Physical Dysfunction Anne has been diagnosed with ALS, stage 2.

She has been experiencing moderate, selective weakness in both her upper and lower extremities and slightly decreased independence in ADLs. What intervention should you use to focus on performance in Areas of Occupation? a. Integrate hand orthotic use into daily activities b. Integrate energy conservation into daily activities, work and leisure c. Consider orthotic support d. Encourage deep breathing exercises, chest stretching, and postural draining if needed (pedretti) Answer: A: hand orthotic use is necessary to facilitate performance in ADLs since the patient experiences weakness in both her upper extremities. Incorrect: B is an intervention used in stage 1 ALS, since at this stage, the patient experiences mild weakness and clumsiness and is ambulatory and still independent with ADLs. C and D are interventions that focus on client factors. 2. A patient four days status post transtibial amputation is transported to occupational therapy for a scheduled treatment session. Assuming an uncomplicated recovery, the MOST appropriate patient transfer to utilize from a wheelchair to a mat table is: a. Two-person lift b. Hydraulic lift c. Stand pivot d. Sliding board (giles) Answer: C: this is used when a patient is able to stand and bear weight through one or both of the lower extremities; the patient must possess functional balance and the ability to pivot. Incorrect: A: this is used to transfer a patient between two surfaces of different heights or when transferring a patient to the floor. B: a device is required for dependent transfers when a patient is obese, when there is only one therapist available to assist with the transfer or when the patient is totally dependent. D: this is used with a patient who has sitting balance, some upper extremity strength, and can adequately follow directions. 3. A patient rehabilitating from extensive burns to the right upper extremity often complains of severe pain in the arm during occupational therapy treatment sessions. The present plan of care emphasizes range of motion, stretching, and positioning. The MOST appropriate action to address the patient’s complaint is to: a. Reduce the frequency and duration of the treatment sessions b. Schedule treatment sessions when the patient’s pain medication is most effective c. Avoid treatment activities that are uncomfortable for the patient d. Request that the referring physician increase the dosage of the patient’s pain medication (giles) Answer: B: patient should receive the optimal benefit of pain medication during their scheduled therapy session; greater tolerance may allow the patient to make more rapid progress in therapy. Incorrect: A: reducing the frequency and duration of treatment will not allow for adequate intervention and burn care; patient participation may decrease as well as secondary to pain if they are not treated in coordination with the pain medication schedule. C: patients with burns will likely have discomfort with all activities and treatments; avoiding certain treatments would be negligent. D: The physician is responsible for prescribing the correct amount of medication. Increasing the dosage of the pain medication may not benefit the patient if occupational therapy is not performed at an appropriate time. 4. An occupational therapist attempts to transfer dependent patient from a wheelchair to bed. The therapist is concerned about the size of the patient, but is unable to secure another staff member to assist with the transfer. Which type of transfer would allow the therapist to move the patient with the GREATEST ease? a. Dependent standing pivot 1.

b. Hydraulic lift c. Sliding board d. Assisted standing pivot (giles) Answer: B: this transfer allows the therapist to transfer the patient independently from the wheelchair to the bed without jeopardizing patient or staff safety. Incorrect: A: would not be appropriate for a therapist to that is concerned about the patient’s size. This transfer requires the therapist to perform 100% of the activity. C: requires the patient to possess adequate sitting balance and actively participate in the transfer; this type of transfer would not be appropriate for a dependent patient. D: requires the patient to stand and participate in the transfer. 5. An occupational therapist measures a patient for a wheelchair. When measuring back height, which method is MOST accurate? a. Measure from the seat of the chair to the base of the axilla and subtract 2 inches b. Measure from the seat of the chair to the base of the axilla and subtract 4 inches c. Measure from the seat of the chair to the acromion process and subtract 2 inches d. Measure from the seat of the chair to the acromion process and subtract 4 inches (giles) Answer: B: back height should be determined by measuring from the seat of the chair to the base of the axilla and subtracting four inches. This method will allow the back height to fall below the inferior angle of the scapula. The height of the seat cushion used, if applicable, must be added to the obtained measurement. Incorrect: A: measuring from the seat of the chair to the base of the axilla and subtracting 2 inches would result in the back height being at the mid-scapular level; this back height would be too high to allow for optimal mobility. C: measuring from the seat of the chair to the acromion process and subtracting two inches would result in a back height that is excessive and would significantly restrict the patient’s movement. D: Measuring from the seat of the chair to the acromion process and subtracting four inches is more desirable than option C, but would still not allow the back height to fall below the inferior angle of the scapula. 6. An occupational therapist transports a patient with multiple sclerosis to the OT room for her treatment session. The patient is wheelchair dependent and uses a urinary catheter. When transporting the patient, the MOST appropriate location to secure the collection bag is: a. In the patient’s lap b. On the patient’s lower abdomen c. On the wheelchair armrest d. On the wheelchair cross brace beneath the seat (giles) urine drains into a collection bag as a result of the effect of gravity; therefore the collection bag from a urinary catheter must be positioned below the level of the bladder. Answer: D. positioning the collection bag on the cross brace beneath the seat will allow it to be below the level of the bladder and will minimize the possibility that the bag or tubing will be pulled or snagged. Incorrect: A. securing the collection bag in the patient’s lap would result in the collection bag being at a similar level as the patient’s bladder. The position would interfere with virtually any activity that required movement. B. the lower abdomen is above the level of the bladder and would also interfere with any movement. Additionally, the patient may be embarrassed or bothered by having the collection bag in such a visible location. C. the wheelchair armrest is above the level of the bladder and therefore would impede the flow of urine into the collection bag. 7. Carson is a 5-year old client who sustained a C6 spinal cord injury secondary to a motor vehicle accident (MVA). The injury occurred to the right side of his spinal cord. The OT begins the evaluation knowing that the sensation will most likely be impaired on the left side of the body, below the level of the lesion is: a. Two-point discrimination b. Touch localization

c. Raynaud’s Phenomenon
 b. Accurate insight about current abilities d. Ask the physician to write an order for an immediate video fluoroscopy and a pureed diet.html) Answer: A Incorrect: B. Baltimore. Active wrist flexion and extension exercises d.html) Answer: C. The best splint for conservative management is: a.html) Answer: D. The resident wants to eat meals in the facility dining room but is embarrassed about frequently dropping assistive eating devices and having several incidences of coughing while eating.com/2012/10/past-nbcotquestions-on-fb-otr-set. Vacuuming floors in the main living area of the home d. C. Shoulder and elbow b. Pain and temperature will be absent on the left side of the body below the level of the lesion to the right half of the spinal cord.com/2012/10/past-nbcotquestions-on-fb-otr-set. Temperature d. Inform the dining staff to cut the resident’s food into small pieces and provide built-up utensils.blogspot. Immobilization d. 14.html) Answer: A: patients at Level VII (Automatic-Appropriate) on the Rancho Los Amigos Scale appear appropriate and oriented. Static MP extension splint c. MV.blogspot. Exercise in treatment today should focus on: a. D: These are not typically considered mealtime risks associated with ALS. Williams and Wilkins. (http://almostot. MD: Lippincott. C (2008). and two-point discrimination will likely remain intact. Which characteristic of an individual’s cognitive-behavioral function is TYPICALLY included in the description of this level? a. B. D: Cryotherapy is the recommended modality immediately following an acute injury and during an acute inflammatory phase. Reliable carry-over of learning for most ADL (http://almostot. b. Coordinate with the multi-disciplinary team to identify specific feeding and swallowing objectives. d. Peripheral nerve distribution b. MV. Trombly-Latham. Which flexor tendon protocol is used with very young children or adults who are noncompliant? a. Amytrophic lateral sclerosis (ALS) is a progressive neurological disease. Trombly-Latham. Occupational Therapy for .com/2012/10/past-nbcotquestions-on-fb-otr-set. A symptom associated with dysphagia is variation in voice quality or loss of voice after swallowing. Regurgitation of food and liquids after swallowing (http://almostot. Reference: Radomski. Peripheral nerve distributions are used for clients who experience trauma to the peripheral nerves either by injury or disease.). B. Tenosynovitis (http://almostot. Duran uses passive flexion and extension. Chris fractured his right wrist and underwent a closed reduction 7 weeks ago. The resident’s upper extremity functional strength is Trace (1/5) on the left and Poor Minus (2-/5) on the right. Occupational Therapy for Physical Dysfunction (6th ed. Incorrect:
A. Elbow extension splint d. Consistent orientation to person and place b. Acute ligament sprain
 c. Static splinting of the wrist is recommended at night to minimize the pressure in the carpal tunnel. These conditions respond positively to the use of a cold PAM 13. and central nervous distributions occur when clients sustain head injuries or some other trauma to the brain or spinal cord. The OT receives orders to evaluate and treat a patient with a T2 spinal cord injury (SCI). C: These options should not be considered until after the team has established feeding and swallowing objectives.blogspot. 11. Light-headedness when moving from a wheelchair to the dining chair b. 15. B. Pages 1092-1095. touch localization. his cast was removed today. Kleinert c. but they do not require the detailed attention required to install curtain rods.c. Passive wrist flexion and extension exercises c. Antideformity splint (JBReview) Answer: A. Wrist cock-up splint with the wrist in neutral b. Advise the dietary staff to provide the resident with a room temperature clear liquid at every meal. Central nervous distribution d. Care coordination with the multi-disciplinary team meets best practice standards. and Chow uses a combination of Kleinert and Duran. What will be the focus of the sensory testing? a. 12. Variation in voice quality or loss of voice after swallowing d. An OTR is preparing to interview an outpatient who has a TBI and is functioning at Level VII (AutomaticAppropriate) on the Rancho Los Amigos Scale. Using a roller brush to paint an interior wall of the home c. 1322 16. C: These tasks require motor planning. Brachial plexus distribution (JBReview) Answer: B.blogspot. The OT receives an order to splint a patient with carpal tunnel syndrome. Individuals who have constructional apraxia have difficulty constructing/assembling objects. The resident’s symptoms of coughing while eating/swallowing could indicate dysphagia. Immobilization is the only protocol that does not require client participation. Dermatomal distribution c. 9. Washing the interior sides of single pane windows b. Kleinert uses rubber bnd traction. they do not require the detailed attention required to follow instructions for installing the curtain rods. Incorrect: A. Isolated extensor digitorum communis (EDC) exercises and wrist extension exercises (JBReview) Answer: C. Screening results indicate the resident’s functional status may be declining. Following written instructions for installing curtain rods (http://almostot. During which home maintenance tasks would symptoms related to constructional apraxia be MOST EVIDENT? a. Chow (JBReview) Answer: C. Reference: Radomski. What care coordination task should the OTR complete FIRST based on the results of the screening? a. Incorrect: A. and a pounding headache after eating c. as in following instructions for installing curtain rods.blogspot. Heavy sweating. C (2008). Independent evaluation and intervention of the resident’s swallowing difficulties is beyond the scope of practice for the entry-level OTR. For questions 15-17: Scenario: An entry-level OTR who works in a long term care facility is screening a resident who has amyotrophic lateral sclerosis and uses a wheelchair.com/2012/10/past-nbcotquestions-on-fb-otr-set. It is important to retrain the wrist extensors independent of the EDC. Myofascial trigger points
 d. 8.com/2012/10/past-nbcotquestions-on-fb-otr-set. The use of cryotherapy as a physical agent modality (PAM) is CONTRAINDICATED for clients who have which diagnoses? a. Joint motion or kinesthesia (JBReview) Answer: C. It is also important to retrain the EDC independent of the intrinsics 10. They frequently display robot-like behaviors and require minimal assistance for routine ADL. flushed skin.html) Answer: D. Duran b. Realistic judgment for future planning c. Joint motion. Which of the following symptoms is this resident MOST at risk for experiencing during a meal? a.

