NBCOT Practice Exam 60 Questions with Complete Solutions., Exams of Laboratory Practices and Management

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NBCOT Practice Exam 60 Questions with Complete

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A COTA is gathering information about the dressing skills of a 10 - year-old child who has moderate cognitive and developmental delays secondary to autism spectrum disorder. Which data-gathering method would provide the MOST OBJECTIVE information about the child's current dressing skills? A. Asking the parents to complete a questionnaire B. Observing the child during BADL routines C. Having the child complete a simple checklis - Correct Answer B The use of cryotherapy as a physical agent modality (PAM) is CONTRAINDICATED for clients who have which of the following diagnoses? A. Raynaud's Phenomenon B. Acute ligament sprain C. Myofascial trigger points D. Tenosynovitis - Correct Answer A An OTR is completing a self-care assessment with a resident in a long-term care facility. Nursing staff referred the resident to OT after observing a decline in the resident's function following an exacerbation of COPD one month ago. Medical history is also significant for residual cerebellar symptoms secondary to an excision of a brain tumor 5 years ago. The client has Fair Plus (3+/5) functional strength of bilateral upper extremities. During the assessment, the OTR asks the resident to "pick up your shirt from the nightstand." When reaching for the shirt, the resident has to stabilize the arm to prevent reaching beyond or short of the shirt. When documenting the session, what term should the OTR use to BEST describe the resident's action? A. Decreased motor planning B. Dysmetria C. Dysdiadochokinesia - Correct Answer B A service competent school-based COTA is collaborating with an OTR prior to the initial evaluation of a student who has a developmental delay. Which part of the student's evaluation is within the scope of practice for the COTA to complete?

A. Documenting outcomes of unstructured parent interviews B. Administering and scoring standardized handwriting assessments C. Assessing fine and gross motor patterns during classroom activities - Correct Answer B During an OT session, a client makes a statement about feeling depressed as a result of an injury. Under which section of the SOAP note should the OTR document this information? A. Subjective B. Objective C. Assessment D. Plan - Correct Answer a A COTA and an OTR are gathering information about the play skills of a 7 - year-old child who has autism spectrum disorder. Which data gathering method would provide the MOST BENEFICIAL information about the child's spontaneous play skills in context? A. Play checklist during an age-appropriate board game B. Structured observation in a simulated setting C. Distant observation of the child playing with other children - Correct Answer C A client had a repair of the median nerve on the dominant upper extremity after sustaining a work-related laceration of the wrist 6 weeks ago. The client has been undergoing rehabilitation and resumed light work as a warehouse stocker several days ago. During a follow-up appointment, the OTR observes several blisters on the client's index finger. What INITIAL action should the OTR take based on this observation? A. Advise the client to file an incident report with the employer. B. Teach the client protective sensory re-education strategies. C. Contact the case manager to modify the client's job tasks. - Correct Answer B A service competent school-based COTA is collaborating with an OTR prior to the initial evaluation of a student who has a developmental delay. Which part of the student's evaluation is within the scope of practice for the COTA to complete? A. Documenting outcomes of unstructured parent interviews B. Administering and scoring standardized handwriting assessments

C. Assessing fine and gross motor patterns during classroom activities - Correct Answer b Which physical agent modality is MOST EFFECTIVE for reducing pain and inflammation within the first 24 to 48 hours of sustaining a soft tissue injury? A. Fluidotherapy B. Moist hot packs C. Cryotherapy D. Thermal ultrasound - Correct Answer c a COTA is instructing a client who has paraplegia on methods for completing sliding board transfers. what method should the COTA do first when initiating this type of transfer with the client? - Correct Answer C An OTR is preparing to administer a standardized developmental screening to a premature infant who is at-risk for developmental delay. In addition to noting the assessment date and the infant's birth date, what information MUST be gathered in order to calculate the infant's corrected age? A. Original projected due date B. Typical gestational age C. Number of weeks premature - Correct Answer C A client in the mid-stage of Alzheimer's disease lives at home with a spouse as the primary caregiver. The spouse wants the client to remain at home as long as possible; despite a progressive decline in the client's cognition. What strategy should be included in the recommendations for supporting the client's aging-in-place? A. Establish a routine schedule of familiar daily activities to encourage engagement. B. Have the client use a variety of assistive devices to minimize task demands. C. Plan most activities for the morning to avoid the effects of sundowning. - Correct Answer A During which home maintenance tasks would symptoms related to constructional apraxia be MOST EVIDENT? A. Washing the interior sides of single pane windows

