Missed NBCOT True learn questions

An OT practioner is working with a client who has had a brain injury. The client complains of blurry vision, when reading and watching tv. Which is most appropriate for the OT to address?

Visual field, visual acuity, oculomotor, or attention?

Visual acuity

A client is referred to OT following a recent stroke. Prior to stroke, client worked as a scientist and was very active in teh community, teaching and providing science lectures to local schools. Following the stroke, the client experienced alexia and is unable to read. The client is very emotional regarding this functional loss and displays both depression and anger. Which of the following best describes this clients response to the functional loss.

Anxiety Disorder, Adjustment Disorder, Depressive disorder or Bipolar disorder

Adjustment disorder

In a prevention program provided to expectant mothers, what would an OT recommend to reduce the risk of having a pregnancy affected by spina bifida?

Folic acid, zinc, vitamin D, or calcium?

Folic acid

An occupational therapy practitioner working in a community-based mental health program is collaborating with a multidisciplinary team to support a client experiencing difficulty with daily functioning. The client reports intense fear and avoidance of shopping in any type of store and refuses to use public transportation, including taxis and ride-sharing services. The client previously worked at a local museum but left the position due to these challenges. Based on the client’s reported occupational limitations, which diagnosis is MOST consistent with the pattern of avoidance described?

Social anxiety, generalized anxiety disorder or agoraphobia?

Agoraphobia

This primitive reflex develops in utero at approximately 20 weeks and should be fully developed at birth. This specific reflex assists with movement down the birth canal, as during contractions the lower back of the baby is stimulated causing involuntary movement of the hips. This reflex also helps children reach developmental milestones such as belly crawling and hands and knees crawling. Which reflex is BEST described here?

Tonic labyrthine, spinal galant, moro, or stepping relfex

Spinal galant reflex

An occupational therapy practitioner is providing a lecture to a group of nursing students regarding the role of occupational therapy with clients who experience bulimia nervosa.  The occupational therapy practitioner would like to address the topic of this population's distorted beliefs in the context of occupational performance and how occupational therapy can help. Which intervention approach is MOST appropriate for the occupational therapy practitioner to include in the lecture that is characteristic of occupational therapy’s role with the desired topic?

cognitive behavioral approach, motivational interviewing, or building healthy routines and habits

cognitive behavioral approach

An OTR is preparing to evaluate a client in an outpatient setting. During the chart review, the OTR notes in the medical chart that the client has a diagnosis of early-stage age-related macular degeneration (loss of central vision). Based on the client's diagnosis, which activity would MOST likely be impacted?

reading a book, navigating a crowded store, diving during the daytime, or depth perception when reaching for a cup

reading a book

An occupational therapy practitioner is evaluating a 6-year-old child referred for difficulty completing classroom participation tasks that require hand strength and coordinated movement patterns. During tasks that require the child to control objects with a broad surface area, the practitioner observes inconsistent performance. When assembling a science project, the child drops wide plastic lids and has difficulty stabilizing large circular materials on the table. Later, while preparing a snack activity, the child attempts to open a tightly sealed jar of jelly. The child struggles to maintain enough contact to generate rotation of the lid, repeatedly losing grip and becoming frustrated. Based on these observations, which grasp pattern is MOST likely limited?

Disc grasp, lateral pinch grasp, hook grasp, or pincer grasp

disc grasp

A client is referred to occupational therapy in an acute care setting. The client has a deep partial thickness burn over the nondominant extremity. Which information is MOST appropriate for the OTR to provide to this client during evaluation?

high potential for scarring and contractuers, low potential for scarring and contractures, absence of pain due to nerve ending loss, or surgical intervention needed

high potential for scarring and contractures

A child in the classroom is referred to occupational therapy with decreased focus and poor impulse control.  The child has been observed to become easily triggered by anger responses during class time.  The occupational therapy practitioner has been invited to support the teaching team to help facilitate improved success in the classroom for this child.  As part of the process, the occupational therapy practitioner reviews reflex integration through basic movement activities with the class to review any non-integrations that may be impacting all of the students.  Given the observations regarding the student referred for occupational therapy, which reflex might still retained?

moro reflex, root reflex, asymmetric tonic neck reflex, or tonic labyrythine relfex

moro relfex

A caregiver presents to outpatient occupational therapy with an infant diagnosed with fetal alcohol syndrome. The caregiver is concerned about the child's developmental progress—specifically challenges with feeding, play, early self-care skills, and overall occupational engagement that may affect future functional performance. The caregiver wants to better understand the disorder, particularly how prenatal alcohol exposure can impact both physical and cognitive development, leading to difficulties in achieving daily occupational tasks. Which of the following BEST describes fetal alcohol syndrome?

fetal alcohol syndrome causes brain damage and delayed growth, fetal alcohol syndrome causes the brain to develop abnormally, redulting in a smaller head or FAS isa condition where the child’s head persistently tilts to one side

FAS causes brain damage and delayed growth

An occupational therapy practitioner is working with a caregiver on facilitating feeding for a child with developmental delay. The caregiver wants to introduce soft foods to the child. Which motor movement must be integrated and demonstrated for the child to be able to eat a soft banana or avocado?

lateral jaw movements and munching patterns, lateral jaw movements and rooting, lateral tongue movement and sucking reflex, or coordinated such and swallow

lateral jaw movements and munching patterns

An occupational therapy practitioner is completing a worksite evaluation for a client recently referred due to acute low back pain. The client reports difficulty completing essential job duties due to increased discomfort throughout the workday. Which of the following should the practitioner assess FIRST to guide recommendations for intervention?

