NBCOT Exam Trivia Quiz

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  • 1/312 Questions

    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
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About This Quiz

This NBCOT Exam Trivia Quiz assesses knowledge crucial for occupational therapists, focusing on TBI management, pediatric positions, and ethical responses to elder abuse. It's designed to test readiness for professional certification and enhance practical skills in handling diverse patient scenarios.

NBCOT Exam Trivia Quiz - Quiz

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  • 2. 

    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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  • 3. 

    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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  • 4. 

    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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  • 5. 

    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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  • 6. 

    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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  • 7. 

    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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  • 8. 

    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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  • 9. 

    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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  • 10. 

    Neurological: Mrs. Miller is a 31 y/o female diagnosed with a traumatic brain injury.  As the occupational therapist you are using a transfer of training approach to help Mrs. Miller recover from her traumatic brain injury. You want Mrs. Miller to develop and carry out a daily schedule of activities. Which is the MOST appropriate to do during your treatment session?

    • Prepare a simple meal

    • Organize a list of daily activities

    • Write a shopping list

    • Complete an interest checklist

    Correct Answer
    A. Organize a list of daily activities
    Explanation
    Pendleton, H.M. & Schultz-Krohn, W. (2006). Pedretti’s occupational therapy practices skills for physical dysfunction. St. Louis, MO; Mosby Elsevier.
    Fleming-Castaldy, R.P. (2009). National Occupational Therapy Certification Exam Review & Study Guide.

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  • 11. 

    Pediatrics:  What is the correct sequence for the Development of Play?

    • Symbolic play, exploratory play, creative play, games

    • Exploratory play, creative play, symbolic play, games

    • Exploratory play, symbolic play, creative play, games

    • Creative play, symbolic play, exploratory play, games

    Correct Answer
    A. Exploratory play, symbolic play, creative play, games
    Explanation
    -exploratory play happens from 0-2 years, symbolic play 2-4 years, creative play 4-7 years and games with rules and directions 7-12 years.

    NBCOT Review and study guide, pg 95

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  • 12. 

    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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  • 13. 

    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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  • 14. 

    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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  • 15. 

    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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  • 16. 

    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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  • 17. 

    Pediatrics:  What is the correct sequence for the Development of Play?

    • Symbolic play, exploratory play, creative play, games

    • Exploratory play, creative play, symbolic play, games

    • Exploratory play, symbolic play, creative play, games

    • Creative play, symbolic play, exploratory play, games

    Correct Answer
    A. Exploratory play, symbolic play, creative play, games
    Explanation
    Answer: C
    -exploratory play happens from 0-2 years, symbolic play 2-4 years, creative play 4-7 years and games with rules and directions 7-12 years.

    NBCOT Review and study guide, pg 95

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  • 18. 

    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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  • 19. 

    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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  • 20. 

    General Rehab: A 62 year old widow, who lives alone, is preparing to be discharged from a SNF after 4 weeks of therapy following a hip replacement.  The most important equipment the OT should recommend would be:

    • Wheeled walker

    • Bedside commode

    • Weighted hairbrush

    • Long handled reacher

    Correct Answer
    A. Long handled reacher
    Explanation
    Source: long handled reachers help patients reach for items without breaking their hip precautions. A wheeled walker would be a PT thing! A bedside commode would not be appropriate for someone who is being discharged home and a weighted hairbrush has nothing to do with hip surgery.

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  • 21. 

    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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  • 22. 

    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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  • 23. 

    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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  • 24. 

    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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  • 25. 

    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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  • 26. 

    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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  • 27. 

    Neurological: You are the treating therapist for recently TBI patient in an acute care hospital. Upon initial evaluation, your patient was given a Glasgow score of 9. Currently your patient is a rancho level 6. Which would be the most effective method of intervention for your clients motivation, cognition, and memory impairments?

    • Abstract, problem solving community re-entry scenario's

    • Higher level money management problems

    • Simple, everyday ADL's repetition activity

    • Self directed UE ROM/strengthening exercises

    Correct Answer
    A. Simple, everyday ADL's repetition activity
    Explanation
    Neurological Rehabilitation, 5th edition. Umphred, D. A.. Mosey, 2007. Pg 537- 551.

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  • 28. 

    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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  • 29. 

    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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  • 30. 

    Mangement & Evidence: Working in a SNF setting, you notice a patient is fatigued and seems more weak then usual. After weighing the patient, you determine that they have lost 9 lbs in the past week. What course of action should you take?

    • Notify nursing and patients physician

    • Consult the dietitian

    • Discontinue the exercise and activities portion of intervention and focus on discussion/observation.

