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18.An OT practitioner is treating a client who has a swallowing limitation, partly caused by the inability to receive visual and olfactory stimulation before eating. This limitation typically occurs in which stage of the swallowing process? a. Oral preparatory phase b. Oral phase c. Pharyngeal phase d. Esophageal phase

124. An adult with MS has decreased sensation of the buttocks and bilateral lower extremities. When educating and individual with absent sensation, the OT practitioner should include: A. Training to inspect for pressure sores on bony prominences and affected areas B. Instructions pertaining to careful trimming of fingernails and toenails C. Padding to areas of a splint that cause redness on the individual D. Hypersensitivity training

124. The OT practitioner is evaluating two-point discrimination in an individual with a median nerve injury. The MOST appropriate procedure is to: A. Apply the stimuli beginning at an area distal to the lesion progressing proximally B. Test the involved area first, then the uninvolved area C. Present test stimuli in an organized pattern to improve reliability during retesting D. Allow the individual unlimited time to respond

125. A sixth grader with a diagnosis of athetoid cerebral palsy needs an adapted computer for communication. Her upper extremity control is poor because of fluctuating muscle tone. The BEST way for her to operate her computer is to use a: a. single pressure switch firmly mounted within easy reach b. lightweight keyboard placed at midline c. low-resistance mouse and pad d. mercury-switch headband set to respond to minimal movement

126. An OT practitioner is training an individual in the principles of joint protection. The principles that the OT would MOST likely include would be: A. Using the strongest joint, avoiding positions of deformity, and ensuring correct patterns of movement B. Massaging a joint before exercise C. Practicing vivid imagery and relaxation exercises during difficult functional activities D. Application of heat before treatment and application of cold after range of motion treatment

180. An OT practitioner is supervising an OT aide. The MOST appropriate kinds of activities and level of supervision for the aide include: a. selected task in which aides have been trained with intense close supervision. b. various intervention activities with routine supervision. c. completing ADL training with a patient without supervision. d. selecting adaptive equipment from a catalog with general supervision.

126. An OT practitioner is working with a client who has severe cognitive deficits. Using a functional skill training approach, the MOST appropriate method to teach the client to brush his or her teeth is based on: a. rote repetition of the task sub steps with gradually fading cues. b. practice of fine-motor activities that incorporate motions needed in tooth brushing c. teaching the caregiver how to set up the task and guide the client‟s performance. d. use of instructional cards which the client will learn to use to remind him of how to perform the task.

127. As part of an initial evaluation of an individual with carpal tunnel syndrome, the OTR evaluates light touch sensation using a cotton ball. After wearing a wrist splint for 2 weeks the patient returns for a reevaluation, which the COTA performs. At this time, the MOST appropriate method for reevaluation of light touch is to use: A. A cotton ball B. An aesthesiometer C. Semmes-Weinstein monofilaments D. A pin or straightened paper clip

127. Which of the following would be the BEST cup for the OT practitioner to recommend using when working with an individual who tend to drink too quickly? a. a vacuum feeding cup b. a "nosey cup" (cut out for the nose) c. a mug with two handles d. a cup with a large drinking spout

128. The OTR is organizing a group picnic outing to a park. The most important precaution for the OTR to implement for those group members taking neuroleptic medications is to: a. encourage the use of PABA-free sunblock and hats b. encourage members to move slowly when changing positions from sitting to standing c. encourage members to use an antiperspirant and wear light colored clothing d. take along such low-calorie snacks as carrot sticks and celery sticks

129. To avoid overstimulation when handling a stable, 12 week premature infant in the NICU setting, an OT practitioner must FIRST: a. provide gentle human touch to enable the infant to slowly respond to intervention b. establish a calm state by utilizing the infant‟s musical mobile c. swaddle the infant in a blanket and cuddle to provide containment and warmth to assist with self-regulation d. establish a bond through visual orientation to the therapist‟s face

13.An OT practitioner is working with a client who sustained a traumatic injury to the right upper extremity during a motorcycle accident. The client states that he does not understand why he has paralysis to the deltoid, brachialis, biceps, and brachioradialis muscles. In addition to this, the client‟s arm hangs limply with minimal functional movement noted in the hand. The OTR suggests that this injury MOST accurately describes: A. A brachial plexus injury B. A long thoracic nerve injury C. An axillary injury D. A Volkmann‟s contracture

13.As part of an initial evaluation of an individual with carpal tunnel syndrome, the OTR evaluates light touch sensation using a cotton ball. After wearing a wrist splint for 2 weeks the patient returns for re-evaluation, which the COTA performs. At this time, the MOST appropriate method for re-evaluation of light touch is to use: a. a cotton ball b. an aesthesiometer c. Semmes-Weinstein monofilaments d. a pin or straightened paper clip

130. An individual with complete C7 quadriplegia demonstrates fair+ strength in the wrist extensors. Which of the following interventions will MOST effectively increase strength in the wrist extensors? a. a craft activity using increasingly heavy hand tools b. mildly resistive activities that are halted as soon as the individual begins to fatigue c. electric stimulation to the wrist extensors d. moderate resistance during active range of motion to the wrist

133. An OT practitioner is running a living skills group. Before the active involvement of the participants, the practitioner needs to review lecture materials for 30 minutes. The group composition that is MOST LIKELY to result in an increased focus on the group leader and decreased interaction among the group members is a: A. Group size of fewer than five members B. Group made up of members of differing ages C. Group size between 7 and 10 members D. Group with members who have similar goals and abilities

135. What wheelchair feature would be MOST appropriate to recommend for an individual who will be traveling by car with the family to community outings and bringing his or her wheelchair? A. A lightweight folding frame B. A one-arm drive C. An amputee frame D. A reading backrest

138. An OT manager is developing a proposal for OT services in the NICU. Using the developmental support care approach as the basis for services, how would the OT BEST describe OT‟s scope of practice in the NICU? A. Modifying the environment to protect the infant from overstimulation and inappropriate stimuli B. Providing PROM positioning and handling fabrication of splints, and referral to early intervention C. Educating parents and hospital staff D. Implementing motor and behavioral skill acquisition through developmental milestone positioning

139. An OT practitioner enters the room of a patient who recently had a RCVA with flaccidity to the left UE. The therapist begins to perform upper extremity passive range of motion (PROM) treatment when marked pitting edema of the left hand is noted. What is the FIRST thing the OTR should do? A. Perform PROM and then position and elevate the affected extremity B. Fabricate a resting splint for the affected extremity C. Take no action at this time and wait for the edema to subside D. Have the individual attempt to squeeze a ball

139. Which of the following would be the BEST cup for the OT practitioner to recommend using when working with an individual who tends to drink too quickly? A. A vacuum feeding cup B. A nosy cup (cut out for the nose) C. A mug with two handles D. A cup with a large drinking spout

119. An individual with fine motor incoordination reports difficulty with self-care. Which of the following options would this individual find MOST beneficial? a. Wash mitt b. Spray deodorant c. Toothpaste with a flip-open cap d. Toothbrush with a built-up handle

140. An OT practitioner is working as a consultant to a long-term care facility that is designing a dementia care unit. The OT would MOST likely recommend which type of environmental attributes as therapeutic? A. Controlled stimulation with meaning full sensory cues B. High sensory stimulation, to encourage active engagement C. Subdued, low sensory stimulation environment, to prevent agitation D. Stimuli that are very similar to that found in the residents‟ home environments

141. A child diagnosed with ataxic CP exhibits tremors in the upper extremities. When she feeds herself, the tremors cause most of the food to fall off her spoon before it can reach her mouth. Which of the following adaptations should the OT practitioner recommend? A. Replace the spoon with a blunt-ended fork B. Build up the handle of the spoon C. Give the child a swivel spoon D. Bend the spoon handle 45 degrees

141. An elderly man admitted to the hospital after a car accident. He sustained a right pelvic fracture and verbalizes extreme pain with ambulation. The orthopedic doctor has recommended that the patient perform "toe touch only" weight bearing on his right foot for 6 to 8 weeks. The OT should instruct the patient to use a walker when performing which of the following activities? a. transferring on and off a commode seat b. working on bed mobility c. performing self-feeding d. working on distal lower extremity dressing

143. A 60-year-old automobile mechanic with diabetes has been referred to OT following an above-knee amputation. The patient has impaired sensation in the remaining LE and will be using a wheelchair for the foreseeable future. The FIRST patient education subject the OT practitioner should cover is: A. Skin inspection B. Grooming techniques (shaving, trimming, toenails, etc.) C. Retirement planning D. Returning to work

103. An OT practitioner positions an infant in the supine position and places attractive toys overhead to provide an opportunity to work against gravity. This position is MOST effective for developing which ability? A. Shoulder flexion and protraction B. Shoulder extension and retraction C. Development of head control D. Development of trunk control

148. By using an interest checklist that includes a report of both interests and actual participation in activities, an OT practitioner will MOST likely collect information on client‟s: a. use of time b. developmental level c. mood and affect d. communication skills

104. A supervising OT asks an experienced COTA to complete a portion of an assessment. The portion that is MOST appropriate for the COTA to complete independently would be: A. Collecting chart review information B. Analyzing and interpreting assessment information C. Establishing the treatment goals D. Establishing the treatment plan

149. An OT practitioner working in an acute care hospital is writing a progress note in the chart for a treatment session hold earlier that day. Medical documentation should include which of the following? a. concise objective information b. speculative and judgmental information c. objective and speculative information d. subjective information and personal opinions

105. An OT practitioner is performing a kitchen evaluation with an individual with limited shoulder ROM the day before discharge. The individual demonstrates difficulty retrieving items from the higher shelves. Which of the following recommendations will BEST facilitate home management for this individual? A. Store the most frequently used items on the shelves just above or below the counter B. Use the largest joint available to move or lift items from the high shelves C. Perform shoulder range of motion exercises 10 times each, twice a day D. Continue reaching for items on high shelves because it will help improve range of motion

105. An OT practitioner is treating a client who developed severe PIP joint contractures in the third digit, 2 months after a burn injury. Which of the following static splinting techniques would BEST address the needs of this individual? A. Plaster cylindrical splint B. Dynamic outrigger splint C. Blocking splint D. PIP-DIP splint

105. An elderly client, who has had several falls at home and ambulates with a cane, is preparing for discharge to the home of an adult child who is renovating some rooms for the parent. The OT has been asked to recommend flooring for the client‟s rooms. The BEST recommendation for the OT to make is: A. Carpeting with low or looped pile B. Wood floor C. Area rugs D. Carpeting with dep pile and padding

106. An OT practitioner is preparing for the discharge of a preadolescent child with limited strength and endurance. Which of the following home adaptations is MOST important to recommend? a. mount lever handle on doors and faucets b. remove all throw rugs c. install non-skid pads on steps d. mount a table top easel for written home work

181. A patient who has had surgery for a malignant tumor was seen once in OT and is being discharged home, though the patient is weak and needs to continue receiving IV chemotherapy with a home health nurse. The MOST appropriate recommendation the OT practitioner could make for this patient to receive OT services would be: a. from a home health OTR or COTA b. staying in the hospital a little longer. c. going to a rehabilitation center. d. coming back for outpatient OT.

107. An OT practitioner is fabricating a static splint to prevent further injury, reduce pain, and encourage proper positioning. Which if the following would BEST address these goals? a. a resting pan splint for a client after a TBI who has been unresponsive in the intensive care unit for 3 weeks, yet grimaces with passive digit extension b. a dynamic extension splint for a client with radial nerve injury sustained after skiing accident c. an articular splint after surgical repair of PIP joint for a burn injury d. a spring coil splint for a client with a median nerve injury sustained in a boating accident

107. An OT practitioner is working on feeding with an individual with a C3 spinal cord injury. The strategy that will enable the HIGHEST level of independence is for the individual to: A. Clearly direct a caregiver in preferred head position, food portion size, and choice of food to eat B. Use a mobile arm support C. Use a wrist support with a utensil inserted into the cuff D. Use a universal cuff with a utensil inserted into the cuff

182. An OT practitioner is a member of a treatment team reviewing the treatment options for an individual who is experiencing acute psychiatric symptoms but not suicidal. This individual has been living with family members. The BEST treatment environment for this individual to receive OT services would be: A. Partial hospitalization B. Day care C. Home health care D. Community mental health center

2. A preteen with a diagnosis of spastic CP is enjoying computer- assisted learning while making significant progress in written communication, but he complains of general fatigue, body aches, and eye strain. Based on this information, which area would be MOST relevant for the OT practitioner to reassess? A. The time he spends at the computer B. The size of the computer screen C. The challenge level of the learning program D. His control of the keyboard

111. In the middle of a wheelchair to bed transfer, an obese patient begins to slip from the grasp of an average-size OT practitioner. The BEST action for the OT practitioner to take is to: a. ease the patient onto the floor, cushioning his fall. b. reverse the transfer getting the patient back in the wheelchair. c. continue the transfer, getting the patient to the bed. d. call next door for assistance.

2. In the assistive technology evaluation process, the OT on an assistive technology team is MOST likely to: A. Make recommendations for ways of accessing the technology. B. Recommend communication strategies. C. Seek funding sources for the technology. D. Solve mechanical or software problems.

20.Which aspects of psychosocial performance are MOST important to emphasize in developing a client‟s work potential in a prevocational program? A. Punctuality, accepting directions from a supervisor, and interacting with co-worker B. Memory, sequencing of the work tasks, attending to work tasks and making decisions C. Standing tolerance, eye-hand coordination, and endurance D. Maintaining personal cleanliness and adhering to safety precautions

200. An OT public relations campaign is being instituted in your state. It was suggested by the OT state representative that a committee be formed in order to externally educate potential consumers of OT. Which of the following BEST represents an appropriate form of external marketing? A. Community newsletter B. Departmental open house C. In-service to all rehabilitation nurse D. Participation in conferences

37.An individual with underreactive sensory processing has been referred to OT. Based on a SI FOR, activities for this individual should have which of the following facilitatory characteristics? A. Arrhythmic and unexpected B. Arrhythmic and slow C. Sustained and slow D. Unexpected and rhythmic

38.A sixth grade student has a diagnosis of juvenile rheumatoid arthritis. Which of the following leisure activities would BEST suit this child for helping him maintain range of motion? A. Swimming B. Basketball C. Soccer D. Aerobics

149. The goal of an arts and crafts group for chronically mentally ill individuals is to improve their decision-making abilities. The MOST appropriate approach to initiating a mosaic tile activity would be to: A. Provide each patient with an individual project & have him/her choose a tile color for the project B. Have the patients choose from a variety of projects C. Have the patients decide on a design, size, shape, and colors for a group mosaics project D. Have each patient decide on a pattern and two tile colors to use in his or her mosaic project

150. A young child with a diagnosis of spina bifida has been referred for an assessment. When collecting the initial data by interviewing the child‟s mother, the OT should focus PRIMARILY on: a. the mother‟s concerns and goals for her child b. medical management c. equipment needs d. the physical layout of the home

163. The family of an individual with paraplegia is moving into a new apartment and they need to select a surface for the living area. Finances are limited, but they are looking for the surface that will be easiest for maneuvering a wheelchair. Which of the following is the MOST appropriate surface for this situation? a. linoleum floor b. short pile carpeting c. deep pile carpeting d. several area rugs

114. A client is being seen by OT to promote independence in meal preparation and clean-up activities. The method of structuring activity practice that would BEST promote retention of learning and transfer of skills is to: a. practice preparing a variety of foods, using different cooking methods and recipes. b. practice cooking one meal from beginning to end in the same kitchen setting several times. c. Practice making a sandwich until that is mastered, then practice preparing another part of a meal until the person has mastered that skill, etc. d. Practice performing each step of the food preparation process, such as cutting vegetables.

114. An individual with Guillain-Barre Syndrome demonstrates poor to fair strength throughout the upper extremities. Which is the most appropriate approach for the OT practitioner to use in the EARLY stages? A. Gentle, nonresistive activities B. Progressive resistive exercise C. Fine motor activities D. Active range of motion against moderate resistance

164. A research question had been identified and a literature review completed by an OT practitioner. The NEXT step for the OT researcher is to: A. refine the question and develop the background. B. decide on methodology. C. establish boundaries for the study. D. collect and analyze data.

10.An individual demonstrates the ability to pick up a penny from a flat surface. This represents which of the following prehension patterns? a. Lateral b. Palmar c. Tip d. Three-jaw chuck

115. The goal for an elderly person with Parkinson‟s disease is to dress herself independently. The BEST adaptation to compensate for this person‟s physical deficits would be: a. Velcro closures on front-opening clothing b. Large buttons on front-opening clothing c. Larger clothing slipped on overhead with no fasteners d. Stretchy fabric clothing with tie closures in the back

116. A student has been working on learning to activate a switch for a communications device needed in the fourth grade classroom. The switch is mounted on the wheelchair tray, but the student is having difficulty operating it because of excessive muscle tone. Despite practicing for extended periods of time, the student is not making any progress. The OTR decides to: a. work on coordinated reach in side lying position first and then transfer the skill to sitting position b. passively stretch the student‟s upper extremity to increase range of motion c. use a brightly colored switch to increase visibility d. use systematic behavioral reinforcement through shaping

116. In establishing long-term goals for an individual with T4 paraplegia in a rehabilitation setting, the OT practitioner would MOST likely predict that the patient will attain what level of independence with bathing, dressing, and transfers? A. Complete independence with self-care and transfers B. Independence with self-care and minimal assistance with transfers C. Minimal assistance with self-care and moderate assistance with transfers D. Dependence with both self-care and transfers

167. An individual has demonstrated competence in heating canned soup. The OT practitioner recommends modifying the treatment plan and upgrading the cooking activity to: A. Baking brownies B. Making an apple pie C. Making toast D. Making a fresh fruit salad

117. A patient diagnosed with Parkinson‟s disease is being seen by an OT practitioner to develop a routine for performing self-care activities. The therapist is MOST likely to begin this process by instructing the patient that self-care activities: a. are more easily performed if coordinated with consistent timing of medications. b. should be performed before medications are taken. c. should be attempted only with the assistance of others. d. should be performed at intervals throughout the day until completed.

117. An individual in the early stages of amyotrophic lateral sclerosis (ALS) has been referred for OT in an outpatient setting. Which of the following interventions is MOST appropriate for this individual? A. Work simplification and energy conservation B. Progressive resistive exercises C. Splinting D. Active and passive range of motion exercises

167. An individual with underactive sensory processing has been referred to OT. Based on a SI frame of reference, activities for this individual should have which of the following facilitatory characteristics? A. Arrhythmic and unexpected B. Arrhythmic and slow C. Sustained and slow D. Unexpected and rhythmic

117. During a stress management group, an individual recently diagnosed with multiple sclerosis (MS) complains that his teenage children are resistive to helping with chores that were previously his responsibility, such as mowing the lawn and taking out the trash. The 168 stress management technique that would MOST successfully address this concern is: A. Using effective communication skills B. Applying time management techniques C. Deep breathing D. Laughter

58.An OT practitioner is treating a client who developed a severe PIP joint contractures in the third digit, 2 months after a burn injury. Which of the following static splinting techniques would BEST address the needs of this individual? A. Plaster cylindrical splint B. Dynamic outrigger splint C. Blocking splint D. PIP-DIP splint

119. When developing play activities for a child with acute juvenile rheumatoid arthritis, which of the following precautions should the OT practitioner follow? A. Avoid light touch B. Avoid rapid vestibular stimulation C. Avoid resistive materials D. Avoid elevated temperatures

84.An OTR is preparing to do a parachute activity as part of a sensory integration program and several of the patients in the group are taking antipsychotic medications. The OTR should be alert for which possible side effect that could occur as a result of this activity? A. Postural hypotension B. Photosensitivity C. Excessive thirst D. Blurred vision

122. Upon completion of a level-II fieldwork placement on a rehabilitation unit, a student is functioning slightly below minimal entry-level competence. The supervising fieldwork educator should: A. Fail the student B. Pass the student with the requirement that the student not practice in a rehabilitation setting C. Pass the student and recommend additional training or volunteer work in a rehabilitation setting D. Pass the student

168. While completing the assessment and treatment planning process, an OT practitioner confers with the client to establish program goals. As the OT writes these goals, they should MOST appropriately reflect: A. Specific measureable statements with time frames B. Time frames for what will be accomplished C. Specific measurements of the individual‟s skills and performance D. Activities to be completed that corresponds with the goals and objectives

1. A 4 month-old infant being seen for an OT assessment shows a strong preference for the left hand when reaching for a rattle at midline. Considering the development of dominance in normal children, the OT practitioner should conclude that: a. Further observation and evaluation of right sided is indicated b. Development of hand dominance is proceeding in a typical manner c. Hand dominance will not develop until age 1 year d. Unilaterally precedes bilaterality in typical development

1. Results of an OT evaluation show that a young child has many tactile defensive behaviors. The MOST appropriate beginning activity for intervention would require that: A. The therapist has the child play "sandwich" between heavy mats B. The therapist applies a feather brush lightly to the child‟s arms and legs C. The child is blindfolded ad must guess where he or she is touched on the body D. The therapist has the child play the "duck, duck, goose" circle game

101. During a routine transfer, a patient‟s legs buckle, causing him and the OT practitioner to fall to the floor. The most appropriate way for the OT practitioner to document this accident is in a(n): A. Incident report B. Daily progress note C. Letter to the department head D. Verbal report to the department head

102. An individual with emphysema reports recently "having an accident" when unable to make it to the bathroom in time. When the home health OT practitioner recommends a bedside commode, the idea is immediately rejected. Which of the following actions should the OT practitioner take FIRST? a. identify options and the consequences of each option b. decrease the effects of prolonged inactivity c. practice with a "demo" bedside commode d. allow time for the individual to think about the bedside commode

18.An OT practitioner asks a client who recently sustained a head injury to repeat a random list of numbers 1 minute after hearing the list. The OTR is MOST likely evaluating: A. Short-term recall B. Attention C. Hearing D. Abstraction

22.The BEST position that the OT practitioner can place a 15-month-old child in to provide the opportunity to further develop trunk rotation is the: A. Supine position B. Prone position C. Sidelying position D. Sitting position

62.When preparing a home program with the goal of independent toileting for a young child with postural instability, the MOST important adaptation the OT practitioner can recommend is: A. Replacing zippers and button with velcro closures B. Mounting a safety rail next to the toilet C. Introducing toilet paper tongs D. placing a colourful "target" in the toilet bowl

108. During a perceptual evaluation, an OT practitioner determines that an individual exhibits constructional apraxia, body scheme disturbances, and unilateral neglect. During the functional part of the evaluation, these deficits are MOST likely to contribute to self-care difficulties related to: A. Spatial relations B. Dressing apraxia C. Anosognosia D. Figure-ground discrimination

23.In order for an individual sitting in a wheelchair to achieve maximal pelvic stability, the seat belt should be positioned: A. Inferior to the ischial tuberosity B. Superior to the iliac crest C. Inferior to the anterior superior iliac spine D. Superior to the posterior superior iliac spine

35.An OT practitioner is assessing a client‟s mental status, oral structures, and motor control abilities of the head, extremities, and trunk. The practitioner has MOST likely received a referral for a: A. TMJ evaluation B. Cranial nerve evaluation C. Dysphagia evaluation D. Dysmetria evaluation

12.A child with a learning disability has difficulty integrating visual, auditory, vestibular, and somatosensory stimuli, and responds to stimuli primarily with defensiveness. The area of the central nervous system that serves as a center for these functions is the: A. Reticular formation B. Superior and inferior colliculi C. Cerebral cortex D. Cerebellum

12.A mother of child who is medically indigent and does not have health insurance is concerned about payment for laboratory work and OT services in the hospital. The OT practitioner explains that federal and state programs exist that fund health care for the poor and medically indigent. This program is referred to as: A. Medicare B. Medicaid C. Worker‟s compensation D. Education for All Handicapped Children Act

137. An OT practitioner has been asked to design a series of stress management sessions for individuals with multiple sclerosis (MS). The FIRST session should include: A. Time management technique B. Self-assessment C. Aerobic exercise D. Progressive resistive exercise

137. An OT practitioner is working with an individual with impaired memory. When the client is unable to follow verbal instructions, the practitioner changes the approach to demonstration. This is an example of: A. Activity analysis B. Activity adaptation C. Grading of the activity D. Clinical reasoning

1. A person with a long history of Parkinson‟s disease is experiencing considerable fatigue during the day. The OT practitioner‟s MOST appropriate response to help the person maintain his other level of function is to teach the person how to: A. "work through" the fatigue B. Perform desired activities in a simplified manner, to conserve energy C. Perform additional exercises to increase energy level D. D. eliminate activities and reduce activity level as much as possible

101. While measuring the active range of motion of a patient‟s metacarpophalangeal (MCP) joints, it is MOST important for the OT practitioner to provide stabilization: A. Above the MCP joints B. Below the MCP joints C. At the wrist D. On top of the MCP joints

169. An OT practitioner is working on functional mobility skills with a child who has a pes varus deformity of the foot. The OT can BEST document this as a(n): A. enlarged great toe B. club foot C. pronated foot D. unstable heel

12.Of the following, the MOST important aspect of administering a standardized test for an OT practitioner is the use of: a. subjective judgment to determine how best to administer the test b. previous experience as a way to gauge test results c. stated instructions for administration and scoring d. practice to learn the best way to administer and score the test

116. The BEST way for an OT practitioner to utilize sensory stimulation for the child with tactile defensiveness is to: a. apply light touch stimulation such as tickling on the abdomen for desensitization b. avoid all forms of tactile stimulation to accommodate child‟s preferences c. allow child to self-apply tactile stimuli to maximize child‟s tolerance d. avoid all deep pressure tactile stimuli to decrease defensiveness

119. An artist recently diagnosed with MS is interested in pursuing a leisure activity that will promote physical fitness. Because the individual‟s symptoms are limited to mild UE numbness and slight weakness in the dominant hand at this point, the BEST activity to recommend is: A. Volleyball B. Painting with the dominant hand C. Swimming in a cool water pool D. Jogging on a track or treadmill

78.Which individual would benefit the MOST from using a wrist-driven flexor hinge splint during a prehension activity? A. A client with a C1 injury B. A client with a C3 injury C. A client with a C6 injury D. A client with a T1 injury

12.A computer programmer arrives at an OT clinic complaining of pain while on the job. Which of the following are MOST likely to be considered work-related injuries specifically linked to the age of technology? A. Systemic diseases B. Edema and paresthesias C. Burns and electrocution D. Carpal tunnel and chronic cervical tension

192. An OT providing services to a community mental health program has been asked to examine the effectiveness of the OT groups that have been provided over the past 6 months. Which of the following procedures should be used to accomplish this goal? a. Quality assurance b. Peer review c. Utilization review d. Program evaluation

144. An OT practitioner is working with an individual who is unable to complete the multiple steps that are necessary to brush his teeth. In response to this, the practitioner modifies the activity by having the client perform the task one step at a time while gradually adding on more steps with each success. The OT is attempting to employ which of the following? A. Repetition B. Cueing C. Rehearsal D. Chaining

144. An OT practitioner treats most clients under the behavioural FOR. The activity feature that is MOST consistent with a behavioural FOR is: A. The level of skill is appropriate for the generally expected skills for that age B. The symbolic potential of the activity C. The combined activity demands of sensations, perceptions and motor skills D. The measurability of activity performance

144. An individual with c8 quadriplegia is most likely to require which of the following in order to perform self-feeding? a. total assistance b. support of the upper extremity against gravity c. a universal cuff d. no assistive devices

160. A child with a swallowing dysfunction is being discharged with a home-feeding program that includes eliminating foods with consistencies that are difficult to swallow. The OT would MOST likely recommend that the following type of food texture be AVOIDED: a. smooth semisolids (pureed bananas). b. lumpy semisolids (cottage cheese). c. liquids and solids combined (minestrone soup). d. thickened liquids (malted milk).

160. A client that the OT practitioner is working with uses a wheelchair and requires minimal assistance with all transfers and basic ADL. The client is expected to remain at this functional level. Which of the following would be the MOST appropriate community living option for this client at discharge? A. A cradle-to grave home B. A transitional living center C. An adult day program D. A clustered independent living arrangement

37.An OT practitioner is preparing for the discharge of a preadolescent child with limited strength and endurance. Which of the following home adaptations is MOST important to recommend? A. Mount lever handles on doors and faucets B. Remove all throw rugs C. Install nonskid pads on steps D. Mount a table top easel for written homework

36.When deciding if a standardized test is valid, the MOST important aspect for the OT practitioner to determine is whether the test: A. Measures the skill or function it claims to measure B. Provides similar scores on serial test administrations C. Provides similar scores when administered by two different examiners D. Is based on a normative population

37.A child avoids playground equipment that requires her feet to be off the ground. This behavior MOST likely indicates: a. tactile defensiveness b. developmental dyspraxia c. gravitational insecurity d. intolerance for motion

124. An OT practitioner is running a discharge planning group in which individuals discuss their personal feelings and concerns about returning to the community. Which of the following would be the BEST method to facilitate this process? a. Patients write fears and concerns on index cards. The OT practitioner collects and reads the cards to the group for discussion b. Patients write fears and concerns on index cards and then take turns reading their cards to the group c. Patients each take a turn verbalizing their fears and concerns to the group d. The psychologist speaks to the group about discharge fears in general

130. A child with athetoid CP demonstrates a jaw and tongue thrust when a food-filled spoon is placed in his mouth. To decrease this problem, the therapist is MOST likely to recommend a positioning strategy that includes increased: A. Neck flexion B. Shoulder retraction C. Hip extension D. Neck extension

197. A research question has been identified and a literature review completed by an OT practitioner. The NEXT step for the OT researcher is to: a. refine the question and develop the background b. decide on methodology c. establish boundaries for the study d. collect and analyze data

110. An OTR is preparing to do a parachute activity as part of a sensory integration program and several of the patients in the group are taking antipsychotic medications. The OTR should be alert for which possible side effect that could occur as a result of this activity? A. Postural hypotension B. Photosensitivity C. Excessive thirst D. Blurred vision

36.An OTR observes an individual having difficulty trying to find white socks on a bed with white sheets. The MOST appropriate performance component for the OT to address is: A. Figure-ground discrimination B. Unilateral neglect C. Position in space D. Cognitive mapping

112. An OTR is working as a consultant to a health care facility to assist the facility in achieving compliance with the Americans with Disability Act (ADA), Title III. The PRIMARY focus of the OT‟s efforts would be to make recommendations about: A. Improving accessibility in building access, building interiors, and rest rooms B. Modifying equipment, providing assistive aids, and training in adaptive methods so a disabled person can perform a particular job C. Providing education to persons who hire personnel concerning nondiscriminatory behaviors and procedures regarding persons with disabilities D. Assistive technology systems to facilitate job performance of disabled employees

120. An OT practitioner is educating a middle-aged roofer who is recovering from full-thickness burn about hypertrophic scarring. The OTR should FIRST inform the client that: a. the depth of the wound and location and the patient‟s race and age can all influence scar formation b. full-thickness wounds typically heal without significant scar formation c. surgical intervention eliminates all risk of hypertrophic scarring d. hypertrophic scars involving the joints do not interfere with range of motion

106. In administering an assessment of fingertip pinch strength, the OT practitioner would instruct the individual being tested to place the finger in which position? A. Thumb against the tip of the index finger B. Thumb against the side of the index finger C. Thumb against the tips of the index and middle fingers D. Thumb against the tips of all the fingers

107. Which of the following is MOST important when using a remotivation approach with a group of elderly individuals? a. Use pictures, music, and discussion to encourage discussion of memories b. Discuss an upcoming holiday and base an activity on that holiday c. Adapt the environment to maximize independent functioning d. Focus on group activities designed to enhance interpersonal skills.

108. A child with poor balance is unable to put on and remove lower- extremity clothing. Which of the following approaches would BEST address this functional problem? a. teach the child to dress in a sidelying position b. add loops to the waistbands of pants and skirts c. use Velcro fasteners in place of zippers d. teach the child to dress in standing position

109. An individual with an IV drug use problem has developed AIDS. The OT evaluation revealed that the individual‟s major problems are with daily tasks, self-esteem, physical conditioning, and anxiety. Which of the following approaches would be MOST beneficial to the client? A. Have the patient use stress reduction using meditation, yoga, and energy conservation techniques B. Have the patient participate in aerobic activities to combat deconditioning C. Provide video lectures on AIDS to educate the client about the disease process D. Incorporate energy conservation techniques and daily aerobic activities into the client‟s ADL

135. The PRIMARY functions of an OTR leading a therapeutic group in the beginning stages of group development will be to: a. set the climate, provide structure, and offer support. b. leave members to set the climate, provide structure, and offer support to each other. c. aid group members in separation d. work individually with group members until each is ready to join group activity.

142. An individual with depression is ready to return to the job held before taking a leave of absence. Which of the following is the FIRST action the OT practitioner should take? a. perform a job analysis b. request reasonable accommodation c. emphasize activities that promote a sense of self efficacy d. encourage the individual to participate in a weekly support group

150. An occupational therapist is discharging a 4-year-old child with athetoid cerebral palsy from a rehabilitation setting to home. The MOST appropriate instructions for the OTR to provide to the family for maintaining correct jaw control while feeding the child from the side are: a. "Jaw opening and losing are controlled with your index and middle fingers; place your thumb on the child‟s cheek." b. "Jaw opening and closing are controlled with your index and middle fingers; place your thumb on the child‟s larynx for stability." c. "Jaw opening and closing are controlled with your whole hand on the child‟s jaw" d. "Jaw opening and closing are controlled with your index and middle fingers; place your thumb on the child‟s ear for stability."

153. An OT practitioner should discontinue OT services when which of the following has taken place? a. The goals have been met and the individual can no longer benefit from OT services b. The goals have not been met and the individual could benefit from continued services c. The goals have been met but the individual could benefit from continued services d. The individual feels that he or she has not made gains despite objective measures to the contrary

155. An OT practitioner is assessing hand sensation in an older adult with diabetic neuropathies who frequently complains of hand pain it appears that the client would benefit from a desensitization program. The OT informs the client that hypersensitivity training is typically graded from: A. soft to hard to rough B. tap to rub to touch C. light to medium to heavy D. rough to hard to soft

156. An individual tells the OT practitioner, "I don‟t know about going home tomorrow, I wanted to be discharge yesterday and the doctor suggested I stay in the hospital another day". Which of the 177 following responses MOST accurately reflects an active listening approach? A. "It sounds as if you‟re not sure whether you are ready to be discharged" B. "You know, your doctor is a very intelligent person" C. "How about calling your doctor when you get home if you feel a panic attack coming on." D. "You‟ve been doing extremely well; what are you afraid of?"

157. A preteen with a diagnosis of spastic cerebral palsy is enjoying computer assisted learning while making significant progress in written communication, but he complains of general fatigue, body aches, and eye strain. Based on this information, which area would be most relevant for the OT practitioner to reassess FIRST? a. The time he spends at the computer b. The size of the computer screen c. The challenge level of the learning program d. His control of the keyboard

158. A COTA and OTR have effectively worked together for the past 5 years. Which of the following BEST describes the supervisory process between a COTA and a supervising OTR at this level? A. A mutual process B. A evaluative process C. A counselling processing D. A learning process

159. A long term goal for a 60-year-old client with back pain is to be able to return to work as an illustrator. The client has achieved the short- term goal of sitting at a work table for 20 minutes. The BEST example of a revised short-term goal for this client is: a. "Client will draw sitting at work table." b. "Client will draw 1 hour, taking stretch breaks every 20 minutes." c. "Instruct client in stretching techniques to be performed every 20 minutes." d. "Instruct client in the use of proper body mechanics that apply to prolonged sitting."

159. The OT practitioner has completed patient education with an individual who has just received a splint for carpal tunnel syndrome. When documenting this session, the OT practitioner will indicate that the patient was instructed in precautions, wearing schedule, and care of a: A. Wrist cock-up splint B. Thermoplastic splint C. Resting hand splint D. Dynamic MP flexion splint

16.In an OT clinic, a patient with severe hand weakness as a result of arthritis is preparing for discharge. The OT is performing an evaluation to determine the person‟s ability to function at home. In terms of home safety, the skill that would be MOST important for this person to demonstrate would be the ability to: A. Work locks and latches on doors or windows B. Manipulate built-up utensils while eating C. Demonstrate energy conservation technique D. Manipulate fasteners on clothing for easy dressing and undressing

16.Which of the following of the following performance components are MOST important to consider when analyzing activities for use with adults with psychosocial problems? a. The amount of self-control demands, time management demands, self-expression opportunities, and interest in the activity b. Age appropriateness, prehension patterns required, and the presence of small pieces that could be mistakenly swallowed c. Tactile, kinesthetic, visual and olfactory properties d. Space requirements, equipment and supply needs, cost and safety considerations

160. A child displays poor postural stability because of low muscle tone. To promote beginning antigravity control, the FIRST activity that should be performed is: A. pull-to-sit, leaning back against therapy ball B. prone scooter obstacle course C. hippity-hop races D. batting a balloon while the child is suspended in net

161. An individual with poor writing skills needs to produce large amounts of legible material upon returning to work. The MOST appropriate method of compensation the OT could recommend would involve having the person: A. learn to type B. practice fine motor coordination exercises C. practice letter or shape formations D. strengthen the finger flexors and extensors

162. Which of the following is the MOST important precaution to emphasize to parents when discharging a child with lower extremity paralysis as a result of myelomeningocele? a. practice skin inspection b. avoid feeding the child chewy foods that may cause choking c. monitor apnea episodes d. avoid situations that can stimulate tactile defensiveness

163. A 4-month old infant being seen for OT assessment shows a strong preference for the left hand when reaching for a rattle at midline. Considering the development of dominance in normal children, the OT practitioner should conclude that: A. further observation and evaluation of right sided dysfunction is indicated. 226 B. development of hand dominance is proceeding in a typical manner. C. had dominance will not develop until age 1 year. D. unilaterally precedes bilaterally in typical development.

169. An OTR is using leather stamping as part of a group activity but feels the need to increase the problem solving processes within the group. The BEST approach for encouraging problem solving in a craft media group is to: A. Begin with activities that have obvious solutions and high probabilities of success and then gradually increase the complexity B. Begin with activities that require gross motor responses and progress to activities that require fine motor responses C. Structure the number and kinds of choices available D. Gradually increases the time used in the activity by 15-minute increments.

17.During the evaluation of a child diagnosed with autism, the child demonstrates craving for tactile stimulation, rubbing objects on his arms and legs. He also avoids being touched by others, The OTRs FIRST interpretation is that this is a sensory integration related to: a. poor modulation of tactile input b. hypersensitivity to tactile input c. hyposensitivity to tactile input d. poor modulation of proprioceptive input

170. An OT is employed by a community health center has determined that there is a need to provide groups of clients with specific diagnoses. One group the therapist is recommending starts with the clients engaging in a game of rhythmic exercises performed to music. The group activity also includes teaching the clients strategies to get up from chair and start walking and specially adapted handwriting activities. This is MOST likely and OT group for people with the diagnosis of: a. Parkinson‟s disease b. Guillain-Barre c. COPD d. SCI

171. An OTR and COTA are each completing sections of a discharge summary. The section LEAST appropriate for the COTA and MOST appropriate for the OTR to complete is the: A. Discharge recommendations B. Patient‟s current level of independence in ADL C. Patient‟s most recent strength and coordination measurements D. Patient‟s discharge disposition

172. Which aspects of psychosocial performance are MOST important to emphasize in developing a client‟s work potential in a prevocational program? A. Punctuality, accepting directions from a supervisor, and interacting with co-workers B. Memory, sequencing of the work tasks, attending to work tasks, and making decisions C. Standing tolerance, eye-hand coordination, and endurance D. Maintaining personal cleanliness and adhering to safety precautions

173. An OT practitioner in a long-term care facility is working with several residents who seem very isolated and disengaged from the other residents. The OT has identified a need to provide these residents with a group activity that would enhance self-esteem, provide opportunities for social skills and assist residents in integrating past experiences with present life. The BEST type of group to accomplish these goals is a: A. Reminiscence group B. Meditation group C. Grooming activities group D. Movement activities and games group

174. An OTR working as a consultant to a health care facility to assist the facility in achieving compliance with the Americans with Disability Act, title III. The PRIMARY focus of the OT‟s efforts would be to make recommendations about: a. improving accessibility in building access, building interiors, and rest rooms b. modifying equipment, providing assistive aids, and training in adaptive so a disabled person can perform a particular job c. providing education to persons who hire personnel concerning non-discriminatory behaviors and procedures regarding persons with disabilities d. assistive technology systems to facilitate job performance of disabled employees

174. Which of the following components is MOST essential to include when designing a work-hardening program? a. Pain management techniques b. Achieving a balance between work and leisure c. Energy conservation techniques d. Vocational counselling

175. A fall prevention program is being implemented by an OT who works in life-care retirement community. The BEST way to implement this type of program at the primary level of prevention would be to: a. develop a protocol for environmental modification to reduce fall risks in the life-care retirement community b. observe ADL performance to identify those residents at highest risk for falls c. make recommendations for wheelchair positioning for those who have had at least one fall d. provide intervention to improve balance for those residents who demonstrate the need

176. Which of the following activities would be MOST appropriate for vocational skills training for high school students with severe learning disabilities? a. stocking shelves at a local grocery b. packaging items in a local sheltered workshop c. cleaning the school cafeteria after lunch d. reading want ads and role playing interviews

177. An OTR and COTA share and coordinate therapy for a caseload. Which of the following jobs would be MOST appropriate for the COTA to perform: a. completing the chart reviews. b. completing the no standardized portions of the evaluation. c. interpreting the results of the no standardized portion of the evaluation. d. independently designing a treatment plan for the individual.

