mental health
A client arrives at the occupational therapy clinic 10 minutes late for a session crying uncontrollably. When the COTA® attempts to engage the client in conversation, the client responds, "I don't want to talk about it. Is that so bad?" Which response would be MOST effective? A. "Let's have our session later, after you've stopped crying." B. "You are upset. How can I help you?" C. "Come on, now; that's enough of that." D. "It must very difficult.
it must be very difficult
A COTA® is approached by a client with Alzheimer's dementia who asks, "Do I finish high school next year, or am I already finished? I don't want to go back." What is the BEST response for the COTA® to make? A."Try to remember that you completed high school 60 years ago. Would you like to see your graduation picture?" B."I'll have to find out if you finished high school. Could you ask me again at a later time?" C."It sounds like you're a little worried about that. You're already finished with high school. You don't have to go back." D."Didn't you go to college?"
"It sounds like you're a little worried about that. You're already finished with high school. You don't have to go back."
A COTA® working in an outpatient mental health setting meets with a client with depression 3 weeks after the client's discharge from the hospital. The client expresses concern about phenelzine (Nardil), a monoamine oxidase inhibitor (MAOI) the client has been prescribed, saying that the drug's negative side effects deplete the client's ability to function. The client plans to stop taking the medication. What is the COTA®'s MOST appropriate response? A."Discontinue use of the medication until you see your doctor." B."Remember the dietary restrictions related to MAOIs." C."Side effects are present in all medications. You just have to get used to them." D."Let's get your psychiatrist or a nurse on the phone now so you can discuss your concerns."
"Let's get your psychiatrist or a nurse on the phone now so you can discuss your concerns."
A client who presents at an outpatient occupational therapy clinic for an evaluation is crying, because the client will not be able to go home in time to attend the wedding of a family member. Which response BEST communicates empathy? A. "Why don't you come back later when you are feeling better?" B. "You seem upset that you are going to miss the wedding." C. "Life goes on. It will be OK." D. "You need to stop crying so we can complete your occupational therapy session today."
"You seem upset that you are going to miss the wedding."
AA client served 18 months in a forensic facility and was released to a halfway house; the client is now participating in a community reentry program. Which areas would be the focus for an occupational therapy program? Select the 3 BEST choices. A.Dressing and bathing skills B.Decision-making skills C.Budgeting and shopping skills D.School readiness skills E.Prioritization and time management skills F.Home management and homemaking skills
.Budgeting and shopping skills Prioritization and time management skills Home management and homemaking skills
A client with bipolar disorder in an outpatient setting is having difficulty following a medication routine. The client does not understand the physician's orders for the medication and prefers to take medication with some alcohol because it "helps take the edge off." What approach would be appropriate for the COTA® to take on this visit? A.Provide the client with information about the prescribed medication, dosage and timing, precautions, and side effects. B.Develop a treatment plan that includes activities to enhance occupational balance and leisure. C.Instruct the client in breathing and relaxation activities to decrease the feeling of being on edge. D.Suggest that the client participate in a group facilitated by the COTA titled "Get Your Life Back—NOW!"
