NBCOT- COTA Success: Ultimate Exam
Prep
A client with bilateral elbow contractures has 45° active extension and 90° active flexion
of both elbows and 5° supination/pronation. Upper extremity muscle strength is Normal
(5/5). Which activity would be MOST DIFFICULT for the client to perform without using
compensatory movements?
A.Putting a belt through pant belt loops
B.Tying shoelaces
C.Using a spoon to eat soup -
\C
The results of a task analysis of each of these activities indicate that using a spoon to
eat soup requires supination and would be MOST DIFFICULT for the client to perform
without using compensatory movements.
A COTA is working with the Individualized Education Program (IEP) team to determine
a student's eligibility for school-based OT intervention. What information does the team
rely upon for making final eligibility determinations?
A.Classroom performance and curriculum-based needs
B.Birth history and previous early intervention services
C.Physician's referral and diagnosis severity
D.Standardized test scores and documented disability -
\Correct Answer: A
Rationale:
The Individuals with Disabilities Education Act (IDEA) mandates that eligibility
requirements for IEP services are based on a student's classroom needs and
performance in relation to curriculum-based objectives.
A 4-year-old child with pervasive developmental delay requires maximum assistance for
toileting. The COTA is teaching the child's parents strategies for improving the child's
independence with these tasks. During a session, the parents indicate that over the past
several months the child typically does not have a bowel movement for several days at
a time due to constipation. Which recommendation should the COTA provide the
parents in response to this comment?
A.Consult with a dietitian to learn how to increase the amount of fiber in the child's diet.
B.Schedule an appointment with the child's primary physician to rule out gastrointestinal
issues.
C.Ask a pharmacist to recommend a non-prescription children's stool softener for the
child. -
\Correct Answer: B
Rationale:
A referral to the primary physician is warranted to determine if there is a medical cause
for the child's constipation.
,A COTA is preparing to assess light touch sensation of a client who has an acute radial
nerve palsy. Based on the TYPICAL pattern of sensory impairment for this condition,
where on the dorsum of the affected hand should the COTA expect to detect diminished
light touch?
A.Entire length of the fifth digit
B.Fingertips of the index and middle fingers
C.Area over the first dorsal interossei -
\Correct Answer: C
Rationale:
The area over the first dorsal interossei falls within the sensory distribution of the radial
nerve.
A COTA working in a long term care facility is responsible for teaching the residents
strategies for supporting their independence with BADL. During BADL sessions over the
past week, several of the residents reported that the assistive devices used during the
sessions are not available to them when completing routine BADL with the nursing
aides. What action would be MOST BENEFICIAL for the COTA to take in response to
these reports?
A.Submit an incident report about the nursing aides to the appropriate supervisor.
B.Present in-service training to nursing staff about the benefits and uses of BADL
devices.
C.Ensure the assistive devices are in a visible location and labeled with the residents'
name.
D.Advise the residents to ask for the assistive devices prior to starting BADL. -
\Correct Answer: B
Rationale:
Providing in-service training to the nursing staff will allow the opportunity to teach
information about the benefits and use of BADL devices and to facilitate a collaborative
approach in supporting each resident to meet their goals.
A COTA is selecting activities to include in a homemaking skills session with a client
who has an anxiety disorder. A review of the occupational profile indicates the client
immigrated to the United States with a spouse and two children one year ago. Stress of
the relocation and symptoms of the anxiety disorder are interfering with the ability to
complete simple daily tasks. One of the client's goals is to fully participate in family roles
and routines. What activities should the COTA include in the session in order to support
the client's goal?
A.Provide instruction about using appliances typically found in homes in the U.S.
B.Incorporate the client's culture and values into the session activities.
C.Teach the client about the family values system in the United States. -
\Correct Answer: B
Rationale:
The COTA should gather information about the client's values, routines, habits, and
expectations. When teaching homemaking skills, the COTA should respect and support
the client's cultural preferences.
