NBCOT – QUESTIONS AND ANSWERS (100% VERIFIED)

NBCOT – QUESTIONS AND ANSWERS (100% VERIFIED) A patient in the early stages of amyotrophic lateral sclerosis (ALS) presents with weakness in the thenar eminence. During which ADL task would the evaluating OTR® MOST LIKELY observe the effect on function? A. Transferring from the bed to the bedside commode B. Taking a sip from a glass of water C. Reaching overhead to don a T-shirt D. Squeezing toothpaste onto a toothbrush - D Typical early signs of ALS are distal, with weakness of the small muscles of the hand being the most typical initial symptom. The muscles that make up the thenar eminence are responsible for opposition of the thumb. Squeezing toothpaste and holding a toothbrush require grasp-and-pinch patterns that involve thumb opposition. Neurological: Which of the following methods is INCORRECT when working with a TBI patient with a Rancho Level IV? A. Work in a quiet environment with minimal distracters B. Maintain a predictable daily structure and routine C. Be calm and confident in your approach with the patient D. Maintain the activity despite agitation from patient - D During this stage of recovery, we want to decrease the pt's agitation by attempting to normalize the environrment and providing consistency and predicability that counters their confusion. If a pt becomes agitated or restless during an activity, change the activity or move to another environment. Pediatrics: Prone is often the position of choice for which of following: A. Infant with contractures B. Agitated, arching infant C. Infant with newly repaired abdominal defect D. To promote midline orientation - Neurological: What does a score of 9 mean on the Glasgow Coma Scale? A. Minor brain injury B. Moderate brain injury C. Severe brain injury D. Fully conscious - Management & Evidence: When arriving to an elderly patient's home who lives with her daughter and son-in-law for a treatment session, the OTL/R notices that the patient's glasses are broken and the patient has new bruises on her forearms around her wrists. The OTL/R asks the patient once the son-in-law leaves the room what happened and the patient reports that the son-in-law has been physically abusing her for the past two weeks. What is the most appropriate action the OTL/R should take? A. Contact supervisor to report suspicious elderly abuse and suggest that Adult Protective Services get involved B. Continue with treatment session and see if abuse continued until next session C. Call the local police station to report suspicious elderly abuse D. Explain to the son-in-law the allegations and get his side of the story before doing anything - General Rehab: When completing a home evaluation, what would be the most important suggestion to the patient to prevent falls: A. Teach energy conservation techniques B. Order appropriate adaptive devices and train safe us C. Remove throw rugs from floors D. Arrange furniture for easy maneuverability - An OTR® completes a work tolerance screening with a worker at a manufacturing plant. What should be included in the documentation? A. Weight limits for various job tasks B. Worker's reported desire to remain in the job C. Worker's ability to perform ADLs D. Financial issues the worker experiences - A Work tolerance screenings identify limitations in the worker's ability to meet the activity demands of essential job functions, such as weights, distances, forces, angles, repetitions, and tools. How would the OTR® BEST establish service competency? A. Review the COTA®'s documentation of multiple patients whose feeding impairments warranted adaptive equipment, then discuss the outcomes with the COTA®. B. Observe the COTA® educate clients on how to use adaptive feeding equipment to ensure the COTA® instructs clients in the same manner as would the OTR®. C. Compare outcomes by rating the same client's performance with the adaptive feeding equipment at the same level of independence. D. Collect information from various sources, including other therapists, the COTA®'s documentation, and feedback from clients, to determine competency. - C Service competency is defined as "the process of teaching, training, and evaluating in which the OTR® determines that the COTA® performs tasks in the same way that the OTR® would and achieves the same outcomes" (Youngstrom, 2009, p. 943). In this example, both the COTA® and OTR® observe the same client performing a task and rate that performance in a similar manner. Comparing outcomes helps to ensure clients receive care of equal quality. An OTR® is working with a client with Down syndrome to develop cooking skills. The client successfully makes a peanut butter and jelly sandwich. Which therapeutic activity would be BEST for the next treatment session? A. A turkey-and-cheese sandwich B. A microwavable dinner C. A grilled cheese sandwich D. A stir-fry vegetable dish over brown rice - C The activity analysis skill here is grading; the OTR® recognizes the success of a multistep cold meal and appropriately upgrades the task to require more complex steps. An OTR® is working with a client with chronic obstructive pulmonary disease on therapeutic exercise and how to measure exercise tolerance. The client is performing seated bilateral shoulder flexion with 3-lb weights and rates this activity as "very, very easy." How would the OTR® appropriately grade this activity? A. Change the muscle groups used by switching to shoulder abduction. B. Advise the client to perform the task in a standing position. C. Switch the client to a resistance band. D. Increase the number of repetitions and have the client perform the exercises while standing. - B If the client states that the current exercise is too easy, the OTR would appropriately upgrade the task. Performing these exercises in a standing position uses trunk and leg muscles, thereby increasing the physical demands. Neurological: When screening for impairments of cranial nerve 5, Trigeminal Nerve, all would be appropriate screens except: A. Detect light touch, sharp touch and hot and cold touch to the patient's forehead, cheek, jaw and chin. B. Place your index and middle finger over the patient's Adam's apple or laryngeal muscles to see if the larynx rises and falls normally as the patient swallows. C. Touch the patient's cornea with a cotton swab to check for a corneal reflex or blink. D. Ask the patient to move his or her jaw from side to side looking for asymmetry of jaw movement. - B