the clients current pain and management strategies and medication adherence, the ergonomic setup and physical demands of the clients job and tasks at work, or the client’s spinal range of motion during simulated work related lifting tasks

the ergonomoic setup and physical demands of the clients job tasks and workstation

A toddler is working with an occupational therapist on transitioning to solid foods. Which motor motion is required for the toddler to transition to solid foods?

gag relfex, rooting reflex, transverse tongue relfex, or rotary chewing

rotary chewing

A preschooler has begun to write with the thumb and index finger on the pencil while resting the pencil on the DIP (distal interphalangeal joint) of the third finger. The child has begun to control the pencil with the fingers instead of the arm. Which grasping pattern is being utilized by the preschooler?

palmar supinate grasp, digital pronate grasp, immature static tripod grasp, or dynamic tripod grasp

dynamic tripod grasp

An occupational therapy practitioner is completing an occupational profile interview with the caregiver of an older adult receiving outpatient therapy. The caregiver reports that the client becomes intensely fearful of being left home alone and experiences recurrent episodes of apprehension when attempting to leave the home. These episodes are characterized by shortness of breath, chest tightness, and avoidance of previously valued activities. The caregiver reports that the client has undergone recent medical evaluation, with no acute cardiopulmonary findings identified. These symptoms are significantly limiting the client’s participation in therapy and other daily occupations. What is the MOST APPROPRIATE NEXT STEP for the occupational therapy practitioner to take to address the caregiver’s concerns?

decline to conitue OT services, request a referral to a psychiatrist, modify OT plan for in home strategies, provide caregiver ed

request a referral to a psychiatrist

A 48-year-old woman with Stage III (severe) rheumatoid arthritis is being evaluated in an outpatient clinic. During the evaluation, which initial action should the occupational therapy practitioner take to establish realistic client goals?

determine OT performance status, obtain a client histroy through an OT profile, or assess occupational performance with an occupational profile

obtain a client history through an OT profile

A client with a history of anxiety reports that the diagnosis is impacting daily life. The client reports after a break-in incident years ago while the client was away from home, the client must check the locks on the doors and windows in a certain order multiple times before going to bed every night. The client now reports productivity at work has slowed and limits the amount of social interaction outside of work. What is the MOST likely diagnoses related to client's reported behaviors?

PTSD, OCD, or agoraphobia

OCD

A client is referred for occupational therapy. Upon reviewing the chart, the OTR notes that the client’s A1C is 9.8%. Which BEST reflects the meaning of this A1C level?

A1C is a 2-3 month average, clients is above normal, A1C is daily and above normal, A1C is measured within 6 months, or A1C a 2-3 month average and is below normal

A1C is 2-3 measurement, clients is above normal

In the context of working with an interdisciplinary transition team to support students transitioning from school to adulthood, which areas of occupation should the occupational therapy practitioner prioritize to address the needs of these students most effectively?

IADL’s, ADL’s, or play and leisure activites

IADL’s

A client is participating in cardiac rehabilitation. The client tells the occupational therapy practitioner that the cardiologist started the client on "water pills" at the most recent clinic visit. The client questions the purpose of this new medication and is concerned that this is causing frequent urination. Which is the MOST APPROPRIATE response for the occupational therapy practitioner?

these pillis release excess water to lower BP and reduce edema, frequent urination is normal and is used to prevent heart attacks, or please speak directly with the cardiologist

release excess water and reduce BP and reduce edema

A client is referred for an OT evaluation. The referral states that the client is experiencing ideational apraxia. Which of the following will the occupational therapy practitioner MOST LIKELY observe during evaluation with this client?

initiation of the task, inappropriate use of the item, manipulation of the item, visual search for item

inappropriate use of the item

A client with a history of diabetes mellitus reports progressive worsening of the ability to grasp items such as a coffee mug or a writing utensil. The OTR will include strength testing in the evaluation of this client. What is the NEXT consideration the OTR should include in the evaluation to understand why the client is having grasping difficulty?

assess for apraxia, assess for light touch sensation, assess for extinction, or perform a babinski test

assess for light touch sensation

An occupational therapy practitioner is evaluating a 3-month-old infant with suspected developmental delay. Which reflex should no longer be present in a typically developing infant at this age?

palmar grasp reflex, rooting reflex, moro reflex, plantar grasp relfex

rooting reflex

A 75-year-old male recently diagnosed with Parkinson's disease receives a referral for occupational therapy services. The occupational therapy practitioner begins the session with an interview with the client and spouse to complete an occupational profile. The spouse shares that it takes longer for the client to eat. The spouse says, "This morning, he sat there with the spoon in his hand. It seems like for a moment he forgot how to use the spoon! Then just like that he started to finally use it to eat his oatmeal.” What should the occupational therapy practitioner conclude is the PRIMARY cause for this observation?

bradykinesia, procedural memory deficit, akinesia

akinesia

A client is referred for occupational therapy services with a diagnosis of ataxia. When the occupational therapy practitioner is preparing for the evaluation, which of the following should they prepare to assess?

spasticity, coordination or skin detrioration

coordination

When learning to walk, a 12-month-old child is observed to take steps forward and lose balance. When falling forward, the child's shoulders and arms remain in a neutral position, abducting the fingers, and completing wrist extension. When documenting these observations, which reflex did NOT emerge at the appropriate age?

none, the child’s reflex’s are intact, forward parachute reflex, moro reflex, asymmetric tonic neck reflex

forward parachute reflex

A client sustained multiple injuries from a blast while serving overseas. The client was admitted to the polytrauma center of the Department of Veterans Affairs presenting with headache, dizziness, nausea, vomiting, visual changes, and sensitivity to noise and light. Which of the following focal neurologic deficits may indicate the presence of mild traumatic brain injury?

