Master NBCOT Exam: Essential Practice
Prep for Mini Test 2.
An OTR is developing an intervention plan for a child who has multiple physical
disabilities. Which contextual factors are MOST IMPORTANT for the OTR to consider
as part of this decision making process? -
\Parent goals and research studies supporting the proposed intervention (Although all
options represent considerations when developing an intervention plan, using the
principles of evidence-based and client-centered practice are most important.)
An OTR working in a pediatric acute care setting is contributing to the discharge
recommendations for a patient who was admitted to the hospital due to a pulmonary
exacerbation of cystic fibrosis. Current medical interventions include mechanical
ventilation support for breathing and multiple intravenous medications. The patient is
weaning from the ventilator and long-term therapy goals include optimizing the patient's
performance in ADL and IADL. Which discharge setting would be MOST BENEFICIAL
for the OTR to recommend for the patient's next level of care? -
\Long-term Acute care
An OTR working in an acute care setting is contributing to the discharge
recommendations for an older adult inpatient. The patient has mild cognitive impairment
and was admitted to the hospital 4 days ago due to a syncopal event with a diagnosis of
atrial fibrillation and hypertension. The patient lives with family who are available to
provide care as needed, but the patient wants to be independent in ADL. Currently, the
patient completes BADL with supervision, but occasionally relies on physical assistance
from a caregiver to stand up from the toilet. Which discharge setting would be MOST
BENEFICIAL for the OTR to recommend for the patient's next level of care? -
\Home with home health services (This patient does not meet criteria for inpatient
rehabilitation. The discharge recommendation for this patient is home with OT through
home health services because the family are able to provide periodic assistance when
needed as the patient makes progress towards independence in ADL.)
An OTR working in a home health setting is collaborating with a client who has mild
dementia to establish client-centered goals and to obtain informed consent for the
intervention plan. Which action should the OTR complete NEXT as part of the informed
consent process for this client? -
\Assess the client's decision-making skills.
What is the FIRST action an OTR should take if a client who has paranoid personality
disorder becomes suspicious and reports feeling exploited during an intervention
session? -
\Avoid confrontation and remind the client of the intentions of the therapeutic
relationship. (The general approach with a client who has a paranoid personality
, disorder is to avoid confrontation, and progressively engage the client to develop a
trusting and effective therapeutic relationship.)
An inpatient in an intensive care unit is in the initial acute phase of Guillain-Barré
syndrome. The OTR modified the nurse call bell to allow the patient to use available
neck movement to push against a switch attached to the pillow. What additional
interventions would be MOST BENEFICIAL for the patient during this phase of the
disease process? -
\Positioning and PROM to minimize contractures
To influence modifiable risk factors for readmission, which action should be a priority for
an OTR working in an acute care hospital to complete prior to a patient's discharge
home? -
\Address unmet IADL and ADL needs.
(ADL and IADL needs are considered modifiable risk factors that the OTR can address
to positively influence the risk for readmission.)
An OTR working in an outpatient setting is planning intervention for a client who has a
trigger finger of the third digit on the dominant hand and wants to avoid surgical
intervention. The client reports symptoms associated with this condition are limiting the
ability to participate in everyday activities. What should the OTR include as part of the
INITIAL intervention with this client? -
\Prescribe a static immobilization orthosis to position the affected MCP joint at 0° and
instructions to avoid MCP flexion. (For a diagnosis of trigger finger, the optimal position
includes maintaining the MCP joint at 0° while allowing the DIP and PIP full AROM, and
instructions to avoid MCP flexion.)
An inpatient in the cardiac intensive care unit had a myocardial infarction 3 days ago.
The patient is overwhelmed and shocked by the unexpected change in functional
abilities. To facilitate a positive adaptive response to this medical situation, what action
would be MOST BENEFICIAL for the OTR to take? -
\Provide support and empathy while the patient expresses feelings.
An OTR is evaluating an older adult in patient who has had a rapid decline in self-
feeding and dressing skills. The patient was confused and unable to respond to verbal
instructions. Before the OT intervention plan was implemented, medications were
adjusted and the patient's mental status improved. What action should the OTR take
FIRST in this situation? -
\Reevaluate the patient
An OTR, who works in medical oncology, plans to have an inpatient walk to the
bathroom and complete all steps for showering. Prior to the session, the OTR reviewed
the medical record and noted that the international normalized ratio (INR) value for the
patient is greater than 5.0. What action should the OTR take based on this INR value? -
\Cancel the intervention session planned for the day. (A patient with an INR > 5 is at risk
for bleeding and is typically placed on bedrest or activity restrictions.)