.Provide the client with information about the prescribed medication, dosage and timing, precautions, and side effects
An adult with posttraumatic stress disorder (PTSD) is admitted to an inpatient psychiatric unit after a suicide attempt. What would be the BEST initial intervention for a COTA® to attempt with this client? A.Individualized assertiveness training B.Reality-orientation group C.Relaxation-focused group D.Daily routine group
.Relaxation-focused group
A COTA® is establishing an occupational therapy group in a state correctional facility for clients with schizophrenia who are the parents of small children. What area of focus would be MOST important for a group in this setting? A.Psychoanalytic intervention B.Skills in performing ADLs and IADLs C.Strength and endurance training D.Indoor sports activities
.Skills in performing ADLs and IADLs
Which occupational therapy group would benefit MOST from a highly directive and authoritative leadership style? A.A group of preschool children exploring sensory experiences to develop age-appropriate prehension and grasp skills B.A group of adolescents diagnosed with oppositional defiant disorder attending a gang prevention group in an alternative education setting C.A group of middle-aged clients in an outpatient day treatment setting who are learning to manage their depression D.A group of healthy older adults in an apartment complex exploring ways to stay fit and healthy
A group of adolescents diagnosed with oppositional defiant disorder attending a gang prevention group in an alternative education setting
Which occupational therapy groups would benefit from a highly directive and authoritative leadership style? Select the 3 BEST choices. A.A group of young adults who were recently released from incarceration engaging in a court-ordered community reentry program B.A group of adolescents diagnosed with oppositional defiant disorder attending a gang prevention group in an alternative education setting C.A group of middle-aged clients in an outpatient day treatment setting who are learning to manage their depression D.A group of healthy older adults in an apartment complex exploring ways to stay fit and healthy E.A group of older recent stroke survivors engaging in a ROM and exercise group F.A group of preschool children exploring sensory experiences to develop age-appropriate prehension and grasp skills Submit Answer
A group of young adults who were recently released from incarceration engaging in a court-ordered community reentry program A group of adolescents diagnosed with oppositional defiant disorder attending a gang prevention group in an alternative education setting A group of older recent stroke survivors engaging in a ROM and exercise group
Using the Allen Cognitive Level Screen-5 for screening, followed by use of the Allen Diagnostic Module and the Routine Task Inventory for confirmation of screening results, the supervising OTR® identifies Level 4 as the current level of functioning of a client in an adult day treatment center. What is the MOST appropriate scenario for activity completion for this client? A.The task includes mostly familiar steps but also one step requiring new learning. B.The project and tasks involved are relatively unstructured. The client is given opportunities to find and revise errors. C.A model of the completed project is provided for the client to imitate. Simple instructions are provided. D.The project is designed to encourage relatively independent planning and organizing to complete tasks.
A model of the completed project is provided for the client to imitate. Simple instructions are provided.
A client scores an Allen Cognitive Level (ACL) of 4.0 with the Allen Cognitive Disability Framework. A COTA® is working with the client in an adult day treatment center. A. Any project with mostly familiar steps; no more than two steps of the task should require new learning. B. A project that is unstructured; the client should be given opportunities to find and revise errors. C. A project that is set up with a model final product; simple instructions should be provided, along with supervision. D. A project that encourages relatively independent planning and organizing to complete; none of the steps should require new learning
A project that is set up with a model final product; simple instructions should be provided, along with supervision.
A client arrives at the occupational therapy clinic 10 minutes late for an appointment, crying uncontrollably. When the COTA® attempts to engage the client in conversation, the client responds, "I don't want to talk about it. Is that so bad?" What responses from the COTA would be appropriate? Select the 3 BEST choices. A."It must be very difficult." B."I understand; would you like to take a few more minutes?" C."Thank you for being here; take your time and speak when you are ready." D."Let's have our session later, after you've stopped crying." E."You are upset. How can I help you?" F."Come on, now; that's enough of that."
A."It must be very difficult." B."I understand; would you like to take a few more minutes?" C."Thank you for being here; take your time and speak when you are ready."
