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NCTRC: CHAPTER 11 EXAM
QUESTIONS AND ANSWERS
in the therapeutic recreation service delivery model, as the client gains in ability to make rational choices and become independent, the CTRS A: reduces control over the intervention B: provides a greater number of community integration activities C: focuses to a greater degree on the client's functional abilities D: switches focus to quality of life - Correct Answers -A what is likely to be the nature/role of CTRS in an acute care setting where the medical model is the mode of operation? A: design recreation participation programs for evening/weekend participation B: conduct one-on-one sessions with clients using leisure as a diversionary tool C: prepare individualized treatment programs based on physician's orders D: plan leisure education sessions so clients gain an awareness of leisure and life satisfactions - Correct Answers –C what is a primary outcome of completing a task analysis? A: behaviors needed to complete a skill are listed in a teaching sequence B: a hierarchy of skills used in an activity are prepared C: each behavioral area exhibited in an activity is compared with one another D: the time necessary for intervention is determined - Correct Answers -A while leading a reminiscing group at the long-term care facility, the CTRS was unprepared to console/counsel a patient when he talked about a traumatic and difficult childhood. The CTRS had inappropriately planned and analyzed the activity in which of the following domains? A: physical B: emotional C: social D: cognitive - Correct Answers -B which of the following documents most directly justify reimbursement for TR services? A: client assessment, treatment protocols, and quality improvement documentations B: flow charts and trend analysis C: utilization review documents, treatment protocols, and risk management studies D: policy and procedures manuals - Correct Answers -A for which group of clients is recreation participation programs most suited? A: clients who need to improve physical well-being and health
B: clients who need to develop new leisure time skills C: clients who need to develop functional skills D: clients who need to practice interaction skills in supervised situations - Correct Answers -D during a planning session for a community outing, the CTRS told the group that each person was a team member and was responsible for making decisions and helping to plan the outing. the CTRS was using which of the following types of leadership style? A: autocratic B: democratic C: laissez-faire D: motivational - Correct Answers -B which of the following is the BEST example of self-advocacy by someone with a mental illness? A: responding to a newspaper article saying that mental health services are a waste of money with facts about recovery B: going to the supermarket to buy groceries C: joining a weekly support group for individuals with mental illness D: bringing toys to a children's residential facility during the annual holiday toy drive - Correct Answers -A the CTRS can make which of the following assumptions about clients in a day care center for older adults? A: they are in need of acute medical care B: they have or can arrange transportation and have a reasonable level of health C: they live below the income poverty level D: they need reality orientation and remotivation training activities - Correct Answers -B in 2001, the world health organization defined quality of life as A: return to health after a lengthy period of illness or disability B: a person's perception of their overall health and well-being C: the achievement of homeostasis D: a major factor in ratings of patient satisfaction with health care services - Correct Answers -B the client, a 13-year-old boy, has been diagnosed with autism. the CTRS should be aware of which of the following possible effects of autism on leisure activity participation? A: reduced tolerance for heat B: inability to stay awake during activities C: strong need for multiple play partners D: inability to communicate preferences - Correct Answers -D focus charting is used when the treatment team wants to A: show similarities and differences between clients
D: guilty of malfeasance - Correct Answers -D substance-related disorders are categorized according to which axis in the diagnostic and statistical manual IV-TR? A: axis I- clinical disorders B: axis II- personality disorders; mental retardation C: axis III- acute medical conditions D: axis IV- psychosocial and environmental problems - Correct Answers -A the CTRS was interviewing the client and said, "I'm not sure what you mean by that. Can you explain it to me?" the CTRS was using which of the following communication techniques? A: teach back B: summarization of feeling C: confrontation D: request for clarification - Correct Answers -D Obsessive-compulsive disorder is categorized according to which axis in the diagnostic and statistical manual IV-TR? A: axis I- clinical disorders B: axis II- personality disorders; mental retardation C: axis III- acute medical conditions D: axis IV- psychosocial and environmental problems - Correct Answers -B during an assessment interview, the client stated, "I hate physical activities. They just wear me out. But my sister just loves to be involved in sports." The CTRS responded, "you don't like