NBCOT Full Practice Exam Flashcards
An OTR® is working with a 5-year-old child with autism to develop in-hand manipulation skills. Which activity is BEST to help this child develop shifting?
Separating Playing Cards
Shifting: moving objects using pads of the fingers for repositioning
At what stage of Alzheimer’s disease (AD) does nerve cell damage cause significant motor impairments that limit the ability to complete life tasks?
Late Stage
An OTR® is providing intervention to a client with an anxiety disorder who hyperventilates when faced with difficult work tasks. The OTR works with the employer to identify work tasks in which the client can be successful. What frame of reference does this intervention suggest?
Cognitive Disability
uses the client’s strengths to allow for function like training c/gs for environmental modification
What would be considered the first line of treatment in the acute setting for the medical management of a cardiovascular accident (CVA)?
Thrombolytic agents
Through what type of interventions is the field of occupational therapy MOST likely to be successful in demonstrating a population impact on the problem of cocaine and amphetamine abuse disorder?
Preventive
What is SETT?
Allows for collaboration and communication among educational team members to support good decision making to determine the AT needs of a student.
The client added that the low back pain started after the stressful life events. Malingering and fear of illness do not seem to be a part of this scenario. What is the client’s likely diagnosis?
Conversion Disorder
What presentation does a child with congenital club hand will have?
Partial or full absence of the radius and bowing of the ulnar shaft
aka Radial club hand
For a client with C5 spinal cord injury (SCI) in the acute phase of rehabilitation, what is the BEST position to place the client’s forearms in?
Pronation
An OTR® conducts a screening with a second-grade student who was referred to occupational therapy for handwriting legibility. In which way would the OTR® assess legibility during the screening?
Legibility Formula= calculate the number of written words dividing to the number of legible word
The Children’s Health Insurance Program provides coverage for which group of people?
Children and families whose income is too high for Medicaid but too low to afford private insurance
The client with diabetes and obesity is bedbound and has developed a decubitus ulcer. Where is the decubitus ulcer MOST likely to occur on the client’s body?
Elbow
decubitus ulcer most commonly occurs at a boney prominence that been compressed for a while
During the range of motion (ROM) assessment, the OTR® notices that the client has more passive ROM (PROM) in bilateral shoulder flexion than active ROM (AROM). What could be the cause of these ROM limitations?
Muscle Weakness
The caregiver of a client with Alzheimer’s disease questions the home health OTR® about a recent increase in the client’s dosage of donepezil (Aricept) prescribed by the physician. What is the OTR®’s most appropriate suggestion for the caregiver?
Observe the client for signs of dizziness, which increases potential for falls.
Which of the following elements is an important component of the Recovery Model?
A: Peer support and teaching
Person-driven and belief that a person with mental illness can recover and lead a satisfying life.
Key to RECOVERY: Connectedness and Social supports
Is this true? A health care professional other than an OTR® can supervise occupational therapy students on Level I fieldwork.
True
An OTR® wants to use a cognitive strategy to address a motor learning deficit with a client. The client is having difficulty with lower body dressing after hip replacement. Which is the BEST example of a cognitive strategy to use with this client?
Client imagines using a dressing stick while the OTR describes the process of lower body dressing as the client visualizes completing the activity.
Use guided imagery
What is the COTA’s role during evaluation process
Can perform delegated assessments and provide reports of a client’s capabilities to the OTR®
What organization provides resources and advocates for policy related to community mobility for children?
SAFEKIDS-USA
Which is the MOST appropriate position for a client with a hip replacement to perform lower-body dressing?
Sitting on the side of the bed or on a chair with arm rests
What FOR states that a child’s true performance occurs in natural environments?
EHP
What FOR assesses the client’s current cognitive functioning to maximize supports in the environment that will facilitate maximal occupational performance?
Cognitive-Disability Model
What should the OTR®; do for the affected upper extremity when positioning a client with hemiparesis in side lying on the affected side?
Protract the arm forward
What should you expect for a child at age 2 to complete IND?
- doff coat (unfastened/ubnutton)
- doff shoes untied
- pull down pants
- locate armholes in shirt
Community mobility is defined as?
moving around in the community or using public or private transportation,
This FOR approach makes use of projective media such as clay, magazine collages, painting, and poetry.
Psychodynamic approach
What are essential job functions?
