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176 terms

NBCOT Practice Questions

STUDY
PLAY
A 5 year old child who has mild developmental delay is learning to self-dress. Most recently, the child has mastered putting on and taking off a coat, as well as buttoning and unbuttoning it. From the dressing tasks listed, which should the child learn to do next based on the typical development sequence for dressing?
Pulling up a jacket zipper would be the next dressing skill the child should learn.
An entry level OTR who works in a long-term care facility is screening a resident who has ALS and uses a wheelchair. The resident's UE functional strength is Trace (1/5) on the left and Poor Minus (2-/5) on the right. 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. What care coordination task should the OTR complete FIRST?
Coordinate with the multi-disciplinary team to identify specific feeding and swallowing objectives.
An entry level OTR who works in a long-term care facility is screening a resident who has ALS and uses a wheelchair. The resident's UE functional strength is Trace (1/5) on the left and Poor Minus (2-/5) on the right. 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. What symptom is the resident most at risk for experiencing during a meal?
Variation in voice quality or loss of voice after swallowing, which is a symptom of dysphagia.
Which factor is MOST IMPORTANT to determine when considering if the resident would benefit from a mobile arm support?
Amount of upper extremity passive joint mobility
At a minimum, what information should the OTR document to increase the likelihood of additional authorized visits?
Functional problem statements indicating the need for skilled services
How should the OTR respond to the client's concerns about splinting?
Encourage full participation in daily tasks by collaborating on ways to modify typical daily activities
Your patient had a CVA several weeks ago. Which task oriented approach would be most beneficial to include as part of the intervention plan for maximizing the client's physical abilities?
Constraint-induced movement therapy is a task-oriented approach to motor acquisition.
For a patient who had a CVA several weeks ago, which type of activity should be included as part of the INITIAL intervention to REMEDIATE the client's motor impairment?
Weight bearing through the affected upper extremity prior to an activity
Which assessment should be included as part of the initial evaluation and can be administered by the COTA?
COPM
What is contraindicated during phase I of cardiac rehab?
Isometric exercises can cause a rapid and sudden increase in blood pressure
AOTA
Publishes Standards of Practice for Occupational Therapy and the Reference Manual of official Documents of the AOTA.
NBCOT
Responsible for issues related to certification and certification renewal
ACOTE
responsible for accreditation of OT education standards in support of the practice standards set forth by the AOTA
Negligible Correlation
0 - .2
low correlation
.2 - .4
moderate correlation
.4 - .6
high correlation
.6 - .8
.8 - 1.0
very high correlation
Constructional Apraxia
have difficulty constructing/assembling objects
A client has Poor minus (2-/5) functional strength of the dominant UE. What is the most effective method for grading an activity to improve the client's muscular strength?
Increasing the amount of time an isometric contraction is held
What is the PRIMARY purpose for completing a dysphagia screening for an inpatient who had a right CVA several days ago?
To observe the patient's oral motor control and determine a need for further evaluation. A screening is not used for diagnostics or treatment planning - it allows the OTR to quickly detect the presence of a deficit and determine if an in-depth evaluation is needed.
An OTR is preparing to interview an outpatient who has a TBI and is functioning at Rancho Level VII. What charcteristic of an individual's cognitive behavioral function is typically included in the description of this level?
Consistent orientation to time and space. Patients at this level frequently display robot-like behaviors and require minimal assistance for routine ADL.
Cognitive Behavioral Therapy
The individual can change their behavior by first challenging their negative assumptions (cognitions) relating to trigger events.
If a client presents with a boutonniere type deformity, what is the most likely cause?
Rupture or lengthening of the central slip of the EDC
Rupture of the flexor digitorum superficialis tendon or lengthening of the lateral slips of the EDC may result in...
swan neck deformity
An OTR who receives a referral for a 5 yr old with PDD should first gather background information on the child by:
discussing the child's history with the caregiver to identify the child's present level of performance in different occupational roles
When considering the readiness of a client for a power wheelchair, the OTR should primarily be concerned with
Cognitive ability, to ensure that the individual has the awareness, problem solving, and decision making capabilities to learn how to consistently and safely operate the chair
agoraphobia
a morbid fear of open spaces (as fear of being caught alone in some public place)
During an OT session at an outpatient facility, the client states that being injured has caused considerable stress at home. The client often feels frustrated and angry and reports a concern for having to physically discipline her children. The FIRST action that the OTR should take is to:
further explore the situation since the child may be at risk. Gathering specific information about the client's comment is critical due to the seriousness of the accusation. Therapists are required by law to report any situation where abuse is suspected. Documentation occurs after all information is obtained from the individual. More information is needed before any action is taken.
