Exam questions

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Which of the following would be a typical outcome of functional intervention? (A) Increased leisure skills (B) Increased awareness of leisure activities and opportunities (C) Increased physical endurance (D) Decreased recidivism

Which of the following federal acts defined therapeutic recreation as a related area of service and was responsible for allowing more people with disabilities to be served by CTRSs? (A) 1973 Rehabilitation Act (B) Smith-Sears Veterans Rehabilitation Act (C) Individuals with Disabilities Education Act (D) White House Conference on Handicapped Individuals Act

The client's goal is to develop appropriate competitive skills. The CTRS selects table games like checkers and tic tac toe to initiate intervention. At what social interaction level has the CTRS begun intervention? (A) Extra individual (B) Aggregate (C) Inter-individual (D) Unilateral

The Analysis part of a SOAP note contains what types of information? (A) Assessment (B) Activity recommendations (C) Interpretation of data (D) Revisions in the treatment plan

Accreditation standards for ambulatory health care, behavioral health care, home care, and hospitals come from which of the following organizations? (A) Agency for Healthcare Research and Quality (AHRQ) (B) Commission on Accreditation of Rehabilitation Facilities (CARF) (C) Joint Commission (JCAHO) (D) Health Care Financing Administration (HCFA)

Which of the following assessments was designed to coincide with the Functional Independence Measure (FIM)? (A) Leisure Diagnostic Battery (LDB) (B) Comprehensive Evaluation in Recreational Therapy Scale (CERT) - Psych (C) Leisure Competence Measure (LCM) (D) Leisure Activities Blank (LAB)

Which of the following is LEAST likely to be recorded in an updated progress note? (A) Client assessment results (B) Objective data (C) Subjective data (D) Advance towards goals

(A) Client assessment results

In which of the four domains, does the statement below fall under? To improve ability to locate leisure partners (A) Cognitive (B) Affective (C) Physical (D) Social

(A) Cognitive

A CTRS has been hired as Director of TR Services at the local rehabilitation center to start a new program of services and wants to provide the highest quality services available. She reviews which TR standards to assure program compliance? (A) ATRA Standards of Practice (B) Joint Commission (JCAHO) standards (C) NCTRC certification standards (D) ATRA Code of Ethics

(A) ATRA Standards of Practice

Which of the following is NOT a characteristic of a SMART objective? (A) Aimed only on the strengths of the client (B) Meaningful to the client's future leisure behavior (C) Achievable within the time frame and with resources allotted (D) Measurable in change of skill, attitude, or behavior

(A) Aimed only on the strengths of the client

What is a Flow Sheet? (A) An easy method for seeing progressive results of health screenings (B) A time sheet for employees (C) A specific type of incident reporting (D) A record of how many times a client reported being in flow during a TR intervention

(A) An easy method for seeing progressive results of health screenings

The CTRS is leading a group of elderly clients who are disoriented using Validation Therapy. Name the phrase being used when the CTRS says, "Mr. Smith did you remember to bring the poem you wanted to share with us? You did. Great! OK, let's listen to Mr. Smith's poem." (A) Birth of the Group—Creating Energy (B) Life of the Group—Verbal Interaction (C) Movement and Rhythm (D) Closing of the Group with Anticipation for the Next Meeting

(A) Birth of the Group—Creating Energy

Which of the following is the BEST example of a client outcome measure, collected as part of the therapeutic recreation department's quality improvement efforts? (A) Change in clients' health status or well-being (B) Change in client's attendance at programs (C) Development of a baseline for expected client behavior (D) Development of one-to-one treatment programs

(A) Change in clients' health status or well-being

This document, which often replaces treatment plans, involves all disciplines and specifies actions and outcomes that are expected at prescribed intervals throughout the recovery process. What is it called? (A) Critical pathway (B) Progress note (C) Protocol (D) Client evaluation

(A) Critical pathway

The CTRS in a long-term care facility plans on designing a program that maximizes interaction between residents. Which of the following would be a PRIMARY consideration in developing and modifying this program? (A) Existing social skills of the residents (B) Available facilities (C) Necessary equipment and materials (D) Number of qualified staff

(A) Existing social skills of the residents

The Leisure Competence Measure (LCM) parallels the format of which of the following client assessments? (A) Functional Independence Measure (FIM) (B) Rancho Los Amigos Scale (C) Brief Leisure Rating Scale (BLRS) (D) Leisure Barriers Inventory (LBI)

(A) Functional Independence Measure (FIM)

A baby born with fetal alcohol syndrome will most likely have which of the following symptoms or characteristics? (A) Intellectual disability, facial abnormalities, and stunted growth (B) Enlarged heart, chemical tolerance, and bowed legs (C) Stunted growth, heart disease, and short stature (D) Facial abnormalities, tendency to weep, and stunted growth

(A) Intellectual disability, facial abnormalities, and stunted growth

Validity, as a measurement characteristic, asks which of the following questions? (A) Is the instrument measuring what it is intended to measure? (B) Will the same results happen if the instrument is given a second time? (C) Does the manual include directions for administering, scoring and interpreting results? (D) How consistent are the results from one client to another?

(A) Is the instrument measuring what it is intended to measure?