Pages 433-434. Trombly-Latham. Schultz-Krohn W (eds). Pages 38. Identify the areas of occupation the client wants or needs to do. Observe specific client factors during a typical BADL task. 471-476 For questions 20-23: A client has moderate hemiplegia. MD: Lippincott. Page: 127. Which task-oriented approach would be MOST BENEFICIAL to include as part of the intervention plan for maximizing the client’s physical abilities? a. The client rates the pain as a 3/10 using a visual analog scale. This client is very weak as noted in a muscle grade of Poor minus (2-/5). c. Ability to attach the device to the patient’s wheelchair c. Cognitive and . MV. Occupational Therapy for Physical Dysfunction (6th ed. 815.html) Answer: D. Incorrect: A. The client plans to return to work as a librarian.). Dominance retraining during a variety of writing and drawing tasks (http://almostot. D: Volkmann’s ischemia is a complication associated with an elbow fracture.). Pedretti’s Occupational Therapy: Practice Skills for Physical Dysfunction (6th ed. Decreasing the resistance and increasing the number of repetitions c. Evaluation results indicate the client has full functional ROM and normal sensation and skin pallor of the hand. 445 18. C: These could be included as part of the initial evaluation but only after learning about the client’s wants and needs. MO: Elsevier Mosby. Williams and Wilkins. For clients with this amount of weakness. What should the OTR conclude is the PRIMARY cause for this discrepancy? a.Physical Dysfunction (6th ed. D: These are not remediation activities. Williams and Wilkins.).blogspot.html) Answer: A. What is the MOST EFFECTIVE method for grading an activity to improve the client’s muscular strength? a.). A client who had a distal humerus fracture 8 weeks ago has been referred to OT one day after removal of a long arm cast. Post-traumatic ischemia (http://almostot. D: Athetoid movements typically are not associated with ALS. Baltimore.blogspot. Trombly-Latham. MV. Baltimore. Perform a standardized assessment of motor and process skills. Incorrect: A. 1113 19. Pages 1092-1096.). Louis. Louis. Constraint-induced movement therapy is a task-oriented approach to motor control acquisition. Training on the use of adaptive equipment to support an area of occupation c.com/2012/10/past-nbcotquestions-on-fb-otr-set. Completing movements through a full arc of motion against gravity (http://almostot. Soft tissue tightness d. Reference: Radomski. An OTR and COTA in an outpatient setting are collaborating to initially evaluate the client using an ecological model. B: Assessing the resident’s ROM should be done before identifying the staff’s ability or the ability to attach the device to the wheelchair. Pages 1092-1096. Screening results indicate this resident has significant weakness secondary to the disease.blogspot. Secondary nerve injury c. dysarthria and diplopia secondary to having had a CVA several weeks ago. Reference: "American Occupational Therapy Association (2008).blogspot. Pedretti’s Occupational Therapy: Practice Skills for Physical Dysfunction (6th ed. It has the potential to be a secondary complication associated with aggressive passive ROM. MD: Lippincott. (http://almostot. Louis. (2006). Williams and Wilkins. Results indicate the client has Poor minus (2-/5) functional strength of the dominant upper extremity. C. St. Reference: Radomski.com/2012/10/past-nbcotquestions-on-fb-otr-set. Amytrophic lateral sclerosis (ALS) is a progressive neurological disease. 576 & Gillen G. 62(6). Occupational Therapy for Physical Dysfunction (6th ed. Repetitive practice of an occupational performance skill in context b. An OTR has completed a manual muscle test of a client. MD: Lippincott. Which type of activity should be included as part of the INITIAL intervention to remediate the client’s motor impairment? a. Schultz-Krohn W (eds). C (2008). Records indicate the client is a single parent of an adolescent. Reference: Radomski. 20. Amount of upper extremity passive joint mobility d. Staff’s ability to set up the device for the resident b. St. Dominance retraining activities d.com/2012/10/past-nbcotquestions-on-fb-otr-set. Reference: Pendleton HM. 21.blogspot. Which factor is MOST IMPORTANT for the OTR to initially determine when considering if this resident would benefit from a mobile arm support? a. Williams and Wilkins. This information can then be used to help determine the type and focus of the remainder of the evaluation. the most effective method for increasing strength is to increase the amount of time an isometric contraction is held. Evidence indicates that repetitive practice of a skill in context will help with cortical map reorganization for regaining functional use of the affected extremity. Increasing the number of repetitions while maintaining the same resistance b. B: Nerve injuries secondary to an elbow fracture typically impact the ROM and sensation of the hand.com/2012/10/past-nbcotquestions-on-fb-otr-set. A client with this compartment syndrome would have sensory. Baltimore. 1331 17. Reference: Pendleton HM. MO: Elsevier Mosby. Weight bearing through the affected upper extremity prior to an activity d. St. Visual attention and scanning exercises (http://almostot.html) Answer: C. What is the FIRST step the OTR should take when evaluating this client? a. MD: Lippincott. MO: Elsevier Mosby. American Journal of Occupational Therapy.com/2012/10/past-nbcotquestions-on-fb-otr-set. motor and vascular changes in the hand.html) Answer: B. Occupational Therapy for Physical Dysfunction (6th ed. D: These will not help the client maximize physical abilities. Pedretti’s Occupational Therapy: Practice Skills for Physical Dysfunction (6th ed.com/2012/10/past-nbcotquestions-on-fb-otr-set. (2006). Incorrect: B.). This approach focuses on facilitating use of the affected arm during activities and helping the client overcome learned nonuse. Pages: 124. (2006). C (2008). Augmentative communication b. C (2008). Baltimore. Increasing the amount of time an isometric contraction is held d. C. Incorrect: A: This grading method is best for increasing endurance. Soft tissue changes due to immobilization should be considered as the primary cause of the client’s elbow ROM deficits.). Constraint-induced movement therapy c.362 & Pendleton HM. Assess deficits related to the client’s performance skills and patterns. The resident must have sufficient passive ROM to effectively use a mobile arm support. b. Heterotopic ossification b. Schultz-Krohn W (eds). Incorrect: A. Pages 793-798. Elbow goniometric measurements show the client’s passive elbow ROM is significantly less than the norms.793-798 22. Incorrect: A: This is typically associated with significant pain with active motion and swelling around the affected joint. Occupational Therapy Practice Framework: Domain & Process (2nd ed.html) Answer: C.). d. The practitioner should begin the evaluation process by learning what the client wants or needs to do. MV. Trombly-Latham. D: This may be too difficult for a client with Poor minus (2-/5) strength. 649. (2009). B.html) Answer: C.blogspot. Presence of upper extremity athetoid movements (http://almostot. B.

