NBCOT pre-test

An OTR is analyzing the progress monitoring graph for a student in the third grade who has a learning disability and has been participating in OT for 3 years. Based on the data collected each week, the student has been making steady improvements; however, the rate of progress has decreased over the past year. What action should the OTR take based on this analysis of the progress monitoring graph?

A. Collect data more frequently.

B. Change the intervention strategy.

C. Recommend discharge from services.

A 3-year-old toddler, who has a developmental delay, recently learned to jump with both feet. Based on developmental milestones, what gross motor skill should the OTR work on NEXT?

A. Throw a 3-inch (7.62cm) ball.

B. Ride a tricycle.

C. Pull a toy while walking.

Which of the following would be the MOST DIFFICULT activity for a client who has mild (stage III) Alzheimer’s disease to perform?

A. Following the typical steps associated with brushing teeth

B. Remembering the name of a new member of a social group

C. Navigating a familiar route throughout the neighborhood

An inpatient had a C6 spinal cord injury one week ago. Results of the ASIA (American Spinal Injury Association) Impairment Scale indicate the classification of the patient's injury is ASIA A. What do the results of this scale suggest?

A. Complete motor and sensory impairment below the level of the lesion

B. Sensory incomplete impairment below the level of the lesion

C. Motor incomplete impairment below the level of the lesion

An OTR is using the fingerbreadth palpation method to measure the shoulder subluxation of a client with hemiplegia. Which option is the MOST EFFECTIVE test position to place the client in to achieve reliable measurement results?

A. Supine in bed with the arm resting beside the body.

B. Upright seated position with the arm hanging down at the side.

C. Side-lying position on a firm surface with the affected arm parallel to the torso.

A client sustained a mild contusion of the dominant upper extremity 8 weeks ago limiting ADL. The client has not been able to work as a receptionist and reports fluctuating debilitating discomfort of the affected upper extremity when trying to reach forward to pick up objects. Which condition is TYPICALLY associated with these reported symptoms?

A. Peripheral vascular disease

B. Functional neurological symptom disorder

C. Complex regional pain syndrome

An OTR is using the Borg's Rating of Perceived Exertion (BRPE) Scale to determine activity progression for a client during intervention. At the start of treatment, the client rated the level of exertion for showering as 17. Two weeks later, the client's rating changed to 9. What does this change in BRPE score for showering represent?

A. Exertion level is 'somewhat hard,' and the client has achieved maximum performance.

B. Exertion level is 'very hard,' and the client perceives showering as more difficult to perform.

C. Exertion level is 'very light,' and the client perceives showering as easier to perform.

Which of the following symptoms are TYPICAL of a client who has a spinal cord injury and is experiencing autonomic dysreflexia?

A. Bradycardia, nasal congestion, increased blood pressure, and pounding headache

B. Significant edema in the lower extremity with a spot that is warm to the touch

C. Tachycardia, jaw pain, decreased blood pressure, nausea, and vomiting

While interviewing an adult client who has schizophrenia, the OTR notices that the client frequently uses nonsense words during verbal expression. What is the BEST option to describe this behavior?

A. Confabulation

B. Dysarthria

C. Neologism

Which peripheral nerve is typically associated with Guyon's canal syndrome?

A. Ulnar

B. Radial

C. Median

An OTR administered a standardized visual perceptual test to a student in the first grade who has a learning disability. The student scores within normal limits on all other subtests, but performs well below the norm on the figure-ground subtest. Based on these findings, what would be the MOST DIFFICULT activity for the student to complete?

A. Learning grade-level sight words for reading.

B. Writing the alphabet without letter reversals.

C. Finding a writing utensil on a cluttered desk.

An OTR is working with a client in a home health setting who has a wound on the posterior aspect of the proximal forearm. The wound is 3 cm (1.81 inches) in diameter and is being treated by the wound care nurse with a transparent film dressing. The wound is dry, and the margins are pink and flat. What is the PRIMARY reason for using a transparent film dressing on this client’s wound?

A. To provide hydration to the wound while offering pain relief with a hydrogel sheet

B. To create a moist healing environment while absorbing discharge from the wound

C. To keep bacteria out of the wound while promoting autolytic debridement

An OTR, who works in a hospital setting, is teaching strategies to an inpatient who sustained T10- T12 compression fractures 2 days ago. The medical orders indicate that the patient must wear a custom thoracolumbar sacral (TLSO) orthosis for 3 months and put on the orthosis when lying in bed. At the start of the session, the patient tells the OTR, "I put on the brace while sitting on the edge of the bed." Based on the medical order, how should the OTR respond to the patient?

A. Continue the technique of sitting on the edge of the bed to put on the brace.

B. Log roll from side to side to put on the orthosis before transferring out of bed.

C. Use a verbal pain scale and lay down if pain level is greater than 4 out of 10.

As part of using the evidence-based practice process to determine the best intervention for a client, the OTR has posed a clinical question and has conducted a search of a scholarly electronic database. What is the NEXT step in the evidence-based practice process?