A COTA® working in an outpatient psychiatric setting has been meeting monthly with a closed-membership group of people with depression to promote socialization. Up to this point, the group has been functioning as a parallel group, but the participants are ready to progress to the next level, a cooperative group. Which activities would be MOST appropriate for such a group? A.Organize making a quilted wall hanging for the reception area where each participant contributes a square B.Appoint a leader to organize a sale of baked goods for which the participants are responsible for promoting C.Have participants plant seeds in ceramic pots that they decorate themselves D.Distribute journals in which participants write their own poetry collection
A.Organize making a quilted wall hanging for the reception area where each participant contributes a square
An 18-year-old client is admitted to an inpatient psychiatric hospital. The psychiatrist describes an uninterrupted 18-month period of illness that includes visual and auditory hallucinations. What type of issues would the COTA® expect to see when the client attempts to do a task? A. Aggressive outbursts of behaviors when frustrated with a project B. Overassertive, controlling behaviors during group activities C. Difficulty engaging in problem solving D. Panic over task choices
Aggressive outbursts of behaviors when frustrated with a project
A COTA® is using Fidler's task-oriented group as a context for treatment to help participants explore healthy ways to deal with conflict. Which of the following activities would be BEST for this group? A.An activity that is challenging and likely to cause tension among members B.An activity that is highly structured so participants know exactly what is expected of them C.A parallel group activity that enables participants to work alongside one another D.An activity that facilitates participants' success and thus improves their self-esteem
An activity that is challenging and likely to cause tension among members
Which class of psychopharmaceutical drugs is mood elevating but may increase suicidal tendencies in young adults and carries a small risk of causing hypomania or mania? A. Adrenergic receptor drugs B. Antidepressants C. Anticholinergics D. Antipsychotics
Antidepressants
A COTA® is scheduled to lead a discussion group for clients attending an outpatient psychiatric facility. What planning should the COTA® do in advance of the discussion to MOST EFFECTIVELY promote interaction within the group? A.Arrange the chairs so the group and leader sit in a circle B.Place the chairs in rows with the least talkative participants in front C.Sit next to the participants who tend to be most quiet D.Have the most talkative participants directly across from the COTA®
Arrange the chairs so the group and leader sit in a circle
During an occupational therapy intervention session, which approach would pose the biggest barrier to engaging in a client-centered process with an adult client who is able to converse? A. Paying attention to the meaning of nonverbal cues B. Being directive with the client C. Being too empathetic with the client D. Asking too many closed-ended questions
Asking too many closed-ended questions
A COTA® is providing intervention to a client with an anxiety disorder who hyperventilates when faced with difficult work tasks. The COTA suggests that the client use breathing techniques and relaxation breaks during the work day to minimize the client's response to stressful events at work. What frame of reference does this intervention suggest? A.Cognitive-behavioral B.Psychodynamic C.Cognitive disability D.Behavioral
Behavioral
While participating in an occupational therapy activity group, a client becomes highly confrontational with other clients in the group for no apparent reason. During a discussion with the OTR® and COTA®, the client states that if she continues self-mutilating behaviors, her family will no longer allow the client to live at home. Documentation from the psychologist indicates that the client has behaved this way for years. What diagnosis does this client MOST likely have? A. Narcissistic personality disorder B. Borderline personality disorder C. Paranoid personality disorder D. Posttraumatic stress disorder (PTSD)
Borderline personality disorder
A client served 18 months in a forensic facility and was released to a halfway house; the client is now participating in a community reentry program. Which of the following areas of occupation would be the best focus for an occupational therapy program? A.Dressing and bathing skills B.Decision-making skills C.Budgeting and shopping skills D.School readiness skills
Budgeting and shopping skills
A COTA® believes that changing clients' negative beliefs ultimately reduces negative emotional statements and leads to a change in behavior. What is the COTA's main theoretical perspective? A.Cognitive disability B.Developmental C.Cognitive D.Sensorimotor
Cognitive
