nbcot: *practice questions*

Myasthenia gravis

"grave muscular weakness" chronic autoimmune neuromuscular disorder that is characterized by fluctuating weakness of the voluntary muscle groups.

A local pharmacy hires an OTA to consult on the redesign of the pharmacy's customer service area. Which height should the OTA recommend the pharmacy counter be no higher than? A. 29 inches B. 33 inches C. 35 inches D. 31 inches

31 inches

Guidelines for activity following electricoconvulsive treatment

6 hours after treatment the patient can engage in structured tasks

6 month old, 34 week gestation; calculated corrected age

Actual age - weeks premature = corrected age

Supported employment provides support to clients with disabilities through training and support WHERE?

At the job site.

Seriously emotionally disturbed

Behavior modification

A client with a spinal cord injury and an OTA set a goal for the client to be independent in all aspects of bowel and bladder care, including skin inspection. Which of the following is the highest or most severe level of complete spinal cord injury the client can have to be able to achieve this goal? A. C7-8 B. C4-5 C. C5 D. C6

C7-8

A young adult recovering from cardiomyopathy is being evaluated in outpatient cardiac rehabilitation. The client achieved independence with BADL during inpatient cardiac rehabilitation. Since discharge, the client relies on family and friends for assistance with ADL. During the evaluation, the client walked slowly on a treadmill at 2.0 miles per hour for 20 minutes with normal cardiovascular response. What interpretation can the OTR make based on the client's performance during this portion of the evaluation? A. Client is appropriately relying on assistance to help conserve energy during the day. B. Client is demonstrating malingering behaviors with caregivers at home. C. Client is following appropriate guidelines for ADL during this phase of recovery. D. Client may not have a clear understanding of current physical abilities for ADL.

Client may not have a clear understanding of current physical abilities for ADL.

Vocational rehabilitation service is for clients who leave a workplace for what reason? In order for what outcome?

Clients who leave a workplace because of impairments can receive assistance from vocational rehabilitation to RETURN to that or another workplace.

A resident with ALS wants to eats meals in the facility dining room but is embarrassed about frequently dropping assistive eating devices and having several incidences of coughing while eating. What care coordination task should the OTR complete first?

Coordinate with the multi-disciplinary team to identify specific feeding and swallowing objectives. Swallowing difficulties are out of the OTR scope of practice for an entry level OTR

workstation modifications, changed work methods, or tool modifications are examples of what type of control?

Engineering controls

Allen Cognitive Level Screen scoring

Level 3: running stitch Level 4: whipstitch Level 5: cordovan stitch overall levels 3.0-5.8

Client in a work hardening program 8wks with shoulder pain and weakness.What info is most important for the OTR to gather from the client prior to establishing the intervention plan? A. Client's perception of current strengths and abilities B. Complete medical and psychological history. C. Impact of injury on current BADL routines D. Objectives analysis of the client's job demands

Objectives analysis of the client's job demands

A person blinded in an accident begins an OT community re-entry program for persons with visual loss. The OTA collaborates with the individual to develop an intervention plan. Which should be included in the plan as an initial focus of intervention? A. Developing computer skills B. Adapting meal prep techniques C. Exploring vocational interests D. Organizing the clients morning routine

Organizing the clients morning routine

An OTR is designing a wheelchair seating system for a student who has scoliosis secondary to spina bifida. Which feature should be considered FIRST for achieving optimal functional seating?

Position and stability of pelvis in chair

A client who had a distal humerus fx 8 weeks ago has recently had their long arm cast removed. Has full functional ROM and normal sensation and skin pallor of the hand. Pain of 3/10. Elbow passive elbow ROM is less than the norms. What is the primary cause for this discrepancy?

Soft tissue tightness (due to immobilization) Heterotropic ossificiation - typically associated with significant pain with active motion and swelling around the affected joint. has the potential to be a secondary complication associated with aggressive passive ROM Secondary nerve injury - typically impact ROM and sensation in hand Post traumatic ischemia - would also have sensory, motor, and vascular changes in the hand

15-18 months

Spoon

An OTA works with an individual with cubital tunnel syndrome who reports numbness and tingling. Which of the following is the most likely location for this persons sensory symptoms? A. The ulnar aspect of the forearm and hand B. Along the radial nerve distribution of the hand C. The medial aspect of the forearm and hand D. Along the ulnar distribution of the hand

The ulnar aspect of the forearm and hand

An elder expresses concerns about the ability to preform daily tasks. The individual has somatosensory deficits consistent with the normal aging process. The OTA recommends adaptive equipment to assist with task performance. Which AE should the OTA recommend the person use during meal prep and feeding? A. Utensils with narrow smooth groups B. Utensils with wide textured grips C. A rocker knife D. Dycem pads

Utensils with wide textured grips

1. Which of the following statements about OT FW is accurate? a. a health care professional other than an OTR can supervise OT students on Level I FW b. payers are not able to regulate the supervision of OT students c. initial suggested supervision for level II OT student is indirect d. An OT or COTA can supervise a level II OT FW student

a. a health care professional other than an OTR can supervise OT students on Level I FW

School basic life skills preparation class

addresses BADLS dressing, feeding, hygiene for students who are unable to complete these tasks due to severe cognitive limitations

An OTA provides caregiver education to the family of an individual who is dependent in all self-care. During instrcution on proper w/c postioning, where should the OTA advise the family to place the w/c needed? A. at waist level B. midway between waist and trunk C. at the widest point of the individuals midsection D. at hip level

at hip level

equinovarus

club foot

Using a day planner and a color-coded filing system are ____strategies to improve organizational skills.

compensatory strategies

capital assets

improvements or purchases that cost more than a set amount (>$500) and are expected to last more than a year (a new ADL kitchen, computer equipment)

An OTA implements intervention using a contemporary neurorehabilitation approach by having a person with a neurological impairment practice an activity in different contexts. Which is the primary purpose of this approach? A. to facilitate the generalization of learning B. to make it more difficult to transfer learning C. to foster an unstructured approach to different situations D. to determine if the client is easily confused

to facilitate the generalization of learning

anosognosia

unawareness or denial of deficits

Whirlpool

used to clean and debride wounds

exploration of relationships is typical for what age? what kinds of activities would these kiddos want to do?

-0-2 years -visual and auditory stimulation: cause and effect type stuff (hitting a keyboard to produce music)

-spoon use in children, what age? -straw use

-12-18 months -18 months

At what age should transition planning occur on an IEP? At what age should they implement these transition services?

-14 (or younger) -16 (or younger)

-Standard narrow wheelchair measurements -Regular w/c measurements -Slim adult standard chair -Junior standard chair

-16" wide x 16" deep x 20" high -18" wide x 16" deep x 20" high -14" wide x 16" deep x 20" high -16" wide x 16" deep x 18.5" high

Describe Allen Cognitive Levels 2.4-2.8 ADLs

-24 hour on site supervision -allow extra time -requires total assistance with medication management, nutrition -HOH and cueing requiring for BADLs -structured bathroom visits (every 2 hours)

Minimum and optimal doorway clearance width (measured from door to frame) for w/c

-32" minimum, 36" optimal -hallways/ramp widths should also be 36"

If a ramp leads to a door, what must be present?

-5'x5' platform before the door that extends at least 12" (18" is preferred) along the side of the door to allow for door swing without backing up

What must occur before conducting a visual perceptual evaluation?

-anatomical visual assessment to determine visual acuity by a optometrist

Ideational apraxia, what kind of cues would improve performance?

-breakdown in knowledge of what is to be done and how to perform specific activities -physical prompts assist the individual

Allen Cognitive Levels 5.0-5.2

-can live alone in community but recommended to have weekly supervision -supervision for medication management (pillbox) -still may need assistance with IADLs

Entry level occupational therapists should receive ___ supervision. What about intermediate level OTs? Advanced OTs?

-close: daily, direct contact -routine -general -minimal

Types of supervision

-close: daily, direct contact -routine: direct contact > every 2 weeks -general: >monthly -minimal: as needed, <monthly

Allen Cognitive level 4 Goal Directed actions

-completes a series of steps to match a sample of a finished product -visually directed (match a sample directly, do 1 step at a time) -keep things in sight and in the same place (grooming tools) -ability to carry simple tasks through to completion, relies on visual cues -may be able to perform established routines but cannot cope with unexpected events -sort laundry by matching colors

Level 5 Allen Cognitive level: exploratory actions

-discovers how doing things differently produces different effects -trial & error thinking -new learning occurs -this may be the usual level of functioning for 20% of the population -plan a 3 course meal

Allen Cognitive levels 4.6-4.8

-do not need 24/7 supervision anymore, daily or weekly supervision -assistance with IADLs

Allen Cognitive Level 6 Planned Actions

-estimates effect of actions on concrete objects -anticipates secondary effects -ex: smooths out leather lacing, has correct change -absence of disability, person can think of hypothetical situations and do mental trial and error problem solving

At what age can kids use a fine pincer grasp? At what age can kids use a radial digital grasp to pick up a block?

-fine pincer grasp 12 months *regular pincer (without use of fingertips) 10 months -radial digital grasp 8 months

Allen Cognitive Level 2 postural actions

-initiates gross body movements -moves the whole body in space associated with comfort (posturing, statue-like, catatonic) -there is some awareness of large objects in the environment and the individual may assist the caregiver with simple tasks -exercises that require imitation of another's posture

Scissor skills

-interest in scissors 2-3 y/o -holds & snips with scissors 2-3y/o -open/close scissors in a controlled fashion 2-3 y/o +manipulates scissors in a forward motion 3-4 y/o -coordinates lateral directions of scissors 3-4 y/o -cuts a straight forward line 3-4 y/o +cut SIMPLE figure shapes 4-6 y/o +cut COMPLEX figure shapes 6-7 y/o

If a ramp is excessively long or if there is a sharp turn in the direction of the ramp, what is required?

-long ramp or 90 degree turn: 4'x4' landing -180 degree turn" 4'x8' landing

What are residents responsible for in a half way house?

-maintenance of their rooms and personal items (laundry) -maintenance of entire household (cleaning and cooking) -performance of IADL, independently or with assistance

-monoplegia -hemiplegia -paraplegia -quadriplegia -diplegia

-monoplegia: one extremity -hemiplegia: upper & lower extremity on same side -paraplegia: lower extremities -quadriplegia: all extremities -diplegia: less UE involvement, greater LE involvement

Neurophysiological frame of reference

-neurodevelopmental treatment approach (NDT) -proprioceptive neuromuscular facilitation (PNF) -Brunnstrom's approach -Margaret Rood's approach

Release development

-no release (0-1 month) -involuntary release (1-4 months) -two stage transfer (5-6 months) -one stage transfer (6-7 months) -voluntary release (7-9 months)

Principles of neurodevelopment treatment approach (NDT)

-normalization of movement patterns -integration of both sides of the body/reestablish symmetry of the sides of the body to increase functional use -establishment of the ability to weight bear and weight shift through the limbs -establishment of normal righting and equilibrium patterns

Average period of immobilization (splint wear) after skin grafting?

-on at all times except during dressing changes for 5-10 days

Ramp slope

-one foot of slope for every inch of rise, 1:12 optimal (for every 1" of vertical rise, 12" of ramp is required) -e.g. six steps of 7 inches each results in a rise of 42 inches

Multiple sclerosis (MS) symptoms

-paresthesias in one or more extremities -weakness or clumsiness in leg or hand -VISUAL disturbance -EMOTIONAL disturbance -balance loss/vertigo -bladder dysfunction -cognitive features (apathy, memory loss, lack of judgment, inattention)

What is the best approach to decrease a gag reflex?

-press down firmly on the center of the tongue and apply pressure distal to proximal (lateral and circular movements facilitate gag reflex

Allen Cognitive Model level one automatic actions

-responds to stimuli from someone else -does not change response to stimuli *example: may not perform the most basic self care functions independently

Routine Task Inventory

-self report and caregiver report -therapist observation -ADLs (bathing, grooming, medication, etc) -measures an individuals level of impairment in ADLs according to Allen's cognitive model levels. Includes 6 physical scales in areas of grooming, dressing, bathing, walking, feeding, and toileting and 8 IADL preparing food, spending money, taking medication, doing laundry, shopping, telephoning, traveling

Allen Cognitive level 3 manual actions

-use hands and other body parts to manipulate objects -seemingly purposeless and repetitious manipulation of objects -the individual may be able to perform a limited number of tasks with long term repetitive training -sanding wooden bookends

Interpretation levels of correlation = r

0 - .2 suggests a negligible correlation .2-.4 low correlation .4-.6 moderate correlation .6-.8 high correlation .8-1.0 very high correlation

Wraparound armrests reduce w/c width by _ inch

1

Toileting skills

1 y/o: discomfort when wet/soiled 1.5 y/o: sit on toilet when placed there 2 y/o: urinates regularly 2.5 y/o: regular toileting w/occasional accidents, tells someone if they need to go to bathroom 3 y/o: goes to bathroom independently, may need help with wiping 4-5 y/o: independent in toileting (can tear tp, wife, flush, etc)

Order of stitches on allen cognitive level screen (ACL)

1. Running stitch 2. whipstitch 3. single cordovan stitch

Which level of SCI is appropriate for the task 1. button buttons with button hook 2. use mobile arm supports for feeding 3. tie shoes using thick shoelaces 4. brush teeth using tenodesis splint

1. c6 2. c5 3. c8 4. c6

Types of play and ages

1. exploratory play: 0-2 years 2. symbolic play: 2-4 years 3. creative play: 4-7 years 4. games: 7-12 years

Rancho Levels: what is appropriate for each scenario 1. sensory stimulation activities such as moving to music 2. repetitive self care tasks (brushing hair) 3. community re-entry (taking a bus) 4. simple meal preparation tasks (making a sandwich)

1. level 3 2. level 5 3. level 7 and 8 4. level 6

Four sequential phases of motor control by Rood (neurophysiological FOR)

1. reciprocal inhibition/innervation (reflex) 2. co-contraction (stability) 3. heavy work (mobility superimposed on stability, proximal muscles contract and move while distal segments are fixed) 4. skill (stabilized proximal segment while distal segment moves in space)

Stages of motor learning

1. skill acquisition: initial instruction and practice 2. skill retention: 'carry over' 3. skill transfer: use skill in new context

Rood approach ontogenic motor patterns

1. supine withdrawal 2. rollover (mobility) 3. prone extension 4. neck co-contraction (first stability pattern) 5. prone on elbows (stability) 6. quadruped (stability) 7. standing

The Americans With Disabilities Act (ADA) requires employers with__or more employees to provide reasonable accommodation for qualified applicants and employees with disabilities.

15 or more. Allowing an individual with a disability to work at home may be a form of reasonable accommodation. The Americans With Disabilities Act (ADA) requires employers with 15 or more employees to provide reasonable accommodation for qualified applicants and employees with disabilities. Because the company has 8 employees, this accommodation may be an undue hardship for the employer.

