final pass the OT

What OT intervention is typically included in the post-surgical management of patients with Dupuytren's disease? Select the 3 best answers.

A/PROM and then progress to strengthening when wounds are healed Splint the affected joints in flexion Functional tasks that emphasize flexion (griping) and extension (release) Splint the affected joints in extension

Upon completing 25% of a task, a client is given which FIM score?

2 - Helper-complete dependence

At what age should transition planning begin for a child receiving birth-to-three services?

2 years, 6 monts

In order for both Registered Occupational Therapists and Certified Occupational Therapy Assistants to remain in good standing and to be able to continue working in their chosen professions, how many Professional Development Units (PDUs) does the NBCOT® require each certified therapist to accrue, during a 3-year renewal cycle?

36

Upon completing 75% of a task, a client is given which FIM score?

4

At what age can a child be expected to dress themselves independently and without supervision?

5-6

Christina, an 18-year-old student who attends a local music school has been referred to the hand therapy clinic for a custom-made splint. Christina recently sustained an injury to her right dominant upper limb and has been diagnosed with a minimally displaced distal radial fracture. The main goal during therapy is for Christina to regain functional wrist extension while her fracture heals. What type of splint would be the BEST to help Christina achieve her main goal of obtaining functional wrist extension?

A custom-made circumferential splint

An adolescent patient who has Down Syndrome is attending OT in an outpatient setting. The main goal of OT intervention is to help the patient develop basic cooking skills. The patient has just successfully learnt to make a peanut butter and jelly sandwich. Which therapeutic activity would be BEST to plan for the NEXT treatment session?

A grilled cheese sandwich

An entry-level COTA® is preparing to co-lead an assertiveness training group. All the members of the group have some form of depression and display a low self-esteem. Discussing the group process with the OTR®, encourages the COTA® to examine her therapeutic role in this type of group. What type of leader should the COTA® be, to successfully facilitate the group process?

A leader who encourages members to share similar situations and reactions with each other

Before deciding to incorporate a superficial thermal agent into a patient's treatment plan, the OTA must know in which situations this modality is contraindicated. Select the 3 scenarios in which using a superficial thermal agent is contraindicated. Select 3 best answers.

A patient diagnosed with a DVT A patient diagnosed with a neuropathy A patient born with Hemophilia A

A 67-year old patient who has a left complex tibial fracture is due to be discharged. The patient plans on returning to his home and has been given strict non-weight bearing precautions for 10-12 weeks. For mobility, he has been provided with a manual wheelchair. The patient lives in a single-level home which has 3 steps at the entrance. To access his home, he will therefore need a ramp. To determine the dimensions of the ramp, the following specifications have to be taken into consideration: 3 steps, each 5" high and a ½" threshold at the entrance door. What would the recommended length of the ramp be, to allow the patient accessibility to his home?

A ramp length of 17 feet

A patient who recently sustained a work-related injury which resulted in her acquiring a superficial second-degree burn to her right upper extremity, is recovering in the medical ward. The patient asks you how long it will take for her burn to heal. How should you respond to this patient's question?

A superficial-partial thickness burn typically heals within 21 days

A high school student with a significant learning disability has turned 21 years old and is no longer eligible for services through the public school system. He is not yet ready to transition to supported employment. What type of program should he enroll in to help him continue to learn vocational skills?

A vocational workshop, also called a sheltered workshop

Which primitive reflex helps to develop a child's eye-hand co-ordination?

ATNR

Brian, a former college football player who acquired a C7 spinal cord injury during practice, is being seen in an inpatient rehabilitation unit for a repetitive stress injury. Symptomatically, Brian complains of chronic pain in both his wrists and shoulders. The stress injury can be attributed to him having to use his manual wheelchair for long distances over various terrains. The patient prefers not to use a power-assisted wheelchair. A recommendation was made for an add-on feature to his existing wheelchair as an alternative mode of wheelchair propulsion. What would the BEST type of wheelchair be that would enable the patient to continue being independent in his mobility but reduce upper extremity strain?

Adapt the wheelchair with a crank and lever hand control

A 28-year-old inpatient who sustained a TBI from a football injury is functioning at Rancho Los Amigos 7 (Automatic, Appropriate). He is generally co-operative and requires no mobility aids, but he demonstrates decreased judgement. The COTA® has assessed the patient's vision, visual perceptual skills and cognition, and has found deficits in these areas. To maximize the patient's engagement in his occupations, what type of intervention would be MOST EFFECTIVE during this phase of the patient's rehabilitation?

Adaptive strategies to complete grooming and dressing in his room

Ensuring the privacy and protection of patients' healthcare data is mandatory by law. Which statements are TRUE about patient confidentiality in healthcare? Select the 3 best answers.

Always safeguard private information about patients, employees, colleagues, and students Confidentiality may be breached when reporting suspected abuse Confidentiality may be breached when the safety of a patient is at risk

Mary, a 55-year-old self-employed web designer, is receiving occupational therapy in an outpatient stroke rehabilitation program. The focus of intervention is on training Mary in strategies to compensate for her difficulty with saccades, which are the eye movements one uses to rapidly refixate from one object to another. One of Mary's goals is to return to meeting her friends at the local coffee cafe for their weekly board game night. Post CVA, Mary's husband drives her to the café to avoid having her cross any roads. He has however noticed that when she is walking towards the café, she does not notice people crossing in front of her, from her side view. Which activities should the COTA® use to address Mary's deficit so that her participation in her preferred leisure activity can be maximized?

An object-matching activity in which familiar objects are placed in plain sight on multiple shelves

An OTR® and COTA® are collaborating to develop a program for residents in a long-term care facility who have been diagnosed with dementia. The focus of the program is to reduce depression, increase orientation, and promote social participation within the group. The clinicians decide to follow the Remotivation Process. The group is structured as follows: Group members choose a genre of music from their past. A picture of a recognizable, famous singer whose music is associated with that genre is passed around. What task should be introduced NEXT to meet the goals of the group?

Ask each participant a short question about the music topic and encourage individual contributions, such as imitating the singer or singing one of the singer's tunes

At a long-term care facility, while engaged in a game of soccer with other residents, a patient with schizophrenia starts behaving as though he is being followed, suggesting that he is experiencing a delusion. How should the OTA handle this situation?

Ask the patient to kick the ball

To help her stay sober through leisure skill acquisition, a patient who abuses substances such as alcohol and pain medication, has been referred for OT Intervention. In order to achieve this goal, what is the BEST course of action this patient's OTA should take?

Assist the patient in planning and scheduling leisure activities

The OTR® is working with an elderly patient who is recovering from a CVA. Which of the following activities can the OTR® delegate to an aide?

Assist the patient with routine dressing, after training and competency have been demonstrated

What is your role in a task-oriented group?

Assists with activity selection, facilitates discussion, and assists members in exploring relationship between thoughts, feelings and actions

An OTA is working with a 12-month-old girl who presents with a developmental delay. At this stage, the child's only means of mobility is rolling on the floor and the goal is to help her develop other modes of mobility. She is able to sit with minimal support and in prone, she is able to push up on extended arms and shift her weight backward. Which developmental milestone should the OTA work on NEXT to help this child progress towards achieving her goal of becoming more mobile?

Assuming a 4-point kneeling position on hands and knees

David, a 52-year-old male who has a history of COPD has been referred for OT intervention. David lives alone in a double story house and he usually enjoys going for leisurely walks around his neighborhood. Recently however, David has been experiencing more frequent episodes of dyspnea which is impacting on his physical activity, including walking up his stairs at home and performing his BADLs. David has had to resort to sponge bathing at the bathroom sink and he tries to avoid using his stairs as much as possible. The OTR® decides to instruct David on using a pursed lip breathing technique for dyspnea relief, but he has difficulty performing this breathing pattern. What modality would be the MOST helpful for David to use to help him improve his technique so that he can increase his tolerance for performing physical activities?