Which of the following is an advantage of the Functional Independence Measure (FIM?) (A) It encourages repeated measurement/assessment of skills over time (B) It has been validated with the Rehabilitation Measurement Tools (RMT) series (C) It requires minimal prompting (D) It requires input from family members who best know the client

(A) It encourages repeated measurement/assessment of skills over time

The CTRS uses the concept of active treatment in planning his TR programs. Which of the following describe this approach? (A) Medically necessary, outcome-oriented interventions that specify intensity, frequency, and duration (B) Focus is on self-determination and enhancement of enjoyment (C) Interventions that are based on research, best practice, and, when possible, program protocols (D) Interventions are based on strengths, resources, and capabilities of clients and their families

(A) Medically necessary, outcome-oriented interventions that specify intensity, frequency, and duration

Which federal legislation attempts to equalize mental health services with other medical services? (A) Mental Health Parity and Addiction Equity Act (B) Americans with Disabilities Act (C) Equity Healthcare for All Americans Act (D) Equal Illness, Equal Healthcare Act

(A) Mental Health Parity and Addiction Equity Act

The national voluntary professional registration program that preceded the National Council for Therapeutic Recreation Certification was administered by the (A) National Therapeutic Recreation Society (NTRS) (B) American Therapeutic Recreation Society (ATRA) (C) American Association of Recreational Therapy (AART) (D) Council for the Advancement of Hospital Recreation (CAHR)

(A) National Therapeutic Recreation Society (NTRS)

The Idyll Arbor Activity Assessment (IIAA) assessment tool is primarily intended for which population? (A) Older adults living in long-term care facilities (B) Older adults living independently in the community (C) Children in pediatric hospitals (D) Individuals with developmental/intellectual disabilities

(A) Older adults living in long-term care facilities

Spina bifida typically results in which of the following activity limitations? (A) Paralysis below the lesion (B) Increased likelihood of blood disorders (C) Decreased attention span (D) Increased motor activity in the lower extremities

(A) Paralysis below the lesion

Which of the following is an example of a "structure" indicator in therapeutic recreation services? (A) Proportion of CTRSs to other therapists (B) Proportion of clients who receive therapeutic recreation services (C) Proportion of clients treated according to therapeutic recreation protocols (D) Client achievement of social interaction skills objectives

(A) Proportion of CTRSs to other therapists

The client has arthritis that results in fine motor difficulties and has joined a cooking program. Which of the following adaptations would be most appropriate? (A) Provide kitchen tools with large, padded handles. (B) Complete any cutting before the start of the program. (C) Provide a "buddy" for the individual client. (D) Provide a "buddy" for each client in the program.

(A) Provide kitchen tools with large, padded handles.

When using active listening with a client, it is important for the CTRS to do which of the following? (A) Reflect the feeling tone the client communicates (B) Respond immediately to the client's statements (C) Nod his/her head and speak to the client frequently (D) Ask questions so the client will know the CTRS is listening

(A) Reflect the feeling tone the client communicates

Which of the following is a TRUE statement about the Mini Mental State Exam? (A) Scores between 24 and 30 indicate normal cognition. (B) The professional must have a minimum of a masters degree to administer it. (C) The MMSE is not able to distinguish between different types of dementia. (D) The MMSE takes 10-15 minutes to administer

(A) Scores between 24 and 30 indicate normal cognition.

The CTRS wants to assess clients for placement into a leisure education program. The CTRS should make sure the instrument is valid and measures which of the following? (A) Social skills, leisure activity skills, leisure resources, and leisure awareness (B) Functional limitations, social skills, and physical abilities (C) Leisure interests, functional limitations, leisure awareness, and leisure resources (D) Decision-making skills, small group and large group interaction skills, and leisure resources

(A) Social skills, leisure activity skills, leisure resources, and leisure awareness

One of the primary processes used by the Optimizing Lifelong Health Through Therapeutic Recreation Model is (A) functional improvement (B) selection of appropriate activities (C) prescriptive activities (D) leisure experiences

(B) selection of appropriate activities

A CTRS selects the Comprehensive Evaluation in Recreational Therapy Scale (CERT-Psych) to measure behavior of a client as observed in group activities. Which assessment characteristic has the CTRS considered in making this selection? (A) Validity (B) Reliability (C) Usability (D) Practicability

(A) Validity

Developing an individualized intervention plan is easiest when (A) a comprehensive program plan is in place (B) an activity inventory is used for the client assessment (C) an activity and task analysis has been completed (D) the therapist has at least two years of experience with the client group

(A) a comprehensive program plan is in place

The CTRS had young children with behavioral problems (like kicking and biting) compete with each other on two bowling teams. Instead of realizing the children had difficulty interacting in the_____interaction pattern and having them practice skills at that level, she had them participating in an activity that required a _______ interaction pattern, and thus, the children became aggressive and the activity failed. (A) aggregate, intergroup (B) intraindividual, extraindividual (C) aggregate, interindividual (D) cooperative, competitive

(A) aggregate, intergroup

The medical term "ad. lib." is the abbreviation for (A) as patient can tolerate (B) give freedom liberally (C) as often as possible (D) daily

(A) as patient can tolerate

A CTRS is responsible for administering the MDS 3.0 to her residents. She knows the first step is to (A) determine whether the resident can indicate a preference (B) discuss the resident's needs with the interdisciplinary treatment team (C) assess the resident's leisure preferences and interests (D) create a variety of activities of interest to the residents

(A) determine whether the resident can indicate a preference

Within the Individuals with Disabilities Education Act of 2004, and updated in 2011, Part C now includes individuals with (A) developmental delays aged 2 and under (B) autism spectrum disorder, including Asperger's Syndrome (C) mental illnesses as long as they are in school (D) traumatic brain injury, regardless of age

(A) developmental delays aged 2 and under

One of the MOST important aspects of a client/ therapist relationship is for the CTRS to (A) have an unconditional positive regard for the client (B) let the client know he/she is always right (C) establish a position of authority with the client (D) establish a relationship with the client's family

(A) have an unconditional positive regard for the client

The primary role of CTRSs working with individuals who have autism is to (A) have them learn a variety of leisure skills that their peers might know (B) improve their cognitive acuity (C) teach them how to adapt to a non-autistic world (D) learn leisure skills that they can use as adults