, A COTA, who works in a hospital setting, is teaching precautions to an inpatient who
recently had open heart surgery. Which of the following would be the MOST
EFFECTIVE communication methods for the COTA to use in the education session to
promote the patient's understanding of the information presented?
Select the three BEST responses.
A.Fill quiet moments with conversation and additional information.
B.Make eye contact during the intervention session.
C.Explain the information thoroughly using evidence and medical language.
D.Provide detailed instructions to the patient and the caregiver.
E.Be approachable and allow the patient to ask questions.
F.Present small amounts of information at a time and give the patient time to respond. -
\Correct Answers: B,E,F
Rationale:
These options represent effective communication methods that result in enhanced
health literacy of the patient.
A client who has multiple sclerosis works as an administrative assistant in a large
corporation. Fatigue and weakness interfere with the client's ability to complete job
tasks. The corporate physician is requesting a job site analysis for this client. What is
the PRIMARY purpose of this type of analysis?
A.To identify the management's willingness to provide special accommodations
B.To assess the client's vocational interests in relation to work assignments
C.To determine the critical work demands in relation to the client needs
D.To observe the client interacting with co-workers within the office environment -
\Correct Answer: C
Rationale:
The PRIMARY purpose of this type of analysis is to observe the client performing job
tasks in a natural environment. This will provide objective information for determining
the impact of the disease in relation to the critical demands of the job.
An inpatient who has congestive heart failure has had a recent decline in function and
now requires a wheelchair for mobility. A COTA is completing a home visit in
preparation for the patient's discharge to live with family. The family lives in an
apartment on the second level of a multi-level apartment building. During the home visit,
the COTA identifies several areas in the apartment that are not accessible by a
wheelchair. What is the NEXT action the COTA should take based on this information?
A.Have family members notify the apartment manager of needed changes.
B.Suggest ways the furniture should be arranged for wheelchair access.
C.Collaborate with the patient and family to discuss the patient's needs. -
\Correct Answer: C
Rationale:
Prior to providing recommendations, the COTA should first discuss options with the
client and the family to establish client-centered priorities.
Prep
A client with bilateral elbow contractures has 45° active extension and 90° active flexion
of both elbows and 5° supination/pronation. Upper extremity muscle strength is Normal
(5/5). Which activity would be MOST DIFFICULT for the client to perform without using
compensatory movements?
A.Putting a belt through pant belt loops
B.Tying shoelaces
C.Using a spoon to eat soup -
\C
The results of a task analysis of each of these activities indicate that using a spoon to
eat soup requires supination and would be MOST DIFFICULT for the client to perform
without using compensatory movements.
A COTA is working with the Individualized Education Program (IEP) team to determine
a student's eligibility for school-based OT intervention. What information does the team
rely upon for making final eligibility determinations?
A.Classroom performance and curriculum-based needs
B.Birth history and previous early intervention services
C.Physician's referral and diagnosis severity
D.Standardized test scores and documented disability -
\Correct Answer: A
Rationale:
The Individuals with Disabilities Education Act (IDEA) mandates that eligibility
requirements for IEP services are based on a student's classroom needs and
performance in relation to curriculum-based objectives.
A 4-year-old child with pervasive developmental delay requires maximum assistance for
toileting. The COTA is teaching the child's parents strategies for improving the child's
independence with these tasks. During a session, the parents indicate that over the past
several months the child typically does not have a bowel movement for several days at
a time due to constipation. Which recommendation should the COTA provide the
parents in response to this comment?
A.Consult with a dietitian to learn how to increase the amount of fiber in the child's diet.
B.Schedule an appointment with the child's primary physician to rule out gastrointestinal
issues.
C.Ask a pharmacist to recommend a non-prescription children's stool softener for the
child. -
\Correct Answer: B
Rationale:
A referral to the primary physician is warranted to determine if there is a medical cause
for the child's constipation.
,A COTA is preparing to assess light touch sensation of a client who has an acute radial
nerve palsy. Based on the TYPICAL pattern of sensory impairment for this condition,
where on the dorsum of the affected hand should the COTA expect to detect diminished
light touch?
