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A series of practice questions for the nbcot exam, focusing on occupational therapy case scenarios. Each question presents a clinical situation involving a patient with a specific condition and requires the user to select the most appropriate intervention or action. The questions cover a range of topics, including assessment, intervention planning, and client management. This resource is valuable for students preparing for the nbcot exam, as it allows them to practice applying their knowledge to real-world scenarios.
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An OTR is developing an intervention plan for a 4-year-old child with autism spectrum disorder. The child demonstrates echolalia and has frequent behavioral outbursts when transitioning from one activity to another. A primary goal is for the child to successfully navigate transitions. Which strategy would be MOST BENEFICIAL to include in the intervention plan to support progress toward this goal? a. An illustrated communication board to visually support effective comprehension b. A written schedule placed in the child's bedroom with predictable events and routines c. A behavior management plan with built-in rewards and natural consequences - CORRECT ANSWER- -A A patient in an acute care hospital who has renal disease, diabetes, and atrial fibrillation is scheduled to participate in OT. Before beginning the session, the OTR reviews the medical record and finds the patient's INR is 2.5, blood glucose level is 100 mg/dL, and sodium levels are below the normal range. What action should the OTR take based on these lab values? a. Ask nursing staff if it is necessary to provide the patient with a snack prior to the start of the treatment session.
b. Monitor the patient for fluctuations in cognition during the planned treatment session. c. Encourage the patient to drink water at regular intervals throughout the session. d. Measure the patient's blood pressure at rest in supine and repeat after the patient moves to sitting on the edge of the bed. - CORRECT ANSWER- -b A 10-year-old child has end stage metastatic disease and resides at home with a single parent as the primary caregiver. Although hospice care providers are enabling the child to remain at home, the parent is concerned about the challenges associated with caring for the child as the disease progresses. After acknowledging the parent's concern, what action should the OTR take INITIALLY in response to the parent's concern? a. Provide the parent with a list of private-pay certified homecare agencies ni the area. b. Discuss the benefits of relocating the child to a hospice home near the current residence. c. Te a c h r e l e v a n t c a r e g i v e r t e c h n i q u e s a n d c o p i n g s t r a t e g i e s b a s e d o n t h e p a r e n t ' s l e a r n i n g s t y l e. - CORRECT ANSWER- -C An OTR is assessing the current wheelchair seating system of an adult client with congenital muscular dystrophy. The OTR observes that the wheelchair has a 95 ° seat-to-back angle with a 3 °-5° angle-in-space recline. What is the PRIMARY effect of this seating position on the client?
** not C, bc they may not choose an appropriate sensory one, and b is directly sensory An older adult client had a CVA one month ago. Results of the Behavioral Inattention Test indicate the client scored below standard on the line bisection and letter cancellation tasks. What do the results of this assessment suggest? a. Behaviors are consistent with unilateral visual neglect b. Further cognitive perceptual testing is indicated. c. Inattention to detail wil influence completion of daily tasks. - CORRECT ANSWER- -a An OTR is recommending adaptive dressing techniques for a 12-year-old child who wil be wearing a Milwaukee cervico-thoraco-lumbo-sacral orthosis for the treatment of scoliosis. The child is ambulatory and wil be wearing the orthosis 23 hours per day. Which clothing adaptation would be MOST BENEFICIAL to include as part of the recommendation?
c. Wear back opening tunic tops to provide as much coverage over the orthosis as possible. - CORRECT ANSWER- -b An older adult client had a CVA one month ago. Results of the Behavioral Inattention Test indicate the client scored below standard on the line bisection and letter cancellation tasks. What do the results of this assessment suggest? a. Behaviors are consistent with unilateral visual neglect.