(A) have them learn a variety of leisure skills that their peers might know

In a therapeutic recreation program accredited by Joint Commission (JCAHO), the goal would be to (A) improve health care quality and patient safety (B) improve baseline, functional abilities of all clients (C) discharge all clients to their own homes/ communities (D) reduce errors and improve confidence

(A) improve health care quality and patient safety

When an assessment is norm-referenced, it means that the assessment was/is (A) interpreted based on the average scores for that person's peer group (B) based on a normal population's average scores (C) references using the major texts in the TR literature (D) based on scores of normal behavior expected within that developmental life stage

(A) interpreted based on the average scores for that person's peer group

A CTRS, who works with 3- to 5-year-olds in a preschool program, uses Erikson's Theory of Psychosocial Development to improve the age-appropriateness of his programs. Specifically he teaches the children to (A) know when to take action and when to use self-restraint (B) play games that require intra-group social interaction skills (C) meet their own needs through intrinsically motivated play (D) recognize their own strengths and weaknesses

(A) know when to take action and when to use self-restraint

If an individual experiences a stroke on the right side of his/her brain, the typical effects include (A) lack of depth perception, intuition, and nonverbal perception (B) inability to remember past events and to read (C) inability to communicate and organize thoughts (D) increased lability and anger control

(A) lack of depth perception, intuition, and nonverbal perception

The "day-to-day behavioral expression of one's leisure-related attitudes, awareness, and activities revealed within the context and composite of the total life experience" is a person's (A) leisure lifestyle (B) recreation well being (C) quality of life (D) leisure well being

(A) leisure lifestyle

While a medical model of health care focuses on the pathology of a person, the salutogenic model of health focuses on (A) lifestyle factors that support, enhance, and produce health (B) social relationships that need to be terminated prior to full recovery (C) total lifestyle environment to which the patient will return (D) direct reimbursement of services

(A) lifestyle factors that support, enhance, and produce health

A strategic plan is a method of (A) projecting future needs and activities of an organization (B) continuous quality improvement (C) protocol development and implementation (D) resource utilization

(A) projecting future needs and activities of an organization

The best direct way to promote the value of therapeutic recreation (TR) services within a facility is to (A) provide in-service trainings to other disciplines (B) attend hospital grand rounds (C) create and post an activity calendar on the unit (D) create a multidisciplinary assessment

(A) provide in-service trainings to other disciplines

One of the best ways to reduce variability in health care due to region, facilities, or personnel is to (A) provide services based on research outcomes (B) adhere to all HIPAA regulations (C) use a Total Quality Management (TQM) model of care (D) facilitate peer review of intervention protocols

(A) provide services based on research outcomes

The Current Procedural Terminology (CPT) codes created by the American Medical Association describe (A) reimbursable intervention units (B) recommendations for weekly physical activity (C) protocols for the treatment of post-traumatic stress disorder (D) risk management procedures used by most hospitals

(A) reimbursable intervention units

The results from any assessment should give the CTRS a clear indication of (A) the programs in which the client should be placed (B) the client's leisure interests (C) the validity of the tool (D) how successful the client has been in achieving the program outcomes

(A) the programs in which the client should be placed

Listed below are four steps to "thought stopping." 1. Imagine the thought 2. Unaided thought interruption 3. Aided thought interruption 4. Thought substitution Which of the following correctly orders these steps from first to last? (A) 1, 2, 3, 4 (B) 1, 3, 2, 4 (C) 4, 3, 1, 2 (D) 4, 3, 2, 1

(B) 1, 3, 2, 4

The Fox Activity Therapy Social Skills Baseline assessment was developed for use with which population? (A) Older individuals in nursing homes (B) Adults with developmental disabilities (C) Adults with mental health disturbances (D) Disabled children in inclusion programs

(B) Adults with developmental disabilities

Which of the following organizations allows for chapter affiliation by local groups of CTRSs? (A) National Therapeutic Recreation Society (NTRS) (B) American Therapeutic Recreation Association (ATRA) (C) Recreation Therapy Section (RTS) (D) National Council for Therapeutic Recreation Certification (NCTRC)

(B) American Therapeutic Recreation Association (ATRA)

Which of the following is an example of using "displacement" as a defense mechanism? (A) Not remembering that the event occurred (B) Attributing the action or behavior to another person (C) Using a subordinate as the scapegoat (D) Not acknowledging the magnitude of a stressful event

(B) Attributing the action or behavior to another person

One of the barriers to evidence-based practice (EBP) is that (A) there is too much information about too many interventions (B) CTRSs do not have enough time to search out EBP information (C) CTRSs have adequate research training and experience (D) it's not clear whether EBP really improves patient care

(B) CTRSs do not have enough time to search out EBP information

In a leisure resources session, the CTRS asked the client, "How would you locate a fitness center in your hometown?" The CTRS's question is at what level of Bloom's Cognitive Taxonomy? (A) Knowledge (B) Comprehension (C) Evaluation (D) Analysis

(B) Comprehension

The CTRS wants to assess clients' sensory abilities in functional areas such as visual acuity, depth perception, auditory acuity, and tactile sensation. The best assessment instrument for this use might be the: (A) Therapeutic Recreation Assessment of Function (TRAF) (B) Comprehensive Evaluation in Recreation Therapy - Physical Disabilities (CERT-PD) (C) FOX Assessment (D) Functional Assessment of Therapeutic Recreation Skills

(B) Comprehensive Evaluation in Recreation Therapy - Physical Disabilities (CERT-PD)

The CTRS working in a psychiatric facility for adults needs an assessment instrument that has the capability of monitoring clients in the three areas of general performance, individual performance, and group performance. Which of the following published assessment instruments would be MOST suitable? (A) Leisure Diagnostic Battery (LDB) (B) Comprehensive Evaluation in Recreational Therapy Scale (CERT-Psych) (C) Self-Leisure Interest Profile (SLIP) (D) Leisure Activities Blank (LAB)

