Upper Extremity NBCOT questions and
answers.
COTA is teaching discriminative sensory reeducation techniques to a client who has
had a median nerve surgical repair. Which method is BEST for reeducation of
discriminative sensibility?
A. Educate the client to avoid working around machinery.
B. Advise the client to use vision to compensate for sensory loss.
C. Educate the client to identify items by touch both with and without vision on a daily
basis.
D. Educate the client to avoid temperatures below 60°. -
\C. Educate the client to identify items by touch both with and without vision on a daily
basis.
A COTA is treating a client who sustained dorsal hand burns secondary to a work-
related injury. In the intensive care unit phase of treatment, which technique for
completing ROM of the hand is safest?
A. Passively range all digits and joints at once
B. Passively range each digit and joint individually
C. Instruct the client to actively flex and extend all digits
D. Instruct the client to wear a resting hand splint at all times -
\B. Passively range each digit and joint individually
A large outpatient hand clinic employs certified hand therapists who are either licensed
OTR®s or licensed physical therapists. COTA®s are used to efficiently manage
caseloads. Which description of the supervision requirement for COTAs working in this
environment is MOST accurate?
A. Must be supervised by a licensed OTR in accordance with state licensure and scope
of practice for COTAs
B. Does not require supervision if the COTA has a minimum of 5 years of experience
treating clients with upper-extremity conditions
C. Can be supervised by a licensed OTR or physical therapist regardless of any other
certifications
D. Can be supervised by a licensed OTR or physical therapist as long as the supervisor
is a certified hand therapist -
\A. Must be supervised by a licensed OTR in accordance with state licensure and scope
of practice for COTAs
,COTA® is educating a client about what to expect in the process of wound healing after
surgery. What are the expected phases of wound healing in the order they occur?
A. Inflammation, proliferation, and remodeling
B. Coagulation, tension, and scar formation
C. Proliferation, inflammation, and remodeling
D. Tension, coagulation, and scar formation -
\A. Inflammation, proliferation, and remodeling
A COTA® is treating a client who sustained second- and third-degree burns on the
dorsal forearm and hand. Which intervention techniques would be appropriate for this
client? Select the 3 BEST choices.
A. Volar resting hand splint
B. Volar intrinsic plus splint
C. PROM of hand into a fist, then extension of all finger joints
D. PROM of hand with each joint isolated
E. For positioning in supine, hand above elbow and elbow above heart
F. For positioning in supine, hand level with elbow and elbow level with heart -
\B. Volar intrinsic plus splint
D.PROM of hand with each joint isolated
E. For positioning in supine, hand above elbow and elbow above heart.
A COTA® is treating a client with a cumulative trauma disorder resulting from work in an
automotive assembly plant. Acute symptoms have subsided, and the client is preparing
to return to work. Which strategies should the COTA® train the client in to prevent
symptoms from recurring?
A. Deep breathing and relaxation exercises
B. Activity modification and proper body mechanics
C. Joint protection and pacing techniques
D. Energy conservation and work simplification techniques -
\B. Activity modification and proper body mechanics.
A COTA® is working with a client who has a distal radius fracture. Functional outcome
reporting is required by the facility. Which approach to functional outcome measurement
is MOST consistent with client-centered care?
A. Continuously updated and recorded range of motion measurements, to facilitate
functional return
B. Documentation of quantitative and qualitative data in the medical record, to facilitate
the OTR®'s assessment of the clinical outcomes
C. Standardized assessment data within the medical record, to guarantee payment by
third-party payers
, D. The Disabilities of the Arm, Shoulder and Hand (DASH) measure, to collect
occupational profile data -
\B. Documentation of quantitative and qualitative data in the medical record, to facilitate
the OTR®'s assessment of the clinical outcomes.
A COTA® is working with clients who have delayed healing of wounds. Which clients
would be likely to take the longest amount of time to heal? Select the 3 BEST choices.
A. An 80-year-old client with diabetes
B. A 60-year-old client with shingles
C. A 50-year-old client with hypertension
D. A 77-year-old client with a foot ulcer
E. A 21-year-old client with a radial fracture
F. An 18-year-old client with a tendon injury -
\A. An 80-year-old client with diabetes
B. A 60-year-old client with shingles
D. A 77-year-old client with a foot ulcer
A client with a nondisplaced shaft fracture of the right fifth metacarpal has a physician's
order for full-time splinting. Which orthosis would the COTA® be MOST likely to
fabricate?
A. Dorsal hood splint with the wrist in approximately 20° flexion, all
metacarpophalangeal (MCP) joints of the affected hand in 70°-90° flexion, and
interphalangeal (IP) joints of the affected hand in 0° extension
B. Volar-based ulnar gutter with MCP and IP joints of the ring and fifth fingers in 0°
extension and the wrist in neutral
C. Dorsal-based wrist cockup splint with MCP and IP joints free and the wrist in
approximately 20° extension
D. Volar-based ulnar gutter with MCP joints of the ring and fifth fingers in 70°-90°
flexion, fourth and fifth IP joints in 0° extension, and the wrist in approximately 20°
extension -
\D. Volar-based ulnar gutter with MCP joints of the ring and fifth fingers in 70°-90°
flexion, fourth and fifth IP joints in 0° extension, and the wrist in approximately 20°
extension
For clients who have arthritis, which aspect of the overall occupational therapy
intervention plan is the MOST crucial?
A. Self-efficacy
B. Splinting
C. Compliance with the independent home exercise program
answers.
