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196. A 5-year-old has severe conductive hearing loss. Diagnoses have determined this was caused by Treacher-Collins syndrome, a hereditary underdevelopment of the external canal and middle ear. Another diagnosis that could lead to conductive hearing loss is: a. Otitis media b. Hypoxia c. Hydrocephalus d. Meningitis

197. In an effort to shape the behavior of your patient during treatment you choose to reinforce a certain behavior every single time that it is demonstrated. What schedule of reinforcement does this represent? a. Continuous b. Intermittent c. Fixed ratio d. Fixed interval

198. You have a new 15-year-old patient who presents with rapidly occurring motor and vocal tics that they have been experiencing for more than a year and a half. You suspect: a. Tourette's disorder b. Substance abuse anxiety disorder c. Posttraumatic stress disorder d. Conversion disorder

199. An OT has been hired by an agency to address "aging in place with older adults." The therapist would definitely require knowledge and skills related to: a. Vocational development b. Driving rehab c. Environmental adaptation d. Leisure pursuits

199. The BEST treatment for children with autism involves: a. Sensory-motor intervention and therapy to learn self-management skills b. ROM and muscle strengthening c. Perceptual-motor training d. Cognitive-perceptual training

2. In the assessment phase of early intervention, an OT assesses the daily living skills of an infant. In the context of early intervention, the areas that are being assessed are: a. Feeding and sleeping patterns b. Play and leisure patterns c. Motor development patterns d. Sensory development patterns

2. The OT was asked to design a tendonesis splint for a patient with an incomplete C6 SCI. Which therapeutic goal would this treatment MOST likely support? a. Patient will be able to use the hands to perform grasp and release. b. Patient will be independent with manipulation of fasteners. c. Patient will assist with self-feeding using adapted equipment. d. Patient will be able to put on and remove garment using overhead

20. A 5-year-old child presents with difficulty climbing stairs, rising from a sitting or lying position, and demonstrates progressive fatigue caused by muscle weakness. The OT might suspect a problem with: a. Duchenne's muscular dystrophy b. Limb-girdle muscular dystrophy c. Fascioscapulohumeral muscular dystrophy d. A congenital muscular dystrophy

20. OTs contribute to the goal of inclusion for all children. When children are included, services are provided in a: a. Natural environment b. Special education classroom c. Specifically designated area d. Rehab clinic

201. You are preparing to evaluate a teenager that was admitted to your unit, using a developmental framework to guide your decision making. The tool would you MOST likely use as part of your evaluation is: a. Adolescent Role Assessment b. Milwaukee Evaluation of Daily Living Skills (MEDLS) c. Learner Magazine Picture Collage d. Azima Test Battery

202. A 73-year-old is experiencing cognitive deficits and has limited physical capabilities because of Parkinson's disease. Which of the following would be the MOST appropriately used intervention for this client? a. Craft groups involving the construction a memory book b. Leisure planning groups to develop a plan for regular leisure involvement c. Exercise groups to build endurance d. Problem-solving groups to help him deal with life changes

203. During an interview with a new patient on the psychiatric unit, the patient asks if they should divorce their spouse. Your BEST response would be: a. "That's not a decision that i can make. I don't know what it is like to be in your situation, but we can talk about it and see if it helps you to make a good decision for yourself." b. "Why don't you ask your doctor?" c. "Yes. Your spouse seems to be no good from what you have told me. Go ahead and divorce." d. "If it were me, I'd dump your spouse."

204. During the evaluation of a patient, the patient says that things are hopeless and "I might as well be dead," as the patient had planned. In this case you would: a. Ask some questions to find out more b. Tell the patient that those thoughts are stupid c. Ignore it and change the subject to something brighter d. Tell the patient that you have thought about suicide, too, and that it is normal

208. All of the following are essential services of a Psychosocial Rehabilitation program except: a. Medication management b. Daily living skills training c. Vocational rehabilitation d. Case management

21. The OT is working with a child who has some behavioural issues and the child's family as well. What are important cultural contextual factors that need to be considered in therapy? a. The family's view of disability, discipline, and value of independence b. The school's view of the child's academic performance c. The family's view of their fit and status in the community d. The family's financial status and level of education

21. The behavioural characteristics of autism, a pervasive developmental disorder (PDD), can be classified into 4 subclusters of disturbances. Of these disturbances, which is MOST closely related to prognosis? a. Disturbances in communication b. Disturbances in behaviors c. Disturbances in social interactions d. Disturbances of sensory and perceptual processing

210. The BEST example of a statement that would document the patient's prognosis is: a. The patient may require prolonged time to perform transfers because of poor motor planning ability. b. The patient received a home program on energy conservation and work simplification. c. Compared to the norm, grip strength is within normal limits and age appropriate. d. The patient performed a stand pivot transfer to and from the wheelchair to bathtub.

212. During a session on bed positioning, the OT should instruct a patient with thoracic outlet syndrome to sleep in: a. Sidelying on the unaffected side with a pillow under the cervical region b. A facelying position with the arms above the head c. Sidelying on the affected side to provide proprioceptive input to the shoulder d. Supine position with the arms above the head.

216. A client is referred for an OT evaluation. As you observe the client briefly in the clinic, the patient fluctuates between crying and laughing. You label the patient's affect as: a. Labile b. Constricted c. Bland d. Flat

216. The OT is providing rehab to a person who is paraplegic. When performing activities to the LE, the OT should instruct the person to: a. Support the trunk with one extremity while performing tasks with the other b. Use bilateral coordination to perform LE activities c. Perform all activities close to the midline of the body for success d. Secure the assistance of the caregiver

217. A client has been in a fixed position for days and has not responded to others in the environment. The client just sits and stares and does not move. This immobile, constantly maintained position is often seen in: a. Catatonia b. Mimicry c. Mutism d. Depression

219. A client has difficulty sticking to the subject in discussions in groups. The client shifts from one idea to another in all conversations. This is known as: a. Flight of ideas b. Poverty of thought c. Blocking d. Dysthymic disorder

22. A 3-year-old child is diagnosed with CP and failure to thrive, and reportedly has difficulty with drooling, chewing, and swallowing. The OT should address: a. Oral motor deficits b. Motor sensory deficits c. Self-feeding d. Vestibular input

22. An important cultural consideration when working with a child with behavioural issues and the family is: a. The family's view of disability b. A therapist's personal views c. Societal views of the family's culture d. Societal expectations of the disabled

223. A Grade 6 student seems to panic every time an oral presentation is required in class. The patient reports a fear of being humiliated or embarrassed. This fear disrupts the child's functioning in many school situations. The child is likely struggling with a: a. Social phobia b. Impulse control disorder c. Obsessive-compulsive disorder d. Antisocial personality disorder

223. The OT is working on balancing a check book with a patient that has a TBI. When the patient becomes visibly agitated, the OT should: a. Change the activity to redirect attention b. Stop treatment and refer to the physician c. Suggest that medication be given d. Wait a little while and then try again

224. A high-powered executive of a Fortune 500 company recently retired because the company offered a substantial early retirement package that the individual could not refuse. After 6 months, the individual gradually began to be less motivated, refusing to get out of bed in the morning, and reported numerous somatic complaints to the family physician, who admitted the individual to the hospital for testing. When referred to the OT for evaluation, the BEST framework to guide the assessment would most likely be: a. MOHO b. Developmental FOR c. Cognitive Disabilities FOR d. Cognitive Behavioral FOR

225. You used the ACLS to evaluate your patient and the person scored a 5.4. A group treatment that would be MOST appropriate for the patient is: a. Cooking b. Movement c. Simple crafts d. Grooming

226. Anxiety over shortness of breath may be reduced in cardiac and chronic obstructive pulmonary disorder patients by employing the stress management technique visualization. This technique is effective because it: a. Helps persons to mentally transport out of the situation b. Promotes scanning of the environment surrounding the individual c. Allows person to distinguish between figure-ground concepts d. Allows the person to examine future goals

228. The OT is consulting with an employer about the high incidences of cumulative trauma disorder in the workplace and has been asked to make recommendations about prevention. According to the OT the BEST solution for prevention of cumulative trauma is to: a. Assess work areas for the appropriateness of furnishing and accessories b. Purchase a supply of braces and Ace bandages to use for support when working c. Start a job rotation plan immediately d. Introduce employees to scheduled breaks and relaxation techniques

23. A way to distinguish an Interdisciplinary Model from a Multidisciplinary Model is: a. The team requires group synthesis b. Members always have consensus c. Each member is respected for his/her expertise in a defined practice area d. Members have a good understanding of other professionals' scopes of practice

23. An office worker experienced an injury that resulted in being confined to a wheelchair. When the worker returned to work, an OT was consulted to assess the worker and make recommendations about reasonable accommodations. The OT's recommendations should address: a. Accessing the building, the work area, and bathrooms b. Remodelling the building to accommodate the individual's wheelchair c. Renting a new office space for the individual d. Investigating other job possibilities

230. According to biomechanical principles, muscles too weak to resist gravity should be: a. Placed in a functional position b. Placed in an antideformity or safe position c. Supported by using a sling or lapboard for support d. Strengthened with the use of isokinetic exercise

232. A 6-year-old elementary school child has a problem with handwriting. The child demonstrates gaps in handwriting skills that could improve with a comprehensive, repetitive program that focuses on the acquisition of these skills. A behavior the child should exhibit at this stage to improve handwriting is: a. At the acquisition stage, a child observes the behavior of others and determines the consequences, and these observations are stored in memory for later use b. The child may decide to perform the behavior, depending on the child's perception of the situation and the consequences c. The child learns through experiences (e.g., problem solving) in situations in which a child, an activity, and an adult are components d. The child may take the initiative to observe other children performing the same task and practice until skill is mastered

232. The OT needs to employ a compensatory treatment for an individual who has sensory problems. Which strategy would be the MOST effective? a. Use the uninvolved extremity to test temperatures and items for safety before engaging in the activity b. Perform a graded program that includes applying different textures and media to a hypersensitive body part c. Bombard as many senses as possible to promote sensory reintegration and sensory return d. Perform a program to help a patient correctly interpret and differentiate between sensory stimuli

234. According to OT principles, which scenario demonstrates the MOST appropriate use of therapeutic exercise? a. The patient performs stretching and ROM of the UE, followed by a self-feeding activity. b. The patient performs 10 repetitions of elbow curls on the first visit and increase to 20 reps on the next visit. c. The patient engages in a meal preparation and cooking activity from a wheelchair. d. The patient performs graded isometric, isotonic, and eccentric strengthening on the same day.

24. Which of the following services for children are primarily provided by physical therapists? a. Motor learning b. Fine motor c. Augmentative communication d. Social skill development

240. An OT program designed to teach an individual with CP to compensate for poor handwriting would MOST likely to involve the individual: a. Learning to type on a computer b. Practicing manipulation of nuts and bolts c. Practicing letter or shape formation d. Strengthening the intrinsic muscles of the hands

242. The OT wishes to assess if the patient can detect and identify placement of parts of the body and body positions with the vision occluded. The sensorimotor component being evaluated is: a. Kinesthesia b. Proprioception c. Functional mobility d. Postural control

244. What is the MOST useful piece of adaptive equipment to use for an individual with tremors who has difficulty stabilizing and scooping food from a dish during mealtime? a. A non-skid mat b. A plate guard c. Swivel utensils d. A deep rimmed dish

245. A 10-year-old child in the 3rd grade has age-appropriate reading and writing abilities but deficits when performing simple subtraction and addition problems. The child also has difficulty solving problems that involve multiple steps or columns. To assist this child with these performance deficits, the OT should assess: a. Visual memory and spatial relations b. Visual-discrimination problems c. Object (form) problems d. Visual acuity

249. The OT wants to observe the dynamic balance of a client. An activity the therapist could use to observe this skill is: a. Transferring in and out of the bathtub/shower b. Putting on a shirt over head c. Throwing a ball d. Driving a car

250. An adult patient refuses to do any of the craft projects that you have in your clinic. Your best NEXT step would be to: a. Ask what the patient enjoys doing and see if there is an alternative therapeutic activity that the patient might agree to engage in b. Tell the patient to go back to the patient's room then and you will document that the patient refused c. Ignore the patient, give attention to the other patients and see what happens d. Tell the patient that a craft must be done because the doctor ordered it

251. An OT administers a standardized test to assess fine motor coordination patterns and speed of manipulation in a patient with RA. One method to determine of the patient's performance on the test is within normal limits is to: a. Compare the scores with the normative data available b. Perform test-retest procedures on the patient c. Record clinical observations on patient's performance while testing d. Compare scores to a similar standardized assessment

252. An angry adolescent has a history of breaking things when angry and then feels guilty about it later. The BEST choice of activities for this client would be: a. Wedging clay to make a pot b. Knitting c. Painting a landscape picture d. A current events group

252. What processing deficit might the OT need to address in a patient with advanced chronic obstructive pulmonary disease? a. Confusion b. Recognition c. Memory loss d. Categorization

254. A typical psychosocial response that may be seen in a patient with HIV/AIDS that will also have influence on treatment is: a. Mourning b. Manic episodes c. Increased socializations d. Manic-depressive episodes

254. You have a patient who has memory problems. Which of the following would you MOST likely use? a. A written schedule of daily activities to remind the patient where they needs to be b. A daily log for the patient to express himself in writing c. A picture board to help communicate the patient's needs d. Flash cards to help the patient practice new words

256. An intervention that involves the provision of visual or auditory cues about physical processes, such as heart rate and muscle tension, that allows the patient to gain control over them is: a. Biofeedback b. Bradycardia c. Psychodynamics d. Psychodrama

257. Which of the following is a treatment used with depressed patients as a last resort and involves using electricity to cause a patient to have a seizure? a. Electroconvulsive therapy b. Insulin therapy c. Cryogenics d. Hypnosis

26. An interdisciplinary team is working with a Grade 4 student who receives special education and related services and is demonstrating problem behaviors. The FIRST step the team should follow is: a. Develop a comprehensive description of the problem, including individual and environmental factors that influence the issue b. Make a decision and develop a plan for achieving the solution c. Define the roles the multiple services have been playing in the child's intervention plan d. Identify as many strategies as possible to reduce barriers and increase supports

261. An OT has been working to improve the memory of a client on the mental health unit who exhibits mild cognitive deficits. Initially, the client was asked to identify the names of several common household objects, which they have mastered. To progress this patient , the NEXT step for the OT is to: a. Introduce several more new items b. Work on regrouping of the same items c. Require that the patient spell all items d. Ask the patient to locate the old items among several new items

261. Which of the following is the BEST example of inclusive or integrated school-based OT services? a. The OT joins the teacher in assisting individual students to complete planned curriculum activities in the classroom. b. The OT works with a small group of students in the back of the classroom. c. The OT brings in fine motor activities for a student to complete at the desk. d. The OT provides classroom staff with activities to follow through on with students during the week.

262. Which of the following interventions would be MOST reflective of direct OT services provided in an educational model as opposed to a medical setting? a. Attending a field trip to assist a student who has difficulty transitioning cope in the unfamiliar environment b. One-on-one sensory integration therapy c. Puling a student out to a separate room to practice fine motor activities d. Adapting a worksheet for a student to complete in class

264. A person with a long history of substance abuse who develops Korsakoff's syndrome is likely to: a. Confabulate to fill in memory gaps b. Start using heroin c. Develop tardive dyskinesia d. Develop tics

265. Trichotillomania is a condition that involves: a. Pulling out one's own hair b. Getting hysterical when someone tickles you c. Getting hysterical when someone frightens you d. Fainting at the sight of blood

268. The Wilbarger approach is a complementary treatment in SI designed to address what? a. Sensory defensiveness b. Self-regulation c. Sensory modulation d. Vestibular processing

270. A treatment used with patients as a last resort and involves using electricity causing a patient to have a seizure is: a. Electroconvulsive therapy b. Insulin therapy c. Cryogenics d. Hypnosis

270. Which of the following might a school-based OT try during therapy with a student demonstrating visual discrimination difficulties? a. Cutting out a significant part of a magazine picture and asking the child to try to determine what is missing b. Using visually and tactilely stimulating activities, gradually increasing the sustained attention required for tasks c. Playing a concentration game d. Showing the student a group of objects, then asking the student to try which one is missing after one has been removed from the group

275. Sensory defensiveness, gravitational insecurity, aversive response to movement, and poor registration are associated with: a. Poor sensory modulation b. Poor kinesthesia c. Dyspraxia d. Poor bilateral integration and sequencing

278. A student described as underresponsive or presenting with a high neurologic threshold on the Sensory Profile may display the following behavior at school: a. Risk-taking behavior, such as jumping off playground equipment b. Difficulty copying from the board c. Fear of playground equipment or sports d. Moving or pulling away from unexpected touch

28. A medically fragile preterm infant was recently discharged from the hospital. His early intervention team provides home-based services using a transdisciplinary model with the nurse as the primary interventionist. The intervention provided by the OT on this team would be: a. Consulting with and coaching the nurse b. Providing one-on-one intervention in the home c. Assisting with group sessions in the clinic d. Co-treating with other therapy services in the clinic

280. Non-standardized observations used to assess SI in a school-based setting may include the following, except: a. Stereognosis and touch localization b. Prone extension and supine flexion c. Crossing midline and hand preference d. Sequential finger touching and finger to nose

29. A patient with a brachial plexus injury secondary to an automobile accident has a good distal UE function, but the shoulder, elbows, and proximal muscle are weak with a general muscle grade of 3-/5. What piece of adapted equipment may assist this individual in being able to use the extremity for activities, such as feeding and simple grooming of the face and hair? a. A mobile arm support b. A forearm splint with a universal cuff c. A humeral brace d. A tenodesis splint

30. The MOST complex skill that a 2 1/2-year-old child can demonstrate on the Peabody Developmental Motor Scales is: a. Snipping paper b. Cutting across a 6-inch piece of paper c. Cutting a circle d. Cutting a square

31. A 6-year-old has gaps in handwriting skills that can improve with an intensive, repetitive program that focuses on acquisition or learning of these skills. A behavior that the child would exhibit during this stage of intervention to improve handwriting would be: a. At the acquisition stage, a child observes the behavior of others and determines the consequences, and these observations are stored in memory for later use. b. The child may decide to perform the behavior, depending on the child's perception of the situation and the consequences. c. Children first experience activities (e.g., problem solving) in situations in which a child, an activity, and an adult are components and then gradually the adult's speech becomes part of the child's cognitive repertoire. d. The child is guided only by an adult during activities.

31.The inpatient department strives for 75% productivity for all therapy staff. Today the OT worked for 9 hours. The OT attended a 1-hour staff meeting and net with an OT student for 45 minutes after lunch. How much time can the OT allot to documentation and still meet the productivity goal for the day? a. 0.5 hour b. 1 hour c. 1.5 hour d. 2 hours

32.In order to ensure the quality of OT education, academic programs must meet the minimum standards established by the: a. ACOTE b. AOTA c. CHEA d. U.S. Department of Education

36. A problem that limits in-hand manipulation is: a. Limited finger isolation and control b. Inability to hold more than one object in the hand at the same time c. An inability to maintain long sitting d. Difficulty combining wrist extension with finger extension

36. An expected outcome for a complete C3 tetraplegic would be: a. The patient will direct a family member/attendant verbally in the patient's care. b. The patient will use a splint for tenodesis action. c. The patient will feed himself with a ratchet splint. d. The patient will assist with dressing.

38.The OT supervisor evaluates the staff's performance by comparing the individual's productivity to the department's productivity standard. This is an example of: a. Controlling b. Budgeting c. Staffing d. Decision making

39. A sign of SI disorder is: a. Oversensitivity to touch, movement, sights, or sounds b. Inattentive impulsive behavior c. More active when compared to other children d. Impulsive behavior

39. The contract therapist is working in the schools this week. Where would the therapist look to find the school-based OT's treatment plan for a Grade 3 with severe learning disabilities and hearing impairment? a. Individualized Education Plan (IEP) b. Individualized Family Service Plan c. 504 plan d. 700 form

4. When reviewing license renewals, the OT director realizes that one OT does not have a current license in the state. Further investigation reveals that the individual never passed the NBCOT certification examination and is not a member of AOTA. The OT director immediately notifies all pertinent departments/agencies. Which department/agency has NO jurisdiction over this practitioner? a. AOTA b. Human Resources department c. NBCOT d. State Regulatory Board

40.To facilitate effective communication between an OT supervisor and employee, the supervisor should: a. Communicate what is expected of the employee b. Express disappointment regarding the employee's behavior c. Offer criticism to stimulate discussion d. Meet with the employee away from the workplace to facilitate a conversation

41. The most relaxed line of sight with the head erect is 10-15 degrees below the horizontal plane. Using ergonomic principles for comfortable visual reach, where should the OT recommend that the employee put the list of codes that are frequently needed while typing at the computer? a. Taped to the monitor above the screen b. Taped to the desk surface to the left of the keyboard c. Taped to the monitor below the screen d. Printed on the mouse pad

43. A child who is withdrawn has an OT goal of increasing ability to express feelings. Which intervention strategy would MOST effectively promote this skill? a. Drawing a self-portrait b. Talking about feelings in a small group of peers c. Playing a video game familiar to the child d. Watching a movie about a child with similar psychosocial behavior

43. A condition that can cause double vision or mental suppression of one of the images that affect the development of visual perception is: a. Strabismus b. Phoria c. Myopia d. Astigmatism

43. Which of the following theories/approaches would be MOST associated with intervention emphasizing structure and feedback during performance of a hand skill as well as repetition of the activities? a. Motor learning theory b. Developmental FOR c. Sensory Integration FOR d. Behavioural theory

43.Which of the following characteristics distinguishes a leader from a manager? a. Looks to the future b. Focuses on daily operations c. Maintains the status quo d. Focuses on efficiency

44.An administrator of OT would design a strategic plan for the purpose of: a. Developing new service lines and measuring outcomes b. Receiving insurance reimbursement c. Providing disciplinary actions d. Providing feedback to employees on work performance

45. An 8-month-old infant is not able to orient the hand properly for grasping before reaching and does not have any sensory deficits. The OT should assess: a. Depth perception b. Visual tracking c. Visual memory d. Visual attention

45.Medicare Part A is referred to as: a. Hospital insurance b. Supplementary medical insurance c. Federal-state medical insurance d. A managed care program

47.The director of OT was approached by the hospital's administration to establish "new and profitable" lines of rehab services. The director has identified hand therapy as a potential service and proceeds to develop a business plan. The FIRST market analysis activity that should be undertaken to initiate the business plan is to: a. Clearly identify the potential or existing client's needs and wants b. Persuade the potential referral sources to utilize the proposed service c. Create awareness of the service d. Increase accessibility to the consumer

5. An OT in early intervention suggests to a family that their child, who is sensory defensive, would benefit from having the tags cut out of his Tshirts. The term that BEST describes this type of intervention is: a. Adaptation b. Supportive c. Reframing d. Remediation

5. An employee in the OT department repeatedly makes derogatory remarks about a foreign-born therapist. These remarks are made in front of other staff and patients. Which agency is the MOST appropriate choice to report the employee's behavior? a. AOTA's Commission on Standards and Ethics (AOTA-SEC) b. Equal Employment Opportunity Commission (EEOC) c. NBCOT d. American Occupational Therapy Foundation (AOTF)

5. The parent of a child that is being treated in therapy describes how the child covers their ears when riding in the car with the windows down. The parent does not understand why the child persists in this behavior. The OT explains that this behavior could be the result of: a. Sensory defensiveness b. Gravitational insecurity c. Underresponsiveness d. Aversion to movement

50. A 6-year-old first grader is referred to OT by a teacher. The teacher observes that the child does not interact in the classroom and is extremely quiet. The child is typically sad and lacks enthusiasm for activities that classmates enjoy, and wants to take naps at recess. When presented with new challenges the child is sometime tearful and makes self-deprecating remarks. The mental health diagnosis that the behavior MOST closely resembles is: a. Mood disorder b. Anxiety disorder c. Bipolar disorder d. PDD

50. A patient with a diagnosis of arthritis was referred for splinting to alleviate symptoms of pain and swelling in the distal right UE. Which splint design would be the MOST appropriate? a. A resting hand splint b. A static progressive splint c. A dynamic splint d. A serial static cast

50. An OT in a community center would like to select the best activity to facilitate socialization and to increase several participants' energy level. The BEST choice would be: a. A chair aerobic group b. A cooking group c. A card game tournament d. A walk along a path in the park

50.The OT manager plans to hire an aide to work in a large OT department that provides services in both an inpatient and outpatient setting. This is a newly created position, which requires the manager to develop a written job description. In order to comply with the Americans with Disabilities Act of 1990 (ADA; Public Law 101-336), the OT manager must identify: a. Essential and marginal job functions b. The type of person suited for the job c. The policy for hiring employees d. The department's productivity standard

51.The rehab manager has recently hired an OT with a disability. The manager must make reasonable accommodations as required by the Americans with Disabilities Act of 1990 (ADA; Public Law 101-336). All of the following are examples of reasonable accommodations, except: a. Medication monitoring b. Modified work schedules c. Physical changes to the workstation d. Adjustment of supervisory methods

53. A client with RA has developed a boutonniere deformity of the right index finger. In order to correct this deformity, the OT must fabricate a splint that positions the: a. PIP joint into extension and the DIP joint into flexion b. PIP joint and the DIP joint into flexion c. PIP joint into hyperextension and the DIP joint into flexion d. Metacarpal in flexion and the PIP joint and the DIP joint into extension

53.The OT manager recognizes that limited growth opportunities are the main contributing factor to the recently experienced high turnover rates. In order to recruit and retain qualified staff, the MOST effective strategy for the OT manager to employ to combat high turnover of employees would be: a. Involve employees in the work design process and create development opportunities b. Provide formal mechanisms and encourage employees to express work-related concerns c. Use market information to determine wage and benefit programs d. Match employee skills with the job and define job prior to employment

54. An OT must evaluate a patient who recently had a heart attack. What critical reasoning approach should be followed to establish the occupational profile? a. Narrative reasoning b. Pragmatic reasoning c. Scientific reasoning d. Ethical reasoning

55. A 3-year-old child with a diagnosis of developmental coordination disorder is being seen in a private clinic for SI-based OT. The OT sets up an obstacle course with tunnels and cones. The OT encourages the child to explore it. It is MOST likely that the OT is trying to: a. Support the child's development of adaptive motor responses in novel situations b. Assess whether or not the child demonstrates and aversive response to having both feet off the ground c. Provide the child with opportunities to increase trunk and UE strength d. Help the child develop essential preacademic skills

56. When evaluating a client's shoulders ROM, the therapist asks the client to move the UE through the available AROM. The client was able to move the extremity through approx. half of its range, but required assistance to complete the full arc of motion. The OT would document that the muscle strength in this extremity is: a. Fair minus b. Good minus c. Fair d. Very poor

56.As life expectancy increases, attention needs to be directed toward services that will be required in the future. In addition to healthcare, education, transportation, and recreation, a community-based priority for OT practice is: a. Housing b. Adult daycare c. Spirituality d. Leisure

58. Which ADL activity would the OT caution a patient with recent hip replacement to avoid? a. Tying shoes b. Pulling up pants c. Putting on shirt d. Bathing the back

59. A patient recently experienced a nerve compress that caused the right dominant hand to be limp. Client factors affected are both sensory and motor, including no active wrist extension or forearm supination. Based on this scenario, the OT should assess: a. Motor and sensory problems affecting the posterior arm and fingers b. Sensory problem and edema of the involved extremity c. Paresthesia of the anterior aspect of the arm and fingers d. Motor and sensory problems associated with anterior arm and fingers

59. A patient with a T1 SCI wants to become independent in functional mobility. The OT should incorporate: a. Teaching the patient how to use a manual wheelchair b. Walking using short leg braces and crutches c. Drivers training in a regular vehicle d. Caregiver's training to assist the patient with mobility

59. The OT is providing service to a 10-year-old patient with spina bifida to address toileting at school. The patient is incontinent and has expressed embarrassment to the teacher and the OT. It is likely that the OT will recommend: a. That the student use the toilet at regular intervals throughout the day b. That the teacher and student will work out a signal when the student wants to use the bathroom c. That the child wear pants with an elastic waistband so that they can be pulled down quickly d. That the child only go to the bathroom when the other students in the class go

59.An 8-year-old child will require on-going services after being discharged from the hospital rehab unit to home. The most effective way that the OT can facilitate transition is to: a. Organize a meeting between the school and the rehab team b. Discuss the need for a referral with the doctor c. Facilitate a meeting between Medicaid services and the family d. Provide a list of community OT practitioners to the family

61. A football athlete with an incomplete C7 SCI seeks the OT's opinion about the ability to live independently. The BEST response from the OT would be: a. "You will be able to live independently with modifications such as adapted devices for ADLs, a wheelchair, and sliding board." b. "You can live along most of the time, but will require a caregiver for such tasks as driving, cooking, and ADLs." c. "Persons with this level of spinal cord lesion will require an attendant." d. "Persons with this level of injury can live independently with a manual wheelchair for mobility."