Functions that an employee must be able to complete, with or without a reasonable accommodation
One of the inpatients who has a C7 tetraplegia wants to play tennis with the other patients. Which adaptation would be MOST BENEFICIAL for enabling the patient to participate in this game?
Fasten hook-and-loop straps to secure the paddle to the hand.
to compensate for limited grasp and dexterity
An OTR® is working with a child on shoe tying. At around what age can the OTR® expect a typically developing child to master this skill?
6
Which functional writing activities should a 6 y.o child be able to complete without adult assistance?
Copying a triangle, printing own name, and copying most letters
During a journal reading activity, a client becomes very emotional when disclosing sensitive personal feelings on how the client’s family perceives the client’s admission to the mental health facility. Several other clients recognize that they share the same feelings and perceptions, which makes the client feel better. According to Yalom’s therapeutic factors in groups, what curative factor is this?
Universality
-gained from other members’ sharing of similar feelings, thoughts, and problems.
An OTR® evaluates a client who has just entered the plateau phase of Guillain-Barré syndrome (GBS). When assessing ADLs, what would the OTR® most likely expect to see?
Edema and weakness in the lower extremities, which makes bathing and dressing difficult
An OTR® is working with a client with C5 spinal cord injury. In which position is it BEST to splint to prevent deformity in the acute stage of injury?
Wrist extension, thumb opposition
An adult with posttraumatic stress disorder (PTSD) is admitted to an inpatient psychiatric unit after a suicide attempt. What would be the BEST initial intervention for an OTR® to attempt with this client?`
Relaxation-focused group
Describe the progression of DMD?
The condition progresses quickly, and children often need to use a wheelchair by age 9.
Which consideration is MOST important for a safe transfer?
Client’s physical and cognitive status
What evidence does the literature provide that supports a psychosocial focus with older adults and driving cessation?
Driving cessation has been linked to social isolation, depression, and early nursing home admission.
Approximately what percentage of the U.S. rural population does NOT have access to public transportation?
75%
According to the Occupational Therapy Practice Framework, which of the following elements is part of the domain of occupational therapy?
Domain of OT
- Context and Environment
- Occupations
- Client Factors (values, body fx, body structures)
- Performance Skills (motor, processing, social interaction)
- Performance Patterns (habits, routines)
What physical indicator suggests that the child might be receiving too much vestibular input?
-nausea, dizziness, blanching, HYPERACTIVE, lethargy
Why might a client with early-stage dementia appear rigid in routines?
May be compensating for memory loss
How do the majority of older adult nondrivers in the United States travel in the community?
AS passengers driven by someone else in private cars
What does the festinating gait look like?
Small and rapid
An OTR® in an outpatient facility is working with a client with Guillain-Barré syndrome (GBS) who is in the recovery phase. During ADL and IADL tasks, on what is education primarily focused?
Energy Conservation
An older adult client is having difficulty locating curbs, stairs, and objects in low-lit areas within the home environment. Which area is MOST relevant to assess during the evaluation?
Contrast Sensitivity
-Can limit person’s ability to locate curbs, stairs, objects in low light within environment/
What is accommodative facility?
the speed of focus adjustment and ability to maintain focus over time
-may have problems with driving
Which tissue needs to be debrided for healing of a wound to occur?
Black or yellow necrotic tissue
-possibly infected tissue need to be removed for healing to occur
An OTR® is instructing a client post–hip surgery on after-toileting cleansing while adhering to appropriate hip precautions. What method is the BEST to prevent further injury?
wipe between the legs in a sitting position on an elevated toilet seat
With which of the following clients would it be MOST appropriate for the OTR® to use guided imagery?
Generalized Stress Disorder
Contraindicated for people with hallucination potential
During an intervention session in which a client with unilateral neglect reads single letters across several lines, the OTR® uses a vertical line on the left side of the page to cue the client to read the correct line. Which intervention technique is the OTR using?
anchoring
cueing that brings attention back to the neglected side
What is the BEST recommendation regarding frequency of pressure relief technique?
Every 30 mins
An older adult client who has difficulty completing feeding tasks demonstrates compensatory movements including holding food close, tilting the head when eating, and closing one eye when moving the fork to the mouth. Which factor would the OTR® assess FIRST during evaluation?
Visual foundation skills
comprised of visual acuity, oculomotor control, pursuits, saccades, fields
A client presents with decreased orientation. What is the most effective strategy for an OTR® to implement to assist with this cognitive impairment?
