Download Occupational Therapy Practice Test Study Guide and more Exams Occupational therapy in PDF only on Docsity!
1 /
NBCOT Exam Questions with Correct Answers 2024
Solutions
1.OTR Study Guide Domain 1: Practice Test 1An OTR who works in an elementary school is preparing to evaluate a student in fifth grade who has a learning disability and ADHD. Which standardized assessments would be MOST EFFECTIVE for the OTR to include as part of the evaluation process?: Bruininks-Oseretsky Test of Motor Proficiency (BOT) and Evaluation Tool of Children's Handwriting (ETCH) These assessment tools are used to measure skills and abilities that are associated with school-related occupational performance. 2.A 2-year-old toddler, who has a developmental delay, recently learned to release a 2-inch (5.08 cm) ball into a large toy box. What fine motor skill should the OTR work on NEXT?: Complete a 3- to 4-piece puzzle. In the development of play occupations, a child who is able to release an object into a toy box would NEXT be expected to be able to put together a 3- to 4-piece puzzle. O'Brien, J. C., & Kuhaneck, H. (2020). Case-Smith's Occupational therapy for chil- dren and adolescents (8th ed., p. 118). St. Louis, MO: Elsevier. 3.An OTR is evaluating an inpatient who recently had a severe TBI and is emerging from coma. The patient is functioning at a Level III (Localized response) on the Rancho Los Amigos scale. Which is the FIRST cognitive function the OTR should assess?: Level of arousal A component of the evaluation for a patient who is functioning at a Level III (Localized response) on the Rancho Los Amigos scale is to screen the patient's level of arousal and alertness. 4.Domain 1: Practice Test An OTR is developing an intervention plan using a bottom-up approach for clients who have hemiplegia and hemi-neglect secondary to having a CVA more than one year ago. Which of the following intervention techniques has evidence supporting its efficacy for reducing the effects of "learned non- use" through cortical reorganization?: Constraint-induced movement
2 / therapy (CIMT) This is an evidence-based functional approach for promoting use of a hemiparetic upper extremity. 5.OTR Study Guide Domain 1: Practice Test For a typically developing child, which postural reflex becomes evident be- tween 6-9 months of age and continues throughout life?: Forward protective
4 / In the developmental sequence of gross motor development and mobility skills, a child who has mastered four-point positioning would be expected to progress to rocking on hands and knees NEXT.
5 / 10.An OTR working in an inpatient mental health setting is using a cognitive behavioral approach to select an intervention activity for a young adult un- dergoing treatment for symptoms associated with body dysmorphic disorder. The patient is employed in a successful career and enjoys outdoor activities such as jogging and hiking, but has difficulty forming and maintaining inter- personal relationships. One of the patient's goals is to improve self-image and the ability to express feelings. Which activity would be MOST BENEFICIAL to include as part of the intervention for supporting this goal when using this approach?: Teaching the patient to use a dysfunctional thought record for describing distressing situations and emotional responses Having the client maintain a journal of distressing events and associated feelings or thought processes is integral to a cognitive behavioral approach. 11.OTR Study Guide Domain 1: Practice Test An OTR is using a top-down approach to select interventions for a client who has unilateral neglect secondary to a CVA. Which intervention would be MOST BENEFICIAL to include as part of the client's intervention when using this approach?: Place commonly used toiletry items to the client's affected side during self-care tasks. This represents a top-down approach because it focuses on a strategy the client can use in everyday life. Top Down Approach: The occupational therapist evaluates the patient's functional status in relation to his or her daily occupations and develops the treatment plan based on the patient's ability to participate in those occupations. To acquire or restore the skills necessary to participate in occupation. To maximize existing skills and adapt activities to allow independence in occupation. Addresses functional performance. Treatment goals address participation in func- tional activity at the existing level of disability.