(B) Comprehensive Evaluation in Recreational Therapy Scale (CERT-Psych)

The CTRS is looking for an assessment instrument to measure functional skills. Which of the following is most likely to be an appropriate instrument? (A) Leisurescope (B) Comprehensive Evaluation in Recreational Therapy-Psych/Behavioral/Revised (C) Leisure Diagnostic Battery (D) Therapeutic Recreation Leisure Barriers Inventory

(B) Comprehensive Evaluation in Recreational Therapy-Psych/Behavioral/Revised

Which of the following are NOT typical characteristics of someone who has been diagnosed with schizophrenia? (A) Thought disorder (B) Dysmorphia (C) Blunted or flat affect (D) Social withdrawal

(B) Dysmorphia

Which of the following is an example of a program based on the principle of "normalization?" (A) Older adults with sensory deficits are taken to a playground (B) Female teenagers with developmental disabilities play video games and listen to music (C) Youths in juvenile detention attend programs on vacationing overseas (D) All children with disabilities are registered for community recreation programs

(B) Female teenagers with developmental disabilities play video games and listen to music

A CTRS is interested in determining a patient's leisure interests. From the following options, the CTRS should choose which assessment? (A) Leisure Diagnostic Battery (LDB) (B) Leisurescope (C) BANDI-RT (D) Comprehensive Evaluation in Recreational Therapy Scale (CERT) - Psych

(B) Leisurescope

Which of the following is NOT a factor in selecting an activity for client participation? (A) Activities must have a direct relationship to the client goal (B) Non-traditional activities make the intervention more fun for clients (C) A single activity or session is not likely to produce a desired behavioral change (D) Consider the types of activities in which people will engage when they have the choice

(B) Non-traditional activities make the intervention more fun for clients

The CTRS was offered free tickets for patients to attend a special performance of a play during the afternoon, but instead chose to have the patients/ clients pay and attend a night performance. The CTRS was demonstrating which of the following mainstreaming principles? (A) Integration (B) Normalization (C) Least restrictive environment (D) Deinstitutionalization

(B) Normalization

In a DARP note, which of the following would be an entry for "R?" (A) Patient will initiate one conversation with per, within one week. (B) Patient called yoga studio in hometown for information on upcoming classes (C) Patient correctly recalled name and place of birth (D) Patient oriented x3

(B) Patient called yoga studio in hometown for information on upcoming classes

In what document would the CTRS be MOST likely to find information on staff benefits? (A) Quality improvement records (B) Policy and procedure manual (C) Intern manual (D) Personnel files

(B) Policy and procedure manual

In which of the following steps does the CTRS examine how the content and process of the activity will contribute to the accomplishment of client objectives? (A) Assessment (B) Program planning (C) Program implementation (D) Program Evaluation

(B) Program planning

Which organization oversees the accreditation of physical medicine programs? (A) Joint Commission (JCAHO) (B) Rehabilitation Accreditation Commission (CARF) (C) American Therapeutic Recreation Association (ATRA) (D) Centers for Medicare and Medicaid Services (CMS)

(B) Rehabilitation Accreditation Commission (CARF)

The CTRS can use which of the following to prove program efficiency? (A) Attainment of client outcomes (B) Resource consumption (C) Use of quality improvement results (D) Review of standards of practice

(B) Resource consumption

Which of the following TR service models has as its overall purpose to make more autonomous choices that will lead to higher quality of life? (A) Leisure Ability Model (B) Self-Determination and Enjoyment Enhancement Model (C) Health Protection/Health Promotion Model (D) Therapeutic Recreation Health Outcome Model

(B) Self-Determination and Enjoyment Enhancement Model

Which of the following is an example of a quality assurance indicator for client assessment? (A) The client will complete the assessment as directed by the CTRS, 100% of the time. (B) The CTRS will complete client assessments within 72 hours of admission, 80% of the time. (C) The CTRS will match the content of the assessment with the content of the program, 100% of the time. (D) None of the above

(B) The CTRS will complete client assessments within 72 hours of admission, 80% of the time.

Which of the following is an important premise of reality therapy? (A) The CTRS helps the client stay oriented to time, person and place (B) The client is responsible for all of his or her behavior (C) The CTRS helps the client explore connections between past experiences and present actions (D) The CTRS helps the client focus on stopping irrational thoughts

(B) The client is responsible for all of his or her behavior

Three early professional organizations for TR (HRS, NART & RTS) formed the Council for the Advancement of Hospital Recreation (CAHR). What was the major accomplishment of CAHR in 1956? (A) A combined professional philosophy for the entire field (B) The creation of the National Voluntary Registration Plan for TR Personnel (C) The creation of the National Therapeutic Recreation Society (D) The first standards of practice for TR practitioners

(B) The creation of the National Voluntary Registration Plan for TR Personnel

An example of a quality assurance process that might be examined is (A) The adequacy of space dedicated to TR services (B) The interactions between staff and clients (C) The qualifications of staff (D) Risk management training

(B) The interactions between staff and clients

A CTRS solely uses an activity inventory to assess clients' functional abilities. Which of the following is MOST likely to happen? (A) The validity of results is increased (B) The validity of results is decreased (C) The reliability of results is increased (D) The reliability of results is decreased

(B) The validity of results is decreased

A client in a stroke rehabilitation program states, "I really like to spend time with my family and have two activities planned for this weekend." She is expressing emotions at what level of the Krathwohl's Affective Taxonomy? (A) Responding (B) Valuing (C) Organization (D) Characterization

(B) Valuing

All of the following may be questions that the CTRS uses to improve clarity and completeness to a narrative note EXCEPT (A) How did I first become aware of the problem? (B) What has the client said about the problem that is not significant? (C) Is this the same problem that was exhibited last week? (D) What is the plan for dealing with the problem?

