Master NBCOT with Essential
Cardiopulmonary Questions.
An OTR® is providing occupational therapy services to a client in acute care who was
diagnosed with a pulmonary embolism. What is the most typical cause of a pulmonary
embolism?
A. Deep vein thrombosis
B. Pulmonary hypertension
C. Pulmonary edema
D. Lung cancer -
\The right answer is A
Most pulmonary embolisms are caused by a deep vein thrombosis in a lower extremity.
Smith-Gabai, H. (2011). The pulmonary system. In H. Smith-Gabai (Ed,), Occupational
therapy in acute care (pp. 147-182). Bethesda, MD: AOTA Press; p. 165.
Explanations of Incorrect Answers
B, C, D: Clients with pulmonary hypertension, pulmonary edema, and lung cancer are
not at high risk for pulmonary embolism.
When evaluating a client in a skilled nursing facility, the OTR® notes that the client's
skin has a yellowish cast, the fingernail beds are bluish in color, and the client has
noticeable edema in both lower extremities. What condition would MOST likely cause
these symptoms?
A. Right-sided congestive heart failure
B. Left-sided congestive heart failure
C. Aortic stenosis
D. Aortic insufficiency -
\The right answer is A
When the right side of the heart fails, blood flows back into the venous system.
Symptoms of right-sided heart failure include cyanotic nail beds, jaundice, and lower-
extremity edema.
Smith-Gabai, H. (2011). The cardiac system. In H. Smith-Gabai (Ed.), Occupational
therapy in acute care (pp. 75-120). Bethesda, MD: AOTA Press; p. 99.
Explanations of Incorrect Answers
B: When the left side of the heart fails, blood flows back into the lungs, causing difficulty
breathing, anxiety, and cerebral hypoxia.
,C, D: Aortic stenosis and aortic insufficiency have symptoms similar to those of left-
sided heart failure.
An OTR® is working with a client with chronic obstructive pulmonary disease (COPD)
on a morning ADL routine. Which treatment strategy BEST describes how this client can
be independent in showering?
A. Use a shower chair, bathe with hot water from a handheld shower, use relaxation
breathing, and inhale on exertion
B. Use a shower chair, bathe with warm water from a handheld shower, use pursed lip
breathing, and exhale on exertion
C. Sit in the tub for support, bathe with hot water from the tub spout, pace by washing
one extremity at a time and then resting, and lean backward in the tub
D. Sit in the tub for support, bathe with cool water from the tub spout, use a fan to
decrease humidity, and rest arms on the sides of the tub -
\The right answer is B
Using a shower chair, bathing with warm water from a handheld shower, using pursed
lip breathing, and exhaling on exertion all contribute to independent showering for a
client with COPD.
Huntley, N. (2008). Cardiac and pulmonary diseases. In M. V. Radomski & M. C.
Trombly Latham (Eds.), Occupational therapy for physical dysfunction (6th ed., pp.
1295-1320). Baltimore: Lippincott Williams & Wilkins.
Explanations of Incorrect Answers
A: Hot water adds to humidity and makes breathing more difficult. The client should use
pursed lip rather than relaxation breathing techniques and should exhale rather than
inhale on exertion.
C: Using a shower chair takes less energy than getting into and out of a tub. Hot water
adds to humidity and makes breathing more difficult. Leaning forward in the tub
releases the diaphragm and makes breathing easier.
D: Using a shower chair takes less energy than getting into and out of a tub. Cool water
may chill the client and require more energy for tasks. Resting the arms on the thighs,
not on the sides of tub, releases the diaphragm and makes breathing easier.
An OTR® is working with a client who suddenly complains of pressure and tightness in
the chest. The client's symptoms resolve with rest and a nitroglycerin tablet
administered under the tongue. What condition is the client MOST likely to have
experienced during the treatment session?
A. Stable angina
B. Unstable angina
C. Myocardial infarction
, D. Atrial flutter -
\The right answer is A
Stable angina usually resolves with rest, nitroglycerin, or both.
Smith-Gabai, H. (2011). The cardiac system. In H. Smith-Gabai (Ed.), Occupational
therapy in acute care (pp. 75-120). Bethesda, MD: AOTA Press; p. 83.
Explanations of Incorrect Answers
B: Unstable angina does not resolve with rest or nitroglycerin. It requires emergency
treatment.
C: Myocardial infarction also requires emergency treatment.
D: Atrial flutter is usually treated with other medications, ablation, or cardioversion.
An OTR® is working with an acute-care client who has a ventricular assist device.
Which precaution is essential when engaging this client in occupational activities?
A. Do not administer an exercise stress test to this client.
B. Instruct the client in sterile dressing changes to prevent infection.
C. Educate the client to avoid yearly influenza and pneumonia vaccines.
D. Avoid disconnecting the drive line to the power source during movement. -
\The right answer is D
A ventricular assist device requires a power source to function properly. The drive line
connects to the power source. If the OTR is not careful, the drive line can become
disconnected during activity.
Smith-Gabai, H. (2011). The cardiac system. In H. Smith-Gabai (Ed.), Occupational
therapy in acute care (pp. 75-120). Bethesda, MD: AOTA Press; p. 104.
Explanations of Incorrect Answers
A: OTRs do not generally administer exercise stress tests.
B: Clients with burns or open wounds (not clients with a ventricular assist device) are
usually instructed in sterile dressing changes by a nurse.
C: Clients with a ventricular assist device are educated by nursing professionals, not
OTRs, to receive yearly vaccines to prevent influenza and pneumonia.
An OTR® is working with a client who is experiencing dyspnea while performing a daily
occupation in sitting. What sitting position would BEST minimize the client's dyspnea
while performing the occupational task?
