Occupational Therapy Interventions and Considerations, Exams of Occupational therapy

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NBCOT National Board for Certification of

Occupational Therapy 2024 Multiple choice

Questions with Answers and Rationales

100% Pass | Graded A+

David Mungai [Date] [Course title]

NBCOT National Board for Certification

of Occupational Therapy 2024 Multiple

choice Questions with Answers and

Rationales 100% Pass | Graded A+

An individual with left hemiplegia who is right hand dominant receives training to resume independent driving. The OT recommends the use of: a. "palming" of the steering wheel b. hand controls for brake and gas pedals c. left-sided accelerator pedal d. a spinner knob on the steering wheel - Answer>> d. a spinner knob on the steering wheel A 15 year old with a complete myelomeningocele at the T9 level is diagnosed with diabetes. The OT home education program will most likey focus on: a. regular skin inspection performed by a parent b. consumer-initiated pressure relief c. upper extremity strengthening d. bowel and bladder care - Answer>> c. consumer-initiated pressure relief An OT designs a dynamic splint for an individual recovering from tendon repair. To ensure an appropriate angle of pull, the therapist positions an outrigger at: a. 110 degrees to the joint b. 60 degrees to the joint c. 90 degrees to the joint d. 45 degrees to the joint - Answer>> c. 90 degrees to the joint An individual recovering from hip replacement surgery prepares for discharge home. He has a secondary diagnosis of GERD. The

A child with tactile-defensiveness is receiving intervention from an OT using a SI approach. In introducing tactile stimuli to the child the most appropriate method for the therapist to use is: a. apply the stimulus in the direction opposite of hair growth with vision occluded b. apply light touch across the face and abdomen with vision occluded c. provide light brushing across the palmar surfaces of the extremities with the child watching d. provide deep touch and firm pressure where the child can see the stimuli - Answer>> d. provide deep touch and firm pressure where the child can see the stimuli An OT receives a referral to evaluate an individual's executive functioning following a mild CVA. The OT will most likely assess the person's: a. initiation and planning b. orientation, attention, and memory c. job interests and efficacy d. spatial relations and praxis - Answer>> a. initiation and planning A child with a diagnosis of TBI is seen in OT for the initial evaluation. The child presents with extension of both UE's and flexion of both LE's following a stimulus of neck extension. The OT interprets and describes this observation as: a. +ATNR, which is "normal" b. +STNR, which is "abnormal", and has reappeared after the TBI c. +STNR, which is "abnormal" in a child this age, the reflex has not yet been integrated d. +ATNR, which is "abnormal", and has reappeared after the TBI

• Answer>> b. +STNR, which is "abnormal", and has reappeared after the TBI

During a parallel task group, one of the clients agitated and fidgety. She gets up and looks out the window occasionally for a few minutes and then returns to the task. The therapist's best response is to: a. tell her she must remain in her seat or leave the room b. say nothing c. ask the other members if she is bothering them d. talk to her after the group and tell her she is not yet ready for this group - Answer>> b. say nothing An OT works in an adult home. A resident has just returned from the hospital and is receiving 400mg of Thorazine to control symptoms. He has ben attending OT for a gardening group, physical exercise group, and a current events group prior to his hospitalization. He would like to resume participation in these groups. The OT advises him that prior to his group participation, a potential side effect he should be aware of, and take precautions for, is: a. photosensitivity b. akathisia c. akinesia d. tardive dyskinesia - Answer>> a. photosensitivity An OT interviews a COTA for a position at a high school for gay and lesbian youth. The position involves the provision of transitional vocational programming and life skills training. The COTA uses a wheelchair for mobility and has dysarthric speech. During the interview, the OT should ask the OTA about her: a. sexual orientation b. religious/personal beliefs and homosexuality c. her verbal group leadership skills d. accommodations needed due to her evident disabilities - Answer>> c. her verbal group leadership skil

with schizophrenia, paranoid type. The best arrangement of the room is: a. eight chairs placed around a large table, with the therapist at the front of the room b. nine chairs placed in a circle, with no assigned seats c. nine chairs placed around a large table, with assigned seats and the therapist between the two persons with schizophrenia, paranoid type d. two semi-circles of four chairs facing the therapist, the two patients with schizophrenia, paranoid type, in the front row. - Answer>> b. nine chairs placed in a circle, with no assigned seats A child with myelomeningocele meets the short-term goals of achieving functional gross grasp and lateral pinch. After several additional weeks of OT, the child does not meet the goals of demonstrating pincer grasp and three jaw chuck. The therapist should modify the treatment plan to: a. splint the index finger in 30 degrees PIP flexion and 30 degrees DIP flexion to achieve pincer grasp b. increase strength of lateral pinch as a basis to develop pincer grasp and three jaw chuck c. teach the child to use gross grasp and lateral pinch in functional activities d. have the child use ulnar grasp for daily activities - Answer>> c. teach the child to use gross grasp and lateral pinch in functional activities Following the performance of a home exercise program prescribed one week ago, an individual with bilateral UE weakness reports that he is experiencing pain in both shoulders and elbows. The pain is consistent for up to eight hours. The individual's OT is on vacation for two weeks and a recently hired entry-level OT has been assigned to cover his caseload. The