61.The Rehab Director is interested in expanding OT services to include a hand rehab clinic. In order to validate the support for such as program, the director should conduct: a. A market analysis b. An organizational assessment c. A promotional campaign d. A program evaluation

62. The OT is helping a child who is in Grade 2 hold a pencil by using just 3 digits. The OT notices that child lacks stability on the ulnar side of the hand making it difficult to functionally hold the pencil with the 1st 3 digits. It is likely that the OT will try to encourage the child to: a. Hold a small paper clip against the palmar side of the hand with the 4th and 5th digits while maintaining a 3 digit pencil grasp b. Hold the pencil with a 4 digit grasp and the use of a built-up pencil gripper c. Try writing with the other hand d. Participate in craft projects that require tearing paper and spreading paste

65. The OT administered a norm-referenced test to a client who exhibited performance deficits with fine motor coordination. When scoring the test, the OT should: a. Compare the patient's performance to the average score of a similar population b. Compare the patient's performance to a defined list of skills c. Compare the patient's performance to a specific objectives and normal function d. Rate the patient's performance based on a progressive scale

65. While reviewing a child's past medical history, the OT learns that the child has difficulty with visual pursuit. This child would also need intervention for: a. The ability to continue fixation on a moving object to maintain a continuous image b. The ability to rapidly change fixation from one point in the visual field to another c. The ability to fix eyes on a stationary object d. The ability to put forth conscious mental effort to concentrate on a visual task

65.As a result of a complaint, the Ethics Commission agreed on disciplinary action in which licensure to practice was removed for 1 year. This punitive action represents: a. Suspension b. Censure c. Revocation d. Reprimand

66.Which scenario represents a Sua Sponte Complaint to the Ethics Commission? a. The state licensure board informs the Ethic Commission about disciplinary action taken on individual due to unethical behavior. b. An OT complains to the Ethics Commission that their supervisor was unethical with billing practices. c. The administrator files a complaint that the OT treated patients of one ethnic group different than other individuals. d. The physician sends a letter of complaint stating that the therapist was using inappropriate treatment techniques for a particular group of patients.

67. A 7-year-old with SI dysfunction is working with an OT on the school's playground. The child looks at all of the playground equipment and verbalizes a detailed plan on how to move across the various obstacles. When asked to execute these actions, the child had difficulty making the body do what was conceptualized. The OT needs to address SI dysfunction related to: a. Somatodyspraxia b. Gravitational insecurity c. Modulation d. Tactile defensiveness

68. A client with a nerve resection is being evaluated for sensory return. The OT can BEST assess the client by: a. Tapping over the nerve to elicit feelings distal to the suture site b. Performing MMT of individual muscles c. Using test tubes filled with hot and cold water to distinguish differences in temperature d. Occluding vision and asking client to identify areas touched with a cotton ball

71. A patient with an upper motor neuron spinal cord lesion at C6 began receiving OT 2 weeks after the injury. During the third week, the therapist notices an increase in spasticity. The therapist should: a. Conclude that symptoms are typical after spinal shock b. Conclude that the patient maybe in respiratory distress c. Suspect that a contracture is developing d. Looks for signs of autonomic dysreflexia

71. The OT is working on feeding with a child who is hypertonic. The BEST method to use for jaw control while feeding is to: a. Apply hand to child's chin from front or side to promote chin tuck and provide stability to jaw b. Apply one hand to forehead and the other hand to chin to control opening and closing of the mouth c. Apply pressure to sides of jaw at the mouth level and press to facilitate opening of the mouth d. Apply hand to forehead and push head into extension to facilitate opening of the mouth

73.OT services are covered under Medicare when: a. Prescribed by a physician and considered reasonable and necessary b. Initiated by an OT in private practice c. The OT has liability insurance d. Other services such as PT and speech are covered

74. A 45-year-old with TOS has been in a work rehab program for 3 weeks and is about to transition to part-time work at the local glass plant, the client's current place of employment. Before making the transition, an assessment of the client's ability to successfully perform their job duties is needed. The BEST approach for the OT to use to gather this data is through: a. Skilled observations b. Norm-referenced measurements c. Informal measures such as a checklist d. Standardized assessments

74. A 7-year-old child with ASD has difficulty making eye contact. The BEST way for the OT working with the child to encourage the child to make eye contact is to: a. Provide positive reinforcement when the child does engage in eye contact b. Manually turn the child's head so that the child must look at the OT c. Give a verbal direction paired with a visual support d. Ask a peer to model the desired behavior or response

76. A school-based OT is working on handwriting with a student who has difficulty maintaining sustained attention. The BEST approach that the OT can use to increase the student's vigilance in therapy is to provide a student with: a. Novel materials and numerous activities that encourage the generalization of learned skills b. An opportunity to engage in a task that will take the entire session c. Repetitive materials that the student is accustomed to and encourage the student to attend to the familiar d. Activities that are process driven and do not require goal-oriented attention

76. The OT discovers that a patient cannot extend the elbow when positioned for MMT against gravity. In adjusting for the effects of gravity, the OT should position the patient: a. In sitting with humerus and elbow flexed and supported to 90° b. In side lying with arm that being tested raised to shoulder level c. In supine with humerus and elbow flexed to 90° d. In prone with arm abducted to 90°

76.The director of an adult day care center for individuals with Alzheimer's requests assistance from an OT consultant to provide information on how to identify the earliest warning signs of deterioration in persons with Alzheimer's so that immediate intervention could be provided. The OT reports that the main problem associated with the early stages of Alzheimer's is: a. Memory impairment b. Repetitive speech c. Incontinence d. Mood swings

77. A patient with RA complains of pain in bilateral shoulder when reaching overhead and performing cooking activities. ROM measurements reveal approximately 80-83 degrees of AROM in shoulder and 100-110 degrees of PROM. Using an adapted technique, the OT should recommend: a. Standing to perform cooking and to obtain items overhead b. Incorporating AROM and passive stretching c. Using a long-handled lightweight piece of adapted equipment d. Using a reacher

78. An OT is working in a rehab setting with an individual who has emphysema and is dependent on oxygen. While providing intervention to improve home management, the OT should: a. Monitor activity tolerance using a pulse oximeter b. Limit activity until oxygen is discontinued c. Request oxygen be discontinued during activities d. Keep treatment session short no more than 15 minutes

78.In a research proposal, what would the following statement represent: "There is a statistically significant difference in reduced symptoms in persons with CTS when splinting as compared to using a home exercise program." a. Hypothesis b. Null hypothesis c. Independent variable d. Dependent variable

79.An OT student on fieldwork receives a referral to evaluate a client diagnosed with coronary artery bypass surgery. Identify the sequence the student would follow during the evaluation (according to the OTPF): a. Gather significant medical data, create occupational profile, administer assessments, develop problem list, formulate goals, and plan the intervention b. Create occupational profile, administer assessments, gather significant medical data, develop problem list, formulate goals, and plan the intervention. c. Administer assessments, develop problem list, gather significant medical data, formulate goals, and plan the intervention d. Create occupational profile, gather significant medical data, administer assessments, develop a problem list, formulate goals, and plan the intervention

8. A child has poor ability to maintain trunk and neck extension. The OT uses which of the following as the BEST technique to facilitate increased strength and control: a. Have child prone on a therapy ball and play with toys b. Have child supine on a platform swing while playing with toys c. Have child in side lying on a mat shield playing with toys d. Have child sit on physioball while playing with toys

8. A patient with CRPS has severe edema and increased pain while performing simple grooming activities such as face washing. The initial care plan should focus on: a. Pain management b. Using the uninvolved extremity c. Gentle mobilization d. Light activities, such as brushing teeth

80. After 3 months of intervention, the OT notices that the child is beginning to integrate the reflex that turns the head toward the child's extended arm while in prone. This reflex is: a. ATNR b. STNR c. Moro reflex d. TLR

80. While performing a grooming evaluation, a client is noted to smear toothpaste over their hands and face. The OT should assess the client for possible issues with: a. Ideational apraxia b. Ideomotor apraxia c. Spatial relations deficit d. Motor apraxia

81. An OT is evaluating the degree of spasticity present in a client's right UE. There is no active movement, but the therapist determines that there is resistance to passive movement; however, full ROM can be achieved. The degree of spasticity describe is generally classified as: a. Mild b. Moderate c. Severe d. Fluctuating

82. When evaluating a client you use a cross out sheet and a balloon activity. You are MOST concerned with: a. Visual scanning b. Visual acuity c. Ocular control d. Visual perception

83. A child with spina bifida uses a variety of different positioning devices throughout the day. The OT would like the child to be in a stander during their treatment session. The OT will MOST likely choose to position the child in: a. A mobile stander b. A prone stander c. A supine stander d. A hydraulic stander

84.The "stress-vulnerability model" refers to: a. The impact that environmental stress can have on the functioning of mentally ill patients in the community, especially those diagnosed with schizophrenia b. The stress caused by the lack of governmental funding for mental health services c. The vulnerability in our healthcare systems caused by the increasing number of mentally ill patients d. The stress on the community caused by mentally ill individuals that have been de-institutionalized

86. A patient with emphysema complains of SOB and generalized weakness in the UE when performing daily chores. The OT should encourage: a. Pursed lip breathing when working b. Gravity assisted exercises before performing chores c. Use of oxygen with daily activities d. Avoidance of activities that consume a lot of energy

86. Some children tend to seek out large quantities of intense sensory stimulation. This "sensory seeking" behavior is thought to be related to a sensory system that is: a. Hyporesponsive b. Hyperresponsive c. Defensive d. High registering

87. A child has difficulty recognizing letters in different styles or print or in making the transition from printed to cursive letters. The child has a visual discrimination problem of: a. Form constancy b. Spatial vision c. Figure ground perception d. Binocular fusion

88.In working with psychiatric patients, it is important to: a. Involve their families whenever appropriate and possible b. Treat the patient without reviewing their histories to avoid prejudging them c. Never trust what their families say about them, because most of them are mentally ill, too d. Warn the community that they live in about their mental illness

89. You are working with a 60-year-old patient who has sustained a CVA. The patient presents with low muscle tone. You are working on neuromuscular re-education and utilizing a Rood approach by helping the patient position himself on hands and knees and asking the patient to do an activity with the stronger arm. By doing this you are utilizing: a. Proprioceptive facilitatory techniques of joint compression b. Proprioceptive facilitatory technique of vestibular stimulation c. Inhibitory technique of joint compression d. Inhibitory technique of neutral warmth

9. An OT went to a workshop and learned a new treatment for people with Parkinson's disease. The OT wants to determine if the technique is more beneficial than what is currently being done in the clinic. Using the principles of evidence-based practice (EBP), what is the FIRST step for this OT? a. Formulate a specific question comparing the outcomes of the 2 different treatment approaches b. Do an Internet search on treatment of people with Parkinson's disease c. Randomly assign clients to one of two treatment groups d. Review the OT textbooks at the local university

9. The OT is treating a patient with a history of coronary artery disease. During the treatment, the patient complains of recurring angina that increases when performing activities in standing. The MOST appropriate course of action by the OT is to: a. Stop treatment and contact the physician b. Stop treatment until symptoms subside c. Assist patient in taking medication for chest pain d. Perform treatment in a sitting position

90.A female patient privately shares with the OT that she was sexually abused as a child. The OT should: a. Share this information with team members to ensure that the care provided is appropriate b. Promise not to share the information because it was communicated privately c. Inform others during the group therapy session, so that they will give the patient support d. Encourage the patient to disclose this information in group therapy to help others who may have had similar experiences

91. When instructing a hemiplegic patient on dressing techniques, it is very important that the patient is instructed in which of the following? a. The weaker arm or leg is dressed first b. The stronger arm or leg is dressed first c. Clothes with elastic are easier to wear d. Clothes a size larger than usual are easier to wear

91.Which of the following is a symptom that occurs as a result of long-term use of antipsychotic medications? a. Tardive dyskinesia b. Echolalia c. Pica d. Tachycardia

93. When facilitating movement in a patient who has sustained a CVA, you use the technique of tapping the wrist extensors. This would come from: a. Brunnstrom b. Bobath c. PNF d. None of the above

94.In a skilled nursing facility, the patient's need for services and the prospective per diem rate are established by a resident assessment tool called the: a. Minimum Data Set b. FIM c. COPM d. RBRVS

95. The OT evaluated a patient in the cardiac ICU and is in the process of developing the intervention plan. What are the 2 primary components that should be included? a. The anticipated outcome and the methods to achieve those outcomes b. Rehab potential and realistic time frame for seeing the patient c. Specific intervention techniques and rationale for being chosen d. The type of tests given and interpretation of the results

95.An OT involved with a self-help group for patients with the diagnosis of "panic disorder with agoraphobia" would MOST likely take the role of a: a. Consultant b. Primary group leader c. Case manager d. Full group member

98. A client with ideomotor apraxia would MOST likely: a. Grasp a washcloth and be unable to sequence the movement b. Grab the washcloth but appear unsure of how to use the soap c. Grab the washcloth and the soap but only wash one side of the body d. Grab the soap and the washcloth but be unable to maintain balance

98.The following are considered primary services under the Individuals with Disabilities Education Act (IDEA): a. Specially designed instruction (special education) b. OT and speech therapy c. OT and PT d. Transportation and psychological services

1. Entry into the early intervention system begins with which of the following: a. Screening for developmental delay b. Individualized Family Service Plan c. Screening for family environmental risk factors d. Individualized Education Plan (IEP)

10. An OT has to calculate the corrected age for a child that was born prematurely. The child had a due date of September 20, 2005 and their birth date was June 12, 2005. The child was born 3 months, 8 days premature and is currently 1 year, 1 month, 25 days old. The therapist determines the corrected age is: a. 10 months, 17 days b. 12 months, 2 days c. 9 months, 8 days d. 7 months, 10 days

10.An OT is trying to determine whether playing music during therapy affects ADL performance. Comparing functional independence measure scores after treatments with and without the music, BEST indicates what aspect of the treatment: a. Effectiveness of the treatment b. Efficiency of the treatment c. Reliability of the treatment d. Validity of the treatment

100. Which statement would be the MOST appropriate for the OT to document in the plan section of the SOAP note? a. Client given educational materials to practice correcting posture and trunk balance during daily routine. b. Client able to respond to verbal instructions and questions with correct responses 3 out of 3 times. c. Client indicates that the LTG is to return to work on a full time basis. d. Client assessed for use of in compensatory techniques while cooking in the clinic kitchen.

101. An intervention that would benefit a client with hypotonia in the extremities and trunk is: a. Performing fast brushing over the entire trunk and extremities b. Slowly stretching each extremity c. Wrapping the patient in a heavy blanket d. Providing relaxing auditory stimulation

102. An OTA with 5 years of experience in a mental health setting is being reassigned to work in an orthopedic outpatient rehab center. What level of supervision should the OT provide? a. Close b. Routine c. General d. Minimal

102. The OT would administer a test of visual-motor integration to a child who MOST likely has difficulty with: a. Copying letters 20 b. Putting puzzles together c. Selecting geometric shapes that are the same d. Finding a figure embedded in a beach scene

102. The role of an OT during a feeding group is MOST appropriate during this phase: a. Oral preparatory and oral phases b. Oral and pharyngeal phases c. Pharyngeal and esophageal phases d. Oral preparatory, oral, pharyngeal, and esophageal phases

103. The MOST common compensation principle for a client who has weakness is: a. A trigger reacher to get the pants over the feet b. Loops to manipulate the LE c. A universal cuff to assist with grip and closures d. A standard dressing stick

105. An OT is providing intervention for a client who had a stroke involving Broca's region in the left hemisphere. This client would have difficulty with: a. Expression b. Receptive language c. Both expressive and receptive language d. A rapid speech pattern

106. Among children who are autistic, the MOST significant area of impairment tends to be: a. Social b. Cognitive c. Self-care d. Motor

109. A patient with fibromyalgia lives alone and is a meticulous housekeeper; however, the patient cannot hire anyone to assist with household chores because of financial resources. During a home visit, the patient requests advice on the best method to perform household duties. The OT should recommend that the patient: a. Schedule homemaking chores so that heavy tasks are alternated during the week b. Invite friends and neighbours to asses with some of the heavier tasks on an alternating basis c. Seek funding from social services to hire in-home assistance for household chores d. Consider attending a support group to deal with the limitations of this condition

109. An OT might encourage a 70-year-old client to use a slower gait: a. So that the client can conserve energy to prevent muscle fatigue b. Because walking at a speed consistent with the client's age is most appropriate c. So that the client can adjust better to the physical activity d. To prevent overexerting the heart and other bodily systems

109. An enriched environment with appropriate stimulation will cause positive brain change in the growing child. This concept may be referred to as: a. Just right challenge b. Inner drive c. Neural plasticity d. Child development

11. A 3-year-old child has been referred for early intervention. In the discussion about intervention with the family, the team should be sure to: a. Use lay terminology to describe the early intervention process b. Explain conditions in detailed technical and medical terms c. Discourage parents asking questions d. Ignore parents' feedback and ideas on intervention

116. In inpatient cardiac rehab, the OT should concentrate on: a. Educating about risk factors and appropriate home activities for discharge b. Maximizing psychosocial and vocational status in the community c. Assessing the ability to resume occupation related to job performance d. Establishing a daily exercise routine to build strength and endurance

117. The goal of therapy for a patient is to develop and improve hand coordination and skills. The OT should recommend purposeful activities, such as: a. Games, crafts, and self-care tasks b. Using Thera-Putty and hand gripper c. Cone stacking and placing pegs in a board d. Playing a "clapping game"

117. The parents of a child in kindergarten need instruction in the wear and care of their child's hand splint. They should also be cautioned to: a. Note and report to the OT any irritation and pressure problems b. Use disinfectants regularly to destroy bacterial growth c. Let the child's tolerance determine the wearing schedule d. Avoid putting the splint in the trunk in the car

12. A 45-year-old patient is in the 1st stage of RSDS/CRPS with the classic signs of hand edema, fear of ROM, and pain in the shoulder and hand of the involved extremity. What is the FIRST priority of treatment? a. Reduction of edema b. Aggressive PROM c. Instruct in self ROM d. Perform grip strength test

12. A child has difficulty with in-hand manipulation or only finger to palm transition to manipulate objects between 2 hands, and uses support surfaces to assist in object manipulation. The therapist can use which of the following activities to improve this occupational performance: a. Surfaces as a support b. Objects that roll c. Tiny objects d. Hold hands away

120. An OT, consulting with a business, has been asked to develop employment pre-placement screening for the employees. According the American with Disabilities Act of 1990 (ADA; Public Law 101-336), the employer cannot ask certain information during the employment preplacement screening. The OT must advise the employer of ADA compliance issues. The type of information the employer could request during the preplacement screening is: a. Can the applicant meet the physical demands of the job? b. What medical condition(s) does the applicant have? c. What type of disability does the applicant have? d. What medications does the applicant currently take?

120. The OT instructs the family of a pre-schooler with athetoid CP on feeding. To maintain jaw control, the OT should recommend: a. Placing fingers on face to create chin tuck and manipulate mandible b. Vibrating the child's gums and teeth prior to feeding c. Holding tightly to the child's lower jaw of control d. Stimulating the child's upper lip by tapping to get closure

122. An upper-extremity musculoskeletal disorder that would be considered a work-related condition is: a. Primary thumb carpal-metacarpal OA b. Cervical stenosis c. Lateral epicondylitis d. Dupuytren's contracture

122. In a skilled nursing facility, to compensate for diminished taste and sense of smell in an elderly patient, the OT should: a. Emphasize texture and appeal of food b. Recommend a diet of puree food c. Consult the speech therapist d. Emphasize eating highly seasoned food

124. The OT performs an ergonomic evaluation of an employee's workstation at a manufacturing plant. The OT recommends modifying the workstation by raising the height of the assembly line by approx. 5 inches and suspending a counterbalanced power screwdriver overhead. These ergonomics interventions are considered: a. Engineering control b. Work practice control c. Administrative control d. Rehabilitative control

128. The OT supervisor of an occupational rehab program is contacted by a case manager regarding the program's functional captivity evaluation (FCE) services. A worker's compensation case manager wanted to know more about the utility of FCEs for their clients. The OT should list all of the following as possible roles of FCEs in occupational rehab EXCEPT: a. To determine if a work-related impairment exists b. To establish a rehab treatment plan for an injured worker c. To determine at what level a return to work would be appropriate d. To determine employability of workers with impairments

13. Which one of the 4 components of the adaptation process pertains to reception of sensory stimuli from internal and external environments? a. Assimilation b. Accommodation c. Association d. Differentiation

13.An OTA refuses to teach hemi dressing techniques to a home health client after learning that the client is homosexual. Which principle of the AOTA Code of Ethics has the OTA violated? a. Beneficence b. Confidentiality c. Duties d. Veracity

130. An OT presents a child with 10 pictures and asks the child to pick out 2 that are the same. It is MOST likely that the OT is facilitating the child's development of: a. Visual discrimination abilities b. Spatial perception abilities c. Visual closure abilities d. Visual pursuit abilities

130. During a mental health group exercise, the OT provides the participants with an activity that requires them to interact, share ideas, and provide directions to each other in order to make successful progress from one step to another. MOST likely the OT is facilitating: a. Information exchange b. Verbal and nonverbal communication c. Social play d. Physical interaction

132. A pre-adolescent presents with social immaturity and problems socializing. Which of the following goals would BEST meet the client's needs? a. Patient will initiate and engage independently in a 15-minute structured game, with one peer, by the end of the 3rd OT session. b. Patient will initiate making the bed each day for 5 consecutive days. c. Patient will talk at length about the parent-patient relationship and feelings about having no childhood friends. d. Patient will share all feelings with the group.

133. A 23-year-old client sustained work-related CTS in their right dominant hand. Past medical history is unremarkable. The OT assessed the demands in the work environment, which indicated that the client was required to utilize a power sander frequently (1/3 to 2/3 of the day) to sand unfinished wood furniture. The work-related risk factor the OT would MOST likely describe as the strongest contributor to the client's CTS is: a. Excessive vibration b. Forceful pinching c. Excessive finger movements d. Static UE postures

133. In evaluating a new geriatric patient, you note that the patient spends most of the day in front of the TV. The patient tells you that the TV watching has been going on ever since the patient's spouse died 5 years ago. An appropriate goal to set might be: a. Patient will explore possible leisure options in OT sessions, to help improve life balance and increase socialization and will pick 2 new activities to begin participating in by the end of the week. b. Patient will watch only 2 hours of television each day. c. Patient will stop sitting around and start doing things. d. Patient will talk about the loss of the spouse in OT groups.

136. An OT is working in an outpatient hand clinic with an 11-year-old child who has a diagnosis of juvenile RA. After completing an occupational profile, the OT decides that it would be beneficial to further assess the child's skills. The OT will MOST likely choose an assessment that measures: a. Gross motor and fine motor skills b. Visual motor integration skills c. Achievement toward developmental milestones d. Processing and communication skills

137. An OT is working with a child to develop age-appropriate hand skills. Before beginning the session, the OT makes sure that the treatment room is well lit so that the child will have the maximum advantage of using their visual skills. Vision is important for the development of hand skills because: a. Vision provides motivation and feedback for motor movements. b. Vision provides a child with a sense to determine if an object is heavy or light. c. Vision and hand skill develop at the same rate. d. The use of color vision attracts children to novel objects that they want to explore.*

137. The OT is working with a 5-year-old child to develop pre-writing skills. The child has adequate fine motor strength, eye-hand coordination, ability to hold a writing utensil, and the capacity to make circles and letters. However, the child is unable to perceive the differences between letters. During a treatment session, the OT will likely encourage the child to: a. Play a matching game b. Pick up small items with tweezers c. Complete dot-to-dot pictures and mazes d. Maneuver through an obstacle course

138. Which of the following is the MOST significant factor in determining if a student should receive school-based OT services? a. IEP team decision b. OT evaluation results c. Insurance coverage d. Parent preference

139. A 4-year-old child presents with significant motor delays. The focus of OT is to assist the child in grasping toys. MOST likely, the OT will first address: a. Voluntary hand opening b. Carrying the object c. Supination d. Finger flexion

139. Which of the following is the MOST appropriate example of a task an OT may delegate to a classroom staff for a student with identified SI differences? a. Physically applying a vibrating toy to a student b. Requiring a student to go down the slide a set number of times while on the playground c. Monitoring a student in completing a written sensory diet of heavy work activities d. Spinning a student on a swing

14. A Grade 2 with CP has demonstrated poor handwriting skills. The child has difficulty holding a pencil and very restricted hand movement. The child is an average student and does not appear to have any cognitive learning disabilities. A recommendation for the intervention plan for Grade 2, based on her needs in Grade 4 and 5, would be: a. Begin to teach the child keyboarding skills to prepare for word processing using a computer for written assignments b. Provide systemic practice using kinesthetic patterns to improve letter formation and legibility c. Use templates for alphabets so that the child can practice and learn letter formation d. Enforce a strict writing program in the classroom for the teacher to implement

141. An OT is providing early intervention services to an infant that was 13 weeks premature. The infant's parent reports that the child cries and tenses in an extension pattern when picked up and fed, or if the diaper is changed. However, the child tends to calm down and accepts a bottle readily when placed in the care seat. The OT should evaluate this child for: a. Sensory defensiveness b. Inadequate anticipatory behaviors c. Sensory registration difficulties d. Difficulty regulating postural mechanism

141. The OT has provided a Grade 4 student with a built-up pencil grip, but the student continues to hold his pencil too tightly and presses very hard on the paper when writing. At times the student presses so hard that the paper tears. MOST likely the OT will provide this student with: a. A notebook to write on top of b. A tape recorder to dictate the work c. Worksheets to practice handwriting d. A thicker pencil

143. A 3-year-old child with a diagnosis of developmental coordination disorder is being seen in a private clinic for OT. The OT sets up an obstacle course and encourages the child to explore it. It is MOST likely that the OT is trying to: a. Support the child's development of automatic motor responses in novel situations b. Assess whether or not the child demonstrates an aversive response to having both feet off the ground c. Provide the child with opportunities to increase trunk and UE strength d. Help the child develop essential pre-academic skills

143. A parent reports that their child sleeps pushed up against the sides of the crib. The parent states that the child pushes hard into one end of the crib. The OT realizes that this child requires treatment that focuses on: a. Proprioceptive input of deep pressure b. Vestibular input of spinning c. Light touch d. Kinesthetic input

146. An OT chooses to evaluate a child using the Sensory Profile developed by Dunn. The OT is hoping to gain information: a. That links the child's sensory processing abilities with performance in typical ADLs b. Related to the child's ability to balance and use bilaterally coordinated movements c. That explains the child's difficulty with ideation, planning, and execution of motor sequences at home and at school d. That informs treatment planning for concerns related to functional communication

147. You currently work in an outpatient clinic and have evaluated a 35- year-old patient who is status post - 3 months from SCI at the level of C6. The patient's UE function is consistent with his stated level of injury. Which of the long-term goals is unrealistic? a. Patient will be independent with bathing utilizing adaptive equipment b. Patient will be independent with eating pre-cut food after set-up and adaptive equipment as needed c. Patient will dress upper body independently after set-up d. Patient will be independent with directing bowel and bladder care

149. A child who is averse to vestibular input may experience the following reaction immediately after going down a playground slide: a. Dizziness and nausea b. Avoidance of touch c. Difficulty sequencing the actions needed to climb on the monkey bars without assistance d. Increased muscle tone throughout trunk

149. You are working with an 18-year-old who has a C5 SCI. The patient has not begun to self-feed. Based on the level of the injury, a piece of equipment that would benefit the client is: a. Wrist splint with u-cuff b. U-cuff c. No equipment needed d. Tendonesis splint

150. You are working with a 47-year-old client who has SCI. the client demonstrates some hypertonicity in the UE. A method to perform ROM while preserving tenodisis is: a. Wrist flexed, fingers extended b. Wrist extended, fingers extended c. Wrist radial deviated, fingers extended d. Functional position

155. While an OT is working with a patient during an ADL session, the patient begins to dress the OT's arms instead of the patient's arms. This can be BEST described as: a. Somatagnosia b. Difficulty with sequencing c. Spatial neglect d. None of the above

158. An OT is preparing to evaluate a child in the school systems and would like to use a top-down approach. It is likely that one of the first things that the OT will do as part of the assessment is choose an assessment that measures: a. How much the child participates at school b. The child's visual motor skills c. The child's fine motor strength d. The child's time on task

159. You are working with a 35-year-old client who has sustained a right CVA and demonstrates a left inattention. Your remedial strategies might include: a. Providing tactile cues to the left side b. Placing the television on the right side of the room c. Placing all of the client's items on the right side of the client's body d. All of the above

16. The OT makes recommendations to a patient after hip replacement surgery for positioning in a wheelchair. Which set of instructions would adhere to safety precautions? a. Keep legs abducted with abductor pillow and affected leg in neutral b. Keep legs together by using an adductor strap to prevent external rotation of legs c. Sit in a regular wheelchair with feet supported on foot rest d. Sit in regular wheelchair with affected leg in full extension

163. An OT is asked to assess a child's handwriting. During an observation, the OT notes that the child holds their pencil by resting it against the distal phalanx of the radial side of the middle finger while the pads of the thumb and index finger control it. This grip can best be described as: a. Dynamic tripod grasp b. Lateral tripod grasp c. Modified tripod grasp d. Quadripod grasp

164. Praxis, or motor planning, is comprised of 3 distinct components. They are: a. Ideation, planning, and execution b. Ideation, execution, and follow through c. Ideation, planning, and sequencing d. Ideation, problem solving, and preparing

165. A 7-year-old with athetoid CP exhibits poor arm and hand control. A strategy that would help with self-feeding is: a. Using a spoon with a built-up handle b. Placing in a high chair c. Using a wider and flatter dish d. Providing foot support

167. A 12-month-old has respiratory problems and sometimes requires oxygen support. Rapid and shallow breathing hamper the child's ability to swallow because it interferes with the coordination of the suckswallow- breathe sequence. This would be remedied if the child's breathing were slowed down. A strategy that would benefit the child during intervention is: a. Place the child in an upright position while feeding b. Use thickened liquid for greater proprioceptive input c. Use a neck flexion and improve closure of the larynx d. Use oral vibration

169. You are evaluating the motor control of a 65-year-old client who sustained brain stem CVA 3 months ago. When performing the finger to nose test, the client reach seems to have: a. Ataxia b. Chorea c. Ballism d. Athetoid movement

17. A type of sensory input that has a strong effect on arousal that is used by OTs to prepare a child for a therapeutic activity is: a. Vestibular input by swinging the child b. Visual input through a computer game c. Olfactory input with harsh odors d. Auditory input by reading the child a story

