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Castaldy B

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1. An occupational therapist provides consultation services to a
psychogeriatric unit for individuals with mid-stage dementia. In
designing the activity program, which groups are best for the
occupational therapist to include?
c
A. Reality Orientation
B. Sensory stimulation
C. Reminiscence
D. Coping Skills
2. The parents of a five-year-old with attention deficit with hyper-
activity disorder (ADHD) express difficulty managing the child's
aggressive behavior towards older siblings. Which is the most
effective strategy for the occupational therapist to recommend to
the parents?
A. Allow the child to vent aggressive feelings on a stuffed animal
b
or dol
B. redirect the child's energy into acceptable and safe play activ-
ities
C. provide consistent punishment for aggressive behavior
D. send the child to stay with a family member or close friend for
an extended "time-out"
3. An individual with rheumatoid arthritis has developed sever-
al boutonniere deformities. Which of the following is the most
accurate description for the occupational therapist to include in
documentation of the individual's presenting signs?
A. hyperextension of the PIP joint and lesion of the DIP joint c
B. ulnar deviation and subluxation of the MCP joints
C. flexion of the PIP joint and hyperextension of the DIP joint
D. Heberden's nodes at the DIP joint and Bouchard's nodes at the
PIP joints
4. An occupational therapist receives a referral to provide
home-based services to an elder adult who lives alone in a
fourth floor walk-up apartment. Upon entering the apartment, the
therapist notes the sweltering heat. The apartment has no fans or
air conditioners. The client's skin is hot, dry and red, and breathing
is labored. The therapist offers the client a glass of water and
places ice compresses on the arterial pressure points to help with
cooling. Which is the most important action for the therapist to take
next?
A. Cancel the intervention session and call for an ambulance to
a
provide emergency medical services.
B. Proceed with the planned intervention session and include
documentation about client's environmental conditions in the in-
tervention report.
C. Contact the home health agency's case manager to report
the client's environmental conditions and then proceed with the
planned intervention session.
D. Cancel the intervention session and advise client to speak to
a doctor on how to best address the impact of hot weather on
personal health
5. An occupational therapist observes an OTA having difficulty
transferring a client with athetoid movements from a mat to a
wheelchair. Before the therapist can cross the room to help with
the transfer, the OTA slides with the client to the floor. The therapist
assists the OTA in safely returning the client to the wheelchair.
They assess that the client appears to be unharmed and return d
the client to the unit for a medical evaluation. Which action should
the therapist take next?
A. Counsel the OTA on the need to ask for assistance with difficult
transfers
B. Require the OTA to attend a transfer training inservice

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C. Document the OTA's unsafe actions in the personnel record
D. Complete an occurrence report according to facility standards.
6. A teenager with spinal muscle atrophy shows decreased trunk
balance and strength. Upper extremity strength and ROM are
unchanged from the last evaluation. Which is the best recommen-
dation for the occupational therapist to make?
a
A. A re-evaluation of the client be completed
B. The client be referred to an orthotist for a soft spinal support
C. The client be measured for a power wheelchair
D. A trunk strengthening program be initiated with the client.
7. An occupational therapist consults with a home care agency
interested in starting a falls prevention program. Which should the
occupational therapist do first?
A. Review available evaluation protocols b
B. Review available screening tools
C. Create a new screening tool
D. Design an evaluation protocol
8. A four month-old with arthrogryposis remains in position when
placed and shows little spontaneous movement. The occupational
therapist implements intervention to work on rolling. Which po-
sitional changes should the therapist include in the intervention
session? b
A. Prone to supine
B. Supine to side-lying
C. Prone to side-lying
D. Supine to prone
9. An occupational therapist designs a dining rehabilitation pro-
gram in a longterm care facility. The occupational therapist in-
structs paraprofessional staff in proper feeding techniques. Which
point is most important for the therapist to include in this staff
training?
A. Meals should occur in a homelike environment with staff con-
versing with the elders being fed.
a
B. Individuals with swallowing difficulties should be fed in a group
so that staff can remind them to swallow at the beginning of each
meal.
C. Placing three fingertips on the throat and pressing firmly will
stimulate a swallow response
D. The head should be tilted slightly backward during feeding to
facilitate an assisted swallow
10. Following nerve injury repair surgery, an individual is evalu-
ated for sensory return. which measurement tool is best for the
occupational therapist to use to assess for the return of vibration?
A. A tuning fork a
B. Nylon filament
C. A disk-crimination
D. The ninhydrin test
11. During a group session at an adult day care program an older
adult consistently complains that everyone is mumbling. After
the group, which action should the occupational therapist take in
response to these statements?
A. Notify the client's primary care physician that the person exhib-
ited evidence of paranoia.
d
B. Collaborate with the program director to remove groups from
the client's program plan.
C. Document objective data about the complaints in the person's
chart
D. Notify the primary care physician that the person may need an
audiological evaluation.

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12. The occupational therapist completes an intake interview for a
work hardening program. As the individual is leaving, the person
gives the therapist a hug and expresses much gratitude. The
individual then tries to kiss the therapist on the lips. Which action
is best for the therapist to take in response to this situation
A. Forcibly push the individual away while telling the person that
the behavior is inappropriate and unacceptable.
c
B. Say nothing but decline the person's admission to the work
hardening program based upon the person's inappropriate be-
havior
C. State that the individual's behavior overstep professional
boundaries nad makes the therapist uncomfortable
D. Tell the person the behavior is inappropriate and unacceptable
and decline the person's admission to the program
13. A person with a traumatic brain injury is assessed to score a
6 on the Glasgow Coma Scale. Which should the occupational
therapist use to initiate intervention with this person?
A. Demonstrated directions b
B. Sensory stimulation
C. Verbal cues
D. Hand-over-hand assistance
14. An occupational therapist working in an outpatient cardiac re-
habilitation center develops an intervention plan for an individual
who has entered the convalescence stage of cardiac recovery.
Which activities should the therapist recommend be included in
this intervention plan? a
A. Weeding a garden and doing low impact aerobics
B. Putting away groceries and keyboarding
C. Washing dishes and playing tabletop board games
D. Carrying groceries upstairs and playing basketball
15. An individual recovering from an exacerbation of multiple
sclerosis is referred by a primary care physician to an outpatient
occupational therapy clinic. The referral requests that the occupa-
tional therapist complete a functional capacity evaluation. Which
is the most likely reason for this referral? d
A. Determination of cognitive level
B. Determination of disability status
C. Assessment of instrumental activities of daily living
D. Assessment of return-to-work capabilities.
16. To develop social interaction skills, an occupational therapist
implements a group program for students with Asperger's syn-
drome. Which group is best for the therapist to include in this
program?
c
A. A directive group
B. A topical group
C. A developmental group
D. A task-oriented group
17. A home-care occupational therapist plans intervention for an
individual with agoraphobia with panic attacks. The occupational
therapist plans to use a cognitive-behavioral approach. Which
appraoch is most effective for the therapist to use during inter-
vention? d
A. A token reward system
B. Behavioral extinction
C. Sensorimotor tasks
D. Systematic desensitization
18. A non-English speaking family attends a discharge planning
session. The assigned occupational therapist does not share the
language of the family. Which action should the therapist take
first?