exercise, while your sister does." the CTRS was using which of the following communication techniques? A: probe B: summarization C: redirection D: confrontation - Correct Answers -B which of the following is an example of an interdisciplinary treatment team? A: each team member independently assesses and plans interventions for the client B: each team member is responsible for collaborating with others on identifying common goal areas; then selects the best intervention within his or her discipline C: each team member works across disciplinary boundaries to develop goals and plans, and often co-treatments D: each team member is cross-trained in each other's discipline and there are virtually no boundaries between disciplines - Correct Answers -B the CTRS wants to help clients with mental health issues increase physical flexibility. What activity is most appropriate for this purpose? A: yoga B: volleyball
C: softball D: core training - Correct Answers -A which of the following activities is most appropriate for improving clients' knowledge of the benefits of leisure? A: social interactions skill instruction B: knowledge of leisure resources C: leisure awareness D: leisure interest exploration - Correct Answers -C therapeutic recreation services are often included in a facilities' per diem rate which means that services are A: directly billable in 15-minute increments B: part of one daily charge for allowable costs C: established on a case-by-case basis D: discounted for large groups negotiated by insurance company - Correct Answers -B a CTRS wants to assess a patient's/client's ability to follow simple directions. the CTRS should assess behavior from which of the following domains? A: cognitive B: physical C: emotional D: social - Correct Answers -A which of the following is NOT a primary symptom of substance use disorders? A: inability to distinguish healthy and non-healthy eating B: difficulty withdrawing or eliminating the substance from one's routine C: continued choice to use the substance despite problems associated with use D: change in the individuals' tolerance for the substance - Correct Answers -A spina bifida typically results in which of the following activity limitations? A: paralysis below the lesion B: increased likelihood of blood disorders C: decreased attention span D: increased motor activity in the lower extremities - Correct Answers -A the diagnostic and statistical manual of mental disorders IV-TR classifies which type of disorders? A: mental illness B: intellectual disability C: cognitive impairments D: learning disabilities - Correct Answers -A clinical supervision is different than managerial supervision in that it A: can only come from CTRSs B: involves mentoring about practice situations and wisdom
D: equal illness, equal healthcare act - Correct Answers -A after administering the leisure diagnostic battery (LBD), the CTRS scored the client's sub-scales and found that the client had an external locus of control, among other findings. Which of the following client statements would confirm these assessment results? A: "I am a very goal-oriented person." B: "I want you to make that decision for me." C: "i am saving money to go on a vacation next month." D: "i followed up on our conversation and I'm entering that writing contest next week." - Correct Answers -B a clinical CTRS and a community CTRS are conducting a marketing analysis to set-up a joint outpatient TR rehab program. Which statement identifies a factor that would be considered an opportunity to promote this joint venture? A: PT and OT are currently contracting their services in the community B: a private health care company is providing in-home care in the area C: patient length of stay in inpatient rehabilitation is continuing to decrease D: an ADA survey is presently being conducted in the community - Correct Answers -C when an assessment is norm-reference, it means that the assessment was/is A: interpreted based on the average scores for that person's peer group B: based on a normal population's average scores C: references using the major texts in the therapeutic recreation literature D: based on scores of normal behavior expected within that developmental life stage - Correct Answers -A a CTRS who works with 3- to 5- year-olds in a preschool program, uses Erikson's theory of psychosocial development to improve the age-appropriateness of his programs. specifically he teaches the children to A: know when to take action and when to use self-restraint B: play games that require intra-group social interaction skills C: meet their own needs through intrinsically motivated play D: recognize their own strengths and weaknesses - Correct Answers -A which of the following is a question that addresses content validity? A: how accurately does current content reflect future content? B: how closely related are items on a single assessment? C: how consistent are scores over different parts of the assessment? D: how adequately does the sample of assessment items represent the totality of the content to be measured? - Correct Answers -D a CTRS has been hired as Director of therapeutic recreation services at the local rehabilitation center to start a new program of services and wants to provide the highest quality services available. She reviews which therapeutic recreation standards to assure program compliance?
