Occupational Therapy Interventions and Assessments, Exams of Occupational therapy

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NBCOT National Board for Certification

of Occupational Therapy Exam Multiple

Choice Questions and Answers 100%

Pass | Graded A+

David Mungai [Date] [Course title]

NBCOT National Board for Certification

of Occupational Therapy Exam Multiple

Choice Questions and Answers 100%

Pass | Graded A+

A client's wrist and thumb joints are limited in range of motion, and the client complains of some mild discomfort that affects the client's caregiving duties at home. The OTR® wants to facilitate movement, increase circulation, and decrease pain. What would be the MOST appropriate use of thermal modalities? A. Use deep heat while stretching the client's stiff joints. B. Use superficial heat before or during a passive stretch. C. Use superficial heat or deep heat without stretching the client's stiff joints. D. Use a different modality for this problem. - Answer>> The right answer is B Mild heat before or during a passive stretch will give the best results and increase range of motion and circulation, because the heat will have a soothing effect and decrease discomfort. A: Deep heat is indicated for contractures, scarring, pain, and muscle spasms, not for generalized stiffness. C: Use of heat should always be paired with some type of movement, stretch, or activity. D: Heat is indicated when an OTR wants to increase motion and circulation and a client complains of aching pain. Retired NBCOT® Question

What is included when using a top-down approach to reduce risks in jobs? A. Work hardening program to increase endurance B. Maintaining neutral spine alignment in lifting C. Involving managers in work simplification D. Individual workstation ergonomic assessment - Answer>> The right answer is C A top-down approach includes systemwide changes and management support of the change process. A, B, D: These options are bottom-up approaches that focus on addressing the person's risk for the job task. A client with stroke is in inpatient rehabilitation, and at the start of the intervention session the OTR®; is observing as the client sits at the dining table in a wheelchair. The client's hips are extended, and the client is leaning on the unaffected left upper extremity. What should the OTR's FIRST approach be? A. Reposition the client in the wheelchair with hips flexed at 90° and the upper extremity resting in the lap B. Transfer the client to another wheelchair that provides a lap tray for upper-extremity support. C. Transfer the client to a standard chair with arms for positioning in posterior pelvic tilt. D. Complete the Berg Balance Scale to determine the client's postural needs - Answer>> The right answer is A

Ideal seated posture for a client with hemiparesis is hips flexed at 90° with shoulders over hips and arms relaxed in lap; the upper extremities should not be used to provide support in sitting. B: Clients with hemiparesis need frequent repositioning in sitting to maintain upright posture; supine positioning does not facilitate the return of muscle strength for sitting and should not be the first choice. C: Changing the chair surface does not necessarily improve the client's positioning in the chair. D: The Berg Balance Scale is recommended as an evaluation tool for clients with stroke, but assessment is not the appropriate first approach given the client's current position. Correcting the client's positioning is first priority. An OTR® has discontinued occupational therapy services with a client. A month after the completion of services, the client and the OTR see each other unexpectedly at the local grocery store. They both express interest in dating the other person. They start dating within a month of this meeting at the grocery store. A. This action is illegal and should be reported to the authorities immediately. B. This action is within the occupational therapy ethical guidelines for the principle of Nonmaleficence. C. This action is within the occupational therapy ethical guidelines for the principle of Beneficence. D. This action may or may not be ethically appropriate and needs to be investigated further. - Answer>> The right answer is D

B. The OTR® should encourage the client to take frequent breaks during lower body ADL tasks. C. The OTR® should train the client in the use of lower body adaptive equipment such as a sock aid. D. The OTR® should educate the client's caregivers on appropriate assistance to provide to the client during dressing. - Answer>> The right answer is B Because the client's primary complaint is fatigue, taking rest breaks would be appropriate. A: Given that HD is a progressive loss of motor control, an intense exercise routine would most likely be too difficult for the client. C: Incoordination and decreased motor control would make learning adaptive equipment difficult. D: Although caregiver education would be important, encouraging independence in ADLs as the client is able is still important to reduce caregiver burden and stress. X- An OTR® is working with a client who is concerned about resuming sexual activity after an amputation. What education strategy would be appropriate for the OTR to use with this client? A. Encourage the client's exploration of his or her "new" body. B. Suggest that the client speak with a psychiatrist. C. Provide educational materials in a group setting. D. Discuss the use of a sex surrogate. - Answer>> The right answer is A

