Occupational Therapy Certification Exam Practice Test

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General Rehab: Which of the following is a contraindication for electrical stimulation usage?
- Knee replacement
- Hip replacement
- Pacemaker
- COPD

About This Quiz

Occupational Therapy Certification Exam Practice Test; It is actively responsible for developing, administering, and reviewing the certification process regarding occupational therapy. So, if you are looking towards taking an exam for the same, this quiz has a lot to offer you.

Occupational Therapy Certification Exam Practice Test - Quiz

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2.

Neurological: A patient just experienced a L ACA infarct CVA, what is the best statement concerning the patient’s question about rehabilitation potential?
- You will be able to regain the full function you experienced before your stroke.
- You suffered a severe stroke and will never regain any function.
- You will be a able to perform the tasks that you performed before the stroke, however you may need to use different methods and adapt your lifestyle.
Correct Answer

A. You will be a able to perform the tasks that you performed before the stroke, however you may need to use different methods and adapt your lifestyle.

Explanation

Rationale: It is not appropriate to tell a patient that they will become fully functional or not be able to regain any function, but it is important to remain realistic with the patient about expectations for therapy.
Source: National Occupational Therapy Certification Exam: Review and Study Guide by Rita P. Fleming-Castaldy

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3
3.

Pediatrics: A mother reports that her 16 month old has meltdowns whenever water touches her, when she is in public restrooms and hears toilets flushing or hand dryers, when she sees curtains moving at home while windows are open, and whenever she plays with toys that are too visually stimulating. This child most likely has:
- Sensory underresponsiveness
- Sensory overresponsiveness
- Sensory seeking behaviors
- Gravitational insecurity
Correct Answer

A. Sensory overresponsiveness

Explanation

Answer: B. This child has tactile defensiveness with water, which is a problem associated with overresponsiveness. Overresponsiveness is also known as hyperresponsivity or sensory defensiveness. She has auditory hyperresponsiveness with loud sounds too, and visual overresponsivity with the movement of the curtains. While answer D (gravitational insecurity) is a type of overresponsiveness, this child does not have any signs of gravitational insecurity.

Reference: Case-Smith & O’Brien, Occupational Therapy for Children, 6th edition, pages 346-347

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4.

Psychology: What is NOT a sign/symptom of schizophrenia?
- Delusions
- Hallucinations
- Disorganized behavior
- Significant weight loss
Correct Answer

A. Significant weight loss

Explanation

Significant weight loss is a sign of major depression not schizophrenia
reference: psych notes, author: pedersoen, darlene

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5.

Pediatrics: A mother reports that her 16 month old has meltdowns whenever water touches her, when she is in public restrooms and hears toilets flushing or hand dryers, when she sees curtains moving at home while windows are open, and whenever she plays with toys that are too visually stimulating. This child most likely has:
- Sensory underresponsiveness
- Sensory overresponsiveness
- Sensory seeking behaviors
- Gravitational insecurity
Correct Answer

A. Sensory overresponsiveness

Explanation

Answer: B. This child has tactile defensiveness with water, which is a problem associated with overresponsiveness. Overresponsiveness is also known as hyperresponsivity or sensory defensiveness. She has auditory hyperresponsiveness with loud sounds too, and visual overresponsivity with the movement of the curtains. While answer D (gravitational insecurity) is a type of overresponsiveness, this child does not have any signs of gravitational insecurity.

Reference: Case-Smith & O’Brien, Occupational Therapy for Children, 6th edition, pages 346-347

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4
6.

General Rehab: A client with deficits in stereognosis would have MOST DIFFICULTY with?
- Identifying coins in his/her pocket.
- Finding the route back to his/her room.
- Identifying a familiar face.
- Determining the distance from the front of the sink to the facet.
Correct Answer

A. Identifying coins in his/her pocket.

Explanation

Rational: The correct answer is A because stereognosis is the perceptual skill that enables an individual to identify common objects and geometric shapes through tactile perception without the aide of vision. Stereognosis is essential to occupational performance because the ability to see with the hands is critical to many daily activities.
Source:Text book- Pedretti’s Occupational Therapy: Practice Skills for Physical Dysfunction and the OT Advantage website

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1
7.

General Rehab: You are seeing a patient in isolation, with a diagnosis of MRSA. What precautions should you take before treating the patient?
- Discharge the patient and refuse to treat them.
- Donn gloves, mask, and gown and continue treatment within the patient’s room. Wash hands and disinfect treatment tool upon conclusion of intervention.
- Treat the patient in their room without precautions.
- Donn gloves only, and wash hands after treating the patient.
Correct Answer

A. Donn gloves, mask, and gown and continue treatment within the patient’s room. Wash hands and disinfect treatment tool upon conclusion of intervention.