(B) What has the client said about the problem that is not significant?

One reason that individuals older than 65 experience increased pain is that they (A) have more body parts failing (B) are unable to report it adequately (C) are often unable to speak or gesture (D) experience more side effects from numerous prescribed medications

(B) are unable to report it adequately

Which of the following is NOT assessed as part of a cognitive assessment for older adults? (A) memory (B) communication skills (C) problem solving skills (D) safety awareness

(B) communication skills

The TR department may determine if it was providing quality care by (A) completing program evaluations with clients at the end of 10% of the programs (B) finding that 10% of all clients reviewed averaged at least two community involvements per month (C) measuring the total number of client community involvements and dividing by 10 (D) referring 10% of the clients to communitybased TR programs post-discharge

(B) finding that 10% of all clients reviewed averaged at least two community involvements per month

The medical term "qid" is the abbreviation for (A) white blood count (B) four times a day (C) quadriceps (D) within normal limits

(B) four times a day

One advantage to records reviews for client assessment data collection is that (A) information from relatives is readily available (B) it is usually time efficient (C) it can reduce time spent in treatment team meetings (D) it is required by the Joint Commission

(B) it is usually time efficient

In systems program design, a performance measure (PM) is the same as a(n) (A) assessment item (B) outcome statement (C) enabling objective (D) mission statement

(B) outcome statement

Chronic users of cocaine may experience all of the following, EXCEPT (A) depression (B) periods of excessive sleep (C) hypertension (D) respiratory and/or cardiac failure

(B) periods of excessive sleep

All of the following are examples of leisure barriers measured in the Leisure Barrier Inventory, EXCEPT (A) time, money, and transportation (B) poor self-concept (C) availability of leisure partners (D) understanding of leisure as a concept

(B) poor self-concept

The content of the assessment must match the content of the (A) activity analysis (B) program (C) treatment plan (D) quality improvement plan

(B) program

The CTRS designed a program to assist older adults with intellectual disability to share their previous life experiences after reading poetry about children. The CTRS was using a technique known as _____. (A) reality orientation (B) remotivation (C) teach back (D) cognitive restructuring

(B) remotivation

The primary purpose of a therapeutic recreation service model is to (A) provide data for comprehensive program development (B) serve as a guide for the development of programs offered to clients (C) provide a standard by which programs can be evaluated (D) distinguish between services provided within various settings

(B) serve as a guide for the development of programs offered to clients

Asking the question, "How stable is the instrument over a given period of time?" is an example of looking at the assessment's (A) concurrent validity statistics (B) test-retest estimates (C) Cronbach's alpha (D) internal consistency estimates

(B) test-retest estimates

An example of quality assurance structure that might be examined is (A) the development of treatment plans (B) the departmental budget allocation (C) client independence at discharge (D) the number and types of equipment used by clients

(B) the departmental budget allocation

One method to increase inter-rater reliability in observations is to (A) improve the construct validity of the instrument (B) use clearly defined and non-overlapping categories (C) support the results with extensive interviews (D) purchase and compare similar interest inventories

(B) use clearly defined and non-overlapping categories

Which part of the SOAP note focuses on the CTRS's interpretation of the client's actions and verbalizations? (A) S- Subjective data (B) O - Objective data (C) A - Analysis (D) P - Plan

Which part of the SOAP progress note is the following statement, "The client lacks adequate knowledge of community resources to be able to function independently." (A) S - Subjective (B) O - Objective (C) A - Assessment (D) P - Plan

Which of the following is MOST LIKELY to be recorded in an updated progress note? (A) Subjective information from client's family (B) Comprehensive discharge summary (C) Achievement of goals from previous plan (D) Client assessment results

Which of the following is NOT an advantage of the Mini Mental State Exam? (A) Short administration time (B) Few resources required (C) Certification for administration is easy to obtain (D) Reasonable reliability over time

Which of the following is NOT a principle of activity analysis? (A) Analyze the activity as it is normally engaged in (B) Analyze the activity with regard to the minimal level of skills required for basic, successful participation (C) Complete the activity analysis at least 24 hours before leading the activity (D) When completing an activity analysis, rate the activity as compared to all other activities

The CTRS was interacting with the client and said, "You said you wanted to become more physically active, but you refused to come to exercise class today." The CTRS was using which of the following communication techniques? (A) Teach back (B) Summarization of feeling (C) Confrontation (D) Request for clarification

Reliability, as a measurement characteristic, asks which of the following questions? (A) Does the manual include directions for administering, scoring and interpreting results? (B) Does the instrument match the programs offered to clients? (C) Does the instrument yield accurate information about the client? (D) Is the instrument measuring what it is intended to measure?

