ME: A. ChatGPT: B.

27. An OTR is developing an exercise program for a client who has moderate hem1plegIa Observation results indicate that the client lacks active upward rotation of the scapula and external rotation of the humerus of the involved upper extremity. Which type of exercise Is CONTRAINDICATED to include in the client's home program? A, Bearing weight on the affected forearm placed on a table. then turning the trunk away from the supported position B. Clasping both hands to reach upward beyond 90 degrees of shoulder flexion C. Cradling both arms at chest level to abduct and adduct the shoulders D. using a hand-over-hand movement to slide a dust cloth across the tabletop

B.

28. An 18-month•Old child Is hypotonic and cannot fully extend the neck and trunk against gravity. Which position would be MOST EFFECTIVE to place the child in to facilitate antigravity movement and promote hand usage? A. Fully upright in a standing frame B. Prone on a 45-degree Wdge positioned on the floor C. Seated upright on a large therapy ball D. Straddle-sit position on a bolster

C. Option C, guiding the swing into a slow linear movement, is the most appropriate response in this situation. Slow linear movement can provide gentle vestibular input without the intense rotational stimulation that may be contributing to the autonomic activation. Linear movement is often more organizing for individuals with sensory modulation deficits and can help the child regulate their arousal level.

29. An 8-year-old child has sensory modulation deficits and is participating In outpatient OT. While spinning in the tire swing. the child begins to show mild signs of autonomic activation. How should the OTR INITIALLY respond to this observation? A. Begin to slowly rotate the swing 1n the opposite direction B. Remove the child from the swing immediately C. Guide the swing into a slow linear movement D. Stop the swing to Irnt1ate intense tactile st1mulat1on.

B. if the goal is to provide a strong stimulus, such as in the context of sensory stimulation for a patient with a traumatic brain injury, targeting the olfactory cortex with strong-smelling substances would generally be more effective in eliciting a response.

3. An OTR is working on pre-feeding activities with an inpatient who had a recent TBI and is functioning at Level Ill (Localized Response) on the Rancho Los Amigos scale. Which technique would be MOST EFFECTIVE when providing graded stimulation of the patient's cranial nerves? A. Gently rub the patient's tongue using a cotton swab saturated with salty and sweet flavorings. B. Hold strong-smelling cooking extracts. such as artificial vanilla. close to the patient's nose for 2-5 seconds. C. Place a small piece of the patient's favorite sweet food on the patient's tongue. D. Use soft candy items as rewards for positive responses to voice commands.

D. Option D is the most appropriate course of action in this scenario. By respecting the client's decision, the occupational therapist can maintain a client-centered approach and honor the client's preferences and wishes. However, scheduling a reevaluation in one month allows for ongoing monitoring of the client's condition and reassessment of their factors. This allows the client to reconsider their decision if they experience any changes in their condition or if their needs evolve over time.

30. An older adult outpatient client has hem1plegia of the dominant extremity after having a CVA 2 weeks ago. Results from a motor evaluation administered one day ago indicate mild UPPE'I extremity weakness and decreased fine motor dexterity when compared to the nondominant extremity. The client acknowledges the results but declines services. stating that the deficits do not interfere with day-to-day activities. What action should the OTR take in this situation? A. Administer a standardized ADL assessment to ensure the client's functional skills are within normal limits B. Document the client's response, indicating that additional services and follow-up are not medically necessary C. Provide the client with a medium resistance therapy band to use for strengthening the upper extremity at home. D. Respect the client's decision and schedule a reevaluation in one month to reassess the client's factors

D. Anosognosia is a condition in which a person is unaware or in denial of their neurological deficits or physical impairments, often as a result of brain injury or neurological condition such as stroke. In this scenario, the client denies having any problems moving the affected arm, despite objective evidence indicating otherwise. Option C ("Client is in denial about current physical impairments") is somewhat accurate, but it lacks the specific terminology related to neurological deficits or anosognosia.

31. A client has moderate hemiplegia due to a recent CVA. The client requires assistance for transfers and does not have functional motor control of the affected upper extremity. When asked about the lack of upper extremity motor control. the client denies having any problems moving the arm. Which of the following statements should be used in the documentation to describe the client's response? A. "Client is a fall risk due to ideational apraxia" B. "Client requires maximum assistance during transfers" C. "Client is in denial about current physical impairments." D. "Client demonstrates behaviors consistent with anosognosia"

B. Low contrast sensitivity and a high contrast threshold indicate that the client has difficulty distinguishing between objects with subtle differences in brightness or color. This suggests that the client will require magnification during fine motor tasks to enhance their ability to perceive details and distinguish between objects more effectively. Option C (The position of lighting impacts the client's ability to see objects) is a possibility, as lighting conditions can affect visual perception, but this conclusion cannot be directly drawn from the contrast sensitivity test alone.

36. An OTR has completed a contrast sensitivity and lighting test with a patient who has low vision. The client has a high contrast threshold and low contrast sensitivity. What conclusion can the OTR make based on these findings? A. The client is a good candidate for Braille training B. The client will require magnification during fine motor tasks C. The position of lighting impacts.s the client's ability to see objects. D. The use of fluorescent lighting is best for seeing objects clearly

B. This method involves considering the number of weeks of prematurity and subtracting it from the infant's chronological age to obtain the corrected age. This adjusted age is used to account for premature birth and more accurately assess the infant's developmental milestones based on the expected developmental trajectory for their corrected age rather than their actual birth date.

38. An OTR is about to administer a standardized developmental screening to a 6•month•old infant born at 34 weeks gestation. What method should the OTR use to calculate the infant's corrected age prior to administering the test? A. Subtract the day. month. and year of the infant's birth date from the date of testing B. Subtract the infant's measurement of prematurity from the infant's chronological age C. subtract the month and year of testing from the month and year of the infant's birth date. D. Subtract the number of weeks of full-term gestation from the actual weeks of gestation.

C. Visual reminders are helpful for individuals with cognitive impairments, such as dementia, as they provide cues and prompts for daily activities. Posting visible signs on each door serves as a constant visual cue to remind the client to lock the door. This approach is practical and aligns with the principle of environmental modification to support independent living for individuals with cognitive challenges.

39. An older Adult client has been diagnosed with early-stage dementia. The client lives alone in an apartment. One of the client's goals is to remain in the current apartment as long as possible. During an aging-in-place assessment, the OTR determines that the client has difficulty remembering the sequence of steps for securing the locks on a door. Which option would be MOST EFFECTIVE for supporting long-term aging in place? A. Engage the client in repetitive drills using blocked practice to facilitate carry-over of learning B. Identify a programmable environmental control device that can be used in the client's home C. Post visual reminders on each door of the home to indicate the need to lock the door. D. Provide a checklist the client can use to check in-home security at the end of each day

C. Use a tub-transfer bench for getting into and out of the bathtub. A tub-transfer bench would facilitate safer and more manageable transfers in and out of the bathtub for a patient with limited mobility due to an L1 spinal cord injury. It provides a stable surface for the patient to sit on while transferring, reducing the risk of falls or injuries during the transfer process. This modification promotes independence and safety in the patient's home environment.

4. An inpatient who has an L1 spinal cord injury is preparing for discharge from a rehabilitation unit to home. The patient's home has a wheelchair-accessible bathroom with a bathtub that has a wall-mounted showerhead and shower curtain. Which home modification should the OTR recommend for this patient? A. Replace the shower curtain with a tub-mounted sliding door. B. Place a shower chair with suction feet in the bathtub. C. Use a tub-transfer bench for getting into and out of the bathtub. D. Fasten a removable grab bar to the side rim of the bathtub.

A - chatgpt C - me

40. OTR is evaluating an adult client who is Diagnosed With focal hand dystonia of the nondominant hand. Symptoms interfere with the client's employment as a professional musician. What information would be MOST IMPORTANT for the OTR to gather prior to establishing an intervention plan? A. Movement patterns the client uses during work B. Amount of assistance the client needs during ADL C. Grip and pinch strength measurements of both hand D. Sensory mapping using monofilament instruments

D. Moving the patient apart from the rest of the group can address the issue of high noise levels and potentially enhance the patient's ability to focus on and follow written instructions for the recipe. This individualized approach recognizes the patient's specific needs and aims to create a more conducive environment for successful participation in the activity. It also demonstrates the principles of environmental modification to support the patient's engagement and success in the task at hand.

41. A patient has schizophrenia and Is undergoing inpatient treatment. One of the goals Is to assess the patient's ability to live independently. During a meal preparation group activity, the patient has difficulty following written instructions for a recipe, and indicates that the noise level of the group is too high to complete the assigned tasks. What action should the OTR take based on the patient's responses A. Evaluate the patient's meal preparation skills individually at another time B. Ask the group to work more quietly during the remainder of the activity C. Document the patient's inability to concentrate long enough to cook safely D. Move the patient apart from the rest of the group to complete assigned tasks

D. Using a lap belt can help stabilize the pelvis and prevent the child from pushing into extension. The 45° angle is often recommended to provide appropriate support while minimizing the risk of the child sliding out from under the belt. This method helps create a more stable seated position, making it easier for the parents to position the child for feeding in the wheelchair. (chatgpt answered and need to check 45 angle lap belt)

42. A 5•year•old child has severe extensor tone and shortened hamstrings secondary to athetoid cerebral palsy. The child typically pushes into extension when in a seated position in the wheelchair. making it difficult for the parents to position the child for feeding. Which method should the OTR advise the parents to use INITIALLY to stabilize the child in the wheelcha11? A. Insert a small roll behind the lumbar spine to promote an anterior pelvic tilt B. Insert a wedge cushion In the chair seat to raise the distal portion of the thighs approximately 3 in (7. 62 cm) C. Place the feet on the footrests with the knees positioned in less than 90° of flex1on to pull the ischia1I tuberosities into a posterior pelv1c tilt. D. Secure a lap belt at a 45• angle across the child's hips to stabilize the pelvis

D. Supporting the infant's shoulders and trunk provides stability while allowing controlled movement of the ball. This helps engage the infant's neck muscles in a controlled manner, facilitating the development of neck flexion. The slow rocking back and forth can encourage the infant to use neck muscles to maintain head control during the activity. This graded approach ensures that the activity is challenging yet appropriate for the infant's current developmental stage.

