NBCOT OTR Missed Questions and
Answers.
An OTR® performs an evaluation on a client who has a new diagnosis of Parkinson's
disease (PD), Stage 1. The client's goal is to maintain employment as an administrative
assistant in a moderate-paced law firm. With which intervention would the OTR® BEST
begin treatment?
A. Instruct the client in adaptive equipment such as large-button telephones and distal
wrist weights.
B. Develop a home exercise program for the client to maximize balance and strength.
C. Plan the client's work day so that the most difficult tasks align with the time when
medications are at optimal effect.
D. Advise the client to alert superiors and coworkers to the new diagnosis to gain
support and help modify work tasks. -
\C. Plan the client's work day so that the most difficult tasks align with the time when
medications are at optimal effect.
What strategy might an OTR® appropriately recommend to caregivers of a client with
Alzheimer's disease to assist with fall prevention?
A. Engage the client in daily, structured activity.
B. Provide visual reminders in the home environment.
C. Install grab bars in the bathroom.
D. Engage the client in an exercise program. -
\A. Engage the client in daily, structured activity.
A client with advanced amyotrophic lateral sclerosis (ALS) is new to a computerized
communication device. On what would the OTR® treating this patient focus?
A. Positioning, to ensure proximal support on a lap tray
B. ROM exercises, to enable the patient to adequately reach the device
C. Trunk strengthening, to enable upright sitting during use of the device
D. Adapting the device with larger buttons and controls, to enable independent use -
\A. Positioning, to ensure proximal support on a lap tray
The simplest and first approach would be to ensure positioning so that the client can
see the device and having the neck and shoulder (proximal muscles) stabilized to allow
the most distal control. The placement of the device is also important, with a lap tray to
secure the device in bed or on the wheelchair.
A client was recently diagnosed with multiple sclerosis and has been referred to
occupational therapy for evaluation. When assessing the client's occupational
performance, which information should the OTR® consider?
A. ADL assessments completed on the first visit
B. Observations of the client's performance over a period of time
C. Results of specific measures, such as the manual muscle test
,D. Observation of the client's routine early in the morning -
\B. Observations of the client's performance over a period of time
Observing the client over a period of time allows the OTR® to identify variability in
endurance and fatigue a client with MS may experience.
How can you make bed mobility easier for clients with Parkinsons Disease? -
\Environmental modifications for improving bed mobility include using light bedding
(e.g., changing from flannel to satin sheets), using a firm mattress, lowering the height
of the bed, and using a bed rail for support.
A client with a recent diagnosis of dementia is receiving occupational therapy. The
caregivers are most distressed about significant behavioral changes that have occurred
since the client was diagnosed. The client has become increasingly impulsive and
difficult to redirect. What type of dementia does this client MOST LIKELY have?
A. Frontotemporal dementia
B. Alzheimer's dementia
C. Vascular dementia
D. Dementia with Lewy bodies -
\A. Frontotemporal dementia
The distinguishing feature of frontotemporal dementia is behavioral changes with an
increase in disinhibited behavior, decreased social tact, lack of empathy, and lack of
interest.
B, C, D: None of these dementia categories has behavioral changes as a significant
symptom
A client with amyotrophic lateral sclerosis reports functional limitations when completing
his daily routine. The OTR® has completed ADL and IADL assessments as part of the
evaluation and is considering how the client's upper-extremity motor control is affecting
his functional ability. Which assessment would be MOST effective for assessing this
client's upper-extremity ability?
A. Modified Ashworth Scale
B. Trigger point evaluation
C. FIM™
D. Purdue Pegboard test -
\D. Purdue Pegboard test
The Purdue Pegboard test is a timed test of upper-extremity function and is useful in
determining a client's functional limitations.
The Modified Ashworth Scale is a measure of spasticity.
An OTR® is providing intervention in the home of a client who is recovering from
Guillain-Barré syndrome. The client ambulates independently using a walker, but
,becomes unsteady when tired. What should the OTR® include as part of the
intervention for supporting the client's safety at home?
A.
Talk with family members about providing contact-guard assistance whenever the client
is engaged in daily tasks.
B.
Advise the client to complete self-care tasks while seated in a wheelchair in the home
bathroom.
C.
Problem-solve with the client to identify and eliminate existing fall risks within the home.
D.
Teach the client diaphragmatic breathing techniques to use during functional ambulation
at home. -
\The right answer is C
Providing safety strategies for proper use of a walker within the home is the most
effective intervention strategy because it allows the client to identify situations that could
be modified for better safety.
Not B bc that would decrease independence.
While assessing muscle tone in an inpatient who has multiple sclerosis, the OTR®
moves the patient's upper extremity rapidly through its full range while the patient
relaxes the limb. 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?
A. Hypertonicity
B. Flaccidity
C. Spasticity
D. Weakness -
\C - Spasticity
Spasticity is indicated when a sudden catch or resistance occurs within a quick
movement throughout the range of motion for the extremity
A: Hypertonicity is typically elicited during slow joint movements.