Auditory biofeedback to the sequence and speed of simulated breath sounds

a 32-year-old inpatient who is experiencing a psychotic episode has been seen by the COTA® to educate him on the effects his antipsychotic medications may have on his ability to function in his daily activities. During the session, the patient begins demonstrating akathisia. After discussing this observation with the supervising OTR®, the COTA® implements a certain strategy to help the patient cope with the side effects of his medication. What strategy would be beneficial to teach this patient?

Avoid activities that require sitting for long periods or standing still

A 28-year-old male athlete had an acquired brain injury 3 weeks ago from playing football. The patient is currently in an inpatient unit at a city hospital and is functioning at Level II (Generalized response) on the Rancho Los Amigos scale. The patient's mother and father would like to be involved in their son's care and want to find ways to help him. What are the MOST beneficial tasks that the patient's parents can be taught, at this stage of the rehabilitation process?

Bed positioning and controlled sensory stimulation

Stacy, a 58-year-old mother of four children is recovering from a total hip arthroplasty which has been complicated by the formation of a DVT. As a result, Stacy has been prescribed blood thinners. Which precaution is the MOST important for Stacy to be aware of in terms of her current medical status?

Bleeding of the gums requiring need to substitute a hard-bristle brush for a soft one

A 5-year-old child who has cerebral palsy has been referred to OT for eating and swallowing difficulties. Upon evaluation, the OT has identified that the child has poorly developed oral-motor control. In order to further develop this child's oral-motor skills, which activity should the OTA select to improve this child's oral-motor control?

Blowing a paper boat across a tub of water

Sustaining a closed head injury may result in a patient demonstrating aphasia. What are the key differences between Broca's aphasia and Wernicke's aphasia that would allow you to distinguish between these 2 types of aphasia?

Broca's aphasia is characterized by slow and incorrectly articulated speech and with Wernicke's aphasia the patient exhibits well-articulated speech, which lacks meaning

Which setting would be best for a patient with a history of a mental illness who needs assistance with employment, community support, and housing programs?

Clubhouse

A COTA® is working with a patient who has had an exacerbation of COPD on a graded grooming task at the sink. The patient is on continuous supplemental oxygen, with a baseline oxygen need of 2L/min at 90-93%. When the COTA® progresses the task from sitting to standing, the patient demonstrates respiratory distress and his SpO2 levels begin to drop to well below target range. The COTA® assists the patient back to his seat and instructs him to use the pursed lip breathing technique which results in the patient recovering to baseline, after 3 min. This event occurs a second time when the task is once again attempted but this time, the recovery time was longer. The COTA® reacts to these events by immediately measuring the patient's SpO2 using another type of pulse oximeter and checks that the oxygen tubes are intact. Both times, similar readings were obtained, and the tubing was intact. What should the COTA® do NEXT?

Collaborate with nursing or respiratory therapist to determine if titration is necessary

A patient recently sustained a fracture to his right humerus while playing football. He is being treated conservatively and has been provided with a cast which he is required to wear for the next 6-weeks. During this period of immobilization, what should the OT practitioner MAINLY focus on?

Compensation techniques

An OTA has recently passed her NBCOT® exam and she has received her license, allowing her to practice in her chosen career. The OTA has applied to work at an assisted living facility. What job task is the OTA allowed to complete without having to be supervised by the OTR®?

Complete a medical chart review

A 5-year-old child has mild delays in visual perceptual skills. The OTA asks the child to complete a 30-piece farm animal puzzle, however, after putting 5 pieces together, the child puts his head on the table. How should the OTA respond to the child's action?

Complete part of the puzzle for the child and allow him to finish it

If a patient is experiencing pain in their arm or leg following an injury or surgery, and the pain is much greater than the severity of the initial injury, which syndrome is most likely occurring?

Complex Regional Pain Syndrome (CRPS)

Medicare Part B removed the therapy cap in 2019, and OT services now have unlimited coverage if deemed medically necessary. In which settings would a 36-year-old patient who is recovering from a recent TBI be eligible for outpatient OT services?

Comprehensive home health care and hospital outpatient clinics

A 4-year-old boy with spastic hemiplegia cerebral palsy is working with an OT practitioner in an outpatient center. The OT practitioner places a mitt on the child's unaffected upper extremity while having him reach to remove magnets from a metal door with his affected upper extremity. What type of intervention technique is being used in this scenario?

Constraint -induced movement therapy (CIMT)

Bill, an 80-year-old resident of a long-term care facility, is recovering from a recent CVA of his right parietal lobe. Bill has been admitted to a post-acute rehabilitation facility where he uses a wheelchair for mobility,only requiring minimal assist for navigation. Bill is keen to attend most of the activities in the rehab facility and as he is a former commercial graphic artist, he thoroughly enjoys any sketching activities . During a recent session, Bill drew a two-dimensional two-story house leaving out the left side of the house, and the chimney and front porch reversed. Based on his drawing, what difficulty is Bill MOST LIKELY demonstrating?

Constructional apraxia and left-sided neglect

Elisa, a 45-year old mother of two, has recently been admitted to an inpatient rehabilitation unit for exacerbation of her Multiple Sclerosis. Prior to the exacerbation, Elisa had been independent in self-care and community mobility, and shared household tasks with her husband and teenage children. She reports a recent decline in her short-term memory recall and that she has been unintentionally forgetting a few items on her list at the grocery store. The COTA® decides to train Elisa in the use of a story memory technique which teaches skills to use context and imagery to facilitate learning. Which approach should the COTA® take to help Elisa facilitate memory retrieval?

Create 1 mental image that "paints" a picture of a story that calls to mind a list of items or tasks the person needs to recall

Over the weekend an entry level OTA went to a conference on fabricating splints. When she returned to the hand clinic on Monday, she wanted to incorporate what she learned into her treatment sessions. What did the OTA need to do before using her newly-learned splinting techniques with her patients?

Demonstrate her competence in splinting to her supervising OT

Jeremy, a 40-year old former competitive skier, sustained an incomplete C6 spinal cord injury, a year ago. He was recently admitted for the treatment of a Stage II pressure sore on his left ischial tuberosity, for which he is having to use a wound vac. Jeremy is 5 foot 6 inches and weighs 170 pounds. Prior to his pressure sore developing, he was able to perform sliding board transfers with lateral weight shifting, only needing contact guard to minimal assist. Jeremy is being seen with his caregiver for self-care training. Which task should the COTA® teach the caregiver, to ensure Jeremy's safety with self-care tasks?

Dependent squat pivot-transfer from wheelchair to 3-in-1 drop-arm bedside commode over the toilet

Doug, a 28-year-old inpatient with C6 tetraplegia, is working with an COTA® on an intermittent catheter program for bladder management. His goal is to be independent in catheterization and hygiene so that he does not need long-term assistance from a caregiver. Once a therapeutic protocol has been established, the COTA® will co-treat the patient with the nursing staff to teach him how to insert and place the catheter so that he can to learn the process of self-catheterization. After determining the patient's cognitive ability to learn self-catheterization, what is the NEXT step the COTA® should take, to help progress the patient towards his goal?

Determine the patient's capability to access the packages and manipulate the tubing

A patient with COPD has recently been admitted to the medical ward due to a significant decline in his overall level of functioning. For mobility, he now requires the use of a wheelchair, with an attachment for his oxygen tank. The patient is expected to be discharged and he will be returning to his apartment which he shares with his wife and adult son. Before returning home, the OTR® conducts a home visit and identifies several areas in the apartment that are not wheelchair accessible. What should the OTR® do NEXT to address this situation?

Determine the routines and needs within the apartment space for both the patient and the family

Elizabeth, a single mother of 3 children is facing the challenges of raising her youngest child who has been diagnosed with an autism spectrum disorder (ASD). Elizabeth's frustration mainly stems from the lack of emotional support from her extended family members; disruption of her sleep; and lack of time for herself due to the fact that she continuously has to reorganize her occupations in order to meet her child's special needs. Following the Occupational Adaptation model, which 3 of the following activities would MOST LIKELY help Elizabeth cope better with her stress and reduce the demands of her role as the mother? Choose the 3 best answers.