43. A 6•month•old infant who has Down syndrome and hypotonicity has difficulty maintaining head control when pulled from supine to sitting. The OTR plans to work with the infant on therapeutic ball activities to facilitate isolated neck flexion. How should the OTR INITIALLY grade this activity? A. Grasp the infant's upper arms while moving the ball In angular patterns B. Hold the Infant's hands while moving the ball side to side C. Stabilize the infant's pelvis while slowly rocking the ball in diagonal patterns. D. Support the infant's shoulders and trunk while slowly rocking the ball back and forth.

C. Time management and social skills Evaluating time management skills provides insight into the client's ability to organize tasks and meet deadlines, which is essential in a work setting. Social skills are also crucial, as they impact the client's ability to interact with colleagues, supervisors, and clients. Since the client is interested in working with a landscaping company, effective communication and collaboration are vital aspects of the job. While other factors like lifting capacity, endurance, memory, physical stamina, strength, and adaptability are important, focusing on time management and social skills is particularly relevant for assessing vocational readiness and success in a work environment for an individual with chronic schizophrenia.

44. An OTR Is preparing to complete a vocational-readiness assessment with an adult client who has chronic schizophrenia. The client wants to work with a landscaping company. What performance skills should the OTR INITIALLY evaluate to provide information about the client's current work behavior? A. Lifting capacity and endurance B. Memory and physical stamina C. Time management and social skills S. Strength and adaptability

B. Have the client practice using the prosthetic controls and perform isolated movements in front of a mirror This approach allows the client to focus on refining control of the myoelectric prosthesis through isolated movements. Practicing in front of a mirror provides visual feedback, helping the client better understand the movements and make adjustments. This graded activity helps improve coordination and control over time, promoting more effective use of the prosthetic device.

45. An adult client who has an upper extremity transhumeral amputation of the dominant extremity is learning to use a myoelectric prosthesis. During a bedside dressing assessment, the OTR observes that the patient Is using exaggerated trunk movements to operate the prosthesis. How should the OTR grade the activity to facilitate the client's ability to control the prosthesis? A. Advise the client to use the nondominant extremity as an assist during the task B. Have the client practice using the prosthetic controls and perform isolated movements in front of a mirror C. initiate a program of resistive strengthening and endurance exercises for the residual limb. D. Teach the client ways to practice a variety of movement patterns without the prosthesis

B. Determine the client's typical mealtime habits and routines. Understanding the client's typical mealtime habits and routines can provide valuable insights into their preferences, comfort level, and familiar activities. This information can guide the planning of the meal preparation activity, helping to create an environment that aligns with the client's cognitive abilities and supports their success during the group activity. It allows the OTR to tailor the intervention to the client's individual needs and enhance their engagement in the meal preparation process.

46. An adult client has chronic sch1zophrenia and is functioning at Allen Cognitive Level 4 (Goal-directed Actions). The client currently resides in a group home. One of the intervention goals is for the client to participate in meal preparation activities with other residents. What preparation should the OTR make in advance of the group to support the client's success during this activity? A. Ask the client to list meal preparation task preferences B. Determine the client's typical mealtime habits and routines C. Engage the client in the meal planning process. D. Plan a meal that does not require the use of a stovetop or oven.

C. Impaired self-awareness of performance errors. In this case, the client's self-report indicates independence with ADL and IADL, while the PASS assessment reveals a lower score for safety and adequacy. This suggests a lack of awareness by the client regarding their actual performance errors and safety concerns. Impaired self-awareness is a common feature in various neurological conditions, including Parkinson's disease, and can impact a person's ability to accurately assess their own abilities and limitations.

47. An OTR working man in an outpatient setting has completed an initial evaluation with a client who has early-stage Parkinson's disease. The client has mild motor symptoms, scored within normal limits on the Montreal Cognitive Assessment (MoCA), and reports independence with ADL and IADL. Medication management scores of the Performance Assessment of Self-care Skills (PASS) are 2/3 for independence. 1/3 for safety. and 1/3 for adequacy. What does the discrepancy between the results of the PASS (where higher scores indicate greater independence) and the subjective report suggest about the client? A. 1ntentiona1 masking of changes in cognitive capacity B. Confabulation during a report of occupational abilities C. Impaired self-awareness of performance errors

A. The high percentage (80%) of patients requiring additional adaptive devices and durable medical equipment after discharge suggests a potential gap in the discharge planning process. Including predischarge home evaluation visits for patients with CVA would allow the occupational therapist to assess the home environment and identify any necessary modifications or adaptive devices before the patient returns home. This proactive approach can help optimize the home environment for the patient's safety and independence, potentially reducing the need for additional equipment and interventions after discharge.

48. An OTR has completed a utilization review of services provided to patients who completed inpatient rehabilitation after having a CVA. Results indicate that within one week after discharge, 80% of the patients who were discharged home required additional adaptive devices and durable medical equipment as determined by home health OT. What action should the OTR take based on the outcome of this study? A. Recommend including predischarge home evaluation visits as part of the discharge planning for patients in this diagnostic group B. Compile a list of equipment that patients in this diagnostic group should purchase prior to discharging home C. Develop a home access1b1lity survey for patients to complete at d1schage and several weeks after d1scharge.

C. Extent to which each intervention plan reflected patients' perceived needs. This option addresses the alignment of intervention plans with the patients' perceived needs. It involves examining whether the goals set in the intervention plans accurately reflect the specific needs and priorities as perceived by the patients. If there is a mismatch between the intervention goals and the patients' perceived needs, it may impact the effectiveness of the intervention and the likelihood of goal achievement. Adjusting the intervention planning process to better incorporate patients' perspectives can enhance goal relevance and increase the likelihood of successful outcomes.

49. The OT staff in an inpatient setting has developed a continuous quality improvement initiative to measure the percentage of intervention goals achieved. Results suggest that although patient improvement was evident in the documentation. the goals of the original intervention plan were not always achieved by the time of discharge. What should the OT staff investigate NEXT based on the findings? A. Relationship of intervention goals to the presenting occupa11onal performance deficit B. Consistency in therapy minutes allocated for daily OT treatment sessions C. Extent to which each intervention plan reflected patients' perceived needs

C.

5. An 8-year-old child had an acquired brain injury 3 weeks ago and is an inpatient in a children's hospital. The child has a tracheostomy, is on medication to stabilize seizure activity. and is functioning at Level II (Generalized Response) on the Rancho Los Amigos scale. At least one member of the child's family spends each day and most nights at the hospital with the child. What type of controlled sensory stimulation can the OTR teach the family to benefit the child at this stage of the rehabilitation process? A. Change the child's position from supine to supported sitting intermittently throughout the day. B. Rub the child's extremities with lotion while providing verbal cues about position and body awareness. C. Pass a cotton ball saturated with ammonia or artificial vanilla under the child's nose for 2-5 seconds three to five times per day. D. Ask the child to clap hands or move the arms and legs to the rhythm of a favorite song several times per day.

me: C. Chatgpt: B. Educate the direct-care staff about the resident's meal set-up and utensil use. Educating the direct-care staff about the resident's specific needs, including the use of the universal cuff and the preferred meal set-up, ensures consistent support and promotes the resident's independence during mealtimes. Staff members who are aware of the resident's requirements can provide appropriate assistance and create an environment that fosters the resident's autonomy in self-feeding. This collaborative approach helps to maintain continuity in care and maximizes the resident's independence in the long term

50. An OTR has completed a self-feeding reevaluation of a resident in a long-term care facility. Results indicate the resident would benefit from using eating utensils inserted in a universal cuff instead of using utensils with built-up handles. The OTR provides the assistive eating utensils and assesses the resident's ability to use the utensils. What additional action should the OTR take to support the resident's long-term independence with self-feeding? A. Advise the resident to use the universal cuff during several meals and then reassess B. Educate the d1r«t-care staff about the resident's meal set-up and utensil use C. Schedule several mealtime sessions to train the resident how to don and doff the cuff.

B. Position the client during meals in a chair that semi-reclines 30 degrees to 40 degrees. Positioning the client in a semi-reclined position can help facilitate safer swallowing during meals. This position aids in reducing the risk of aspiration, which is particularly important when there is bulbar involvement in amyotrophic lateral sclerosis (ALS). It allows for better control of oral secretions and helps the client manage their swallowing function more effectively. The semi-reclined position is a supportive measure to enhance safety and comfort during meals for individuals with bulbar symptoms.