Reisburg's Stages of Dementia Scale AKA Global Deterioration Scale

7 levels, level 7 most severe level 1: no cognitive decline level 2: very mild cognitive decline level 3: mild CD level 4: moderate CD level 5: moderately severe CD level 6: severe CD level 7: very severe cognitive decline https://www.fhca.org/members/qi/clinadmin/global.pdf

When do kids start finger feeding independently

9-13 mo

At what age do kids begin finger feeding

9-13 months

What angle should an outrigger be placed on a dynamic splint?

90 degrees to the joint

An individual recovering from hip replacement surgery prepares for discharge home. The client has a secondary diagnosis of gastric esophageal reflux disease (GERD). Which is the best position for the OTA to recommend to this client? A. "Palming" the steering wheel B. Hand controls for brake and gas pedals C. A spinner knob on the steering wheel D. Left-sided accelerator pedal

A spinner knob on the steering wheel

A top-down approach:

A top-down approach includes systemwide changes and management support of the change process. eg Involving managers in work simplification.

A grocery store company hires an OTR® to complete work tolerance screenings for potential employees. The company has no written policies regarding work screening processes. What should the OTR®'s FIRST step be?

A. Assess whether work tolerance screenings can be completed in the absence of written policies-Correct. The OTR® must consider the potential ethical dilemmas that may arise in the absence of written policies, particularly for applicants who fail the screening. B.Provide a written statement indicating that the organization is required to provide written policies for work screenings C.Complete the work tolerance screenings as the OTR® would for any organization D.Offer to write policies for the work tolerance screening process for the organization

A client diagnosed with C7 spinal cord injury requires a functional capacity evaluation to determine whether the client can perform the physical demands of the job of sporting events promoter. What task demand would be MOST appropriate for the OTR® to assess?

A.Lifting and balancing B.Pushing and pulling C.Sitting and fingering - correct D.Grasping and releasing

An OTR is preparing to interview an outpatient who has a TBI and is functioning at Level VII (automatic-appropriate) on the Rancho Los Amigos Scale. Which characteristic of an individual's cognitive-behavioral fx is typically included in the description of this level? A: consistent orientation to person and place B: realistic judgement for future planning C: Accurate insight about current abilities D: Reliable carry-over of learning for most ADL

A: Consistent orientation to person and place (Level VII) At this level they frequently display robot-like bx and require minimal assistance for routine ADL. They appear oriented and appropriate.

A. Have the client complete three trials on the second handle setting of the Jamar dynamometer. B. Have the client complete one trial on each of the five handle settings of the Jamar dynamometer. C. Have the client perform rapid exchange between the left and right hands for a total of 20 trials for each hand using the Jamar dynamometer. WRONG. D.Have the client perform two trials on each of the five handle settings of the Jamar dynamometer and compare the results with normative data. WRONG.

A: This tests grip strength. Not insincerity. The second handle setting is the standard setting for testing grip strength over 3 trials. B: This tests insincerity. C: Rapid exchange grip testing requires 10 trials for each hand. D: The standard five-level grip test requires one trial per handle setting.

A: Vocational counseling and assessment is a component of ____ program. B: Instruction in proper body mechanics can be incorporated into the ______program. C: Before making modifications to tools, the client should undergo treatment to maximize _____ abilities.

A: work hardening program B: work conditioning program. C: maximize functional abilities.

Contrast baths and other CRPS interventions type I

AKA hot/cold immersion therapy gentlest PAM intervention facilitates opening and closing of vascular and lymphatic vessels preferred modality for CRPS *also use cold packs and retrograde massage for CRPS *manually washing a car (stress loading, scrubbing and carrying)

vocational rehabilitation workshop

AKA sheltered work shop. -significant cognitive deficits and intellectual disorders that limit their ability to participate in unstructured work environments -highly structured, repetitive, concrete tasks that require minimal technical skills (assembly work)

Which organization should the OTR contact for obtaining the most up to date resources for resolving uncertainty in practice?

American Occupational Therapy Association

Which factor is MOST IMPORTANT to determine when considering if the resident would benefit from a mobile arm support?

Amount of upper extremity passive joint mobility

A client in the descending phase of Guillain Barre syndrome has bilateral shoulder strength of 2/5. The client fatigues easily. Which equipment should the OTA recommend to enhance the person performance of activities of daily living? A. An overhead suspension sling B. Long-handled utensils and tools C. Angled/curved handled utensils and tools D. An environmental control unit

An overhead suspension sling

An OTR® is treating a client after surgery for De Quervain's tenosynovitis. The client is employed as a receptionist in a dental office and will participate in a return-to-work program designed by the OTR®. Which option would be CONTRAINDICATED for treatment?

Application of a resting hand splint at night to stabilize the affected joint. Splints are typically applied during the acute phase of injury. The splint typically prescribed for De Quervain's is a forearm-based thumb Spica splint to immobilize the wrist, thumb carpometacarpal and metacarpophalangeal joints, placing the abductor pollicis longus and extensor pollicis brevis at rest. A resting hand splint is not indicated because the entire hand does not required immobilization

A client just received iontophoresis. Within several minutes of removing the electrodes what should be done to the skin that came in contact with the electrodes? a. Wipe the area with an alcohol pad b. Vigorously massage the area c. Apply a lotion with a neutral pH d. Rub an analgesic lotion into the area

Apply a lotion with a neutral pH

An OTA working in a skilled nursing facility observes a resident with the cognitive disabilities don slippers by putting them on the wrong feet. The resident plans to go to visit a friend on another floor and does not seem aware that the slippers on the wrong feet. Which is the best action for the OTA to take in response to this situation? A. Say nothing for this error may embarrass the resident B. Say nothing but follow the resident to the friends room to ensure a safe arrival C. Ask the resident to look at the slippers to see if the error is noticed D. Approach the resident and advise the resident to reverse the slippers

Approach the resident and advise the resident to reverse the slippers

When should the discharge planning process start for a pt. who has been referred to OT in an acute inpatient rehabilitation unit? A. After the intervention plan has been developed B. As soon as the information gathering process begins C. Once the pt's functional improvement plateau D. When progress toward short-term goals is evident

As soon as the information gathering process begins

A 4-year-old child with attention deficit hyperactivity disorder is using a tire swing for vestibular input to feel more organized. After a few minutes, the child appears to have some autonomic reactions to the fast swinging. Which course of action for the OTR® is BEST?

Ask the child to slow down the swinging by pulling a trapeze bar for proprioceptive input

An OTA works in a school setting with adolescents with Aspergers syndrome. The need for a social skills training group is identified. One activity that the OTA plans to use in the group is role-playing. Which is the most effective way for the OTA to determine relevant scenarios for the role-play activities? A. Survey the teachers on social difficulties displayed in class B. Survey parents on social difficulties they have observed in the adolescents C. Review literature on adolescent social skill development D. Ask the group members about their social concerns

Ask the group members about their social concerns

A patient has cerebellar ataxia and will be discharged in 2 days from an inpatient rehabilitation facility to live at home with family. The patient is afraid of falling, especially during BADLs activities in the bathroom. What action is the MOST IMPORTANT for the OTR to take to reduce the patients fear and promote a safe transition to home? a. Assess the home layout to advise the family about modifying potential hazards b. Incorporate dynamic balance exercises into each intervention session c. Provide the family members with handouts about home safety and fall risks d. Recommend the patient and family attend a post-discharge fall prevention class

Assess the home layout to advise the family about modifying potential hazards

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

Bearing weight on the affected forearm placed on a table then turning the trunk away from the supported position

The Occupational therapist and OTA collaborate to plan intervention for a client with a recent diagnosis of complex regional pain syndrome (CRPS) Type 1. Which intervention approach is most effective to use to reduce pain and increase function? A. Hot packs B. Biofeedback C. Paraffin D. Passive ROM

Biofeedback

A client with arthritis of both hands has ulnar drift of MPs during the finger extension and flexion and at rest. The person also has a lengthening of the central slips of the extensor digitorum communis tendon of the right index and middle fingers. Which of the following should the OTA report the person is exhibiting? A. Swan-neck deformities B. Trigger-finger deformities C. MP palmar subluxation- dislocations D. Boutonniere deformities

Boutonniere deformities

What factor is most important for the OTR to initially determine when considering a patient with ALS for a mobile arm support? A: staff's ability to set up the device for the resident B: Ability to attach the device to the patient's wheelchair C: Amount of UE passive joint mobility D: Presence of UE athetoid movements

C - ALS is progressive and patient must have sufficient passive ROM to effectively use a mobile arm support Athetoid movements are not typically associated with ALS

What symptoms is a patient with ALS most at risk for experiencing during a meal? A. light headedness when moving from wheelchair to dining chair B. heavy sweating, flushed skin, and a pounding headache after eating C. variation in voice quality or loss of voice after swallowing D. regurgitation of food and liquids after swallowing

C - because ALS is a progressive neurological dx. The resident's symptoms of coughing while eating/swallowing could indicate dysphagia. A symptom associated with dysphagia is variation in voice quality or loss of voice after swallowing

During an OT session, the OTA notes that a client who has a spinal cord injury at the C-5 level is flushed and sweating excessively. The client requests that the session and early. The client reports having a pounding headache that has become impossible to ignore. Which is the best initial action for the OTA to take in response to this situation? A. Check the client catheter line B. Call the transporter to return the client to the clients room C. Reports the clients symptoms to the clients unit head nurse D. Stop the session and recline the client in the w/c for a rest break

Check the client catheter line

An OTR® is writing treatment goals for a client receiving occupational therapy services in a work conditioning program after a right shoulder sprain. The client is employed as a surgical technician in an outpatient surgery center. Which option is the BEST example of a long-term goal? A. Client will return to full duty as a surgical technician in a full-time capacity within 4 weeks. B. Client's employer will implement reasonable accommodations to promote the client's ability to complete full-time physical demands as a surgical technician within 4 weeks. C. Client will return to full duty as a surgical technician with the ability to carry over proper body mechanics to reduce risk for reinjury. D. Client will use proper body mechanics 100% of the time while completing the job of a surgical technician within 4 weeks.

Client will return to full duty as a surgical technician in a full-time capacity within 4 weeks. The goal is client centered, objectively focused on the goal of full-duty and full-time employment in the role of surgical technician within a specified timeline.

An OTR has completed a developmental assessment of a 6-year-old child who has Down syndrome. Results indicate the child is dependent in all self-care tasks. The parents do not place a high priority on dressing independence, but the OTR does. What action should the OTR take as part of the intervention planning process? a. Ask for the parents' consent to begin working on specific self-care skills with the child b. Collaborate with the parents to identify mutually acceptable treatment goals for the child c. Inform the parents that school-age children are expected to be independent with self-care d. Talk with the parents about establishing independence in self-care skills as a primary goal

Collaborate with the parents to identify mutually acceptable treatment goals for the child

An OTA observes a colleague using fluidotherapy on a patient with an insensate hand after being informed by the supervising therapist that this physical agent modality (PAM) is contradicted for this specific case. The colleague justifies the use of this PAM based on the patients request for the intervention. The OTA meets with the OT supervisor to express concern about the colleague behavior. Which ethical principle does the OTA identify the colleague is violating? A. Judgement B. Competence C. Autonomy D. Justice

Competence

A person fell and sustained bilateral Colles' fractures. The client wore bilateral short-arm casts for six weeks. After cast removal, the client began OT sessions to increase endurance and strength prior to returning to work. The client tends to work hard when performing resistive exercises with both wrists. The OTA monitors the client for overexertion. Which behavior indicates overexertion? A. Decreased respiration rate during resistive wrist flexion B. Increased ability to achieve full ROM of the wrist C. Complaints of pain in the wrist extensors D. Consistent strength in wrist extension activities

Complaints of pain in the wrist extensors

An OTR® is asked to consult with a local meat packing plant to establish a work injury prevention program because of an increase in the number of work-related musculoskeletal disorders among employees. For the program to be successful, what should the OTR® FIRST ensure?

Complete employee participation. Four characteristics of successful implementation of a successful work injury prevention program are : ongoing management support, supervisory support, employee participation, and ongoing support and reinforcement of program. The meat packing plant sought out the services of the consultant, therefore demonstrating a commitment to establishing a culture of safety and wellness for its employees. Employee participation is a key component of success.

Hearing impairment, normal walk, run, posture, decreased balance on spring

Conflicting sensory input inhibit appropriate vestibular reactions

A client with COPD is doing ADL rehab as part of outpatient pulmonary rehab program. client reports right shoulder discomfort for last several days which is constant during day and worse at night. Over the counter pain meds don't help. Pulse oximetry is 89%. What should OT do? A. Administer physical agent modality to relieve shoulder pain B. Advise client to increase frequency of pursed lips breathing C. Complete sensory and motor assessment to determine shoulder pain D. Contact referring physician to report client symptoms

Contact referring physician to report client symptoms

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

Cooked pasta with melted cheese http://gicare.com/diets/dysphagia-diet/

An entry level OTR who works in a long-term care facility is screening a resident who has ALS and uses a wheelchair. The resident's UE functional strength is Trace (1/5) on the left and Poor Minus (2-/5) on the right. The resident wants to eat meals in the facility dining room but is embarrassed about frequently dropping assistive eating devices and having several incidences of coughing while eating. What care coordination task should the OTR complete FIRST?

Coordinate with the multi-disciplinary team to identify specific feeding and swallowing objectives.

An OTA is hired to work in the occupational therapy document of an acute psychiatric unit. The OTA requests an orientation to hospital policies and procedures. Which is the most important focus for the OTA to learn the policies and procedures of during the initial orientation session? A. Crisis intervention B. Reimbursement C. Employee benefits D. Group program scheduling

Crisis intervention

An OTR® completed a functional capacity evaluation on a client previously employed as a painter before undergoing a rotator cuff repair. To ensure quality services are provided as part of this client's work conditioning program, what should the OTR® do FIRST?

D Aerobic conditioning is a component of a work conditioning program.

An OTR is collaborating with a social worker and a RN to develop a new domestic violence prevention program for a community mental health center. The need for this service has been identified through situation, social, and epidemiological analyses. What is the NEXT step in program development when using an ecological model? A. establish policies and procedures for the program B. Identify a process for tracking program outcomes C. Develop multi-disciplinary intervention protocols D. Determine bx and environmental risk factors

D - decisions on program format and content should be based on identifying participant's risk factors and understanding the impact of the environment on bx

During which home maintenance tasks would symptoms related to constructional apraxia be most evident? A: washing the interior sides of single pane windows B: using a roller brush to paint an interior wall of the home C: Vacuuming floors in the main living area of the home D: following written instructions for installing curtain rods

D - individuals with constructional apraxia have difficulty constructing/assembling objects, as in following instructions for installing curtain rods

The client sustained the injury while working as a sous chef. Which option would provide the OTR® with the MOST comprehensive summary of the physical demands of the client's job?