171. You work in an acute care facility and have been asked to see a 70-year- old patient. While the patient is sitting, you observe that the client positions their left arm a flexed elbow and hand pulled to their body. You want to evaluate the client's tone the BEST evaluation for this is: a. Ashworth b. Wolf c. MMT d. Jebsen

173. You are working on an inpatient rehab unit and are assigned a 25-year- old client who has sustained a brain injury from gunshot wound. As you enter the client's room, the client is eating breakfast. The client states that they are done eating breakfast, but you notice that only food on the right side of the tray has been eaten. Through a full evaluation of visual abilities is needed, you suspect that the client is dealing with which of the following: a. Left inattention b. Right field cut c. Decreased oculomotor control d. Diplopia

174. A preparatory activity for handwriting is to listen to rhythmic music while sitting in a rocking chair. The model of practice that this relates to is: a. Sensorimotor b. Psychosocial c. Biomechanical d. Psychoeducational

175. A child has difficulty in placing cursive letters on the line and spacing words and does not use margins properly. 60% of the child's work is not legible. The child gets poor grades not because of lack of content but because of lack of legibility. A compensatory intervention that would help is: a. Give more oral assignments b. Allow use of a computer for all schoolwork c. Use smaller-lined paper and write on every line d. Use fingerprint spacing using an ink pad before finger spacing

176. A 6-year-old has managed to write some of the easier manuscript letters, such as o, l, and t, but has difficulty in writing letters such as b, q, and g. An intervention strategy to use with this child would be: a. Introduce letters with common formational features as one group b. Reinforce newly acquired letters by getting him to write them repeatedly c. Have him write the letters repeatedly on a blackboard while standing d. Choose a commercially available handwriting intervention method and follow it strictly

176. An OT is attempting to evaluate the reading ability of a patient who has sustained a right CVA with some difficulty. The patient reports that they are typically use reading glasses but cannot locate them. Instead of ending the session, the OT could compensate by: a. Increasing print size b. Turning off the TV c. Reading the questions to the patient d. Writing words in red on a pink paper

178. A second grader has illegible script, and the OT feels that along with remedial techniques the child would benefit from compensatory activities using the sensorimotor approach. The OT recommends use of chalk or grease pencils as writing tools to improve legibility. The reasoning behind this is: a. It will provide additional proprioceptive input b. It will provide a structured manner for writing c. It will provide strength to the hand d. It can alleviate fatigue

18. An essential element of a pain program that the OT should address with every patient is: a. Coping mechanisms b. Cognitive skills c. Medication management d. Basic ADL

180. An OT must evaluate a patient who recently had a heart attack. A critical reasoning approach to follow to establish an occupational profile is: a. Narrative reasoning b. Pragmatic reasoning c. Scientific reasoning d. Ethical reasoning

181. A 3-year-old has spina bifida and needs mobility augmentation to be able to move outdoors, in hallways, and in corridors. A mobility device that could be recommended would be: a. Hand-propelled tricycle model b. Supine scooter c. Aeroplane mobility device d. Crocodile posterior walker

184. As an OT, it is important to know the basis of an infant's oral tactile defensiveness before planning an intervention program that could help resolve it. A possible cause of oral hypersensitivity would be: a. Procedures in the oropharyngeal area as a newborn b. Poor nutritional intake as an infant c. Low birth weight d. Respiratory problems from birth

186. A 3-year-old with autism has severe SI problems. A characteristic the child is likely to display would be: a. Stereotyped movements or types of play b. High play organization c. Limited and abnormal movement d. Engagement in social play with 2-3 people at a time

186. A 6-year-old receives OT for improving fine motor functions. An activity that would help improve eye-hand coordination is: a. Playing with toy hammer and nails b. Practicing in-hand manipulation by rotating small objects in her hand c. Rolling Play Doh into a ball d. Finger painting using shaving cream

187. An OT has identified that a child exhibits certain features of creating letters that affect legibility, such as improper letterforms and poor leading in and leading out of letters. A feature that would also significantly affect legibility would be: a. Incomplete closure of letters b. Insufficient orientation of letters on the baseline c. Poor orientation of letters on line d. Inconsistency of slant

19. The BEST statement regarding the use of NDT with children is: a. NDT is most effective for certain children, primarily those with CP, in developing specific motor skills b. Performance areas targeted when using NDT should not be specifically and routinely measured to determine whether progress toward expected outcomes is satisfactory c. Clinical trials have demonstrated that functional performance in children who receive intensive NDT is significantly higher than the performance of children who receive regular OT that emphasized functional activities d. Clinical trials have demonstrated that NDT is effective for infants with spastic diplegia

19.An OT manager is asked to prepare a report of revenue for the cardiac program. The manager budget would MOST likely show: a. Income b. Operating costs c. Capital equipment expenses d. Direct expenses

191. A well-respected professor recently suffered the loss of a spouse and only child in an automobile accident. The client feels guilty for not being in the car with them and was unable to prevent the tragedy. The client is obviously suffering from depression and has now lost all interest and motivation in normal daily activities and has stopped habitual performance of a balanced lifestyle. The client feels that the client has no control over the client's "world" and what happens any more. The client knows that their suicidal thoughts are not healthy, but the client says that they lack the skills to make things better. The BEST framework to use in your approach to evaluating this client is: a. MOHO b. Developmental FOR c. Cognitive Disabilities FOR d. Behavioural FOR

1. The Individualized Family Service Plan (IFSP) is established in early intervention by the: a. Assessment team without family input b. Assessment team with family input c. Family without team input d. Primary therapy service

100. The MOST appropriate piece of adaptive equipment for an individual with a mild to moderate left CVA would be: a. Button hook b. Universal cuff c. Card holder d. Dressing loops

101. An office worker has TOS. What modifications might the OT consultant recommend for the workstation? a. Place any overhead items near the front of the shelf to minimize full extension when reaching. b. When sitting at the desk, use a chair with arm rests to allow support to the UE. c. Place heavier items furthest away on the desk surface. d. Place lighter items furthest away on the desk surface.

103. A teenager with a history of juvenile RA needs to manage the medications routine. The teenager inquires about typical side effects of the medications. The OT should refer the teenager to information related to: a. Antidepressants b. NSAIDs c. Anticoagulants d. Barbiturates

103. An 8-month-old infant assumes a quadruped position and then rocks back and forth; this behavior indicates: a. Repetitive behaviors b. Normal development c. Fluctuating muscle tone d. Being stuck in a movement pattern

103. An OTA works in a skilled nursing facility and is supervised by direct contact every 2 weeks with interim written or verbal communication. When performing the employee's appraisal, the director should document the level of supervision for the assistant as: a. Close b. Routine c. General d. Minimal

104. A patient with a total shoulder arthroplasty has been receiving therapy for 1 week. The patient has achieved pain-free ROM to within functional limits. The OT should progress treatment to include: a. Lifting activities b. Initiation of activities in standing c. IADL d. Activities involving speed, such as throwing a ball

104. An OT employed for less than a year on an acute care unit has mastered the basis routine and job requirements but continues to need mentoring when working on specialty units such as cardiac critical care. What level of role performance is the OT apparently functioning? a. Entry level b. Intermediate level c. Advance level d. Supervisory level

104. An elementary school conducted a "spine screening"; two students were noted to have an exaggerated curvature of the thoracic spine. This is characteristic of: a. Lordosis b. Kyphosis c. Lumbardosis d. Pulmonary infusion

105. An employer requests that the OT makes recommendations about universal design in the new retirement complex. The OT would MOST likely recommend: a. Placing labels in Braille to identify the rooms of the housing units b. Placing railing and bars in the bathrooms and on stairs or steps c. Installing a pool for recreational purposes d. Creating walking trails within the residential neighborhood

105. In order for a person to receive services available for developmental disability, he/she must meet the criteria of a condition that has: a. Early onset, but brief manifestation in limited functioning b. Onset of the condition before the age of 22 c. Physical dysfunctions with an onset after age 7 d. Onset prior to preschool years

106. Clients demonstrating a left visual field deficit are more likely to have difficulty learning to use compensatory strategies than patients demonstrating a right visual field deficit because: a. Clients read from left to right so it is easier to scan from left to right b. Clients with a left hemisphere lesion usually retain scanning skills c. Clients with a right hemispheric lesion usually have extensive cognitive lesions d. Clients with a right hemisphere lesions always demonstrate left neglect

11. An OT is designing an intervention plan that focuses on modification of the behavior of a person with a TBI who exhibits emotional liability and who has difficulty maintaining employment because of chronic lateness. Which contextual factor should guide the OT in decision making? a. Physical b. Social c. Temporal d. Cultural

110. The child is unable to assume prone extension or maintain it when placed by the therapist. The OT would write this in which portion of the report: a. Subjective b. Clinical observations c. Standardized testing d. Functional limitations

111. Although the patient is quite thin, when the patient looks in the mirror the patient believes that they look overweight. This patient has an inaccurate: a. Self-concept b. Body image c. Body scheme d. Seriation concept

112. Intervention planning involves writing goals to guide the intervention process. Select the MOST appropriate written goal for a client who can no longer do laundry because of lower back pain: a. The patient will be instructed in techniques to do tasks related to laundry without pain. b. The patient will use work simplification techniques and proper body mechanics to do laundry independently. c. The patient will be taught work simplification tasks to be able to do laundry. d. The patient will be independent when performing laundry tasks.

113. An elderly client is observed by an OT as having an unsteady gait, and the client has to hold onto the wall when coming in and out of the bathroom. The OT should assess the patient for: a. Visual deficits b. Postural control c. A possible wheelchair or walker d. Apraxia

114. An older person with functional impairments and poor physiological reserve who has difficulty living independently is known as the: a. Elderly b. Frail elderly c. Vulnerable aged d. Aged adult

116. An OT is assessing sensation in a 75-year-old patient. The results show decreased light touch and normal protective sensation. The therapist should document that: a. Sensation is significantly impaired b. Sensation is appropriate for age c. Further testing is needed d. Stereognosis should be tested

116. Which statement would be documented in the "plan" portion of a SOAP note? a. Problems include decreased coordination, strength, sensation, and proprioceptive in left UE. b. In order to return to work, patient will demonstrate increase of 10# of grasp in L hand, in 3 weeks. c. Patient would benefit from further instruction in total hip precautions for LB dressing, bathing, and hygiene. d. Patient attended job skills group with prompting by nursing and OT staff.

12. A 6-year-old is interested in learning to roller skate. However, after the initial few minutes of practice the child does not continue with it and appears to lack the will to follow up what was started. This behavior is typical of Erik Erikson's psychosocial development stage that deals with: a. Basic trust versus mistrust stage b. Autonomy versus doubt and shame stage c. Self-identity versus role diffusion stage d. Security versus instability

121. A client with a diagnosis of C6 cervical disc herniation secondary to forceful cervical flexion injury at work is seen in an outpatient rehab clinic. On examination by the OT, the client complains of pain, weakness, and paresthesia in their right UE. The MOST likely cause of the patient's right UE symptoms is: a. Double crush syndrome b. Cervical radiculopathy c. CTS d. TOS

123. The OT performs an ergonomic evaluation of an employee's computer workstation. One recommendation to the employee is to perform stretching of the extremities and back every 30-45 minutes. What category of ergonomic intervention is this an example of? a. Engineering control b. Work practice control c. Administrative control d. Rehabilitative control

125. A patient with a head injury demonstrates confusion and constant agitation. The OT intervention should focus on: a. Self-care skills b. Attention span and safety c. Sequencing and organizing tasks d. Functional transfers

126. A 54-year-old client sustained a work-related lateral epicondylitis in the right dominant UE. The OT assesses the work environment, including the client's ability to use a screwdriver frequently to assemble circuit boards. According to the OTPF, the component that is being assessed in this manner is the client's: a. Body function and body structure b. Activity demands c. Social routines and habits d. Sequencing and timing skills

127. The OT is trying to facilitate the appropriate finger grasp pattern of a child around 8-9 months of age by having the child trap a small cracker between the thumb IP joint and radial side of his flexed index finger. The therapist is working to facilitate the: a. Three-jaw chuck b. Inferior pincer grasp c. Radial digital grasp d. Raking grasp

128. An individual with a TBI has difficulty with auditory processing. When communicating with the individual, the OT should: a. Move to quiet environment b. Speak slowly c. Use visual cures d. Have person use a hearing aid

13. A child is participating in SI therapy. During the intervention session, the OT notices that the child does NOT become dizzy during a spinning activity. The OT discusses this with the child's mother and explains that the child is: a. Hyperresponsive b. Hyporesponsive c. Sensory defensive d. Gravitationally insecure

13. A client with a TBI is attending a work rehab program. The LTG is to have the patient resume work at a food processing plant handling the canning process. Overall strength and coordination are good, but the client exhibits occasional angry outbursts with other workers. The OT program should include: a. A program that stimulates the procedures for canning b. Prework hardening with emphasis on social interactions and work readiness c. Recommendations to physician for medication to help impulse control d. Recommendation for client to delay therapy until behavior is controlled

132. The OT is providing services to a child with spastic hemiplegia. The child demonstrates an associated grasp on the affected side when using the unaffected hand, thus making difficult for the child to engage in bilateral tasks. The child would like to take off their shoes. It is likely that the OT will suggest that the child: a. Sit on a chair with a high back and hold on to the chair with one hand while using a dressing hook to push off the shoes one at a time b. Sit on a low stool so that both of his feet are on the floor while holding onto the stool with both hands for support and pushing the child's shoes off one at time by digging the child's heel into the ground c. Lay supine on the child's bed and flex the child's hips and knees so that the child can reach his feet to pull off the shoes one at a time d. Sit on a chair and cross one leg over the other so that the child can reach down and remove each shoe one at a time

134. The OT is working with a child on reaching for toys. In order to prepare the child for reaching, the OT first facilitates dynamic weight bearing and weight shifting on elbows and hands. The OT intervention is MOST likely guided by the principles of: a. Biomechanical model b. NDT c. SI theory d. MOHO

136. An infant in the neonatal ICU is being transitioned from a nasogastric tube to a bottle for feeding. When presented with the bottle, the infant demonstrates aversive responses, such as arching away, crying, and grimacing. The OT is working to minimize the child's aversive response to oral-tactile stimuli. It is likely that to address this concern that the OT will: a. Modify the characteristics of the infant's food b. Provide graded tactile input c. Position the child in a position to support physiologic function d. Recommend supplemental feedings

14. A 4-year-old has been diagnosed with mental retardation. A characteristic that is likely to occur with impaired intellectual ability is: a. Acceptable social skills b. Impairment of occupational performance areas c. Development of bizarre attachment to unusual objects d. Poor eye contact

14. A patient recently experienced a nerve compress that caused the right dominant hand to become limp. Client factors affected are both sensory and motor, including no active wrist extension or forearm supination. Which activity would be the MOST difficult when attempting to use the right hand? a. Putting the arm in the sleeve of a shirt b. Using a toothbrush c. Donning a shirt overhead d. Putting on house slippers

14.The administrator at a hospital wants to start a lymphedema treatment program before a competitor hospital's program opens in 6 months. The OT director knows that the outpatient therapist has no training in lymphedema treatment but agrees to begin marketing and offering the services immediately. What principle of the AOTA Code of Ethics has the OT director violated? a. Beneficence b. Duties c. Fidelity d. Justice

140. An 8-year-old child is receiving OT to address functional bilateral hand skills. The child has a great deal of difficulty with refined movements. Before presenting the child with greater challenges, the OT will first engage the child in: a. Performing a two-dimensional art project b. Playing catch with a large inflatable beach ball c. Cutting out complex shapes d. Playing a video game with a handheld controller

142. A school-based OT is working with a student who has ASD. The child engages in sensory seeking behavior by crashing into the lockers while walking in the hallway. In order to support the student in adaptively responding to the environment before entering the hallway, the OT will likely provide the student with: a. Vestibular input in the form of swinging on a doorway swing in the classroom b. Proprioceptive input in the form of joint compression applied to UE and LE c. Tactile input in the form of finger painting d. Visual input in the form of a picture that explains where they are going in the school building

144. An OT is working with a 4-year-old on buttoning a series of 3 large buttons. The child is successful with unbuttoning and performing other tasks that require the same level of fine motor dexterity but continues to have difficulty buttoning. The OT may decide to further assess the child's: a. Pinch strength b. Perceptual abilities c. UE strength d. Sensory regulation skills

145. An OT is working with a Grade 4 student who has difficulty with handwriting. The child's work samples show that the child is unable to consistently write text within the writing guidelines. This is a problem with: a. Letter formation b. Alignment c. Spacing d. Near-point copying

148. As a home health therapist, you are treating a 55-year-old who has a very supportive spouse and a caregiver during the day who helps with self-care and other tasks needed in the home. The patient enjoys their children and grandchildren who live in the immediate area. The patient is currently in stage 3 of ALS, with severe weakness of the ankles, wrists, and hands. The patient minimally ambulates and fatigues easily. An appropriate intervention would be: a. Light strengthening program b. Help prioritize activities and provide work simplification c. Learning how to cook three-course meals d. Worksite assessment

15. A 3-year-old has accidentally ingested lead while playing near ceramic tiles that the family bought to renovate their house. A system that an OT working in pediatric acute care would note to be affected by lead poisoning would be: a. Vocal b. Circulatory c. Digestive d. Cardiac

15.An OTA called in sick for a week. The supervisor expresses concern to the new department manager and reports that 2 years ago this individual needed a 3-month leave of absence for treatment of severe depression. Which principle of the AOTA Code of Ethics has the OT supervisor violated? a. Autonomy b. Fidelity c. Nonmaleficence d. Veracity

152. Using an adaptive approach, one way to suggest for someone to modify the home for decreased acuity would be to: a. Use non-slip rugs b. Increase light while minimizing glare c. Notify neighbours of the problem d. Encourage driving cessation

153. You are working with a 70-year-old patient who sustained a left parietal stroke 10 months ago, and the family reports that they want the patient to see on the right side. The patient has just completed outpatient therapy at a nearby facility. You decide to use an adaptive approach and family education with this patient. An example of the strategies you may suggest include: a. Providing computer retraining so that the patient will learn to look to the right side b. Placing all necessary items on the right side of the patient c. Providing scanning worksheets that are placed in midline and cue the patient to make sure the patient looks to the right when completing the activity d. Placing the TV remote control consistently on the patient's right side

156. You are treating a 20-year-old patient who sustained a brain injury 10 months ago. The patient recently moved into a group home and is learning to regain independence. In therapy, the patient recently achieved the goal of doing laundry independently. When the patient returned to therapy, the patient reported that the patient was unable to complete her laundry at the group home. This would be called difficulty with: a. Social skills b. Generalization c. Sequencing d. Attention

157. You have been referred a 32-year-old parent of 2 young children who has been recently diagnosed for multiple sclerosis. Your evaluation reveals that the patient's performance skills of motor control and cognition are all within normal limits. Education of the patient should include: a. End of life issues b. Energy conservation c. Memory strategies d. Bathroom modification ideas

16.An OTA in a long-term care facility forgot to renew the OTA license and informed the facility administrator. The admin told the OTA that getting the license renewed wasn't necessary because the OTA had current certification from NBCOT. Although the OTA had always renewed the license at a previous job, the OTA did not do it this time. Which principle of the AOTA Code of Ethics did the OTA violate? a. Duties b. Justice c. Nonmaleficence d. Veracity

160. You are working with a 53-year-old client who has had a right CVA. The patient is lying on a therapy mat and you are performing PROM to her left arm. Once you have the patient's arm in 90 degrees of flexion, the patient complains of some discomfort and pain. The BEST course of action would be: a. Continue as tolerated, because PROM must be maintained b. Begin the ROM again and make sure the scapula is gliding c. Continue and do not go past the point of pain d. Consult an orthopaedic specialist

161. A patient with a C5 SCI has been admitted to the inpatient rehab unit for therapy. To teach self-feeding, the OT might use adaptive equipment such as: a. Built-up handle utensils b. A mobile arm support c. Dynamic tendonesis splints d. Short opponens splints

161. During an interview with the caregiver of a 6-month-old, the OT is told that the infant is right-hand dominant. Based on this information, the OT concludes that: a. The child's development may be advanced. b. The child's hand dominance may be indicative of CNS dysfunction. c. The caregiver may only be presenting toys to the right of the child. d. The child sleeps in the prone position.

167. A 65-year-old client has sustained a mild left CVA. You are currently seeing the client on the inpatient rehab unit. The client is independent with all self-care and basic ADLs. The client desires to go home and live alone. The BEST evaluation tool to use in this situation is: a. Barthel Index b. The Kohlman Evaluation of Living Skills c. FIM d. Functional Test for the Hemiparetic Upper Extremity

168. An 8-year-old exhibits hyperextension of the trunk and neck and has a tonic bite. A strategy that would promote improved oral motor control during feeding would be: a. Seating him in a beanbag chair for feeding b. Using a spoon to create downward pressure on the center of his tongue c. Using a bolster under his arms for support d. Applying touch pressure on his cheeks

168. You are evaluating a 25-year-old client who has sustained a brain injury from a MVA. During your motor evaluation of the elbow the client demonstrates nonvoluntary repetitive contractions of the biceps. This is described as: a. Synergy b. Clonus c. Flaccidity d. Spinal hypertonia

17. A 50-year-old patient with a chronic pain condition is receiving OT for 2 weeks. The patient's complaints include diminished participation in community activities and socialization and difficulty with some home management tasks. A primary focus of the OT intervention plan should be: a. Management of the pain medication b. Improving patient means of coping and adapting c. Elimination of pain to participate in social and community activities d. Teaching biofeedback techniques

17.An OT walks into a patient's room and finds the patient lying on the floor next to the bed. The OT has been previously reprimanded for forgetting to put the bed rails up after treatment. After checking to be sure the patient has no broken bones and is not in severe pain, the therapist helps the patient back into bed, then leaves the room without reporting the incident. Which terms BEST describe the OT's conduct? a. Legal and ethical b. Legal but unethical c. Ethical but illegal d. Illegal and unethical

170. A 5-year-old child with neuromuscular dystrophy is undergoing OT. While dressing the child is extremely impatient and gets discouraged when not able to dress correctly. An intervention approach that could be used is: a. Restore approach b. Backward chaining c. Forward chaining d. Adaptatory approach

175. The following performance skill deficit may be seen after a SCI: a. Aphasia b. Clonus c. Agnosia d. Apraxia

179. You are evaluating a 67-year-old patient who had a stroke 3 weeks ago, and this is your fourth day of therapy in the patient's room. The patient has begun ambulating with hand hold assist during ambulation to the bathroom; the patient is unable to find the bathroom located in the room. This would be an example of: a. Lack of orientation b. Topographical disorientation c. Visual field cut d. Homonymous hemianopsia

18. A 5-year-old child has been diagnosed with a pervasive disorder that affects both the neurologic and motor behavioural functions. The diagnosis that MOST closely relates to the child's condition is: a. Respiratory distress syndrome b. Tourette's syndrome c. Asperger's syndrome d. Learning disabilities

18. A child with ADHD and sensory modulation dysfunction is being treated in OT using a SI approach. An intervention strategy that is used to improve his ability to attend in the classroom would be: a. Using occupation as means b. Modifying the environment c. Therapeutic use of self d. Group work

182. An 18-month-old with arthrogryposis is alert, sensitive, and very eager to explore the environment. The therapy team wants to use a mobility device that allows the child to be in an upright, hands-free, weightbearing position, while providing AROM. Because the child will be moving about inside a small apartment, an important requirement is that the device allows for a high degree of maneuverability. A mobility device that would be MOST suitable for this child would be: a. The aeroplane mobility device b. The Transitional Ortho-Therapeutic Walker (TOTWalker) c. The ABLER, a mobile stander d. Crocodile posterior walker

183. A 5-year-old with moderate spastic diplegia uses a push walker, but the OT has recommended a manual wheelchair for mobility in the school and community. A feature that would allow for independent transfer in and out of the chair would be: a. Large front tires b. Wheel locks c. Higher seat height d. Increased height of push handles

183. Characteristics of PDD are: a. Normal sensory processing b. Restricted, repetitive patterns of behavior, interests, and activities c. Pervasive long-standing feelings of uneasiness d. Difficulty with selective or sustained attention to tasks

189. A 7-year-old needs augmentative mobility. The OT has identified the child as a "marginal ambulatory." The condition that this describes is: a. A progressive neuromuscular disorder b. Cerebral palsy with less involvement c. Osteogenesis imperfecta d. Spinal muscular atrophy type I

189. A bipolar I patient with manic symptoms has been on your unit many times. You know that this patient is fond of you, but this time shocks you by greeting you with a confession of love and a marriage proposal. Which of the following would be your BEST response? a. Tell the patient that it is a ridiculous thing to say and you'll have the nurse prescribe more medication b. Tell the patient that, of course, you are flattered, but that your role is to work together in OT and it is extremely important that you maintain a professional relationship in order to provide the best quality of care c. Let the patient know that you do think that the patient is "kind of cute" and maybe something can be worked out after they leave the hospital d. Tell the patient that it is inappropriate behavior, which must top immediately

192. A preterm new-born has been diagnosed to have moderate meconium aspiration syndrome (MAS), inadequate oxygenation, and a depressed respiratory drive. Equipment that could be used for oxygen therapy with assisted ventilation would be: a. Bag and mask ventilation b. Mechanical ventilation c. Continuous positive air pressure (CPAP) d. Extracorporeal membrane oxygenation (ECMO)

193. A visual problem a child with juvenile diabetes is likely to develop is: a. Glaucoma b. Cataract c. Amblyopia d. Myopia

193. Which of the following statements is true for the Cognitive Disabilities FOR? a. Patients can learn new skills to improve their performance of tasks b. Making environmental changes can enhance a client's performance c. A person's measured cognitive level can fluctuate greatly d. It is only useful with the chronically mentally ill

194. A 4-year-old has a common pediatric eye disorder, which is blurred vision and external strabismus because the eyeball is too long. The disorder must be corrected with lenses or it can have a significant impact on development. This disorder is: a. Hyperopia b. Myopia c. Astigmatism d. Coloboma

194. When applying a Psychoanalytic FOR perspective to mental health OT intervention: a. Psychopathology is believed to be the result of faulty learning. b. Occupation can be used to uncover unconscious drives and feelings. c. Cognitive functioning is the result of a physical or chemical dysfunction in the brain. d. The environment must be adapted to positively impact the patient's functioning.