b. Further cognitive perceptual testing is indicated. c. Inattention to detail wil influence completion of daily tasks. - CORRECT ANSWER- -a A young adult patient who is in an acute rehabilitation facility recently sustained a frontal lobe TBI and subarachnoid hemorrhage. The patient si currently functioning at Level VI (Confused, Appropriate) on the revised Rancho Los Amigos scale of cognitive functioning. The patient is a full-time college student and lives in an apartment with friends. The discharge plan is for the patient to return home to live with both parents, who will provide caregiver assistance. Scenario item 1of 4 Which performance-based activities would be beneficial for the OTR to ask the patient to complete to provide information about the patient's process skills? a. Preparing a favorite cold snack and beverage b. Making a grocery list to buy ingredients for a cookie recipe c. Squeezing toothpaste onto the bristles of a toothbrush d. Gathering toiletries and items needed for showering - CORRECT ANSWER- -a, b, d A young adult patient who is in an acute rehabilitation facility recently sustained a frontal lobe BI and subarachnoid hemorrhage. The patient is currently functioning at Level VI (Confused, Appropriate) on the revised Rancho Los Amigos scale of cognitive functioning. The patient is a full-time college student and lives in an apartment with friends. The discharge plan is for the patient to return home to live with both parents, who will provide caregiver assistance.
b. Interact with computer software programs focused on improving memory and attention. c. Play simple card games requiring recognition and matching. d. Play age-appropriate board games with standard rules. e. Assemble a simple puzzle located on a table in a common space used by all patients. f. Prepare a snack with cues t o eat when watching football on television. - CORRECT ANSWER- -b, c, e An OTR si completing afeeding assessment of an inpatient who had aresection of aright hemispheric brain tumor 5days ago. When self-feeding, the patient has good hand-to-mouth patterns, manipulates utensils without difficulty, and uses an efficient swalow. However, the patient selects only foods that are positioned on the right side of the plate. Which intervention should hte OTR include ni sessions ot increase the patient's self-feeding skils? a. Provide the patient with options for using partial visual occlusion when eating. b. Have hte dining staf use the clock technique for positioning foods no the patient's plate. c. Teach the patient to use visual scanning and anchoring techniques when eating. - CORRECT ANSWER- -C A client has bilateral peripheral neuropathy secondary ot a6-year history of diabetes melitus. Evaluation results indicate the client has 20/20 visual acuity, ful active ROM of the upper extremities, and 2/5 two-point discrimination on the tips of al digits. Symptoms interfere with the client's ability ot prepare family meals. Which adaptation should the OTR recommend as part of the intervention for supporting the client's engagement ni meal preparation tasks? a. Tactile cues on appliance knobs and angled miror mounted over the back of the stove b. Cookware with weighted botoms and pan holder with suction feet c. Forearm-length oven mitts and cookware with silicone handles - CORRECT ANSWER- -C An OTR si working with an inpatient who has respiratory distress, altered consciousness and dysphagia. The patient's nutritional intake is provided through a nasogastric tube. The priority for OT intervention at this time is positioning the patient to prevent bed sore injuries. Which
precaution should the OTR take during intervention sessions ot avoid complications associated whti the nasogastric tube? a. Roll the patient onto their right side and stabilize the patient with pillows before turning off the feeding pump. b. Ensure the head of the bed is elevated to aminimum of 30 ° during and immediately after feeding. c. Ask the primary care nurse to stop the feeding pump prior to andd during intervention sessions. - CORRECT ANSWER- -b A client with age-related macular degeneration reports that progressive symptoms of this condition interfere with the completion of daily tasks. Which strategy would be MOST BENEFICIAL to incorporate into the intervention for supporting the client's engagement ni occupation? a. Adaptive eye movement patterns using eccentric viewing b. Visual scanning techniques using organized visual search patterns c. Spatial motor cueing techniques using visual anchoring - CORRECT ANSWER- -b Aclient who had a CVA 3months ago has regained most motor and sensory function, but residual homonymous hemianopsia persists. One of the intervention goals is for the client to resume a favorite leisure skil of growing vegetables ni an outdoor garden. Which strategy would be MOST BENEFICIAL ot teach the client ot use when tending ot the garden? a. Left-right scanning techniques b. Full occlusion eye-patching c. Tactile cueing techniques - CORRECT ANSWER- -a An OTR and the director of an adult day program are developing supported employment program. Using information from a survey of potential employers, the OTR recommends the development of a job skills training program to simulate the specific job tasks that will be required at the job site. The program director supports the recommendation. What si the NEXT action the OTR should take in this situation? a. Develop goals and objectives for the program