most appropriate recommendation the covering therapist can give the individual is to: a. reduce the intensity of exercise by 50% and reassess the person during the next treatment session b. stop exercising completely until the primary therapist returns and can re-evaluate the person's status c. continue with the current exercise program to develop tolerance d. take a pain relief medication 30 minutes prior to exercising - Answer>> a. reduce the intensity of exercise by 50% and reassess the person during the next treatment session An OT conducts a home evaluation for an individual with a complete T10 level SCI. The only entrance to the home has five steps, a total of 35 inches in height. The therapist recommends that the family have a ramp constructed that is: a. 35 feet long b. 17.5 feet long c. 48 feet long d. 70.5 feet long - Answer>> a. 35 feet long An individual recovering from a TBI is assessed to be at Level VI of the Rancho Level of Cognitive Functioning Scale. The OT implements treatment by using: a. sensory stimulation activities such as moving to music b. repetitive self-care tasks such as brushing hair c. community re-entry activities such as taking a bus d. simple meal preparation tasks such as making a sandwich - Answer>> d. simple meal preparation tasks such as making a sandwich An elementary school teacher has been recently diagnosed with MS. To accommodate the effects of MS on her ability to teach, the occupational therapist recommends using: a. a high stool to compensate for LE weakness.

c. neoprene hand-based splints with thumbs in opposition d. serial casting of wrists in extension and thumbs in opposition - Answer>> c. neoprene hand-based splints with thumbs in opposition Following medical treatment for a brain tumor, a client is referred to OT home care services for a functional evaluation. During the initial interview, the person reports that he cannot locate items that he wants and needs. For example, at lunchtime when he went to the pantry to find a can of soup he could not locate it. Based upon this self report, the OT determines the need for further evaluation to assess: a. visual acuity b. visual scanning c. spatial relations d. topographical orientation - Answer>> b. visual scanning An adult with ALS frequently coughs or chokes when eating finely chopped foods and drinking thin liquids. The speech pathologist and OT collaborate and recommend a videofluoroscopy procedure when the person: a. is able to consume chopped foods and apple juice with no difficulty b. demonstrates minimal limitations in cognitive level, consistent with initial evaluation c. demonstrates only oral stage problems d. cannot tolerate therapy focused on improving feeding and swallowing skills - Answer>> b. demonstrates minimal limitations in cognitive level, consistent with initial evaluation A 6-year-old child with autism receives home care OT intervention services. The mother identifies a primary goal of developing the child's independent toileting skills. The child is completely dependent and the mother reports not attempting toilet training for

several years. The OT identifies that the first intervention goal is to have the child: a. sit on the toilet with supervision b. tell someone he needs to go to the bathroom c. indicate when his diaper is wet or soiled d. non-verbally indicate the need to go to the bathroom - Answer>> c. indicate when his diaper is wet or soiled As a result from a trauma 10 months ago, a 13 year-old incurred a unilateral below-elbow amputation. Due to a recent growth spurt, she is being re-evaluated for a new prosthesis. During the evaluation, she angrily tells the OT that she does not want the new prosthesis because it is "annoying to have to wear one every day". She states she often takes off her current prosthesis and that she "can't stand the claw" but that she "needs it sometimes" to perform desired activities. The most appropriate first action for the therapist to take is to: a. refer her to the child psychologist to deal with adjustment to disability b. recommend a prosthesis with a cosmetic hand c. recommend she attend a teen amputee support group d. work on developing unilateral skills for completion of meaningful activities - Answer>> d. work on developing unilateral skills for completion of meaningful activities An individual incurred a C-4 SCI. During the initial evaluation, he refuses to speak to the OT. The most appropriate action for the therapist to take is to recognize his response and then: a. continue with the occupational performance interview b. explain what OT can offer the individual to adjust to decreased abilities c. ask the individual to having nursing contact OT when he is ready for the assessment