51. An OTR is evaluating a client who is in stage II of amyotroph1c lateral sclerosis. During a mealtime assessment in the client's home. the OTR observes that the client has mild bulbar involvement impacting the ability to swallow and finish eating a meal. What should the OTR advise the caregivers to include as part of the client's mealtime routine? A. Arrange for meals to take place in a relaxed and unhurried atmosphere B. Position the client during meals in a chair that semi·recllnes 30 degrees to 40 degrees C. Prepare the client foods that have a thin liquid consistency. D. Provide the client with a nosey cup for drinking liquids.

Chatgpt: D. While supine in bed, put on socks and shoes, then put on underpants and trousers by rolling side-to-side in bed. This technique allows the patient to use a supine position to manage lower body dressing independently. Rolling side-to-side is a practical approach that can be adapted to the patient's abilities, and it provides a controlled and stable environment for dressing tasks. It is important to tailor the techniques to the patient's specific needs and abilities to promote successful and independent dressing.

58. A patient In a rehabilitation facility has a complete C8-Tl spinal cord 1n1ury. The patient is learning techniques to maximize independence with dressing. Which techniques should the OTR teaches the patient to support progress toward this goal? A. Put on undergarments and trousers In bed. then transfer to a wheelchair to complete upper body dressing B. Use a universal cuff with a buttonhook and a zipper-pull to fasten froot•opening clothing C. Wear a wost-driven flexor h1n,ge orthos1s for pulling on and fastening ctoth1n,g. D. While supine in bed. put on socks and shoes. then put on underpants and trousers by rol!1ng s.ide-to-s1de in bed.

C. Client may not have a clear understanding of the current physical ability for ADL. The client's ability to walk on a treadmill at 2.0 miles per hour for 20 minutes with a normal cardiovascular response suggests a reasonable cardiovascular capacity. However, the fact that the client achieved independence with ADL during inpatient rehabilitation but now relies on friends and family for assistance may indicate a discrepancy between the client's physical capacity and their perceived ability to perform daily activities. The OTR may consider that the client could be underestimating their own capabilities or may not have a clear understanding of their current physical abilities for ADL. Further exploration and communication with the client about their perceived limitations and abilities may be necessary to address this potential discrepancy.

52. A young adult client recovering from cardiomyopathy is being evaluated in outpatient rehabilitation. The client achieved independence with ADL during inpatient rehabilitation. Since discharge, the client relies on friends and family for assistance with an ADL. During the evaluation, the client walked slowly on a treadmill at 2.0 miles (3.22 km) per hour for 20 minutes with normal cardiovascular response. What interpretation does the OTR make based on the client's performance during this period of the evaluation? A. Client is appropriately relying on assistance to help conserve energy during the day B. Client is following appropriate activity guidelines for ADL during this phase of recovery C. Client may not have a clear understanding of the current physical ability for ADL.

C. Risk factor for potential aspiration of food. In Parkinson's disease, individuals may experience difficulties with oral and pharyngeal phases of swallowing, which can lead to the retention of food in the oral cavity. This can increase the risk of aspiration, where food or liquid may enter the airway instead of the esophagus. Observing a bolus of food being retained in the mouth may suggest the need for further assessment and intervention to address swallowing difficulties and reduce the risk of aspiration in patients with Parkinson's disease.

53. A patient who has Parkinson's disease is participating in OT to increase independence with self-feeding. During a session, the OTR notes that the bolus of food becomes a pocket between the patient's teeth and cheek. What does that Indicate? A. Necessity to lake a drink of water to clear the mouth B. Preparation for the oral stage of swallowing C. Risk factor for potenta1 aspiration of food D. Too large piece of food placed in the mouth

C. Volar fingertips. Two-point discrimination refers to the ability to perceive two separate points touched simultaneously on the skin. The volar (palmar) fingertips are highly sensitive and have a high density of touch receptors (Meissner's corpuscles), making them particularly adept at discriminating between two closely spaced points. This sensitivity is crucial for fine motor tasks and sensory discrimination in activities involving the hands.

54. Where on the human hand is two-point discrimination MOST refined? A. Dorsum of the hand B. Center of the palm C. Volar fingertips D. Radial side of the index finger

C. Drop wrist. A drop wrist occurs when there is weakness or paralysis of the wrist and finger extensors, typically due to damage to the posterior branch of the brachial plexus. This results in the inability to extend the wrist and fingers fully, leading to a characteristic downward positioning of the wrist. The other options, such as "Claw hand," "Benedictine hand," and "Ape hand," are associated with different nerve injuries or conditions.

55. An OTR has completed a manual muscle test of a client who has a brachia! plexus injury. Results of the evaluation indicate the injury impacted the posterior branch of the brachia! plexus. What is the classic functional deformity associated with this injury? A. Claw hand B. Benedictine hand C. Drop wrist D. Ape hand

B. Complete a standardized assessment to obtain objective information on the patient's coping skills. Completing a standardized assessment focused on the patient's coping skills can provide objective information about their current emotional and psychological state. This assessment can help identify specific areas of concern, the severity of emotional distress, and potential coping strategies the patient is currently using or lacking. The results can guide the development of a more individualized intervention plan that addresses the patient's emotional needs and facilitates engagement in the rehabilitation process.

56. An OTR working in an inpatient rehabilitation setting Is completing an initial evaluation with a young adult who recently underwent a transfemoral amputation. The patient's responses during the evaluation indicate the patient is extremely angry, has a sense of panic. and is fearful about current physical limitations. The patient does not believe participation in OT will Improve functional abilities. Which action would be MOST BENEFICIAL for the OTR to take prior to finalizing the intervention plan for this patient? A. Arrange a meeting with the patient and the patient's relevant others to discuss goal-setting B. Complete a standardized assessment to obtain Objective information on the patient's coping skills C. Consult with the clinical psychologist to determine behavior objectives for this patient.

B. Determine if the client has completed a release of information form for the neighbor. Before contacting the neighbor to discuss the client's progress, it is essential to ensure that the client has given consent for the release of their health information. This can be achieved through a release of information form. This step is crucial for maintaining client confidentiality and adhering to privacy regulations. Once it is confirmed that the necessary consent is in place, the OTR can proceed with discussing the client's progress with the neighbor as requested.

57. An OTR is providing home-based services to an older adult client who is recovering from a hip fracture. The client's only social support is a neighbor who is willing to assist the client with home management tasks. During a home visit, the client asks the OTR to contact the neighbor to discuss the client's progress. What INITIAL action should the OTR take based on this request? A. Ask the client what type of information should be shared with the neighbor B. Determine if the client has completed a release of information form for the neighbor C. Prepare a list of home-making tasks the client can safely complete to give to the neighbor.

B. Have the child assemble dressing picture cards in sequence prior to dressing. Using dressing picture cards in sequence can serve as a visual cue and a step-by-step guide for the child, helping them remember the dressing sequence and fostering independence. This method leverages visual memory and provides a clear, structured approach to self-dressing. It is particularly beneficial for a child with memory deficits and can be a valuable tool in promoting independence in the dressing routine.

59. A 10-year-old child has memory deficits and mild right hemiplegia secondary to an acquired brain injury 2 months ago. The child requires moderate assistance with self-dressing. Which intervention MOST EFFECTIVELY supports the child's independence with selfdressing"? A. Establish a consistent routine and location for the child to dress B. Have the child assemble dressing picture cards in sequence prior to dressing C. Provide the child with loose•fitting clothing with few fasteners.

D. Mobility requirements and habits of the customer. Understanding the specific mobility needs, habits, and preferences of the customer is crucial in selecting an appropriate wheelchair. Factors such as the customer's functional abilities, lifestyle, and environmental considerations play a significant role in determining the most suitable wheelchair features, configuration, and accessories. This person-centered approach ensures that the chosen wheelchair meets the individual needs of the customer and promotes optimal mobility and independence.

60. An OTR is providing consultative services to a medical equipment vendor The vendor asks the OTR to assist in the selection of a new wheelchair for a customer who has severe physical disabilities. When providing this type of service. what information is MOST IMPORTANT for the OTR to use as the basis for the selection criteria? A Seating system that the customer Is currently using B. Allowable reimbursement from third-party payers C. Prescription is written by the customer's primary physician D. Mobility requirements and habits of the customer

A. Learn to select specific treatment and medical diagnosis codes. Understanding how to select appropriate treatment and medical diagnosis codes is foundational for accurate billing and reimbursement. Proper coding ensures that the services provided align with the patient's condition and the interventions delivered. This accurate documentation is crucial for reimbursement and compliance with insurance requirements. Once the OTR has a solid grasp of coding procedures, they can then build on this foundation by incorporating evidence-based treatment methods and procedural terminology in their documentation (Option C) for a comprehensive and accurate representation of the occupational therapy services provided.

61. An OTR recently started a new job at a skilled nursing facility and will routinely submit billing information to support reimbursement for occupational therapy service, What action should the OTR take FIRST to effectively support optimal reimbursement? A. Learn to select specific treatment and medical and diagnosis codes B. Understand resource utilization groups and diagnostic-related categories C. Document evidence-based treatment methods and use procedural terminology

C. Place the sock over the patient's foot and have the patient pull the sock up from the ankle. By completing all steps of the task except the last one (pulling the sock up from the ankle), the therapist facilitates success for the patient in the initial session. As the patient becomes more proficient, the therapist can gradually shift to completing fewer steps until the patient is performing the entire task independently. This method helps build confidence and allows the patient to experience success in the early stages of rehabilitation.