An OTR is teaching isometric exercises to an older adult client who had an open reduction external fixation of a distal radius fracture 3days ago. What is the PRIMARY precaution the OTR should take when the client is engaged in these exercises? a. Ensure a Valsalva maneuver occurs before the final repetition of the exercise. b. Advise the client ot exhale when exerting effort during each repetition. c. Avoid contraction of the muscles distal to the fracture site. - CORRECT ANSWER- -C however at first GPT said B and then i re asked and it said C, so u want to avoid valsalva with isometric so breathing is most imp with isometric, but bc the ORIF was.3 days ago it is C Apatient ni an intensive care unit si recovering from respiratory failure and was recently weaned from mechanical ventilation. At the start of an ADL session, the OTR observes the patient's vital signs ot be within normal limits when the patient si positioned ni bed with the head of the bed raised ot 30 °. The OTR assists the patient ot transfer from the bed to arecliner chair and notes hte patient's physiologic responses ot this movement activity are as folows: heart rate = 12 beats per minute, blood pressure = 160 / 10 mmHg, oxygen saturation = 93% and respiratory rate = 12 breaths per minute. What action should the OTR take NEXT based on these vital signs? a. Alert the patient's primary nurse and proceed with the planned session. b. Activate the emergency response system and discontinue the session. c. Assist the patient in transferring from the chair back to the bed and position in a supine. - CORRECT ANSWER- -B A third grade teacher provided an OTR with a student's handwriting sample. The OTR notes that the handwriting contains letter reversals with the letters disproportionately sized and spaced on the page. What additional information would be MOST IMPORTANT for the OTR to obtain from the teacher? a. Amount of support the parents provide the student with class assignments at home b. Extent to which the student gets along with peers and attends to other classwork c. Strategies the teacher typically finds helpful for remediating these handwriting issues - CORRECT ANSWER- -C
As part of the initial evaluation, an UI K is developing the occupational profile with a client who has paranoid schizophrenia. During the introductions, the client becomes suspicious, retuses to answer questions, and reports teelings of persecution. What is the FIST step the OR should take when engaging this client in the evaluation process? a.Use an open-ended question and answer format. b.Clearly explain the purpose of the interview. c. Postpone the interview until symptoms decrease - CORRECT ANSWER- -C Postpone the interview until symptoms decrease Given that the client is exhibiting symptoms of paranoia and feelings of persecution, it may be best to postpone the interview until the symptoms decrease. Engaging in an evaluation process with a client who is actively experiencing paranoid thoughts may not be productive or beneficial. Once the client's symptoms have decreased, they may be more willing to engage in the evaluation process and provide more accurate information. Which rewriting skill emerges between 10 - 12 months of age in a TYPICALLY developing child? A.Drawing a circle B.Imitating a vertical line C.Scribbling on paper - CORRECT ANSWER- -At the age of 10 to 12 months, a typically developing child is expected to start scribbling on paper. This early scribbling is a key developmental milestone that signifies the child's emerging motor skills and hand-eye coordination. The ability to draw more complex shapes like circles or to imitate vertical lines typically develops later, around 2 to 3 years of age. Therefore, the correct answer is:
Therefore, the correct answer is: A. Refer the employee to OT for an evaluation and cite standards in the Architectural Barriers Act. An OT administers several standardized assessments to a student in the third grade who has a learning disability. Which scores are MOST BENEFICIAL to consider when developing measurable goals for the student? a. Standard score B.Age-equivalent score C. Percentile score - CORRECT ANSWER- -When developing measurable goals for a student, the most beneficial scores to consider are the standard scores. Standard scores provide a clear indication of how the student's performance compares to the normative sample, allowing for specific, measurable, and meaningful goals to be set. Therefore, the correct answer is: A. Standard score An OR is working with a patient in a cognitive retraining program. The treatment goal is for the patient to attend to a task for 30 minutes. The patient has attended 3 sessions and is able to remain focused for 10 minutes. What action should the OT take NEXT to support progress toward the goal? A.Refer the patient to a task-oriented group. B.Introduce backward chaining techniques. C.Simplify the task and slowly increase duration. D.Modify the intervention plan to increase the rate of progress. - CORRECT ANSWER- -To support progress toward the goal of the patient attending to a task for 30 minutes, the OT should take a gradual approach that allows the patient to build their attention span incrementally. Simplifying the task and slowly increasing the duration is a practical and effective strategy to help the patient achieve this goal without causing frustration or overwhelming them. Therefore, the correct answer is:
C. Simplify the task and slowly increase duration. A patient who recently had a traumatic transfemoral amputation in a motor vehicle accident is unable to answer several questions during the initial interview with the OTR. The pt is overwhelmed by the hospital environment and frightened of the medical situation. Which of the following provides the BEST description of the patient's response to this unexpected injury? A.Shock B.Denial C. Mourning - CORRECT ANSWER- -A A patient who recently had a traumatic transfemoral amputation in a motor vehicle accident is unable to answer several questions during the initial interview with the OTR. The pt is overwhelmed by the hospital environment and frightened of the medical situation. Which of the following provides the BEST description of the patient's response to this unexpected injury? A.Shock B.Denial C. Mourning - CORRECT ANSWER- - Results of standardized testing indicate that a student in the second grade demonstrates challenges with praxis. Which of the following activities would be the MOST CHALLENGING for the student based on this information? A. Building a toy car from a random assortment of Intendcling blocks that are in a large container. B.Following Illustrated pictures to complete a routine warm-up exercise in a physical education class C. Writing the correct responses to a spelling test given verbally in the classroom - CORRECT ANSWER- -A A preschool student with cortical vision impairment receives OT in the early childhood setting. The teacher has concerns regarding the student's ability to indicate preferred activities during free-play time when students are allowed to select from several different defined areas of the
C.Extra-pyramidal signs and symptoms - CORRECT ANSWER- -Narcotic medications (opioids) commonly have side effects that include sedation, drowsiness, and impaired cognitive function. These effects can impact a patient's ability to stay alert and process information effectively during activities of daily living (ADL) sessions. Therefore, the OT should advise the patient to take precautions against: A. Decreased alertness and central processing An OTR who works in the home health setting is teaching medication management strategies to an older adult client who has diabetes and hypertension. One of the intervention goals for the client is to increase compliance in adhering to the prescribed medication regimen. In addition to providing assistive devices and education to the client, what would be the MOST EFFECTIVE approach in improving medication adherence in this client? A. Establish a habit of counting the remaining pills in each bottle. B.Dedicate set periods of time in the day for taking medication. C.Combine medication schedule with familiar ADL routines - CORRECT ANSWER- -Combining the medication schedule with familiar ADL routines is the most effective approach to improving medication adherence in this client. By integrating medication-taking into activities of daily living (ADLs) that the client already performs regularly, it becomes easier for them to remember to take their medications consistently. Therefore, the most effective approach in improving medication adherence in this client is: C. Combine medication schedule with familiar ADL routines. What is the PRIMARY purpose for using the principles of motivational interviewing to collaboratively establish goals with a client who has substance use disorder? A. Determine preferred leisure activities that the client finds rewarding B.To help establish feasible outcomes that will support long-term success