PTSD amnesia for less than a day, change in personality for 2 days or less, or an inital glascow coma scale with a score of 6

PTSD amnesia for less than a day

A client is referred to the outpatient occupational therapy clinic following extensor tendon repair to zone VI of the right, dominant dorsal hand. What information about extensor tendon injuries is MOST beneficial for the occupational therapy practitioner to remember when planning treatment?

injuries require dynamic splinting after an immobilization period of 3 weeks, injuries need early passive motion to prevent adherance extensor lag, or injuries may benefit from immediate controlled mobilization protocols

injuries need early passive motion to prevent adherance extensor lag

An infant is assisted into a sitting position from supine. The OTR observes that when the child is initially moved, the infant’s head lags followed by flexion bringing the head to midline. What does this observation BEST indicate?

moro reflex, traction, plantar grasp, necessitates medical attention

traction

A client, who recently experienced a cerebrovascular accident (CVA) with lesions in the occipital lobe, is unable to recognize food when placed on the plate. Which BEST describes the perceptual impairment observed?

agnosia, aphasia, visual neglect, hemi iinattention

agnosia

A 3 month old child with a complex neurological disorder demonstrates a closed grasp movement pattern when an item is placed in the hand. The child will close the hand around the object, often fifth finger first. Which grasping pattern or reflex is the child demonstrating?

palmar reflex, palmar grasp, radial palmar grasp, radial digital grasp

palmar reflex

An occupational therapy practitioner is assessing a client and observes the client attempting to spread butter on bread before removing the cover from the butter dish and also noticed the client attempt to use a toothbrush to clean the mirror.  Which is MOST APPROPRIATE question for the occupational therapy practitioner  to ask the client to further assess the behavior?

“can you show me how to brush your teeth?”, “how would you use this object?”. “what is this object?”

how would you use this object

An administrative assistant works full-time at an insurance company. The client complains of pain in the wrist and thumb area and sought medical attention. The physician diagnosed the client with De Quervain's syndrome and referred the client to occupational therapy for evaluation and treatment. Which activities should the client AVOID at this time based on symptoms and diagnosis?

using a key to unlock a door, filing folder on ann overhead cabinet, or texting on a cell phone?

texting on a cell phone

A 27-year-old client is diagnosed with bipolar disorder and is found to have difficulty holding a job. The client's co-workers expressed concern to the supervisor regarding the client's behavior, especially those observed during manic episodes. The client has difficulty engaging with co-workers, often resulting in arguments and disputes over roles. The client demonstrates limited communication skills with co-workers and has difficulty verbalizing needs, often becoming frustrated quickly. The client expressed fear of losing the job.  The occupational therapy practitioner created a therapy plan that aims to address the client's interpersonal and social functioning skills in the workplace. Which of the following approaches is MOST APPROPRIATE?

electroconvulsive therapy, interpersonal psychotherapy, or cognitive behavioral therapy

interpersonal psychotherapy

An OTR is evaluating a client following a cerebrovascular accident. The client notes depression and feels unmotivated to participate in therapy and improve function. The OTR asks the client to list priorities of activities as well as identify occupations that the client desires or expects to perform. Which BEST represents how the OTR will document this information?

occupational profile, outcome measures, functional goals, goals for discharge

occupational profile

Which of the following assesses protective sensation?

disk-criminator, monofilament, moberg pick-up test, or boley gauge

monafilament

An occupational therapy practitioner is assessing the muscle strength of the client's shoulder flexion and recognizes that the client can only achieve less than 50% full active range of motion (AROM) against gravity. In order to determine the specific grade of the strength the client has in flexion, what is the BEST position in which the occupational therapy practitioner can place the client?

sitting, prone, side lying on non-testing side, or side lying on testing side

side-lying on the non-testing side

A 67-year-old retiree, who has been attending occupational therapy sessions to address upper extremity pain, verbalized that he was pleased that he can now successfully complete all of his self-care activities with less pain. He said, “It is a good feeling to see my arm working more and to be able to take care of myself. I just wish I can do more things to keep me occupied. I want to be busy again and take my mind off the pain. If I am doing something I do not dwell on the pain." Which of the following assessment instruments is the BEST for the OTR to administer based on this comment?

COPM, activity sort card, brief pain inventory, disability of the arm should and hand

activity sort card

A client is recovering in the cardiac rehabilitation unit of the hospital. The client stated a desire to try to sit up at the edge of the bed to shave and brush teeth. The occupational therapy practitioner began to set up the bedside table and noticed that the client was provided with a standard self-care kit, which includes liquid soap, toothbrush, toothpaste, disposable razor, wash basin, shaving cream, and comb. The occupational therapy practitioner already reviewed the client's chart and recommended using an electric razor as a precaution. Which type of medications should the practitioner be particularly aware of because they may cause excessive bleeding if the client accidentally cuts the skin?

atenolol, lopressor, warfarin, digoxin

wafarin

An occupational therapy practitioner is evaluating problem-solving and sequencing skills of a client with a long-standing history of mental illness while making brownies from a mix. The client is hesitant to engage in the task and requires multiple cues in order to initiate the task. To promote engagement of the client during the evaluation, which is the most appropriate INITIAL action for the occupational therapy practitioner to take based on this observation?