A client who has had an abrupt change in the body could benefit from encouragement from the OTR to explore ways in which the client's body has changed to encourage problem solving. B: Unless the client's history has other indicators, an OTR is capable of intervening with a client who has concerns about sexual activity. C: Because sexual activity is private, providing educational materials in a group setting would not be appropriate and would reduce the OTR's ability to provide client-centered care. D: A sex surrogate is used to explore sexual dysfunction or sexuality. Other strategies and educational materials would be more appropriate with this client. If the client had ongoing issues, a sex surrogate might be an option. DK- Retired NBCOT® Question An occupational therapy clinic has purchased a new standardized assessment tool. The occupational therapy practitioners are checking the interrater agreement for routinely using the tool. The point-by-point agreement for all raters at the clinic was found to be 70%. What information does this calculation provide? A. Additional practice for administering and scoring the tool is needed. B. Minimum acceptable standards for interrater reliability have been met. C. Service competency for raters using the assessment tool has been attained. D. The majority of raters administered the assessment tool correctly. - Answer>> The right answer is A

C: The client does not have adequate ability to move and steady the head to use a head pointer as an input device. Although the head is stabilized with a headband, the child needs to turn the head to complete suction regularly, so it is not desirable to use the same system for input. Using eye tracking, the child can close the eyes when turning the head for suctioning and cease the input. With a head pointer, the child could have difficulty ceasing input when turning the head for suctioning. D: Switch-encoding input requires the ability to input with at least one finger control. Although the client has some right thumb adduction, it is not adequate to operate a switch-encoding input device. An OTR® in an inpatient setting is inviting an adolescent with major depression to participate in an individual treatment session. The adolescent has refused to participate for 3 days, claiming not to feel well. How should the OTR® BEST respond? A. "I think that participating in occupational therapy will make you feel a lot better." B. "I noticed you've been feeling like this for 3 days straight now, and it might be helpful for you to participate in occupational therapy." C. "I can see that you aren't feeling well. Let's try doing something you like that will not take too long and see what happens." D. "I can see that you aren't feeling well, and I'm sorry for this. Can we try again tomorrow?" - Answer>> The right answer is C When working with a client who is depressed, it is essential to relate with understanding and empathy. Encouraging participation in any way can be helpful.

A, B: Using a "snap out of it" attitude will not be beneficial for a depressed client. D: Not participating in any activity at all will not be beneficial for a depressed client. X- Retired NBCOT® Question A home health client has hemiplegia secondary to having had a CVA 1 month ago. The client completes BADL using assistive devices and ambulates in the home with a quad cane. The client requires stand-by assistance for balance when walking outdoors on uneven surfaces. One of the client's goals is to resume a favorite leisure activity of gardening in a small backyard vegetable garden. Which task would be MOST BENEFICIAL to have the client complete as part of the initial intervention for progressing toward the client's goal? A. Apply adaptive strategies during graded outdoor gardening tasks. B. Set up a routine maintenance schedule to care for indoor flowers and plants. C. Practice mobility skills for going to and from a community gardening class. D. Participate in building planter boxes to establish a raised garden bed. - Answer>> The right answer is A Graded gardening tasks outdoors will allow the client to progress to performing this leisure activity, and working on outdoor gardening tasks will allow the client to gain skills in the natural context of the activity as long as the practitioner has deemed the activity is safe for the client to perform.

A. An iPad application for correct letter formation B. Computer software that prompts a child to copy a sentence in cursive C. A pencil grip to facilitate pencil grasp during writing D. Internet games on visual-perceptual skills - Answer>> The right answer is C Of the options, only a pencil grip is considered a basic technology. A, B, D: These options are considered educational and electronic technologies. A client with amyotrophic lateral sclerosis requires significant assistance with ADLs because of limited upper-extremity function and fatigue. The client reports an increase in shoulder pain, and the OTR® observes edema in the hand. The client uses a wheelchair, and during the occupational therapy evaluation the OTR observes the client's arm hanging at the side of the wheelchair. Which intervention is BEST to address the shoulder pain and hand edema? A. Train the caregiver in PROM for the arm and hand B. Advise the client to continue normal activities using the arm as tolerated to provide active motion C. Fit the client with an adaptive device for grasp, such as a universal cuff D. Provide appropriate arm support using a sling or wheelchair device - Answer>> The right answer is D

Because of the client's dependence on wheelchair positioning and loss of upper-extremity function, external arm support may be needed to facilitate proper positioning while in wheelchair and thereby minimize shoulder pain and hand edema. Forwell, S. J., Hugos, L., Copperman, L. F., & Ghahari, S. (2014). Neurodegenerative disorders. In M. V. Radomski & C. A. Trombly Latham (Eds.), Occupational therapy for physical dysfunction (7th ed., pp. 1076-1102). Baltimore: Lippincott Williams & Wilkins; p.