177. An OTR with expertise in hand rehabilitation is assessing a COTA‟s service competency in hand function assessment. At what point is service competency established? A. When the COTA consistently obtains the same results as the OTR B. After the COTA passes the NBCOT examination C. When the COTA has obtained a specified number of continuing education credits in hand rehabilitation D. After the COTA has practiced for a minimum number of years, as specified by state licensure

177. The OT is leading a grooming group for female clients in a psychosocial treatment setting. Which if the following options BEST complies with universal precautions? a. use disposable cotton swabs and have client bring their own cosmetics b. use disposable gloves when combing the client‟s hair c. wash and dry makeup brushes between uses d. avoid bringing cosmetics in glass containers to the group

178. A COTA and OTR have effectively worked together for the past 5 years. Which of the following BEST describes the supervisory process between a COTA and supervising OTR at this level? a. mutual process b. evaluative process c. counselling process d. learning process

18.An OT practitioner is assessing the ROM of an individual who demonstrates internal rotation of the shoulder to 70 degrees. The practitioner would MOST likely document the patient‟s AROM as: A. Within normal limits B. Within functional limits C. hypermobility that requires further treatment D. limited mobility that requires further treatment

182. An individual tells the OT practitioners, "I don‟t know about going home tomorrow. I wanted to be discharged yesterday and the doctor suggested I stay in the hospital another day." Which of the following responses MOST accurate reflects an active listening approach? A. It sounds as if you‟re not sure whether you are ready to be discharged. B. You know, your doctor is very intelligent person. C. How about calling your doctor when you get hoe if you feel a panic attach coming on. D. You‟ve been doing extremely well what are you afraid of?

182. During a routine transfer, a patient‟s legs buckle, causing him and the OT practitioner to fall to the floor. The most appropriate way for the OT practitioner to document this accident is in a(n): a. incident report. b. daily progress note. c. letter to the department head. d. verbal report to the department head.

184. A hospital-based multidisciplinary team meets bimonthly to monitor their services in regard to the creation of an environment that meets or exceeds consumer needs. This model is MOST appropriately called: a. total quality management. b. cost accounting. c. employee empowerment. d. horizontal structuring.

184. A therapist is working with an individual who was admitted to an inpatient psychiatric program for major depression. This individual is also diagnosed with stage 4 AIDS. The BEST general focus of treatment at this point would be to: A. restore and maintain functional performance of self-chosen performance of valued occupational roles. B. increase physical endurance and maintain desired self-care tasks. C. facilitate resolution of current and anticipated losses through the grieving process. D. restore and maintain functional performance of the individual‟s primary work role.

185. An OT is establishing a department in a rural long-term care facility. When developing the policies and procedures for documentation in the facility, which of the following documents would be MOST useful? a. Uniform Terminology for Occupational Therapy b. Occupational Therapy Code of Ethics c. Occupational Therapy Standards of Practice d. Occupational Therapy Roles

185. An OT practitioner is conducting a program evaluation for the quality assurance program in the OT department. The MOST appropriate area for the OT to evaluate would be the: A. Levels of self-care skills attained by clients with head trauma at discharge B. Number of patient visit in 1 month C. Pay scale of therapists compared with others in area facilities D. Annual department expenditures on supplies

186. An OT practitioner is coordinating a cooking group, as a part of the competency training program for leading the group, the OTR must demonstrate an awareness of the policies and procedures that relate to the storage and maintenance of a staple products, as well as food handling. This policy will MOST likely be part of the facility‟s: a. infection control plan b. risk management plan c. emergency procedures plan d. environmental survey plan

187. An OT practitioner is collecting data for a quality assurance project. The advantage of asking a closed question is that the format: A. Allows the therapist to obtain facts B. Avoids emphasizing feelings being expressed by the patient C. Can help the therapist who is in a hurry D. Forces the person to give the answer that the therapist needs

188. According to the Joint Commission on Accreditation of Hospital Organization (JCAHO) an OT managing delivery of therapy services in a hospital setting would have to review and update occupational therapy policies and procedures as follows: a. review and update annually. b. review and update on years in which JCAHO surveys are performed. c. review and update when new occupational therapy managers take over a department. d. review every other year.

191. At the beginning of fieldwork, a student asks an OTR who is the clinical supervisor about student objectives. The MOST accurate statement about student objectives for fieldwork is: a. objectives vary in each facility. b. objectives are standardized for all facilities. c. are written by the NBCOT. d. must meet state licensure requirements.

193. A new, inexperienced COTA has joined the staff of a rehabilitation facility and the OTR is required to provide close "supervision" for the first few months. As specified by AOTA, the amount of supervisory by AOTA, the amount of supervisory contact the OTR should provide to the COTA is: a. contact the supervisor once a day. b. contact with supervisor once a week. c. contact with supervisor once a month. d. contact with supervisor as needed.

193. A supervising OT asks an experienced COTA to complete a portion of an assessment. The portion that is MOST appropriate for the COTA to complete independently would be: A. Collecting chart review information B. Analyzing and interpreting assessment information C. Establishing the treatment goals D. Establishing the treatment plan

193. Which of the following inpatient services can be billed as OT services for a client whose hospitalization is covered by Medicare? A. Treatments from the OT plan provided by an OT practitioner B. Treatments from the OT plan provided by a music therapist C. Treatments from the OT plan provided by a recreational therapist D. Treatments from the OT plan provided by an art therapist

195. An OT practitioner in private practice is preparing to act as a consultant to a community agency. The FIRST step would be to: a. negotiate the contract b. establish trust c. assess the environment d. identify problems

199. Upon completion of a level-II fieldwork placement on a rehabilitation unit, student is functioning slightly below minimal entry-level competence. The supervising fieldwork educator should: a. fail the student. b. pass the student with the requirement that the student not practice in a rehabilitation setting. c. pass the student and recommend additional training or volunteer work in rehabilitation setting. d. pass the student.

21.An OTR observes that an individual on a purees diet has demonstrated a gurgle or wet voice after swallowing a second time. The diet had not been difficult for the individual until this instance. The MOST appropriate recommendation for the OTR to make is for this person to have a: a. videofluoroscopy b. diet change to include thin liquids c. tracheostomy d. regular diet

22.The goal of an arts and crafts group for chronically mentally ill individuals is to improve their decision-making abilities. The MOST appropriate approach to initiating a mosaic tile activity would be to: A. Provide each patient with an individual project and have him or her chooses a tile color for the project B. Have the patient choose from a variety of projects C. Have the patients decide on a design, size, shape and colors for a group mosaics projects D. Have the patients decide on a pattern and two tile colors to use in the his or her mosaic project

23.When teaching children with moderate mental retardation to feed, groom, and dress themselves, the OT is MOST likely to use which technique? A. Chaining B. Practice and repetition C. Demonstration D. Role modelling

24.Poor impulse control has been identified as the primary deficit in a 12- year-old boy with conduct disorder. Which of the following is the MOST effectively written functional OT goal? A. Within 6 months, the client will participate in classroom activities for 1 hour without disruptive outbursts, twice a day B. Within 6 months, the client will attend to an activity for 30 minutes, demonstrating improved impulse control C. The client will show a 50% reduction in the frequency of disruptive outbursts within 6 months D. When presented with a new activity, the client will follow directions without protest, four out of five times, within 6 months

25.An OT practitioner is assessing the range of motion of an individual who demonstrates internal rotation of the shoulder to 70 degrees. The practitioner would MOST likely document the patient‟s active range of motion: a. within normal limits b. within functional limits (WFL) c. hypermobility that requires further treatment d. limited mobility that requires further treatment

26.The OT practitioner is evaluating two-point discrimination in an individual with a median nerve injury. The MOST appropriate procedure is to: a. apply the stimuli beginning at an area distal to the lesion progression proximally b. test the involved area first, then the uninvolved area c. present test stimuli in an organized pattern to improve reliability during retesting d. allow the individual unlimited time to respond

28.During an initial evaluation, an OT practitioner documents that the client‟s chart reveals a history of both depression and substance abuse. The term that indicates a diagnosis from two mental diagnostic categories is: A. Dual diagnosis B. Multiply handicapped C. Axis I and II duplicity D. Primary and secondary diagnoses

3. In assessing the dressing skills of a 5-year-old child, the OT practitioner observed that the child is able to put on a jacket, zip the zipper, and tie a knot in the draw string but needs verbal cueing to tie a bow. The OT practitioner would MOST likely determine that the child‟s dressing skills are: A. Age appropriate B. Delayed C. Advanced D. Limited

30.An OT manager is developing a proposal for OT services in the neonatal intensive care unit (NICU). Using the developmental support care approach as the basis for services, how would the OT BEST describe OT‟s scope of practice in the NICU? A. Modifying the environment to protect the infant from overstimulation and inappropriate stimuli B. Providing passive range of motion (PROM), positioning and handling, fabrication of splints, and referral to early intervention C. Educating parents and hospital staff D. Implementing motor & behavioral skill acquisition through developmental milestone positioning

31.The MOST appropriate assessment instrument for the OT practitioner to use for measuring range of motion of the hand is: a. a goniometer b. a dynamometer c. a pinch meter d. an aesthesiometer

32.The OT practitioner is assessing an individual who demonstrates normal range of motion when flexing the elbow but hyperextends by 15 degrees when the elbow extended. The practitioner will MOST LIKELY record the measurement as: A. -15 to 140 degrees B. 0 to140 degrees C. 15 to 140 degrees D. -15 to 120 degrees

34.An OT practitioner is administering a standard test to a young client who suddenly becomes uncooperative and complains that the test is "too hard." The MOST appropriate response for the OT practitioner would be to: a. switch to easier items to improve the child‟s self-esteem b. terminate the session and schedule another session for the remainder of the test c. follow administration instructions and note changes in behavior d. adapt the remaining test items to ensure success

35.An OTR observes an individual having difficulty trying to find white socks on a bed with white sheets. The MOST appropriate performance component for the OT to address is: A. Figure ground discrimination B. Unilateral neglect C. Position in space D. Cognitive mapping

38.During a stress management group, and individual recently diagnosed with MS complains that his teenage children are resistive to helping with chores that were previously his responsibility, such as mowing the lawn and taking out the trash. The stress management technique that would MOST successfully address this concern is: A. Using effective communication skills B. Applying time management techniques C. Deep breathing D. Laughter

39.Evaluation results for a person with arthritis will MOST accurately reflect true functional abilities if scheduled: a. early morning (8 to 10 AM) b. afternoon c. late morning (10 to 11 AM) d. early morning and again in the afternoon

40.Setting up an obstacle course that provides several options for allowing a child to choose the direction he will take (unstructured) would be MOST appropriate if the OT practitioner wished to encourage: A. Exploratory play B. Symbolic play C. Creative play D. Recreational play

41.A child displays poor postural stability because of low muscle tone. To promote beginning antigravity control, the FIRST activity that should be performed is: A. Pull-to-sit, leaning back against therapy ball B. Prone scooter obstacle course C. Hippity-hop races D. Batting a balloon while the child is suspended in net

43.In assessing if a person is a candidate for using a mobile arm support, the OT practitioner would have to determine if the person demonstrate which of the following? a. incoordination b. lateral trunk stability c. fair plus elbow flexion d. poor head control

44.When providing adaptive equipment to an individual with arthritis, the OT practitioner would explain that the PRIMARY purpose of using this equipment is to: A. Decrease joint stress and pain B. Correct deformity C. Simplify work D. Decrease independence

47.An individual with poor writing skills needs to produce large amounts of legible material upon returning to work. The MOST appropriate method of compensation the OT could recommend would involve having the person: A. Learn to type B. Practice fine motor coordination exercises C. Practice letter or shape formations D. Strengthen the finger flexors and extensors

48.A child with poor anticipatory postural control demonstrates inadequate playground skills, losing her balance when trying to anticipate movement. Which of the following activities will BEST promote the development of these skills? A. ballet B. soccer C. basketball D. ping pong

52.An OT practitioner is making a home visit to an elderly client who lives alone. The client exhibits severe hand weakness. When addressing safety in the home, the OTR should be MOST concerned with the client‟s ability to: A. Work locks and latches on doors and windows B. Use built-up utensils while eating C. Use energy conservation techniques D. Manipulate fasteners on clothing

52.An individual begins therapy with a blood-thinning medication after surgery for an endarterectomy. Which would be the BEST grooming tool for the OT practitioner to recommend for use in the hospital and after discharge? A. An electric razor B. A single-blade safety razor C. A straight razor D. A double-blade safety razor

56.A client with a history of COPD has limited endurance. The long-term goal for this client is to prepare three meals a week. The MOST relevant short-term goal for the OT practitioner to focus on is: A. The use of energy conservation B. Work-hardening activities C. Graded activities to increase strength D. Safety in the kitchen

56.To promote play skills and self-expression in a child who is withdrawn, an OT practitioner should FIRST select activities that: a. promote open-ended symbolic play, such as using action figures, puppets and dolls b. provide a defined structure, such as simple craft activities with instructions c. promote social interaction, such as game of tag with peers d. provide a means of tension release, such as leather tooling or wedging clay

57.An OT practitioner is working with an individual with amyotrophic lateral sclerosis (ALS) who is no longer able to ambulate for kitchen or home management activities. Which of the following interventions BEST addresses the goals of independence in meal preparation for this individual? a. Meal preparation techniques using a wheelchair b. Training in the use of adapted cooking equipment c. Simple cooking activities while standing at the counter for gradually increasing amounts of time d. Begin with cold meals and progress to hot meals

58.An individual with Alzheimer‟s disease has difficulty following multiple step instructions. Which method will the OT practitioner instruct the caregiver to use when presenting instructions? a. Give one or two-step instructions frequently repeated b. Provide three-step instructions with gestures for demonstration c. Write instructions down that are over three steps for the individual d. Have individual verbally repeat instruction after the therapist gives them

59.An individual with left hemiparesis and impaired balance wishes to vacuum the floors upon return home. The BEST type of vacuum cleaner for the OT practitioner to recommend is a(an): A. Canister vacuum cleaner B. Upright vacuum cleaner C. Self-propelled vacuum cleaner D. Handheld cordless vacuum cleaner

6. A preschool child with spastic cerebral palsy uses "bunny-hopping" for functional mobility during an OT evaluation. This indicates that a primitive pattern is being used for mobility. Which of the following reflexes is MOST likely being used by the child? a. STNR b. ATNR c. TLR d. neck righting reflex

6. The OTR is assessing the muscle tone of a child with athetoid CP. In documenting the assessment results, the therapist would MOST likely describe the quality of the muscle tone as: A. Fluctuating B. Spastic C. Flaccid D. Rigid

60.Which of the following is the BEST example of the subjective section of a discharge summary? A. "Pt. reports overall pain levels are lower and ability to perform ADL has improved." B. "Pt continues to c/o back pain with activity." C. "Pt. has improved from minimal assistance to independence in ADL performance." D. "My back hurts when I get in and out of the tub, and when I lift bags of groceries."

62.A child with poor anticipatory postural control demonstrates inadequate playground skills, losing her balance when trying to anticipate movement. Which of the following activities will BEST promote the development of these skills? A. Ballet B. Soccer C. Basketball D. Ping-pong

62.In establishing long term goals for an individual with T4 paraplegia in a rehabilitation setting, the OT practitioner would MOST likely predict that the patient will attain what level of independent with bathing, dressing, and transfers? a. complete independence with self-care and transfers b. independence with self-care and minimal assistance with transfers c. minimal assistance with self-care and moderate assistance with transfers d. dependence with both self-care and transfers

63.A therapist is working with an individual who was admitted to an inpatient psychiatric program for major depression. This individual is also diagnosed with stage 4 acquired immunodeficiency syndrome (AIDS). The BEST general focus of treatment at this point would be to: a. restore and maintain functional performance of self-chosen occupations that enhance competent performance of value occupational roles b. increase physical endurance and maintain desired self-care task c. facilitate resolution of current and anticipated losses though the grieving process d. restore and maintain functional performance of the individual‟s primary work role

63.An elderly man was admitted to the hospital after a car accident. He sustained a right pelvic fracture and verbalizes extreme pain with ambulation. The orthopaedic doctor has recommended that the patient perform "toe touch only" weight bearing on his right foot for 6 to 8 weeks. The OT should instruct the patient to use a walker when performing which of the following activities? A. Transferring on and off a commode seat B. Working in bed mobility C. Performing self-feeding D. Working on distal lower extremity dressing

64.Following a heart attack, an individual report to the OT practitioner that his wife overreacted and that there is really nothing wrong with him. The nurse reports poor compliance with cardiac precautions. Which of the following is the MOST important action for the OT practitioner to take? A. Monitor the individual‟s response to activities to prevent him from performing at activity levels that are too high and unsafe. B. Instruct the individual in energy conservation techniques to minimize energy expenditure. C. Emphasize the consequences of not observing cardiac precautions and provide concrete proof of the myocardial infarction (MI) to the individual. D. Refer to the individual for psychological services.

64.When planning treatment for individual diagnosed with eating disorders the OT practitioner‟s initial OT treatment goals would MOST likely address: A. Increasing self-awareness through expressive activities. B. Increasing awareness of nutritional issues. C. Improving school performance skills. D. Making recommendations or referrals for family therapy.

66.An individual has sustained a large, full thickness burn to both upper extremities while running a fireworks display. The client is in the acute care phase of treatment. Which of the following BEST represents an acute care rehabilitation goal? A. Prevent loss of joint and skin mobility B. Provide adaptive equipment C. Provide compression and vascular support garments D. Prevent scar hypertrophy through scar management techniques

69.When providing adaptive equipment to an individual with arthritis, the OT practitioner would explain that the PRIMARY purpose of using this equipment is to: A. Decrease joint stress and pain B. Correct deformity C. Simplify work D. Decrease independence

7. An OT practitioner positions and places attractive toy overhead to provide an opportunity to work against gravity. This position is MOST effective for developing which ability? A. Shoulder flexion and protraction B. Shoulder extension and retraction C. Development of head control D. Development of trunk control

72.An OT practitioner making a bedside visit finds her patient poorly positioned with an edematous upper extremity caught between the mattress and the bed rail. The MOST appropriate intervention to address the edema in the upper extremity is to: A. Elevate the arm on pillows so it rests higher than the heart B. Massage the arm gently, stroking toward the fingers C. Instruct him to avoid active range of motion D. Instruct him to avoid PROM

73.An OT practitioner is educating a client with a cumulative trauma disorder about common work related risk factors. The OTR explains to the client that many of the PRIMARY risk factors are: A. Repetition, high force and awkward joint postures B. Progressive resistive exercise, joint mobilization and weight bearing C. Inflammation, swelling, and pain D. Fatigue, muscle cramps and paresthesias

74.The OT practitioner is leading a grooming group for female clients in a psychosocial treatment setting. Which of the following options BEST complies with universal precautions? A. Use disposable cotton swabs and have clients bring their own cosmetics B. Use disposable gloves when combing client‟s hair C. Wash and dry makeup brushes between uses D. Avoid bringing cosmetics in glass containers to the group

75.While participating in the first session of a relapse prevention group, a client reports that he often misses a dose of his medication because he forgets when to take it. Which of the following actions should the OT take FIRST? A. Ask group members to discuss how they feel about taking their medications. B. Suggest using a diary to record each dose of medication C. Instruct him in the use of a timer to assist in medication management D. Make sure he knows what his medication schedule is

79.An elderly patient who was hospitalized for a right CVA with left UE flaccidity and decreased sensation is beginning to experience sensory return in the left UE. The OTR should recommend modifying the treatment plan to include: A. Remedial treatment, such as rubbing or stroking the involved extremity B. Remedial treatment, such as the use of hot mitts to avoid burns C. Compensatory treatment, such as testing bathwater with the uninvolved extremity D. Compensatory treatment, such as using a one-handed cutting board to avoid cutting the insensate hand

8. An OT practitioner is working with a 3-year-old who has spastic diplegia. The mobility device which would be MOST appropriate to use in assisting this child to explore space would be: A. A body length prone scooter B. An airplane mobility device C. A tricycle D. A power wheelchair

80.A hospital-based multidisciplinary team meets bimonthly to monitor their services in regard to the creation of an environment that meets or exceeds consumer needs. This model is MOST appropriately called: A. Total quality management B. Cost accounting C. Employee empowerment D. Horizontal structuring

81.An OT practitioner is working with a group of patients who have orientation deficits resulting from head injuries. Using an adaptive or compensatory approach, the MOST appropriate intervention would be to: A. Provide verbal cues, external aids such as calendars and family pictures, and opportunities to practice using the external aids B. Reduce the number of distractions; move the group to a quiet room C. Present information in short units, spaced with time between each segment D. Connect new information to previously learned knowledge and skills

81.An individual with depression is ready to return to the job held before taking a leave of absence. Which of the following is the FIRST action the OT practitioner should take? A. Perform a job analysis B. Request reasonable accommodation C. Emphasize activities that promote a sense of self-efficacy D. Encourage the individual to participate in a weekly support group

82.Which of the following sequence of method is MOST appropriate to achieve sensory desensitization? a. Textured material, rubbing, tapping, and prolonged contact b. Massage, facilitory electrical stimulation and a progressive desensitization program c. Pressure, percussion, vibration, icing and edema massage d. Visual compensation and functional use of the extremity

83.A child observed grabbing toys from others, becoming easily frustrated and is unable to sit still. This behavior MOST likely indicates: A. Activity analysis B. Activity adaptation C. Grading the activity D. Clinical reasoning

83.A client with CP has severe motor impairment resulting in insufficient arm and hand motion, and insufficient grasp or prehension to access a computer keyboard. The BEST low-technology solution for improving his ability to access keys would be a(n): A. Head pointer and slanted keyboard B. Typing splint C. Adapted mouse D. Built-up pencil to press the keys

83.An OT practitioner is assessing hand sensation in an older adult with diabetic neuropathies who frequently complains of hand pain. It appears that the client would benefit from a desensitization program. The OT informs the client that hypersensitivity training is typically graded from: A. Soft to hard to rough B. Tap to rub to touch C. Light to medium to heavy D. Rough to hard to soft

84.An individual has sustained a large, full-thickness burn to both upper extremities while running a fireworks display. The client is in the acute care phase of treatment. Which of the following BEST represents an acute care rehabilitation goal? A. Prevent loss of joint and skin mobility B. Provide adaptive equipment C. Provide compression and vascular support garments D. Prevent scar hypertrophy through scar management techniques

85.An OT practitioner provides a leatherworking activity to an individual with C7 quadriplegia in order to increase grip strength. Which component of this activity would be MOST effective in promoting this goal? A. Holding the hammer B. Holding the stamping tools C. Squeezing the sponge to wet the leather D. Lacing with a needle

86.An OT practitioner is instructing a client to perform stand-to-sit chair transfers after a total hip replacement. Before sitting down from a standing position, the OTR FIRST instructs the client to: a. extend the operated leg forward, reach back for the armrests, and slowly sit, while attempting to not lean forward b. extend the nonoperated leg forward, while gradually flexing the operated side, reaching back for the armrests, and slowly sit, while attempting to not let lean forward c. flex the operated leg, then flex the nonoperated leg, reach back for the armrest and slowly sit, while attempting to not lean forward d. never perform stand to sit transfers with a client with a new total hip replacement until 2 weeks after surgery

86.An individual who sustained a C7-8 spinal cord injury 5 years ago has been admitted to an inpatient psychiatric unit. The OT practitioner should inform the staff that this individual will MOST likely be able to perform wheelchair-to-commoda transfers at which of the following levels? A. Independent with a sliding board B. Assisted, using a stand-pivot transfer C. Dependent in all transfers D. Independent without adaptive equipment

87.An OT practitioner is educating a client with a cumulative trauma disorder about common work-related risk factors. The OTR explains to the client that many of the PRIMARY risk factors are: a. repetition, high force, and awkward joint postures b. progressive resistive exercise, joint mobilization and weight- bearing c. inflammation, swelling, and pain d. fatigue, muscle cramps and paresthesias

88.A client is experiencing acute right upper extremity and hand lymphedema after a recent mastectomy. The client‟s primary complaint is joint stiffness. The INITIAL techniques the OTR can implement to alleviate joint stiffness would MOST likely be: a. contrast baths, active and passive range of motion and retrograde massage b. ultrasound, electrical stimulation, and dynamic splinting c. resistive exercises, weight-bearing and lifting d. joint mobilization, serial casting and dynamic splinting

88.An individual who is being discharged home after practicing in a patient pulmonary rehabilitation program for chronic obstructive pulmonary disease (COPD) is given a list of tips to use in the home to promote function. Which one of the following items is MOST likely to be on the list? A. Perform pursed lip breathing when doing activities B. Use a long-handled sponge while in the shower C. Take hot showers to reduce congestion D. Avoid air conditioned rooms during warm months

90.An individual who is several days s/p myocardial infarction experiences nausea during a bathing evaluation. Which of the following is the FIRST action the OT practitioner should take? A. Stop the activity B. Document the symptoms C. Instruct the individual to sit and then continue the activity D. Ask the individual if he feels like he can continue the activity

90.An individual with an UE fracture has asked an OT practitioner how to maintain strength in her arm until the cast is removed. The activities that would BEST accomplish this goal are those which incorporate: A. Isometric muscle contractions B. Isotonic muscle contractions C. Progressive resistance D. Passive movement

91.The OTR instructs a client with chronic neck pain to use psychosocial pain management techniques. Which if the following BEST represents psychosocial strategies commonly used by OT practitioners? a. biofeedback, distraction and relaxation techniques b. specific skill training c. strength and endurance building techniques d. cognitive retraining techniques

92.An OT practitioner is making a home visit to an elderly client who lives alone. The client exhibits severe hand weakness. When addressing safety in the home, the OTR should be MOST concerned with the client‟s ability to: A. Work locks and latches on doors and windows B. Use built-up utensils while eating C. Use energy conservation techniques D. Manipulate fasteners on clothing

92.An individual in an adult day program demonstrates poor social skills and frequent sexual acting-out. The activity that would MOST effectively provide release for this individual‟s sexual tension is: A. Jogging B. Macramé C. Reading Playboy magazine D. Ballroom dancing

94.A 45-year-old client with COPD has this long-term goal of being able to shop independently for groceries. The client has achieved the short- term goal of going to a convenience store and purchasing three items. Which statement is the BEST example of a revised short-term goal? A. "Client will purchase 10 items at the supermarket with supervision." B. "Client will cook a one-dish meal." C. "Client will shop independently for a birthday present for her daughter." D. "Instruct client in energy conservation techniques that apply to grocery shopping.‟"

97.When instructing the parents of a toddler in the use of common household objects. the practitioner document this as: A. Checking for irritation and pressure problems B. Avoiding excessive heat exposure C. Cleansing the splint regularly D. Adhering strictly to the wearing schedule

99.An OT practitioner has been working with a cognitively intact patient to train him in the safe use of a tub bench for transferring for several sessions. According to motor-learning principles, the BEST way to give feedback about the person‟s performance to ensure that this person learns the skill is to provide: A. Summary feedback, given at the end of the patient‟s attempts. 118 B. Continuous feedback to let the person know how he is processing. C. Feedback about the performance whenever the patient makes a mistake. D. Give no feedback during or after the practice session.

25.In a home program to promote beginning symbolic play for a child with developmental delay, the OT practitioner would MOST likely recommend playing with: A. Busy box, nesting toys, and blocks B. Board games C. Craft kits D. Doll house and dress up clothes

126. A child with a physical disability and poor postural stability is developmentally ready for toileting. Which of the following elements of the treatment plan should be considered FIRST? A. Training in management of fasteners B. Provision of foot support C. Provision of a seatbelt D. Training in climbing onto the toilet

39.While observing a child for the first time, the OT practitioner notes that the child responds to a loud noise by abducting and extending the arms. The reflex observed in this child is documented by the OT as a: A. Rooting reflex B. Moro reflex C. Flexor withdrawal reflex D. Neck righting reaction

110. A patient with a short below-elbow amputation is lacking sensation in the residual limb. The MOST appropriate intervention would be for the OT to teach the patient: A. Techniques of tapping, rubbing, and application of textures to the residual limb B. To routinely inspect skin closely for signs of skim breakdown C. To perform deep massage on the residual limb D. The necessary procedures of proper skin hygiene

124. A PT practitioner receives a referral to fabricate a splint that will assist with the maintenance of a functional hand position while keeping the soft tissue of the hand in a midrange position. Which splint would the OTR MOST likely select to address these needs? a. A bivalve cast b. A resting pan splint c. A dynamic extension splint d. A wrist cock-up splint

100. An auto mechanic is currently in a work hardening program after being in a car accident that left him with numerous upper and lower extremity impairments. The ultimate goal for this individual is to return to full employment as an auto mechanic. Which of the following BEST represents a work hardening activity for this individual? a. lifting weights b. working on a mock car engine c. visiting the work site garage d. preparing a light lunch at mealtime

101. An OT practitioner is planning a self-feeding session with an individual with a C5 spinal cord injury. Which piece of feeding equipment would be MOST appropriate for the OT practitioner to introduce to the client? a. a wrist driven flexor hinge splint b. a mobile arm support c. an electric self-feeder d. built-up utensils

102. A client‟s family wants to build a ramp to the primary entrance of the home. The OT practitioner advises the family that the ramp should be graded with a maximum slope of: A. 1 inch of ramp for every foot of rise in height. B. 1 foot of ramp for every inch of rise in height. C. 10 inches of ramp for every 2 inches in height. D. 1 foot of ramp for every foot of rise in height.

103. The OT practitioner who is measuring the strength of a patient‟s three-jaw-chuck grasp pattern must know how to use a(n): A. Aesthesiometer B. Pinch meter C. Dynamometer D. Volumeter

103. When planning intervention for individuals in the acute phase of cardiac rehabilitation, it is MOST important for the OT practitioner to select activities that: a. can be accomplished without causing fatigue b. decrease the effects of prolonged inactivity c. promote strength, range of motion and endurance d. can be carried out independently after discharge

104. A person with a long history of Parkinson‟s disease is experiencing considerable fatigue during the day. The OT practitioner‟s MOST appropriate response to help the person maintain his or her level of function is to teach the person how to: A. "work through" the fatigue B. Perform desired activities in a simplified manner, to conserve energy C. Perform additional exercises to increase energy level D. Eliminate activities and reduce activity level as much as possible

104. While working with child who has a neuromuscular disorder, the OT practitioner places the child in a sitting position on therapeutic ball, starts moving the ball and asks the child to reach for a toy while sitting on the moving ball. The primary purpose of this activity is MOST likely: a. increasing upper extremity strength b. facilitating postural reactions c. decreasing tactile defensiveness d. improving visual perception

105. An OTR is working on sitting balance with an individual with C6 quadriplegia. The BEST position for the individual‟s hands to be in when using them for support is to have the fingers: a. extended and adducted b. flexed at all joints c. extended and abducted d. adducted and flexed only at the metacarpal phalangeal joints

107. An individual uses a mouthstick when working with a computer. Which of the following devices will prevent the mouthstick from accidentally striking other keys? A. A moisture guard B. A keyguard C. An auto-repeat defeat D. One-finger-access software

108. A child with CP demonstrates poor head control, high LE extensor tone, and high lower extremity tone, and high UE flexor tone. The BEST device for positioning this child for feeding is a: A. Prone stander with lateral trunk supports B. Corner chair with head support and padded abductor post C. Wedge that positions the hips in 15 degrees of flexion when the child is supine D. Bolster chair without back support

108. A method that an OT practitioner can use to document total finger flexion without recording the measurement in degrees would be to: A. Measure the passive flexion at each joint and total the numbers B. Measure the distance from the fingertip to the distal palmar crease with the hand in a fist C. Measure the active flexion at each joint and total the measurements D. Measure the distance between the tip of the thumb and the tip of the fourth finger

11.A school-age child demonstrates aggressive and disruptive behavior in school, which is a result of a low sensory threshold. Which of the following suggestions would be MOST useful to discuss with the teacher regarding an upcoming class trip by bus to the zoo? A. Review the bus rules with the child and apply consequences consistently B. Let the child sit at the front of the bus and use a tape player and earphones C. Give the child the responsibility of monitoring classmates as "bus patrol" D. Let the child set the criteria for a successful trip and provide a reward if the criteria are met

110. A home health OT is working with an individual who is ambulatory but demonstrates poor balance. The individual has a walker, a standard cane and a wheelchair at home, but financial constraints have prevented any home modifications. Which of the following ambulatory methods would be MOST appropriate for use during meal preparation training? A. Use a standard cane B. Use a walker C. Use a wheelchair D. Hold on to counters and walls

110. While running a nutrition awareness group, an OY practitioner observes that one member tends to monopolize the discussion be frequently interrupting. Which intervention would be NEST to implement after other, more conservative approaches have been unsuccessful? a. Sit beside the person who is monopolizing and touch his or her hand or arm as a reminder not to interrupt others who are talking. b. Confront the individual‟s behavior: Are you aware that your frequent interruption prevents others from having a chance to contribute? c. Redirect the individual: Now let‟s hear what others have to say about this. d. Restructure the task: Select a group activity that requires sequential turn taking.

111. When there is not a referral for OT services, it is MOST important for the COTA involved in the provision of services to know that: A. The OTR is operating outside the scope of practice and regulating agencies should be notified. B. The OTR must assume responsibility for all OT services delivered C. A written letter of consent must be received from the patient or a significant other D. The COTA should seek a referral from the patient‟s family physician

112. Which of the following is the BEST instruction to impart to a caregiver regarding how to propel a wheelchair down a steep ramp? a. tip the wheelchair backward and guide it down the ramp backwards b. tip the wheelchair backward and guide it down the ramp forwards c. allow the patient to propel the wheelchair independently d. obtain the assistance of a second individual

114. When administering an evaluation of upper extremity function to a newly admitted patient with Guillain-Barre syndrome, it is MOST important to: A. Test proximal muscle strength first B. Perform the evaluation over several sessions C. Include sensory testing D. Evaluate range of motion

115. An OT practitioner realizes that an adult worker with a developmental disability is having difficulty learning an assembly sequence. The practitioner decides to use backward chaining. Backward chaining can BEST be implemented by: A. Encouraging the individual to reverse the packaging sequence B. Having the worker put only the last piece into the game package C. Putting only the pencil or the pad into the game box D. Having the OT demonstrate and repeat the correct sequence before each of the worker‟s attempts

116. An early intervention OT practitioner is working with a toddler whose significant physical disabilities have limited the child‟s ability to explore the environment. The BEST "low-tech" assistive technology play aid to allow the child to experience cause and effect and some control over an aspect of his or her environment would be: A. A tape recorder for the child to listen to music. B. A switch-adapted battery-operated toy car that knock down a block tower C. Storybook software for use on a computer D. Powered wheelchair

117. An OT practitioner is planning to use remedial strategies to prepare individuals treated in a psychosocial setting for job hunting. The activity MOST consistent with this approach is: A. Reviewing an interest checklist B. Holding a class about job-seeking strategies C. Modifying the work environment to reduce stress D. Using an expressive group magazine collage using pictures of different type of jobs

117. An individual consistently confuses white glue with white grout during a tile activity. Which of the following actions would be consistent with an activity adaptation approach? a. Review with the individual the difference between glue and grout b. Replace the white glue with blue glue c. Avoid the use of white tiles d. Complete the last step of the activity (applying grout) for the individual has learned how to apply grout

118. A child has mastered brushing her teeth with the OT practitioner giving verbal and physical cues. What would be the NEXT step in the process of reducing the intrusiveness of cues? A. Verbal cues B. Verbal and gestural cues C. Physical cues D. Verbal and physical cues

118. A third grade student receives direct OT services provided through the public school system. Which of the activities should the OT practitioner recommend to the gym teacher to BEST consolidate the child‟s skills in spatial organization and motor planning? a. relay races b. obstacle courses c. the balance beam d. freeze tag

119. A patient who is being discharged from a rehabilitation center to home has Parkinson‟s disease and is at risk for aspiration. When instructing the primary caregiver in proper positioning during feeding, the OT practitioner should recommend: a. feeding the patient in bed in a supine position b. seating the patient upright on firm surface with the chin slightly tucked c. positioning the patient in a semireclined position in reclining chair d. feeding the patient in bed in a sidelying position

120. A patient who sustained head trauma is receiving an OT program of repetitive pegboard, paper and pencil tasks, and computer activities to remediate attention and memory deficits. The type of client MOST likely to benefit from this type of cognitive remediation is one who has: A. Cognitive deficits which must be treated within a short treatment time frame B. Awareness, minimal deficits, and learning potential C. Difficulty transferring learned skills to new situations D. A history of cognitive deficits resulting from a head trauma years ago

122. A child with a diagnosis of mental retardation is currently learning to independently tie her shoes. The facilitated generalization of this skill, the OT practitioner should: a. fit the child‟s shoes with Velcro closures b. have the child practice tying her shoes at home as well as in school c. use a backwards-chaining technique d. provide brightly colored shoelaces

122. According to Signe Brunnstrom, a person who demonstrates developing spasticity on the hemiplegic side of the body with weak, associated movements in synergy and little active finger flexion would be in which stage of recovery? A. One B. Two C. Three D. Four

122. An OT practitioner is interviewing a client who believes she is suffering from chronic low back pain. As part of the educational process, the OTR explains the differences between acute versus chronic pain to the client. Chronic pain is: A. Pain that is associated with an inflammation or irritation that lasts for a brief period of time. B. Pain as a result of disease or injury that persists for long segments of time and has not resolved itself in the anticipated time. C. Pain as a result of surgery that lasts for hours, days, or weeks. D. Pain that presents itself through motor behaviors such as limping.

127. Prevention of cumulative trauma disorders (CTD) in the primary focus of an OT practitioner who is working as an industry consultant. The MOST appropriate way to reduce risk of CTD in an industry where there is heavy keyboard use is to: a. teach employees to identify the symptoms of cumulative trauma disorder early. b. educate employees about ergonomic adaptations including correct typing techniques, posture, hand positioning, and equipment modification. c. provide inexpensive resting splints to employees to rest hands and wrists at night if symptoms appear. d. instruct employees in exercise routines to increase strength in weak upper extremities.

128. A nonspeaking person who uses a wheelchair is suddenly making many errors on the augmentative communication device but experienced no difficulty the previous day. Which of the following is the FIRST step the OT practitioner should take in responding to this problem? A. Refer the person to physician for evaluation B. Reposition the person in the wheelchair to allow optimal range of motion C. Reassess the person‟s communication abilities D. Replace the communication device

128. The MOST appropriate treatment sequence for an OT practitioner to follow when providing a cold pack to an individual with edema of the hand is: A. Precede the cold packs with purposeful activity B. Provide the cold packs followed by purposeful activity C. Provide the cold packs as the main focus of intervention D. OT practitioners should never provide this type of intervention

129. A resident of a long-term care facility is being seen by the OT practitioner in the mornings to help the resident reestablish dressing routines after a period of illness. The client is in a weakened condition and has mild cognitive deficits. The BEST way to structure the task is to: A. Have the resident select the clothing they prefer, then dress the client B. Have the resident dress in bed with garments which are stretchy and one size larger than usual; preview each step of the process with the resident C. Have the resident walk to retrieve clothing garments and encourage independent performance D. Place clothing within close reach of the resident, encourage the resident to proceed as you provide distant supervision

13.A Grade 2 child has a diagnosis of muscular dystrophy. The child operates a manual wheelchair, but his mobility is slow because of muscle weakness. The OT should consider a powered wheelchair when the: A. Child starts junior high school and will be expected to switch classrooms several times daily B. Child‟s speed over long distances becomes less than that of a walking person C. Child‟s home can be made accessible for a power wheelchair D. Child becomes unable to propel a manual wheelchair

13.The OT practitioner has just completed observation of a child eating lunch. Which of the following statements BEST describes the OBJECTUVE observations? A. "The child did not appear to like the food presented." B. "The child demonstrated tongue thrust." C. "The child was uncooperative and kept pushing the food out of her mouth." D. "The child was obviously not hungry at the time."