Explanation

Rational: Standard precautions include wearing disposable gloves, a face shield and gown when treating a patient in an isolated environment to prevent spreading the disease to other personnel and residents.
Source: http://www.edcp.org/guidelines/mrsa.cfm

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8.

Orthopedic: Which of the following is a hip precaution for the first 8 weeks after a hip replacement?
- Do not cross legs or ankles
- Do not bend knee
- Do not lay on back
- Do not lay on stomache
Correct Answer

A. Do not cross legs or ankles

Explanation

Legs ankles should not be crossed, do not bend at the waist, and you should not lie on your side.
Source- http://www.hipsandknees.com/hip/hipprecautions.htm

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9.

Pediatrics: Sensory Integration is...
- Something that begins after age 7
- The process of turning sensation into perception
- Primarily controlled by the cardiovascular system
- Something that is an “all-or-nothing” response
Correct Answer

A. The process of turning sensation into perception

Explanation

Sensory integration begins to occur at conception. It is primarily controlled by the brain. People have a spectrum of different sensory integration levels, it’s not something that either you have or you don’t have.
Source: “Sensory Integration and the Child” by A.Jean Ayers, PhD

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2
10.

Orthopedic: Immediate precautions following a total hip replacement procedure include which of the following?
- No hip flexion beyond 90, no hip rotation, no crossing legs, no adduction and no bending or bringing foot close to hands
- No hip flexion beyond 120, no twisting, no adduction
- No lifting, no bending, no twisting
- No hip flexion beyond 70, no hip rotation, no crossing legs
Correct Answer

A. No hip flexion beyond 90, no hip rotation, no crossing legs, no adduction and no bending or bringing foot close to hands

Explanation

Answer: a. following a total hip procedure including a total hip replacement the patient is to follow these precautions, no hip flexion beyond 90, no hip rotation, no crossing legs, no adduction and no bending or bringing foot close to hands

Crepeau, E.S., Neistadt, M.E. (1998). Williard and Spackman’s Occupational Therapy Ninth Edition. Baltimore, MD: Lippincott Williams & Wilkins.

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2
11.

Orthopedic: For an individual with RA, treatment should include:
- Joint protection education
- Adaptive equipment
- Community resources
- Low impact exercises
- All of the above
Correct Answer

A. All of the above

Explanation

All of the choices would benefit a patient with RA. Community resources can include support groups, the Arthritis Foundation, transportation options, etc.

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2
12.

Orthopedic: Which of the following does NOT describe a proper tip for good body mechanics when sitting?
- Your feet should be flat on the floor.
- Your knees are positioned higher than your hips.
- Work is placed directly in front of you.
- Arms rested on armrests.
Correct Answer

A. Your knees are positioned higher than your hips.

Explanation

When seated, it is best to be positioned with your knees and hips level to reduce any unnecessary strain on your back.

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13.

Neurological: You are evaluating a 73-year-old patient who presents with rigidity, resting tremor, hypokinesia, and postural instability. What is this patient’s most likely diagnosis?
- Parkinson's Disease
- Huntington's Disease
- Multiple Sclerosis
- Cerebral Palsy
Correct Answer

A. Parkinson's Disease

Explanation

Lundy-Ekman, L. (2007). Neuroscience: Fundamentals of rehabilitation. (3rd ed., p. 352). St. Louis: Saunders Elsevier.

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0
14.

General Rehab: You are treating a patient who has experienced decreased oxygenation. What breathing technique should you instruct the patient in to increase oxygenation?
- Inhale slowly through the nose and exhale through pursed lips
- Inhale and exhale through the nose and mouth
- Inhale through the mouth and exhale through the nose
- Inhale and exhale slowly through the mouth
Correct Answer

A. Inhale slowly through the nose and exhale through pursed lips

Explanation

Radomski, M. & Trombly Latham, C. (2008). Occupational Therapy for Physical Dysfunction. (6th ed). Baltimore, MD: Lippincott, Williams & Wilkins, Page 1309.

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15.

General Rehab: Which of the following methods is the BEST way to evaluate for a hook grasp?
- Direct the individual to hold a sewing needle while it is being threaded.
- Observe the individual lift a tall glass filled with water
- Have the individual hold a heavy handbag by the handles
- Hand the individual a key to place in a lock.
Correct Answer

A. Have the individual hold a heavy handbag by the handles

Explanation

The needle would be held with a two point pinch while being threaded. A glass would be held with a cylindrical grasp and the key being place in a lock would be held with a lateral pinch.