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A. Make a referral for a home-care therapist to visit the family to
provide in-home education.
B. Obtain a translator to communicate with the family during the
session. b
C. Attempt to communicate with the family through non-verbal
communication
D. Consult with the case manager to develop a discharge plan.
19. The parents of an infant born at 32 weeks gestation are about
to take the baby home after four weeks in the neonatal intensive
care nursery. Which is most important for the occupational thera-
pist to instruct the parents to avoid?
A. Placing the infant in the prone position for sleeping a
B. Placing the infant in the supine position for sleeping
C. Using an infant swing with a head support for calming
D. Presenting toys in the mid-line with the infant in the prone
position for playing.
20. Following an acute hospitalization for the medical manage-
ment of a CVA, an individual receives home-based occupational
therapy services, The occupational therapist is working on dress-
ing skills with the patient. During one session, the therapist has the
individual dress in the bedroom and during the next session the
therapist has the client dress in the bathroom. During the following
session, the therapist has the client don and off a sweater and b
coat in the living room. Which motor learning technique is the
therapist using?
A. Variable activities
B. Variable conditions
C. Repetition
D. Generalization
21. An occupational therapist provides bedside BADL training to
a patient recovering from multiple injuries incurred during a motor
vehicle accident. The patient's children arrive for a visit and ask
the therapist to let them look at their parent's chart while they wait
outside the room for the session to conclude. Which response is
best for the therapist to make in response to this request?
A. Tell the family members that they must have the permission of
a
their parent before they can look at the chart.
B. Commend the family members for their interest in their parent's
status and give them the chart to read
C. Tell the family members they cannot see the chart because they
could misinterpret the information
D. Tell the family members to go ask the unit's charge nurse for
permission to look at the chart.
22. An occupational therapist provides intervention for an individ-
ual with a swallowing disorder. To elicit swallow reflex, the occupa-
tional therapist provides sensory input to the inferior faucial arch-
es. Which should the therapist use to provide this intervention?
c
A. A tongue depressor
B. A moistened cotton swab
C. A chilled dental examination mirror
D. A warmed metal teaspoon
23. A child with a diagnosis of traumatic brain injury (TBI) is
evaluated by an occupational therapist. The child presents with
extension of both upper extremities and flexion of both lower
extremities following a stimulus of neck extension. When inter-
preting this observation, which statement is most accurate for the
d
therapist to document?
A. The presence of +ATNR, which is "abnormal" and has reap-
peared after the TBI
B. The presence of a +STNR, which is "normal" and not affected
by the TBI
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C. The presence of a +ATNR, which is "normal" and not affected
by the TBI
D. The presence of a +STNR, which is "abnormal" and has reap-
peared after the TBI
24. An individual with moderate intellectual disability moves into
a group home. An initial goal established for this resident is the
development of socially acceptable table manners. The occupa-
tional therapist uses a behavior modification approach to achieve
this goal. Which intervention technique is best for the therapist to
include in the design of the group home dining experience? d
A. Negative reinforcement for socially inappropriate behaviors
B. Clear explanations of behaviors expected during dining
C. Clear explanations about the effects of inappropriate behaviors
on others
D. Rewards for socially appropriate behaviors.
25. A toddler with severe congenital anomalies and an irreparable
cleft palate has do not resuscitate (DNR) order. Whilebeing fitted
for a molded seat for a wheelchair, the child stops breathing and
trunks blue. The entry level occupational therapist determines that
the child has a brachial pulse. Which ofthe following is the first
action the therapist should take in response to this situation?
A. Inform the physician about the situation and the child's DNR c
order
B. Call the supervising occupational therapist to discuss the best
response.
C. Implement the facility's emergency procedure
D. Perform obstructed airway maneuver and monitor heart rate for
five minutes
26. A seven-year-old child with spina bifida at the C7 level receives
homebased occupational therapy services. Which ability is most
relevant for the occupational therapist to focus on during inter-
vention?
a
A. Dressing the lower body
B. Dressing the upper body
C. Brushing teeth
D. Playing tabletop games
27. An OT administrator is designing a patient satisfaction ques-
tionnaire to be administered upon discharge from the OT program.
The administrator designs the questionnaire so that individuals
will indicate their level of agreement with a series of statements
by circling a number with 1 = very dissatisfied, 2= dissatisfied, 3=
neutral, 4= satisfied and 5 = very satisfied. Which method of data b
collection is the administrator using?
A. Gutman scale rank ordering
B. A Likert scale
C. Retrospective data
D. A semantic differential
28. a ten-year-old with congenital anomalies wears bilateral an-
kle-foot orthoses. The parents want the child to be able to don and
doff shoes independently, but the child cannot tie shoes. Which is
the best foot wear recommendation for the therapist to make for
the child to wear? c
A. Leather slip-on loafers
B. Slip -on tennis shoes with no laces
C. Running shoes with Velcro shoe closures
D. Hi-rise sneakers with sliding adapters on the laces
29. A patient who is status-post left frontal lobe ischemia has
difficulty bearing weight through the right lower extremity dur-
ing reaching activities (e.g., standing at a sink during morning
self-care routine). The occupational therapist implements a Motor

