NBCOT

A 4-year-old child has spastic quadriplegic cerebral palsy and is dependent on caregivers for all aspects of bathing. The child's parents indicate that it is becoming difficult to wash the child in the home bathtub and ask the COTA about available equipment options that would make this task more manageable. Which equipment should the COTA recommend placing in the tub to support safe bathing?

Bath transfer bench with a nonskid seating surface Hammock chair with suction feet and head support Trunk support ring with a molded back and adjustable legs

A COTA is leading a group at a community wellness center. The group is for individuals who require a wheelchair for mobility and who have recently become new parents. What information is MOST IMPORTANT to include as part of the group?

Best ways to position furniture and wall-hangings in an infant's room Body mechanics to use when lifting an infant from various surfaces Types of activities to optimize parent-infant bonding interactions

A 10-year-old child sustained a TBI several days ago and is functioning at Level VI (Confused, Appropriate) on the Rancho Los Amigos scale. One of the inpatient rehabilitation goals is for the child to bathe independently. Which approach is MOST EFFECTIVE for facilitating success with bathing tasks based on the child's current cognitive level?

Have the child follow sequential picture cards for each bathing task. Provide intermittent verbal instructions throughout the bathing activity. Use hand-over-hand assistance for each step of the bathing routine.

Which property of thermoplastic material is MOST EFFECTIVE for fabricating an orthosis for elbow extension?

High conformability High drapability Maximum resistance to stretch

A COTA is developing recommendations for an older adult client with urinary urgency. The client has difficulty removing clothing fast enough and frequently soils clothing while in the bathroom. Which recommendation would be MOST BENEFICAL for the COTA to include in the initial intervention with this client?

Limit fluid intake during mealtimes. Follow a planned time schedule for toileting. Include pelvic floor exercises in daily routines.

An inpatient who is recovering from meningitis is participating in a rehabilitation program. The patient requires 25% assistance to complete grooming tasks. What terminology BEST describes the level of assistance the patient requires for grooming?

Maximum assist Moderate assist Minimal assist

Which government program is associated with health insurance for individuals based on financial need?

Medicare Part D Managed care Medicaid

A COTA is preparing to fabricate a thermoplastic hand orthosis for an adolescent who has moderate spasticity. Which of the following types of material is BEST to use for this orthosis?

Perforated plastic that is at least 1/8 inch (0.31 cm) thick Solid plastic that is resistant to stretch when heated Colorful plastic that has some flexibility for contouring Semi-rigid plastic that is less than 1/16 inch (0.16 cm) thick

An inpatient was admitted to a psychiatric facility 3 days ago for treatment of depression. The patient has low self-esteem and difficulty making decisions. Which type of activity would be MOST BENEFICIAL for this patient during the initial phases of recovery?

Physically challenging tasks Routine, familiar tasks Socially engaging tasks Timed, multi-step tasks

A client with mild cognitive decline often forgets to take prescribed medications during community outings and has several pills remaining in the pill bottle at the end the month. In addition to recommending a pill storage box to organize medications, what would be the MOST BENEFICIAL intervention approach for this client?

Provide education on the benefits and rationale for each of the prescribed medication. Have the client use an alerting device to signal the scheduled time to take medication. Assist the client in creating an illustrated picture board that summarizes the medication schedule.

A COTA is teaching a client, who has chronic bronchitis, a breathing technique to use when experiencing shortness of breath during ADL. The COTA instructs the client to count slowly during respiration and to exhale longer than inhale. Which breathing technique do these instructions represent?

Pursed lip breathing Relaxation breathing Abdominal breathing

During an ADL group session, an inpatient with quadriplegia reports a sudden onset of a pounding headache, begins to perspire excessively, and has chills. What INITIAL action should the COTA take in response to these symptoms?

Recline the back of the patient's wheelchair. Transport the patient to their room to rest. Stop the activity until the patient's vital signs stabilize. Activate the facility medical alert system.

A 6-year-old-child with ADHD is overly active in the evening and has difficulty falling asleep. Which of the following would be the MOST EFFECTIVE strategy to include in the child's sleep hygiene regimen?

Recommend a high carbohydrate evening snack. Use a heavy blanket for proprioceptive input. Establish a consistent bedtime routine.

Which adaptive ADL equipment would be MOST BENEFICIAL for a client who has Poor (2/5) hand strength?

Toothbrush with built-up handle Button hook Utensil inserted into a universal cuff

A hospital-wide interprofessional continuous quality improvement (CQI) committee has identified customer satisfaction as an opportunity for improvement. As part of this team, the COTA is responsible for contributing customer satisfaction information specifically related to OT services. After discussing the initiative with the OTR manager, what should the COTA do NEXT to contribute to this process?

Understand the current level of satisfaction with OT service delivery and outcomes. Develop a customer satisfaction survey to send to patients recently discharged from OT. Initiate a process improvement plan for the OT clinic designed to reduce customer dissatisfaction.

A student in the second grade has decreased strength and poor postural control that interferes with the student's handwriting skills. Which strategy would be MOST BENEFICIAL for supporting the student's handwriting development?

Arrange a desk area for the student to use away from other students. Encourage whole-body movement activities prior to writing. Have the student practice tracing enlarged letters of the alphabet. Provide the student with letter formation worksheets for homework.

A client has joint stiffness of both hands secondary to osteoarthritis. The COTA, who is service competent in using physical agent modalities, is applying paraffin as an adjunct to activity with this client. What is the recommended time frame for the application of the paraffin modality?

5-10 minutes 15-20 minutes 25-30 minutes

The dining room aides of an assisted living facility have receiving more requests to assist residents during mealtimes. The nurses report this is due to recent admissions of several residents who have low vision, and ask the COTA for recommendations for increasing residents' independence with feeding. What action would be MOST BENEFICIAL for the COTA to take based on this request?

Arrange dining room seating so at least one resident who does not have a visual deficit sits at each dining table. Train the dining aides on how to respond to the residents' requests for assistance during meal times. Advise dining aides to serve food on brightly colored trays with each food group on a separate plate. Complete a meal time observation to identify the residents' mealtime barriers and needs.

Which variable listed below can be graded to MOST EFFECTIVELY increase physical endurance?

Amount of resistance needed during an activity Coordination required for controlled movement Speed in which the activity is completed Total amount of time spent on an activity

A hospital-based OTR and COTA are collaborating to reevaluate a patient who has Parkinson's disease. Which task can the COTA complete as part of the information gathering process?

Analyze the findings of a quality of life inventory Interpret the results of an ADL assessment Administer a standardized test of cognitive function

A COTA is providing intervention for a client who has Parkinson's disease and lives alone. The client independently uses a wheelchair for mobility within the home and during community outings; however, the client frequently forgets to lock the brakes on the wheelchair prior to standing up. Which intervention would be MOST BENEFICIAL for improving the client's safety when transferring to and from the wheelchair?

Apply brightly colored tape to the wheel locks of the wheelchair. Post a reminder sign beside the client's bed and in the bathroom. Place a safety belt with push-button release on the wheelchair.

An outpatient client, who is a professional violinist, has stopped playing the violin secondary to focal hand dystonia of the dominant upper extremity. The client wants to resume playing the violin but symptoms associated with the condition make it difficult. Which intervention would be MOST BENEFICIAL to support progress toward the client's goal?

Apply different textures and temperatures of sensory stimulation on the upper extremity Place the violin in a vertical stand and learn to play the instrument in an upright position Modify an extended length bow by attaching an oversized rubber hand grip

A COTA is teaching proper bed positioning to the family of a client who has left hemiplegia. What is the PRIMARY reason for teaching the family to position the client as indicated in the picture below?

To prevent a flexor synergy To allow unrestricted movement of the unaffected side To maintain proper joint alignment

What is the PRIMARY reason for encouraging an inpatient who recently had surgery to use an incentive spirometer?

To prevent risk of deep vein thrombosis To decrease intensity of pain To maintain healthy lung function

What is the PRIMARY purpose for teaching a client who has subacute rheumatoid arthritis to use the assistive device pictured below?

To protect the hand from slipping onto the blade To increase leverage for slicing hard to cut foods To reduce deforming forces on the MCP joints

Pictured below is an orthosis on the 5th digit of a client's hand. Which option represents the proper purpose for using this type of orthosis?

To reduce a finger contracture secondary to intrinsic muscle tightness To prevent swan neck deformity secondary to subacute rheumatoid arthritis To prevent a drop finger deformity secondary to an acute mallet finger injury

A client who has substance use disorder has been able to maintain employment, but has difficulty managing time, interacting with others, and attending to homemaking activities. What should be the PRIMARY focus of the initial intervention for supporting the client's participation in occupation?

To transition the client to a structured group living environment To promote practical skills for basic personal life management To encourage the client to participate in leisure activities with friends

A COTA is documenting the assistance level needed for a resident of a nursing home who has moderately severe cognitive decline secondary to dementia. The resident needs 75% hand-over-hand assistance to reach toward a toothbrush. What is the BEST descriptor for the COTA document in this situation?

Total assistance Maximal assistance Minimum assistance

A COTA is making a pattern on paper prior to fabricating a resting hand orthosis for a client with rheumatoid arthritis. What actions MUST the COTA take to ensure the size of the paper pattern is correct?

Trace around the contours of the hand and forearm leaving extra margins so the orthosis will fall midline around the arm and hand. Cut the paper pattern slightly smaller than drawn to avoid using excessive thermoplastic material during fabrication. Inspect the pattern to ensure the length of the orthosis will fit one third of the way up the forearm toward the elbow.

An older adult inpatient in a rehabilitation setting is scheduled to participate in a bathing session. The patient requires assistance with transfers and uses durable medical equipment and adaptive devices. The OT aide is assigned to help the COTA during this session. Based on practice guidelines which task can the OT aide complete?

Transfer patient to shower bench Gather necessary adaptive equipment Educate nursing on level of assist needed

A client who has a C2 (ASIA B) spinal cord injury wants to be able to turn on and off a light using a switch. Which factor is MOST IMPORTANT to consider when selecting a control interface for the client to meet this objective?

Type of wireless technology available within the client's home Ease of the client's ability to physically operate the device Frequency of signal interference with other devices within the area

Which situation listed below warrants a referral to a driver rehabilitation specialist?

A client's family member expresses concern about an older adult client's competence to drive a vehicle. A client who had a total hip replacement 2 months ago wants to resume driving after not driving since the date of surgery. A young adult client who has epilepsy wants to learn how to drive for the first time.