7 / meals when discharged home. What INITIAL action should the OTR complete to support the patient's success with this goal?: Identify the patient's typical mealtime routines and habits. An integral part of developing a client-centered intervention plan is to learn about the client's typical mealtime routines and habits. 13.OTR Study Guide Domain 1: Practice Test An OTR working in an outpatient setting is completing an initial interview with an older adult client who has recently been diagnosed with a progressive neurological disease. What method should the OTR use during the course of the interview to communicate effective listening and client- centered under- standing?: Share examples of adaptations that help to overcome adversity. The OTR is demonstrating client-centered practice by using active listening skills and encouraging the client to continue to participate in the discussion. 14.Which dressing task requires the MOST challenging integration of perfor- mance skills and patterns for a typically developing 3-year-old child?: Unfas- tening the zipper of a front-opening jacket This skill requires a complex integration of visual and somatosensory systems that typically develops by the third year of age. 15.OTR Study Guide Domain 1: Practice Test A client who has schizophrenia is participating in OT to improve functional living skills. The client's goal is to be able to independently prepare family meals. The client has successfully used a checklist strategy to gather and keep track of items while preparing a simple cold snack. Which of the following tasks would present a "just right" challenge when using the checklist strategy to progress towards the client's goal?: Setting the dining table for a group meal Results from an analysis of the task the client has mastered (gathering and keeping track of items while preparing a simple cold snack) and the task of setting the table for a group meal demonstrates that the tasks have similar demands. To successfully implement the checklist strategy during meal preparation, the client will benefit from using it across multiple task components and contexts. 16.OTR Study Guide Domain 1: Practice Test
8 / Which of the following options represent a condition that requires close monitoring of a client's wound due to having the GREATEST risk for infection? A.Vascular ulcer left uncovered during healing
10 / The client has good motor control but has residual problems with executive
11 / functioning. One of the client's goals is to be independent with homemaking tasks. During a meal preparation session, the client cooks a meal, but makes no attempt to clean the cooking utensils and dishes or put the food items away after completing the cooking task. Which area of executive function appears to be MOST affected by the TBI as evidenced by this behavior? A.Emergent awareness B.Selective attention C.Environmental gnosia D.Episodic memory: A.Emergent awareness B.Selective attention C.Environmental gnosia D.Episodic memory Deficits in emergent awareness are characterized by difficulty or inability to recog- nize and correct errors in performance. 20.What critical functional advantage is TYPICALLY observed in a client who has a complete C6 spinal cord injury compared to a client who has a complete C5 spinal cord injury? A.Improved gross grasp from innervation of the extrinsic flexors B.Ability to use triceps strength during transfers C.Ability to use the radial wrist extensors to supplement grasp D.Improved trunk control to bend side to side without falling: C. Ability to use the radial wrist extensors to supplement grasp Clients who have a complete C6 spinal cord injury TYPICALLY have innervation of the radial wrist extensors. This allows the use of a tenodesis grasp to attain a higher level of functional independence. 21.OTR Study Guide Domain 1: Practice Test A 5-year-old child has mild developmental delay. Motor and praxis skills are intact. Which action would be BEST to observe when screening emotional regulation skills? A.Taking turns while playing a board game B.Responding to the feelings of others
13 / Emotional self-regulation is BEST observed during a situation where the child is responding to the feelings of others. 22.An OTR is evaluating a client who has an ulnar nerve injury at the wrist level of the right dominant extremity. During which task would this injury be MOST evident? A.Turning a key in the car ignition B.Operating a desktop calculator C.Holding coins in the palm of the hand D.Carrying a briefcase: Ulnar nerve palsy at the wrist impairs the hypothenar muscles and first dorsal interosseous muscle resulting in the difficulty turning a key or performing a lateral pinch. 23.OTR Study Guide Domain 1: Practice Test An OTR is administering the Functional Independence Measure (FIM) as part of the initial evaluation of an inpatient who had a left CVA with aphasia 5 days ago. The patient has right hemiparesis and requires moderate assistance to maintain balance while standing. What action should the OTR take when completing this assessment? A.Observe as the patient performs ADL routines with the typical methods used prior to admission. B.Introduce a reacher and other adaptive equipment to maximize patient's level of performance. C.Provide the patient with visual and tactile cues to sequence each step of the task.: A.Observe as the patient performs ADL routines with the typical methods used prior to admission. Administration of the Functional Independence Measure (FIM) includes assessing the patient's complete ADL routines with the typical methods used prior to admis- sion. 24.OTR Study Guide Domain 1: Practice Test A patient in a skilled nursing facility had a CVA one week ago. An initial screen- ing indicates the patient has hemiplegia, ambulates using a quad cane and has good memory. Nursing staff report the patient consistently has difficulty finding the way from the dayroom to the dining room. What type of assessment should be included as part of the initial evaluation to determine the underlying neurobehavioral problem associated with this difficulty?
