NBCOT RATIONALE (Ethics, Work, SOP, PEDs, mixed) Flashcards
What is the difference between intensity, frequency, and duration?
Intensity= light, moderate, or heavy. But in terms of session–> the amount of time spent in a session.
Frequency= sessions per day or per week
Duration= length of time over the course
In order to identify a client’s essential job function, what should the comprehensive FCE assess?
Assess the demands outlined from the Dictionary of Occupational Titles (DOT) job classification and description.
During the platuea phase of Guillan-Barre Syndrome, what does the OT typically observe in terms of communication?
inability to communicate vocally. (because this disease paralyze the head and neck muscles)
For clients with MS, what is an effective strategy to recommend in dealing with fatigue to complete tasks within the day?
Scheduling tasks in intervals throughout the day will best address energy conservation and compensate cognitive strategy.
What is correlation coefficient?
Compares the variables of one measure to the variables of another measure.
Closer to 1= the stronger the relationship between variables.
e.g: .71= strong positive correlation
What are some interventions you can do with a pt w/ median nerve injury after surgery?
AROM of wrist, thumb, fingers 24-48 hrs post/op. MEDIAN NERVE GLIDES
Besides endurance, what should the OTR assess for a pt who has GBS in the acute phase?
Sensation
What are fading approaches?
Reducing or eliminating supports as client skills improve and develop.
What is scaffolding method?
The OT helps the client break down parts of the task that are difficult and the client completes it.
How should you address fatigue while building strength during the recovery phase of GBS?
Taking rest periods without pushing to the point of fatigue while gradually increasing tolerance for activity.
What is the hierarchy of functional return?
Gradual gradation of tasks
- Gross to fine motor movements
- increased resistance
- repetition from simple to complex tasks with postural changes to promote neuromuscular reeducation.
What is a work therapy program?
Work therapy may occur during any point in the healing of injured tissues. It typically occurs during the acute phase of rehabilitation before tissue reaches homeostasis.
A pt with CRPS in Type 1, what should be the focus on work conditioning program?
Treatment should focus on management of pain and edema along with AROM. The most recognized therapeutic intervention for CRPS is a stress loading program (scrubbing and carrying)
What is the jurisdiction of the AOTA Ethics Commission?
ONLY OT/OTA members of AOTA
What happens when medical entry is not present during documentation?
Information that must be entered out of sequence should be entered into the medical record as a late entry and must be identified as such per AOTA guidelines.
What is the Joint Commision’s focus?
Improving health care services by facilitating effective and safe services.
An OTR® is working with an infant who is recovering from a brachial plexus injury. What type of sling should the OTR® fabricate?
Sling that fits around the humerus
What is the typical duration of Ayres SI treatment?
1-2 times/ week for 2 years
What should the OTR expect to see for a child with fluctuating tone from low to normal when reaching for a toy positioned on the table?
A limb that appeared to be athethoid.
Characterized by tone that fluctuates from low to normal with little spasticity.
A student in the first grade has illegible handwriting. Results of a standardized assessment indicate the student scored 0.5 standard deviations from the mean on a gross motor subtest and 2.0 standard deviations from the mean on a fine motor subtest. What do these results indicate?
SD that less than 1.5 of score suggest a need for OT services. The GM does not suggest the delay, but FM does and can be addressed through intervention plan to improve handwriting.
What intervention should the OT do for a child with dysgraphia?
Provide the child with a copy of partially completed notes so he only has to fill in key words. Dysgraphia is a learning disability associated with difficulty producing written language.
Which occupation might the child have difficulty with bradydactyly participate in?
Buttoning shirt buttons. A child with bradydactyly has overly large digits and may have difficulty with ADLs that require FM manipulation.
An OTR working in a school setting receiving referral for SPED services. What is the first thing the OTR should do as part of the evaluation process?
Gather information to create student’s occupational profile
An OTR in I/P facility working with a group of adolescents and a group member becomes frustrated w/a teammate and is angry. What is the BEST response in this situation?
Offer choices for effective coping strategies to deal with emotional outbursts.
“You seem upset, would you take a minute to calm down or go back to your room for now?”
What visual skills are affected as a result of CNS damage?
Stereopsis. (Binocular depth perception)
What intervention strategy would be appropriate when working with a child with sickle-cell anemia?
Pain management
Which biomechanical technique would be appropriate to include in the client with juvenile RA during exacerbation?
AROM Program. A/PROM exercises along with splinting, monitoring joint function, preventing deformation, teaching energy conservation techniques, AE are all recommended.
Which condition that often occurs concurrently with oppositional defiant disorder should the OTR® look for?