Reference: Johnson, Lorch, and DeAngelis: Occupational Therapy Exam Review Guide. ed 3. FA Davis Company, Philadelphia,2006.

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16.

Neurological: Which of the following strategies is NOT an effective psychosocial intervention for clients recovering from a cerebral vascular accident?
- Exploration and education in coping skills
- Involvement of client in goal setting and selecting interventions
- Focus solely on the client’s inappropriate behaviors during therapy sessions
- Socialization and support groups
Correct Answer

A. Focus solely on the client’s inappropriate behaviors during therapy sessions

Explanation

“C” is the correct answer since focusing on the client’s negative behaviors solely is detrimental to the client’s recovery. The therapist is not allowing the client to make his/her own decisions in their recovery. Incorporating Choices A, B, and D into client sessions provide a more holistic approach.

Source: Cara, E. & MacRae, A. (2005). Psychosocial occupational therapy: A clinical practice (2nd ed.). Clifton Park, NY: Thomson Delmar Learning.

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3
17.

Orthopedic: The purpose of getting an orthopedic surgical patient up and moving as soon as the doctors approves it is to: (Choose the best answer)
- Make sure the patient does not get too bored
- Prevent complications from immobilization and improve healing
- Prevent the patient from getting stiff
- To prevent to patient from nerve damage
Correct Answer

A. Prevent complications from immobilization and improve healing

Explanation

Answer: b. it is important to get an orthopedic surgical patient up and moving as soon as the doctors approves it to prevent complications from immobilization and improve healing for the patient

Crepeau, E.S., Neistadt, M.E. (1998). Williard and Spackman’s Occupational Therapy Ninth Edition. Baltimore, MD: Lippincott Williams & Wilkins.

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1
18.

General Rehab: Sensory modulation disorder is one type of SI dysfunction characterized by fluctuating or extremes in responsiveness to the intensity of one or more sensations. Specific behaviors may include:
- Tactile defensiveness
- Gravitational insecurity
- Aversion to movement
- Feeling overwhelmed in high-stimulus environments
- All of the above
Correct Answer

A. All of the above

Explanation

Resource: Crepeau, E.B., Cohn, E.S., Boyt Schell, B.A., Williard & Spackman's Occupational Therapy, 11th Edition.

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19.

General Rehab: During the evaluation of the same COPD patient, the OT sets a short term activity tolerance goal of the pt performing an activity in the 1.0-2.5 METS range. What activity would match that level of exertion?
- Redecorating and moving furniture around the room.
- Washing windows outside
- Carrying groceries upstairs
- Setting a table while sitting
Correct Answer

A. Setting a table while sitting

Explanation

Answer = D (please refer to Radomski & Latham in the OT for Physical Dysfunction, 6th Ed., pg. 1304)

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20.

Neurological: Which of the following signs and symptoms are the best common factors occurring in Alzheimer’s disease?
- Disorganized thinking, delusions, hallucinations, and social withdrawal with an onset early in life
- Progressive mental deterioration consisting of memory loss, confusion, and disorientation
- An inability to read at a level that correlates with the person’s overall intelligence
- The inability to plan, to maintain goal orientation, and to make decisions
Correct Answer

A. Progressive mental deterioration consisting of memory loss, confusion, and disorientation

Explanation

Alzheimer’s disease is characterized by progressive mental deterioration, which primarily includes symptoms such as memory loss, confusion, and disorientation. These symptoms worsen over time and significantly impact daily functioning and quality of life. The other options describe symptoms that can occur in other neurological or psychological conditions but are not the primary indicators of Alzheimer's disease.

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21.

General Rehab: When transferring a patient an OT can best protect themselves from injury by doing which of the following?
- Stepping back from the individual
- Keeping the knees bent
- Keeping the back in a flexed position
- Maintaining a narrow base of support
Correct Answer

A. Keeping the knees bent

Explanation

Rationale: Keeping the knees bent keeps you in the correct anatomical position for a transfer. All other answers are incorrect, and could possibly result in injury to the individual performing the transfer. You should stand close to the individual, keep the back in a neutral position, and maintain a wide base of support.

Source(s):

Johnson, C. R., Lorch, A., & DeAngelis, T. (2006). Occupational Therapy Examination Review Guide. Philadelphia: F.A. Davis Company

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22.