196. Systematic desensitization and exposure techniques used with phobic patients stem from which framework? a. Developmental FOR b. Behavioural FOR c. MOHO d. Psychoanalytical FOR

197. A 3-year-old child has a hearing impairment. This is caused by meningitis after birth, which resulted in damage to the innermost hair cells of the cochlea. The child misses vowel sounds but hears many consonants. Voices sound weak and thin, but they are understandable if the child is close enough to the speaker. A description of this hearing loss would be: a. High-frequency loss b. Low-frequency loss c. Flat loss d. Total loss

198. You are treating an adult patient in your clinic using a psychoanalytical approach. The activity that would be MOST useful to you is: a. A leather cigarette case kit b. Pottery clay c. A Monopoly game d. A pre-cut wooden key rack

20.An OT manager must prepare a capital budget to request a piece of equipment. The item that would MOST likely be listed in this budget is: a. Dynamometer b. Fluido-therapy machine c. An office chair d. Splinting materials

200. An OT client is experiencing extensive occupational dysfunction caused by HIV and depression. The patient reports a loss of interest in most activities, including self-care and leisure, and has a limited tolerance for any physical activity. You suspect that this is partially because of decreased self-worth and fear of failure. The BEST activities to use in initial treatment interventions might include which of the following? a. Leading group exercises each morning on the unit b. ADL practice and expressive arts c. Communication groups d. Assertiveness training

203. You are leading a group on an inpatient and your patients are mostly young schizophrenics. Attention to tasks is short and they need constant redirection to participate effectively. Which kind of group would MOST appropriately meet their needs? a. Psychoeducational b. Current events with a directive format c. Self-esteem building d. Leather crafts

205. In a behavioural approach to mental health evaluation and treatment: a. The focus is on the past and what made the person misbehave b. Maladaptive behaviors are considered the result of faulty learning c. Projective techniques are commonly used d. The focus is on adapting the environment to support best performance

206. You have a 17-year-old in your group who begins to act out and verbally threaten others. You've given the patient several warnings to discontinue this behavior and they have been ignored. The BEST thing to do next would be: a. Call security and have the client physically removed from the group b. Ask the client to leave the group and tell the client that if the client complies you will meet with the client later to discuss the situation c. Demand that the client discontinue the client's behavior and threaten the client with removal d. Take all the other patients out of the room and then confront the client alone

206. You've decided to use projective techniques in evaluating your patients. It is important to: a. Start interpreting their responses in the middle of the session b. Get validation from the patient for any information that the process elicits c. Use the techniques in a large, open group setting d. Run and share your interpretations with the doctor as soon as the patient finishes the task

207. Mentally healthy people: a. Should be able to think, feel, and act anyway that they want b. Have the psychological make-up to realize their goals c. Have never experienced stress in their lives d. Know how to manipulate people to get their needs met

209. A 35-year-old fire fighter is admitted to the hospital with severe burns. The patient experiences changes in cognition within a few hours of admission. The patient is confused, disoriented, and having problems focusing their attention. You realize that the patient is probably suffering from: a. Amnesia b. Delirium c. Dementia d. Alzheimer's

21. Evidence-based practice is the determination of intervention strategies based on: a. Extant research findings b. Research findings, the OT's own experiences, and family priorities c. An OT's expert opinion d. Other disciplines' practice

211. A patient that you are seeing has come to you with a diagnosis of borderline personality disorder. The axis that you would find noted in this patient's chart is: a. Axis I b. Axis II c. Axis IV d. Axis V

211. The OT is providing intervention for a patient with a right radial nerve compression. The MOST immediate action to take is to: a. Teach alternative methods for self-feeding b. Provide a dynamic splint for wrist drop c. Teach ROM to prevent muscle tightness d. Provide a forearm sling to prevent wrist drop

212. A disease of the nervous system (not the brain) would be reported under this axis: a. Axis I b. Axis III c. Axis IV d. Axis V

213. A patient that has been admitted to your unit has an Axis I diagnosis of dysthymic disorder. You note from previous admissions that the patient 42 also has intellectual disabilities. The axis that the patient's mental retardation is listed under is: a. Axis I b. Axis II c. Axis III d. Axis IV

217. The OT needs to perform a dependent transfer with a person who is too weak to move independently. The BEST technique is to: a. Stand in front of the person and encourage standing upright, then pivoting to the side b. Use one person technique by standing in front of the person and placing them in a forward flexed position c. Ask another OT to assist; both will secure the patient under the arms and will pull into a standing position d. Secure a transfer belt around the individual and pull to stand

218. A patient with chronic back pain is also a mechanic and needs to be able to perform the job as it provides the only household income. What is the MOST important compensatory strategy the OT should include when advising about occupational performance? a. When in pain, sit to perform major tasks b. Reinforce body mechanics and pacing of work c. Work during the periods when pain has subsided d. Use adaptive equipment to minimize stress to joints

22.The new OTA in a large university medical center has 3 years of experience in a small community outpatient clinic that served adults only. Which BEST describes the appropriate level of supervision that the OT should provide? a. Close supervision on all units b. Close supervision in special units such as intensive care and routine supervision on other units c. Routine supervision on all units d. Routine supervision for adult patients and close supervision for pediatric patients

221. A college student just relocated to begin a degree program. Two weeks before the patient left home, the patient's significant other of 3 years broke up with them. The patient always thought that they would get married after they graduated. After an intense orientation day for the patient's new school, the patient is found sitting on the floor of their dorm, sobbing uncontrollably, and expressing thoughts of worthlessness and suicidality. Which of the following would be found in the patient's Axis I? a. Posttraumatic stress disorder b. Major depression, single episode c. Life changes; move for college and breakup with significant other d. Schizophrenia

221. A patient in a wheelchair exhibits moderate postural instability and weakness in the trunk and shoulders but has fair to good hand skills. To encourage bilateral UE use the OT should: a. Place lateral supports in the wheelchair b. Attach a lapboard to the wheelchair c. Use a head harness to hold patient upright d. Recline the back of the wheelchair

222. A patient with intention tremors is having difficulty with grooming activities. To promote functional performance, the OT should incorporate: a. Using long handles on equipment used for grooming b. Using weighted cuffs on wrists while performing grooming tasks c. Sitting at a table to perform the grooming tasks d. Having patient take medication prior to engaging in the activity

222. There is an abrupt change in a client's occupational functioning. The client is suddenly unable to walk and reports no feeling from the waist down. Testing identifies no neurologic or orthopaedic reason for these symptoms. This is an example of: a. Tactile hallucinations b. Conversion symptoms c. Magical thinking d. Delusions of grandeur

224. The BEST strategy to use with a contracted joint that has a soft end field is to: a. Perform tendon gliding exercises b. Apply low load long duration stretch c. Use a quick stretch technique d. Perform active ROM

229. Which activities should the OT incorporate as interventions for a client with visual acuity problems? a. Racking horizontally and vertically b. Contrasting of bright, bold colors with a background c. Verbal cues to attend to the neglected side d. Tracing letter and number with the tips of the fingers

231. The OT is asked to perform a home assessment for an individual prior to discharge from skilled nursing care. The initial step in the process is: a. Interview family members and friends who may take part in the individual's care b. Identify the roles and occupational tasks the individual will be performing c. Identify obstacles that would interfere with easy mobilization and access to the home d. Access mobility issues that may interfere with the individual's occupational performance

231. Which of the following approaches might the OT use for sensory reeducation of a person following peripheral nerve injury? a. Applying pressure and performing massage b. Object recognition, manipulation, and localization c. Alternately using heat and cold d. Using vision as compensation for deficits

235. An OT is training a patient in the principles of joint protection techniques before they are discharged. Education would focus on: a. Massaging a joint before exercise b. Using the strongest joints and avoiding positions of deformity c. Practicing vivid imagery and relaxation during difficult activities d. Applying heat before treatment and cold after ROM

235. The OT receives a referral to treat a 45-year-old patient diagnosed with lung CA that has metastasized to the brain. The physician asked that the patient be seen that day because the patient is scheduled to receive radiation treatment in the afternoon. When the therapist approaches the patient, they refuse to be seen because insurance coverage has run out and the patient cannot afford to pay for treatment. Responding consistently with the Code of Ethics, the OT will MOST likely: a. Treat the patient per the physician order and notify the nurse of the situation b. Not treat the patient based on the refusal and document interaction in the chart c. Treat the patient but do not charge or document the service provision d. Not treat the patient but charge for the time spent reviewing medical records

236. A patient in an automobile accident sustained an amputation of the right ring finger at the PIP joint. The patient complains of shocking pain when the finger touches most items and is concerned about returning to their job as an administrative secretary where more than 50% of the work involves typing on a computer. For the early phase of sensory reeducation, the OT should: a. Apply stimuli using light moving stroke to the affected area b. Use graded items including coarse to soft touch c. Wrap the digit in a light-weighted material or gauze d. Immerse the affected hand in a container of rice with various textured items

236. An important FIRST step to perform for a patient who is in need of a program for dysphagia is to examine: a. Ability to bring food to the mouth for self-feeding b. Oral and pharyngeal control, motion and sensation c. Which texture of food will work best for eating d. The type of adaptive utensil to use

237. A patient can perform self-feeding with regular utensils. However, meal time must be monitored because of frequent coughing and fear of choking. Which is the BEST example of a statement that would document the patient's needs at mealtime? a. Patient requires minimal assist with self-feeding. b. Patient must be supervised during meals. c. Patient requires moderate assistance in self-feeding. d. Patient is dependent on caregiver for meals.

239. Before providing intervention, the OT must establish baseline data on the individual's level of endurance. An objective method to measure endurance is: a. Asking the patient to rate the level of fatigue on a scale of 1-10 b. The number of repetition of an activity per unit of time c. Using clinical observation to note change in rate of response d. Taking blood pressure before and after an activity

239. The OT is instructing a patient with severe pulmonary condition in modifications of self-care skills. In order to monitor endurance for these basic activities, the OT should: a. Take the client's blood pressure often during the treatment session b. Have the patient rest every few minutes c. Stop the activity every few minutes, and have the client rate their level of fatigue d. Observe the breathing pattern of the patient while performing the activity

24.Which statement is NOT true regarding Medicare Home Health regulations? a. A client must need skilled nursing, PT, and/or speech-language pathology services before receiving OT services. b. OT must discharge the client from services when all other services are ended. c. Most home healthcare services are provided under Part A. d. Home health agencies are paid a single rate for each 60 days of services, with higher rates being possible if a specific level of therapy is provided.

243. During treatment, what approach should be the OT follow when working with an individual that has a history of orthostatic hypotension? a. Keep the individual in a sitting position during therapy b. Assist the individual in slowly changing positions c. Place the individual in a reclined position during therapy d. In therapy, alternate between period of work and rest

243. In testing for a patient's ability to identify numbers or letters by tracing shapes on the surface of the skin, the therapist is assessing: a. Stereognosis b. Graphesthesia c. Form constancy d. Visual closure

247. The OT completes an occupational profile on a 16-year-old with juvenile RA. Using scientific reasoning, the NEXT step in the process is: a. Identify goals and concerns of the client b. Administer a functional motion assessment c. Develop treatment goals and timelines d. Identify activities for intervention

248. The OT administered a visual perceptual assessment tool to a patient with Bell's palsy degeneration at the beginning of therapy prior to the family-rehab team meeting. Administering an assessment tool in this fashion measures: a. Inter-rater reliability b. Test-retest reliability c. Standard error of measurement d. Central tendency

251. Which of the following would MOST likely be part of an OT wellness and prevention program for older persons? a. ADL training b. Leisure planning education c. Education in effective communication with co-workers d. Reminiscence groups

255. A patient with a diagnosis of agnosia should be assessed in the area of: a. Motor apraxia b. Visual and tactile perception c. Swallowing d. Postural control

258. During an interview, the OT discovers that a 77-year-old client is having difficulty recalling tasks that they need to perform while engaging in their volunteer work. Based on this information, the assessment should include the: a. Kohlman Evaluation of Living Skills b. ACL c. Role checklist d. Interest checklist

259. A new patient has just been brought to the psychiatric unit and you cannot understand anything the patient is saying. Every 5th word that the patient speaks seems to be in English. Your NEXT step would be: a. Find an interpreter that can translate b. Go back to the patient's chart and see if there are any notations addressing this behavior c. Give the patient a craft project to do and see how the patient performs d. Discharge the patient from your caseload, because you cannot help

259. In working with individuals who have been burned, the OT's role would be limited to: a. Treating wounds and avoiding contractures b. Evaluating any deficits in occupational performance, including psychosocial issues, and providing intervention that meets the patient's current occupational needs c. Fitting burn garments and maintaining ROM d. ROM and splinting as needed

26. A 3-year-old child has demonstrated delayed reflexes and locomotor skills and cannot grasp objects properly. The child trembles while walking and can't maintain balance. The therapist working with the child needs to obtain T scores and Z scores along with Developmental Motor Quotient scores. A test that would allow a therapist to obtain scores is: a. Bayley Scales of Infant Development - II (BDSI-II) b. Peabody Developmental Motor Scales - 2 (PDMS-2) c. Bruininks-Oseretsky Test of Motor Proficiency (BOTMP) d. Pediatric Evaluation of Disability Inventory (PEDI)

26.As healthcare costs escalate, healthcare providers and third-party payers work to develop systems to contain costs. The various payment models shift the risk between the provider and the payer. Which statement is NOT true? a. In a fee-for-service system the payer has the risk because it must pay all covered costs. b. In capitation the payer has the risk because many enrollees might receive service in the same month. c. In a prospective system the provider has the risk because costs might exceed payment. d. In a fee-for-service system the payer can cut costs by negotiating rates.

260. A 21-year-old patient was admitted following a suicide attempt. In your first convo the patient expresses some worry over missing their college classes while in the hospital. The BEST next step for you is to: a. Contact the patient's teachers to let them know that the patient is in a psychiatric hospital b. Encourage the student to contact the teachers and inform them about class attendance c. Call the patient's parents and have them call the patient's teachers to tell them that the patient is in the psychiatric hospital, so that you do not break confidentiality d. Tell the patient to withdraw from the patient's classes to get rid of the stress

262. An elderly client has been bought to your unit for evaluation. The client has obvious cognitive deficits that impair social and occupational functioning. The client's child tells the team that these problems have been developing gradually over a long period of time, and that the client just continues to get worse. You suspect: a. A head injury b. Alzheimer's c. Major depression d. Substance-induced amnestic disorder

264. Which of the following is the BEST example of grading an activity to provide the "just right" challenge for a student receiving school-based OT? a. The OT recommends that the classroom teacher provide the student with a copy of materials that are to be copied from the board to accommodate for visual perceptual difficulties. b. The OT holds a cut and paste worksheet vertically to encourage the student to obtain wrist extension when cutting with scissors, enabling the student to better cut along a line. c. The OT provides a pencil grip to cue the student to use a functional grasp for writing and drawing tasks. d. The OT adapts a student's classroom seating to support better posture.

267. An OT using relaxation training would MOST likely be addressing person with: a. Manic-depressive disorder b. Depression c. Schizophrenia d. Anxiety

268. You are trying to interview a client, but the client constantly changes the subject and it seems that a single word can trigger the client's conversation to take an entirely new direction. This behavior is known as: a. Confusion b. Flight of ideas c. Psychosis d. Delusions

269. Which of the following would be the MOST appropriate activity to encourage development of in-hand manipulation skills? a. Placing small pegs in a pegboard b. Rotating a pencil in one hand to erase c. Using a key to open a lock d. Placing pegs in a pegboard

27. A 60-year-old patient with OA is receiving home health services. The patient informs the OT about plans to meet friends for dinner on the upcoming weekend at a local restaurant to try out the adapted eating utensils. Based on the patient's action, the OT should: a. Meet the patient at the restaurant to ensure proper use of adapted equipment b. Discharge the patient for OT services c. Set more advance goals related to community mobility, such as grocery shopping d. Advise the patient to wait until other goals are met in therapy

27. What role do nurses play in early intervention for children? a. Providing educational materials on augmentative communication and mobility equipment b. Screening and assessing the psychologic, physiologic, and developmental characteristics of the child and family c. Providing treatment to increase joint function, muscle strength, mobility, and endurance d. Provide social skills training for the child as is appropriate

271. A patient on an inpatient psychiatric unit has to be watched closely because they tend to drink water excessively. In fact, the patient has been known to turn the water on in the shower and place their mouth under the faucet to drink. This type of behavior is associated with a condition called: a. Polycytosis b. Polydipsia c. Polymyalgia d. Hyperemesis

272. You have been asked to see a profoundly mentally handicapped individual for OT services. You can expect that the client will be: a. Able to feed and dress independently b. Dependent on others for personal care c. Able to carry on simple conversations using complex sentences d. Able to complete household chore with minimal assist

277. If a school-based OT is interested in evaluating the amount of assistance a middle school student requires and their performance for tasks, such as eating and drinking, clothing management, and written work, the MOST appropriate assessment would be: a. Adolescent/Adult Sensory Profile b. School Function Assessment c. Bruininks-Oscretsky Test of Motor Proficiency d. FIM for Children

28.When completing the budget variance each month, the OT director must explain why actual expenses were greater or lower than budgeted expenses. Which of the following items in the variance report is an operating/indirect expense, as opposed to a direct expense? a. Salary for therapists b. Phone bill c. Medical/surgical supplies (splinting material) d. Storeroom supplies (lymphedema bandages and electrodes)

281. You are evaluating a 55-year-old patient with ALS who is nonambulatory (now using a power wheelchair) and has significant arm weakness. At this time the patient's deficit areas are limited to lower motor neuron deficits. An area of occupation that should be addressed is: a. Dressing b. Feeding c. Health management and maintenance d. Care of pets

29.The OT director is preparing the operating and capital budget for next fiscal year. There are several items needed for the OT department. Which of these items is NOT a capital expense? a. Fluidotherapy machine to replace old one ($4500) b. 2 new pediatric assessment kits ($400 each) c. Large splint pan ($750) d. Refrigerator for ADL kitchen ($900)

30. A 6-year-old has some difficulty taking part in group activities with friends at school. An explanation of this child's behavior using the dynamic systems approach would be: a. Learns and develops certain skills by observing the behavior of others b. Functional performance would depend on the interactions of the child's inherent and emerging skills, the characteristics of the desired task or activity, and the environment in which the activity is performed c. Develops a system by which to extract information from the environment and interpret the information d. Organizes a behavioural response such as a motor skill

30.The new pediatric clinic had net revenue of $400,000 last year and expenses of $370,000. What was the profit margin for the clinic? a. 5% b. 7.5% c. 12% d. 25%

32. An 8-year-old with sensory processing problems has been referred to the school-based OT. The child is sensory-seeking and active in the classroom by hitting and biting other children. The child does not seem aware that these behaviors are socially inappropriate. Deep pressure helps the child focus up to at least 10 minutes. The BEST method from the coping model to assist the child with coping and developing peer relations in the classroom would be: a. Allow the child unsupervised interaction with their peers, where they feels less pressured and would likely develop peer relations with students in the second-grade classroom. b. Reorganize material and people around the child to allow the child to focus better on the activity at hand. Personal social skills may be emphasized by practice of social skills in the context of games with peers. Timely, positive, and explicit feedback to the child's coping efforts helps the child experience a sense of mastery. c. Create an environment for artistic development by providing the child with colors, paper, clay, and toys that bring out the child's creativity. d. Provide bouncing on a physioball and swinging from a platform covered with cushioning.

33. A grasp that is often used to control tools or other objects is: a. Hook grasp b. Power grasp c. Lateral pinch d. Tip pinch

33. An appropriate sensorimotor activity for an infant of age up to 6 months is: a. Sitting erect and unsupported for several minutes b. Rolling sequentially to progress across the room c. Crawling forward d. Pulling to stand

34. The grasp a 5-year-old child uses to firmly hold a pencil to write/draw is a: a. Static tripod grasp b. Dynamic tripod grasp c. Pincer grasp d. Radial digital grasp

34.State regulatory agencies often require OT practitioners to provide proof of continuing competence when renewing licensure, registration, or certification. What evidence is MOST often used to demonstrate continuing competence? a. Certification of moral character b. Continuing education credits c. NBCOT certification d. Absence of any disciplinary action

35. The biomechanical FOR is MOST likely to be used in assessing and intervening for hand skills problems in children with: a. Motor planning difficulties b. Limitations in ROM, strength, or endurance c. Tactile and/or proprioceptive sensory problems d. Postural tone and coordination problems

35. To evaluate the proper fit of a splint given to a patient, the OT should: a. Instruct the patient to return to the rehab facility if any redness occurs b. Observe for signs of redness after 20 minutes of wearing the splint c. Use a splint pattern to custom make the splint for the patient d. Observe for pressure marks after 24 hours of wearing the splint

36.Which of the following is considered an emerging practice area for OT? a. Hand therapy b. Functional capacity evaluations c. Ergonomic consulting d. School system pediatric

37. A 5-year-old has special needs that make it difficult for the child to participate in community activities with other children. The child's parents are concerned that they are the only socialization agents for the child, because community social activities simply do not accommodate their child. Most social interactions are with adults, and the child has never really interacted with peers or made friends. This is a source of great stress for the parents. A coping strategy that the OT could suggest is: a. Participate in recreational and leisure activities that will expose the child to environments other than the house or school b. Develop friendships with other parents in a similar situation and form part of a support group c. Discuss alternative strategies with the OT that will help the child perform daily living activities with greater skill and independence d. Discuss with the OT the various professional services that are available

37.A main objective of writing a business plan is to: a. Market the business to potential customers b. Share critical business information with decision makers c. Establish departmental policies and procedures d. Grow the business over a specified period of time

38. A 4 ½-year-old child is diagnosed with dyskinetic CP. The OT treating the child needs to assess the child in order to design an appropriate intervention program. Which of the following standardized tests should the OT administer? a. School Function Assessment (SFA) b. Gross Motor Function Measure (GMFM) c. Sensory Integration and Praxis Tests (SIPT) d. Miller Assessment for Preschoolers (MAP)

39.The hospital administrator is concerned about numerous billing errors in the outpatient rehab department. A new OT manager has been hired and charged by the hospital administrator to review and correct the billing processes. An initial step to rectify this situation would be to: a. Educate the staff to assign proper ICD codes to patients when admitted b. Educate the staff to assign proper Current Procedural Terminology (CPT) codes to patients when charging for evaluations and treatments c. Ensure that the stuff is reaching productivity standards by reviewing policies and procedures d. Teach the billing clerk how to catch and rectify mistakes in billing that are made by the staff

40. An OT is doing a job match search for an injured worker whose functional capacity evaluation recommended "sedentary work" as defined by the Dictionary of Occupational Titles. Which job requirements BEST reflect sedentary work? a. Exerting up to 5 lbs. of force frequently; no walking or standing. b. Exerting up to 10 lbs. of force occasionally; walking and standing occasionally. c. Exerting up to 15 lbs. of force occasionally; 10 lbs. of force frequently; 5 lbs. of force constantly. d. Exerting up to 20 lbs. of force rarely; standing and walking <50% of the day

41. A 5-year-old child exhibits left spastic hemiplegia, associated increased tone, forearm pronation, and fisting during stressful activities. With the left hand, the child is able to use a palmar grasp and rarely uses this hand as a stabilizer in bilateral activities. The child also has difficulty completing in-hand manipulation activities with the right hand as the only in-hand manipulation skills, but is able to consistently use finger to palm translation and palm to finger translation. Which of the following types of hand skill activities are MOST likely to be appropriate for intervention at this time? a. Pincer grasp with the left hand b. Stabilization of objects with grasp with the left hand c. Complex rotation with stabilization skills d. Simultaneous bilateral manipulation skills

42. A tendency to generate responses that are appropriately graded in relation to incoming sensory stimuli, rather than underreacting or overreacting to them, is called: a. Sensory registration b. Sensory modulation c. Sensation seeking d. Sensory discrimination

42. The owner of Acme Factory consulted an OT for advice on where to place the safety off switch on a new machine. The owner wants it to be as high as possible. The employees are predominantly men and range in height from 5-6 ft. tall. What is an appropriate height for the button that will be accessible to all employees? a. 60 inches from ground b. 70 inches from ground c. 80 inches from ground d. 90 inches from ground

42.An OT is the new director of a comprehensive rehab facility. As the director, the OT leads a group of OTs, OTAs, PTs, PTAs, speech language pathologists, and therapy aides. Within the first week on the job, the director becomes aware of the fact that therapy aides perform multiple tasks including patient transporting, setting up and cleaning the treatment area, and conducting therapy groups without routine supervision. The director knows that such action is in violation of the state's OT Practice Act. The BEST course of action by the new director is: a. Nothing, because the facility's chief operating officer reported that the facility has operated in this manner for the past 5 years b. Review the practice act with your staff and require full compliance with state regulations c. Contact the facility's administration and lodge a complaint d. Allow the aides to continue with present job duties and require therapists to provide close supervision during therapy groups

44. To promote visual tracking for a preschooler who has poor tracking skills, which recommendation is the MOST appropriate for the OT to make to the parents for a home program? a. Throwing and catching a ball b. Catching and bursting soap bubbles c. Playing softball d. Tossing and catching water balloons

45. Which of the following intervention strategies would you choose to use with children who possess basic in-hand manipulation skills but need to improve them? a. Encourage the child to manipulate objects between the two hands b. Provide verbal cueing and/or demonstration of skills c. Use materials to promote complex rotation with stabilization skills d. Use support surfaces to assist in object manipulati

46. An 8-year-old tries to avoid reading lessons, is restless in the classroom, and when admonished complains of tired eyes. When made to read, the child often makes mistakes, such as reading "was" for "saw," and makes errors in copying from the blackboard and exhibits poor spelling. The probable cause is: a. Impairment of topographic orientation b. Spatial vision problem c. Impairment of figure ground distinction d. Visual discrimination problems

47. An 18-month-old was diagnosed with SI dysfunction. The child is undergoing OT as well as speech therapy for speech delays. The child's parents are eager to know the length of time required to cure their child. How would an OT address their concern? a. Give them a tentative time period based on the severity of the problem b. Tell them that OT aims at improving the SI functions and the quality of life of a child c. Tell them that it is impossible to give a fixed time period d. Tell them the child will never be cured

48. A 5-year-old displays disorganized behavior. The child's mother says that the child is not spontaneous during play or school activities. For example, the child has trouble completing a simple puzzle and when left alone wanders aimlessly. The child's peers say the child is slow. Which of the following BEST describes such behavior? a. He is clumsy and awkward. b. He has dyspraxia. c. He has somatodyspraxia. d. He has difficulty in bilateral integration and sequencing.

48. Goals for children in school should be written in terms of classroom behaviors needed for academic performance. Which is an example of a goal reflecting this thinking? a. The student will maintain prone extension posture over a therapy ball in 2 out of 3 trials by the end of the grading period. b. When engaged in written assignments in class, the student will maintain an upright sitting posture without verbal cues in 2 of 3 observations. c. The student will point to all lowercase ms on a candy wrapper within 5 minutes in 2 out of 3 trials. d. To increase UE strength, the student will lift 2 lbs. weights with 10 repetitions bilaterally in 2 out of 3 trials.

49. A 2-year-old is reported by a parent as being shy and passive. The child does not show much enthusiasm for doing new things, playing with children, interacting with family, or going to new places. As the OT, the FIRST step would be to identify the child's temperament style before beginning to plan your intervention strategy. The temperament style that BEST describes this child is: a. Easy child b. Slow to warm up child c. Difficult child d. Forward child

49. A client diagnosed with a wrist sprain is referred to OT for a splint to promote rest but also to allow hand use. The OT would most likely fabricate a splint so that the: a. Hand is posed in a functional position b. Palmar bar is proximal to the distal palmar crease c. Palmar bar is distal to the distal palmar crease d. Width is less than one-half the circumference of the forearm

49. A community outing of bowling is planned for a group of elderly patients from a day care center. Neuromuscular factors that the OT must consider before engaging in the activity are: a. Cognition and ability to follow instructions b. Strength, coordination, and endurance c. Attention span and hearing ability d. Visual scanning and tracking

51. A 7-year-old child is being evaluated by an OT for learning disabilities. The therapist observed that the child acts before thinking, often forgets things, and sometimes leaves schoolwork unfinished. When engaged in an activity the child continuously tries to redirect. The diagnosis that BEST describes the behavior tries to redirect. The diagnosis that BEST describes the behavior is: a. OCD b. ADHD c. PDD d. Childhood conduct disorder

55. A 50-year-old patient with a crush injury to the right dominant hand has severe pitting edema. The BEST technique for the OT to use for splinting is: a. To provide a standard resting hand splint that promotes finger thumb opposition b. To place extremity in a functional position and use a wide bandage to hold splint in place c. To use a dynamic splint that allows periodic controlled motion of the involved extremity d. To provide an antispasticity hand splint and use wide straps to hold splint in place

56. The OT is providing services in the school system and is asked to provide consultation to a teacher who has a student with a hearing impairment in the classroom. The teacher knows that the child can lip read and consults with the OT in preparation for the student. After listening to the teacher's concerns, the OT provides some recommendations. One recommendation the OT might make to the teacher is to: a. Limit the amount of verbal interactions between the teacher and the student b. Avoid standing in front of the window while conducting a lesson c. Exaggerate mouth movements when speaking to the student d. Seat the child in the back of the classroom

57.At a skilled nursing facility, a team of rehab professionals has received orders for therapy to assess function, gait, transfers, and bed mobility. In addition to the OT, other member of the professional team should include the: a. Orthopaedic doctor and PT b. PT and nursing staff c. PT and chaplain d. Speech therapy and nursing staff

6. A child being treated in OT cries and becomes upset whenever it is touched lightly or unexpectedly. The OT recommends to the child's parents that the child should be touched using deep pressure. This is an example of utilizing techniques for: a. Sensory discrimination b. Sensory modulation c. Vestibular receptivity d. Tactile responsivity

60. During a treatment session, a patient with a C5 SCI complains of dizziness and a severe headache and is noticed by the OT to be flushed and sweating profusely. The BEST course of action for the OT to take is to: a. Lie the patient down to rest for about 30 minutes or until symptoms subside b. Contact the physician and report signs of autonomic dysreflexia c. Take the blood pressure because of the suspected signs of orthostatic hypotension d. Assist the patient in taking medication for the symptoms

62. A patient with diabetes is employed as a bricklayer. The patient has recently developed a neuropathy leading to impaired sensation in the UE. In regards to work, the OT needs to caution the patient to examine their hand frequently for: a. Swelling and dryness b. Bruising and redness c. Dryness and erythema d. Excessive perspiration

62.The administrator of an outpatient rehab center files a complaint against a staff OT with the Ethics Commission (EC) for an ethical violation. As a final action by the EC, the individual was given a reprimand. Which scenario represents this disciplinary action? a. The individual was suspended from practicing for 3 months b. A letter was sent to the individual identifying the issue and expressing disapproval of the behavior. c. The individual was placed on probation and monitored by the administrator for a specified period of time. d. The name of the individual and the action committed was published in the state OT licensure board newsletter.