Which of the following is an example of a transdisciplinary treatment team? (A) Each team member independently assesses and plans interventions for the client (B) Each team member is responsible for collaborating with others on identifying common goal areas; then selects the best intervention within his or her discipline (C) Each team member works across disciplinary boundaries to develop goals and plans, and often co-treats clients (D) Each team member is cross-trained in each other's discipline and there are virtually no boundaries between disciplines

The CTRS locates research that concludes that yoga is better than guided imagery for stress management for individuals with addictions. The CTRS is using (A) Formative evaluation (B) Summative evaluation (C) Evidence-based practice (D) Clinical guidelines

The CTRS wants to make sure that she is providing the best possible intervention to help the client reach his goals. Which of the following will be most helpful? (A) Zero-based budgeting (B) Prospective payment (C) Evidence-based practice (D) Program evaluation

The CTRS in a facility for at-risk youth plans on designing an anger management skills program. Which of the following would be a PRIMARY consideration in developing and modifying this program? (A) Available facilities (B) Necessary equipment and materials (C) Existing emotional control of the youth (D) Existing physical abilities of the youth

The CTRS evaluated the 16-week summer programming sessions at 4-week, 8-week, and 12- week intervals to gather which of the following types of program evaluation information? (A) Instantaneous time sampling (B) Quality assurance health care monitoring (C) Formative (D) Summative

Which of the following is an example of clinical supervision? (A) Overseeing clients on a community out-trip (B) Overseeing clients during an in-house discussion group (C) Helping a junior professional become a better practitioner (D) Performing personnel evaluations on staff as least once per year

The following scale is taken from which assessment instrument used by CTRSs? Family/friends support ___ ___ ___ broad support for leisure activities (at least 2x week) ___ ___ ___ support of leisure activities moderate (4-7x month) ___ ___ ___ family/friendship relations strained; some effort made ___ ___ ___ isolated; no family or friends make contact with resident (A) General Recreation Screening Tool (GRST) (B) Functional Assessment of Characteristics for Therapeutic Recreation - Revised (FACTR-R) (C) Idyll Arbor Activity Assessment (IIAA) (D) Leisure Competence Measure (LCM)

A clinical CTRS and a community CTRS are conducting a marketing analysis to set-up a joint outpatient TR rehab program. Which statement identifies a factor that would be considered an opportunity to promote this joint venture? (A) PT and OT are currently contracting their services in the community (B) A private health care company is providing inhome care in the area (C) Patient length of stay in inpatient rehabilitation is continuing to decrease (D) An ADA survey is presently being conducted in the community

For a service to be reimbursable, in many instances insurance companies require the therapist to provide what information or evidence? (A) Assessment tools sanctioned by JCAHO, HCFA, or CARF (B) Source-oriented medical records (C) Physician's orders (D) Risk management plan for the activity

The Functional Assessment of Characteristics for Therapeutic Recreation-Revised (FACTR-R) measures which of the following? (A) Leisure functioning (B) Decision-making skills (C) Prerequisite skills related to leisure participation (D) Leisure skills typically needed to live in the community

In which of the following steps does the CTRS use modalities and facilitation techniques to improve the delivery of programs? (A) Assessment (B) Program planning (C) Program implementation (D) Program evaluation

Which of the following is typically NOT part of a progress note? (A) Setbacks for meeting goals (B) New patterns of behavior (C) Program outcomes (D) Natural supports used for participation

Under the condition of active treatment, the CTRS must be able to (A) Provide written documentation regarding the outcomes of activity analysis (B) Justify the cost billed to third-party insurance (C) Project a reasonable expectation timeline for achievement of outcomes (D) Assess recreation and leisure interests

When a CTRS provides an accepting and understanding attitude to a client and, as a result, that positive involvement reduces the client's feelings of loneliness and worthlessness, and helps the client to take responsibility to alter irresponsible behavior, the CTRS is probably using what therapy? (A) Psychoanalytic (B) Behavior (C) Reality (D) Rational emotive

Neuroleptics are a class of prescription medications for which of the following disorders? (A) Agoraphobia (B) Tardive dyskinesia (C) Schizophrenia (D) Neuropathy

Which of the following is NOT a disadvantage of the Mini Mental State Exam? (A) Does not distinguish at the higher and lower ranges of impairment (B) May not detect specific areas of lesions (C) Scores may be affected by demographics such as age and education (D) It requires high verbal fluency

CTRSs and activity personnel typically complete which section of the MDS 3.0 assessment? (A) Section A Functional Abilities and Wellness (B) Section C Activity Interests and Participation (C) Section F Preferences for Customary Routine and Activities (D) Section K Activities of Daily Living and Leisure Experiences

Which of the following strategies might a CTRS use to improve the self-efficacy of her clients? (A) Negative reinforcement (B) Positive reinforcement (C) Social or verbal persuasion (D) Large print materials

Which of the following statements is TRUE about the following objective? When given a choice of three activities, the client will verbalize his favorite leisure activity to participate with friends. (A) The condition is missing (B) The behavior is missing (C) The criterion is missing (D) The objective is complete as is

The CTRS is concerned with determining whether program goals have been achieved and whether resources were used efficiently. She is concerned with _________________. (A) evidence-based practice (B) benchmarking (C) accountability (D) service delivery

In medical terminology AROM means (A) about the room once (B) asynchronous range of motion (C) active range of motion (D) higher than average

One of the problems with client assessment in TR services is that (A) there are too many assessments from which to select (B) clients are too diverse to be assessed (C) assessments that are validated for practice are difficult to find and use (D) the information they gather is often in conflict with that of other treatment team members

If the CTRS wants the results of the assessment and the outcomes of program participation to be most helpful to the client after discharge, the CTRS will make sure the assessment tasks and questions are _____________ (A) interdisciplinary (B) evidence-based (C) authentic (D) conceptual

In the Functional Independence Measure (FIM), communication is measured by (A) ataxia and apraxia (B) how the client interacts with others during a leisure education social skills program (C) both comprehension of incoming messages and expression of outgoing messages (D) the degree of aphasia experienced by the client

The CTRS needs to write a summary of the patient's response to treatment, including functional level and treatment goals and outcomes. This structure criteria is found in the ATRA Standards of Practice under (A) assessment (B) plan (C) discharge/transition planning (D) written plan of operation

All of the following areas of a TR department's written plan of operation may have specific, written policies and procedures, EXCEPT (A) obtaining physician's orders for treatment of clients (B) employee hiring and firing procedures (C) how CTRSs apply for recertification (D) procedures for obtaining supplies from the dietary department