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Re-learning Program (MRP). Which is the best intervention for the
therapist to provide according to this approach?
A. Therapeutic handling to affect the central nervous system
B. A stool to sit on during reaching activities d
C. Joint compression to the right lower extremity during reaching
activities
D. Verbal and visual feedback while practicing reaching.
30 . A new outpatient mental health facility offering occupational
therapy services opens in a community of 100,000. The occu-
pational therapy director of an established outpatient program is
concerned that the new program will affect service delivery. Which
action is best for the director of the established program to take
in response to this potential competition?
A. Wait for the new facility to implement services and develop
c
services in the areas not covered by that facility
B. Offer the same services that the new facility offers and adver-
tise a competitive price.
C. Conduct a program evaluation and develop a marketing plan
based on the results
D. Design an intensive marketing campaign to a local consumers
and third party payers
31. An individual with obsessive-compulsive personality disorder
participates in a vocational program (TEP). The client is con-
cerned that compulsive behaviors are interfering with job perfor-
mance and may result in the loss of a new TEP placement. Which
is the therapist's best response to these expressed concerns?
A. Instruct the client to speak directly to the TEP supervisor about
the right to receive reasonable accommodations. d
B. Schedule a re-evaluation of the client's work behaviors and
skills
C. Assure the client that it is natural to have initial difficulties at a
new job
D. Schedule an appointment with the client and the TEP supervi-
sor
32. In an acute inpatient psychiatric facility, an occupational ther-
apist designs therapeutic activity group for individuals with poor
orientation to reality. Which is the best activity choice for the
therapist to provide on this group?
A. A discussion of the effects of hospitalization on occupational b
roles
B. The assembly of wooden toys for a children's unit
C. Guided imagery for stress management
D. Structured verbalizations for personal assets and limitations
33. An occupational therapy professional educational program
provides an after-school play program for normally developing
children to help students understand typical development. The
students observe a child who is beginning to use blunt scissors to
snip paper. The child opens and closes the scissors and moves
them in a controlled forward motion, but the child cannot cut cir- b
cles or figure shapes. At which age are these behaviors typical?
A. 2 years-old
B. 3 years old
C. 4 years old
D. 5 years old
34. An adult who incurred a severe traumatic injury (TBI) is enter-
ing the second week of care at a long-term TBI rehabilitation cen-
ter. The patient's family visit regularly and frequently asks multiple
questions of the treatment team. A team and family conference is
planned to address family concerns. Which is the most important
information for the team to share with the family?
A. Realistic and clear information about the individual's current
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status and care plan
B. Each team member's expert opinion about the expected prog-
nosis and discharge recommendations
C. Reimbursement information about each professional services a
to assist in determining treatment choices
D. Community resources that are available to support the family
and provide respite care
35. An occupational therapist supervises a Level II fieldwork stu-
dent regarding the evaluation procedures of a work hardening
program. The therapist explains that some individuals attending
the program magnify their symptoms to retain benefits; therefore
the validity of some evaluation measures may be compromised.
Which assessment tool does the therapist identify as providing a
the most valid results?
A. A volumeter
B. A dynamometer (all five positions)
C. A standardized pegboard test
D. A total active motion (TAM) evaluation
36. Two occupational therapy assistants (OTAs) working for a
school district are assigned to two different schools. One school
has a supervising occupational therapist, the other school does
not. The OTA without a supervising therapist expresses concern
to the OTA who is supervised about the lack of supervision. Which
is the best response for the supervised OTA to take in response
to this situation? a
A. Report the situation to the OT supervisor
B. Share information acquired during supervisory sessions with
the unsupervised OTA
C. Advise the unsupervised OTA to contact the state regulatory
board
D. Report the situation to the school district's administration.
37. A single parent of two school-aged children is employed as
a truck driver working the 11 pm - 7 am shift. The client was
hospitalized for depression following the sudden death of the
client's spouse one year ago. The deceased spouse's primary role
had been home maintainer. The client was rehospitalized this past
weekend for an exacerbation of depression. Which skills are most
relevant for the occupational therapist to evaluate?
A. Interpersonal
B. Self-management
C. Cognitive
D. Leisure
38. An individual with a body mass index (BMI) of 35 is joining
a community based wellness program conducted by an occu-
pational therapist. When formulating an individualized wellness
plan, which condition should the occupational therapist take into
consideration as an increased risk for this person? b
A. Hypothermia during exertion
B. Hyperthermia during exertion
C. Rapid weight loss during the initial weeks
D. Increased anxiety and depression
39. The supervisor of an acute inpatient unit requests that a
recently hired entry-level therapist writes summaries of several
evaluation sessions that were completed by another therapist.
The evaluating therapist had to leave work unexpectedly due to a
medical emergency and is not expected to return to work. Which
d
is the best response for the therapist to make in response to this
request?
A. Comply with the supervisor's request but ask for the supervisor
to cosign the notes
B. Request time to complete an independent evaluation of each
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individual previously evaluated
C. Report the supervisor's request to the facility's administration
D. Suggest that the therapist's evaluation results be documented
by the supervisor
40. An individual prepares for discharge home following rehabili-
tation for a left CVA. Residual difficulties include fair dynamic bal-
ance, decreased upper extremity (UE) strength and poor dexterity.
The individual's stated priority is to be able to ambulate safely
to the senior center located in the client's apartment building.
Which ambulatory aid would be most effective for the occupational b
therapist to recommend to this client?
A. A hemi-walker
B. A rolling walker
C. A side-stepper walker
D. A standard walker
41. An individual with rheumatoid arthritis (RA) is currently in
a stage of remission. During this inactive chronic phase of this
disease, the occupational therapist works with the client to main-
tain range of motion (ROM) and muscle strength. Which of the
following is most effective for the therapist to recommend the client
b
include in a daily home exercise program?
A. Passive ROM
B. Active ROM
C. Isotonics
D. Progressive resistance
42. An occupational therapist employed in a pediatric clinic par-
ticipates in an initial performance appraisal. The supervisor iden-
tifies the area needing improvement as handling skills in working
with children with various types of cerebral palsy. Which isthe most
effective way for the occupational therapist to improve handling
skills?
A. Observe an experienced occupational or physical therapist use
c
handling techniques
B. Complete an evidence-based practice literature review on the
use of handling techniques for children with cerebral palsy
C. Participate in an advanced level experiential course on han-
dling techniques
D. Participate in a teleconference on handling techniques for
children with cerebral palsy
An adult who incurred a traumatic brain injury three months ago
is referred to a home care agency to receive OT services. The
client's referral states that cognition is at Level VII of the Rancho
Los Amigos scale and that grasp and shoulder mobility are limited.
During the initial interview, the client reports being frustrated by
the inability to independently engage in the previously enjoyed
and personally meaningful activity of cooking. The client reports
frequently losing place when reading recipes and an inability to
"find" things in the kitchen. b

43. Upon evaluation, the client exhibits difficulty with the letter
cancellation task. Which visual deficit should the occupational
therapist document as present?
A. Imagery
B. Scanning
C. Cognition
D. Memory
An adult who incurred a traumatic brain injury three months ago
is referred to a home care agency to receive OT services. The
client's referral states that cognition is at Level VII of the Rancho
Los Amigos scale and that grasp and shoulder mobility are limited.
During the initial interview, the client reports being frustrated by
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the inability to independently engage in the previously enjoyed
and personally meaningful activity of cooking. The client reports
frequently losing place when reading recipes and an inability to
"find" things in the kitchen.

44. During meal preparation tasks the client ignores items on the
left side of the counter. The therapist decides to use a compen-
d
satory functional approach to improve the client's performance.
Which is the most appropriate method for the therapist to use
during intervention to develop meal preparation skills?
A. Encourage bilateral activities
B. Place all items on the right side of the counter
C. Practice scanning activities
D. Place a brightly colored placemat on the left side of the counter
An adult who incurred a traumatic brain injury three months ago
is referred to a home care agency to receive OT services. The
client's referral states that cognition is at Level VII of the Rancho
Los Amigos scale and that grasp and shoulder mobility are limited.
During the initial interview, the client reports being frustrated by
the inability to independently engage in the previously enjoyed
and personally meaningful activity of cooking. The client reports
frequently losing place when reading recipes and an inability to
"find" things in the kitchen.

45. The client responds well to the compensatory approach when


c
performing countertop meal preparation tasks. The therapist de-
cides to use a dynamic interactional approach as the theoretical
foundation for cognitive perceptual intervention for other meal
preparation activities. During a session to train the client in scan-
ning strategies, the client accurately finds two items in a refriger-
ator. Which is the therapist's most appropriate initial response to
the client's task success?
A. Praise the client for successful task completion
B. Ask the client to now find three items in the refrigerator
C. Ask the client how he/she knows that the items are correct
D. Ask the client to now find two items in the pantry.
An adult who incurred a traumatic brain injury three months ago
is referred to a home care agency to receive OT services. The
client's referral states that cognition is at Level VII of the Rancho
Los Amigos scale and that grasp and shoulder mobility are limited.
During the initial interview, the client reports being frustrated by
the inability to independently engage in the previously enjoyed
and personally meaningful activity of cooking. The client reports
frequently losing place when reading recipes and an inability to
"find" things in the kitchen.

46. During an intervention session focused on the development of b


grasp and shoulder mobility, the occupational therapist asks the
client to move numerous identical one pound cans of vegetables
from the counter top to the cabinet shelf above the counter. Ac-
cording to contemporary motor learning approaches, which type
of practice has the therapist designed this activity to provide to
the client?
A. Random practice
B. Blocked Practice
C. Planned practice
D. Contextual practice
An adult who incurred a traumatic brain injury three months ago
is referred to a home care agency to receive OT services. The
client's referral states that cognition is at Level VII of the Rancho
Los Amigos scale and that grasp and shoulder mobility are limited.
During the initial interview, the client reports being frustrated by
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the inability to independently engage in the previously enjoyed
and personally meaningful activity of cooking. The client reports
frequently losing place when reading recipes and an inability to
"find" things in the kitchen.