Sit on a chair at the bathroom sink to complete grooming tasks. Louis. D: general term used to describe a group of reflexes that are responsible for the development of upright posture and smooth transitional movements. and crying. Her overall posture and tone c. Schultz-Krohn W (eds). Type of wheelchair the patient currently uses d. with extension: the upper extremities extend and lower extremities flex. (2006). there is immediate abduction. without integration. it is not fully integrated until the child’s second year.html) Answer: D. Speed is an issue only when work cannot be completed within the parameters set in class. C: stimulated by a loud. productivity and leisure skills.com/2012/10/past-nbcotquestions-on-fb-otr-set. Which reflex could interfere with the infant’s ability to roll? a. and occupations. Pages 38-42 23. Katie can form all letters correctly but she presses hard. 813 24. with flexion: upper extremities flex and the lower extremities extend. not necessarily when compared to peers. 1145-1147 25. the upper and lower extremities on the face-side will extend while the upper and lower extremities on the skull-side flex.html) Answer: C. The COPM is a clientcentered tool that supports this model by addressing a client’s perception of their performance in areas of occupation and their satisfaction with this performance across 3 key areas: self-care. D: Athetoid movements are typically associated with lesions of the basal ganglia. and although it takes her longer than her peers. Righting reflex (giles) Answer: B: this reflex assists the mother when feeding an infant. Isometric exercises can affect the cardiovascular system by causing a rapid and sudden increase in blood pressure. . Schultz-Krohn W (eds). (2006). Ambulate from the bed to the bathroom for BADL. Which factor MUST be considered when determining if this patient is a candidate for a mobile arm support? a. St. Asymmetrical tonic neck reflex b. Pedretti’s Occupational Therapy: Practice Skills for Physical Dysfunction (6th ed. will normally cause an infant to cry.com/2012/10/past-nbcotquestions-on-fb-otr-set. A patient who had a myocardial infarction 2 days ago is participating in Phase I of cardiac rehabilitation.Perceptual Rehabilitation: Optimizing Function. 3. Moro reflex c.com/2012/10/past-nbcotquestions-on-fb-otr-set. D: normal age of response 6-8 months. Symmetrical tonic neck reflex (giles) Answer: A: when the infant turns its head to one side. 2. The patient’s goal is to eat meals independently. Measure perceived exertion during personal hygiene activities. Pages: 674. response is similar to Moro reflex but the elbows remain flexed and the hands closed. c. Rooting reflex c.blogspot. which of the following reflexes would NOT be integrated? a. Landau reflex d. an 8-year old female who has been referred to you to assist with her handwriting. produces an extension response within the lower extremities and trunk. Pages: 719-724 Incorrect: A: This should not influence the decision as to whether a patient is a candidate for using this device. A patient must have adequate passive mobility to be able to operate the MAS. Moro reflex c. Louis.). Schultz-Krohn W (eds). environments. B. sudden noise. Reference: Pendleton HM. An inpatient sustained an incomplete cervical spinal cord injury 2 months ago. Incorrect: A. Moro reflex b. The response is abduction of the arms with the fingers open. Symmetrical tonic neck reflex (giles) Answer: C response begins at 3 months. This action is utilized to assess: a. An occupational therapist assesses a one-month-old infant. B. followed by the arms crossing the trunk into adduction. The patient’s upper extremity functional strength is Trace (1/5) on the left and Poor Minus (2-/5) on the right. Louis. Bay Area Functional Performance Evaluation (BaFPE) c. MO: Elsevier Mosby. slumps while writing. Which of the following activities is CONTRAINDICATED for a patient to do during this phase of rehabilitation? a. b. Her ability to copy b. C: stimulated as weight is placed on the balls of the feet when the infant is upright. equilibrium reactions occur in response to a change in body position or surface support to maintain body alignment. she can complete the assignment in the allotted time. This is a standardized assessment that a service competent COTA could administer. MO: Elsevier Mosby. Inorrect: A: normal response from birth to 6 months. This is a problem with: a. Pedretti’s Occupational Therapy: Practice Skills for Physical Dysfunction (6th ed. you notice that parts of her fingers are blanching due to how tightly she is holding her pencil. Canadian Occupational Performance Measure (COPM) d. Which assessment should be included as part of the initial evaluation and can be administered by the COTA? a. Reference: Pendleton HM. Assuming normal development. Functional Independence Measure (FIM) b. Her posture and tone are causing her decreased speed. Positive support reflex d. This physiological response is contraindicated during this phase of cardiac rehabilitation. St. and splaying of the fingers followed by adduction of the upper extremities across the chest. d.). Pages 38. St. Incorrect: A: This tool is designed for collecting information about a client to generate group data and analyze functional outcomes in inpatient rehabilitation settings. Complete isometrics and gentle stretching prior to lower body dressing. Amount of time needed to set up the device for each use b. The ecological model looks at the unique and dynamic relationship between people. During the treatment session. D: These tools are designed primarily for clients who have a psychiatric diagnosis or cognitive deficit. Her speed (JBReview) B. Louis. D: stimulated by movement of the head. Incorrect: A: simulated by the head suddenly dropping into extension for a few inches. Pedretti’s Occupational Therapy: Practice Skills for Physical Dysfunction (6th ed. You are working with Sally. (http://almostot.blogspot. C: These activities are typically included in the OT intervention during phase I cardiac rehabilitation. Reference: Pendleton HM. (2006). the child will be unable to roll. 4. Startle reflex d. An occupational therapist identifies that an infant is unable to roll form prone to supine. MO: Elsevier Mosby. B: normal response is from 28 weeks of gestation to 5 months. MO: Elsevier Mosby. Pediatric OT An occupational therapist completes a developmental assessment on a seven-month-old infant. You have her put the 1. extension. While observing her writing her name on the paper. Amount of upper extremity passive joint mobility c. the therapist strokes the cheek of the infant causing the infant to turn its mouth towards the stimulus. Asymmetrical tonic neck reflex b.). 5. Incorrect: B: stimulated by a sudden change in position of the head. C: Mobile arm support mounts are adjustable to fit a variety of wheelchairs. Presence of upper extremity athetoid movements (http://almostot.blogspot. Allen Diagnostic Module (ADM) (http://almostot.html) Correct: B. St.

although his difficulty is with writing and may impact his educational performance. The therapist and family identify strengths and . If there are any avoidance of behaviors b. Rehabilitation is more appropriately addressed in the outpatient therapy setting. and whether or not a keyboard would improve her performance cannot be determined from passive range of motion. Give him a pencil with a pencil grip to pattern his hand (JBReview) Answer: C 9. She needs a harder surface to write on b. Jonathan is an 8-year old boy who is demonstrating handwriting difficulties and fine motor delays that are interfering with his ability to produce written workat a pace equal to his peers. Where would she most likely receive therapy services? (JBReview) D. Giving her an incentive program for increasing her attention span c. you find that there is not much resistance felt in her muscles as you move them. c. Her upper extremity tone and strength is within normal limits. Julie is a 6 year old female with left hemiparesis due to a stroke. and he has no complaints of fatigue. Alonzo is a child with Down Syndrome who has an active IFSP. you find he does not use a dynamic tripod grasp. 15. Natasha is a 5 year old with a history of brain tumor whose parents are concerned about her IEP. You are asked by the classroom teacher to evaluate Jim. you notice that she is wiggling in her seat with her feet dangling. not because of her decreased attention span. Although she demonstrates significant impairment with the left upper extremity. Where would he most likely be referred for evaluation for occupational therapy services? (JBReview) Answer: D. but it would not be the first thing you would do. She has endurance and coordination issues. and now you are going to directly observe Emma’s writing. and shoulder through their range of motion. wrist. She is holding the pencil tightly because her tone is increased in her arms and hands. The first thing you should do is: a. Nothing. A. She uses classroom tools appropriately. An IFSP or individualized family service plan is a result of the evaluation completed on an at-risk child that has been referred to early intervention. Making sure the table/desk is at the right height so she can see what she’s doing d. he is school aged. It is an outline of the family’s services and who is providing them. She needs a word processor (JBReview) Answer: C. Evaluation of tone may be part of your assessment at some point. She is able to self-ambulate around the school environment. 13. He may benefit from assistive technology. You are called to observe a kindergartner who is having difficulty with writing skills. Choose from the following possible intervention settings: A. His writing is legible. For questions 10-16: Define which specialized pediatric setting would be most appropriate for intervention services for the patients in the following case scenarios. She does not currently demonstrate significant tonal involvement that is greatly impacting her function. What will you be able to tell through observation? a. B. She demonstrates significant range and strength limitations and increased tone in her left hand. Tyrone is a 10-year old boy status post fracture to his radius and is having difficulty with writing postsurgery. Jennifer is a 3-year old with spastic diplegia whose family is concerned about her development. What may help improve the situation? a. 14. According to the teacher. Posture and pencil grip d. Early Intervention School based Hospital-based acute Hospital-based outpatient 10. She would be best served in the least restrictive environment of early intervention services provided in the home or consultative group setting. Who would be most appropriate to provide consultative services? (JBReview) Answer: A. Where would Alonzo most likely receive services? (JBReview) Answer: A. D. Giving her something for under her feet to stabilize her b. this is an acceptable grip pattern d. Michael is a 13 year old male who is status postinvolvement in a motor vehicle accident in which he sustained a concussion and a fractured femur. Ability to form letters c. 8. Give a standardized writing test such as the ETCH d. Instruct him on how to change his grip to dynamic tripod b. She holds the pencil tightly because she is fixating or blocking due to decreased tone in her arms and hands d. During your observation. You have looked at the samples and interviewed the teacher. pencil stabilized at tips of all four fingers). you decide that: a. it is due to a temporary impairment. C. 16. she is independent in her educational setting and would not qualify for school services. What do you do next? a. In the acute setting patients are frequently referred to occupational therapy services just prior to discharge. During this assessment. Gather handwriting samples and talk to his teacher about her concerns b. a third grader with mild cerebral palsy. or kneels on her chair. An IEP is an individualized education plan and is developed in the school system to address the child’s present level of performance and how his or her disability impacts the child’s function in the school environment and participation in the curriculum. When you see the child. Give a standardized visual motor test. Michael and his parents are concerned about him being able to dress his lower extremities due to his external fixator and about him being able to carry his books at school. School-based therapy services are not provided when a student has a temporary impairment. Jennifer is age 3 years or younger and at risk for developmental delay. She frequently drops objects and has difficulty with her dressing and feeding skills. Based on this information. Giving her a harder surface would not change her performance. but more of a lateral quadruped grip (thumb slightly wrapped. elbow. You are asked to evaluate the pencil grip of a sixth grader. and his delay has a direct impact on his educational performance. All of the above e. 6. forearm. (JBReview) Answer: A. 11. you need to know what the specific concerns are before you can decide if a standardized test is necessary. Where would Michael most likely be referred to help his family address their concerns? (JBReview) Answer: C. She may not be able to steady herself or see her work. Where would he most likely be referred for an evaluation for OT services? (JBReview) Answer: B. B. Evaluate Jim’s muscle tone c. Give him a home program to work on in hand manipulation skills c. Increased tone in her arms and hands would be revealed during range of motion. the parent’s issue is with the IEP. Which setting would help the parents address these issues? (JBReview) Answer: B. She is compensating for decreased shoulder stability by fixating. 7. the grip appears to be awkward. 12. and C (JBReview) Answer: D. A and C (JBReview) Answer: E. often stands up to write.pencil down ad instruct her to relax while you passively move her fingers. so she may be standing or kneeling to compensate.

