NBCOT Prep B 170 Questions_ answered correctly;
Distinction level Exam Guide.
B1. An occupational therapist provides consultation services to a psychogeriatric unit for
individuals with moderately severe cognitive decline. In designing the activity program, which
groups are best for the occupational therapist to include?
a. Reality orientation.
b. Sensory stimulation.
c. Reminiscence.
d. Coping skills. Correct Answer: a
B2. The parents of a five-year-old with attention deficit with hyperactivity disorder (ADHD)
express difficulty managing the child's aggressive behavior toward older siblings. Which is the
most effective strategy for the occupational therapist to recommend to the parents?
a. Allow the child to vent aggressive feelings on a stuffed animal or doll.
b Redirect the child's energy into acceptable and safe play activities.
c Provide consistent punishment for aggressive behavior.
d Send the child to stay with a family member or close friend for an extended "time-out."
Correct Answer: b
B3. An individual with rheumatoid arthritis has developed several boutonniere deformities.
Which of the following is the most accurate description for the occupational therapist to
include in documentation of the individual's presenting signs?
a Hyperextension of the PIP joint and flexion of the DIP joint.
b Ulnar deviation and subluxation of the MCP joints.
c Flexion of the PIP joint and hyperextension of the DIP joint.
d Heberden's nodes at the DIP joints and Bouchard's nodes at the PIP joints. Correct Answer: c
B4. An occupational therapist receives a referral to provide home-based services to an older
adult who lives alone in a fourth floor walk-up apartment. Upon entering the apartment, the
therapist notes the sweltering heat. The apartment has no fans or air conditioners. The client's
skin is hot, dry, and red, and breathing is labored. The therapist offers the client a glass of water
and places ice compresses on the arterial pressure points to help with cooling. Which is the
most important action for the therapist to take next?
a Cancel the intervention session and call for an ambulance to provide emergency medical
services.
b Proceed with the planned intervention session and include documentation about client's
environmental conditions in the intervention report.
c Contact the home health agency's case manager to report the client's environmental
conditions and then proceed with the planned intervention session.
d Cancel the intervention session and advise the client to speak to a doctor on how to best
address the impact of hot weather on personal health. Correct Answer: a
,B5. An occupational therapist observes a COTA® having difficulty transferring a client with
athetoid movements from a mat to a wheelchair. Before the therapist can cross the room to
help with the transfer, the COTA® slides with the client to the floor. The therapist assists the
COTA® in safely returning the client to the wheelchair. They assess that the client appears to be
unharmed and return the client to the unit for a medical evaluation. Which action should the
therapist take next?
a Counsel the COTA® on the need to ask for assistance with difficult transfers.
b Require the COTA® to attend a transfer training inservice.
c Document the COTA®'s unsafe actions in the personnel record.
d Complete an occurrence report according to facility standards. Correct Answer: d
B6. A teenager with spinal muscle atrophy shows decreased trunk balance and strength. Upper
extremity strength and ROM are unchanged from the last evaluation. Which is the best
recommendation for the occupational therapist to make?
a A re-evaluation of the client be completed.
b The client be referred to an orthotist for a soft spinal support.
c The client be measured for a power wheelchair.
d A trunk strengthening program be initiated with the client. Correct Answer: a
B7. An occupational therapist consults with a home care agency interested in starting a falls
prevention program. Which should the occupational therapist do first?
a Review available evaluation protocols.
b Review available screening tools.
c Create a new screening tool.
d Design an evaluation protocol. Correct Answer: b
B8. A four-month-old with arthrogryposis remains in position when placed and shows little
spontaneous movement. The occupational therapist implements intervention to work on
rolling. Which positional changes should the therapist include in the intervention session?
a Prone to supine.
b Supine to side-lying.
c Prone to side-lying.
d Supine to prone. Correct Answer: b
B9. An occupational therapist designs a dining rehabilitation program in a long-term care
facility. The occupational therapist instructs paraprofessional staff in proper feeding
techniques. Which point is most important for the therapist to include in this staff training?
a Meals should occur in a homelike environment with staff conversing with the residents being
fed.
b Residents with swallowing difficulties should be fed in a group so that staff can remind them
to c swallow at the beginning of each meal.
c Placing three fingertips on the throat and pressing firmly will stimulate a swallow response.
d The head should be tilted slightly backward during feeding to facilitate an assisted swallow.