"Clinical indicators" are used in quality improvement to (A) evaluate the degree of client satisfaction with services received (B) compare one discipline's outcomes to other disciplines' outcomes (C) measure how well the targets were achieved (D) provide a basis for evidence-based practice

In establishing an environment that embraces multiculturalism, the CTRS would (A) make sure all ethnic holidays are on the activity calendar (B) introduce signage that includes both English and Spanish, and possibly French (C) recognize people's differences while establishing a sense of unity (D) follow the agency directives with regard to nondiscrimination toward foreigners

A CTRS, who works at a residential facility for at-risk youth, uses Piaget's Cognitive Theory of Development to develop age-appropriate activities. For the 2- to 7-year-olds, she specifically focuses on (A) advanced language skills (B) development of abstract reasoning (C) symbolic play such as playing house or using puppets (D) group consensus about the rules of games

The CTRS asked clients who had recently experienced strokes to identify their highest priorities, set goals, and develop an action plan for their leisure. The technique is called (A) goal orientation (B) self-actualization (C) time management (D) remotivation

(D) 1970s

The CTRS supervisor uses a formative evaluation of the TR student intern. Which of the following is a key characteristic of formative evaluation? (A) Allows for a summary of all strengths and weaknesses (B) Focuses on only on the intern's areas of accomplishment (C) Forms the basis of the student's grade (D) Allows for corrective action to come after the evaluation

(D) Allows for corrective action to come after the evaluation

When using behavior modification with a female child who is emotionally disturbed, the CTRS teaches her separate hygiene behaviors (e.g., brushing her teeth, combing her hair) and then combines them altogether in a morning wake-up routine. What behavior modification technique is the TRS using? (A) Shaping (B) Modeling (C) Extinction (D) Chaining

(D) Chaining

A client in a substance abuse program, states, "I am looking forward to going home, but I worry if I can maintain my sobriety." He is expressing emotions at what level of the Krathwohl's Affective Taxonomy? (A) Responding (B) Valuing (C) Organization (D) Characterization

(D) Characterization

The CTRS is most likely to work with which of the following disciplines to provide medical play to hospitalized children? (A) Physical therapy (B) Occupational therapy (C) Nursing (D) Child life

(D) Child life

The CTRS is leading a group of elderly clients who are disoriented using Validation Therapy. In which phase does the CTRS serve refreshments and plays an upbeat song? (A) Birth of the Group—Creating Energy (B) Life of the Group—Verbal Interaction (C) Movement and Rhythm (D) Closing of the Group with Anticipation for the Next Meeting

(D) Closing of the Group with Anticipation for the Next Meeting

Which statement describes an intent or purpose common to both systems planning and quality improvement plans? (A) Each describes the relationship of the comprehensive program to individual treatment plans (B) Each outlines the relationship between the agency and departmental procedures (C) Both define the components of department programs (D) Each provides a systematic method to evaluate service delivery

(D) Each provides a systematic method to evaluate service delivery

In a leisure decision-making session, the CTRS asked the client, "What skills and abilities contribute to your ability to have fun?" The CTRS's question is at what level of Krathwohl's Cognitive Process Taxonomy? (A) Remembering (B) Applying (C) Analyzing (D) Evaluating

(D) Evaluating

Most video games use which of the following social interaction patterns? (A) Intragroup (B) Multilateral (C) Interindividual (D) Extraindividual

(D) Extraindividual

Which social interaction pattern focuses on action with an object in the environment, requiring no contact with another person? (A) Intragroup (B) Multilateral (C) Interindividual (D) Extraindividual

(D) Extraindividual

Which of the following is typical behavior experienced during a manic episode for someone who has been diagnosed with bipolar disorder? (A) Ability to focus for long periods of time (B) Increased need for sleep and rest (C) Decreased sexual drive (D) Extreme irritability

(D) Extreme irritability

Which of the following is NOT a reason for client documentation? (A) For financial reasons (B) For legal justification of services rendered (C) For statistical data (D) For attendance records

(D) For attendance records

Teenscope is a useful assessment to place adolescent clients into which types of TR programs? (A) Treatment (B) Social skills (C) Leisure resources (D) Leisure skills

(D) Leisure skills

Which of the following is an example of universal design? (A) Escalators (B) Revolving doors (C) Zippers on clothing (D) Low-floor or "kneeling" buses

(D) Low-floor or "kneeling" buses

Which of the following are NOT minimal expectations of all CTRSs? (A) Read professional journals, attend professional conferences, and network (B) Retain professional certification and join appropriate professional organizations (C) Study external accreditation documents and professional standards (D) Maintain professional knowledge as it was at graduation

(D) Maintain professional knowledge as it was at graduation

In this excerpt of a client's treatment plan, which of the following, if any, was MOST likely identified as the client's problems? 1. Enroll pt. in Leisure Planning class Tuesdays and Thursdays. Focus on taking responsibility and decision-making. 2. Enroll pt. in Social Singles Club weekly. Focus on initiating and maintaining conversations with peers. (A) A lack of knowledge of leisure resources and lack of social partners (B) A lack of conversational abilities and decreased concentration skills (C) A lack of repertoire of activity skills and inability to identify leisure value system (D) None of the above

(D) None of the above

Which of the following is NOT a requirement of the Health Insurance Portability and Accountability Act (HIPAA) of 1996 and later rules? (A) Give patients notice about how their health information will be used (B) Make a good faith effort to ensure patients understand their rights (C) Obtain written authorization from the patient for purposes other than treatment, payment, or operations (D) Perform research on evidence-based and best practice health care