B: Flaccidity indicates a lack of muscle tone with no resistance during passive
movement.
D: Weakness is assessed through active movement such as moving the extremity
against gravity.
A client with dementia quits bathing routines before completing them and has difficulty
measuring shampoo and lotion. The areas of the body that are usually washed are
more distal (hands, arms). The client might attempt to wash the back, but not
consistently. At what stage is this client, according to the Allen Cognitive Level Screen?
A. 4.0
B. 3.8
, C. 3.6
D. 3.4 -
\C. 3.6 - At Level 3.6, the client will be able to wash most distal portions of the body and
those that are easily seen but will not always follow the sequence thoroughly. The client
may quit before completion and may have difficulty with measuring soaps, lotions, and
deodorant.
A, B: At Levels 4.0 and 3.8, the client will typically recognize the need for a bath and will
bathe thoroughly as long as no major problems develop during the bathing process (i.e.,
lack of soap).
D: At Level 3.4, the client will typically wash only areas easily seen and reached. The
client may wash one area repetitively and may forget to rinse or dry off.
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. The caregiver is particularly concerned about potential consequences of the
increased dosage. What is the OTR®'s most appropriate suggestion for the caregiver? -
\Observe the client for signs of dizziness, which increases potential for falls.
Donepezil is a cholinergic-modulating drug that may improve memory and cognition and
reduce negative mood, anxiety, and hallucinations; however, dizziness is a side effect.
An OTR® has received a referral to evaluate a client with dementia who lives alone in
the community. When the OTR® arrives at the client's home, the OTR® notices that the
client is well groomed but appears to have forgotten that the OTR® had called earlier in
the day to set up the appointment. Which area of occupation would be a priority to
assess during the initial occupational therapy assessment?
A. Bathing and showering
B. Sleep
C. Emergency system access
D. Personal device care -
\C. Emergency system access
The client has early-stage dementia as evidenced by short-term memory deficits but
maintains the ability to complete routine ADLs. Other ADLs are likely intact, but IADLs,
in particular those that require higher level executive function, would be affected at this
stage. In addition, the client lives alone so understanding the client's safety in the
community would be important.
ABD not impaired at this stage
A client will initiate dressing at the appropriate time of the day but will not attend to the
day, temperature, or season. The client is able to don clothing slowly but has difficulty
with fasteners or fails to see errors in the back (i.e., not tucking in the shirt). At what
stage of the Allen Cognitive Level Screen is this client?
Answers.
An OTR® performs an evaluation on a client who has a new diagnosis of Parkinson's
disease (PD), Stage 1. The client's goal is to maintain employment as an administrative
assistant in a moderate-paced law firm. With which intervention would the OTR® BEST
begin treatment?
A. Instruct the client in adaptive equipment such as large-button telephones and distal
wrist weights.
B. Develop a home exercise program for the client to maximize balance and strength.
C. Plan the client's work day so that the most difficult tasks align with the time when
medications are at optimal effect.
D. Advise the client to alert superiors and coworkers to the new diagnosis to gain
support and help modify work tasks. -
\C. Plan the client's work day so that the most difficult tasks align with the time when
medications are at optimal effect.
What strategy might an OTR® appropriately recommend to caregivers of a client with
Alzheimer's disease to assist with fall prevention?
A. Engage the client in daily, structured activity.
B. Provide visual reminders in the home environment.
C. Install grab bars in the bathroom.
D. Engage the client in an exercise program. -
\A. Engage the client in daily, structured activity.
A client with advanced amyotrophic lateral sclerosis (ALS) is new to a computerized
communication device. On what would the OTR® treating this patient focus?
A. Positioning, to ensure proximal support on a lap tray
B. ROM exercises, to enable the patient to adequately reach the device
C. Trunk strengthening, to enable upright sitting during use of the device
D. Adapting the device with larger buttons and controls, to enable independent use -
\A. Positioning, to ensure proximal support on a lap tray
The simplest and first approach would be to ensure positioning so that the client can
see the device and having the neck and shoulder (proximal muscles) stabilized to allow
the most distal control. The placement of the device is also important, with a lap tray to
secure the device in bed or on the wheelchair.
A client was recently diagnosed with multiple sclerosis and has been referred to
occupational therapy for evaluation. When assessing the client's occupational
performance, which information should the OTR® consider?
A. ADL assessments completed on the first visit
B. Observations of the client's performance over a period of time
C. Results of specific measures, such as the manual muscle test
,D. Observation of the client's routine early in the morning -
\B. Observations of the client's performance over a period of time
Observing the client over a period of time allows the OTR® to identify variability in
endurance and fatigue a client with MS may experience.
How can you make bed mobility easier for clients with Parkinsons Disease? -
\Environmental modifications for improving bed mobility include using light bedding
(e.g., changing from flannel to satin sheets), using a firm mattress, lowering the height
of the bed, and using a bed rail for support.