Develop a household management system with expected roles of each family member to share responsibilities at home. Include the child's siblings in the home exercise program during OT treatment sessions Incorporate stress reduction techniques along with the child prior to an activity that is challenging for the child

A 65-year old widow who has an anxiety disorder and lives alone is showing signs of mild cognitive decline. She currently volunteers at a local community center doing general cleaning. A bake-off at the center is scheduled in a week and the patient decides to volunteer at that event, as well. She is required to attend several planning sessions before the event. She is assigned to work on tasks such as making decorations and posting signs for the event. The patient is feeling anxious as the day of the event approaches. Which strategies can the COTA® teach the patient so that she can manage her anxiety and cope with her assigned tasks?

Develop an actionable list which she can be checked off as she prepares for each activity

Gertrude is an 80-year-old woman with stage 3 Alzheimer's disease. What symptoms would you expect to observe as Gertrude completes daily activities?

Difficulty finding the right word when speaking. misplacing valuable objects, trouble with planning or organizing

Ralph, a 69-year-old cab driver who recently had to undergo coronary artery bypass grafting, is due to be discharged from a post-acute rehabilitation facility. Ralph has completed 2 weeks of OT and as part of his discharge plan, his spouse with whom he resides, needs to be provided with information that will ensure a smooth transition for Ralph. What is the MOST IMPORTANT information that should be given to Ralph's spouse pre-discharge?

Directions regarding sternal precautions and activity guidelines

An OT Practitioner has been working with a 22-year-old professional cyclist who has been diagnosed with De Quervain's tenosynovitis. After his 4-week follow up, the patient has been medically cleared to begin strengthening exercises in preparation for him resuming his cycling. To establish a baseline, the OT practitioner needs to assess the patient's functional hand strength for cycling. Which type of assessment is the MOST appropriate for this purpose?

Dynamometer to determine the level of grip strength to hold the handlebars

A COTA® is performing upper-extremity activities with a patient who is recovering from a R CVA. The COTA® notes that the patient has a decrease in passive ROM in the left upper extremity. What factors are most likely contributing to this decrease in ROM?

Edema, joint contractures, and weakness

A patient with heart disease and anxiety has been admitted to an in-patient rehab unit. The patient has stated that they would like to work on gardening tasks. What is the most appropriate action the OTA should take next, in this scenario?

Educate the patient on treatment interventions that are implemented in the inpatient rehabilitation unit

An OTA is working at an inpatient rehabilitation facility with a patient who has a complete C8-T1 spinal cord injury (SCI). Currently, the patient is functioning at a FIM level 2 (maximal assistance) when it comes to dressing skills. What would be the best technique to incorporate into therapy sessions to improve independence in dressing?

Educate the patient on ways to don lower body dressing in bed, then transfer the patient to a supported chair/wheelchair to complete upper body dressing

An OTA is working with a patient who has been diagnosed with cubital tunnel syndrome affecting their dominant upper limb. The OTA has instructed the patient to avoid sleeping on their stomach but the patient is unsure if they will be able to comply as this is a habit they have tried to break in the past. The OTA then decides to focus on modifying the position of the patient's limb when they are sleeping. Which type of splint should the OTA recommend in this scenario?

Elbow splint for nighttime use

A patient who is nonverbal successfully uses an augmentative communication device. During an occupational therapy session, the device stopped working. What should the OTA do to help this patient?

Evaluate the patient's augmentative device settings

According to his homeroom teacher, a 11th grade student who is a paraplegic wants to start using the community bus to travel to his mom's house after school. He currently uses a manual wheelchair for mobility, but he is wanting to find a way to reach his destination without having to propel himself for such a long distance. Previously, the student has not needed special education and he therefore has never had an IEP. What advice should the OT practitioner give the homeroom teacher?

Find out if the student is eligible for special education and it's related services

Marty, a drywall carpenter, has been referred to OT for treatment of a repetitive stress injury caused by overuse of his abductor pollicis longus (APL) and extensor pollicis brevis (EPB) of his dominant upper extremity. When assessed Marty was found to have a positive result for the Finkelstein's test, swelling on the radial side of his wrist and a consistent pain level of 5/10. Marty's goal is to return to work in 4 weeks' time, which is possible if his affected hand is immobilized and his work modified. In order to support his goal of returning to work within this time frame, what will need to be incorporated into his intervention plan?

Forearm-based thumb spica orthosis that places the wrist in neutral and thumb in opposition and activity modification to avoid pinching during activities

Using the cognitive behavioral frame of reference, which intervention would be best to work on social interaction with a group of 6 patients with PTSD?

Have all the patients decorate the hospital Christmas tree using all the materials provided

An OTA is showing a Fieldwork II student how to assess the grip strength of a patient who presents with carpal tunnel syndrome. Using a dynamometer, how can the OTA ensure that they get the MOST ACCURATE measurements? Select the 3 best answers.

Have the patient flex the elbow at 90 degrees with the gauge held lightly by the examiner as needed Measure 3 trials with the non-injured hand for comparison Have the patient squeeze the gauge with maximal effort while the forearm is in neutral position

A COTA® is working with a patient who had a carpal tunnel release of his left hand, 6 weeks ago. The surgical site is closed, but the patient has developed scar tissue which is limiting movement of his hand. As part of the adjunct to therapy, the COTA® begins using paraffin dip before beginning the treatment session. Which of the following procedures are MOST IMPORTANT to follow during administration of this modality? Select the best 3 answers.

Have the patient slowly dip and raise his affected hand in the paraffin several times until the hand becomes thick with paraffin Cover the hand in a plastic bag, wrap in a towel, and rest the hand on a table 10 - 20 min Maintain the temperature of the paraffin bath between 125- and 130-degrees F

A patient who is recovering from a R CVA presents with unilateral neglect. While participating in a gardening activity, planting flowers, the OTA places a pile of soil in front of the patient and asks them to scoop the soil into a container. The patient only scoops some of the soil and then stops the activity as if they have placed all the soil into the container. What remedial strategy can the OTA teach the patient, to support long-term independence?

Have the patient visually scan the table for all the soil

A salesman with a progressive disease is often late to meetings because he gets tired trying to propel his manual wheelchair from the parking lot to his office. What should the OTA recommend to him?

Have the salesman use a powered wheelchair to get from the parking lot to his meetings

During a home health session with a patient who has mid-stage dementia, her caregiver reports that the patient is becoming very agitated and physically and verbally aggressive at bath time. The patient expresses that bathing "hurts" her, especially when she is lowered into the bath. The caregiver however indicates that she believes the patient is acting in this manner on purpose, as she does not like to bathe and is not concerned about her own hygiene. How should you respond to the caregiver in this scenario? Select the 3 best choices.

Help the caregiver to understand the patient's functional level, including limitations and abilities Encourage the caregiver to speak calmly, using short sentences when the patient becomes agitated Recommend ways to simplify the environment to support the patient's best functioning

A 26-year-old woman who is employed as a sous chef at a local restaurant recently had to undergo a below elbow amputation to her right dominant upper limb. She is currently being educated on the use of her prosthesis which is externally powered and has a hook TD. The COTA® is working with the patient on the third step of the Post-Prosthetic Phase which involves training her in the use of the prosthesis. Only after completing this phase, will the patient be ready to perform functional bilateral tasks. Which of the following activities would be MOST BENEFICIAL to incorporate into this step, in this phase of intervention?

Holding and placing a tomato on a shelf without crushing it

You are working with a 4-year-old boy who has been diagnosed with a global developmental delay. Retained primitive reflexes have been identified as an important goal to focus on during his OT intervention. Incorporating which specific posture into the boy's therapy sessions would help to inhibit his Tonic Labyrinthine Prone Reflex?