63. A client with a 1-week-old crush injury of the right hand caused by a factory accident is referred for splinting. The injury resulted in a loss of muscle tissue in the hand and the wound has not completely healed. To facilitate healing and function, the optimal splinting position that the OT should use is the: a. Resting hand position b. Intrinsic plus c. Intrinsic minus d. Hand in full extension

63. When treating a child for issues related to feeding, the OT wants more information related to the child's respiratory control. It is likely that the OT will refer the child to a: a. Gastrointestinal specialist b. Pulmonary specialist c. Otolaryngologist d. Neurologist

64. A Grade 3 student who receives special education services has been hitting other children on the playground. The interdisciplinary team serving this student meets to develop an IEP. The FIRST step the team should follow the activities list below is: a. Make a decision and develop a plan for achieving the solution b. Develop a comprehensive objective description of the problem c. Get input form the other children that were recipient of the problem behaviors d. Identify as many strategies as possible to reduce barriers and increase supports

64. A patient with intention tremors is observed to have frequent spills of food and drink while eating. To facilitate greater control during mealtime, the OT should: a. Provide a large, long-handled tablespoon for eating b. Use a weighted cuff on the wrist to assist patient during meals c. Train a caregiver to assist the patient during meals d. Raise the eating surface closer to the face

64. The OT is working in early intervention with a 34-month-old child. The OT will be assessing the child as part of the transition from early intervention to the school systems. The OT would like to work one-onone with the child and assess the child's abilities in the following skill areas: object manipulation, grasping, and visual motor integration. It is likely that the OT will choose: a. An assessment that measures eye-hand coordination skills b. A global assessment that measures motor skill development c. An assessment that measures a child's ability to participate in selfcare, mobility, and social functions d. An assessment that measures fine and gross motor skills

64.The insurance company of a client being seen by the OT requests information on the client's status. The OT should: a. Ask the insurance company to put their request in writing before sending the information b. Obtain written approval from the client before releasing the information c. Tell the client to send the information to the insurance company d. Ask the administrator to communicate with the insurance company about the client's status

65. A child with a diagnosis of ADHD has considerable difficulty paying attention in school and also has difficulty with coordination. Which activity would be the MOST effective intervention to promote learning for this child? a. Assembling a colourful puzzle with 2 other students b. Playing a rhythmic clapping game about numbers c. Blowing bubbles with other students on the playground d. Removing the child from the rest of classmates to work alone

68.What legislation grants parents and students access to and confidentiality of educational records? a. IDEA b. The Family Educational Rights and Privacy Act c. Americans with Disabilities Act d. The Social Security Act

69. The OT is interested in determining the degree of sensory discrimination present in the fingertips of a patient with scleroderma. The BEST assessment to use is the: a. Fingertip wrinkling test b. Monofilament test c. Distinguishing between light and deep touch d. Test for stereognosis

7. A child has transitioned from early intervention into preschool. The child has Asperger's disorder and ADHD. The child has problems sitting still for more than 5 minutes during class. The teacher has contacted the school OT to find out how to help this child. The therapist recommends that the BEST way to address this issue is: a. Put the child in time out in a quiet place b. Allow the child to bounce on a therapy ball c. Redirect the child to sit and complete the activity d. Have the child stand while up against a wall

7. A patient diagnosed with insulin dependent diabetes mellitus is referred to OT for splinting. A primary area that must be assessed before prescribing a splint is: a. Edema b. Sensation c. Pain d. Fine motor manipulation

70. A patient with arthritis has a boutonniere deformity of the left middle finger. To correct the deformity, the OT would position the digit in: a. PIP joint extension and DIP joint hyperextension b. PIP joint extension and DIP extension c. Both PIP and DIP joint flexion d. PIP flexion and DIP

70.A key step in strategic planning and setting up programs and goals in healthcare organizations is to use a SWOT Analysis. What is the purpose of a SWOT Analysis? a. To identify the step to program development b. To examine effects of internal and external environments of the organization c. To address laws governing the operation of the organization d. To examine global and international trends affecting the organization

71.In the Core Values and Attitude document, the specific core value that emphasizes the importance of valuing the inherent worth and uniqueness of each person is: a. Justice b. Dignity c. Prudence d. Altruism

72. A school-aged child with figure-ground concerns is being seen in OT. The OT will most likely recommended that the classroom teacher: a. Place a red line on the left side of the paper b. Use a frame to block out all areas of the page except for the information that the child is supposed to be focusing on c. Provide the child with a copy of all notes that are written on the chalkboard d. Allow the student to use a highlighter marker

74.The hospital admin presents an in-service to employees about a policy that governs the interchange of healthcare information and financial data, and protects the confidentiality of patients. This policy is the known as the: a. Americans with Disabilities (ADA) b. Health Insurance Portability and Accountability Act (HIPAA) c. IDEA d. Family Educational Rights and Privacy Act (FERPA)

75. A patient with a long-term illness has been bedridden for longer than a month. The condition of the patient has improved. The patient can now perform bed mobility and transfer in and out of bed into a chair for basic self-care without fatigue. Using a progressive mobilization program to improve occupational performance, the NEXT step for the home health OT is to: a. Extend the time for performing ADL tasks in sitting b. Move to the bathroom for performing ADLs c. Add additional tasks to be performed at bedside d. Begin performing some ADL tasks in standing while at bedside

75. An 8-month-old preterm infant has obvious motor delays. The type of assessment that would enable the pediatric OT to determine the degree of the infant's delay is: a. Skilled observations b. Criterion referenced c. Interview with parents d. Ecological measures

75. An OT is training a caregiver to position an 18-month-old child with low tone in a sidelyer so that the child can explore a toy. Provided that the child does not have scoliosis, the OT will MOST likely recommended that the caregiver position the child: a. So that the weaker side is on the upside and more mobile b. For equal amounts of time on both sides throughout the day c. So that the child's weaker arm is on the downside d. So that the downside leg is flexed at the knee and the upside leg is extended

77. The OT is requested to evaluate a mechanic's ability to locate and use small tools. The MOST appropriate sensory assessment to use is: a. A monofilament test b. A test for stereognosis c. Two-point discrimination d. An asthesiometer

78. A school-based OT is working with a Grade 3 student who has difficulty with handwriting. Before working on handwriting at a table in the back of the classroom, the OT should FIRST be sure that the child is positioned: a. So that the table is at the child's wrist height b. So that the table is at the child's elbow height c. So that the table is at the child's shoulder height d. In a slightly reclined position at the desk

8. An OT is asked to administer a test to a child and compare the assessment results/scores to the sample population of children that have similar characteristics as this child. The BEST type of evaluation to administer would be: a. Criterion-referenced test b. Norm-referenced test c. Skilled observation d. Checklist

81. A school teacher requests the assistance of the OT to recommend activities to facilitate drawing in a 4-year-old child. The OT would advise the teacher that an appropriate activity to facilitate drawing is to have the student: a. Draw circles and lines b. Imitate simple figures c. Connect the dots d. Play tic tac toe

81. A young child is working in OT on increasing visual-motor integration skills by tracing on a line with a marker. To further address this goal, the OT may also encourage the child to: a. Hop up and down b. Build a cube tower c. Match a picture to an object d. Imitate motor movements without verbal cue

82. A 5-year-old child has mastered a pincer grasp for writing in school. In order to progress, the OT should provide writing activities to facilitate a: a. Primitive pincer grasp b. Dynamic tripod grasp c. Palmar grasp d. Radial digital grasp

83.An OT using the evidence-based practice approach to determine the BEST intervention for treating a complicated diagnosis must first: a. Search and sort the evidence b. Formulate the question c. Conduct a literature search d. Appraise the evidence

84. An OT is treating a child that has difficulty with stability because of a lack of antigravity muscle strength. The BEST intervention for the OT to use is: a. Increasing muscle elongation b. Blocking or fixing certain joints c. Promoting equilibrium reactions d. Facilitating righting reactions

84. The OT is working in the school systems with the 18-to-21-year-old population. The focus of OT is MOST likely to address: a. Educational goals b. Transition goals c. Leisure goals d. Self-care goals

86.In community-based OT mental health services the primary role of the OT is: a. Educator b. Clinician or case manager c. Job coach d. Supervisor

87. The OT is educating a caregiver on how to carry a 30 lbs. child with severe spasticity who is in a predominantly flexed position. It is MOST likely that the OT will recommend that: a. The caregiver position the child so that both of the child's legs wrap around the caregiver's waist; the caregiver should support the child with one hand under one buttock and the other hand high on the child's back. b. The caregiver position the child so that the child is on its side with its back up against the caregiver's stomach; coming from behind, the caregiver should hold the child by positioning 1 arm between the child's legs with 1 hand supporting the child at its stomach and the other arm wrapping around the child's chest and the other hand supporting the child at the elbow. c. The caregiver position the child over the caregiver's shoulder with the child's arms tucked down at its sides and its legs fully extended. d. The child is carried like a cradled baby with the caregiver supporting the child with both hands under its buttocks

88. A SCI patient who can breathe on his own uses a sip and puff switch to operate his power wheelchair and environmental control unit and a mouthstick for writing, table games, and the computer would MOST likely have a SCI at this level: a. C3 b. C4 c. C5 d. C6

88. You are observing another therapist in your clinic area instructing a patient who has sustained a brain injury in using association. You know the therapist is using a remediation technique to address a deficit in: a. Attention b. Memory c. Scanning d. Motor planning

90. While doing a worksite assessment in the hospital business office, an OT found several employees complaining of neck and shoulder pain. It was determined that making a simple change in the set-up of the computer stations could reduce symptoms. The change to computer monitor that would MOST affect neck and shoulder discomfort is: a. Lower the monitor to the desk surface b. Move the computer monitor closer to the employee's face c. Tilt monitor forward d. Put a non-glare screen on the monitor

91. The MOST beneficial piece of adaptive equipment to aid a client with C6 tetraplegia to work toward independence with LE dressing is: a. A trigger reacher to get the pants over the feet b. Loops to manipulate the LE c. A universal cuff to assist with grip and closures d. A standard dressing stick

92. With adaptive equipment and set up, the patient can perform self-feeding and engage in light hygiene, grooming, and UE dressing with minimal assistance, as well as writing and use of a computer but requires an attendant to perform all other self-care. The OT would generally expect to see these goals achieved with a patient that has a SCI at level: a. C4 b. C5 c. C6 d. C7

94. The MOST appropriate model to use with clients with CNS dysfunction is: a. MOHO b. Rehabilitation model c. Biomechanical model d. Motor control model

96. A patient recently diagnosed with a left CVA presents with symptoms of bilateral UE tremors, edema in the right fingers, dorsum of the hand, and enlarged DIP joints. However, good return of function is noted proximal to the wrist. In the early phase of rehab, the OT should focus on splinting to: a. Correct contractures b. Prevent secondary complications c. Decrease pain d. Substitute for sensorimotor function

96.Individual diagnosed with oppositional defiant disorder in childhood or adolescence are MOST often diagnosed with which of the following conditions when they reach adulthood: a. Bipolar disorder b. Antisocial personality disorder c. Schizophrenia d. Borderline personality disorder

99. Which is the BEST means for documenting a goal statement? a. Therapist will instruct the patient in overhead dressing techniques. b. Patient will participate in meal preparation for 15 minutes without breaks. c. Patient will perform 10 repetitions of active assistive shoulder ladder exercises. d. Patient will show increased endurance for performing ADLs.

1. The OT rehab department is conducting outcome studies. Which of the following outcome statements reflects the appropriate way to report the comparison of the consultative and directs model of intervention? a. The group receiving consultative intervention achieved a higher number of goals. b. The group receiving direct intervention achieved a higher number of goals. c. The number of goals achieved was statistically the same when using consultation versus direct intervention. d. The goals of both the consultative and direct intervention models were the same.

105. The OT should instruct a patient with de Quervain's tenosynovitis to minimize functional activities involving: a. Reaching overhead b. Grasping c. Forced pinch d. Total arm extension

106. An OT acting in the role of a consultant in a school-based setting would: a. Teach a child how to tie their shoes b. Hold an educational session for parents on sensory integration during play activities c. Assist the teacher in learning techniques to assist children with handwriting d. Work on feeding techniques with a child who has CP

107. A stand pivot transfer would be used for a client when a client: a. Can come to standing and weight shift while the therapist secures the client with a transfer belt b. Is learning to use a walker for ambulation c. Is able to do some, but not full, weight bearing on one or both legs d. Has LE that are too weak for weight bearing

107. An OT assessing movement determines that a child has oscillating vision. An area for further assessment might be: a. Eye hand coordination b. Equilibrium c. Muscle tone d. Drawing ability

108. In providing instructions and training to a family for a person that will require assistance in transfers, the OT should tell them that when performing transfers: a . Allow the client to put the arms around the neck of the person performing the transfer and pull to stand b. Stand behind the patient and push the individual forward c. Keep the back and spine straight as possible and lift or rotate using the arm muscles d. Keep the back curved so as not to put pressure on the legs when lifting

108. When a child is able to organize a successful, goal-directed action on the environment, it is referred to as a(n): a. Inner drive b. Sensory nourishment c. Adaptive response d. Sensory diet

11. A child has difficulty searching for objects that have dropped from the wheelchair tray. The BEST method for the OT to use to adapt the child's environment so the child can engage in play and foster independence is to: a. Have the child play when someone is present b. Have the child watch videos c. Tie a string to toys that is attached to the wheelchair d. Lower the tray and place at a slight angle

110. An elderly client with no visual deficits exhibits difficulty with balance and also reports a tendency to occasionally fall. The OT should assess: a. Labyrinthine righting reflexes b. Tactile discrimination c. Vestibular function d. Visual memory

110. For a patient with cognitive deficits, intervention is organized around 4 phases. The MOST advanced phases of cognitive retraining should involve: a. Anticipation b. Application c. Adaptation d. Acquisition

111. During a home health visit, the OT observed several items that require modification in the home of an elderly patient. In terms of priority, the environmental hazard that needs the MOST immediate attention is: a. The cracked toilet seat b. A malfunctioning thermostat c. A throw rug d. A cluttered kitchen

113. A client being treated in outpatient therapy for extensor tendon repair missed 3 appointments while sick with the flu. When writing the monthly report, the therapist explained why the client did not achieve her short-term goals in the time frame specified. Which is the MOST appropriate section of the SOAP note for this documentation? a. S b. O c. A d. P

113. An OT consultant is asked to recommend equipment using universal design principles to incorporate in a retirement village. What approach might the OT take? a. Assess the potential residents and recommend customized equipment based on each person's needs b. Recommend installing special lifts in the housing units with stairs c. Recommend items that eliminate barriers, such as widening doors or lowering counters d. Suggest installing voice control for lights and doors

114. After talking to nursing, the inpatient rehab OT treated the patient in the room for instruction in safety and adaptive equipment for toileting, along with dressing and grooming activities. The patient was motivated and worked hard throughout the treatment session. Which is the BEST choice for the subjective portion of the daily SOAP note? a. Patient was cooperative and engaged in social conversation throughout the treatment session. b. Patient reports that the patient feels good today c. Patient is unable to move her right UE as well today as yesterday, although it doesn't really hurt but feels "tight". d. Nursing staff reports that patient is unsafe to toilet independently.

115. After a stroke, a patient had difficulty picking up pills from the table, difficulty buttoning, and completing jigsaw puzzles, which was a favourite leisure activity. During part of the treatment session, the patient worked on putting in and removing pieces from a jigsaw puzzle, and practice manipulating different sized coins from a flat table surface. When documenting the treatment, the BEST choice for an objective statement is: a. Patient worked for 15 minutes placing and removing jigsaw puzzle pieces. b. Patient worked on tripod grasp using various coins and jigsaw puzzle pieces. c. Patient worked for 15 minutes on tripod grasp in order to be able to grasp objects used for leisure activities and ADLs d. Patient worked on tripod grasp to be able to perform leisure activities and ADLs

115. After the evaluation, the OT recommends that the patient work on dressing skills and basic ADLs. However, the patient indicates that these are tasks that the spouse can assist with; the patient would rather concentrate on re-establishing leisure pursuits. What action should be taken by the OT? a. Insist the patient perform basic ADLs as this will be helpful to the spouse b. Bargain with the patient to work on both areas c. Switch emphasis of treatment based on client's preferences d. Refuse treatment because the patient and therapist disagree

118. To bill Medicare Part B for a piece of adapted equipment, such as wheelchair, the OT must document that the: a. Equipment will enable independent functioning b. Patient has secondary insurance for co-pay c. Equipment is medically necessary d. Equipment was ordered by the physician

119. The Individuals with Disabilities Education Act (IDEA) of 1990 mandates the inclusion of specific transition services in a student's IEP when the student reaches 16 years of age. The MOST appropriate contribution to the transition process by OT would be evaluation of the student's: a. Mobility and gait-related skills b. Communication and process skills c. Job-related interests and abilities to facilitate worker-job match d. Participation in the classroom to facilitate skills

119. The OT should avoid isometric strengthening as a prelude to functional activities for patients with: a. Diabetes b. Cumulative trauma disorder c. Cardiovascular problems d. Arthritis

123. Because of frequent bouts of weakness, an individual requires help approx. 60% to 70% of the time getting into and out of bed and going to the bathroom. When instructing the caregiver on the level of help the person will need, the OT would recommend: a. Minimum assistance b. Moderate assistance c. Maximum assistance d. Constant supervision

124. A patient with a head injury is confused at times but demonstrates appropriate behaviors and is responsive to others. The individual is also scheduled for discharge, and the family will need a home program for basic ADLs and safety. The OT should advise the family to: a. Perform self-care tasks for the individual and provide constant supervision for safety b. Provide assistance with self-care tasks and frequently supervise for safety c. Provide cueing and directions for self-care tasks and minimal supervision for safety d. Encourage the individual to perform self-care when confusion is at a minimum to ensure safety

125. A client on temporary leave from work at a factory that manufactures dental supplies is referred to an occupational rehab program for therapy 24 and work reconditioning. The OT gathers data on the organization, its senior level management, and demographic of the employees. Contextually, the OT is addressing: a. The physical work environment b. The social work environment c. The political and cultural work environment d. The personal and temporal work environment

125. After performing ergonomic evaluations of several production lines involving 30 employees at a pharmaceutical manufacturing facility, the OT recommends a reduction in productivity rates and limited overtime and introduces job rotation for all production lines. These ergonomic interventions are considered: a. Engineering control b. Work practice control c. Administrative control d. Rehabilitative control

126. The MOST effective OT intervention recommendation to prevent a client from developing a work-related wrist and hand musculoskeletal disorder is: a. Personal protective equipment such as padded work gloves b. Work practice controls such as stretching c. Engineering controls such as workstation modification d. Administrative controls such as job rotation

127. A 55-year-old patient with osteoporosis is being discharged from acute care with functional independence in all occupational performance areas. What discharge recommendations would be appropriate for this individual? a. Provide a list of alternatives for leisure pursuits b. Recommend that a family member take over driving responsibilities c. Instruct on in-home safety and energy conservation d. Provide alternative instructions on how to perform self-care

129. An OT is assisting a child with positioning scissors. The OT wants to be sure that the child is using the scissors appropriately. It is likely that the OT will cue the child to hold the scissors by: a. Placing the child's thumb in 1 loop and 4 remaining fingers in the other loop of the scissors b. Placing the child's thumb and index finger in the loops of the scissors, with the middle finger resting against the shaft of the handle c. Placing the child's thumb and middle finger in the loops of the scissors, with the index finger resting against the shaft of the handle d. Telling the child to the hold the scissors "like a big boy"

129. An adolescent has been admitted to your unit with a diagnosis of conduct disorder. Substance abuse is also suspected. The client is capable of meeting all the basic needs but maladaptive behavior is disrupting performance. The MOST appropriate OT goal for a treatment plan would be that the patient will: a. Become independent in ADLs by end of week by taking a shower without assistance every day for 5 consecutive days b. Attend OT group for 2 weeks and choose a vocational pursuit by the end of week 2 and develop a plan for the necessary schooling, etc. c. Demonstrate appropriate group behavior, such as waiting the patient's turn, raising a hand to speak, etc., in all OT groups for 1 week d. Not curse

133. The OT is consulting with a special education preschool teacher who leads a class of children with significant motor involvement. The teacher describes one student who has an open-mouthed posture and drools throughout the day. The teacher would like to assist this student in maintaining a closed mouth and swallowing his saliva periodically. It is likely that the OT will recommend that the teacher: a. Support the child by placing her middle finger just behind the chin, with the index finger and thumb wrapping around either side of the child's jaw b. Provide the child with a bib or washcloth to absorb the drool and prevent any from getting on the child's clothing c. Place the index finger in a horizontal position between the child's upper lip and nose and provide firm and continuous pressure d. Remind the student to close the student's mouth and swallow while modelling this behavior

134. A child who lacks the automatic ability to modulate auditory information is in a classroom full of children who are being instructed in a math lesson. While the teacher is reviewing how to subtract fractions, the child may: a. Cover their eyes to block visual input b. Start rocking back and forth to increase vestibular input c. Cover their ears to block out the teacher's voice d. Get up and start dancing to music they hear off in the distance

134. Which of the following is the BEST example of a functional goal in school-based OT? a. The student will stack eight 1 inch blocks, 4 of 5 trials, by the end of the semester. b. The student will place 5 pegs in a pegboard, 2 of 3 trials by the end of the semester. c. The student will use a visual schedule to independently transition between class activities, 80% of the time, by end of the semester. d. The student will cut along a line with scissors by the end of the semester

135. The OT is treating an 18-month-old child with significant motor impairments. The OT would like to introduce the child to assistive technology so that the child may produce greater effects within the context of his home. The OT might first introduce him to a: a. Augmentative communication device b. Environmental controls c. Single switch d. Computer with touch screen

136. At what age should children be expected to begin to cut a simple circle or square with scissors? a. 1-2 years b. 2-3 years c. 3-5 years d. 5-6 years

137. Important considerations for the IEP team in determining the need for OT as a related service would include each of the following except: a. The results and recommendations of an OT evaluation b. Whether the problem requires the unique expertise of an OT c. Whether the problem interferes with the student's participation in the educational program d. Whether the student's classroom has an aide to follow through on OT suggestions

139. The OT student is trying to describe how a child's eyes look to the student's supervisor. The OT student notices that at times one of the child's eyes turns out ever so slightly and the child has reported double vision. The OT supervising the student explains that the child's history includes information indicating that the child's eyes are misaligned, causing a condition called: a. Myopia b. Esotropia c. Strabismus d. Amblyopia

140. An OT is interviewing a child's parent as part of an IE. Among other things, the child's parent mentions that the child often complains of being nauseated after riding on an escalator. The OT suspects that the child might have a SI dysfunction related to poor processing of: a. Tactile information b. Visual information c. Vestibular information d. Auditory information

142. What is the primary resource a school-based OT uses in determining the FOR and interventions MOST appropriate to meet team identified educationally relevant goals? a. Outpatient therapy goals b. OTA observations c. Clinical reasoning d. Teaching styles used in the classroom

143. An OT is taking a developmental history for a 3-year-old child. During the interview, the OT learns that the child experienced a breech delivery. The OT later observes the child and finds the arm in an awkward position with the shoulder adducted and internally rotated, elbow extended, forearm pronated, and wrist flexed. This posture is characteristics of: a. Atrophy of shoulder girdle muscles b. Upper motor neuron lesion c. Brachial plexus lesion d. Spinal nerve injury

146. An 18-year-old patient who sustained a severe brain injury 6 months ago is seeing you for therapy. The patient's finger flexion spasticity is now to the point of being painful with passive movement of fingers to 0° and 20° of wrist flexion. Pain also begins with 20° wrist extension if the fingers are flexed. The thumb is adducted into the palm. Which splint would be BEST for this patient? a. A dorsal-based forearm splint with finger separators b. Neoprene thumb abduction splint c. A volar-based forearm splint with cone shaped hand piece d. A soft prefabricated hand splint

147. An OT is working with a child with Down syndrome to put on a pair of pierced earrings. The child MOST likely has difficulty with this task because of: a. A short hand b. Delayed bone ossification c. A lower set thumb d. Hypotonia

148. A student with ADHD constantly looks up to the chalkboard while copying information. In addition to concerns related to maintaining attention, the student MOST likely has difficulty with: a. Visual discrimination b. Visual closure c. Visual memory d. Position in space

15. A patient with SCI at the level of C8 would like to be independent in mobility. Based on the expected functional outcomes, the OT would recommend the following pieces of adapted equipment: a. Manual wheelchair b. A motorized wheelchair c. A manual wheelchair and sliding board d. A walker and wheelchair

15. An effective compensatory strategy that can be used with children is: a. Providing deep pressure using a weighted vest to a child with hypersensitivities b. Praising a child when sharing his materials with a peer c. Providing peel-off stickers to a child who has poor drawing skills d. Having the child sit on a physioball during art class

151. An OT working with a child receiving early intervention services and using neuromaturational theory of developmental assumes that the child's rate of motor development is: a. Dependent on multiple variables b. Determined by the interaction between the child's individual systems and the child's context c. Dependent on low-level skills that are required as a foundation for higher-level skills d. Dependent on the caregiver's influence and the culture in which the child is being raised

152. A child with spastic diplegic CP is referred for OT. MOST likely the child will present with functional deficits related to: a. Moderate involvement on all 4 extremities b. Involvement in UE and LE on one side of the body c. Mild involvement in UE and significant involvement in LE d. Involvement in LE only

153. An OT working in the school system is choosing an evaluation tool to use a Grade 4 student who is having difficulty with handwriting. The OT would like to be able to compare the student's performance on this assessment to the performance of other students who have taken the same assessment. The OT would MOST likely choose a: a. Standardized assessment b. Criterion-referenced assessment c. Norm-referenced assessment d. Observation-based assessment

155. An OT is working with a child who presents with delayed in-hand manipulation skills. The OT is working with the child to develop simple rotation skills, which are necessary to unscrew a bottle top. The child will MOST likely also need this in-hand manipulation skill to: a. Pick up a small piece of cereal that is placed at midline to self-feed b. Move a key from the palm to the fingers to place in a lock c. Pick up a pencil that is placed horizontally with the writing end pointing toward the ulnar side of the child's preferred hand d. Move a coin from the finger pads to the finger tips to place inside of a bank

156. An OT is evaluating a 14-month-old child. According to typical development, the child should be able to: a. Jump up and down without external support b. Bend down to pick up a toy off the ground without external support c. Stand without external support d. Walk without external support

158. You are treating a C7 SCI patient who is working on independent feeding. One way to grade this activity would be to: a. Provide built-up handle utensils b. Provide plate guard c. Go from eating pudding to steak d. Provide a u-cuff

159. An OT is working with a 16-year-old student with a mental impairment who is interested in getting a part-time job. As part of therapy, the OT asks the student to complete a self-assessment that will yield information regarding the child's values and sense of volition. It is MOST likely that the OT is working within the theoretical framework of the: a. Acquisitional Learning theory b. PEO model c. MOHO d. COPM

164. A 12-month-old with oral hypersensitivity and extreme aversion to textured food. The child spits, gags, or coughs whenever pureed food is offered. This is a critical problem, because it limits nutritional intake. The BEST intervention activity would be: a. Use salty and sweet foods alternatively on the tongue b. Apply vibration to the mouth and near the vestibular receptors c. Consult with a nutritionist regarding the effect of dietary change d. Place food on the posterior part of the tongue for improved tolerance

166. A 1-year-old infant with autism has oral hypersensitivity. The BEST intervention to help the child cope would be: a. Soft white bread b. Dried fruits and pretzels c. Soft crackers and cookies d. Raw vegetables

169. A 16-month-old and has significant motor problems. Drinking is a more difficult skill for the child to achieve than eating solid foods. An appropriate liquid to include in the child's daily feedings would be: a. Encourage the child to have vegetable broth b. Make sure the child drinks water c. Include thick cream soups in the diet d. Provide fruit juices with a thin consistency

171. A 4-year-old has moderate motor limitations. An OT is helping the child with brushing teeth and bathing. A tool that would be helpful in this process is: a. Trunk support b. Weighted tooth brush c. Enlarged tooth brush handle d. Electric toothbrush

172. A 7-year-old child displays limited writing performance in class and often rests its head on the desktop while writing. Sometimes, the child slips out of his chair. The OT decides that the child would benefit from a handwriting intervention program with preparatory activities, such as calisthenics. This would include pushups on the floor, resistive exercises with the Thera-Band, and writing in the prone position. Selection of this type of preparatory intervention would be because: a. Muscle tone needs to be decreased b. Energy levels need to be decreased c. Proximal strength and stability need to be improved d. Proprioceptive feedback needs to be enhanced

172. You are seeing an 80-year-old client with a diagnosis of Parkinson's disease. Your motor evaluation reveals resistance throughout PROM of bilateral UE with all speeds of movement. This would be BEST described as: a. Hypertonus b. Spasticity c. Rigidity d. Clonus

173. A child exhibits muscle tension when holding a pencil by exerting too much pressure while writing and often tears the paper. The OT wants to modify the grip pattern. A remedial intervention that could be used is: a. Teach him to use a mature grasp b. Give him an unconventional writing tool c. Introduce a rubber-band sling d. Teach him to use wider-lined paper

177. An OT may have to direct and guide functional written communication by using a combination of compensatory and remedial intervention approaches. A remedial handwriting intervention plan for handwriting would be: a. Include more oral activities b. Add cushions and a foot rest to the student's desk c. Use adhesive strips as spacers between words d. Move the student's desk away from the window to the middle of the room

178. A 55-year-old patient sees an OT for an evaluation of UE function 1 week after Botox to the patient's finger flexors in the right UE. The patient had a stroke 1 year ago and is continuing to work on increasing function. During your evaluation you find that you are unable to fully extend the wrist and the fingers. One of the goals you establish with the patient is to increase ROM in this area. The BEST way to achieve this goal is by: a. AROM b. PROM c. Splinting to provide low load prolonged stretch d. Stretching and weight bearing

179. A Grade 4 student has difficulty holding down more than one key on a keyboard simultaneously and uses only one hand at a time. A possible intervention strategy that the OT could suggest is: a. Change the height of table or chair b. Use an expanded keyboard with larger keys c. Use a chord keyboard d. Add cushioning around the keyboard

180. A 7-year-old with motor limitations gets tired doing writing assignments and has poor handwriting. The OT feels that making a transition from handwriting to text generation would help the child. A software program that would help the child is: a. Imagination Letter series b. Abbreviation expansion c. Talking word processor d. Early Learning House Series

181. A 9-year-old with anxiety has recently started taking a psychotropic medication. An OT is working with the child to improve handwriting and attention skills. The child has started complaining of dryness of the mouth and constipation. The BEST approach to address these symptoms would be: a. Increase the fiber in the child's diet to improve the constipation and increase fluid intake for the dryness. b. Suggest an appointment with the child's primary care physician for a physical check-up. c. Suggest referring to the prescribing psychiatrist. These may be side effects of the drugs that the child is taking. d. Suggest to the child's parents that the child begin an exercise regimen to increase bowel activity.