62. A patient in rehabilitation recently has moderate cognitive impairment secondary to an acquired brain 1n1ury. The patient is currently dependent on caregivers for dressing. As part of a dressing session, the OTR plans to use backward chaining techniques to engage the patient in the task of putting on a sock. What action represents this approach as part of an initial session with this patient? A. Ask the patient to cross one leg over the other, in preparation for putting the sock on the foot B. Hand the patient the sock and ask the patient to put the sock over the toes C. Place the sock over the patient's foot and have the patient pull the sock up from the ankle. D. Provide a picture of the end goal and have the patient arrange sequential picture cards for each step of the task.

C. Observe the patient's ability to complete typical routines for toileting. In this scenario, observing the patient's ability to complete typical routines for toileting will provide valuable information about their functional independence, balance, and executive function. Toileting activities involve various movements and coordination, providing insights into the patient's current abilities and challenges. Assessing toileting routines is relevant to the patient's goal of staying home alone, as it involves self-care tasks that are crucial for independence. This observation will help the OTR understand the patient's level of function and tailor the rehabilitation plan to address specific needs related to toileting and other daily activities.

64. An OTR working in a rehabilitation setting is completing an initial evaluation tor a patient who underwent surgery for resection of a brain tumor 3 days ago. The patient currently requires minimal assistance to complete self-care due to apraX1a. 1mpa1red executive function, and decreased balance, The patient lives at home with a spouse who works outside the home. The patient's priority is to be able to stay home alone while the spouse is at work. Which INITIAL action should the OTR take to acquire more information related to the patient's pr1or1ty? A. Determine the amount of assistance the family is able to provide the patient after discharge B. Assess the patient's neurobehavioral responses during simple meal preparation. C. Observe the patient's ability to complete typical routines for toileting

D. Triceps and shoulder depressors. For wheelchair transfer to even surfaces, triceps strength is crucial for pushing up from the wheelchair, and shoulder depressors (muscles that lower the shoulder girdle) play a role in stabilizing and controlling the movement during the transfer. In a person with complete C7 tetraplegia, the key muscles innervated at the C7 level are the triceps (allowing elbow extension) and muscles that depress the shoulder, such as the latissimus dorsi and teres major. These muscle groups are essential for performing effective wheelchair transfers. While other muscle groups mentioned (biceps, deltoids, wrist extensors) are important for various upper extremity functions, they may not be as directly related to the specific requirements of wheelchair transfers for someone with C7 tetraplegia.

75. An inpatient has complete C7 tetraplegia and is scheduled to begin transfer training. innervation of which muscle groups would be the BEST indicator of the patient's potential for achieving independence with wheelchair transfer to even surfaces without the use of assistive equipment? A. Biceps and wrist extensions B. Deltolds and biceps C. OeltOlds and shoulder depressors D. Triceps and shoulder depressors

C. Patient's room with the patient seated fully upright in a bedside chair. For a patient at Level IV (Confused, Agitated) on the Rancho Los Amigos scale with a recent traumatic brain injury (TBI), creating a quiet and controlled environment is crucial. The patient's room provides a familiar and less stimulating setting, reducing potential distractions or triggers for agitation. Additionally, having the patient seated fully upright in a bedside chair promotes proper positioning and stability during the self-feeding session. This environment allows the occupational therapist to focus on the patient's specific needs, provide appropriate assistance, and gradually work towards the goal of independence with self-feeding. As the patient progresses and gains more control, the intervention can be modified to incorporate social aspects or group settings. However, initially, a quieter and more individualized environment is of

65. An inpatient had a recent TBI and functioning at Level IV (Confused. Agitated) on the Rancho Los Amigos scale. The patient is dependent on the staff of meal set•up and requires moderate assistance to eat a meal. One of the intervention goals is for the patient to be independent with self-feeding. During a self·feeding session. which mealtime environment would support INITIAL progress toward this goal? A. Dining room with other patients who have similar functional abilities B. OT clinic during a scheduled mealtime group with other patients C. Patient's room with the patient seated fully upright 1n a bedside chair

A. Provide further discussion about how OT will help improve daily living skills. In this situation, the OTR should engage in further discussion to educate the patient about the role of occupational therapy and how it can contribute to improving daily living skills. It's important to address the patient's concerns and explain the relevance of occupational therapy in enhancing independence in activities of daily living (ADLs). By providing information and clarifying the purpose of OT services, the OTR may be able to alleviate the patient's misconceptions and encourage participation. Respecting the patient's wishes is crucial, but attempting to engage in a conversation and providing more information about the potential benefits of occupational therapy can help build rapport and collaboration between the therapist and the patient. If, after further discussion, the patient still refuses, the OTR can document the refusal

66. An OTR working in a skilled nursing facility is beginning an initial patient interview. After the OTR provides the patient with a brief introduction to OT services. the patient refuses to participate In an evaluation. stating, "This is childish. I'm here to get stronger. There's an enure staff that can help me get dressed." What action should the OTR take based on this response? A. Provide further discussion about how OT will help improve daily living skills. B. Assure the patient that strengthening exercises will be included in the intervention C. Respect the patient's wishes and document the refusal in the medical record.

A. Ensure standard Precautions are used when attending to the patient. The first action the OTR should take after the patient sustains a superficial cut is to ensure standard precautions are used when attending to the patient. Standard precautions involve the use of personal protective equipment (such as gloves) to prevent the spread of infection. This is important when there is exposure to blood or body fluids. After addressing the immediate safety concern, the OTR can then proceed to assess the situation, identify the cause of the cut, and work with the patient to develop a safer approach to shaving. This may involve exploring alternative shaving methods, such as using an electric razor, or implementing process improvements to prevent recurrence, as mentioned in option C. However, the immediate priority is to address infection control measures to protect both the patient and the healthcare provider.

67. An inpatient with mild hem1pleg1a wants to be able to use a disposable razor for facial shaving. During one of the grooming sessions. the patient sustains a superficial cut to the chin and begins to bleed. What action should the OTR take FIRST based on this occurrence? A. Ensure standard Precautions are used when attending to the patient. B. Have the patient complete the task using an electric razor C. Identify process improvements to prevent recurrence. D. Use sterile procedures when attending to the patient

C. Non-skid strips on edges of stair steps. Given the patient's transient moderate vertigo and the need to navigate a multi-level home independently, non-skid strips on the edges of stair steps are a priority. These strips help prevent slips and falls, providing additional safety when ascending or descending stairs. While other options, such as installing grab bars and using a shower chair, are important for bathroom safety, addressing the risk of falls on the stairs is particularly critical in this case. Non-skid strips enhance traction and reduce the likelihood of accidents on staircases, contributing to the overall safety and independence of the individual in their home environment.

68. A young adult inpatient has transient moderate vertigo secondary to an inoperable brain tumor. The patient Is typically able to ambulate and complete ADL independently. The OTR 1s evaluating the home set·UP 1n preparation for the patient's discharge to live alone in a multi-level home. In addition to installing grab bars in the hallways. bathrooms. and stair. which feature should be a priority for the patient to have in the home by the discharge date? A. Environmental Control unit for in-home monitoring B. Shower chair or tube bench In the shower or bathtub C. Non-skid strips on edges of stair steps D. Ramp to the main entrance of the home

A. Conflicting sensory input is inhibiting appropriate vestibular reactions. The child's ability to demonstrate normal postural reactions for walking, running in place, and skipping suggests that basic postural control and motor skills are intact. However, the difficulty in maintaining balance specifically on a platform swing indicates a challenge with vestibular processing. The platform swing provides complex and unpredictable sensory input, and the child may be experiencing conflicting information from the vestibular system, leading to difficulty in maintaining balance. Therefore, the OTR can conclude that conflicting sensory input is inhibiting appropriate vestibular reactions, and interventions aimed at addressing sensory processing and integration may be beneficial for the child to improve balance on the platform swing.

69. A school-age child has profound hearing 1mpa1rment. The child demonstrates normal postural reactions for walking, running in place, and skipping. but unable to maintain balance when moving in various directions on a platform swing. What conclusion can the OTR make based on these observations? A. Conflicting sensory input is inhibiting appropriate vestibular reactions B. Low muscle tone prevents the child from responding to transitional movements C. Persistent primitive reflexes are interfering with transitional movement patterns. D. The child lacks anticipatory control required for higher•level motor skills

C. Provide additional structure to continue with the assigned task. In this situation, the OTR should provide additional structure to help the patient stay focused on the assigned task of setting the table for the meal. Individuals experiencing symptoms associated with the manic phase of bipolar disorder may have difficulty with attention and impulsivity. Offering clear instructions, breaking down the task into smaller steps, and providing cues or reminders can help the patient maintain focus and successfully complete the assigned activity. Assigning a more challenging task or partnering with another patient may not be appropriate in this context, as it could contribute to increased distraction or disrupt the therapeutic goals of the meal preparation group. Providing additional structure aligns with the principles of occupational therapy and supports the patient in achieving success in the current task.

70. A patient is undergoing inpatient treatment to stabilize symptoms associated with the manic phase of bipolar disorder. As part of a meal preparation group, the patient is assigned to set the table for the meal. The patient becomes highly distracted and wants to be involved in a more challenging activity. What action should the OTR take to support the patients' success during this task? A. Assign the patient to a more challenging meal preparation task B. Partner the patient with another patient to complete the task C. Provide additional structure to continue with the assigned task.

