NBCOT Test Prep A_ Questions & Answers.

NBCOT Test Prep A_ Questions & Answers Summer 2022/2023. NBCOT Test Prep A_ Questions & Answers A1. An older adult with peripheral neuropathy resulting from the chronic effects of diabetes expresses concern over the ability to have a satisfying sexual relationship with a partner. Which is the most beneficial recommendation for the occupational therapist to make to the older adult? a. Experiment with different positions during sexual expression activities. b. Focus on intact senses and areas of intact sensation. c. Schedule sexual expression activities after rest periods. d. Advise the older adult to accept decreased abilities in sexual expression as a normal part of aging. A2. An individual with amyotrophic lateral sclerosis requires the use of an environmental control unit (ECU) to access electrical devices and a personal emergency response system. The individual lives alone and self-directs personal care attendants to perform personal activities of daily living. During instruction to the individual on the capabilities and use of the ECU, which is most important for the occupational therapist to discuss with the client? a. The ECU's back-up power source and charging instructions. b. Additional assistive technology available. c. Augmentative alternative communication options. d. Funding for the ECU and assistive technology. A3. A nine-year-old child identifies the assembly of a model as the most desired play activity. The occupational therapist determines that the child would have difficulty completing the selected model. Which action is most effective for the therapist to take during the next intervention session? a. Allow the child to work on the model and provide maximum assistance as the child completes the project. b. Explore with the child why completing the model is desired by the child and provide alternative project choices. c. Break the project down into accomplishable segments and instruct the child to complete one segment at a time. d. Explain to the child several reasons why the selected model is not the best choice for the child and provide alternative project choices. A4. A child with myelomeningocele meets the short-term goals of achieving functional gross grasp and lateral pinch. After several additional weeks of occupational therapy, the child does not meet the goals of demonstrating pincer grasp and three jaw chuck. Consequently, the therapist modifies the child's intervention plan. Which intervention is best to include in the revised plan? a. Increase strength of lateral pinch as a basis to develop pincer grasp and three jaw chuck. b. Teach the child to use gross grasp and lateral pinch for functional activities. c. Teach the child to use ulnar grasp for functional activities. A5. An individual attends an outpatient parenting skills group. The person has a history of serious recurrent depression and is taking Nardil. The client complains of recurrent headaches and difficulty focusing during the day (e.g., when helping children with their homework). Which action is best for the occupational therapist to make in response to the client's expressed concerns? a. Instruct the client in stress reduction techniques. b. Ask the group for suggestions on how to deal with the parenting stress of homework. c. Suggest that the individual consult with a nurse practitioner for headache relief strategies. d. Tell the client you will be notifying the psychiatrist of these complaints. A6. A religious congregation obtained private funding to build a ramp so that members with disabilities can attend services. The entrance to the congregation's building has six steps with a rise of 7 inches each. Which is best for the occupational therapist hired by the congregation to recommend for construction of this ramp? a. 42 feet long with a 3′ × 3′ landing at the ramp's midpoint. b. 48 feet long with a 3′ × 3′ landing at the ramp's midpoint. c. 42 feet long with a 5' × 5' landing at the ramp's midpoint. d. 48 feet long with a 5' × 5' landing at the ramp's midpoint. A7. A child with juvenile rheumatoid arthritis wears bilateral night resting splints with wrists in 0° of extension, MPs and IPs flexed, ulnar deviation of 10°, and thumbs in opposition. The child complains of pain in the wrists upon awakening. No redness is noted upon removing splints. Range of motion (ROM) measurements show ulnar deviation of 5°. Which action should the occupational therapist take in response to this complaint and these observations? a. Modify the splints at the wrist. b. Pad the ulnar aspect on the inside of the splints. c. Discontinue the splints and monitor the status of pain for two weeks. A8. A 15-year-old with asymptomatic HIV attends an outpatient clinic. The occupational therapy protocol for patients diagnosed with HIV includes presentation of information on safe sex. The adolescent's parents refuse to allow this information to be presented to their child. Which is the best action for the therapist to take in response to this situation? a. Ask the adolescent's opinion and act on their refusal or consent. b. Document that the parents refuse the intervention for their child. c. Refer the family to the social worker for counseling. d. Have the parents sign a waiver that they refused the intervention for their child. A9. An individual who has Parkinson's disease presents with poor trunk rotation during ambulation and while performing ADL. According to neurophysiologic approaches, which is the most effective therapeutic intervention for the occupational therapist to use with this person? a. Facilitation of trunk rotation using neurodevelopmental handling techniques. b. Slow rolling with the person supine with knees and hips flexed. c. Engagement in ADL using diagonal patterns. d. Provision of a rolling walker to compensate for limited rotation and enhance mobility. A10. An individual who incurred a cerebrovascular accident (CVA) six months ago is receiving outpatient occupational therapy to address residual cognitive-perceptual deficits (i.e., unilateral inattention and spatial relations impairments). The individual drives daily despite strong suggestions from family members to discontinue this activity. The family members share their concerns about the person's capabilities to drive safely with the occupational therapist. Which is the best action for the therapist to take in response to