47. The client is attending a vocational rehabilitation program


three days a week but is frequently late due to difficulties with
getting ready in the morning. The client asks the home-care
therapist for suggestions to address this problem. Which is the
most appropriate action for the occupational therapist to take in b
response to the client's request?
A. Advocate that the vocational program provide the client with a
flexible start time
B. Develop a visual chart with the client depicting the necessary
sequence of his morning activities
C. Advise the client to call the vocational program to tell staff when
running late
D. Advise the client to wake up one hour earlier on vocational
rehabilitation program days
48. An occupational therapist is conducting a community trans-
portation group with individuals attending a traumatic brain injury
day treatment program in an urban area. Which should the group
do first?
c
A. Read a subway or bus map
B. Take a subway or bus as a group
C. Determine a destination
D. Purchase a subway or bus fare card.
49. The administrator of a large rehabilitation hospital reviews
the occupational therapy staffing schedules. The administrator
determines that of the 12 full-time therapists, six work full-time
in the inpatient department, two work full time in the outpatient
department, two divide their hours equally between the inpatient
and outpatient department and two divide their house equally
between administrative/managerial work and direct care provision
c
on the inpatient unit. Which is most accurate staffing for the
administrator to document for the occupational therapy inpatient
department in the annual report?
A. Twelve full-time equivalent employees
B. Ten full-time equivalent employees
C. Eight full-time equivalent employees
D. Six full-time equivalent employees
50. A person recovering from a cerebral vascular accident has
left-sided weakness and dysphagia. Which of the following is the
most effective directive intervention approach to help the person
successfully swallow invested food?
d
A. Provide pureed, thick liquids
B. Provide thermal stimulation to the inferior faucial arches
C. Tilt the person's head back and towards the left side
D. Provide small, warm boluses
51. An individual cannot independently get from a supine position
to a sitting position. The person has good scapular, shoulder
and elbow muscle strength. Which of the following should the
occupational therapist recommend as most effective for the client
to use to improve bed mobility? d
A. A leg lifter
B. A bed rail assist
C. A log roll technique
D. A rope ladder
52. An adult diagnosed with bipolar disorder has been taking lithi-
um for five years. Prior to a weekly occupational therapy vocation-
al planning group, the client reports noticeable functional changes
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since the last group session. In describing these changes, the
client reports symptoms that may be indicative of a possible
lithium overdose. With the client's permission, the therapist con-
tacts the psychiatrist to describe the client's concerns. Which
symptom would the therapist most likely report as indicative of
b
this problem?
A. Reduction in mood swing
B. Gross hand tremors
C. Decreased velocity of speech
D. Fine hand tremors.
53. A school-based occupational therapist is teaching orientation
and mobility skills to an adolescent with a degenerative visual
disorder. Which is the most effective motivational technique for
the therapist to use with this student?
A. Provide concrete structure structure and frequent feedback to
ensure accurate orientation and safe functional mobility
c
B. Keep sessions short to allow time for emotional adjustment to
orientation and mobility challenges
C. treat the student as an adult and incorporate the student's
orientation and mobility goals into intervention sessions.
D. Limit anxiety by practicing the techniques in a quiet and self-
contained environment; e.g., an empty classroom
54. An occupational therapist working in a skilled nursing facility
conducts an inservice on validation therapy for the recently hired
staff of a new psychogeriatric unit. Which fundamental principle of
validation therapy is important for the therapist to include in this
presentation?
A. Listen to the words an individual uses to ascertain the person's
underlying message a
B. Provide highly structured, activities to refocus the individual on
reality
C. Provide unstructured activities to facilitate the expressions of
feelings.
D. Listen to the words an individual uses and provide reality
orientation for invalid statements.
55. An occupational therapist conducts an intervention session
with a client recovering from a CVA to develop transfer skills.
The client has a co-morbidity of epilepsy. As the client stands
to complete a transfer from the wheelchair to the bed, the client
reports feeling sensations that are indicative of an aura. Which is
the best immediate action for the therapist to take in response to
d
this situation?
A. Provide reassurance and ask for guidance from the physician
B. Return the client to a seated position in the wheelchair until
sensations pass
C. End the session so the client can rest
D. Guide the person into a sidelying position on the bed.
56. An occupational therapist is scheduled to give a one-hour pre-
sentation to a support group of parents of infants with a diversity
of developmental disabilities. Which of the following is the most
important focus of the therapist's presentation?
A. Demonstration of infant positioning techniques
b
B. Discussion of typical areas of concern addressed by OT prac-
titioners
C. Demonstration of different types of developmental assess-
ments
D. Discussion of the Individual Family Service Plan (IFSP)
57. Several adolescents with behavior problems attend a
school-based afterschool program. They work at an egocen-
tric-cooperative level in a group dealing with issues related to
school performance and peer pressure. Which of the following
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would be most likely for the occupational therapist to observe the
participants doing in the group?
a. Actively taking on roles such as energizer, coordinator or opin-
ion giver
b. Focusing on the group tasks rather than the feelings of the
b
participants
c. Making decisions with minimal to no supervision from the group
leader
d. Performing group skills consistent with the developmental level
of 15 to 18 years of age
58. An occupational therapist leads a social skills group for chil-
dren aged 10- 12 with conduct disorders. Which is the most
effective response for the occupational therapist to provide in
response to this complaint?
A. Encourage the child to complete the activity with the group a
B. Allow the child to leave the group since uninterested
C. Allow the child to suggest a different group activity
D. Tell the child the complaint will be discussed at the next family
meeting
59. The occupational therapist plans intervention for a client with
a recent diagnosis of complex regional pain syndrome (CRPS)
Type I. Which intervention approach is most effective to use to
reduce pain and increase function?
b
A. Hot packs
B. Biofeedback
C. Paraffin
D. Passive Range of motion
60. Several newly homeless veterans with a variety of men-
tal health diagnoses attend an occupational therapy community
re-entry group conducted in a community based-shelter. Which
should be the primary focus of the initial group session?
A. Development of home management skills such as meal prepa-
ration c
B. Determination of financial assets and money management
skills
C. Identification of local resources such as soup kitchens and thrift
stores
D. Exploration of vocational interests and employment possibilities
61. An occupational therapist provides home-based services to
a homemaker who incurred a right CVA eight months ago. The
individual and the therapists have chosen to focus on kitchen
activities during the intervention session. The therapist has the
client stand in front of the counter with an open dishwasher to
the left. The therapist asks the client to put the clean dishes into
an open overhead cabinet to the right of the client. By setting up d
the activity in this manner, which proprioceptive neuromuscular
facilitation (PNF) technique is the therapist using?
A. Heavy work/mobility superimposed on stability
B. Reciprocal inhibition/innervation
C. Diagonal patterns of D2 flexion/extension
D. Diagonal patterns of D1 flexion/extension
62. An occupational therapist conducts a sensory evaluation of an
individual recovering from a left cerebral vascular accident. The
individual has right hemiplegia and expressive aphasia. During
the evaluation of stereognosis which should the therapist have
the client use to identify responses to the testing stimuli? b
A. Pictures of the objects
B. A set of identical objects
C. Cards with "one"and "two" printed on them
D. Cards with "yes"and "no" printed on them