A. Replace distorted thoughts and fears with positive ones. A cognitive-behavioral approach involves identifying and challenging negative thought patterns and replacing them with more balanced and positive thoughts. This approach is effective in managing anxiety by addressing and changing the cognitive aspects that contribute to anxiety. Encouraging patients to replace distorted thoughts and fears with positive ones is a key component of cognitive-behavioral therapy (CBT) and can help individuals develop healthier coping mechanisms for daily living.

71. An OTR is leading an educational group for inpatients admitted to a behavior health unit. What method represents a cognitive-behavioral approach the patients can use to effectively manage anxiety in daily living? A. Replace distorted thoughts and fears with positive ones B. Use journaling activities to express feelings and thoughts C. Engage in a hobby or leisure activity to divert attention from stress

B. Train the adolescent to use a table-mounted mobile arm support. Given the limitations in elbow flexion due to heterotopic ossification, a table-mounted mobile arm support can be a beneficial compensatory strategy to improve independence with self-feeding. This device assists in providing additional support and elevation for the arms during activities such as eating. It helps compensate for the reduced range of motion in the elbows, allowing the adolescent to bring food to their mouth more easily. While elevating the surface may be helpful in certain situations, a table-mounted mobile arm support specifically addresses the limitations in elbow flexion and can enhance the adolescent's ability to perform self-feeding tasks more effectively.

72. An adolescent sustained a 50% total body surface area burn 3 months ago. The adolescent recently developed heterotopic ossification of both elbows as a secondary complication. Evaluation indicates the adolescent is able to actively flex both shoulders from 0° to 100° and both elbows from 45° to 90". The adolescent currently requires assistance with feeding. Which compensatory strategy would be MOST BENEFICIAL for 1mprovmg the adolescents' 1ndependence with self-feeding? A. Elevate the surface on which the plate and eating utensils are placed B. Train the adolescent to use a table-mounted mobile arm support C. Provide the adolescent with elongated and angled eating utensils

B. Inhibitory casting in submaximal range of extension. Inhibitory casting involves applying casts in a submaximal range of joint motion to reduce spasticity and improve range of motion. This method is commonly used to manage spasticity in pediatric populations. In the case of the 7-year-old child with severe flexion posturing of bilateral upper extremities, inhibitory casting can be beneficial in addressing the parents' concern about difficulty moving the child's arms for bathing and dressing. The casting is applied in a way that encourages gradual stretching and lengthening of the affected muscles while providing sensory input to reduce spasticity. This approach can be particularly effective when performed during periods when the child's muscles are more relaxed, such as during sleep. It is important to closely monitor the child's response and adjust the casting as needed to avoid causing pain or discomfort.

73. A 7-year-old child has severe flexion posturing of bilateral upper extremities Secondary to anoxic encephalopathy. The parents indicate it is becoming more difficult to move the child's arms for bathing and dressing. They also indicate that when the child is sleeping. the muscles are more relaxed, which allows the parents to open the fingers and move the elbows out of the flexed posture. When the OTR moves the child's elbows. muscle tone increases and the child winces in pain. Which spasticity management option for the elbows would be MOST BENEFICIAL to include as an adjunct to therapy to address the parent's concern? A. Continuous passive motion during hours of sleep B. inhibitory casting in submaximal range of extension C. inflatable orthoSIS with 30-40 mm Hg of pressure D. Serial casting to the maximal range of extension

C. Shift trunk weight forward bringing both shoulders over the thighs. To avoid backward swaying and falling during stand-pivot transfers, the OTR should instruct the patient to shift their trunk weight forward, bringing both shoulders over the thighs. This forward weight shift helps in maintaining balance and stability during the transfer. It's crucial to emphasize proper weight distribution and alignment to prevent falls. While options A and B may also contribute to stability, option C specifically addresses the backward swaying issue by instructing the patient to shift their weight forward. This technique is often effective in enhancing the patient's ability to perform stand-pivot transfers safely.

74. An in-patient recovering from Guli1ain-Barre syndrome has Fair plus (3+/5) to Good minus (4-/5) strength in both lower extremities. The patient typically completes stand-pivot transfers with minimal assistance. During one transfer, the patient sways backward and falls back into the wheelchair seat. What should the OTR instruct the patient to do to avoid this occurrence when the patient repeats the transfer? A. Position of the feet shoulder width apart and perpendicular to the transfer surface B. Scoot forward to position the hips evenly in the middle of the wheelchair seat. C. Shift trunk weight forward bringing both shoulders over the thighs. D. Use both hands to push down on the wheelchair arm rests

C. Stabilize the wrist in neutral while moving the IP joints of each finger into an intrinsic-minus position. In the context of a patient with full-thickness burns on the dorsum of both hands who is currently in a medically induced coma, the OTR should take precautions during passive range of motion (ROM) to prevent contractures and maintain joint integrity. Stabilizing the wrist in a neutral position while moving the interphalangeal (IP) joints of each finger into an intrinsic-minus position is a suitable precaution. This helps prevent further complications, such as joint contractures, and maintains the hands in a functional position. Options A and B might not be as suitable in this case because maintaining the wrist in a specific range of extension or flexing the wrist while holding the fingers in composite flexion may not be appropriate given the patient's current condition and the presence of full-thickness burn

76. An inpatient sustained a 50% total body surface area burn 3 days ago involving primarily the torso and bilateral upper extremities. Medical records indicate the patient is currently in a medically induced coma and has full-thickness burns on the dorsum of both hands. The OTR is scheduled to begin a program of ROM and preventive positioning at the patient's bedside. Which precaution should the OTR take when completing passive ROM of the patient's hands during this phase of medical care? A. Maintain the wrist in 45°-70° extension while completing isolated movement to each IP joint B. Extend and flex the wrist while holding the patient's fingers in composite flexion. C. Stabilize the wrist in neutral while moving the IP joints of each finger into an intrinsic-minus position.

D. Contact the referring physician to report the client's symptoms. The client's report of right shoulder discomfort, worsening pain at night, and non-relief with nonprescription analgesics, along with a low oxygen saturation level of 89%, suggests the need for medical attention. In this case, it's important to prioritize the client's overall health and well-being. Contacting the referring physician is crucial to communicate the new symptoms and the decrease in oxygen saturation. Shoulder pain, especially if it is worsening and not responding to over-the-counter pain relief, may indicate an underlying issue that requires medical assessment. The decrease in oxygen saturation also raises concerns about the client's respiratory status, which should be addressed promptly by the medical team. While occupational therapists can provide interventions for shoulder pain and breathing techniques, the priority in this situation

77. A client who has COPD is participating in an AOL session as part of an outpatient pulmonary rehabilitation program. The client reports a several-day history of right shoulder discomfort. Low-grade pain is constant during the day and worsens at night. Nonprescription analgesics do not relieve the symptoms. Pulse oximetry indicates oxygen saturation of 89%. What action should the OTR take based on this report? A. Administer a physical agent modality to relieve the shoulder pain. B. Advise the client to increase the frequency of pursed lip breathing during activity. C. Complete a sensory and motor assessment to determine the cause of the shoulder pain. D. Contact the referring physician to report the client's symptoms.

D. Enable the word prediction option within the software. Enabling the word prediction option within the software can be a beneficial modification to improve the student's ability to complete written communication. Word prediction software suggests words as the user types, reducing the number of keystrokes required and potentially improving speed and efficiency. For a 9-year-old student with a C2 spinal cord injury using a head switch to operate a virtual keyboard, word prediction can assist in completing assignments more quickly. It anticipates the next word the user is likely to type based on the context, allowing the student to select or complete words with fewer switch activations. While other options like attaching a sip-and-puff control, installing voice recognition software, and providing practice activities may have their merits, enabling word prediction specifically addresses the observed issue of slow spee

78. A 9-year-old student who has a C2 spinal cord injury just received new software for a computer that doubles as an environmental control unit. This allows the student to use a head switch to operate a virtual keyboard displayed on a monitor. The OTR observes that the student's speed and efficiency is slow when operating the switch for writing class assignments. What modifications should be made to the computer to improve the student's ability to complete written communication? A. Attach a sip-and-puff control to operate the keyboard. B. Install voice recognition software onto the computer. C. Provide practice activities to improve speed and accuracy. D. Enable the word prediction option within the software.

A. Perceptions of current abilities for resuming job tasks. The most important information for the occupational therapist to gather from the client prior to establishing the intervention plan for a work hardening program is the client's perceptions of their current abilities for resuming job tasks. Understanding the client's own assessment of their capabilities, expectations, and concerns related to returning to work is crucial for tailoring the intervention plan to meet their specific needs. While comprehensive medical and psychological history (option B), impact of injury on current BADL (Basic Activities of Daily Living) routines (option C), and risk factors associated with typical work tasks (option D) are important considerations, the client's self-perception of their readiness to resume job tasks directly informs the focus and goals of the work hardening program. This information allows the occupational therap

79. A workers' compensation case manager referred a client to a work hardening program. The client had a surgical repair of a work-related rotator cuff injury 8 weeks ago and has been on medical leave due to pain and decreased ROM. What information is MOST IMPORTANT for the OTR to gather from the client prior to establishing the intervention plan? A. Perceptions of current abilities for resuming job tasks B. Comprehensive medical and psychological history C. Impact of injury on current BADL routines D. Risk factors associated with typical work tasks

ME: D. ChapGPT: A.