A. Implement the intervention and evaluate the effectiveness of the outcome for the client.

B. Review evidence with the client to make a collaborative decision about the intervention plan.

C. Appraise the literature to select quality evidence that answers the posed clinical question.

When writing a Patient Intervention Comparison Outcome (PICO) question, which method will yield the BEST search results when developing the “P” component of a clinical question?

A. Define the parameters for critical appraisal of results related to the target population.

B. Determine the client’s main concern, medical status, or medical diagnosis.

C. Identify psychosocial, contextual, and social barriers to the client’s participation.

An OTR is developing a Patient Intervention Comparison Outcome (PICO) question as part of the evidence-based practice process for outpatient clients who have upper extremity spasticity secondary to a traumatic brain injury. The OTR wants to compare the improvement of functional outcomes in clients who wear a custom-made orthosis to those who complete a daily stretching program at home. In this situation, what is the Intervention (I) component of the clinical question?

A. Custom-made orthosis

B. Upper extremity spasticity

C. Traumatic brain injury

An OTR working in the home health setting is instructing the parent on play strategies for a 3-year-old child with autism spectrum disorder. The OTR observes the parent interrupting the child's play and making developmentally inappropriate demands. Based on the behaviors observed during this session, what action should the OTR take?

A. Recommend that the parent and child attend a play group with peers.

B. Suggest that the parent schedule a 1:1 clinic-based session for the child.

C. Provide the parent with feedback when positive interactions are observed.

An OTR is collaborating with an inpatient who has moderate dementia to develop a discharge plan. The primary concern is to identify the safest discharge location. What responsibility does the OTR have during this phase of client-centered intervention planning for this patient?

A. Ask a surrogate decision-maker to assist the patient in the selection process.

B .Provide a list of discharge options to the patient from which to select.

C. Encourage the patient to advocate for their preferred discharge site.

An OTR is using a developmental frame of reference to evaluate a child who has a mild intellectual disability. What information should be included in the client's evaluation report when using this approach?

A. Comparison of the child's abilities to that of a typically developing child of the same chronological age

B. Summary of the child's unique characteristics, context, and personal goals for the future

C. Identification of the client's cognitive level as supported by participation in meaningful activities

What is the PRIMARY purpose for collecting data and completing a re-evaluation of a client who has been participating in an occupational therapy program?

A. To demonstrate a commitment to professional standards of practice and to allow for evidence to be infused into the clinical reasoning process

B. To comply with state mandated regulatory requirements and to acquire essential information required by the health insurance provider

C. To measure functional changes that occur as intervention progresses and to make applicable modifications to the intervention plan

Which activity is developmentally appropriate for a TYPICALLY developing 14-month-old toddler?

A. Pretending to feed a stuffed toy

B. Planning to put on a puppet show

C. Fixing a break in a toy train track

An OTR who works in an outpatient setting is teaching self-management strategies to a client who has rheumatoid arthritis. The client works full-time as a kindergarten teacher. After working with students in the classroom, the client has pain in both hands that persists for several hours into the evening. Which self-management strategy would be MOST BENEFICIAL for this client?

A. Plan to increase anti-inflammatory medication on scheduled work days.

B. Identify classroom activities that are causing the discomfort.

C. Modify work-related tasks to promote MCP ulnar deviation.

An inpatient who had a posterior cerebral artery stroke 3 days ago requires assistance from the OTR to maintain upright sitting when positioned on the edge of the bed. Based on the typical sequelae associated with the location of this stroke, what is the PRIMARY reason for this occurrence?

A. Unilateral neglect

B. Contralateral hemianopia

C. Postural malalignment

A patient in an acute care setting had an anterior cervical discectomy and fusion 2 days ago. Currently, the patient requires verbal cues to maintain spinal precautions during ADL. One of the intervention goals is for the patient to independently use post-operative precautions during ADL. When documenting the patient’s progress toward this goal, which information is BEST to include in the "A" section of the SOAP note?

A. The patient will be instructed in spinal precautions to improve safety during ADL.

B. The patient required moderate assist to follow spinal precautions during ADL.

C. The patient would benefit from additional instruction in spinal precautions during ADL.

What is the PRIMARY reason for prescribing a pouch sling to an inpatient with flaccid hemiplegia who recently had a middle cerebral artery (MCA) stroke with an NIH Stroke Scale score of 32?

A. Prevent the short-term and long-term sequelae of shoulder subluxation.

B. Support the weight of the affected upper extremity during transfer training.

C. Encourage shoulder adduction and internal rotation of the humeral head.

A client who has a C4 spinal cord injury uses an automatic scanning method to type and send emails. One of the client’s goals is to increase typing speed. Which rate enhancement approach would be MOST BENEFICIAL for the OTR to recommend?

A. Increase the amount of information associated with each keystroke.

B. Optimize the location of word lists and letters on the monitor.

C. Maximize performance by transitioning to a direct selection method.

An OTR is determining wheelchair specifications for a client who has as an L1 spinal cord injury. The client wants a wheelchair that is stable for use on even and uneven terrain. Which of the following shows the MOST EFFECTIVE relationship between the client’s center of mass and the axle position to help achieve this objective?