130. An individual who is s/p total hip arthroplasty (posterolateral approach) is working on independence in lower extremity dressing. Which of the following instructions is MOST important to convey to this individual? A. Sit during dressing activities B. Avoid internal rotation and adduction of the involved hip C. Use a long-handled shoe horn and dressing stick D. Wear shoes with elastic laces

130. An individual with amyotrophic lateral sclerosis (ALS) has asked an OT practitioner how to maintain strength in a weak (fair plus) wrist extensors. Which is the MOST appropriate intervention for the OT practitioner to recommend? a. Cock-up wrist support b. Playing Velcro checkers to tolerance c. Active range of motion for wrist daily without resistance d. Wrist extension exercises several times a day against maximal resistance

131. A patient who has had a CVA has difficulty using his left upper extremity for reaching activities because of fluctuating muscle tone. According to the Neurodevelopmental Treatment (NDT) approach, one of the MOST effective ways to teach a person to normalize high muscle tone in affected extremities prior to functional activities is by: A. Placing a weighted cuff on the extremity B. Weight bearing through the upper extremity is sitting or standing C. Using the unaffected arm for all reaching activities D. "forced use" of the affected extremity

131. An OT practitioner is using a sensory integration approach with a group of regressed individuals with limited attention spans. Most group members can tolerate a group situation for nor more than a half-hour. Which of the following activities would be BEST for beginning the session? A. Go around the circle and ask each patient to introduce himself/herself B. Pass around a scent box and ask each patient to smell the contents C. Ask each patient to select a favorite poem and read it D. Discuss the lunch menu and heathy eating habits

131. The OT practitioner is treating a person with mild carpal tunnel syndrome. The MOST important instruction for the therapist to give the patient is to avoid: A. Extension B. Flexion C. Ulnar deviation D. Radial deviation

132. A therapist is working with a patient who has had an UE amputation to determine whether a hook terminal device (TD) or a functional prosthetic hand would be most appropriate for the patient. The patient‟s primary concern is his ability to return to work and function as a carpenter. The MOST important factor in the OT‟s recommendation would be that: A. A functional prosthetic hand has a better cosmetic appearance B. A hook provides better prehensile function and allows greater visibility of objects C. A hook weighs less than a hand D. A functional hand is covered by a rubber glove that stains easily

132. Which of the following is the MOST important adaptation to recommend to an individual returning home following a total hip replacement? 126 A. Move items form high cabinets to lower locations B. Obtain a raised toilet seat C. Place high-contrast tape at the edge of each step D. Install a handheld shower head

133. A hospital‟s public relations department plans to take some pictures of the OT staff working with patients. Before proceeding, which of the following MUST be obtained? A. The correct spelling of the patients‟ names for the photograph caption B. The patients‟ written consents to take the photographs and use them for publicity C. The department head‟s written consent to take photographs and use them for hospital purposes D. The correct spelling of the patient‟s diagnoses and names for the photographs‟ captions

133. An OT practitioner is performing an assistive technology intervention with a client who is has severe limitations of motor function resulting from CP. The FIRST function of the OT in this process is to: a. identify the most appropriate commercially available forms of assistive technology b. identify the abilities, needs, and life goals of the client c. select the appropriate method of accessing the technology d. modify the assistive technology device to meet the needs if the client

134. An OT practitioner requests that an OT student treat a client with a condition involving the upper extremity. The OTR suggests the use of contrasts baths, retrograde massage, and pressure wraps. The OT student can consider these interventions a PRIMARY technique to address: a. heterotopic ossification b. edema c. wound healing d. scar management

134. When a fifth grader with hypertonicity is seated for schoolwork, she tends to adduct her legs and extend her hips and spine. The BEST way for the OTR to position the child in order to give her better postural control in sitting would be: A. Tilted forward 20 to 30 degrees B. Upright C. Reclining 45 degrees D. In a lateral tilt of 45 degrees

135. An OT is running a group for individuals who have difficulty managing anger. Based in a cognitive-behavioral frame of reference, which of the following steps would the OT BEGIN with? a. Discuss the benefits of alternative beliefs about anger and responses to anger b. Develop awareness about what produces anger and how the client respond to anger c. Role play a situation that presents minimal difficulty to group participants d. Role play a situation that present significant difficulty to group participants

135. An individual has been instructed to place towels, one at a time, on a high shelf in order to increase shoulder flexion. The individual is able to easily place 10 towels. Which of the following modifications would MOST effectively improve endurance in the shoulder flexors? A. Place the towels on a higher shelf B. Increase the number of towels from 10 to 20 C. Place the towels on a lower shelf D. Add a 1-pound weight to each arm

136. An OT practitioner is performing discharges teaching with a client who sustained a deep laceration of the median and ulnar nerves. The practitioner informs the clients that the two tactile senses that are the earliest to recover after a peripheral nerve injury are: a. vibration and pain b. temperature and pain c. light touch and proprioception d. tactile localization and proprioception

136. An individual with C4 quadriplegia is able to independently use a mouth stick to strike keys on a computer keyboard for 15 minutes. To upgrade this activity, therapist should: A. Provide a heavier mouth stick B. Have the individual work at the keyboard for 30 minutes C. Progress the individual to a typing device that inserts into a wrist support D. Teach the individual how to correctly instruct a caregiver in use of the keyboard

137. A client is having difficulty getting around within her home as a result of low vision. The MOST appropriate strategy to improve accessibility would be to: a. instruct the client to sit while performing ADL b. provide strong color contrast at key areas to identify steps, pathways, etc. c. recommend the client arrange to get assistance when moving within her home d. recommend training

137. A toddler has feeding difficulties because of deficient oral-motor control and oral defensiveness. The child‟s parents would like to eat family meals together and include such foods as meats (cut up), sandwiches, and vegetables. The OT practitioner explains to the parents that they can start to introduce these foods when their child is able to tolerate which foods? a. Apple sauce and mashed bananas b. Dry cereals with milk c. Strained fruits and vegetables d. Scrambled eggs

138. A patient with neurological deficits has been unable to carry over skills learned previously in therapy and has exhibited no capacity to learn new information. The MOST appropriate intervention approach to improve ADL functioning for this patient would be: a. repetitive practice of simple ADL under therapist guidance b. recommendation of environmental adaptations and assistance for ADL c. ADL training in the familiar home environment d. forward or backward chaining techniques

139. An OT practitioner is instructing a client with a total hip replacement how to perform a passenger side car transfer. Which of the following BEST represents the initial steps of this transfer? a. Stand the body parallel to the car, hold onto a stable section of the car, lift and place the left leg into the car, and slowly sit and follow with opposite leg. b. Back up the body to the passenger seat hold onto a stable section of the car extend the involved leg, and slowly sit in the car. c. Back up the body to the passenger seat, hold into a stable section of the car, flex both legs simultaneously, and slowly sit in the car. d. Back up the body to the passenger seat, hold onto a stable section of the car, flex the involved leg, and slowly sit in the car.

139. An individual alternately exhibits laughing and crying throughout a treatment session. This behavior should be documented as: A. Mania B. Emotional lability C. Paranoia D. Denial

14.An OT practitioner conducting a hard assessment would use which instrument to measure the strength of the three-jaw chuck: a. an aesthesiometer b. a pinch meter c. a dynamometer d. a volumeter

14.Which of the following instructions should the OT practitioner follow when administering standardized tests to young children? A. Test in a stimulating environment B. Follow test manual directions C. Always administer test in a single session D. Carry on a conversation with the child

140. A second grade child has a diagnosis of muscular dystrophy. The child operates a manual wheelchair, but his mobility is slow because of muscle weakness. The OT should consider a powered wheelchair when the: a. child starts junior high school and will be expected to switch classrooms several times daily b. child‟s speed over long distances becomes less than that of a walking person c. child‟s home can be made accessible for a power wheelchair d. child becomes unable to propel a manual wheelchair

140. The OT practitioner is instructing a patient who has had a myocardial infarction in energy conservation techniques. The BEST example of limiting the amount of work needed for a task is: A. Using a side-loading washer B. Wearing permanent-press clothing C. Using an extended-handle dustpan D. Using good body mechanics

141. A patient needs assistance with memory problems. The strategy BEST reflects an external compensation method of intervention is: A. Teaching the person to retrace steps mentally to stimulate memory. B. Teaching the person to use a diary or log. C. Training the person to repeat important pieces of information aloud to aid memorizing. D. Working with a memory training computer program.

142. An OT practitioner is fabricating a splint for a client who sustained a low-level ulnar nerve injury. The OTR explains that the PRIMARY purpose of an ulnar nerve splint is to: a. block hyperextension of the PIP joints and allow PIP flexion. b. block hyperextension of the MCP joints and allow MCP flexion. c. block PIP flexion and allow for PIP hyperextension. d. block MCP flexion and allow for MP hyperextension.

145. An OT practitioner is instructing a patient with left hemiplegia and unilateral neglect to put on a t-shirt. The BEST sequence to teach the patient would be: a. (1) place left had into sleeve and pull up sleeve past elbow; (2) place right hand into sleeve and pull up sleeve; (3) pull shirt up over head; (4) pull shirt down over trunk. b. (1) position shirt on lap; (2) place left hand into sleeve and pull up sleeve past elbow; (3) place right hand into sleeve and pull up sleeve; (4) pull shirt up over head. c. (1) position shirt on lap; (2) place right hand into sleeve and pull up sleeve past elbow; (3) place left hand into sleeve and pull up sleeve; (4) pull shirt up over head. d. (1) pull shirt up over head; (2) place left arm into sleeve; (3) place right arm into sleeve; (4) pull down shirt over trunk.

145. An individual in the late stages of AIDS is bedridden, and flexion contractures have begun to develop in his right hand. Which of the following types of splints would be MOST appropriate for this individual? A. Dorsal wrist splint B. Functional position resting splint C. Volar wrist cock-up splint D. Dynamic finger extension splint

146. A woman who had a CVA exhibits random movements in all four extremities. What is the MOST appropriate switch to use on the controls for her wheelchair? A. Infrared switch B. Slip and puff switch C. P switch D. Rocking lever switch

146. An OT practitioner is working on sequencing skills with a young patient who is s/p TBI. The MOST effective activity to promote development of these skills is: a. leather stamping using tools in a random design b. stringing beads for a necklace, following a pattern c. putting together a 20 piece puzzle d. playing Concentration

146. While evaluating a middle-aged individual, the therapist asks the client about the grade school he or she attended. This is an example of the OT practitioner attempting to obtain data pertaining to the individual‟s: A. Retention B. Remote memory C. Orientation D. Recent memory

147. An elderly client was hospitalized for an episode of acute depression after the death of his spouse. The client is preparing for discharge and would like to return to his home but is fearful of spending his days alone. The BEST environment for the client to continue socialization and participation in meaningful occupation would be: A. Partial hospitalization B. Adult day care C. Home health care D. Psychosocial rehabilitation center

148. An OT practitioner is preparing an individual with burns to perform a home program of positioning and splinting. To prevent deformity, the OT practitioner would be MOST likely to recommend that the individual: A. Discontinue the positioning and splinting program upon returning home‟ B. Continue the same positioning and splinting program that was indicated before discharge C. Continue with the positioning and splining program only during the day D. Continuing with positioning and splinting program only during the night

149. An individual with lower extremity paralysis uses a standard annual wheelchair and is ready to be discharged to home. During the home evaluation, the OY practitioner notes that the entrance to the bathroom is 32 inches wide and the toilet is 15 inches high. Which of the following recommendations will MOST facilitate use of the bathroom for this individual? a. Widen the doorway b. Raise the toilet c. Widen the doorway and raise the toilet d. Widen the doorway and lower the toilet

15.An individual was unable to achieve the goal "the client will initiate two requests to other group members for sharing materials within a 1- week period." The NEST revised goal is: A. "The client will initiate two requests to other group members for sharing group materials within a 2-week period." B. "The client will initiate one request to one other group member for sharing or using group materials within a 1-week period." C. "The client will initiate two requests to each of the five group members for sharing one group tool within 2 weeks." D. "The client will say hello to the group leader at the start of each group session."

150. A 9-year-old with a diagnosis of mental retardation has been receiving OT in order to become independent in dressing and feeding and is now being discharged. The BEST advice for the OT practitioner to give his parents in order to maintain the child‟s independence in dressing at home is: A. Give assistance when the child asks for it to provide a successful experience B. Give praise for completed dressing; do not help the child get dressed C. Give him oversize clothing with Velcro closures and large snaps D. Give him verbal prompts when needed and help him with closures only

151. The MOST effective method of compensation for both unilateral neglect and absence of sensation in an upper extremity with good motor control is to: A. avoid the use of sharp tools or scissors and to avoid extreme water and temperatures. B. wear noisy bracelets on the wrist or ankle as a reminder to visually scan toward the affected side. C. use an electric shaver. D. wear elbow pads on the affected side.

152. An OT practitioner Is educating the parents of a high school age patient who is being discharged from the burn center to his home environment after an 8-month inpatient stay for severe burns. The therapist is reviewing common psychological reactions that occur is burn victims. The therapist will MOST likely educate the client and family about: a. the possibility of decreased range of motion and sensation. b. the potential for depression and low self-esteem. c. the likelihood of violent behavior and sexual acting out. d. the potential for delirium and fatigue.

152. When preparing to discharge a child with juvenile rheumatoid arthritis, what is the MOST important information to share with the child‟s teacher? A. A summary of the child‟s cognitive and visual perceptual skills B. Methods of accommodation in the classroom C. Information on the child‟s range of motion status D. A summary of the child‟s progress in OT

153. A patient is being discharged after hospitalization for a cerebrovascular accident and a 2-week inpatient rehabilitation program. He requires minimal assistance in advanced ADL but is independent in most basic ADL, and his RUE function is improving. He plans on eventually returning to work as a cashier. What would be the MOST appropriate recommendation concerning OT services? A. Home health OT B. Outpatient OT C. A work-hardening program D. Discontinuation of OT services

153. An individual being evaluated for meal preparation skills demonstrates minimal to moderate difficulty when asked to prepare a macaroni and cheese dish. Which of the following is the MOST appropriate cooking activity to use for the next OT session? a. Making baked chicken and mashed potatoes b. Making a peanut butter and jelly sandwich c. Preparing a can of soup d. Making instant pudding

154. A school-age child with fine-motor difficulties is ready for discharge from outpatient OT services. Which of the following is the MOST important to focus? a. The child‟s interests and hobbies b. The child‟s writing, dressing and self-feeding skills c. The child‟s academic achievement d. The availability of the child‟s parents for follow up services

155. An OT practitioner is developing transition activities for a group of 16-year-old students diagnosed as trainable mentally retarded. Which of the following activities would be BEST for addressing goals related to transition? A. Role-play ordering food in the classroom B. Go out for lunch to a fast-food restaurant C. Order a take-out lunch by phone D. Select lunch items from a picture menu in the classroom

156. A young individual with MS is about to be discharged to home. The client is independent in bathtub transfers using a grab bar. The MOST important self-care recommendation the OT practitioner can make regarding bathing is to: A. Use cool water B. Use moderately heated water C. Take showers and avoid bathing D. Bathe at the sink with a basin

156. An individual with ALS swims three times a week to maximize strength and endurance. Initially able to swim for only 10 minutes, the individual is now able to swim 20 minutes without becoming fatigued. The NEXT step is: a. continue the program of swimming 20 minutes three times a week. b. decrease swimming frequency to two times a week. c. increase swimming time to 25 minutes or to tolerance. d. provide adaptive equipment that will enable the individual to swim using less energy.

157. In evaluating an adolescent with psychosocial problems, an OTR would be MOST likely to begin the process by screening the adolescent‟s level of functioning in which areas? A. Play and social behavior, overall development, and visual motor skills B. Socialization, task performance, daily living skills, and time management C. Interest in work; leisure, and self-care D. Motor skills, sensory processing, and cognition

158. A child with limited upper extremity range of motion is being readied for discharge. The MOST important home adaptation for the OT practitioner to recommend concerning use of the toilet is: a. installation of safety bars next to the toilet seat. b. mounting of a wide base toilet seat. c. placement of a skid proof stepping stool next to the toilet. d. installation of a bidet with spray wash and air drying mechanism.

158. An 8-year-old is being treated in OT for social withdrawal and depression. At the time of discharge, the BEST recreational activity for the OT practitioner to recommend for the child is: A. Swimming lessons B. Boy scouts C. Computer games D. Piano lessons

159. An OT practitioner uses a remediation of functional performance deficits approach in addressing individuals treated in a psychosocial setting. The activity that is MOST consistent with this approach is: A. An expressive group magazine collage\ B. A class about job-seeking strategies C. The modification of the environment to provide familiar visual cues D. A review of the individual‟s balance of time among ADL, work, and leisure activities.

16.An OT practitioner is treating a client who demonstrates pain, progressive weakness of the thumb, atrophy of the thenar muscles and numbness and tingling in the thumb, index, long and half of the ring fingers. The client is not experiencing proximal upper extremity limitations so the practitioner will MOST likely suspect problems with which of the following? A. Ulnar nerve B. Median nerve C. Radial nerve D. Brachial plexus

160. A child short-term goal is to "demonstrate increased manipulation skills by opening a 3 inch screw top jar independently." The MOST important tool the OTR will need to reassess the child‟s progress is: a. a goniometer b. a 3-inch screw top jar c. a dynamometer d. a developmental fine motor assessment

162. An adolescent with mental retardation is planning to enter a supported employment program in the community after leaving school. Which area of intervention would the OT practitioner be MOST likely to focus on? A. Developing the student‟s leisure interests and play skills. B. Developing the student‟s vocational interest, social skills, and community mobility skills. C. Facilitating development of the student‟s gross motor skills. D. Facilitating development of the student‟s fine motor skills.

163. An OTR and COTA are collaborating on a discharge summary. Which of the following is the MOST appropriate contribution for the COTA to make? a. Describe the treatment received b. Make the referral for community based services c. Compare the initial and final status d. Formulate the OT follow-up plans

163. The discharge disposition of an individual is: "The patient will return home upon discharge and receive services from the Bureau of Vocational Rehabilitation for vocational placement." This type of discharge plan is BEST described as: A. A follow-up plan B. Aftercare C. A home program D. Home health services

181. A fieldwork supervisor is completing the final evaluation of a student who is in the last week of level-11 fieldwork, the supervisor must determine that the student is functioning: A. Slightly below entry level B. At or above the minimal entry level of competence C. At an intermediate skill level based on the Occupational Therapy Roles D. At an advanced skill level based on the Occupational Therapy Roles

164. Which of the following statements would BEST explain the purpose of a prevocational evaluation program to a new participant? A. "The program will help you to learn about your interests, talents, and skills for assembly jobs" B. "This program will help you to learn about the skills you have that are needed on MOST jobs and about your potential work" C. "This program will help you identify the responsibility you have to your employer while you are in treatment and to inform your employer of these responsibilities" D. "This program will help you to develop skills for getting a job"

165. An OT practitioner is treating a client who has demonstrated a decrease in paranoid behavior. The BEST way to document this change is: a. The patient is no longer as afraid of men. b. The patient has not accused any men of attacking her this week. c. The patient is participating more actively in beauty group. d. The patient will tolerate sitting next to a man in group one time this week.

165. An individual who is being discharged in one week is functioning at Allen‟s Cognitive level 4 and needs to take 2 different psychotropic medications twice daily. Which of the following is the MOST appropriate discharge recommendation? a. instruct the client to take medication at 9 AM and 9 PM b. instruct the client to take "one white and one blue pill" with the morning and evening meals c. instruct the caregiver to remind the client to take medication twice daily d. instruct the caregiver to place pills into client‟s hands at the designated times

165. In preparing a patient with a unilateral below-knee amputation for discharge from a rehabilitation facility, the MOST important adaptive equipment for the OT to recommend is: A. Lightweight cooking utensils B. A tub bench and toilet rails C. Long-handled dressing devices D. A reacher

166. "The patient arrived without her walker 3 out of 3 days this week." The MOST appropriate section of a SOAP note for the OT practitioner to place this statement is the: A. Subjective B. Objective C. Assessment D. Plan

166. An elderly has Alzheimer‟s disease and is about to be discharged to home, where she lives with her husband. She does not always recognize her children, shows a tendency to wander, and has frequent episodes of incontinence. Which of the following is the MOST important item for the OT practitioner to include in the family discharge planning conference? a. strategies the patient can use for incontinence b. strategies that the husband can use to prevent the patient from wandering c. strategies that the patient can use to prevent wandering d. reality orientation techniques to increase recognition of her children

166. An individual has made gains in fine-motor coordination in the past week. Which of the following statements belongs in the assessment section of a SOAP note? a. Patient performed the Nine Hole Peg Test in 20 seconds. b. Patient reports being able to button the buttons on most items of clothing. c. Patient is demonstrating gradual improvement in fine motor coordination. d. Family reports patient is performing more fine motor activities independently.

166. The OT practitioner is instructing a patient who has had a myocardial infarction (MI) in energy conservation techniques. The BEST example of limiting the amount of work needed for a task is: A. using a side-loading washer. B. wearing permanent press clothing. C. using an extended handle dustpan. D. using good body mechanics.

167. An OT practitioner is working with an individual who has identified alcohol abuse as a contributing factor to the depression that he has been experiencing. The practitioner is discussing discharge plans with this individual. At discharge, the MOST appropriate type of group to refer this individual to is a(an): a. advocacy group b. self-help group c. support group d. psychotherapy group

168. A COTA and OTR are planning for the discharge of a child from an early intervention program. What advice to the parents will MOST likely result in effective carryover of a therapeutic home program? a. Set aside a certain time daily to focus on therapeutic activities. b. Incorporate therapeutic activities into family routines. c. Provide therapeutic activities on an as needed basis. d. Do therapeutic activities daily, but vary the time of day.

168. An OT practitioner is instructing a client with a total hip replacement how to perform a passenger side car transfer. Which of the following BEST represents the initial steps of this transfer? A. Stand the body parallel to the car, hold onto a stable section of the car, lift and place the left leg into the car, end slowly sit and follow with opposite leg B. Back up the body to the passenger seat, hold onto a stable section of the car, extend the involved leg, and slowly sit in the car. C. Back up the body to the passenger seat, hold onto a stable section of the car, flex both legs simultaneously, and slowly sit in the car D. Back up the body to the passenger seat, hold onto a stable section of the car, flex the involved leg, and slowly sit in the car.

168. An individual was unable to achieve the goal "the client will initiate two requests to other group members for sharing materials within a 1-week period." The BEST revised goal is: A. "The client will initiate two requests to other group members for sharing group materials within a 2-week period." B. "The client will initiate one request to one other group member for sharing or using group materials within a 1-week period." C. "The client will initiate 2 requests to each of the 5 group members for sharing one group tool within 2 weeks." D. "The client will say hello to the group leader at the start of each group session."

169. An OT practitioner in a long-term care facility would like to provide an activity to engage a number of residents with dementia who wander and pace the halls throughout the day. The BEST type of activity to plan for these residents would be: A. Reminiscing about previous jobs B. Walking as part of a walking club C. Singing oldies in a group D. A craft activity requiring concentration

17.A child is lacing a series of geometric beads from a stimulus card and is unable to identify a moon-shaped bead when it is turned sideways on the table. This MOST likely indicates difficulty with: A. Figure-ground perception B. Form constancy perception C. Position in space perception D. Visual sequencing

194. An OTR is working with an individual who tests positive for HIV. The individual is working on a copper tooling project when he cuts his finger on the edge of the copper. Which of the following are the MOST APPROPRIATE precautions to follow? A. Suicidal precautions B. Universal precautions C. Escape from unit precautions D. Medical precautions

17.An OT practitioner is performing an environmental assessment to determine accessibility for a client who will be returning home. The FIRST step in this process is to: A. Identify the barriers to movement and function in the home environment B. Identify an analyze the tasks and occupations that the client will be performing in the home C. Identify the aspects of the environment which support movement and function in the home D. Determine the social environment of the client

170. A home health OT is working with individual who is ambulatory but demonstrates poor balance. The individual has a walker, a standard cane and a wheelchair at home, but financial constraints have prevented any home modifications. Which of the following ambulatory methods would be MOST appropriate for use during meal preparation training? A. Use a standard cane B. Use a walker C. Use a wheelchair D. Hold on to counters and walls

170. An OT practitioner working in a drug and alcohol rehabilitation center is educating clients about discharge options. The PRIMARY expectation for becoming a member in a self-help group for alcohol problem is: a. members are encouraged to tell the other members their names and where they live and work b. members share their experiences and struggles with alcohol use c. members are required to attend a set number of meetings d. members are encouraged to give advice to others

172. An OT practitioner is working with a client diagnosed with a mild sprain. The client cradles her hand and appears to be hypersensitive to light touch. The individual also presents with edema, pain, shiny skin, and excessive dryness of the extremity. Based on this, the OTR assumes that the client is MOST likely suffering from: A. Neuromas B. reflex sympathetic dystrophy C. carpal tunnel syndrome D. desensitization

173. An OT has been hired to develop social skills training programs for persons with long-term mental illness in a community mental health facility. The OT needs to select a behavior to assess as an outcome measure. Which would BEST indicate that the program was successful in achieving goals for this population? A. Improved ability to balance rest, work, and play and leisure B. Improved verbal and nonverbal communication skills C. Improved ability to identify areas for vocational exploration D. Improved ability to perform daily self-care and home management activities

173. In establishing a wellness program for older adults, the OT practitioner is MOST likely to incorporate activities that: a. improve weakness following a CVA b. increase a physical activity and fitness c. improves social skills for depressed elders d. increase independent performance

174. A toddler diagnosed with developmental delays does not finger-feed when presented with food in the clinic. The BEST way to obtain further information about his feeding skills is to A. interview his parents to determine his favorite foods. B. observe him in his home during feeding time. C. review his chart for food allergies. D. repeat the observation in a quiet area (in order to minimize distractions).

174. Which of the following is the BEST activity for reducing the physical symptoms of muscle tension associated with anxiety disorders? A. Copper tooling B. Aerobic exercise C. Line dancing D. A woodworking kit

175. An OT practitioner is leading a discussion with a group of individuals who are diagnosed with major depression. The MOST helpful approach for the therapist to take is to: A. Be upbeat, positive, and cheerful when encouraging the individuals to discuss their feelings B. Offer even-tempered acceptance, reflecting back what is heard without agreeing the situation is hopeless C. Remain silent and still while the individuals are describing their feelings D. Allow the individuals to structure and lean the group discussion

175. An OT practitioner is transferring a client with hemiplegia from a wheelchair to an elevated mat. The client is able to place both feet on the floor and move the buttocks to the edge of the wheelchair. The therapist then places one had on the client‟s right anterior pelvis and the other hand on the client‟s left shoulder. The client is set up so the transfer can be performed toward the client‟s stronger side. The client then pushes to a standing position and pivots with the therapist‟s guidance. This is MOST likely an example of a(n): A. independent transfer from wheelchair to mat B. assisted stand pivot, transfer C. pneumatic lift transfer D. dependent stand pivot transfer

176. During group activity, an OT practitioner observed a client making frequent negative comments pertaining to the collage activity that the group is working on. These comments are most likely an indication of: A. Passivity B. Insecurity C. Hopelessness D. Indecision

179. An OT practitioner is working on a feeding program for an individual with amyotrophic lateral sclerosis (ALS) who is in the late stages of the disease process. Which of the following is the MOST appropriate intervention for this individual? A. Provide is rocker knife, plate guard, and nonskid mat B. Implement a pureed diet and allow adequate time for eating C. Emphasize upper extremity strengthening D. Minimize the use of adaptive equipment

179. The OT is working with a patient on an acute care floor when the patient‟s IV equipment disengages, splashing the therapist in the eye with the medication and IV "backwash" fluid. The therapist‟s FIRST response should be to: a. rub the eye and continue treatment. b. rinse the eye with an eye wash or water immediately. c. write an incident report. d. cover the eye with a bandage and contact the immediate supervisor.

180. An advanced-level COTA who has worked at an independent living center for the past 7 years has been offered the position of director of the program. There are no funds to pay for OTR supervision. According to the AOTA, can the COTA accept the position? a. only if the COTA can find some way to fund OTR supervision b. yes, as long as state regulations allow autonomous practice and the COTA recognizes situations that require consultation with referral to an OTR c. no, the COTA cannot work in this practice setting without OTR supervision d. only if the COTA relinquishes use of the credentials "COTA"

181. An OT practitioner is working to reduce the application of restraints for the population of a long-term care facility. The MOST appropriate form of intervention for the OT to provide is: A. Identifying legal issues related to restraint reduction. B. Providing staff education, recommendations, and support for restraint alternatives. C. Investigating incidents of resident abuse related to restraint reduction. D. Assessing the level of risk and liability involved with restraint use.

181. When working with clients who experience low back pain, it is important is practice functional technique such as lifting and carrying. Which of the following BEST represents a correct lifting method? A. Keep both knees straight, flex the back, and keep object an arm‟s distance away from the body B. Bend both knees, keep the back straight, and bring object close to the body when lifting C. Keep both knees and back straight and bring object close to the body when lifting D. Bend one knee while keeping the other leg straight and keep the object arm‟s length away from the body

183. A young individual with MS is about to be discharged to home. The client is independent in bathtub transfers using a grab bars. The MOST important self-care recommendation the OT practitioner can make regarding bathing is to: A. use cool water B. use moderately heated water C. take showers and avoid bathing D. bathe at the sink with a basin

183. While documenting the week‟s OT sessions in an individual‟s chart, an OT practitioner notices that a progress note from 2 weeks ago was not completed. The therapist recalls providing treatment that week and how the patient responded. The ONLY appropriate action for the OTR take is to: a. complete the note using the original date. b. document services provided and date the note as a late entry. c. leave the chart as is without documenting services provided. d. write a brief note stating that documentation was not completed for the specified dates.

184. A client uses a wheelchair and is independent in transfers and basic ADL. With continued OT intervention, he is expected to be able to function independently in the community. The MOST appropriate community living option for him, at this time, would be a(n): a. cradle-to-grave home b. transitional living center c. adult day program d. clustered independent living arrangement

184. An OT manager in a large department is trying to determine which staff will be able to supervise level-11 fieldwork students in the upcoming months. OT practitioners may only be selected to be primary student supervisors if they: A. Are certified OT practitioners with at least 6 months of experience B. Have at least 1 year of experience as a certified OT practitioner C. Are certified by the NBCOT D. Have supervised a level-1 student before the level -11 student

184. An OTR has requested that a COTA document an initial note in the chart of a new patient. The COTA should document which of the following in the initial note? A. The treatment and changes in the patient‟s condition B. The source of the referral, the reason for the referral, and the date the referral was received C. A summary and analysis of the patient‟s assets and deficits D. The projected outcome of treatment

186. An OT practitioner is working in a psychiatric OT department that uses a variety of craft paints, stains, and sharp tools. In order to ensure patient safety, the practitioner MUST complete which of the following activities on a daily basis? A. Label chemicals used within the department B. Complete a tool count of departmental sharps C. Obtain a locked storage cabinet for sharps D. Decline suicidal clients the opportunity to participate in craft groups

186. An OTR is working with a patient that has Medicare part B. The OTR informs the patient that Medicare part B will MOST likely reimburse for assistive devices, such as a wheelchair, if it meets the criteria of: a. increasing functional independence. b. medical necessity. c. maintaining patient function. d. reducing deformity.

187. A physician‟s referral for OT services may be required by which of the following: a. AOTA, federal and state governmental agencies b. federal and state governmental agencies and third-party payers c. third-party payers, individual facilities and AOTA d. AOTA, third-party payers and state governmental agencies

187. An OT practitioner working in a school based setting is interested in training students in level-II fieldwork. Before accepting level-II students, the OT practitioner should have at least: a. 6 months experience b. 1 year experience c. 2 years experience d. 3 years experience

188. A COTA working in outpatient rehabilitation teaches herself how to use paraffin by reading books on physical agent modalities (PAMs), carefully reading the instructions that came with the paraffin 185 bath unit, and practicing on herself for several weeks. Is it now acceptable for this COTA to provide paraffin treatments? A. No, COTA may not administer PAMs B. No, it violates the OT Code of Ethics C. Yes, she has demonstrated service competency D. Yes, only when an OTR is on duty in the facility

188. When there is not a referral for OT services, it is MOST important for the COTA involved in the provision of service to know that: A. The OTR is operating outside the scope of practice and regulating agencies should be notified B. The OTR must assume responsibility for all OT services delivered C. A written letter of consent must be received for the patient or a significant other D. The COTA should seek a referral from the patient‟s family physician

191. An OT practitioner works with an entry-level COTA on an inpatient psychiatric unit. They each work 4 days a week, overlapping schedule only on Mondays. It would be inappropriate for the OTR to ask the COTA to: a. lead the daily craft group b. evaluate clients who are admitted on the weekends c. assist individuals in carrying out their ADL on Saturday and Sunday mornings d. lead a leisure planning group on Saturday afternoon

194. A clinical manager of an OT department is reviewing sterilization policies based in universal precautions. The manager revealed that this policy will MOST likely state that: a. all equipment is to be sterilized annually b. any equipment that has come into contact with body fluid must be sterilized before using the equipment again c. all equipment is to be sterilized at the end of each day d. all equipment is to sterilized after each use

39.When working with a child who exhibits tactile defensiveness, which of the following areas should be evaluated FIRST? A. Reading skills B. Dressing habits C. Social skills D. Leisure interests

195. A hospital‟s public relations department plans to take some pictures of the OT staff working with patients. Before proceeding, which of the following MUST be obtained? A. The correct spelling of the patients‟ names for the photograph caption B. The patients‟ written consents to take the photographs and use them for publicity C. The department head‟s written consent to take the photographs and use them for hospital purposes D. The correct spelling of the patients‟ diagnoses and names for the photographs‟ captions

196. A manager of an OT department is attempting to increase the visibility of the OT department within the setting. This type of promotion is commonly done through internal marketing. In order to market internally, the OT manager would MOST likely employ which of the following? a. a community newsletter b. a presentation to physicians c. a local community workshop d. a booth at a local health fair

196. An OTR and a COTA work in a collaborative relationship. The teamwork between the two professionals is BEST exemplified by which of the following examples? A. The OTR completes the assessment and instructs the COTA to provide a specific intervention B. The COTA updates the OTR on the progress a patient has made in the past week, and both provide information to update the goals C. The COTA gives a progress note to the OTR and the OTR writes the discharge summary based of the progress note D. The OTR tells the COTA what type of equipment to order for a patient and the COTA orders the equipment from a medical equipment company

2. An OT practitioner is evaluating an individual who recently sustained a cerebrovascular accident (CVA). The sensory portion of the test would be invalid for an individual with which one of the following impairments? a. Expressive aphasia b. Receptive aphasia c. Agnosia d. Ataxia

2. An OT practitioner realizes that an adult worker with a developmental disability is having difficulty learning an assembly sequence. The practitioner decides to use backward chaining. Backward chaining can BEST be implemented by: A. Encouraging the individual to reverse the packaging sequence B. having the worker put only the last piece into the game package C. Putting only the pencil or the pad into the game box D. Having the therapist demonstrate and repeat the correct sequence before each of the worker‟s attempts

20.On an assessment report, the OT practitioner documents that a person exhibits elbow flexion strength of grade 1. According to the manual muscle test system of letters and numbers, the word that would be the equivalent of grade 1 would be: A. Absent B. Trace C. Good D. Normal

200. An OT practitioner is performing an environmental assessment to determine accessibility for a client who will be returning home. The FIRST step in this process is to: A. identify the barriers to movement and function in the home environment. B. identify and analyze the tasks and occupations the client will be performing in the home. C. identify the aspects of the environment which support movement and function in the home. D. determine the social environment of the client.

200. OT practitioner spends 15 minutes reviewing a new patient‟s chart and talking to the nurse, who indicates that the patient is preoccupied with finances. As the OT practitioner enters the room, the patient states that he does not want to be seen by any of the therapists because his insurance has run out and he cannot afford to pay for the treatment. Which of the following action would be MOST appropriate for the OT practitioner to take? a. Treat the individual per the physician‟s order and notify the nurse that the man‟s preoccupation with finances continues. b. Do not treat the individual based on his refusal and document the interaction in the chart. c. Treat the individual but do not charge or document the services. d. Do not treat the individual and only charge for the time spent completing the chart review.

21.An OT practitioner is working with a client in a work program setting. What is the FIRST step to achieving the program objective of preventing reinjury within a work program? A. Performing a prework screening B. Learning proper body mechanics C. Participating in work hardening D. Engaging in vocational counselling

22.Which of the following activities would MOST effectively evaluate group interaction skills? A. The clients make individual collages, sharing a set of magazines to complete the activity. B. All group members construct one tower that incorporates all of the pieces provided in a set of constructional materials (e.g., LegosTM, TinkertoysTM, or ErectorTM set). C. All group members work together to make pizza and salad for their lunch that day. D. Each client selects a short-term craft activity from four available samples.

24.A toddler diagnosed with developmental delays dos not finger-feed when presented with food in the clinic. The BEST way to obtain further information about his feeding skills is to: a. interview his parents to determine his favourite foods b. observe him in his home during feeding time c. review his chart for food allergies d. repeat the observation in a quiet area (in order to minimize distractions)

24.An OT practitioner is working with the caregiver of a newly diagnosed client with Alzheimer‟s disease. The caregiver insists on keeping the client out of a skilled nursing facility. In this case, caregiver education is vital. It is important to make the caregiver aware that the early stages of dementia, Alzheimer‟s type, may be detected in behaviors such as: A. Difficulty swallowing food B. Forgetting to turn off the stove burner C. Angry outbursts at close family members D. Restless pacing around the house

26."The patient arrived without her walker 3 out 3 toys this week." The MOST appropriate section of a SOAP note for the OT practitioner to place this statement is the: A. Subjective B. Objective C. Assessment D. Plan

26.During assessment of a 10-month-old child with Down syndrome, the OT notes hyperextensibility of all joints, which MOST likely reflects: A. Increased muscle tone B. Decreased muscle tone C. Anterior horn cell disease D. Muscle and joint disease

27.When providing OT for children who have been diagnosed with a terminal illness, the PRIMARY focus for OT intervention would be: A. Educational activities B. Play and self-care activities C. Socialization activities D. Motor activities

27.While in the hospital, a 48-year-old roofing contractor experienced extrapyramidal syndrome after being placed on neuroleptic medications. The patient is to continue taking the medications after discharge from the hospital. It is MOST important to advise the patient to: a. keep time in the sun as brief as possible b. avoid use of power tools and sharp instruments c. get up slowly from a standing, sitting or lying position d. be aware of the dehydrating effects of caffeinated drinks and alcohol

29.In using an assessment that is "norm referenced" for children, the OT practitioner assumes that the test: a. measures normal behavior of children b. compares performance with a normal standard c. is valid and reliable d. should be used with a normal population

3. An OTR has asked a COTA to identify how a patient spends his leisure time, which leisure activities he especially enjoys, and which others he has participated in that he would be interested in renewing. The MOST appropriate tool for the COTA to use is: A. An evaluation of living skills B. An interest checklist C. An activity configuration D. A self-care evaluation

3. The OT practitioner is treating a person with mild carpal tunnel syndrome. The MOST important instruction for the therapist to give the patient is to avoid: A. Extension B. Flexion C. Ulnar deviation D. Radial deviation

30.An OT practitioner observes a 5 year old child with Down syndrome who has low muscle tone sitting on the floor exclusively using a W sitting position. This observation MOST likely indicates that the child is: A. Developing abnormally B. Using a noncompensatory position to achieve stability C. Demonstrating typical development for a child with Down syndrome D. Using a position normal for a younger child not for a 5 year old child

32.When preparing a home program with the goal of independent toileting for a young child with postural instability, the MOST important adaptation the OT practitioner can recommend is: A. Replacing zippers and buttons with Velcro closures B. Mounting a safety rail next to the toilet C. Introducing toilet paper tongs D. Placing a colorful "target" in the toilet bowl

33.An auto mechanic is currently in a work hardening program after being in a car accident that left him with numerous UE and LE impairments. The ultimate goal for this individual is to return to full employment as an auto mechanic. Which of the following BEST represents a work-hardening activity for the individual? A. Lifting weights B. Working on a mock car engine C. Visiting the work site garage D. Preparing a light lunch for mealtime

33.During a coloring activity, an OT practitioner observes a preschooler stabilizing a crayon between the thumb and fingers. The practitioner MOST accurately documents this grasp as: A. Pincer grasp B. Radial-digital grasp C. Palmar grasp D. Lateral pinch

33.During the evaluation of a 6-month-old baby, the OT practitioner gently pulls the infant from a supine position into a sitting position by the hands. The child demonstrates the ability to hold her head and trunk in alignment against gravity. This observable movement can MOST accurately be described by the OT as: A. Protective reaction B. Flexion righting reaction C. Body righting on body reaction‟ D. Optical righting reaction

36.An OT practitioner is performing a home management evaluation of an ambulatory individual with cerebral palsy (CP) who is cognitively intact but exhibits and ataxic gait pattern. The PRIMARY focus if the evaluation should be on: a. safety and stability b. the individual‟s ability to reach and bend c. whether the individual has adequate strength to perform homemaking tasks d. fatigue and endurance level

36.An OTR has asked a COTA to identify how a patient spends his leisure time, which leisure activities he especially enjoys, and which others he has participated in that he would be interested in renewing. The MOST appropriate tool for the COTA to use is: A. An evaluation of living skills B. An interest checklist C. An activity configuration D. A self-care evaluation

39.An OT practitioner is developing transition activities for a group of 16 year old students diagnosed as trainable mentally retarded. Which of the following activities would be BEST for addressing goals related to transition? A. Role play ordering food in the classroom B. Go out for lunch to a fast-food restaurant C. Order take out lunch by phone D. Select lunch items from a picture menu in the classroom

4. A young child has been wearing left upper extremity prosthesis for 3 weeks. When consulting with the child‟s preschool teacher, the OT practitioner recommends: A. Offering toys that the child can manipulate with one hand B. Stressing bilateral activities incorporating the prosthesis C. Teaching the child one-handed manipulation techniques D. Involving the child in activities that do not require manipulation, such as sing-alongs

4. The OT practitioner is making recommendations to a community living site for a 13-year-old child who has mental retardation. Which of the following statements most accurately describes the functional ability of this child who is in the moderate (trainable) range of intellectual ability? A. The client requires nursing care for basic survival skills. B. The client can usually handle routine daily functions. C. The client requires supervision to accomplish most tasks. D. The client is able to learn academic skills at the third to seventh grade level.