these expressed concerns? a. Report the individual to the department of motor vehicles. b. Suggest that the individual attends a driver training program. c. Report the information to the physician. d. Validate the family members' concerns about the individual's driving risk. A11. Following a left CVA, an individual receives OT services at a sub-acute rehabilitation facility. The patient's personal goal is to be independent in dressing. The patient demonstrates decreased memory, poor sequencing skills, and ideational apraxia. Which of the following is most effective for the therapist to provide when teaching one-handed dressing techniques to this patient? a. Step-by-step verbal instructions. b. Sequenced photographs of the steps in dressing. c. Physical prompts to initiate the steps in dressing. d. A full length mirror for the client to observe self-dressing performance. A12. An elementary school teacher has been recently diagnosed with multiple sclerosis (MS). Which adaptation is best for the occupational therapist to recommend the teacher use to accommodate for the effects of MS on classroom teaching? a. The use of anchoring techniques to compensate for scanning deficits. b. A daily list of tasks to compensate for cognitive deficits. c. A motorized scooter to compensate for decreased endurance. d. A high stool to compensate for lower extremity weakness. A13. An occupational therapist conducts an initial home visit to a family with a premature infant who, at four months and 5 lbs., has just been discharged from the hospital. The child has multiple developmental disabilities. Which is most important for the therapist to do during this first session with the family? a. Communicate effectively to develop a therapeutic relationship with the family. b. Teach the family proper body mechanics for lifting the child. c. Teach the family assertiveness training to develop advocacy skills. d. Determine whether adaptive aids or positioning equipment is needed. A14. A 3-year-old child with left spastic hemiplegia due to cerebral palsy is evaluated for early intervention services. During the evaluation the occupational therapist observes behaviors that seem to indicate the presence of visual deficits. Based on these observations, which action should the occupational therapist take? a. Completion of a motor-free visual perceptual assessment. b. Completion of a developmental vision assessment. c. Refer the child to an optician. d. Refer the child to an optometrist. A15. An occupational therapist constructs a splint for a person who incurred full thickness facial and anterior neck burns. In which position should the therapist splint the neck? a. Extension. b. 15° flexion. c. 15° lateral flexion. d. 15° hyperextension. A16. An occupational therapist reviews the use of the occupational therapy department's resources to determine medical necessity and cost efficiency. Which service management task is the therapist performing? Utilization review. Retrospective peer review. Total quality management. Risk management. A17. A 6-year-old has thumb weakness that is most evident in the child's poor ability to perform thumb opposition. During evaluation, which activity will the therapist most likely observe the child having difficulty performing? Rolling a piece of clay into a ball. Turning a pencil over to erase. Picking up coins. Separating two pieces of paper. A18. Questions A18 to A22 are based on the following information. A private practice comprised of five occupational therapists provides home-based services to a variety of adult clients in a two-county area. They are expanding their practice to include home-based services in another county. This private practice has also recently been awarded the early intervention service provider contract for all three counties. The practitioners plan to hire three entry-level occupational therapists and two certified occupational therapy assistants (COTA®s) to fill the service needs of their growing practice. The COTA®s have extensive experience in home-based service provision. The private practitioners plan to provide all of their new employees with a comprehensive orientation program and the shadowing of an experienced therapist for two weeks. A18. To ensure the provision of best practice, the new entry-level occupational therapists will be provided with supervision of their caseloads. At what level should this supervision be provided? a. Routine. b. General. c. Close. d. Minimal. Questions A18 to A22 are based on the following information. A private practice comprised of five occupational therapists provides home-based services to a variety of adult clients in a two-county area. They are expanding their practice to include home-based services in another county. This private practice has also recently been awarded the early intervention service provider contract for all three counties. The practitioners plan to hire three entry-level occupational therapists and two certified occupational therapy assistants (COTA®s) to fill the service needs of their growing practice. The COTA®s have extensive experience in home-based service provision. The private practitioners plan to provide all of their new employees with a comprehensive orientation program and the shadowing of an experienced therapist for two weeks. A19. The private practitioners pay for their newly hired occupational therapists' registration for an advanced course on pediatric assessment. Which is the most important outcome of attending this course for the occupational therapists? Networking with other pediatric professionals. Improving their professional skills and competence. Keeping up-to-date on current trends in occupational therapy. Questions A18 to A22 are based on the following information. A private practice comprised of five occupational therapists provides home-based services to a variety of adult clients in a two-county area. They are expanding their practice to include home-based services in another county. This private practice has also recently been awarded the early intervention service provider contract for all three counties. The practitioners plan to hire three entry-level occupational therapists and two certified occupational therapy assistants (COTA®s) to fill the service needs of their growing practice. The COTA®s have extensive experience in home-based service provision. The private practitioners plan to