14 / A.Functional assessment of topographical orientation and visual perception B.Attention and depth perception subtests from a standardized cognitive assessment C.Cognitive-behavioral assessment of executive function during a familiar ADL task: A.Functional assessment of topographical orientation and visual percep- tion Since the patient has intact memory, the behavior suggests topographical disorien- tation. The test for this is typically a functional test. Contributing visual perceptual deficits should also be considered. 25.An inpatient had a myocardial infarction 2 days ago and is beginning phase I cardiac rehabilitation. Which activity is an ESSENTIAL component of the initial assessment with this patient?: Monitoring the patient's orthostatic tolerance during movement For the safety of the patient, the patient's physiologic response to activity must be monitored during this early phase of cardiac rehabilitation. 26.OTR Study Guide Domain 1: Practice Test An OTR is evaluating the visual function of a patient who is emerging from coma. The patient opens eyes spontaneously and in response to auditory stimulation. What visual function is MOST IMPORTANT for the OTR to observe in a patient at this level of function?: oculomotor control It is beneficial to assess basic visual skills such as oculomotor control when a patient is emerging from coma. 27.OTR Study Guide Domain 1: Practice Test A client in an outpatient setting sustained an acquired brain injury 2 months ago. Evaluation results indicate the client has functional ROM and strength, but continues to require assistance with ADL due to moderate visual and vestibular processing deficits. Which intervention represents an adaptive ap- proach for improving the client's performance in areas of occupation? A.Incorporating progressively more challenging tasks into a functional activ- ity B.Engaging the client in valued activities that promote postural stability
16 / C.Teaching the client to use proprioceptive cues during functional activities D.Providing the client with an exercise program for improving gaze stabiliza- tion: C .Teaching the client to use proprioceptive cues during functional activities The adaptive approach places emphasis on the client's abilities. This top-down ap- proach aims to facilitate functional performance through compensatory techniques. 28.A high-school student with autism spectrum disorder excels academically but has difficulty organizing assignments and homework. The OTR plans to evaluate the student's relative strengths and weaknesses to guide interven- tion planning. One of the student's goals is to learn an organization system. Which of the following is the BEST assessment for this purpose? A.Canadian Occupational Performance Measure (COPM) B.Behavior Rating Inventory of Executive Function (BRIEF) C.Executive Function Performance Test (EFPT): Behavior Rating Inventory of Executive Function (BRIEF) The objective of the Behavior Rating Inventory of Executive Function (BRIEF) is to evaluate self-regulation and executive function in adolescents who have neurologi- cal or developmental conditions. 29.Short Form-36 Health Survey (SF-36): This is a survey used as a measure of general health and well-being. It has been used in medical outcomes studies and is sensitive to change in health status. 30.OTR Study Guide Domain 1: Practice Test A client has a peripheral neuropathy of the dominant hand. A screening indicates thenar muscle atrophy with loss of thumb opposition and palmar abduction, inability to pick up a key or coin from a table top, and decreased grip and pinch strength compared to the non-affected hand. Based on these findings, where on the client's hand would an OTR expect to find sensory disturbances during a Semmes-Weinstein monofilament assessment? A.Volar and dorsal surfaces of the small finger and radial half of the ring finger
17 / B.Volar surface of the thumb, index, long, and radial half of the ring fingers C.Entire palm and tips of the index, long, ring, and small fingers: B.Volar surface of the thumb, index, long, and radial half of the ring fingers
19 / sessment tool administered to adults who have mental health conditions, neurolog-
20 / ical impairment, and intellectual disability Features include:
- measures affective, cognitive, and performance ability
- contains 2 subtests: Task-Oriented Assessment (TOA) and Social Interaction Scale (SIS) -Assessment of Task Performance: -assesses the cognitive, affective, performance, and social interaction skills required to perform activities of daily living -Method: brief interview, Task Oriented assessment, Social interaction Scale, Op- tional self-report social interaction questionnaire, and perceptual motor screening -population= adults with psychiatric, neurological, or developmental diagnoses -measures cognition, affect, and performance -administration contains two parts: test & interview -behavioral anchored rating scale -involves a task of drawing a house floor plan -80-120 minutes 35.acute care hospital: Stay can be as little as one day Abrupt change in contact may influence level of performance Stress associated with multiple medical tests and interventions Medical lines and tubes may impact level of occupational performance Emphasis of care is on promoting medical stability Associated with a sudden change in the clients functional abilities Therapeutic intervention approaches are applied within the