A. Center of mass directly above the axle of the chair

B. Center of mass ahead of (i.e. anterior to) the axle of the chair

C. Center of mass behind (i.e. posterior to) the axle of the chair

An OTR is gathering information to develop wheelchair recommendations for an outpatient client who has a progressive neurodegenerative disease. Currently, the standard wheelchair used by the client no longer meets daily needs due to an exacerbation of the disease process. Which question would be MOST BENEFICIAL to ask the client to contribute to the information-gathering process?

A. How many hours can you sit in your chair before you need to lie down and rest?

B. Do you think you would benefit from a custom-contoured seating system?

C. Have you ever had lower extremity extensor tone when seated in your chair?

A 12-year-old child with Prader-Willi syndrome and morbid obesity is transitioning to an outpatient bariatric program for adolescents. During the goal-setting process with the OTR, the child states, "I want to be on the school swim team and do well in school, but it’s really hard because kids make fun of me and the teachers don’t listen to me." What INITIAL action should the OTR take based on the child's statement?

A. Discuss the child's concerns with the interprofessional team.

B. Help the child identify ways to discuss concerns with peers and teachers.

C. Provide opportunities for the child to resolve issues associated with bullying.

A 7-year-old student has mild hypotonicity secondary to cerebral palsy. When completing at-desk assignments, the student is able to effectively grasp a built-up writing utensil, but leans on the surface of the desk with both upper extremities when writing on paper. This results in illegible handwriting and inefficient completion of the assignments. Which type of seat would be MOST BENEFICIAL for supporting the student’s ability to complete at-desk writing tasks?

A. Adaptive chair with adjustable lateral support

B. Adjustable sit-to-stand chair with a chest strap

C. Standard desk chair with inflatable disc cushion

A 16-year-old student has severe anxiety and agoraphobia. The student rarely leaves the home, receives home tutoring, and participates in interactive online high school classes. One of the Individualized Education Program (IEP) transition goals is for the student to learn how to use public transportation. The student is motivated to achieve this goal, and the OTR plans to use metacognitive strategies as part of the intervention sessions. What should be the FIRST step of the intervention process when using this type of strategy?

A. Teach the student breathing exercises to use during outings in the community.

B. Help the student to develop a plan for progressing toward the transportation goal.

C. Obtain schedules and route information for public transportation near the student’s home.

An OTR is planning a social skills program for elementary school-aged children who have behavioral problems. One of the objectives of the program is to improve peer relationships. What type of after-school activity would be MOST BENEFICIAL for supporting this objective?

A. Arts and crafts group to create a collaborative project

B. Special interest club related to a specific leisure activity

C. Yoga class to teach the children stress reduction techniques

For many years the OT staff of a children's hospital were provided a budget for each certified OT practitioner to attend professional development courses or conferences. This benefit is no longer offered due to recent budget cuts. The OT manager wants to continue supporting ongoing professional development activities to enable staff to maintain NBCOT certification. Which method provides a cost-effective option for staff to obtain NBCOT-recognized professional development units?

A. Facilitate routine discussions among staff about best practice guidelines for specific pediatric practice area topics.

B. Select online videos relevant to pediatric practice trends for staff to watch and then discuss during weekly team meetings.

C. Establish a journal club where staff read peer-reviewed articles, and maintain a log of information that is applicable to children seen at the hospital.

An OTR works in a behavioral health facility with adolescents who have eating disorders. The OTR is preparing an activity to use during a support group for the adolescents and their families. One of the goals of the group is for the families to learn how they can foster a relapse prevention strategy in the home environment. Which activity would provide the BEST opportunity for achieving this goal?

A. Engage the group in meal planning exercises for selecting healthy food options and portions.

B Provide examples of assistive device options that can be used to track daily calorie intake.

C. Define and discuss the features of a safe and reassuring mealtime environment.

An OTR completed an evaluation for a 10-year-old student who has a learning disability. An Individualized Education Program (IEP) team meeting is scheduled with the parents to develop recommendations for the student. What action should the OTR take prior to the planned team meeting?

A. Have the parents submit a prioritized list of goals they want their child to achieve.

B. Provide the parents with a summary of the assessment results.

C. Meet with the teacher and parents to discuss initial recommendations.

A 2-year-old child was admitted to the hospital 3 days ago with a diagnosis of failure to thrive. A screening indicates the child uses a spoon to self-feed but is not able to use a fork, requires assistance for all dressing, builds a tower of up to four cubes, scribbles spontaneously but does not imitate or copy lines, and throws a ball overhand. The child did not hop on one foot, jump in place, or walk up steps. Throughout the screening, the child avoided eye contact, was somewhat irritable, and required redirection. What do the results of this screening suggest?

A. The child has attained age-appropriate developmental milestones.

B. Delays are evident in the area of fine and gross motor development.

C. Further assessment of development and emotional function is indicated.

An inpatient had a transhumeral amputation 2 days ago. Which interventions are priorities to include as part of the patient's sessions during this phase of postoperative recovery?