C. To facilitate a discussion with the client about making behavioral changes - CORRECT ANSWER- -The primary purpose of using the principles of motivational interviewing to collaboratively establish goals with a client who has a substance use disorder is to: C. Facilitate a discussion with the client about making behavioral changes. Motivational interviewing aims to evoke and strengthen a person's motivation for change by exploring and resolving ambivalence. By engaging in collaborative goal-setting, the therapist helps the client identify their own reasons for change and elicits commitment to specific behavioral changes that support recovery from substance use disorder. An OTR who works in a home health setting is working with a client who recently had surgery for a bowel resection and a colostomy. The client receives assistance from a caregiver to manage the colostomy but wants to be independent. What is the FIRST action the OTR should take to support progress toward this goal? A. Analyze each of the steps associated with colostomy care. NBCOT B.Develop recommendations to modify the client's bathroom. C.Provide options for storing colostomy supplies near the toilet. - CORRECT ANSWER- -A. An OTR is reviewing the results of a randomized control trial that studied the effectiveness of facilitation techniques versus functional electrical stimulation (FES) for neuromuscular reeducation in adults who have hemiplegia. Participants (n=38) had reduced independence in ADL and all participated in OT for 60 minutes 3 days per week for 16 weeks. Members of the intervention group received facilitation techniques as a preparatory method prior to occupation- based activities whereas the control group received FES. Statistical results of the pretest post- test ADL scores indicate p < 0.05 for the intervention group and p > 0.05 for the control group. Based on these study results, which action is BEST for the OT to incorporate into the intervention plan?
B. Position communication devices for ease of use. Positioning communication devices for ease of use can help ensure that the student can effectively communicate and engage in classroom activities despite their upper extremity contractures. This intervention supports the student's participation and access to learning opportunities. An OT is providing an intervention for a student in kindergarten who has severe quadriplegic cerebral palsy and uses a power wheelchair for mobility. The classroom teacher reports that the student is not meeting grade-level expectations for written communication. One of the Individualized Education Program (IEP) goals is for the student to independently write their first name. What intervention strategy is BEST for the OT to implement when working with this student? A.Introduce letter stamps as an alternative means for writing the name. B. Provide an enlarged tracing template for name-writing practice. C. Work on finger isolation hand exercises to improve pencil grasp. - CORRECT ANSWER- -Given the student's severe quadriplegic cerebral palsy and the goal of independently writing their first name, the most appropriate intervention strategy would be one that accommodates the student's physical abilities and promotes independence in achieving the goal. Therefore, the best intervention strategy for the OT to implement when working with this student is: A. Introduce letter stamps as an alternative means for writing the name.
Letter stamps provide a functional alternative to traditional handwriting, allowing the student to independently create their name despite physical limitations. This intervention promotes the student's autonomy and success in achieving the IEP goal. For which client condition is the use of cryotherapy as a physical agent modality INDICATED? A.Acute lateral epicondylitis with pain making it difficult to grasp an object B. Grade 4 carpal tunnel syndrome with preserved motor response C. Ravnaud's disease with cyanosis and increased swelling - CORRECT ANSWER- -A. An OTR is leading a cooking group with young adults who have voyeuristic disorder. At the start of a session, the OR collaborates with the group members to select a recipe that facilitates co- occupation among the participants. What is the PRIMARY purpose for using co-occupation during the cooking group? A. To Provide participants the opportunity to redirect urges toward positive social engagements with others. B. To control sudden urges that participants may experience during structured and meaningful social interactions C. To help participants pay attention and stay focused on an occupation-based task as a distraction to urges - CORRECT ANSWER- -A. To provide participants the opportunity to redirect urges toward positive social engagements with others. By engaging in a cooking group activity that involves collaboration and interaction among the participants, the focus shifts from voyeuristic urges to positive social interactions and meaningful engagement with others. Co-occupation fosters a supportive environment where individuals can connect with peers, share experiences, and build relationships, thereby helping to redirect their attention away from voyeuristic behaviors towards healthier social interactions.