a 7 year old little boy. He is holding his right upper extremity in elbow and wrist flexion. Which of the following statements best describes how you would teach the parents to bring their child from the supine to the sitting position? a. firm massage strokes with stretch (JBReview) Answer: C. He is having problems with pulling up his pants after they are put on. Placing rings over his feet . There are larger diapers available and they should call their durable medical equipment (DME) company to get some because it is not likely that he will be toilet trained b. You are working with Tony. Cast the arm for stretch and neutral warmth. Casting the arm would provide a prolonged stretch and more long-lasting impact to the tone of the arm. the first place to start is evaluating the child and helping the parents address strategies to address the issues the child is having with developing independence in toileting. Tell them to place their hand behind his head and slowly push him up into a sitting position because hip flexion helps to break up tone b. holding his upper arms near the shoulders. Placing his leg through a ring b. What do you tell his parents? a. He has significantly increased tone in his right upper extremity. During home program instruction encourage the parents to hand him things to his left upper extremity. and shortening of the agonist as well as the lengthening and weakness of the antagonist muscle to provide appropriate biomechanical alignment of the joint and improve functioning. Your 5 year old patient. The extensor muscles are also tight b. you would expect that: a. Provide slow. Use quick stroking movements along the muscle with the muscle on stretch c. Which techniques would be the best idea to help decrease the tone? a. 18. and because toileting requires the appropriate sequencing of several tasks. They should begin to remodel their bathroom because it is likely that he will not be independent with toileting d. then. What would be the best activity to use during treatment? a. you are having him play Connect Four. c. 23. Tap the muscle belly to inhibit or deactivate the muscle b. 21. weakness. Care must be given in treatment to address the tightness. Vibration is facilitatory and would increase tone. If a child you are treating has increased tone in the flexor muscles of the arm resulting in severe elbow flexion. 19. Buttoning skills d. Luke. Bathing skills (JBReview) Answer: C. 20. d. You are working with the family of a 5 year old child with cerebral paly who has increased extensor tone. This works on a portion of buttoning. it would be very difficult with a 5 year old and it would become more difficult as the child grows. What ADL skill could you be addressing with this activity? a. You are working with a child with mental retardation. Although B is true. Tapping and quick stroking are both facilitatory and would increase tone. Slow. Handing the patient items in the left UE would not help address the child’s increased tone in his or her right UE and would encourage decreased use of the right UE. The extensor muscles are overstretched and weak c. it would be better to help inhibit the ATNR pattern by bringing the baby’s head into midline through rolling him or her into side lying 24. What would be the best thing to tell the parents to do to help make dressing the child easier? a. Evan is a 3-year old male with a history of cerebral palsy. Placing your hand behind the head of someone with extension patterns usually encourages them to push into extension. The family has difficulty getting this patient from supine to sitting after completing his diaper changes. During treatment the best thing you could do would be which of the following? a. Gently roll the baby toward you so that the baby’s head comes into midline and his or her arms relax. making dressing easier. Weight bearing through right side sitting while facilitating use of the left UE is the best way to inhibit the tone in the right UE. Place the child in supported sitting and slowly stretch and move his right upper extremity through full range b. (JBReview) Answer: C. Using rotation of the trunk and bringing him into flexion will help to decrease his extensor tone and mimics the natural progress of coming from supine into sitting. In treatment. It will be easier to get the shirt on if you dress the extended arm first and then the flexed arm c. This tone is noted to increase with participation in all functional activities. it is unlikely that the child will be able to be toilet trained (JBReview) Answer: B. which is placing an object (button) into a slot (buttonhole). You know that his increased tone is interfering with his ability to participate in occupations. You are working with a 4-year old male who has increased tone in the muscles of his upper arm. gently lift his shoulders up and toward you as you use your body to push his legs back so that he ends up in a sitting position. tightness and shortening in the agonist muscle almost always produces weakness and overstretching of the antagonist muscle. Option D does not facilitate the patient to be active in any way. Children with mental retardation have difficulty with sequencing activities. Although the other statements might be true to a point and/or could be used appropriately during some point of treatment. The child you are trying to dress continues to go into asymmetric tonic neck reflex (ATNR) pattern. has decreased upper extremity strength and decreased hand strength. All of the above (JBReview) Answer: B. It will be easier if you dress the flexed arm first and then the extended arm because the flexed arm is closer to the head and easier to get in d. Tell them to hold his upper arms and gently lift and turn the shoulders to rotate the trunk slightly and then come up d. b. and his parents are concerned because he is not yet toilet trained at age 4 years of age. 17.weaknesses in the discharge environment and develop an intervention plan. Many children with mental retardation just take longer to potty train and you can help them with some strategies to progress him along c. The extensor muscles have not been affected because they are innervated differently d. 22. It would be best to dress the child in a sitting position because this is how a child at that age would be dressing (JBReview) Answer: A. Provide vibration to the right upper extremity (JBReview) Answer: C. firm massage strokes can help decrease tone but are more temporary in nature. a game where you place checkers in slots and see who is the first to get four in a row of a particular color. Gross Grasp skills c. Position him in right side sitting with support at his elbow and have him shoot baskets with his left hand d. Your goal is for him to be independent in donning his pants. Pulling the patient into sitting does not encourage active use of the abdominals through normal patterns. Tell them it would be easiest to hold him by his hands and slowly pull him into a sitting position c. Feeding skills b. Tell them to flex his legs and knees so they face up in the air and use your body to hold his legs in this position.

but keeps getting lost. an occupational therapist asks a patient to count from one to twenty-five 1. it requires the person to exert a sustained. (Anderson) Answer: (A) Examples of dual diagnostic categories are mental health and mental retardation and mental health and mental retardation (answer A). Individuals may enjoy using a library whether they can read or not so the ability to read is not essential to this goal and does not need to be evaluated (answer B). Bipolar disorder. Psychodynamic
 c. a patient denies frequent cocaine use and cites a recent bonus as proof that work performance is not being negatively affected by substance use. B. they do not directly relate to the situations described by the patient in the initial interview. Arthritis and peripheral vascular disease. but should occur after evaluation has been completed.html) Correct: C. Stepping into a box (JBReview) Answer: C. Psychosocial Occupational Therapy: A Clinical Practice (2nd ed. Abstract ability can be assessed by asking a person to interpret a common proverb or to describe similarities or differences between two objects. b. Psychosocial Occupational Therapy: A Clinical Practice (2nd ed. Incorrect: B.c.). an OT practitioner will MOST likely collect information on an individual’s: a. Problem-solving and ethical behavior (http://almostot. The other activities help in getting his legs in the pants 25. however. Attention deficits are common with many neurological disorders including brain injury. d. Change Jennifer’s positioning during dressing. the OT practitioner may identify discrepancies between interests and actual play and leisure behavior.html) Correct: A. Incorrect: “Multiply handicapped” is the coexistence of physical and mental health types of problems such as . and arthritis. Motivational
 d. You are specifically addressing Luke pulling up his pants after they are on. 5.blogspot.blogspot. such as having her sit supported in the corner to dress d. and amputation. Take the individual in the library and obtain a library card. Which of the following actions should the OT practitioner take FIRST in the evaluation process? a. Attention can be assessed by asking a patient to count from one to twenty-five by increments of three. Which theoretical model does this approach exemplify?
 a. Current values and interests c. day. Orientation (giles) Attention is defined as the capacity of the brain to process information from the environment or from long-term memory. b. By using an interest checklist that includes a report of both interests and actual participation in activities. Use a set of sequencing cards that depict a child completing the different stages of dressing c. Assess the individual’s topographical orientation skills. Thomson Delmar. (Anderson) Answer: (A) By comparing interests and actual participation. Cognitive-behavioral
 b. The complexity and familiarity of the task determines the degree of attention required to complete the task. MacRae A (2005). developmental level. communication skills. Depression. Assess the individual’s ability to read. d. b. and facilitate temporal organization. the OTR describes how trigger events and irrational thinking can lead to substance misuse. D. 4. Pages: 456-457 Incorrect: A. the individual’s community mobility skills must first be assessed. mental retardation.
 3. Interpersonal and coping skills d. and achievement as related to a client’s areas of occupation. Constructional ability c. city. D: Although these areas may need to be addressed during the occupational therapy intervention. These performance areas should be addressed by developing an intervention plan that facilitates effective interpersonal and coping skill acquisition with the goal of promoting participation in all areas of occupation. Leisure-time management b. Reference: Cara E. using sequencing cards is the best activity to help Jennifer put her clothes on in order. Which cognitive function does this task MOST accurately assess? a. c. c. During an initial evaluation. and D are not directly addressed using this method. Play games or sing songs that help to identify body parts b.com/2012/10/past-nbcotquestions-on-fb-otr-set. C. Provide wrist loops to make it easier for Jennifer to pull up her clothing (JBReview) Answer: B. An OTR is facilitating a group for clients with polysubstance use. This information can help address the individual’s use of time. although the other activities can be used to help with dressing. Abstract ability d. Psychiatric OT During an initial OT interview. by increments of three. Constructional ability can be assessed by asking a person to copy figures consisting of varying sizes and shapes or to draw a known item such as a clock. Attention b. and place (e.g. use of time. Depression and substance abuse. She has difficulty with putting her clothes on in the appropriate order. C. Based on the patient’s account. Incorrect: Learning to take the bus and obtaining a library card (answers A and C) are important steps toward independent library use.g. Answer: A. an OT practitioner documents that the individual’s chart reveals a dual diagnosis from two mental health diagnostic categories. The task should be relatively easy for most individuals. 
D: The Model of Human Occupation emphasizes exploration. 6. Jennifer is an 8 year old female with a history of developmental delay. sseason_).). (Anderson) Answer: (D) To plan an appropriate intervention. As a component of cognitive assessment. depression. Incorrect: The issues in answer B. or state). Playing tug of war d. month. An individual with mental illness wants to travel to the library independently. The patient reports using cocaine only when under a deadline at work or when having to entertain business clients. During the first group session. d. The individual MOST likely has a history of: a. name). Orientation can be assessed by asking a person to identify time (e. Human occupation (http://almostot. consistent effort. competence.
Reference: Cara E. The patient’s account indicates a lack of insight related to which of the following performance areas? a. Which activity would be the best to do with her during treatment? a.com/2012/10/past-nbcotquestions-on-fb-otr-set. Thomson Delmar. stroke and dementia. Page: 453
 Incorrect: B: The premise behind psychodynamic models is that the individual’s substance misuse has resulted from earlier psychological conflicts
C: Motivational strategies encourage the individual to consider change through exploration and feedback on alternative options. 2.g. Identify the bus that goes to the library and obtain a bus schedule. c. person (e. MacRae A (2005). mood and affect. The premise behind cognitive-behavioral therapy is that the individual can change their behavior (substance misuse) by first challenging their negative assumptions (cognitions) relating to trigger events. Constantly getting lost is a strong indicator that the individual may be impaired in the area of topographical orientation. the dependence on cocaine use appears to be in direct relation to the patient’s inability to manage stress appropriately.