A COTA working in a hospital setting wants to search current evidence about intervention methods that can be incorporated into intervention sessions with patients. Which search method would be MOST BENEFICIAL to use for this purpose?

Access information through an online social media platform. Read single-subject case studies written by clinical experts. Find studies based on systematic randomized control trials.

A student in the fifth grade has a pervasive developmental delay. During a pull-out session with the COTA, the student draws a self-portrait that depicts self-harm. When questioned about this picture, the student says, "Everyone would be better off if I didn't exist." After obtaining more information from the student about these feelings, which course of action should the COTA take in response to this situation?

Accompany the student to the classroom after the session, and inform the teacher about the comment. Document the details of the concerning behaviors, and contact the student's parents by telephone. Escort the student to a supervised environment, and inform the school principal.

A patient was admitted to an intensive care unit 3 days ago with acute respiratory failure. Medical history is significant for severe rheumatoid arthritis diagnosed 3 years ago. The OTR and COTA are collaborating to develop a restorative program that a nursing aid will use with the patient to support functional mobility until the patient is medically able to participate in ADL sessions. What information should be included as part of this program?

Active assistive ROM prior to the scheduled morning self-care routines Active ROM of bilateral upper extremities using a series of progressive activities Gentle passive ROM of the involved joints several times per day

A 5-year-old child with recent onset of Type III spinal muscular atrophy has been in a children's hospital since the time of diagnosis 2 weeks ago. The child will be discharged home in the next few days to live with the parents and several siblings. Which information is MOST IMPORTANT for the COTA to report to the interprofessional team during the child's discharge planning meeting?

Adaptive equipment recommendations Community-based support services IEP recommendations for return to school

During an intervention session, a COTA is checking the fit of an elbow extension orthosis fabricated for a resident who has mild dementia and general debilitation. The primary purpose of the orthosis is to prevent an elbow flexion contracture. What should the COTA include as part of the session to determine if the orthotic is meeting this objective?

Add additional padding to the orthosis over bony prominences. Review the wearing schedule with the resident and the primary caregivers. Determine if the orthotic is holding the joint in the end-range position.

An 8-year-old student has a moderate congenital hearing impairment and wears bilateral hearing aids. The student does not like wearing the aids at school and tells the COTA, "Most of the time, I can't hear what people are saying anyway." A recent audiology report indicates the hearing aids are in good working order. Which strategies should the COTA implement in the school environment based on the student's report?

Adhere tactile markings that help the student identify frequently used items. Advise the teacher to use a circular seating arrangement for class discussions. Determine ways to reduce ambient background noises in the classroom. Provide the teacher with basic sign language words to use with the student. Recommend the teacher limit visual distractions in the classroom. Teach the student to use an augmentative communication board.

A 9-year-old child has autism spectrum disorder and is non-verbal. The child has no sense of danger and is at risk for wandering away from the home and away from a caregiver during outings in the community. The caregiver is concerned for the child's safety and asks for suggestions to reduce these wandering behaviors. Which strategies represent the LEAST RESTRICTIVE options for supporting the child's independence in the home and community?

Advise residents in the surrounding neighborhood about the child's tendencies. Have the child carry a mobile phone with an enabled electronic tracking device. Implement a token economy to reward the child for days without wandering. Install locks on the doorways in the home at a height that is out of the child's reach. Register the child's identifying information with emergency response providers. Secure a medical alert identification bracelet on the child's wrist.

A COTA works in an inpatient mental health program that uses the cognitive behavioral approach to guide intervention for adolescents with eating disorders. One of the adolescents in the program has severe anorexia nervosa and has agreed to go on a social outing to the movies. Just prior to the outing, the adolescent refuses to participate and says, "The smell of the popcorn will make it too hard for me to resist tasting a piece of popcorn. Then I'll ruin everything." Which action represents the use of cognitive framing to respond to the adolescent's comment?

Advise the adolescent that the other participants will be experiencing the same feelings. Ask the adolescent to indicate the positive aspects of attending the outing. Tell the adolescent that the staff will provide support if anxious feelings occur during the outing.

A COTA is helping a kindergarten student who has autism spectrum disorder establish routines for following classroom expectations. Each morning, the teacher expects each student to hang up his or her coat and backpack on a hook in the closet before proceeding to a designated play area of the classroom. Instead of following this routine, the student typically walks directly to the play area after entering the classroom. Which strategy would be MOST EFFECTIVE to include as part of the intervention for helping the student follow the morning routine?

Advise the caregiver to bring the student to the classroom 15 minutes early each morning for additional assistance. Help the student create a social story about following the rules that the teacher establishes for the classroom. Use the student's favorite superhero to decorate a specific hanging space close to the classroom door.

A young adult client with a mild intellectual disability is participating in a work placement program. The work supervisor reports the client is typically late for work. What strategies should the COTA incorporate into the program to improve the client's on-time arrival at work?

Advise the client to set an alarm watch to sound at the scheduled start time. Have the client list tasks that need to be completed each day before going to work. Introduce the client to the principles of energy conservation for reducing fatigue. Use a daily log to assist the client to prioritize daily tasks and routines. Help the client develop a plan for situations that may result in tardiness. Give the client a complete list of tasks that need to be performed each day.

A high school student who has a mild cognitive impairment participates in a transition preparation group as part of an Individualized Education Program. During the past several sessions, the student has refused to participate in the planned activities. Which action would be MOST BENEFICIAL for the COTA to take in response to the student's refusal?

Advise the student that participation in the program activities is a legal requirement. Ask the student to identify preferred activities to make the session more enjoyable. Provide the student with a list of alternative activities related to the intervention goals.

A patient in an intensive care unit is recovering from respiratory failure and requires mechanical ventilation for breathing support. At the start of a bedside ADL session, the patient is positioned in supine-lying in bed with the head of the bed raised to 30°. The COTA observes the patient's vital signs to be within normal limits. The COTA raises the head of the bed to 80°, checks the vital sign monitor and notes the patient's physiologic responses to this movement activity is as indicated in the image below: After returning the patient to supine-lying, what action should the COTA take NEXT based on these vital signs?

Alert the patient's primary nurse. Elevate the patient's feet. Activate the emergency response system.

A 4-year-old child has age-appropriate motor skills, but communication, social play, and ADL skills are at a 2-year-old level. Which technique would be MOST BENEFICIAL to use with the child for promoting cognitive development for self-dressing?

Allowing the child to play dress-up while offering visual cues as needed Having the child use a doll to practice putting on and taking off clothing Rewarding the child for each piece of clothing properly donned each morning Using a dressing board for training the child to button, zipper, and snap

A student in kindergarten has myelomeningocele at the T4-T6 level. One of the intervention goals is to increase the student's peer interactions on the school playground during recess. Which mobility option would be MOST CONSISTENT with the student's expected level of function?

Ambulate on poured-in synthetic surfaces while wearing a thoracic-hip-knee-ankle orthosis. Operate a power wheelchair that has a joystick control and lateral trunk supports. Walk with platform crutches on a flat surface while wearing an ankle and foot orthosis.

A patient on an acute oncology unit recently underwent surgery for a radial neck dissection. During a self-care session at the bathroom sink, the patient states, "I am afraid to look at myself in the mirror." What action should the COTA take in response to the patient's comment?

Ask questions to gain insight into the patient's perspective on their body image. Encourage the patient to participate after covering the mirror at the sink with a towel. Initiate a conversation on adapting to the change in physical appearance.

A COTA working in a residential mental health facility is leading a group for young adolescents diagnosed with schizophrenia. A new participant in the group interferes with the group process by criticizing the activity, bullying other participants, and interrupting the COTA. Which actions represent steps of a redirection continuum that should be used to address the adolescent's disruptive behaviors during the group activity?

Ask the adolescent a direct question about the activity. Encourage other participants to express their feelings to the adolescent. Have the adolescent explain the disruptive actions to the group. Implement a brief timeout in a predesignated area of the room. Sit next to or in close proximity to the adolescent. Suggest alternative methods of positive communication.

A 17-month-old child who has fetal alcohol syndrome recently developed skills for maintaining an upright sitting position for several minutes at a time while unsupported. Which intervention activity would support the NEXT level of motor development while sitting?

Ask the child to lean to one side to reach for a toy while straddling a cylindrical bolster. Encourage the child to throw a ball while seated cross-legged on a platform swing. Have the child raise both arms above the head in rhythm to music while sitting on the floor.

A COTA working in an outpatient clinic is gathering information about an older adult client who recently had a CVA and has ideomotor apraxia. Which method would be MOST BENEFICIAL for obtaining information about the influence of the patient's apraxia on everyday activities?

Ask the client to name familiar ADL utensils (e.g. a comb and brush). Have the client put on clothing during morning ADL (e.g. a shirt and pants). Ask the client to imitate familiar gestures (e.g. waving good-bye and crossing legs).

Which intervention technique is MOST BENEFICIAL to use initially with a client who has recently been diagnosed with homonymous hemianopsia?

Ask the client to read a paragraph displayed on a vertical computer monitor. Have the client use smooth visual pursuits to track a moving object. Teach the client to locate a solid line placed within the affected visual field.

A client in an outpatient setting has generalized debilitation with Fair minus (3-/5) functional muscle strength in both upper extremities following a prolonged hospital stay for pneumonia. One of the client's goals is to complete personal grooming tasks such as brushing and styling hair independently. Which activity would be MOST EFFECTIVE to include as part of a strengthening program for supporting progress toward this goal?

Ask the client to repetitively reach for an object positioned overhead while providing assistance to guide the arm through the full ROM. Have the client complete isometric contractions of the upper arm for 10 second intervals intermittently throughout the day. Provide the client with a structured program of light resistance therapy band exercises for the elbow and shoulder.

A COTA working in an outpatient behavioral health program is using the Model of Human Occupation (MOHO) to guide activity selection for a young adult client who has borderline personality disorder. The client engages in self-cutting behaviors several times when alone at home. One of the client's goals is to develop strategies to decrease the frequency of these behaviors. Which activity represents the MOHO approach for supporting this goal?

Assist the client to identify leisure activities that can be integrated into daily and weekly routines. Instruct the client in the benefits of changing preconceived attitudes and perspectives on self-image. Provide the client with a list of positive affirmations to use intermittently throughout the day.