80. An OTR is preparing to use a goniometer to measure active flexion of a client's elbow. The client is positioned in supine with the shoulder in neutral and the forearm supinated. On which anatomical landmark should the OTR align the axis of the goniometer to accurately measure this motion? A. Olecranon process B. Acromion process C. Medial epicondyle of the humerus D. Lateral epicondyle of the humerus

D. Visual field function Assessing the client's visual field function would be the most important factor to consider prior to engaging them in a cooking activity. Given their severe low vision secondary to diabetic retinopathy, understanding the extent of their visual field loss is crucial for ensuring their safety and ability to navigate the kitchen environment effectively. Visual field function refers to the area that a person can see without moving their eyes. Clients with diabetic retinopathy may experience peripheral vision loss or other visual field deficits, which can impact their ability to detect obstacles, locate objects, and navigate their surroundings safely, especially in a potentially hazardous environment like a kitchen. By assessing the client's visual field function, the occupational therapist can tailor interventions, provide appropriate adaptations, and offer strategies to optimize the client's in

81. A client has severe low vision secondary to diabetic retinopathy. The client wants to independently cook family meals. Which client factor would be MOST IMPORTANT to assess prior to engaging the client in a cooking activity? A. Muscular endurance B. Muscle tone C. Tactile discrimination D. Visual field function

C. Interpret data by monitoring equipment and understanding pertinent medical information from the clinical record. In an acute care setting, patient safety is paramount, especially when dealing with medically unstable patients. Therefore, an entry-level OTR aiming to increase competency in patient safety should prioritize learning how to interpret data by monitoring equipment and understanding pertinent medical information from the clinical record. This skill allows the OTR to stay informed about the patient's condition, vital signs, and any changes in medical status. Being able to interpret this data accurately is essential for recognizing signs of deterioration or instability in a patient's condition promptly. It enables the OTR to make informed decisions about interventions, therapy techniques, and patient management strategies to ensure the safety and well-being of the patient during therapy sessions.

82. An entry-level OTR is developing a professional learning plan to increase competency in providing OT to patients in a hospital setting. The OTR has limited experience working with patients who are medically unstable and wants to write a learning goal to ensure competency in patient safety. Which topics should the entry-level OTR include in the professional learning plan to increase competency in patient safety in an acute care setting? A. Identify community resources to support positive patient outcomes and find payer sources for commonly recommended medical equipment. B. Recall principles of client-centered practice and know models of practice applicable to the hospital environment. C. Interpret data by monitoring equipment and understanding pertinent medical information from the clinical record.

A.B.E A. Canadian Occupational Performance Measure This assessment would help identify the patient's self-perceived occupational performance issues and priorities, providing insight into areas of dysfunction and goals for therapy. B. Occupational Circumstances Assessment Interview and Rating Scale This assessment would aid in understanding the patient's current occupational circumstances, including roles, routines, and environmental factors, which can influence their mental health and functioning. E. Worker Role Interview This assessment focuses on the individual's work history, strengths, and barriers to employment. Given the patient's age, assessing their vocational history and potential barriers to work could be valuable for treatment planning. These assessments would provide comprehensive information about the patient's occupational performance, circumstances, and vocational history, which are important considera

83. The following information is repeated for scenario items 1 through 4. A young adult patient with borderline personality and polysubstance use disorder was recently admitted to a psychiatric hospital. The patient has extreme mood fluctuations with bursts of anger. difficulty focusing on non-preferred topics. a tendency to interrupt. and a preoccupation with conflicts within family and friend networks. Scenario item 1 of 4 Which assessments are beneficial to administer as part of the information-gathering process? You need to select 3 choices A. Canadian Occupational Performance Measure B. Occupational Circumstances Assessment Interview and Rating Scale C. Worker Role Interview D. Kohlman Evaluation of Living Skills E. Model of Human Occupation Screening Tool F. Home Assessment Profile

B,D,E B. Create systems for promoting behavioral change. Developing strategies to promote behavioral change can help the patient begin to address mood fluctuations, bursts of anger, and difficulty focusing, leading to improved self-regulation and coping skills. D. Process thoughts and experiences that preceded the admission to the hospital. Processing thoughts and experiences that led to the hospital admission can help the patient gain insight into their behavior and emotional triggers, which is essential for therapeutic progress and developing coping strategies. E. Explore techniques for the development of positive coping strategies. Exploring techniques for developing positive coping strategies can empower the patient to manage extreme mood fluctuations, bursts of anger, and preoccupations with conflicts in healthier ways, fostering emotional regulation and resilience.

84. The following information is repeated for scenario items 1 through 4. A young adult patient with borderline personality and polysubstance use disorder was recently admitted to a psychiatric hospital. The patient has extreme mood fluctuations with bursts of anger. difficulty focusing on non-preferred topics. a tendency to interrupt. and a preoccupation with conflicts within family and friend networks. Scenario item 2 of 4 What goals would be realistic for the patient to achieve during the first week of OT intervention? You need to select 3 choices A. Identify one personal strength to increase self-awareness. B. Create systems for promoting behavioral change. C. Verbalize a routine to promote medication compliance. D. Process thoughts and experiences that preceded the admission to the hospital. E. Explore techniques for the development of positive coping strategies. F. Verbalize thoughts and feelings about family interactions.

ChatGPT: B,E,F ME: A,B,E

85. The following information is repeated for scenario items 1 through 4. A young adult patient with borderline personality and polysubstance use disorder was recently admitted to a psychiatric hospital. The patient has extreme mood fluctuations with bursts of anger. difficulty focusing on non-preferred topics. a tendency to interrupt. and a preoccupation with conflicts within family and friend networks. Scenario item 3 of 4 Which interventions represent the use of the dialectical behavioral therapy approach? You need to select 3 choices A. Facilitate self-reflection that promotes rumination and generalization. B. Complete a grid on emotional reactions to challenge negative thinking. C. Self-monitor experiences of anger by tallying for a 24-hour time period. D. Explore various textured food items to practice awareness without judgment. E. Identify stressful social interactions and role-play these scenarios with the OTR. F. Teach methods to tolerate current emotions without attempting to control or change them.

B,E,F

86. The following information is repeated for scenario items 1 through 4. A young adult patient with borderline personality and polysubstance use disorder was recently admitted to a psychiatric hospital. The patient has extreme mood fluctuations with bursts of anger. difficulty focusing on non-preferred topics. a tendency to interrupt. and a preoccupation with conflicts within family and friend networks. Scenario item 4 of 4 The patient frequently interrupts other participants during group sessions and disrupts the group process. What actions are BEST for the OTR to take in this situation? You need to select 3 choices A. Have the participants determine the pace of tasks and the content of discussion. B. Keep group discussions focused on the identified topic or task. C. Allow participants to direct communication toward the OTR. D. Maintain an authoritative leadership style during group sessions. E. Use direct open-ended questions to engage each group member. F. Redirect the patient and plan to discuss the comments with the patient after the group session.

C. Grooming while seated at a bathroom seat Grooming while seated requires minimal exertion and is likely to fall within the range of activities allowed for someone with a restriction of 1.5 METs.

87. A patient had a coronary artery bypass graft one week ago. The patient will be discharged from the inpatient rehabilitation unit to live at home with family. One of the patient's goals is to resume homemaking and childcare tasks. The cardiologist is allowing the patient to resume an activity level of no more than 1.5 metabolic equivalent (METs) units. Which activity represents a maximum allowable MET-level activity for this patient? A. Moving laundry from the washer to the dryer B. Assisting a young child with bathing and dressing C. Grooming while seated at a bathroom seat D. Standing under warm water in the shower

Based on the information provided, the client's persistent swelling and lack of response to elevation, ice, or active ROM exercises suggest that the edema may be due to lymphedema, a common complication following mastectomy. Given that the affected upper extremity is firm to the touch with no pitting of the skin, this further supports the possibility of lymphedema. The most appropriate action for the OTR to take to effectively manage the client's edema in this case would be: C. Obtain circumferential measurements for ordering a customized compression glove. This option aligns with best practice for managing lymphedema, as compression garments can help reduce swelling by providing external pressure to facilitate lymphatic drainage. The circumferential measurements would ensure the compression glove is properly fitted to the client's affected extremity, maximizing its effectiveness in managing edema.

89. An entry-level OTR is evaluating a client who has persistent swelling of the non-dominant extremity after undergoing a mastectomy 4 weeks ago. The swelling interferes with the ability to complete fine motor tasks and does not decrease with the use of elevation. ice. or active ROM exercises. The OTR notes the client's affected upper extremity is firm to the touch and there is no pitting of the skin. Results of a volumetric test indicate the affected upper extremity displaces 20 ml of water more than the non-affected extremity. The client has full functional active ROM of bilateral upper extremities. Based on these results. which action should the OTR take to MOST EFFECTIVELY manage the client's edema? A. Identify options for providing the client with manual edema mobilization. B. Initiate a program of retrograde massage as an adjunct to functional activities. C. Obtain circumferential measurements for ordering a customized compression glove.