DOT. The DOT is a standardized classification system used to define physical demands of work and occupations within the United States. It is the primary source for generic occupational descriptions worldwide and was last revised in 1991.

The family of an individual being discharged from a spinal cord injury center offers the OTA a substantial cash gift. The OTA refuses the money but the family insists that the OTA take the cash gift. Which is the OTA'S best response? A. Donate the money to the hospital B. Thank the family and donate the money to charity C. Use the money to purchase an item on the OT departments "wish list" D. Decline the gift

Decline the gift

A person is recovering from a major cardiac infarct. During the initial OT session, the patient loudly and vigorously expresses plans to immediately resume a daily rigorous exercise routine. The OTA reports the individual's plan to cardiac rehab team and explains that the individual appears to be in which following disability adjustment stage? A. Shock B. Acting Out C. Denial D. Acceptance

Denial

An OTA is conducting a community transportation group with individuals attending a traumatic brain injury day treatment program in an urban area. Which should the group do first? A. Read a subway map B. Take a subway as a group C. Determine a destination D. Purchase a subway fare card.

Determine a destination

An OTA working on an acute psychiatric inpatient unit conducts a series of groups for clients newly admitted to the unit. Which group leadership style is most effective for the OTA to assume when leading these groups? A. Advisory B. Facilitative C. Laissez-faire D. Directive

Directive

A school based OTA receives a referral for a student who has illegible handwriting, poor attending behaviors, questionable visual skills, and problems with pencil management, After speaking with the teacher and OT, reviewing classroom work samples, and reading the students history, which action should the OTA take next? A. Provide pencil grips and specialized paper as a trial to determine interventions B. Directly observe the student during a naturally occurring writing time C. Administer a standardized visual perceptual and visual motor assessment D. Administer a standardized handwriting assessment

Directly observe the student during a naturally occurring writing time

work program documentation should include -Progress notes that include pain reports, psychosocial complaints, modalities received, job analysis, and plans for next session; Daily notes that reflect a detailed description of circuit training, including duration, number of repetitions, or both;Progress notes that reflect the client's attendance, number of sessions, and response to the program; but not:

Do not include Progress notes that reflect daily gradations of activities and exercises arranged in a therapeutic hierarchy

A patient has been discharged from rehab facility six months ago. An OTA who works at the facility sees the former pt. and the OT has treated the pt. in a dating situation. The OT confirms involvement in a personal relationship with the former pt. What is the OTA's best response to this situation? A. Report the therapist to the NBCOT B. Advise the facility director C. Do nothing D. Report the therapist to the OT supervisor

Do nothing

An OTR® is adapting the environment to reduce the incidence of repetitive strain injuries among office workers. To maximize the effectiveness of the ergonomic program, what would the OTR® be MOST likely to include? A. Visual reinforcement with signs posted around the office and workstations B. Empowerment of the workers and creation of a positive group-safety culture C. A series of lectures and videos showing bad versus good workstation ergonomics D. Education of supervisors in how to identify noncompliant workers Empowerment of the workers and creation of a positive group-safety culture. Motivation is a big factor for change to occur. Creating a sense of teamwork allows for mutual support to accomplish goals together.

Empowerment of the workers and creation of a positive group-safety culture. Motivation is a big factor for change to occur. Creating a sense of teamwork allows for mutual support to accomplish goals together.

An individual receives treatment for major depression on an inpatient psychiatric unit. The patient has received and electroconvulsive treatment (ECT) treatment at 8am. At 2 pm, the patient walks into the OT department stating a desire to participate in the leisure skills group. Which is the OTA's best response? A. Encourage the client to select one of three structured leisure activities to complete B. Call nursing staff to escort the client back to the client's room C. Commend the client's motivation but remind the client that rest is recommended for 24 after ECT D. Provide the client with a leisure history questionnaire to complex

Encourage the client to select one of three structured leisure activities to complete

The members of a clubhouse attain a level of cohesion which enables them to perform at a cooperative level. Two members disagree with the others on the details of a group project. How should the OTA leading this group respond to this conflict? A. Clarify all viewpoints and facilitate the members in decision making B. Listen to all viewpoints and suggest that members vote to determine the project details C. Mediate only when the members have reaches a deadlocked situation. D. Encourage the members to explore alternative methods to resolve the conflict

Encourage the members to explore alternative methods to resolve the conflict

A teenage girl with juvenile RA identifies a goal of applying her own makeup. Which adaptation is most beneficial for the OTA to recommend? A. Silver ring splints to hold makeup applicators B. Enlarged soft foam handles on makeup applicators C. Long thin handles on makeup applicators D. Taking a long hot shower to decrease stiffness prior to initiating the task

Enlarged soft foam handles on makeup applicators

A patient who has depression has been taking an antidepressant for 3 weeks. The patient has been participating in a daily OT group. During the most recent group activity, the patient reports having more energy despite still feeling depressed. Based on this report, what precautions should the OTR take? a. Ensure the activity environment provides structure and allows for continuous observation b. Avoid gross motor activities that may exacerbate medication side effects c. Use sedentary tx to avoid the potential for disruptive hyper manic outbursts d. Minimize the use of FM activities to avoid frustration d/t cogwheel rigidity

Ensure the activity environment provides structure and allows for continuous observation

A graduate student with an anxiety disorder reports feeling confused about the future. During the OT evaluation, the client relates decreased feelings of competence for a chosen field of study and overall poor personal causation. Which is the best initial action for the OTA to take in response to the client's stated concerns? A. administer a vocational intrest inventory B. provide activities related to the clients chosen field of study C. refer the client to the state office of vocational and educational services D. Establish short term goals with high potential for attainment

Establish short term goals with high potential for attainment

An older adult with a diagnosis of osteoarthrisits in both knees is referred to inpatient OT. During screening, the pt. expresses a desire to return home to live alone independently. Which should the OTA do first in response to the patients stated goal? A. Recommend adaptations to the patients home environment to increase safety B. Evaluate the patients BADL and IADL using the standardized measure C. Teach the patient energy conservation techniques to use during IADL tasks D. Train the pt. in a home resistive exercise program to build strength and ROM

Evaluate the patients BADL and IADL using the standardized measure

A 3-year-old has spastic cerebral palsy. The child's parents are learning techniques to use when dressing the child. How should the parents position the child to MOST EFFECTIVELY to inhibit muscle tone before putting on the child's shoes and socks? a. Facing upward on the parent's lap with the child's hips and knees in flexion b. Prone on the floor flexing the child's knee to 90o one at a time c. Side-lying on the bed with the child's hips and knees fully extended d. Supine on a firm surface with the child's hips and knees fully extended

Facing upward on the parent's lap with the child's hips and knees in flexion

A two year old receives home care early intervention services. The occupational therapy intervention plan includes a goal to develop the child's pincer grasp. Which is the most appropriate activity for the OTA to work on with the child during an intervention session? A. Finger feeding of O shaped cereal B. Picking up marbles C. Drawing with jumbo crayons D. Stacking one inch cubes

Finger feeding of O shaped cereal

An entry level OTA conducts an in service at an outpatients w/c clinic for individuals with central nervous system dysfunction. According the the principles of w/c prescription, which of the following statements is accurate for the OTA to make during the presentation? A. Firm seats are needed to provide stability B. Soft seats are needed to prevent decubiti C. Back heights should be extended to facilitate weight shifting D. Seat angles should be 45 degrees to prevent falling forward

Firm seats are needed to provide stability

A young adult with a ulnar nerve injury of the dominant extremity has a zero muscle strength of the hand muscles innervated by the ulnar nerve. Which characteristic compensatory posturing of the hand would be most evident when the client attempts a powerful lateral pinch? A. Clawing of the index and middle fingers B. Flexion of the IP joint of the thumb C. Flexion of the thumb mcp joint D. Hyperextension of the thumb IP joint

Flexion of the IP joint of the thumb

Several adolescents with behavior problems attend a school- based after school program. They work at an egocentric-cooperative level in a group dealing with issues related to peer pressure. Which of the following would be most likely for the OTA to observe the participants doing in the group? A. Actively taking on roles such as energizer, coordinator, or opinion greeter B. Focusing on the group tasks rather than the feelings of the participants C. Making decisions with minimal to no supervision from the group leader D. Performing group skills consistent with the developmental level of 15 to 18 yoa

Focusing on the group tasks rather than the feelings of the participants

vocational evaluation

For a person who is unable to return to a previous job. provides actual or simulated work for assessment, usually 3-10 days, in public and private medical or nonmedical settings.

An adult who incurred a CVA has difficulty with increasing amounts of stimuli. This is noted in all modalities. The OTA documents these observations. Which cognitive perceptual dysfunction should the OTA report the client is exhibiting? A. Inability to abstract B. Poor organizational skills C. Poor semantic memory D. Generalized attention deficit

Generalized attention deficit

An OTR is working on pre-feeding activities with an inpatient who had a recent TBI and is functioning at Level III (localized response) on the Ranchos Los Amigos Scale. What technique would be MOST EFFECTIVE when providing graded stimulation of the patient's cranial nerves? a. Gently rub the patient's tongue using a cotton swab saturated with salty and sweet flavorings b. Hold strong smelling cooking extracts such as artificial vanilla, close to the patients nose for 2-5 seconds c. Place a small piece of the patient's favorite sweet food on the patients tongue d. Use soft candy items as rewards for positive responses to voice commands

Gently rub the patient's tongue using a cotton swab saturated with salty and sweet flavorings

A child with mild cerebral palsy receives OT intervention in a preschool setting. The OTA has collaborated with the OT to develop an intervention plan. Which intervention approach should the OTA employ to facilitate development of typical grasp patterns? A. Place soft foam tubing around objects to be grasped B. Analyze the present components of the child's grasp C. Analyze the missing components of the child's grasp D. Grade the sizes and shapes of objects to be grasped

Grade the sizes and shapes of objects to be grasped

An OTA conducts an intervention session with a client recovering from a CVA to develop transfer skills. The client has a co-morbidity of epilepsy. As the client stands to complete a transfer from the wheelchair to the bed, the client reports feeling sensations that are indicative of an aura. Which is the best immediate actin for the OTA to take in response to this situation? A. Provide reassurance and ask for guidance from the OT B. Return the client to a seated position in the w/c until the sensations pass C. End the session so the client can rest D. Guide the person into a side-lying position on the bed

Guide the person into a side-lying position on the bed

An OT and OTA co-lead a work adjustment group. one member has become progressively more dependent on the OTA for directions, praise, and input throughout the group activities. Which action should the group leaders initially take in response to these behaviors? A. Schedule several individual sessions with the OTA and group member to examine the issues of dependency and transference B. Inform the attending psychiatrist that the group member is exhibiting signs of dependency and transference C. Have the OTA work with the person during group session to develop independence in task completion D. Have another therapist co-lead the group with the OT and reassign the OTA to another group

Have the OTA work with the person during group session to develop independence in task completion

An OTR® is in the process of completing a functional capacity evaluation (FCE) on a client employed as a cashier in a lumber yard. The client was referred to occupational therapy after sustaining a ruptured biceps while lifting a sheet of lumber. The OTR® suspects the client is exhibiting less than maximum effort during assessment. How would the OTR® BEST assess grip strength to determine whether client is exhibiting maximal effort?

Have the client complete one trial on each of the five handle settings of the Jamar dynamometer. The five-level grip test is used to determine maximum and consistent effort by clients. The OTR® should expect the strongest grip on the second and third handle settings. Just squeeze ONE trial for each of 5 settings.

A client with a disability works through a supported employment agency in a hotel housekeeping department. The client has difficulty staying on task. Which support would be the MOST effective in helping this client stay on task?

Hold a social event for workers in the housekeeping department. Socializing and developing relationships with coworkers provide a natural support and opportunities to work along with and mentor with coworkers without disabilities; such activities also assist in learning the culture of a workplace.

Job coaching

Ideal for clients in transition services from school to work.

A three year old with severe congenital anomalies and irreparable cleft palate has a do not resuscitate (DNR) order. While being fitted for a molded seat for a w/c, the child stops breathing and turns blue. The OTA determines that the child has a brachial pulse. Which of the following is the first action the OTA should take in response to this situation? A. inform the physician about the situation and the childs DNR order B. call the supervising OT to discuss the best response C. Implement the facilities emergency plan D. Perform obstructed airway maneuver and monitor HR for five mins.

Implement the facilities emergency plan

A single parent with RA and two school ages children reports difficulty completing a home exercise program. The parent states that multiple familial, work, and home management responsibilities fill the day and additional activities cannot fit into the day. Which is the best action for the OTA to take in response to these realities? A. Explain and reinforce the importance of AROM for remediation of dysfunction B. Provide intervention for time management and temporal adaptation C. Incorporate the parents engagement in a diversity of role activities into the home program D. Increase the frequency of OT sessions to compensate for lack of follow-through on the home program

Incorporate the parents engagement in a diversity of role activities into the home program

An OTR has completed a MMT of a client results indicate the client has 2-/5 functional strength of the dominant UE. What is the most effective method for grading an activity to improve the client's muscular strength?

Increasing the amount of time an isometric contraction is held Increasing # of repetitions with same resistance would increase endurance!!!

An outpatient client has a seizure disorder secondary to having a TBI 2 months ago. The client is independent with BADL but has some difficulties with problem solving, planning and judgement. The client will be home alone during the day as the spouse has accepted a new job. What info is MOST IMPORTANT to gather when determining the client's safety for being alone when the spouse is at work? A. Ability to prepare nutritious daily meals B. Functional mobility throughout the home C. Info on daily medication routine D. Level of independence using assistive devices

Info on daily medication routine

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

Initiate a referral to an early intervention program in the family's community

A client with Down syndrome is preparing for transition from high school to work and is seeking a work placement. The client needs to identify vocational interests and abilities for general job tasks. To which service should the OTR® refer the client?

Job coaching. Provides vocational evaluation to identify a client's vocational interests and abilities along with physical and mental tolerances for general job activities.

job demand analysis

Job demand analysis looks to define the essential ACTUAL job demands. It often includes questionnaires, interviews, observation, and formal measurements and is conducted in the ACTUAL work environment.

An assembly-line worker is returning to work after being treated for cubital tunnel compression at the left elbow from prolonged pressure on surfaces. What is the MOST appropriate height for this client's workstation?

Just below elbow height. The ideal position for precision assembly is to position the workstation above elbow height, but for a worker with recent nerve compression at the elbow, it is important to set up the work environment so as to not induce further prolonged pressure at the elbow. Therefore, the workstation should be just below elbow height, eliminating all pressure at the elbow. In this case, use of a magnifying device will allow for precision in assembly, compensating for the lack of close proximity.