B. Using a roller brush to paint an interior wall of the home C. Vacuuming floors in the main living area of the home D. Following written instructions for installing curtain rods - Correct Answer d What clinical symptom is typically present in the affected hand of a client who has severe carpal tunnel syndrome? A. Positive Tinel's sign at the wrist B. Decreased light touch of all digits C. Numbness of the small finger D. Atrophy of the extrinsic muscles - Correct Answer a What is the PRIMARY purpose for completing a dysphagia screening for an inpatient who had a right CVA several days ago? A. To detect silent aspiration and identify foods that are safe for the patient to eat B. To identify causes for aspiration and the need for referral to speech therapy C. To observe the patient's oral motor control and determine a need for further evaluation D. To determine the patient's tolerance to various food textures prior to requesting a modified diet - Correct Answer C An OTR is facilitating a group for clients diagnosed with a polysubstance use disorder. During the first group session, the OTR describes how trigger events and irrational thinking can lead to substance misuse. Which theoretical model does this approach exemplify? A. Cognitive-behavioral B. Psychodynamic C. Human Occupation - Correct Answer a A COTA witnesses an OT aide using a goniometer to measure a patient's upper extremity ROM. What action should the COTA take in response to this observation? A. Determine if the aide has established service competency for this task. B. Show the aide how to use the instrument according to facility policies. C. Ask the aide to stop the activity and discuss the situation with the supervisor. - Correct Answer c

A client sustained a non-displaced distal radius fracture 8 weeks ago. The OTR receives a consult from the client's physician to initiate ultrasound and therapeutic exercise. The state regulatory board allows occupational therapists to use physical agent modalities (PAM), however, the OTR assigned to the client has not had PAM training. How should the OTR respond to this referral? A. Follow the protocol for ultrasound as outlined in the instruction manual. B. Refer the client to an occupational therapist who is experienced in ultrasound. C. Apply moist heat to the affected hand and wrist instead of ultrasound. - Correct Answer B An adolescent-age student has athetoid cerebral palsy and has been participating in school-based OT since pre-school. After transitioning to the sixth grade in a new school, the teachers report the student is not using assistive devices, is sullen, and does not interact with peers. What INITIAL action should the OTR take in response to the teachers' reports about this student? A. Revise the IEP goals to focus on student preferences. B. Establish new goals to work toward self-sufficiency. C. Develop a transition plan for promoting autonomy. D. Complete an evaluation using a top-down approach. - Correct Answer D A COTA is working with a student in the third grade who has a sensory processing deficit. Intervention activities include providing sensory-based movement activities to facilitate an appropriate level of arousal. Which responses are common indicators that the activity is beginning to exceed the student's sensory threshold?Select the 3 BEST choices. A. Uncontrollable jerky motions of the extremities during parachute games B. Facial paleness while spinning in a net suspension swing C. Fidgeting in a desk chair when participating in a board game D. Irregular involuntary movement of both eyes while on a tilt and spin board E. Holding on tightly when being gently pushed on a platform swing F. Body language consistent with lethargy during a gross motor game - Correct Answer B, C, E

An OTR is evaluating the effectiveness of an OT home program for clients who have been diagnosed with an anxiety disorder. Which qualitative measure would be MOST BENEFICIAL to use as part of this evaluation process? A. Retrospective record reviews to measure the percentage of clients who attained occupation-based goals B. Occupational role checklists administered at the start and then several months after completion of the program C. Standardized, norm-referenced or criterion-referenced occupation-based assessments - Correct Answer b QUALITATIVE A young adult on an inpatient surgical unit 4 days after the excision of a brain tumor is medically stable and participates in therapy 3 hours per day. Currently, the patient requires moderate assistance with BADL due to perceptual deficits and decreased balance. The patient will be discharged from this facility in one day. Which transitional setting would BEST support the patient's current level of function? A. Assisted living center B. Residential skilled nursing facility C. Acute inpatient rehabilitation unit D. Patient's home with outpatient therapy - Correct Answer c An OTR has completed an initial evaluation of an 18 - month-old child who has hypotonicity. The child's mother reports the child does not crawl and resists being placed in a hands and knees crawling position. During the evaluation the child is able to maintain head control, roll, and sit unsupported for several minutes. After the OTR places the child in a crawling position, the child is able to maintain the position for about 30 seconds. The child does not spontaneously initiate locomotion. What statement accurately reflects the child's current motor skills? A. The child exhibits tactile hypersensitivity that impacts the child's ability to maintain postural stability. B. The child has decreased postural stability for completing developmentally appropriate gross motor tasks.