A: PROM is important in maintaining upper-extremity mobility but is not the first priority when a client is experiencing shoulder pain and hand edema. B: The pain and edema need to be addressed first for client to be able to participate in typical activities. C: A universal cuff is contraindicated with hand edema, and the evaluation findings do not indicate that the client is experiencing decreased grasp strength. The Children's Health Insurance Program provides coverage for which group of people? A. Children who are disabled and are able to be mainstreamed into a regular school classroom B. Children and families whose income is too high for Medicaid but too low to afford private insurance C. Children whose parents are disabled and are unable to work and therefore afford health insurance

What assistive technology would be appropriate to recommend to a client who has middle-stage dementia or the client's caregivers? A. Medication dispensers B. Medication reminder boxes C. Door alarms D. Electric hospital bed - Answer>> The right answer is C When used in middle-stage dementia, door alarms can be useful in improving safety of the client with dementia and reducing caregiver burden. A, B: Medication dispensers and reminder boxes would be most appropriate in early-stage dementia. D: An electric hospital bed would be most useful during late-stage dementia. A patient with deep partial-thickness burns has an extremely edematous right hand. The patient has multiple open wound areas on the dorsum of the hand and between the web spaces. What is the BEST approach for assessing the effectiveness of treatment in reducing swelling? A. Take circumferential measurements of the forearms, wrists, palms, and digits. B. Use a volumeter to measure water displacement of the forearms and hands. C. Ask the patient to elevate the right hand above the level of the heart. D. Compare differences in time in completing the Nine-Hole Peg Test. - Answer>> The right answer is A

Even though both circumferential and volumeter measurements are appropriate for edema measurement, the patient has multiple open wound areas, and allowing the hand to get wet might not be appropriate. Circumferential measurement is the more appropriate approach. It might be necessary to obtain the doctor's agreement before wetting a hand with open wounds. B: It is not appropriate to wet the open wounds at this stage. C: Elevation of the edematous hand above the level of the heart is a method of intervention to decrease edema; it is not an approach for measuring edema. D: The Nine-Hole Peg Test is a test of coordination and does not directly measure the amount of edema. X-STUDY A client is able to say only "yes," "no," or "hello." This client is also incontinent of bladder and bowel and is unable to walk. In which stage of Alzheimer's disease (AD) is this client? A. Early B. Middle C. Late D. Mild cognitive impairment - Answer>> The right answer is C Late-stage AD is characterized by limited speech, decreased ambulation, and incontinence. A: People in early-stage dementia are likely to begin having difficulty within the community and with IADLs but have intact ADL performance. They typically have no problems with bladder or bowel related to AD. B: People with middle-stage dementia will also continue to have skills in habitual ADLs and routines. They can also maintain

D: Because the client has met discharge criteria, keeping the client in the facility when otherwise able to return home is not ethical. A client with a herniated lumbar disk was referred to occupational therapy. The OTR® completes an initial evaluation and develops an intervention plan. Which task can the OTR® assign to the COTA®? A. Write up the initial evaluation B. Alter the initial plan to address pain C. Do a complete reevaluation of strength D. Educate the client in proper body mechanics - Answer>> The right answer is D The COTA®'s focus is on intervention implementation under the guidance of the OTR®. The COTA® may carry out the plans detailed in the intervention plan, including educating the client. A: The COTA® may provide reports to the OTR® during the evaluation process, but the OTR® is responsible for completing the initial evaluation report. B: The COTA® must consult with the OTR® on any changes to the intervention plan. C: The COTA® may carry out reevaluations, but under the supervision of the OTR®. DK- STUDY An inpatient who has Stage III lung cancer undergoes surgery for removal of axillary lymph nodes of the dominant upper extremity, followed by palliative chemotherapy. The patient is referred to occupational therapy for ROM, edema

management, and preparation for hospice care at home. Which intervention modality is CONTRAINDICATED for reducing edema of this patient's affected extremity? A. Gradient compression garments B. Superficial slow-speed vibration C. Manual decongestive therapy D. Transcutaneous electrical nerve stimulation - Answer>> The right answer is D Use of modalities may exacerbate edema conditions and are generally contraindicated in situations of cancer. A: Gradient compression garments such as stockings and sleeves may be useful in providing limb support, which promotes edema reduction and is not contraindicated for reducing edema with cancer. B: Superficial slow-speed vibration would not be contraindicated as an intervention to reduce edema with cancer. C: Manual decongestive therapy will target the pathways of the lymph, promote edema reduction, and is not contraindicated in reducing edema with cancer. What is the BEST compensatory strategy an OTR® can apply to address the on-road performance of a client with visual field deficits? A. Compensate with extra head turns and frequent eye movements. B. Use prescription lenses.