According to SI frame of reference, tx is most effective when:
a child directs his or her actions within an environment structured by an OTR that provides the just-right challenge. The child's skills and abilities are facilitated in an environment where the child is directing their participation in activities
An individual who is referred to OT to increase socialization and develop leisure skills sits alone, despite the active involvement of the other group members. To increase the individual's involvement in the group, the OTR's MOST APPROPRIATE FIRST action would be to
review the goals and purpose of the group with the individual. In order for the individual to become involved in a group process, the group norms and expectations must first be explained to the client.
The BEST position in which to feed an 8-month old with severe hypotonia is
semireclined with the neck in neutral and head at midline. This will promote correct alignment of body parts during feeding and requires minimal active muscular control
An individual has difficulty conceptualizing and organizing future events, and is experiencing decreased feelings of competence. The BEST treatment intervention is to have the individual:
prioritize short term goals with a high chance of success. Feelings of competence are enhanced by successful progression toward achievable goals
A 15 month old child with motor delays is able to get into a sitting postition, but does not pull up to standing. Which developemental milestone is the OTR MOST LIKELY to emphasize next?
Creeping - The Developmental Frame of Reference suggests that once a child has achieved the developmental skill of sitting, the next skill to achieve is creeping.
Before recommending purchase of adapted switches for a 3 year old with severe cerebral palsy, the OTR must FIRST:
determine goals - considering how a new piece of equipment will fit into a person's occupational roles should be the first consideration for identifying equipment needs
When positioning an individual with flaccid hemiparesis in a wheelchair, an OTR using NDT would place the affected arm in:
a supported position, with the scapula protracted and the arm forward to inhibit abnormal patterns of movement and inhibit synergistic posturing and help to maintain scapular mobility for normal movement patterns
An OTR is working on pencil grasp with an 8 yr old. The child consistently uses a palmer grasp. The MOST EFFECTIVE activity to facilitate the development of a more mature pencil grasp pattern is:
stringing small beads would be most effective way to improve functional coordination and use of intrinsic muscles of the hand. This activity would also promote a more refined distal fingertip control. Distal control in intrinsic muscle strength and coordination are important components of a mature pencil grasp.
When learning one-handed dressing techniques, an individual with right hemiplegia, aphasia, and ideational apraxia would MOST LIKELY benefit from which of the following treatment approaches?
Tactile cueing for initiating dress because ti uses the individual's existing strengths to minimize the functional deficits resulting from aphasia and ideational apraxia
To maximize independence in feeding, an individual with a complete C-5 quadriplegia will most likely benefit from a:
plate guard, a wrist-hand orthosis with a utensil slot, bent angled utensils, and a long straw with a straw holder. A wrist-hand orthosis would compensate for the absence of wrist extensors/flexors. Bent angled utensils aid in maximizing self-feeding skills by compensating for the absence of radial and ulnar deviation. A plate guard provides a barrier against which the individual could push food to get the food onto a fork.
C5
will have the following movements: elbow flexion, forearm supination, shoulder external rotation, should abduction to 90 degrees.
What technique helps to normalize tone and promote sensory feedback in a pt who had a CVA with resulting hypertonicity?
weight bearing/joint compression is an inhibitory technique described in both Rood's and Bobath's theories
The parents of a 6 month old who has mild spasticity have been instructed in a positioning program for home. The BEST way to assess the effectiveness of the intervention program is to:
have the parents demonstrate correct positioning
Based on a child's performance, a school-based OTR believes that program modifications in the IEP are needed. The first course of action the OT should take should be to:
Prepare a summary of the additional needs for the multidisciplinary team
Based upon the initial evaluation results of a patient with a brain tumor, independence in upper body dressing is established as a short-term goal. After 2 weeks of treatment the patient is not progressing as quickly as expected. The FIRST thing the OTR should do is:
contact the physician to discuss the patient's progress. It may be appropriate to modify the patient's plan but the OTR should FIRST discuss this with the physician
An OTR emplyed by a multi-state entertainment theme park corporation can FIRST enhance the corporation's awareness of their role in assuring parks accessibility and ADA compliance by:
identifying barriers which inhibit customer use. Determine occupational needs of the organization. The first step of the process would be to identify the needs and issues surrounding parks accessibility and ADA compliance.