A. Phantom limb management strategies, edema reduction techniques, and joint mobility exercises

B. Limb hygiene instructions, scar massage techniques, and residual limb shaping methods

C. Graded weight-bearing activities, desensitization techniques, and wound management

An OTR is selecting a wheelchair for a patient in an acute rehabilitation center who sustained a complete T10 spinal cord injury. The patient plans to return to work as an attorney and wants to be as independent as possible with community mobility during a typical work day. The OTR has arranged for the patient to participate in a driver rehabilitation program after discharge and is now in the process of recommending a manual wheelchair for the patient. Which type of wheelchair features would be MOST BENEFICIAL for meeting the patient’s daily needs?

A. Rigid frame with projection grips on the wheel rims

B. Lightweight folding frame with a low backrest height

C. Fixed tilt-in-space seat with mid-level backrest height

An OTR is planning an intervention session for an inpatient who sustained a C5 (ASIA B) spinal cord injury 2 weeks ago. One of the patient's priorities is to be independent with self-feeding. Which adaptive equipment is MOST BENEFICIAL for supporting progress toward this goal?

A. Mobile arm support

B. Tenodesis orthosis

C. Mechanical feeder

A patient in a subacute rehabilitation facility is preparing for discharge home in 5 days. The patient had a prolonged course of rehabilitation due to complications associated with congestive heart failure, atrial fibrillation, and hypertension. After setup for safety has been provided, the patient currently requires supervision for ADL and minimal assistance for routine IADL. The family reports concerns about the patient’s safety in the home and their ability to provide post-discharge assistance. Which assessment tool would be MOST BENEFICIAL for providing the family with an objective indicator of the patient’s ability to safely return home?

A. Barthel Index of ADL

B. Kitchen Task Assessment

C. Kohlman Evaluation of Living Skills

An OTR is using a health promotion and prevention model to guide educational programming for clients who have rheumatoid arthritis. The OTR already has developed a program focused on secondary prevention and wants to provide additional information based on a tertiary health promotion strategy. What information should the OTR include as part of this additional programming?

A. Types of adaptive devices that can be used to promote function in the home

B. Self-help classes focused on minimizing the influence of joint deformities

C. Opportunities for increasing participation in a variety of community activities

Which of the following strategies would be MOST EFFECTIVE to include in a sleep hygiene regimen?

A. Read in bed before sleep.

B. Take one nap during the day.

C. Increase exposure to natural daylight.

A patient in a long term care hospital sustained a TBI one month ago. The patient is functioning at Level III (Localized Response) on the Rancho Los Amigos scale but periodically becomes restless and pulls at medical lines and tubes. The OTR plans to administer a behavior-based assessment that will quantify the patient’s current abilities and can be used to effectively monitor outcomes throughout the patient’s recovery. Which assessment would be BEST to use for this purpose?

A. Coma Recovery Scale-Revised (CRS-R)

B. Disability Rating Scale (DRS)

C. Agitated Behavior Scale (ABS)

As part of a process improvement plan, the OTR supervisor in a rehabilitation facility reviewed the OT staff’s use of evidence in daily clinical practice. A key issue noted during the review was that the clinicians were aware of the benefits of evidence but were inconsistent in researching and integrating new evidence into client intervention. Which action would be MOST BENEFICIAL for reversing this trend?

A. Include evidence-based practice competencies into new staff orientation and the annual review process.

B. Develop a policy outlining specific methods for implementing evidenced-based standards into daily practice.

C. Conduct inservice training to promote the use of resources for collecting and evaluating current evidence.

An inpatient, who has schizophrenia, has been stabilized on medications and performs at Allen's Cognitive Level 3 (Manual Actions). The patient and caregiver have declined the treatment team recommendation that the patient move into a residential care facility. What is the MOST IMPORTANT discharge recommendation the OTR should provide to the caregiver?

A. Involve the patient in a structured outpatient program.

B. Modify the home environment prior to discharge.

C. Provide the patient with 24-hour supervision.

While the OTR is transferring a resident of a skilled nursing facility who has Alzheimer's disease, the resident falls and immediately reports intense hip pain. After attending to the resident and informing the physician, which action should the OTR take NEXT?

A. Find contact information for the resident's legal guardian.

B. Notify the risk management team about possible litigation.

C. Document the incident according to facility guidelines.

Which level of evidence is strongest and includes a systematic review, or meta-analysis, of multiple well-designed, randomized control trials?

A. Level 1

B. Level III

C. Level V

An OTR is evaluating a patient, who had a traumatic T8 (ASIA A) spinal cord injury 3 days ago. The patient is optimistic and refuses therapy saying, “With some rest and support from family, I will be up and walking again soon.” Which of the following provides the BEST description of the patient’s response to this unexpected change in functional abilities?

A. Shock

B. Denial

C. Mourning

Which of the following actions MUST an OTR, who works in a home health setting, take when contributing data from the occupational therapy evaluation to the Outcome and Assessment Information Set (OASIS)?