C. The child has the ability to initiate transitional movement patterns and achieve developmentally-appropriate locomotion. D. The child has the p - Correct Answer b A client has severe peripheral neuropathy and a moderately weak grasp bilaterally. The COTA is teaching the client adaptive homemaking techniques. Which recommendation would be MOST BENEFICIAL for the client to use in the kitchen? A. Adhere Velcro® dots on appliance controls. B. Install extended lever-type faucet handles. C. Use a reacher to pick up items from the floor. - Correct Answer b A Level II fieldwork OT student and a supervising OTR are meeting a client for the first time. The OT student greets the client by stating, "I am the occupational therapist who will be working with you." The supervising OTR immediately informs the client that the student is completing a fieldwork rotation and has not yet graduated from an OT program. After the session, the OTR meets with the student to review the professional code of ethics. Which ethical principle directly relates to this situation? A. Beneficence B. Fidelity C. Veracity - Correct Answer c For which of the following conditions is the use of a static restriction orthosis TYPICALLY indicated?Select the 3 BEST choices. A. Swan-neck deformity B. Flexor tendon repair C. Extrinsic flexor tightness D. Radial nerve palsy E. Ulnar nerve palsy F. MCP joint arthritis - Correct Answer A, E, F An OTR is completing a self-care assessment with a resident in a long term care facility. Nursing staff referred the resident to OT after observing a decline in the resident's

function following an exacerbation of COPD one month ago. Medical history is also significant for residual cerebellar symptoms secondary to an excision of a brain tumor 5 years ago. The client has Fair Plus (3+/5) functional strength of bilateral upper extremities. During the assessment, the OTR asks the resident to "pick up your shirt from the night stand." When reaching for the shirt, the resident has to stabilize the arm to prevent reaching beyond or short of the shirt. When documenting the session what term should the OTR use to BEST describe the resident's action? A. Decreased motor planning B. Dysmetria C. Dysdiadochokinesia - Correct Answer B A COTA is fabricating a thermosplastic splint as conservative treatment for a client who has early symptoms of cubital tunnel syndrome. What would be the PRIMARY purpose of this splint? A. Substitute for absent muscle function B. Prevent elbow flexion during hours of sleep C. Block ring and small finger MCP joint hyperextension D. Minimize wrist flexion and extension during work - Correct Answer B A client has difficulty swallowing secondary to multiple sclerosis. The OTR manually assists the client in performing a chin tuck prior to the client swallowing a bite of food. What is the PRIMARY benefit of facilitating this position? A. To hasten overall oral-motor responses for chewing and forming a bolus of food B. To maximize tongue elevation when pushing the food bolus to the back of the mouth C. To prevent food and secretions from entering the larynx below the level of the vocal cords - Correct Answer C An occupational therapist reviews the use of the OT department's resources to determine medical necessity and cost efficiency. Which service management task is the therapist performing? A. Utilization review B. Retrospective peer review

C. Total quality management D. Risk Management - Correct Answer A A client who has mild to moderate memory deficits secondary to dementia recently started using prescription eyeglasses for near vision tasks. The client frequently misplaces the glasses. The family reports the client becomes frustrated and agitated when unable to locate the glasses. What option should the COTA initially recommend to the client for reducing the occurrence of this problem? A. Store the glasses in the drawer of a bedside table after each use. B. Fasten the eyeglass frames to an eyeglass chain to wear around the neck. C. Give the eyeglasses to a family member or caregiver to store after each use. - Correct Answer B A patient in the early stages of amyotrophic lateral sclerosis (ALS) presents with weakness in the thenar eminence. During which ADL task would the evaluating OTR® MOST LIKELY observe the effect on function? A. Transferring from the bed to the bedside commode B. Taking a sip from a glass of water C. Reaching overhead to don a T-shirt D. Squeezing toothpaste onto a toothbrush - Correct Answer D An OTR® completes a work tolerance screening with a worker at a manufacturing plant. What should be included in the documentation? A. Weight limits for various job tasks B. Worker's reported desire to remain in the job C. Worker's ability to perform ADLs D. Financial issues the worker experiences - Correct Answer a A COTA® is working toward service competency for adaptive feeding equipment instruction. How would the OTR® BEST establish service competency?