ADHD
The OTR wants to determine whether the child has difficulty with integrated process of handwriting rather than specific components that support production. Which assessment can the OT use?
Print Tool
Which would best describe the correct use of a weighted vest?
The vest weight should be no more than 10% of the child’s body weight.
Which occupation would a child with poor interoceptive sensory skill have difficulty with?
Toileting. Interoception is the ability to perceive information from inside the body.
What is tonic-clonic seizures?
people experience an “aura” or a sensation that the seizure is about to begin. During this type of seizure, people usually lose consciousness and their body goes through a series of rhythmic clonic contractions.
What is myclonic?
seizures involve a single muscle group.
What is akinetic seizures?
involve the loss of normal muscle tone for approximately 30 minutes or more.
what is absence seizures?
Looks like they are “zoning out” or daydreaming; these seizures are characterized by a brief lapse or loss of awareness. In addition, clients who experience absence seizures will suspend all motor activity (even eye blinking) during a seizure. These seizures usually last less than 30 seconds.
According to the biomechanical model of practice, which piece of adaptive equipment would MOST LIKELY promote a more functional forearm position for handwriting?
A rubber band sling
Transitional grasp would promote a more neutral wrist position and pronated forearm position.
An OTR® is reviewing a chart on an infant who was referred to the developmental follow-up clinic. The OTR® notes that the mother transmitted syphilis to the baby during birth. Which impairments might be seen in the child?
Poor tolerance of passive range of motion
Congenital syphilis may result in osteochondritis at the joints, other bone anomalies, dental anomalies, and visual and auditory deficits. PROM may be painful.
The infant has bronchopulmonary dysplasia (BPD). Which occupation would be affected by this condition?
Feeding
Infants with BPD may require the use of mechanical ventilation and other traumatic interventions to treat acute respiratory problems. In addition, they may experience excess mucus and airway thickening that may make feeding difficult.
An OTR® recognizes that a client with an incomplete spinal cord injury will be ready for discharge to home in the next few weeks. What is the BEST method to determine the client’s occupational performance?
A home evaluation
A goal for a client with traumatic brain injury is to be accurate with orientation to place and time. The client is at Rancho Level IV (i.e., with confusion and agitation). What intervention is appropriate to meet this goal?
Have client use a logbook that provides a calendar with the current therapy session schedule
An OTR® has completed a screening of fine motor skills with all of the students enrolled in a kindergarten class. The results indicate that five students in the class are functioning in the lower 25th percentile. What INITIAL action should the OTR® take in response to these findings?
Discuss the students’ results and potential follow-up options with the classroom teacher.
An OTR® is working with a child who has a diagnosis of myclomeningocele spina bifida. Which ADLs might be difficult for a child with this condition?
Toileting
Bowel and bladder programs may need to be implemented to help children with toileting across environments
According to the Healthcare Common Procedure Coding System (HCPCS) for durable medical equipment, including wheelchairs and their accessories what is HCPCS code for a standard wheelchair?
K001
Which client would be MOST appropriate for vocational evaluation?
A client with a recent spinal cord injury who wants to pursue a new occupation.
The treating OTR®; has received permission to provide pro bono services to ensure that the client continues on the path to recovery. What ethical principle likely informed the OTR’s decision in this situation?
Justice
An OTR® has developed a prevocational program for clients who have an enduring mental illness. Program modules include assessing the advantages and disadvantages of employment, evaluating work and leisure skills, practicing completion of job applications, and learning to write resumes and cover letters. Which frame of reference reflects the design of this program?
Cognitive-Behavioral
The client attempted to return to work; however, the pain persists, and the client is unable to sleep at night, affecting the ability to focus and complete daily tasks. In determining the client’s ability to return to work, what should the occupational therapist do FIRST?
Simulate a workstation to assess the job the client must perform daily.
Which statement BEST describes the role of occupational therapy in an early intervention program under the Individuals With Disabilities Education Act Part C?
Occupational therapy is one of 16 primary services provided for children in need of early intervention services.
What is the purpose of the Disciplinary Council as described in the Enforcement Procedures for the Occupational Therapy Code of Ethics and Ethics Standards?
To give the Respondent an opportunity to present evidence and provide witnesses to answer and refute a charge
GCS SCORES FOR MILD
13-15
GCS SCORES FOR MODERATE
9-12
GCS SCORES FOR SEVERE
8 or less
A client with Down syndrome is preparing for transition from high school to work and is seeking a work placement. The client needs to identify vocational interests and abilities for general job tasks. To which service should the OTR® refer the client?
Job coaching
An OTR® is working with a child who is overresponsive to vestibular input, extremely scared of movement, and fearful of jumping. What type of sensory dysfunction might this child have?
Gravitational Insecurity