General Rehab: Which of the following evaluation methods can not be used to test manual dexterity/motor function?
- Purdue Pegboard
- Minnesota Rate of Manipulation Test
- Bay Area Functional Performance Eval.
- 9-hole Peg Test
Correct Answer

A. Bay Area Functional Performance Eval.

Explanation

the Bay Area Functional Performance Eval. is used as phsychological/cognitive battery. All other responses assess manual dexterity/ fine motor coordination and function.

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23.

Pediatrics: You are an OT working in a pediatric early intervention setting. You have observed a child in the classroom throwing tantrums during activities such as finger painting and playing in sand, the child often is seen playing in the room away from other children and often will not eat during snack time trying to get out of the chair and move away from the table. Based on observation, which sensory modulation problem would you conclude is causing this child's behavior?
- Gravitational Insecurity
- Tactile Defensiveness
- Hyporesponsivity
- Auditory Defensiveness
Correct Answer

A. Tactile Defensiveness

Explanation

Case-Smith, O'Brien; Occupational Therapy for Children, 6th Edition, 2010, pg 346.

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1
24.

Pediatrics: When working with a sensory defensive child, if they are fearful or hesitant when climbing stairs and hold railings tightly, which sensation are they having a reaction to?
- Touch/Tactile
- Visual Sensation
- Vestibular/Movement
- Pain/Tactile
Correct Answer

A. Vestibular/Movement

Explanation

These children will also dislike tipping their heads backwards, activities that require you to move in space, and swinging on a swing where their feet won’t touch the ground.

Resource: Too loud Too Bright Too fast Too Tight. What to do if you are sensory defensive in an overstimulating world. Sharon Heller, Ph. D

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1
25.

Neurological: You are seeing a patient who shows aggressive behavior and keeps removing his restraints and pulling at his catheter. Pt. lacks short term recall and seems to be acting out based on past events. Pt is unable to complete self feeding and dressing without maximum assistance. What Rancho level is your pt. functioning at?
- I – no response
- III- localized response
- IV-confused/agitated
- VII- automatic/appropriate
Correct Answer

A. IV-confused/agitated

Explanation

Gutman, S.A., & Schonfeld, A.B.(2009) Screening Adult Neurological Populations, 2nd edition. The American Occupational Therapy Association, Inc. (p 4-7)

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3
26.

General Rehab: Which mobility skills should be accomplished first?
- Bed transfers
- Bed mobility
- Mat transfers
- Toilet & tab transfers
Correct Answer

A. Bed mobility

Explanation

bed mobility (hierarchy of mobility skills - bed mobility, mat transfers, bed transfer, toilet & tab transfer)
source: “Occupational Therapy for Physical Dysfunction” M. V. Radomski & C. A. T. Latham p. 819

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27.

General Rehab: People who are afraid of falling appear to enter a debilitating spiral exhibiting all of the following except:
- Loss of conﬁdence
- Restriction of physical activities and social participation
- Physical frailty
- Increased independence
Correct Answer

A. Increased independence

Explanation

The correct answer is D: People with a fear of falling become less independent.

Zijlstra, R., van Haastregt, J., Rossum, E., van Eijk, J., Yardley, L., Kempen, G. (2007). Interventions to Reduce Fear of Falling in Community-Living Older People: A systematic Review. The American Geriatrics Society. 55:603-615.

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28.

General Rehab: When working with a patient 1 day post a total shoulder arthroplasty it is appropriate to do:
- Resistive strengthening exercises
- AROM exercises hitting full ROM in all planes
- Codman’s pendulum exercises
Correct Answer

A. Codman’s pendulum exercises

Explanation

Rationale: It is not appropriate to do resistive exercises or full range of motion exercises one day post surgery due to the risk of dislocation, however to keep the shoulder from freezing Codman’s pendulum exercises are the most appropriate.
Source: National Occupational Therapy Certification Exam: Review and Study Guide by Rita P. Fleming-Castaldy

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1
29.

Neurological: A patient displays “alien-arm” syndrome, and is unable to attend to the arm to correct it. This patient is most likely presenting with:
- Visual field cut
- Unilateral neglect
- Tunnel vision
- Cataracts
Correct Answer

A. Unilateral neglect

Explanation

Laurie Lundy-Ekman (2007). Neuroscience Fundamental for Rehabilitation 3rd Edition. St. Louis, MO: Saunders-Elsvier. (230).

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30.

Orthopedic: Your pt presents with hand numbness, mostly at night, pain and paresthesia in the thumb, index, and middle finger. What nerve compression disorder coincides with these symptoms?
- Cubital Tunnel Syndrome
- Carpal Tunnel Syndrome
Correct Answer

A. Carpal Tunnel Syndrome

Explanation

Vining-Radomski, M., Trombly-Latham, C. (2008). Occupational therapy for physical dysfunction. Philadelphia, PA: Lippincott Williams & Wilkins. pp 1148.