Prep for Mini Test 2.
An OTR is developing an intervention plan for a child who has multiple physical
disabilities. Which contextual factors are MOST IMPORTANT for the OTR to consider
as part of this decision making process? -
\Parent goals and research studies supporting the proposed intervention (Although all
options represent considerations when developing an intervention plan, using the
principles of evidence-based and client-centered practice are most important.)
An OTR working in a pediatric acute care setting is contributing to the discharge
recommendations for a patient who was admitted to the hospital due to a pulmonary
exacerbation of cystic fibrosis. Current medical interventions include mechanical
ventilation support for breathing and multiple intravenous medications. The patient is
weaning from the ventilator and long-term therapy goals include optimizing the patient's
performance in ADL and IADL. Which discharge setting would be MOST BENEFICIAL
for the OTR to recommend for the patient's next level of care? -
\Long-term Acute care
An OTR working in an acute care setting is contributing to the discharge
recommendations for an older adult inpatient. The patient has mild cognitive impairment
and was admitted to the hospital 4 days ago due to a syncopal event with a diagnosis of
atrial fibrillation and hypertension. The patient lives with family who are available to
provide care as needed, but the patient wants to be independent in ADL. Currently, the
patient completes BADL with supervision, but occasionally relies on physical assistance
from a caregiver to stand up from the toilet. Which discharge setting would be MOST
BENEFICIAL for the OTR to recommend for the patient's next level of care? -
\Home with home health services (This patient does not meet criteria for inpatient
rehabilitation. The discharge recommendation for this patient is home with OT through
home health services because the family are able to provide periodic assistance when
needed as the patient makes progress towards independence in ADL.)
An OTR working in a home health setting is collaborating with a client who has mild
dementia to establish client-centered goals and to obtain informed consent for the
intervention plan. Which action should the OTR complete NEXT as part of the informed
consent process for this client? -
\Assess the client's decision-making skills.
What is the FIRST action an OTR should take if a client who has paranoid personality
disorder becomes suspicious and reports feeling exploited during an intervention
session? -
\Avoid confrontation and remind the client of the intentions of the therapeutic
relationship. (The general approach with a client who has a paranoid personality
, disorder is to avoid confrontation, and progressively engage the client to develop a
trusting and effective therapeutic relationship.)
An inpatient in an intensive care unit is in the initial acute phase of Guillain-Barré
syndrome. The OTR modified the nurse call bell to allow the patient to use available
neck movement to push against a switch attached to the pillow. What additional
interventions would be MOST BENEFICIAL for the patient during this phase of the
disease process? -
\Positioning and PROM to minimize contractures
To influence modifiable risk factors for readmission, which action should be a priority for
an OTR working in an acute care hospital to complete prior to a patient's discharge
home? -
\Address unmet IADL and ADL needs.
(ADL and IADL needs are considered modifiable risk factors that the OTR can address
to positively influence the risk for readmission.)
An OTR working in an outpatient setting is planning intervention for a client who has a
trigger finger of the third digit on the dominant hand and wants to avoid surgical
intervention. The client reports symptoms associated with this condition are limiting the
ability to participate in everyday activities. What should the OTR include as part of the
INITIAL intervention with this client? -
\Prescribe a static immobilization orthosis to position the affected MCP joint at 0° and
instructions to avoid MCP flexion. (For a diagnosis of trigger finger, the optimal position
includes maintaining the MCP joint at 0° while allowing the DIP and PIP full AROM, and
instructions to avoid MCP flexion.)
An inpatient in the cardiac intensive care unit had a myocardial infarction 3 days ago.
The patient is overwhelmed and shocked by the unexpected change in functional
abilities. To facilitate a positive adaptive response to this medical situation, what action
would be MOST BENEFICIAL for the OTR to take? -
\Provide support and empathy while the patient expresses feelings.
An OTR is evaluating an older adult in patient who has had a rapid decline in self-
feeding and dressing skills. The patient was confused and unable to respond to verbal
instructions. Before the OT intervention plan was implemented, medications were
adjusted and the patient's mental status improved. What action should the OTR take
FIRST in this situation? -
\Reevaluate the patient
An OTR, who works in medical oncology, plans to have an inpatient walk to the
bathroom and complete all steps for showering. Prior to the session, the OTR reviewed
the medical record and noted that the international normalized ratio (INR) value for the
patient is greater than 5.0. What action should the OTR take based on this INR value? -
\Cancel the intervention session planned for the day. (A patient with an INR > 5 is at risk
for bleeding and is typically placed on bedrest or activity restrictions.)