Correct Answer: a
,B10. Following nerve injury repair surgery, an individual is evaluated for sensory return. Which
measurement tool is best for the occupational therapist to use to assess for the return of
vibration?
a A tuning fork.
b Nylon filament.
c A disk-criminator. Correct Answer: a
B11. During a group session at an adult day care program, an older adult consistently complains
that everyone is mumbling. After the group, which action should the occupational therapist
take in response to these statements?
a Notify the client's primary care physician that the person exhibited evidence of paranoia.
b Collaborate with the program director to remove groups from the client's program plan.
c Document objective data about the complaints in the person's chart.
d Notify the primary care physician that the person may need an audiological evaluation.
Correct Answer: d
B12. The occupational therapist completes an intake interview for a work hardening program.
As the individual is leaving, the person gives the therapist a hug and expresses much gratitude.
The individual then tries to kiss the therapist on the lips. Which action is best for the therapist
to take in response to this situation?
a Forcibly push the individual away while telling the person that the behavior is inappropriate
and unacceptable.
b Say nothing but decline the person's admission to the work hardening program based upon
the person's inappropriate behavior.
c State that the individual's behavior oversteps professional boundaries and makes the
therapist uncomfortable.
d Tell the person the behavior is inappropriate and unacceptable and decline the person's
admission to the program. Correct Answer: c
B13. A person with a traumatic brain injury (TBI) is assessed to score a 6 on the Glasgow Coma
Scale. Which should the occupational therapist use to initiate intervention with this person?
a Demonstrated directions.
b Sensory stimulation.
c Verbal cues.
d Hand-over-hand assistance. Correct Answer: b
B14. An occupational therapist working in an outpatient cardiac rehabilitation center develops
an intervention plan for an individual who has entered Phase 2 of cardiac recovery. Which
activities should the therapist recommend be included in this intervention plan?
a Weeding a garden and doing low-impact aerobics.
b Putting away groceries and keyboarding.
c Washing dishes and playing tabletop board games.
d Carrying groceries upstairs and playing basketball. Correct Answer: a
, B15. An individual recovering from an exacerbation of multiple sclerosis is referred by a primary
care physician to an outpatient OT clinic. The referral requests that the occupational therapist
complete a functional capacity evaluation. Which is the most likely reason for this referral?
a Determination of cognitive level.
b Determination of disability status.
c Assessment of instrumental activities of daily living.
d Assessment of return-to-work capabilities. Correct Answer: d
B16. To develop social interaction skills, an occupational therapist implements a group program
for students with autism spectrum disorder (ASD). Which group is best for the therapist to
include in this program?
a A directive group.
b A topical group.
c A developmental group.
d A task-oriented group. Correct Answer: c
B17. A home-care occupational therapist plans intervention for an individual with agoraphobia
with panic attacks. The occupational therapist plans to use a cognitive-behavioral approach.
Which approach is best for the therapist to use with the client during the intitial intervention
session?
a A token reward system.
b Behavioral extinction.
c Relaxation techniques.
d Systematic desensitization. Correct Answer: c
B18. A non-English-speaking family attends a discharge planning session. The assigned
occupational therapist does not share the language of the family. Which action should the
therapist take first?
a Make a referral for a home care therapist to visit the family to provide in-home education.
b Obtain a translator to communicate with the family during the session.
c Attempt to communicate with the family through nonverbal communication.
d Consult with the case manager to develop a discharge plan. Correct Answer: b
B19. The parents of an infant born at 32 weeks' gestation are about to take the baby home
after four weeks in the neonatal intensive care nursery. Which is most important for the
occupational therapist to instruct the parents to avoid?
a Placing the infant in the prone position for sleeping.
b Placing the infant in the supine position for sleeping.
c Using an infant swing with a head support for calming.
d Presenting toys in the mid-line with the infant in the prone position for playing. Correct
Answer: a
Distinction level Exam Guide.