In prone, assume a posture of extension (arms and legs extended, lifting chest off surface)- Superman position

You are working in the field of early intervention. While reviewing a patient's chart, you read that this patient's reflexes have not been integrated. What does the term reflex integration mean?

Inhibition of primitive reflexes by the higher centers of the brain resulting in purposeful movements

A 9-year-old boy is beginning to have difficulty using the computer due to loss of vision caused by muscular dystrophy. Which of the following recommendations will be the best adaptation for allowing him to continue using the computer?

Install a program that reads screens

For a patient who sustained deep partial thickness and full thickness burns to the dorsal surface of his hand and forearm, which type of splint would be the MOST appropriate?

Intrinsic plus splint

An OTA is working with a patient who is functioning at level 4 according to the Rancho Los Amigos Scale. How can the OTA optimize success in her treatments with this patient?

Keep the room quiet and calm by turning off the TV

An OT is working with a patient who has a traumatic brain injury and is functioning at a Level IV (Confused/Agitated) on the Rancho Los Amigos Scale. After several therapy sessions, the OT has determined that the patient has reached maximum cognitive capacity. On which frame of reference should the OT use to base her next treatment session? Allen Cognitive Model

Lifestyle Performance Model

A 60-year-old inpatient who is recovering from a myocardial infarction which she had 1 month ago, is being seen in outpatient therapy. The patient lives alone in a 2-story apartment and plans to return to work at the local bakery, as soon as possible. At this stage of her recovery, the patient is only permitted to perform activities which expend 2.0 to 3.5. MET Levels. Educating the patient on which types of activities are appropriate is part of the COTA® 's intervention plan. Which of the following activities would be CONTRAINDICATED at this time?

Lifting a bag of flour up the 4-step back entry of the bakery from the loading dock

An OTA is working with a patient who has Guillain-Barré syndrome (GBS) and her main goal is to be able to use her desktop computer for her work. After several attempts of clicking the mouse to control the cursor to scroll through web pages, the patient is unable to complete the task and becomes very upset. What is the NEXT step the OTA should take?

Look at the computer control settings

A 75-year-old resident at a skilled nursing facility is participating in OT. She has been losing weight at a rate of 2 pounds per week which the dietician is addressing. During the initial OT evaluation, it was determined that the resident has mild dementia and moderate hearing loss. One of the goals of her OT intervention is to improve task initiation for increased engagement in self-feeding. Given her deficits, what would the BEST action be for the COTA® to take when providing instructions to the resident during treatment sessions?

Maintain direct eye contact when speaking with the resident

An OTA leads several mental health groups at a local church. Topics include ways to relieve anxiety, ways to increase social skills, and crafts that help bring self-awareness. What would be the PRIMARY role of the OTA when leading an egocentric cooperative group in this setting?

Make suggestions to allow patients to choose and carry out the task and group plan

A COTA® is leading a group of 5 high-functioning adult patients who have all been diagnosed with Schizotypal personality disorder (STPD). The aim of the group is to prepare the patients to be re-integrated into the community so that they can resume their previous roles. One of the patients is however anxious about being discharged and verbalizes concern about how people will react to him when he returns to his work. He states, "I believe if I'm not right in the head, I can't do anything in life". Which intervention would be the MOST EFFECTIVE in addressing this patient's concern and beliefs?

Matching the patient with a peer educator who has a history of a mental disorder similar to the patient's

Henry, a 42-year-old software engineer who has multiple sclerosis, uses a standard wheelchair for mobility. He has recently had an exacerbation of his symptoms, especially in his level of fatigue. Henry also complains of more severe upper back and neck discomfort, and increased weakness in his upper extremities. He works in IT and his workstation is equipped with a computer monitor adjusted to eye level, and a wrist-rest in front of his keyboard. Henry currently remains seated in his wheelchair throughout his workday and he states that he plans to continue to do so. Which modification would be MOST BENEFICIAL to recommend to Henry so that he can continue sitting in his wheelchair during work tasks, without exacerbating his symptoms even further?

Moldable insert, forearm supports, and lumbar support

Diane, a 52-year-old professional baker with a history of uncontrolled hypertension, suffered a left middle cerebral artery CVA 6 months ago. Diane's main goal is to return to work, but she continues to present with a right hemiparesis and limited hand function. For improved grasp, the COTA® decides to incorporate a PAM into Diane's sessions to facilitate active finger flexion. Which of the following modalities is the MOST appropriate to use with Diane during her treatment sessions?

Neuromuscular electrical stimulation followed by functional activities

What are the hip precautions (posterior approach) which an OTA must educate a patient who recently had a total hip replacement?

No flexion beyond 90 degrees and do not adduct legs

With which type of condition is using a paraffin bath contraindicated?

Open wounds

A patient who is passionate about being outdoors, has been diagnosed with dry macular degeneration. The patient especially enjoys bird-watching but she is finding it very difficult to pursue her interest due to her sensitivity to outdoor light. Currently, the patient uses a standard pair of sunglasses and she has asked you to recommend suitable sunglasses which would allow her to spend more time outdoors. What type of sunglasses are the MOST effective, to protect the patient's eyes from direct sunlight?

Orange tinted lenses

An OTA is conducting a highly structured directive group to assist mental health patients who are low functioning. What type of intervention would occur in stage 1?

Orientation activity

What type of activity would an OTA perform at the first stage of a highly structured directive group consisting of low functioning mental health patients?

Orientation activity

The OTR® has given the COTA® a new treatment plan for a patient on the intensive care unit. The patient has scored a 3 on the Glasgow Coma Scale. What treatment activities should the COTA® plan to use with this patient?

Passive range of motion to the upper extremities

An OTR® works with a COTA® in a school-based setting. The OTR® wishes to train the COTA® in the administration of certain portions of standardized tests used to evaluate new students. Which test is appropriate for the COTA® to assist in administering?

Peabody Developmental Motor Scales

While conducting a group session with a patient who has early-stage Alzheimer's, the OTA notices that the patient answers every question they are asked with the same answer and then spontaneously begins to repeat that same word repeatedly. After the session, the OTA will document in her notes that this patient is exhibiting what type of behavior?

Perseveration

What can a patient accomplish in terms of their living arrangements at Allen's Cognitive Level 5?

Person may live alone with weekly checks to monitor safety and examine potentially dangerous effects of impulsive behavior

What suggestions are the MOST beneficial to give to a nurse helping a Stage 3 Alzheimer's patient complete their ADL's?

Physical and verbal assistance

A patient who sustained a TBI when he fell from a 2-story building while working at a construction site, presents with decreased skills related to his executive functioning. One of his main goals is to be able to resume preparing meals independently for his family. He however demonstrates difficulty with planning, sequencing, and organizational skills which are essential skills needed for planning and preparing meals. Using a neuro-functional approach, which is the BEST method to improve the patient's ability to prepare meals, so that he can progress to achieving his goal?

Plan several sessions focused on helping the patient to plan and prepare a simple meal

An OTA working with a child who presents with generalized hypotonia is focusing her treatment session on facilitating active trunk and neck extension. Which activity should the OTA use to achieve this treatment goal?

Playing bean bag toss while prone on a platform swing

Elizabeth, a 16-year-old girl, was recently involved in a MVA which resulted in her sustaining an extensive crush injury to her right upper limb. Subsequently, she had to have her right dominant arm amputated, below her elbow. Elizabeth is the lead violin chair in her high school string orchestra, and she wishes to continue playing the violin with dreams of studying at the music conservatory. She has been fitted with a myoelectric body-powered prosthesis which has an accessory grip to hold her bow, a spring for wrist actions, and a mechanism which allows for pronation and supination. Elizabeth has completed practicing grasping and controlling the bow. Which of the following activities should the COTA® work on NEXT during the Functional Training step of the Post-Prosthetic Phase?

Playing simple scales to integrate bilateral use

Martin is a 43 year old man who sustained a C3 spinal cord injury 10 weeks ago. The OT is conducting a wheelchair assessment with Martin to improve his independence with mobility. During the assessment, Martin is intubated and his tracheostomy cuff is fully inflated. What kind of propulsion should the OT recommend for Martin?