A 15-year-old student in high school has autism spectrum disorder. The transition plan recently was updated to include the student's long-term independent living objective. After completion of high school, the student wants to move out of the parents' home and live alone in an apartment. Which intervention would be MOST BENEFICIAL to promote progress toward this objective?

Assist the student in advocating for personal care supports. Encourage the student to identify a meal preparation goal. Help the student develop routines for daily living.

A COTA has started a meal preparation session in the therapy kitchen with an inpatient who has generalized debilitation and a history of substance use disorder. During the session, the patient is restless and needs verbal cues to attend to instructions. Abruptly, the patient reports feeling angry and appears ready to strike out at the COTA. What immediate action should the COTA take FIRST?

Attempt to calm the patient using a soothing tone. Remove other patients from the therapy area. Call for additional staff to provide assistance.

Which of the following examples represent a statement using person-first language?

Autistic preschool student Client with schizophrenia Below-knee amputee

A client who has Parkinson's disease, hypertension, coronary artery disease, and diabetes mellitus is participating in home health OT. The client is independently able to complete functional transfers, but has fallen several times without sustaining significant injury. Which factor is MOST IMPORTANT for the COTA to consider when gathering information about the client's fall risk?

Availability of funding to purchase durable medical equipment Possibility of medication side effects due to polypharmacy Client's ability to select and put on well-fitted footwear

A COTA working in a memory care unit is collaborating with an OTR to assess the dressing skills of a client who has severe cognitive decline due to Alzheimer's disease. Which context would be MOST conducive for obtaining information about the client's functional ability?

Bedside during the typical facility care schedule In the bathroom immediately after morning self-care routines At a time and in a setting most familiar to the client

.An adolescent patient in a rehabilitation setting recently sustained a C6 (ASIA B) spinal cord injury. The patient is learning to transfer from the bed to the wheelchair. Which transfer method is MOST BENEFICIAL to teach this patient to use based on the expected functional outcome for this injury?

Bent pivot Sliding board Stand pivot

What is the PRIMARY purpose for conducting a comprehensive developmental evaluation for an elementary student who has a learning disability?

To predict grade-level academic success in the classroom setting To understand contextual factors that influence the student's performance To determine the student's strengths based on developmental milestones

A 4-year-old child has moderately poor visual-spatial skills and difficulty integrating both sides of the body. Which activity would be MOST BENEFICIAL to include as part of the intervention for promoting initial improvement of these skills?

Carrying dishes from table to sink Swinging on a suspension swing Pushing a toy cart through a maze Playing with small interlocking blocks

A 4-year-old child with Rett syndrome has characteristic excessive hand wringing and hand-to-mouth patterns. The neurologist ordered a right volar long arm immobilization orthosis to control the negative effects of these movements, and the COTA fabricated the orthosis 2 weeks ago. During a follow-up appointment, the parents report difficulty adhering to the prescribed wear schedule because the child removes the orthosis when the parents are not in line of sight. After inspecting the child's skin and ensuring an effective fit, which action should the COTA take to support better compliance with the wear schedule?

Change the orthosis to a circumferential clamshell design. Provide the parents with a stockinette to place over the orthosis. Replace the hook and loop straps with riveted snap closures.

An OTR and a COTA are developing a plan to monitor intervention outcomes for a 3-year-old child who has a sensory modulation disorder. Observation in multiple contexts indicates the child is frequently preoccupied with sensory items and toys made of soft fabric. One of the intervention goals is to increase the child's participation in developmental play activities with peers. Which option is MOST BENEFICIAL to include as part of the plan for monitoring the child's progress over time?

Checklist of games and toys that provide the optimal level of sensory arousal Method for tracking the frequency of sensory-seeking behaviors Schedule for administering a sensory integration screening each week

Which information MUST be documented in the Individualized Family Service Plan for children who meet eligibility criteria for OT services?

Child-centered objectives that are prioritized by the primary caregivers Specific recommendations for assistive technology and adaptive devices Subjective statements from the children related to needs and wants

An interprofessional team is implementing a Multisystemic Therapy approach to guide interventions for a student in the fourth grade who is diagnosed with oppositional defiant disorder. Although the student wants to participate in group games during physical education class, the student typically disrupts the games by arguing, refusing to follow rules, and becoming angry. What should be the PRIMARY focus of OT intervention for this student when using this approach?

Cognitive reframing of negative behaviors Development of positive peer relationships Implementation of a structured sensory diet

A 10-year-old child who sustained a TBI 3 weeks ago has made significant progress in an inpatient pediatric rehabilitation setting, but mild cognitive and physical deficits persist. The child will be discharged home to live with family in several days and will be transitioning back to school as soon as possible. What role does the inpatient OT team have in supporting the child's transition back to school?

Communicate with the special education team regarding the child's needs. Complete the initial paperwork for services under section 504 of the IDEA. Provide the IEP team with unmet goals to carry over in the school environment.

A resident in a long term care facility has a moderately depressed mood. The resident enjoys crafts and agrees to participate in a craft group. Which activity would be MOST BENEFICIAL for supporting the resident's success during the group?

Completing a paint-by-number plastic suncatcher Assembling a wooden birdhouse from a kit Hand sewing fabric pieces together to make a pillow Using a pattern to stamp a design on a leather wallet

Pictured below are two children playing at a sand table. What type of play environment does this represent?

Constructive Exploratory Pretend

A patient with secondary progressive multiple sclerosis is learning to use a utensil placed in a universal cuff for self-feeding. The patient requires minimal hand-over-hand assistance to load the utensil, and to bring the food from the plate and place it in the mouth. After swallowing a bite of food during the mealtime session, the patient coughs weakly several times, and speaks with a wet voice quality. What action should the COTA take in response to this observation?

Consult with the supervising OTR prior to proceeding with the meal. Reposition the utensil so food is placed on the posterior part of the tongue. Have the patient complete a swallow with the chin tucked toward the chest.

A COTA working in a home health setting is scheduling appointments for a toddler who has pervasive developmental delay. The child has a tracheostomy and uses a ventilator for respiratory support. To support optimal therapy outcomes for this child, what is MOST IMPORTANT for the COTA to consider when setting a schedule?

Coordinate therapy sessions to coincide with home-based nursing appointment times. Suggest that the family use the intervention time as a respite to complete household activities. Select a time when a family member is available to participate in the intervention session.

A 5-year-old child with a high-level neural tube deficit is transitioning from a home-based learning environment to a kindergarten classroom. Which piece of positioning equipment would be MOST BENEFICIAL to have in the classroom to support the child's participation in occupation?

Corner chair with lateral support and abductor wedge Mobile arm supports Para podium stander Portable incline desktop stand for writing

A 5-year-old student with autism spectrum disorder often uses repetitive self-regulatory behaviors such as hand flapping and pencil tapping. These behaviors interfere with the student's ability to stay on task during in-seat assignments and are distracting to peers. One of the intervention objectives is to decrease the frequency of these behaviors in the classroom. Which action should the COTA take as an INITIAL step for supporting this goal?

Create a calming space in the classroom for the student during periods of high anxiety. Identify the emotional and contextual triggers that prompt the onset of the behaviors. Provide an adaptive replacement that is less bothersome to the other students.

A 6-year-old child has poor lip closure control secondary to hypotonia. The child is able to bring a cup to the mouth and initially provide suction on a straw, but becomes frustrated when liquid in the straw falls back into the cup. One of the intervention goals for the child is to independently drink from a cup with a straw. Which adaptive drinking aid would be MOST EFFECTIVE to support the child's progress toward this goal?

Cup with sip spout and a clip-on straw holder Extra-long, wide-diameter drinking straw Specialized straw with one-way valve

A 5-year-old child with mild developmental delay has poor in-hand manipulation skills. During a drawing activity, the child picks up a crayon with the right hand and then uses the left hand to reposition the crayon in the right hand before starting to draw. Based on this observation, which activity would be MOST BENEFICIAL to include as part of the intervention for supporting age-appropriate in-hand manipulation skill development?

Cutting paper into strips for a craft project using blunt-tip scissors Picking up a puzzle piece and placing it into the jigsaw puzzle Turning the pages of a picture book and searching for key items

A resident of a nursing home, who has Alzheimer's disease, is dependent in self-feeding. Recently, the resident refuses to eat when the caregiver offers food. The facility staff asks the COTA for suggestions on how to increase the amount of food eaten at meals. Which strategy would be MOST BENEFICIAL to include in the recommendations to the staff?

Educate the client on adequate oral intake. Play soothing music in the room where the resident is fed. Alternate bites of hot and cold foods.

An inpatient is preparing for discharge from an acute mental health setting after undergoing treatment for major depression. The patient will receive follow-up services at a community mental health program. The COTA is contributing outcomes information to the OTR for inclusion in the patient's discharge summary. What information would be MOST BENEFICIAL to use for this purpose?

Description of job-related skills the patient used during activities Patient's functional potential based on current rate of progress Subjective impressions of the patient's functional independence Current self-care abilities compared to initial evaluation results

A patient with a mild intellectual disability recently had transabdominal surgery for an intestinal fistula repair. The COTA is planning intervention to provide the patient with strategies to complete BADL while following post-operative precautions. What principles should the COTA incorporate into the session to improve the client's understanding of the information?

Determine the patient's ability to understand the information presented Use verbal directions as a primary mode of giving information Explain the meaning of occupational therapy terminology Give detailed directions on each step of the activity Use appropriate cultural references and therapeutic use of self Share the information in an environment conducive to learning

A 6-year-old child recently sustained a TBI and is preparing to transfer from a pediatric intensive care unit (ICU) to a general acute care unit. Currently, the child is functioning at Level III (Localized Response) on the Rancho Los Amigos scale and has hypertonicity in all four extremities. As part of the child's overall care plan, the COTA developed a positioning program that nursing and family are implementing in the ICU. Which action should the COTA take as part of the intervention planning process to support carry-over of the positioning program for this NEXT level of care?

Develop a detailed description of the positioning program to place with the child's belongings. Ensure the family understands the importance of and purpose for the positioning program. Provide a verbal report to OT colleagues that includes the child's current positioning schedule.

A resident of a nursing home has moderate-severe cognitive decline. The resident frequently wanders into the room of other residents and takes items from the closets and drawers. The facility staff has asked the COTA for suggestions on how to reduce the occurrence of this behavior. Which strategy would be MOST BENEFICIAL for the COTA to recommend?