40.The OT is assessing sensory awareness in an individual whose diagnosis is CVA. The MOST appropriate technique to use is to: A. Test the individual‟s affected extremity before the unaffected extremity. B. Demonstrate the procedure on the unaffected extremity, then occlude the individual‟s vision. C. Demonstrate the procedure on the affected extremity, then establish rapport with the individual. D. Interview the individual and assess only the areas that he or she reports are impaired.

41.An OT practitioner in a work-hardening program needs background information about an individual‟s work history. The BEST method for obtaining detailed information about the individual‟s job requirements is: a. interviewing the individual b. examining an analysis of the individual‟s job c. looking up the individual‟s job in the Dictionary of Occupational Titles d. requesting information from the referring physician

41.Which of the following instructions should the OT practitioner follow when administering standardized tests to young children? A. Test in a stimulating environment B. Follow test manual directions C. Always administer test in a single session D. Carry on a conversation with the child

42.An OT practitioner is reviewing a patient‟s chart before evaluating the patients chart before evaluating the patient. Based on the physician‟s history and physical examination, the practitioner is able to identify the patient‟s deficits and assessments that will best assess the problem areas. This form of clinical reasoning is MOST likely an example of: a. procedural reasoning b. conditional reasoning c. interactive reasoning d. narrative reasoning

44.In planning a therapeutic dressing program for a first grade child who is mentally retarded, the therapist‟s FIRST consideration should be the need for: a. adaptive equipment b. adaptive clothing c. proper positioning d. adapted teaching techniques

45.A child with CP tends to flex forward while riding her adapted tricycle even though her LE are correctly positioned. The adaptation that would BEST enable her to maintain a more upright position is: A. Raising the seat height B. Raising the handlebars C. Lowering the seat height D. Lowering the handlebars

45.A therapist who is planning treatment for a child with athetoid CP is concerned about the child‟s inability to control flexion and extension of the arm when reaching for a toy. The child flexes too much or extends too much, which makes placements of the hand very difficult. The MOST appropriate goal for this type of problem in hand function would be to improve the: A. Ability to isolate movement B. Ability to grade movement C. Ability to control how fast movement occurs D. Bilateral integration of arm movements

45.An individual alternately exhibits laughing and crying throughout a treatment session, this behavior should documented as: A. Mania B. Emotional lability C. Paranoia D. Denial

46.After a radial nerve injury, an individual initially had trace muscle strength in elbow extension. One week later, strength is noted to have increased to poor minus. The individual is ready for which activity? a. passively self-ranging the injured arm b. extending the elbow in mid-range 30 to 40 degrees with the forearm resting on the table on the table c. pushing a cup filled with pennies with the back of the hand, with arm resting on the table d. lifting a book placed on the back of the hand up off the table

46.An OT practitioner has been assigned to develop an expressive activity group for women who have experienced emotional and physical abuse. The BEST choice would be: A. Mediation and yoga exercises B. Writing a soap opera C. Personal hygiene and grooming classes D. Aerobics and fitness program

46.When administering an evaluation of upper extremity function to newly admitted patient with Guillain-Barre syndrome, it is MOST important to: A. Test proximal muscle strength first B. Perform the evaluation over several sessions C. Include sensory testing D. Evaluate range of motion

47.A child has poor independent sitting skills as a result of inadequate postural reactions. The FIRST activity the OTR would use to promote the development if independent sitting: a. swinging on a playground swing with a bucket seat b. wide-base sitting on the floor while batting a ball c. straddling a bolster swing while batting a ball d. riding a hippity-hop, while hand for support

48.An OT practitioner has been asked to develop a program of self- awareness activities for a group of substance abusers. A graded program to develop an individual‟s self-awareness MUST include activities that: a. encourage self-awareness b. are structured by the OT practitioner to encourage self- reflection and feedback c. provide opportunities for the patient to be self-aware d. allow for increasing social interaction

49.An OT practitioner is working with a child who has a mild spastic cerebral palsy. The evaluation has shown that the child has poor in- hand manipulation skills. What type of activity would be BEST for practicing this ability? a. grasping blocks to build a building b. placing pegs from one pegboard to another c. carrying a bag of Lego blocks with a handle d. removing a nut from a bolt

5. An OT practitioner is working with a client diagnosed with a mild sprain. The client cradles her hand and appears to be hypersensitive to light touch. The individual also presents with edema, pain, shiny skin, and excessive dryness of the extremity. Based on this, the OT assumes that the client is MOST likely suffering from: a. neuromas b. reflex sympathetic dystrophy c. carpal tunnel syndrome d. desensitization

5. While observing a client who has just been admitted to the rehabilitation unit after a right CVA with left hemiplegia, the OT practitioner notices that the patient‟s right arm lays limply by the patient‟s side. In documenting this observation, the OT will MOST likely use the term: A. Paralysis B. Flaccidity C. Subluxation D. Spasticity

50.An individual with lower extremity paralysis uses a standard manual wheelchair and is ready to be discharged to home. During the home evaluation, the OT practitioner notes that the entrance to the bathroom is 32 inches wide and the toilet is 15 inches high. Which of the following recommendation will MOST facilitate use of the bathroom for this individual? A. Widen the doorway B. Raise the toilet C. Widen the doorway and raise the toilet D. Widen the doorway and lower the toilet

51.An OT practitioner has planned to assess group interpersonal skills in an activity-based group of seven individuals. Shortly before the group is to begin, the therapist is asked to add two newly admitted clients to the group. Which of the following actions would yield the MOST efficient and effective result? A. Ask one or two of the original seven members to wait until later and include the two new clients in the group B. Add the two new clients and then divide the members into two groups C. Interview the two new clients separately and continue with the original evaluation group of seven D. Proceed with the group as planned, adding both new clients to the original seven

52.A treatment plan for a child with a visual discrimination problem would MOST likely include which of the following adaptations of visual materials? A. Low contrast and defined borders B. High contrast and defined borders C. High contrast and unclear borders D. Low contrast and unclear borders

53.An 8 year old boy is being treated in OT for social withdrawal and depression. At the time discharge, the BEST recreational activity for the OT practitioner to recommend for the child is: A. Swimming lessons B. Boy scouts C. Computer games D. Piano lessons

54.An OT practitioner is planning to use remedial strategies to prepare individuals treated in a psychological setting for job hunting. The activity MOST consistent with this approach is: A. Reviewing an interest checklist B. Holding a class about job-seeking strategies C. Modifying the work environment to reduce stress D. Using an expressive group magazine collage using pictures of different types of jobs

54.An individual with right unilateral neglect is able to track from the left side to the midline of the body on paper and pencil tasks. The BEST treatment activity for this person to work on crossing the midline to improve writing would to be: a. have the individual practices wheeling a wheelchair following a taped line in the floor b. place commonly used self-care items on the left side c. have the individual trace lines across the page with the right index finger from the left to the right side d. place playing cards in a horizontal row from right to the left in sequence

55.An OT practitioner is leading a group session on the topic of "handling anger" with a group of clients who have deficits in psychosocial functioning. The MOST effective way for an OT practitioner to structure this group would be to: A. Begin with "Today we are going to discuss how we handle anger" and wait for discussion to start B. Start by having the members make a collage or drawing which symbolizes how they handle anger C. Ask each member what activities they would like to do during this session D. Begin with a personal anecdote related to handling anger, and ask each member to do the same

7. A person with functional limitations in shoulder abduction and external rotation is performing self-care activities. The OTR is MOST likely to observe the client having difficulty during which self-care activity? A. Buttoning a shirt B. Combing the hair C. Tucking in a shirt in the back D. Tying a shoe

55.The OT practitioner is making recommendations to a community living site for a 13 year old child who has mental retardation. Which of the following statements most accurately describes the functional ability of this child who is in the moderate (trainable) range of intellectual ability? A. The client can requires nursing care for basic survival skills B. The client can usually handle routine daily functions C. The client requires supervision to accomplish most tasks D. The client is bale to learn academic skills at the third to seventh grade level

57.An OT practitioner is using a sensory integration approach with a group of regressed individuals with limited attention spans. Most group members can tolerate a group situation for no more than a half- hour. Which of the following activities would be BEST for beginning the session? A. Go around the circle and ask each patient to introduce himself or herself B. Pass around a scent box and ask each patient to smell the contents C. Ask each patient to select a favorite person and read it D. Discuss the lunch menu and healthy eating habits

57.To practice transfers using a transfer board with a patient, the OT practitioner must have the patient use a wheelchair that has: A. Detachable footrests B. Detachable armrests C. Antitip bars D. Brake handle extensions

58.A family would like to place grab bars around the toilets in the house for easy access during transfers by the mother, who uses a wheelchair. At what height should they be placed? A. 28 to 32 inches B. 33 to 36 inches C. 38 to 41 inches D. 43 to 46 inches

59.An individual with a cognitive disability has recently joined a sheltered workshop setting and has been referred to for assignment to the appropriate group. The individual demonstrates the ability to copy demonstrated directions presented one step at a time and visualizes an end product. However, the individual is unable to recognize errors and may not be able to correct them when they are pointed out. The MOST appropriate group for this individual is the one involved with: a. sorting plastic utensil into separate containers b. assembling packets that include a knife, fork, spoon, and napkin based on sample c. selecting matching shoelace from a mixed pile and lacing them onto a display card d. gluing labels to cans and placing them in the appropriate container according to color

60.An OT practitioner is working with a homemaker who sustained a mild head injury. The client frequently forgets appointments and wakes up late for work. The practitioner suggests the use of external memory devices. Examples of external memory devices that might assist this individual would be: A. Visual imagery and a diary B. Labeling and calendars C. Mnemonics and verbal cues D. Log and repetition

60.When providing occupational therapy for children who have been diagnosed with a terminal illness, the PRIMARY focus for OT intervention would be: a. educational activities b. play and self-care activities c. socialization activities d. motor activities

63.An OT practitioner is simulating cylindrical grasping activities with a client who desires to work on the skills necessary to be a carpenter. Which if the ff. activities would MOST likely address these needs? A. Positioning a nail on a piece of wood B. Hammering a nail into a piece of wood C. Carrying a pail of bolts D. Unscrewing a lunchbox thermos

64.A preschooler has poor visual tracking skills, which affect her performance on tasks requiring eye-hand coordination. Which of the following activities is most appropriate for the OT practitioner to recommend to the child‟s parent‟s in order to promote beginning visual tracking skills during summer vacation? A. Tossing and catching a water balloon B. Catching and bursting soap bubbles C. Throwing and catching a beach ball D. Playing softball

66.An OT practitioner is assisting an individual with mild hemiparesis in transferring from the wheelchair to a mat table using a stand pivot transfer technique. The FIRST verbal cue the OT gives to the individual is: A. "Stand up." B. "Scoot forward to the edge of the wheelchair." C. „Unfasten the wheelchair brakes." D. "Position the wheelchair so that it directly faces the mat table."

67.The OT is working with a patient on an acute care floor when the patient‟s IV equipment disengages, splashing the therapist in the eye with the medication and IV "backwash" fluid. The therapist‟s FIRST response should be to: A. Rub the eye and continue treatment B. Rinse the eye with an eye wash or water immediately C. Write an incident report D. Cover the eye with a bandage and contact the immediate supervisor

68.An OT practitioner is working with a client in a work program setting. What is the FIRST step to achieving the program objective of preventing reinjury within a work program? a. performing a prework screening b. learning proper body mechanics c. participating in work hardening d. engaging in vocational counselling

68.An individual who previously worked as a cashier in a clothing store has been referred to a work-hardening program following knee surgery. Limitations are present in standing tolerance and balance. The activity that will BEST prepare this individual to return to work is: A. Moving piles of clothing from one end of the clinic to the other B. Folding laundry and putting it in a basket while standing C. Washing dishes while standing D. Putting price tags on clothing while sitting

68.An individual with a high-level SCI is returning home. Which type of adaptive technology would the client MOST likely require to ensure safety in the home? A. An environment control unit (ECU) B. A call system for emergency and nonemergency use C. A remote control power door opener D. An electric page turner

68.During an interview, the OT practitioner decides to respond to an individual by paraphrasing. The PRIMARY reason for this type of response is to: A. Refocus or redirect the individual‟s comments B. Show acceptance and understanding to the individual C. Force the individual to make a choice D. Encourage an individual to give additional information

70.After administering an interest checklist, the therapist documents that the individual has identified a few solitary leisure interest and no interests involving social interaction. Based on this information, what is the BEST activity to use in the next session of a leisure counseling group? A. A leisure inventory assessment B. An activity exploring leisure opportunities and problems C. A magazine picture collage D. A calendar of community leisure activities for the first week after discharge

70.In establishing a wellness program for older adults, the OT practitioner is MOST likely to incorporate activities that: A. Improve weakness following CVA B. Increase physical activity and fitness C. Improve social skills for depressed elders D. Increase independent performance of transfers

71.An OT practitioner is using a visual perceptual frame of reference. Which of the following would be the FIRST step in planning a program for a child with visual perceptual problems? a. Visual memory skills b. Visual attention skills c. General visual discrimination skills d. Specific visual discrimination skills

71.An OT practitioner is working with a patient with a high-level spinal cord injury who has no functional movements to determine the best method of input access for a powered wheelchair. The MOST likely recommendation for this patient to activate the wheelchair would be to use a: A. Joystick B. Sip-and-puff switch C. Single-switch digital control D. Mouth stick

71.An adolescent with mental retardation is planning to enter a supported employment program in the community after leaving school. Which area of intervention would the OT practitioner be MOST likely to focus on? A. Developing the student‟s leisure interests and play skills B. Developing the student‟s vocational interests, social skills, and community mobility skills C. Facilitating development of the student‟s gross motor skills D. Facilitating development of the student‟s fine motor skills

72.An OT manager in a large department is trying to determine which staff will be able to supervise level-II fieldwork students in the upcoming months. OT practitioners may only be selected to be primary student supervisors if they: A. Are certified OT practitioners with at least 6 months of experience B. Have at least 1 year of experience as a certified OT practitioner. C. Are certified by the NBCOT D. Have supervised a level-I student before the level-II student

72.The MOST effective method of compensation for both unilateral neglect and absence of sensation in an upper extremity with good motor control is to: A. Avoid the use of sharp tools or scissors and to avoid extreme water temperatures. B. Wear noisy bracelets on the writs or ankle as a reminder to visually scan toward the affected side. C. Use an electric shaver. D. Wear elbow pads on the affected side.

73.An individual covered by Medicare who has been receiving OT and PT in the home is now able to transfer in and out of the car with supervision of a caregiver. The individual has visited friend who lives 30 minute away. OT services are still required to improve mobility, upper extremity function, and home management skills. Which of the following actions should the OT practitioner take FIRST? A. Provide a home program and discharge the patient B. Explain to the patient and caregiver that one must be "homebound" in order to be eligible for home care services C. Refer the patient for outpatient therapy and provide a comprehensive discharge summary to the outpatient setting D. Communicate with the PT and inform her of the patient‟s status

74.An OT practitioner is working with an older adult who has diabetes, poor vision, and peripheral neuropathies. The client also has difficulty discriminating between medications. The BEST adaptation for the OTR to provide is: A. Braille labels B. Labels with white print on a black background C. A pill organizer box D. Brightly colored oils with each type of medication a different color

75.An OT practitioner is working with a patient who has recently experienced a traumatic amputation of his right upper extremity at the short below-elbow level. Which of the following areas of patient education would the practitioner work on FIRST in the OT intervention program? a. Training to put on and take off the prosthesis b. Training in residual limb wrapping c. Activities to teach grasp and prehension functions d. Training to resume vocational activities

75.In preparing a patient with a unilateral below-knee amputation for discharge from a rehabilitation facility, the MOST important adaptive equipment for the OT to recommend is: A. Lightweight cooking utensils B. A tub bench and toilet rails C. Long-handled dressing devices D. A reacher

76.An OT practitioner is working on transfer training with a young client who recently underwent bilateral below the knee amputations. Which of the following should the OTR FIRST suggest for independent transfers from the wheelchair to the bathroom tub seat? A. Stand pivot transfers B. Sliding board transfers C. Dependent lift transfer D. Transfers should not be initiated until receiving prosthetics

76.The goal for patient who has had a CVA is to be able to put on a shirt independently. The MOST effective way to structure dressing training for maximum learning retention and generalization of the skills is: A. Teaching and practicing each segment of the dressing procedure during consecutive treatment sessions B. Practicing the whole task of putting on a shirt in a setting similar to the real environment C. Providing dressing simulation activities (button boards, etc.) D. Allowing the client to view a videotape on how to put on a shirt and written directions for completing steps for dressing

77.An individual confides to the OT practitioner that he is concerned that lower extremity flaccidity may cause problems during sexual activity. The BEST strategy for the OT practitioner to recommend is: a. use a side lying position b. use of pillows to prop up body parts into the desired position c. incorporate slow rocking into movements d. avoid movements that elicit a quick stretch

78.A resident in a long-term care facility is being treated by the OTR to regain self-feeding skills. The MOST effective strategy for beginning self-feeding with a resident who is tactilely defensive around the facial area is to: A. Have the therapist clear food pocketed in the resident‟s cheeks B. Use a guiding technique: place food in the resident‟s hand and bring it to the mouth C. Wipe food particles off a person‟s mouth and chin as he or she eats D. Allow resident to select whatever food or beverage he or she prefers

79.An OT practitioner is treating a patient who has difficulty maintaining attention to a task but is aware of the problem. The best example of a strategy that the OT can teach the patient to control effects of attention deficits would be: a. simplifying the instructions given to accomplish the task so only one step is presented at a time b. learning the self-monitoring technique of asking oneself if any part of the task has been missed c. providing practice is shape and number cancellation worksheets d. removing unnecessary objects from around the task area to decrease distractions

80.A patient with an indwelling catheter asks his therapist for advice concerning sexual activity. Which of the following responses is MOST appropriate? A. Refer the patient to his physician B. Discuss precautions necessary for sex when an indwelling catheter is present C. Teach the individual how to remove and replace the indwelling catheter D. Explain that it is dangerous and difficult to have sex when an indwelling catheter is present

81.The MOST effective way to adapt a chair to inhibit a child„s extensor tone and allow the child to maintain a sitting position is to use: a. lateral trunk supports b. a seat belt placed at a 45-degree angle at the hips c. a wedge-shaped seat that is higher in the front d. a lapboard

82.A school age child with fine motor difficulties is ready for discharge from outpatient OT services. Which of the following is the MOST important information to focus on? A. The child‟s interests and hobbies B. The child writing, dressing and self-feeding skills C. The child‟s academic achievement D. The availability of the child parents for follow up services

82.During a cooking evaluation, an individual with a history of TBI exhibits moderate UE incoordination. Which of the following recommendations would be MOST beneficial for this individual? A. Use a built-up utensil handles B. Use heavy utensils, pots, and pans C. Use a high stool to work at counter height D. Place the most commonly used items on shelves just above and below the counter

84.A client that the OT practitioner is treating brings an order from his physician requesting treatment for epicondylitis. Which of the following adjunct activities should be used to treat the ACUTE symptoms of tennis elbow? A. Passive range of motion (PROM), weight bearing and mobilization B. Resistive exercises, heat application and work simulation C. Heat application, PROM and strengthening D. Ice application, immobilization and splinting

85.An IT practitioner is working with an elderly woman with a diagnosis of depression and dementia during the clean-up portion of a cooking activity. The patient begins to dry the plates and utensils she has already dried. The OTR should: a. tell the client that the same dishes and utensils are being redried b. put the dried dishes away and begin to hand the client wet dishes c. ask the client to stop the activity because it seems too difficult d. ask the client to describe what she is doing

86.An individual with strong dependency needs is able to lace a leather wallet only with consistent verbal cueing. Which is the BEST way to grade this activity in order to decrease dependency? A. Provide written instructions on lacing techniques and ask the individual to continue on her own B. Ask the individual to try some lacing with distant supervision and praise her for what she has been able to do C. Ask the individual to take the lacing to her room and continue without the OTs assistance D. Tell the individual to complete a small amount of lacing while the OT assists another patient in the same room

87.After administering an interest checklist, the therapist documents that the individual has identified a few solitary leisure interests and no interests involving social interaction. Based on this information, what is the BEST activity to use in the next session of a leisure counselling group? A. A leisure inventory assessment B. An activity exploring leisure opportunities and problems C. A magazines picture collage D. A calendar of community leisure activities for the first week after discharge

87.During an interview, the OT practitioner decides to respond to an individual by paraphrasing. The PRIMARY reason for this type of response is to: A. Refocus or redirect the individual‟s comments B. Show acceptance and understanding to the individual C. Force the individual to make a choice D. Encourage an individual to give additional information

89.An individual attending an adult day program has expressed interest in obtaining employment. In groups, however, the individual grabs tools from others, frequently acts out of turn, and has difficulty accepting feedback. Participation in which one of the following interventions is MOST appropriate for addressing this individual‟s limitations and helping to prepare the individual for a work environment? A. Operating the photocopy machine in a clerical group B. Handing out trays and utensils in a food service group C. Placing books back on the shelves in a library group D. Balancing the books at the end of the day in a thrift store group

89.While observing a client who has just been admitted to the rehabilitation unit after a right CVA with left hemiplegia, the OT practitioner notices that the patient‟s right arm lays limply by the patient‟s side. In documenting this observation, the OT will MOST likely use the term: A. Paralysis B. Flaccidity C. Subluxation D. Spasticity

9. An individual who had a stroke is copying a picture of a clock. The drawing appears as a lopsided circle with a flat side on the left. The numbers 1 through 8 are written in numerical order around the right side of the clock. The hands are correctly drawn on the clock to represent three o‟clock. The individual‟s performance appears to demonstrate: a. right hemianopsia b. left unilateral neglect c. cataracts in the left eye d. bitemporal hemianopia

91.An OTR is working on sitting balance with an individual with C6 quadriplegia. The BEST position for the individual‟s hands to be in when using them for support is to have the fingers: A. Extended and adducted B. Flexed at all joints C. Extended and abducted D. Adducted and flexed only at the MCP joints

91.While assessing dressing skills with a patient who recently had a stroke, the OT practitioner notes that the individual is unable to see buttons on a printed fabric. This MOST likely indicates that the client may be having difficult with: A. Spatial relations B. Figure-ground perception C. Body image D. Visual closure

92.When working with a child who exhibits tactile defensiveness, which of the following areas should be evaluated FIRST? A. Reading skills B. Dressing habits C. Social skills D. Leisure interests

95.When working clients who experience low back pain, it is important to practice functional techniques such as lifting and carrying. Which of the following BEST represents a correct lifting method? a. Keep both knees straight, flex the back and keep object an arm‟s length away from the body b. Bend both knees, keep the back straight, and bring object close to the body when lifting c. Keep both knees and back straight and bring object close to the body when lifting d. Bend one knee while keeping the other leg straight and keep the object an arm‟s length away from the body

96.An OT practitioner is working with a client who is has had a TBI and demonstrates deficits in sequencing and problem solving. The client has successfully prepared a cold meal in today‟s treatment session. The next meal preparation activity the OTR should have client prepare is a: A. Fruit salad B. Cup of instant soup C. Casserole D. Spaghetti dinner with salad and garlic bread

96.An individual with Guillain-Barre syndrome complains of pain during passive range of motion to the shoulder. Which is the MOST important technique for the OT practitioner to use while performing PROM with this individual? a. work proximal to distal b. proceed only to the point of pain c. limit the number of repetitions to 10 d. gently encourage the individual to work through pain

97.A child diagnosed with mental retardation has been participating in a craft group structured as a parallel group. The child is now developing skills such as sharing materials and interacting with other group members. The NEXT level of structured activity which the OT practitioner would recommend for the child is in a(n): A. Egocentric cooperative group B. Project group C. Cooperative group D. Mature group

98.An OT practitioner is working on a feeding program for an individual with ALS who is in the late stages of the disease process. Which of the following is the MOST appropriate intervention for this individual? A. Provide a rocker knife, plate guard, and nonskid mat B. Implement a pureed diet and allow adequate time for eating C. Emphasize upper extremity strengthening D. Minimize the use of adaptive equipment

99.An OT practitioner is fabricating a splint for a client with swan-neck deformities. This splint is designed to maintain the client‟s fingers in a position which prevents further: A. Hyperextension of the PIP and DIP joints B. Hyperextension of the PIP joint and flexion of the DIP joint C. Flexion of the PIP joint and hyperextension of the DIP joint D. Hyperextension of the MP joint and flexion of the PIP joint

99.While in the hospital, a 48 year old roofing contractor experienced extrapyramidal syndrome after being placed on neuroleptic medications. The patient is to continue taking the medication after discharge from the hospital. It is MOST important to advise the patient to: A. Keep time in the sun as brief as possible B. Avoid use of power tools and sharp instruments C. Get up slowly from a standing, sitting or lying position D. Be aware of the dehydrating effects of caffeinated drinks and alcohol

101. An individual with ALS and mild dysphagia becomes extremely fatigued at breakfast, lunch, and dinner. Which is the FIRST intervention the OT practitioner should considering recommending? a. Speak with the physician about tube feedings b. Sit in a semi reclined position during meals c. Eat six small meals a day d. Substitute pursed foods for liquids

163. An OT practitioner has been hired to develop a community- based program for patients with chronic mental illness. The FIRST step in the process which the practitioner must complete is: A. Program planning B. Program implementation C. Needs assessment D. Program evaluation

10.An OTR is performing a UE functional assessment on an elderly client with rheumatoid arthritis. The OTR is MOST likely to determine that the client has limited internal rotation if the client is unable to touch the: A. Back of the neck B. Top of the head C. Lower back D. Opposite shoulder

10.The therapist needs to identify an activity that will address psychosocial goals by (1) allowing the individual to experience success using a messy process and (2) requiring the individual to delay gratification. The activity process that is the BEST for providing this experience is: A. Working in a group of three other individuals B. Selecting the design pattern for a tile trivet C. Applying grout to a tile trivet and waiting for it to dry D. Encouraging the individual to clean off the table at the end of the group session

100. An OT practitioner is working in an outpatient upper extremity and hand clinic. The practitioner‟s case load consists of clients who have tendinitis, nerve compression syndromes, and myofascial pain. The OT practitioner can assume that these diagnoses are MOST commonly associated with: A. Osteoarthritis conditions B. Peripheral vascular diseases C. Cumulative trauma disorders D. Neuroma-related conditions

100. An OT wishes to assess the results of a life-skills training program provided to individuals at a shelter for abused women. Which of the following methods would be BEST for obtaining this information? A. Final evaluation of each client involved B. Client satisfaction survey C. Program evaluation D. Utilization review

48.Which individual would benefit the MOST from using a wrist-driven flexor hinge splint during a prehension activity? A. A client with a C1 injury B. A client with a C3 injury C. A client with a C6 injury D. A client with a T1 injury

101. The OT is working with an individual in a psychosocial partial hospitalization program who is having difficulty making decisions. The therapist has suggested a baking activity but the client as unsure if she wants to do this activity. The therapist‟s response that would BEST facilitate decision making is: A. "I think baking would be a helpful activity to try. Baking something you like offers you several choices and decisions. You wanted to bake cookies today, didn‟t you?" B. "I think baking would be a helpful activity to try. Baking something you like offers you several choices and decisions. Why do you want to bake?" C. "I think baking would be a helpful activity to try. Baking something you like offers you several choices and decisions. These choices and decision can help you feel more positive about making other decisions. You can choose a cake mix or a cookie mix. Which would you like?" D. "I think baking would be a helpful activity to try. Baking something you like offers you several choices and decisions. These choices and decision can help you feel more positive about making other decisions. You can choose a cake mix or a cookie mix. Do you want to bake cookies?"

102. An individual with hand weakness has difficulty holding a fork. Using a biomechanical frame of reference, which of the following interventions would be MOST appropriate? A. Elicit functional grasp using reflex inhibiting postures B. Stimulate the hand flexors to promote a functional grasp C. Repeatedly squeeze with the hand against increasing amounts of resistance D. Build up utensils handles

103. An OTR performing a motor skills evaluation observes that a child is awkward at many gross motor tasks, particularly those which require relating the body to objects in space. Though able to skip rope in the regular forward pattern of movement, the child is unable to skip rope backwards, even after several attempts. This information would lead the therapist to be particularly observant for additional signs of: A. Delayed reflex integration B. Inadequate bilateral integration C. Developmental dyspraxia D. General incoordination

105. A client with hemiplegia and her spouse are working on toilet transfer training activities with the OT practitioner. The BEST way for the OT practitioner to teach the couple to perform transfers will be: a. only to the unaffected side of the client‟s body b. only to the affected side to the client‟s body c. to both sides of the client body d. only to the side of the body from which the client will be approaching the toilet

106. An OT practitioner, along with the assistive technology team, has made specific recommendations for electronic assistive technology for an adult with muscular dystrophy. After the devices are ordered, and modified as necessary, the NEXT step in the process of implementation is for the OT to: a. Evaluate how well the whole system works. b. Evaluate if the assistive technology devices match the needs of the client. c. Train the client in the operation of the assistive technology system and in strategies for its use. d. Determine if funding is available for the assistive technology recommended.

107. A COTA frequently administers the ACLS Test and then discusses it with the supervising OTR. Which of the following MOST accurately describes the OTR‟s role during these discussions? A. Determine the COTA‟s service competency B. Collect data on the patient‟s performance C. Interpret the results based on data collected by the COTA D. Developed the treatment plan

109. An OT is planning intervention for an individual who recently experienced a left CVA resulting in right-sided hemiplegia and motor apraxia. To BEST facilitate the individual‟s attempts to perform morning ADL the OT should plan to: A. Provide the individual with detailed, step-by-step commands for each task throughout the ADL process B. Make the environment as simple and uncluttered as possible and use sharp contrast to make objects clearly stand out C. Have the individual visualize the task first and then provide general statements such as "Let‟s get ready." D. Teach the individual to move slowly through the environment and encourage touching of objects during the task

109. An OTR is on the treatment team for patients with lower extremity amputations in a rehabilitation hospital. The PRIMARY role of the OT in the management of lower extremity amputation is: a. fabricating artificial limbs b. providing therapeutic exercise, wound care, pain management and gait training c. providing a program to enhance occupational performance in ADL, work, and leisure d. assessing the client‟s social environment and making recommendations

109. While preparing for his first presentation at a professional conference, an OT realized he does not have the name of the author of an article containing critical information he planned on photocopying and distributing. Which of the following is the MOST appropriate action for the OT to take? A. Distribute the handout and apologize for not having the author‟s name B. Show the handout with and overhead projector and apologize for not having the author‟s name C. Use the handout only as a resource while developing the presentation D. Refrain from using the handout in any way

11.A preteen with a history of TBI is relearning to prepare simple foods but has been having difficulties with sequencing so the OT practitioner has provided the patient with a chart of steps to follow. The child has just learned to prepare his favourite sandwich without "losing his place" in the process but continues to need occasional verbal reminders to look at the chart and to ensure safety. At this point, the child‟s MOST recent level of independence would be documented as: A. Independent B. Independent with setup C. Supervision D. Minimal assist

11.An OT practitioner is informing a child‟s caregiver about when developmental milestones of childhood occupations typically occur. The therapist reports that infants sit without support for a few minutes by: a. 3 to 5 months of age b. 6 to 7 months of age c. 8 to 9 months of age d. 13 to 15 months of age

11.An adolescent patient is attending a craft group for the first time. The OT practitioner is observing the patient closely for signs of aggressive and violent behavior. The individual has MOST likely been diagnosed with: A. Hyperactivity B. Attention deficit disorder C. Conduct disorder D. Oppositional defiant disorder

110. An OT practitioner who is leading a stress management group explains to the members that stressors can be MOST accurately described as the: a. process by which individuals adjust to daily stressful events within their environments b. body‟s reactions to threat, often described as "fight or flight" c. precipitating conditions and events that elicit stress reactions d. process of "fit" between the individual and his or her environment

111. A client with paranoia prefers to stay away from the group, working alone at another table. The BEST action for the OT practitioner to take is to: A. Encourage the client to join the group B. Tell the client he is required to sit with the group C. Tell the client it is okay to work where he is until he feels comfortable in joining the group D. Stay with the client until he is ready to join the group

112. A 16-year-old boy with juvenile rheumatoid arthritis is ready to begin shaving but has difficulty as a result of limited range of motion in his shoulders and elbows. Which of the following is the BEST adaptation for him to use? A. Electric razor attached to universal cuff B. Safety razor with built-up handle C. Safety razor with extended handle D. Safety razor attached to universal cuff

112. An adult with polymyositis and dermatomyositis, is able to complete full range of shoulder flexion while in a supine position during an evaluation with an OT practitioner. However, against gravity, the client is only able to achieve 50% of the range for shoulder flexion. The practitioner grades this muscle as: A. Good (4) B. Fair (3) C. Fair minus (3-) D. Poor plus (2+)

113. A child with athetoid cerebral palsy is learning to use augmentative communication and is frustrated because it takes so long to produce a sentence. Which of the following is the BEST solution for this problem? a. a larger monitor b. a voice output tool c. word prediction software d. masking inappropriate keys

113. AN OT practitioner working for the school system has identified a general need to enhance the fine coordination skills of the elementary school students to facilitate better writing skills. The BEST population-based interventions would be to: A. Screen students for writing problems and provide in-depth assessment of those identified B. Provide remedial activities for those students identified having fine coordination deficits C. Recommend activities develop fine coordination that teachers can incorporate into classroom programming D. Recommend additional OT staff to provide direct services for students

113. After wearing a new splint for 20 minutes, an individual develops a reddened area along the ulnar styloid process. The MOST important first modification the OT practitioner should make to correct the splint is to: A. Line the splint with moleskin B. Line the splint with adhesive-backed foam C. Flange the area around the ulnar styloid D. Reheat and refabricate the entire splint

113. An individual who recently experienced an MI is now medically stable and has been referred to OT. In order to determine the individual‟s current endurance level, the OT practitioner plans to monitor performance of self-activities. The FIRST step is to: A. Take the individual‟s vital signs after performance of self-care activities B. Observe the individual for signs and symptoms during self-care activities C. Take the individual‟s vital signs at rest D. Take vital signs 5 minutes after the individual has completed self-care activities

114. A 78 year-old individual who is ambulating in the home informs the OT practitioner that improving balance is a major concern. Although the patient took showers in the past, now his fear of falling limits him to sponge baths. The OT practitioner tells the individual that it is wise to avoid situations in which the risk of falling is high. Which of the following should the OT practitioner advise the individual to do NEXT? a. try the bathtub instead of the shower b. purchase a shower chair c. describe how using a shower chair improves safety d. stretchy fabric clothing with tie closures in the back

114. An artist recently diagnosed with MS is interested in pursuing a leisure activity that will promote physical fitness. Because the individual‟s symptoms are limited to mild UE numbness and slight weakness in the dominant hand at this point, the BEST activity to recommend is: A. Volleyball B. Painting with the dominant hand C. Swimming in a cool water pool D. Jogging on a track or treadmill

115. An OT practitioner is working with a client who demonstrates the inability to swallow when attempting to self-feed water ice. The OTR should interpret the inability to swallow as: A. Deglutition B. Dysmetria C. Dysphagia D. Dysarthria

115. An entry-level OT practitioner wants to know the extent of her liability when providing occupational therapy. Which of the following answers is MOST accurate? A. Only OTRs need to have liability insurance B. Only COTAs need to have liability insurance C. Both OTRs and COTAs should have liability insurance D. Neither OTR or the COTA need to have liability insurance

116. A client requests a drink of water after working on UE exercises during therapy. The OT practitioner reads in the patient‟s chart that "Mr. J is on a nonoral feeding program." The OTR interprets that: A. The client is on thin liquid only feedings. B. The client is on stage I foods only. C. The client is receiving nasal tube feedings. D. The client is eating pureed only foods.

123. An individual with Parkinson‟s disease exhibits a lack of facial expression, resulting in decreased communication. The BEST strategy to promote improved social interaction through facial expression is to: A. Teach caregivers to give patient time to reply and to ask questions so that short responses are required. B. Give a word chart or communication board to prevent frustration. C. Teach use of mirror feedback to make the person aware of his or her facial expression. D. Instruct in deep breathing, articulation, speech volume, breaking up sentences into segments.

124. A client with cognitive deficits exhibits little transfer of skills from one activity to the next. Which intervention would be BEST to assist this client in performing the steps of doing his laundry? A. Performing memory drills of the steps involved in doing in a laundry activity B. Placing serial pictures of a laundry activity in sequence C. Making a checklist of steps in the process, then consulting the list while doing laundry in the actual setting D. Reading a story about a person doing

125. An OT practitioner has been hired to develop a community- based program for patients with chronic mental illness. The FIRST step in the process which the practitioner must complete is: A. Program planning B. Program implementation C. Needs assessment D. Program evaluation

154. An OT practitioner is planning a meal preparation activity for an adult client with attentional and organizational deficits secondary to alcohol abuse. The treatment goals address the client‟s difficulties in properly sequencing tasks. The MOST appropriate activity to use FIRST is: A. Setting the table B. Planning an entire meal C. Baking cookies using a recipe D. Preparing a shopping list

125. The goal for an elderly client with lower extremity weakness is to be independent with bathing, but this requires the tub to be more accessible to the client who uses a walker. Which environmental adaptation would be BEST to achieve this? A. Place the light switch outside the door so the bathroom is lit before entering B. Provide long-handled adaptive devices to facilitate lower extremity dressing C. Provide transfer tub bench and install grab bars D. Place nonskid decals in the tub and mats on the floor to prevent slipping on the wet floor

126. An individual with chronic obstructive pulmonary disease (COPD) with low endurance is taught to modify his bathing techniques for carryover after discharge. The BEST bathing method would be: a. tub bathing method with hot water b. standing for a quick shower c. using a bath chair and hand-held shower with tepid water d. tub bathing using lukewarm water

127. An individual with a low back injury lives alone and must be able to do laundry independently. Which of the following recommendations will BEST protect the back from reinjury? A. Place the clean laundry basket on the floor next to a chair and sit for folding B. Stop the activity when pain becomes severe C. Divide the laundry into several small loads for carrying D. Carry the laundry in one or two large loads

129. An OT practitioner is showing a parent how to bathe a child with hypertonic muscle tone. Which of the following approaches is MOST appropriate to use? a. Avoid the use of adaptive equipment. b. Avoid explanations of the procedure. c. Handle the child slowly and gently. d. Stand and lean over the tub to support and wash the child.