B1. An occupational therapist provides consultation services to a psychogeriatric unit for
individuals with moderately severe cognitive decline. In designing the activity program, which
groups are best for the occupational therapist to include?
a. Reality orientation.
b. Sensory stimulation.
c. Reminiscence.
d. Coping skills. Correct Answer: a
B2. The parents of a five-year-old with attention deficit with hyperactivity disorder (ADHD)
express difficulty managing the child's aggressive behavior toward older siblings. Which is the
most effective strategy for the occupational therapist to recommend to the parents?
a. Allow the child to vent aggressive feelings on a stuffed animal or doll.
b Redirect the child's energy into acceptable and safe play activities.
c Provide consistent punishment for aggressive behavior.
d Send the child to stay with a family member or close friend for an extended "time-out."
Correct Answer: b
B3. An individual with rheumatoid arthritis has developed several boutonniere deformities.
Which of the following is the most accurate description for the occupational therapist to
include in documentation of the individual's presenting signs?
a Hyperextension of the PIP joint and flexion of the DIP joint.
b Ulnar deviation and subluxation of the MCP joints.
c Flexion of the PIP joint and hyperextension of the DIP joint.
d Heberden's nodes at the DIP joints and Bouchard's nodes at the PIP joints. Correct Answer: c
B4. An occupational therapist receives a referral to provide home-based services to an older
adult who lives alone in a fourth floor walk-up apartment. Upon entering the apartment, the
therapist notes the sweltering heat. The apartment has no fans or air conditioners. The client's
skin is hot, dry, and red, and breathing is labored. The therapist offers the client a glass of water
and places ice compresses on the arterial pressure points to help with cooling. Which is the
most important action for the therapist to take next?
a Cancel the intervention session and call for an ambulance to provide emergency medical
services.
b Proceed with the planned intervention session and include documentation about client's
environmental conditions in the intervention report.
c Contact the home health agency's case manager to report the client's environmental
conditions and then proceed with the planned intervention session.
d Cancel the intervention session and advise the client to speak to a doctor on how to best
address the impact of hot weather on personal health. Correct Answer: a
,B5. An occupational therapist observes a COTA® having difficulty transferring a client with
athetoid movements from a mat to a wheelchair. Before the therapist can cross the room to
help with the transfer, the COTA® slides with the client to the floor. The therapist assists the
COTA® in safely returning the client to the wheelchair. They assess that the client appears to be
unharmed and return the client to the unit for a medical evaluation. Which action should the
therapist take next?
a Counsel the COTA® on the need to ask for assistance with difficult transfers.
b Require the COTA® to attend a transfer training inservice.
c Document the COTA®'s unsafe actions in the personnel record.
d Complete an occurrence report according to facility standards. Correct Answer: d
B6. A teenager with spinal muscle atrophy shows decreased trunk balance and strength. Upper
extremity strength and ROM are unchanged from the last evaluation. Which is the best
recommendation for the occupational therapist to make?
a A re-evaluation of the client be completed.
b The client be referred to an orthotist for a soft spinal support.
c The client be measured for a power wheelchair.
d A trunk strengthening program be initiated with the client. Correct Answer: a
B7. An occupational therapist consults with a home care agency interested in starting a falls
prevention program. Which should the occupational therapist do first?
a Review available evaluation protocols.
b Review available screening tools.
c Create a new screening tool.
d Design an evaluation protocol. Correct Answer: b
B8. A four-month-old with arthrogryposis remains in position when placed and shows little
spontaneous movement. The occupational therapist implements intervention to work on
rolling. Which positional changes should the therapist include in the intervention session?
a Prone to supine.
b Supine to side-lying.
c Prone to side-lying.
d Supine to prone. Correct Answer: b
B9. An occupational therapist designs a dining rehabilitation program in a long-term care
facility. The occupational therapist instructs paraprofessional staff in proper feeding
techniques. Which point is most important for the therapist to include in this staff training?
a Meals should occur in a homelike environment with staff conversing with the residents being
fed.
b Residents with swallowing difficulties should be fed in a group so that staff can remind them
to c swallow at the beginning of each meal.
c Placing three fingertips on the throat and pressing firmly will stimulate a swallow response.
d The head should be tilted slightly backward during feeding to facilitate an assisted swallow.