Discuss options with the resident for alternative hobbies and enjoyable leisure pursuits. Develop a behavior management plan using positive reinforcement and rewards. Identify spaces within the facility that are appropriate for the resident to rummage.

A young adult client sustained a C8 (ASIA A) spinal cord injury 8 months ago. Prior to the injury the client participated in a variety of outdoor adventure sports. During a session with the COTA, the client mentions an interest in learning adaptive strategies for resuming these activities. What action should the COTA take in response to learning this information?

Discuss the influence of current physical limitations on participation in high-risk leisure activities. Arrange for the client to meet with an equipment vendor who specializes in sport wheelchairs. Provide the client with a list of community resources that support athletes with disabilities.

A COTA is reviewing the medical record of a patient in an acute care hospital. In addition to a hospitalist, who is coordinating the medical care for the patient, the patient is also under the care of a gastroenterologist. What is the PRIMARY specialty area of a gastroenterologist on the interprofessional team?

Disorders of the stomach, gallbladder, liver, and pancreas Diseases associated with aging and older adults Conditions related to blood and blood-forming tissue

A 9-year-old child who has moderate hemiplegia often neglects to use the affected upper extremity. Which activity would be MOST BENEFICIAL for encouraging the child's bilateral fine motor control?

Drawing on a chalkboard Tossing a beanbag at a target Playing a game of darts Playing with a hand-held video game

An inpatient who has Guillain-Barré syndrome is participating in an inpatient rehabilitation program and is able to complete grooming tasks independently while supported in an upright sitting position in bed. One of the intervention goals is for the patient to perform grooming independently while sitting on the edge of the bed. Which is the MOST EFFECTIVE activity to include in the intervention program to promote progress toward this goal?

Dress lower extremity while supported in a supine position Reach for objects while sitting forward in a high-back chair Strengthen upper extremity with use of a weighted dowel

A COTA is fabricating an orthosis to increase wrist ROM of a 9-year-old child who has a 20° flexion contracture of the wrist secondary to arthrogryposis. Which type of orthosis would be OPTIMAL to use as an adjunct to a home stretching program for achieving this objective?

Dynamic mobilization orthosis Nonarticular orthosis Serial static immobilization orthosis

A client is participating in an activity group in a community-based mental health center. The group plans to make decorations for an upcoming traditional religious holiday event. The client refuses to participate in the task citing a conflict with personal religious beliefs. How should the COTA respond to the client's refusal?

Encourage the client to respect the values of the other group participants. Explore specific reasons for the conflict between the activity and religious beliefs. Offer an alternate activity that is pertinent to the established goals.

Which intervention activity would be MOST BENEFICIAL to use with a resident at a skilled nursing facility who is disoriented to time?

Encourage the client to write in a journal each evening before bed. Ask the client to find the location of the facility on an enlarged map. Have the client routinely look outside to use visual cues of the season.

A patient who has osteoarthritis and mild cognitive decline is ready for discharge from an acute care setting to live alone. The patient requires assistance with bathtub transfers, lower body bathing, and home management skills. Which recommendation would be MOST BENEFICIAL to include as part of the patient's discharge planning process?

Engage in a home exercise program for improving upper extremity function. Establish a structured schedule of ADL tasks to complete each day. Consider transitioning to a nursing facility for ADL safety and regular meals. Arrange for services in the home that include a personal care attendant.

A COTA is preparing a group activity for adolescents who have physical disabilities and are transitioning into adulthood. The purpose of the activity is to increase the adolescents' awareness of community support agencies. What is the MOST EFFECTIVE action for the COTA to take as the group facilitator to support this goal?

Engage the group in a collaborative project to develop a comprehensive list of community-based resources. Lead a discussion about the value of creating a broad network based on lifestyle preferences and needs. Teach the group ways to conduct an online search for a variety of websites and virtual support groups.

A COTA is selecting intervention activities for a client who has upper extremity hemiplegia with mild flexor spasticity. One of the client's goals is to use the affected extremity during dressing. Which intervention activity would be MOST EFFECTIVE for normalizing the client's upper extremity muscle tone?

Engaging the client in progressive resistive exercises at the start of the session Having the client bear weight over the affected side before and during dressing Briskly tapping over the flexor muscles when the client reaches for clothing Providing quick stretch to the affected upper extremity prior to dressing

A young adult client has a severe panic disorder that interferes with the ability to interact socially with peers and family. The client's goal is to attend a sporting event with friends, but reports a typical pattern of cancelling the commitment to attend just prior to the event. The client states, "When I am getting dressed to go out, I start to feel short of breath and dizzy and have overwhelming feelings of anxiety." What INITIAL action should the COTA take to grade social interactions to support progress towards this goal?

Establish a time to interact socially with another client who has similar symptoms and goals. Structure an individualized session where the COTA and the client simulate social situations. Recommend the client attend a social skills group to learn adaptive strategies.

A school-based COTA is using a health promotion approach to support the school's anti-bullying initiatives. Which option would be MOST BENEFICIAL to implement for supporting this initiative when using this approach?

Establish an after-school group for fostering friendship development and social participation. Initiate a play-based club to offer developmentally appropriate activities for interested students. Provide the classroom teacher with adaptive strategies to help deal with bullying behaviors.

A COTA wants to use current evidence to learn more about the benefits of using assistive technology for pediatric clients who have a progressive neurological condition. The COTA found very few randomized controlled trials in the literature related to assistive technology and this pediatric population. Based on this finding, which level of evidence would provide the BEST information to meet the COTA's needs?

Expert opinions of board-certified pediatric clinicians Practice guidelines for the pediatric population Systematic scoping review from a variety of sources

An inpatient has left hemiplegia and poor trunk control secondary to a stroke 6 weeks ago. The patient is at risk for falling when positioned in an upright unsupported sitting position. One of the intervention goals is to maximize the patient's independence during dressing while maintaining sitting balance on the edge of the bed. Which technique would support progress toward this goal?

Facilitate neck extension to shift the patient's center of gravity posteriorly. Stabilize the patient's thighs and buttocks on the sitting surface. Encourage trunk rotation through contraction of the right lateral flexors.

An 8-year-old child has generalized dystonia and is dependent on a power wheelchair for all mobility. The child's parents recently purchased a modified wheelchair-accessible van with an automatic lift and a lowered floor. The child remains seated in the wheelchair when travelling in the van. Which option results in an increased safety risk when preparing the child to ride as a passenger in this vehicle?

Fastening a standard seat belt across the child's shoulder and lap Positioning the wheelchair in a front-facing position behind the front passenger seat Using a wheelchair tie-down to secure the wheelchair to the van floor

A 2-year-old child with Down syndrome has an oral-motor deficit resulting in ineffective chewing skills. The child is not eating solid food but is able to safely swallow liquids from a bottle with a standard nipple. One of the intervention goals is to improve the child's oral-motor control for chewing solid food. Which type of solid food texture should be introduced to the child at the start of a feeding program?

Finely chopped Fork mashed Smooth pureed

A COTA working in an acute pediatric hospital uses a variety of toys during developmental play therapy sessions. Which preventive measure is MOST IMPORTANT for the COTA to take after a child finishes using a toy?

Follow facility policies and procedures for cleaning and disinfecting the toys. Wipe each toy with a cloth soaked in a diluted bleach and hot water solution. Place each toy in a separate plastic bag and follow procedures for sterilization.

A COTA is working in a busy therapy gym with a client who had a recent transfemoral amputation and a history of substance use disorder. The client is motivated to participate and follows instructions at the beginning of the session, but abruptly begins to shout obscenities and becomes visibly angry. After calling for additional staff to provide assistance, what immediate action should the COTA take NEXT?

Follow hospital policy to write an incident report. Remove other clients from the therapy area. Attempt to physically restrain the client.

Which of the following play skills is considered age-appropriate for a TYPICALLY developing 4-year-old child?

Following rules while playing group board games Role-playing a bathing routine with a favorite doll Creating stories with "pretend" characters Kicking soccer ball with consistent accuracy Participating in a game of jump rope with peers Building a play "castle" with blankets and chairs

An OTR and a COTA are collaborating to complete the initial assessment of a student in kindergarten who recently was diagnosed with autism spectrum disorder. Which information would be MOST BENEFICIAL to obtain from the student's parents as part of this process?

Frequency at which stereotypical behaviors associated with this diagnosis occur at home Performance patterns the student typically uses during routine daily activities at home Techniques the parents find effective to use at home for managing the student's behavior

A school-age child has severe tactile defensiveness secondary to congenital cortical blindness. The student will be participating in OT to improve sensory processing prior to learning Braille. Which activity should be included as part of the child's INITIAL intervention for supporting this objective?

Fun activities that reinforce pre-reading concepts Drills for assigning meaning to raised dots on paper Graded play using a variety of textured materials

A newly certified COTA is scheduled to begin work in an outpatient OT clinic. According to professional practice standards, what is the MINIMUM amount of supervision the COTA should receive prior to completing service competency requirements established by the clinic?

General supervision in line-of-sight from an OTR supervisor General supervision from an OTR or intermediate-level COTA Close supervision from an OTR or advanced-level COTA Line-of-sight supervision from an OT practitioner who has service competence

A COTA working in a skilled nursing facility is planning a mealtime intervention session for a resident who has dementia and is blind. Currently, the client is fed a regular diet by the nursing staff. One of the intervention goals for the resident is to be independent in self-feeding. Which technique would be MOST BENEFICIAL to promote initial progress toward self-feeding?

Give verbal cues to the resident to hold a weighted spoon in the dominant hand and instructions to load food onto the utensil. Press gently on the resident's tongue with a spoon dipped in flavored liquid before each bite of food. Provide hand-over-hand assistance to assist the resident to bring a spoon loaded with food toward the mouth.

A COTA is scheduled to provide intervention for an inpatient admitted to an acute-care hospital 3 days ago. The patient has a history of COPD and was hospitalized with symptoms of pneumonia and influenza. What additional information would be MOST IMPORTANT for the COTA to obtain from the medical record prior to beginning the treatment session with this patient?

Guidelines for infection control precautions Presence of medical lines and urinary catheter Activities that decrease oxygen saturation

A 10-year-old child has poor motor control and incoordination of the dominant upper extremity secondary to a cerebellar brain tumor. One of the goals is to help the child independently complete a grooming routine. Which assistive device would be MOST BENEFICIAL for the child to use for supporting this goal?