A.Entire length of the fifth digit
B.Fingertips of the index and middle fingers
C.Area over the first dorsal interossei -
\Correct Answer: C
Rationale:
The area over the first dorsal interossei falls within the sensory distribution of the radial
nerve.
A COTA working in a long term care facility is responsible for teaching the residents
strategies for supporting their independence with BADL. During BADL sessions over the
past week, several of the residents reported that the assistive devices used during the
sessions are not available to them when completing routine BADL with the nursing
aides. What action would be MOST BENEFICIAL for the COTA to take in response to
these reports?
A.Submit an incident report about the nursing aides to the appropriate supervisor.
B.Present in-service training to nursing staff about the benefits and uses of BADL
devices.
C.Ensure the assistive devices are in a visible location and labeled with the residents'
name.
D.Advise the residents to ask for the assistive devices prior to starting BADL. -
\Correct Answer: B
Rationale:
Providing in-service training to the nursing staff will allow the opportunity to teach
information about the benefits and use of BADL devices and to facilitate a collaborative
approach in supporting each resident to meet their goals.
A COTA is selecting activities to include in a homemaking skills session with a client
who has an anxiety disorder. A review of the occupational profile indicates the client
immigrated to the United States with a spouse and two children one year ago. Stress of
the relocation and symptoms of the anxiety disorder are interfering with the ability to
complete simple daily tasks. One of the client's goals is to fully participate in family roles
and routines. What activities should the COTA include in the session in order to support
the client's goal?
A.Provide instruction about using appliances typically found in homes in the U.S.
B.Incorporate the client's culture and values into the session activities.
C.Teach the client about the family values system in the United States. -
\Correct Answer: B
Rationale:
The COTA should gather information about the client's values, routines, habits, and
expectations. When teaching homemaking skills, the COTA should respect and support
the client's cultural preferences.
, A COTA, who works in a hospital setting, is teaching precautions to an inpatient who
recently had open heart surgery. Which of the following would be the MOST
EFFECTIVE communication methods for the COTA to use in the education session to
promote the patient's understanding of the information presented?
Select the three BEST responses.
A.Fill quiet moments with conversation and additional information.
B.Make eye contact during the intervention session.
C.Explain the information thoroughly using evidence and medical language.
D.Provide detailed instructions to the patient and the caregiver.
E.Be approachable and allow the patient to ask questions.
F.Present small amounts of information at a time and give the patient time to respond. -
\Correct Answers: B,E,F
Rationale:
These options represent effective communication methods that result in enhanced
health literacy of the patient.
A client who has multiple sclerosis works as an administrative assistant in a large
corporation. Fatigue and weakness interfere with the client's ability to complete job
tasks. The corporate physician is requesting a job site analysis for this client. What is
the PRIMARY purpose of this type of analysis?
A.To identify the management's willingness to provide special accommodations
B.To assess the client's vocational interests in relation to work assignments
C.To determine the critical work demands in relation to the client needs
D.To observe the client interacting with co-workers within the office environment -
\Correct Answer: C
Rationale:
The PRIMARY purpose of this type of analysis is to observe the client performing job
tasks in a natural environment. This will provide objective information for determining
the impact of the disease in relation to the critical demands of the job.
An inpatient who has congestive heart failure has had a recent decline in function and
now requires a wheelchair for mobility. A COTA is completing a home visit in
preparation for the patient's discharge to live with family. The family lives in an
apartment on the second level of a multi-level apartment building. During the home visit,
the COTA identifies several areas in the apartment that are not accessible by a
wheelchair. What is the NEXT action the COTA should take based on this information?
A.Have family members notify the apartment manager of needed changes.
B.Suggest ways the furniture should be arranged for wheelchair access.
C.Collaborate with the patient and family to discuss the patient's needs. -
\Correct Answer: C
Rationale:
Prior to providing recommendations, the COTA should first discuss options with the
client and the family to establish client-centered priorities.