A COTA® is working in a nonprofit transitional work program for people who have mental illnesses. Which assessment would be MOST effective for determining goals from the client's perspective? A.Canadian Occupational Performance Measure B.Valpar Component Work Samples C.Minnesota Rate of Manipulation D.Semmes-Weinstein monofilament test
Canadian Occupational Performance Measure
A COTA®'s guiding framework about improving the lives of clients with mental illness is that changing clients' negative beliefs about experiences and situations ultimately reduces negative emotional states and behaviors. What is the COTA®'s main theoretical perspective? A.Psychoanalytic B.Developmental C.Cognitive-behavioral D.Occupational
Cognitive-behavioral
Which group activity would be the MOST appropriate to engage clients in an expressive activity using the psychodynamic approach? A. Baking chocolate chip cookies B. Constructing a magazine collage C. Hiking in the woods D. Attending a dance performance
Constructing a magazine collage
A COTA® working in a neurology unit was referred a client with low back pain. During the interview, the client confides that stressful life events have recently been prominent in the client's life. The client added that the low back pain started after the stressful life events. Malingering and fear of illness do not seem to be a part of this scenario. What is the client's likely diagnosis? A.Low back pain B.Factitious disorder C.Histrionic personality disorder D.Conversion disorder
Conversion disorder
A COTA® works in an outpatient setting with clients with anxiety disorders. Which skills are MOST essential to the needs of this population? A.Coping skills B.Energy conservation C.Memory retraining D.Creative expression
Coping skills
COTA® is running a group with clients with schizophrenia in an inpatient psychiatric facility. The group members have low cognitive ability, minimal insight into the condition, and low motivation, and they do not know each other very well. What leadership style would be BEST for the COTA to use? A.Directive B.Facilitative C.Cooperative D.Advisory
Directive
A client who has undergone electroconvulsive therapy (ECT) in the early morning arrives for an evening occupational therapy task group in an inpatient psychiatric unit. What is the COTA®'s BEST choice for working with the client at this time? A.Contact the nursing staff to escort the client back to the client's room. IncorrectB.Remind the client of the need for 24 hours of bed rest after ECT. C.Invite the client to participate in a different group that focuses on reminiscence. D.Encourage the client to choose one of the available tasks to work on during the group.
Encourage the client to choose one of the available tasks to work on during the group.
A COTA® works with elderly clients with low vision. A client with macular degeneration is referred after substantial symptom progression and loss of vision. The client's spouse states that for the past 3 months, the client has uncharacteristically refused to participate in social activities, is frequently irritable and uncommunicative, and is unwilling to perform personal care or routine tasks. What should the COTA® advise the spouse to do? A. Consider exploring assisted living alternatives. B. Insist that the client resume accompanying the spouse to bridge club and prepare a snack to share with the club. C. Encourage the client to consult a mental health provider. D. Advise the client and spouse to seek professional counseling to adjust to the inevitable changes in the marriage.
Encourage the client to consult a mental health provider. People with low vision are at high risk for mood disorders and depression.
A COTA® in an adult day treatment program decides to use a group intervention with clients with schizophrenia who live in a supported living environment with 24-hour supervision. The COTA believes that a sensorimotor approach would help the clients reach their goal to increase independence in overall function and goal-directed activity in the home context. What would be an appropriate group activity that uses the sensorimotor approach? A. Discussing task performance B. Exercising to music C. Using a sensory room D. Baking cookies
Exercising to music
A COTA® who works with adult clients with mental illness attends an introductory workshop on guided imagery. The COTA wants to begin applying the skills obtained from the workshop with clients. For which type of disorder is guided imagery an appropriate intervention technique? A. Generalized stress disorder B. Chronic schizophrenia C. Bipolar disorder with psychosis D. Schizoaffective disorder
Generalized stress disorder
What is the FIRST step in the process of designing a group protocol for clients with mental illness? A.Find appropriate dates and times for conducting the group. B.Identify the appropriate outcomes of the group and methods for tracking and recording them. C.Develop group goals and determine the size of the group. D.Identify a problem and the factors that will motivate the people in the group to change.
Identify a problem and the factors that will motivate the people in the group to change.