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1
31.

General Rehab: When completing a home evaluation, what would be the most important suggestion to the patient to prevent falls:
- Teach energy conservation techniques
- Order appropriate adaptive devices and train safe us
- Remove throw rugs from floors
- Arrange furniture for easy maneuverability
Correct Answer

A. Remove throw rugs from floors

Explanation

Answer: c. Remove throw rugs from floors

Rationale: All are interventions to prevent falls. However, the most important factor when assessing ones home would be to remove throw rugs. This is an immediate intervention that could be implemented at that moment.
Source: National Occupational Therapy Certification Exam Review and Study Guide 5th Edition by Rita P. Fleming-Castaldy (page 319)

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32.

General Rehab: Passive stretching to increase ROM should not involve:
- Hold the stretch for 15-30 seconds
- Holding the stretch a few degrees beyond the point of discomfort
- Quick, vigorous movements
- Relief of discomfort immediately after release of stretch
Correct Answer

A. Quick, vigorous movements

Explanation

To increase (and not just maintain)ROM, the limb must be stretched to the point of maximal stretch, which is just a few degrees beyond the point of mild discomfort- this can be assessed by patients verbal or facial indications. The mild discomfort should not linger after release of stretch (if it does, you may have injured the tissue). The most effective stretch is a slow, controlled movement which allows for the tissues to adjust gradually. The stretch should be held for 15-30 seconds. Quick movements are counterproductive and should be avoided, as connective tissue will resist the movement as a protective mechanism.
Reference:
Occupational Therapy for Physical Dysfunction 6th Edition (Mary Vining Radomski & Catherine A Trombly Latham)

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33.

Orthopedic: Which of the following would be the LEAST important to stress to a patient following back precautions?
- Do not bend
- Do not lift more than 5 pounds
- Do not twist trunk
- Do not dress without supervision
Correct Answer

A. Do not dress without supervision

Explanation

when a patient is following back precautions remember no bending, lifting or twisting. (BLT)
Source: Back precautions from Riverside Hospital

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1
34.

General Rehab: When working with a patient with motor control dysfunction an occupational therapist can observe the patient during an assessment of basic activities of daily living and instrumental activities of daily living. The therapist must observe how problems in motor control affect motor performance. What other area(s) of patient’s performance should the therapist be concerned with?
- Sensation
- Perception
- Cognition
- Medical status
- All of the above
Correct Answer

A. All of the above

Explanation

REFERENCE: Occupational Therapy Practice Skills for Physical Dysfunction, Fifth Edition, Pg. 362

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35.

General Rehab: If a patient presents to the clinic with a high level of shoulder pain what type of interventions should you avoid initially?
- Strengthening
- ROM
- Posture education
- Modalities
Correct Answer

A. Strengthening

Explanation

Rationale: Strengthening should wait to be done until pain is low so that further pain is not caused.

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2
36.

Neurological: You read in a TBI patient’s chart that they are at Level III of the Rancho Los Amigos Levels of Cognitive Function Scale. Which of the following is NOT an appropriate intervention for a patient at this level of cognition?
- Simple ADL to promote automatic responses
- Sensory stimulation such as tactile, visual, auditory, temperature, and proprioception
- ROM to prevent contracture/tone and spasticity management
- Multi-step command following
Correct Answer

A. Multi-step command following

Explanation

Rationale: A patient at Rancho Level III has a localized response to stimuli and their response is directly related to the type of stimuli they are receiving. At this point you want to stimulate them as much as possible to get consistent and automatic responses (choice A and B). You also want to keep them positioned and provide ROM since they do not have a lot of active movement (choice C). Choice D is beyond their ability at this point, because they are not even able to follow one-step commands at this level. They are simply responding to stimuli.

Source: Occupational Therapy for Physical Dysfunction, Sixth Edition, Radomski and Latham, p. 1048

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37.

Pediatrics: A child with tactile defensiveness can probably best tolerate:
- Light touch
- Actively self-applied stimuli
- Stimuli applied when unable to see the source of touch
- Hair brushing
Correct Answer

A. Actively self-applied stimuli

Explanation

Rationale: Children with tactile defensiveness do not seem to mind deep touch as it is calming. Light touch is most aversive. They should always see the source of touch and tend to tolerate actively self-applied stimuli better than when it is done passively by a therapist or someone else.
*Source: Occupational Therapy for Children textbook (By Case-Smith) p. 378

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38.