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63. A young adult with a T9 - T10 spinal cord injury wishes to
engage in sports activities. Which wheelchair features are best
for the occupational therapist to recommend to this client?
A. A heavy-duty foldable frame with a high back c
B. An ultra-light foldable frame with a high back
C. An ultra-light rigid frame with a low back
D. A heavy-duty rigid frame with a low back
64. An entry-level occupational therapy assistant (OTA) recently
hired for an outpatient rehabilitation clinic requires supervision
during the direct supervisor's scheduled vacation. To maximize
departmental efficacy, who should provide supervision to the
OTA?
A. The rehabilitation clinic's administrator
B. An OTA with experience
C. An occupational therapist
D. An OTA with advanced credentialing.
65. A child with developmental delay has poor oral motor control.
Which should the occupational therapist do to facilitate lip clo-
sure?
A. Give pressure with the index finger under the law
B. Place food on a spoon and firmly place the spoon on the back d
part of the tongue
C. Place the thumbs on the lateral ends of the mandibles
D. Give a slight upward of the index-finger from the lower jaw to
the lower lip.
66. A client recovering from a left CVA demonstrates increased
flexor tone in the dominant right upper extremity while trying to
re-learn to write with the left hand. Which of the following is most
accurate for the therapist to taste the client is exhibiting when
documenting this observation? a
A. An associated reaction
B. A crossed flexion reaction
C. A tonic labyrinthine reflex
D. An asymmetrical tonic neck reflex
67. A person with scleroderma has limited upper extremity ROM.
Coordination is within functional limits. The occupational thera-
pist assesses the individuals computer inputting capabilities and
provides a recommendation to improve efficacy. Which adaptation
would be most effective for this person? d
A. An expanded keyboard
B. A concept keyboard
C. A key guard
D. A contracted keyboard
68. An individual is referred by a physician to an outpatient
occupational therapy program for an evaluation. The person's
insurance company does not cover outpatient OT service. Which
action is best for the therapist to take in response to this situation?
A. Follow the physician's order and let the person pay the bill when
it is received.
c
B. Refuse to accept the referral and advise the person to seek
additional insurance coverage
C. Explain the limitation of the insurance coverage and let the
person decide whether to complete the evaluation
D. Request that the program's billing department submit a bill
using a code that is covered by the insurance company.
69. An elementary school-aged child with Duchenne's muscular
dystrophy receives occupational therapy services. The family es-
tablishes a goal of maintaining the child's leisure and social par- d
ticipation. Which is the best activity for the occupational therapist
to recommend the family pursue with this child?

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A. Electronic sports (e.g., Wii bowling)
B. Adapted little league baseball
C. Wheelchair basketball
D. Recreational swimming
70. An occupational therapist conducts an on-site accessibili-
ty assessment with a building contractor who is remodeling an
apartment building. The therapist recommends modifications for
doorways which do not meet minimum accessibility width stan-
dards. The contractor states the building's owner wants to exceed
minimum standards without incurring unreasonable costs. Which
a
is the most preferred doorway measurement for the occupational
therapist to recommend the contractor use for the remodeling?
A. 36 inches
B. 32 inches
C. 34 inches
D. 38 inches
71. An occupational therapist works in a school system with a
child with developmental delays. One of the goals of treatment is
to develop pre-writing skills. The child exhibits the ability to grasp
a pencil proximally with crude approximation of the thumb, index
and middle fingers and the ring and little fingers slightly flexed.
The therapist develops an intervention plan. Which grasp should c
be the focus for the implementation of intervention?
A. Digital pronate grasp
B. Static tripod posture grasp
C. Dynamic tripod grasp
D. Palmar supinate grasp
72. An older adult diagnosed three years ago with dementia.
Alzheimer type has been admitted to the hospital for regulation
of medication. The occupational therapist determines that the
patient demonstrates diminished memory skills since the previous
evaluation, but is still able to live independently at home with
support and supervision. During the discharge planning meeting,
d
which activity should the therapist recommend family members
perform for the patient?
A. Weeding the garden
B. Sorting and folding laundry
C. Preparing cold sandwiches
D. Cooking hot meals
73. During an occupational therapy screening session, the ther-
apist observes that a child bangs toys on a tabletop but is unable
to to give up a toy upon request. The occupational therapist
documents these behaviors. Which developmental level would
be most accurate for the therapist to report the child's observed
a
behaviors indicates?
A. 3-4 months
B. 7-8 months
C. 9-10 months
D. 11-12 months
74. Occupational therapy services are provided to the clients of a
psychogeriatric unit in a skilled nursing facility. An occupational
therapist presents an inservice or restraint reduction to the unit's
direct care staff. Which of the following would the therapist identify
as a permissible use of a restrain?
A. A bed guardrail to prevent a confused resident from wandering
c
in the evening
B. Prescribed medication to control a resident's agitated behavior
C. A lap board to enhance a resident's self-directed functional
behavior
D. A wheelchair with a lap belt to prevent a person with ataxic gait
from falling
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75. A client attends a work hardening program. The client arrives
on time for the scheduled session but complains of significant
substernal pain, extreme discomfort in the epigastric area, indi-
gestion and nausea. Which is the best action for the occupational
therapist to take in response to the client's expressed complaints?
A. Initiate the session and provide breaks and activity modifica-
tions as needed. b
B. Cancel the session and immediately call emergency medical
services (EMS)
C. Cancel the session and tell the client to call to reschedule when
feeling better
D. Cancel the session and call the client's physician to discuss the
client's complaints
76. Several residents of a skilled nursing facility report that they
are bored with their individual daily range of motion exercise pro-
grams. The occupational therapist collaborates with the physical
therapist to design a group format to facilitate participation in
range of motion exercises. Which would be most beneficial for the
therapist to recommend incorporating into the proposed group?
A. The use of several exercise videos with diverse exercise styles a
and music
B. The pairing of residents to perform gentle range of motion on
each other
C. The use of exercises performed in rhythm to a marching band
video
D. The provision of coffee and cake after the group
77. The parents of an 18-month-old bring their child to a free
community unity developmental screening. The child can attend
to shapes and use them appropriately. However, the parents are
worried because the child cannot match shapes or manipulate
different shaped objects into a shape sorter. Which is the best
response for the occupational therapist to make in response to
the parents' expressed concern?
A. Advise the parents that the child is showing a typical age-ap- a
propriate skill
B. Complete an occupational therapy evaluation of the child's
cognitive skills
C. Refer the child to the early intervention program for develop-
mental delay
D. Provide the patients with activity recommendations to develop
shape recognition
78. A young adult recently diagnosed with undifferentiated schiz-
ophrenia is referred to an occupational therapy day treatment
program. Which should the occupational therapist do first with the
client?
A. Determine short-term and long-term goals for program partic- c
ipation
B. Model desired behaviors during occupational therapy groups
C. Have the client complete an occupational interest checklist
D. Encourage the client to maintain a daily log of medication intake
79. An occupational therapist working in a skilled nursing facility
observes a resident which cognitive disabilities don slippers by
putting them on the wrong feet. The resident plans to go visit a
friend on another floor and does not seem aware that the slippers
are on the wrong feet. Which is the best action for the therapist to
take in response to this situation? d
A. Say nothing for this error may embarrass the resident
B. Say nothing but follow the resident to the friend's room to
ensure a safe arrival
C. Ask the resident to look at the slippers to see it the error is
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D. Approach the resident and advise the resident to reverse the
slippers
80. An individual with Parkinson's disease exhibits difficulty mov-
ing from sitting in a chair to standing. Which technique is best for
the occupational therapist to recommend the person use to help
successfully complete this functional mobility activity?
A. Rise from the chair while sitting with buttocks against the back
of the chair c
B. Extend both legs so that both feet are in front of the chair while
rising
C. Sit at the edge of the chair and rock back and forth before rising
D. Rise while weight-bearing on one foot and pushing up with both
arms
81. An occupational therapist provides an accessibility consulta-
tion to a business that has hired a new employee who uses a
wheelchair for mobility. The only entrance to the business has four
steps, each seven inches high. Which ramp height is best for the
therapist to recommend the business have constructed? b
A. 14 feet
B. 28 feet
C. 35 feet
D. 46 feet
82. A middle school-aged with right upper extremity amelia at-
tends occupational therapy to learn how to dress independently.
Which of the following is most beneficial for the occupational
therapist to focus on during intervention?
A. Donning and doffing a variety of shirt types of personal prefer-
a
ence
B. Donning and doffing only shirts that can be donned overhead
C. Donning and doffing shirts that button in the front
D. Donning and doffing shirts with velcro tabs sewn on to replace
buttons
83. An occupational therapist plans intervention for an individual
with
cognitive perceptual deficits. In deciding whether to use a dynamic
interactional approach or deficit-specific approach which is most
important for the occupational therapist to consider? a
A. The client's auditory processing skills
B. The availability of familial support
C. The client's social interaction skills
D. The client's problem-solving skills
84. A child with developmental delay has mastered the ability to
cut simple figure shapes with scissors. Which scissor activity is
best for the occupational therapist to next introduce to the child?
A. Cutting simple geometric figures b
B. Cutting complex figure shapes
C. Cutting multiple circles
D. Cutting additional simple figure shapes
85. A high school student is referred to occupational therapy for
ADL training. The student has not received occupational therapy
services for the past seven years. The student has non-spastic
cebral palsy resulting in right side hemiparesis and decreased
muscle tone. The student plans to attend college and live on cam-
pus. During a transition planning meeting the student's teacher
d
reports the student has had several accidents during a meal
preparation class (i.e., incurring cuts when using a knife and
burning hands when taking items out of the oven). As part of the
transition plan, the occupational therapist will teach the student
adaptive techniques used in a kitchen setting to compensate for
right side weakness. Which of the following adaptations should