129. An OT practitioner is working with a patient who has mild difficulties swallowing. The OT instructs the patient that the BEST position for him to maintain during feeding activities is: A. 30 degrees of neck extension B. 10 degrees of head extension past the midline C. 10 degrees of head flexion from the midline D. 30 degrees of head flexion

130. The supervisor of OT is off work and in a local establishment listening to a band with her friends. She observes one of the therapists she supervises at another table being intimate with a gentleman she is currently treating on an outpatient basis. Which of the following actions should the supervisor take in order to be consistent with the OT Code of Ethics? A. Indicate to the therapist that she may maintain the relationship as long as it does not impair the patient‟s treatment B. Notify the state licensure board and terminated the employee C. Notify NBCOT of the situation and reassign the patient to a different therapist D. Discipline the employee and refer the patient to anther outpatient center

131. An individual with low endurance complains of becoming too fatigued during sexual activity to enjoy it. The BEST strategy for the therapist to recommend is for the individual to: a. time sex for the end of the day. b. take the top, prone position. c. take the bottom, supine position. d. experiment with a variety of positions.

132. An OT practitioner working in a sheltered workshop with adult clients with developmental disabilities is preparing for a group of clients functioning at Allen‟s Cognitive Level 4. Which of the following is the BEST method for introducing an assembly activity? a. Provide repetitive, one-step activities. b. Demonstrate a three-step assembly process. c. Provide project samples for clients to duplicate. d. Provide written directions for the individuals to follow.

132. Staff members in a group home report to the OT practitioner that several of the men repeatedly try to touch female clients and staff and often make sexual gestures and comments. Which of the following environmental modifications would be MOST likely to reduce this behavior? A. Provide a relatively active and stimulating environment with opportunities for these individuals to engage in real-life activities B. Stand to the side of these individuals instead of face to face during interactions with them C. Avoid having these individuals in close proximity to others to reduce opportunities for physical contact D. Advise these individual in a calm nonjudgmental manner about the behavior you expect

132. The OTR is teaching a student how to perform range of motion exercises with a patient who has quadriplegia. In order to encourage the development of tenodesis, the OTR must be sure to position the patient‟s wrist in: a. the neutral position during finger flexion and extension b. flexion during finger flexion and extension c. extension during finger flexion and extension and flexion during finger extension d. flexion during finger flexion and extension during finger extension

133. Which of the following devices will be required by an individual with C7-8 quadriplegia when performing oral hygiene activities? A. Mobile arm support with utensil holder B. Universal cuff C. Toothbrush with built-up handle D. Wrist support with utensil holder

134. An OT practitioner is planning to demonstrate and then involve a group of individuals in practicing "broken record" behaviors. Which of the following interventions BEST encompasses the broken record technique? A. Music therapy activities B. Self-awareness activities C. Assertiveness training D. Psychodrama approaches

134. An elderly patient, who lives alone, has been briefly hospitalized following a car accident and is being discharged from the acute care setting. The patient continues to need rehabilitative services to maximize functional independence and eventually return home. This person is medically stable, motivated, and cognitively intact and has rehabilitation potential. But the person tires quickly, is weak, and tolerates only brief periods of therapy. The MOST appropriate recommendation for the OT to make regarding this patient is: A. Attending an inpatient physical dysfunction rehabilitation program B. Extending the patient‟s stay in the familiar acute care hospital to receive additional therapy C. Attending a rehabilitation program in a skilled nursing or extended care facility D. Seek nursing home placement for this patient

134. During and oral motor evaluation, an OT practitioner asks the client to stick out her tongue. Next, the client is asked to move her tongue from side to side. The two functions that the OT practitioner is attempting to facilitate are: a. protrusion and humping b. lateralization and tipping c. protrusion and lateralization d. lateralization and humping

162. An OT practitioner is working with an individual who demonstrates the inability to begin a task or activity. The practitioner documents that the client MOST likely has problems with: A. Attention B. Concentration C. Initiation D. Apraxia

135. An OTR/COTA team need to report discharge information and document the information in the patients‟ chart, at what level does the COTA participate in making discharge recommendations? A. An entry level COTA may perform the task independently. B. An intermediate-level COTA may perform the task independently. C. A COTA contribute to the process by does not complete the task independently. D. A COTA cannot perform the task.

136. When adapting toilet for use by a child with poor postural control, the OT practitioner should pay PRIMARY attention to which of the following issues? a. Can the toilet paper be reached without a major weight shift? b. Is the flush handle easy to manipulate? c. Can the child‟s feet reach the floor? d. Is a non-skid mat placed in the floor to prevent slipping?

137. Many COTA are employed in long-term care facilities and perform many functions. The function which the OTR MUST perform in this setting is: A. activity programming, environmental adaptations, and caregiver and staff educations B. ADL training and running feeding and leisure activity groups C. interpreting results of assessments for the purposes of treatment planning D. positioning, providing adaptive devices, and instructing in use of splints

138. A mother of four teenage children who was diagnosed with a right CVA is receiving home care OT services. The treatment plan includes "activities" to improve left upper extremity function@ and activities to improve balance in sitting and standing. Which of the following activities would be most appropriate? a. Stacking cones b. Door pulley c. Folding laundry d. Throwing a ball

138. A young child with hypertonicity is unable to bring his hands to midline to reach for a toy while in the supine and sitting positions. The BEST position to use in order to reduce the effects of abnormal patterns and facilitate midline grasp is: A. The standing position B. The prone position C. The sidelying position D. The quadruped position

138. Which of the following is the MOST appropriate goal to address when working with clients diagnosed with cognitive disorders? A. Improve their social skills in relating to others B. Create new habits of time use C. Implement compensatory strategies to manage the environment D. Facilitate resumption of previous life roles

139. Inpatient OT treatment groups for individuals with schizophrenia are MOST appropriate when they provide the opportunity for group members to: a. disclose themselves in the groups b. develop insight into their feelings c. practice social and life skills d. deal with expression of anger

14.Which of the following is the MOST appropriate goal to address when working with clients diagnosed with cognitive disorders? A. Improve their social skills in relating to others B. Create new habits of time use C. Implement compensatory strategies to manage the environment D. Facilitate resumption of previous life roles

140. An OT practitioner is working on hand function with a school-age child diagnosed with juvenile rheumatoid arthritis. Which of the following devices will MOST effectively prevent hand fatigue? a. Reacher b. Jar opener c. Pencil gripper d. Plate guard

140. The OT practitioner is attempting to better understand a particular phenomenon by conducting a small research study. Initially, the OTR identifies a potential research question. The NEXT step in the process would be to: A. state the purpose B. design the research C. complete a review of the literature D. establish boundaries for the study

141. An OT practitioner is evaluating a young cabinet maker who complains of sensory changes over the dorsal thumb and proximal phalanx of the index, long, and half of the ring finger. The practitioner will MOST likely suspect involvement of the: A. ulnar nerve B. median nerve C. radial nerve D. brachial plexus

141. An individual with quadriplegia complains of frequently slumping to the side when sitting in a wheelchair. The wheelchair adaptation that would BEST enable this individual to maintain an optional position is: a. a reclining wheelchair b. an arm trough c. lateral trunk supports d. lateral pelvic supports

142. When ordering a wheelchair for an individual with MS, the MOST important consideration is the adaptability of the wheelchair in anticipation of: A. Gradual gains in strength B. Growth of the individual C. Further decline D. Improved wheelchair mobility

143. A 1-year-old child is working on increasing neck flexor strength. At this time, the child can maintain head alignment when tilted backward from an upright supported sitting position, to a 45-degree incline, but loses control when tilted further back. The NEXT important step in the intervention is to work on head and head neck alignment: a. in a sidelying position while batting a toy b. in a prone position while watching a peek a boo game c. by tilting backwards up to 60 degrees while rocking d. in a supine position, while watching an overhead mobile

143. A nursing home resident with Alzheimer‟s disease also has limitations in shoulder range of motion. The OT goal for this patient is to improve shoulder motion so that the person can resume self- care activities. Which strategy which would be MOST effective in getting the client actively engaged? a. Telling the resident to perform repetitions of active UE range of motion exercises independently. b. Training the resident to use long handled adaptive devices to compensate for decreased shoulder motion. c. Incorporating simple, familiar activities such as hanging up clothing or catching a ball. d. Performing PROM exercises on the resident.

143. An OT practitioner is assessing a client who has schizophrenia and appears to be experiencing acute symptoms of the disease. Which of the following is considered to be an acute or positive symptom of schizophrenia that the OT might document in her assessment? A. Flat affect B. A lack of pleasure C. Hallucinations D. Withdrawal from others

145. The therapist need to identify an activity that will address psychosocial goals by (1) allowing the individual to experience success using a messy process and (2) requiring the individual to delay gratification. The activity process that is the BEST for providing this experience is: A. Working in a group of three other individuals B. Selecting the design pattern for a tile trivet C. Applying grout to a tile trivet and waiting for it to dry D. Encouraging the individual to clean off the table at the end of the group session

146. An OT practitioner is working with an individual who is about to be discharged from OT after rehabilitation for a hand injury. The client has not been able to work for 3 months and is still unable to perform the job requirements as a sales manager in a clothing store. Which of the following recommendations should the OT practitioner recommend concerning OT services? A. The client should continue to perform a home program at time of discharge. B. The client should receive home health OT. C. The client should enrol in a work-hardening program. D. The client should discontinue OT services at the time of discharge.

147. A 78-year-old individual who is ambulating with a walker in the home informs the OT practitioner that improving balance is a major concern. Although the patient took showers in the past, now his fear of falling limits him to sponge baths. The OT practitioner tells the individual that it is wise to avoid situations in which the risk of falling is high. Which of the following should the OT practitioner advise the individual to the NEXT? A. Try the bathtub instead of the shower B. Purchase a shower char C. Describe how using a shower chair improves safety D. Explain that therapy will improve his balance.

147. The spouse of an individual being treated for bipolar disorder describes the frustration he experiences in regard to the ups and downs of his wife‟s condition. The support group that the OT practitioner would MOST likely refer this individual to is: a. Al-Anon b. family therapy c. National Alliance for the Mentally III d. Recovery, Inc.

148. In selecting a standardized test to use with a child, an OT practitioner can assume that the test: A. is valid. B. has normative data. C. has standard format. D. is reliable.

148. The husband of an individual who is being treated for bipolar disorder describes his frustration with the ups and downs of his wife‟s condition. Which of the following is the BEST support group to recommend to this husband? a. Al-Anon b. Family therapy c. National Alliance for the Mentality III d. Recovery, Inc.

149. A young client who will be using a wheelchair after discharge from the rehabilitation facility is going home. In determining accessibility of the interior home environment, the FIRST area of evaluation the OT will be concerned with is: A. location of telephones and appliances. B. arrangement of furniture in bedrooms. C. steps, width of doorways, and threshold heights. D. presence of clutter in the environment.

15.An individual that an OT practitioner is treating is suddenly diagnosed with a disabling condition. Which would be the FIRST adaptive response that would MOST likely pass in time without intervention? A. A dependency reaction B. A stress reaction C. A grief response D. A desire to set unrealistic goals

15.Infants and preschool children with musculoskeletal disorders require ongoing examination of their upper extremity strength, coordination, and functional abilities. The OT practitioner will obtain the majority of assessment information during infancy and preschool through: a. assessments related to the specific diagnosis that determines hand function b. dynamometer and pinch meter function c. observation of play and hand function d. functional independence measures

150. A client who is an alcoholic is in search of a group to attend upon discharge that will assist with the rehabilitative process. The MOST appropriate self-help group for the OT to recommend to an individual who abuses alcohol is: A. Mothers Against Drunk Drivers (MADD) B. Al-Anon C. Alcoholics Anonymous (AA) D. Group therapy

151. An OT is participating in the evaluation of an older adult in the early stage of Alzheimer‟s disease. The deficit MOST likely to be evident is: A. Aphasia B. Incontinence C. Memory impairment D. The inability to dress and undress

151. The treatment environment in which an OTR would be MOST likely to emphasize discharge planning for addressing mental health problems would be a(n): a. club house b. community mental health center c. acute care hospitalization d. quarterway house

152. The benefits that a correct sitting position has in relation to hand function is explained to the parents of a child with CP. The child currently uses compensatory movements because of the inability to sit independently. Which aspect of therapeutic positioning should the OTR stress? A. Stabilizing the trunk B. Placing weight on the arms C. Stabilizing the pelvis, hips, and legs D. Stabilizing the head and neck

152. Upon completion of the initial interview and chart review, the NEXT step to be taken by the OT is to: A. Analyze the data B. Develop a treatment plan C. Perform selected assessments D. Select appropriate evaluation procedures

153. An adult with schizophrenia walks with a shuffling gait and hunched posture. Using a movement-centered frame of reference, which of the following activities would MOST effectively contribute to normalization of this individual‟s posture? A. Dancing with rapid alternating movements B. Playing the game twister C. Digging a garden with a shovel D. Rocking in a rocking chair

154. A client diagnosed with schizophrenia is taking a neuroleptic medication to control hallucinations. While in the hospital, the client experienced postural hypotension as a side effect of the medication. Before discharge, the MOST important advice to give this client concerning medication management is: A. To keep time in the sun as brief as possible B. To avoid using power tools and sharp instruments C. To get up slowly from a standing, sitting, or lying position D. About the dehydrating effects of caffeinated drinks and alcohol

154. An OT practitioner is administering a standardized test to a young client who suddenly becomes uncooperative and complains that the test is too hard. The MOST appropriate response for the OT practitioner would be to: A. switch to easier items to improve the child‟s self-esteem. B. terminate the session and schedule another session for the remainder of the test. C. follow administration instructions and note changes in behavior. D. adapt the remaining test items to ensure success.

154. An OT practitioner is determining a third-grader‟s readiness for discharge from direct OT as a related service. The essential criteria which the practitioner needs to assess is: a. whether the areas of concern to the OT interfere with the child‟s education. b. the degree of functional skills possessed by the child. c. the level of independence in ADL. d. the degree of accessibility of the learning environment.

155. A preteen with a history of TBI is relearning to prepare simple foods but has been having difficulties with sequencing so the OT practitioner has provided the patient with a chart of steps to follow. The child has just learned to prepare his favorite sandwich without "losing his place" in the process but continues to need occasional verbal reminders to look at the chart and to ensure safety. At this point, the child‟s MOST recent level of independence would be documented as: A. Independent B. Independent with setup C. Supervision D. Minimal assist

155. An OT practitioner in a psychosocial setting is documenting a client‟s responses to an activity. Which of the following is the most OBJECTIVE statement? a. "the client did not want to finish her stencilling activity" b. "the client was hostile to another client in the activity group" c. "the client independently selected one of six craft designs presented" d. "the client demonstrated an appropriate level of frustration tolerance during most of the activity"

155. An OT practitioner is working in an acute care inpatient psychiatric facility. Upon admission, the FIRST step in planning for the discharge of a socially isolated individual is to: a. provide community re-entry activities introduce the individual to community resources to use after discharge. b. evaluate the individual‟s occupational performance. c. educate the family about the individual‟s ability to return home. d. make a referral to an outpatient socialization program.

156. An OT practitioner providing home-based care to an individual with AIDS learns from his caregiver that he has become too weak to turn himself in bed. What is the MOST important modification to the treatment plan for the OT practitioner to recommend? a. to begin a strengthening program b. to begin a bed mobility program c. to teach the caregiver how to lift and turn the client safely d. to provide an environment control unit to the client

157. A child who has difficulty with visual perception of "position in space" will soon be discharged from an outpatient occupational therapy program and the OT practitioner will be meeting with the classroom teacher and parents. Of the following, which would be the BEST activity to promote this type of visual perception? a. Identifying letters on a distracting page. b. Finding geometric shapes scattered in a box. c. Following directions about objects located in front, in back, and to the side. d. Making judgements about moving through space.

157. A client with hemiplegia and her spouse are working on toilet transfer training activities with the OT practitioner. The BEST way for the OT practitioner to teach the couple to perform transfers will be: A. only the unaffected side of the client‟s body B. only to the affected side of the client‟s C. to both sides of the client‟s body D. only to the side of the body from which the client will be approaching the toilet

157. An OT practitioner is considering possible topics for a discharge planning group for individuals on an inpatient psychiatric unit. Which of the following topics would be MOST important to cover because it is significantly related to the possibility of rehospitalization? A. Managing family conflicts B. Living skills needed for keeping aftercare appointments C. Coping strategies for continuing medication compliance D. Education about problems with alcohol and substance abuse

158. During OT treatment, a child has a seizure. The MOST important actions for the OT practitioner during the seizure are to: a. check breathing and administer mouth to mouth resuscitation if necessary b. attempt to restrain the child‟s movement to prevent injury c. ease the child to a lying position, remove or pad nearby objects, loosen clothing d. take no actions except observation of the child

158. In carrying out inpatient treatment groups for individuals with schizophrenia, the OT practitioner should routinely: A. Use projective media such as clay to facilitate expression of feelings B. Allow an individual group member to work in an isolated area away from the group C. Use simple and highly structured activities D. Discuss the individuals‟ delusions with them

159. An OT practitioner working in a sheltered workshop with individuals with mental retardation must be aware of how the agency that provides series to the developmentally disabled population is accredited. Which of the following is responsible for accrediting these workshops? A. JCAHO B. CARF C. AC MRDO D. NLN/APHA

159. An individual will be performing sliding board transfers with assistance from family members upon discharge. When ordering the wheelchair, which features will be MOST important to include? a. one-arm drive and low backrest b. reclining backrest and elevating footrests c. swing-away footrests and removable armrests d. elevating footrests and removable armrests

161. A patient is about to be discharged after completing a rehabilitation program following a total hip replacement. In assessing the home environment, the OT practitioner takes into consideration the patients poor visual acuity. The MOST appropriate adaptation to ensure that the client can go up and down the stairs safely is: a. installing a stair glide b. installing hand rails in both sides of the steps c. marking the end on each step with high contrast tape d. instructing the patient to take only one step at a time when going up or down

161. The OT practitioner has fitted a 6-year-old child for an adapted seat for use in the home for mealtime and other table-top activities. Which of the ff. instructions is MOST appropriate to convey to the parents? A. Adapt the seat as needed B. Bring the seat in for each weekly therapy session in order to adjust it according to the child‟s growth C. Bring the seat in for reevaluation within 6 months D. Keep the seat until the end of the IEP

161. The therapist is re-evaluating and individual‟s PROM for elbow flexion by completing three consecutive measurements. A 10-degree discrepancy exists between the first two measurements and the third. The MOST likely response of the therapist would be to: a. check the alignment of the goniometer. b. use a larger goniometer. c. use a smaller goniometer. d. attempt to force the individual‟s arm further into flexion.

164. An individual is about to be discharged to home following a hip arthroplasty. He is able to ambulance with a quad cane, but his balance remains slightly impaired. During the home evaluation, which is the MOST important safety recommendation for the OT practitioner to make? a. Remove all throw or scatter rugs b. Place lever handles on faucets c. Install a ramp if steps exist d. Install a handheld shower

164. The OT observes that a child moves from a completely prone position to a prone-on-elbow position. In reporting the child‟s progress, the OTR documents that the child is gaining control in the midline position through the development of: A. Primitive reflexes B. Prehensile reactions C. Righting reactions D. Equilibrium reactions

165. A 1-year-old child is working on increasing neck flexor strength. At this time, the child can maintain head alignment when tilted backward from an upright supported sitting position, to a 45- degree incline, but loses control when tilted further back. The NEXT important step in the intervention is to work on head and neck alignment: A. in a side lying position while batting a toy. B. in a prone position while watching a peek-boo game. C. by tilting backward up to 60 degrees while rocking. D. in a supine position, while watching an overhead mobile.

165. When reporting data collected to the OTR, it is MOST important for the COTA to: A. Observe everything the patient said and did during the interview and provide extensive notes for the OTR to read. B. Provide the OTR with a comprehensive treatment plan based on the results of the evaluation. C. Provide a summary of observations of the patient‟s behavior, including what the patient said and did during the interview. D. Provide an interpretation of how the patient behaved during the interview.

166. Before working in a chronic psychiatric unit, a practitioner must understand the effect that certain medications have on daily function. The extrapyramidal side effect syndrome experienced by individuals receiving antipsychotic medications that impairs swallowing and leads to involuntary jerky arm and leg movements can BEST be described as: A. Parkinsonian syndrome B. Antipsychotic medication overdose C. Tardive dyskinesia D. Lithium toxicity

168. Several clients are about to be discharged from an inpatient psychiatric unit to a variety of community programs. Which of the following areas is MOST important to address in a discharge planning group? a. developing ADL routines b. self-awareness c. relapse prevention d. social skills

169. An OT manager is preparing the OT staff for a visit from an accrediting agency. The accrediting agency that surveys the inpatient and comprehensive outpatient rehabilitative programs is BEST represent by which of the following: a. AOTA b. JCAHO c. CARF d. NBCOT

170. An OT practitioner is working with an individual who has had an injury to the nondominant right cerebral hemisphere. The MOST relevant communication strategy to enhance this person‟s understanding of directions would be to provide: A. Written information presented on the left side of the body B. Exaggerated facial expressions and body gestures rather that words C. Simply stated, concrete verbal instructions D. Pictures of instruction presented on the left side of the body

171. An OT practitioner working in a sheltered workshop with individuals with mental retardation must be aware of how the agency that provides services to the developmentally disable population is accredited. Which of the following is responsible for accrediting these workshops? a. JCAHO b. CARF c. AC MRDD d. NLN/APHA

171. In a long-term care facility, a number of residents have Parkinson‟s disease and would benefit from regular group activity which would help decrease the effects of muscular rigidity. The BEST activity the OT could recommend for this purpose would be: A. Weight training B. Walking C. Tai Chi D. Gardening

171. The husband of an individual who is being treated for bipolar disorder describes his frustration with the ups and downs of his wife‟s condition. Which of the following is the BEST support group to recommend to this husband? A. Al-Anon B. Family therapy C. National Alliance for the Mentally III D. Recovery, Inc.

172. An OPT practitioner is providing accessibility consultation services to a local library. In the back of the library there is a reference room with a doorway that has a threshold of 1-inch height. Concerning the threshold and accessibility according to the ADA guidelines, the BEST recommendation would be: a. Keeping the threshold as is, place a sign near the door alerting people to the threshold. b. Providing a throw rug which covers the threshold. c. Removing the threshold altogether. d. Ramp the threshold.

172. An OTR is a team member of a work hardening program. Which of the following would BEST represent the goal that an OT practitioner would document regarding this type of program? a. ADL retraining to increase the ability to perform household skills independently b. progressive resistive exercise to increase endurance for self- care skills c. work simulation to increase strength and endurance for necessary work related skills d. vocational retraining to increase the ability to re-enter the job market

173. The OT is working with and individual in a psychosocial partial hospitalization program who is having difficulty making decisions. The therapist has suggested a baking activity but the client as unsure if she wants to do this activity. The therapist‟s response that would BEST facilitate decision making is: A. I think baking would be a helpful activity to try. Baking something you like offers you several choices and decisions. You wanted to bake cookies today, didn‟t you? B. I think baking would be a helpful activity to try. Baking something you like offers you several choice and decision. Why do you want to bake? C. I think baking would be a helpful activity to try. Baking something you like offers you several choices and decisions. You wanted to bake cookies today, which would you like? D. I think baking would be a helpful activity to try. Baking something you like offers you several choice and decision. Do you want to bake cookies?

174. Which of the following is the most appropriate emphasis for a cooking group for young women with eating disorders? A. Increasing knowledge of a variety of weight loss techniques B. Information on the calorie content of different foods C. Preparing and consuming nutritional and normal-sized portions of food D. Preparing healthy and appealing looking meals

175. An OT wishes to assess the results of a life-skills training program provided to individuals at a shelter for abused women. Which of the following methods would be BEST for obtaining this Information? a. Final evaluation of each client involved b. Client satisfaction survey c. Program evaluation d. Utilization review

177. The OT practitioner is treating a patient with a standard above elbow amputation who is experiencing hypersensitivity of the residual limb.The OT would most likely perform which of the following interventions in this preprosthetic phase of treatment? A. Activities to strengthen the residual limb B. Activities to increase the range of motion of the residual limb C. Activities which provide tapping, application of textures, and weight the range of motion of the residual limb D. Activities for practicing putting on and taking off the UE prosthesis

178. A clinical manager of OT supervises an employee who has demonstrated specialized skills in treatment and serves as an expert for her peers. This practitioner has completed research, leadership training, and assisted in continuing education activities. The manager of the department is MOST likely to supervise this individual at what level? A. Close supervision B. Intermediate supervision C. Advanced supervision D. Educator supervision

179. An OTR needs to provide "general supervision" to an experienced COTA in a long term care treatment setting. As defined by the AOTA, the OTR will have contact with the COTA: A. Once a day B. Once a week C. Once a month D. Ass needed

180. An OT practitioner is assessing a client who has schizophrenia and appears to be experiencing acute symptoms of the disease. Which of the following is considered to be an acute or positive symptom of schizophrenia that the OT might document in her assessment? A. Flat affect B. A lack of pleasure C. Hallucinations D. Withdrawal from others

180. The precaution MOST frequently used by OT practitioners and others in the health care field to prevent infection is: A. The wearing of goggles B. The wearing of a mask C. Frequent handwashing D. The wearing of a gown over work clothes

180. The supervisor of OT is off work and in a local establishment listening to a band with her friends. She observes one of the therapists she supervises at another table being intimate with a gentleman she is currently treating on an outpatient basis. Which of the following actions should the supervisor take in order to be consistent with the OT Code of Ethics? A. Indicate to the therapist that she may maintain the relationship as long as it does not impair the patient‟s treatment B. Notify the state licensure board and terminate the employee C. Notify NBCOT of the situation and reassign the patient to a different therapist. D. Discipline the employee and refer the patient to another outpatient center.

183. An elderly patient was hospitalized for a total hip replacement and is preparing to be discharged to a caregiver‟s home. The OT practitioner has recommended a program to address the patient‟s decreased mental abilities, specifically poor memory and difficulty with orientation to place and time. The BEST way for this individual to receive OT services is: A. Partial hospitalization B. Adult day care C. Home health care D. A psychosocial rehabilitation center

185. An individual with ALS swims three times a week to maximize strength and endurance. Initially able to swim for only 10 minutes, the individual is now able to swim 20 minutes without becoming fatigued. The NEXT step is: A. continue the program of swimming 20 minutes three times a week. B. decrease swimming frequency to two times a week. C. increase swimming time 25 minutes or to tolerance. D. provide adaptive equipment that will enable the individual to swim using less energy.

185. When an experienced OT practitioner completes a ROM evaluation of an individual and asks the supervisor to retest the person to check the results, the OT practitioner is MOST likely seeking: A. Supervisory feedback B. Evidence of competence C. Evidence of interrater reliability D. Evidence of incompetence

186. An OTR is performing an UE functional assessment on an elderly client with rheumatoid arthritis. The OTR is MOST likely to determine that the client has limited internal rotation if the client is unable to touch the: A. back of the neck B. top of the head C. lower back D. opposite shoulder

187. A patient who has had a TBI beginning OT. The OTR practitioner needs to access whether this person can transfer learning from one activity to another in order to plan treatment appropriately. The MOST appropriate way for an OT to: A. describe situations that might be unsafe and ask the patient how he would respond. B. give the patient a simple jigsaw puzzle to solve. C. have the patient get dressed in a certain way, then change the task at the next session. D. give the patient simple calculations to perform.

187. An entry-level OT practitioner wants to know the extent of her liability when providing occupational therapy. Which of the following answers is MOST accurate? A. Only OTRs need to have liability insurance B. Only COTAs need to have liability insurance C. Both OTRs and COTAs should have liability insurance D. Neither OTR or the COTA need to have liability insurance

188. The OT observes that a child moves from a completely prone position to a prone on elbow position. In reporting the child‟s progress, the OTR documents that the child is gaining control in the midline position through the development of: A. primitive reflexes B. prehensile reactions C. righting reactions D. equilibrium reactions

189. A home health OT has received a referral for a Medicare patient. Which one of the following items is MOST necessary to have before the therapist can initiate evaluation or treatment? a. Identification of the deficits that impair functional abilities. b. Established short-term and long-term goals. c. A physician‟s order identifying services to be provided. d. The individual‟s history of the current illness.

19.A pre-schooler with a diagnosis of developmental delay is very withdrawn and passive. While working on toilet skills, the child reaches out for a toothbrush and starts brushing her hair with it. The OT practitioner recognizes the PRIMARY importance of this behavior as: a. demonstrating attention-getting behavior b. a sign of cognitive limitation c. indicating initiative and beginning task-directed behavior d. demonstrating misinterpretation of cues because of a visual deficit

19.An OT practitioner observes a child with a learning disability use an unusually tight grip when writing with a pencil. The child also frequently breaks his pencil from applying too much pressure on the paper. This type of problem is MOST likely caused by inadequate sensory information from the: A. Vestibular system B. Auditory system C. Somatosensory system D. Visual system

190. An individual demonstrates the ability to pick up a penny from a flat surface. This represents which of the following prehension patterns? A. Lateral B. Palmar C. Tip D. Three-jaw chuck

190. The manager of an OT department is planning for reallocation of space that the department occupies. The manager studies and identifies the flow of staff and patients through the clinic, offices, and ADL apartment. In so doing, the manager has MOST likely: A. Identified elements critical for selecting a new location for the department B. Determined equipment needs C. Analyzed the work flow D. Determined functional areas

191. A home health OT has received a referral from an individual with Medicare coverage. Which one of the following actions must occur before the therapist can initiate evaluation or treatment? A. Identify the deficits that impair functional abilities B. Establish short and long term goals C. Obtain a physician‟s plan of care identifying services to be provided D. Obtain the individual‟s history of the current illness

191. An OT practitioner is treating a middle-aged client who has CTS. The industrial nurse indicated that the condition was a result of repetitious fine motor skill execution required as an essential job function. The OT suggests to the client that the payment program MOST likely to reimburse for OT service is: A. Medicare B. Medicaid C. Worker‟s compensation D. The Education for All Handicapped Children Act

191. An older adult with diabetes is working on a macramé project as a way increasing standing tolerance. The MOST relevant safety factor for the OT practitioner to take into consideration is the: A. length of the cords she will start with B. thickness of the cords she will be using C. texture of the cords she will be using D. type of surface she will be standing on

192. A COTA frequently administers the ACLS test and then discusses it with the supervising OTR. Which of the following MOST accurately describes the OTR‟s role during these discussions? A. Determine the COTA‟s service competency B. Collect data on the patient‟s performance C. Interpret the results based on data collected by the COTA D. Develop the treatment plan

192. An OT practitioner who is leading a stress management group explains to the members that stressors can be MOST accurately described as the: A. process by which individuals adjust to daily stressful events within their environments. B. body‟s reactions to the, often described as flight, or flight. C. precipitating conditions and events that elicit stress reactions. D. process of fit between the individual and his or her environment.

193. A COTA and OTR jointly decide to discharge an individual after the goal of independence has been achieved. However, they are instructed by the facility administrator to continue treating, or at least billing, the individual for two sessions per day for the next week, because his insurance will allow it. What is the most appropriate action for the OT practitioners to take? a. continue to work on activities the individual particularly enjoys twice a day whenever possible b. discontinue treatment but continue to bill as directed by the administrator c. inform the administrator they are unable to provide services to individuals who can no longer benefit from OT d. compromises with the administrator and agree to drop in and check on the individual once a day and bill accordingly

193. An OT practitioner is teaching a client who recently sustained an above elbow amputation how to dress with one hand. Teaching a client to perform a familiar activity or skill is called the: A. problem-solving method B. retraining method C. altered task method D. compensation method

194. A school age child has Duchenne muscular dystrophy. Although he is able to use a manual chair for distances between classes, he is tired on arrival. What would be the BEST recommendation the OTR could make for wheelchair use at school? A. Retain the manual chair to build up strength B. Change to an ultralight sports model because it requires less strength C. Change to a power wheelchair to reduce effort D. Encourage walking with a walker to alternate mobility methods

194. An OT practitioner is completing research on patients with hemiplegia and functional return of the upper extremity. The practitioner is attempting to obtain a random sample of patients. Collecting a random sample MOST likely means that the therapist will use: A. The entire population of the facility‟s stroke patients B. All patients who have had a CVA with resulting deficits in the upper extremity function C. A numbers table to select the population D. A small group of patients who are representative of the population with each individual meeting criteria, which validates that they are a representative subset of the population

194. Many COTAs are employed in long-term care facilities and perform many functions. The function which the OTR MUST perform in this setting is: a. activity programming, environmental adaptations, and caregiver and staff education. b. ADL training, and running feeding and leisure activity groups. c. interpreting results of assessments for the purposes of treatment planning. d. positioning, providing adaptive devices, and instructing in use of splints.

195. An OT practitioner evaluation a child notices a bruise on the child‟s shoulder that looks like an adult‟s hand and fingerprint. Which of the following actions is it MOST critical for the OT practitioner to take? a. Discuss this with the family member who picks up the child. b. Observer further additional injuries. c. Make a report to appropriate authorities. d. Avoid becoming involved in personal family matters.

196. The OT practitioner is attempting to better understand a particular phenomenon by conducting a small research study. Initially, the OTR identifies a potential research question. The NEXT step in the process would be to: A. State the purpose B. Design the research C. Complete a review of the literature D. Establish boundaries for the study

49.When developing play activities for a child with acute juvenile rheumatoid arthritis, which of the following precautions should the OT practitioner follow? A. Avoid light touch B. Avoid rapid vestibular stimulation C. Avoid resistive materials D. Avoid elevated temperature

197. An advanced-level COTA has expressed interest in taking on some administrative duties in an OT department. Which of the following tasks would be MOST appropriate for the OTR to assign the COTA? A. Development of a quality-assurance program B. Supervision of entry-level OTRs and COTAs C. Supervision of noncertified personnel D. Development of marketing strategies to promote a new program

197. Direct OT services are being discontinued for a student with attention deficit disorder, but consultation will be provided to help the child adjust to the new classroom. Which of the following recommendations is MOST appropriate? A. Use dim lighting and reduce glare by turning down lights B. Remove all posters and visual aids to reduce visual distractions C. Provide a screen to reduce peripheral visual stimuli D. Restructure classroom activities into a series of short term task

198. An OTR/COTA team need to report discharge information and document the information in the patient‟s chart. At what level does the COTA participate in making discharge recommendations? a. an entry-level COTA may perform the task independently b. an intermediate-level COTA may perform the task independently c. a COTA contributes to the process but does not complete the task independently d. a COTA cannot perform the task

198. One OT practitioner witnesses another OT practitioner under the influence of alcohol treating patients. The practitioner decides to take actions to prevent this practitioner from practicing in the United States. Which of the following would be MOST appropriate organization to contact? a. AOTA b. State regulatory board c. NBCOT d. Administration of the facility

198. The BEST way to instruct an individual with hemiparesis to button a shirt to: A. button all the buttons before putting the shirt on. B. get the shirt all the way on, the line up the buttons and holes and begin buttoning from the top. C. get the shirt all the way on, then line up the buttons and holes and begin buttoning from the bottom. D. use a buttonhook with a built-up handle.