Neurological: Upon evaluating and working with Mr. Smith following a CVA, you notice he is having difficulty with ADL activities, bumping into objects, misreading literature, and abbreviating scanning while performing various therapeutic activities. Mr. Smith also is reluctant to change head position duing tasks and states "Only one-half of my eyes seem to be working!" You realize Mr. Smith is most likely suffering from:
- Visual accommodative disorders
- Visual field deficits
- Visual attention deficits
- Visual acuity impairments
Correct Answer

A. Visual field deficits

Explanation

Gutman, S.A., & Schonfeld A.B. (2009). Screening Adult Neurologic Populations, 2nd Edition. The American Occupational Therapy Association; AOTA Press.

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39.

Neurological: Which of the following methods is INCORRECT when working with a TBI patient with a Rancho Level IV?
- Work in a quiet environment with minimal distracters
- Maintain a predictable daily structure and routine
- Be calm and confident in your approach with the patient
- Maintain the activity despite agitation from patient
Correct Answer

A. Maintain the activity despite agitation from patient

Explanation

D is the correct answer. During this stage of recovery, we want to decrease the patient’s agitation by attempting to normalize the environment (A,B) and. providing consistency and predictability that counters their confusion (C). If a patient becomes agitated or restless during an activity, change the activity or move to another environment. Source: Occupational Therapy for Physical Dysfunction.

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3
40.

Management & Evidence: When arriving to an elderly patient’s home who lives with her daughter and son-in-law for a treatment session, the OTL/R notices that the patient’s glasses are broken and the patient has new bruises on her forearms around her wrists. The OTL/R asks the patient once the son-in-law leaves the room what happened and the patient reports that the son-in-law has been physically abusing her for the past two weeks. What is the most appropriate action the OTL/R should take?
- Contact supervisor to report suspicious elderly abuse and suggest that Adult Protective Services get involved
- Continue with treatment session and see if abuse continued until next session
- Call the local police station to report suspicious elderly abuse
- Explain to the son-in-law the allegations and get his side of the story before doing anything
Correct Answer

A. Contact supervisor to report suspicious elderly abuse and suggest that Adult Protective Services get involved

Explanation

Answer: a. Contact supervisor to report suspicious elderly abuse and suggest that Adult Protective Services get involved

Rationale: Role of Occupational therapist is required to suspected or observed cases of elder abuse. Since the patient stated the son-in-law was abusing her and their was proof from the broken glasses and the bruises on her forearms and wrists, the OTL/R is required by law to report this case to Adult Protective Services so they can investigate.
Source: National Occupational Therapy Certification Exam Review and Study Guide 5th Edition by Rita P. Fleming-Castaldy (page 122)

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41.

General Rehab: Which option below is most important as the INITIAL OT intervention for an individual with a severe form of Guillain-Barré syndrome who has complete paralysis?
- ADL training
- Balance and core strengthening activities
- Passive ROM, splinting, and positioning
- Resistive activities for intrinsic hand strengthening
Correct Answer

A. Passive ROM, splinting, and positioning

Explanation

Rationale: Since the individual has a severe form of Guillain-Barré, the most important initial approach is to protect weak muscles and prevent contractures. Although ADL performance is important for this patient, protecting muscles and maintaining ROM is most important and light ADL training should follow. After strength improves, balance and strengthening interventions can then be used.

Source(s):

Blesedell Crepeau, E. Cohn, E., Boyt Schell, B. A. (2003). Willard and Spackman's Occupational Therapy. Philadelphia: Lippincott Williams & Wilkins.

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42.

Pediatrics: What would you recommend to parents of an infant who demonstrates low tone, cries a lot, and has a difficult time being soothed?
- Loosely wrap the infant in a shirt that smells like the mother
- Provide frequent and rapid changes in movement to offer sensory input
- Tightly swaddle the infant in blankets
- Do nothing, this is typical behavior of an infant
Correct Answer

A. Tightly swaddle the infant in blankets

Explanation

Answer: C
Fleming-Castaldy, Rita. National Occupational Therapy Certification Exam: Review & Study Guide, 5th edition, (2009). Pg. 96-99

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43.