An OTR working in a long-term care facility is asked to recommend seating approaches for the residents in the dining program. The BEST approach to meet the needs of the entire group would be to:
assess the resident's needs and strengths. Determine occupational needs of the program.
When does Asymmetric Tonic Neck Reflex disappear?
4 months
When does the stepping reflex disappear?
2 months
When does palmar grasp reflex (spontaneous grasp of adult fingers) disappear?
3-4 months
When can a child lift self by arms when prone?
2 months
When can child sit alone?
6-7 months
When can child crawl?
7 months
When can child pull to stand?
8 months
WHen can child stand alone?
11 months
When can child build a tower of 2 cubes?
13 months
Reaching at 3 months
Voluntary reaching gradually improves in accuracy. It does not require visual guidance of arms and hands, but rather a sense of movement and location.
Reaching at 9 months
Infant can redirect reaching to obtain a moving object that changes direction.
When can a baby roll from tummy to back and back to tummy?
4-5 months
What is the primary purpose of the chin tuck?
To prevent food secretion from entering the larynx below the level of the vocal chords
A client who has motor deficits secondary to the onset of
Huntington's disease is participating in OT. One of the client's
goals is to be independent with dressing. Which intervention
activity is BEST to include as part of the initial intervention
plan?
Educate the client and caregivers about methods for adapting the fasteners on the client's clothing. HD is a progressive neurodegenerative disorder. Symptoms
include choreo-athetoid movements and alterations in behavior and cognitive functions. A client in the early stages would benefit most from learning techniques to compensate for motor deficits.
A 5-year-old child who has mild developmental delay is learning to self-dress. Most recently, the child has mastered putting on and taking off a coat, as well as buttoning and unbuttoning it. From the dressing tasks
listed, which should a child learn to do NEXT based on the typical developmental sequence for dressing?
Pulling up a jacket zipper
Minimum width of a hall for a wheelchair
36 in
Minimum clear width for a wheelchair is _____ inches for a door.
32
If wheel chair ramp changes direction the minimum size of the landing is:
5' by 5'
Wheel chair hand rail height
33" to 36"
Standard wheelchair width
24-27"
Phase I Cardiac Rehab
Acute care
-3-5 day hospital stay for uncomplicated MI
-initiate activity once stable for 24hrs
-low intensity (2-3 METs) progressing to 3-5 METs by discharge
-lifting restricted for 6 wks
-monitored low level physical activity
-self-care
-reinforcement of cardiac & post-surgical precautions
-energy conservation education
-graded activity
Phase II Cardiac Rehab
Pt. is out of the hospital and goes to a rehab center. Target HR during rehab is 10bpm below the rate of ischemic change. Subacute (outpatient) rehab; most payers allow 36 visits (3x/wk for 12 wks); for pts at risk for arrhythmias or angina that benefit from ECG monitoring; 30-60 min session with warm up and cool down; gradually weaned to self-monitoring; exit point is 9 METS (5 METS for most daily activities); strength training after 3 wks of rehab, 5 wks post-MI, or 8wks post-CABG; elastic bands or 1-3 lb weights, to mod loads of 12-15 reps
Phase III Cardiac Rehab
Community exercise program, post phase II rehab; entry level criteria is 5 METs, clinically stable angina, and arrhythmias controlled with meds; progress to self-regulation; 50-85% capacity 3-4 times/wk for 45 min sessions; discharge in 6-12 mo; 5 wks post-surgical or MI; 3 wks post-PTCA; no evidence of unstable s/s; resistance with 50% or more of 1 RM, 1-5 lb weights, RPE 11-13; RPP prescribed by ETT
Fine Motor Development 8 month
mouths toys, accurately reaches for toys, transfers toys hand to hand, bangs objects together, grasps small objects in fingertips
Gross Motor Development 8 months
sits independently, rolls, stands with support, and crawls on belly
When does the Moro Reflex disappear?