Hair brush with an extended handle Nail clippers with a suction cup base Toothbrush with a contoured grip

A 2-year-old child has hypotonia resulting in developmental delay. Currently, the child has good head control, can roll from supine to prone, and shifts weight from side to side in prone. One of the intervention goals is for the child to master movement in a quadruped position. Which facilitation activity is MOST BENEFICIAL to include as part of the initial intervention for progressing toward this goal?

Have the child reach for a toy with alternating hands while lying in prone over a therapy ball that is 31 inches (78.74 cm) in diameter. Place the child in a hands-and-knees position on the floor while providing stabilization at the pelvis. Position the child in prone on a wedge cushion on the floor to provide joint approximation on propped arms.

A COTA is providing education to an older adult client who is hard of hearing. What are the BEST methods to support the client's ability to comprehend the information?

Keep background noise to a minimum. Face the client when talking. Use a rapid rate of speech. Request a sign language interpreter for the session. Provide adequate lighting in the environment. Provide an informational handout.

A 5-year-old child recently underwent treatment for a severe gastrointestinal illness. Despite a full recovery, the child refuses to eat. The parents report that prior to the illness, the child routinely ate meals with the family and was not a picky eater. One of the intervention goals is for the child to resume age-appropriate eating. Which behavioral management technique would be MOST EFFECTIVE for promoting incremental improvements for supporting progress toward this goal?

Have the child select several foods to taste from a list of preferred foods. Introduce one type of nutritious food at a time until acceptance is achieved. Provide motivating reinforcements to the child during mealtime sessions.

A 10-year-old child is undergoing treatment in a pediatric hospital after having an open reduction and internal fixation of bilateral femur fractures. The discharge planning team indicates the child will be discharged home in 3 days. Although the child has made progress, several of the intervention goals have not been achieved. Which action should the COTA take to maximize the child's progress prior to discharge?

Have the child's parents attend remaining sessions so that they can assist with goal achievement after discharge. Identify the child's current level of participation and barriers influencing the expected outcomes for each goal. Increase the frequency and duration of OT sessions to enable more opportunities to work toward unmet goals.

What type of activity would be MOST BENEFICIAL for an inpatient who recently had a CVA with hemiplegia and has a significant gaze preference? Position the television and meaningful objects in the client's unaffected field of view. Have the client look at the affected side when applying lotion to the upper extremity. Encourage the client to look in a mirror during grooming and hygiene activities.

Have the client look at the affected side when applying lotion to the upper extremity.

A COTA is planning to transfer an inpatient who is morbidly obese from sitting on the edge of the bed to a bedside chair. To ensure a safe transfer, what is the FIRST action the COTA needs to take in this situation?

Have the patient weight shift back and forth when standing. Determine adequate lower extremity muscle strength. Encourage the patient to sidestep from the bed to chair.

A student in the fourth grade has mild developmental delay secondary to Down syndrome. The student has difficulty with tabletop writing tasks due to poor proximal stability. Which recommendation represents a compensatory strategy for enhancing proximal stability when writing?

Have the student stand at a counter-height tabletop during writing tasks. Put a medium-sized triangular grip on the student's writing utensil. Allow the student to write in a prone position bearing weight on the forearms. Fasten a one pound (0.45 kg) weight on the student's wrist during the writing task.

Several students in a preschool class are having difficulty tracing lines and forming the letters of their own names using the correct direction and sequence. The teacher asks the COTA for activity suggestions to help improve the students' pre-writing skills. The COTA observes the students during classroom activities and determines they are kinesthetic learners. Which activity is MOST EFFECTIVE for the COTA to recommend when supporting the students' learning style?

Have the students use their fingers to draw letter shapes in the air with hand-over-hand assistance as needed. Provide each student with a colorful worksheet to connect dots that form the shape of the letters in their name. Teach the students a descriptive story about letter formation that they can recite each time they form a letter.

A 5-year-old child has hypersensitivity to clothing textures secondary to tactile defensiveness and is only willing to wear the same shirt and pair of pants each day. The child has verbal outbursts, cries, and becomes physically aggressive when the parent attempts to dress the child in any other clothing. One of the intervention goals is for the child to dress without triggering these behaviors. Which strategy is MOST EFFECTIVE for supporting this goal?

Help the child self-select daily outfits from similar clothing texture options. Problem solve clothing options that meet the child's sensory based needs. Recommend the parent launder the child's pants and shirt each evening.

A client who has an ulnar nerve injury works as an office clerk. Which manual task would be MOST DIFFICULT for this client to complete without using compensatory techniques?

Holding several pieces of paper between the thumb and the index finger. Pressing down firmly with the palm of the hand on the top of a stapler. Pushing the drawer of a file cabinet closed using the proximal portion of the palm.

A COTA working in an outpatient rehabilitation setting is interviewing a young adult client. The client was recently diagnosed with post-traumatic stress disorder and depression secondary to sustaining an amputation of the dominant upper extremity 3 months ago. What questions would be beneficial to ask about the client's leisure and social participation when gathering information to contribute to the occupational profile?

How anxious do you feel about doing things with your non-dominant arm? Do family and friends seem to interact differently with you now? What things do you choose to do, rather than things you have to do? Is there an activity that you particularly enjoy watching or participating in? Which of your preferred activities are you unable to do since the accident? What activities do you like to do with family and friends in your spare time?

A COTA is completing an initial interview with the spouse of an older adult client who has end-stage Alzheimer's disease. The client resides at home with the spouse who is the primary caregiver. Which option represents an open-ended question the COTA should ask during the interview?

How much assistance do you provide for bathing activities? What activities do you want to work on during these sessions? Do you receive help from family or friends on a regular basis?

Which adaptive toileting equipment would be MOST BENEFICIAL for a client who is unable to reach to complete personal hygiene after toileting?

Reacher Long-handled mirror Toilet tissue aid

An older adult client with COPD has recently started using home oxygen 24 hours per day, but continues to have dyspnea with basic daily tasks. Currently, the client lives alone and wants to remain as independent as possible with ADL and leisure activities. What strategies should the COTA advise this client to use to support progress toward this goal?

Identify a maximum number of activities that can be completed each day. Plan to take rest breaks intermittently throughout the day. Problem solve alternate ways to conserve energy during tasks. Ask friends or neighbors to assist with strenuous household activities. Hire a chore worker to assist with routine home management. Store typically used supplies for an activity within reach.

A COTA is part of a school-wide committee that is developing a positive behavioral intervention and support (PBIS) program. One of the goals of the program is to teach prosocial behavior to all students who attend the school. To support this goal, which of the following recommendations should the COTA make to the committee?

Identify each student's preferred recreational or leisure activities. Define desired social behaviors and expectations for all students. Develop individual behavior plans for students with conduct problems.

A client who has dementia attends an adult daycare program. The client has been participating in a daily current events group. The COTA notes that the client's frequency of interacting during the group has decreased over the past few sessions, and the client now has intermittent verbal outbursts that disrupt the group's discussion. What action should the COTA take based on this observation?

Identify possible triggers for the change in level of interaction with others in the group. Ask the client direct questions to facilitate appropriate communication within the group. Provide immediate feedback during the group when the client demonstrates signs of agitation.

A client has recently developed symptoms associated with diabetic retinopathy. The client lives alone in a split-level home and requires daily support from a homecare assistant for meal preparation and homemaking. One of the client's goals is to be able to independently read the mail. Which low vision device would be MOST BENEFICIAL to recommend for this purpose?

Illuminated hand magnifier with a built-up handle High power convex lens magnifier mounted on an adjustable stand Eyeglasses with high plus aspheric lens magnification

A client who has incoordination of the dominant upper extremity secondary to Parkinson's disease is learning compensatory strategies to use when dialing on a smartphone. Which strategy would support the client's independence when using the phone?

Increase the volume control to maximum level. Customize the screen settings to full brightness. Install an application to enlarge the size of the numeric buttons.

A client who has schizophrenia is attending a community-based program that operates using a clubhouse model. Which type of intervention would BEST support the client's engagement in occupation when using this model?

Independent living skills activities developed jointly by program members and OT staff Work skills classes that follow a step-wise protocol and workbook of activity assignments Interpersonal skill development guided by outcomes of standardized assessments

Which legal document guides intervention for students who receive OT services in a school setting?

Individualized Family Service Plan (IFSP) Individualized Education Program Plan (IEP) 504 plan through the Rehabilitation Act

A client who has intention tremors of the dominant arm secondary to multiple sclerosis is learning compensatory strategies to use when typing on a computer keyboard. Which of the following strategies should the COTA use FIRST for promoting independence with keyboard tasks?

Install an on-screen virtual keyboard to access with an alternative pointing system. Place a keyguard over the standard keyboard to allow only desired keys to be selected. Customize accessibility features that are built into the computer's operating system.

An inpatient sustained a C2 fracture 3 days ago and is immobilized in a halo vest. Motor and sensory function is intact, but the patient is restricted in movement by the halo vest. One of the intervention goals is for the patient to be independent in self-feeding. Which strategy would be MOST BENEFICIAL to teach the patient to use during mealtime?

Instruct the patient to eat finger food or food that can be eaten with a spoon. Ensure there is color contrast between the plate and the table surface. Position the plate further away from the patient but within line of sight.

A resident was recently admitted to a skilled nursing facility after having a myocardial infarction. Medical records indicate that the resident has tested positive for methicillin-resistant staphylococcus aureus (MRSA) and staff are required to follow contact precautions. What action should the COTA take during intervention activities with this resident?

Keep other residents a minimum of three feet away from the resident. Wear a biosafety mask. Wear gloves and a protective gown.

A client with diabetes mellitus has low vision that interferes with the client's ability to read instructions on a prescription medication bottle. What would be the MOST BENEFICIAL strategy to support the client's independence in reading these instructions?

Large-print medication diary or notebook Daily pill box with a built-in auditory alarm Illuminated handheld magnification device

What is the most important action for the COTA to take FIRST when molding heated thermoplastic material during fabrication of a hand-based orthotic?

Let the material cool so that it can be placed on the skin and tolerated by the client. Position the client's forearm in supination to allow gravity to help mold the material. Ensure that the material is properly aligned with the palmer arches and joint creases.