    • All of the above

    Correct Answer
    A. All of the above
    Explanation
    Rational: Failure to thrive (FTT) is common within the nursing home environment, and it is important that clients demonstrating symptoms of FTT conserve their energy. Nursing personnel and the physician should be notified to modify treatment/medications, and the dietitian should be notified to monitor calorie intake. Client should conserve what energy they have remaining, and physical activities should be discontinued until weight is regained.
    Source: www.fpnnoteook.com, presentation/in-service on FTT

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  • 31. 

    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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  • 32. 

    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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  • 33. 

    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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  • 34. 

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

    • Knee replacement

    • Hip replacement

    • Pacemaker

    • COPD

    Correct Answer
    A. Pacemaker
    Explanation
    Pacemakers are a contraindication for any electrical stimulation or diathermy usage.
    Source- http://www.biomedofla.com/images/contraindications.htm

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  • 35. 

    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
    “B” is the correct answer (memory is the major factor in Alzheimer’s). “A” consists of the symptoms of schizophrenia, “C” represents dyslexia, and “D” represents the signs/symptoms for Parkinson’s disease.

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

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  • 36. 

    Psychology: A young female presents to the ER with increased sweating, chest pain, nausea and fear of losing control. She states that this has happened several times in the last 3 months and typically the symptoms subside after 10 minutes. She is scared and wants to make sure she isn’t having a heart attack. After doing an EKG and several other tests, cardiac problems are ruled out and more information is sought out about her symptoms. The patient states that as of two months ago she has become scared to be in crowded places and avoids anywhere that has lines or crowds and avoids situations where she knows she will feel this way (supermarkets, movie theaters and buses). What is her diagnosis?

    • Panic Attack

    • Panic Disorder without Agoraphobia

    • Panic Disorder with Agoraphobia

    • Agoraphobia

    Correct Answer
    A. Panic Disorder with Agoraphobia
    Explanation
    Panic Attack and Agoraphobia are NOT codable disorders, the specific disorder in which panic attack or agoraphobia occur are the actual diagnoses so A and D can be ruled out. Because the patient has become increasingly worried about being in places or situations in which she can’t escape when a panic attack occurs and she avoids situations in which she notes panic and anxiety, agoraphobia should be included in the diagnosis, which excludes B as well.

    References:
    DSM-IV-TR (Panic Disorder Question)
    http://www.uptodate.com/patients/content/topic.do?topicKey=~UUVUUsuHJkzvcYr&selectedTitle=1~83&source=search_result (Schizophrenia Question)
    http://www.nimh.nih.gov/health/publications/bipolar-disorder/how-does-bipolar-disorder-affect-someone-over-time.shtml (Bipolar Disorder Question)

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  • 37. 

    General Rehab: If a patient presents to the clinic in the freezing phase of adhesive capsulitis what type of interventions should be avoided?

    • Aggressive stretching

    • ROM that is painful for less than a few minutes

    • Posture education/scapular kinematics

    • Modalities/corticosteroids

    Correct Answer
    A. Aggressive stretching
    Explanation
    Rationale: The primary treatment goal of the freezing phase is to prevent motion loss. Overstretching the capsule during the freezing phase may enhance the inflammatory process. For more information see chapter 10 in Cynthia Cooper text “Fundamentals of Hand Therapy.”

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  • 38. 

    Neurological: An OT is providing intervention for a client who had a stroke involving Broca's region in the left hemisphere. This client would have difficulty with:

    • Expression

    • Receptive language

    • Both expressive and receptive language

    • A rapid speech pattern

    Correct Answer
    A. Expression
    Explanation
    : a. expression (client's with Broca's aphasia have slowed labored speech with some apraxia also noted, but they have good receptive language skills unless it is too rapid or lengthy.
    Pedretti L, Early MB: Occupational therapy: practice skills for physical dysfunction, ed 5, St. Louis, 2001, Mosby. (Found in the Q & A for the Occupational Therapy Board Examination by Patricia Bowyer and Dorthy Bethea, 2007)

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  • 39. 

    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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  • 40. 

    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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  • 41. 

    Neurologic: What is the most common brain tumor?

    • Glioblastoma

    • Anaplastic

    • Astrocytoma

    Correct Answer
    A. Astrocytoma
    Explanation
    Astrocytoma is the most common brain tumor because it originates from astrocytes, which are star-shaped cells that support and nourish neurons. These tumors can occur in different parts of the brain and can vary in grade, with low-grade astrocytomas being less aggressive and high-grade astrocytomas being more aggressive. Glioblastoma and anaplastic are also types of brain tumors, but they are less common compared to astrocytoma.

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  • 42. 

    General Rehab: You suspect your client may have a visual field cut and would like to conduct a gross screen to find out.  Which of the following are examples of screens for visual field deficits that could be used in addition to careful observation during ADL task?