3-4 months
symmetric tonic neck reflex
onset: 4-6 months, disappears: 8-12 months
Stimulus: place infant in the crawling position and extend the head
Response: Flexion of the hips and knees
*Breaks up total extensor posture
When should head lag stop when lifting the baby up to sitting from a lying down position?
6 months
equilibrium reactions
stimulus: displace center of gravity by tipping support surface, response: righting of head/trunk/limbs
When does the asymmetric tonic neck reflex appear and disappear?
present at 1 month, disappears at 4 months
asymmetric tonic neck reflex
Onset age: 37 wks gestation
Integration age: 4-6 months
Stimulus: Fully rotate infant's head and hold for 5 seconds.
Response: Extension of extremities on the face side, flexion of extremities on the skull side.
Relevance: Promotes visual hand regard.
flexion righting reaction
when the child is pulled to a sitting position, the development of antigravity neck flexion is associated with the child's ability to maintain head and trunk alignment against the pull of gravity
support reaction
the ability to co-activate muscle groups of the appropriate extremity to support body weight or posture in a certain position
dysesthesia
Touch sensation experienced as pain
backward chaining
A teaching procedure in which a trainer completes all but the last behavior in a chain, which is performed by the learner, who then receives reinforcement for completing the chain. When the learner shows competence in performing the final step in the chain, the trainer performs all but the last two behaviors in the chain, the learner emits the final two steps to complete the chain, and reinforcement is delivered. This sequence is continued until the learner completes the entire chain independently.
chorea
Sudden, jerky, purposeless movements. Characteristic of basal ganglia lesion (e.g., Huntington's disease) (Chorea = dancing (Greek). Think choral dancing or choreography)
Huntington's Disease
a human genetic disease caused by a dominant allele; characterized by uncontrollable body movements and degeneration of the nervous system; characterized with ataxic gait with choreoathetoid movements, rigidity develops with progression
ideational apraxia
regarded as higher level disorder in which the individual movements are intact but the execution of complex sequential movements with objects is impaired.
Considered severe from of ideomotor apraxia
misuse of objects can be seen in confusional states & dementia & may have little to do with apraxia
ideomotor apraxia
a condition where a person plans a movement or task, but cannot volitionally perform it. Automatic movement may occur, however, a person cannot impose additional movement on command
short form 36 health survey
-survey used to measure general health and well being
-it has been used in medical outcomes studies and is sensitive to change in health status
(i.e. to determine if participation in rehab is beneficial to a clients health, well being, and general quality of life)
While assessing the motor skills of an 8 month old child, the OT observes him assume a quadruped position and then begin to rock back and forth. This behavior most likely indicates:
normal development
while standing and holding onto furniture, a 3 yr old boy with delayed motor development shifts his weight onto one leg and steps to the side w the other. This movement is
cruising
During an initial interview parents describe their child as having severe difficulty in communicating and interacting with other and also exhibits repetitive and ritualistic behaviors. This is most likely
PDD
Can a child with a flaccid bladder be toilet trained?
No
MOHO primarily focuses on:
the effect of personal traits and the environment on role performance
An infant born 15 weeks premature has a hx of mult medical issues including retinopathy of prematurity, mechanical ventilation for 5 weeks, and poor feeding skills. The infant is now 43 weeks old, medically stable and engaging infant, with a g-tube and O2 supplement of 2 L by nasal cannula. What is the MOST appropriate intervention to pursue at this time?
Multisensory input, because an infant reaching full term or post term needs a multisensory diet to assist with age appropriate motor and behavioral skill acquisition and it is often found tht premature infants are limited in the amount of social interaction and sensory stimuli they receive since they have necessary medical equipment etc. If the infant were 32 to 35 weeks they would need range of motion and positioning, because of immature sensory systems and compromised respiratory systems.
An individual with strong dependency needs is able to lace a leather wallet only with consistent verbal cueing. Which is the BEST way to grade the activity in order to decrease dependency?