An OTR fabricated a forearm-based thermoplastic thumb spica splint for an outpatient one week ago. On a follow-up visit, the OTR removes the splint and notes small, red, elevated, inflamed papules on the client's forearm. What INITIAL action should the OTR take in response to these findings? A. Change the splint to a prefabricated splint B. Discontinue the use of the splint and contact client's referring physician (a lot of people picked this answer) C. Line the splint with a 1/16 inch (1.5 mm) absorbent padding D. Modify the splint wear times and educate the client about proper hygiene

Line the splint with a 1/16 inch (1.5 mm) absorbent padding ???

10 year old has poor directionality skills secondary to a learning disability. This results in difficulty reading. Which activity would most effectively address this aspect of spatial vision? A. Follow verbal instructions to crawl through a maze while blindfolded B. Locating pictures of specific objects in a hidden pictures coloring book C. Participating in a timed virtual reality memory game on the computer D. Playing computer based games that require scanning objects at various speeds

Locating pictures of specific objects in a hidden pictures coloring book or Playing computer based games that require scanning objects at various speeds

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

Move the patient apart from the rest of the group to complete assigned tasks??

An OTR is evaluating an adult client who is diagnosed with focal hand dystonia of the non-dominant hand. Symptoms interfere with the client's employment as a professional cellist. What information would be MOST IMPORTANT for the OTR to gather prior to establishing an intervention plan? a. Amount of assistance the client needs during BADLs b. Grip and pinch strength measurements of both hands c. Movement patterns the client uses during work d. Sensory mapping using monofilament instruments

Movement patterns the client uses during work

During a group session an older adult complains that everyone is mumbling. Which action should the OTA take after the group in response to these statements? A. Notify the client physician that the person exhibited evidence of paranoia B. Collaborate with the OT to remove groups from the clients intervention plan C. Document objective data about the complaints in the persons charts D. Notify the OT that the person may need an audiological evaluation

Notify the OT that the person may need an audiological evaluation

OSHA

OSHA is an agency of the U.S. Department of Labor. Its mission is to ensure safe and healthful working conditions.

Ergonomic evaluation involves:

Observation during normal work hours. Interviewing client/supervisor. Workstation/environment set up. Intv: engineering controls: modifying environment, station, setup of devices. work practice controls: modifying work habits, body mechanics, stretching exercises. Administrative controls: changing overtime work, regular rest breaks, providing equipment.

During the initial evaluation for a client with Parkinson's disease, the OTR® asks the client to "pretend you are brushing your teeth," that is, show the movement of brushing teeth without using the supplies needed for brushing teeth. The client is unable to initiate movement of the dominant arm toward the mouth to demonstrate oral hygiene. Which step should the OTR take NEXT in the evaluation of this client? A. Try a wrist weight to stabilize the arm during teeth brushing B. Ask whether the caregiver can provide arm support to bring the hand to the mouth C. Observe as the client brushes teeth with toothbrush and toothpaste at the bathroom sink D. Provide a mobile arm support to compensate for arm movement when brushing teeth

Observe as the client brushes teeth with toothbrush and toothpaste at the bathroom sink. The client may not have understood the verbal instructions, and performing the task in the actual context may allow for more accurate demonstration of the client's abilities.

An OTA works with an individual recovering from a TBI in a rehab hospital. The OTA uses a transfer of training approach to help the patient develop and carry out a daily schedule of activities upon the patients return home. A. Preparation of a simple meal B. Organization of a list of daily activities C. Composition of a shopping list D. Completion of an interest checklist.

Organization of a list of daily activities

In a program for survivors of domestic violence which of the following would the OTA do when using a client-centered approach? A. Offer specific suggestions for more effectively dealing with confrontations B. Respond to self-deprecating comments with positive feedback on personal characteristics C. Reinforce only the consumers neutral comments about themselves D. Paraphrase the consumers statements about past difficulties to help clarify feelings

Paraphrase the consumers statements about past difficulties to help clarify feelings

A nine year old with diagnosis of cystic fibrosis is hospitalized in a small rural hospital. Currently there are no other children in the hospital and the hospital does not have a pediatric play area. The head nurse asks the OTA to suggest appropriate play activities that hospital volunteers can provide to the child. Which is the most age appropriate activities for the OTA to suggest? A. Dressing paper dolls B. Coloring in coloring books C. Playing card games D. Cutting and pasting picture onto cards.

Playing card games

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

Position the client during meals in a chair that semi-reclines 30-40 degrees

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

Post visual reminders on each door of the home to indicate the need to lock the door

A 2-year-old child has mild oral delay and is participating in an early intervention feeding program. Which option has the MOST impact on the child's tongue control during meals? A. Food consistency B. Jaw movement C. Lip closure D. Postural alignment

Postural alignment

The population of an urban homeless shelter includes individuals with historic of chronic alcohol abuse who are at risk for developing peripheral neuropathy. The OTA consulting at this shelter monitors the residents status to ensure early detection of this problem. Which is the most important observed status change for the OTA to report? A. Progressive deterioration in visual acuity B. Progressive deterioration of sensorimotor functions of the lower extremities C. Rapid onset of intention tremors D. Rapid loss of sensorimotor functions of the facial and neck muscles.

Progressive deterioration of sensorimotor functions of the lower extremities

6. An 18 month-old child is hypotonic and cannot fully extend the neck and trunk against gravity. Which position would be MOST EFFECTIVE to place the child in to facilitate antigravity movement and promote hand usage? a. Fully upright in a standing frame b. Prone on a 45 degree wedge positioned on the floor c. Seated upright on a large therapy ball d. Straddle-sit position on a bolster

Prone on a 45 degree wedge positioned on the floor

An OTR working in a skilled nursing facility is beginning an initial patient interview. After providing the patient with a brief introduction to OT service the patient refused to participate in an evaluation, stating "This is childish, I'm here to get stronger. There is an entire staff that can help me get dressed." What action should the OTR take based on the response? a. Provide further discussion about how OT will help improve daily living skills b. Assure the patient that strengthening exercises will be included in the intervention c. Respect the patient's wishes and document the refusal in the medical record d. Advise the patient that an assessment is mandated by the insurance company

Provide further discussion about how OT will help improve daily living skills or assure the patient that strengthening exercises will be included in the intervention

What is an effective strategy to facilitate maximal independence in self-feeding with a client who has middle- to late-stage dementia? A. Change the client's diet to foods that are palatable and easy to chew. B. Change the consistency of foods to allow for easier chewing and swallowing. C. Provide hand-over-hand guidance for food retrieval and utensil-to-mouth motions. D. Provide constant verbal cues throughout feeding to improve attention to the self-feeding task.

Provide hand-over-hand guidance for food retrieval and utensil-to-mouth motions. Hand-over-hand guidance is an effective strategy to encourage maximal independence through participation in daily living tasks, including self-feeding.

An OTR® is hired as a consultant to design a productive modified-duty program for a small manufacturing plant. Which element should the OTR® NOT incorporate into the program design?

Provide opportunities for injured workers to interact with coworkers in the context of the work environment. Although opportunities to interact with coworkers provide the injured worker the benefit of socialization and exposure to the work environment during recovery, they are not the primary focus of modified duty programs.

A person recovering from a cerebral vascular accident has left sided weakness and dysphagia. Which of the following is the most effective direct treatment approach to help the person successfully swallow ingested food? A. Provide pureed, thick liquids B. Provide thermal stimulation to the inferior faucial arches C. Tilt the person's head back and towards the left side D. Provide small, warm boluses

Provide small, warm boluses

A 5 yr. old with mild developmental delays is learning how to self-dress. The child has mastered putting on and taking off a coat as well as buttoning and unbuttoning it. What should the child learn next based on the typical developmental sequence for dressing?

Pulling up a jacket zipper (putting on a belt in waistband loops, tying shoelaces, tightening and fastening belt buckles all require higher levels of skill)

Musculoskeletal evaluation involves:

ROM, strength (Manual Muscle Testing MMT), sensation, volume, soft tissue status.

The use of cyrotherapy as a physical agent modality is contraindicated for clients who have what diagnosis? What diagnosis can you use it for?

Raynaud's Phenomenon Use it for: acute ligament sprain, myofascial trigger points, tenosynovitis

A child diagnosed with DD has been participating in OT in a preschool setting. The child has achieved all STG and LTG and will be discharged from OT. The OTR is concerned about future functional delays. What should the OTR do? a. Recommend a routine assessment schedule for child b. Provide the parents a checklist to track the child's development c. Refer the child to non-school-based agency for routine re-eval d. Request monthly updates from the teacher on the child's progress

Recommend a routine assessment schedule for child

Accommodations may involve altering the job duties or work schedule, modifying the facility, purchasing adaptive equipment or assistive technology, or modifying or designing a new product.

Redesigning the office space to limit distractions to promote the client's ability to attend to tasks would be the most appropriate choice.

Workers' compensation claims resulting from low back muscle strains and sprains have increased at an auto mechanic company, and management asks an OTR® for a consultation on implementing an injury prevention program. Which goal would be reasonable for this program?

Reduce costs for the employer resulting from lost work days and workers' compensation claims. A goal of any injury prevention program is to minimize employer expenses related to lost time and wages.

HS student is a L4-L5 paraplegic. He ambulates with crutches and has normal cognition and does not require OT services. He does however want to use public transportation to go from HS to a class at vocational center across town. what should the OT recommend? A. Request eval according to IFSP B. Refer student for eval on section 504 C. Schedule the student for initial screening as per Americans with disabilities act D. Set up a meeting with the schools special education team to establish an IEP for the student

Refer student for eval on section 504?

An OTR working in an outpatient setting is completing an initial interview with an older adult who has been recently diagnosed with progressive neurological disease. What message should the OTR use during the course of interview to communicate effective learning and client-centered understanding? a. Discuss intervention based on the diagnosis b. Offer suggestions as client discloses concerns and problems c. Provide examples of how other clients have overcome similar adversity d. Respond by paraphrasing statement the client makes

Respond by paraphrasing statement the client makes

A patient with Parkinson's disease is participating in OT to increase independence with self-feeding. During a session, the OTR notes that the bolus of food becomes pocketed between the patient's teeth and cheek. What does this indicate? a. Necessity to take a drink of water b. Preparation of the oral stage of swallowing c. Risk factor for potential aspiration d. Too large of a piece of food placed in the mouth

Risk factor for potential aspiration

An OTA implements intervention in a preschool program for children with tactile defensiveness. In the prior intervention session, the children had responded favorably when the OTA had rolled a large ball over their bodies as they lay supine on a mat. Which intervention method should the OTA use next? A. Roll the large ball with increased pressure across the children's bodies B. Bounce the ball across the children's bodies C. Have children jump into a pool filled with small balls D. Roll the large ball as in prior session, with that children prone

Roll the large ball with increased pressure across the children's bodies

A ten year old with congential anomalies wears bilateral ankle foot orthoses. The parents want the child to be able to don and doff shoes independently, but the child cannot tie shoes. Which is the best footwear recommendation for the OTA to make for the child to wear? A. Leather slip-on loafers B. Slip on tennis shoes with no laces C. Running shoes with velcro shoe closures D. Hi-rise sneakers with sliding adapters on the laces

Running shoes with velcro shoe closures

An adolescent had a CVA one week ago and has just transferred to an inpatient rehabilitation facility. The OTR is planning an intervention schedule for the adolescent. Insurance guidelines specify a minimum of 3 hours of therapy per day for reimbursement. Typically, patients in the facility who are referred to OT are scheduled for at least one diagnosis-specific group session per day. Currently, the average age of the patients on the unit who have neurological impairments is 68-years-old. What is the BEST OT option for this newly admitted adolescent? a. Assign the adolescent to a gross motor and self-care group with the other patients who have had a CVA b. Contact the insurance company to explain the situation and ask for an exception to policy c. Provide the patient with individual sessions for 2 hours and then have an OT aide provide therapy for the remaining hour d. Schedule the adolescent for one-on-one sessions to meet the specified time requirements

Schedule the adolescent for one-on-one sessions to meet the specified time requirements

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

Secure the pelvic band to adequately stabilize the student's pelvis

An individual with developmental disabilities scores a Level 3 on the Allen Cognitive Level Test. The OTA collaborates with the occupational therapist to plan intervention. Which activities should the OTA and Occupational Therapist include in the intervention plan to help meet the client's functional needs? A. Community mobility activities such as taking a bus B. Home management activities such as preparing a food shopping list C. Self-care activities such as brushing teeth D. Leisure activites such as completing a 50 piece puzzle

Self-care activities such as brushing teeth

A 7-year-old has severe flexion posturing of bilateral upper extremity secondary to anoxic encephalopathy. The parents have difficulty moving the child's arms for bathing and dressing. They also indicate when the child is sleeping, the muscles become more relaxed and they perform passive range of motion to open the fingers and move the elbows out of the flexed position. When the OTR moves the client's arm, the child winces in pain. Which spasticity management technique for the elbows would be the MOST BENEFICIAL to include as an adjunct to therapy to address the parents' concern? a. Continuous passive range of motion during hours of sleep b. Inhibitory casting in sub-maximal range of extension c. Pressure splints inflated to approximately 30-40 mm Hg d. Serial casting to maximal range of extension

Serial casting to maximal range of extension

An OTA working on an active cardiopulmonary rehabilitation unit collaborates with the occupational therapist to plan intervention for an individual who can complete activities in Stage II of cardiac recovery at a MET level of 1.4-2.0. Which activities should the OTA recommend be included in this intervention plan? A. Shaving and crafts B. Self-feeding and reading C. Deep breathing exercises and table top games D. Showering and isometric exercises

Shaving and crafts

Two weeks after beginning kindergarten, a five year old with myelomeningocele develops sudden onset of headaches, vomiting, irritability, and "sunken" appearance of eyes without signs of a fever. When the OTA reports the child's presenting symptoms, which condition should the OTA identify as a concern A. Stomach flu B. Tethered cord C. School anxiety D. Shunt malfunction

Shunt malfunction

A patient with a left CVA and resulting contralateral hemiplegia participates in OT. When documenting the patients performance during an intervention session, which ability is most likely for the OTA to state is intact? A. Temporal sequencing of a morning self-care routine B. Receptive language during a leisure planning group C. Spatial perception while in the ADL apartment D. Motor planning during a Tai Chi group

Spatial perception while in the ADL apartment

An eight year old with hypotonic cerebral palsy receives school based OT to improve fine motor skills. The child holds a thick marker with a static tripod grasp and holds a #2 pencil with a gross rasp. The OTA collaborates with the OT to modify the intervention plan. The improvement of which grasp would be best to include in the revised OT intervention plan as a STG? A. dynamic tripod with the thick marker B. Static tripod with a pencil C. Lateral pinch with a thick marker D. Dynamic tripod with a pencil

Static tripod with a pencil

A school ages child who is right hand dominant complains of numbness and tingling after writing for more 15 minutes. A neurological exam shows no reason for numbness and tingling. Which action would be most beneficial for the OTA to recommend to the child? A. Use a pencil held in a universal cuff B. Elevate the right UE at night and whenever possible during the day C. Stretch the right UE every 15-20 minutes during writing activities D. Use a custom-molded pencil grip made of splinting material

Stretch the right UE every 15-20 minutes during writing activities

An individual with left hemiplegia who is right hand dominant receives training to resume independent driving. Which adaptation is best for the OTA to recommend the client use? A. Supine with elevation of the shoulder and head B. Sidelying with the neck in neutral C. Sidelying with elevation of the shoulder and head D. Supine with elevation of the hips

Supine with elevation of the shoulder and head

What type of research should you review to obtain the strongest level of evidence regarding interventions?