182. An 8-year-old 3rd grader is generally well-behaved. The child's parents are very fastidious. The child is very particular about keeping their room and table tidy. While doing these tasks, the child restarts and repeats the process again and again. If the child is not allowed to continue the activity for as long as they want, they become anxious and beg to be allowed to finish. This behavior can BEST be described as: a. ADHD b. Bipolar disorder c. OCD d. Schizophrenia

184. A preterm infant born at 34 weeks gestation. The infant had transient respiratory distress of the newborn (TRDN) for which oxygen was given from an oxyhood for 48 hours. Oral feedings began on the third day and intake was fairly good. The physician had ordered a transition from a regular 3-hour feeding schedule to cue-based oral feeding for the infant. The nurse has observed that the infant feeds well initially and then becomes disorganized and tachypneic. An approach that would ensure the infant feeds without compromising nutrition would be: a. To receive nasogastric tube (NGT) feedings only b. To be fed a preset volume for a preset duration of time c. To feed only till cues suggest stress and fatigue d. To feed by a percutaneous endoscopic gastrostomy tube

185. Therapy occurs at home for a child who exhibits developmental delays because of Down syndrome. In this natural learning environment, various activities and learning experiences occur. An activity that the child could participate in which would be a structured would be: a. Playing at the playground b. Attending a mother-infant playgroup c. Hippotherapy d. Regularly playing in the sandbox

188. A bulimic patient that you are working with is in a day treatment program. Which of the following activities would you MOST likely use with the patient during treatment? a. Simple craft kits b. Time management groups c. Stress management groups d. Reminiscence groups

188. A typically developing 5 1⁄2-month-old infant is able to roll easily from prone to supine positions and vice versa. Assuming that locomotion skills continue to develop at an average rate, the child would reach this mobility milestone at 9 months: a. Creeping and moving from sitting to quadruped and back b. Pivoting in the prone position c. Standing and cruising along furniture d. Ambulating upright and independently

19. A 5-year-old child with DS shows significant loss of weight, high fever, and paleness, and is diagnosed with acute lymphoid leukemia. In which of the following phases of leukemia will he be administered chemotherapy to treat small deposits of cells that remain after remission? a. Phase I - Induction therapy b. Phase II - CNS prophylaxis c. Phase III - Intensification and consolidation d. Phase IV - Maintenance or continuation therapy

190. A child with extremely low birth weight was born 3 months early. An age classification that might help predict potential medical and developmental problems that might occur after birth is: a. Chronologic b. Corrected c. Gestational d. Postconceptional

191. An infant was born at 29 weeks' gestation. This makes the infant extremely vulnerable to light in the neonatal ICU. The reason for this is structural immaturity in the visual system. The structural and functional immaturity that demands that the infant's eyes be shielded from bright lights is: a. Eyelids are still fused b. Lens are not fully developed c. Irises do not constrict significantly d. Neurons of the visual cortex are absent

192. Which occupational therapy FOR or model of practice, used in mental health intervention, emphasizes that assessment is the MOST important role for the OT? a. MOHO b. Developmental FOR c. Cognitive Disabilities FOR d. Person-Environment-Occupation Performance Model (PEO)

195. A 5-year-old was diagnosed with amblyopia 1 year ago. This is a condition of diminished visual acuity. The child has depth perception problems and is often seen tilting their head. Along with treatment, regular assessment is needed to monitor progress of child's visual acuity. A test that could be administered to assess improvement in visual skills is: a. The HOTV test (Matching Test) b. The LH Symbols (LEA Symbols) c. The preferential Looking Test (PL) d. The Snellen vision chart

195. Directive group formats used under MOHO will: a. Vary in routine and organization b. Provide practice in advanced communication and assertiveness techniques c. Use co-leadership whenever possible d. Expect patients to be able to tolerate a minimum of 1-hour sessions for skill development

2. An OT has begun implementing intervention strategies with an infant. One of the parents is very anxious about making sure that the strategies that the OT is utilizing are followed correctly. The BEST method for teaching the parent the strategies is: a. To provide written handouts b. To model techniques in sessions c. To gear to parent learning style d. To provide illustrations and videos

2. An OTA is working with a patient in a community transitional program. The patient is near discharge and needs to have an intervention review. The OT should direct the OTA to: a. Select the evaluation methods and measures b. Interpret and analyze the assessment data c. Complete the interest checklist with the patient d. Develop the goals and treatment plan

201. Using a life span developmental approach in working with older client, a therapist might use which of the following programming in treatment? a. Expressive arts group b. Exercise group c. Reminiscence group d. Communication group

202. When interviewing a mental health client it is important to: a. Allow the content of the interview to follow the client's train of thought b. Allow your personal feelings to impact the professional relationship that is developing c. Remain open and accepting toward the client d. Stop the interview immediately when any maladaptive behavior occurs

205. You are visiting the home of a client recently diagnosed with Alzheimer's. The environment is terribly cluttered and seems to add the patient's current level of confusion. You are decided to: a. Clean up the place by yourself, throw away a lot, and put everything else away properly to help organized the environment for the client b. Leave it alone and just recognize that this is how the person will be living c. Engage family members in helping the client to sort through some of the cluttered items and make some choices about what to and what not to keep d. Encourage the family to hire a housekeeper, who will make sure that the environment is clean and tidy all the time

207. Which of the following activities would be MOST appropriate to use in intervention for a child with ADHD? a. Gross motor group b. Handwriting practice c. Social skills group d. Leisure skills group

208. An 11-year-old is referred for OT. During observation you note that the client is socially immature and has great difficulty engaging with other kids. You read in the child's chart that for the last 10 years the child lived 41 on a remote island with only their parents for company. The child has never learned to play or interact with children their age. Because of the child's lack of exposure to such normal skill building opportunities, you decide that the BEST framework to use in addressing this case would be: a. Cognitive Disabilities FOR b. Cognitive-Behavioral FOR c. Developmental FOR d. Psychoanalytical FOR

214. A client has experienced recent stresses because of a job loss and its accompanying financial problems. The axis this is reported under is: a. Axis II b. Axis III c. Axis IV d. Axis V

214. Which patient should the OT recommend to use a sliding board? a. An elderly patient with a history of falls b. A patient wearing a leg cast c. A patient with LE weakness d. A patient who fatigues easily

218. A client comes to your OT group for the first time and is talking very fast, insists on discussing why their religion is the "one true religion," and reports that they have not slept for weeks but doesn't need to because they "feel great!" The diagnostic category these symptoms fit in is: a. Alcohol dependence b. Major depressive disorder 43 c. Bipolar disorder I d. Dysthymic disorder

219. During a home health visit, a patient experiencing cancer fatigue states that the goal is to be able to prepare simple meals. What strategy should the OT suggest as the MOST efficient way to engage in this occupation? a. Have patient prepare the item and elicit help from caregiver for actual cooking b. Prepare meals on an alternating schedule about three to four times per week c. Organize work areas and store frequently used items in easily accessible areas d. Think ahead and schedule rest breaks during meal preparation and cooking

22. An OT is working with a 68-year-old retiree. The individual shares that it is important to wake at the same time every day, meet friends for coffee at 9am, watch a favourite TV show at 8pm every night, and play golf on Saturdays. When designing the treatment plan, the OT should heavily focus on: a. Purposeful activity b. Occupational performance c. Habituation d. Social skills

225. A patient complains of increased pain after receiving a passive joint mobility exercise in therapy 2 days earlier. On examination, the OT notices redness and inflamed joints. The NEXT course of action is to: a. Discontinue therapy b. Use a more gentle technique for passive mobilization c. Change to gentle active and active assist activities d. Immobilize the affected body parts

226. You've been asked to evaluate a patient on another unit that the doctor is thinking about discharging. Nursing personnel have expressed some concerns about judgment and decision-making once home. The assessment tool you would choose is: a. Work Performance Inventory b. Occupational Role History c. Kohlman Evaluation of Living Skills (KELS) d. Comprehensive Occupational Therapy Evaluation (COTE)

227. A patient in a skilled nursing facility exhibits hyposensitivity of oral motor musculature. To benefit the patient , the OT should introduce: a. A pureed diet b. Eating crunchy vegetables c. The use of bolus or flavourful foods d. A bland diet

227. The most life-threatening side effect of antipsychotic medications is: a. Tardive dyskinesia b. Parkinsonian syndrome c. Neuroleptic malignant syndrome d. Orthostatic hypotension

228. A 70-year-old patient with mild dementia has moderate difficulty performing IADLs specifically related to home and money management. An initial assessment should focus on: a. IADLs b. Financial management tasks c. Cognitive issues d. Home and money management

229. During the intervention review, the OT indicated that the patient has shoulder abduction of a grade of 2. This means that when assessing movement: a. Tension can be palpated in the muscles that being tested b. The body part move through partial range in a gravity eliminated position c. The body part moves through the full range in a gravity eliminated position d. The body part moves less than full range against gravity

23. A kindergarten teacher observed that a 5-year-old child does not participate in play with other children and avoids movement activities on the playground. A screening test you would recommend for this child to determine if there is a need for a more comprehensive examination is: a. Ages & Stages Questionnaires b. The First STEP c. Short Sensory Profile d. Denver Developmental Screening Test-II (Denver-II)

23.An OTA with 8 years of experience transfers from the substance abuse unit to the orthopaedic team. After saying "you remember hip precautions," the supervisor sends the OTA to treat a patient who underwent a total hip arthroplasty 3 days ago. While practicing dressing, the patient leans forward to do shoe tying and has immediate pain in the operative hip. Two days later the patient has to undergo additional surgery. Liability in this case is the primary responsibility of: a. The OTA b. The OT c. Both the OTA and the OT d. The physician

230. An OT is administering a sensory test to a patient with an ulnar nerve injury. The initial step in performing the test begins by: a. Applying the stimulus to the affected area with vision occluded b. Applying the stimulus to the affected area without occluding vision c. Establishing an area that tests within normal limits d. Mapping the distribution of the peripheral nerves in the extremity

233. In an inpatient setting, assessments of individuals with a diagnosis of TBI often begin with: a. IADLs b. Basic ADL skills c. Visual screens, perception, and cognition d. Mobility

233. Which technique reflects a desensitization treatment for an individual with a sensory issue? a. Teaching a spinal cord injured client how to inspect the parts of the body that lack sensation b. Using the less affected hand to perform activities such as cooking, eating, or ironing c. Performing a graded therapy program that includes applying different textures and media to a sensitive part of the body d. Encouraging the use of vision and other senses to prevent injury specific parts of the body

234. A patient with deep partial thickness burns has an extremely edematous right arm with some open wound areas still visible. The OT wants to assess the effectiveness of the treatment in reducing the amount of swelling present. The BEST approach is to: a. Use a volumeter b. Assess pain level before and after treatment c. Do circumferential measurements d. Ask the patient if the extremity feels higher

238. When administering a standardized test, the BEST strategy for the therapist to follow is to: a. Modify the testing instructions as needed b. Use 2 persons to administer the test for consistency c. Follow the testing procedures as stated d. Administer testing procedures over 2 sessions

238. Which method would be the MOST effective for scar reduction caused by traumatic injuries or burns? a. Ace bandage b. Friction massage c. Compression d. Splinting

24. The OT is working with a 2-year-old child. The goal is to encourage age appropriate play activities for development. The OT should recommend activities and toys to encourage: a. Exploratory and social play b. Attending to others and the environment c. Functional or relational play d. Constructive play

240. Two therapists administered a test approximately 1 week apart that assessed fine motor prehension skills in a patient. The test results showed no change in the individual status between the first and last testing session. This would indicate that the test instrument has: a. Internal validity b. External validity c. High reliability d. Low reliability

241. An OT is providing pre-prosthetic training to a young male with a left transhumeral amputation. Appropriate goals at this stage are to: a. Assist the person to explore new interests and leisure skills b. Practice balance activities in sitting and standing c. Promote skin healing and conditioning d. Assist in developing a new body image with prosthesis

241. An instrument/technique the OT might choose to assess moving two- point discrimination of a client with sensory deficits in the fingers is: a. Monofilament test b. A paper clip c. Disk criminator d. Stereognosis test

244. The OT is evaluating a child with mild spastic diplegia. A performance deficit that is important to assess is: a. Tactile defensiveness b. Gravitational insecurity c. Postural insecurity d. Overresponsiveness

245. An OT is working with an individual who has hypotonia in the UE. An appropriate intervention for this deficit is to have the patient: a. Perform equilibrium activities b. Perform strengthening against gravity c. Perform alternate weight bearing and reaching activities d. Clasp both hands together and reach up to hit a ball

247. You're working with an elderly patient who has cognitive difficulties and low vision issues. You decide that some simple crafts might be use in treatment. Which of the following crafts would be the MOST appropriate to use: a. Paint by number kit b. Wood burning on a small wooden box lid c. Copper tooling using recessed plastic forms d. Coloring a poster

25. An OTA works with an OT in an early intervention at a local school. The portion of the evaluation that the OT can assign the OTA to perform is: a. Selecting evaluation methods and measures b. Interpreting and analysing assessment data c. Administering some of the assessments d. Documenting some of the goals

25. At a day camp for children with mental retardation, the OT is planning a group activity to work on structured skills, such as being able to follow directions. Although delayed in terms of cognitive maturation, the majority of the children function around a developmental age of 7-8. The OT should select: a. A puppet show b. Playground sliding board and swinging c. Musical chairs d. A sing-along

253. A patient has just joined your group. The patient worries about everything. Which of the following would be BEST activity for this patient in OT? a. Wedging clay to make a pot b. Assertiveness training c. Relaxation exercises d. Leatherwork

255. You've been asked to evaluate a young adult who has previously been diagnosed with everything from schizophrenia to depression. This person has been able to live with minimal support in the community but struggles with maintaining a work role. You evaluate the client and note difficulty in the initiation of tasks but motivation to work and the desire to do a good job. Your recommendation would MOST likely include: a. A sheltered workshop environment providing a highly structured environment b. New efforts to independently find work in a fast food business c. A job coach in a supportive and structured work environment d. A less stressful work environment, where he can work more independently and at his own pace

257. A client presents with depressive symptoms, a possible personality disorder, and chronic back pain. The axis that you would find the chronic back pain listed under is: a. Axis I b. Axis II c. Axis III d. Axis IV

258. In working with a chronic pain patient , the OT would MOST likely: a. Suggest what medications would be best for the patient's pain b. Ignore the patient's complaints and tell them that "it is all in your head" c. Analyze the patient's occupational performance deficits and provide intervention to help the person regain control over their life d. Tell the patient that the only way that they will get better is if they exercise, even though they are in pain

263. In psychiatric practice it is considered a "dual diagnosis" when the patient: a. Presents with 2 separate psychotic disorders. b. Presents with a heart condition and a mental problem. c. Presents with a substance abuse problem and a psychiatric diagnosis. d. Has been admitted 2 different times and under 2 different diagnoses.

266. A low score on the COTE means that the patient: a. Is low functioning and needs a great deal of OT intervention b. Has a poor memory c. Is high functioning and needs limited OT intervention d. Has severe motor difficulties

269. A disorder that involves a client intentionally causing their body harm to produce physical symptoms of illness/injury to fulfil their psychological need for attention from medical personnel is: a. Narcolepsy b. Pedophilia c. Munchausen's d. Voyeurism

27.A patient received several rehab therapies including OT 5x per week for 6 weeks following a fall with resultant elbow and hip fracture and surgical repair. In which setting was the patient MOST likely seen for this length of stay? a. Inpatient acute b. Inpatient rehab c. Skilled nursing facility d. Home health

276. During an assessment of developmental delay, the OT determines that a child has accurate and direct reaching abilities and can grasp with the fingertips. The child also plays with toys at the midline, can bang objects together, and release them into a container. The NEXT skill for the OT to assess is to determine if the child can: a. Assemble a 4 to 5 piece puzzles b. Use one hand while the other manipulate c. Draw with crayons d. Snip with scissors and turn pages

279. A school-based OT evaluating a student with autism may anticipate observing all of the following behaviors, except: a. Limited social interaction, such as limited eye contact b. Limited communication, such as echolalic speech c. Altered growth, including specific facial features d. Unconventional behaviors, such as rocking, spinning, or hand- flapping

28. A child loses its balance and falls down whenever it tries to catch a ball thrown in its direction; otherwise the child can sit, stand, and walk well. The OT would determine that the child has a problem with: a. Development of higher-level balance skills b. Protective reactions c. Anticipatory postural control d. Labyrinthine head righting

29. A 4-year-old child is being assessed for possible vestibular disorder. In which of the following evaluation areas would the child face difficulties maintaining stance? a. Eyes closed, stable platform b. Eyes open, swayed-reference platform c. Eyes closed, swayed-reference platform d. Eyes open stable platform

29. An 8-year-old child with normal intelligence has trouble concentrating on schoolwork. The social worker reveals to the OT that one of the child's parents has been unemployed for some time, while the other parents does odd jobs to make ends meet. In reflecting on these issues and Maslow's hierarchy of needs, the OT might conclude that: a. The child is acting out against their parents because of their living situation b. The child is probably borderline learning disability c. Basic physiological needs of the child are not being met d. Basic safety needs of the child are not being met

3. A patient is referred to OT for splinting. The goal of splinting is to increase ROM that will eventually allow improvement in fine motor coordination and prehension patterns. Which strategy should the OT use to accomplish this goal? a. Apply a dynamic splint for controlled motion b. Apply prolonged stretch to the joint and soft tissue c. Position the extremity in a functional hand position d. Position the extremity in the safe hand or antideformity position

3. An OT arrives at a child's home to begin a treatment session. When the therapist enters the home the child is running through the house screeching. The OT determines that the FIRST step in the intervention session will be: a. Sitting still on a therapy ball b. Placing the child in a high chair c. Rhythmic linear swinging d. Rapidly brushing extremities

31. A 3-year-old child spends much time seated on the floor. The child supports this position by placing their left hand on the floor and cannot sit without the support. The child also demonstrates poor skills with its left hand. The general motor area that will MOST likely need attention first to help improve hand skills is: a. Inadequate isolation of movements b. Poorly graded movement c. Limitations in trunk movement and control d. Disorder in bilateral integration of movements

31. A 30-year-old patient sustained partial thickness burns over a total body surface of 50% including the patient's bilateral arms and upper trunk. In the acute phase of a burn, the OT should focus on: a. Scar management b. Returning sensation c. Preventing deformity d. Loss of fluid

32. A patient presents with morning stiffness, joint inflammation, muscle weakness, and difficulty with community mobility and ADLs. The OT's initial goals should be: a. Preservation of muscle strength b. Maintenance of lifestyle c. Relief of pain and inflammation d. Education of patient to use adapted equipment

32. MOST infants first hold objects between thumb and radial fingers at approximately: a. 4-5 months b. 6-7 months c. 8-9 months d. 10-11 months

34. A patient with peripheral neuropathy has impairment of sensation in bilateral feet and hands. The main focus of treatment should be: a. Desensitization techniques b. Sensory retraining/reeducation c. Compensatory techniques related to safety d. Assisting patient in diminishing astereognosis

34. The MOST important information that an OT gains from assessing a child's ball throwing skills is the child's: a. Use of thumb opposition b. Voluntary release of the ball c. Sequence and timing of arm movements d. Accuracy in hitting a target area

35. An OT is treating a 4-year-old child who has demonstrated delays in reaching major motor milestones. The child's parents ask if their child will be able to attend a regular school and live a normal healthy life in the future. A response the OT can provide to address their concerns is: a. Make definitive optimistic statements about the future to boost their morale b. Tell them that it's not possible to make any predictions about the future c. Help parents understand the range of possibilities by telling them about the continuum of services for older children and young adults in the community d. Tell them that the future outlook for their child is bleak

35.An OT suspects physical abuse after noticing bruises on the face and back of a child during the treatment session. The appropriate action to take is: a. To ask the child questions about the bruises b. To confront the parents about the cause for the inflictions c. To make a report to the appropriate authorities d. To ignore the bruises because proof of suspicion is difficult

37. The BEST description of the MOHO is: a. Activity applies the mechanical principles of kinetics and movement. b. Sensorimotor principles are applied to activity and occupation. c. Engagement in occupation occurs within the environment. d. The CNS produces well-modulated movements utilized in occupation

39. A 2-year-old child shows poor head control in the prone and sitting positions. What intervention would the OT to motivate and help the child gain head control? a. Use of a therapeutic ball b. Use of a therapeutic wedge c. Biofeedback d. Use of toys or the parent's voice to motivate the child

4. An OT is treating a patient with a Colles fracture. The patient's forearm has been immobilized for 3 weeks and will require 4 additional weeks in the cast before the patient can begin functional tasks. An initial focus of treatment should be: a. PROM b. Placement of the extremity in a sling c. Movement of the joints surrounding the fracture d. To avoid treatment until the cast is removed

4. In early intervention there are different types of risk factors. A child with Down syndrome is an example of: a. Biological risk b. Environmental risk c. Established risk d. Recurring risk

40. The developmental stage that allows for discrimination and localization of tactile sensations to become more precise, and allows refinement of fine motor skills like grasping a pencil or manipulating Play Doh is: a. First 6 months b. Second 6 months c. 1-2 years d. 3-7 years

41. A child with mild spastic diplegia usually displays: a. Tactile defensiveness b. Gravitational insecurity c. Postural insecurity d. Overresponsiveness

44. A 4-year-old pre-schooler has difficulty building with LEGO blocks because of the use of an immature pincer grasp, poor voluntary release skills, and difficulty stabilizing objects with one hand while manipulating with the other. Which of the following is MOST likely to be one of the intervention strategies that the OT would use? a. Promote the child's ability to vary all joint positions in the arm while sustaining grasp b. Provide splinting to support the wrist c. Emphasize development of a mature finger pad grasp pattern d. Improve symmetrical bilateral hand skills

45. A child in middle school has Duchenne's muscular dystrophy. The child uses a manual wheelchair for short distances but is often late and fatigued on arriving to class. The BEST recommendation the OT could make for the use of the wheelchair in school is: a. Have a peer push the student to all classes b. Continue to use the manual wheelchair for UE strengthening c. Exploring obtaining an electric wheelchair d. Ask teachers to forgive the student's lateness to class

46. A 7-year-old with a diagnosis of mild retardation is learning to tie their shoes in therapy at school. To reinforce and facilitate generalization of the skill, the OT recommends: a. That the parents purchase brightly-colored shoe laces b. Fitting the child's shoes with Velcro closures c. Having the child practice shoe tying at home d. Providing elastic shoe laces

46. Which of the following are characteristics of classic SI treatment? a. It can be applied individually or in groups b. It is given in the form of consultation c. It puts emphasis on the inner drive of the child d. It uses group therapy programs

47. A 9-year-old child has difficulty in focusing on tasks in school and is often not able to screen out unnecessary information. The child gets distracted by unrelated data and fails to obtain specific information necessary for the task. The OT should assess the child for difficulties with: a. Visual scanning b. Visual memory c. Selective attention d. Alertness

49.The OT director must determine the staffing needs of a new home health department. Twenty-four hours of patient treatment are projected for each day of the week. Each OT's productivity is expected to be 6 hours per day. How many full-time equivalent (FTE) therapists would the OT director need to hire to complete the work each day? a. 2 FTEs b. 3 FTEs c. 4 FTEs d. 5 FTEs

5. A patient with COPD has achieved independence with minimal supervision and is being discharged. Because the patient has no family, alternate living arrangements are needed. The OT should recommend: a. A group resident home b. Home health care c. An assisted living facility d. Partial hospitalization

51. An elderly patient exhibits skin breakdown caused by perspiration while wearing a splint. The OT would MOST likely correct this problem by addressing: a. Conformability of the splint b. Elasticity of the splint c. Permeability of the splint d. Drapability of the splint

51. Through an OT profile, the OT discovers that an elderly client recently lost a spouse for whom the client was the primary caregiver. Which is the BEST intervention strategy to address the client's use of time? a. Suggest visiting with church members and family b. Organize the client's friends to go shopping c. Provide an opportunity for volunteering d. Mention sleeping as a way of avoiding thinking about the loss

52. OT potentially may have to address aging issues in these 3 categories: a. Parental, biological, and psychological b. Psychological, chronological, and parental c. Chronological, biological, and social d. Parental, social, and biological

54. An elderly client presents with an ulnar nerve injury, for which the OT fabricates a splint. The therapist must take into consideration which of the following goals? a. Assist function of the thumb for tip-to-tip prehension b. Assist grasp by providing stability of the wrist in extension c. Prevent clawing and assist in grasp and release d. Prevent overstretching the wrist extensors

54. The OT is treating a patient in the acute care burn unit who recently experienced deep partial thickness burns to the left UE and LE. The main focus of splinting is: a. Scar reduction and management b. To prevent the spread of infection c. Joint mobility as the wound heals d. Functional use of the UE

54.The OT manager recognizes that the department has pay inequities, which has led to several employees' resignation over the past 6 months. In order to achieve equitable pay, the MOST effective strategy for the OT manager to employ is to: a. Involve employees in the work design process and create development opportunities b. Provide formal mechanisms and encourage employees to express work-related concerns c. Use market information to determine wage and benefit programs d. Match employee skills with the job and define job prior to employment

55.Several teachers inquire about a child's eligibility to receive OT services. The OT should educate the teachers that a child is eligible for school-based OT services when the: a. Parents demand service b. Principal determines that OT is needed c. Child's ability interferes with the child's educational goals d. Teacher completes the appropriate paperwork for a referral

56. An elderly patient with CTS was provided a dorsal-based wrist cock-up splint 1 week earlier. During the next visit, the patient complained of pain and discomfort over the radial styloid area after wearing the splint for 60 minutes. The OT should: a. Place padding inside the splint over the affected area b. Discard the splint and fabricate another c. Spot heat the splint and stretch out over the affected area d. Decrease the amount of splint wear time to 30 minutes

57. The OT is working in the hospital with an 8-year-old child who has burns over 70% of the body. During the initial acute phase of treatment, the OT's primary objective is to: a. Assess the child's community participation skills b. Return the child to developmentally appropriate levels of play c. Prevent loss of joint mobility d. Educate the parent on how to advocate for the child's needs when returning to school

58.A 3-year-old has muscular dystrophy and is often hospitalized. The child has acute exacerbation of asthma. What kind of hospital care would this require? a. Critical care and periodic hospitalization b. Intensive care and periodic hospitalization c. Acute care and periodic hospitalization d. Special medical care and ambulatory services

6. A patient with a hip fracture is discharge to home at supervised status in toileting and transfers. In the home program, the OT would recommend that the caregiver: a. Initially perform 1 to 2 steps of the activities b. Provide verbal cueing and physical cueing 25% of the time c. Be available to assist the patient with these activities for safety d. Provide verbal cueing and directions throughout the activities

6. An OT is using the Peabody Developmental Motor Scales to evaluate a child. The therapist is assessing the child's: a. Performance of tasks that support school participation b. Visual perception skills in community settings c. Gross and fine motor skills d. Performance in everyday tasks

6. Which is NOT a function of NBCOT? a. Establishing standards of certification for OT practitioners b. Protecting the public from incompetent practitioners c. Promoting the growth of the profession of OT d. Granting certificates in recognition of entry-level competence

60. A patient with C6 tetraplegia is referred to an inpatient rehab unit. The OT intervention plan should highlight the asset that: a. Normal bowel and bladder control are present b. Trunk stability is present c. There are no cognitive losses d. Motor control of the UE is intact

60. The OT is working with an 11-year-old child who complains of hand fatigue after writing 2-3 short sentences. After observing the child complete a handwriting task, the OT discovers that the child uses an efficient grip but exerts an increase amount of pressure when writing. To address this issue, the OT might recommend that the child: a. Dictate the answers b. Use a built-up pencil grip to maintain the use of an efficient grasp c. Write on a surface that provides the child with more feedback d. Use a keyboard to eliminate writing tasks

61. A 30-year-old patient sustains an isolated, minimally displaced fracture of the left wrist as a result of a fall. The initial treatment includes immobilization in a dorsal splint secured with an Ace bandage and the extremity positioned in a sling. The NEXT step in treatment should consist of: a. Activities related to strengthening b. Application of the splint for an additional 10 days c. Controlled active mobilization d. Application of a hinged elbow splint

61. The OT is working with an 8-year-old patient who has a diagnosis of attention deficit disorder (ADD). At school, the patient often gets in trouble for walking around the room and finds it difficult to sit and work for long periods of time. The OT might recommend that: a. The child use color-coded folders to organize the various different subjects. b. The teacher discusses with the child's parents the possibility of medication to control the increased energy level. c. The child stands at a counter in the back of the room to complete assigned work. d. The child uses an assignment notebook to record all assignments that were missed while the child was wandering around the classroom.

62. A client with a right CVA has a severe flexor synergy pattern of the left UE. What type of splint should the OT recommend to promote functional movement and engagement in occupation? a. Resting hand b. Wrist cock-up c. Anti-spasticity d. Ulnar gutter

63. An individual who recently received radiation in the area of the head and neck drools, pocket foods, and coughs. The OT should: a. Recommend increasing liquid and a cough suppressant b. Recommend a feeding tube c. Provide intervention for dysphasia d. Advise that these are common radiation reactions, which will disappear over time

66. A patient with rotator cuff repair surgery to the left nondominant shoulder 3 days ago is referred to OT for an evaluation. An assessment that might be contraindicated is: a. Sensory testing b. ROM testing c. MMT d. Self-care assessment

66. The OT is working with a Grade 3 student on handwriting. The OT is asking the child to copy a sentence from the chalkboard to the paper. The OT notices that the child writes down 1 letter at a time and then looks back to the chalkboard to complete 1 sentence. The child is MOST likely experiencing difficulty with: a. Visual closure b. Selective attention c. Visual memory d. Figure-ground

67. An OT would recommend the use of a wheelchair with removable arms to a client with: a. A head injury who gets confused when trying to use the arm rests b. Ataxia who needs to use the bathroom sink c. A T4 spinal cord lesion performing transfers d. Alzheimer's who has difficulty reaching items on the floor

68. A 7-year-old child exhibits problems with gravitational insecurity. The BEST playground activity the OT can recommend to the patient is to have the child to: a. Hang upside down on the jungle gym b. Play on the sliding board c. Roll in the sandbox d. Play in the swing set

69. An OT works in an early intervention program with children that exhibit SI deficits. The BEST approach to improve the children's sensory deficits and occupational performance is to: a. Promote random play activities b. Promote activities that facilitate equilibrium and righting reactions c. Provide controlled motor, proprioceptive, and tactile activities d. Provide group activities that increase interactive play

69. The OT is working with a 9-year-old student in the school system. The child has adequate UE control but limited fine motor control and dexterity making handwriting difficult. The OT would like to introduce keyboarding to the student but knows that a standard keyboard will not support success with the task. It is likely that the OT will choose: a. A head mouse b. A mini-keyboard c. An expanded keyboard d. A voice activated software program

7. An OT is treating a patient with a musculoskeletal degenerative disease. Using conditional reasoning to guide the decision making about intervention, the OT would primarily focus on: a. The procedures required to assess the individual's performance b. The individual's interests, values, concerns, and level of motivation needed to participate in therapy c. The impact of the diagnosis on the environmental, social, and future performance of the individual d. The individual's explanation and description of the cause of their disability

7. Which statement about NBCOT is NOT true? a. The NBCOT certification exam is the same in all 50 states, U.S. territories, and foreign countries where it is given. b. Recertification from NBCOT is required in order to use the initials OTR or OTA. c. NBCOT is a subsidiary of AOTA. d. NBCOT can take disciplinary action against incompetent or unethical OT practitioners or exam candidates.