Power w/c equipped with chin or head controls

Becky, a 52-year-old Accountant and mother of 3 teenagers, has recently been diagnosed with a substance abuse disorder. Becky is currently attending a work readiness group which is being held at a mental health facility. The COTA® and OTR® are co-leading the group with the objective of using the performance subsystem component, of the Model of Human Occupation. Which activity best supports the goal of Becky being able to return to work upon discharge?

Practice basic work skills such as focus, organization of time and work materials, and quality of workmanship

If using PAMs on their own as a therapeutic intervention is not considered occupational therapy, then what is the purpose of using PAMs as part of a patient's intervention plan?

Preparation for or concurrently with purposeful and occupation-based activities

An OT practitioner is working with a patient who is recovering from a recent TBI. The focus of the intervention is currently on meal preparation. The patient has successfully prepared cold cereal. In order to appropriately grade this activity, what is the next type of meal the OT practitioner should select, to help this patient progress to the next level?

Prepare a hot beverage, soup, or prepared dish, such as hot chocolate

What type of activity would a patient with an ulnar nerve entrapment have the MOST difficulty performing?

Pressing keys on a keyboard

An OTA is running a group at the local community center for seniors. The focus of the group will be on fall prevention. What level of prevention, will this group be addressing?

Primary prevention

What would not be part of a functional assessment of ROM of the hip?

Pronation would not be part of the assessment

Roberta, a resident in a long-term care facility has been diagnosed with Secondary-Progressive Multiple Sclerosis. She does not present with any type of tremor which can be associated with MS. Roberta does, however, have chronic lymphedema, affecting her right dominant upper limb, which is secondary to a right-sided mastectomy which she underwent a year ago. Roberta's main goal at this stage, is to become more efficient in self-feeding. Although she is on a regular diet and she has the ability to use cutlery, she has recently been losing weight due to not being able to finish her meals. What is BEST recommendation you can make to maximize Roberta's performance in self-feeding, so that she can achieve her goal?

Provide a lightweight spork and a high-rimmed dish

A COTA® is working with a 26-year-old man who sustained an incomplete C3 spinal cord injury. The patient has been in an inpatient rehabilitation unit for the past 10 weeks and he is due to be discharged. He will be returning home, and his wife has agreed to be his primary caregiver. For mobility, the patient uses a powered wheelchair which he maneuvers using a sip-and-puff system. In order to help this patient maximize his level of independence for self-feeding, what is the BEST STRATEGY to teach the patient?

Provide clear instructions for the wife on head positioning and tray setup

An OTA is leading a group in a rural outpatient facility. The group consists of 8 single parents who have all been diagnosed with GAD. The group is designed to run over a 12-week period, with weekly sessions which will focus on the management of anxiety. Using the CBT approach, what is the best way to ensure that what is learnt in the group setting, will be integrated into the members' daily routine?

Provide patients with new skills they can easily incorporate into their daily routine

In preparation for feeding a child with Cerebral Palsy (CP), what should the COTA® do to prevent tongue thrust?

Push the tongue down with a spoon

A COTA® who is working in a psychiatric facility observes that a new OT aide has violated departmental policy by leaving a pair of scissors out on a table. What action should the COTA® take FIRST?

Put the scissors away and remind the aide of the policy

A 160-pound male war veteran who previously had a left transmetatarsal amputation due to a crush injury, is being seen in an inpatient rehabilitation unit, following a recent right above-knee amputation. The patient states that he wants to continue being mobile within the community so that he can participate in his weekly bowling matches at his neighborhood bowling alley. He is right hand dominant and has access to a lightweight manual wheelchair with removable arm rests. Which of the following adaptations can be made to the patient's existing wheelchair, so that he can continue to pursue his leisure interests?

Rear anti-tippers

An OTR® and COTA® are collaborating to improve service delivery in a skilled nursing facility. The clinicians recently conducted a needs analysis and based on their findings, determined the need to develop a low vision program within the facility. This need was identified from the many residents reporting difficulty in completing their daily tasks due to poor vision. Which of the following proposals would be MOST appropriate to recommend, so that the residents' needs can be met? Choose the best 3 answers.

Recommend the dining room menus have increased font add a small bump on the doors to indicate th room number use contrasting color to indicate the beside and banthroom call lights

Which actions listed below reflect the Occupational Therapy Code of Ethics principle of Autonomy? Select the 3 best choices.

Refraining from discussing a patient's progress with a family friend who enquires about the patient Discussing the benefits and risks of electrical neuromuscular stimulation with a patient prior to initiating the treatment Honoring a female patient's request to receive treatment from a female therapist

A patient who has been provided with a forearm volar wrist splint develops "window" edema between the splint's straps. In addition to elevating the patient's limb, what is the BEST way to manage this patient's edema?

Replace straps with bias-cut wrapping, from the distal to the proximal end

An OT is informed about the scheduled date and time for a patient's care plan meeting. The OT is, however, unable to attend the meeting as she will be at a continuing education workshop on that day. The OT, therefore, asks the OTA to attend the meeting in her place. What is the OTA permitted to do in this meeting?

Report on the patient's progress at the meeting

While providing home health services to a 73-year-old patient with a traumatic brain injury, the COTA® notices a bruise on the patient's right cheek. When questioned about her bruise, the patient states she fell but the COTA® suspects the patient's explanation may not be true. What course of action should the COTA® take NEXT?

Report the possibility of abuse according to the home health agency's policy

In a rehab clinic, an OTA is working on dressing with a 47-year-old patient who has been diagnosed with Lewy body dementia. Suddenly, the patient states that she is feeling light-headed and dizzy when she attempts to stand up from a lying positon. What is the most likely reason for this sudden change in the patient's state and how should the OTA react in this situation?

Return the patient to the bed and raise their legs with pillows

A 6-year-old girl demonstrates sensory modulation difficulties. She is hypersensitive to most types of fabrics which limits the clothing that she is able to wear. She chooses only soft fabrics and always insists that the tags on her clothing are removed. In terms of ADLs, what issues can the OTA expect when it comes to bathing?

She may be resistant to washing her hair

For a patient who is recovering from a recent CVA, how should they be positioned when lying on their affected side?

Side-lying on affected side- Pillows under the head with top leg forward, flexed at hip and knee, and leg resting on pillow in front of the affected leg. Affected leg placed with thigh so that it is in line with the trunk, knee slightly flexed and arm forward

A COTA® is collaborating with an OTR® on developing a work hardening outpatient program, for an inpatient rehabilitation hospital. What is the MOST IMPORTANT criteria that should be considered when developing this program?

Simulation of work activities based on typical work tasks to improve strength and endurance necessary for work performance

A patient has progressed from stage 1 (1-1.4 MET) to stage 2 (1.4 to 2.0 MET) in his cardiac rehab. As his OTA, what ADL and mobility activities can you introduce to this patient at this stage of his rehab?

Sitting and shaving

A patient with a rotator cuff tendonitis is having trouble sleeping due to pain and discomfort. What sleeping position would be BEST to recommend to this patient?

Sleep in a reclined supine position

A 43-year-old male sustained a full thickness burn to both his upper extremities, including the dorsal surface of his hands. Part of the patient's first OT treatment session is focused on mobilizing his fingers. Which exercise would be the most appropriate to perform, at this stage of the intervention process?

Stabilizing the wrist to 15 degrees of extension while performing isolated movements to IP joint

Sara, an OTA, is working in a skilled nursing facility with a group of patients aged 65 - 72 years old. The focus of the group is on promoting gross motor movements. More than half of the group members present with deficits in their postural stability, mild tremors, and for mobility they rely on using a cane. None of the group members have deficits in their cognition or attention. The common goal for this group is to increase their participation in meaningful activities and to remain safe while performing standing ADLs. Which of the following activities would be the MOST EFFECTIVE in helping the group members to achieve their goals?