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the therapist recommend to improve the student's independence
in preparing meals safely?
A. Prepare foods that do not require cutting
B. Use a microwave oven to cook food
C. Use a weighted knife to cut food
D. Use oven mitts that extend to the elbows
86. An individual recently discharged from acute psychiatric unit
interviews for a position in a transitional employment program
(TEP). The person answers the interviewing therapist's questions
in a direct yet subdued manner and rarely looks at the therapist.
Which is most accurate for the therapist to document in the
summary of the interview? b
A. The individual should have medications evaluated before start-
ing the TEP
B. The individual demonstrated limited eye contact
C. The individual exhibited poor social interaction skills
D. The individual appeared depressed
87. An adult is hospitalized and diagnosed with mild chronic
obstructive pulmonary disease (COPD). During the discharge
planning session, the person identifies a desire to exercise reg-
ularly. Which of the following should the occupational therapist
recommend the client pursue? a
A. The hospital wellness program's yoga group
B. Low-impact aerobics at local gym
C. Weight-lifting under the direction of a personal trainer
D. Jogging in local park with friends
88. An individual who is acutely psychotic has been brought to the
hospital by a legal guardian. The individual neither responds to
questions nor attends to visual stimuli in the room. Who should the
therapist collaborate with to determine the individual's short-term
goals? a
A. The guardian
B. The individual
C. The psychiatrist
D. The case manager
89. In an outpatient rehabilitation clinic, an occupational therapist
is treating a high-school student with spina bifida resulting in full
motor paralysis and sensory deficits L1 spinal cord level. The
client is a competitive swimmer and is able to transfer indepen-
dently from the wheelchair to the pool without an assistive device.
The client's goal is to learn how to mount and ride a horse. Which
is best for the therapist to do initially to help the client attain this
goal?
d
A. Implement a home-based transfer training program for the
client's family to learn how to assist with mounting a horse
B. Develop an exercise program for the client to do at home on a
daily basis to increase upper extremity strength
C. Encourage the client to extend scheduled swimming sessions
and practice mounting large inflatable tubes in the pool
D. Consult with a stable owner to discuss alternative of mounting
a horse
90. An occupational therapist provides intervention to develop in-
dependent feeding skills in an 18-month-old child with significant
developmental delays. The child has mastered the ability to hold a
spoon and bang it on the tray of the high chair. The child can also
hold and suck on a cracker. Which activity is best for the therapist
a
to provide next during intervention?
A. Finger-feeding soft foods
B. Scooping food and bringing it to the mouth
C. Taking cereal from a spoon held by the therapist
D. Bringing a filled spoon to the mouth
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91. The residents of a halfway house plan a community leisure
activity for a Saturday. Two residents state that they cannot par-
ticipate in Saturday activities due to religious observances. The
other residents express strong interest in the activity. Which is the
occupational therapist's best response to this situation?
A. Schedule an in-house Saturday leisure activity for two obser-
b
vant residents
B. Explore with the group an alternative schedule for a community
leisure activity
C. Schedule an in-house Saturday leisure activity for all residents
D. Recommend the two observant members seek approval from
their religious leadership to attend the Saturday activity
92. The occupational therapist meets with the nursing staff that
will be providing primary care to the patient at the patient's
bedside. The occupational therapist recommends that the direct
care staff position the patient in left sidelying. Which is the best
bed position for the therapist to recommend for placement of the
patient's right arm? b
A. In 90° of humeral abduction and internally rotated
B. Pronated with arm forward on a pillow and the elbow extended
or slightly flexed
C. On the person's side, adducted and internally rotated
D. In 90° of abduction of the humerus with neutral rotation
93. The occupational therapist also advises the direct care staff
on proper positioning of the patient's right arm while the patient
is seated in a wheelchair. Which is the most appropriate recom-
mendation for the therapist to make for positioning of the patient's
arm? a
A. Rest the person's arm on a wheelchair lap board
B. Rest the arm in the person's lap with the hands folded
C. Wear a resting hand splint to avoid joint contractures
D. Have the person wear a shoulder sling throughout the day
B94. While completing the screening, the occupational therapist
observes that the patient uses only the left side to participate in
activities. The therapist suspects that the patient has unilateral
neglect and difficulties with body scheme. Which should the ther-
apist have the patient do during the OT evaluation to determine if
b
these deficits are present
A. Point to various body parts named by the therapist.
B. Complete an upper extremity dressing evaluation.
C. Complete the draw-a-person test.
D. Complete a body puzzle.
B95. During the initial ADL evaluation, the therapist notes that
the patient consistently spills food due to an inability to adjust
movements while cutting food and moving the food from the
plate to the mouth. Which deficit does this behavior most likely
indicate? c
A. Ideational apraxia
B. Asomatognosia
C. Motor apraxia
D. Tactile agnosia
B96. Upon evaluation, the therapist determines that the patient
has right homonymous hemianopsia. The therapist provides rec-
ommendations to modify the patient's room to enhance indepen-
dence. Which are the most appropriate recommendations for the
therapist to make for the placement of the patient's telephone and
d
radio?
A. Telephone on the left side and radio on the left side.
B. Telephone on the right side and radio on the right side.
C. Telephone on the right side and radio on the left side.
D. Telephone on the left side and radio on the right side.
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B97. In an outpatient rehabilitation clinic, an occupational thera-
pist is developing a fall prevention group for at risk elderly clients
with Parkinson's disease. The clients live alone and have had
at least three falls within the past six months. When presenting
strategies to prevent falls, which is the most common risk factor
a
for falls in the elderly that the therapist should review with clients
A. Ascending and descending stairs.
B. Dressing while seated in a chair.
C. Walking with a walker with wheels.
D. Transferring out of the shower with grab bars
B98. An occupational therapist working in a school system must
incorporate the Individuals with Disabilities Education Act (IDEA)
in the program. In which of the following locations should the
therapist provide intervention?
A. Regular classroom while general education are not in session.
B. Special education classroom while other children with disabil- c
ities are present.
C. Regular classroom while general education classes are in
session.
D. Private occupational therapy room designed for children with
disabilities.
B99. An occupational therapist conducts an in-service at an
outpatient wheelchair clinic for individuals with central nervous
system dysfunction. According to the principles of wheelchair
prescription, which of the following statements is accurate for the
therapist to make during the presentation? a
A. Firm seats are needed to provide stability.
B. Soft seats are needed to prevent decubiti.
C. Back heights should be extended to facilitate weight shifting.
D. Seat angles should be 45° to prevent falling forward
B100. An occupational therapist working in an outpatient clinic ob-
serves the clinic's administrative assistant leaving patient records
open on the clinic's reception counter. The assistant has left the
clinic to go for lunch. Which action is the best for the therapist to
take in response to this observation?
A. Remind the administrative assistant of the need to keep patient
records private when the assistant returns from lunch. c
B. Immediately contact the administrative assistant's direct super-
visor to report this observation.
C. Pick up the records and place them in a location out of public
view.
D. Discuss the issue with the clinic's director during their next
scheduled supervision session.
B101. An occupational therapist works in a program for survivors
of domestic violence. Which of the following would the therapist
do when using a clientcentered approach?
A. Offer specific concrete behavioral suggestions for dealing with
confrontations.
B. Respond to the participants' self-deprecating comments with d
positive feedback on personal characteristics.
C. Reinforce only the participants' neutral comments about them-
selves and personal skills.
D. Reflectively paraphrase the participants' statements to help
clarify their feelings.
B102. A patient is recovering from a right CVA resulting in severe
left hemiplegia and visuospatial deficits. The person's left lower
extremity has pitting edema. Which wheelchair would be best for
d
the occupational therapist to recommend for this patient?
A. A powered wheelchair with a joystick control and dual elevating
leg rests.