70. A 65-year-old patient who sustained a myocardial infarction 1 week prior has been referred to cardiac rehab. To determine the functional capacity, the OT should initially assess: a. Caregiver's ability to handle the patient at home b. Resumption of sexual activity with spouse c. Endurance for grooming, hygiene, dressing, and eating d. Ability to return to work on a part-time basis

72. A patient with DM also has complications of peripheral neuropathy. During the evaluation, the OT discovers that there are additional tactile processing issues. Further assessment should focus on: a. Visual deficits b. Fatigue and endurance c. Fine and gross coordination d. Reflexes

73. An OT is working with a young child who has a diagnosis of a TBI and presents with poor postural alignment and increased tone unilaterally. The OT is working in the NDT FOR and is concerned because the child presents with decreased degrees freedom at the shoulder joint. In this situation, prolonged fixing can MOST likely lead to: a. Impaired sensation in the affected extremity b. Decreased ROM at joints distal to the shoulder c. Contracture at the shoulder joint d. Dissociation of movement patterns

74. A technique that an OT working with a patient with a C5 SCI would recommend is: a. Perform wheelchair push ups b. Rely on a caregiver c. Shift weight by using arm rests d. Use a gel cushion

77.An OT is conducting a research study on the effects of splinting in reducing CTS. One group in the study receives the splinting treatment and a second group receives an exercise program. In this type of research the group receiving the exercise program is called the: a. Experimental group b. Population c. Control group d. Sampling group

78. A common behavioural change in one-third to one-half of client with a TBI is: a. Inappropriate sexual behavior b. Increased initiation with tasks c. Posttraumatic agitation d. Bizarre verbalizations

8. The school-based OT suspected that children with slow handwriting speed would score lower on perceptual motor tests than children with average handwriting speed. The OT reviewed the literature and found a study claiming a correlation between the 2 issues. The authors reported P < 0.05. The OT found this article to support the theory, because: a. <5% of the participants showed a correlation between handwriting speed and perceptual motor skills. b. <5% of the participants did not show a correlation between handwriting speed and perceptual motor skills. c. <5% probability exists that findings occurred by chance. d. <5% of results had to be discarded as inaccurate or unreliable.

81.Using a formative program evaluation process, the OT supervisor must assess the effectiveness of rehab services in an inpatient facility. What type of information would be useful to analyze in a formative program evaluation? a. Changes in a specific group of patient's level of assistance at discharge b. The level of satisfaction of recipients of a newly implemented program c. Feedback on the new billing procedures that was recently implemented d. Input on the number of persons completing a program successfully

82. A child is hospitalized related to complications from cystic fibrosis (CF). Inpatient OT will MOST likely focus on teaching the child: a. AROM b. Strengthening activities c. Energy conservation techniques d. Ways to compensate for decreased balance

82.A patient tells the OT how much the services provided have helped in coping with their depression. The patient then offers a gift of appreciation to the therapist. The OT's BEST response is to say: a. "I love the gift, but I need to report it to my administrator in order to follow regulations." b. "Thank you, that's great. What is it?" c. "Just knowing that you appreciate my helped is reward enough. I appreciate the gesture, but i cannot accept the gift." d. "Please mail it to my house. I cannot accept the gift on the hospital premises."

83. A 2-year-old with CP has poor head control in the prone and sitting positions. One technique to engage the child and facilitate head control is: a. Using of a therapeutic ball b. Placing the child over a wedge c. Using biofeedback d. Performing a visual scanning activity

83. A 65-year-old client had a right stroke in the nondominant hemisphere of the parietal lobe. During an ADL evaluation, the client dressed the unaffected limb but not the affected limb. This is an indication of: a. Visual field cut b. Ideomotor apraxia c. Unilateral body neglect d. Ideational apraxia

84. An OT asks a patient to demonstrate how to brush the teeth; the patient then picks up the toothbrush by the bristles with a tip-to-tip pinch. This is caused by: a. Difficulty with visual figure-ground b. Ideomotor apraxia c. Ideational apraxia d. Semantic memory loss

85. Hemianopsia is a loss of visual field secondary to a stroke. The MOST probable visual loss for a right CVA would be: a. Temporal side of the right eye and the nasal side of the left eye b. Nasal side of the left eye and the nasal side of the right eye c. Nasal side of the right eye and temporal side of left eye d. Nasal and temporal sides of the left eye only

85. The OT is leading a group of children in an early childhood classroom. The OT is working with the children on their cutting skills. Before being able to cut a piece of paper in half, the children must be able to: a. Trace their names b. Cut on thin lines c. Snip with scissors d. Tear cardboard

85.Which of the following statements is true? a. OTs working in mental health have prescription privileges. b. OTs working in mental health are allowed to treat patients without a doctor's order. c. OTs working in mental health do not diagnose patients. d. OTs working in mental health are now considered "qualified mental health providers" (QMHPs) in all 50 states.

87. When working with a patient with severe perceptual dysfunction, the therapist should: a. Incorporate exercise to help build strength on the involved side b. Focus on large components of the activity with emphasis on verbal explanation and demonstration of each component c. Provide as many tactile cues as possible paired as appropriate with verbal cues d. Utilize sidelying as much as possible to increase sensation and proprioceptive feedback on the uninvolved side

89. An elementary student has been referred to you for a comprehensive handwriting assessment. Your FIRST priority would be: a. Administering a standardized visual perceptual test b. Evaluating the student's actual performance in handwriting c. Assessing the student's performance in the context of the classroom d. Interviewing the child's parents, teachers, and other team members

89.Patients with mental illness: a. Are always unpredictable b. Are usually out of control c. Can frequently benefit from OT services d. Are often too sick to benefit from OT services

9. An OT working with a 2-month-old child alternates between repeatedly raising the child from a supine position into sitting and slowly lowering the child back into a supine position. The OT is MOST likely trying to elicit: a. Protective reactions b. Neck lateralization c. Neck flexion d. Reflex reactions

90. According to Bobath, the BEST way to regulate increased flexor tone of the UE is by: a. Positioning the pelvis forward b. Positioning the body in supine c. Weight bearing over the involved UE d. Trunk rotation

90. You are treating a client that recently has a SCI at C5. The BEST piece of equipment to the client with feeding, hygiene, grooming, writing, and driving a power wheelchair would be: a. Deltoid assist b. Weighted pulley c. Mobile arm supports d. Suspension sling

91. The OT is advising a patient who is returning to work after being treated for a nerve compression at the elbow on positioning. The OT should include in the list of instructions that it is important to avoid: a. Postures that involve elbow flexion b. Postures that involve elbow extension c. Direct pressure to the affected area d. Reaching downward

92. According to Bobath, the MOST effective way to encourage movement when treating a subluxed shoulder is to use a: a. Sling b. Taping c. Proper positioning d. All of the above

92. An OT developed neck and shoulder pain after just 20 minutes of using a laptop computer at home but not after 1 hour of using the desktop computer at work. The MOST likely reason for this is: a. Small mouse in center of keyboard b. Small keyboard with no wrist rest c. Smaller screen size d. Decreased contrast on screen

92.An OT working at an inpatient rehab unit would need to be familiar with the Medicare Prospective Payment System (PPS) that classifies patients into categories based on: a. Resource utilization groups (RUGs) b. Diagnostic related groups (DRGs) c. Case mix groups (CMGs) d. Resource-based relative value scale (RBRVS)

93. The BEST activity for someone with a visual field deficit is: a. Reading from a book b. Making a calendar c. Balloon batting d. Completing a crossword puzzle

93.A quadriplegic patient confesses to the OT that he is concerned about meeting his wife's sexual needs now that he is paralyzed. The BEST response of the OT would be to: a. Recommend to the physician that the patient begin taking antidepressants because he is probably depressed b. Tell the patient to discuss this issue with his wife and work it out between them c. Allow the patient to talk about his concerns, explore options, and offer to refer him to a specialist with expertise on this issue d. Refer the patient to a psychologist, because talking about these issues is beyond the scope of OT practice

94. A patient who suffered a minor stroke is referred to outpatient OT with approval for only 2 visits. Based on the set time limit to see this patient, the focus of treatment will be determined based on the client's: a. Most significant client factor deficit b. Level of independence in occupational performance areas c. Stated goals d. History and needs of the family

95. During an intervention session, the OT simulates the need for the client to walk up stairs to a kitchen with a painful/weak left leg. The patient should be instructed to move the: a. Left leg up to the next step with the cane b. Right leg up to the next step with the cane c. Right leg up and then his left leg/cane d. Left leg up and then his right leg/cane

96. OTs use all of the following modalities during intervention except: a. Adaptive clothing b. Work simplification and energy conservation c. Use of physical agent modalities d. Use of communication devices and environmental controls

97. A 2-year-old client with delayed motor skills shifts his weight onto on leg and steps to the side with the other in a movement pattern described as: a. Dancing b. Creeping c. Cruising d. Crawling

97. The goal of treatment for a patient with impaired sensation is to promote touch localization to improve interpretation of tactile sensation with work activities. During a sensory re-education program, the OT should emphasize: a. Activities related to stereognosis b. Distinguishing hot and cold temperatures c. Graphesthesia and identifying moving and static stimuli d. Topographic orientation

99. A 6-year-old child presents with increased tone of the right UE and LE, including flexion contractures of the elbow and wrist and the thumb adducted in a fisted hand. The child also has mild flexion contracture of the right knee and walks on the toes. The OT would plan assessments and interventions appropriate for: a. Spastic diplegia b. Flaccid paraplegia c. Spastic hemiplegia d. Flaccid monoplegia

1. A 2-year-old child receives early intervention. The OT needs to discuss the child's progress with the parents. The OT needs to remember which of the following when communicating with the child's parents: a. Talk and do not allow the parents to discuss their concerns and needs as the OT is the expert b. Provide the parents with the information about the child's ability when compared to its peers c. Tell the parents that it is too bad that all their needs cannot be met and that is just the way things are d. Suggest alternative resources to parents even when their requests cannot be met within the system

10. A patient diagnosed with Alzheimer's disease is being discharged to home. In preparing the home program, the OT should primarily emphasize: a. Cognitive activities to keep the patient's mind engaged b. Use of memory aids throughout the patient's home c. Recommendations for support services and adult day care d. Education of the caregiver on disease process and strategies

10. An OT is working with a child who has CP. The child has limited ROM in bilateral UE and is unable to reach out for objects. The OT provides intervention that focuses on allowing the child to participate in play activities. The BEST position to place the child in is: a. Sidelying b. Prone c. Supine d. Sitting

100. A child uses a wide-base of support when walking because of instability and poor weight shifting. This is characteristic of: a. Mental retardation b. Scoliosis c. Juvenile RA d. Ataxic cerebral palsy

100. Which of the following statements describe the collaborative relationship between the OT and the OTA in a school-based setting? a. The OT may assign the OTA to perform all aspects of service. b. The OTA is responsible for seeking the supervision required for delegated areas of intervention. c. The OTA establishes intervention priorities. d. The OT is accountable for implementation of intervention.

101. A preschool child has been referred to OT for a screening. The OT's next step is to: a. Observe the child's developmental behaviors b. Establish a treatment plan c. Gather information from the teachers and parents d. Determine the need for further evaluation

101. An IEP team meeting MUST include each of the following except: a. A regular education teacher's attendance b. A review of the student's strengths c. The parent's attendance d. A physician's attendance

102. A patient recently underwent a rotator cuff repair. The BEST instruction to provide to a patient whose goal is to be independent in dressing as soon as possible is to: a. Use one-handed technique for dressing b. Proceed with use of both cautiously while dressing c. Proceed as normal as there are no restrictions d. Use the affected extremity as an active assist

104. In general, which is the MOST appropriate ADL accommodation for hemiplegia? a. Weighted items b. Lightweight items c. Assistive equipment d. Adapted techniques

106. An OT is working to facilitate motor skills and control with a group of patients that have Parkinson's disease. The BEST activity to use is: a. Bowling b. Card game tournament c. Gardening d. Rhythmic musical game

107. A technique frequently used for improving postural control and improving stability in the scapulohumeral area is: a. Sensory integration b. Weight training c. Standing table d. UE weight bearing

108. A psychosocial reaction of an elderly client who experiences difficulty understanding normal speech sounds might be: a. Decreased physical reactions b. Decreased paranoid tendencies c. Increased social activities d. Increased paranoid tendencies

11.What is MOST likely to be found in quantitative research? a. Lengthy, descriptive, narrative text b. Open-ended interviewing c. Small sample chosen according to goals of the study d. Standardized tests and scales

111. The OT in a skilled nursing facility is asked to recommend the best type of clothing to facilitate dressing for the general patient population. The OT would MOST likely recommend: a. Loose fitting garments that can be pulled overhead b. Garments that have a combination of elastic and buttons or zipper closures c. Front opening, firm fitting garment without excess fabric and zipper closures d. Front opening, loose fitting garments with large fasteners or Velcro closures

112. A tool that helps to decrease directional confusion and facilitate a mature pencil grasp during writing activities is: a. A pencil grip b. Lined paper c. A smaller diameter pencil d. A vertical writing surface

112. As a person ages, the OT must be concerned about the individual's capabilities along a continuum of mental or cognitive functioning, also known as: a. Biological age b. Chronological age c. Social age d. Psychological age

114. The OT is working with a patient to increase arousal and attentiveness. The patient has mastered the ability to visually attend. The OT should NEXT incorporate: a. Identifying objects b. Imitation of postures c. Figure-ground activities d. Visual tracking

115. Family structures change through births, deaths, and marriages. The social context that BEST illustrates this is: a. Family structures are static. b. Families are ruled by tradition. c. Family housing is changed periodically. d. Family structures are dynamic.

117. A client's loss of ROM, grip strength, and sensation caused by a work- related injury would be documented by the OT as a(n): a. Handicap b. Disability c. Dysfunction d. Impairment

118. An OT would expect a patient that presents with performance deficits caused by issues related to visual processing to demonstrate difficulties with: a. Tracking b. Attending to objects c. Focusing on multiple objects d. Discrimination between objects

118. An infant's parents want to watch the OT work with their child on the neonatal ICU. Using a client-centered approach, the OT should: a. Tell the parents to leave during treatment because too many people in the room can be distracting b. Schedule a time to talk to the parents, different from the therapy session c. Ask the parents to get permission for the doctor before sharing updates on the child d. Offer instruction on handling and positioning

119. An elderly client using hearing aid, eyeglasses, and a night-light is making use of: a. Over-the-counter remedies b. Assessments c. Props d. Interventions

12.An OT is dating a client in the work hardening program. When the client's case manager asks if the patient is ready to return to work, the OT states that additional time in therapy is needed. Which principle of the AOTA Code of Ethics has the OT violated? a. Autonomy b. Beneficence c. Fidelity d. Nonmaleficence

120. An OT is writing a functional problem list. Which of the following should be included? a. Decreased ROM of the UE b. Decreased muscle strength at a grade of fair minus c. Swelling of right UE d. Limited ability to grasp because of edema

121. A client with scleroderma is being seen for a home program. Using the MOHO as a FOR, the OT evaluation of the individual should focus primarily on: a. The problem areas and deficits b. Clarification of thoughts, feelings, and experiences that influence behavior c. Cognitive function, including assets and limitations d. The impact of personal traits and the environment on role performance

121. A patient with a kyphotic posture would possibly have difficulty putting on which type of garment? a. Socks b. Button down top c. Belt d. Pull over

122. During a family conference, the OT recommends a large piece of adapted equipment that the patient will need when discharged. The family would like to obtain the equipment but is concerned about the expense. In advising the family, the OT should use this type of reasoning: a. Narrative b. Scientific c. Ethical d. Pragmatic

123. The OT is evaluating a client with a "suspected" work-related musculoskeletal disorder. During an occupational interview with the client, the OT determines that the client is exposed to multiple risk factors. Which of the following is considered a work-related risk factor for developing a musculoskeletal disorder? a. Sedentary lifestyle b. Obesity c. Awkward postures d. Diabetes

124. Prior to discharge, the OT needs to determine how efficient a patient is when performing morning ADLs. The BEST measure to use is to assess: a. The amount of time it takes to complete the self-care tasks b. The complexity of the tasks that need to be done during the morning c. If pain is present when performing the morning self-care routine d. The number of times adapted equipment is used during the morning routine

126. A patient with a diagnosis of a TBI exhibits inappropriate episodic outbursts and has difficulty with concentration, memory, and following directions for ADLs and IADLs. What FOR would guide the OT in determining the BEST treatment approach? a. Rehabilitation b. Biomechanical c. Neurodevelopmental d. Cognitive behavioral

127. The OT conducts a worksite visit and assesses an injured client's workstation. The information gathered by the OT will be used to first: a. Develop an occupational profile b. Analyze occupational performance c. Develop an intervention plan d. Implement an intervention plan

128. A child in OT is throwing a tennis ball at a target. It is likely that the OT is trying to develop a: a. Radial digital grasp b. Cylindrical grasp c. Disc grasp d. Spherical grasp

129. The OT is required to perform an evaluation to determine the maximum amount of weight the client can lift, push, pull, and carry. According the OTPF, the client's maximum capacity for lifting, pushing, pulling, and carrying is an assessment of: a. Job performance b. Employment capacity c. Physicality d. Strength and effort

130. You have received an order for ADL training for a newly admitted adolescent with conduct disorder. The written order came from a new medicine resident that is unfamiliar with psychiatric OT services. From your 1st observation it is obvious that this adolescent has no need for ADL training. Your NEXT step would be to: a. Go ahead and follow the order as written b. Ignore the order and do what is more appropriate for the patient as a qualified professional c. Confront and tell the doctor that you are going to educate the doctor d. Ask to speak with the doctor, briefly explain OT services, and discuss rewriting the order so that you can evaluate the patient's OT needs and treat accordingly

131. An individual suspected of having a work-related de Quervain's condition is referred for an evaluation. The MOST appropriate provocative test for the OT to perform during the initial evaluation is: a. Phalen's b. Grind c. Cozens d. Finklestein's

131. The OT is consulting with a speech and language pathologist on positioning of a child who has CP with increased tone. The speech and language pathologist wants the child to observe her mouth and repeat what the speech and language pathologist says. It is likely that the OT will recommend that the child be seated in the child's wheelchair with the speech and language pathologist: a. Standing above the child so that the child looks up b. Standing behind the child so that the child turns around c. Sitting beside the child so that the child turns to her side d. Sitting directly in front of the child so that the child looks forward

131. Your patient is refusing all groups. You would: a. Realize that you can't make the patient go and remove the patient from your caseload b. Tell the patient that it's mandatory and the doctor said that the patient has to participate c. Get the nurse to make the patient go d. Ask the patient to tell you why they do not want to participate

132. The OT consultant interviews the HR director and floor supervisor of a manufacturing plant. The OT learns that the company has been negatively affected by recent changes in statues set forth by the Occupational Safety and Health Administration (OSHA). According to the OTPF, this information provides the OT with a better understanding of the organization's: a. Social context b. Virtual environment c. Physical context d. Cultural context

135. An OT is working in the school system with a 7-year-old child who has severely impaired cognition and motor abilities. The child requires a great deal of assistance with feeding, toileting, and other basic self-care tasks. It is MOST likely that the OT will choose an assessment that measures: a. Gross motor and fine motor skills b. Visual motor integration skills c. Achievement toward developmental milestones d. A child's ability to participate in self-care, mobility, and social functions

135. Which of the following skills is considered the BEST predictor of handwriting ability? a. Letter recognition b. Visual perceptual c. Hand dominance d. Visual-motor

138. An OT is working with a child who demonstrates persistent primitive reflexes after a brain injury. The OT is working with the child to actively grasp and release blocks. The child is having difficulty releasing the blocks into a bin. This is MOST likely caused by the persistence of the: a. ATNR b. Avoiding response c. Traction response d. Grasp reflex

138. The OT is working with a group of Grade 1 students. As the children copy a 4-word sentence, the OT observes that the children are having difficulty leaving large enough spaces in between words. The OT might encourage the children to: a. Skip lines on the paper b. Use paper with raised writing lines as tactile cues for letter placement c. Use grid paper d. Place a penny at the end of one word before writing the next one

140. Which of the following could a school-based OT use that would MOST appropriately allow parents to routinely express concerns to the OT? a. Individualized handouts including pictures or diagrams b. A home program designed to fit into the family's routine c. Attendance at the annual IEP team meeting d. Notebook sent back and forth between a school-based OT and parents

141. Which of the following would be an appropriate goal for a school-based OT applying the SI framework? a. The student will swing on therapy swing for 60 seconds without signs of distress by the end of the 6 weeks. b. The student will demonstrate decreased signs of tactile defensiveness by end of semester. c. The student will improve body awareness by wearing a weighted vest as prescribed by therapist, daily. d. The student will independently choose a coping strategy to use when cued by the classroom staff by end of 6 weeks.

142. An OT is working as part of an acute rehab team at a children's hospital. The OT is given an order to make static splints for a 14-year-old child who has just received a continuous intrathecal baclofen pump. It is MOST likely that this pump was put in place to reduce: a. Curvature of the spine b. Seizure activity c. Pressure in the brain caused by hydrocephalus d. Spasticity

144. A patient with RA has been receiving therapy for 2 weeks to work on strengthening and fine motor skills to improve occupational performance in the areas of cooking, manipulation of fasteners for dressing, and the performance of leisure tasks, such as playing cards and board games. Today, the patient arrives in an exacerbated state with swollen inflamed joints. The OT should: a. Modify treatment to focus on performing light leisure activities such as playing cards and board games b. Continue current treatment but reduce the time frame of the treatment session c. Discontinue treatment and reschedule when inflammation has subsided d. Modify treatment to focus on resting of joints and engage in light activities as tolerated

144. A preterm infant has difficulty maintaining lip seal on a bottle's nipple during feeding. The OT can support this child's participation in feeding by: a. Touching the child's cheek to elicit the rooting reflex b. Swaddling the baby with arms and legs tucked in towards the midline or with hands by face c. Positioning the infant in an upright sidelying position to simulate the position of breast feeding d. Providing firm, steady jaw support externally under the base of the tongue and firm, but gentle cheek support

145. You are working with a 45-year-old patient who is recovering from a C5 SCI. The patient is tetraplegic and you are addressing self-feeding during your treatment session. During your session the patient's legs began to bounce up and down repeatedly to the extent that the patient's arms are shaking from the movement and the patient is unable to continue to self-feed. Your BEST course of action would be the following: a. Make the room warmer as this will make the patient's legs stop shaking b. Use a Hoyer lift to transfer the patient onto a bed or mat to stop the shaking c. Ask the patient to stop feeding and relax so the shaking will stop d. Provide weight bearing through the patient's knees toward the patient's ankles to stop the shaking

150. A child with SI dysfunction who has difficulty with anticipatory projected movement sequences would also have difficulty: a. Organize movements to climb up the stairs b. Developing a motor plan to use scissors to cut out picture for a collage c. Using 2 hands together to fly a kite d. Catching a ball that is thrown

151. You are currently seeing a 16-year-old who has sustained a TBI and is in the hospital waiting to transfer to a rehab center. The client is beginning to exhibit hypertonus and tight fisting of both hands. You decide to fabricate bilateral hand splints for the following goal: a. Prevent skin breakdown b. Prevent contracture c. Increase functional use d. A and B

154. A 6-month-old child who was born at 30 weeks' gestation is being evaluated to determine eligibility for early intervention services. The child's adjusted age is approximately: a. 2 months b. 2.5 months c. 3 months d. 3.5 months

154. You are working in the hospital and receive a consult to see a 65-yearold patient who has recently had a left CVA. When you enter the room and explain the role and purpose of OT, the patient immediately states the desire to brush the patient's hair. As the patient reaches for the brush and then brushes their hair with their right hand, you notice that although the patient has adequate ROM, to complete the task the patient has difficulty with the fine adjustments needed to brush the patient's hair. You then know that the following deficit area requires further evaluation: a. Attention b. Sequencing c. Spatial neglect d. Motor apraxia

157. While working in a clinic, the OT concludes that a child has gravitational insecurity. According to the SI theory, this issue is MOST significantly connected to the: a. Proprioceptive system b. Tactile system c. Auditory system d. Vestibular system

16. A child has difficulty coordinating 2 hands together. The child tends to neglect his left hand. To provide more proprioceptive input to the child's left arm and to strengthen it, you design a bilateral activity in which the child wears a 2-pound weight on the left wrist. This type of intervention strategy is: a. Grading the activity to provide the "just right" challenge b. Modifying the environment c. Promoting participation and preventing disability d. Providing augmented sensory cueing and feedback

16. A child with CP shows significant impairment in the function of the LE with mild involvement of the UE. The classification of CP for this child would be: a. Hemiplegia b. Tetraplegia c. Choreoathetosis d. Diplegia

160. A 9-month-old infant experiences some difficulties with spoon-feeding. While the OT is observing the caregiver feeding the infant, it is noted that the infant demonstrates a rhythmic in-and-out pattern of tongue movement. This movement pattern can BEST be described as tongue: a. Retraction b. Instability c. Tip elevation d. Thrust

162. A child is having difficulty catching a ball with 2 hands. The OT wishes to further evaluate the child's bilateral integration skills in the context of a functional activity. The OT will likely see if the child is successful when: a. Shifting weight on to one leg in preparation for kicking a ball with the opposite foot b. Swiping at a balloon with either hand c. Throwing a tennis ball at a target d. Holding paper with one hand and using scissors to cut with the opposite hand

162. A patient admitted to the geriatric unit with a diagnosis of Alzheimer's disease can no longer live alone. A family member is now planning to have the patient move into the family member's home. The primary focus of the OT intervention will MOST likely consist of: a. Maximizing the patient's current cognitive perceptual skills b. Improving the patient's level of independence with ADL tasks c. Training the patient and family in the use of adaptive and bathroom equipment d. Providing caregiver training with strategies on how to adapt tasks or the environment

163. An 11-month-old continues to have formula as a primary source of nutrition. There are oral structural changes that occur as the child nears 12 months of age, and feeding in a reclined position would increase the possibility of aspiration. Which of the following oral structural changes make it imperative for the child to feed in an upright sitting position? a. The epiglottis and soft palate are in direct proximation b. The hyoid, larynx, and epiglottis ascend c. The oral cavity is small with fatty cheeks and the tongue d. The pharynx is elongated

165. According to the SI theory, 3 senses are considered to have the most impact on a child's ability to process sensory information and produce an adaptive response. These senses are: a. Auditory, tactile, and vestibular b. Visual, vestibular, and proprioceptive c. Visual, auditory, and olfactory d. Vestibular, proprioceptive, and tactile

166. The parent of a child with Asperger's syndrome shares with the OT that when the child is playing at the park, the child often enjoys climbing on the monkey bars and jumping down. The parent reports that the child is regularly encouraged to play ball, go into the sandbox, and/or ride on the swings. However, the child usually refuses and continues to climb on to the top of the monkey bars and jump off. Based on this information, it MOST likely that the child is: a. Avoiding playing with other children and interacting with his parent b. Hyposensitive to tactile input c. Seeking tactile input d. Seeking vestibular and proprioceptive input

17. A 7-year-old child is diagnosed with ADHD. An etiology for ADHD would be: a. Environmental factors b. Visual and auditory stimulation c. Food allergies and food additives d. Neurochemical imbalances

170. The first step in a visual assessment of a 50-year-old patient who has sustained a brain injury would be: a. Tracking b. Visual field confrontation testing c. Convergence testing d. Visual history

174. You are evaluating a 75-year-old client who has been diagnosed with a CVA. Your first visit is during a morning ADL routine. The client is currently sitting in a wheelchair at the sink and is requesting to brush their teeth. Several performance skills can be evaluated during this task. A behavior that would demonstrate a spatial relations deficit is: a. Forgetting to turn of the water b. Requiring verbal cues to put the toothbrush into their mouth c. Requiring verbal cues to put the toothpaste on the brush before brushing their teeth d. Requiring assistance for positioning the toothbrush under the faucet

177. A 19-year-old patient sustained a right CVA. Even though you are seated in a quiet environment the patient seems very slow in answering your questions. From the patient's behavior you feel that the patient needs further assessment for: a. Inattention b. Receptive aphasia c. Expressive aphasia d. Delayed processing of information

18.The principle of beneficence is BEST described as: a. A healthcare practitioner is required to act as other healthcare professionals would act in similar situations b. A healthcare practitioner should act in ways that do not cause harm or injury to others c. A healthcare practitioner is required to present choices so that individuals are able to select the best choice for treatment d. A healthcare practitioner should act in ways to promote the welfare of other people

185. A child should be able to go to the toilet independently but may still require some assistance with cleaning and clothing adjustment at: a. 1 1⁄2 years b. 2 1⁄2 years c. 3 years d. 4-5 years

187. An 8-year-old has SCI and is in acute care. Assessment would also include evaluation of the need for specialized equipment. What specialized equipment would be necessary for use in the hospital and after discharge? a. Pressure garment b. Splints c. Adapted toilet seat d. Adapted utensils

19. A patient with CTS has been receiving therapy for 2 weeks. The patient recently developed paresthesia with radiating pain in the forearm, wrist, and hand. The OT should: a. Begin desensitization activities b. Stop therapy until symptoms disappear c. Begin PROM exercise d. Provide a splint

190. The BEST OT intervention for a patient with a generalized anxiety disorder (GAD) would be: a. 1000-piece puzzle b. Relay races c. Assertiveness training d. Deep-breathing and relaxation exercises

20. A 6-year-old child in Grade 1 has difficulty coordinating both hands together. The child tends to neglect the left hand. To provide more proprioceptive input to the left arm, and to strengthen it, the OT designs a bilateral activity in which the child wears a 1 lbs. weight on the left wrist. What type of intervention strategy should the OT use? a. Grading the functional activity b. Modifying the school environment c. Training in developmental sequencing d. Providing augmented sensory cueing and feedback

200. An adolescent was just admitted to your unit with a diagnosis of conduct disorder. The patient is noted to be having problems in home relationships and their grades have taken a turn for the worse. Coming from a MOHO perspective, the MOST appropriate evaluation to use would be: a. Kohlman Evaluation Living Skills (KELS) b. Large Allen Cognitive Levels (LACL) c. Peabody Developmental Motor Scales (PDMS) d. Adolescent Role Assessment

204. Which of the following groups is appropriate to use for Level 2 clients when using a Cognitive Disabilities FOR? a. Cooking b. Work evaluation c. Grooming d. Movement

209. Which scenario represents the MOST appropriate means for OTs to use physical agent's modalities? a. The OT applies a hot pack to decrease stiffness of the neck and shoulder. b. A patient with OA is prescribed fluidotherapy for 20 minutes to the affected extremity. c. Patient receives contrast heat and cyrotherapy treatments to minimize edema. d. A patient is prescribed fluidotherapy for 20 minutes, then works on buttoning shirt.