A: ATRA standards of practice B: Joint commission (JCAHO) standards C: NCTRC certification standards D: ATRA code of ethics - Correct Answers -A which of the following is NOT a benefit of evidence-based practice A: helps focus intervention programs on client outcomes B: improves relative consistency from program to program C: eliminates need for program evaluation data D: helps determine content of client assessments - Correct Answers -C the intent of the federal initiative called healthy people 2020 is to A: heighten awareness of the overall health of Americans, including those with disabilities B: ensure that Americans understand that eating fast food is the prime predictor of obesity C: monitor the increasing amount of time Americans are spending on exercising D: monitor the effects of low-carbohydrate diets on the obesity of Americans - Correct Answers -A the CTRS had eight four-year-ole children who had behavioral problems (like kicking, biting, and spitting on others) compete with each other on two bowling teams. Instead of realizing the chilren had difficulty interacting in the ______________ interaction pattern and having them practice skills at that level, she had them participating in an activity that required a ________________ interaction pattern, and thus, the children became aggressive and the activity failed. A: aggregate, intergroup B: intraindividual, extraindividual C: aggregate, interindividual D: cooperative, competitive - Correct Answers -A Which statement best describes an outcome of completing activity analysis? A: activities are referenced according to their difficulty B: the amount of time necessary for the clients to acquire the skill is determined C: the skills necessary to perform the activity are identified D: the types of adaptations needed by clients are determined - Correct Answers -C in which of the following steps does the CTRS place the client into the most appropriate programs? A: assessment B: program planning C: program implementation D: program evaluation - Correct Answers -A while teaching adolescents with mild intellectual disability the card game of "pinochle," the CTRS found that the rules were too complicated for the clients to be successful. the
B: "i don't care where we eat, you always choose anyway" C: "I'd like to try that new Italian restaurant by the mall" D: "You should know where I wan to eat by now" - Correct Answers -C A CTRS working in a psychiatric facility needs to find information about specific mental illnesses and conditions. Which of the following references would be MOST appropriate? A: physicians' desk reference B: diagnostic and statistical manual-IV-TR C: therapeutic recreation and the nature of disabilities D: comprehensive accreditation manual for behavioral health care - Correct Answers -B the client tends to blame others when something goes wrong and had a difficult time accepting responsibility for her actions. What therapeutic recreation facilitation technique is MOST LIKELY to be helpful for this client? A: reality therapy B: anger management C: resocialization D: validation therapy - Correct Answers -A a facility that provides comprehensive services for individuals with physical disabilities on an inpatient and outpatient basis is called a A: community mental health center B: physical medicine and rehabilitation center C: sheltered workshop D: homebound program - Correct Answers -B in human anatomy, the scapula performs what function? A: it produces extension and flexion of the upper leg B: it forms the should joint where many bones and muscles originate C: it forms the elbow joint with the humerus proximally D: it serves as the foundation for speech - Correct Answers -B when assessing a child's ability to remain seated during a 30-minute activity, the CTRS would look for which of the following behavioral characteristics? A: duration of behavior B: frequency of behavior C: intensity of behavior D: rate of the behavior - Correct Answers -A the client, a 10 year-old boy, has been diagnosed with attention-deficit/hyperactivity disorder (ADHD). the CTRS should be aware of which of the following possible effects of ADHD? A: decreased ability to follow directions B: blunted feelings C: above average organizational skills
D: loss of personal sense of identity - Correct Answers -A the joint commission (JCAHO) identifies three categories of outcome measures; health status, patient perceptions of care, and client performance outcomes. The CTRS reports on clients' functional improvement, which falls in which of the following outcome categories? A: health status B: patient perceptions of care C: client performance outcomes D: none of the above - Correct Answers -C the symptoms of anorexia nervosa are A: refusal to eat, loss of hair, and frequent vomiting B: binge eating, depression, and weighting constantly C: secretive behavior, hyperactivity, and depression D: growth o f fine body hair and loss of 25 percent body weight - Correct Answers -D the MDS 3.0 is an assessment completed for individuals in which type of