B. Completing hand-to-mouth patterns for self-feeding Rett syndrome is a neurodevelopmental disorder that affects motor skills and can cause difficulties wit

89. Which mealtime task would be MOST DIFFICULT for a 20-month-old toddler who was recently diagnosed with Rett syndrome? A. Maintaining head control when sitting in a child's high chair B. Completing hand-to-mouth patterns for self-feeding C. Swallowing flavored juices from a standard baby bottle

A. Plan to partner the student with a designated peer mentor. Partnering the student with a designated peer mentor can provide structured support and guidance during social interactions. This approach allows the student to learn from a peer who can model appropriate social behaviors and responses in real-time. Peer mentors can offer encouragement, support, and positive reinforcement to help the student develop social skills in a safe and inclusive environment.

90. A verbal kindergarten student has difficulty with social skills secondary to autism spectrum disorder. During play-based activity in the classroom. a peer offers the student a toy and the student begins to cry and flap arms. What action should the OTR take NEXT to support the child's development of social skills? A. Plan to partner the student with a designated peer mentor. B. Model the expected behavior of accepting a toy from a peer. C. Teach the student the age-appropriate verbal response.

A. Outpatient therapy The client is considering attending a work hardening program in addition to outpatient therapy. Therefore, outpatient therapy is the intervention being considered for addressing the client's debilitating fatigue and facilitating their return to work.

91. An OTR is developing a Patient Intervention Comparison Outcome (PICO) question as part of the evidence-based practice process for an outpatient client who completed chemotherapy treatment for breast cancer 9 months ago. The client's goal is to return to work, but the client reports debilitating fatigue limiting ability to perform job duties. The client asks the OTR if attending a work hardening program in addition to outpatient therapy would be an added benefit. In this situation. what is the Intervention (I) component of the clinical question? A. Outpatient therapy B. Chemotherapy treatment C. Debilitating fatigue

A. Amount and type of exudate Assessing the amount and type of exudate is crucial for understanding the wound's healing progress and determining appropriate wound care management. Excessive exudate can indicate inflammation, infection, or other underlying issues affecting wound healing. Additionally, the type of exudate (serous, serosanguinous, purulent, etc.) provides insights into the wound's status and guides treatment decisions, such as selecting the appropriate dressing type.

92. An OTR is evaluating an outpatient client who has a wound on the dorsal surface of the hand. The OTR removes the alginate dressing. measures the size of the wound, inspects the condition of the tissue at the margins, and looks for signs of infection. What additional information is MOST IMPORTANT for the OTR to collect for the comprehensive assessment of the wound? A. Amount and type of exudate B. Debridement plan to remove slough and eschar C. Progression schedule for transitioning to a less absorbent dressing type

A. Integrate the evidence with clinical experience, client preferences, and the practice setting. This step involves synthesizing the evidence obtained from the literature search with the OTR's own clinical expertise, considering client preferences, and taking into account the specific context of the practice setting. By integrating these elements, the OTR can make informed decisions about the most appropriate intervention for the client's needs.

93. An OTR is using the systematic evidence-based practice process to guide clinical decision making. The OTR has searched the literature for relevant information and has determined the best evidence related to a specific clinical question. What is the NEXT step in the evidence-based practice process? A. Integrate the evidence with clinical experience, client preferences. and the practice setting. B. Modify clinical practice guidelines and distribute them to colleagues in the therapy department. C. Summarize pertinent information to engage clients in selecting preferred intervention options.

C. Secure a strip of brightly colored tape on the left side of the computer monitor. Anchoring involves providing a visual cue or marker to draw the individual's attention toward the neglected side. In this case, securing a strip of brightly colored tape on the left side of the computer monitor serves as an anchor, helping the client with left neglect to become aware of and attend to the neglected left side of the screen while reading emails.

94. A client who has left neglect is learning how to use anchoring as a compensatory technique when reading emails on a computer screen. Which of the following options represents the use of this method? A. Position the computer monitor to the right of the client's midline. B. Rotate the client's chair 45° to the left so the monitor is in the intact visual field. C. Secure a strip of brightly colored tape on the left side of the computer monitor.

B. Tilt-in-space wheelchair with an adjustable seat-to-back angle. A tilt-in-space wheelchair allows for the entire seating system to tilt backward while maintaining the same seat-to-back angle. This feature can help distribute pressure and provide postural support for individuals with poor trunk control or who are unable to maintain an upright posture independently. The adjustability of the seat-to-back angle allows for customization to accommodate the client's specific needs and preferences, enhancing comfort and positioning while minimizing the risk of pressure ulcers and other complications associated with poor posture. Therefore, option B is the most appropriate choice for this client.

95. An OTR is recommending a new wheelchair for a young adult client who has severe hypotonia and lives in a residential group home. The client is unable to hold their head in a neutral position and independently maintain an upright posture. Which type of seating system would be MOST BENEFICIAL to include in the wheelchair specifications for this client? A. Manual recline wheelchair with the seat-to-back angle fixed at 45° B. Tilt-in-space wheelchair with an adjustable seat-to-back angle C. Rigid frame. standard wheelchair with a seat-to-back angle set at 90°

C. Maintain the knee in extension when the patient is in a supine position. Maintaining the knee in extension while in a supine position helps to prevent contractures and maintains proper alignment of the residual limb. This position also reduces the risk of hip flexion contractures and maintains the overall integrity of the residual limb. Therefore, option C is the most appropriate choice for supporting progress toward the objective of teaching proper positioning of the residual limb for sleeping.

96. An OTR is providing instructions to an inpatient who had a transtibial amputation 4 days ago. One of the objectives for the session is to teach the patient proper positioning of the residual limb for sleeping. What position of the affected extremity is BEST for the OTR to recommend to support progress toward this objective? A. Place the hip in flexion when the patient is in a side-lying position. B. Promote knee flexion when the patient is in a prone position. C. Maintain the knee in extension when the patient is in a supine position.

A. Survey. Surveys are commonly used in program evaluations to gather feedback and assess satisfaction levels from clients regarding the services provided. By administering surveys, the OTR can collect quantitative data on various aspects of the OT services, such as effectiveness, accessibility, communication, and overall satisfaction. Surveys allow for standardized data collection and analysis, providing valuable insights into client perceptions and areas for improvement within the outpatient clinic. Therefore, option A, a survey research model, would be the most appropriate choice for this study design.

97. An OTR is conducting a program evaluation for client satisfaction of OT services within an outpatient clinic. Which research model would be MOST EFFECTIVE for the study design? A. Survey B. Historical C. Correlational

B. Walk alongside residents who are going to the dining room as part of a walk-to-dine program. OT aides can assist with facilitating participation in therapeutic activities such as walking programs under the supervision and direction of an occupational therapist. This task involves providing support and encouragement to residents during the activity but does not involve direct assessment or intervention beyond the scope of the aide's training. Therefore, option B aligns with the appropriate responsibilities of an OT aide in this setting.

98. According to the professional guidelines for supervision. which client-related task can an OT aide who works in a residential skilled nursing setting be assigned to complete? A. Assist a resident to transfer from the bed to a wheelchair for transport to an initial evaluation. B. Walk alongside residents who are going to the dining room as part of a walk-to-dine program. C. Collect basic information from a resident to contribute to the occupational profile.

A. Create a list of questions to use for evaluating the applicability of the research to practice. Creating a list of questions to evaluate the applicability of the research to practice helps the OTR assess the relevance and potential impact of the findings on their clinical work with children in the hospital. These questions may address factors such as the population studied, intervention methods used, outcomes measured, and the feasibility of implementing the intervention in the hospital setting. This process aids in determining the extent to which the research findings can be applied to inform OT interventions for pediatric patients in the specific context of the children's hospital. Therefore, option A is the most appropriate next step for critically appraising the literature in this scenario.

99.. An OTR working in a children's hospital routinely reads pediatric-related research but is not always certain if the evidence presented in the research can be applied to OT interventions used with children in the hospital. After locating the evidence. what step should the OTR take NEXT to critically appraise the literature? A. Create a list of questions to use for evaluating the applicability of the research to practice. B. Select a systematic method to assign a meaningful value to each research article reviewed. C. Organize the studies by age of children who participated in the intervention and control groups.

D. In the context of transferring a student with cerebral palsy from a wheelchair to a stander, the next step after moving the student to the stander is typically to ensure proper stabilization and support. Securing the pelvic band is essential for providing stability to the pelvis and preventing the student from sliding or moving out of the stander during classroom activities. This helps maintain a safe and comfortable position for the student while promoting engagement in various learning and motor activities.