Evaluate client’s cog function to make a simple meal, determine client’s interest in meal prep as a goal, schedule client for meal prep group sessions to improve skill level, or determine the clients home environment and need for meal prep

determine the client’s interest in meal prep as a goal

A client is receiving occupational therapy services in an acute care hospital after sustaining a T4 spinal cord injury and is being treated for a recent blood clot found in the right lower extremity. The occupational therapist is working with the client on rolling on a mat table to assist with lower body dressing. During the session, the client describes sudden onset of a severe headache, reporting increased anxiety, and shows increased perspiration. What immediate action is MOST APPROPRIATE for the occupational therapist to take in this situation?

assistn client into a seated position and wait for symptoms to pass, place the client on the left side, instruct client to perform pursed lip breathing technique, place the client into a seated position and take BP in both arms

Place client in seatd position and take BP in both arms

An OTR is evaluating a client diagnosed with HIV. Having experienced multiple falls, the client was referred to occupational therapy to address dynamic balance. The client identifies difficulty completing IADL around the house. The OTR provides education regarding adaptive strategies to protect against falls during the evaluation. Which BEST reflects the type of prevention the OTR is providing this client?

positive prevention, primary prevention, secondary prevention, tertiary prevention

tertiary prevention

An OTR is providing a group intervention in a kindergarten classroom. The OTR is focusing on fine motor tasks, pencil grasp, and sitting posture. One of the students is displaying a digital pronate grasp while coloring. Which remedial approach should the OTR later incorporate into the 1:1 session with this student?

practice stacking small cubes while seated, use small crayons for coloring tasks, to be completed in prone, or provide students with pencil grips and a slanted board for each desk, or practice removing small beads from medium resistance theraputty

use small crayons for coloring tasks to be completed in prone

An occupational therapist working in an outpatient setting has developed intervention strategies to promote remediation of brain injury. The occupational therapy practitioner identifies that many of the clients who have participated in the remediation strategies have improved in independence and occupational engagement over the course of rehabilitation. The occupational therapy practitioner begins to collect data from the clients who have completed the intervention program and identifies themes that emerge from the data. Which BEST represents the thinking process that the occupational therapist is using to gather evidence to support these interventions?

inductive reasoning, deductive reasoning, problem mapping

inductive reasoning

An occupational therapy department has recently been reassigned to a new holistic department within a large hospital system. The holistic department consists of multiple professionals who focus on promoting holistic care and wellness within the hospital system. The occupational therapy department and the holistic department have not previously worked together and many of the professionals are reluctant to engage with each other and worried that there will be overlap of professional skills and scope of practice. During the first department meeting, personalities and preferences struggled to align and the 2 groups disagreed on many items. Which BEST represents the stage of group development that this newly formed department is experiencing?

storming, norming, forming, or adjourning

forming

A client completed a driving evaluation to determine safety behind the wheel. The client was recommended for driving cessation. Which action is most important for the OTR to take next?

provide additional interventions specific to driving, refer a physician for further recommendations, educate and provide training for alternatives, provide multiple driving restrictions

education and provde training for alternatives

An 82-year-old client in a skilled nursing facility is receiving occupational therapy following a recent left shoulder arthroplasty. Orthopedic orders permit passive and active shoulder motion up to 90° of elevation only for the next two weeks, with no clearance for strengthening, resistance, or weight-bearing through the operative upper extremity. The client is cognitively intact, highly motivated, and requests therapy activities that feel functionally relevant. The occupational therapy practitioner (OTR) is supervising an occupational therapy assistant (OTA) and must ensure all interventions remain within postoperative precautions while promoting engagement in daily routines. Which intervention is MOST appropriate to delegate to the OTA during the next two weeks?

A. facilitate seated grooming tasks at the sink with frequently used items positioned between waist and chest height

B. engage client in B/L folding and stacking of towels at a table encouraging the operative arm to assist with stabilizing the stack to promote symmetrical UE use,

C. practice transferring lightweight objects from a countertop to an upper cabinet using the operative arm to improve functional reach and confidence during home management tasks,

D. intruct client in bed mobility strategies that require pushing through the operative UE to assist with rolling and transitioning to sitting

A. Faciliate seated grooming tasks…

During a discharge session, the occupational therapist reviews the home exercise program and precautions with the client. The occupational therapist carefully reviews essential, concrete information and asks the client to perform several exercises to ensure understanding. What is the therapist utilizing to facilitate patient understanding and compliance?

adult learning theory, universal health literacy strategies, behavioral cues for low literacy or cooperative learning

universal health literacy strategies

A 33-year-old parent of 9-month-old twins was diagnosed with an autoimmune disorder and chronic fatigue syndrome. The parent desires to return to work and financially provide for the family, but is worried about having enough energy left to spend time with the family at the end of the day. What would be the MOST EFFECTIVE energy conservation strategy the OTR could recommend to support this client in maintaining effective work participation and family participation simultaneously?

provide education on the use of pacing throughout day, collaborate with client ro determin meaningful activities, encourage client to plan workday with energy conservation techniqwues, educate client on MET levels

collaborate with client to determine meaningful activities

An OTR is working in a residential treatment facility with a young adult with history of a traumatic brain injury. The OTR is working on self-regulation strategies to minimize aggression and frustration. The OTR recognizes that the behavior is most often triggered when the client can’t communicate wants and needs, or the staff misunderstands attempts to communicate. What is the NEXT step the OTR should take to best serve the client?

discharge the client and consult with an onsite social worker, refer the client to a SLP, re-eval the client to consider other strategies to address behavior or speak with the staff and encourage limited communication with the client to avoid behavior disruptions

refer client to SLP

An occupational therapy practitioner evaluates a 57-year-old client who is admitted to a skilled nursing facility post left, transtibial amputation. The occupational therapy practitioner notes that nursing performed wrapping of the residual limb in the hospital. During the evaluation, the occupational therapy practitioner observes functional cognitive, visual, and UE motor skills. What is the BEST way to transition limb-wrapping responsibilities to the client?