and unrealistic goals (answers A. Regression (answer D) is when an individual reverts to infantile or childlike behavior as a way of dealing with a difficult situation. and answer C is linked to sensory integrative frames of reference. They also can interfere with the recovery process when they are present in the extreme. and D all draw attention to individual’s errors. c. A stress reaction c. Neurodevelopmental group (answer C) use gross motor activity and sensory stimulation techniques to enhance sensory integration in persons with ling histories of schizophrenia. c. d. Directive group. B. A mourning response d. Removing unnecessary objects from around the task area to decrease distractions. Learning the self-monitoring technique of asking oneself if any part of the task has been missed. b. A woman who had a stoke tries unsuccessfully to put on a blouse using a one-handed technique. c. Answer C. c. Put the dried dishes away and begin to hand her wet dishes. 12. c. Rationalization (answer C) is when an individual makes excuses for unacceptable behavior. c. simplifying instructions. d. This approach is preferable to drawing attention to errors. Baking cookies using a recipe. (Anderson) Answer: (C) Baking cookies (answer C) is a well delineated meal-preparation activity that provides structure with a specific sequence of tasks. Incorrect: Dependency. (Anderson) Answer: (D) Observation and analysis of behaviors as well as identifying specific measurable outcomes which will indicate change in behaviors are characteristic of the behavioral frame of reference. Which would be the adaptive response that would most likely pass in time without intervention? a. Leisure activity planning. Projection. Denial. Planning a meal (answer B) involves a great deal of organizational ability. 14. is an example of remedial skill training activity. The most appropriate activity to use FIRST in addressing sequencing skills is: a. Incorrect: Activity groups (answer A) require a higher level of task behavior and ability to engage in occupation to enable skill development. “I can do it. is an example of adapting the environment to compensate for attention deficits. An OT practitioner is treating an individual who has difficulty maintaining attention to a task. measurable outcomes. but is aware of the problem. Ask the client to stop the activity because it seems too difficult. b. (Anderson) Answer: (D) Directive groups have a highly structured approach and are often used in acute care psychiatric settings for patients with psychoses who display disorganized thinking and disturbed functioning. 9. Psychoeducation groups (answer B) which are based on cognitive behavioral theory and focus on teaching information and techniques require a level of learning capacity that may be impaired during acute mental illness. An OT practitioner is treating an individual who has suddenly been diagnosed with a disabling condition. An OT practitioner is planning a meal preparation activity for an individual with cognitive deficits in the areas of attentional and organizational skills. (Anderson) Answer: (B) Teaching the client to self-monitor is an example of a strategy to control the tendency to miss details involved in the task process. whereas answer C would reflect physical diagnostic categories. as is the use of reinforcement methods (applied reward systems) to develop desired behaviors and skills. Psychoeducational group. answer B is linked to psychoanalytical frames of reference. is an example of the method of adapting the amount of information presented during the task. Regression. practicing shape and number cancellation worksheets. During the clean-up portion of a cooking activity. Answer D. I’m just not trying hard enough.” The OT practitioner most accurately recognizes this as: a. an elderly woman with a diagnosis of depression and dementia begins to dry the plates and utensils she has already dried. C. d. b. Planning a meal. Setting the table. A dependency reaction b. The MOST appropriate type of group to use is a(n): a. and D) are responses that would not normally pass in time. Incorrect: Projection (answer B) is a process by which a “…person attributes to another person the unacceptable thoughts and feeling he/she is having”. and motor skills. b. Simplifying the instructions given to accomplish the task so only one step is presented a time. and would not be an appropriate choice for an initial activity to address goals relating to sequencing tasks. Incorrect: Answer A is linked to developmental frames of reference. d. (Anderson) Answer: (B) Compensating for mistakes helps to increase the sense of self-worth and integrity of individuals with dementia. Level of skill required that is appropriate for the generally expected skills for that age. Symbolic potential and use of activities to explore personal meaning. information or wishes out of consciousness”. The OT practitioner should: a. Memory retraining activities for the client. b.answers B and D. Tell the client that the same dishes and utensils are being redried. Incorrect: Answer A. b. Combined activity demand of sensations. Instructing caregivers in task breakdown. Incorrect: Answers A. Incorrect: Setting a table or preparing a shopping list (answers A and D) do not necessarily require sequencing of tasks. especially in situations in which safety is not an issue. Observable analysis. 13. . She states. An OT practitioner is seeing a home health-care client who is in the middle stages of Alzheimer’s disease and whose memory is now interfering with the performance daily self-care activities. Providing practice in shape and number cancellation worksheets. 8. Neurodevelopmental group. A desire to set unrealistic goals (Anderson) Answer: (C) Mourning (answer C) is an adaptive mechanism used for dealing with a disabling condition because a loss of function has occurred. 10. Preparing a shopping list. 11. The MOST relevant OT intervention at this point would be: a. and reinforcement for building specific skills. This individual may be having difficulty accepting her stroke and is using denial to avoid dealing with it (answer A). ADL retraining program for the client. removing unnecessary objects from the task area to decrease distractions. An OT practitioner who selects the behavioral frame or reference for an individual with a psychosocial issues is primarily seeking an approach which focuses on the: a. Activity group. (Anderson) Answer: (A) “Defense mechanisms or defenses are uses unconsciously by the person’s ego in order to keep anxiety-producing thoughts. perceptions. Rationalization. c. stress reaction. b. as with mourning. The BEST example of a strategy that the therapist can teach the person to control effects of attention deficits would be: a. An OT practitioner is planning group programming in an acute care psychiatry setting for severely mentally ill individuals who display disorganized thinking and difficulty functioning in many areas. 7. d. Ask the client to describe what she is doing. d. d.