A. Enter scores obtained from performance-based assessment measures directly into the OASIS.

B. Understand the OASIS conventions and definitions to communicate evaluation results.

C. Collaborate with other clinicians contributing to the OASIS to avoid discrepancies in scores.

An OTR, who works in a home health setting, is collaborating with a client and a caregiver to support progress toward the client's goal to be independent in ADL. During the session, the caregiver tells the OTR about a new plan to have the client attend an adult day-care center several days per week and asks the OTR if this plan would jeopardize the client's homebound status. Based on the definition of homebound in the Medicare Benefit Policy Manual, how should the OTR respond to this query?

A. Attendance at a therapeutic adult day-care program is permissible under the regulations.

B. Weekly scheduled attendance at the adult day-care program may not exceed 3 days.

C. Participation in any routine activities outside the home disqualifies the client from services.

An OTR is planning intervention for an older adult client who has diabetes, heart failure, and hypertension. The client lives alone and is independent in ADL, but relies on neighbors and family members who live nearby for assistance with yard work and community errands. The client wants to age in place. Which option is essential for the OTR to support the client's goal to live in the home for as long as possible?

A. Understand the role and responsibility of unpaid caregivers.

B. Know of available options for accessible housing.

C. Collaborate with the interprofessional team on identified goals.

An OTR, who works for a home health agency, is providing services to Medicare clients in the home. What actions MUST the OTR take to support reimbursement for occupational therapy services from Medicare to the home health agency?

A. Document evidence to support selected intervention methods.

B. Meet payer requirements and regulations in their daily practice.

C. Attend an interprofessional care plan meeting at the start of service.

Which ADL would a client who has a complete C4 spinal cord injury be expected to complete independently?

A. Perform self-feeding with a mobile arm support and universal cuff.

B. Use a sip-and-puff mechanism to mobilize a power wheelchair.

C. Brush teeth after setup and with adapted grooming aids.

Which of the following symptoms are associated with a client who is experiencing a complex tonic-clonic seizure?

A. Sudden movement of a single body part with no change in vital signs

B. Abruptly stopping an activity with a blank stare and fluttering eyelids

C. Stiffening of extremities with rhythmic, bilateral jerking of limbs

A client with chronic obstructive pulmonary disease, has dyspnea during ADL. The client has learned breathing techniques to use during activity and has applied the principles of energy conservation into daily routines. During an intervention session, the client said, “I have so many things to do every week, and I just don’t have the energy to do it all.” What is the FIRST action the OTR should take to respond to the client’s concern?

A. Provide a home exercise program.

B. Discuss how to prioritize occupations.

C. Teach a variety of relaxation strategies.

An OTR, who works in a home health setting, is teaching a client how to get up from the floor after a non-injurious fall. The OTR teaches the client to first remain calm, then scan the body for injuries. After the client determines that no serious injury has occurred, what should the OTR instruct the client to do next?

A. From a supine position, bend knees and cross arms over the chest before sitting up.

B. Attempt to move into a half-kneeling position with one leg situated in front of the body.

C. Look for a sturdy piece of furniture, then move into a quadruped position to crawl toward it.

An OTR, who works in a home health setting, is assessing the fall risk of an older adult client who lives alone. Which of the following options represent client factors that increase the risk of a fall?

A. Chronic medical condition and poor family support

B. Advanced age and altered mental status

C. Low socioeconomic status and inadequate social network

An OTR working in a community hospital is contributing discharge recommendations for an inpatient who has end-stage renal disease and terminal pancreatic cancer. The patient is not able to return home and recently requested a medical plan that includes comfort measures only. One of the intervention priorities is to provide options and strategies for optimal participation in ADL. Which discharge setting would be MOST BENEFICIAL for the OTR to recommend for the patient's next level of care?

A. Subacute rehabilitation

B. Inpatient hospice

C. Long-term acute care

An OTR, who works in a hospital setting, is completing an initial evaluation of an inpatient with multiple medical problems and general debilitation. In addition to assessing motor and performance skills, the OTR wants to administer a brief screening tool to measure the patient’s process skills. Which assessment is BEST for this purpose?

A. Quick Neurological Screening Test (QNST)

B. Montreal Cognitive Assessment (MoCA)

C. Canadian Occupational Performance Measure (COPM)

An OTR, who works in a hospital setting, has been providing daily services to an inpatient who had a CVA with flaccid hemiplegia 5 days ago. At the next scheduled session, the OTR notices that the affected upper extremity has developed significant edema and is warm to the touch. What action MUST the OTR take based on this observation?

A. Inform the referring physician of the noted changes.

B. Provide a compression glove and full arm sleeve.

C. Post instructions to position the arm in an elevated position.

An OTR, who works in the hospital setting, uses a computer to enter data into the electronic health record during the evaluation process. After completing the initial interview at the patient's bedside, the OTR plans to assess the patient's ability to complete toilet transfers in the bathroom adjacent to the hospital room. Before moving away from the computer, what action should the OTR take to protect the patient's data in the health record?