Systematic reviews, meta-analyses

A middle school student with learning disabilities exhibits no behavioral problems in the classroom. However, whenever the class is in line waiting to switch classrooms, the student becomes agitated and often pushes classmates. The OTA consultant advises the teacher that this behavior may be indicative of an underlying problem. Which of the following is most accurate for the OTA to identify as a potential disorder warranting further evaluation. A. Gravitational insecurity B. A Conduct disorder C. Antisocial tendencies D. Tactile defensiveness

Tactile defensiveness

A 10-year-old child has memory deficits and mild right hemiplegia secondary to an acquired brain injury 2 months ago. The child requires moderate assistance with self-dressing. Which intervention MOST EFFECTIVELY supports the child's independence with self-dressing? a. Establish a consistent routine and location for the child to dress b. Have the child assemble dressing picture cards in sequence prior to dressing c. Provide the child with loose-fitting clothing with few fasteners d. Teach the child to refer to a printed list of sequenced dressing instructions

Teach the child to refer to a printed list of sequenced dressing instructions

A child with myelomeningocele meets the short-term goals of achieving functional gross grasp and lateral pinch. After several additional weeks of OT, the child does not meet the goals of demonstrating pincer grasp and three jaw chuck. The therapist should modify the treatment plan to:

Teach the child to use gross grasp and lateral pinch in functional activities

An adult participated in daily OT after incurring severe lacerations and median ulnar nerve damage from shattered glass. The wounds have healed and the patient is being discharged. The final evaluation shows minimal limitations in palmar sensation, joint ROM lacking ten to 20 degrees of full ROM, and palmar scarring. The OT and OTA collaborate to prepare the home program for this patients. Instructions for which intervention are most important to include in this plan? A. Use a resting splint B. Tendon gliding exercises C. Weight bearing exercises D. Home management tasks

Tendon gliding exercises

A client with developmental coordination disorder is referred for evaluation by the transition services team at a high school. Which assessment is the MOST appropriate for the OTR® to complete first with the client?

The Self-Directed Search measures a client's vocational interests.

The U.S. Department of Labor is the department of the U.S. government responsible for occupational safety, wage and hour standards, unemployment insurance benefits, reemployment services, and some economic statistics.

The U.S. Department of Labor is the department of the U.S. government responsible for occupational safety, wage and hour standards, unemployment insurance benefits, reemployment services, and some economic statistics.

An OTA works with adolescents who are survivors of child abuse. OT intervention can be provided in groups or on an individual basis. Which of the following would indicate to the OTA that intervention should be provided to an adolescent on an individual basis rather than in a group? A. The adolescent wants more socialization experiences B. The adolescent could benefit from feedback from peers C. The adolescent desires greater control over the environment D. The adolescent needs an opportunity to gain situational perspective

The adolescent desires greater control over the environment

A child with autism receives home care OT intervention services. The parents identifies a primary goal of developing the child's independent toileting skills. The child is completely dependent and the parent reports not attempting toilet training for several years. The OTA collaborates with the OT to establish to establish the first intervention goal for the child. Which behavior should this goal address? A. The child's ability to sit on the toilet with supervision B. The child's ability to verbally tell someone of the need to go to the bathroom C. The child's ability to non-verbally indicate the need to go to the bathroom D. The child's ability to indicate when the diaper is wet or soiled

The child's ability to indicate when the diaper is wet or soiled

Functional capacity evaluation, Job site evaluations and Prework screening have what in common?

They are given after a client has a job or job offer. Functional capacity evaluation provides information about a client's physical abilities to complete a SPECIFIC job activity. Job site evaluations assess the physical demands and layout of a SPECIFIC job setting. Prework screening is done when a client has been offered a job.

An OTR® will be presenting the benefits and description of work therapy programs at an in-service meeting. How would the OTR® describe these programs?

They occur at any point in the treatment of injured tissues. Work therapy may occur during any point in the healing of injured tissues. It typically occurs during the ACUTE phase of rehabilitation before tissue homeostasis.

An OTR is preparing to complete a vocational readiness assessment with an adult client with chronic schizophrenia. The client wants to work with a landscaping company. What performance skills should the OTR initially evaluate about the client's current work behaviors? a. Lifting capacity and endurance b. Memory and physical stamina c. Strength and adaptability d. Time management and social skills

Time management and social skills

An OTA provides home care services to an individual with advanced stages of dementia. The family caregiver expresses increased concern over the person's wandering behavior during the late night and early morning hours. The caregiver expresses fear that the individual will leave the house while everyone is asleep. Which recommendation is best for the OTA to initially make to the caregiver in response to this potentially dangerous exit doorways. A. Consult with the home care case manager for an assessment for skilled nursing facility placement B. Use the bed guard rails to ensure that the individual remains in bed at night C. Install deadbolt lock on the individuals door D. Use full length mirrors or wallpaper to camouflage exit doorways

Use full length mirrors or wallpaper to camouflage exit doorways

An entry level OTR who works in a long-term care facility is screening a resident who has ALS and uses a wheelchair. The resident's UE functional strength is Trace (1/5) on the left and Poor Minus (2-/5) on the right. The resident wants to eat meals in the facility dining room but is embarrassed about frequently dropping assistive eating devices and having several incidences of coughing while eating. What symptom is the resident most at risk for experiencing during a meal?

Variation in voice quality or loss of voice after swallowing, which is a symptom of dysphagia.

An upper-extremity functional capacity evaluation (FCE) for an outpatient occupational therapy department currently developing a return-to-work program?

Very generic : Initial intake interview, subjective pain assessment, ADL assessment, musculoskeletal evaluation, physical demand testing, material handling SKILLS (NOT Assessment of manual material handling) , and postevaluation questionnaire

A 6-year-old child who has Down's syndrome has been participating in OT to promote visual-motor integration. Standardized tests of visual attention indicate the child scored -1.0 standard deviations from the norm. Based on the hierarchy of visual-skills development, which client factors should be addressed NEXT? a. Visual imagery b. Visual discrimination c. Visual cognition d. Visual memory

Visual memory or discrimination.. take your pick

What is vocational evaluation?

Vocational evaluation ASSESSES a client's readiness and ability to engage in a particular occupation. Vocational evaluation may be conducted for :1) a person who has not worked previously, 2) who has been injured and is preparing to return to work, or 3) is unable to return to a previous job. Vocational evaluation may be general or specific addressing a person's potential for work or readiness to return to a specific occupation.

An OTA works on feeding with a toddler who has a hyperactive gag reflex. What should the OTA do to decrease the gag reflex? A. Have the child suck through straws of progressively longer lengths B. Walk a tongue depressor from the front of the tongue to its back C. Quickly ice the childs throat laterally D. Have the child blow bubbles

Walk a tongue depressor from the front of the tongue to its back

Which is the most effective approach for an OTA to use when giving directions for a task to an individual with schizophrenia who is experiencing auditory hallucinations? A. Written direction for making vanilla pudding B. General verbal directions for a group collage C. Verbal step by step directions for making a leather link belt D. Demonstrate steps in a beginning level swing dance class

Written direction for making vanilla pudding

An adolescent with spinal muscle atrophy shows decreased trunk balance and strength during intervention sessions. UE strength and ROM appear unchanged. When discussing these observations with the occupational therapist, which is the best recommendation for the OTA to make? A. a re-evaluation of the client be completed B. the client be referred to an orthotist for a soft spinal support C. The client be measured for a power w/c D. a trunk strengthening program be initiated with the client.

a re-evaluation of the client be completed

The parent of newborn infant has bilateral shoulder weakness and is referred to OT for training in energy conservation techniques for the performance of parenting and home management tasks. Which adaptation(s) is/are most effective for the OTA to recommend the parent use? A. a top loading washer and dryer for clothing care B. a steamer, steamer basket, and/or crock pot for meal prep C. a front pack carrier for holding the infant D. cloth diapers and use of a weekly diaper care service

a steamer, steamer basket, and/or crock pot for meal prep

An OTA supervises a Level 11 Fieldwork student regarding the evulation that some individuals attending the program magnify their symptoms to retain benefits; therefore the validity of some evalautions measures may be compromised. Which assessment tool does the OTA identify as providing the most valid results? A. a volunteer B. a dynamometer (all five positions) C. a standardized pegboard test D. a total active motion (TAM) evaluation

a volunteer

8. Which high school extracurricular activity would a youth with oppositional defiant disorder by most likely to succeed at? a. An art program with well-established boundaries in which students are encouraged to pursue their own interests b. A chess club in the library in which students participate in tournaments and, when not playing, participate observers c. A school basketball team that has the rule that students cannot play in a game if they miss a practice or are tardy or absent from school d. A science club in which students work together in small groups to prepare science projects for the state science fair

a. An art program with well-established boundaries in which students are encouraged to pursue their own interests

2. According to the Standards of Practice for OT which of the following is a requirement to practice as an OTR in the U.S. a. Completing licensure, certification, or registration requirements b. Passing state licensure examination for OT c. Graduating from a private OT program d. Successfully finishing an independent fieldwork experience

a. Completing licensure, certification, or registration requirements

14. A large outpatient hand clinic employs certified hand therapists who are either licensed OTRs or licensed PT's. COTAs are used to efficiently manage caseloads. Which description of the supervision requirement for COTA working in this environment is most accurate? a. Must be supervised by a licensed OTR in accordance with state licensure and scope of practice for COTAs b. Does not require supervision if the COTA has a minimum of 5 years of experience treating clients with upper extremity conditions

a. Must be supervised by a licensed OTR in accordance with state licensure and scope of practice for COTAs

3. Older women who are members of an ethic minority and live on lower incomes have been identified as using public transportation more than most people in their age cohort. How might this reliance on public transportation influence the engagement in community occupations of this population? a. Participation in community occupations will be limited by the hours of transportation service and the cost to use it b. Access to taxi services will expand this population's access to community occupations. c. Public transportation offers access to more geographic areas than does a private automobile

a. Participation in community occupations will be limited by the hours of transportation service and the cost to use it

16. A COTA is shifting roles within a skilled nursing facility to become the manager of the therapeutic recreation department. In which way does supervision from the OTR change? a. Supervision is no longer needed b. Supervision is an as-needed basis c. The OTR and COTA meet monthly to discuss clients d. The OTR and COTA meet quarterly to discuss clients

a. Supervision is no longer needed

5. Believing that treatment was not medically necessary, a third-party payer has denied payment for OT services. What step should OT take to appeal the denial of payment? a. Write an appeal letter that explains the client's need for the OT services that were provided b. Correct technical errors in previously submitted documentation c. Write an appeal letter that requires reconsideration of previously submitted documentation d. Ask the payer whether a different intervention would better fit the payment guidelines

a. Write an appeal letter that explains the client's need for the OT services that were provided

Enforcing stretch breaks are examples of what type of control?

administrative controls.

An OTA with 15 years of practice and administrative experience in a community mental health day program wants to work for a school system. Which position is the best match for the OTA's qualifications? A. an entry level OTA B. a senior OTA C. a director of the after school activity programs D. an OTA specialist in behavioral problems

an entry level OTA

Coping Inventory

assesses coping skills, habits, and behaviors to cope with self and with the environment in three areas: productive, aging, and flexible, for those aged 15 and older. This is an appropriate evaluation for a student who will be transitioning to life after high school.

work tolerance screening

assesses physical AND cognitive abilities for essential job functions. Done after client has received a job offer.

retrospective review

auditing of medical records by third party payers to ensure appropriate care was rendered

6. A client arrives for an OT eval. Upset because of an inability to travel home in time to attend the wedding of a family member. Which reponses by the OTR communicates a professional use of empathy? a. "Why don't you come back later when you are feeling better? b. "You seem upset that you are going to miss the wedding." c. "Life goes on. It will be okay" d. "You need to calm down so we can complete your OT for today."

b. "You seem upset that you are going to miss the wedding."

8. An OTR is evaluating a 16-year old adolescent with major despression and suicide precautions in an inpatient facility. Which source of info. Will best enable the OTR to document the intensity, severity, and duration of these symptoms? a. Observation during occupational performance b. A life events inventory of the client c. Interviews with caregivers d. Interviews with roommates in the facility

b. A life events inventory of the client

19. An OTR has just begun working on the cardiology unit of an acute care hospital and will be responsible for supervising the COTA that has been working there for 5 years. What is the best level of supervision? a. Continuous b. Minimal c. Routine d. Close

b. Minimal

11. Which characteristic of a general education classroom would promote access to the general education curriculum of a student diagnosed with level 1 autism spectrum disorder without intellectual impairment (Asperger syndrome)? a. Large classroom size b. Predictable transitions c. Teacher's gender d. Low level of structure

b. Predictable transitions

11. An adolescent hospitalized for suicidal ideation and depression is meeting with an OTR for discharge planning. What aspect of the discharge plan is MOST urgent? a. Provide client education on the effects of prescription medication b. Review the contract for safety procedures the client will follow when thoughts of suicide commence c. Contact the client's school system to see if a suicide prevention program is in place d. Reinforce the need for follow-up OT treatments to monitory progress

b. Review the contract for safety procedures the client will follow when thoughts of suicide commence

An OT consulting with a transitional living program housing adults with mental illness is working with a resident to support their new role as a part time employee of the library located a few blocks from the residence. The resident doesn't drive, which intervention is best to address com mobility skills relevant to their situation? a. teach the client how to safely move heavy books b. educate client about pedestrian safety and practice the walk to work c. educate client on automobile safety in the event that the client can find a ride to work d. work with client to obtain a drivers license

b. educate client about pedestrian safety and practice the walk to work

Allen Cognitive level 3.0-3.4 ADLs

basically the same as 2.4-2.8 -try to get them to take an active role with dressing/feeding tasks

When working with a client with chorninc pain, the OTR needs to set a tone that will facilitate a therapeutic relationship with the client. Which statement sets an open and appropriate tone when working with a client who has chronic pain? a. your pain is all in your head. All you have to do is ignore it b. I have pain when I wake up in the morning. I have arthritis. It usually takes a while before it gets any better. Maybe you should try to exercise in the morning to get things moving like I do c. I realize that you are in pain. Lets try this activitiy and see what happens. If you need to stop, let me know, but I would like to see you push yourself. d. I think we should slowly increase the time you are spending at work-related tasks

c. I realize that you are in pain. Lets try this activitiy and see what happens. If you need to stop, let me know, but I would like to see you push yourself.