198. The FIRST step a COTA should take upon receiving a written referral for OT services for an acute care patient being discharged in 2 days is to: A. Initiate the ADL component of the evaluation B. Begin a chart review C. Notify the OTR D. Screen the patient

199. An OT practitioner is speaking with parents who believe that their child with CP could benefit from OT consultation at school. In order for a school aged child to receive OT services within a school system, which of the following forms must be completed FIRST? A. UB-82 B. FIM C. IEP D. HCFA-1500

199. An OTR arrives for a home health visit on a Thursday morning (1/14/01), but the client is not feeling well, so they reschedule for the following day. The practitioner‟s charges for the week are due on alternating Thursday afternoons. Anticipating a follow-up visit with the client the next day (1/15/01) and reluctant to wait another 2 weeks to submit for payment, the practitioner bills for treatment using the 1/14/01date. The OT practitioner‟s action is: A. Acceptable because treatment has been scheduled for the next day B. Acceptable if the agency she works for allows it C. Unacceptable because it violated the Code of Ethics D. Unacceptable because if the patient is still ill and unable to participate in therapy on 1/15/01, a delay of more than 1 day is unacceptable for billing purposes

20.OTs working in the area of early intervention have frequent contact with a child‟s parents. Which of the following statements BEST describes how parents should be involved in the OT program? A. Parents should not be present during OT sessions B. Parents should be trained as substitute therapists C. Parents should be considered as part of a collaborative partnership with therapists D. Only on parent needs to be present when the OT program is discussed

200. While preparing for his first presentation at a professional conference, an OT realizes he does not have the name of the author of an article containing critical information he planned n photocopying and distributing. Which of the following is the MOST appropriate action for the OT to take? a. distribute the handout and apologize for not having the author‟s name b. show the handout with an overhead projector and apologize for not having the author‟s name c. use the handout only as resource while developing the presentation d. refrain from using the handout in any way

21.A child with a learning disability has significant problems with visual memory. An OT practitioner may use which of the following to better enhance visual memory? A. Provide memory tasks that are of low interest to the child B. Decrease visual attention before doing memory tasks C. Combine task with additional sensory input (tactile, proprioceptive, and auditory) D. Repeat the visual memory task once

22.A therapist is evaluating an individual with a peripheral nerve injury for strength, range of motion and endurance. The most appropriate frame of reference on which to base the evaluation is: a. rehabilitative FOR b. neurodevelopmental FOR c. biomechanical FOR d. psychoanalytic FOR

25.A 3-year-old child is able to use the toilet independently except for wiping and readjusting clothing afterward. This behavior indicates the child is performing at which of the following levels? A. Significantly below age level. B. Slightly below age level C. At age level D. Above age level

49.When leading groups, OT practitioners should demonstrate consistency from day to day. Inconsistent behavior would MOST likely result in: A. Overdependence of group members B. Group members knowing what to expect from the group leader C. Anxiety and confusion among group members D. Group members receiving too much praise

26.During a tub transfer training session, an individual requires cueing to lock his wheelchair brakes and requires assistance to lift his legs from the wheelchair into and out of the tub. He is able to scoot himself from the wheelchair to the tub bench with occasional loss of balance. How should the individual‟s performance be documented? A. Dependence B. Minimal assistance C. Moderate assistance D. Maximal assistance

28.An adult with schizophrenia walks with a shuffling gait and hunched posture. Using a movement-centered FOR, which of the following activities would MOST effectively contribute to normalization of this individual‟s posture? A. Dancing with rapid alternating movements B. Playing the game Twister C. digging a garden with a shovel D. Rocking in a rocking chair

29.When ordering a wheelchair for an individual with multiple sclerosis, the MOST important consideration is the adaptability of the wheelchair in anticipation of: A. Gradual gains in strength B. Growth of the individual C. Further decline D. Improved wheelchair mobility

3. In selecting a standardized test to use with a child, an OT practitioner can assume that the test: a. is valid b. has normative data c. has a standard format d. is reliable

30.A patient who has had a traumatic brain injury is beginning OT. The OTR practitioner needs to assess whether this person can transfer learning from one activity to another in order to plan treatment appropriate way for an T to observe this learning ability would be to: a. describe situations that might be unsafe and ask the patient how he would respond b. give the patient a simple jigsaw puzzle to solve c. have the patient get dressed in certain way, then change the task at the next session d. give the patient simple calculations performs

30.An OT practitioner is assessing a client‟s ability to perform work and productive activities. Examples of these occupational performance areas include: A. Health maintenance, socialization, and community mobility B. Feeding, eating, and sexual expression C. Clothing care, cleaning, and volunteering D. Reading, watching television, and doing small handicrafts

31.An 11-month-old child who was born 3 months prematurely is being evaluated at an OT outpatient clinic. The MOST accurate assessment profile can be obtained if the OTR compares this child‟s abilities with those of a normal child aged: A. 11 months B. 14 months C. 8 months D. 10 months

31.An OT practitioner is speaking with parents who believe that their child with CP could benefit from OT consultation at school. In order for a school-age child to receive OT services within a school system. Which of the following forms must be completed FIRST? A. UB-82 B. FIM C. IEP D. HCFA-1500

31.An OT practitioner requests that an OT student treat a client with a condition involving the upper extremity. The OTR suggests the use of contrast baths, retrograde massage, and pressure wraps. The OT student can consider these interventions as PRIMARY techniques to address: A. Heterotropic ossification B. Edema C. Wound healing D. Scar management

32.A client experiences chronic pain while engaged in household chores. Because of this pain, the client avoids actions that require motor performance. OTR observes a MOTOR response to pain, as demonstrated by the patient‟s: a. inability to concentrate on tasks because of pain b. frequent complaints of aching pain c. repeated protecting of the joints while moving d. refusal to partake in certain ADL to prevent the accompanying pain

33.A client who recently started using a wheelchair will be returning to work and OTR is evaluating the client‟s work place for accessibility, according to ADA guidelines. The doorway to the client‟s office has a clear opening of 28 inches. Which of the following recommendations would be MOST appropriate to facilitate clear passage of the wheelchair through the doorway? a. The doorway width needs to be expanded to have a minimum clear opening of 32 inches b. The client needs to obtain a wheelchair narrower than 28 inches c. The doorway width needs to be expanded to have minimum clear opening of 45 inches d. The doorway width is satisfactorily and needs no modification

34.The OT practitioner has fitted a 6 year old child for an adapted seat for use in the home of mealtime and other table top activities. Which of the following instructions is MOST appropriate to convey to the parents? A. Adapt the seat as needed B. Bring the seat in for each weekly therapy session in order to adjust it according to the child‟s growth C. Bring the seat in for reevaluation within 6 months D. Keep the seat until the end of the IEP

35.A child with learning disabilities that have resulted in low frustration tolerance and poor self-esteem is learning how to tie shoelaces. Which of the ff. methods would be MOST appropriate for this child? A. Physical guidance B. Verbal cues C. Backwards chaining D. Forward chaining

35.A therapist reviews an individual‟s chart as part of the screening process. The psychiatrist has written "observe for side effects with current anti-anxiety medications." The OT practitioner is MOST likely to report about which of the following side effects? a. akathisia b. confusion c. extrapyramidal syndrome d. tardive dyskinesia

37.A parent observes her infant "cruise," while holding onto furniture, and asks the OT practitioner at what age a normal child begins to cruise, while holding onto furniture. The OT practitioner tells the parent that this behavior typically occurs between the ages of: A. 3 and 5 months B. 6 and 8 months C. 9 and 12 months D. 13 and 15 months

38.During a functional assessment of a person‟s strength, the therapist observes that the individual can move the arm through the full range of motion to reach a high bathroom shelf, but can lift and place nothing heavier than a can of spray deodorant on the shelf, suggesting that the person can tolerate only minimal resistance against gravity during arm motion. The strength according to the manual muscle test (MMT) is: A. Fair minus (3-) B. Fair (3) C. Fair plus (3+) D. Good minus (4-)

38.The OT treatment approach that will MOST likely meet the overall needs experienced by individuals with substance abuse problems is to: a. assist with skill development in the areas of leisure, cognition and perception, self-expression, and ADL b. educate the family members about making safety modifications to the kitchen area c. encourage Alcoholics Anonymous (AA) involvement; provide retraining of neglected ADL; explore work-related values d. make aftercare arrangements for vocational counselling and AA; provide time management; education for self-care activities

4. An OT practitioner is evaluating a client who is unable to name or demonstrate the use of common household objects. The practitioner documents this as: a. Apraxia b. Stereognosis c. Visual agnosia d. Alexia

42.An OT practitioner providing home-based care to an individual with acquired immunodeficiency syndrome (AIDS) learns from his caregiver that he has become too weak to turn himself in bed. What is the MOST important modification to the treatment plan for the OT practitioner to recommend? A. To begin a strengthening program B. To begin a bed-mobility program C. To teach the caregiver how to lift and turn the client safely D. To provide an environmental control unit (ECU) to the client

43.During the interview with the parents of a 3-year-old child with mild CP, the OT practitioner learns that the child is regularly fed by his grandmother and does not have any independent feeding skills. The FIRST issue the OTR needs to explore further is: A. The degree of abnormal muscle tone in the UEs B. The possibility of developmental delay C. The cultural context and family interaction patterns D. The need for adapted equipment

43.The treatment goal for a 4 year old child with hypotonia is to improve grasp. Which of the following activities would be BEST for preparing the child‟s hand for grasp activities? A. Dropping blocks into a pail B. Placing pegs on pegboard C. Weight-bearing on hands D. Holding and eating a cookie

44.A 12-year-old will be discharged after having received treatment for anxiety disorder. Which would be the MOST appropriate recommendation for an extracurricular school activity: A. Competitive gymnastics team B. Debating club C. School newspaper D. Basketball team

44.An OT instructor is teaching a group of OT students about various hand grips and their relationship to specific muscles and nerves. A hook grasp, for example, would MOST likely be used to hold: A. A sewing needle while it is being threaded B. A tall glass half filled with water C. A heavy handbag held by the handle D. A key while it is being placed in a lock

46.Direct OT services are being discontinued for a student with attention deficit disorder, but consultation will be provided to help the child adjust to the new classroom. Which of the following recommendations is MOST appropriate? A. Use dim lighting and reduce glare by turning down the lights B. Remove all posters and visual aids to reduce visual distractions C. Provide a screen to reduce peripheral visual stimuli D. Restructure classroom activities into a series of short-term tasks

47.A 6-month-old child, when pulled into sitting with several trials, demonstrates head lag. The OT practitioner evaluating this child should MOST accurately conclude that head control is: A. Developing in a typical manner B. Slightly delayed by 1 month C. Significantly delayed by several months D. Advanced

47.An OT practitioner is working with an individual who demonstrates the inability to begin a task or activity. The practitioner documents that the client MOST likely has problems with: A. Attention B. Concentration C. Initiation D. Apraxia

48.An OT practitioner working for the school system has identified a general need to enhance the fine coordination skills of the elementary school students to facilitate better writing skills. The BEST population-based intervention would be to: A. Screen students for writing problems and provide in-depth assessment of those identified B. Provide remedial activities for those students identified having fine coordination deficits C. Recommend activities to develop fine coordination that teachers can incorporate into classroom programming D. Recommend additional OT staff to provide direct services for students

5. Before treating a client referred to the hand center for a nerve injury, the OTR must understand the nerve pathways that innervate the hand. The nerves of the hand are MOST commonly referred to as: A. Lateral, medial, and central B. Femoral, obdurator, and sciatic C. Radial, median, and ulnar D. Dorsal, lateral, and volar

51.An OT practitioner is beginning training in meal preparation with a homemaker after a TBI. The activity that should be introduced FIRST is: a. making a peanut butter and jelly sandwich b. preparing a hot cup of tea with sugar c. pouring a glass of orange juice d. cooking a grilled ham and cheese sandwich

51.An OT practitioner is working with a group of individuals with substance abuse disorders. The practitioner wants to use an activity that will allow the clients to experience success after making amess and one that will delay gratification. The activity process that BEST provides this experience is: A. Working in a group with three other individuals B. Selecting the design pattern for a tile trivet C. Applying grout to a tile trivet and waiting for it to dry D. Encouraging the individual to clean off the table at the end of the group

51.An OT practitioner is working with an individual who is about to be discharged form OT after rehabilitation for a hand injury. The client has not been able to work for 3 months and is still unable to perform the job requirements as a sales manager in a clothing store. Which of the following recommendations should the OT practitioner recommend concerning OT services? A. The client should continue to perform a home program at time of discharge. B. The client should receive home health OT. C. The client should enroll in a work hardening program. D. The client should discontinue OT services at the time of discharge.

52.The occupational therapist is developing a treatment plan for a child with motor planning deficits. The MOST important emphasis of motor planning activities for the child will be on activities that promote: a. automatic movement b. reflexes c. coordination d. cognitive planning

53.An OT practitioner is working with a group of individuals with Parkinson‟s disease in an aquatic exercise program. The 3 performance components MOST important for successfully walking across the pool are: A. Strength, fine motor coordination, and kinesthesia B. Visual motor integration, postural control, and gross motor coordination C. Vestibular processing, postural control, and muscle tone D. Range of motion, praxis, and crossing the midline

54.The home health OT practitioner is seeing a client in the middle stages of Alzheimer‟s disease. The family is very concerned that the client‟s memory loss is now interfering with performance of daily activities, even familiar self-care activities. The MOST relevant OT intervention at this point would be to: A. Memory retraining activities for the client B. ADL retraining program for the client C. Instructing caregivers in task breakdown D. Leisure activity planning

55.An individual with right unilateral neglect is able to track from the left side to the midline of the body on paper-and-pencil tasks. The BEST treatment activity for this person to work on crossing the midline to improve writing would be to: a. Have the individual practice wheeling a wheelchair following a taped line on the floor. b. Place commonly used self-care items on the left side. c. Have the individual trace lines across the page with the right index finger from the left to the right side. d. Place playing cards in a horizontal row from right to left in sequence

55.While performing endurance training activities, an individual on a cardiac rehabilitation unit begins to slow down, using progressively smaller movements to perform the activity. Which of the following is the most appropriate action for the OT practitioner to take? A. Stop the activity B. Upgrade the activity for the next session C. Modify the activity to make it less challenging D. Replace the activity with isometric exercises

56.A school-age child with multiple handicaps is beginning to develop some controlled movement in the UE. It would be MOST appropriate to introduce switch-operated assistive technology when the child: A. Develops tolerance of an upright sitting posture B. Can reach and point with accuracy C. Demonstrates any reliable, controlled movement D. Develops isolated finger control

57.OTs working in the area of early intervention have frequent contact with a child‟s parents. Which of the following statements BEST describes how parents should be involved in the OT program? A. Parents should not be present during OT sessions B. Parents should be trained as substitute therapist C. Parents should be considered as part of a collaborative partnership with therapist D. Only one parent needs to be present when the OT program is discussed

58.An OT practitioner is planning a meal preparation activity for an adult client with attentional and organizational deficits secondary to alcohol abuse. The treatment goals address the client‟s difficulties in properly sequencing tasks. The MOST appropriate activity to use FIRST is: A. Setting the table B. Planning an entire meal C. Baking cookies using a recipe D. Preparing a shopping list

59.After completing the initial evaluation of a home care patient, the home care OTR expects the patient to achieve independence in self- care activities at different times - that is, grooming first, then upper and lower extremity dressing, then toileting. When writing the treatment goals, which of the following choices MOST appropriately reflect incremental improvements? A. Patient will be independent in self-care in 3 weeks. B. Patient will be independent in grooming, dressing, and toileting in 3 weeks. C. Patient will be independent in grooming in 1 week, in upper and lower extremity dressing in 2 weeks and in toileting in 3 weeks. D. Patient will be independent in upper extremity dressing in 2 weeks and independent in lower extremity dressing in 3 weeks.

6. An OT practitioner is working in an outpatient upper extremity and hand clinic. The practitioner‟s case load consists of clients who have tendonitis, nerve compression syndromes and myofascial pain. The OT practitioner can assume that these diagnoses are MOST commonly associated with: A. Osteoarthritis conditions B. Peripheral vascular diseases C. Cumulative trauma disorders D. Neuroma-related conditions

6. An OT practitioner observes the following: A patient who‟s asked to show the path she would take to get from her room to the therapy clinic at the other end of the corridor becomes easily confused and makes several wrong turns. This behavior MOST likely indicates: A. Spatial relations disorders B. Figure-ground discrimination deficits C. Topographical disorientation D. Form discrimination deficits

61.A child with behavioral problems has difficulty with peer interactions. Which of the following aspects of the treatment plan is MOST important? A. Provide activities in an authoritarian environment B. Allow the child the opportunity to develop basic social skills on his own C. Provide enjoyable activities in a safe and accepting environment D. Strictly enforce rules for a group play

64.An older adult with diabetes is working on a macramé project as a way of increasing standing tolerance. The MOST relevant safety factor for the OT practitioner to take into consideration is the: a. length of the cords she will start with b. thickness of the cords she will be using c. texture of the cords she will be using d. type of surface she will be standing on

65.A fifth grade child with significantly low muscle tone caused by Duchenne‟s muscular dystrophy is losing trunk control in sitting. Which of the following frames of reference should the OT practitioner consider when reevaluating the treatment program? A. Neurodevelopmental treatment B. Sensory integration C. Biomechanical D. Visual perceptual

65.A middle-aged client with paraplegia is learning to perform wheelchair to car transfers with an OT practitioner. Which is the BEST way for the OTR to recommend independent car transfers? A. By teaching a family member to assist with all car transfers B. By teaching the client to use public transportation in place of practicing car transfers C. By learning to use a sliding board with car transfers D. By learning to use tenodesis functions when transferring to the car

65.An OT manager is preparing the outpatient OT staff for a visit from an accrediting agency. The accrediting agency that surveys inpatient and comprehensive outpatient rehabilitation programs is BEST represented by which of the following; A. AOTA B. JCAHO C. CARF D. NBCOT

66.The OT practitioner working in partial hospitalization program needs to select a game that allows group members equal opportunities to win and can be played by individuals functioning at various levels. The game type the BEST suits this purpose is: a. games of strategy b. hobbies c. games of chance d. competitive games

67.An OT practitioner applies weights to the wrists of a woman who is making a macramé planter to improve strength in her shoulder. The MOST accurate description of this treatment approach is: A. Neurophysiological B. Neurodevelopmental C. Biomechanical D. Rehabilitative

67.Staff members in a group home report to the OT practitioner that several of the men repeatedly try to touch female clients and staff and often make sexual gestures and comments. Which of the following environmental modifications would be MOST likely to reduce this behavior? A. Provide a relatively active and stimulating environment with opportunities for these individuals to engage in real-life activities. B. Stand to the side of these individuals instead of face to face during interactions with them C. Avoid having these individuals in close proximity to others to reduce opportunities for physical contact D. Advise these individuals in a calm, nonjudgmental manner about the behavior you expect

7. An OT practitioner is evaluating a young cabinet maker who complains of sensory changes over the dorsal thumb and proximal phalanx of the index, long, and half of the ring finger. The practitioner will MOST likely suspect involvement of the: a. ulnar nerve b. median nerve c. radial nerve d. brachial plexus

70.The BEST way to instruct a n individual with hemiparesis to button a shirt is to: A. Button all the buttons before putting the shirt on B. Get the shirt all the way on, then line up the buttons and holes and begin buttoning from the top C. Get the shirt all the way on, then line up the buttons and holes and begin buttoning from the bottom D. Use a buttonhook with a built-up handle

71.In an acute mental health, an individual refuses to participate in OT activities, and the therapist notes the refusal in the subjective section of a documentation note. Which form of refusal would MOST likely reflect acute depression? A. "I had an argument with another group member and I‟m too angry." B. "I don‟t want to participate because I don‟t know how to do the activity." C. "I‟m just too tired." D. "I‟m waiting for my visitors to come."

72.An OT receives a consult for an infant in the neonatal intensive care unit (NICU) with a history of maternal drug abuse during pregnancy. Using a sensory integrative approach, what is the FIRST action the OT should take? a. Determine the mother‟s current medical status, parental involvement and support systems. b. Recommend a social work referral to address social concerns, provide emotional support and community program information and make a referral to the department of human services. c. Modify the environment to protect the infant from excessive and/or inappropriate sensory stimulation prior to direct intervention. d. Assess motor and behavioural skills to identify areas of developmental delay in order to educate family and medical staff of necessary positional and environmental strategies for skill acquisition.

75.An OT practitioner in working on keyboarding activities with a client with asymmetrical muscle tone who keeps falling to the side while sitting in a wheelchair. What is the MOST appropriate wheelchair adaptation the practitioner can use to stabilize the upper body in a midline position? A. Change to a reclining wheelchair B. Use an arm trough C. Provide lateral trunk support D. Provide lateral pelvic support

77.The benefits that a correct sitting position has in relation to hand function is explained to the parents of a child with CP. The child currently uses compensatory movements because of the inability to sit independently. Which aspect of therapeutic positioning should the OTR stress? A. Stabilizing the trunk B. Placing weight on the arms C. Stabilizing the pelvis, hips, and legs D. Stabilizing the head and neck

78.An individual with a fast-growing brain tumor gas begun ignoring food on the left side of the meal tray. Which of the following approaches would be MOST appropriate for this individual? A. Focus on remediation B. Educate the patient to increase left-side awareness C. Implement compensatory strategies D. Select appropriate adaptive equipment

78.In order for an individual sitting in a wheelchair to achieve maximal pelvic stability, the seat belt should be positioned: a. inferior to the ischial tuberosity b. superior to the iliac crest c. inferior to the anterior superior iliac spine d. superior to the posterior superior iliac spine

8. A child has considerable difficulty with a problem solving when playing with Legos and become frustrated and gives up easily. This MOST likely indicates a problem in which area of play? a. Sensorimotor b. Imaginary c. Constructional d. Game

8. A teenage patient is hospitalized with anorexia nervosa. An OT practitioner has been assigned to collect data on the child‟s family background, education, and habits through a chart review. Where will the practitioner MOST likely find this information? A. In the nurse‟s notes B. In the doctor‟s notes C. In the social worker‟s notes D. In the admitting note

81.A client is participating in an assertiveness training group within a work setting. The expected outcome of this intervention is that the client will MOST likely improve the ability to: 114 A. Engage in relevant conversations with coworkers B. Use appropriate facial expressions when disagreeing with coworkers C. Express disagreement with coworkers in a productive manner D. Use courteous behavior when disagreeing with coworkers

85.A child with a diagnosis of athetoid CP would like to be able to dress herself independently. Which of the following clothing features could the OT practitioner recommend that would be MOST useful in facilitating self-dressing? A. Mini tees made of elasticized fabric B. Dresses with side zippers and zipper pulls C. Oversized t-shirts and elastic-top pants D. Shirts with front closures, such as snaps or large buttons

88.An OT is planning to provide a program to address the needs of persons with Alzheimer‟s disease and their families as part of a hospital outreach program. One of the areas of intervention which would be MOST beneficial to maintaining safety and supporting function at home in the advanced stages of Alzheimer‟s is: A. Strength and endurance activities B. Cognitive rehabilitation techniques C. Environmental modification D. Assertiveness skills

9. A child has poor visual attention, which affects the child‟s school work. To improve the child‟s attention during a visual task, the OT is MOST likely to recommend: A. Increasing competing sensory input - work with lively background music B. Increasing competing visual input - work against a patterned background C. Reducing competing sensory input - use headphones during work D. Reducing visual input - use dim lighting

91.An OT practitioner who needs to transfer an obese man is not confident she can manage the transfer alone. The BEST action for the OT practitioner to take is to: A. Use proper body mechanics B. Ask someone from PT to do the transfer C. Ask another OT practitioner for help D. Refrain from transferring the patient

92.An OT practitioner is providing instruction to caregivers in long term care facility concerning assisting a resident whose severe attention span deficits impair the ability to participate in self-feeding. The OT practitioner is MOST likely to recommend which method? a. Demonstration of feeding process for the resident b. Providing verbal feedback to the resident about how he or she is progressing c. Hand-over-hand assistance d. Chaining

93.An OT practitioner is working with a homemaker who sustained a partial-thickness burn 6 months ago. Which scar management technique is MOST appropriate for the OTR to introduce during the rehabilitative phase of treatment? A. Preventing scar development through static splinting B. Controlling edema to prevent loss of range of motion C. Minimizing scar hypertrophy through compression garments and proper skin care D. Promoting self-care skills in order to resume the role of homemaker

93.An OTR has been working in a medical setting with a 6 year old child who has had a traumatic brain injury. At what point should the OTR recommend discharge? a. When the child refuses to attend OT b. When the child is ready to make the transition to first grade c. When the child has achieved a maintenance level of functioning d. When the child is considered to be completely recovered

94.A child is on a pureed diet because of an inability to chew food. The MOST effective for the OTR to facilitate the child‟s ability to chew would be to: a. encourage the child to remove food from the spoon with his teeth b. stimulate the management of texture by using vegetable or beef soup c. increase the management of texture by slowly increasing texture of food with a baby food grinder d. stimulate biting and chewing by placing a raisin between a child‟s teeth

94.An OT practitioner working in a sheltered workshop with adult clients with developmental disabilities is preparing for a group of clients functioning at Allen‟s Cognitive Level 4. Which of the following is the BEST method for introduction an assembly activity? A. Provide repetitive, one step activities B. Demonstrate a three-step assembly process C. Provide project samples for clients to duplicate D. Provide written directions for the individuals to follow

95.After evaluation, a short-term goal for an individual who had a total hip replacement was to dress with minimal assistance, using adaptive equipment and verbal cues to follow hip precautions. After 1 week of treatment, the individual is able to dress with standby assistance, using adaptive equipment and verbal cues to follow hip precautions. What skills does this person need to demonstrate before changing the goal? A. Less time needed to perform dressing B. Improved concentration C. Ability to consistently follow hip precautions D. Ability to use adaptive devices appropriately

97.A 3 year old child with a diagnosis of mental retardation is dependent in all areas of dressing. If the OT practitioner uses a developmental approach with this child, which skill should FIRST be addressed? a. Putting on garments with the front and back of clothing correctly placed b. Putting on a t-shirt c. Removing pants d. Buttoning and tying bows

98.An OT practitioner is evaluating a client who is unable to name or demonstrate the use of common household objects. the practitioner document this as: A. Apraxia B. Stereognosis C. Visual agnosia D. Alexia

D. Plans section 16.Which of the following is the BEST position for promoting isolated head control in a child with very limited postural control and significant upper and lower extremity weakness? A. Standing in a standing frame with knee and hip support B. Quadruped with chest supported in a sling C. Prone over a wedge D. Sitting on a therapy ball with hips supported by the therapist

100. During a home visit, a client with rheumatoid arthritis informs the OT practitioner that her joints have recently become very painful and inflamed. She reports she has been performing her activity program despite the pain and demonstrates a series of briskly executed active range of motion movements. The BEST response of the OT practitioner is to instruct the client to: A. Continue performing her program as she has been. B. Instruct her to perform gentle active range of motion with weight as tolerated. C. Eliminate all range of motion exercises for a week. D. Perform only gentle active range of motion.

102. An individual with MS reports extreme frustration because her house is so dirty. When she does attempt to clean it, she is too exhausted to do anything else afterward. She does not think she can afford to pay someone else to clean. Which of the following strategies is MOST appropriate for this individual? a. Convince the individual to hire a house cleaner b. Prescribe activities that will increase strength c. Use the largest joint available for the task d. Alternative tasks that require standing with those that can be performed sitting

102. When an OT practitioner makes or issues splints, the PRIMARY criterion common to all splints is that the: A. Finger should be flexed in a functional position B. Thumb is opposed and abducted C. Splint should be worn at all times D. Pressure marks or redness from the splint should disappear after 20 minutes

1. To assess an individual who is suspected of having carpal tunnel syndrome, the OTR tests for Tinel‟s sign by gently tapping the median nerve at the level of the carpal tunnel with the person‟s wrist positioned in: A. 10 degrees of ulnar deviation B. 10 degrees of radial deviation C. 20 degrees of flexion or 20 degrees of dorsiflexion D. Neutral

10.Through the evaluation process, the therapist may consider many possibilities for intervention; however, the specific plan for implementation of intervention is MOST often developed at which point in the OT process? A. After observation or screening B. After the interview C. After the evaluation D. After the development of the goals and objectives

103. An OT practitioner is fabricating a dynamic splint for a butcher who sustained a low level radial nerve injury while slicing lunchmeat at the deli where he works. The OTR explains to the client that a dorsal dynamic splint for this type of nerve injury should: a. provide wrist extension, MCP flexion and thumb flexion b. prevent wrist extension, MCP extension, and thumb extension c. prevent wrist extension, MCP flexion and thumb flexion d. provide wrist extension, MCP extension, and thumb extension

104. A young child has a diagnosis of spastic quadriplegia. The OT practitioner is teaching the child‟s parents how to effectively position the child sitting so that participation in family games will be facilitated. What is the MOST important point the practitioner can make? a. make sure the child‟s head is upright b. make sure the child‟s arms are on the armrests c. make sure the child‟s back is straight d. make sure the child‟s hips are secured against the back of the seat

104. An OT practitioner is educating a level-I OT student about the various types of splints primarily used in burn units. Which of the following BEST represents these splints? A. Resting splints and ankle foot orthotics B. Dynamic and posterior neck splints C. Below-the-knee amputation and burn wrist cock-up splints D. Airplane and burn hand splint

106. A young client who is diagnosed with depression tells an OT practitioner about feelings associated with being alone and afraid. A chart review reveals that the individual leads a very isolated lifestyle. The BEST way for the practitioner to respond is to: A. Reassure the client that they can be friends B. Tell the client, "I know how you feel." C. Encourage the client to socialize more often D. Use active listening techniques

106. An OT practitioner is assessing hand function in a man with arthritis by observing him as he makes a peanut butter sandwich. The individual is unable to remove the lid from a 28-ounce peanut butter jar but is able to stand at the counter, spread peanut butter on the bread with a knife, and replaces the lid when he has finished making the sandwich. These observations would MOST accurately reflect deficit in the performance component: A. Range of motion B. Coordination C. Endurance D. Strength

108. A child with a diagnosis of ADHD also exhibits perceptual deficits. The activity that would be the MOST effective intervention for this child to train visual attention is: a. Playing a game if Memory in which images are matched by memory. b. Assembling a 200-piece puzzle. c. Finding Waldo against a complex visual background d. Blowing cotton balls into a target.

109. An attractive unmarried patient with a spinal cord injury (CSI) is on a rehab unit and constantly flirts with the OT and PT staff. The staff should reach by: a. Firmly rejecting his advances. b. Flirting back in order to promote his self-esteem. c. Selecting one team member to discuss the effects of SCI on sexual functioning with the patient. d. Setting personal boundaries appropriate to the therapist-patient relationship.

111. A client that the OT practitioner is treating brings an order from his physician requesting treatment for epicondylitis. Which of the following adjunct activities should be used to treat the ACUTE symptoms of tennis elbow? A. PROM, weight bearing, and mobilization B. Resistive exercises, heat application, and work simulation C. Heat application, PROM, and strengthening D. Ice application, immobilization, and splinting

111. An individual demonstrate a left visual field cut as a result of a CVA and demonstrates difficulty crossing the midline during many self- care activities. Which of the following interventions would best represent a REMEDIAL approach to addressing this deficit area? a. Placing self-care supplies to the individual‟s right side b. Patient and family education regarding the effects of visual field loss c. Verbal and tactile cueing to look to the right side d. Weaving on wide frame loom

112. A physical education teacher is being treated for osteoarthritis of the upper and lower extremities. Which of the following neuromuscular activities would the therapist MOST LIKELY suggest to prevent further complications? a. Lifting weights three times a week for 1 hour b. Listening to relaxation tapes three times a week before bedtime. c. Vocational retraining d. Low-impact aerobics three times a week for 1 hour

113. Upon arrival to an infant‟s therapy session in the neonatal intensive care unit (NICU), the OT finds the infant‟s parents present. Of The following, which is the OPTIMAL intervention to pursue? a. Review the chart to complete birth history information and speak to the infant‟s primary nurse. b. Introduce yourself as their child‟s OT, explain and excuse yourself from the situation secondary to limited availability for intervention. c. Issue written positioning and state regulation and readiness information for the parents to review. d. Perform behavioral techniques and developmental positioning with parental observation and interaction.

115. An OT practitioner is working with a medically stable client who sustained bilateral upper extremity partial thickness burns 3 days ago while frying chicken. Which of the following BEST represents a typical ADL intervention? a. Instruct the client to use all adapted equipment. b. Encourage independent compression garment, application. c. Perform bilateral upper extremity PROM exercises twice a day. d. Encourage independent self-feeding and dressing skills with minimal use of adapted utensils and tools.

118. An OT practitioner is performing sensation testing on an individual with hemiplegia. The therapist should FIRST: A. Apply the stimuli distally to proximally B. Test the involved area then the uninvolved area C. Present test stimuli in an organized pattern to improve reliability during retesting D. Apply the stimuli to the uninvolved area proximally to distally in a random pattern

118. An individual diagnosed with Guillain-Barre syndrome exhibits good upper extremity strength. The activity that would be MOST appropriate for further strengthening is: A. Peeling potatoes B. Vacuuming C. Polishing furniture D. Washing windows

118. The BEST method for handling a child who exhibits tactile defensiveness is to: a. tickle him during play times. b. play loud music when undressing him. c. lightly stroke his arms and legs during baths. d. hold him firmly when picking him up.

119. In a work-hardening program, an OT practitioner is teaching a man with an excessive anterior pelvic tilt how to use proper body mechanics during lifting tasks. The MOST appropriate emphasis of the instruction should be correction of: A. Stenosis B. Scoliosis C. Kyphosis D. Lordosis

145. A resident of a long term care facility has been referred to the OT practitioner because of difficulties with eating. The FIRST step of intervention the OT performs with this resident at mealtime is to: a. provide skid-proof placemats, plate guard, and utensils with built up handle b. observe for swallowing after each bite of food c. instruct the caregivers about a special eating setup for the resident d. position the person in an upright posture, make sure head is flexed slightly and in midline

120. A long-term goal for an individual with progressive weakness is for the family to carry out his feeding program. They have achieved the short-term goal of understanding how the individual‟s disability affects his ability to feed himself. Which statement is the BEST example of a revised short-term goal? A. "Pt. will participate in feeding program." B. "Pt. will feed himself with moderate assistance." C. "Family will feed patient safely and independently 100% of the time." D. "Family will demonstrate independence in current positioning and feeding techniques."

120. An OT practitioner is assessing hand function in a man with arthritis by observing him as he makes a peanut butter sandwich. The individual is unable to remove the lid from a 28-ounce peanut butter jar but is able to stand at the counter, spread peanut butter on the bread with a knife, and replace the lid when he has finished making the sandwich. These observations would MOST accurately reflect deficit in the performance component: A. Range of motion B. Coordination C. Endurance D. Strength

120. The spouse of a patient with a progressive disease has come into the OT department to learn how to help the spouse perform functional activities at home. The FIRST focus of caregiver education for this person should be: a. methods for motivating the patient to perform ADLs. b. how to analyze activities to solve problems. c. instruction in how to provide cues to the patient. d. instruction in how to perform the activities safely.

121. A first grader has difficulty with poor finger isolation. The MOST appropriate activity for the OT practitioner to recommend to the teacher is: A. Crayon drawing on sandpaper B. Copying shapes from the blackboard C. Rolling out Play Doh with a rolling pin D. Picking up raising with pair of tweezers

121. Adults with mental retardation can be offered a variety of work alternatives. Which of the following MOST likely involves simple assembly or sorting and packaging tasks with supervision and subcontracted piecework? A. An adult activity center B. Supervised employment C. Job coaching D. A sheltered workshop

121. An OT practitioner is instructing a person with arthritis how to maintain range of motion while performing household activities. Which of the following activities MOST effectively accomplishes this? a. use short strokes with the vacuum cleaner b. keep elbow flexed when ironing c. keep lightweight objects on low shelves d. use dust mitt to keep fingers fully extended

121. An individual complains of perspiration which is causing his resting hand splint to be uncomfortable. The BEST action for the OT practitioner to take is to: a. recommend putting talcum powder in the splint. b. line the splint with moleskin. c. fabricate a new resting hand splint with perforated material. d. provide a stockinet, for the individual to wear inside the splint.

121. When evaluating the somatosensory system, the OTR would have to include testing procedures for? A. Taste B. Smell C. Vision D. Touch

122. Which of the following is the FIRST step an OT practitioner should take when initiating a safe wheelchair transfer? a. have the patient scoot forward to the front of the seat b. position foot plates in the up position c. swing away the leg rests d. lock the brakes

123. An OT practitioner is planning a program for an individual who needs to increase shoulder strength, ROM, and endurance. Which of the following activities is MOST suitable for periodic upgrading? A. Blowing up and tying balloons of various sizes B. Playing a game of balloon darts C. Painting faces on balloons D. Playing balloon volleyball

123. An OT practitioner is training an adult worker with a developmental disability to put a pencil in a box before putting the score pad in the box for a game packaging task in a sheltered workshop assembly line. The employee has not done this task before. The type of reinforcement schedule that will BEST achieve the goal of learning this task sequence is: a. intermittent reinforcement with correct responses. b. reinforcement every 10 minutes. c. reinforcement for every fourth correct response. d. continuous reinforcement of correct response.

123. An individual has been referred to OT following open heart surgery and a period of prolonged bedrest. After the individual is able to tolerate sitting unsupported at the edge of the bed, the NEXT activity the OT practitioner should introduce is: a. peeling potatoes while seated b. wheelchair propulsion at 1.2 mph c. taking a shower d. walking at 1 mph

123. While observing a newly referred child in the playground, the OT practitioner suspects that the child has dyspraxia. The MOST relevant assessment to determine the child‟s level of performance will be one which determines the child‟s ability to: A. Print or write B. Read C. Calculate mathematics D. Plan new motor tasks

125. An individual with Guillain-Barre syndrome was recently admitted to a rehabilitation unit and is expected to remain for 3 to 4 weeks. When should the OT practitioner order adaptive equipment for this individual? a. After the patient and family have accepted the individual‟s disability b. As soon as the insurance provider approves it c. Within the first week of therapy d. Just before discharge

125. The adaptation that provides the MOST benefit for an individual with paraplegia in the area of dressing is: A. A buttonhook zipper pull device B. A clip-on tie C. Adapted shoes D. Loose-fitting clothing

126. In planning therapeutic dressing program for a first grade child who is mentally retarded, the therapist‟s FIRST consideration should be the need for: A. Adaptive equipment B. Adaptive clothing C. Proper positioning D. Adapted teaching techniques

127. An OT practitioner is teaching several older adults with COPD energy conservation techniques in home management skills. Following learning principles for older adults, the MOST effective way to present the information would be for the OT to: A. Present all the important principles to be covered together in a single presentation B. Keep the presentation loosely structured, rather than highly organized C. Attempt to persuade clients about the importance of those points on which the clients don‟t seem to agree D. Present important principles in small units that are spaced at a slower than normal pace

128. On the way to lunch, an OT practitioner is stopped by a patient‟s spouse and questioned for 15 minutes about the patient‟s progress. What is the MOST appropriate action for the OT practitioner to take when determining how the patient will be treated and charged for the scheduled one-hour treatment session? A. Charge the patient for an additional 15 minutes of treatment for the time spent with family member B. Reduce the patient‟s therapy to 45 minutes and charge for 1 hour of treatment to cover the time spent with the family member C. Reduce the patient‟s therapy to 45 minutes and charge patient for 45 minutes of treatment D. Treat the patient as scheduled and charge for the 1 hour of direct time spent with the patient

128. While participating in activities to improve strength, an individual with multiple sclerosis (MS) who was recently admitted to the hospital complains of fatigue. Which of the following actions is the most appropriate for the OT practitioner to take? a. Instruct the individual to work through the fatigue to complete the session. b. Instruct the individual to work through the fatigue for another 5 to 10 minutes. c. Discontinue strengthening activities. d. Give the individual a rest break.

129. An OT practitioner is instructing an individual with left hemiplegia how to remove a t-shirt. The correct sequence is: A. (1) remove shirt from unaffected arm; (2) remove shirt from affected arm; (3) gather shirt up at the back of the neck; and (4) pull gathered back fabric off over head B. (1) remove shirt from affected arm; (2) remove shirt from unaffected arm; (3) gather shirt up at the back of the neck; and (4) pull gathered back fabric off over head C. (1) gather shirt up at the back of the neck; (2) pull gathered back fabric off over head; (3) remove shirt from affected arm; and (4) remove short from unaffected arm D. (1) gather shirt up at the back of the neck; (2) pull gathered back fabric off over head; (3) remove shirt from unaffected arm; and (4) remove shirt from affected arm

131. Which of the following activities would be BEST to promote prewriting skills with a child in preschool or kindergarten? a. maneuvering through obstacles and focusing on making turns b. having the child create his or her own books in specific topics c. rolling clay into a ball d. drawing lines and shapes using shaving cream, sand or finger paints

133. An OT practitioner is working with a client who complains of pain while completing kitchen cleaning tasks. Which of the following positions would be MOST effective in alleviating low back pain when the patient is loading the dishwasher? a. Place dishes next to dishwasher and load from a standing position. b. Wash dishes in the sink. c. Place dishes next to dishwasher and load from the front of the dishwasher. d. Place dishes near the dishwasher, bend down on one or both knees, and load.

136. A newly referred patient complains of frequently dropping lightweight items and reports a numb feeling in both hands. Which of the following instruments is MOST important for evaluating this individual? A. Goniometer B. Dynamometer C. Pinch meter D. Aesthesiometer

136. A woman experienced repeated sexual abuse by her father as a child and now describes her father‟s abusive actions as being caused by his stress of being fired from a job because of new management. The defense mechanism she is MOST likely to be using is: A. identification B. projection C. denial D. rationalization

14.A student is unable to focus on a blackboard 20 feet away and then refocus on the book on her desk to copy a mathematics problem. This MOST likely indicates a problem with: A. Ocular motility B. Binocular vision C. Convergence D. Accommodation

142. An OT practitioner is requested to evaluate and make recommendations to a jobsite that is in search of ergonomic adaptations. An example of this type of adaptation might be: A. introducing relaxation seminars for employees decrease stress while on the job B. treating corporate clients for cumulative trauma disorders C. initiating a smoking cessation program D. suggesting furniture and accessories that promote better positioning at work

142. An individual with mental illness wants to travel to the library independently but keeps getting lost. Which of the following actions should the OT practitioner take FIRST? A. Take the individual to the library and obtain a library card B. Assess the individual‟s ability to read C. Identify the bus that goes to the library and obtain a bus schedule D. Assess the individual‟s topographical orientation skills

143. OT services in a long-term care facility are provided by two OTRs and one COTA through a contract agency. When the absence of one of the OTRs creates a staffing shortage, the administration instructs the present OTR to perform evaluation only and instructs the COTA, a new graduate, to perform all treatment planning and implementation until they are full staffed again. No time is designated for supervision. What is the MOST appropriate way for the OT staff to respond? A. Follow the administrator‟s instructions. B. Express concern to the administrator about inadequate supervision and then follow administrator‟s instructions. C. Express concern in writing contract agency and then carry out the administrator‟s instructions. D. Explain to the administrator this is not an appropriate solution end then develop an alternate solution.

144. An OT practitioner is fabricating a dynamic splint for a butcher who sustained a low-level radial nerve injury should: A. provided wrist extension, MCP flexion, and thumb flexion B. prevent wrist extension, MCP extension, and thumb extension C. prevent wrist extension, MCP flexion, and thumb flexion D. provide wrist extension, MCP extension, and thumb extension

144. An OT practitioner is working with a confused patient who is having difficulty placing both feet into his pants legs. An example of a pre functional treatment activity would MOST likely be: a. pulling up pants during toileting activities. b. teaching the individual to use a reacher to pull up his pants to knee level. c. pulling off socks using a dressing stick. d. having him place his feet through loops of therapeutic band.

176. The OT treatment goal for a child with athetoid CP is self-feeding. Which of the following adaptations would BEST solve the problem of food sliding off the plate when the child attempts to pick it up with spoon? A. Swivel spoon B. Nonslip mat C. Mobile arm support D. Scoop dish

145. On completion of an evaluation of a child with CP. The OT has identified the primary objective of inhibition of flexor spasticity in the hand. The activity that would be MOST appropriate in meeting this objective would be: A. building a block tower B. active release of blocks into a container C. traction on the finger flexors D. weight-bearing over a small bolster in prone

146. An OT practitioner has conducted a home evaluation for a client with Parkinson‟s disease whose primary functional problems are caused by a shuffling gait. The MOST relevant environmental recommendation the OT could make to address a potential safety hazard is to: a. increase illumination in hallways. b. screen out distracting stimuli in the environment. c. place door locks higher or lower than eye level. d. remove scatter rugs throughout the house.

147. A child with developmental delays has just developed the strength and stability in his right hand to hold scissors properly and make snips in the paper. Which of the following would be the NEXT scissors skill to develop? a. Cut cardboard and cloth b. Cut along curved lines to cut out a circle c. Cut along straight lines to cut a triangle d. Cut the paper in two following a straight line

147. An individual with mental illness has accepted a secretarial position but is concerned about high levels of distractibility that may interfere with concentration and job performance. Which of the following interventions is MOST appropriate for this individual? A. Arrange for the individual to have a job coach B. Ask the employer to provide more frequent breaks C. Explain the problem of distractibility to the employer D. Ask the employer to provide an isolated cubical as the work space

148. During discharge planning, the patient asks the OTR, "What should I do when people at work ask me where I have been all this time?" How can the OTR BEST address this concern? A. Arrange for the patient to discuss this with the social worker B. Suggest that the patient tell the truth C. Suggest that the patient report having been on an extended vacation D. Arrange for the patient to attend a discharge group to discuss these concerns

149. An OT practitioner is working on LE dressing with a young adult with a SCI. As the client attempts to put on his underwear, he notices and erection and asks the practitioner how it is possible for him to have an erection and if he will be able to have sexual intercourse. The OT practitioner is slightly embarrassed and uncomfortable with the questions. The BEST action for her to take is to: A. Tell him she will find out the answers to his questions and get back to him with an answer by the next morning B. Answer his questions to the best of her ability and quickly return to the LE dressing program 130 C. Refer him to his psychiatrist D. Refer him to her OTR supervisor who has attended a workshop on sexuality and SCI

15.The OT practitioner has written the following statement: "Continue social skills training program and encourage client to attend one new after school club activity within the next week." The MOST appropriate section to place this statement is the: A. Subjective section B. Objective section C. Assessment section D. Plans section

150. An OT providing services to a community mental health program has been asked to example the effectiveness of the OT groups that have been provided over the past 6 months. Which of the following procedures should be used to accomplish this goal? A. Quality assurance B. Peer review C. Utilization review D. Program evaluation

151. An OT practitioner in an acute care hospital is using the SOAP note format to document information about an individual with dementia. Which statement is the BEST example of subjective information? a. The therapist will establish a daily self-feeding routine using verbal and physical cues to encourage the individual to pen containers on the lunch tray. b. The individual has been able to identify closed liquid-beverage containers on the meal tray for four of six presentations. c. The individual is able to identify and drink liquids presented in cups without lids but leaves beverages in closed containers untouched. d. The individual asks for more beverages during meals, but appears surprised when the therapist indicate beverages in closed containers are on the meal tray.