setting? A: correctional institutions B: adult day care centers C: outpatient rehabilitation programs D: nursing homes - Correct Answers -D where is he latissimus dorsi muscle located in the human body? A: leg B: neck C: abdomen D: mid-back - Correct Answers -D current research has shown that the most common TR services billed for reimbursement include A: client assessment, leisure education, and community re-entry B: client assessment, social skills training, and ADLs C: stress management, group activities, and outpatient services D: values clarification, leisure education, and functional skills training - Correct Answers -A all of the following are considered disadvantages of reviewing medical records instead of interviewing or observing the client EXCEPT A: reducing redundancy for the clients B: potential inaccuracy of the data C: limited amount or kinds of data D: reducing personal contact with the client - Correct Answers -A muscle atrophy is caused by which of the following situations? A: lack of intelligence
spina bifida is a condition in which the spinal column A: was injured by traumatic force B: is injured posthumously C: collapses upon itself D: has failed to develop - Correct Answers -D Which of the following is NOT a characteristic of "high performance teams" of people working in a health care environment? A: decisions are made by group members B: each person shares in the responsibility for success C: each person works in his or her "work silo" D: responses to request are timely and efficient - Correct Answers -C which part of the SOAP progress note is the following statement, "the client lacks adequate knowledge of community resources to be able to function independently." A: S- subjective B: O- objective C: A- assessment D: P-plan - Correct Answers -C which of the following is an example of "objective" data that may be recorded in a progress note? A: the client stated, "I really got a lot out of this program!" B: the client's family said the client was progression with the outpatient therapy C: it appears the client is depressed D: the client goes to his room immediately following all sessions - Correct Answers -D according to the transtheoretical model, if the client has been walking three miles every other day in order to increase his physical activity levels, he is at what stage of of behavior change? A: precontemplation B: contemplation C: preparation D: action - Correct Answers -D compare the two progress notes written below:
- Friday, 12/11- Pt. seemed withdrawn on community outing Friday night
- Friday, 12/11- While pr. was attending community outing Fright night, she conversed only once with other pts. for approximately one minute. Pt. remained alone in the corner of the van during transit, and stayed at a separate table during most of the night. Progress note 2 is the better written than progress note 1 because it A: states more consistent information B: relies on profession judgments C: state behavior rather than conclusions D: uses less professional jargon - Correct Answers -C
in establishing an environment that embraces multiculturalism, the CTRS would A: make sure all ethnic holidays are on the activity calendar B: introduce signage that includes both English and Spanish, and possible French C: recognize people's difference while establishing a sense of unity D: follow the agency directions with regard to nondiscrimination toward foreigners - Correct Answers -C an insurance carrier's cost control method of paying a prearranged amount for specific service, no matter what the actual cost of those services might be, is called A: third-party reimbursement B: prospective payment C: cost allocation D: unit cost - Correct Answers -B the best indication that pain is present is A: regression to child-like behaviors B: self-report of the client C: swelling and redness in the area D: a similar occurrence in the past 24 hours - Correct Answers -B the CTRS might use each of the following to assess leisure interests of a client EXCEPT A: administering an activity interest inventory to the client B: interviewing the client regarding her leisure interests C: interviewing the family and/or significant others regarding the client's leisure interests D: administering the functional independence measure (FIM) - Correct Answers -D which of the following is NOT an appropriate question for a cognitive assessment for older adults in long-term care? A: what day is the week is it today? B: how would you find someone to play cards with while here in the facility? C: how often do you talk with family members? D: what leisure activities did you like o do before you became a resident here? - Correct Answers -C the CTRS should use which of the following activities to improve the dynamic balance of youth with hearing impairments? A: standing on one foot, with arms outstretched B: leisure education C: running D: tumbling - Correct Answers -D the CTRS observes the client's ability to complete a five-minute walking endurance test. what functional behavior is being assessed? A: cognitive