Ask the individual to try some lacing with distant supervision and praise her for what she has been able to do. The next step would then be to tell the individual to complete some lacing while the OT assists another pt in the same room.
When working with a child who is at risk for shunt malfunction, it is MOST important for the therapist to observe for:
unexplained sensory loss
For self-feeding with C5 spinal cord injury, what piece of equipment would be MOST appropriate?
Mobile Arm Support
When planning intervention for individuals int he acute phase of cardiac rehab, it is most important for the OT to select activities that:
Decrease the effects of prolonged inactivity, such as thromboembolism, orthostatic hypotension, and muscle atrophy
What is the MOST important when using a remotivation approach with a group of elderly individuals?
Use of photos, music, and discussion to encourage discussion of memories
A child with ADHD also exhibits perceptual deficits. What activity would be MOST effective intervention to train visual attention?
Blowing cotton balls at a target because child with ADHD have difficulty with sustained attention and effort and blowing cottons balls at a target is a short-term activity with immediate reward for successful completion rather than delayed gratification
An OT is training an adult worker with a developmental disability to put a pencil in the box before putting in the score pad in the box for a game packing task in a sheltered workshop. The pt has not done this before. What type of reinforcement schedule would be BEST to achieve the goal oflearning this task sequence?
continuous reinforcement of correct responses - continuous reinforcement is best for learning new behaviors, intermittent reinforcement is best for maintaining behaviors.
A pt with Guillain Barre is expected to stay in hospital 3-4 weeks. When should the OT practitioner order adaptive equipment?
Just before discharge to accurately determine the pt's needs
For a pt at ACL 4, what is the BEST method for introducing an assembly activity?
Provide project samples for clients to duplicate
For a pt at ACL 3, what is the BEST method for introducing an assembly activity?
Provide repetitive, one-step activities. Pt will not likely produce consistent results.
For a pt at ACL 5, what is the BEST method for introducing an assembly activity?
Demonstrate a 3 step assembly process
For a pt at ACL 6, what is the BEST method for introducing an assembly activity?
Provide written directions for the individuals to follow
A toddler has feeding difficulties because of deficient oral-motor control and oral defensiveness but the parents want him to be able to eat cut up meats and veggies. The OT tells the parents the child can start eating these foods when their child is able to tolerate what?
Dry cereals with milk.
How to increase oral tolerance and control of food
Gradually modify textures from smooth and consistent (strained fruits and veggies) to smooth and slightly varied (apple sauce and mashed bananas and scrambled eggs) to increasingly resistive foods and a combination of contrasts such as hard and crunchy mixed with soft or liquid (i.e. dry cereal and milk). After the child has mastered this level of control and tolerance, he can safely proceed to an even greater variety of textures, tastes, and temperatures offered at family meals.
After a total hip replacement how does the pt perform a passenger side car transfer?
Back up the body to the passenger seat, hold onto a stable section of the car, extend the involved leg, and slowly sit in the car.
What is the ONLY activity that will facilitate hand function in the preparation phase?
Weight-bearing on hands
What help improve the ability of someone with a C6 or C7 SCI to hold something?
Wrist splints to promote development of tenodesis by allowing the finger flexors to shorten so the person will have a functional grasp when the wrist is extended.
An OT is positioning a child with poor muscle tone and postural instability into a prone stander to develop head righting. The child rapidly shows fatigue. How can the therapist BEST adjust the stander to decrease these reactions while continuing to address the goal of head righting?
Position the stander at 75 to 90 degrees from the floor so that the child doesn't have to work against gravity a lot, but isn't standing up straight which would be the easiest.
What is an effective strategy for increasing attention to the left for a person who has a diagnosis of unilateral neglect?
Encouraging available hemiplegic limb movements before or during a task because any movement will activate additional motor units which will then increase attention to the Left
What is the best height for a toilet for someone with lower extremity paralysis in a standard wheelchair?
18 inches which is the height of a standard wheelchair seat, making transfers easier
ACMRDD
Accredation Council for services for the Mentally Retarded and other Developmentally Disabled Persons
JCAHO
Joint Commission of Accreditation of Hospital Organizations reviews medical care of hospitals, psychiatric facilities, hospices, long-term care agencies, and MR/DD programs seeking accreditation.