make a plan with the nurse and client to transition wrapping to the client, encourage nursing staff to continue wrapping the client’s residual limb for now, educate family on wrapping technique so they can be involved in care, or arrange for therapist to wrap the limb to ensure proper prosthesis shaping

make a plan with the nurse and client to transition wrapping to the client

An occupational therapist is working with a client who has vision loss. The client presents to the occupational therapy session with a pamphlet for a new technology device that has been provided to other clients with vision loss to improve independence. The client requests to try the device if possible. The occupational therapist is knowledgeable about the new technology but does not feel that this device is beneficial for this client due to the high complexity of the technology. Which is the MOST appropriate response for the occupational therapist to have with this client?

negotiate with the client to trial various devices and determine the most appropriate to address goals, advise the client that the technology is too doffocilt to learn and the device is inappropriate, or listen completely to the client’s goals and desires for the device and then discuss why the device is inappropriate

negotiate with the client to trial various devices and determine the most apprpriate to address goals

An occupational therapy practitioner develops goals for a client to address active range of motion (AROM). Which goal is MOST APPROPRIATE?

the client will improe AROM by 10 degrees in order to complete ADL, the client will increase arom required to improve adl, specifically dressing, or in two weeks, the client will demonstrate 10 degrees of extension required for dressing

in two weeks, the client will demonstrate 10 degrees of extension required for dressing

An occupational therapy practitioner is new to working with neonates and families in the neonatal intensive care unit. What is the MOST EFFECTIVE method for providing occupational therapy services in today’s neonatal intensive care unit?

decrease stimulation to the infants immature nervous system, provide sensory stimulation to compensate for perceived deprivation, or modify the environment for neotes so they can tolerate more stimuli, or provide individualized family centered developmentla care

provide indivisualized family centered developmental car

A client was diagnosed with lateral epicondylitis and is now progressing out of the acute phase.  What is the MOST important component of client education for this condition as they progress to the next phase of therapy?

learning how to properly don/doff splints, learning self-management techniques, recognize the benfits of physical agent modalities in the healing process

learning self-management techniques

An occupational therapy practitioner in the school setting is a member of a special education team. The team has been asked to determine the eligibility for special education services for a student who struggles accessing education at the same rate as peers. The team is reviewing the data provided by team members, including parent report and formal evaluations. Which of the following MUST be considered when looking at learning disability as a potential qualifier for special education services?

academic skills, inclusing reading writing and math abilities, to identify areas of difficulty, or learning challenges associates to another developmental, neurological or motor disorder, or learning challenges appear to be in one specific area of education

academic skills including reading writing and math abilities to identfiy areas of difficulty

An occupational therapy practitioner is working with a client diagnosed with stage II complex regional pain syndrome (CRPS) of the nondominant hand following a stroke 6 months ago. The client demonstrates inability to move the hand following the stroke, but over time has developed CRPS in the hand. The client experiences extreme pain in the hand and displays pitting edema and discoloration. Which is MOST appropriate for the occupational therapy practitioner to address initially with this client?

reduce sympathetic stimulation, start joint mobilization techniques, or fabricate custom immobilization ortohses for the wrist and hand

reduce sympathetic stimulation

A client is recovering from a recent exacerbation of congestive heart failure. The client has a history of coronary artery disease and is diagnosed with class III cardiovascular disability using the Specific Activity Scale. The client was referred to occupational therapy to increase independence with instrumental activities of daily living. Which of the following instrumental activities of daily living can the occupational therapy practitioner INITIALLY include in the plan of care?

simple gardening, shoveling snow, washing dishes, writing at a desk

washing dishes

An occupational therapy practitioner completes an evaluation for a client who lives in an assisted living center. The client has meals provided throughout the day and has assistance with home management, including laundry. Which is the MOST APPROPRIATE for the occupational therapy practitioner to assess regarding the client’s IADL performance?

determine modofications for home management, assess financial and safety and emergency maintenance, or evaluate the clients sleep prep routine

assess financial and safety and emergency maintenance

An occupational therapist is working with a teenage client and the family to improve community engagement. The occupational therapist implements an indirect service approach to implement change. When using this approach, the occupational therapist may implement which of the following?

provide education to family regarding best ways to communicate expectations during tasks, provide training regarding self advocacy for differences in learning needs, promote trainign for the teenager to identify accessibility needs in the community setting, or promote the development of new individual skils through a specialized adapted job

provide education to the family regarding the best ways to communcate expectations during tasks

A client with significant vision loss is seen in an outpatient rehabilitation setting. The entry-level occupational therapy practitioner working with the client is unsure of how to evaluate and provide effective interventions to address the vision loss. Which is the MOST APPROPRIATE way for the occupational therapy practitioner  to address this client’s vision needs?

read and reseach on vision impairments, attend a CEU course on vision loss, refer the client to an advanced practioner specializing in low vision

refer the client

A client is working with an occupational therapist following a hand injury. During the evaluation, the occupational therapist identifies that the client was a chef working in a professional kitchen when the hand injury occurred. The client would like to return to working in the kitchen. The occupational therapist decides to implement a restorative approach with this client. Which functional outcome is MOST appropriate for the occupational therapist to include in the treatment plan for this client?

client will use a built up handle, client will demonstrate increase dbaility or use injured hand durin kitchen activities, client will reduce the number of tasks required of the client during the kitchen act. or client will avoid using the injured hand during kitchen tasks

client will demonstrate increased ability to use the injured hand during kitchen activitied

An occupational therapist provides services in a non-profit community setting with various clients transitioning from homelessness to work. The occupational therapist notices that clients frequently miss appointments, cannot accurately fill out paperwork, and often appear confused and frustrated during sessions. Which BEST describes what the occupational therapist is observing at the community setting?