Visual reminders
like providing orientation poster with day/time information listed in common areas
In addition to being a means to move from one place to another, what is the relationship of community mobility to participation?
Occupation enabler
An OTR®; is concerned with preventing shoulder pain in a client with hemiparesis in the acute stages of stroke recovery. Which intervention is appropriate to prevent shoulder pain in this client?
Move the upper extremity with external rotation, shoulder flexion within 90°, and scapular protraction to allow for optimal motor recovery by promoting soft-tissue elongation.
The OTR® would like to put together focus groups to explore the experiences of individuals who are adjusting to spinal cord injury. What study design methodology would be best for this type of research project?
Phenomological
focus groups with open-ended interview Q’s
The psychiatrist describes an uninterrupted 18-month period of illness that includes visual and auditory hallucinations. What type of issues would the OTR® expect to see when the client attempts to do a task?
Aggressive outbursts
Pt has schizophrenia and frustration and aggression with tasks is common.
Based on observations, the OTR® wants to improve the child’s classroom environment to promote more opportunities for success. Which rational intervention (RI) approach would the OTR® use?
Facilitation
-characterized by observing the child and responding to child’s needs
Rational Intervention (RI): Matching
Match response to the child’s behavior
RI: Monitoring
observing the child
RI: Gentle Correcting
Alter the environment reminding child of the expectations, model appropriate bx, and redirect
What conclusion can you draw for a new resident moving his wheelchair forward by gripping the front of the push rim and giving it multiple tiny pushes?
Seat back height is too high.
When the seat back height is above the lower angle of the scapula, it can prevent adequate shoulder extension
What is kyphosis?
an abnormal rounding of the upper back
pelvis rotate posteriorly increasing trunk flexion
pathological deterioration of the vertebrae of the thoracic spine
Which intervention strategy would be appropriate when teaching a compensatory approach for the production of written language to a child who has a diagnosis of developmental coordination disorder?
Instruct the child in keyboarding
Which STORCH infection would require the OTR® to use universal precautions to prevent the OTR® from contracting an infection when working with the infant and mother?
Cytomegalovirus
because the virus is dormant and therapist may still contract it
The chart indicates that the Down syndrome client has a history of patent ductus arteriosus (PDA). What are the risks associated with this condition?
Heart failure and inadequate brain O2
A client with rheumatoid arthritis (RA) presents with the right index finger in 30° of proximal interphalangeal (PIP) flexion and 20° of distal interphalangeal (DIP) hyperextension. What type of finger deformity does the client have?
Boutonniere
What are diagnostic symptoms for borderline personality disorder ?
Self-mutilation, destruction, unstable mood, fears of abandonment that lead to instability
The OTR® notes a slight catch of the upper extremity in the midrange of motion. Which of the following occurred during the assessment of this movement?
Spasticity
An OTR®; who passed the initial NBCOT exam has decided not to be recertified through NBCOT. Which consequence will result from the OTR’s decision?
may practice occupational therapy in a state that does not require certification, but the OTR’s credentials will change to OT.
An OTR® is preparing a forearm splint for a client with a high complete spinal cord injury. What surface of the client’s forearm should the base of the splint rest upon?
Dorsal
An OTR® is training a client with a new transradial amputation to wrap the residual limb with an elastic bandage. What is the PRIMARY reason for wrapping the residual limb?
Develop a tapered distal end
What is occlusion?
Covering part or all of one eye.
OT can apply only under the direction of a physician?
What is windswept deformity?
Pelvis rotated to one side, resulting in the spine, trunk, and thighs moving to the opposite side
An OTR® is working with a client who has just had a total hip replacement using an anterolateral approach. Which type of equipment is MOST important for maintaining appropriate hip precautions?
Abductor wedge
What is the first step in eccentric viewing techniques?
increasing the client’s awareness of the central scotoma, or blind spot
An OTR® is performing upper-extremity activities with a client experiencing left hemiparesis. The OTR® notes a decrease in ROM in the left upper extremity. What factors BEST describe this decrease in ROM?
EDEMA, JOINT CONTRACTURE, WEAKNESS
An OTR® is evaluating a client with Parkinson’s disease who lives at home but has begun to have mobility challenges. Which intervention is BEST to facilitate lifestyle changes to improve safety?
Rhythmic beat technique to facilitate mobility