provide all of their new employees with a comprehensive orientation program and the shadowing of an experienced therapist for two weeks. A20. The supervising occupational therapists meet to plan the workload of the recently hired COTA®s. Which task is best for them to assign to the COTA®s? The in-home evaluation of the adult clients' instrumental activities of daily living. The determination of long-term goals to include in the adult clients' OT home care intervention plan. The design of home-based sensory integration protocols for infants and toddlers with sensory processing disorders. The administration and interpretation of the Hawaii Early Learning Profile (HELP) to infants and toddlers. Questions A18 to A22 are based on the following information. A private practice comprised of five occupational therapists provides home-based services to a variety of adult clients in a two-county area. They are expanding their practice to include home-based services in another county. This private practice has also recently been awarded the early intervention service provider contract for all three counties. The practitioners plan to hire three entry-level occupational therapists and two certified occupational therapy assistants (COTA®s) to fill the service needs of their growing practice. The COTA®s have extensive experience in home-based service provision. The private practitioners plan to provide all of their new employees with a comprehensive orientation program and the shadowing of an experienced therapist for two weeks. A21. The private practitioners meet with their accountant to plan fiscally for their expanded practice. How would the accountant classify the fees that the practice receives from their early intervention contract? Accounts payable. Capital assets. Productivity standards. Accounts receivable. Questions A18 to A22 are based on the following information. A private practice comprised of five occupational therapists provides home-based services to a variety of adult clients in a two-county area. They are expanding their practice to include home-based services in another county. This private practice has also recently been awarded the early intervention service provider contract for all three counties. The practitioners plan to hire three entry-level occupational therapists and two certified occupational therapy assistants (COTA®s) to fill the service needs of their growing practice. The COTA®s have extensive experience in home-based service provision. The private practitioners plan to provide all of their new employees with a comprehensive orientation program and the shadowing of an experienced therapist for two weeks. A22. The accountant asks the private practitioners to present their budget for anticipated direct expenses of their growing practice. Which is the most appropriate item to include in this budget request? The rent and utilities of the practice's primary office. An integrated computer system for paperless documentation by all staff. Staff vacation and sick time. Supplies of items used in in-home therapy sessions. A23. A young adult with a diagnosis of schizophrenia is scheduled to be discharged from an inpatient setting to a halfway house and psychosocial clubhouse. The occupational therapist is assisting the team with the discharge plan. Which is the most important information for the therapist to provide to the team about this person? The person's instrumental ADL skills. The person's vocational potential. The person's social interaction skills. A24. Following the performance of a home exercise program prescribed one week ago, an individual with bilateral upper extremity muscle weakness reports experiencing pain in both shoulders and elbows. The pain persists for up to five hours. The individual's occupational therapist is on vacation for two weeks and a recently hired entry-level therapist has been assigned to cover the vacationing therapist's caseload. In response to these reported symptoms, which is the best action for the covering therapist to take in response to this individual's reporting symptoms? Recommend the person stop exercising completely until the primary therapist returns and can re-evaluate the person's status. Reduce the intensity of exercise by 50% and reassess the person during the next intervention session. Continue with the current exercise program to develop tolerance. Advise the individual to take a pain relief medication 30 minutes prior to exercising. A25. A child with spinal muscle atrophy can no longer reach beyond 90° of shoulder abduction and 90° of shoulder flexion. The parents state that the child can no longer don or doff a T-shirt. Which is the best approach for the occupational therapist to recommend the child use for dressing? Place the T-shirt directly on the child's lap, have the child don the arms first, then don the head of theT-shirt. Have the child learn to don and doff front-opening shirts instead of T-shirts. Have the child support the elbows on a table at chest height to don the T-shirt over arms, then don over the head. Have the child sit with the trunk well-supported, lean to the right and don the right arm, repeat to the left, and then don the head of the T-shirt. A26. An individual recovering from a CVA has received extensive motor learning intervention. The client can now transfer a learned motor skill to different contexts. The client also demonstrates the ability to successfully problem-solve during motor activities in different contexts. In documenting the client's progress, which stage of motor learning is most accurate for the occupational therapist to document the individual has achieved? Skill acquisition. Skill transfer stage. Skill retention. A27. An occupational therapist provides consultation services to members of a town chamber of commerce who have expressed interest in improving their businesses' accessibility. Which is the minimum door width that the occupational therapist should recommend to the chamber members as accessible and not requiring modification? 28 inches. 32 inches. 30 inches. 