A. Review the COTA®'s documentation of multiple patients whose feeding impairments warranted adaptive equipment, then discuss the outcomes with the COTA®. B. Observe the COTA® educate clients on how to use adaptive feeding equipment to ensure the COTA® instructs clients in the same manner as would the OTR®. C. Compare outcomes by rating the same client's performance with the adaptive feeding equipment at the same level of independence. D. Collect information from various sources, including other therapists, the COTA®'s documentation, and feedback from clients, to determine competency. - Correct Answer c In this example, both the COTA® and OTR® observe the same client performing a task and rate that performance in a similar manner. Comparing outcomes helps to ensure clients receive care of equal quality An OTR® is working with a client with Down syndrome to develop cooking skills. The client successfully makes a peanut butter and jelly sandwich. Which therapeutic activity would be BEST for the next treatment session? A. A turkey-and-cheese sandwich B. A microwavable dinner C. A grilled cheese sandwich D. A stir-fry vegetable dish over brown rice - Correct Answer c An OTR® is working with a client with chronic obstructive pulmonary disease on therapeutic exercise and how to measure exercise tolerance. The client is performing seated bilateral shoulder flexion with 3 - lb weights and rates this activity as "very, very easy." How would the OTR® appropriately grade this activity? A. Change the muscle groups used by switching to shoulder abduction. B. Advise the client to perform the task in a standing position. C. Switch the client to a resistance band. D. Increase the number of repetitions and have the client perform the exercises while standing. - Correct Answer B An OTR is teaching joint protection strategies to a client recently diagnosed with rheumatoid arthritis. The client enjoys cooking large family meals, but pain in the MCP

joints and wrist are interfering with the ability to cut meats and vegetables. In addition to recommending the use of an adapted cutting board, which type of knife would be beneficial for the client to use? A. Serrated knife with finger contoured handle B. Universal cuff attachment for standard slicing knife C. Wheel configured knife with non-slip padded grip D. Carving knife with handle set at 90° angle - Correct Answer c A patient who has congestive heart failure is learning to use energy conservation techniques during self-care activities. The COTA is monitoring the patient's vital signs during the intervention session. Which vital sign responses indicate the need to discontinue the activity? Select the 3 BEST choices. A. Heart rate increase of 5 beats per minute B. Pulse oximetry oxygen saturation level of 98% C. Rating of perceived exertion (RPE) reported as 15 D. Heart rate of 20 beats per minute above resting heart rate E. Respiratory rate of 15 breaths per minute F. Systolic blood pressure greater than 220 mmHg - Correct Answer f, c, d A client has difficulty swallowing secondary to MS. the OTR manually assist the client in performing a chin tuck prior to the client swallowing a bite of food. what is the PRIMARY benefit of facilitating this position? A. to hasten overall oral motor responses for chewing and forming a bolus of food B. to maximize tongue elevation when pushing the food bolus to the back of the mouth C. to prevent food and secretions from entering the larynx below the level of the vocal chords - Correct Answer C A COTA is facilitating a thermoplastic orthosis as conservative treatment for a client with early symptoms of cubital tunnel syndrome. What would be the PRIMARY purpose of the orthosis? A. to substitute for absent muscle function B. to prevent elbow flexion during hours of sleep