CARF
Commission on Accreditation of Rehab Facilities reviews programs in free standing facilities as well as those that are part of a hospital system
What is the maximum height a door threshold can be for a person in a wheelchair?
Half an inch, beveled
Program evaluation
a systematic collection and reporting of outcomes data to document program effectiveness and cost-efficiency
An OT is evaluating a pt who had a CVA. The sensory portion of the test would be invalid for an individual with:
Receptive aphasia, because pt w receptive aphasia cannot comprehend spoken or written language so they couldn't understand verbal directions or consistently respond to stimuli
A preschool child with spastic cerebral palsy uses "bunny hopping" for functional mobility during an OT evaluation. This indicates that a primitive reflex pattern is being used for mobility. What reflex is most likely being used?
Symmetric Tonic Neck Reflex: Because it assists the child in a quadruped position. It provides bilateral arm extension and hip flexion with the head raised (and bilateral arm flexion and hip extension when the head is lowered), which can be used to move forward.
What performance components are MOST important to consider when analyzing activities for use with adults with psychosocial problems?
The amount of self-control demands, time management demands, self-expression opportunities, and interest in the activity.
Phases of Swallowing
1) oral preparatory
2) oral
3) pharyngeal
4) esophageal
A preschooler with a dx of developmental delay is very withdrawn and passive. While working on toilet skills, the child reaches out for a toothbrush and starts to brush her hair with it. The OT recognizes the primary importance of this behavior as:
indicating initiative and beginning task-directed behavior. Because the child is so withdrawn, any spontaneous action should be seen as a positive sign. It is very important to encourage the child in independent exploratory behavior in order to develop task competence and become less withdrawn.
Directive group treatment is MOST appropriate in acute care mental health for individuals with:
Disorganized psychosis: directive group tx is a highly structured approach that is used in acute care psychiatry for minimally functioning individuals. It is useful for disorganized and disturbed functioning with pts with psychoses.
What should pt on neuroleptic meds avoid?
Individuals experiencing extrapyramidal syndrome, which may cause muscular rigidity, tremors, and/or sudden muscle spasms, should avoid using power tools or sharp instruments. Also pts on neuroleptic meds will have increased sensitivity to the sun and should avoid too much sunlight.
What is an example of a motor response to pain?
repeated protecting of the joints while moving
An OT is administering a standardized test to a yong client who suddenly becomes uncooperative and complains that the test is "too hard." The MOST appropriate response for the OT would be to:
follow administration instructions and note changes in behavior
What is a common side effect of anti-anxiety medication?
confusion
The OT tx that would most likely meet the needs experiences by individuals with substance abuse problems is to:
assist with skill development in the areas of leisure, cognition, and perception, self-expression, and ADL
Protective reaction when falling forward includes:
shoulder flexion, internal rotation, and shoulder adduction
The goal for an adolescent with anorexia is to improve self-concept. Which component of meal preparation activity BEST addresses this goal?
State strengths and limitations regarding performance in the activity. Self-concept is defined as the value of one's physical and emotional self. Stating one's strengths and limitations about their performance is a reflection of self-concept.
An older adult with diabetes is working on a craft project involving cords as a way of increasing standing tolerance. The MOST relevant safety factor for the OT to take into consideration is the:
texture of the cords because individuals with diabetes frequently have poor circulation and sensation in their extremities so skin damage should be avoided since healing is compromised.
An older adult with back pain is working on a craft project involving cords as a way of increasing standing tolerance. The MOST relevant safety factor for the OT to take into consideration is the:
type of surface the pt stands on
An older adult with limited range of motion is working on a craft project involving cords as a way of increasing standing tolerance. The MOST relevant safety factor for the OT to take into consideration is the:
length of cord
An older adult with limited hand function is working on a craft project involving cords as a way of increasing standing tolerance. The MOST relevant safety factor for the OT to take into consideration is the:
width of cord
When planning a therapeutic program for a child who has deficits in visual discrimination, the first step is to provide matching activities that require:
the ability to recognize objects, because a child must be able to recognize an object before discriminating among its specific visual attributes
An OT is using a visual perceptual frame of reference. What would be the first step in planning a program for a child with visual perceptual problems?