but would not be as effective as a diary for remembering whether the medications where taken. Inc. Establish a routine of taking medications the same time every day. but will not address the primary problem of performance of self-care activities. Which of the following reinforcement schedules would MOST likely achieve the goal of learning this task sequence? a. labeled location. (Anderson) Answer: (D) Continuous reinforcement is helpful with training of new behaviors and should be provided every time the correct behavior occurs. as part of a hospital outreach program. The OT is working with a patient who needs to be independent in medication management prior to discharge. Answer D. c. 20. the OT practitioner should be particularly observant for which of the following side effects? a. Use a diary to record each dosage after it is taken. Which of the following is the BEST support group to recommend to a husband who describes having difficulty in coping with the ups and downs of his wife’s bipolar disorder? a. but also may produce sleep. b. Al-Anon b. and their families. it is MOST important to: a. Family therapy c. Reinforcement over 10 minutes. keeping the medications in a special location. completely isolating the person from others. (answer D) is a self-help support group for clients with mental disorders. An OT practitioner is planning a program to address the needs of persons with Alzheimer’s disease. b. Incorrect: At this stage of the disease. Encourage more rapid responses. (Anderson) Answer: (C) This is a support group that is open to clients and families and focuses on education and support related to all mental illnesses. or breaking down tasks into simple steps and then providing step-by-step instructions. d. will allow the client to perform activities as capabilities decline. but should give him or her time to process information and respond. Answer D. C. d. Require group members to observe each other. rather than the initial stages of group development. Give simple directions and patiently wait for responses. Incorrect: Answer B is incorrect because it reflects minimal direction from the leader which is uncharacteristic of OT groups. Teach staff not to disturb persons while they are experiencing the hallucinations. Inc. set the climate. (Anderson) Answer: (C) Severe depression can result in slowing of cognitive and motor functions. c. b. and answer B. 19. Incorrect: Answer A. (Anderson) Answer: (C) Answer C. is the best approach because activities can help people with hallucinations to “…divert attention from their symptoms”. Reinforcement for every fourth correct response. Leisure activities (answer D) structured to meet the needs of the client with Alzheimer’s disease could be helpful. 21. relax muscles. establishing a routine. Too much stimulation (answer B and D) may cause the individual to withdraw even further. Work individually with group members until each is ready to join group activity. Extrapyramidal syndrome. An OT practitioner consulting in a supervised living environment is teaching the residential staff strategies to help minimize the effect of hallucinations for residents with schizophrenia. b. Incorrect: Intermittent reinforcement (answer A) and fixed interval reinforcement (answers B and C) are best for maintaining behaviors. providing activities. can have the effect of increasing hallucinations if they find the environment stimuli too stressful. is not recommended because interpersonal contact can be beneficial for reinforcing reality and reducing hallucinations. memory retraining (answer A) and ADL retraining (answer B) will probably not be effective. could be helpful in reminding the patient to take the medication. Answer B. c. Observe. b. Move the persons experiencing hallucinations to more stimulating environments. d. moving a person to a more stimulating environment. Antianxiety medications reduce anxiety. (Anderson) Answer: (C) Using a diary to record each dosage (answer C) would be most effective because it would provide the patient with a written record of when the medication was taken. c. c. arranging to have a caregiver remind the patient. Keep the medications in a special. Incorrect: The OT practitioner must not rush the individual (answer A). Aid group members in separation and reinforce gains made in groups. Incorrect: Answer A. Answer C is incorrect because the group leader perform these functions at the termination stage. Akathisia. Suggest moving persons experiencing hallucinations to areas where they can be completely isolated from other people. c. (Anderson) Answer: (A) Answer A reflects typical leadership involvement in OT groups. Intermittent reinforcement with correct responses. Working individually with group members (answer D) is incongruous with current OT group treatment formats that use properties of the group to achieve therapeutic goals. known as psychomotor retardation. and D. An OT practitioner is training an adult worker with a developmental disability to put a pencil in a box before putting a score pad in the box for the game packaging task in a sheltered workshop assembly line. The focus of the program that would be MOST beneficial maintaining safety and supporting function home for people in the advanced stages of Alzheimer’s is: . 16. and model desired behaviors. Which of the following would be the MOST effective suggestion for the OT practitioner to offer? a. (Anderson) Answer: (B) Medication side effects are typically observed and reported by OT practitioners. Provide activities involving large groups. Tardive dyskinesia. would not facilitate independence to medication management. Arrange for a caregiver to remind the patient when medications should be taken. leaving people experiencing hallucinations alone would have no benefit in reducing attention to the hallucination. Recovery. An individual with an anxiety disorder has been placed on new antianxiety medication. extrapyramidal syndrome. b. Incorrect: Al-Anon (answer A) is a support group for alcohol use among family members. 17. 15. The PRIMARY functions of an OT practitioner leading a therapeutic group in the beginning stages of group development are to: a. Decreased arousal and drowsiness.(Anderson) Answer: (C) Instructing the client’s caregivers in task breakdown. The MOST effective technique for the OT to teach the patient to remember whether he has taken his medication is to: a. d. set the climate. Provide extensive visual and auditory sensory stimulation. National Alliance for the Mentally Ill d. When working with an individual who is severely depressed and demonstrates psychomotor retardation. Incorrect: Akathisia. d. d. 22. and tardive dyskinesia (answers A. 18. Attempt to provide meaningful activities that will engage attention. Recovery. While monitoring the individual over the next few days. and model desired behaviors. Continuous reinforcement of correct responses. respectively) are adverse effects commonly linked to antipsychotic medications. Family therapy (answer B) is not a support group. and impair memory.

Practitioner who demonstrates common assertiveness techniques to the group members. Strength and endurance activities. d. Professional Roles 1. An occupational therapist employed in an outpatient orthopedic clinic examines a patient diagnosed with cerebral palsy. OT practitioners should leave doors open and avoid being alone (answer D) with individuals who are hostile or violent. Incorrect: Reducing distractions and keeping lights low (answer A) may be useful environmental adaptations for individuals with mania or hyperactivity. and discussing delusions are all contraindicated for people with schizophrenia. an OTA may be able to modify a parameter of an existing intervention within an established plan of care. An alteration in the patient’s level of motivation (giles) Answer: D: OTA often deals with changes in patient’s level of motivation. (Anderson) Answer: (C) Environmental modification is the area of intervention that can be best assist in maintaining safety and supporting function at home by providing the physical and sensory environments to compensate for deficits. Discussing delusions (answer D) is undesirable because it is likely to reinforce them.a. Allowing an individual group member to work in an isolated area away from the group. Secure the patient’s surgical report b. Incorrect: A: informing the patient of their area of expertise would likely make the patient question the therapist’s competence. isolation. Answer B is an example of catharsis. If the therapist plans on deviating from the established protocol. B: An OT is solely responsible for modifying an established plan of care. but this would not be part of the regular group routine. In carrying out inpatient treatment groups for individuals with schizophrenia. A request by the occupational therapist assistant d. The physician referral includes a very specific post-operative protocol. to facilitate expression of feelings. This type of admission makes it inappropriate to simply treat the patient without utilizing available resources. 2. it is necessary to contact the referring physician when deviating from the established protocol. As a result. the OT practitioner would be MOST likely to use which of the following intervention methods initially? a. B: a thorough examination must be completed regardless of whether the referral includes a very specific protocol or simply an order to “evaluate and treat”. Environmental modification. Co-treat the patient with another more experienced therapist c. Discussions about the individuals’ delusions. such as clay. the therapist receives external assistance and at the same time improves his skills with a particular patient population. Providing a stimulating environment and real life activities (answer B) is recommended for individuals experiencing delusions. Incorrect: Projective activities (answer A) are most useful for encouraging expression of feelings. would not provide adequate justification for deviating from the established protocol. Contact the referring physician (giles) Answer: D: protocols are often established by physicians to ensure that health care providers progress patients in a predictable manner without jeopardizing the patients’ post surgical status. Incorrect: Strength and endurance activities (answer A) will have no direct effect on safety in the home. Leader who provides the group members with definitions of assertion. b. Carefully document any modification d. Incorrect: Answers A and C are approaches designed to impart information. Practitioner who encourages group members to share similar situations and reactions with one another. the MOST appropriate action is to: a. 25. The MOST appropriate therapist action is: a. d. A patient status post hand flexor tendon repair is examined in occupational therapy. (Anderson) Answer: (C) Becoming familiar with an environment in an advance and knowing what to expect can help reduce anxiety. however. . C: when possible the therapist should contact the referring physician prior to making any modifications to a protocol. It may be appropriate to separate individuals (answer B) who are violent or unable to tolerate the presence of others nearby. Use of assertiveness skills (answer D) would be inappropriate for dealing with the kinds of communication problems encountered with persons who have Alzheimer’s 23. Which of the following would not necessitate a supervisory visit by the occupational therapist: a. An individual with an anxiety disorder feels so overwhelmed he cannot get himself from his room to OT group each morning. Assertiveness skills. however. Simple and highly structured activities. c. b. (Anderson) Answer: (C) Projective media. (Anderson) Answer: (D) Answer D is an approach designed to develop cohesiveness and universality among members. Provide a stimulating environment with real life opportunities. c. Cognitive rehabilitation techniques. An occupational therapist is responsible for supervising an occupational therapist assistant at an off site location. The MOST important curative factor to regularly include in an assertiveness group is a: a. A modification in the patient’s plan of care c. Group leader who allows and encourages all group members to physically and verbally release their aggressive feelings toward inanimate objects. 24. c. A change in the patient’s medical status b. Refuse to treat the patient (giles) Answer: B: by co-treating the patient. Seeing others as similar has been identified by individuals as a curative factor. Leave doors open and avoid being alone with the individual. Inform the patient of your area of expertise b. Incorrect: A: a change in the patient’s medical status requires reassessment and possibly a change in the established plan of care. d. The therapist has limited experience with cerebral palsy and is concerned about his ability to provide appropriate treatment. c. Reduce distractions and keep the lights low. C: An OT is required to provide patient-related consultation at the request of another practitioner. Treat the patient d. An OT practitioner is leading an assertiveness group with clients demonstrating low self-esteem. This observation in isolation would not warrant a supervisory visit by the OT. Give him a tour of the OT department and a schedule of activities. 3. b. b. C: the question states that the therapist is concerned about his ability to treat the patient. and aggression. Which of the following strategies will be MOST helpful? a. Projective media. Incorrect: A: familiarity with the surgical report would be helpful for the therapist. passivity. Complete a thorough examination c. D: refusing to treat the patient would not be necessary since the therapist has available resources to offer assistance. d. Cognitive rehabilitation techniques (answer B) are not indicated for conditions with progressive cognitive deterioration. which may not be helpful to all members and requires the practitioner to understand precautions for the use of catharsis.