Correct Answer: a
,B10. Following nerve injury repair surgery, an individual is evaluated for sensory return. Which
measurement tool is best for the occupational therapist to use to assess for the return of
vibration?
a A tuning fork.
b Nylon filament.
c A disk-criminator. Correct Answer: a
B11. During a group session at an adult day care program, an older adult consistently complains
that everyone is mumbling. After the group, which action should the occupational therapist
take in response to these statements?
a Notify the client's primary care physician that the person exhibited evidence of paranoia.
b Collaborate with the program director to remove groups from the client's program plan.
c Document objective data about the complaints in the person's chart.
d Notify the primary care physician that the person may need an audiological evaluation.
Correct Answer: d
B12. The occupational therapist completes an intake interview for a work hardening program.
As the individual is leaving, the person gives the therapist a hug and expresses much gratitude.
The individual then tries to kiss the therapist on the lips. Which action is best for the therapist
to take in response to this situation?
a Forcibly push the individual away while telling the person that the behavior is inappropriate
and unacceptable.
b Say nothing but decline the person's admission to the work hardening program based upon
the person's inappropriate behavior.
c State that the individual's behavior oversteps professional boundaries and makes the
therapist uncomfortable.
d Tell the person the behavior is inappropriate and unacceptable and decline the person's
admission to the program. Correct Answer: c
B13. A person with a traumatic brain injury (TBI) is assessed to score a 6 on the Glasgow Coma
Scale. Which should the occupational therapist use to initiate intervention with this person?
a Demonstrated directions.
b Sensory stimulation.
c Verbal cues.
d Hand-over-hand assistance. Correct Answer: b
B14. An occupational therapist working in an outpatient cardiac rehabilitation center develops
an intervention plan for an individual who has entered Phase 2 of cardiac recovery. Which
activities should the therapist recommend be included in this intervention plan?
a Weeding a garden and doing low-impact aerobics.
b Putting away groceries and keyboarding.
c Washing dishes and playing tabletop board games.
d Carrying groceries upstairs and playing basketball. Correct Answer: a
, B15. An individual recovering from an exacerbation of multiple sclerosis is referred by a primary
care physician to an outpatient OT clinic. The referral requests that the occupational therapist
complete a functional capacity evaluation. Which is the most likely reason for this referral?
a Determination of cognitive level.
b Determination of disability status.
c Assessment of instrumental activities of daily living.
d Assessment of return-to-work capabilities. Correct Answer: d
B16. To develop social interaction skills, an occupational therapist implements a group program
for students with autism spectrum disorder (ASD). Which group is best for the therapist to
include in this program?
a A directive group.
b A topical group.
c A developmental group.
d A task-oriented group. Correct Answer: c
B17. A home-care occupational therapist plans intervention for an individual with agoraphobia
with panic attacks. The occupational therapist plans to use a cognitive-behavioral approach.
Which approach is best for the therapist to use with the client during the intitial intervention
session?
a A token reward system.
b Behavioral extinction.
c Relaxation techniques.
d Systematic desensitization. Correct Answer: c
B18. A non-English-speaking family attends a discharge planning session. The assigned
occupational therapist does not share the language of the family. Which action should the
therapist take first?
a Make a referral for a home care therapist to visit the family to provide in-home education.
b Obtain a translator to communicate with the family during the session.
c Attempt to communicate with the family through nonverbal communication.
d Consult with the case manager to develop a discharge plan. Correct Answer: b
B19. The parents of an infant born at 32 weeks' gestation are about to take the baby home
after four weeks in the neonatal intensive care nursery. Which is most important for the
occupational therapist to instruct the parents to avoid?
a Placing the infant in the prone position for sleeping.
b Placing the infant in the supine position for sleeping.
c Using an infant swing with a head support for calming.
d Presenting toys in the mid-line with the infant in the prone position for playing. Correct
Answer: a