34 inches. A28. A client expresses an interest in playing a computer game with another group member during a leisure skills group. The occupational therapist reviews the client's cognitive evaluation and agrees that the game is a good choice for the client's cognitive level. After 15 minutes of engaging in the computer game, the client rubs both eyes, looks around, and reports trouble focusing. Which should the therapist do in response to these observations and client statements? Provide verbal encouragement for the client to complete the game before taking a break. Suggest the client and the other member play a different video game that is easier for the client. Discontinue the session and advise the client to select a different leisure activity to do with the othermember. Suggest the client and the other member pause the game to talk about the game's progress after significant plays. A29. A 19-year-old with a diagnoses of persistent depressive disorder attends a vocational rehabilitation program. When the client arrives for the work adjustment group, the therapist notes that the client demonstrates an unsteady gait and slurred speech. The client's breath smells of alcohol. Which is the best action for the therapist to take in response to these observations? Follow program procedures to arrange for transportation to bring the client home. Introduce the topic of alcohol's effect on work performance as the focus of the scheduled group session. Have the client meet with the social worker to discuss treatment options for potential alcohol abuse. Contact the client's parents to pick the client up to bring the client home. A30. A toddler with spastic quadriplegic cerebral palsy demonstrates a consistent tonic bite reflex. Which technique should the occupational therapist use to help inhibit this reflex? Move a spoon from side to side on the tongue. Walk a spoon down the tongue, from proximal to distal. Press a spoon down firmly on the center of the tongue. Stroke the tongue in a circular motion with a firm object. A31. A child with a tactile defensive sensory modulation disorder attends a private early intervention clinic. The occupational therapist collaborates with the child's parents to develop strategies and guidelines to help the child handle the symptoms of this disorder at home. Which is the best recommendation for the therapist to make to the parents? Avoid the use of swings and other moving equipment during play activities. Encourage the use of swings and other moving equipment during play activities. Soften the child's clothing by repeated laundering and remove clothing tags. Provide a variety of textures in the clothing the child wears. A32. A newly hired COTA® is instructed by the director of rehabilitation to supervise two hospital volunteers as they learn how to assist patients in safely completing bed to wheelchair transfers. The COTA® informs the supervising occupational therapist of the director's request. Which is the first action the occupational therapist should take in response to this request? Advise the COTA® to comply with the request. Advise the COTA® to refuse the request. Observe the COTA® to assess service competence in transfer training. Explain to the director of rehabilitation why the request is inappropriate. A33. A single parent is hospitalized for an exacerbation of schizophrenia. Actively psychotic upon admission, the client has been stabilized on medication. The client is currently not demonstrating hallucinations or delusions. Residual deficits include several negative symptoms and decreased cognitive skills. At the team meeting, the psychiatrist decides to discharge the client within 48 hours. The client lives with their elementary-school aged children. Which is the best recommendation for the occupational therapist to make during this team meeting? An extension of hospitalization to further evaluate cognitive skills. A family meeting to discuss the need for the children to assume home management tasks. A home visit to assess the client's safety skills within the home environment. A referral to social services to explore foster care for the children. A34. An individual recovering from hip replacement surgery prepares for discharge home. The client has a secondary diagnosis of gastric esophageal reflux disease (GERD). Which is the best bed position for the occupational therapist to recommend to this client? Supine with elevation of the shoulders and head. Sidelying with the neck in neutral. Sidelying with elevation of the shoulders and head. Supine with elevation of the hips. A35. An occupational therapist designs a dynamic splint for an individual recovering from tendon repair. At which angle should the therapist position the outrigger? 45° to the joint. 90° to the joint. 60° to the joint. 110° to the joint. A36. The transition plan for a high school senior with developmental delay includes a referral to a vocational rehabilitation workshop job setting. The student has set a goal to live independent of family. Which is the best living environment for the occupational therapist to recommend for this student? An apartment in a subsidized housing project. A group home with case managers available on-call. A supported apartment with a roommate. A group home with daily on-site supervision. A37. The parents of a two-year-old child with unilateral congenital upper extremity amputations express concern to the home-care occupational therapist about their child's complete disinterest in toilet training. At which point should the occupational therapist advise the parents to begin toilet training? When the child indicates discomfort with being wet or soiled. Immediately, because toileting is a developmentally appropriate task. When the child is 3 years old, as this is the typical developmental age for toilet training. A38. A school-aged child who is right-hand dominant complains of numbness and tingling after writing for more than 15 minutes. A neurological exam shows no reason for the numbness and tingling. Which action would be most beneficial for the occupational therapist to recommend to the child? Use a pencil held in a universal cuff to complete writing activities. Elevate the right upper extremity at night and whenever possible during the day. Stretch the right upper extremity every 15-20 minutes during writing activities. Use a custom-molded pencil grip made of splinting material when writing. A39. An occupational therapist leads a transitional planning group for high school students with conduct disorders. The school fire alarm goes off five minutes before the group's scheduled termination. There have been six false alarms during the past three days at the school. Several of the students laugh and say