B and D have no significant objective measures to back up the documentation. American Occupational Therapy Association (AOTA)

 (http://almostot. If a sterile item becomes contaminated. These documents clarify and support occupational therapy practice and define the minimum standards for the practice of occupational therapy. B. It is important for all health care facilities to establish a committee who develops an infection control policy and then closely monitors the policy to ensure that it remains consistent with current O. Sleeves of the gown c. Answer: A. Front of the gown below waist level (giles) once a sterile field has been established an occupational therapist must be careful to maintain the sterile field and minimize any chance of contamination. 4.A guidelines. In researching the topic. answerable clinical question usually has four components: 1) patient/problem of interest. For questions 8-10: SCENARIO: An OTR attended a professional development activity on sensory integration strategies for children with autism spectrum disorder. Which area od the protective clothing would NOT be considered sterile even before coming in contact with a non-sterile object? a. however.S. An occupational therapist wearing sterile protective clothing establishes a sterile field prior to changing a dressing on a wound. The MOST appropriate INITIAL action is: a.H. Patient cannot lift 20 pounds b. however.01 (r = 0. Provide free hepatitis B immunizations to staff c. the initial action needs to focus on developing a policy consistent with current O. to make clinical decisions. this vaccine does not have to be free. The OTR is uncertain if nutritional supplements are within the professional standards of practice for the occupational therapy profession.when a modification does occur it is necessary to document the change. Patient complains of pain constantly and is therefore magnifying c. Locate the most current best evidence from the literature c. Pose an answerable clinical question b. impact and applicability d. Inc. Which of the following are examples of proper documentation? a. These components form the acronym PICO.A.A.01) between the use of a specific nutritional supplement and sensory processing skills.blogspot. he is malingering. Separate sterile items from non-sterile items. 3. The patient exhibits trunk stiffening and cannot control appropriate faulty body and postural mechanics. C. Incorrect: The NBCOT is responsible for issues related to certification and certification renewal The National Autism Association provides education and resources about autism but does not have jurisdiction about OT practice standards. The first step an occupational therapist should take to incorporate current best evidence into the practice of occupational therapy is to: a. 7. Incorect: A: Health care facilities are required to provide follow up to employees exposed to blood and body fluids. B: Health care facilities are required to offer the hepatitis B vaccine to employees who are at substantial risk of occupational exposure to hepatitis B. th D: 4 step: integrating the evidence. Educate staff about policies (giles) the Occupational Safety and Health Administration (O. Patient had been instructed on proper maintenance of body mechanics over a 50 minute period and still did not demonstrate proper control d. The American Occupational Therapy Association (AOTA) publishes the Standards of Practice for Occupational Therapy and the Reference Manual of Official Documents of the American Occupational Therapy Association.S. Gloves offer protection to the therapist’s hands to reduce the likelihood of becoming infected with microorganisms and decrease the risk of the patient receiving microorganisms from the therapist.S. 8.H. Know which items are sterile. The sleeves of a sterile gown are considered to be sterile after they are applied. Answer: D. National Autism Association (NAA)
 c. (JBReview) Answer: C: this describes the most objective findings to explain why things are occurring. Know which items are not sterile. During the seminar. American Council on Occupational Therapy Education (ACOTE)
 d. National Board Certification in Occupational Therapy (NBCOT)
 b. This action is considered the starting point for searching the literature for information related to the question. A well-built. A risk management committee composed of various members of the rehabilitation team is charged with identifying methods to prevent employee exposure to blood and body fluids. a gown is used to protect the therapist’s clothing from being contaminated or soiled by a contaminant. Critically appraise the evidence for its validity. Develop an infection control policy that conforms to Occupational Safety and Health Administration guidelines d. but usually is offered without charge or with a substantial discount. nd Incorrect: B: 2 step: locate the best evidence to answer the rd question. the OTR reads a peer-reviewed article that indicates a correlation of 0. Patient dropped the box and could not explain his inability to hold it. The ACOTE is responsible for .H. 6. Provide follow-up to employees if exposed to blood and body fluids b.H. Which organization should the OTR contact for obtaining the most up-to-date resources for resolving this uncertainty? a.S. Gloves b. 4. The front of the gown above the waist level is considered to be sterile after the gown is applied. Integrate the evidence into clinical decision making (giles) the first step in evidence-based practice is to pose an answerable clinical question. 3) comparison of intervention. the presenters discussed anecdotal evidence for the use of nutritional supplements to improve sensory processing. The four rules of asepsis that a therapist should follow are: 1. therefore. 5. Front of the gown above waist level d. guidelines. along with the clinical experience and the patient’s unique values and circumstances. Choices A. this is the first step. the committee was charged with identifying methods to prevent employee exposure to blood and body fluids. 2) intervention. C: 3 step: critically appraise the evidence you find. Patient has not demonstrated proper body and lifting mechanics during a 30 pound unilateral carrying test over a distance of 20 feet. requirements.html) Answer: D. 2. this is an important action. D: staff is required to be educated on established policies. the front of the gown below the waist level is not considered to be sterile after the gown is applied since there is an increased chance of incidental contact with a non-sterile object without the therapist’s knowledge Incorrect: A. the situation must be remedied immediately. The gown also reduces the probability of the therapist transmitting a microorganism from their clothing to the patient. if relevant 4) the clinical outcomes of interest. Sterile gloves are considered to be sterile after they are applied.A) requires that health care facilities provide employees with information and instruction in techniques to protect them from infectious diseases Answer: C: health care facilities are required to have a formal infection control policy that is consistent with O.com/2012/10/past-nbcotquestions-on-fb-otr-set.

equipment needs or equipment provided to the patient.” (Kielhofner. No correlation
 b. What is the NEXT step in program development when using an ecological model? a. Perform selected assessments. recommendations for additional therapy or actions on the part of the patient (e. Upper Saddle River. the symbol representing correlation = r. p.html) Answer: D. Research in Occupational Therapy: Methods of Inquiry for Enhancing Practice. Determine behavioral and environmental risk factors (http://almostot.). home health. the NEXT step to be taken in the OT process is to: a. The shape of the distribution of the data collected from the sample is independent of the type of sample. An OTR is collaborating with a social worker and a registered nurse to develop a new domestic violence prevention program for a community mental health center. PA: FA Davis Company. Decisions on program format and content should be based on identifying participants’ risk factors and understanding the impact of the environment on behavior. MD: AOTA Press. The sample size will be large c. The following is how values are typically interpreted • 0 -. Incorrect: Assessments are then performed (answer C) to gather information to identify problem areas and plan treatment. answer D. (2008).). Simple random sampling does not ensure that the data collected will be normally distributed. Pages 101-125 12. A : When considering the strongest level of evidence. Develop a treatment plan. Identify a process for tracking program outcomes c. .40 is a low correlation • . C. Answer C belongs in the assessment section. non-randomized studies
 c. (2006). and if there is no correlation. Systematic reviews are considered to be the strongest level of evidence because they provide an overall conclusion based on review of all the evidence available on the topic. Philadelphia. The need for this service has been identified through situational. What do the research findings from the peer-reviewed article indicate for the level of correlation?
 a. Davis Co. “The patient demonstrates independence in performing the home exercise program. Which of the following is the BEST example of the plan section of a discharge summary when using the SOAP note format? a. to a nursing home or to outpatient therapy).com/2012/10/past-nbcotquestions-on-fb-otr-set.blogspot.00 is a very high correlation” (Kielhofner. 263) “The strongest correlations are 1.00. Incorrect: B.accreditation of occupational therapy education standards in support of the practice standards set forth by the AOTA. An occupational therapist participating in a research project elects to use to use a simple random sample to draw a sample from the population. Meaningful use of leisure time. Analyze the data. b. Upon completion of the initial interview and chart review. the researcher ensures: a.” c. and therefore may not be the best design to prevent threats to internal validity for an intervention study such as this. After the assessments are complete. social and epidemiological analyses. “The patient reports intentions to continue to practice proper body mechanics at work. d. 15.blogspot. Case report with expert opinion
 b.html) Answer: D. Reference: Kielhofner G.com/2012/10/past-nbcotquestions-on-fb-otr-set. Page: 666-670 11. Develop multi-disciplinary intervention protocols d. Incorrect: A. Incorrect: B. C.20-. 14. b. The Occupational Therapy Manager (5th ed. Adaptive equipment needs. The data collected from the sample will be normally distributed b. “The patient expressed a desire to return to work. Philadelphia.aota. D: A correlation of 0 .blogspot.A. McCormack G (eds). The administrator of an assisted living facility has asked an OT practitioner to help implement programming that will decrease the number of residents needing to move from the assisted living facility to nursing homes. Simple random sampling does not determine the size of the sample. Systematic reviews. C. Balancing work. (2006). these research designs appear lower on the hierarchy of evidence than a systematic review. c. “The interpretation of the correlation coefficient is the strength of the relationship. Answer B is an example of a statement that belongs in the objective section of a discharge summary. Reference: Jacobs K. Rockville. High correlation d. d. and plans for discharge.com/2012/10/past-nbcotquestions-on-fb-otr-set.g.aspx 9. (Anderson) Answer: (D) An OT evaluation begins with the initial interview and chart review.html) Answer: A: "When calculating correlation. which guide the OT practitioners in deciding on a frame of reference and the identification of specific evaluation procedures or assessments. 262). Two-groups. B. but does not yet demonstrate the capacity for the required sitting tolerance. Which type of research should the OTR review to obtain the strongest level of evidence regarding this intervention?
 a.60-. Low correlation c. To ensure that the sample will have proportional representation from all parts of the population. 13. Pages 319-320 Fazio L. 2006. Each selection is independent and every member of the population has an equal chance of being selected for the sample.” d. B. Fall prevention..g. 2006. Establish policies and procedures for the program b. Incorrect: Answer A is a subjective report.60 is a moderate correlation • . G. That every member of the population has an equal opportunity of being chosen (giles) Probability samples are created through a process of random selection. (2011).org/Practitioners/Official. and rest.. the therapist would create a proportional stratified sample. case series
 d.20 suggests a negligible correlation • .40-. Answer: D. “Recommend the use of lumbar support and regular performance of home program. PA: F. c. Incorrect: A.00 and -1. the OTR uses clinical reasoning skills to analyze the data (answer A) and to identify the person’s strengths and weaknesses. By selecting this type of sample.” b. Single subject design. specific interventions are selected. leisure. p. Developing Occupation-Centered Programs for the Community (2nd ed. Inverse correlation

 (http://almostot.80-1. meta-analyses (http://almostot. The treatment plan (answer B) is develop after the individual’s problems have been identified and evaluation data have been analyzed. outpatient therapy.20 suggests a negligible correlation Reference: Kielhofner. The MOST important area for the practitioner to address is: a. New Jersey: Pearson Prentice Hall.. The sample will have proportional representation from all parts of the population d.” (Anderson) Answer: (D) The plan section of a discharge summary contains the patient’s discharge d isposition (e. Finally. the correlation coefficient is 0. each member of the population has an equal chance of being chosen.80 is a high correlation • . or performing a home program). 10. a simple random sample is unbiased. C: These steps are completed after behavioral and environmental factors are identified. Select appropriate evaluation procedures. Research in occupational therapy: Methods of inquiry for enhancing practice. Reference: http://www.