    • Static confrontation test; examiner sits in front of pt and has pt fixate on a centrally placed object- examiner holds up a target in each of four quadrants of visual field. Pt indicates whether he or she sees the target.

    • Kinetic test; examiner stands behind the pt and moves a target in from the periphery while the pt fixates on a central target. The pt indicates as soon as he or she notices the target.

    • You ask the pt to follow the tip of your pen with their eyes as you glide the pen through the air making an "H" and an "X".

    • A & B

    Correct Answer
    A. A & B
    Explanation
    ANSWER: A. and B. (but remember, these are only gross screens- standardized versions of these tests are included in the biVABA- brain injury visual assessment battery for adults)
    Reference: Pedretti: OT, Practice Skills for Physical Dysfunction- Fifth Edition, page 404

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  • 43. 

    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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  • 44. 

    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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  • 45. 

    General Rehab: A patient with macular degeneration is having difficulty with meal preparation. The following are environmental factors to consider to improve the patient's ability to perform meal preparation except:

    • Changing the lighting

    • Marking the controls with bright contrasting colors

    • Suggest laser surgery to improve eye sight

    • Organize the kitchen and keep items in their assigned places

    • Use dark cutting boards for light colored food and light cutting boards for dark food

    Correct Answer
    A. Suggest laser surgery to improve eye sight
    Explanation
    Reference: Occupational Therapy for Physical Dysfunction, Sixth Edition, p. 731-732

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  • 46. 

    Neurological: When positioning a stroke patient in supine with hemiplegia, what is the correct position?

    • Place a pillow under the involved scapula and hip

    • Place a pillow under the uninvolved scapula and hip

    • Place a pillow under the knee of the involved side

    • Place a pillow under arm on the uninvolved side

    Correct Answer
    A. Place a pillow under the involved scapula and hip
    Explanation
    Rationale: You place a pillow under the involved scapula and hip to prevent retraction in these areas. You can place an additional pillow alongside the client’s involved leg to keep the hip from externally rotating if necessary. Do not place a pillow directly behind the knee as this may contribute to DVT or knee flexion contracture.
    Source: Willard and Spackman 10th ed. Pg 605

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  • 47. 

    Orthopedic: When adhering to hip precautions after a THR, which of the following would be an appropriate OT treatment?

    • B UE strengthening exercises

    • Strengthening exercises of affected LE

    • Instruction in & practice the use of AE for lower body dressing

    • Transfer training with tub bench and getting on and off toilet with raised toilet seat

    • None of the above

    • Both C and D

    Correct Answer
    A. Both C and D
    Explanation
    Answer: f. Instruction in & practice the use of AE for lower body dressing and transfer training with tub bench and getting on and off toilet with raised toilet seat

    Rationale: Role of Occupational therapist is to adhere to hip precautions after surgical repair of hip fractures. In order for the patient to continue adl independence, instructing the pt with lower body dressing using AE allows the patient to complete the tasks being modified independent. In addition, the patient needs to be able to complete tub transfers safely and use a raised toilet seat while adhering to hip precautions. Strengthening of B UE and/or exercises for affected hip could be an appropriate treatment; however, this is not relevant to hip precautions.
    Source: National Occupational Therapy Certification Exam Review and Study Guide 5th Edition by Rita P. Fleming-Castaldy (page 140)

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  • 48. 

    Pediatrics: An OT is working with a child that is suspected of having difficulties with visual perceptual skill. Developmentally, the first visual component that needs to be assessed is:

    • Pattern recognition

    • Scanning skills

    • Visual attention

    • Oculomotor control

    Correct Answer
    A. Oculomotor control
    Explanation
    D. Oculomotor control, Visual field and visual acuity are considered to be primary visual skills and serve as the foundation as hierarchy of visual perceptual skills.
    Mosby's Q & A Review for the Occupational Therapy Board Examination. Patricia Bowyer EdD OTR/L BCN (Author), Dorothy P. Bethea EdD MPA-OTR-L (Author)

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  • 49. 

    Pediatrics: You are evaluating an infant in an outpatient clinic for feeding problems.  What is the first step in the evaluation process?

    • Discussing information about the child’s medical history

    • Evaluating the child for clinical signs of underlying disorders

    • Assessing the developmental and neuromotor status of the infant

    • Asking parents and caregivers questions about feeding, eating, and swallowing

    Correct Answer
    A. Asking parents and caregivers questions about feeding, eating, and swallowing
    Explanation
    Schuberth, L.M., Amirault, L.M., and Case-Smith, J. (2010). Feeding intervention. In J. Case- Smith & J. Clifford O’Brien (Eds.), Occupational therapy for children (pp. 446-473). Maryland Heights, MO: Mosby Elsevier

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