General Rehab: Per physician referral, an OT in acute care conducts an evaluation with an adult with a new diagnosis of COPD. The OT evaluates the pt and is contemplating possible treatment ideas. The therapist should do the following except:
- Modifying the environment (establishing a place to sit in the bathroom while performing ADL)
- Encourage the pt to hold their breath and breathe shallowly and fast
- Educate the pt on energy conservation techniques (ex. Planning similar activities together)
- Provide education on pursed lip and diaphragmatic breathing
Correct Answer

A. Encourage the pt to hold their breath and breathe shallowly and fast

Explanation

Answer = B (please refer to Radomski & Latham in the OT for Physical Dysfunction, 6th Ed., pg. 1308)

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44.

General Rehab: A client is hypertonic in their right UE distal to the elbow secondary to a CVA. The OTR facilitates the client into a right side-lying position for therapeutic exercise. What is the primary benefit of facilitating this position?
- To increase comfort for the client.
- To reduce tonicity.
- To allow for set-up of an electric stimulation unit.
- To practice safe bed mobility.
Correct Answer

A. To reduce tonicity.

Explanation

Rationale: The correct answer is B) to reduce tonicity. By side-lying on the affected side, the client is weight bearing through the hypertonic limb which has been shown to be effective in reducing tone. While answers A,C, and D may all be reasons why a client would be in a side-lying position they are not the primary reasons in this scenario.

Pendleton, H.M., Schultz-Krohn, W. (2006). Pedretti’s Occupational Therapy Practice Skills for Physical Dysfunction (6th edition). St. Louis, MO: Mosby Elsevier.

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45.

General Rehab: In what age-range are symptoms of multiple sclerosis most likely to emerge?
- 11-19
- 20-40
- 50-75
- 75 and up
Correct Answer

A. 20-40

Explanation

Rational: Individuals may begin to notice symptoms such as an incoordination or paresthesias of limbs, trunk, or face, as well as an overall fatigue.
Source: Willard & Spackman’s Occupational Therapy, v. 10

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46.

Pediatric: A child presents with increased tone, which activity would be the most appropriate?
- Fast circular motions on a swing
- Slow linear movements in a rhythmical pattern
- Loud sudden music
- None of the above
Correct Answer

A. Slow linear movements in a rhythmical pattern

Explanation

Cheatum, B.A. & Hammond, A.A. (2000). Physical activity for improving children’s learning and behavior: A guide to sensory motor development. Chicago: Human Kinetics.

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47.

Management & Evidence: When working with patients with mental health diagnoses it is important to take the individual’s personal desires into accordance when making therapy goals. Which OT assessment is not in accordance with the Model of Human Occupation frame of reference?
- Self-Assessment of Occupational Functioning (SAOF)
- Allen Cognitive Level Screen (ACLS)
- Interest Checklist (IC)
- Role Checklist (RC)
Correct Answer

A. Allen Cognitive Level Screen (ACLS)

Explanation

Allen Cognitive Level Screen (ACLS). The ACLS is an assessment that looks at cognitive disability and predicts how individuals will function in the community, as well as predict unsafe behaviors associated with specific cognitive levels. The SAOF, IC and RC are self-report assessments that allow for personal reflection.

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48.

General Rehab: An adult is hospitalized and diagnosed with mild COPD. In planning for d/c, the pt wants to continue to exercise. The most appropriate recommendation for the OTR/L to make would be that the pt. participate in:
- The hospital wellness program of yoga and stretching
- Weight lifting under the direction of a personal trainer
- Walking with a local fitness group
Correct Answer

A. The hospital wellness program of yoga and stretching

Explanation

The yoga and stretching program would put the least amount of pressure on the cardio-vascular and pulmonary systems. Also this activity will be monitored by hospital staff rather than personnel who are not familiar with COPD.
Reference: Fleming-Castaldy, R.P. National Occupational Therapy Certification Exam Review and Study Guide; pg 479

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49.

General Rehab: During the initial ADL evaluation the patient is provided a toothbrush and asked to brush their teeth. The patient begins to brush their hair with the toothbrush. Which behavior is this most likely indicative of?
- Motor apraxia
- Ideational apraxia
- Astereognosis
- Simultanognosia
Correct Answer

A. Ideational apraxia

Explanation

ANSWER: b, ideational apraxia is a conceptual deficit seen as an inability to use real objects appropriately.
Occupational Therapy: Practice skills for physical dysfunction 6th edition, chapter 24

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Occupational Therapy Certification Exam Practice Test

General Rehab: Which of the following is a contraindication for electrical stimulation usage?

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Neurological: A patient just experienced a L ACA infarct CVA, what is the best statement concerning the patient’s question about rehabilitation potential?

Psychology: What is NOT a sign/symptom of schizophrenia?

General Rehab: A client with deficits in stereognosis would have MOST DIFFICULTY with?