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B. A lightweight active duty wheelchair with dual elevating leg
rests.
C. A one-arm drive chair with an elevating leg rest on the left.
D. A hemiplegic chair with an elevating leg rest on the left.
B103. An older adult with a diagnosis of osteoarthritis in both
knees is referred to inpatient occupational therapy. During screen-
ing, the patient expresses a desire to return home to live alone
independently. Which should the occupational therapist do first in
response to the patient's stated goal?
A. Recommend adaptations to the patient's home environment to
increase safety. b
B. Evaluate the patient's BADL and IADL using a standardized
measure.
C. Teach the patient energy conservation techniques to use during
IADL tasks.
D. Train the patient in a home resistive exercise program to build
strength and ROM.
B104. An older teenager with a congenital right below-elbow
amputation had never wanted a prosthesis before. Now the teen
wants a prosthesis "to look good at the prom and more 'normal'
when doing things with my friends." Which action would be most
beneficial for the occupational therapist to take to meet the client's
expressed needs?
c
A. Recommend a prosthesis with a cosmetic passive hand.
B. Recommend a prosthesis with a voluntary opening hook.
C. Recommend a prosthesis with a myoelectrically controlled
hand.
D. Recommend counseling to explore the client's sudden preoc-
cupation with body image.
B105. An adult is referred to occupational therapy for ADL training.
The patient incurred a fracture of the right proximal humerus and
is using a shoulder immobilizer for the first two weeks to aid
healing and help control pain. The patient is right hand dominant.
Which activity will be the most difficult for the patient? a
A. Putting on a pullover top.
B. Completing online banking.
C. Taking off a winter coat.
D. Brushing their teeth.
B106. An occupational therapist is treating an individual with
Parkinson's disease in an outpatient setting. The therapist ob-
serves that the person attends regularly but has little energy and
does not seem to be performing the prescribed home program.
Which is the best action for the therapist to take in response to
these observations?
A. Advise the physician to complete a referral for a psychiatric c
evaluation.
B. Tell the person that the completion of the home program is vital
to recovery.
C. Interview the person and complete a standardized depression
scale.
D. Defer intervention until the person's depression is treated.
B107. An occupational therapist working for a home care agency
provides an inservice to new employees on Medicare reimburse-
ment guidelines for durable medical equipment (DME). Which
item would the therapist describe as reimbursable by Medicare?
A. A raised toilet seat for a patient after a hip replacement.
c
B. A reacher for a person with arthritis in both hips.
C. A walker for a person who cannot ambulate in the home without
one.
D. Grab bars in the bathroom for a person who cannot bathe or
toilet without them.
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B108. An individual has had a brain tumor removed from the
cerebellum. The occupational therapist conducts a screening to
determine the need for the further evaluation. During the screen-
ing the therapist observes deficits that indicate the need for further
evaluation. WHich would be most relevant for the therapist to a
evaluate based on this screening?
A. Proprioception and coordination.
B. Tactile and sensory integration.
C. Vision and visual-perception. D. Audition and communication.
B109. A client participates in occupational therapy for intervention
following a rotator cuff injury. The therapist provides progressive
resistive exercises. When grading these exercises, which of the
following is best for the therapist to increase?
A. The amount of resistance provided with a stronger level of
therapy band. a
B. The range of motion involved in completing the exercises.
C. The proximal load on the muscles the client uses during the
exercises.
D. The repetitions of external rotation exercises with less distal
weight.
B110. A toddler attends an early intervention program as a result
of developmental delay. Over the past two weeks, the toddler has
successfully completed the activities the occupational therapist
has provided in order to develop a palmar grasp. Which action
should the therapist take next in response to the child's progress?
c
A. Continue providing the child with the activities to refine palmar
grasp.
B. Review the initial evaluation to determine new goals.
C. Provide activities to develop a radial palmar grasp.
D. Provide activities to develop an ulnar palmar grasp
B111. A child with congenital anomalies has severe develop-
mental delay. The child demonstrates motor and cognitive skills
at the nine-month level. Which is the best adaptation for the
occupational therapist to use during intervention to develop the
child's visual and auditory awareness?
A. A hand-held rattle of the child's favorite cartoon character. c
B. A wrist bracelet with blinking lights that makes noise when
moved.
C. A button switch that activates a CD player when the switch is
pressed.
D. A communication device that offers selections of "yes" and "no".
B112. An adult incurred an injury to the anterior spinal artery at
the T12 level. The occupational therapist completes a sensory
evaluation with this client. Which sensation is most likely for the
therapist to document that the individual has retained?
a
A. Proprioception.
B. Pain.
C. Light touch.
D. Temperature.
B113. An occupational therapy administrator implements a quality
improvement program at a large private hand therapy clinic. The
administrator determines that the clinic's occupational therapy
assistants (OTAs) are not completing their assigned initial screen-
ings in a timely manner. This has resulted in scheduling delays
for complete functional evaluations. Which initial action is most
b
effective for the administrator to take in response to this situation?
A. Counsel the OTAs on the need to adhere to screening sched-
ules.
B. Examine the organizational structure of the screening process.
C. Assign the occupational therapists to complete all screenings.
D. Redesigns the screening to simplify the process.
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B114. An occupational therapist designs a qualitative research
study to examine the efficacy of an after-school play-based
program for the development of social interaction skills. Which
method of data collection is best for the therapist to use?
A. The therapist's observations of the participating children in the
classroom and during recess.
a
B. The completion of a social skills Likert-scale questionnaire by
the participants' teachers.
C. The completion of a social skills Likert-scale questionnaire by
the participants' parents.
D. The administration of a social skills evaluation pre- and postin-
tervention.
B115. A person fell and sustained bilateral Colles' fractures. The
client wore bilateral short-arm casts for six weeks. After cast
removal, the client began OT sessions to increase endurance and
strength prior to returning to work. The client tends to work hard
when performing resistive exercises with both wrists. The thera-
pist monitors the client for overexertion. Which behavior indicates c
overexertion?
A. Decreased respiration rate during resistive wrist flexion.
B. Increased ability to achieve full ROM of the wrist.
C. Complaints of pain in the wrist extensors.
D. Consistent strength in wrist extension activities.
B116. The administrator of a home care agency tells the occupa-
tional therapist to submit all intervention plans to the client's third
party payers prior to the implementation of treatment. Which is
the most accurate term for the therapist to use when documenting
these actions? d
A. Concurrent review.
B. Peer review.
C. Utilization review.
D. Prospective review.
B117. An individual is recovering from deep partial thickness
burns on the upper extremities, chest and lower neck. The oc-
cupational therapist provides equipment to prevent positions that
can result in contracture. Which are the most important positions
for the therapist to prevent? a.
A. Positions of comfort.
B. Anti-deformity positions.
C. Positions resulting in edema.
D. Positions of pain.
B118. A cooking group meets for 1 ½ hours each week at a
partial hospitalization program. During the group, members do
not smoke, they wait for everyone to be served before eating and
they clean up after the meal. When reporting these observations,
which of the following is the most accurate statement for the
b
therapist to make?
A. The group protocol is clear.
B. Group norms are being followed.
C. Group sanctions are effective.
D. A diversity of group roles is evident
B119. An older adult recovering from myocardial infarction is
referred to occupational therapy for a home care evaluation.
The referral states that the client has high blood pressure and
medication-related orthostatic hypotension. Which precaution is
most important for the occupational therapist to observe with this d
client?
A. Adherence to dietary restrictions during meal preparation ac-
tivities.
B. Avoidance of activities that require movement against gravity.