negative client behaviors, behavioral cues on low literacy, universal health literacy strategies, adult learning theory

behavioral cues on low literacy

A client with anorexia is admitted to an inpatient psychiatric unit. A team of healthcare professionals including an occupational therapy practitioner complete a single, holistic, client-centered assessment. The team determines that the occupational therapy practitioner will implement intervention with the client; however, all disciplines, regardless of function, contributed knowledge and skills to the assessment, the plan of care, and the interventions. The team interacts with one another without discipline-specific boundaries. Which BEST reflects the type of team represented?

transdisciplinary team, interdisciplinary team, reseach based team, or multidisciplinary team

transdisciplinary team

An occupational therapy practitioner working in the acute care setting is evaluating a client who recently received an above-the-knee amputation. The client is a member of the Iroquois Nation and lives on a nearby reservation alone in a one-level house. The client is hoping to return home to the reservation upon discharge over the next few days. Currently, the client requires moderate assistance to transfer from the bed to the wheelchair using a standard walker. The client requires moderate assistance to bathe and don/doff lower-body clothing. The client has poor static standing balance and is unable to safely free hands from the walker to perform clothing management or any standing grooming/bathing tasks unsupported. The client is adamant to return home at discharge and states that other members from the nation will provide support. What is the BEST step for the occupational therapy practitioner to take toward recommending an appropriate discharge plan?

coordinate care with a cultural broker from the nation to determine if there is appropriate support available to d/c the client home, recommend the client discharge to short term rehab, request that hispital admin allow the client to rehab in hospital before discharging home alone, or reccomend client d/c home alone with home OT to focus on regaining ind with functional amblation of adls

coordinate care with a cultural broker from the nation to determine if there is appropriate support available to d/c the client home

A client presents for evaluation and reports total blindness, refusing to open the eyes when asked during the evaluation. During the chart review, the OTR did not identify vision loss as an impaired client factor. Which is the BEST action for the OTR to take?

recommend mental health assessment to address depression, recommend a complete eye exam, decline OT eval, encourage client to to open eyes

reccommend a complete eye exam

A worker who sustained a job-related injury has nearly completed an occupational therapy plan of care and has met functional goals for strength, endurance, and task performance. Prior to full return to work, which action should the occupational therapy practitioner take to best support carryover of skills and reduce risk of reinjury in the worker’s usual job role?

worksite evaluation, job demand analysis, work hardening, or work conditioning

worksite evaluation

While working on a new project, the group assigned to the project has worked out challenges among the team members regarding personalities and preferences. The team has started to create potential solutions. The group has determined strengths and weaknesses among the team members and a leader has emerged. Which BEST represents the stage of group development that this group is experiencing?

forming, storming, norming, or performing

norming

What are the appropriate steps for the occupational therapy practitioner to take next to ensure the client's safety, for a client who is on a dysphagia diet level 3, when eating scrambled eggs and pancakes with syrup, along with fresh pineapples, after ensuring proper positioning?

provide oral motor exercises while the client begins to eat, remove the cup of pineapples from the tray, cut the pancakes into bitesized pieces

remove the cup of pineapples from the tray

An occupational therapy practitioner is evaluating a client diagnosed with major depressive disorder. The client has difficulty verbalizing specific goals for occupational therapy and instead provides vague and nondescript information regarding functional needs and goals. Which is MOST appropriate for the occupational therapy practitioner to implement for the development of client-centered and obtainable goals with this client?

A. provide decreased structure, encourage abstract and complex ideas for goals

B. Provide increased structurem simple directions, and focus on short term goals

C. provide decreased structure, encourage engagement and explortion of novel occuptions

D. Provide increased structures, complex directions and understndable limits for goals

B.

An occupational therapy practitioner is working with a 10-year-old child who will only eat mashed foods, does not like noises (e.g., becomes upset when the phone rings), and has difficulty sitting during meals. The child's parents report that the child does not like new clothes and cannot wear jeans. What type of sensory processing problem should the occupational therapy practitioner address INITIALLY when planning intervention activities?

over responsiveness, reduced sensory registration, tactile perception, proprioception problems

over responsiveness

An occupational therapy practitioner is working with a client in an acute care burn unit. The client sustained deep partial-thickness burns to the anterior forearm and is receiving daily dressing changes. The client reports moderate pain during dressing changes and expresses frustration about not being able to participate in grooming and feeding tasks due to discomfort and limited mobility. The client’s primary goal is to regain functional use of the affected upper extremity for ADLs while minimizing pain and risk of infection. Which type of wound dressing should the occupational therapy practitioner recommend to the interdisciplinary team to BEST support tissue healing, reduce pain, and facilitate early functional movement of the upper extremity?

biologic dressings, hydrogel dressings, biosynthetic dressings

biologic dressings

An occupational therapy practitioner wants to maximize the effects of a stretching program for a client who sustained a work-related injury to the non-dominant, left upper extremity. The occupational therapy practitioner and client noticed improvements in elbow active range of motion (AROM) after stretches performed in treatment, but the client reports that stiffness and joint limitations return the next morning. Which of the following treatments is MOST APPROPRIATE to add to the existing stretching program to facilitate longer lasting gains in active range of motion (AROM)?

contrast baths, ultrasounds, paraffin

ultrasound

An occupational therapy practitioner working in an outpatient clinic is evaluating a client currently undergoing chemotherapy treatments for breast cancer. The doctor referred the client for occupational therapy evaluation to promote strengthening and endurance, specifically to address chemotherapy-related side effects. The client states the shoulder is very sore from a recent strain injury while reaching into an overhead cupboard. The client requests heat modality prior to exercise for comfort. How should the occupational therapy practitioner respond?