Contact the patient and reschedule b. is in reference to the rights of individuals to be provided information regarding their health care as well as to make choices about their own health care. The JCAHO reviews the medical care provided by hospital organizations. which are supposed to reflect the same construct. The term that BEST describes the mandate of confidentiality of patient information and also holds the practitioner to remain faithful to the pa tient’s BEST interest is: a. B and D are incorrect. An OT practitioner is supervising an OT aide. c. there are a number of possible reasons why the patient may have missed the appointment such as an unexpected emergency or neglecting to write down the scheduled appointment. CARF d. The MOST appropriate therapist action is: a. 21. grab bars. An OT practitioner wishes to assess the results of a life skills training program provided to individuals at a shelter for abused women. C. Answer D. Completing ADL training with a patient without supervision. do yield similar results. (Anderson) Answer: (A) To maximize efficiency and costeffectiveness of therapy services. Fidelity is defined as remaining faithful to the patient’s best interest. and not to inconsistency or unreliable measurement the tool should be evaluated for reliability. Beneficence. Will reduce deformity. Internal consistency c. (Anderson) Answer: (B) Fidelity. The tools should have intratester reliability so that any changes recorded can be attributed to progress in therapy and not to reliable measurement Incorrect: A. A patient uses a self-administered assessment tool as a method to record daily progress. is primarily and customarily used to serve a medical purpose. d. Incorrect: AOTA (answer A) was formed in March of 1917 as the National Society for the Promotion of Occupational Therapy. c. 18. However. nonmaleficence. is defined as “the obligation to avoid doing a harm to another or to avoid creating a circumstance in which harm could occur to another. What type of reliability would be the MOST essential using this tool? a. AOTA b. Intertester (giles) Since the assessment tool is used to record daily progress. there has been an increased use of OT aides. Selective adaptive equipment from a catalog with general supervision. and are expected to receive site specific training in selected activities determined by the supervising OT practitioner. An OT manager is preparing the outpatient OT staff for a visit from an accrediting agency. it will be administered repeatedly. Notify the referring physician d. Is medically necessary. JCAHO c. with close supervision. The MOST appropriate kinds of activities and level of supervision for the aide include: a. After waiting several minutes. The accrediting agency that surveys inpatient and comprehensive outpatient rehabilitation programs is BEST represented by which of the following: a. NBCOT (Anderson) Answer: C. Fidelity. There is not any information provided that indicates the patient has missed previous appointments and therefore the situation should be treated as an isolated incident Answer: A. the therapist should . Incorrect: Answers A. Answer: C: Intratester reliability refers to the extent to which scores on the tool obtained by the same tester are consistent. and D are all beyond the scope of the OT aide. 17. If changes in the scores are to be attributed to real progress made in occupational therapy.” Incorrect: Final evaluations of clients involved in the program and client satisfaction surveys (answers A and B) may both be components of the program evaluation. When ordering a wheelchair for an individual who has Medicare. Interrater reliability addresses the consistency of the implementation of a rating system. Internal consistency reliability refers to the consistency of results across items within a test. Utilization review (Anderson) Answer: C. 22. B. This includes statements regarding the confidentiality of patient information. is the concept of striving to bring about the best possible outcome for patients served through treatment modalities. 20. b. Intertester reliability refers to the extent of agreement of the scores recorded by two or more individuals. This is not of concern in the example. informed consent. D. and is generally not useful to a person in the absence of illness or injury”. The NBCOT (Answer D) is the agency that develops and administers the examination for registration as an OT. b. Intratester d. JCAHO (Answer B) is the Joint Commission on Accreditation of Hospital Organizations. c. Parallel forms reliability is not an issue in this example because there is only one form of the assessment tool. beneficence. and must be utilized in accordance with state regulations. the OT practitioner must be sure the wheelchair: a. Notify the patient’s insurance provider c. Selected tasks in which aides have been trained. “Program evaluation is an outcome monitoring system that reflects the results of services on consumers by defining and reviewing the outcomes of care. Incorrect: Answer A. Utilization review (answer D) evaluates the care that is provided to ensure that services were appropriate and not overutilized or underutilized. Medicare part B does not typically cover items such as elevated toilet seats. Nonmaleficence. Reliability of parallel forms refers to the consistency between results of two tests constructed in the same way from the same content domain. Discharge the patient from OT (giles) OTs must decide how to handle missed appointments based on the relative frequency of occurrence and the rationale presented by the patient. and D may all be a part of the broader statement of medical necessity not pertaining to Medicare part B. Will increase functional independence. Reliability of parallel forms b. An occupational therapist employed by a home health care agency knocks on the door of a patient that has a scheduled therapy session. d. Will maintain patient function. C. d. \ Incorrect: Activities and levels of supervision in answers B. Such aides must be very closely supervised. therefore answers A. The Commission on Accreditation of Rehabilitation Facilities (CARF) is the regulatory agency for the provision of rehabilitation services. The reliability of the instrument is evaluated by estimating how well the different items within the test. part B. Utilization review also analyzes the services to ensure that the interventions were provided in an economical manner. falls are the leading cause of accidental death in people over 65 and are a major reason for nursing home placement. b. the therapist concludes the patient is not at home.(Anderson) Answer: (B) All of the answers are important to the quality of life and independence for individuals living in an ALF. Answer C. Informed consent. Final evaluation of each client involved b. As a result. Client satisfaction survey c. Which of the following methods would be the MOST comprehensive method for obtaining this information? a. Program evaluation d. or adaptive equipment because they are not considered to be medically necessary. Various intervention activities with routine supervision. 16.” 19. (Anderson) Answer: (B) Medicare defines medical necessity as “that which can withstand repeated use.

After this has been explained. line. Gloves offer protection to the physical therapist’s hands to reduce the likelihood of becoming infected with microorganisms from a patient and reduce the risk of patient receiving microorganism from the physical therapist. however. gown c. Answer: D. Absences from the home are permitted. Sample size has no specific effect on the reliability of measurements 24.v.V. Explain to the individual and caregiver that one must be “homebound” in order to be eligible for home care services c. Incorrect: A. Incorrrect: A. Inform the PT of the individual’s status. electrolytes. An occupational therapist observes an intravenous line that is tangles around a patient’s bed rail. D. The tubing is a non-sterile object that would not require the use of protective clothing. The gown also reduces the probability of the OT transmitting a microorganism from their clothing to the patient. b. nutrients. C. Gloves. The i. the researcher hopes to increase: a. D. line through direct hand contact. Validity of measurement refers to the degree to which an instrument measures what it is intended to measure. given that the individual is able to leave the home for a social visit and tolerate riding in a car for 30 minutes.V. the insurance provider would receive information on therapy sessions attended. Small samples are less likely to represent the population of interest. 25. B. . Reliability of measurement refers to the consistency with which an instrument or rater measures a variable. short in duration or for the purpose of receiving medical treatment. the greater the probability that a statistical test will lead to rejection of the null hypothesis. the variance in the data. the OT practitioner would communicate with the PT. Gloves. None (giles) An intravenous (i. D. The larger the sample. The mask protects the OT from inhalation of particles or droplets that may contain pathogens and also reduces the transmission of pathogens from the OT to the patient. C.focus on rescheduling the patient’s session. Gloves would not be necessary when handling an I. Gloves. line most commonly consists of plastic tubing and is considered a non-sterile object. What type of medical asepsis is indicated prior to coming in contact with the intravenous line? a. and home management skills. Therefore. The occupational therapist can reposition the I. Incorrect: B.V. and medication. line. If missing scheduled appointments was a recurring theme. this option would be more plausible. Sample size has no specific effect on the validity of measurements. (Anderson) Answer: B. Gloves and gown would not be necessary when handling an I. By including a large number of subjects. a condition referred to as homebound. mask d. The OT practitioner would first inform and explain this criterion to the individual and caregiver. The reliability of the outcome measurements (giles) Sample size is critical to the probability that a statistical test will lead to rejection of the null hypothesis. true differences or relationships (whatever is being tested) are more likely to be detected in large samples. however. A gown is used to protect the OT’s clothing from being contaminated or soiled by a contaminant. In order to be eligible for home care services. The likelihood of rejecting the null hypothesis c. and mask would not be necessary when handling an I. A single missed appointment would not be sufficient grounds to discharge the patient from OT. The individual need not be bedridden. missing a scheduled appointment would not meet this type of criteria. gown. OT services are still required to improve mobility. C. statistical power is a function of the significance criterion (alpha). Effect size is a statistical expression of the magnitude of the difference between different treatments or the magnitude of the relationship between variables. Physicians need to be updated on patient progress and relevant changes in medical status. line. Simply providing a home program and discharging the individual would not meet the individual’s needs because he continues to require therapeutic intervention. An individual covered by Medicare who has been receiving OT and PT in the home is now able to transfer in and out of the car with supervision of a caregiver and visit friends 30 minutes away. The effect size b. it would be unnecessary to notify the provider about a single missed appointment. Which of the following actions should the OT practitioner take FIRST? a. 23. the individual must be confined to home. Incorrect: B. upper extremity function. gown. Sample size has no specific effect on the effect size. C. Gloves b.v) system can be used to infuse fluids. A mask is designed to reduce the spread or microorganisms that are transmitted through the air. and the effect size. Besides sample size. Answer: B. he is not considered homebound. but leaving the residence must require a considerable or taxing effort. An occupational therapist participating in a research project decides it will be necessary to utilize a relatively large sample. but must be infrequent in nature.V. Provide a home program and discharge the individual. and refer the individual for outpatient therapy. The validity of the outcome measurements d. Refer the individual for outpatient therapy and provide a comprehensive discharge summary to the outpatient setting d.

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