151. An individual about to be discharged from an inpatient psychiatric unit asks, "When I apply for jobs, what should put down when it asks if you have been hospitalized in the past 6 months?" The therapist‟s response should include strategies that address: A. Developing assertive ness B. Improving self-esteem C. Anger management D. Managing stigma

152. When a therapist reevaluates a client‟s treatment plan, the therapist would be MOST likely to change activities when the activities: a. continue to provide some degree of challenge b. the activities reflect the client‟s priorities c. the activities help to achieve help to achieve the client‟s goals d. are easily accomplished by the client

153. An individual complains of perspiration which is causing his resting hand splint to be uncomfortable. The BEST action to be uncomfortable for the OT practitioner to take is to: A. recommend putting talcum powder in the splint. B. line the splint with moleskin C. fabricate a new resting hand splint with perforated material. D. provide a stocking for the individuals to wear inside the splint.

156. A child with motor delays is being evaluated to determine how he performs self-care activities. Which evaluation procedure is MOST likely to provide relevant information about self-care function? A. Standardized tests of motor development. B. Review of the medical record. C. Developmental screening test. D. Home observation and parent interview.

160. An OT practitioner is conducting an ongoing assertiveness training group. Which of the following strategies would be MOST helpful in the development of group cohesion? 178 A. Define assertiveness, passivity, and aggression for the group members B. Allow and encourage all group members physically and verbally to release their aggressive feelings toward inanimate objects C. Demonstrate commonly used assertiveness techniques to the group members D. Encourage group members to share similar experiences and reactions with each other

161. An individual with mental retardation lives in a group home and is expected to participate laundry activities. The individual is usually successfully with routine performance of daily tasks, is able to recognize whether clothing is clean or dirty, demonstrates sequencing skills, and is independent in most self-care activities. What advice should the OT practitioner provide to the group home staff to enable the individual to perform laundry activities at the HIGHEST level of independence possible? A. The staff will probably need to instruct individual to place dirty items in the hamper and remove sheets from the bed B. The staff should encourage problem solving when obstacles arise C. The individual will be independent in use of a washer and dryer, but the staff may need to demonstrate the use of new products. D. The staff may need to monitor water temperature and the amount of soap being used

162. An OT practitioner is helping a family plan a wheelchair ramp to the front door of their home. What is the minimum amount of space needed in front of the door to allow easy access by wheelchair? A. 3 feet by 5 feet B. 4 feet by 4 feet C. 4.5 feet by 3 feet D. 5 feet by 5 feet

162. Which of the following is the BEST example of "objective" information as written by an OT practitioner for the objective section of a discharge summary? a. "Pt. reports he can work at the computer much longer and more comfortably than he could initially." b. "Pt. was initially able to work at the computer for only 10 minutes. Upon discharge, he can work at the computer for 3 hours with stretch breaks every 30 minutes." c. "Pt. has improved significantly in his ability to work at the computer." d. "Pt. reports he is now able to work at the computer for 3 hours, where initially he was only able to tolerate 10 minutes."

164. An OT practitioner is writing a daily SOAP note in order to document treatment for a client in the rehabilitation unit. Which of the following documented statements BEST describes an objective basis for judgment? a. "patient enjoys reading photography magazines" b. "patient likes news magazines" c. "patient obviously likes to read sports magazines" d. "patient stated that he likes to read sports magazines"

167. An OT practitioner has been asked to work on laundry skills with an adult with cognitive disabilities. Initially, the OT practitioner recommend that the staff in the group home work with the individual for 2 months on how to recognize when clothing is dirty and needs to be laundered. After 2 months, however, the individual is unable to recognize or judge when clothing is dirty. What is the NEXT step the OT practitioner should take to maximize the individual‟s independence on doing laundry? a. Instruct the individual to wear clothes for 2 days and to then launder those items. b. Assess the individual‟s ability to recognize dirty clothing. c. Recommend that the individual take clothes for dry cleaning rather than wash them at home. d. Recommend to the staff that they do the individual‟s laundry from now on.

167. Each day, an OT practitioner spends a portion of the day on documentation procedures. One of the MOST important purposes of documentation is to: A. Occupy the therapist‟s time between treatments B. Satisfy accrediting agencies C. Be used as a research tool D. Facilitate effective treatment

169. An OT practitioner functioning in the role of a consultant in an adult day care facility would be MOST likely to provide which of the following services: a. evaluating clients to determine OT needs. b. implementing recreational activity groups. c. serving as personal advocate for the client and family liaison. d. providing OT expertise to run the program and solve problems.

17.An OT practitioner treats most clients under the behavioral frame of reference. The activity feature that is MOST consistent with a behavioural FOR is: A. The level of skill required is appropriate for the generally expected skills for that age B. The symbolic potential of the activity C. The combined activity demands of sensations, perceptions and motor skill D. The measurability of activity performance

170. An OT practitioner who makes recommendations to improve accessibility in the community and advocates the rights of individuals with disabilities for employment, housing, public accommodations, public service, public transportation, and telecommunications is working to implement: A. The Architectural Barriers Act of 1969 B. The Federal Rehabilitation Act of 1973 C. The Fair Housing Amendment Act of 1988 D. The Americans with Disabilities Act of 1990

171. Adults with mental retardation can be offered with a variety of work alternatives. Which if the following MOST likely involve simple assembly or sorting and packaging tasks with supervision and subcontracted piecework? a. an adult activity center b. supervised employment c. job coaching d. sheltered workshop

172. The OT is using the Five-Stage group process for adults diagnosed with moderate levels of mental retardation. As a closure activity, which one of the following is the MOST appropriate? A. Reviewing the rules for appropriate behavior in the group B. Discussing emotional reactions to the crafts activity done earlier in the group C. Walking through an obstacle course to music D. Sitting in a circle and reciting a short poem

173. An OT practitioner working in an acute psychiatric facility is meeting with a client who has mental health issues. The client is preparing for discharge and is ready for the least restrictive level of care. The facility the BEST represents the least restrictive level of care is: a. a quarter way house. b. a halfway house. c. a supervised apartment. d. outpatient counselling.

175. An OT practitioner is requested to evaluate and make recommendations to a job site that is in search of ergonomic adaptations. An example of this type of adaptation might be: A. Introducing relaxation seminars for employees to decrease stress while on the job B. Treating corporate clients for cumulative trauma disorders C. Initiating a smoking cessation program D. Suggesting furniture and accessories that promote better positioning at work

176. An OT consults to a vocational instructor in a high school program for students with moderate mental disabilities. Which of the following activities would be MOST appropriately provided by the OT? a. Developing an in-house prevocational work program b. Bringing in outside speakers from different job settings c. Teaching the vocational instructor different assessment tools and scoring procedures d. Meeting the vocational instructor weekly to discuss adaptation to work tasks

176. Following initial evaluation of children needing early intervention services, the OT should: A. Independently develop an IEP B. Collaboratively develop an IEP C. Independently develop an IFSP D. Collaboratively develop an IFSP

177. Which of the following is the BEST method for demonstrating service competency in a standardized evaluation? A. Observe performance of the standardized test by a competent OT practitioner B. Observe a competent OT practitioner, the practice, them teach another individual how to administer the test C. Follow procedures exactly as outlined in the test manuals D. Obtain the same results as another OT practitioner who has demonstrated service competency

178. A senior COTA has been given the responsibility of supervising staff COTAs in an OT department. This means that the: A. Staff COTAs will require only minimal supervision from an OTR. B. The senior COTA‟s caseload will be reduced. C. The senior COTA can redefine the role of COTAs in the department. D. The senior COTA will evaluate, guide, and teach the staff COTAs.

178. An OT practitioner is attempting to decide which type of group to institute within an acute psychiatric setting. The supervising OT suggests the directive group treatment approach because it is MOST appropriate in acute care mental health for individuals with: A. substance abuse problems B. eating disorders C. adjustment disorders D. disorganized psychosis

178. As health care changes through the next century, the focus will move more toward health status and away from health care. This trend focuses on enhancing wellness and health through activities using various strategies, including education and behavioral change efforts. The OT practitioner‟s role in this trend is BEST described as: a. occupational behavior b. intervention c. self-efficacy d. health promotion

179. An OTR has been working in the area of mental health for 3 years and continues to meet with her supervisor every other week. This therapist has mastered basic role function, begun specialization and participates in the education of other personnel. Based on the AOTA document, Occupational therapy roles, this OTR is functioning as an: a. entry-level OTR with close supervision b. intermediate-level OTR with minimal supervision c. advanced-level OTR with general supervision d. intermediate-level OTR with routines supervision

179. OT services in a long-term care facility are provided by two OTAs and COTA through a contract agency. When the absence of one of the OTRs creates a staffing shortage, the administration instructs the present OTR to perform evaluations only and instructs the COTA, a new graduate, to perform all treatment planning and implementation until they are full staffed again. No time is designated for supervision. What is the MOST appropriate way for the OT staff to respond? A. Follow the administrator‟s instructions B. Express concern to the administrator about inadequate supervision and then follow administrators‟ instructions C. Express concern in writing to contract agency and then carry out the administrator‟s instructions D. Explain to the administrator this is not an appropriate solution and then develop an alternate solution

18.A therapist is discussing discharge plans with the parents of a 7-year- old child with sensory defensiveness problems. The OT practitioner is recommending additional activities for a "sensory diet" to provide proprioceptive input. The MOST appropriate activity for this child would be to: A. Walk barefoot on textured surfaces B. Rock over a large therapy ball C. Play in a large box full of styrofoam pellets D. Perform slow push-ups against the wall

181. An individual with advanced lung cancer is about to be discharged from an acute care setting to home. She is depressed, although she remains ambulatory and independent in basic activities of daily living; she tries very quickly and no longer participates in most of her life roles. Which of the following is the BEST action for the OT practitioner to take? a. provide her with a home program b. recommend home health OT c. recommend discontinuation of OT services d. recommend hospice OT

182. During a group community reentry outing, one of the individuals complains of chest pain. The OT practitioner monitors the client‟s heart rate and blood pressure. The therapist interprets the client‟s resting heart rate at 120 bpm, and blood pressure at 220/180 mm Hg. The MOST appropriate action for the OT practitioner to take is to: A. Continue the community reentry outing B. Immediately return the patients to the hospital C. Help the patient lie down and wait until his vital signs return to normal D. Call 911

182. While practicing wheelchair-to-tub transfers in individual‟s external catheter is dislodged and urine spills onto the floor. The therapist notes that the urine appears to have blood in it. Which one of the following response is the MOST appropriate? a. an exposure has not occurred; clean up the area with paper towels and resume treatment as quickly as possible b. an exposure has occurred; close off the area until it can be disinfected and resume treatment as quickly as possible c. an exposure has occurred; clean up the spill with towels, place towels in the dirty laundry bin and resume treatment as quickly as possible d. an exposure has occurred, put on gloves, clean up the spill with paper towels, out the soiled paper towels in a plastic bag, seal the bag, disinfect the area and finish the patient‟s session whatever time is still left

183. An OT manager is attempting to find a way to have financial success in the department while ensuring patient satisfaction. Which of the following is MOST likely to be implemental to assess patient flow, develop critical pathways and cut costs? a. quality improvement b. peer review teams c. cost accounting d. interdisciplinary care improvement teams

183. An individual who has a productive cough is scheduled to have an ADL evaluation by the OTR in an acute care facility. The MOST important action for the OTR to take, according to universal infection precautions, is to: A. Wash hands before and after seeing the client B. Wear gloves C. Wash all surfaces the individual comes in contact with before and after D. Wear gloves, a gown, a mask, and goggles

185. An OT practitioner completing a home assessment has recommended a hospital bed, lightweight wheelchair, bedside commode, reachers long-handled sponge, shower chair, and hand- held shower. The family states they can be billed as durable medical equipment. Which of the following can be billed as durable medical equipment? a. Lightweight wheelchair and reachers b. Shower chair, hand-held shower and bedside commode c. Hospital bed, shower chair and hand-held shower d. Lightweight wheelchair and hospital bed

196. An OT practitioner is asked, "What is the primary emphasis of occupational therapy services?" by another health professional. The MOST accurate response for the OT to give is that the emphasis is on: a. skill acquisition. b. compensation for deficits. c. environmental adaptation. d. reinforcement and enhancement of performance.

186. An OTR is filling out an incident report regarding a patient who was seen on the rehabilitation unit. Which of the following scenarios is the MOST likely to be the subject of an incident report? A. The patient complained of nausea during a standing activity B. A patient with a spinal cord injury indicated that his hand splints were uncomfortable C. A patient who had a total hip replacement did not follow precaution while completing dressing activities but did not complain of discomfort. D. A patient with the diagnosis of a CVA and left neglect caught his left arm in the wheel of the wheelchair, resulting in a cut and bruise

188. An OT practitioner is graduating from an OT program and is seeing employment. An OT job description would MOST likely contain: a. the title of the job, post experience required and job requirements b. a summary of primary job functions, references and job requirements c. the organizational relationships, personality characteristics desired in a job candidate and accomplishments of the candidates d. the title of the job, organizational relationships, essential job functions and the job requirements

189. An OT practitioner in a busy rehabilitation department consistently exemplifies the abilities and performance skills of an outstanding clinician. The manager of the department may financially reward this particular employee through: A. Disciplinary actions B. Performance reviews C. Clinical education D. Merit increases

189. An individual who has been attending a stress management group led by an OTR/COTA team in a private practice brings a long a friend one day. The friend would like to attend the group to learn how to better handle personal stress. This individual, however, does not have a physician‟s referral. The fee is reasonable, and like the others in the group, this new client will pay out of pocket. Will the OT practitioners be able to accept this new person into the stress management group? A. No, the OT cannot be provided without a physician referral B. Only if the client brings a prescription to the next visit C. Yes, because it is a group and not individual treatment D. Yes, if the state law does not require a physician referral

189. The BEST method for handling a child who exhibits tactile defensiveness is to: A. ticket him during play times B. play loud music when undressing him C. lightly stroke his arms and legs during baths D. hold him firmly when picking him up

189. When working within a school system to assist the mainstreaming of a child with spina bifida into a regular classroom, the OT consults with the classroom teacher. The nature of this "consultation" relationship is BEST characterized by the following statement: a. the OT teaches the teacher b. the OT provides therapy to the child c. the OT directs he teacher d. the OT problem solves with the teacher

19.After assessing a client who had recently lost his spouse in a house fire, the psychiatrist classifies the client as having an anxiety disorder caused by the occurrence of major life event. Which of the following BEST represents this disorder? A. Cyclothymic disorder B. Dysthymia C. Schizophrenia D. Post traumatic stress disorder (PTSD)

19.The MOST appropriate device to use for promoting development of upper lip control is a: A. Straw B. Spork C. Deep spoon D. Shallow spoon

190. OT practitioner should PRIMARILY wear gloves when working with: a. individuals with open wounds who have been diagnosed with human immunodeficiency virus. b. individuals with third-degree burns. c. individuals with open wounds who have been diagnosed with hepatitis. d. all individuals with open wounds.

190. The OT department has been asked to provide information to the hospital administration regarding the cost effectiveness of services provided. Which of the following methods would MOST effectively obtain this information? a. outcomes measurements b. utilization review c. program evaluation d. productivity evaluations

190. Which of the following is the BEST example of the plan section of a discharge summary when using the SOPA note format? A. "The patient reports intentions to continue to practice proper body mechanics at work" B. "The patient demonstrates independence in performing the home exercise program" C. "The patient expressed a desire to return to work but does not yet demonstrate the capacity for the required sitting tolerance" D. "The patient has been provided with a lumbar support and a written copy of the home program"

192. A new COTA works in a busy rehabilitation department. Half of the department‟s OT staff, including the supervisor, is out with the flu. The COTA observes an aide carrying out a session of training in ADL with a patient who is scheduled for discharge the next day. The MOST responsible action for the COTA to take is to: a. allow the aide to finish so the patient will be prepared for discharge b. terminate the aide and complete the session herself c. bring the issue to the attention of the facility administrator d. discuss these concerns with an OTR who is present

192. An OT practitioner is writing a job description for an aide position in the OT department. According to AOTA guidelines, which of the following is BEYOND the scope of practice of an aide? 186 A. Cue an individual with schizophrenia to maintain attention to task during a weekly OT-lad cooking group B. Practice use of sock-aid and shoe-horn in OT department with a patient who has had a hip replacement and is able to perform the task safely but takes an excessive amount of time C. Help place food on the spoon for a patient practicing the use of a universal cuff in the patient‟s room at lunchtime, while the OT supervisor runs a lunch group in the dining room D. Help a child maintain correct positioning during paper and pencil activities while the OT works with the child at the next desk

195. An OT practitioner is helping a family plan a wheelchair ramp to the front door of their home. What is the minimum amount of space needed in front of the door allow easy access by wheelchair? A. 3 feet by 5 feet B. 4 feet by 4 feet C. 4.5 feet by 3 feet D. 5 feet by 5 feet

195. At a team planning meeting for a 2-year-old child with multiple handicaps, it is decided that the OT will fulfil the roles of other therapies needed as well. This decision requires a "role release" from the teacher, PT, and speech therapist. Which of the following team approaches for young children does this method describe? A. Unidisciplinary B. Multidisciplinary C. Interdisciplinary D. Transdisciplinary

196. The spouse of a patient with a progressive disease has come into the OT department to learn how to help the spouse perform functional activities at home. The FIRST focus of caregiver education for this person should be: A. methods for motivating the patient to perform ADL. B. how to analyze activities to solve problems. C. instruction in how to provide cues to the patient. D. instruction in how to perform the activities safely.

197. An OT practitioner is conducting a research study on the effects of using a sling with individuals who sustained a stroke with resultant hemiplegia. If the researcher were to choose a sample population for his research, he would MOST likely use: a. the entire population of the facility‟s stroke patients. b. all patients who have had a CA with resulting deficits in upper extremity function. c. a numbers table to select the population. d. a small group of patients who are representative of the population, with each individual meeting criteria which validate that they area representative subset of the population.

197. An OTR who has demonstrated service competency in the use of paraffin baths moves from on state to another to take a position in a hand rehabilitation center, the licensure act in the new state prohibits OT practitioners from using PAMs. The MOST appropriate action for the therapist to take is: A. To use PAMs only under the supervision of a licensed PT B. To use PAMs inly under the supervision of a doctor C. To us only paraffin D. Not to use PAMs in the new state

198. An instructor from a local nursing school has asked an OTR to speak about OT to a class of first-year nursing students. The OTR feels uncertain about doing the lecture because of a lack of resources. The MOST appropriate action for the OTR to take is: A. Recommend to the nursing course instructor that they call AOTA and obtain public relations information to share with her students B. Decline to do the in-service but send information to the instructor C. Decline to do the in-service and find an OT to do the lecture D. Use brochures, posters, videotapes, and films available from the AOTA to enhance presentation

199. An OT practitioner has been running a "beauty group" with a group of chronically mentally ill older women. Which of the following is the MOST important action to take with the makeup at the end of the session? A. Put all supplies in a basket to be used next time 188 B. Label any supplies use by individuals with communicable diseases with the individual‟s name and put the rest in a basket C. Label lipstick with the individual‟s names. Eye makeup and blush can be shared D. Label each item with the individual‟s names. Cosmetics should never be shared

199. On the way to lunch, an OT practitioner is stopped by a patient‟s spouse and questioned for 15 minutes about the patient‟s progress. What is the MOST appropriate action for the OT practitioner to take when determining how the patient will be treated and charged for the scheduled one hour treatment session? a. charge the patient for an additional 15 minutes of treatment for the time spent with family member b. reduce the patient‟s therapy to 45 minutes and charge for 1 hour to treatment cover the time spent with the family member c. reduce patient‟s therapy to 45 minutes and charge patient for 45 minutes of treatment d. treat the patient as scheduled and charge for the 1 hour of direct time spent with the patient

20.When a new patient is referred for psychiatric services, the COTA and OTR both review the chart. The OTR then completes performance measures, and the COTA performs an interview. The COTA/OTR team relies on the interview part of the assessment to address the individual‟s: a. diagnosis b. current medications c. ability to concentrate and solve the problems d. view of the problem and an overall goal

200. The OTR is responsible for overseeing the first step in the OT process, which is the referral. Referral practices vary widely from setting to setting, but the OTR needs to know that the types of referrals required are determined by: A. The AOTA B. The American Medical Association C. State OT associations D. Federal, state and local regulations and third-party payers

21.A child with motor delays is being evaluated to determine how he performs self-care activities. Which evaluation procedure is MOST likely to provide relevant information about self-care function? A. Standardized tests of motor development B. Review of the medical record C. Developmental screening test D. Home observation and parent interview

23.A client who was fitted for an upper extremity prosthetics complains of pain at the stump site. The client comments that the absent limb still feels intact and that the pain is severe. This is the MOST likely an example of: A. Paresthesias B. Phantom link sensation C. Neuromas D. Phantom limb pain

23.An OT practitioner is attempting to decide which type of group to institute within an acute psychiatric setting. The supervision OT suggests the directive group treatment approach because it is MOST appropriate in acute care mental health for individuals with: a. substance abuse problems b. eating disorders c. adjustment disorders d. disorganized psychosis

24.A young client who is diagnosed with depression tells an OT practitioner abut feelings associated with being alone and afraid. A chart review reveals that the individual leads a very isolated lifestyle. The BEST way for the practitioner to respond is to: A. Reassure the client that they can be friends B. Tell the client, "I know how you feel." C. Encourage the client to socialize more often D. Use active listening techniques

25.A child has poor sitting balance, which interferes with seated tabletop activities. Which of the following treatment recommendations is MOST appropriate for promoting the development of ongoing postural adjustments in sitting? A. Use a sturdy chair with lateral trunk supports while the child is doing homework B. Use a corner floor seat with built in desk surface while the child is self-feeding C. Provide a bolster for back support while the child is coloring D. Provide a therapy ball to sit on while the child is playing a game of checkers

27.An OT practitioner is planning discharge and follow-up via a consultant only basis for a child with paraplegic spina bifida who has just started using a powered wheelchair. The community resource that the OT recommends as MOST critical for this child is: A. The local social service agency B. A local wheelchair equipment vendor C. The family physician D. The early intervention program

27.An OTR observes a child with autism waving his hand in front of his eyes repeatedly in an apparently purposeless manner. The MOST relevant observation is the: A. Child‟s ability to focus his eyes at close range B. Degree of wrist mobility C. Hand preference D. Presence of self-stimulatory behavior

28.A child has difficulty controlling food in her mouth when swallowing. In helping the parents to plan snacks, the OT practitioner would be MOST likely to recommend: A. Chicken noodle soup B. Peanut butter C. Carrot sticks D. Applesauce

28.During an initial visit with a 5 year old child with a suspected learning disability, the OT observes the child run across the room, hop around on one foot, pick up a pencil, and draw a stick figure using a tripod grasp. When asked to complete a four-piece puzzle, the child gives up after several unsuccessful attempts. Which type of assessment would MOST effectively address this child‟s area of difficulty? a. Fine motor b. Gross motor c. Developmental d. Visual perceptual

29.A school-age child with visual perceptual deficits is being discharged from OT. Which compensatory technique for dealing with visual figure-ground problems should the OT practitioner recommend to the child‟s teacher? A. Place a red line on the left side of the paper B. Use a timer for certain activities C. Teach the child to use lists and color coding of books and folders D. Block out all areas of the page except important words

29.The OT practitioner is evaluating a client who has position-in-space difficulties. When assessing the sense of proprioc-eption at an individual‟s joint, movement within the range would BEST be performed: A. Until pain is elicited B. Until the stretch reflex is elicited C. At the end ranges of the joint D. At the midrange of the joint

32.An individual with a history of substance abuse lives in a group home. The residential manager has asked the OT practitioner to work with the individual to develop house cleaning skills. Which of the following interventions is most appropriate when a COGNITIVE approach is desired? A. Reward the individual with a snack bar token when chores have been successfully completed B. Praise the individual when chores have been successfully completed C. Post a schedule of each individuals ‟chore responsibilities in a highly visible location D. Conduct a group discussion about responsibilities people have when living in a group home

34.An OT practitioner is working with a motivated and alert adult who recently had a cerebrovascular accident (CVA) affecting the parietal lobe. The client appears to be unaware of his limitations and is unable to learn compensation techniques for neglect despite many training sessions regarding ADL. This condition can MOST be described as: A. A visual field cut B. Apraxia C. Aphasia D. Anosognosia

34.The OT treatment goal for a child with athetoid CP is self-feeding. Which of the ff. adaptations would BEST solve the problem of food sliding off the plate when the child attempts to pick it up with a spoon? A. Swivel spoon B. Nonslip mat C. Mobile arm support D. Scoop dish

36.Working with a preschooler in the home, the OT practitioner observes the child climb into a highchair and jump up and down on a toy trampoline. When presented with a new rocking horse as a birthday present, however, the child is unable to determine how to mount the horse. This MOST likely indicates a problem in the area of: A. Fine motor skills B. Gross motor skills C. Reflex integration D. Motor planning

4. An individual with mental illness wants to travel to the library independently but keeps getting lost. Which of the following actions should the OT practitioner take FIRST? A. Take the individual to the library and obtain a library card B. Assess the individual‟s ability to read C. Identify the bus that goes to the library and obtain a bus schedule D. Assess the individual‟s topographical orientation skill

40.A client that the OT practitioner is working with uses a wheelchair and requires minimal assistance with all transfers and basic ADL. The client is expected to remain at this functional level. Which of the following would be the MOST appropriate community living option for this client at discharge? A. A cradle to grave home B. Transitional living center C. Adult day program D. Clustered independent living arrangement

53.An OT practitioner wants to alter the seating arrangement of a community skills group in order to facilitate communication amongst the members. The BEST arrangement would be to: a. provide enough chairs around a rectangle table b. provide enough chairs around a round table c. provide enough pillows to sit on the floor d. use the couches and chairs that are already in the room

40.After many months of therapy, a pre-school child with Down syndrome has begun to demonstrate protective reactions when falling forward. Which of the following BEST describes the type of movement that has been demonstrated? a. Shoulder flexion, internal rotation and shoulder adduction b. Shoulder flexion and abduction and elbow extension c. Shoulder internal rotation and elbow extension d. Shoulder hyperextension and external rotation and elbow flexion

41.What should the OT practitioner do FIRST to obtain accurate information about a patient‟s family situation and occupational, cultural, and educational backgrounds? A. Read the medical record B. Interview the patient‟s family C. Interview the patient D. Read the social worker‟s report

42.An OT practitioner is preparing the family of 5-year-old child diagnosed with developmental delay for discharge. The child has just achieved independence in self-feeding with a spoon. The BEST suggestion for the parents to help the child maintain her skill level at home is to: A. Use hand-over-hand technique to reinforce correct technique B. Consistently point out incorrect hand placement and or movement patterns C. Let the child‟s older sister feed her occasionally as a reinforcement D. Praise her for what she does well; reinforce her independence

42.Which of the following children with neuromotor impairment would benefit MOST from using a prone scooter for exploratory play? A. A child with cerebral palsy (CP) with predominant extensor tone B. A child with low tone who is easily fatigued C. A child with cognitive limitations and poor sensory awareness D. A child with spina bifida with lower extremity paralysis

43.An infant has begun to sit and is leaning forward onto its arms. The OT practitioner notes during assessment that the infant is able to coactivate muscle groups around the shoulder and arm in order to bear weight on arms in sitting. This demonstrates that the infant has MOST likely developed which type of reactions? A. Protective B. Equilibrium C. Rotational righting D. Support

45.An OT practitioner is selecting treatment activities to see with a young adult diagnosed with a young adult diagnosed with schizophrenia, undifferentiated type that would help to increase the patient‟s ability to receive, process, and respond to sensory information. The MOST suitable activities for this patient would include: a. social skills training b. vestibular stimulation and gross motor exercise c. role-playing d. discussion group

49.On completion of an evaluation of a child with CP, the OT has identified the primary objective of inhibition of flexor spasticity in the hand. The activity that would be MOST appropriate in meeting this objective would be: A. Building a block tower B. Active release of blocks into a container C. Traction on the finger flexors D. Weight bearing over a small bolster in prone

5. To develop the MOST relevant goals and objectives for a child‟s OT program, the OT practitioner should focus goals on: A. The child‟s priorities B. The priorities of the parents or caregivers C. The therapist‟s priorities for solution of problems identified in the OT evaluation D. Child, caregiver, and therapist priorities

50.An OT practitioner is fabricating a splint for an individual who has a carpal tunnel syndrome. Which of the following splint fabrication techniques should be adhered to in order to allow for adequate digit motion? a. Trim line of the splints should extend distal to the MCP crease b. Trim lines of the splint should extend proximal to the DIP joint c. Trim lines of the splint should extend proximal to the MCP crease d. Trim lines of the splint should extend distal to the ulnar 5th MCP crease

50.An OT practitioner is working with a preschooler with spina bifida who is about to transition to a fully inclusive kindergarten. Lower extremity weakness and postural control are primary concerns, along with bilateral and fine motor coordination. Knowing there will be significant emphasis on writing activities, which of the following should be the OT practitioner recommends? A. Send the child to the OT room for fine motor activities when the class is working on writing skills B. Arrange for the child to work in areas of the classroom where distractions can be minimized C. Arrange for the child to have a flat desk to work on, in either standing or sitting positions D. Provide a vertical work surface where writing and other hand skills can be practiced

50.The OT is developing a treatment plan to promote developmental acquisition for an infant in the neonatal intensive care unit. Which of the following actions will have the most PERMANENT impact? A. Modify the environment to protect the infant from additional stressful stimuli B. Recommend early intervention referral to assess infant upon discharge home C. Complete the neurobehavioral assessment and identify interventions emphasizing developmental skill acquisition D. Create a comfortable foundation for a fostering parent skills through parent-therapist collaboration

53.A patient with Parkinson‟s disease has particular difficulty with both starting movement and stopping movement. The BEST strategy for the OT to teach the person and the person‟s caregivers is to: A. Encourage the person to perform deep breathing exercise when movement is "frozen." B. Have the person practice the starting phase of the movement repeatedly. C. Have the person mentally identify the series of steps needed to initiate the movement. D. Provide a sensory cue, such as saying "stop!"

54.According to proper body mechanics, the BEST way for an OT practitioner to perform a stand pivot transfer with a patient is to: A. Move slowly, twisting the body from the trunk B. Keep feet a shoulder-width apart, lifting with the arms. C. Keep knees bent and feet planted when moving D. Maintain a normal curve of the back, slowly shifting feet as the turn is completed

56.An OT practitioner in an acute care hospital is using the SOAP note format to document information about an individual with dementia. Which statement is the BEST example of subjective information? A. The therapist will establish a daily self-feeding routine using verbal and physical cues to encourage the individual to open containers on the lunch tray B. The individual has been able to identify closed liquid-beverage containers on the meal tray for four of six presentations C. The individual is able to identify and drink liquids presented in cups without lids but leaves beverages in closed containers untouched D. The individual asks for more beverages during meals but appears surprised when the therapist indicates beverages in closed containers are on the meal tray

59.An OT practitioner is working with a client who complains of pain while completing kitchen cleaning tasks. Which of the following positions would be MOST effective in alleviating low back pain when the patient s loading the dishwasher? A. Place dishes next to dishwasher and load from a standing position B. Wash dishes in the sink C. Place dishes near the dishwasher and load from the front of the dishwasher D. Place dishes near the dishwasher, bend down on one or both knees, and load

60.The OT practitioner is selecting activities for an 8-year-old child with Duchenne‟s muscular dystrophy. Which of the following developmental issues is MOST important to consider when identifying activities for this child? A. establishment of basic trust B. freedom to use his initiative C. development of self identity D. reinforcement of competence

61.An individual who has been receiving treatment for an overuse syndrome is about to be discharged. Which of the following is the BEST example of the assessment section of a discharge summary? A. "Pt. can work for up to 3 hours at the computer using periodic stretch breaks." B. "Pt. will take stretch breaks every 30 minutes when working at the computer." C. "Pt. reports being able to work at the computer much longer and more comfortably than initially." D. "Pt. has improved significantly in his ability to work at the computer by using periodic stretch breaks."

61.Each morning, an OT practitioner performs ADL training with a teenage client who has quadriplegia. On the first day, the practitioner works with the client, arranging the shirt on the lap. When the client masters that particular skill, they work on sliding both arms into the sleeves and pushing the shirt up past the elbows. When this skill is mastered, they will work on gathering the shirt up at the collar and pulling it on over the head. This technique is BEST known as: A. Repetition B. Cueing C. Rehearsal D. Chaining

61.The goal for an adolescent with anorexia is to improve self-concept. Which component of a meal preparation activity BEST addresses this goal? a. Participate in a nutrition group and plan a healthy meal b. Develop a budget and shop for ingredients with three other group members c. Delegate tasks and prepare the meal with three other group members d. State strengths and limitations regarding performance in one activity

62.A OT practitioner is educating a family member whose sibling was admitted to the intensive care unit alter sustaining an inhalation injury and full-thickness dorsal hand burns while lighting a campfire. The family member does not understand why the client would benefit from hand splints. Which of the following would be the MOST appropriate response to the family member? A. Burn hand splints decrease pain and allow for active range of motion. B. Burn hand splints prevent hypertrophic scarring. C. Burn hand splints prevent the need for skin grafting. D. Burn hand splints prevent stress on the tendons and ligaments, decreasing edema.

63.Each morning, an OT practitioner performs ADL training with a teenage client who has quadriplegia. On the first day, the practitioner works with the client, arranging the shirt on the lap. When the client masters that particular skill, they work on sliding both arms into the sleeves and pushing the shirt up past the elbows. When this skill is mastered, they will work on gathering the shirt up as the collar and pulling it on over the head. This technique is BEST known as: A. Repetition B. Cueing C. Rehearsal D. Chaining

65.The OT practitioner is selecting activities for an 8-year-old child with Duchenne‟s muscular dystrophy. Which of the following developmental issues is MOST important to consider when identifying activities for this child? a. Establishment of basic trust b. Freedom to use his initiative c. Development of self-identity d. Reinforcement of competence

66.A child‟s long-term goal is to increase fine motor skills. The assessment has revealed a deficit in tactile discrimination, specifically stereognosis. The MOST relevant short-term goal would be: A. "The child will correctly identify five out of five finger touched when given tactile stimulus." B. "The child will correctly identify five out of five shapes drawn on the dorsum of her hand." C. "The child will correctly identify five out of five matching textures." D. "The child will correctly identify, by feel only, five out of five common objects."

67.An OT practitioner is working with a man diagnosed with schizophrenia. He states that his main goal is to have a girlfriend. Which of the following statements is the MOST appropriate example of a short term goal? a. The client will develop a friendship with a female within 6 months. b. After each group session, the client will identify the ways in which his disability has interfered with his thinking processes. c. The client will initiate appropriate, casual greetings when beginning casual conversations with female staff. d. During one to two conversations with female group members, the client will make eye contact for 8 to 10 seconds, two times in each half-hour socialization group.

76.In screening a child who has been referred to OT, the PRIMARY goal of the OT is to: A. Obtain necessary information for an OT consultation with teachers or parents B. Test a wide variety of developmental behaviors C. Establish an information base for the OT treatment plan D. Determine the need for further evaluation

69.An OT manager is attempting to find a way to have financial success in the department while ensuring patient satisfaction. Which of the following is MOST likely to be implemented to assess patient flow, develop critical pathways, and cut costs? A. Quality improvement B. Peer review teams C. Cost accounting D. Interdisciplinary care improvement teams

69.To improve written communication, an OT practitioner would be MOST likely to recommend a large keyboard to enhance computer access when the client: A. Has limited UE range of motion but adequate fine coordination B. Fatigues rapidly when reaching for the keys C. Uses only one hand to access the keyboard D. Has good UE range of motion but difficulty accessing small targets

69.When planning a therapeutic program for a child who has deficits in visual discrimination, the FIRST step is to provide matching activities that require: a. discrimination among the colors of objects b. discrimination among the shapes of objects c. discrimination among the positions objects d. the ability to recognized objects

7. An OT practitioner is instructing a family how to observe for sensory overload when carrying out a sensory integration home program. The MOST important autonomic response to watch for is: A. Nausea and dizziness B. Self-stimulation C. Head banging D. Flushing, blanching, or perspiration

70.An OT practitioner is fabricating a splint for a client who has rheumatoid arthritis. Which of the following splints is MOST appropriate for the purpose of resting the joint, decreasing of pain, and preventing contractures? a. a protective MP joint splint b. a wrist stabilization splint c. an ulnar drift positioning splint d. a volar resting splint

73.A client who is s/p traumatic brain injury (TBI) exhibits good strength with ataxia in both upper extremities. The writing adaptation that would be MOST appropriate in compensating for the patient‟s deficit areas would be: A. Using a keyboard B. A universal cuff with pencil-holder attachment C. Using a balanced forearm orthosis with built-up felt-tip pen D. A weighted pen and weighted wrists

73.After one session with a new patient in a psychosocial treatment setting, it has become apparent that the patient is highly distractible and cannot complete a magazine collage in a group. The BEST approach for the OT practitioner to take is to: a. speak slowly and softly to the patient b. coax and praise the patient until she completes the task c. ask the rest of the group member to stop talking d. position the patient so she is facing a blank wall

74.A student OT practitioner needs to design an adaptation and decides to focus on gardening for a client with a back injury. The MOST appropriate adaptation for him to design would be: A. Ergonomically correct hand tools B. A wheelbarrow with elongated handles C. A 12-inch-high eat with tool holders D. A raised-bed garden

74.An OT practitioner is instructing an individual with left hemiplegia how to remove a t-shirt. The correct sequence is: a. (1) remove shirt from unaffected arm; (2) remove shirt from affected arm; (3) gather shirt up at the back of the neck; and (4) pull gathered back fabric off over head. b. (1) remove shirt from affected arm; (2) remove shirt from unaffected arm; (3) gather shirt up at the back of the neck; and (4) pull gathered back fabric off over head. c. (1) gather shirt up at the back of the neck; (2) pull gathered back fabric off over head; (3) remove shirt from affected arm; and (4) remove shirt from unaffected arm. d. (1) gather shirt up at the back of the neck; (2) pull gathered back fabric over head; (3) remove shirt from unaffected arm; and (4) remove shirt from affected arm.