A. Sitting with trunk erect and rigidly in midline
Cardiopulmonary Questions.
An OTR® is providing occupational therapy services to a client in acute care who was
diagnosed with a pulmonary embolism. What is the most typical cause of a pulmonary
embolism?
A. Deep vein thrombosis
B. Pulmonary hypertension
C. Pulmonary edema
D. Lung cancer -
\The right answer is A
Most pulmonary embolisms are caused by a deep vein thrombosis in a lower extremity.
Smith-Gabai, H. (2011). The pulmonary system. In H. Smith-Gabai (Ed,), Occupational
therapy in acute care (pp. 147-182). Bethesda, MD: AOTA Press; p. 165.
Explanations of Incorrect Answers
B, C, D: Clients with pulmonary hypertension, pulmonary edema, and lung cancer are
not at high risk for pulmonary embolism.
When evaluating a client in a skilled nursing facility, the OTR® notes that the client's
skin has a yellowish cast, the fingernail beds are bluish in color, and the client has
noticeable edema in both lower extremities. What condition would MOST likely cause
these symptoms?
A. Right-sided congestive heart failure
B. Left-sided congestive heart failure
C. Aortic stenosis
D. Aortic insufficiency -
\The right answer is A
When the right side of the heart fails, blood flows back into the venous system.
Symptoms of right-sided heart failure include cyanotic nail beds, jaundice, and lower-
extremity edema.
Smith-Gabai, H. (2011). The cardiac system. In H. Smith-Gabai (Ed.), Occupational
therapy in acute care (pp. 75-120). Bethesda, MD: AOTA Press; p. 99.
Explanations of Incorrect Answers
B: When the left side of the heart fails, blood flows back into the lungs, causing difficulty
breathing, anxiety, and cerebral hypoxia.
,C, D: Aortic stenosis and aortic insufficiency have symptoms similar to those of left-
sided heart failure.
An OTR® is working with a client with chronic obstructive pulmonary disease (COPD)
on a morning ADL routine. Which treatment strategy BEST describes how this client can
be independent in showering?
A. Use a shower chair, bathe with hot water from a handheld shower, use relaxation
breathing, and inhale on exertion
B. Use a shower chair, bathe with warm water from a handheld shower, use pursed lip
breathing, and exhale on exertion
C. Sit in the tub for support, bathe with hot water from the tub spout, pace by washing
one extremity at a time and then resting, and lean backward in the tub
D. Sit in the tub for support, bathe with cool water from the tub spout, use a fan to
decrease humidity, and rest arms on the sides of the tub -
\The right answer is B
Using a shower chair, bathing with warm water from a handheld shower, using pursed
lip breathing, and exhaling on exertion all contribute to independent showering for a
client with COPD.
Huntley, N. (2008). Cardiac and pulmonary diseases. In M. V. Radomski & M. C.
Trombly Latham (Eds.), Occupational therapy for physical dysfunction (6th ed., pp.
1295-1320). Baltimore: Lippincott Williams & Wilkins.
Explanations of Incorrect Answers
A: Hot water adds to humidity and makes breathing more difficult. The client should use
pursed lip rather than relaxation breathing techniques and should exhale rather than
inhale on exertion.
C: Using a shower chair takes less energy than getting into and out of a tub. Hot water
adds to humidity and makes breathing more difficult. Leaning forward in the tub
releases the diaphragm and makes breathing easier.
D: Using a shower chair takes less energy than getting into and out of a tub. Cool water
may chill the client and require more energy for tasks. Resting the arms on the thighs,
not on the sides of tub, releases the diaphragm and makes breathing easier.
An OTR® is working with a client who suddenly complains of pressure and tightness in
the chest. The client's symptoms resolve with rest and a nitroglycerin tablet
administered under the tongue. What condition is the client MOST likely to have
experienced during the treatment session?
A. Stable angina
B. Unstable angina
C. Myocardial infarction
, D. Atrial flutter -
\The right answer is A
Stable angina usually resolves with rest, nitroglycerin, or both.
Smith-Gabai, H. (2011). The cardiac system. In H. Smith-Gabai (Ed.), Occupational
therapy in acute care (pp. 75-120). Bethesda, MD: AOTA Press; p. 83.
Explanations of Incorrect Answers
B: Unstable angina does not resolve with rest or nitroglycerin. It requires emergency
treatment.
C: Myocardial infarction also requires emergency treatment.
D: Atrial flutter is usually treated with other medications, ablation, or cardioversion.
An OTR® is working with an acute-care client who has a ventricular assist device.
Which precaution is essential when engaging this client in occupational activities?
A. Do not administer an exercise stress test to this client.
B. Instruct the client in sterile dressing changes to prevent infection.
C. Educate the client to avoid yearly influenza and pneumonia vaccines.
D. Avoid disconnecting the drive line to the power source during movement. -
\The right answer is D
A ventricular assist device requires a power source to function properly. The drive line
connects to the power source. If the OTR is not careful, the drive line can become
disconnected during activity.
Smith-Gabai, H. (2011). The cardiac system. In H. Smith-Gabai (Ed.), Occupational
therapy in acute care (pp. 75-120). Bethesda, MD: AOTA Press; p. 104.
Explanations of Incorrect Answers
A: OTRs do not generally administer exercise stress tests.
B: Clients with burns or open wounds (not clients with a ventricular assist device) are
usually instructed in sterile dressing changes by a nurse.
C: Clients with a ventricular assist device are educated by nursing professionals, not
OTRs, to receive yearly vaccines to prevent influenza and pneumonia.
An OTR® is working with a client who is experiencing dyspnea while performing a daily
occupation in sitting. What sitting position would BEST minimize the client's dyspnea
while performing the occupational task?
A. Sitting with trunk erect and rigidly in midline