C. to block ring and small finger MCP joint hyperextension D. to minimize wrist flexion and extension during work - Correct Answer B A client has severe peripheral neuropathy and a moderately weak grasp bilaterally. The COTA is teaching the client adaptive homemaking techniques. Which recommendation would be MOST BENEFICIAL for the client to use in the kitchen? A. Apply raised adhesive dots on appliance controls. B. Install extended lever-type faucet handles. C. Use a reacher to pick up items from the floor. - Correct Answer B A client who has cognitive and motor deficits secondary to the onset of Huntington's disease is participating in OT. One of the client's goals is to be independent with dressing. Which intervention activity is BEST to include as part of the initial intervention plan? A. Educate the client and caregivers about methods for adapting the fasteners on the client's clothing. B. Teach the client to use a sequenced checklist to mark off tasks as they are completed during dressing. C. Have the client practice using a button-hook and long-handled reacher when completing dressing tasks. D. Use backward chaining methods and hand-over-hand assistance to teach adapted dressing skills. - Correct Answer unknown come back to, D? An OTR has completed the initial evaluation of an inpatient who had a total hip replacement one day ago. Medicare is the primary insurance provider. To maximize third party reimbursement, which statement is BEST to include as part of the initial documentation? A. Intervention will include upper extremity exercises to maintain active ROM and strength. B. The patient will navigate a front-wheeled walker a distance of at least 30 feet during each session. C. OT services are medically necessary to teach movement precautions during self-care tasks. D. Daily OT is recommended to monitor the patient's bathing and dressing skills. - Correct Answer C

A young adult inpatient on a surgical unit in a hospital had an excision of a brain tumor 4 days ago. The patient is medically stable and participates in therapy 3 hours per day. Currently, the patient requires moderate assistance with BADL due to perceptual deficits and decreased balance. The patient will be discharged from this facility in one day. Which transitional setting would BEST support the patient's current level of function? A. Assisted living center B. Skilled nursing facility C. Acute inpatient rehabilitation unit D. Patient's home with outpatient therapy - Correct Answer c An 18 - month-old child has poor trunk control and has not yet developed upright sitting balance. The parent is finding it difficult to support and bathe the child at the same time and asks for suggestions on an adaptive device that can safely support the child during bathing. Which adapted seating equipment is BEST to recommend for use when bathing this child? A. Lightweight trunk support bath ring B. Shower bench with back support, side rails, and safety belt C. Adjustable hammock seat with oversized suction feet - Correct Answer c A 5 - year-old child who has mild developmental delay is learning to self-dress. Most recently, the child has mastered putting on and removing a coat as well as taking off pants with an elastic waistband. Which dressing task should the child learn to do NEXT based on the typical developmental sequence for dressing? A. Pulling up a jacket zipper B. Tying shoelaces C. Tightening and fastening a belt buckle D. Putting on socks correctly - Correct Answer a During which home maintenance task would symptoms related to constructional apraxia be MOST EVIDENT? A. Washing the interior sides of single-pane windows B. Using a roller brush to paint an interior wall of the home C. Vacuuming floors in the main living area of the home

D. Following illustrated instructions for installing curtain rods - Correct Answer d A client with myasthenia gravis wants to be independent with meal preparation. Which symptoms TYPICALLY associated with this condition would make this task difficult for the client to complete independently? Select the 3 BEST choices. A. Ideomotor apraxia B. Lower extremity weakness C. Oculomotor ptosis D. Cognitive decline E. Upper extremity tremors F. Decreased activity tolerance - Correct Answer B, E, F An inpatient who has been prescribed antipsychotic medication is attending an OT group. During one of the group sessions, the patient begins to show symptoms of tardive dyskinesia. What INITIAL action should the COTA take in response to this observation? A. Report the symptoms to the physician or charge nurse. B. Document changes in function due to the onset of symptoms. C. Monitor the duration of symptoms and the patient's reactions. - Correct Answer a An OTR is developing a community-based program for clients who live independently in the community and have diabetes. One of the goals of the program is for the clients to identify lifestyle changes to improve self-management of the disease. Which type of assessment tool represents a wellness model that can be used as part of the program evaluation to determine clients' progress toward this goal? A. Health risk appraisal B. Quality of life measure C. Contextual checklist - Correct Answer b An OTR who works in a home health setting is evaluating a client who has cirrhosis of the liver and substance use disorder. The client requires moderate assistance for ADL due to generalized weakness and fatigue. The client has ascites, lower extremity edema, and multiple hematomas on the body in various stages of healing. Which intervention is CONTRAINDICATED for this client?