76.A homemaker who sustained a CVA with subsequent left hemiparesis is returning home to live with her husband and children. To enable the individual to carry out her prior responsibility of meal preparation, which item would MOST likely to recommended for stabilization when cutting a potato? a. A piece of non-skid backing under the cutting board b. A plate guard around the edge of the board c. A rocker knife d. A cutting board with two nail in it

77.The technique of stabilizing a person‟s forearm on the table when writing would MOST likely be used by the OT practitioner if the person exhibited: A. Decreased vision B. Poor endurance C. Limited fine movement D. Incoordination

77.While practicing wheelchair-to-tub transfers an individual‟s external catheter is dislodged and urine spills onto the floor. The therapist notes that the urine appears to have blood in it. Which one of the following responses is the MOST appropriate? 206 A. An exposure has not occurred; clean up the area with paper towels and resume treatment as quickly as possible B. An exposure has occurred; close off the area until it can be disinfected and resume treatment as quickly as possible C. An exposure has occurred; clean up the spill with towels, place towels in the dirty laundry bin and resume treatment as quickly as possible D. An exposure has occurred; pout on gloves, clean up the spills with paper towels, put the soiled paper towels in a plastic bag, seal the bag, disinfect the area and finish the patient‟s session with whatever time is still left

79.A child with limited upper extremity range of motion is being readied discharge. The MOST important home adaptation for the OT practitioner to recommend concerning use of the toilet is: A. Installation of safety bars next to the toilet seat B. Mounting a wide base toilet seat C. Placement of a skid proof stepping stool next to the toilet D. Installation of bidet with a spray wash and air-drying mechanism

79.A first grade child with a diagnosis of attention deficit disorder, hyperactivity type, is receiving OT to increase his attention span. Keeping this in mind, the OT practitioner introduces a construction activity. When blocks were placed in front of the child, the child swept many of them onto the floor and started throwing the remaining ones around the room. How can the OT practitioner most effectively restructure the activity to facilitate a successful experience for this child? A. Use soft foam blocks B. Provide blocks of one color only C. Use interlocking blocks D. Present only a few blocks at a time

8. The OT practitioner is observing dressing skills in an individual with chronic obstructive pulmonary disease (COPD). While putting on his shirt, the individual becomes short of breath and stops to rest before finishing with the shirt and going on to his trousers. The OTR would recognize this as a deficit in: A. Postural control B. Muscle tone C. Strength D. Endurance

80.An OT practitioner is preparing an outpatient who has received a resting hand splint for discharge. It is MOST important that the patient and caregivers understand the need to: A. Bend the splint if it doesn‟t fit comfortably. B. Discontinue use of the splint if it isn‟t cosmetically pleasing C. Care for the splint with special washing directions D. Observe for signs of pain, redness, and irritation, then discontinue use and repot to therapist

80.Which of the following pieces of adapted equipment would the OT practitioner MOST likely recommend a client continue to use at home after a total hip arthroplasty? a. A wire basket attached to a walker b. A padded foam toilet seat 1 inch in height c. A short-handled bath sponge d. A long-handled bath sponge

82.An individual is unable to bring her hand to her mouth for feeding because of weakness in supination. The MOST helpful adapted utensil for this person would be a: A. Spoon with an elongated handle B. Spork C. Spoon with a built-up handle D. Swivel spoon

83.An OTR is implementing cognitive rehabilitation interventions with a client and has given the client the task of finding telephone numbers of a specific people in the phone book. The client has also been given a card with a series of questions written on it including, "Do I understand what I am supposed to do?" and "Do I have all the information I need?" and "Is this the best way to do this?" This intervention is MOST accurately described as: a. a self-management task with an environment cue b. a task to improve visual scanning c. a memory task with external aid d. a problem-solving task with a "self-task" cueing strategy

84.An individual with joint changes that limit finger flexion would be MOST comfortable using utensils with: a. regular handles b. weighted handles c. a universal cuff attachment d. built-up handles

85.An OT practitioner is working with an individual with impaired memory. When the client is unable to follow verbal instructions, the practitioner changes the approach to demonstration. This is an example of: A. Activity analysis B. Activity adaptation C. Grading the activity D. Clinical reasoning

86.An individual demonstrates a left visual filed cut as a result of a TBI, and demonstrates difficulty crossing the midline during many self- care activities. Which of the following activities would MOST effectively promote this individual‟s ability to cross the midline? A. Making a coil pot out of clay B. Making a macramé planter C. Stringing a bead necklace D. Weaving on a frame Joom

87.An OT practitioner is selecting foods for an initial treatment session with a client with dysphagia. In general, which of the following foods would BEST represent an adequate selection for intervention? A. Vegetable soup B. Salad C. Watermelon D. Eggs

88.An OT practitioner is instructing a person with arthritis how to maintain range of motion while performing household activities. Which of the following activities MOST effectively accomplishes this? A. Use short strokes with the vacuum cleaner B. Keep elbow flexed when ironing C. Keep lightweight objects on low shelves D. Use dust mitt to keep fingers full extended

89.Using the MOHO as a FOR, evaluation of an individual should focus PRIMARILY on which of the following? A. Identification of problem behavior that need to be extinguished B. Clarification of thoughts, feelings and experiences that influence behavior C. Cognitive function, including assets and limitations D. The effect of personal traits and the environment on role performance

89.Which of the following BEST describes how an OT practitioner would document a normally developing infant‟s first steps? a. "The infant uses a narrow base of support and low arm guard position and takes big steps." b. "The infant uses a wide base of support and is independent in stopping and turning." c. "The infant uses a narrow base of support and low arm guard position." d. "The infant uses a wide base of support and high arm guard position and takes short steps."

9. The OT is developing a treatment plan to promote developmental acquisition for an infant in the neonatal intensive care unit (NICU). Which of the following have the most PERMANENT impact? A. Modify the environment to protect the infant additional stressful stimuli 191 B. Recommend early intervention referral to assess infant upon discharge home C. Complete the neurobehavioral assessment and identify interventions emphasizing developmental skill acquisition D. Create a comfortable foundation for fostering parent skills through parent therapist collaboration

9. While observing a newly referred child in the playground, the OT practitioner suspects that the child has dyspraxia. The MOST relevant assessment to determine the child‟s level of performance will be one which determines the child‟s ability to: A. Print or write B. Read C. Calculate mathematics D. Plan new motor tasks

90.A child has difficulty controlling food in her mouth when swallowing. In helping the parents to plan snacks, the OT practitioner would be MOST likely to recommend: A. Chicken noodle soup B. Peanut butter C. Carrot sticks D. Applesauce

90.An individual reports that back pain during sexual activity is so severe that it prevents any enjoyment. The BEST strategy for the therapist to recommend is: a. use a side lying position b. time sexual activity for periods of high energy c. do not discuss pain with sexual partner because it may be a "turn off" d. identify alternative methods for meeting sexual needs that don‟t cause pain

93.A patient is beginning to demonstrate return in the right upper extremity following a CVA, but has mildly impaired proprioception in the right hand, which results in uneven letter formation during writing activities. Which would be the BEST method to help improve letter formation during writing activities? A. The OT practitioner verbally describes how to make a letter as the individual writes. B. The individual watches her grip on a felt-tip pen while writing. C. The individual works with thera-putty to strengthen her hand. D. The individual traces letters through a pan of rice with her fingers.

93.An individual who works as a nurse reports difficulty squeezing the bulb of the sphygmomanometer when taking blood pressures and difficulty opening pill bottles. Which of the following instruments would be MOST appropriate for assessing this individual? A. Goniometer B. Aesthesiometer C. Volumeter D. Dynamometer

94.An OT is explaining to a teacher the kind of high-technology aid that can be used to help a multiply handicapped student with speech and writing deficits function in the classroom. The OT is MOST likely to describe a(n): A. Environmental control unit B. Wanchick writer C. Head pointer D. Electronic augmentative communication device

95.An individual with MS reports extreme frustration because her house is so dirty. When she does attempt to clean it, she is too exhausted to do anything else afterward. She does not think she can afford to pay someone else to clean. Which of the following strategies is MOST appropriate for this individual? A. Convince the individual to hire a house cleaner B. Prescribe activities that will increase strength C. Use the largest joint available for the task D. Alternate tasks that require standing with those that can be performed sitting

95.An individual with paraplegia wishes to become independent in driving an automobile. The most appropriate piece of adaptive equipment for this individual is: A. A palmar cuff for the steering wheel B. A spinner knob on the steering wheel C. Pedal extensions for acceleration and braking D. Hand controls for acceleration and braking

96.An OTR is working with a client who sustained an injury to the right upper extremity while rollerblading. The referral states that the client sustained a Colles‟ fracture. The OTR explains to the client that a Colles‟ fracture is a: A. Fracture to the pisiform B. Fracture to the ulnar styloid C. Fracture the carpometacarpal joint D. Fracture to the distal radius

96.An individual with the goal increasing attention span is frequently observed watching the person next to her instead of performing her assigned task. This behavior MOST likely indicates: A. Memory deficits B. Spatial operations C. Generalization of learning D. Distractibility

97.A patient‟s weight has changed during the course of hospitalization, and the wheelchair seat is now 2.5 inches wider on each side of the patient‟s hips. Which is the BEST recommendation the OT practitioner can make regarding proper wheelchair fit? A. Obtain a wider wheelchair because this one is too narrow B. The patient should be encouraged to lose weight C. The sides of the chair should be padded to improve the fit D. Obtain a narrower wheelchair because this one is too wide

98.An individual with a history of substance abuse live in a group home. The residential manager has asked the OT practitioner to work with the individual to develop house cleaning skills. Which of the following interventions is most appropriate when a COGNITIVE approach is desired? A. Reward the individual with a snack bar token when chores have been successfully completed. B. Praise the individual when chores have been successfully completed C. Post a schedule of each individual‟s chore responsibilities in a highly visible location D. Conduct a group discussion about responsibilities people have when living in a group home

98.In a long term care facility, an elderly resident with dementia repeatedly asks for her mother and becomes increasingly upset. The MOST therapeutic strategy for responding to this resident is to: a. use reality orientation; explain that the person‟s mother has been dead a long time b. set limits: firmly tell the person to stop asking for her mother c. therapeutic "fibbing": tell the person that her mother will be coming shortly d. respond to the emotional tone expressed by the words: provide extra attention and reassurance

99.An OT practitioner is planning treatment for individuals with a variety of personality disorders who have inaccurate perceptions of others and unrealistic perceptions of themselves. The treatment method that might BEST address these problem areas is a: a. small group that provides a wide range of craft activities from which the members are encouraged to select b. session focused on understanding and changing the individual‟s way of relating with the therapist c. social skills training program completed in small groups d. cooperative group activity that both provides and elicits consistent and accurate feedback about interactions within the group

100. Which of the following is the BEST method to use for encouraging problem solving during a craft media group? a. begin with activities that have obvious solutions and a high probability of success and then gradually increase the level of complexity b. begin with activities that require gross motor responses and then gradually progress to fine motor responses c. select activities that require interaction with others and then provide opportunities d. gradually increase the time used in the activity by 15-minute increments

18.A child with spina bifida has a lesion at the lumbar level that causes her bladder to be flaccid. At what age should the OT practitioner consider lack of bladder control as a delay and institute a toilet training program? A. Never, because children with flaccid bladder typically cannot be toilet trained B. At 3 years of age when normally developing children recognize the need to urinate C. At 4 years of age because normally developing children tend to get toilet trained at this age D. At 4 to 5 years of age

19.An OT practitioner is working with a client who demonstrates motor limitations when swallowing. Which of the following represents a motor problem commonly associated with dysphagia? A. Coughing or choking B. Disorientation or confusion C. Pain while swallowing D. Decreased smell and taste

2. An OTR is MOST likely to administer a test of visual motor integration to a child referred to OT for difficulty with: A. Copying letters B. Remembering letters C. Recognizing letters D. Sequencing letters

22.In administering an assessment of finger pinch strength, the OT practitioner would instruct the individual being tested to place the fingers in which position? A. Thumb against the tip of the index finger B. Thumb against the side of the index finger C. Thumb against the tips of the of the index and middle fingers D. Thumb against the tips of all the fingers

33.A child is observed grabbing toys from others, becoming easily frustrated, and is unable to sit still. This behavior MOST likely indicates: A. ADHD B. Mood disorder; manic episode C. Conduct disorder D. Anxiety disorder

34.When measuring elbow range of motion with a goniometer, the OTR must position the axis of the goniometer: A. At the lateral epicondyle of the humerus B. At the medial epicondyle of the humerus C. Parallel to the longitudinal axis of the humerus on the lateral aspect D. Parallel to the longitudinal axis of the radius on the lateral aspect

43.An individual who wears a hip brace is being measured for a wheelchair. The correct seat dimension for the OT practitioner to recommend would be: A. 2 inches wider than the widest point across the individual‟s hips while he or she wears the brace B. 2 inches wider than the widest point across the individual‟s hips C. 2 inches more that the distance from the back of the bent knee to the buttocks D. The same as the distance from the back of the bent knee to the buttocks

44.During morning self-care activities, a client is able to place his dentures in his mouth but has difficulty applying denture cream to the appropriate place on the dentures and attempts to place the cap on the tube backwards then on the wrong end of the tube. This behavior would MOST accurately be reported as: A. Constructional apraxia B. Ideomotor apraxia C. Visual agnosia D. Unilateral neglect

46.A flight attendant with a back injury is participating in a work hardening program. The client can successfully simulate distributing magazines to all passengers in a plane using proper body mechanics. To upgrade the program gradually, the OT practitioner should NEXT request that the client simulate: A. Putting blankets in the overhead compartments B. Distributing meals to the passenger C. Distributing magazines to half of the passengers in the plane D. Putting luggage in the overhead compartments

49.A young child has just learned to sit independently on the floor. Which of the following is the NEXT step toward refining her postural reactions in sitting? A. Sit straddling a bolster with both feet on the floor B. Maintain sitting balance on a scooter while being pulled C. Ride a hippity-hop without falling off D. Maintain floor-sitting position with the therapist providing pelvic support

53.A client is working on prehension skills in order to return to work as a mechanic. Which of the following BEST resembles a prehension activity? a. Loosening nuts and bolts b. Removing an air filter c. Cranking a car jack d. Grasping a hammer

6. Which of the following assessment methods would an OT practitioner MOST likely choose to learn about a family‟s values and priorities? A. Interview B. Skilled observation C. Inventory D. Standardized test

60.Development of a treatment plan for a child with an underreactive vestibular system would MOST likely include specific activities to address: a. Poor postural responses b. Discomfort with motion activities c. Anxiety when his or her feet are off the ground d. Gravitational insecurity

61.An individual learning to use an augmentative communication system has mastered the task of understanding picture symbols and their use. Next step would be: a. Sequencing of picture symbols b. Recognizing letters of the alphabet c. Recognizing whole words d. Spelling letter by letter

62.Which of the following activities would BEST represent an expected outcome for an individual who completes an energy conservation program? a. Getting dressed without becoming fatigued b. Lifting heavy cookware without pain c. Doing handicrafts without damaging his or her joints d. Dusting and vacuuming more quickly

63.An OT practitioner is working with a withdrawn child whose occupational therapy objectives include increasing the ability to express feelings and conflicts. Which of the following activities will MOST effectively promote this skill? a. Drawing a picture titled "This is me" b. Playing adapted soccer with a large ball c. Playing structured board game, such as Monopoly d. Singing folk songs in a group

64.A therapist is planning a simple meal preparation activity that will result in success for a patient with cognitive deficits. The SIMPLEST activity would be preparing: a. A can of soup b. A casserole c. Brownies from a box mix d. A meal with two side dishes and an entrée

81.An OTR is addressing concerns about sexual activity with a person with left sided hemiplegia with spasticity. The BEST recommendation for positioning during sexual intercourse for this person would be: a. lying on the left side while propped with pillows b. lying on the right side while propped with pillows c. lying in a supine position d. lying in a prone position

96.When instructing the parents of a toddler in the use and care of a hand splint, the OT practitioner should put MOST emphasis on: a. checking for irritation and pressure problems b. avoiding excessive heat exposure c. cleansing the splint regularly d. adhering strictly to the wearing schedule

1. While performing a hand reassessment, the OT practitioner notices a deformity developing on the dorsal aspect of the client‟s second digit. The client‟s PIP joint appears flexed, and the DIP appears to be hyperextended. The OTR can BEST describe this condition as a: A. Mallet deformity B. Boutonniere deformity C. Subluxation deformity D. Swan neck deformity

11.While assessing the motor skills of an 8-month old child, the OT practitioner observes him assume a quadruped position and then begin to rock back and forth. This behavior MOST likely indicates: A. Perseverative tendencies B. Normal development C. Low muscle tone D. Limitation in movement repertoire

14.A computer programmer arrives at an OT clinic complaining of pain while on the job. Which of the following are MOST likely to be considered work-related injuries specifically linked to the age of technology? A. Systemic disease B. Edema and paresthesias C. Burns and electrocution D. Carpal tunnel and chronic cervical tension.

17.During evaluation, the OTR asks a client with rheumatoid arthritis to raise her arm. The client‟s range of motion is limited to 90 degrees and she can tolerate moderate assistance in this position. The OTR further observes that passive range of motion (PROM) is the same as active range of motion. The manual muscle test grade would MOST likely be documented as: A. Normal (5) B. Good (4) C. Fair (3) D. Fair minus (3-)

25.An OT practitioner has planned to assess group interpersonal skills in an activity-based group of seven individuals. Shortly before the group is to begin, the therapist is asked to add two newly admitted clients to the group. Which of the following actions would yield the MOST efficient and effective result? A. Ask one or two of the original seven members to wait until later and include the two new clients in the group. B. Add the two new clients and then divide the members into two groups. C. Interview the two new clients separately and continue with the original evaluation group of seven. D. Proceed with the group as planned, adding both new clients to the original seven.

26.An OT practitioner is treating a client who demonstrates pain, progressive weakness of the thumb, atrophy of the thenar muscles and numbness and tingling in the thumb, index, long, and half of the ring fingers. The client is not experiencing proximal upper extremity limitations so the practitioner will MOST likely suspect problems with which of the following? A. Ulnar nerve B. Median nerve C. Radial nerve D. Brachial plexus

27.An OT practitioner is working on morning activities of daily living with a young adult who recently sustained a traumatic brain injury. The client requires prompting to apply shaving cream to his face and to pick up his razor. After these cues, to client is then able to complete the activity. This is MOST likely to be documented as a deficit in which of the following performance components? A. Impulsivity B. Initiation C. Memory D. Attention

30.A method that an OT practitioner can use to document total finger flexion without recording the measurement in degrees would be to: A. Measure the passive flexion at each joint and total the numbers B. Measure the distance from fingertip to the distal palmar crease with the hand in a fist C. Measure the active flexion at each joint and total the measurements D. Measure the distance between tip of the thumb and the tip of the fourth finger

31.The BEST way for the OT practitioner to evaluate the presence of unilateral neglect is by using which of the following paper-and-pencil tests: A. Six-block assembly B. Line bisection C. Proverb interpretation D. Identification of the square on four overlapping fingers

4. An OT student witnesses a seizure in young client with hydrocephalus. The MOST relevant information to document and report to the supervising therapist is: A. The child‟s positioning during the seizure. B. Objective signs and duration of the seizure. C. Responsiveness during the seizure. D. Facial expression during and after the seizure

47.Which of the following intervention is MOST appropriate for an individual who has recently been diagnosed with rheumatoid arthritis and is in the acute stage of the disease: A. Strengthening with restrictive exercises B. Positioning, adaptive equipment, and patient education C. Discharge planning D. Preparing the patient for surgical intervention

48.The occupational therapist is a member of the interdisciplinary team providing transition services for a 17-year-old male with moderate learning disabilities. The goal is to help the student engage in part- time work at a local stationery store. Which of the following interventions is MOST appropriate: A. Have student practice work tasks in the classroom with peers B. Observe performance at the job site and make recommendations to increase productivity C. Teach math and money management skills to help the student handle his pay check. D. Teach the student interviewing skills to increase the likelihood of eventually obtaining full-time employment.

50.The treatment goal that BEST addresses the psychosocial skill of self- expression is: A. The client will identify and pursue activities that are pleasurable to the self B. The client will use facial expressions and gestures that are consistent with stated emotions during assertive, passive, and aggressive role-play situations. C. The client will recognize his or her own behavior and possible negative and positive consequences D. The client will identify his or her own assets

52."The patient has taken a more active role in the task group, as evidenced by the willingness to contribute ideas and offer to assist in designing the unit mural." This statement would MOST appropriately be documented in which portion of a SOAP note? a. Subjective b. Objective c. Assessment d. Plan

54.An OTR is about to begin working with a 2-year-old child with hypotonia and extremely poor head control who is unable to maintain a sitting position. The FIRST pre-sitting activity the OTR should introduce, while providing stability as needed, is: a. Forward and backward movement on a ball with the child in a prone position b. Forward and side-to-side movement with the child sitting on the therapist‟s lap c. Forward and side-to-side movement on a tilting board with the child in a quadruped position d. Placing the child supine on a mat and pulling him or her into a sitting position

66.A pre-schooler has poor visual tracking skills, which affect her performance on tasks requiring eye-hand coordination. Which of the following activities is most appropriate for OT practitioner to recommend to the child‟s parents in order to promote beginning visual tracking skills during summer vacation? a. Tossing and catching a water balloon b. Catching and bursting soap bubbles c. Throwing and catching a beach ball d. Playing softball

7. An OT practitioner works on the trauma unit of a hospital and often sees patients with trauma and disease of the upper extremity musculoskeletal system that can impact their motor control function. Assessment of motor control MOST likely include: A. Evaluation of developmental factors. B. Assessment of upper extremity functions in ADL, work and leisure activities. C. Evaluation of pain, postural control and alignment. D. Assessment of self-concept and self-awareness.

70.During an evaluation, you learn that a young child is easily aroused because of a sensory-processing disorder. Which environmental adaptation would be MOST effective in assisting this individual to fall asleep? a. A mini-trampoline in the bedroom to tire the child out before going to bed b. A noise machine producing white noise at bedtime c. A lightweight, fuzzy blanket, providing light touch d. Shutters on the windows to produce total darkness

71.A deficit in visual memory is affecting a child‟s reading skills. Which would be the BEST game to promote visual memory? a. Dominoes b. Concentration c. Pickup sticks d. Checkers

75.An OT practitioner is transferring a client with hemiplegia from a wheelchair to an elevated mat. The client is able to place both feet on the floor and move the buttocks to the edge of the wheelchair. The therapist then places one hand on the client‟s right anterior pelvis and the other hand on the client‟s left shoulder. The client is set up so the transfer can be performed toward the client‟s stronger side. The client then pushes to a standing position and pivots with the therapist‟s guidance. This is most likely an example of a/n: a. independent transfer from wheelchair to mat b. assisted stand pivot transfer c. pneumatic lift transfer d. dependent stand pivot transfer

78.A physician has informed an OTR that her client‟s headache problem at work is primarily caused by the increased neck and shoulder tension that the individual experiences while typing on a computer. The BEST stress management approach for the OTR to suggest in this situation is: a. assertiveness training focusing on increasing the individual‟s assertiveness with his or her boss b. progressive relaxation exercises and autogenic training c. training in cognitive reappraisal to decrease the frequency of the individual‟s tendency to generalize and exaggerate the negative side of work events d. teaching the individual more effective problem-solving strategies

79.During an infant‟s first OT session, the mother reports she has observed that the baby has difficulty with swallowing and frequently chokes. Which of the following feeding positions will MOST effectively reduce the risk of aspiration and facilitate swallowing? a. Head in neutral position b. Head slightly flexed c. Head slightly extended d. Head rotated toward the feeder

80.An individual with strong dependency needs is able to lace a leather wallet only with consistent verbal cueing. Which is the BEST way to grade this activity in order to decrease dependency? a. Provide lacing instructions on lacing techniques and ask the individual to continue on her own b. Ask the individual to try some lacing with distant supervision and praise her for what she has been able to do c. Ask the individual to take the lacing to her room and continue without the OT‟s assistance d. Tell the individual to complete a small amount of lacing while the OT assists another patient in the same room

88.An OT practitioner is planning a group session in which the group members will be encouraged to participate in a game of chance. Which of the following would MOST likely be considered a game of chance? a. collecting baseball cards b. bingo c. charades d. balloon volleyball

89.Of the following, which would be MOST effective strategy for increasing attention to the left for a person who has a diagnosis of unilateral neglect? a. encouraging participation in bilateral activities b. encouraging any available hemiplegic limb movements before or during a task c. participation in tasks that do not cross the midline d. participation in tasks placed on the uninvolved side

9. An OT practitioner is working on functional mobility skills with a child who has a pes Varus deformity of the foot. The OT can BEST document this as a(n): A. Enlarged great toe B. Club foot C. Pronated foot D. Unstable heel

92.A client with neurological deficits resulting from a head injury was performing the task of reaching for her brush on the shelf of her bathroom cabinet. During this task the OT practitioner observed that the client located the brush but became very distracted by the other items on the shelf. As a result of this observation, the OT is most likely to provide activities that will improve: a. Learning b. selective attention c. figure-ground perception d. problem solving

99.A child with a behavior disorder has an innately difficult temperament. Which of the following treatment approaches is MOST appropriate? a. emphasize limit setting with the child during activities b. help the child develop cognitive strategies for anxiety- producing activities c. help care providers develop an unpredictable routine for activities that disorganize the child d. provide a play environment in which the parent and child can demonstrate conflicts

12.While standing and holding onto furniture, a 3-year-old boy with delayed motor development shifts his weight onto one leg and steps to the side with the other. This movement pattern is best described as: A. Creeping B. Crawling C. Cruising D. Clawing

16.In an acute mental health facility, an individual refuses to participate in OT activities, and the therapist notes the refusal in the subjective section of documentation note. Which form of refusal would MOST likely reflect acute depression? A. "I had an argument with another group member and I‟m too angry" B. "I don‟t want to participate because I don‟t know how to do the activity" C. "I‟m just too tired" D. "I‟m waiting for my visitors to come"

21.An OTR performing a motor skills evaluation observes that a child is awkward at many gross motor tasks, particularly those which require relating the body to objects in space. Though able to skip rope in the regular forward pattern of movement, the child is unable to skip rope backwards, even after several attempts. This information would lead the therapist to be particularly observant for additional signs of: A. Delayed reflex integration B. Inadequate bilateral integration C. Developmental dyspraxia D. General incoordination

24.The OT practitioner working with an infant observes the presence of the first stage of voluntary grasp. Which of the following would be the MOST appropriate statement for documenting this behavior? A. "The infant is exhibiting radial palmar grasp" B. "The infant is exhibiting pincer grasp" C. "The infant is exhibiting ulnar palmar grasp" D. "The infant is exhibiting palmar grasp"

32.An individual with schizophrenia who is newly admitted to the hospital is asked by the therapist to tell about what brought the person to the hospital for admission. The individual responds by saying, "I took a cab". In the report, the therapist is MOST likely to identify this response is an example of: A. Delusional thinking B. A distractible response C. A concrete response D. An insightful response

37.An individual with myocardial infarction (MI) was transferred from the acute care unit to a rehabilitation unit. During the initial interview, he displays good memory of information processed before the MI but poor recall of the period spent in the acute care facility. He is able to recall information since the transfer. The OT practitioner would be MOST likely to document these behaviors as: A. Orientation problems B. Long-term memory deficits C. Anterograde amnesia D. Retrograde amnesia

38.An OTR requests that the COTA conduct a structured interview. During this type of interview, it is MOST important for the COTA to: A. Rephrase the interview question in his or her own words B. Ask questions that he or she thinks are pertinent to this patient. C. Ask additional question as they are stated on the interview sheet D. Ask additional questions (other than those listed) to gain further insight into the patient

39.The OT practitioner plans to use a checklist she has designed for evaluating a child‟s eating performance skills. Which term BEST describes the type of evaluation the OT practitioner will be using? A. Norm referenced B. Criterion referenced C. Skilled observation D. Valid and reliable

40.In the assessment of individuals in whom the early and middle stages of dementia are diagnosed, the functional ability that will MOST likely remain intact for the longest duration is: A. The ability to read the written information B. The ability to write basic information C. The ability to engage in superficial social conversation D. The ability to dress and undress oneself.

41.An OT practitioner is performing sensation testing on an individual with hemiplegia. The therapist should FIRST: A. Apply the stimuli distally to proximally B. Test the involved area then the uninvolved area C. Present test stimuli in an organized pattern to improve reliability during retesting D. Apply the stimuli to the uninvolved area proximally to distally in a random pattern.

42.An OT practitioner observes a 5-year-old child with Down syndrome who has low muscle tone sitting on the floor exclusively using a "W" sitting position. This observation MOST likely indicates that the child is: A. Developing abnormally B. Using a noncompensatory position to achieve stability C. Demonstrating typical development for a child with Down syndrome. D. Using a position normal for a younger child, not for a 5-year- old child.

51.The treatment goal for a 4-year-old child with hypotonia is to improve grasp. Which of the following activities would be best for preparing the child‟s hand for grasp activities? a. Dropping blocks into a pail b. Placing pegs on a pegboard c. Weight-bearing on hand d. Holding and eating a cookie

56.A homemaker is learning how to perform transfers into a bathtub after a total knee replacement. Despite having surgery 2 weeks ago, the client is still unable to extend or flex the knee greater than 20 degrees. Which of the following would MOST likely allow for safe tub transfers? a. Wait another 2-4 weeks, because showering and bathing are contraindicated for individuals with total knee replacements for 4-6 weeks after surgery b. Use of handrail attached to the side of the tub c. Use of a tub transfer bench d. Use of a beach chair in the tub

57.Which of the following activities should be introduced FIRST when treating a child for tactile defensiveness? a. Gently brush the child‟s face and neck b. Rub lotion on the child‟s arms c. Have the child roll around in a carpeted barrel d. Swing the child in a hammock swing

58.A middle-aged client with a diagnosis of reactive depression is admitted to the hospital following an overdose of sleeping pills. The client was recently forced to retire from a job in public relations and his present goals are to increase his sense of competence and encourage development of enjoyable leisure activities. Based on the client‟s OT goals, what is an appropriate FIRST activity to recommend for this patient? a. Pouring and glazing chess pieces b. Designing and building a doll house c. Copper tooling using a template d. Learning how to play bridge

59.The therapist is performing UE activities for an individual with left hemiparesis following a CVA. She observes that active range of motion is limited throughout the LUE. In analyzing this client‟s performance, the therapist is most likely to consider the impact of which factors on range of motion: a. Muscle tone, edema, sensation, and diadokinesis b. Edema, proprioception, and muscle tone c. Edema, contracture, muscle tone, and pain d. Contracture, stereognosis, and sensation

65.An individual with a C6 spinal cord injury has been referred to OT two days‟ post injury. Immobilized with a Halo brace, the individual demonstrates fair plus wrist extension and poor minus finger flexion. Which of the following interventions should be implemented FIRST? a. Volar resting pan splints to prevent flexion contractures b. Wrist support with universal cuff to promote independence c. Wrist splints to promote development of tenodesis d. Instruction in bed mobility techniques to prevent decubiti

69.An infant born 15 weeks prematurely has a history of multiple medical issues including retinopathy of prematurity, mechanical ventilation for 5 weeks, and a poor feeding skills. The infant is now a 43-week-old, medically stable and engaging infant, with a G-tube and oxygen supplement of 2 liters by nasal cannula. Which of the following is the MOST appropriate intervention to pursue at this time? a. Positioning and handling b. PROM of all extremities c. Multisensory input d. Music therapy

74.The home health OT practitioner is seeing a client in the middle stages of Alzheimer‟s disease. The family is very concerned that the client‟s memory loss is now interfering with performance of daily activities, even familiar self-care activities. The MOST relevant OT intervention at this point would be: a. memory retraining activities for the client b. ADL retraining program for the client c. instructing caregivers in task breakdown d. leisure activity planning

77.The OT practitioner is treating a patient with a standard above-elbow amputation who is experiencing hypersensitivity of the residual limb. The OT would most likely perform which of the following interventions in the preprosthetic phase of treatment? a. Activities to strengthen the residual limb b. Activities to increase the range of motion of the residual limb c. Activities which provide tapping, application of textures, and weight bearing to the residual limb d. Activities for practicing putting on and taking off the UR prosthesis

8. A young client who will be using a wheelchair after discharge from the rehabilitation facility is going home. In determining accessibility of the interior home environment, the FIRST area of evaluation the OT will be concerned with is: A. Location of telephones and appliances. B. Arrangement of furniture in bedrooms. C. Steps, width of doorways, and threshold heights. D. Presence of clutter in the environment.

82.A woman with a head injury is impulsive during self-feeding and frequently attempts to place too much food in her mouth at one time. Which of the following methods would MOST effectively control her rate of intake during self-feeding? a. Cut her food into smaller pieces b. Have her count to 10 between bites of food c. Have her put the utensil down until she swallows d. Serve the various food items in separate containers on the meal tray

83.An OT practitioner is teaching a client who recently sustained an above-elbow amputation how to dress with one hand. Teaching a client to perform a familiar activity or skill is called the: a. problem-solving method b. retraining method c. altered task method d. compensation method

84.An OT practitioner is positioning a child with poor muscle tone and postural instability into a prone stander to develop head righting. The child rapidly shows fatigue and associated reactions. How can the therapist BEST adjust the stander to decrease these reactions while continuing to address the goal of head righting? a. Place the child in prone on the floor b. Position the stander at 45 degrees from the floor c. Position the stander at 75 to 90 degrees from the floor d. Position the child upright in a prone or supine stander

85.A new client exhibits no awareness of functional limitations resulting from his recent head injury, and he attempts to perform transfers without assistance. He also has expressed that he doesn‟t see the need for therapy. The BEST approach to promote awareness and insight is to: a. have the patient explain why he believes he is impaired b. provide the client with a checklist of the skills he must have to perform various activities and review these c. have the client predict his performance before an activity, then have him self-evaluate the performance d. disregard the client‟s perceptions and proceed with therapy

90.A school age child has Duchenne muscular dystrophy. Although he is able to use a manual chair for distances between classes, he is tired on arrival. What would be the BEST recommendation the OTR could make for wheelchair use at school? a. retain the manual chair to build up strength b. change to an ultralight sports model because it requires less strength c. change to a power wheelchair to reduce effort d. encourage walking with a walker to alternate mobility methods

91.An individual with hand weakness has difficulty holding a fork. Using a biomechanical frame of reference, which of the following interventions would be MOST appropriate? a. elicit functional grasp using reflex inhibiting postures b. stimulate the hand flexors to promote a functional grasp c. repeatedly squeeze with the hand against increasing amounts of resistance d. build up utensil handles

94.An OT practitioner is planning a community living program for clients who are to be discharged after an average of 25 to 30years of hospitalization. One of the goals of this program is to train the clients to effectively manage their money. Which of the following activities should be used first? a. provide each client with $23 to spend during a group trip to the local shopping center b. provide sample of coins and paper money c. use a board game to introduce the concept of receiving and spending money d. establish a hospital-based community store where the clients can buy clothing

95.An OT practitioner is trying to demonstrate and then involve a group of individuals in practicing "broken record" behaviors which of the following intervention BEST encompasses the broken record technique? a. music therapy activities b. self-awareness activities c. assertiveness training d. psychodrama approaches

97.When leading groups, OT practitioners should demonstrate consistency from day to day. Inconsistent behavior would most likely result in: a. overdependence of group members b. group members‟ knowing what to expect from the group leader c. anxiety and confusion among group members d. group members‟ receiving too much praise

10.The OT practitioner is observing dressing skills in an individual with chronic obstructive pulmonary disease (COPD). While putting on his shirt, the individual becomes short of breath and stops to rest before finishing with the shirt and going on to his trousers. The OTR would recognize this as a deficit in: A. Postural control B. Muscle tone C. Strength D. Endurance

13.An individual who works as a nurse reports difficulty squeezing the bulb of the sphygmomanometer when taking blood pressures and difficulty opening pill bottles. Which of the following instruments would be MOST appropriate for assessing the individual? A. Goniometer B. Aesthesiometer C. Volumeter D. Dynamometer

15.During an initial interview, parents describe their child as having severe difficulty in communication and interacting with others. The OT practitioner also observes that the child exhibits many repetitive and ritualistic behaviors. The behaviors described are MOST likely to be associated with: A. Attention-deficit hyperactivity disorder (ADHD) B. Childhood conduct disorder C. Obsessive-compulsive disorder D. Pervasive developmental disorder of childhood

20.An individual with the goal of increasing attention span is frequently observed watching the person next to her instead of performing her assigned task. This behavior MOST likely indicates: A. Memory deficits B. Spatial operations C. Generalization of learning D. Distractibility

23.After assessing a client who had recently lost his spouse in a house fire, the psychiatrist classifies the client as having an anxiety disorder caused by the occurrence of a major life event. Which of the following BEST represents this disorder? A. Cyclothymic disorder B. Dysthymia C. Schizophrenia D. Post-traumatic stress disorder

28.Using the Model of Human Occupation as a frame of reference, evaluation of an individual should focus PRIMARILY on which of the following? A. Identification of problem and behaviors that need to be extinguished B. Clarification of thought, feelings, and experiences that influence the behavior. C. Cognitive function, including assets and limitations D. The effect of personal traits and the environment on role performance

29.In screening a child who has been referred to occupational therapy, the PRIMARY goal of the occupational therapist is to: A. Obtain necessary information for an occupational therapy consultation with teachers and parents. B. Test a wide variety of developmental behaviors C. Establish an information base for the occupational therapy treatment plan D. Determine the need for further evaluation

3. When performing a "naturalistic observation" of dressing skills with a young child diagnosed with developmental delay, an OT practitioner should FIRST: A. Provide oversized clothing to ensure success. B. Have the child dress and undress in a distraction-free corner of the clinic. C. Provide assistance as needed to minimize frustration. D. Observe the child entering the clinic and taking off his coat and shoes.

35.A woman experienced repeated sexual abuse by her father as a child and now describes her father‟s abusive actions as being caused by his stress of being fired from a job because of new management. The defense mechanism she is MOST likely to be using is: A. Identification B. Projection C. Denial D. Rationalization

45.A college student has been referred to a day treatment program following hospitalization for an acute schizophrenic episode. The individual is uncomfortable in social settings; has difficulty sustaining conversation, is unable to make eye contact, and responds with bizarre comments when spoken to. Which of the following would be the MOST effective treatment approach? A. Vestibular stimulation and gross-motor exercises B. Modification of the environment C. Pleasurable activities that don‟t require conscious attention to movement D. Social skills training

5. An OTR is evaluating an individual who has sustained a left- hemisphere cerebrovascular accident (CVA). After determining that the person was able to read before the CVA, the therapist‟s presents a paper with typed letters of the alphabet randomly dispersed across the page. The individual is then asked to cross out all the M‟s. The OTR observes that that the individual has missed letters in a random pattern throughout the page. This MOST likely indicates: A. A left visual field cut. B. A right visual field cut. C. Functional illiteracy. D. Decreased attention.

55.A sales executive is participating in a time management program. Which of the following would be the expected outcome for the client? a. To control anxiety when arriving late for a meeting b. To take responsibility when late with reports c. To cope with feelings of inadequacy when missing a deadline d. To arrive at work on time consistently

67.An OT practitioner is working with three individuals in a cooking group. The individuals demonstrate difficulty attending to task, frequently ask to leave the room, and do not interact with each other. Based on the developmental group concept, which of the following is the MOST appropriate goal for this group? a. Each member will take a leadership role within the session b. Members will share materials with at least one other group member c. Each member will express two positive feelings about themselves with in the group session d. Each member will remain in the group without disrupting the work of others for 15 minutes

68.A person with peripheral neuropathy exhibits loss of pinprick, light touch, pressure and temperature sensation. The most appropriate form of intervention to address this type of sensory loss would be a program of: a. sensory re-education b. sensory desensitization c. sensory bombardment d. sensory compensation

72.An individual with weak grip strength and poor endurance wishes to bake something for family member‟s birthday. The OTR wants to plan an activity during which a client can work on grasp/release for 5 minutes without becoming exhausted. The MOST appropriate activity for both purposes would be: a. Mixing blueberry muffins from scratch using a hand powered mixer and scooping them into muffin tins with a cup b. Mixing an angel food cake from a box mix using an electric mixer and pouring into a pan c. Mixing cold chocolate cookie dough using a spatula with a built-up handle and dropping dollops onto a tray using an ice cream scoop d. Slicing a prepared roll of sugar cookies at room temperature and placing them on a tray using a spatula

73.In a home program to promote beginning symbolic play for a child with developmental delay, the OT practitioner would MOST likely recommend playing with: a. busy box, nesting toys, and blocks b. board games c. craft kits d. doll house and dress-up clothes

76.An OT is applying PNF techniques for weight shifting during an activity that requires an individual to use the right hand to remove groceries from a bag on the floor to the right. The MOST benefit would be gained from this activity by then placing the groceries: a. on the counter directly in front b. on the counter to the left side c. in the upper cabinet to the right side d. in the upper cabinet to the left side

86.An individual with left upper extremity flaccidity is observed sitting in a wheelchair with his left arm dangling over the side. The FIRST positioning device that should be assessed for this individual is a(n): a. lap tray b. wheelchair armrest c. arm sling d. arm trough

87.An OT practitioner is working with a student on handwriting skills when she instructs the client to stabilize his forearm on the table when writing. The client is MOST likely to be demonstrating: a. decreased vision b. poor endurance c. limited fine movement d. incoordination

93.When working with a child who is at risk for shunt malfunction, it is MOST important for the therapist to observe for: a. increased tone b. headaches c. back pain d. unexplained sensory loss

98.An individual with a C6 spinal cord injury is unable to button his shirt. The OT would be MOST likely to select which type of adaptive equipment to assist this client with buttoning? a. a buttonhook with an extra-long, flexible handle b. a buttonhook with a knob handle c. a buttonhook on a 0.5-inch diameter, 5-inch-long wooden handle d. a buttonhook attached to a cuff that fits around the palm

Johnson BRE

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