NBCOT Practice Questions: Domains 3 & 4

A 12-month-old infant has moderate hypotonia resulting in developmental delay and poor oral motor control. Which position is recommended for this infant for promoting oral motor function during feeding?

Slightly reclined with trunk fully supported and the neck and head at midline

An OTR is providing ramp specifications for a client with a disability who uses a power wheelchair for mobility. What is the minimum gradient for the ramp that the OTR should recommend to this client?

The standard ratio of rise to run for a wheelchair ramp is 1:12.

Universal Design for Learning

The primary objective of applying the universal design for learning principles is to establish the conditions to support all students in mastering the skill of learning.

A resident recently was admitted to a long term care facility after having an intracerebral hemorrhage secondary to a ruptured aneurysm. Currently, the resident is able to verbalize basic needs, can follow simple one-step directions, and has minimal functional movement of all extremities. The resident wants to be able to change channels on the television independently but is unable to hold the remote control device or apply enough pressure on the buttons to activate the device. The OTR is choosing a switch-activated selection device that will enable the resident to complete this task. Which type of switch is OPTIMAL to use with this device?

A plate switch responds to minimal force, so it allows this resident to independently access the channels on the television.

Scaffolding

a cognitive technique where the OTR structures an activity to support for components of the task that are too difficult for the client and provides an opportunity for the client to successfully complete task components within the client's capabilities.

An 8-year-old student with severe achondroplasia has limited hand function with no isolated finger movements. The student is learning to use an adapted computer to optimize performance during classroom assignments. Which modification would BEST support the student's success to access the computer?

Trackball mounted on a stationary base

What is the PRIMARY purpose for having the patient wear a foot drop orthosis?

offer pressure relief while supporting the foot in a neutral position.

An OTR is providing a home program to a client who has stage 1 complex regional pain syndrome. What information should be included in the home program to MOST EFFECTIVELY help the client with symptom management?

Techniques for elevating the hand and completing active ROM exercises

In the presence of complex regional pain syndrome (CRPS), vasospasm and vasodilation results in an abnormal persistence of edema. Edema control is important to include in a home program. If edema is not controlled, the protein-rich exudates that cause swelling will result in collagen formation, which will cause joint stiffness and decreased functional mobility.

Mechanical Debridement

the removal of necrotic tissue using methods such as fluid irrigation and whirlpool.

Interoception

the awareness of sensations from inside the body and having the ability to perceive signals associated with the functioning of internal organs, such as the lungs (respiration) and the heart (heartbeat).

Charcot-Marie-Tooth disease

a neurological disorder that impacts voluntary muscle control and muscle strength. As the condition progresses, an orthosis may assist to compensate for hand weakness and promote function.

A patient in a rehabilitation facility has a C6 (ASIA A) spinal cord injury. The patient is learning techniques to maintain forward sitting balance while sitting on the edge of the bed. Which technique is MOST BENEFICIAL for the OTR to teach the patient to support progress toward this goal?

Lock the elbows in full extension; use shoulder depression, protraction and external rotation, and full wrist extension

A patient with a complete spinal cord injury at the level of C6 has Zero 0/5 strength in the triceps. The patient will benefit from locking the elbows into extension to maintain balance when sitting upright.

Why would you use a hydrogel sheet dressing on a pink wound with low exudate?

To keep bacteria out of the wound while promoting autolytic debridement

What type of wheelchair cushion is lightweight, inexpensive and provides even distribution of pressure relief?

Foam cushion

The primary purpose of the orthotic is to maintain the length of the MCP joint collateral ligaments. How should the MCP joints, IP joints and wrist be positioned in the orthotic to achieve this goal?

MCP joints in 60 - 70 degrees of flexion, IP joints in 0 - 5 degrees of flexion, and the wrist in 25 - 30 degrees of extension

An OTR is fabricating an orthotic for a client who has a claw-hand deformity secondary to an ulnar nerve injury several months ago. Which type of orthotic is indicated for this client?

Hand-based orthotic that positions the fourth and fifth digits in 30° - 40° of MCP joint flexion while allowing IP joint motion

A claw-hand deformity is characterized by hyperextension of the fourth and fifth digits and is typically secondary to an ulnar nerve injury. Blocking the fourth and fifth MCP joints in slight flexion allows the extensor digitorum communis tendon to extend the IP joints in the absence of the ulnar innervated intrinsic muscles. The orthotic will enable the client to have a more functional grasp.