A. Log out of the medical documentation system.

B. Minimize the screen so that a neutral image appears.

C. Turn the computer so that the screen faces the wall.

An OTR is evaluating an inpatient who recently had a CVA with hemiplegia primarily affecting the right parietal lobe. Which of the following impairments are typically associated with a cerebral infarction in the parietal lobe?

A. Anosognosia and dyspraxia

B. Wernicke's aphasia and apathy

C. Executive dysfunction and poor initiation

An OTR holds a 5-month old infant in vertical suspension and observes head position while gently tilting the child from side to side then from front to back. Which automatic reaction is the OTR screening when following this procedure?

A. Equilibrium reaction

B. Protective response

C. Head righting

An OTR is evaluating an outpatient client who had surgery 6 days ago for open reduction and internal fixation of a spiral fracture to the right humerus. The client has an associated radial nerve injury with no active movement at the wrist and hand. What action should the OTR take during this stage of recovery?

A. Fabricate a low-profile orthosis with wrist positioned in slight extension and dynamic extension of MCP joints of fingers and thumb.

B. Provide a prefabricated wrist support with the wrist positioned in neutral allowing free ROM of fingers and thumb.

C. Fabricate high-profile dynamic extension orthosis for wrist, finger, and thumb extension.

A middle-school student who has autism spectrum disorder demonstrates decreased social skills. At lunch when a peer mentor invites the student to sit together, the student begins to rock side to side and flap arms. What action should the OTR take NEXT to support the student’s development of social skills?

A. Teach the student a social script to accept future invitations at lunch.

B. Model the expected behavior and instruct the peer mentor to ask again.

C. Implement a token reward system to provide the student with reinforcement.

An OTR is planning intervention for a client who has a superficial wound below the calf but above the ankle, on the medial aspect of the leg. The wound is shiny, scaly, brownish in color, and weeping. The lower extremity has moderate edema. Based on this information, which condition is TYPICALLY associated with these symptoms?

A. Pressure ulcer

B. Venous ulcer

C. Deep vein thrombosis

An OTR is providing education to a client who has a surgical wound on the volar surface of the wrist. The client is learning to perform moist dressing changes at home. What information should the OTR include in this education session to promote wound healing?

A. Allow time during the dressing change to expose the wound to air and sunlight to dry it out.

B. Cleanse the wound during each dressing change with hydrogen peroxide or soapy tap water.

C. Change the wound dressing at the prescribed frequency unless the dressing becomes saturated.

An OTR who works on an early intervention team is working with a 2-year-old toddler who has a developmental delay. The child is scheduled to start preschool at the beginning of the next school year, and the parent has expressed concern about the toddler's transition from early intervention programming into the preschool setting. What action should the OTR take to ensure a successful transition to the preschool setting?

A. Review recent progress reports and provide the parent with verbal reassurance that the child is prepared for preschool.

B. Modify the intervention priorities to include fine motor and behavioral activities to enhance readiness for preschool.

C. Plan a visit to the preschool classroom to meet the teacher and other members of the education support team.

Which phase of wound healing is TYPICALLY associated with granularization, epithelization, and wound contraction?

A. Inflammatory

B. Proliferation

C. Remodeling

Which physical agent modality is MOST BENEFICIAL during the inflammatory stage of wound healing?

A. Fluidotherapy®

B. Cryotherapy

C. Neuromuscular electrical stimulation

What is the PRIMARY purpose for administering the Craig Handicap Assessment and Reporting Technique (CHART) to an adult client who recently transitioned to living alone in an apartment and is participating in an independent living skills training program?

A. To establish the client’s preferred leisure activities and intervention priorities

B. To gather information about the client’s ability to routinely perform ADL and IADL

C. To measure the influence of the client’s disability on community participation

An outpatient client had a distal radius fracture 4 weeks ago and has been attending OT for ROM of the forearm, wrist, and digits. During a routine follow-up visit, the client reports that the fourth and fifth digits get stuck after making a tight fist and that there is a popping sensation when the digits are actively extended. What action should the OTR take next?

A. Cancel the session to allow client to follow-up with the physician.

B Add strengthening exercises to the therapeutic regimen.

C. Provide education to the client to limit aggressive grasping.

An inpatient had an acute anterolateral myocardial infarction 3 days ago and is beginning phase I cardiac rehabilitation. Which evaluation component is CONTRAINDICATED during the initial assessment with this patient?

A. Measuring the patient’s upper extremity strength

B. Monitoring the patient’s vital signs during activity

C. Determining the patient’s average daily energy expenditure

Which task would be MOST DIFFICULT for a 3-year-old child with Down syndrome who has clinodactyly of the thumb (type III) on the dominant hand?

A. Playing in warm bath water

B. Building a sandcastle

C. Holding a crayon

A 7-year-old child with autism spectrum disorder has difficulty remaining at the table during family mealtimes and requires assistance for self-feeding. When seated in a chair at the table, the child becomes preoccupied with repetitively rubbing both hands on the top of the head limiting ability to self-feed. One of the long-term goals is for the child to routinely participate in family mealtime. Which option would be MOST BENEFICIAL to support this goal?