8. An OTR is working with a client with Alzheimer's disease (AD) in a skilled nursing facility. The client's adult child, who is the client's primary caregiver, appears to be stressed and fatigued and has asked the OTR for advice about how to best manage the parent's progressive decline in function. What would be the best approach? a. Refer the caregiver to a physician for treatment b. Refer the caregiver to the social worker for community resources c. Provide the caregiver with education about the progression of AD d. Suggest that the caregiver use the massage services at the facility.

c. Provide the caregiver with education about the progression of AD

heterotrophic ossification

calcium deposit that may occur in or near a joint after burns/SCI/etc -decrease joint excursion, stiff endpoint, increased pain -aggressive PROM, splinting, heat is contraindicated

An OTA provides intervention for an individual with a swallowing disorder. To elicit a swallow reflex, the OTA provides sensory input to the inferior faucial arches. Which should the OTA use to provide this intervention? A. tongue depressor B. moistened cotton swab C. chilled dental examination mirror D. warmed metal teaspoon

chilled dental examination mirror

Community centers provide services to what certain populations ?

clients who are homeless, have mental illness, are living with HIV/AIDS, are in welfare-to-work programs

Kitchen task assessment (KTA)

cognitive assessment measuring a person's judgment, planning, and organizational skills used to perform a simple cooking task. Originally developed for adults and elders with senile dementia of Alzheimer's type -- expanded for use with individuals with cognitive dysfunction

Direct expenses

costs related to OT service provision such as salaries and benefits (vacation and sick time)

total quality management

creation of an organizational culture that enables all employees to contribute to an environment of continuous improvement

6. A student OT arrives at a facility for Level 2 FW and discovers that the OTR supervisor has to take an unplanned eave for the duration of fieldwork. An entry-level COTA is present at the facility. What options does the student have for appropriate fieldwork supervision at that facility? a. The student may be supervised by the entry level COTA as long as the COTA consults with the OTR b. The student may be supervised by an OTR who works at another facility c. The student may be supervised by an entry-level COTA who works at another facility d. The student cannot complete fieldwork at the facility because adequate supervision is not available.

d. The student cannot complete fieldwork at the facility because adequate supervision is not available.

Kohlman Evaluation of Daily Living Skills

determines an individual's knowledge and/or performance of 17 basically living skills needed to live independently in 5 main areas (self care, safety and health, money management, transportation, telephone use and work and leisure

Purpose of pre-vocational program:

develop an individual's task skills, social interaction skills, and work habits prerequisite to work (independent task initiation and completion, decision making and problem solving, appropriate response to supervision, constructive interactions with coworkers, punctuality, and consistent attendance)

Project group is a type of ___ group

developmental -purpose of developmental groups is to teach the social interaction skills needed for group participation in a sequential manner -provides relevant group structure and activities along a continuum that is consistent with how interaction skills develop normally

Environmental Control Unit (ECU)

devices that allow people with mobility impairments to operate electronic devices, including televisions, computers, lights, appliances, and more. There are many commercially available ECU devices, however they typically fall into two broad categories—stand-alone and computer-based devices. It is most important to tell patients how to power it as a backup source and how to charge it

CARS (Childhood Autism Rating Scale)

diagnostic tool that distinguishes children with autism from children with developmental delays who do not have autism. determines the severity of autism in children over 2.

What kind of splint to use for Erb's palsy

elbow lock splint (stabilizes the elbow to enable to the individual to position the hand closer to or away from his/her body for functional use

The parent of two elementary aged children receives home care hospice services due to metastasized bone caner. The client is in pain and has poor endurance and decreased muscle strength. The client requires moderate assistance with self-care and dressing. Which is the best intervention for the OTA to incorporate into sessions with this parent? A. training in energy conservation techniques for self-care and dressing B. training in joint protection techniques for self-care and dressing C. using biofeedback to reduce the clients pain D. exploring play activities for the parents to do with the children

exploring play activities for the parents to do with the children

How to calculate TAM (total active motion)

extension deficits added and then subtracted from the flexion measurement total ?????

Parallel group

first developmental group level, indicated for persons who have difficulty in social situations -purpose of parallel group is to develop members' basic level of awareness, trust, and comfort with others in the group by having them perform individual tasks the presence of others -require minimal verbal or non verbal interaction with others since interactions are not needed for the successful completion of members' individual tasks

What is the ACOTE responsible for?

for accreditation of OT education standards in support of the practice standards set forth by the AOTA

psychiatric inpatient units are typically acute and patients do not typically stay long so group sessions should be something you can complete in one session.

fyi

executive functioning

higher level cognitive abilities 1.volition 2. planning 3. purposeful action 4. effective performance

Anhedonia

inability to experience pleasure

Dyskinesia:

involuntary, non repetitive, occasionally stereotyped movements affecting distal, proximal, and axial musculature in varying combos, typically a basal ganglia disorder

What is the NBCOT responsible for?

issues related to certification and certification renewal

Nardil (medication for depression). What is important to remember about this medication?

it is a monoamine oxidase inhibitor (MAOI) is has serious side effects when a person eats foods that contain the amino acid tyramine. Tyramine increases BP and may lead to stroke or other cardiovascular reactions. Headache and heart palpitations are the first sign of a problem.

Major focus of hospice care

maintain the individual's control over his/her life while enabling engagement in meaningful activities that are related to the person's valued roles

Myasthenia gravis 3-/5, fair minus feeding, has cuff, guard, straw

motor assessment scale

Is reality orientation (consistently re-orienting a patient) effective with patients with dementia?

no, re-orientation does not improve functional capabilities. this would only highlight the client's deficits and increase caregiver stress

A child with ADHD receives school based OT services. During intervention sessions, which behaviors will the OTA most likely observe the child demonstrate? A. An excessively high energy level that can be lessened by eliminating consumption of caffeine or certain foods. B. Symptoms of learning disabilities as evidenced by difficulties with reading and math C. Poor attention to school and play activities over the past three months D. non-purposeful activity that interferes with function in age-appropriate skills

non-purposeful activity that interferes with function in age-appropriate skills

Clubhouse program utilize a consumer empowerment model that emphasizes the active involvement of all participants in the decision making and implementation processes of the clubhouse. In a group led by an OT, how should the OT lead?

not a directive approach at all

Pronator teres syndrome

numbness and tingling of the thumb, index, middle, and radial half of the ring finger and aching pain in the proximal forearm not evident at night. positive tinels sign at the forearm medial nerve compression *similar symptoms to carpal tunnel syndrome except with this they don't have pain at night and they don't have positive tinels sign at the wrist

Bruininks-Oseretsky Test of Motor Proficiency (BOT)

persons aged 4-21 with clinical validity tests for persons with ASD -assesses fine motor coordination, manual coordination, body coordination, and strength and agility

Who is responsible to take action on an individual's ability to drive?

physician

cubital tunnel syndrome

positive Tinel's sign at cubital tunnel at the elbow, ulnar nerve compression. symptoms of numbness and tingling along the ulnar aspect of the forearm and hand and pain at the elbow with extreme elbow flexion

Guyons canal syndrome

positive tinel's sign at Guyons canal (ulnar nerve impingement) on ulnar side of hand

Erhardt Developmental Prehension Assessment

prehensile development by observing 341 test components which are categorized according to involuntary arm hand patterns, voluntary movements of approach, and prewriting skills -observational checklist used to evaluate children with moderate to severe hand and upper extremity impairments related to neurodevelopment disorders

Breathing strategy for pt with COPD

pursed lip breathing techniques for slow controlled exhalation helps reduce trapping of air in the lungs and promotes better air flow -forceful exhalation is contraindicated

What do the research findings of r=0.01 from the peer reviewed article indicate for the level of correlation?

r = 0.01 = no correlation (The closer the correlation is to 1.0, the stronger the relationship between the two variables. A correlation of 0.0 indicates the absence of a relationship.)

akathisia

restlessness/anxiety. "inability to sit" -drug induced from antipsychotics

A task oriented group has to have what kind of component

self expression

An adult diagnosed with MS over 10 years ago experiences and exacerbation of symptoms. The individual principle complaint is decreased strength and endurance. The person can ambulate short distances with a cane in the home and uses a w/c outside the home. The client asks for suggestions to enable independent home maintenance. Which is the best positioning recommendation for the OTA to suggest the person use during meal prep? A. sitting the w/c with tray table B. sitting at the kitchen table C. leaning against the counter with standing D. leaning against a tall stool while standing

sitting at the kitchen table

A four month old with arthrogryposis remains in a position when placed and shows little spontaneous movement. The OTA implements intervention to work on rolling. Which positional changes should the OTA include in the intervention session? A. prone to supine B. supine to side-lying C. prone to side-lying D. supine to prone

supine to side-lying

6 month old, decreased head control, supine --> sit on ball

support infant shoulders while slowly rocking ball backward and forward

During an intervention session, an eight month old child demonstrates a positive downward parachute reflex. Which is the most accurate statement for the OTA to include in the documentation of this observed behavior? A. the child exhibits normal reflex development B. the child exhibits a developmental delay C. the childs protective extension downward reflex needs to be evaluated by an OT D. The childs standing tilting reflex needs to be evaluated by the OT

the child exhibits normal reflex development

Systematic reviews

the strongest level of evidence because they provide an overall conclusion based on review of all the evidence available on the topic

An individual with bilateral LE amputations and cataracts is newly admitted to a skilled nursing facility. the individual retains some residual vision. During intervention sessions, which is the most effective placement for the OTA to use when presenting materials to the person? A. to the side of the person, with no direct lighting B. directly in front of the person, at eye level C. directly in front of the person, at the table top level D. to the side of the person, with a strong light shining

to the side of the person, with no direct lighting

Silver ring splints

used on individual fingers to prevent boutonniere deformities which can contribute to improve functional grasp

The primary focus of ergonomic evaluation:

work practice and risk for injury resulting from postural or manual material handling.

Policies and procedures aimed at improving the safe performance of work tasks are examples of what type of control?

work practice controls

After a work-related injury to the left index finger, an assembly line worker is fit with a buddy strap incorporating the index and middle fingers. In describing the primary purpose of the strap to the client, which of the following explantations is most accurate for the OTA to state? A. "The strap provides passive ROM to the index finger". B. "The strap reduces edema in the index finger". C. "The strap immobilizes the index finger". D. "The strap provides active ROM to the index finger".

"The strap provides passive ROM to the index finger".

An adolescent with myelomenigocele (spina bifida) at the C8 level wants to access a new computerized play system. Which is the best adaptation for the OTA to recommend the adolescent use to access this system? A. A chin switch B. A tenodesis splint C. A dorsal wrist splint with universal cuff D. A joy stick control

A joy stick control

The members of a group are not working well together and show decreased levels of trust. Which action is most effective for the OTA to take to enhance the group's cohesiveness? A. Begin the group with inspirational phrases B. Verbally reinforce the goals and norms of the group C. Have each member write a journal about his/her perspectives about the group D. Ask members to talk about they do not like about the group

B. verbally reinforce the goals and norms of the group Rationale: The most effective choice is to verbally reinforce the goals and norms of the group. This helps to direct the focus of the members and to address difficulties in keeping that focus. Inspirational phrases can be helpful to instill a positive attitude but they do not address the need to develop group cohesion. Writing in a journal can help develop personal insights but it would not increase group cohesion. Asking for self-disclosure in a group with decreased levels of trust will decrease cohesion. Also, the topic of what members do not like about the group is not likely to facilitate trust, openness, and willingness to share.

When considering the readiness of a client for a power wheelchair, the OTR should primarily be concerned with?

Cognitive ability, to ensure that the individual has the awareness, problem solving, and decision making capabilities to learn how to consistently and safely operate the chair

An OTA leads a community integration for individuals with mild intellectual disabilities who reside in a group home. During a travel training session, a member of the group slips while going up the stairs of the bus. The client quickly gets up, pays the fare, sits down and joking states " Good thing I bounce well". Which action should the OTA take after accessing the person is not injured. A.Cancel the planned activity and return to the group home to file an occurrence report B. Ask the bus driver to radio for an ambulance to obtain a medical assessment to validate the client was not injured. C. Continue with the planned activity and file an occurrence report upon return to the group home D. Continue with the activity and ask the client to report any development of symptoms related to the fall

Continue with the planned activity and file an occurrence report upon return to the group home

While reviewing work hardening program documentation, an OTR realizes there is no entry in the client's medical record of a meeting conducted with the insurance case manager, client, and client's employer regarding light-duty options. According to best practice guidelines, how should the OTR amend the client's medical record to include a summary of the meeting? a. back-date the entry to correspong to the actial date of the meeting b. insert a summary of the meeting into the margins of the client's medical record. D. Enter the information as a late entry into the client's medical record.

D. Enter the information as a late entry into the client's medical record.

Several patients in a cardiovascular unit are referred to occupational therapy for rehabilitation in areas of occupation. Which diagnosis would be an inclusive criterion for participation in the home management activity group conducted in the departments simulated apartment? A. Hypotension B. Unstable angina C. Venous thrombosis D. Uncontrolled atrial arrhythmia

Hypotension

A child with juvenile RA wears bilateral night resting splints with wrists in zero degrees of extension, MPs, and IPs flexed, ulnar deviation of 10 degrees, and thumbs in opposition. The child complains of pain in wrists upon awakening. No redness is noted upon removing splints. ROM measurements show ulnar deviation of 5 degrees. Which action should the OTA take in response to this A. Modify the splints at the wrist B. Pad the ulnar aspect on the inside of the splints C. Discontinue the splints and monitor the status of pain for two weeks D. Construct volar cock-up splint for use during the day

Modify the splints at the wrist

An OTA uses the Rood approach to facilitative motor development. A pediatric client has mastered the neck co-contraction pattern. Which pattern is best for the OTA to implement next? A. Quadruped B. Prone on elbows C. Rollover D. Standing

Prone on elbows

A child with tactile defensiveness is receiving intervention from an OTA who uses a sensory integrative approach. Which method is most effective for the OTA to use when introducing tactile stimuli to the child? A. Provide deep touch and firm pressure where the child can see the stimuli B. Apply the stimuli in the direction opposite of hair growth with vision occluded C. Apply light touch across the face and abdomen with vision occluded D. Provide light brushing across the palmar surfaces of the extremities with the child watching

Provide deep touch and firm pressure where the child can see the stimuli

A patient in a rehabilitation facility has a complete C8-T1 spinal cord injury. The patient is learning techniques to maximize independence with dressing. Which technique should the OTR teach the patient to use to support progress toward this goal? a. Put on undergarments and trousers in bed, then transfer to a wheelchair to complete upper body dressing b. Use a universal cuff with a button-hook and zipper-pull to fasten front-opening clothing c. Wear a wrist-driven flexor hinge splint for pulling on and fastening clothing d. While supine in bed, put on socks and shoes; then put on underpants and trousers by rolling side to side in bed

Put on undergarments and trousers in bed, then transfer to a wheelchair to complete upper body dressing

The parents of a five year-old with ADHD express difficulty managing the child's aggressive behavior towards older siblings. Which is the most effective strategy for the OTA to recommend to the parents? A. Allow the child to vent aggressive feelings on a stuffed animal or doll B. Redirect the childs energy into acceptable and safe play activities. C. Provide consistent punishment for aggressive behavior D. Send the child to stay with a family member or close friend for an extended "time-out".