21.The OT department has had 3 recent resignations and is short-staffed. The Rehab Director reassigns the psychiatric OT to outpatient clinic 2 days per week. A patient comes in with orders for a specific technique related to lymphedema management, and the OT asks that the patient be reassigned because the OT has never had any training in this area. Despite the director's assistance, the OT requests that someone with expertise treat the patient. Which core value and attitude of OT is BEST exemplified by this therapist's action? a. Altruism b. Justice c. Prudence d. Truth

210. The following statement is true for MOST patients diagnosed with dementia: a. The condition is curable and most patients will return to normal functioning b. The onset is usually sudden c. Substance abuse is a leading cause d. The condition is progressive and incurable

213. When discharging a patient with Alzheimer's to a skilled nursing facility, what is the MOST important information to share? a. Summary on cognitive performance b. Recommendations to a support group c. Summary of the patient progress d. Results of the initial evaluation

215. A patient with a diagnosis of chronic pain is referred to OT for coping skills related to pain management. Using the cognitive-behavioural approach that addresses thoughts, emotions, and physiology, which technique might the OT used to assist the patient? a. Teaching how to follow medication routine b. Hypnosis c. Thought stopping d. Relaxation therapy

215. An OT is working with a client who exhibits deficits with UE condition. During a cooking activity, the OT might recommend that the individual: a. Use lightweight utensils, pots, and pans b. Place items within easy reach for greater control c. Use one extremity at a time d. Use heavy-weighted utensils, pots, and pans

220. A client with mild dementia lives in an assisted living facility. The OT is consulted to recommend strategies to help the person maintain functional independence as long as possible. One strategy for promoting independence in occupational performance is to: a. Have patient keep a journal of the most frequent activities during the day b. Improve lighting in all rooms for better localization of items that will be needed daily c. Require a buddy system in which a neighbour can remind the person of what is needed to do d. Place picture, schedules, and items related to daily activities throughout the house

220. Individuals with this diagnosis demonstrate a pervasive pattern of grandiosity, a need for admiration, and a lack of empathy for others. They also may believe that they are exempt from all duties and responsibilities of everyday people. This diagnostic category is: a. Antisocial personality disorder b. Avoidant personality disorder c. Dependent personality disorder d. Narcissistic personality disorder

237. A provocative test that is sometime used to determine the presence of CTS is the: a. Finklestein test b. Froment sign c. Ligamentous instability test d. Phalen sign

24. A scenario in which an OT would use the School Function Assessment examination is: a. To measure the student's schoolwork task performance in the classroom and provide information for effective programs and consultation in the school setting b. To assess what the child "did do" and what the child "could do" to help determine the effect of the child's physical disability on engagement in everyday occupations c. For screening children to determine whether they warrant further, more comprehensive evaluation d. To measure children's ability to participate in the academic and social aspects of the school environment

242. An entry-level OT has a new job at an outpatient rehab facility. The majority of diagnoses are conditions, such as tendonitis, fractures, overuse syndrome, and nerve compression injuries. The OT concludes that the primary FOR used to treat individuals at this facility is: a. Neurodevelopmental b. Cognitive c. Sensorimotor d. Biomechanical

246. A functional reach screen conducted by the OT shows that the client is unable to move body parts independent of each other. The NEXT area to assess is: a. Endurance b. Standing balance c. Strength d. Postural control

246. An individual who is confirmed to a wheelchair is unable to detect pain or pressure sensation. The OT should: a. Encourage the individuals to transfer from wheelchair to a regular chair twice a day b. Suggest the individual use a pillow in the wheelchair c. Require a family member to remind the individual to do pressure relief periodically d. Educate on repositioning and how to check the skin for breakdown

248. A client is choosing to work on tooling a leather wallet like one of his peers, but you know that his attention span is short and that doing such a project would likely set him up for failure. You decide to: a. Let the client go ahead and try it, but tell the client that failure is likely, because the task is too difficult b. Refuse to let the client work on the leather, because the client will just waste the materials c. Tell the client the leatherwork is only for the skilled members of the group d. Encourage the client to work a smaller piece (like a leather round) first to help him determine if the client likes the activity and if the client really wants to invest the time that it will take to complete the task

249. You are working with an adult patient in a day treatment program who wishes to become more assertive. Which of the following is the MOST appropriate goal for this patient's OT treatment? a. Patient will tell others what they think b. Patient will practice assertiveness skills twice a day c. Patient will demonstrate improvement in assertiveness skills d. Patient will demonstrate improvement in assertiveness skills by consistently voicing needs to their spouse, as they arise, for 2 weeks

25. An early intervention service listed in Part C of the Individuals with Education Act (IDEA) is: a. Prenatal care b. Medical care and surgery c. Music therapy d. Nutrition

25.Reimbursement rates vary according to the type of reimbursement system. Which statement is true regarding reimbursement? a. There is an incentive for physicians to limit costs in a fee-forservice system. b. Medicaid is a prospective system. c. Capitation rates vary according to how many patients were treated that mouth. d. A prospective system covers all costs for a specific illness for a specified period of time.

250. An activity that would be contraindicated for an arthritic patient using principles of joint protection with lifting is: a. Pushing or sliding items along kitchen counter b. Changing position often when working c. Storing frequently used items within easy reach d. Carrying items in hands whenever possible

253. A patient presents in the outpatient rehab clinic with deficits in trunk and UE weakness affecting dynamic sitting balance. In this case, the BEST testing procedure to use to evaluate occupational performance skills and deficits would be: a. Clinical observation b. Standardized testing c. Non-standardized testing d. Functional motion assessment

256. A patient with lymphedema is prescribed a resting hand splint to maintain joint alignment and functional positioning. The BEST method the OT could us is: a. A splint secured with a bandage wrapped circumferentially b. A splint with narrow straps secured at the position of the forearm, wrist, and hand c. A splint with wide straps secured at the position of the forearm, wrist, and hand d. A circumferential cast

26. The OT is designing an intervention plan for a 10-year-old with a learning disability. The intervention plan should focus on developing performance skills related to: a. Tactile-kinesthetic input b. Behavioural issues c. Motor function d. Cognition

260. Which of the following is the BEST example of a possible compensatory strategy a school-based OT may use to improve functional written communication for a student? a. Use of an adapted pencil grip b. Handwriting Without Tears c. Classroom based handwriting intervention group d. Keyboarding

263. Which of the following potential sensory diet activities would be the MOST appropriate choice to provide proprioceptive input to for a preschool student? a. Sitting on a therapy ball during fine motor craft activities b. Rocking in a rocking chair while being read to c. Sorting magnetic alphabet letters out of a bin of dried beans d. Picking up weighted beanbags and placing them in a container during clean-up time

265. If you suspect a student diagnosed with seizure disorder or epilepsy is having a seizure during a therapy session during a therapy session, an important response would be: a. Checking the student's mouth b. Calling 911 c. Physically restraining any movements the student makes d. Preventing the child from striking against any objects that may cause injury and allowing the seizure to conclude

266. Which of the following is NOT an example of appropriate consultation in school-based occupational therapy? a. Discussing with a physical education teacher how to adapt activities to allow a student with CP to participate b. Recommending that a student use a pencil grip and incline writing surface to improve handwriting c. Providing the classroom staff with sensory diet activities to help the student regulate the level of arousal d. Providing therapy services in the natural classroom environment, rather than in a pull-out setting

267. Coordinated activities for a student with a disability that is an outcomeoriented process promoting movement from school to post-school activities; based in individual student needs, considering the student's preferences and interests; and including related services, instruction, community experiences, employment, and post-school living objectives, and if appropriate daily living skills and functional vocational evaluation ($300.29) MOST accurately describes which of the following? a. School-based occupational therapy b. Specially designed instruction (special education) c. Individualized Education Plan d. Transition services

27. A 5-month-old infant shows righting reactions of lifting its head when in supine position. When the child is pulled to a sitting position, the child can maintain head alignment with the body without the initial head lag. The child's righting reaction is: a. Neck on body reaction b. Landau reaction c. Body on head reaction d. Flexion reaction

271. Which of the following would be appropriate examples of assistive technology a school-based OT may recommend for handwriting? a. Pencil grip b. Inclined writing surface/slant board/easel c. Dorsal hand weighted d. Word processor

273. A situation in which an OT would not directly address the psychological needs of a client is when they are treating a: a. Patient with learning disabilities b. Patient with RA c. Patient with autism d. Comatose patient

274. A school-based evaluation of a Grade 1 handwriting should always include: a. Administering the Developmental Test of Visual-Motor Integration b. Administering the Motor Free Visual Perceptual Test c. Observing the child write on an inclined surface d. Observing the child write in a natural setting

28. While treating a patient with long-standing shoulder joint stiffness, the OT is told by the patient that another OT used heat treatments in the past both before and after functional activities, which was very helpful. Which would be a necessary FIRST step for the OT to take in regard to using physical agent modalities with this patient? a. Document the length of application and expected response to treatment b. Position the patient in a comfortable position before applying the treatment c. Read the patient medical records to confirm the diagnosis d. Obtain a written prescription from the physician

3. An OT comes to work intoxicated and injuries a patient. The OT's license is revoked for 3 years. Which agency/entity is responsible for this disciplinary action? a. The American Occupational Therapy Association (AOTA) Commission on Standards and Ethics (SEC) b. The Disciplinary Action Committee of the National Board of Certification for Occupational Therapy (NBCOT) c. The National Practitioner Data Bank d. The State Occupational Therapy Regulatory Board

3. An assessment team in early intervention has completed an evaluation of a toddler. In compiling the Individualized Family Service Plan, the goals should be determined by the: a. Service coordinator for the case b. Therapists from each discipline c. Reimbursing agency d. Parents

30. A patient who sustained a severe heart attack was categorized at a metabolic equivalent table (MET) level of 2-3. The patient has completed the goal of doing homemaking activities, such as washing dishes and ironing. The OT should progress intervention to include the occupational task of: a. Driving an automobile b. Performing UE and LE dressing c. Gardening in the yard d. Preparing 1-2 meals per day

33. During a treatment session, the OT observes that the patient can flex the affected shoulder through its full ROM in side lying. The OT should progress to activities that places the extremity in: a. A gravity-assisted position b. A gravity-eliminated position c. A neutral position d. An antigravity position

33.A chiropractor advertises OT services in her office, although neither an OT nor an OTA is employed. To be considered legal, the chiropractor is MOST likely practicing in a state with what form of OT regulation? a. Certification b. Licensure c. Registration d. Title control

36. A 2-year-old toddler has delays in communication, play, and self-feeding. The child's parents have moderate mental retardation and both of them work from home to earn their daily living. A strategy that the OT could suggest to help them in working with their child is: a. Disregard their limited problem-solving skills b. Make decisions for them when they have difficulty planning the next step c. Ignore their internal and external control, self-esteem, and social skills d. Take note of their learning styles and abilities so as to better instruct them

37. A 4-year-old child avoids wearing clothes with waistbands, as well as socks and shoes, and also avoids having their hair combed. Dressing is a very difficult process each day. The OT would suspect that this behavior is caused by: a. Normal age appropriate behavior b. Avoidance of the sensation caused by elastic materials c. Sensory registration difficulty d. Sensory modulation difficulty

38. A 6-year-old child has an inability to discriminate vestibular proprioceptive stimuli. A function that would cause difficulties is: a. Judging the space between objects b. Perceiving form and space and relationships among objects c. Perceiving depth, distance, and location of boundaries d. Judging the correct force to use with people or objects

38. The OT on the spinal cord unit is very frustrated. A 28-year-old patient with C7 tetraplegia refuses to work on dressing techniques, saying that the spouse can assist with dressing. The OT documents that the patient is noncompliant in OT and will not be able to return to work as an attorney. The OT supervisor works with a patient one day, and the patient says that the patient wants to save energy for work and not use it up in the morning trying to get dressed. Allowing the patient to make this choice BEST exemplifies which of the core values and attitudes of OT? a. Altruism b. Dignity c. Equality d. Freedom

4. A goal of early intervention is to provide family-centered service. When an OT assists families in having a clearer understanding of their child's disabilities and strengths, it is an example of: a. Compensation b. Adaptation c. Supporting d. Reframing

40. The OT working with a child on motor disabilities could not see any progress. In analysing the intervention, it was noticed that the OT gave frequent feedback to the child at each step. The OT made the child frequently repeat the movements and also held the child's hands while doing the movements in practice sessions. In spite of OT's efforts, there was no progress in the child's motor learning. Which of the following do you think are the reasons for the child's failure? a. Random scheduling b. Need more feedback c. Require more repetition of movements over a long period of time d. Handling may cause ineffective motor learning

41.The following are all examples of advocacy by OTs, except: a. Seeking a referral for a client b. Writing letters of support for a piece of proposed legislation c. Joining a professional association and serving on a political action committee d. Attending continuing education sessions to advancing your clinical skills

42. Which of the following is a key precaution in using hand splinting for children with spasticity? a. The splint should not be worn during the day, in order to allow for hand use b. The splint should not be worn at night if there is hand flexion during sleep c. The child should wear a splint initially for at least 6-8 hours per day d. The therapist should see the child frequently for follow-up intervention

44. A 10-year-old child is in the 3rd grade. The child's parents are worried about the recent poor performance in math. The child's grades show that the child is age-appropriate in reading and writing, and that the child can perform simple subtraction and addition problems, but the child faces difficulty in solving problems that involve multiple steps or column. This information should clue the OT to screen for: a. Visual-formation problems b. Visual-discrimination problems c. Object (form) problems d. Visual-spatial problems

46.An OT observes a co-worker acting in an unethical manner with a client and reports the individual to the appropriate agency (e.g., state licensure board). This action is an example of: a. Client advocacy b. Organization advocacy c. Healthcare environment advocacy d. Professional advocacy

47. A child who has developmental delays has learned to hold the scissors correctly and can snip paper. What is the NEXT scissor activity to upgrade the child's skills? a. Cut out squiggly shapes b. Cut out large circles and squares c. Cut out paper dolls with various shapes d. Cut on wide pre-drawn straight lines

48. The MOST effective input channel for elementary school children to learn is: a. Auditory b. Visual c. Tactile d. Kinesthetic

48.The owner of a freestanding outpatient rehab clinic decides to perform an organizational assessment using a SWOT Analysis to re-evaluate the clinic's effectiveness relative to the patient population, the community, and the healthcare system. The owner finds that reimbursement from workers' compensation insurers has decreased by an average of 7% per year for the last 3 years. Using the SWOT analysis tool, the director determines that this is a: a. Strength (internal factor) b. Weakness (internal factor) c. Opportunity (external factor) d. Threat (external factor)

52. A child diagnosed with CP has severe spasticity in the bilateral UE. The OT referral states "fabricate splints to prevent hand deformities." The theoretical approach for splinting should emphasize placement of the hands in the: a. Intrinsic minus position b. Anticlaw position c. Resting hand position d. Reflex inhibiting position

52. A patient with a radial nerve injury is re-evaluated by the OT to assess the amount of sensory return as the nerve regenerates. The process for testing sensory return should include application of the stimulus: a. From proximal to distal on the anterior forearm, first, second, and third digits b. In random order to the anterior forearm, first, second, and third digits c. To the medial aspect of the forearm and digits d. In random order to the posterior lateral aspect of the forearm, and first 3 digits

52.The executive director of rehab services has asked the OT department manager to collect data for program evaluation. According to the OTPF, which one of the following service delivery components provides the BEST data to inform program evaluation? a. Evaluation b. Intervention c. Discharge d. Outcomes

53. A 40-year-old patient with a 3-week-old wrist fracture is receiving outpatient therapy focused on early mobilization. The OT should first: a. Determine the patient's tolerance for pain b. View the radiographs to determine the amount of healing that has taken place c. Begin isometric exercise for strengthening d. Teach self-ranging and tendon gliding techniques

53. An 85-year-old client with normal age-related physical changes will have the MOST cardiovascular stress with which of the following activities? a. Brushing teeth at the sink while holding onto the counter b. Getting dressed while sitting on the edge of the bed c. Walking to the mailbox 250 ft. from the house d. Carrying a basket of laundry from the basement

55. To give an up-to-date report at the medical team meeting, the OT must report on the progress of the patient. The most up-to-date information should be obtained by performing a(n): a. Discharge summary/review of outcomes b. Occupational profile c. Initial evaluation d. Intervention review

57. A patient with recent hip replacement surgery was advised to continue to follow hip precautions when discharged home. An important piece of adaptive equipment that the OT might recommend is: a. A wheelchair b. Velcro shoes c. A sliding board d. A raised toilet seat

57. The OT needs to develop the occupational profile of a deaf client. The MOST appropriate assessment method to use would be: a. Interview a family member b. Provide a standardized test to the individual c. Do a home visit to observe the person in action d. Present a written inventory that the person can respond to

58. An 8-year-old child with a history of problems related to developmental dyspraxia has transferred to a new pediatric clinic. The OT at this facility would need to access the: a. Response to tactile stimulation b. Ability to initiate and complete a new activity c. Muscle strength and ROM d. Ability to recall numbers and letters

58. The OT is providing service at school to a 4-year-old patient with arthrogryposis. The child's goal is to increase independence with selffeeding. The OT believes that the child will be more successful if using adaptive equipment during lunchtime. It is likely that the OT will recommend that this child use: a. Built-up utensils b. A non-slip placemat c. An augmentative communication device d. Long handled utensils

60.A 6-year-old with CP has this service mandated under the Individuals with Disabilities Education Act (IDEA) Part B: a. Family training, counselling, and home visits b. Limited access to specialized services c. Interdisciplinary assessment d. Discipline specific education assessment

63.A student on affiliation notices that their supervisor routinely documents treatment units before actually seeing the patient. The student discussed this with the administrator because in the Code of Ethics, this action would violate what principle? a. Duty b. Altruism c. Confidentiality d. Veracity

66. A child who is blind is tactilely defensive. The child recently started kindergarten, and the OT is asked to recommend a method to assist the child to learn Braille. The BEST method for initiating treatment with this child is to: a. Play games that involve following an obstacle course over various textures b. Lightly stroke the child's arms and legs with various textures c. Play seek and find with cotton balls within the child's reach d. Use several scratch and sniff activities during play

67. A client with a shoulder impingement is referred to OT for skilled instructions in dressing. A dressing technique that would have a tendency to cause symptoms to increase is: a. Donning and doffing socks and shoes b. Pulling pants up to waist c. Putting on a shirt with buttons down the front d. Putting on an overhead garment

67.The OTA asked the OT to explain the term "service competency". The BEST response is to explain that service competency: a. Is established when a therapist passes the certification exam b. Is achieved when an individual attains a certain number of continuing education units c. Means individual competency is gained after years of practice d. Occurs when 2 practitioners performing the same procedure gain the same results

68. The OT evaluated a Grade 1 student with mild left hemiparesis. Results from the OT evaluation indicate that the student is able to independently participate in all aspects of the educational environment, including physical education with few adaptations. At this child's IEP meeting, it is likely that the therapist will: a. Recommend direct service to address concerns regarding the child's ability to independently bathe at home b. Not recommend any service because other members of the team can recommend additional adaptations and modifications c. Recommend direct service to address the child's tone and the development of age-appropriate hand skills d. Not recommend direct service because the child is independent at school

69.What Medicare Prospective Payment System (PPS) would an OT employed in a long term facility to direct therapy and billing procedures? a. Resource Utilization Grouping (RUGs) b. Diagnostic Related Groups (DRGs) c. Case Mix Groups (CMGs) d. Resource-Based Relevant Value Scale (RBRVS)

70. A medically fragile infant is being discharged from the hospital and evaluated for home-based early intervention services. The family requests that after all team members assess the child, only 1 or 2 professionals actually come in to the house to provide service to their infant. This approach to service provision can BEST be described as: a. Intradisciplinary b. Community based c. Interdisciplinary d. Transdisciplinary

71. A child has difficulty holding a fork during self-feeding because of decreased sensory receptors in the hand. The OT will MOST likely recommend the use of: a. A weighted utensil b. A utensil with a cuff c. A larger utensil d. A textured utensil

72. An elderly homemaker underwent a total hip replacement 7 days ago. The patient is being discharged with a home program. Following hip precautions, the OT should recommend that when performing some basic ADL tasks, the patient should avoid: a. Leaning over a counter right in front to reach into cabinets b. Bathing in the shower c. Picking up pants from the floor with a reacher d. Sitting on a regular toilet

72.The term that refers to the process of providing information to individuals to assist them in the decision-making process about their own healthcare is: a. Beneficence b. Fidelity c. Autonomy d. Informed consent

73. A patient in a chronic pain management program exhibits constant complaining negative behavior about the presence and intensity of pain. One approach to assist in extinguishing the constant complaining is to: a. Sympathize with the patient when he/she complains b. Refer the patient to the physician or nurse for medication c. Confront the patient about the constant complaining d. Ignore the constant complaining and focus on the positive when it occurs

73. A patient with a diagnosis of lung CA is referred to home health OT. The patient was forced to retire because of the illness and the OT would like to assess the patient's perception and satisfaction with the present level of occupational performance. The BEST type of assessment to use is: a. An interest checklist b. A standardized questionnaire c. A functional motion assessment d. A semi-structured interview

75.An OT has a private practice ergonomics consulting business. The OT has been asked to consult with a local textile plant on ergonomic issues. According to the consultation process, what is the FIRST step the therapist should follow? a. Assessment and communication b. Interactive problem solving c. Evaluation and termination d. Initiation and clarification

76. A patient diagnosed with arthritis complains of pain in the elbows and forearm and has difficulty with self-feeding. ROM assessment reveals limitation in pronation and supination, but elbow flexion and extension are within functional limits. The BEST piece of adapted equipment to use for independence in self-feeding is: a. Long-handled lightweight utensils b. Built-up handled utensils c. Utensils placed in a universal cuff d. A swivel spoon or fork

77. An OT working in early intervention is helping a parent to get the baby to hold and drink from a bottle. Based on typical development, the therapist should begin to introduce this skill between: a. 12-14 months b. 10-12 months c. 8-10 months d. 6-8 months

79. An OT is working with an individual who has low back pain and works as a truck driver. Using the biomechanical approach the OT should: a. Assess the individual to determine other job options b. Recommend the person consider part-time work until pain diminishes c. Refer the person to PT or a chiropractor d. Educate on proper positioning for the work environment

79. The MOST valid and valuable information attained during a motor evaluation to determine the functional level of a client with hemiplegia and resultant UE spasticity would be: a. Gross sensory evaluation b. Standard MMT c. AROM d. Observation of self-care performance

79. When developing a home program for a child with decreased hand and arm strength, the OT will MOST likely suggest that the child is presented with opportunities to: a. Sort dried beans b. Play board games c. Finger paint d. Stir cookie dough

80. A medically fragile preterm infant was recently discharged from the neonatal unit at the hospital. The early intervention team has set up home-based services using a transdisciplinary model with the nurse as the primary interventionist. Using this model, the OT's service for the infant is to: a. Provide a home program for the family b. Provide one-on-one intervention in the home c. Assist with group sessions in the clinic d. Consult with and coaches the nurse

80.The OT practitioner is reviewing the literature to determine the best treatment technique to use with a patient. When evaluating evidence-based research, the level of evidence that is considered to be the strongest is attributed to: a. Case studies b. Cross-sectional surveys c. Cohort studies d. Randomized control trials

85. Using a medical-restorative model, the OT would provide the following intervention: a. Instruct a client on total hip precautions b. Teach compensatory techniques for loss of sensation c. Conduct a socialization group for several mental health patients d. Work on feeding and hygiene with an Alzheimer's patient

86. The OT is working with a left-handed child on letter formation. The OT should cue the child to slant the writing paper so that it is parallel to: a. The right forearm when the child is securing the writing paper with the nondominant hand b. The top of the desk c. The left forearm when the child's forearms is resting on the desk and in a neutral position d. The left forearm when the child's forearms are both resting on the desk and the child's hands are clasped

87.Which of the following is a true statement? a. OTs practicing in mental health never address the physical needs of their clients. b. OTs practicing in mental health are required to have a specialty mental health certification. c. OTs only address their patients' psychosocial issues in mental health settings. d. OTs practicing in mental health address the holistic needs of their clients.

88. An OT is working with a child that is suspected of having difficulties with visual perceptual skill. Developmentally, the FIRST visual component that needs to be assessed is: a. Pattern recognition b. Scanning skills c. Visual attention d. Oculomotor control

89. The highest level of SCI at which you would expect a client to become independent in all self-care and driving with equipment would be: a. C7 b. C8 c. C5 d. C6

9. During an evaluation, the OT must determine a child's exact chronological age. The child was born on March 6, 2003 and the testing date is July 12, 2006. The child's chronological age is: a. 4 years, 6 months, 5 days b. 3 years, 2 months, 6 days c. 4 years, 5 months, 6 days d. 3 years, 4 months, 6 days

93. The optimal workspace for a worker seated at a table is: a. 12 inches to either side of midline and 12 inches in front of the worker b. Approximately 1 hand span width directly in front of the worker c. 180° are from left side of table to right side of table d. Any area that can be reached with shoulders at 15° adduction and 0° flexion

94. An OT is treating a teacher who was injured in a MVA and is now a wheelchair. The school has requested an ergonomic assessment to modify the teacher's classroom. The OT recommends lowering the chalkboard. Without knowing the teacher's height, the highest height for the top of the chalkboard that the OT would recommend is: a. 36 inches b. 42 inches c. 48 inches d. 52 inches

95. An OT is doing a home assessment for a client who will be going home in a wheelchair. The patient is a gourmet cook and wants to put an island in the kitchen for food preparation. The sink is on one wall, with the refrigerator on the wall to the left and the stove/oven on the wall to the right. The client will need to be able to turn all the way around in the wheelchair to access everything. The minimum space required is: a. 40-inch square b. 55-inch square c. 62-inch square d. 74-inch square

96. A patient with fibromyalgia has performance deficits in ADLs, including lack of a daily routine because of a loss of energy and motivation to engage in daily occupations, depression and anxiety, and difficulty managing home and IADL because of fatigue and pain. Based on these performance deficits, the initial focus of treatment should be: a. Completing IADL tasks independently b. Establishing a new daily routine that can be done within the patient's tolerance c. Referring to a support group to address depression and anxiety d. Energy conservation and activities for pain management

97. A client with a head injury is confused and has situational disorientation and short-term memory problems. The BEST intervention to use to address the problem is: a. Place a calendar and schedule in the client's room b. Have the client keep a daily journal with the OT's assistance c. Set a clock timer to remind the patient when activities are scheduled d. Keep a checklist of the day's activities and when they are accomplished

97.Which of the following is the BEST example of an IEP present level of performance statement based on a school-based OT's evaluation? a. The student requires moderate assistance with toileting and minimal assistance with self-feeding. b. The student demonstrates a fine motor skill age equivalent of 36 months on the Peabody Developmental Motor Scales. c. The student demonstrates sensory processing differences, including sensory defensiveness. d. The student is unable to name or legibly write letters and numbers because of delayed visual motor skills.

98. The BEST example of a statement that would be documented in the assessment portion of a SOAP note is: a. Client and spouse participated in a discussion about planning activities of interest for the patient. b. Client complains of difficulty donning night-time splint and requests that the splint be re-evaluated by therapist. c. Family was referred to social services for consideration of alternative placement. d. Client demonstrates good understanding of the home program but requires supervision to perform independently.

98. The parents of a 7-year-old describe their child as having severe difficulty in communicating and interacting with others. On observation, the OT noticed repetitive and ritualistic behaviors. These behaviors are MOST likely associated with: a. Childhood conduct disorder b. ADHD c. OCD d. PDD

99. An OT is reading the chart on a new client with TBI. The issue relating MOST to the client's outcome in OT would be: a. The extent of the tissue damage b. The amount of diffuse axonal injury c. The presence of associated skull fractures d. The amount of time spent in posttraumatic amnesia

99.State and local educational agencies may fund related services through the following resources, except: a. Private insurance b. State Medicaid agencies c. Noneducational public agencies d. Direct billing to families

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