A resident in a long term care setting has Huntington's Chorea and severe cognitive decline. The nurse reports that the resident sits in a standard wheelchair most of the day. Recently, a decrease in the resident's cognition, and an increase in involuntary, non-purposeful dyskinetic movements of the trunk and upper extremity have been hindering the staff's ability to maintain the resident's proper position in the wheelchair. Which seating option would be a beneficial alternative to the resident's current wheelchair?

Lightweight chair with a custom contour seat cushion Reclining high-back power wheelchair Tilt-in-space manual wheelchair

A 4-year-old child with spastic diplegia has level II motor performance for gross motor and manual abilities. The child attends preschool and wants to be able to play independently in the gym and on the school playground with peers. Which adaptive mobility device would be MOST BENEFICIAL for the COTA to recommend to promote progress toward this goal?

Lightweight self-propelled mobile stander Modified tricycle with built-up pedals Riding toy with a parent-guided handle

An inpatient had a C5-6 laminectomy and fusion 2 days ago. The patient is preparing for discharge and learning post-surgical precautions to incorporate into everyday life at home. What should the COTA include in the discharge instructions for this patient?

Limit walking in the home to bathroom visits only, and use a bedside commode at nighttime. Resume driving when free from pain and narcotic use has been discontinued. Avoid reaching for objects above shoulder height and bending the neck forward.

A client who has a complete T8 spinal cord injury is learning compensatory dressing techniques. Which assistive devices would be MOST BENEFICIAL for the client to use to maximize independence during dressing tasks?

Long-handed shoehorn, buttonhook, and zipper pull Dressing stick, spiral shoelaces, and zipper rings Long-handled reacher, sock-aid, and elastic shoelaces Dressing loops, light-weight reacher, and Velcro® closures

A student in kindergarten has hypotonia and poor trunk control secondary to Down syndrome. When sitting on the floor, the student typically positions the legs in a W-sitting pattern. One of the intervention goals is for the student to begin using a more developmentally appropriate position when sitting on the floor to minimize potential problems associated with the student's current preferred position. Which floor-sitting position is BEST for meeting this objective?

Long-sitting Side-sitting Tailor-sitting

A client had surgery to decompress the ulnar nerve 2 weeks ago. The surgical incision is healing as indicated in the picture below. Which intervention should be included as part of the patient's scar management intervention at this phase of healing?

Lotion application and compression wrap Circumferential moist heat packs Continuous wave low intensity ultrasound

A patient was admitted to a locked mental health unit 5 days ago with paranoid delusions and combative tendencies associated with an exacerbation of schizophrenia. The patient is currently considered an elopement risk, but is permitted to leave the unit to attend OT clinic sessions when escorted by a mental health technician. What risk management actions should the COTA take during the patient's scheduled sessions?

Make certain there are physical restraints available to use if combative behaviors occur. Lock the clinic exit doors for the duration of the patient's session. Ensure there are no other patients in the immediate clinic area during the patient's session. Conduct session activities away from the main doorways of the clinic. Inventory supplies prior to the start of the session and before patient leaves the session. Avoid having supplies available that could be used to open door-lock fittings.

An inpatient, who is experiencing an acute manic episode, is participating in an activity group. The COTA asks each patient in the group to make a collage to express preferred hobbies and provides the group with supplies and a variety of magazines for pictures. After 15 minutes, the patient begins to wander around the room and does not make progress on the collage. What action should the COTA take to promote the patient's participation in the activity?

Make sure that all supplies are within reach. Limit the number of available magazines. Provide a variety of preselected pictures.

A kindergarten student who has visual perceptual deficits is able to name letters of the alphabet, but has difficulty with the motor planning skills for writing the letters on paper. One of the intervention goals is for the student to improve writing legibility. Which activity would be MOST BENEFICIAL for the student to complete as a preparatory activity during the initial stages of intervention?

Manipulate brightly colored magnetic letters on a vertical surface. Use firm resistance putty to shape letters of the student's first name. Place alphabet stickers in between the lines on a piece of paper. Copy letters from a template onto wide-ruled paper using a scented marker.

An adolescent with a mild intellectual disability wants to be able to prepare meals independently. One of the short-term goals is for the adolescent to learn how to use a microwave oven to heat a prepared frozen meal. Which contextual strategy would be MOST BENEFICIAL for supporting the adolescent's success with this task?

Mask unnecessary microwave oven operation buttons and adhere pertinent pictures to the exposed buttons. Provide a checklist for the adolescent to refer to when using the microwave oven for meal preparation. Teach the adolescent to use a thermometer to ensure the food has reached the appropriate internal temperature.

A COTA is fabricating a short thumb spica orthosis for a client who has basal joint osteoarthritis. The primary purpose of the orthosis is to improve hand function while protecting the joint during activity. Which position is OPTIMAL for achieving this objective?

Maximum palmar abduction of the first CMC joint with the thumb MCP joint in complete extension Slight thumb MCP joint flexion with the first CMC joint midway between palmar and radial abduction Maximum radial abduction of the first CMC joint with the thumb MCP joint in 25°- 30° of flexion

A client has spasticity in the dominant upper extremity secondary to an upper motor neuron lesion. The COTA, who is service competent in using physical agent modalities, is applying a cold pack over the belly of the biceps to inhibit spasticity prior to asking the client to perform an activity. What is the recommended time frame for the application of this cooling modality?

Minimum of 45 minutes Greater than one hour Up to 30 minutes

A COTA is documenting the assistance level needed for an inpatient who recently had a total hip replacement and has early-stage Alzheimer's disease. The patient is independent in mobility and transfers, but intermittently forgets precautions and requires supervision to maintain safety during ADL. What is the BEST descriptor for the COTA to use when documenting the patient's level of assistance for functional transfers?

Moderate assistance Minimal assistance Standby assistance

Which symptoms typically present the GREATEST barrier to full participation in daily habits and routines for an adolescent who has a diagnosis of cyclothymic disorder?

Multiple depressive and hypomanic episodes Persistent low mood and restless behavior Pervasive mistrust and auditory hallucinations

A parent reports that their child, who is in the first grade, was recently diagnosed with a sensory processing deficit. The Individualized Education Program team is determining the child's eligibility for school-based OT services. As part of this process, the OTR and COTA are gathering information about the child's self-regulation capacities during the school day. What actions would be beneficial to take for obtaining this information?

Observe how the child holds a pencil or crayon when writing and drawing. Ask the teacher about typical behaviors the child displays when waiting in line with peers. Review the child's writing samples to determine the frequency of letter and number reversals. Determine if the child seeks out enclosed spaces during recess or reading time. Verify if the child is able to manage clothing independently during bathroom breaks. Identify the behaviors the child typically displays toward the end of the school day.

Over the last several months, an adolescent with autism spectrum disorder has made significant progress in independently performing a grooming routine. The adolescent is motivated by these successes but continues to become frustrated with facial shaving. Despite watching videos of the task and trying to imitate others, the adolescent has not mastered the skill of shaving. Which technique would be MOST EFFECTIVE to include as part of the intervention to support progress toward the adolescent's independence with facial shaving?

Offer step-by-step verbal instructions until the adolescent is able to routinely shave on a daily basis. Post sequential picture cards illustrating each step of the shaving task on the adolescent's bathroom mirror. Provide assistance with the initial steps of shaving, and support the adolescent to perform the final step.

An inpatient in a rehabilitation facility is in the recovery phase of Guillain-Barré syndrome. The patient is the parent of a 4-month-old infant. One of the patient's long term goals is to be able to lift the infant in and out of the crib prior to discharge in 3 weeks. The patient has met the initial goal of being able to lift a 10-pound (4.5 kg) weight from the floor to a table. Which statement represents an achievable short term goal to include as part of the intervention plan documentation for the NEXT phase of the patient's rehabilitation?

Patient will lift the infant from the floor to the patient's lap from a seated position in a standard wheelchair. Patient will verbalize methods for using proper body mechanics for lifting objects over 50 pounds (22.7 kg). Patient will be able to use proper body mechanics to safely lift 15 pounds (6.8 kg) from the floor to the table 5 out of 5 times without assistance. Patient will increase strength of both upper extremities by at least 2 pounds in one week.

A COTA who works in a home health setting is working with a client who lives with a spouse. The client has mild dementia and age-related macular degeneration. One of the client's goals is to independently prepare meals. As part of the intervention session, the COTA is writing reminder signs to post in strategic locations in the kitchen. What would be the MOST EFFECTIVE action for the COTA to take to help the client use the posted reminder signs?

Place a clear plastic covering on the signs. Use a black felt-tip marker when writing the signs. Add illustrations to enhance the message on each sign.

An adult client with quadriplegic cerebral palsy uses a power wheelchair and is planning an international vacation involving air travel. The COTA is assisting the client to plan ahead for the trip. As part of this process, the client has contacted the airlines and made arrangements for advanced boarding and assistance during the boarding process on the airplane. What additional action should the COTA recommend to the client related to traveling with the power wheelchair?

Place cushions and other loose accessories on the client's chair for storage during the flight. Include basic wheelchair maintenance tools on a packing list. Identify a list of local wheelchair vendors at the destination. Advise airline staff to stow the client's wheelchair in an onboard coat closet. Request the wheelchair be available during the flight to allow bathroom access. Attach illustrated assembly and disassembly instructions to the wheelchair.

A COTA, who works in a home health setting, is working with a client who had open heart surgery and a sternotomy 2 weeks ago. One of the goals for the client is to independently transfer from the toilet while following sternal precautions. Which technique should the COTA to teach the client to support progress toward this goal?

Place feet shoulder width apart, reach for a sturdy object, and slowly pull the body into an upright position. Lean forward with shoulders over the knees, cross arms over the chest, and use leg strength to stand. Scoot to the edge of the toilet, place hands on the seat of the toilet, and push through the arms to stand up.

A client, who has low back pain, is participating in an outpatient program. One of the intervention goals is for the client to learn proper body mechanics to use when picking up objects off the floor. Which strategy should the COTA teach the client to support progress toward this goal?

Place one foot forward to move into a lunge position. Lean forward at the waist to reach toward the floor. Bend at the knees to achieve a squatting position.

Which precaution should be taken during intervention sessions with an inpatient in an acute care setting who has frequent seizures?

Plan sedentary activities at the bedside and have an additional staff member present. Provide treatment in a dimly lit room and have the patient lie in a supine position. Be prepared for protective action and ensure a chair is available for the patient to sit in.