Redirect the childs energy into acceptable and safe play activities.

An individual with a spinal cord injury at the level of T-1 is practicing a stand pivot transfer in the OT department of a rehabilitation center. The patient complains of dizziness and nausea. Which action is most important for the OTA to take first? A. Call for help according to facility procedures B. Return the patient to the wheelchair C. Return the person to the wheelchair and immediately recline it D. Return the patient to the wheelchair and transport the patient back to rest in bed

Return the person to the wheelchair and immediately recline it

An adult is hospitalized and diagnosed with mild chronic obstructive pulmonary disease (COPD). During the discharge planning session, the person identifies a desire to exercise regularly. What should the OTA recommend the client pursue? A. The hospital wellness programs yoga group B. Low impact aerobics at the local gym C. Weight lifting under the direction of a personal trainer D. Jogging with friends

The hospital wellness programs yoga group.

An individual is scheduled for a right hip total arthroplasty. Following surgery, which is the most appropriate bed positioning intervention for the OTA to recommend? A. Side lying with LE adducted B. Use of an abductor pillow between the LE C. Use of hospital bed to elevate the LE to 90 degrees D. Change the position from supine to prone every 2 hours

Use of an abductor pillow between the LE

An individual with advanced Huntington's chorea is admitted to a skilled nursing facility. The resident weights 280 lbs and cannot independently transfer. What is the best recommendation for the OTA to make to the residents direct care staff to ensure safe transfer? A. a mechanical life transfer B. A stand pivot transfer C. a two person lift transfer D. an assisted sliding board transfer

a mechanical life transfer

6. The OTR is working on a task-oriented gardening activitiy with a small group of adolescents in an inpatient mental health setting. One of the participants becomes self-absored and distractible and has bursts of energy that are affecting the other members of the group. a. "How are we doing with our pot transfers? We need to get this done today."- goal directed action b. "Can I speak to you privately about your behavior during the group work?" c. "You seem to be distracting the other members of the group." d. "Please stop whatever it is you are doing."

a. "How are we doing with our pot transfers? We need to get this done today."- goal directed action

1. A school district's supervising OTR receives a phone call from an irate parent of a middle school student whose individualized education plan (IEP) includes OT twice a week. The student did not receive OT for 3 weeks because one of the district's OTR was out with work-related injury. What is the OTR best option? a. Ensure that OT services are provided to this child, because it is included in the child's IEP b. Put the child on a waiting list while the therapist is out c. Reduce the frequency of OT visits to once a week while the therapist is out d. Discharge the child from OT because the parent is difficult to deal with

a. Ensure that OT services are provided to this child, because it is included in the child's IEP

1. When an OTR or COTA completes documentation, which of the following actions is MOST in compliance with HIPAA regulations for maintaining patient privacy and confidentiality? a. Positioning computer screens and patient charts out of others' view b. Collaborating with other therapist in the OTR discipline c. Maintaining electronic client documents d. Keeping hard-copy record in a central area

a. Positioning computer screens and patient charts out of others' view

9. Which suggestion that the OTR might provide to a caregiver who is living with a client who has AD is the best? a. Suggest appropriate activities that can engage the client during unoccupied time and improve daily structure b. Suggest that the caregiver allow the client to continue cooking Indep. With adapted cooking utensils to improve safety. c. Suggest that the caregiver provide challenge to the client's daily routine by maintaining distance during routine tasks d. Suggest modifications to the house environment to include arrows that lead to the bedroom and bathroom

a. Suggest appropriate activities that can engage the client during unoccupied time and improve daily structure

8. An entry-level COTA begins working at a long-term care facility and needs direct continuous supervision. Which statement BEST describes this type of supervision? a. The COTA and supervising OTR are in the rehab. Gym, the OTR observes the COTA's performance b. The COTA and OTR meet at the end of the day to discuss the COTA's caseload and review documentation c. The supervising OTR is in the facility but in another area d. The COTA emails or texts the OTR questions throughout the day as needed, and the OTR reviews the COTA's documentation regularly.

a. The COTA and supervising OTR are in the rehab. Gym, the OTR observes the COTA's performance

12. Which statement Best describes how a COTA assists with performing an OT eval?

a. The COTA may perform delegated assessments and provide reports of a client's capabilities to the OTR

3. The spouse of a client with Alzheimer's dementia tells the OTR that the client has become more agitated, wanders, resists care, and displays inappropriate and sometimes destructive bx. The spouse confides that feelings of stress have begun to feel overwhelming. a. Training the spouse to provide simple, one-step directions and avoid abstractions b. Role playing with the spouse and the client ways of providing explanations that will clarify the client's confusion c. Assertiveness training with the spouse d. Conflict resolution sessions between the spouse and client

a. Training the spouse to provide simple, one-step directions and avoid abstractions

10. A generalist OTR is working with a teenage with developmental disabilityies who hopes to acquire a driver's license. Which intervention MOST appropriately addresses this clients' community mobility needs? a. Training to improve the client's comprehension of travel rules tested in the licensing process b. Practice in driving skills in the OTR's vehicle in the school parking lot c. Practice in handwriting skills to improve the client's communication about driving skills d. Use of cognitive-behavioral therapy to address the client's beliefs about the ability to drive

a. Training to improve the client's comprehension of travel rules tested in the licensing process

76 y/o client will be using a w/c after D/C from acute rehab. Pt has achieved I in w/c mobility on level surfaces but requires min A for transfers. Pt plans to move in with daughter which was not his initial plan. OT is planning a home evaluation with the client and daughter. Before the home evaluation, what will be the most appropriate action for the OT to take? a. interview client and daughter to get occupational profile and determine role expectations the client will assume after D/C b. discuss functional mobility limitations with client and the level of assistance needed for toilet transfer as a part of fall prevention education c. interview daughter about detailed measurements and the layout of the home and acceptance of necessary home modifications d. provide client and daughter with info regarding the ADA's accessibility guidelines for buildings and facilities

a. interview client and daughter to get occupational profile and determine role expectations the client will assume after D/C

2. An OTR wants to search the literature for rationales related to a sensory integration intervention for clients with dementia. Which is an appropriate question for an evidence-based practice literature review? a. "What is a sensory integration approach?" b. "How is sensory integration used with people with dementia?" c. "What is the efficacy of sensory integration?" d. "What are the outcomes of sensory integration?"

b. "How is sensory integration used with people with dementia?"

6. A COTA decides that a client has returned to the previous level of function and continued OT services are no longer needed. Best way to discharge patient? a. COTA sets a last tx day, provides home exercise program and review progress with the patient while completing the discharge notes b. COTA alerts the OTR and the OTR review the documentation discusses the patient's progress and response to intervention, and collaborates on a last tx day c. COTA notified the OTR who meets with the patient to discuss potential discharge from therapy, the OTR proceeds the discharge d. COTA sets a last tx day, provides a home exercise program and home safety packet, and reports final notes on functional levels to the OTR

b. COTA alerts the OTR and the OTR review the documentation discusses the patient's progress and response to intervention, and collaborates on a last tx day

1. An OTR in a home health setting is working with a client in the kitchen and hears a heated argument between the client's spouse and one of the client's children in the next room. The client begins to cry, indicating that the arguing is causing stress. a. Confront the people in the next room b. Call the medical social worker and report the incident c. Drive the client to a shelter d. Try to resolve the conflict

b. Call the medical social worker and report the incident

11. According to the Standards of Practice for OT, which best describes the role of the COTA in client outcomes? a. Develops a transition plan b. Contributes to discontinuation plan - however unable to Ind. Discontinue a client from OT. c. Reduces the intensity of services d. Interprets achieved outcomes

b. Contributes to discontinuation plan - however unable to Ind. Discontinue a client from OT.

1. The director of OT services for a large metropolitan home health agency is conducting a supervisory visit and notices the OTR is writing progress notes on a persona electronic tablet. OT is excited about using tablet and shares with the director that it saves a great deal of time. Most appropriate response from director? a. Applaud the OT for using technology efficiently b. Develop a policy prohibiting the use of personal electronic tablets for note writing c. Ask the OT to describe the use of electronic recording to the other OT at the agency d. Ask home health clients for their opinions regarding electronic record keeping

b. Develop a policy prohibiting the use of personal electronic tablets for note writing

7. An extremely agitated pt. is admitted to an inpatient psychiatric hospital late on a Friday afternoon. Because nursing is short staffed, the nurse on the unit requires that the patient attend an OT group being led by a COTA that evening. The COTA calls the OTR who is working at a location far from the unit, for guidance. The OTR is unable to return to the unit in time to evaluate the patient. What should the OTR recommend to the COTA? a. Allow the patient to attend the group b. Do no allow the patient to attend the group c. Cancel the group and eval. The client d. Allow the patient to attend the group with the understanding that the OTR will complete the eval on returning to the unit.

b. Do no allow the patient to attend the group

15. A COTA has established service competency for administration and scoring of the Mini-Mental State Exam. Which supervision is the most appropriate for the OTR to provide? a. Close supervision on an ongoing basis to ensure maintenance of service competency b. Minimal supervision to periodically recheck that service competency is maintained c. Supervision on an as-needed basis per the COTA's request to fine-tune service competency d. None, unless otherwise indicated by the facility, state law, or licensing changes.

b. Minimal supervision to periodically recheck that service competency is maintained

1. An OTR is working to establish a therapeutic relationship with a client in a skilled nursing facility. Which consideration is the MOST important in establishing an effective relationship? a. The OTR has the power to determine the goals b. The client is an informed equal in the relationship c. The OTR is solely responsible for any positive outcomes d. The client is expected to follow the OTR advice

b. The client is an informed equal in the relationship

The owner of a construction company asks an OT completing work tolerance screenings to notify applicants whether they have been hired on the basis of their screening results. What should the OT do? a. suggest that the owner revise the written policies for work tolerance screenings to reflect this change in the process b. inform the owner that the OT will review the results of the completed work tolerance screening with the owner so the owner can summarize results with applicants and notify them regarding the hiring decision c. keep good documentation of the agreement to support the need for this change in the work tolerance screening process d. implement a quality assurance monitoring system to determine reasonable outcomes for this revised process

b. inform the owner that the OT will review the results of the completed work tolerance screening with the owner so the owner can summarize results with applicants and notify them regarding the hiring decision

3. An OTR is approached by a client with Alzheimer's dementia who asks, "do I finish high school next year, or am I already finished? I don't want to go back." What is the best response for the OTR to make? a. "Try to remember that you completed high school 60 years ago." b. "I'll have to find out if you finished high school. Try not to ask me again." c. "It sounds like you're getting a little worried about that. You're already finished with high school. You don't have to go back." d. "Didn't you go to college?"

c. "It sounds like you're getting a little worried about that. You're already finished with high school. You don't have to go back."

5. An OTR in an acute care setting is working on a dressing program with a client with spinal cord injury. What statement by the OTR is appropriate to facility positive coping for the client? a. "I have selected these clothes for you today." b. "Would you like to wear the blue or the red shirt?" c. "What clothes do you want to wear today?" d. "You should wear these clothes today."

c. "What clothes do you want to wear today?"

An OTR is supervising an OT student for Level II FW. The OTR notices that the student did not gather complete info. Regarding a client's Occ. History. Which comment best represents effective feedback? a. "you missed some info when you were recording the client's occ. History b. "in the future, you need to ask better questions about the client's occ. History c. "in the future, you may want to use a checklist to ensure that your occ. History interviews are comprehensive. d. you should practice doing occ. History interviews

c. "in the future, you may want to use a checklist to ensure that your occ. History interviews are comprehensive.

6. During the OTR initial interview, a client with stage 2 Parkinson's disease explains the importance of the client's role of head of household and expresses a fear of being dependent on his or her children. The client's chief complaints are tremors and fatigue, which are starting to affect the client's performance of higher-level ADL and IADL tasks. a. Energy conservation education, such as delegating tasks to family members to reduce fatigue b. Stress management skills, because stress tends to exacerbate symptoms such as tremors c. Activity and environmental modifications for home management skills to successfully maintain the client's role d. Therapeutic exercise to improve balance, which will enhance the client's participation in higher-level tasks.

c. Activity and environmental modifications for home management skills to successfully maintain the client's role

7. A client with middle-stage dementia has been wandering outside the house in the middle of the night. The client's caregivers have been using monitoring devices and recently added door alarms, but usually are too late. Weather is beginning to get cold, and the caregivers do not want to the client to get frostbite. What is the next intervention for the client? a. Install bed rails to keep the client from climbing out of bed b. Place the client in a nursing home c. Conceal the doorknobs so that the client cannot open the door d. Move the client's bed into one of the caregivers room

c. Conceal the doorknobs so that the client cannot open the door

12. During a commode-to-bed transfer, the client begins to slip from the OTR's grasp. What action is best for the OT to take? a. Continue with the transfer, and try to get the client to the bed as quickly as possible b. Have the client return to the commode c. Ease the client to the floor, then get assistance d. Call for help, and get the attention of the client's nurse

c. Ease the client to the floor, then get assistance

10. An OTR works with elderly clients with low vision. A client with macular degeneration is referred after substantial symptom progression and loss of vision. The client's spouse states that for the past 3 months, the client has uncharacteristically refused to participate in social activities, is frequently irritable and uncommunicative, and is unwilling to perform personal care or routine risks. a. Consider exporing assisted living alternatives b. Insist that the client resume accompanying the spouse to bridge club and prepare a snack to share with the club c. Encourage the client to consult a mental health provider d. Advise the client and spouse to seek professional counseling to adjust to the inevitable changes in the marriage

c. Encourage the client to consult a mental health provider

4. Which statement best describes an important consideration for OTR's working with clients with dementia and their caregivers? a. Providing a variety of new occupations creates a sense of well-being for the caregiver and care recipient b. A brief respite from caregiving benefits the caregiver but is detrimental to the care recipient c. Everyday occupation is central to a caregiver's sense of well-being d. Psychologically resisting the inevitability of chronic illness improves satisfaction with caregiving.