A student in kindergarten has cerebral palsy and recently transitioned to a new school. The student is unable to maintain an unsupported standing position and depends on a wheelchair for seating and mobility. An OTR is teaching classroom aide how to transfer the student to and from a stander for classroom activities. After moving the student from the wheelchair into the stander, what should the OTR teach the aide to do NEXT? A. Adjust lateral trunk supports to snuggly comfort to the student's torso B. Fasten the chest strap to prevent the student from slipping downward C. Position the student's feet and shoulder width apart to improve weight bearing. D. Secure the pelvic band to adequately stabilize the student's pelvis

ME: A,B,F Chat GPT: B,E,F

Scenario item 3 of 4 Wh1Ch elements are MOST IMPORTANT to incorporate into the overall Intervention strategy when using the CIMT approach? You need to select 3 choices A. Apply a mitt to the client's unaffected upper extremity at the start of an activity. B. Engage the client in familiar activities using only the affected upper extremity C. Implement the intervention activities in the clinic environment as much as possible D. limit the use of the intervention approach to a maximum of 2 hours per day E. Provide the client with activity suggestions for encouraging bilateral use of the upper extremity. F. Teach the client how to implement this strategy into daily tasks and routines

A, B, F A. Randomized controlled clinical trial - Randomized controlled trials (RCTs) are considered the gold standard in clinical research. They involve random assignment of participants to different treatment groups and allow for comparison of outcomes between groups, providing strong evidence for the effectiveness of interventions. B. Meta-analysis of level 1 evidence - Meta-analyses combine data from multiple high-quality studies (such as randomized controlled trials) to provide a comprehensive summary of evidence. Meta-analyses of level 1 evidence offer a rigorous evaluation of the effectiveness of interventions, including CIMT. F. Systematic review of cohort studies - Systematic reviews compile and analyze data from multiple studies to provide a comprehensive overview of a particular topic. Systematic reviews of cohort studies, which follow groups of participants over time, can provide valuable evidence regard

Scenario item 4 of 4 Which types of research designs would provide the MOST RELIABLE evidence to support the OTR using CIMT with this client? You need to select 3 A. Randomized controlled clinical trial B. Meta-analysis of level 1 evidence C. Qualitative study of functional outcomes D. Phenomenological review of client experiences E. Participation observation study F. Systematic review of cohort studies

C,D,F C. Hemiplegia secondary to CVA - This component specifies the population of interest, which is essential for identifying relevant studies involving individuals with hemiplegia due to stroke (CVA). D. Improve upper extremity motor performance - This component describes the desired outcome of the intervention, which is to improve upper extremity motor performance. It helps narrow down the search to studies that address this specific outcome. E. Traditional treatment compared to CIMT - This component specifies the comparison of interest, which is between traditional treatment approaches and CIMT. It helps identify studies that directly compare the effectiveness of these interventions for individuals with hemiplegia secondary to CVA.

Scenarioltem 2 of 4 When using the patient, 1ntervention. companson. outcome (PICO) model to compare the traditional treatment to the use of CIMT for this client which of the following components should be part of the clinical question when searching a scholarly database? You need to select 3 choices A. Client-centered practice B. Maxim1ze functional outcomes C. Hemiplegia secondary to CVA D. Improve upper extremity motor performance E. Trad1bona1 treatment compared t0 CIMT F. Occupational therapy and stroke rehabilitation

A,E,F E. Obtain a copy of the student's most recent Individualized Education Program plan. This is crucial for understanding the student's current goals, accommodations, and services, providing valuable context for the evaluation process. F. Observe the student in the classroom during reading time. Direct observation allows the OTR to gather firsthand information about the student's behavior, attention, and interactions in the classroom setting, which is essential for understanding their needs and planning appropriate interventions. A. Administer the Sensory Processing Measure. Given the student's autism spectrum disorder diagnosis and the potential impact of sensory processing difficulties on behavior and attention, administering a sensory processing measure can provide valuable insight into the student's sensory profile and inform intervention strategies. These actions aim to gather comprehensive information abou

The following information Is repeated for scenario items 1 through 4. An OTR is reevaluating a 9-year-old student with autism spectrum disorder in preparation for an upcoming 3-year Individualized Education Program (IEP) review meeting. The teacher tells the OTR that the student rarely interacts with peers and routinely has disruptive outbursts at the start of quiet reading time in the classroom. especially when recess is canceled. Scenario Item 1 of 4 The OTR learns that the student is more focused and attentive to tasks when full-time assistance is provided to follow events listed on a picture schedule Which actions are important for the OTR to complete as part of the INITIAL evaluation of this student? You need to select 3 choices A. Administer the Sensory Processing Measure. B. Ask the student's parents to complete the Ages & Stages Questionnaire® C. Track the number of times the student displays stereotypical behaviors D. Consult with the pediatrician regarding pharmaceutical interventions. E. Obtain a copy of the student's most recent Individualized Education Program plan. F. Observe the student in the classroom during reading time

B,C,E B. Best research data - Evidence-based practice relies on the best available research evidence to guide clinical decision-making. Therefore, the OTR should consider research studies and evidence supporting the effectiveness of CIMT for clients with hemiplegia. C. Standardized assessments - Standardized assessments are essential for evaluating the client's current level of function, determining the appropriateness of CIMT, and monitoring progress throughout the intervention. Using standardized assessments helps ensure that interventions are tailored to the individual client's needs. E. Practitioner's clinical experience - The OTR's clinical experience and expertise play a crucial role in decision-making. While research evidence provides a foundation, the practitioner's clinical judgment and experience help determine how best to apply CIMT to the specific client's needs and circumstances.

The following information is repeated for scenario Items 1 through 4, An OTR Is planning to use constraint•induced movement therapy (CIMT) to improve upper extremity motor performance with a client who has hemiplegia secondary to a CVA Scenario Item 1 of 4◄ When using an evidenced-based practice framework, which set of factors should the OTR use to guide clinical decision-making regarding the usefulness of integrating CIMT into the Intervention plan? you need to select 3 choices. A. Client preferences B. Best research data C. Standardized assessments D. Employer's policies E. Practitioners clinical experience F. Documentation requirements

A,C,D A. Arrange for the student to engage in cooperative structured play activities with three peers. Encouraging the student to participate in structured play activities with peers promotes social interaction skills and provides opportunities for positive social experiences, which can help reduce feelings of isolation and disruptive behaviors. C. Ask the teacher to review the daily class schedule at the start of each school day. Reviewing the daily class schedule helps the student anticipate and prepare for upcoming activities, reducing anxiety and increasing predictability, which may help decrease disruptive behaviors.

The following information is repeated for scenario items 1 through 4. An OTR is reevaluating a 9-year-old student with autism spectrum disorder in preparation for an upcoming 3-year Individualized Education Program (IEP) review meeting. The teacher tells the OTR that the student rarely interacts with peers and routinely has disruptive outbursts at the start of quiet reading time in the classroom especially when recess is canceled. Scenario item 4 of 4 Which of the following recommendations are BEST to include In the student's intervention plan? You need to select 3 choices A. Arrange for the student to engage in cooperative structured play activities with three peers. B. The student will engage in a structured brushing protocol two times per day. 5 days per week. C. Ask the teacher to review the daily class schedule at the start of each school day. D. Trial several different dynamic seating options when the student is seated at a desk. E. Arrange for the student to engage in a therapeutic listening program in the classroom. F. Provide pull-out sensory modulation sessions in the therapy room for 30 minutes each school day.

A. Plan an observation session during the student's lunch and recess breaks. This can provide insight into the student's social interactions and behavior outside of structured classroom settings. C. Complete a standardized sensory integration assessment in the therapy room. This can help determine if sensory processing difficulties are contributing to the student's behavior and social participation challenges. E. Observe the student in gym class participating in an indoor game or activity. This observation can provide information about the student's motor skills, coordination, and ability to participate in group activities in a different environment.

The following information is repeated for scenario items 1 through 4. An OTR is reevaluating a 9-year-old student with autism spectrum disorder in preparation for an upcoming 3-year Individualized Education Program (IEP) review meeting. The teacher tells the OTR that the student rarely interacts with peers and routinely has disruptive outbursts at the start of quiet reading time in the classroom. especially when recess is canceled. Scenario item 2 of 4 Scores on administered tests are below average for social participation and within normal limits for balance and motion. Which additional actions are important for the OTR to take when gathering information during the reevaluation? You need to select 3 choices A. Plan an observation session during the student's lunch and recess breaks. B. Refer the student to the school's resource teacher to rule out auditory deficits. C. Complete a standardized sensory integration assessment in the therapy room. D. Discuss the student's visual acuity with the school nurse. E. Observe the student in gym class participating in an indoor game or activity. F. Observe the student's participation during a math. writing. and art class.

A,D,F A. Staying on task during classroom assignments before taking a break Addressing the student's ability to remain focused and engaged in classroom tasks is essential for academic success and reducing disruptive behaviors. D. Following activities listed on a picture schedule of daily school activities Utilizing a visual schedule can help the student understand and anticipate daily routines, promoting organization and predictability, which may reduce anxiety and disruptive behaviors. F. Initiating positive interactions with peers during small-group work Encouraging the student to engage positively with peers fosters social skills development and increases opportunities for meaningful social interactions, potentially reducing feelings of isolation and disruptive behaviors. These priorities aim to support the student's academic engagement, organization, social skills development, and overall adjustment within the c

The following information is repeated for scenario items 1 through 4. An OTR is reevaluating a 9-year-old student with autism spectrum disorder in preparation for an upcoming 3-year Individualized Education Program (IEP) review meeting. The teacher tells the OTR that the student rarely interacts with peers and routinely has disruptive outbursts at the start of quiet reading time in the classroom. especially when recess is canceled. Scenario item 3 of 4 After 5 minutes of sitting and listening, the student is observed to be restless. getting up and moving around the classroom. Which priorities should the OTR discuss with the interprofessional team and the student's parents at the IEP meeting? You need to select 3 choices. A. Staying on task during classroom assignments before taking a break B. Transitioning the student from using a picture schedule to using a written schedule C. Carrying a lunch tray in the cafeteria with standby assistance from a paraprofessional D. Following activities listed on a picture schedule of daily school activities E. Attending reading lessons with a resource teacher F. Initiating positive interactions with peers during small-group work