Visual attention skills because the prepare and provide foundation skills for other aspects of visual perception. Once visual attention develops, the child can develop visual memory then general and specific visual perceptual skills.
A resident in a long-term care facility has severe attention span deficits that impair the ability to participate in self-feeding. The OT is most likely to recommend what method?
hand-over-hand assistance
In a long-term care facility an elderly resident with dementia repeatedly asks for her mother and becomes increasingly upset. The MOST therapeutic strategy for responding to this resident is to:
respond to the emotional tone expressed by the words: provide extra attention and reassurance
A pt has been referred to OT after open heart surgery and a period of prolonged bedrest. After the pt is able to tolerate sitting at the edge of the bed unsupported, the NEXT activity to OT should introduce is:
walking at 1mph (based on MET levels)
To avoid overstimulation when handling a stable, 12 week premature infant in the NICU setting, an OT practitioner must FIRST:
provide gentle human touch to enable the infant to slowly respond to intervention because the tactile system is the first to develop
An individual with depression is ready to return to the job held before taking a leave of absence. What is the FIRST action the OT should take?
Perform a job analysis. The OT can then work with the pt to maximize performance or request reasonable accommodation.
Medical documentation should be:
concise, objective, and accurate
A COTA and OTR have worked together the past 5 years. What is the supervisory process at this level?
A mutual process
A client uses a wheelchair and is independent in transfers and basic ADL. With continued OT intervention he is expected to function independently in the community. The MOST appropriate community living option for him, at this time, would be a:
transitional living center
Transitional Living Center
provide temporary living arrangements for individuals in the transitional phase between hospital and independent community living
Cradle-to-Grave homes
houses designed with accessibility in mind at the time of construction. Should an individual decide to use a wheelchair later in life his home would already be accessible.
Adult Day Programs
rehab oriented day programs in the community. Not residential.
An OT is developing a department in a rural long-term care facility. When developing the policies and procedures for documentation in the facility, what document would be MOST useful?
Uniform Terminology for Occupational Therapy: a document that defines OT in relationship to performance areas and performance components. Provides a common language for OTs to use to describe individuals and their performance components.
Assessment of Motor and Process Skills
Patient chooses from 63 ADL tasks, OT observes 2-3 tasks, allows therapist to determine ability of client, while taking into account the relative challenge of each or the ADL tasks the client performed.
Barthel Index
measurement of a person's independence in BADLs before and after intervention and the level of personal care needed for the individual
Oral Prep Phase
Oral manipulation, stretch jaws and tongue, create bolus
Oral Phase
Tongue elevates and moves bolus posteriorly and ends with onset of swallow
Pharyngeal Phase
trigger of swallowing → hyoid and larynx move upward and anteriorly
Esophageal Phase
Swallow Phase, food goes down esophagus and into stomach
Treatment for children with oral hypersensitivity
generalized sensory deep pressure or calming strategies such a slow, linear rocking
Mature head lift and trunk lift
6 months
side to side movement on forearms
6 months
lifting arm to grasp toy
6 months
sitting independently with hands free to play and explore
by 7 months
can sit erect and transition from a prone posture to sitting
8-9 months
3-4 month grasp
automatic with mass finger flexion and no thumb
4-5 month grasp
palmar grasp
6 month grasp
radial palmar grasping
7-12 months grasp
radial digital grasping
voluntary release
7-8 months
purposeful release into container, stacking, and placement
10 months
Visual Foundational Skills
Visual acuity, visual fields, and oculomotor skills. Should be tested first in individuals with acquired brain damage to find underlying cause of visual deficit.
Visual acuity
ability of the eyes to make what is seen sharp and clear
visual fields
allow a person to register the entire visual scene
oculomotor control
control of eye movements and allows the person to move eyes without shifting the head for quick and accurate scanning
Visual cognition
the highest level of the visual-perceptual hierarchy, the ability to mentally manipulate visual information and integrate it with other sensory information to solve problems, formulate plans, and make decisions.
BiVABA
The Brain Injury Assessment Batter for Adults - tests visual foundation skills and visual attention with scanning.
rolls from back to stomach and stomach to back
6 months
begins make believe play
2 years
sorts objects by shape and color
3 years
draws circles and squares
4 years