A COTA is using a standard 360° goniometer to measure a client's elbow flexion. To obtain the MOST ACCURATE results, which steps should the COTA use as part of this procedure?

Position the axis of the goniometer on the medial epicondyle of the humerus. Start with the client's arm fully extended at the side of the client's body. Align the stable arm of the goniometer with the midline of the humerus. Bend the arm at the elbow with the palm down and the forearm pronated. Stabilize the goniometer over the muscle belly of the brachioradialis. Ensure the moveable arm of the goniometer is parallel to the radius.

A resident of a skilled nursing facility had a resection of a brain tumor of the left parietal lobe. During ADL sessions, the COTA observes that the resident is unable to find toiletry items on the bathroom sink counter, despite using adequate scanning techniques. The COTA suspects that the resident has visual agnosia and plans to incorporate strategies into the intervention to compensate for this deficit. Which strategy would be MOST BENEFICIAL to use for this purpose?

Position typically used toiletry items in the resident's right visual field. Adhere large print labels to the toiletry items the resident typically uses. Teach the resident to use other senses such as touch to locate toiletry items.

A client who has stage 6 Alzheimer's disease has been unwilling to bathe for over a week. The spouse, who is the primary caregiver, asks the COTA for strategies to support the client in completing bathing activities. Which strategies should the COTA provide to the caregiver to support the client's participation in hygiene activities?

Prepare the bathroom prior to the planned bath time. Plan to complete all the bathing activities as quickly as possible. Simplify the steps of bathing into clearly understood stages. Schedule bathing for the same time every day before breakfast. Offer the client the choice to either take a bath or a shower. Help the client understand the importance of a bathing routine.

An inpatient was admitted to the hospital 3 days ago secondary to Guillain-Barré syndrome. The patient is dependent in ADL. What interventions would be MOST BENEFICIAL for the patient during this phase of the disease process?

Progressive aerobic activities Therapeutic strengthening exercises Electronic aids to support ADL Pain management strategies Positioning methods Weighted eating utensils

A COTA is scheduled to lead a group for young adult clients who have anorexia nervosa. One of the objectives of the group is to explore positive behaviors associated with the clients' occupational performance. Which type of activity would be MOST BENEFICIAL for supporting this objective?

Provide activities based on the clients' self-awareness. Select structured craft activities for the clients to complete. Incorporate the clients' valued activities into the session. Use a variety of role-playing activities emphasizing body image.

A resident in a skilled nursing facility has poor upper extremity motor control and wants to be independent in self-feeding. After collaborating with the resident, what action should the COTA take NEXT to support progress toward this goal?

Provide an adaptive swivel spoon. Recommend finger foods. Place dycem under the plate and drinking cup.

A patient in a hospital setting has pneumonia and is participating in an ADL session while seated in a recliner at the bedside. During a grooming activity, the patient becomes short of breath. In addition to calling for the patient's nurse, what IMMEDIATE action should the COTA take?

Provide the patient with maximal assistance to transfer to the bed and position the head of the bed at a 30° angle. Have the patient bend forward slightly at the waist and lean through the forearms on an overbed table. Administer oxygen through a nasal cannula and monitor oxygen saturation levels using a pulse oximeter.

A 10-year-old child has spastic quadriplegia and is non-verbal. The child is learning to use an augmentative and alternative communication (AAC) word completion system for the first time. This requires the child to use head-turning to activate the control interface. During the initial trial, the child is able to activate the device, but the voice-output message produced is not understandable. Which activity should the COTA have the child practice FIRST to refine the skills needed to operate the AAC?

Providing time-dependent choices using symbols instead of words Playing with a switch-activated toy to master point and click options Using the head switch to express simple messages and intentions

During a meal preparation session in a geropsychiatric facility, a resident who has chronic schizophrenia is preparing cupcakes from a box mix. While stirring the batter, the resident steps away from the kitchen counter and exclaims that there are spiders in the batter. What action should the COTA take to redirect the resident?

Reassure the resident that the lumps in the batter are from the dry mix. Ask the resident to begin placing cupcake liners in the baking pan. Tell the resident to continue the baking task because the vision is not real.

A client who had a recent CVA is participating in a meal preparation session. The client can accurately answer Yes/No questions about preparing vegetables for the meal, but when asked to begin cutting the vegetables, the client attempts to use a spoon to perform the task. Which neurobehavioral deficit is interfering with the client's ability to successfully complete this task?

Receptive aphasia Motor ataxia Ideational apraxia Decreased initiation

A young adult client has progressive limb-girdle muscular dystrophy. The client has had a recent decline in function resulting in poor head and neck control, and has developed a chronic pressure ulcer on the sacrum from sitting in a poorly fitted standard wheelchair. When selecting a new wheelchair for this client, what feature is MOST IMPORTANT to include as part of the wheelchair design?

Reclining back with a seat-to-back angle that opens to 170° Lightweight frame with a fixed 90° hip, knee, ankle sitting position Tilt-in-space seat with tilt ranges from 45° to 65°

A COTA is teaching compensatory strategies to a resident of a skilled nursing facility who has mild cognitive decline. The resident typically arrives in the therapy office for scheduled community outings wearing inappropriate clothing for outdoor weather conditions. Which of the following would be the MOST BENEFICIAL cognitive strategy to teach the resident?

Recommend that the client attend a daily current events group with peers. Have the client routinely check the natural environment for visual cues. Encourage the client to routinely write important information in a journal.

A 4-year-old child has poor motor coordination and limited trunk control secondary to Dandy-Walker syndrome. In preparation for a play session, the COTA positions the child in a standing frame that has a contoured head support, an attached tray table, and an adjustable foot support. When the child is in a full upright position, the child's head falls into forward flexion. Which action should the COTA take to facilitate the child's ability to participate in the play session?

Remove the head support from the stander. Place the stander in a slightly reclined position. Tilt the tray table to a 45° incline in relation to the torso.

Which option would be MOST BENEFICIAL for addressing the problem of heavy pencil pressure during handwriting?

Removeable pencil grip Mechanical pencil Weighted writing utensil

An inpatient who sustained a TBI several days ago has mild hemiparesis and is functioning at a Level VI (Confused-Appropriate) on the Rancho Los Amigos scale. Currently, the patient requires moderate assistance during dressing tasks and avoids using the affected hand during bimanual tasks such as buttoning. As part of a dressing session, the COTA uses blocked practice techniques to initially teach the patient how to fasten the buttons on a front-opening shirt. What is the PRIMARY benefit of using this technique for supporting the patient's independence with self-care?

Repetitive practice of the same movements establishes motor patterns for similar tasks. Massed practice of the same motor skill effectively generalizes to other similar activities. Variability of movements help the client to learn ways to adapt for motor deficits.

A client has symptoms associated with stage 2 Parkinson's disease. One of the intervention goals is for the client to be as independent as possible with self-feeding. Which assistive device would be MOST BENEFICIAL for the client to use during meals to support this goal?

Rocker knife Weighted utensil Long-handle utensil Swivel spoon

A COTA working in a long term care facility is selecting an activity for a group of residents who have dementia. Which type of activity would be MOST BENEFICIAL for improving the residents' alertness and postural reactions?

Role-playing Guided imagery Reminiscence games Parachute games

A high school student had surgical reconstruction of the ulnar collateral ligament of the dominant elbow 4 weeks ago. Due to movement precautions associated with this stage of healing, the student is not able to position a backpack filled with school books and supplies over both shoulders. Which option would be MOST BENEFICIAL for the student to use for carrying school supplies at this time?

Rolling soft-sided backpack with adjustable-height handle Single-strap sling backpack worn over the unaffected shoulder Standard backpack modified to carry the load across the chest

A student in the second grade has illegible handwriting. The student has good proximal control but poor fine motor control and uses a palmar grasp whenever holding a pencil. One of the intervention goals is for the student to learn to use a more mature pencil grasp when writing. Which activity would be MOST BENEFICIAL to include in the intervention for promoting progress toward this goal?

Searching for small objects in a bucket of uncooked rice Finger-painting on a large pad placed on an upright easel Rolling out firm modeling dough on a table top Threading string through pegs on a vertically positioned pegboard

A COTA is making wheelchair recommendations for a client who plans to join a wheelchair basketball team. The client has transfemoral amputations of both legs and currently uses prosthesis for standing activities and ambulating short distances. For community mobility, the client uses a standard wheelchair. Which wheelchair feature would be MOST BENEFICIAL for this client when playing basketball?

Slightly recline the seat so that the client is semi-reclined and hips are in 100° of flexion. Angle the rear wheels of the chair so that the bottom of the rims is farther apart than the top. Adjust the anterior of the seat base to have a forward and downward tilt.

Which adaptive bathing equipment would be MOST BENEFICIAL for a client who has limited hand grasp?

Sponge with an extended handle Bath mitt with a hook and loop strap Hand-held shower with a wall mount

A client who has ataxia of the dominant arm secondary to a cerebellar tumor is learning compensatory strategies to use when self-feeding. Which strategies would be MOST BENEFICAL to support the client's independence when eating?

Stabilize the plate on a non-skid mat and wear a weighted cuff on the wrist. Apply a brightly colored piece of tape to the right of the plate and use visual scanning. Use the clock technique for positioning food on the plate and lightweight utensils.

A young adult client who has spastic diplegic cerebral palsy wants to work as a cashier in a clothing retail store. Based on typical symptoms associated with this disorder, which activity, when completed without compensatory strategies, would present the GREATEST challenge to the client while working at this job?

Standing at the cash register for the duration of a shift Using one hand to pick up a clothing item to scan the bar code Placing purchased clothing items into a shopping bag

Pictured below are several views of the same static orthosis. This orthosis would be the MOST EFFECTIVE intervention for providing which of the following functions?

Stretching the extrinsic finger flexors to reduce soft tissue tightness Elongating the finger flexors for a more effective tenodesis grasp Reducing pain secondary to inflammation of the flexor tendons

A student in kindergarten has moderate extensor tone secondary to athetoid cerebral palsy. The COTA is teaching the classroom aide how to move the student from the wheelchair to the floor so the student can participate in floor-time activities with other students. Which method is MOST EFFECTIVE for the caregiver to use for inhibiting the student's extensor patterns during this transfer?

Support the student's trunk with one arm and abduct the lower extremity with the other arm. Hold the student facing forward with hips and knees flexed and neck slightly flexed. Have the student's back face the caregiver with hips and knees extended and neck slightly flexed. Position the student so the legs straddle the caregiver's hip.