A. provide continuous ultrasound to the most painful point on the shoulder for 8 minutes, sweeping the transducer in that spot

B. Apply a heat pack to the affected area for 10 minutes with 3 layers of towel in between the pack and the clients shoulder

C. Apply a warm compress to the shoulder for 15 minutes

D. Complete gentle stretching and AROM exercises to the affected shoulder within the zone of comofrt while monitoring pain

D.

A client receives inpatient OT for wound management. The client wants to be able to dress independently. The client has a full-thickness wound and complains of pain. Which dressing would the OTR recommend for this client?

an alginate dressing, transparent film dressing, hydrogel dressing

hydrogel sheet

A 50-year-old patient has sustained a crush injury to the right upper extremity and recently developed complex regional pain syndrome (CRPS). When incorporating the biomechanical frame of reference in the initial occupational therapy session, which intervention is MOST likely to be incorporated first?

Instruct the patient to carry small objects to incorporate stress loading, simulate daily activities, engage the patient in gardening tasks, engage the patient in range of motion exercises

engage the patient in range of motion exercises

When providing wound care treatment to a client with a decubitus ulcer on the ischial tuberosity, which should the OTR consider that might negatively impact the wound healing process?

periwound maceration, epithlialization, presence of granulation tissue, wound debridement

periwound maceration

An adult client is recovering from a distal ulnar fracture. The client was in a cast that immobilized the wrist for 6 weeks, which was recently removed. The occupational therapy practitioner conducts an evaluation in an outpatient hand clinic and documents significant stiffness, pain and soreness in the wrist. Which physical agent modality (PAM) is MOST BENEFICIAL for addressing stiffness, pain, and soreness of the wrist? 

Transcutaneous ESTEM, NMES, Paraffin, Therapeutic ultrasound

paraffin

A client with left hemiplegia has recently progressed to using a cane for mobility. The OTR would like to progress bathing and self-care activities in the bathroom but the client needs to ascend stairs to access the bathroom. What is the MOST APPROPRIATE position for the OTR when guarding the client to optimize safety and prevent injury while the client ascends the stairs?

A. stand directly to the L side of the client with feet staggered on adjacent steps

B. stand directly above the client with a wide abse of support and both feet on the step above

C. Stand on the steps below the client and towards the left with feet staggered on adjacent steps

D. Stand directly below the client with a wide base of support and both feet on the step below

C.

An OTR is providing interventions to a client with dementia. The Allen Cognitive Level score reveals the client is performing at a 3.0. Which activity would be MOST appropriate for the OTR to initiate first?

A. A sink sided grooming task with visual cues of each step of the task

B. A simple 3-step recipe using written instructions

C. A lowe body dressing task using adaptive equipment as needed

D. A familiar 2 step craft tas kproviding tactile cues by placing items in the clients hands

D.

A client attends a rehabilitation clubhouse daily. Throughout daily activities, the client is modeling work behavior and completing formalized training alongside the clubhouse staff. Which type of pre-employment does this represent?

sheltered employment, in-house jobs, transitional employment, or pre-employment jobs

in-house jobs

An occupational therapy practitioner is working with a family of a 3-year-old child with autism spectrum disorder who has ongoing sleeping problems. The child has difficulty settling down to fall and stay asleep and occasionally is seen night walking. What intervention is MOST EFFECTIVE for the family and child to promote sleep?

create a consistent bedtime routine, give the child melatonin before bedtime, or engage the child in vestibular input activities prior to bedtime

create a consistent bedtime routine

An occupational therapy practitioner is working on self-feeding with a 5-year-old child diagnosed with cerebral palsy. The client presents with fluctuating tone in all extremities, neck, and jaw. Often, when placing a spoon of food in the mouth, the child bites down hard and is unable to release the bite. The more the spoon is pulled to remove it, the more increased tone in the jaw is exhibited. Using an adaptive approach, what is the BEST course of action for the occupational therapy practitioner to take to promote independence in self-feeding?

eat only finger foods to prevent the bite response, use a vibrating brush to prepare the mouth for feeding, begin the session by introducing a wide range of temperatures to help the child adjust to textures

use a coated spoon

An OTR is working with a client in an outpatient rehabilitation center. The OTR notes that the client becomes breathless during activity and demonstrates shallow breathing. The OTR terminates the activity and encourages the client to practice diaphragmatic breathing. Which is MOST APPROPRIATE for the OTR to implement when teaching this breathing technique?

lay client supine, placing a small book on the abdomen below the xiphoid process, lay client supine and encourage the clinet to tense specefic muscle groups while breathing, practice inhaling for a count of 2, purse lips, and exhale slowly, or encourage client to sit and bend forward slightly

lay client supone, placing a small book on the abdomen below the xiphoid process

An occupational therapy practitioner completed a cognitive evaluation for a client following a severe brain injury. The occupational therapy practitioner utilizes the neurofunctional approach to guide the evaluation as well as when determining interventions. Using this approach, which is BEST for the occupational therapy practitioner to implement?

learning strategies, alter activity demands, environmental changes, or specific task training

specific task trainign

A client with chronic tendinitis is referred to occupational therapy. The practitioner chooses to use a physical agent modality to decrease pain and promote tissue healing. Which modality would be MOST appropriate

contrast baths, deep heat, or hot packs

deep heat

An OTR is providing an intervention to a client who has a diagnosis of lateral epicondylitis. The OTR introduces ice massage as a preparatory activity. Which part of the upper extremity is MOST APPROPRIATE for the OTR to provide ice massage?