A COTA® working in an inpatient mental health forensic facility is leading a group of clients who have histories of emotional outbursts and causing harm to themselves or others. Which group design element would have the highest priority? A.Cognitive and educational level of the participants B.Age and gender of the participants C.Location of the meeting room and exits D.Climate and temperature of the meeting room
Location of the meeting room and exits
A COTA® has been leading a developmental group that is in charge of planning a staff party at an inpatient facility. After a few sessions, the COTA® observes that the group has now bonded with one another and appears united and emotionally supportive of one another. According to Tuckman's theory of group development, at what stage is this group? A.Forming B.Storming C.Norming D.Performing
Performing
A summer picnic has been planned for clients in a day treatment program for people with mental illness. Before leaving, what medication-related precaution should the COTA® review with the clients? A.Effects of combining alcohol use with medications B.Need to protect oneself from direct sun when taking psychotropic medications C.Increased likelihood of temporary ataxia after consuming foods typically contraindicated for monoamine oxidase (MAO) inhibitors D.Need to take medications before leaving for the picnic to avoid losing them
Need to protect oneself from direct sun when taking psychotropic medications
A COTA® is conducting a woodworking group in the psychiatric unit of a federal correctional facility. Which statement best reflects the policies and procedures related to this group that involves the safety and welfare of all inmates at this facility? A.All participants must put away tools and clean up all work areas B.No participant may return to the housing units until all tools have been counted. C.Participants are allowed to have coffee and a snack only at the conclusion of the group session. D.The OTR® may not allow a COTA® to run groups in federal corrections facilities.
No participant may return to the housing units until all tools have been counted.
The caregiver of a client with Alzheimer's disease questions the home health COTA® about a recent increase in the client's dosage of donepezil (Aricept) prescribed by the physician. The caregiver is particularly concerned about potential consequences of the increased dosage. What is the COTA®'s most appropriate suggestion for the caregiver? A. Observe the client for signs of dizziness, which increases potential for falls. B. Because the medication can cause photosensitivity, keep the client out of direct sunlight. C. Have the physician monitor the client closely for potential drug toxicity. D. Monitor the client's hydration carefully because the drug can cause dry mouth and constipation
Observe the client for signs of dizziness, which increases potential for falls
A COTA® working in an outpatient psychiatric setting has been meeting monthly with a closed-membership group of people with depression to promote socialization. Up to this point, the group has been functioning as a parallel group, but the participants are ready to progress to the next level, a cooperative group. Which activities would be MOST appropriate for such a group? A. Organize making a quilted wall hanging for the reception area where each participant contributes a square B. Appoint a leader to organize a sale of baked goods for which the participants are responsible for promoting C. Have participants plant seeds in ceramic pots that they decorate themselves D. Distribute journals in which participants write their own poetry collection
Organize making a quilted wall hanging for the reception area where each participant contributes a square
A COTA® uses cognitive-behavioral interventions in psychosocial practice with clients with stress and anxiety disorders. What intervention is the COTA® MOST likely to use? A.Psychoeducation that provides resources and information about the client's illness and ways to cope with it B.Creative expression using art to free underlying emotions and conflicts C.Psychotherapy that builds trust in the client-therapist relationship and brings unconscious conflicts to a conscious level D.Reminiscence to increase awareness of remote memories and thereby improve the ability to recall and recognize
Psychoeducation that provides resources and information about the client's illness and ways to cope with it
A client has bipolar disorder. Under supervision of an OTR®, a COTA® focuses, with the client's permission, on the client's work environment because the employer appears to be resistant to providing accommodations and the intervention plan includes goals for work. Consequently, the COTA provides educational information to the client's boss about bipolar disorder. What approach does this intervention strategy take? A.Delay deterioration in performance skills B.Maintain performance of component skills C.Prevent secondary disability and anticipatory action D.Reduce behaviors and environmental barriers
Reduce behaviors and environmental barriers
While a COTA® is working with a client on vocational training in a community-based setting, the client becomes frustrated with a computer task and states, "I am too slow at the computer; I can't do this." The COTA responds, "I notice that you take your time to be very careful not to make mistakes while you are working. I am sure that employers would think that is a positive quality in a job candidate." Which interpersonal strategy does the COTA's statement exemplify? A.Interpretation B.Metaphor C.Reframing D.Encouragement
Reframing
A client who has been a participant in a community integration program for adults with mental illness arrives at an occupational therapy group after not being seen for several weeks. The client's mood is noticeably elevated. The client switches from one topic to another in rapid succession and claims to have not slept for 3 days. The psychiatrist describes the client as having manic episodes. What is the BEST course of action for the COTA® to take? A.Recommend individual sessions to catch up on missed goals during the client's absence. B.Allow the client to rest, and then resume therapy. C.Resume group therapy sessions as soon as possible and apply cognitive-behavioral methods. D.Discuss with psychiatrist the possible need for the client to receive medication to improve behaviors.