A. Develop a sensory diet protocol to facilitate a calm state prior to each meal.

B. Provide a behavioral distraction by offering the child a fidget toy for each hand.

C. Identify a list of preferred finger foods that are typically pleasing to the child.

A 10-year-old child who has severe hypertonia uses a wheelchair for mobility and requires maximum assistance for transfers and all ADL. The parents are building a new home and want recommendations for the home bathroom to best accommodate the child's needs. Which of the following features should the OTR recommend for inclusion in these plans?

A. Stall shower with a zero entry and door width of 33-36 inches (84-91 cm)

B. Standard bathtub with padded tub bench with suction feet and adjustable legs

C. Bathtub-shower combination with handheld shower attachment and wall-mounted grab bar

A 6-year-old child has a progressive visual impairment. Results from a recent ophthalmology report indicate the child is now legally blind. The parent and child agree that learning trailing techniques will maximize the child's independence at home and school. Using this technique, what should the OTR teach the child to do as part of orientation and mobility training sessions?

A. Place their elbow in a flexed position with forearm held in a protected position across the body to avoid bumping into objects while moving forward.

B. Take a guide's arm and walk a half step behind and to the side of the guide, and anticipate directional changes based on the guide's movements.

C. Hold their extended arm at a 45-degree angle in front and to the side of the body, and follow a solid surface with the hand.

A 7-year-old child has undergone multiple surgeries and chemotherapy to treat a neuroblastoma of the spinal cord. The child will be returning to school for the first time after a prolonged hospitalization and inpatient rehabilitation. As part of the transition process, members of the rehabilitation interprofessional team are scheduled to meet with the special education team at the child's school. What is the PRIMARY purpose of this type of meeting?

A. Identify Individualized Education Program goals for the remainder of the child’s academic year.

B. Problem-solve potential accessibility issues and modifications needed in the school environment.

C. Review functional gains made in rehabilitation and projected long-term curriculum-based outcomes.

A student in the fourth grade has autism spectrum disorder. The student is independent when eating lunch in the school cafeteria, but frequently spills milk and spits food with undesired textures onto a plate. Peers avoid sitting with the student at lunch due to these behaviors. What action should the OTR take as part of the intervention for helping the student develop socially-acceptable behaviors to use when eating in the cafeteria?

A. Develop a social story for the student related to mealtime behaviors.

B. Role-play a social script with the student related to eating in the cafeteria.

C. Teach the student to use a checklist of appropriate behaviors while eating meals.

A student in middle school who has a mild-moderate intellectual disability wants to learn how to open a single-dial combination lock needed to secure an assigned locker at school. Currently, the student has difficulty manipulating the dial and remembering the directions and number of times to turn the dial. What strategy should the OTR use as an initial step to MOST EFFECTIVELY support the student’s ability to learn this task?

A. Show the student a video demonstration of the task immediately prior to having the student practice opening the lock.

B. Ask the student to verbalize each step required to operate the lock as the student practices using the lock.

C. Have the student practice turning the lock dial back and forth in the directions used for opening the lock.

A student in the fifth grade has a learning disability and speech impairment. The student reads at grade level, but is frustrated by slow handwriting speed. The student has made minimal progress in an intensive handwriting remediation program, and written assignments continue to be illegible. One of the intervention goals is to provide the student with an assistive technology option that improves the student's ability to complete written assignments. Which assistive technology would be MOST BENEFICIAL to recommend for supporting progress toward this goal?

A. Word prediction software with frequency-weighting prediction

B. Electronic in-line phonetic spell check software with auditory cues

C. Picture-supported library software with text-to-speech feature

An OTR working in a behavioral health setting is planning intervention for a 9-year-old child who witnessed a traumatic event several weeks ago. The parents report the child refuses to go to school, wants to sleep in the parents' bed each night, and will not go out of the house or go into another room of the house without holding one of the parents' hands. The child reports having recurrent "bad dreams" about the event and constantly feels as though the event will happen to a family member. During an assessment of the child's play skills, the child becomes agitated and repetitively reenacts the event. What action should the OTR take as part of the INITIAL intervention for this child?

A. Engage the child in puppetry play to help resolve dysfunctional emotions associated with the event.

B. Consult with the parents and teacher to help establish a predictable daily routine for the child.

C. Provide opportunities for int

An OTR is meeting with the special education team to finalize an initial Individualized Education Program (IEP) plan for a preschool student who has congenital muscular dystrophy. What is the FIRST step of this collaborative process?

A. Outline the constraints, scheduling options, and resources for providing school-based services for the student.

B. Review diagnostic information to determine physical barriers influencing participation in typical school activities.

C. Develop a statement summarizing who the student is and what the student needs to do to succeed in school.

A 4-year-old child has extreme food selectivity. One of the intervention priorities is to increase the types of foods the child is willing to eat. Which strategy would be MOST BENEFICIAL to use for modifying the child's behavior to support progress toward this objective?