Standing rhythmic music exercise with the back of a chair on stand-by for stability

A COTA® is working with an insulin-dependent 58-year-old patient on upper body strengthening exercises using the arm bike. The patient starts to become agitated and begins to complain of shakiness and that his hands are feeling clammy, making it difficult for him to grasp the handlebars tightly. What should the COTA® 's IMMEDIATE response be?

Stop the activity, call for assistance, and provide him fruit juice

Gregory is a 40-year-old artist who recently severed his right thumb and index finger while working on a woodworking project. He has been fitted with a thermoplastic thumb splint to compensate for his amputated thumb and he is currently attending the hand clinic with the goals of reinforcing proper wound care, maintaining active ROM and strengthening of his uninjured fingers and, mastering bilateral functional activities. Gregory has stated that his main desire is to regain his independence in all aspects of his life. Using a top-down approach, which types of interventions should the OTA implement to help Gregory achieve becoming independent? Select the best 3 answers.

Substitute the buttons on each pair of trousers with hook-and-loop tape Replace all round tap knobs in the home with levered handles Learn to operate an electric can opener by using his forearm and wrist

An OT practitioner is formulating the OT intervention plan for a patient who has been diagnosed with Pronator Teres Syndrome and presents with significant aching pain in her forearm. What is the FIRST intervention the OT practitioner should implement with this patient?

Support and immobilize the the upper limb. Provide the patient with a splint which maintains the elbow at 90° and the forearm in neutral

A preschool child who has been diagnosed with spastic CP has developed his own method to move around his environment, by using a compensatory crawling strategy of simultaneous hip flexion (bunny hopping). This suggests that he is making use of a retained primitive reflex to help him gain functional mobility. What reflex is this child MOST LIKELY using to achieve mobility?

Symmetrical Tonic Neck Reflex

Zoe is a 14-year-old student who sustained a distal radius fracture to her right dominant hand when she injured her arm during an epileptic seizure. It has been 3-months since the injury and Zoe is still struggling with chronic pain. To help her manage her pain, you have made the clinical judgement to administer a PAM. Which PAM is contraindicated for in this scenario?

TENS

An OTA is working with a patient with diabetic retinopathy on adapting her home to compensate for low vision. Before introducing adaptations, the therapist tries several low tech and low cost interventions, including increasing the level of lighting in areas where most of the patient's activities occur, reducing glare, clearing walkways and reducing clutter in the common areas in her home. After several weeks, the patient's disease has progressed, and she is no longer able to read the dials on her stove. What adaptation should the OTA introduce to help the patient set her stove for cooking tasks?

Tactile pen marks on common stove settings

An OTA is working with a 4-year-old child who continuously sucks and chews his shirt and he is resistant to trying any other chewables such as chew tubes or crunchy snacks. The child's parents want to know how they can stop this behavior as they are concerned about their son's teeth. What strategy would be BEST to recommend to these parents?

Teach alternative calming strategies

A student in elementary school has been diagnosed with dyslexia and as a result, he is falling behind in his school work. Consequently, the student has started to refuse to go to school which is affecting his relationship with his mother. What type of AT would help this student keep up with his school work?

Text-to-speech software

A COTA® is working with a 6-year old child who has a sensory processing disorder. A key therapeutic strategy is to use play activities that would foster an optimal arousal level without overloading the child with sensory input. In order to monitor the child's level of arousal during therapy, what responses should the COTA® be aware of, which would indicate that the child has reached his sensory threshold. Choose the best 3 answers.

The child splays his legs out toward the ground when the therapist pulls him on a scooter board and picks up speed The child hugs the rope ladder tightly as he climbs and stops after advancing 1 rung above the floor the child becomes nauseous and pale

A 5-year-old girl is asked to color-in a picture of a garden which includes a tree, a sun, a flower, and a bunny. As she begins coloring in the picture, she tells the OTA that she cannot see the bunny in the picture. What is the MOST likely reason for this girl not being able to see the bunny?

The girl has difficulty with her visual perceptual skills

An OTA is working with a 6-year-old girl who presents with generalized hypotonia. The focus of the session is on facilitating neck and spine extension, as well as improving shoulder/proximal stability. Which is the BEST activity to use for achieving these goals?

The girl lies prone in a net swing and picks up a bean bag from the ground to toss at a target

What is the MOST appropriate type of toothbrush for a child who presents with oral hypersensitivity?

The most appropriate type would be a soft sponge-tipped toothette

Betsy, a 57-year-old widow, who has Stage I Parkinson's disease is working with a COTA® on fall prevention. Betsy has recently had 2 falls while working in her kitchen and walking in her living room rendering her a high risk for falling. Despite recommendations for increased assistance, she wants to age in place. When reviewing her case during a staff meeting, what information is MOST IMPORTANT to share with the team?

The patient's understanding of the environmental barriers in her home

Following a fall, Travis a 34-year-old male, sustained hairline fractures to both his right scaphoid and trapezium bones. To prevent him from re-injuring the affected areas, Travis has been referred to the hand clinic with a prescription for a splint. What type of splint is the MOST appropriate for Travis?

Thumb opponens splint

Jennifer is a 29-year-old inpatient who has been diagnosed with an upper motor neuron disease. She presents with bilateral wrist drop due to weak wrist and finger extensors and significant tightness in the long flexors. In addition to wrist drop, Jennifer has flexion contractures of the PIP joints of her hands bilaterally, and she demonstrates pronator drift with supination. OT intervention includes fitting Jennifer with bilateral forearm wrist-hand orthoses. What are the 3 PRIMARY benefits for prescribing this type of orthosis for this patient? Choose the best 3 answers.

To decrease the effects of muscle imbalance To enhance performance of fine motor tasks during activities of daily living To prevent joint contracture and relieve pain

a COTA® is working with a 32-year-old male patient who recently sustained an injury to his left non-dominant upper limb, which resulted in him having to undergo a below-elbow amputation of that limb. The focus of OT intervention is on tub-shower transfers. The patient is however experiencing intense sensitivity and pain of the affected limb, and he does not want to wear a prosthesis to perform any of his ADLs. What should the COTA® focus on NEXT during the treatment session?

Training in desensitizing techniques incorporating massage and wrapping of the residual limb

Typically, the Rancho Los Amigos Levels is an evaluation tool used for patients with what type of diagnosis?

Traumatic brain injury (TBI)

Which muscles provide a patient who has SCI C7 with the ability to transfer themselves using a sliding board from a bed to a wheelchair?

Triceps, pectoralis minor, lower fibers of the trapezius, subclavius, and latissimus dorsi

Analisa, a 22-year old college student, recently sustained a TBI from a MVA. She is currently receiving OT as an inpatient at the local hospital. The COTA® has been collaborating with an ophthalmologist who has noted decreased fixation and limited ability to follow moving objects. The COTA®'s intervention is focused on using additional cues to increase attention and avoiding overstimulation. Over the past 4 weeks Analisa has made significant progress. She however reports that she sometimes loses her place while reading a book for an extended period of time, and the print starts to appear blurry and moving. What adaptations would be MOST BENEFICIAL to introduce in order to progress Analisa towards her goal of returning to college? Choose the 3 best answers

Use a guide or window to aid in maintaining place and to limit the amount of work presented at one time Focus on auditory skills while building visual skills Break prolonged near work into shorter tasks

Frank, a 74-year-old man who has bilateral cataracts and a mild memory deficit, lives alone in a single-story house. Frank is independent in all his ADLs, but he is finding it increasingly difficult to remember to take his medication on time. What compensatory strategy should the COTA® recommend to promote success with Frank's medication management?

Use a programmable talking medication pill bottle with auto alarm feature

Barbara, a high school English teacher, is an inpatient at a regional county hospital. She has recently been diagnosed with Schizophrenia, with symptoms triggered by stress. Her illness has interfered with her work tasks, but she would like to return to work on a part-time basis. Her symptoms have been stabilized with antipsychotic medication however, she displays deficits in short-term memory and attention. What compensatory strategies would be MOST BENEFICIAL in ensuring Barbara will be able to return to teaching?