A client in an outpatient setting has amyotrophic lateral sclerosis. The client has spasticity of the dominant upper extremity with Grade 3 tone as measured by the Modified Ashworth Scale. The client is learning inhibitory strategies to use as part of an upper body dressing program. Which technique would be MOST EFFECTIVE to teach the patient to use at the start of a dressing task to support independence with putting on front-opening clothing?

Sustained stretch of the elbow, hand, and finger flexors for 8 - 10 minutes Vibration and manual tapping on primary agonists for 5 - 10 seconds Rapidly alternating flexion and extension movements for 10 - 15 repetitions

A 14-year-old adolescent with a progressive neurological condition has Good (4/5) functional strength of proximal upper extremities and Poor (2/5) strength distally. This interferes with the adolescent's ability to independently self-feed. Which assistive device would be MOST BENEFICIAL for the adolescent to use for maximizing independence while eating?

Swivel spoon with an extended handle Universal cuff with hook-and-loop strap Utensil with a large built-up foam grip

An inpatient has a TBI and is functioning at Level IV (Confused, Agitated) on the Rancho Los Amigos scale. Based on the patient's current cognitive level, which approach would be MOST EFFECTIVE for facilitating the patient's success with ADL tasks?

Teach self-regulation strategies for use during bathing. Encourage recall of typical daily routines. Provide maximal support and structure to brush teeth.

A client in an outpatient mental health clinic has successfully learned strategies to manage symptoms associated with post-traumatic stress disorder, and is preparing for discharge from the program. The client lives independently and attends a software training program through vocational rehabilitation services. What action should the OT team take as part of the client's transition planning process?

Teach the client how to use a desktop computer for use in the home environment. Develop a handout for the client listing potential environmental and social stressors. Provide the client with information about options and resources for ongoing support.

A young adult client with autism spectrum disorder has a goal to independently walk the same distance each day for exercise, but does not want to walk the same route every day. The client has a pedometer to track the distance, but frequently achieves the distance goal in a location away from home. The COTA has tried to establish a variety of predetermined routes with the client, but the client wants to independently select the route during the walk. What would be the MOST BENEFICIAL strategy for the COTA to recommend to this client?

Teach the client to navigate the neighborhood using familiar landmarks and street signs. Find a walking partner to assist the client in returning home within the distance goal. Program a cell phone app to alert the client when the midway point has been reached.

A COTA employed in private practice is providing home-based services for a child who has attention deficit hyperactivity disorder (ADHD). One of the intervention goals is to develop strategies for completing homework assignments. When documenting the child's progress toward this goal, which information is BEST to include in the "O" section of the SOAP note?

The child frequently looks around the room and requires verbal redirection to complete homework. The child is able to attend to worksheet assignments for 5 minutes without getting distracted. The child often drops the pencil on the floor or desk during writing assignments.

An OTR and COTA are establishing a long term goal to be achieved in 8 weeks time for a home health client who had a total hip replacement 7 days ago. The client is having an uncomplicated post-operative recovery, is on partial weight-bearing status, and is following prescribed total hip precautions. Currently, the client ambulates with a walker, avoids bearing any weight on the affected leg due to fear of pain, and requires moderate assistance with transfers. Which statement represents an achievable long-term goal to include as part of the intervention plan for this client?

The client will demonstrate full weight bearing through the affected lower extremity during all functional transfers. The client will complete toilet transfers at modified independent level 100% of the time with a standard walker. The client will be able to verbalize 3-4 pain management strategies typically used during the toileting routine.

An OTR and a COTA are collaborating to evaluate a client who has diabetes mellitus, congestive heart failure, and depression. A screening indicates that the client lives alone and has limited health literacy skills. What information would be MOST BENEFICIAL to contribute to the client's occupational profile?

The client's perception of how well health information is processed and understood The client's satisfaction with their health care providers and medical intervention plan Availability of people in the client's social network who can provide assistance and support

Pictured below is an assistive device mounted over a client's stove. What is the PRIMARY purpose of this device during stovetop cooking?

To enable a client who has paraplegia to see the contents of pots when seated in a wheelchair. To increase the illumination of contents of the pots by redirecting the kitchen lighting to the stovetop. To allow a client with COPD to conserve energy by monitoring contents of pots from a distance.

A COTA and an OTR are collaborating on a quality improvement initiative. The goal of the initiative is to review clinical documentation records to determine the presence of specific criteria. What is the PRIMARY purpose for completing this type of quality initiative?

To identify which staff members are out of compliance with the documentation policy To determine if enhancements are needed for the clinical documentation system To ensure financial reimbursement for rehabilitation services are received from third party payers

A COTA employed in an industrial rehabilitation setting is reviewing the results of a functional capacity evaluation (FCE) of a client who is scheduled to participate in a work hardening program. What is the PRIMARY purpose for reviewing the FCE prior to the start of the program?

To learn the client's physical abilities based on expected job duties and demands. To provide the client's physician a recommendation for the duration of medical leave. To understand the workers' compensation laws that impact the client's plan of care.

What is the PRIMARY purpose for administering a standardized occupational performance survey to clients who are participating in an inpatient hand rehabilitation group activity?

To obtain subjective information about clients' vocational competency. To track normative information about the impact of the injury on clients' life satisfaction. To collect reliable information about clients' engagement in essential activities.

A patient in a subacute rehabilitation facility who has COPD and coronary artery disease is scheduled to begin ADL sessions. The patient wants to return home, and resume independent living. What information should the COTA gather at the start of the INITIAL session with this patient?

Typical grooming and bathing routines the patient uses at home. Length of stay of recent exacerbations requiring inpatient hospital admission. Set-up of the patient's home including durable medical equipment. Nursing personnel assigned to assist the patient with daily bathing. Approximate time of the patient's most recent dosage of pain medication. Living situation and support structure available to the patient.

A client, who has osteosarcoma, reports that fatigue and low activity tolerance interfere with the ability to complete daily activities. One of the client's goals is to use energy conservation strategies to improve endurance for ADL. What is the FIRST action the COTA should take to support progress toward this goal?

Understand the client's readiness to learn. Develop a written handout with illustrations. Identify resources in the client's community.

A client has generalized upper extremity weakness due to multiple sclerosis. One of the client's goals is to cook a family meal. During stove-top cooking, the client experiences poor standing endurance and has occasional mild upper extremity intention tremors. What recommendations should the COTA give to the client for maximizing safety and independence during cooking?

Use a microwave oven instead of a stove-top when cooking. Sit on a counter-height stool while cooking at the stove-top. Use weighted utensils when stirring food on the stove-top.

A client who has adiadochokinesia of the dominant arm secondary to Friedreich's ataxia is learning compensatory strategies to use when washing the exterior of a car. Which strategies would be MOST BENEFICIAL support the client's independence with this cleaning task?

Use a telescoping extension on the hose and a bucket on wheels. Put cleaning supplies in a carrying caddy and place the caddy near the car. Support torso on the side of the car and wear a wash mitt.

An inpatient recently had surgery for a laryngectomy and placement of a permanent tracheostomy tube. One of the intervention goals is for the patient to independently perform personal hygiene routines at home. Which strategy should the COTA teach the patient to use to promote progress toward this goal?

Use sterile wipes to clean the inner cannula. Wear a stoma cover during sponge bath. Keep the stoma dry when showering.

A student in the third grade has difficulty remembering how to form letters and numbers. The student typically remembers only one letter at a time when copying from the dry erase board in the front of the classroom. Evaluation results indicate the student has poor visual memory skills but age-appropriate visual discrimination skills. Which technique would be MOST EFFECTIVE for improving the student's ability to copy from the board?

Using a finger to trace the letters in the air Scanning letters from top to bottom and left to right Chunking information into small units Using imagery to visualize the formation of letters

A student in third grade has sensory modulation dysfunction and refuses to do messy art projects in class. What is the PRIMARY reason for this behavior?

Vestibular under-responsiveness Gravitational insecurity Tactile defensiveness

A COTA working in an outpatient setting has colloborated with an OTR to fabricate a wrist-hand-thumb immobilization orthosis for a client. What information should the COTA provide to the client prior to the client leaving the clinic with the orthosis?

Ways to pad the orthosis if minor irritation occurs Wearing schedule of the orthosis Tips for making minor modifications to the orthosis at home Estimated timeframe for recovery based on orthotic use Signs of adverse reactions to the orthosis Primary purpose of the orthosis

An OTR and a COTA are developing a discharge plan for an inpatient who was recently diagnosed with schizophrenia. Prior to this admission, the patient was independent in all ADL and lived alone, but now requires 24-hour supervision. The patient will be discharged to live with a parent who will be the primary caregiver. What questions would be beneficial to ask the caregiver when gathering information to contribute to the discharge plan?

What is included in your typical daily routines? Will this change in living arrangement influence your current lifestyle? How do you plan to manage household responsibilities? Will you become frustrated with this living arrangement? What concerns do you have about the transition to this new living arrangement? Do you feel you have enough knowledge about the symptoms of this disease?

Which activity would be MOST challenging for an older adult resident who has spinal kyphosis and fixed posterior tilt of the pelvis to complete without using compensatory strategies?

Which activity would be MOST challenging for an older adult resident who has spinal kyphosis and fixed posterior tilt of the pelvis to complete without using compensatory strategies?

An outpatient client who has breast cancer had a total mastectomy 4 weeks ago and recently started radiation therapy treatment. Which ROM exercises would be MOST EFFECTIVE for the COTA to teach the client during this phase of treatment?

Wrist flexion and extension, and hand ROM Elbow flexion and extension, and forearm supination Shoulder flexion, extension, and rotation

A COTA is checking the proper fit of a prefabricated resting hand orthosis for a client who has rheumatoid arthritis. The primary purpose of the orthosis is to allow the hand to rest in the functional position. Which position is OPTIMAL for achieving this objective?

Wrist in 20° flexion and 10° radial deviation; finger MCP joints in 90° flexion, PIP joints in 60° flexion, DIP joints in 40° flexion; thumb CMC joint in adduction Wrist in 20° extension and 10° ulnar deviation; finger MCP joints in 45° flexion, PIP joints in 30° flexion, DIP joints in 20° flexion; thumb CMC joint in abduction Wrist in neutral anatomical position; finger MCP joints in 90° flexion and PIP and DIP joints in full extension; thumb CMC join in adduction