A client with a recent diagnosis of dementia is receiving occupational therapy. The
caregivers are most distressed about significant behavioral changes that have occurred
since the client was diagnosed. The client has become increasingly impulsive and
difficult to redirect. What type of dementia does this client MOST LIKELY have?
A. Frontotemporal dementia
B. Alzheimer's dementia
C. Vascular dementia
D. Dementia with Lewy bodies -
\A. Frontotemporal dementia
The distinguishing feature of frontotemporal dementia is behavioral changes with an
increase in disinhibited behavior, decreased social tact, lack of empathy, and lack of
interest.
B, C, D: None of these dementia categories has behavioral changes as a significant
symptom
A client with amyotrophic lateral sclerosis reports functional limitations when completing
his daily routine. The OTR® has completed ADL and IADL assessments as part of the
evaluation and is considering how the client's upper-extremity motor control is affecting
his functional ability. Which assessment would be MOST effective for assessing this
client's upper-extremity ability?
A. Modified Ashworth Scale
B. Trigger point evaluation
C. FIM™
D. Purdue Pegboard test -
\D. Purdue Pegboard test
The Purdue Pegboard test is a timed test of upper-extremity function and is useful in
determining a client's functional limitations.
The Modified Ashworth Scale is a measure of spasticity.
An OTR® is providing intervention in the home of a client who is recovering from
Guillain-Barré syndrome. The client ambulates independently using a walker, but
,becomes unsteady when tired. What should the OTR® include as part of the
intervention for supporting the client's safety at home?
A.
Talk with family members about providing contact-guard assistance whenever the client
is engaged in daily tasks.
B.
Advise the client to complete self-care tasks while seated in a wheelchair in the home
bathroom.
C.
Problem-solve with the client to identify and eliminate existing fall risks within the home.
D.
Teach the client diaphragmatic breathing techniques to use during functional ambulation
at home. -
\The right answer is C
Providing safety strategies for proper use of a walker within the home is the most
effective intervention strategy because it allows the client to identify situations that could
be modified for better safety.
Not B bc that would decrease independence.
While assessing muscle tone in an inpatient who has multiple sclerosis, the OTR®
moves the patient's upper extremity rapidly through its full range while the patient
relaxes the limb. 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?
A. Hypertonicity
B. Flaccidity
C. Spasticity
D. Weakness -
\C - Spasticity
Spasticity is indicated when a sudden catch or resistance occurs within a quick
movement throughout the range of motion for the extremity
A: Hypertonicity is typically elicited during slow joint movements.
B: Flaccidity indicates a lack of muscle tone with no resistance during passive
movement.
D: Weakness is assessed through active movement such as moving the extremity
against gravity.
A client with dementia quits bathing routines before completing them and has difficulty
measuring shampoo and lotion. The areas of the body that are usually washed are
more distal (hands, arms). The client might attempt to wash the back, but not
consistently. At what stage is this client, according to the Allen Cognitive Level Screen?
A. 4.0
B. 3.8
, C. 3.6
D. 3.4 -
\C. 3.6 - At Level 3.6, the client will be able to wash most distal portions of the body and
those that are easily seen but will not always follow the sequence thoroughly. The client
may quit before completion and may have difficulty with measuring soaps, lotions, and
deodorant.
A, B: At Levels 4.0 and 3.8, the client will typically recognize the need for a bath and will
bathe thoroughly as long as no major problems develop during the bathing process (i.e.,
lack of soap).
D: At Level 3.4, the client will typically wash only areas easily seen and reached. The
client may wash one area repetitively and may forget to rinse or dry off.
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. The caregiver is particularly concerned about potential consequences of the
increased dosage. What is the OTR®'s most appropriate suggestion for the caregiver? -
\Observe the client for signs of dizziness, which increases potential for falls.
Donepezil is a cholinergic-modulating drug that may improve memory and cognition and
reduce negative mood, anxiety, and hallucinations; however, dizziness is a side effect.
An OTR® has received a referral to evaluate a client with dementia who lives alone in
the community. When the OTR® arrives at the client's home, the OTR® notices that the
client is well groomed but appears to have forgotten that the OTR® had called earlier in
the day to set up the appointment. Which area of occupation would be a priority to
assess during the initial occupational therapy assessment?
A. Bathing and showering
B. Sleep
C. Emergency system access
D. Personal device care -
\C. Emergency system access
The client has early-stage dementia as evidenced by short-term memory deficits but
maintains the ability to complete routine ADLs. Other ADLs are likely intact, but IADLs,
in particular those that require higher level executive function, would be affected at this
stage. In addition, the client lives alone so understanding the client's safety in the
community would be important.
ABD not impaired at this stage
A client will initiate dressing at the appropriate time of the day but will not attend to the
day, temperature, or season. The client is able to don clothing slowly but has difficulty
with fasteners or fails to see errors in the back (i.e., not tucking in the shirt). At what
stage of the Allen Cognitive Level Screen is this client?