Use of a calendar notebook listing scripts for tasks, and a wristwatch with an audible, hourly tone

When working with a student with inattention and impulsivity, how should the session be structured?

Use structured activities with clear rules and clear end products

An OTA is working with a patient who has a strong tonic bite reflex. In order to feed this patient applesauce without eliciting the reflex, what type of utensil should the OTA use?

Vinyl-coated spoon

An OTA is working with a group of patients who all have dementia. What sequence of cues is best to use, during a cooking group for these patients?

Visual cue, short verbal cue, touch after you have the person's attention

A 4-year-old boy with Down Syndrome and confirmed atlantoaxial instability (AAI) presents with difficulty walking. What other signs associated with AAI may the OT practitioner observe while working with this child?

Weakness of extremities

Malcolm, a 48-year-old male who fell from a truck and fractured his left humerus, presents with a peripheral neuropathy. As an indicator of his neuropathy, Malcolm is now demonstrating a clinical sign known as the "Hand of Benediction". Which is the BEST description of the term "Hand of Benediction"?

When the patient is asked to make a fist, the 4th and 5th digits (ring and little finger) flex but digits 2 and 3 (index and middle fingers) cannot flex at the MCP or IP joints

As you arrive to treat a patient with COPD, you find her lying in bed with her SAT levels in the low 80's. You make the clinical judgement that the patient is not medically stable to participate in OT intervention. While interacting with the patient, you notice that she appears disoriented and what she says does not make sense. You then ask the nurse for an update on the patient's progress and the nurse reports that the patient needed to sit on a shower chair throughout her bathing and she was unable to assist with washing herself. When writing your SOAP note, what should you report under the "S" portion of the note?

Write down that the patient appeared to be disoriented and report exactly what the patient and nurse said

A patient who has been diagnosed with CTD (cumulative trauma disorder) as a result of practicing the piano for 10 hours daily, over the past 2 years, is being treated by a COTA® in the hand clinic. The COTA® plans to apply an ice pack to the patient's hands as part of their intervention. Is this COTA® permitted to use this modality on this patient?

Yes, as long as service competency has been established and the state laws and regulations permit the use of PAMs

A 6-month-old baby who presents with a slight developmental delay is attending an early intervention therapy group. One of the group exercises involves having the parents place their babies on a therapy ball, in a seated position, and gently bouncing their baby up and down. In this scenario, is it safe for this 6-month-old baby to sit on a therapy ball?

Yes, as long as the baby has good head control and the parent stabilizes the baby properly either at the baby's hips or around their trunk

Can an OTA attend an IEP meeting without the presence of the OT, and make changes to a student's IEP during the meeting?

Yes, the OTA may make changes during the IEP meeting if before the IEP meeting, the OT and OTA discussed and agreed upon potential changes in goals or amount or type of service

Gwen, a 33-year-old woman with a history of depression and anxiety, has been admitted to a short-term inpatient behavioral health hospital. Gwen's goal while there, is to learn how to reduce her stress levels at work and to manage her time more efficiently so that she doesn't have to stay late at work and come home exhausted. Working collaboratively with an OTR®, the COTA® has been asked to gather information about the patient's current time management skills. Which information-gathering tool would provide the MOST comprehensive information about this patient's time management skills?

a daily activity log

An OTA is working with a child who has been diagnosed with spastic quadriplegic CP. As this child is unable to use their hands to access a standard computer keyboard, what alternative option should the OTA investigate in order to help this child use his computer independently?

a head pointer or switch

Diane is a 65-year-old retired physical education teacher who has been diagnosed with osteoarthritis. She is passionate about gardening but she is having difficulty using her gardening tools due to chronic pain in her CMC joints. Diane has elected to be treated conservatively for her condition. She has identified that one of her main goals is to continue working in her greenhouse and the OT practitioner is planning on providing her with a splint to help her achieve her goal. What type of splint BEST supports Diane's desired goal to continue gardening with less pain?

a soft hand-based thumb spica splint which offers light support and little restriction of movement

At what age can a baby be expected to start crawling?

about 7 months

Which of the following terms is most appropriate for a therapist to act as while leading a cooperative group?

advisor

What is the term for an abnormal lack of energy?

anergia

Despite many ADL training sessions with his highly motivated patient Bill, a 72-year-old male who recently had a CVA, the OTA notices his patient seems unaware of his limitations, appears to be unsafe, and is unable to carry out compensation techniques. What behavior is Bill most likely showing?

anosognosia

A patient presents with a neuropathy involving a nerve which originates from the brachial plexus. Due to this neuropathy, the patient's thenar muscles have become paralyzed and appear atrophied. Functionally, the patient is unable to abduct or oppose their thumb. Which deformity is this patient MOST likely displaying?

ape hand deformity

An OT practitioner is working with a 3-year-old boy on dressing skills. What type of technique is demonstrated when the OT practitioner helps the boy put on a t-shirt by using the following method: The OT practitioner puts the t-shirt over the boy's head and helps him to get his arms through the sleeves. The boy then completes the task by pulling down the t-shirt at the front?

backward chaining

Jack is an inquisitive 12-year-old boy who had in the past enjoyed taking objects apart and then putting them back together. However, he has recently started to demonstrate destructive behavior by disassembling objects and then leaving them in pieces. As Jack's parents are concerned about his drastic change in behavior, they consulted with a pediatrician who diagnosed a meningioma. Knowing that Jack has a brain tumor which is affecting his neurological functioning, what is the MOST likely reason why there has been a sudden change in his behavior in relation to his preferred hobby?

constructional disorder

A 45-year-old female patient who has been diagnosed with Raynaud's phenomenon secondary to carpal tunnel syndrome, has been referred to OT for intervention. The OT decides to incorporate a PAM into the patient's treatment plan. Which PAM is contraindicated in this scenario?

cryotherapy

A college student who has been referred to the hand clinic presents with neurological signs affecting his left upper limb. He reports having numbness and paresthesia (tingling) of his small finger and the ulnar half of his ring finger. He also has a weak grasp and a positive Tinel sign. From the patient's history, it appears as if his symptoms may have been caused by his tendency to lean on his left elbow when attending lectures. What condition is this patient MOST likely demonstrating?

cubital tunnel syndrome

An office receptionist, who recently sustained a right-hemisphere CVA, is given a word search puzzle and asked to find a specific list of words. The individual misses 40% of the words randomly dispersed across the puzzle. What does this behavior most likely indicate?

decreased attention

A 17-month-old child who presents with cognitive and gross motor delays is able to hold a spoon in their hand and bang it on the tray of their highchair. What activity should the OT practitioner introduce NEXT to help this child progress in their development?

dipping a spoon in apple sauce

A woman demonstrates difficulty determining the distance between her arm and the counter while attempting to pick up her coffee cup. This problem is an example of what condition?

dysmetria

A patient who recently sustained a hand injury has developed edema in their affected hand. How can the edema be effectively managed? Select the 3 best answers.

elevation compression active range of motion

A toddler walks into the local clinic with her right arm hanging limply by her side. Her shoulder is internally rotated, elbow extended, forearm pronated and wrist flexed. Based on this observation, what type of injury does this child MOST likely have?

erbs palsy

An OT practitioner observes a patient moving her arms through a full ROM when she spontaneously lifts a large towel from a low surface and places it on a towel rack. What muscle grade (MMT score) is this patient demonstrating?

fair plus (3+)

What is the most important topic to include while teaching dementia care strategies to a family caregiver?

focus on verbal cues to explain a situation to the patient

An OT and an OTA meet in person to discuss patients once per month. What type of supervision is the OT providing to the OTA?

general supervision

Terrence, a 60-year-old self-employed auto mechanic, presents with a trigger finger affecting the index finger of his dominant hand. For the past 6-weeks, he has been using heat and ice to reduce the inflammation in his finger, and he has also been wearing an MCP extension splint. Terrence's pain has significantly improved, and he has been cleared by his physician to resume performing functional activities. What type of activities should the OT practitioner AVOID using during his treatment sessions?