A. Reward the child for performing a routine sensory program including tactile stimulation around the lips and tongue.

B. Post a schedule of the expected duration of meals and snacks in a location easily viewed by the child.

C. Develop a food chain that alternates between eating preferred foods and tasting previously rejected foods.

What is the PRIMARY purpose for administering the Child Occupational Self-Assessment to a 14-year-old student who is participating in a special education program?

A. To determine the student's level of social development among peers

B. To gather information about the student's leisure interests and participation

C. To identify the student’s perceived competence and value for everyday activities

A young adult client who has schizoaffective disorder has been working at a transitional employment placement. Currently, the client is at risk of losing the job after arriving to work more than 30 minutes late at least one time per week. One of the intervention goals is for the client to improve time management skills for maintaining current employment. Which of the following strategies should the OTR use FIRST for promoting progress toward this goal?

A. Determine the client’s typical daily time-use patterns.

B. Teach the client to use a programmable alarm.

C. Develop a daily schedule for the client to follow.

An OTR is selecting a wheelchair seating system for a resident in a long term care facility who has severe relapsing-remitting multiple sclerosis. The resident currently uses a power wheelchair with a standard seat, but the resident is developing pressure areas under the ischial tuberosities. One of the goals of the new seating system is to reduce pressure in this area. Which features are MOST BENEFICIAL to recommend for this purpose?

A. Power recline back rest and padded arm rests

B. Tilt-in-space seat and adjustable back rest

C. Wedge cushion and back rest with built-in lumbar supports

An OTR is planning an intervention session for an inpatient who has an end-stage neurodegenerative disease. The patient is dependent in ADL and will be discharged home with hospice care. The patient lives in an apartment with a supportive spouse. The spouse is concerned about performing the role of primary caregiver. Which action would be MOST BENEFICIAL for the OTR to initially take in response to the spouse’s concerns?

A. Provide relevant caregiver training based on the spouse’s learning style.

B. Prepare written caregiver instructions consistent with the spouse’s health literacy.

C. Discuss the benefits of relocating to an assistive living residence to reduce the spouse’s stress.

A client has fatigue and dyspnea secondary to COPD. These symptoms interfere with the client's ability to complete routine daily tasks. The client lives alone and wants to remain independent as long as possible. While observing the client during an ADL session, the OTR observes that the client overexerts the accessory muscles to compensate for dyspnea. What recommendations should the OTR include in ADL sessions to improve the client's activity tolerance?

A. Accomplish most daily tasks in the morning when energy levels are higher, and use controlled abdominal breathing.

B. Complete daily tasks in sitting, and bend forward at the waist to rest the head on crossed forearms when dyspnea occurs.

C. Organize necessary items prior to task initiation, and use diaphragmatic breathing when completing tasks.

An older adult client resides in an assisted living facility. Symptoms associated with bilateral cataracts interfere with the client's independence with ADL. The client is not a candidate for surgery and is afraid that the progressive nature of the symptoms will result in dependence on caregivers to complete these tasks. What should the OTR include as part of the intervention for supporting the client's engagement in ADL tasks?

A. Maximize access to natural light in the bathroom and bedroom.

B. Provide non-prescription, over-the-counter eye glasses.

C. Identify a method for color-coding similarly shaped toiletry items.

Which foods are CONTRAINDICATED for patients who are restricted to a level 2 dysphagia diet?

A. Ripened fruits and cooked noodles with sauce

B. Flavored pudding and moist meatballs

C. Whole-grain breads and fried eggs

An OTR is preparing home modification recommendations for a client who has C8 tetraplegia. The client wants to be able to open and close bedroom and bathroom doors in the home to maintain privacy but is unable to manipulate the round doorknobs currently on the doors. Which modification would be BEST for supporting the client’s independence with this task?

A. Lever-style door handles to replace current doorknobs

B. Door stops to prevent the doors from fully closing

C. Fabric loops attached to the existing doorknobs

An adult client with pervasive developmental disability resides in a group home. One of the intervention goals is for the client to learn skills for preparing a simple meal. During the initial session in the group home kitchen, the OTR notes that the client frequently stops the task to look at other residents playing board games at the kitchen table and in the direction of sounds coming from the community room adjacent to the kitchen. Which intervention strategy would be MOST BENEFICIAL for supporting progress toward the client’s goal?

A. Provide video feedback as a method of reinforcing errorless learning during meal preparation.

B. Have the client wear earplugs and face away from distractors when preparing a meal.

C. Teach the client to use a timer to maintain attention during a specified meal preparation task.

A general education teacher has the students sit in groups with 4 desks connected to each other. A student, who has a behavioral disorder, becomes physically aggressive and strikes out at a peer sitting nearby. One of the intervention goals is for the student to independently complete desk work with peers. Which environmental adaptation would support INITIAL progress toward this goal?

A. Close the classroom door to minimize auditory input from the hallway.

B. Recommend a study carrel to reduce visual input.

C. Rearrange classroom seating to reduce opportunity for tactile input.