Resume group therapy sessions as soon as possible and apply cognitive-behavioral method
During an initial interview with a young adult who has Level 1 autism spectrum disorder without intellectual impairment (Asperger syndrome), the COTA® becomes aware that the client lives alone and is isolated, does not go out much, does not value family relationships, and does not seem to have any friends. Additionally, the client is not gainfully employed and does not take care of the apartment. The client spends most of the day surfing the Web and watching TV. Using the Model of Human Occupation, which of the following assessments would be the MOST appropriate? A. A projective test such as House-Tree-Person B. Worker Role Interview C. Role Checklist D. Canadian Occupational Performance Measure
Role Checklist
A COTA® is working with a client diagnosed with depression who does not seem to care about fulfilling the roles as a parent to teenage children and friend to a person who also is struggling emotionally. Additionally, this client does not show an interest in returning to work or singing in the choir at church. Which assessment would help identify whether the client is devaluing these roles? A.Work Environment Impact Scale B.Role Checklist C.Comprehensive Occupational Therapy Evaluation D.Performance Assessment of Self-Care Skills
Role checklist
An OTR® and COTA® team want to develop interventions for homeless adults with mental illness to improve independent living skills. Which of the following roles is MOST appropriate for the team? A.Employment retraining B.Job searching C.Housing procurement D.Room and self-care management
Room and self-care management
A COTA® is helping a client with Level 1 autism spectrum disorder without intellectual impairment (Asperger syndrome) adjust to the employment demands of a fast-paced office that is noisy and filled with sensory stimulation. Which recommendation would be BEST? A.That the client ask the other workers to be quieter to better be able to concentrate B.That the client use a noise cancellation headset or white noise channeled into ear buds C.That the client's desk be located in the center of a large room with six other desks, providing the support of others D.That the client use a speaker phone to answer calls hands free while using the hands to manipulate a stress ball Submit Answer
That the client use a noise cancellation headset or white noise channeled into ear buds
A COTA® is working with a client who has major depression and works for a service-based business that opens at 9:00 a.m. and closes at 5:00 p.m. The client finds work meaningful but is unable to keep up with a full-time schedule because of the depression. The COTA would like to advocate for workplace accommodations. According to the Americans With Disabilities Act of 1990 (ADA), what is a reasonable accommodation for this client? A. The client should be allowed to work 3 hours per day. B. The client should be given a flexible start time. C. The client could job share with a coworker. D. The client can break for 3 hours in the middle of the day.
The client could job share with a coworker
A client with depression enjoyed exercising in the past because it helped the client experience more positive feelings. The client now has difficulty finding the motivation to participate in exercise. Which strategy would be BEST for the COTA® to use to encourage this client to resume exercise? A.Use motivational interviewing to encourage exploration of desirable leisure activities. B.Provide opportunities for the client to explore new leisure pursuits. C.Use the remotivation approach to determine the appropriate motivational stage for intervention related to exercise. D.Provide the client with useful feedback about performance in occupational therapy interventions related to exercise and why the client should resume it.
Use the remotivation approach to determine the appropriate motivational stage for intervention related to exercise.
A client has two children, a 3½-year-old and a 2-year-old. Because of postpartum depression, she has been unable to return to work since the birth of the younger child. What home- and community-based occupational therapy services would BEST help the client improve her worker role? A.Job simulation and work retraining in the home B.Facilitation of employer-client meetings to negotiate bringing the children to work C.Weekly goal setting, time management activities, and use of a positive-events diary to build self-confidence D.Facilitation of employer-client meetings to negotiate work- at-home options Submit Answer
Weekly goal setting, time management activities, and use of a positive-events diary to build self-confidence