gripping exercises or activities

Sophia, a 25-year-old patient who has a history of not being able to keep a job, has recently been diagnosed with Bipolar disorder. Sophia is currently an inpatient in a psych facility as she is having difficulty controlling her hypomanic symptoms. During her OT sessions, Sophia identifies that her main goal is to find a job. Sophia completed high school and after graduating, she started her first job at a fast-food chain. What type of jobs would you recommend for Sophia to pursue? Select the 3 best choices.

hair stylist, massage therapist, freelance writter

When working with a child who has a sensory modulation disorder, which piece of equipment would be the best to use when focusing on providing vestibular input?

hammock

A patient who is employed as a barista, is recovering from a recent L CVA. The patient has stated that his main goal is to become more independent in his ADLs, so that he can return to his job as soon as possible. Despite providing the patient with assistive devices such as a kettle tipper, to compensate for his hemiparesis, he continues to experience great difficulty with functional tasks such as making himself a cup of coffee. What type of apraxia is this patient demonstrating in this scenario?

ideational apraxia

A patient who sustained a TBI is unable to simulate the action of shaving his face on request, but he is observed using a razor correctly to shave his face when he is performing grooming activities as part of his daily routine. What type of apraxia is this patient demonstrating?

ideomotor apraxia

12-weeks ago, Joyce had a total shoulder replacement of her right upper extremity. She is currently being seen by a home health OTA who has prescribed exercises to strengthen Joyce's shoulder girdle. One of the exercises requires Joyce to stand facing a wall with her shoulders flexed to 90-degrees and her elbows extended. Joyce is then required to hold this position while she presses against the wall for 30-seconds. What type of muscle contraction is Joyce using when performing these exercises?

isometric

A patient recovering from an acute COVID-19 event which resulted in associated cardiac sequelae, presenting as arrhythmias and cardiac insufficiency, has been cleared to start exercising at 1.4 to 2.0 METs (stage 2). For this patient, what type of exercises are contraindicated?

isometric

When an OT practitioner is given a gift by a patient's family and they decline to accept it, which core value are they demonstrating?

justice

At what ACL level is a patient functioning if they are able to perform limited gross motor actions, demonstrating an ability to move against gravity. There is a lack of awareness of the effects that their actions have on objects or other people, and they are at risk of wandering off?

level 2

What ACL level would be given to a patient who is easily distracted by objects in the rehab facility, however, enjoys touching them, altering them, and engaging in simple repetitive crafts?

level 3

What ACL level to be given to a patient who is able to copy demonstrated directions shown to them one step at a time and is interested in doing simple two dimensional projects?

level 4

If a patient is able to foresee errors, reason why they may occur and plan how to avoid them, what ACL would they be given?

level 6

A patient with Muscular Dystrophy has decreased strength and is having a difficult time typing on the computer. What type of adaptive keyboard would be most useful to recommend to this patient?

light touch keyboard

What type of finger deformity is characterized by flexion of the DIP joint at rest and an inability to actively extend the DIP?

mallet finger

A college professor who is employed by the university, is starting to have difficulty remembering where she left her car keys and she often forgets to attend appointments if they have not been written down. What is the MOST LIKELY cause for the change in this woman's behavior?

mild cognitive decline

Shelly is a 4-year-old girl with spastic quadriplegic cerebral palsy. When Shelly hears loud noises, she automatically reacts by extending her neck and upper spine, retracting her scapulae and moving her arms into shoulder extension and elbow flexion. Which primitive reflex is MOST likely causing Shelly to react in this manner?

moro reflex

From the options below, which FOR/Model uses a bottom-up approach?

neurodevelopmental

You are supervising a Level II fieldwork student who appears unmotivated and demonstrates poor clinical reasoning skills and risky behavior in terms of patient safety. Although the student has not disclosed having any mental health issues, you suspect that they may be clinically depressed. Based on this information, what is the MOST important Code of Ethics principle you should adhere to?

non-maleficence

An OTR® is working with a patient who is in the mid stage of Parkinson's disease. The patient presents with marked hand tremors which are impacting on their ability to perform several ADLS including self-feeding, grooming, and teeth hygiene. The OTR® recommends completing a series of large, repetitive UE movements prior to starting any of these activities. The patient is also advised to use weighted tools to complete their ADLs. What FOR has the OTR® based her intervention plan on?

occupational adaptation

An OTA is working with a 12-month-old child on finger-feeding. What is the MOST factor that should be considered when structuring this activity?

place the food is in front of the child

A patient has advanced to the second stage (1.4 to 2.0 MET) of her cardiac rehab and she is very keen to participate in a leisure activity. You suggest knitting as an activity but the patient states that she cannot knit and she has no desire to learn to knit. What other activities can the OTA recommend to this patient while she is at this stage of her recovery? Select the 3 best answers.

playing board game, drawing/painting, playing cards

A COTA® is working with a group of preschoolers who all present with delayed fine motor skills. The selected activity involves having the children ice a piece of a cake and decorate it with small edible toppings. Once all the children have completed the task, the pieces are placed together like a puzzle, to form a whole cake. What type of developmental group is the COTA® using to achieve the goals of the group?

project

A patient with paranoid schizophrenia begins experiencing auditory hallucinations during an OT session. How should the OTA react at this point?

redirect the patient to the activity

What is the name of the hand position which places the MCP joints in flexion and the proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints in extension?

safe position

Juan, a 72-year-old male was recently admitted to a skilled nursing facility for rehabilitation, following a right parietal infarct. Juan is demonstrating difficulty navigating the hallways with his power wheelchair and consistently knocks into the walls and door frames which are on his left side. During meals, he does not eat the food on the left half of his plate even though he is hungry. Based on these observations, what symptom is Juan displaying?

spatial neglect

When certain children encounter tactile stimuli that most people would find to be harmless and non-painful, their behavioral and emotional responses are aversive and negative. What term is used to describe this condition?

tactile defensive

There have been reports that a schizophrenic patient living in a group home does not contribute to meal preparation when he is expected to. The patient was evaluated and it was determined that he is having difficulty initiating tasks. What recommendation should the OTA provide the staff to help them handle this patient's behavior?

tell the staff to provide verbal cues to being the task needed

If a patient feels a compelling need to be in motion and has a sensation of inner restlessness, what movement disorder do these symptoms describe?

the movement disorder like to be akathisia

In an inpatient psychiatric facility, an OTA is working with a patient who has been diagnosed with social phobia. What physical symptoms could the OTA possibly observe in this patient?

the patient may bite her nails, pull her hair, or grind her teeth

A patient wants to learn to play guitar. What is the type of group that they should join?

thematic group

A teacher is working with a small group of first grade students to provide them with instruction in reading. What level of the Response to Intervention (RTI) is this small group of instruction indicative of?

tier 2

An 89-year-old patient with late stage Alzheimer's Disease cannot reposition himself in his wheelchair and suffers recurrent pressure sores. What type of wheelchair feature would allow nursing home staff to provide pressure relief to the man while he is sitting in his wheelchair without having to reposition him?

tilt in space

A COTA® is running a topical group with six inpatients in a rehab facility. After the session, the COTA® completes the necessary paperwork and charges each patient's insurance provider for individual treatment sessions. Which ethical principle is the COTA® violating?

veracity

A patient presents with the following difficulties: Recognizing numbers and letters, remembering sight words, using a calculator - recognizing the symbols on the calculator, and forming a mental image of a word. Which of the patient's visual perceptual skills is most likely poorly developed, in this scenario?

visuall memroy

An OTA is working with a student who can type the first several letters of a word with relative accuracy using a standard keyboard, but the student struggles when having to type longer words, demonstrating significant difficulty with spelling and grammar. Which AT device should the OTA recommend for this student? Audio recorder

word prediction application