A. Progressive resistive exercise to increase strength and activity tolerance B. Dynamic sitting and standing balance techniques when shifting the center of gravity C. Dyspnea relief postures in a sitting position during bathing and grooming - Correct Answer a An inpatient had a total knee replacement 4 days ago. The patient is preparing for discharge to live at home with the spouse. Which information is MOST IMPORTANT to provide to the spouse prior to the patient's discharge home? A. Detailed descriptions about assistive devices issued B. Brochures about outpatient OT service availability C. Informational booklets about durable medical equipment D. Instructions about activity precautions and transfers - Correct Answer d a COTA is interviewing an inpatient who has a major depressive disorder and a substance use disorder. The patient has been unemployed since being fired from a manufactoring job 8 montsh ago. This loss of income has resulted in the patient becoming homeless. What information should the COTA gather FIRST in order to select effective activities for the patient's initial intervention? A. job related skills, training, experience B. current lifestyle concerns, perceptions, and priorities C. responses to structured leisure interest survey - Correct Answer B? A 15 - year-old adolescent inpatient has renal disease. The patient has been socially isolated as a consequence of the multiple medical procedures. One of the patient's goals is to "be with other kids." During an OT session, the patient begins to work on a simple task, but suddenly moves to a corner of the clinic to be alone, stating "the other kids can always do things better." Which intervention strategy would be MOST BENEFICIAL for meeting the patient's emotional and social needs during task completion? A. Have the patient engage in a simple but competitive game with just one peer .B. Provide a group task experience with two or three peers of a similar skill level. C. Allow the patient to find a safe place in the clinic to work alone .D. Assist the patient to successfully complete key steps with the current task. - Correct Answer B

A COTA witnesses an OT aide using a goniometer to measure a patient's upper extremity ROM. What action should the COTA take in response to this observation? A. Determine if the aide has established skills or service competency for this task. B. Show the aide how to use the instrument according to facility policies and procedures. C. Ask the aide to stop the activity and discuss the situation with the supervisor. - Correct Answer c An OTR who works in a memory care unit is leading a task group for several clients who have dementia. When transitioning to the next step of the activity, one of the clients begins shouting obscenities and flipping over tables and chairs. What IMMEDIATE action should the OTR take in this situation? A. Slowly approach the client and calmly ask the client to sit down. B. Escort the client to a secured location and report the incident to the charge nurse. C. Provide physical restraint until the client can regain control of behavior. - Correct Answer a What clinical symptom is typically present in the affected hand of a client who has severe carpal tunnel syndrome? A. Positive Tinel's sign at the wrist B. Decreased light touch of all digits C. Numbness of the small finger D. Atrophy of the extrinsic muscles - Correct Answer a An OTR who works in a hospital setting walks into a patient's room and notices the patient lying on the floor face down near the bed with a portable urinal nearby. The OTR immediately calls for assistance and attends to the patient. After the patient is brought to safety and the physician has been informed, the OTR prepares to complete an incident report. Which option presents the information the OTR should include when completing the incident report for this patient? A. The patient lost balance and fell forward when standing to use a urinal at the bedside. B. Upon walking into the room, it appeared to me that the patient had fallen on the floor. C. The patient was lying prone on the floor near the bed with a portable urinal close by. - Correct Answer C

COTA Weekly Exam Prep Question A student in the first grade has attention deficit hyperactivity disorder. Symptoms interfere with the student's ability to attend to verbal instructions and to finish assignments during a 30 - minute class. One of the intervention goals is to help the student complete a drawing activity in art class. What classroom strategies should the COTA recommend to the teacher for supporting this goal? Select the 3 BEST choices. A. Provide an example of what the finished art project should look like. B. Offer the student options for completing an alternative one-step creative project. C. Allow the student to take mini breaks at predetermined intervals during art class. D. Divide the activity into concrete steps that can be completed one at a time. E. Provide the student with wide barrel drawing utensils to use for the project. F. Reward the student with a sticker for every 5 minutes the student att - Correct Answer A,C,D An OTR is selecting a cognitive strategy for a client who has mild Alzheimer's disease and has difficulty sorting laundry into dark- and light-colored clothing piles. One of the client's goals is to independently complete laundry. Which intervention strategy would be MOST BENEFICIAL for the OTR to teach the client to support progress toward this goal? A. Collaborate with the client to create an easy-to-remember mnemonic. B. Modify the activity and teach the client how to divide the task into several steps. C. Post a color-coded sheet with picture examples for each category - Correct Answer C