General Rehab: You are seeing a patient in isolation, with a diagnosis of MRSA. What precautions should you take before treating the patient?

Orthopedic: Which of the following is a hip precaution for the first 8 weeks after a hip replacement?

Pediatrics: Sensory Integration is...

Orthopedic: Immediate precautions following a total hip replacement procedure include which of the following?

Orthopedic: For an individual with RA, treatment should include:

Orthopedic: Which of the following does NOT describe a proper tip for good body mechanics when sitting?

Neurological: You are evaluating a 73-year-old patient who presents with rigidity, resting tremor, hypokinesia, and postural instability. What is this patient’s most likely diagnosis?

General Rehab: You are treating a patient who has experienced decreased oxygenation. What breathing technique should you instruct the patient in to increase oxygenation?

General Rehab: Which of the following methods is the BEST way to evaluate for a hook grasp?

Neurological: Which of the following strategies is NOT an effective psychosocial intervention for clients recovering from a cerebral vascular accident?

Orthopedic: The purpose of getting an orthopedic surgical patient up and moving as soon as the doctors approves it is to: (Choose the best answer)

General Rehab: Sensory modulation disorder is one type of SI dysfunction characterized by fluctuating or extremes in responsiveness to the intensity of one or more sensations. Specific behaviors may include:

General Rehab: During the evaluation of the same COPD patient, the OT sets a short term activity tolerance goal of the pt performing an activity in the 1.0-2.5 METS range. What activity would match that level of exertion?

Neurological: Which of the following signs and symptoms are the best common factors occurring in Alzheimer’s disease?

General Rehab: When transferring a patient an OT can best protect themselves from injury by doing which of the following?

General Rehab: Which of the following evaluation methods can not be used to test manual dexterity/motor function?

Pediatrics: When working with a sensory defensive child, if they are fearful or hesitant when climbing stairs and hold railings tightly, which sensation are they having a reaction to?

General Rehab: Which mobility skills should be accomplished first?

General Rehab: People who are afraid of falling appear to enter a debilitating spiral exhibiting all of the following except:

General Rehab: When working with a patient 1 day post a total shoulder arthroplasty it is appropriate to do:

Neurological: A patient displays “alien-arm” syndrome, and is unable to attend to the arm to correct it. This patient is most likely presenting with:

Orthopedic: Your pt presents with hand numbness, mostly at night, pain and paresthesia in the thumb, index, and middle finger. What nerve compression disorder coincides with these symptoms?

General Rehab: When completing a home evaluation, what would be the most important suggestion to the patient to prevent falls:

General Rehab: Passive stretching to increase ROM should not involve:

Orthopedic: Which of the following would be the LEAST important to stress to a patient following back precautions?

General Rehab: If a patient presents to the clinic with a high level of shoulder pain what type of interventions should you avoid initially?

Neurological: You read in a TBI patient’s chart that they are at Level III of the Rancho Los Amigos Levels of Cognitive Function Scale. Which of the following is NOT an appropriate intervention for a patient at this level of cognition?

Pediatrics: A child with tactile defensiveness can probably best tolerate:

Neurological: Which of the following methods is INCORRECT when working with a TBI patient with a Rancho Level IV?

General Rehab: Which option below is most important as the INITIAL OT intervention for an individual with a severe form of Guillain-Barré syndrome who has complete paralysis?

Pediatrics: What would you recommend to parents of an infant who demonstrates low tone, cries a lot, and has a difficult time being soothed?

General Rehab: Per physician referral, an OT in acute care conducts an evaluation with an adult with a new diagnosis of COPD. The OT evaluates the pt and is contemplating possible treatment ideas. The therapist should do the following except:

General Rehab: A client is hypertonic in their right UE distal to the elbow secondary to a CVA. The OTR facilitates the client into a right side-lying position for therapeutic exercise. What is the primary benefit of facilitating this position?

General Rehab: In what age-range are symptoms of multiple sclerosis most likely to emerge?

Pediatric: A child presents with increased tone, which activity would be the most appropriate?

Management & Evidence: When working with patients with mental health diagnoses it is important to take the individual’s personal desires into accordance when making therapy goals. Which OT assessment is not in accordance with the Model of Human Occupation frame of reference?

General Rehab: An adult is hospitalized and diagnosed with mild COPD. In planning for d/c, the pt wants to continue to exercise. The most appropriate recommendation for the OTR/L to make would be that the pt. participate in:

General Rehab: During the initial ADL evaluation the patient is provided a toothbrush and asked to brush their teeth. The patient begins to brush their hair with the toothbrush. Which behavior is this most likely indicative of?