d. hyperresponsiveness to sensory stimuli - Answer>> a. seizures A person is five days post CABG. He expresses anxiety about performing any type of activity and reports chest pain during ambulation. The cardiologist has approved activities at a MET level of 2-3. An activity appropriate for the therapist to begin intervention with is: a. grooming in sitting b. grooming while standing at the sink c. showering in standing d. performing light housework - Answer>> b. grooming while standing at the sink A child with mild CP receives OT intervention in a preschool setting. To facilitate development of typical grasp patterns, the most appropriate intervention is for the OT to: a. analyze the present components of the child's grasp b. analyze the missing components of the child's grasp c. grade the sizes and shapes of objects to be grasped d. place soft foam tubing around objects to be grasped - Answer>> c. grade the sizes and shapes of objects to be grasped During an intervention session focused on developing home management skills, a client with a diagnosis of schizophrenia made a grocery list. She grouped needed items together to make shopping easier and listed eggs separately from all the other items. When explaining how she composed her list, the client stated, "Eggs break, they should be on top". The OT documents in the progress report that the client's approach to this task is indicative of: a. diminished insight b. concreteness c. anosognosia

d. poor sequencing - Answer>> b. concreteness An individual who has difficulty with interpersonal relationships at work attends an outpatient work adjustment group. In this group, she listens carefully when an older member, whom she admires, discusses strategies that have helped him to get along well with coworkers. After the group, the OT documents that the individual appeared to benefit from the curative factor of: a. guidance b. catharsis c. identification d. interpersonal learning - Answer>> c. identification An adult receives treatment for major depression on an inpatient psychiatric unit. The client has an electroconvulsive treatment (ECT) at 8 am. At 2 pm, he/she walks into the OT department to attend the leisure skills group. The therapist's best response is to: a. call nursing to have the client escorted back to his room b. provide the client with a leisure history questionnaire to complete c. commend the client's motivation but remind him that he should rest for 24 hours after ECT d. encourage the client to select one of three structured leisure activities to complete - Answer>> d. encourage the client to select one of three structured leisure activities to complete An elder with peripheral neuropathies resulting from the chronic effects of diabetes expresses concern over his/her sexual relationship with his/her partner. The most appropriate response for the OT to make is to suggest the elder and his/her partner: a. experiment with different positions during sexual expression activities b. focus on intact senses and areas of intact sensation c. schedule sexual expression activities around rest periods

c. 10 degrees hyperextension d. 15 degrees hyperextension - Answer>> a. neutral A home care hospice occupational therapist works with an individual with end-stage non-Hodgkin's lymphoma. The individual is very knowledgeable about her illness and has been active in all aspects of her care. She has requested activity ideas to fill the hours while her family is at work and at school. The most appropriate activity for the occupational therapist to suggest is to: a. make personalized memory scrapbooks for each family member b. complete a series of progressive resistive exercises to maintain UE strength and endurance c. research alternative and complementary medicine approaches on the internet d. prepare an entree and dessert for the family's evening meal - Answer>> a. make personalized memory scrapbooks for each family member The administrator of a large urban hospital directs all department managers to review the use of their resources within the hospital to determine medical necessity and cost efficiency. This is an example of: a. retrospective peer review b. total quality management c. utilization review d. risk management - Answer>> c. utilization review The parents of a five year-old child with Rett Syndrome ask the OT for activities that can help their daughter regain lost skills. The therapist designs a home program and recommends that the parents: a. encourage the child to learn pressure techniques b. perform passive ROM c. use four-step sequencing cards to increase attention

d. give positive feedback for active ROM performance - Answer>> b. perform passive ROM An elder with Parkinson's disease has a secondary diagnosis of depression. He exhibits increased confusion and disorientation. The home-care OT advises the elder's spouse to: a. obtain an evaluation from a neurologist to determine if dementia has begun b. contact the elder's psychiatrist for a medical evaluation c. seek support from a caregiver's respite program d. discuss placement alternatives with the social worker - Answer>> a. obtain an evaluation from a neurologist to determine if dementia has begun Following a gunshot wound, an individual has an incomplete C SCI. He has a secondary diagnosis of thromboangitis obliterans. The OT conducts a pre-discharge home evaluation of the client's rented apartment. The most important area for the therapist to assess is the: a. apartment's water temperature b. apartment's electrical capacity for an environmental control unit c. apartment's electrical capacity for an emergency call system d. landlord's willingness to modify the bathroom - Answer>> a. apartment's water temperature Several patients in a cardiovascular unit are referred to OT for rehabilitation in areas of occupation. The only patients who are candidates to participate in home management activities in the OT simulated apartment program are those with the diagnosis of: a. unstable angina b. hypotension c. venous thrombosis d. uncontrolled atrial arrhythmia - Answer>> b. hypotension