the common flexor attachment of the elbow, the common extensor attachment of the elbow, the pronator quadratus, the pronator teres

the common extensor attachment of the elbow

An occupational therapy practitioner plans to use a remedial approach to improve the handwriting skills of a 6-year-old student who has a mild learning disability. The student maintains a very tight grip on a pencil when writing, consistently uses a palmar grasp when holding the pencil, and has directional confusion when forming letters. Which activity would be MOST EFFECTIVE to include as part of the INITIAL intervention when using this approach?

painting letters using a wide barrel brush on paper, implement using a keyboard, provide hand over hand assistance

painting letters using a wide barrel brush on paper

An OTR is intervening with a client in stage 1 (traumatic stage) of complex regional pain syndrome (CRPS). The client’s goal is to complete kitchen activities (washing dishes) with independence, with decreased pain. Which preparatory activity would be MOST beneficial to promote desensitization of the client’s affected hand and wrist prior to the intervention?

ultrasound, arom exercises, fluidotherapy, Prom

fluidotherapy

An OTR is providing intervention to a client who has a diagnosis of shoulder pain. During the interview the client reports that the discomfort started 6 months ago after painting the ceilings in the home. Standardized assessment and objective observation reveals that the client displays decreased AROM, decreased strength, and compensatory movement patterns during ADL/IADLs. Which superficial thermal agent would be MOST appropriate for the OTR to implement?

ice massage ofr 3-5 mins, ice pack to anterior delt for 25 mins, a moist hock pack with 6 layers of towels, a tens unit

a moist hot pack with 6 layers of towels

A client was injured on the job and unable to return to work due to low back pain. The client was referred to occupational therapy to provide rehabilitation and promote return to work. The client is covered by workers' compensation insurance for rehabilitation, which will require an evaluation to justify the need for occupational therapy services. Which is the MOST appropriate for the occupational therapy practitioner to implement with this client during the evaluation?

use a combination of self report questionnares and interview processes to devlop an ot profile, use biomechanical framework, complete an ergonomics eval of hazard assessment to dtermine cause of back pain, complete a functional capactiy eval including eval of physical perofrmce

complete a functional capacity evaluation including evaluation of physical performance

A 75-year-old client with stage II Parkinson’s disease has stopped attending weekly family dinners at a local restaurant. The client expresses embarrassment about spilling food on clothing and the table while eating and reports feeling mildly depressed about withdrawing from family routines. What is the BEST intervention strategy to support the client’s re-engagement in this valued activity?

introduce adaptive feeding equipment, train client in relaxation and pacing techniques during meals, design an intervention plan to include practice eating alone at home before returning to family dinners

introduce adaptive equipment

A client attends occupational therapy twice a week to address changes in visual perception following a cerebral vascular accident (CVA). During a session, the occupational therapy practitioner  provides a light board and has the client recreate a picture using lighted pegs. Which BEST represents the type of intervention the occupational therapy practitioner  has provided?

compensatory, remedial, adaptive, modification

remedial

A client is referred to occupational therapy to support increased self-regulation and functional participation in daily routines. The intervention plan includes autogenic training. Which BEST characterizes this type of training?

a training that involved silent repetition of phrases about homeostasis, a type of training that uses images to reduce stress and distract attention, relaxation training that focuses on a muscle group with systematic tensing

a type of relaxation that involves the silent repeition of phrases about homeostasis

A 22-year-old client presents to occupational therapy with a complete spinal cord injury at the level of L2. Which is the BEST transfer technique the occupational therapy practitioner should perform to initiate transfer training and improve independence in transferring from a bed to a wheelchair?

mechanical lift, slideboard, stand pivot xfer, STS xfer

slideboard

An occupational therapy practitioner is working with a child with autism spectrum disorder on improving play. Which intervention is the MOST APPROPRIATE to use with this child?

build an obstacle course, take turns imitating one another, provide choice boards to aid in understandinf what is it to be done

take turns imitating one another

An occupational therapy practitioner is working with a resident of an assisted living facility who enjoys card and board games. The client begins to complain of bilateral hand pain from moderate to severe rheumatoid arthritis. As a result, the client has been unable to participate in the leisure activities. The rheumatologist referred the client to occupational therapy to address the progression of the arthritis. What is the MOST appropriate intervention that an entry-level occupational therapy practitioner can provide for the client?

observe the card and boars games the client enjoys and modify as needed, used physical agent modalities, provide client with prefabricated resting hand splint, provide client with resistive exercises to strengthen hand

observe board games the client enjoys and modify as needed

A client presents to occupational therapy for evaluation 6 months after experiencing a traumatic brain injury (TBI) related to a workplace injury. The occupational therapy practitioner identifies that the client performs at an 8 (purposeful, appropriate) on the Rancho Los Amigos scale. The client’s main goal for evaluation is to explore new employment options that are appropriate for current skills and abilities. Which work program would be MOST appropriate for this client?

work readiness program, work hardening program, wor conditioning program, vocational rehab program

vocational rehab program

An occupational therapy practitioner is working in home care with a client diagnosed with Alzheimer disease. The client lives at home with an adult son and daughter-in-law. During the day, the client's daughter-in-law is the primary caretaker. The client's daughter-in-law has expressed concerns as the client has been demonstrating an increase in wandering and has become more restless. The daughter-in-law notes that the client has had increased difficulty taking medications, leaving medications without taking them. What recommendations can the occupational therapy practitioner make to help improve medication adherence?

suggest creating a routine and encourage caretaker to use simple clear directions allowing breaks if needed, use alarms and a locked medication dispenser to remind client to take medications, encourage medication schedule

suggest creating a routine