(D) Perform research on evidence-based and best practice health care

Which one of the following components is missing from the discharge summary? Pt. was referred to TR program due to lack of age-appropriate leisure skills and inability to identify preferred community leisure resources. Pt. participated in Leisure Skills Training programs on a weekly basis and Community Activities programs on a daily basis for five weeks. Pt. met all goals. Pt. enrolled in two community-based leisure programs. CTRS will follow-up in three weeks to monitor client progress in community. (A) Major client goals or problems (B) Services received by the client (C) Client attainment of goals (D) Plans for post-discharge involvement

(D) Plans for post-discharge involvement

The CTRS says to the client, "Let's stay in the present and take responsibility for your actions." This CTRS is using which type of "therapy" approach? (A) Gestalt therapy (B) Rational-emotive therapy (C) Cognitive therapy (D) Reality therapy

(D) Reality therapy

The ethical principle of privacy means that (A) Client records are not shared with anyone who does not have authority (B) Clients are treated as equally as possible (C) Past client records are not available after discharge (D) Staff do not search out more information than they need to develop a treatment plan

(D) Staff do not search out more information than they need to develop a treatment plan

Which of the following is a FALSE statement about the Leisure Diagnostic Battery (LDB)? (A) The LDB has both a long and a short form (B) The LDB has two versions, one for adolescents and one for adults (C) Two examples of the LDB scales are Depth of Involvement in Leisure and Barriers to Leisure Involvement (D) The LDB shows the highest reliability and validity for older adults in long-term care facilities

(D) The LDB shows the highest reliability and validity for older adults in long-term care facilities

Which of the following is an example of "objective" data that may be recorded in a progress note? (A) The client stated, "I really got a lot out of this program!" (B) The client's family said that the client was progressing with the outpatient therapy (C) The client interacted with a peer for two minutes, discussing the role of leisure in their lives (D) The client appeared to be lethargic and depressed

(D) The client appeared to be lethargic and depressed

Which of the following is NOT a rule for activity modification? (A) Keep the activity and action as close as possible to the original or traditional activity as possible (B) Modify only aspects of the activity that need adapting (C) Individualize the modifications (D) Use assistive technology wherever possible to ease the physical requirements of the activity

(D) Use assistive technology wherever possible to ease the physical requirements of the activity

Under which of the following conditions should the CTRS conduct a task analysis? (A) When the clients have intellectual disabilities (B) When the client assessment indicates it is needed (C) When the activity requires a lot of equipment (D) When the activity has a specific sequence of steps

(D) When the activity has a specific sequence of steps

DARP notes stand for (A) deficit, activity, recreation, participation (B) document, act, recall, progress (C) document, assessment, record, plan (D) data, action, response, plan

(D) data, action, response, plan

During a leisure education discussion group, the client sits slumped in his chair with his arms folded and legs crossed. Using nonverbal communication cues, the CTRS assumes that the client is (A) actively engaged in the activity (B) becoming overtly aggressive to other patients/ clients (C) disinterested and unengaged in the activity (D) demonstrating a "closed" position to further communication

(D) demonstrating a "closed" position to further communication

If a client receives treatment and was not informed of risks involved and the treatment results in some unwanted side effect or injury, then the client can bring a lawsuit against the CTRS. The CTRS could be found (A) guilty of negligence (B) having a breach of confidentiality (C) to be harmful to all (D) guilty of malfeasance

(D) guilty of malfeasance

The condition called Phenylketonuria is associated with (A) schizophrenia (B) cerebral vascular accident (C) barbiturate addiction (D) intellectual disability

(D) intellectual disability

A CTRS is looking for program ideas for adolescent chemical abusers. The BEST resource for the CTRS is (A) the Therapeutic Recreation Journal (B) state recreation conferences (C) chemical dependence conference (D) other therapeutic recreation professionals who work in chemical dependency

(D) other therapeutic recreation professionals who work in chemical dependency

The overall content covered by the Leisure Diagnostic Battery (LDB) includes (A) leisure participation history (B) leisure interests (C) attitudes toward leisure and work (D) perceived freedom in leisure

(D) perceived freedom in leisure

A CTRS is nonjudgmental, nondirective, and provides an accepting atmosphere allowing the client to assume the same positive self-regard the CTRS has shown to the client. The CTRS is using _______ therapy. (A) gestalt (B) reality (C) rational emotive (D) person centered

(D) person centered

A client's sense of control may be increased through all the following ways EXCEPT (A) asking what type of community event the person would like to attend (B) giving the client an important role in planning to attend the event (C) asking the client to take part in the meal preparation (D) placing the sign-up sheet in the main activity room so all can find it

(D) placing the sign-up sheet in the main activity room so all can find it

The CTRS wants clients with severe intellectual disability to be able to freely choose their preferred leisure experiences. When the CTRS uses a variety of tactile, auditory, and gustatory objects from which the client chooses, it is called ________. (A) reality orientation (B) remotivation (C) assertiveness training (D) sensory stimulation

(D) sensory stimulation

The State Technical Institute's Leisure Assessment Process (STILAP) assessment differs from other activity inventories or leisure interest scales because it (A) focuses on physical activities such as sports and large group games (B) assesses barriers to community integration (C) looks at the entire community environment to which the client is to return (D) translates activity skills into leisure competencies

(D) translates activity skills into leisure competencies

The best time to focus on discharge planning, in most facilities for most clients, is (A) too difficult to tell (B) two weeks before discharge (C) one week before discharge (D) when the client is admitted

(D) when the client is admitted

Which of the following are typical parts of a diagnostic protocol? (A) Assessment, planning, implementation, evaluation (B) Subjective, objective, analysis, planning (C) Comprehensive program descriptions and specific program descriptions (D) Client problems, assessment criteria, process criteria, and outcomes criteria

D) Client problems, assessment criteria, process criteria, and outcomes criteria

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