COTA is teaching discriminative sensory reeducation techniques to a client who has
had a median nerve surgical repair. Which method is BEST for reeducation of
discriminative sensibility?
A. Educate the client to avoid working around machinery.
B. Advise the client to use vision to compensate for sensory loss.
C. Educate the client to identify items by touch both with and without vision on a daily
basis.
D. Educate the client to avoid temperatures below 60°. -
\C. Educate the client to identify items by touch both with and without vision on a daily
basis.
A COTA is treating a client who sustained dorsal hand burns secondary to a work-
related injury. In the intensive care unit phase of treatment, which technique for
completing ROM of the hand is safest?
A. Passively range all digits and joints at once
B. Passively range each digit and joint individually
C. Instruct the client to actively flex and extend all digits
D. Instruct the client to wear a resting hand splint at all times -
\B. Passively range each digit and joint individually
A large outpatient hand clinic employs certified hand therapists who are either licensed
OTR®s or licensed physical therapists. COTA®s are used to efficiently manage
caseloads. Which description of the supervision requirement for COTAs working in this
environment is MOST accurate?
A. Must be supervised by a licensed OTR in accordance with state licensure and scope
of practice for COTAs
B. Does not require supervision if the COTA has a minimum of 5 years of experience
treating clients with upper-extremity conditions
C. Can be supervised by a licensed OTR or physical therapist regardless of any other
certifications
D. Can be supervised by a licensed OTR or physical therapist as long as the supervisor
is a certified hand therapist -
\A. Must be supervised by a licensed OTR in accordance with state licensure and scope
of practice for COTAs
,COTA® is educating a client about what to expect in the process of wound healing after
surgery. What are the expected phases of wound healing in the order they occur?
A. Inflammation, proliferation, and remodeling
B. Coagulation, tension, and scar formation
C. Proliferation, inflammation, and remodeling
D. Tension, coagulation, and scar formation -
\A. Inflammation, proliferation, and remodeling
A COTA® is treating a client who sustained second- and third-degree burns on the
dorsal forearm and hand. Which intervention techniques would be appropriate for this
client? Select the 3 BEST choices.
A. Volar resting hand splint
B. Volar intrinsic plus splint
C. PROM of hand into a fist, then extension of all finger joints
D. PROM of hand with each joint isolated
E. For positioning in supine, hand above elbow and elbow above heart
F. For positioning in supine, hand level with elbow and elbow level with heart -
\B. Volar intrinsic plus splint
D.PROM of hand with each joint isolated
E. For positioning in supine, hand above elbow and elbow above heart.
A COTA® is treating a client with a cumulative trauma disorder resulting from work in an
automotive assembly plant. Acute symptoms have subsided, and the client is preparing
to return to work. Which strategies should the COTA® train the client in to prevent
symptoms from recurring?
A. Deep breathing and relaxation exercises
B. Activity modification and proper body mechanics
C. Joint protection and pacing techniques
D. Energy conservation and work simplification techniques -
\B. Activity modification and proper body mechanics.
A COTA® is working with a client who has a distal radius fracture. Functional outcome
reporting is required by the facility. Which approach to functional outcome measurement
is MOST consistent with client-centered care?
A. Continuously updated and recorded range of motion measurements, to facilitate
functional return
B. Documentation of quantitative and qualitative data in the medical record, to facilitate
the OTR®'s assessment of the clinical outcomes
C. Standardized assessment data within the medical record, to guarantee payment by
third-party payers
, D. The Disabilities of the Arm, Shoulder and Hand (DASH) measure, to collect
occupational profile data -
\B. Documentation of quantitative and qualitative data in the medical record, to facilitate
the OTR®'s assessment of the clinical outcomes.
A COTA® is working with clients who have delayed healing of wounds. Which clients
would be likely to take the longest amount of time to heal? Select the 3 BEST choices.
A. An 80-year-old client with diabetes
B. A 60-year-old client with shingles
C. A 50-year-old client with hypertension
D. A 77-year-old client with a foot ulcer
E. A 21-year-old client with a radial fracture
F. An 18-year-old client with a tendon injury -
\A. An 80-year-old client with diabetes
B. A 60-year-old client with shingles
D. A 77-year-old client with a foot ulcer
A client with a nondisplaced shaft fracture of the right fifth metacarpal has a physician's
order for full-time splinting. Which orthosis would the COTA® be MOST likely to
fabricate?
A. Dorsal hood splint with the wrist in approximately 20° flexion, all
metacarpophalangeal (MCP) joints of the affected hand in 70°-90° flexion, and
interphalangeal (IP) joints of the affected hand in 0° extension
B. Volar-based ulnar gutter with MCP and IP joints of the ring and fifth fingers in 0°
extension and the wrist in neutral
C. Dorsal-based wrist cockup splint with MCP and IP joints free and the wrist in
approximately 20° extension
D. Volar-based ulnar gutter with MCP joints of the ring and fifth fingers in 70°-90°
flexion, fourth and fifth IP joints in 0° extension, and the wrist in approximately 20°
extension -
\D. Volar-based ulnar gutter with MCP joints of the ring and fifth fingers in 70°-90°
flexion, fourth and fifth IP joints in 0° extension, and the wrist in approximately 20°
extension
For clients who have arthritis, which aspect of the overall occupational therapy
intervention plan is the MOST crucial?
A. Self-efficacy
B. Splinting
C. Compliance with the independent home exercise program