c. Everyday occupation is central to a caregiver's sense of well-being

4. An adult client is receiving home health OT services from an OTR. At the initial session, the adult child of the client informs the OTR that the client's spouse passed away 2 months ago. The adult child states that the client has never been so down, that the client has to be encouraged to go to restaurants or movies and the client often cries. a. Tell the client's adult child that the client is experiencing depression and should seek psychiatric care b. Describe the difference between grief and depression to the client's adult child c. Further explore with the client's adult child the extent of the client's sadness and negative moods before recommending a course of action d. Ask the client's adult child about any potential physical or psychological abuse the client may have experienced in his or her lifetime.

c. Further explore with the client's adult child the extent of the client's sadness and negative moods before recommending a course of action

9. An OTR is working with a child diagnosed with oppositional defiant disorder in a public middle school. The child has been breaking rules in the Phys. Ed. Class by not wearing sneakers in the gym, chewing gum during class, and repeatedly forgetting to bring a swimsuit for the swimming class. Which solution would be best for the student? a. Referral to an alternative school located nearby b. Assignment of in-school suspension during gym class c. Implementation of a behavioral plan d. Replacement of gym class with another class

c. Implementation of a behavioral plan

4. Which method would be most effective to gather data on the needs of a homeless population in a large urban area? a. Face-to-face interviews with people who work with the homeless population b. A written survey distributed to people who are homeless c. Interviews with key informants who are homeless d. Telephone interviews with caseworkers at homework shelters

c. Interviews with key informants who are homeless

9. According to the Standards of Practice for OT, which task can the COTA complete in the eval. Process? a. Respond to the initial referral request b. Interpret and document the eval results c. Perform delegated assessments using current tools d. Make recommendations to other professionals

c. Perform delegated assessments using current tools

12. An OTR is assessing a client with bulimia. The client has become preoccupied with hiding purging behaviors from friends and family. While developing an occupational profile with the client, the OTR notices that the client's bulimia has evolved, and that the client has replaced all other activities with the bulimia. a. Teach the client relaxation strategies to provide relief from the stress caused by the bulimia b. Recommend social activities to encourage the client to interact with friends and family in a more positive way c. Provide the client with leisure's activities that will create more balance and offer the client more control over the client's life d. Assign the client small-group activities with other clients to provide the client with info. About the health impact of bulimia.

c. Provide the client with leisure's activities that will create more balance and offer the client more control over the client's life

10. Which recommendation should an OTR make to the caregiver of a client with dementia, who is suffering from caregiver stress? a. Recommend that the caregiver inquire about medication to reduce the caregiver's stress b. Recommend that the caregiver inquire about additional sleep medication for the client c. Recommend that the caregiver contact a local adult day care to inquire about its services d. Recommend that the caregiver find a teenager in the neighborhood who can watch the client

c. Recommend that the caregiver contact a local adult day care to inquire about its services

18. A client with hip osteoarthritis has been referred for an OT assessment and treatment. What can the OTR have a COTA contribute to the assessment? a. Identify whether the client will need OT b. Decide which eval should be completed c. Select and implement therapeutic activities d. Interpret from the outcome if client can engage in occupations

c. Select and implement therapeutic activities

3. An OTR is working in an outpatient setting and observes a COTA setting up electrical stimulation on a patient with a significant cardiac history, including a pacemaker.

c. Stop the COTA from proceeding, check the eval and treatment plan and if needed review physical agent modalities and appropriate use

Evaluating a client in lunchroom, OT under fee-for-service contract observes another client w. level 1 autism reacting negatively to another student that accidentally brushed against him in line. What is the best response for the OT to make? a. Do nothing- OT is on their way to work with another student b. Deliver negative consequences to the client for misbehaving c. Suggest the client move to the end of line to avoid crowd d. Suggest client eat alone in another room to avoid being crowded

c. Suggest the client move to the end of line to avoid crowd

17. An OTR who supervised an OT assistant student in the student's final level II fieldwork in an acute psychiatric hospital hires the student for a COTA position. The student plans to sit for the NBCOT exam in 2 weeks. How should the OT supervise the COTA? a. Supervise the new employee as a COTA/L because the employee has completed all courses and fieldwork b. Always provide direct, face-to-face supervision for the new employee c. Supervise the employee consistent with national and state guidelines on uncertified employees d. Ask the new employee to initiate an OT assessment.

c. Supervise the employee consistent with national and state guidelines on uncertified employees

4. A COTA who spend 2 years working on the ortho. Unit of an acute care hospital is now working on the neuro. Floor. How is appropriate supervision best described? a. The OTR and COTA decide to set up supervisory visits on an as-needed basis b. The COTA requires minimal supervision owing to his or her 2 years of experience c. The OTR and COTA agree that close supervision is best at this time d. The OTR and COTA decide that continuous supervisor is needed.

c. The OTR and COTA agree that close supervision is best at this time

2. An OTR is conducting a group for older adult clients on prep. For driving cessation. Several group members express a fear of using public transportation because they have never done so. a. Referrals to a psychologist to address issues of fear and anxiety b. Driving evals. To ensure that the clients can continue to drive for as long as possible. c. Travel training to practice use of public transportation with the clients until they feel comfortable on their own d. Simulation of public transportation by driving the clients along the same routes used by the transit system

c. Travel training to practice use of public transportation with the clients until they feel comfortable on their own

An OT consultant is educating a group of supervisors from a furniture manufacturing company about common work related risk factors for cumulative trauma disorders. What are some of the primary physical risk factors that the OT would explain to the supervisors? a. regulated temperatures, noise, and lighting b. body mass index greater than 25 c. forceful exertions, repetition and excessive vibration d. old age, being female, and lower socioeconomic group

c. forceful exertions, repetition and excessive vibration

A person with level 1 ASD without intellectual impairment (Asperger's) is having a difficult time transitioning to a new adult foster care home, OT is contracted to make 4 home visits to access the client and provide appropriate intervention. When the OT arrives and attempts to interview the client, he angrily refuses to speak with the OT. What option is the best response? a. stay long enough to convince the client to cooperate so that the placement can be successful b. engage the client in their fav game and convince the client to work together c. leave the home allowing the client to refuse OT services d. tell the client that the OT will stop hassling the client after four visits

c. leave the home allowing the client to refuse OT services

Since getting new workstations, clerical workers at a law office are noticing increased neck stiffness, and OT is prepping a one week educational program for them. What strategy would be most likely to reduce neck stiffness? a. require workers to march in place for 5 mins once every hour b. provide neck strengthening and stretching exercises to improve flexibility c. move computer monitors to align with keyboards so workers face monitor straight on d. position workers with forearms resting on the edge of the desk while typing for support

c. move computer monitors to align with keyboards so workers face monitor straight on

An OTR is working with an adult client with sensory processing difficulties who finds it uncomfortable to commute to a job via train because of the noise of the train and of other passengers talking. Which environmental modification would be appropriate? a. encourage the client to obtain a driver's license and avoid train b. petition the train to set off a section of silence c. recommend the use of noise-cancelling headphones with a device that plays music or books the client enjoys d. get a closer job

c. recommend the use of noise-cancelling headphones with a device that plays music or books the client enjoys

An OTR who has passed the initial NBCOT exam has decided not to be recerified through NBCOT. Which consequences will result from the OTR decision? a. the OTR will not be allowed to practice OT in the USA b. The OTR practice opportunities and credentials will remain unchanged c. the OTR may practice OT in the state that does not require certification, but the OTR's credential will change d. the OTR may practice OT in a state that does not require certification and the OTR credentials will not change

c. the OTR may practice OT in the state that does not require certification, but the OTR's credential will change

An OT who is a certified hand therapist is responsible for supervising a new COTA, what is the purpose of the supervisory process as defined by AOTA? a. to ensure that COTAs treat only clients with diagnoses about which they have extensive knowledge b. to ensure that COTAs practice with in their scope of practice with regard to state laws c. to ensure the safe and effective delivery of OT services and to foster professional competence and development d. to provide evaluative feedback on an ongoing basis to the COTA

c. to ensure the safe and effective delivery of OT services and to foster professional competence and development

7. An OTR in an inpatient facility is conducting a cooking activity to teach effective coping skills to a small group of adolescents. A group member becomes frustrated with a teammate and is angry and verbally threatening. a. "I see that you're becoming upset by your teammate. Let's calm down and berate for 10 seconds." b. "You seem to be getting upset by your teammate. Verbally threatening is not a good behavior to show others." c. "I need you to stop, pause for a while and calm down." d. "You seem really upset right now. Would you want to take a minute to calm down or just go back to your room for now?" - offer choices to deal with emotional outburst

d. "You seem really upset right now. Would you want to take a minute to calm down or just go back to your room for now?" - offer choices to deal with emotional outburst

7. An OTR in an inpatient facility is working with an adolescent with major depression who repeatedly expresses feelings of worthlessness and poor self-concept. What should the OT do? a. Activities that establish normal daily routines b. Activities that engage the client socially c. Activities that do not require too many choices d. Activities that allow for self-expression

d. Activities that allow for self-expression

9. During an OT eval., which approach would pose the biggest barrier to engaging in a client-centered process with an adult client who is able to converse? a. Paying attention to the meaning of nonverbal cues b. Being directive c. Being too empathetic with the client d. Asking too many closed-ended questions

d. Asking too many closed-ended questions

2. An OTR is reviewing hard-copy of client charts before a group session. While reviewing the charts, the OTR receives an urgent phone call and must leave the chart room. How can the OTR ensure that the charts remain protected during the OTR's absence? a. Close the charts and stack them on the table b. Lock the door to the chart room c. Cover the charts with other documents to obscure them from view d. Close the charts and return them to their original secure location

d. Close the charts and return them to their original secure location

5. An OTR works in an interdisciplinary adult day program for clients with chronic mental illness. Other professionals working in the program include a recreational specialist, an art therapist, and a social worker. For what area is the OTR MOST likely to assume leadership? a. Creative expression b. Crisis management c. Sports activities d. Community integration

d. Community integration

A COTA has been assigned to treat a new patient. The OTR has evaluated this patient but has not yet written the documentation. How should the COTA proceed? a. Do not treat the patient and document in the chart that intervention is on hold pending completion of eval. b. Review the chart to understand the patient's conditions and ask the patient what needs to be addressed as part of treatment c. Co-treat with the physical therapist to gain info on reason for admission and special issues, and document accordingly d. Discuss with the OTR reason for admission, precautions, and goals, and proceed, documenting the supervisory visit.

d. Discuss with the OTR reason for admission, precautions, and goals, and proceed, documenting the supervisory visit.

2. A client with a herniated lumbar disk was referred to OT. The OTR completes an initial eval. And develops an intervention plan. Which task can the OTR assign to the COTA? a. Write up the initial eval. b. Alter the initial plan to address pain c. Do a complete reeval. Of strength d. Educate the client in proper body mechanics

d. Educate the client in proper body mechanics

5. A supervising OTR hires two newly graduated COTA's who have different learning styles. One prefers visual learning, and the other prefers hands on learning. Which approach is the best way for the OTR to supervise both COTAS a. Demonstrated tasks and have both COTAs return the demonstration b. Provide written instructions and protocols and discuss them c. Have both COTA role-play clinical scenarios d. Have one COTA perform new tasks and the other observe

d. Have one COTA perform new tasks and the other observe

3. According to the Standards of Practice for OT, what is the role of the COTA in the screening process a. Completing the screening process b. Initialing the screening process c. Analyzing and interpreting screening results d. Providing observations to the OTR

d. Providing observations to the OTR

An adolescent referred for OT has oppositional defiant disorder. During the initial interview, the parent reports that the youth never listens to requests, become angry several times a day, blames mistakes on an older sibling. Which area is most related? a. ADLs b. Rest and Sleep c. Leisure d. Social participation

d. Social participation

11. A client with secondary progressive multiple sclerosis (MS) is recovering from a recent relapse and seeks OT to manage anxiety associated with the disease and its effect on occupational performance. a. Participation in a cognitive retraining group b. Implementation of a home exercise plan that incorporates deep breaking c. Relaxation, such as taking a hot bath or yoga d. Using coping strategies for self-identified difficult tasks or situations

d. Using coping strategies for self-identified difficult tasks or situations

13. Under what circumstances is a COTA allowed to administer the Kohlman Eval. Of Living Skills to a new patient in an inpatient acute psychiatric hospital? a. After an OTR has directed the COTA to initiate the eval process b. When the OTR is unavailable to administer the assessment c. When the OTR is in the room while the COTA administers the assessment d. When the COTA has demonstrated competence in administering the assessment to the OTR

d. When the COTA has demonstrated competence in administering the assessment to the OTR

COTA working on an inpatient rehab has had 2 patients fall in last month. OTR has concerns about the COTA's safety awareness during certain interventions. Which approach is the best for the OTR? a. speak with the rehab manager about possible disciplinary action b. review the documentation of the 2 patients who fell and discuss their cases thoroughly with the COTA to determine cause of the falls c. ask the COTA whether more thorough supervision is needed and then proceed to provide close supervision d. collaborate with the COTA to determine potential causes of the falls and provide direct supervision with more deliberate feedback

d. collaborate with the COTA to determine potential causes of the falls and provide direct supervision with more deliberate feedback

An employer of a meat packing plant contracts an OT to provide consultation due to the recent increase in work-related musculoskeletal injuries. What would the OTs first course of action be? a. conduct role interest checklists with all employees b. complete functional capacity evaluations for injured employees c. administer vocational aptitude tests to all employees d. complete a job site analysis of activity demands

d. complete a job site analysis of activity demands

An OTR is working in a school with high incidence of violence in the district with increasing numbers of students diagnosed with ODD. The superintendent announces the formation of a task force to study the problem. Which response to the announcement would be best? a. document the progress of the OTR has made with students with ODD to justify continuing work with these students b. increase the frequency of visits to the students on the OTR caseload with his diagnosis because the task force will scrutinize intervention with these students. c. research intervention strategies to make sure that the intervention the OTR has been providing to these students is considered d. contact the superintendent and request to be appointed to a seat on the task force to study violence and incidence of ODD.

d. contact the superintendent and request to be appointed to a seat on the task force to study violence and incidence of ODD.

An OT develops an intervention plan for a client with bipolar disorder. OT focuses with the client's permission on the clients work environment because his employer is resistant to provide accommodations. The OT provides educational info to the boss about bipolar disorder. What approach does this strategy take? a. delay deterioration in performance skills b. maintain performance component skills c. prevent secondary disability and anticipatory action d. reduce behaviors and environmental barriers

d. reduce behaviors and environmental barriers

An OTA works with an eight year old with pervasive developmental disabilities in order to improve self-care skills. In teaching the child to brush teeth, the OTA places the toothbrush in the child's hand and guides it to the mouth. To help the child learn to complete the activity the OTA uses the somastosensory system. Which of the following is the most effective for the OTA to use during the next intervention? A. tell the child to brush up and down B. provide hand over hand assistance to brush childs teeth C. touch the childs hand to prompt hand to mouth movements D. instruct the child to follow a pictorial sequence card depicting tooth brushing

provide hand over hand assistance to brush childs teeth