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C. Delay of the OT evaluation until the client's medications are
stabilized.
D. Avoidance of activities that require sudden postural changes.
B120. An occupational therapist measures a person for a wheel-
chair. The widest point across the person's hips and thighs is
16 inches and the greatest length from the person's posterior
portion of the buttocks to the popliteal fossa is 18 inches. Which
wheelchair seat dimensions should the therapist recommend? d
A. 18 inches wide by 20 inches deep.
B. 18 inches wide by 18 inches deep.
C. 16 inches wide by 18 inches deep.
D. 18 inches wide by 16 inches deep.
B121. An occupational therapist provides bed mobility training for
an individual recovering from a left CVA. The therapist notes that
the person's right calf is swollen and warm. The person complains
that it is painful. Which action should the therapist take initially?
A. Elevate the leg and provide retrograde massage.
d
B. Advise the person to tell the physician about the symptoms
during the physician's next bedside visit.
C. Continue with the training and document the symptoms in the
medical record.
D. Contact the change nurse immediately to report symptoms.
B122. An individual with bilateral proximal weakness identifies a
goal of independence in self-feeding. Which equipment is most
beneficial for the occupational therapist to recommend for goal
attainment?
d
A. Extended long-handled utensils.
B. Built-up handled utensils.
C. An electric feeder.
D. Mobile arm supports.
B123. A homemaker and parent is hospitalized for depression and
prescribed Parnate to treat depressive symptoms. The patient's
hobbies are gardening and jogging. Upon discussing the func-
tional effects of medications with the patient, which is the most
important precaution for the occupational therapist to review? b
A. Photosensitivity.
B. Dietary restrictions.
C. Orthostatic hypotension.
D. Amenorrhea.
B124. An occupational therapist establishes a program for a new
acute psychiatric unit at a community hospital. The therapist de-
signs the physical layout of the occupational therapy department
to include storage for arts and crafts materials. Which of the
following should the therapist recommend to store arts and crafts
a
materials?
A. A ventilated locked metal cabinet accessible only to staff.
B. Open shelving accessible to patients.
C. Shelving next to a sink for easy clean up.
D. A locked closet outside of the intervention area to ensure safety.
B125. A person with arthrogryposis undergoes serial casting with
weekly cast changes of the right wrist. Upon cast removal during
the fourth week, the therapist notes a small open area ¼ cm by ¼
cm and a red rash over the ulnar styloid. Which is the therapist's
best response to these observations?
d
A. Pad the area and apply another cast.
B. Refer the individual to the wound care team.
C. Fabricate a static splint that does not impede on the ulnar
styloid.
D. Contact the physician and describe the observations.

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B126. A school based-occupational therapist consults with a
teacher regarding a non-speaking student who uses a wheelchair
and an augmentative communication device. The teacher reports
that the student has been making many errors on the communi-
cation device but that no difficulties had been observed when the
student used the device in the past. Which is the most effective
initial action for the therapist to take in response to the teacher's
report?
c
A. Advise the teacher to contact the student's parents and recom-
mend that they bring the child to a physician for an examination.
B. Reassess the student's motor and communication abilities to
determine needed modifications.
C. Evaluate the position of the student in the wheelchair and the
device on the wheelchair.
D. Reposition the communication device on the wheelchair to
facilitate access and increase accuracy.
B127. An occupational therapist plans individual and group activ-
ities for a child with oppositional defiant disorder. Which is most
important for the therapist to address during group activities?
A. The child's willingness to take in a variety of group roles. b
B. The child's ability to attend to and complete a task.
C. The child's distorted body image.
D. The child's self-regulation of energy and activity levels.
B128. A single parent with rheumatoid arthritis and two
school-aged children reports difficulty completing a home exer-
cise program. The parent states that multiple familial, work and
home management responsibilities fill the day and additional
activities cannot fit into the day. Which is the best action for the
occupational therapist to take in response to these realities?
A. Explain and reinforce the importance of active range of motion
c
exercises for remediation of dysfunction.
B. Provide intervention to develop time management skills and
enable temporal adaptation.
C. Incorporate the parent's engagement in a diversity of role
activities into the home program.
D. Increase the frequency of OT sessions to compensate for lack
of follow through with the home program.
B129. An individual with spinal cord injury (SCI) at the level of T4
is practicing stand pivot transfer in the OT department of a reha-
bilitation center. The patient complains of dizziness and nausea.
Which action is most important for the occupational therapist to
take first?
A. Call for help according to facility procedures. c
B. Return the patient to the wheelchair for a five minute rest break.
C. Return the person to the wheelchair and immediately recline
it.
D. Return the patient to the wheelchair and transport the patient
back to rest in bed.
B130. An individual attends a community day treatment program
to assist in recovery from major depression. The client has fair eye
contact and responds verbally to interactions initiated by others.
The person's cognition is intact. Which group level is best for the
occupational therapist to recommend this client attend? a
A. Project.
B. Parallel.
C. Cooperative.
D. Mature.
B131. An adolescent with spina bifida at the C8 level wants to
access the new computerized play system that was received as
a birthday gift. Which is the best adaptation for the occupational
therapist to recommend the adolescent use to access this sys-
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tem?
A. A chin switch.
B. A tenodesis splint. d
C. A dorsal wrist splint with a universal cuff.
D. A joystick control.
B132. A college is converting an historical building into wheelchair
accessible dormitory space. To allow for a 360° turning radius,
which dimensions are best for the occupational therapist to rec-
ommend as the minimum space between the students' desk and
bed? b
A. 4 feet by 4 feet.
B. 5 feet by 5 feet.
C. 6 feet by 6 feet.
D. 7 feet by 7 feet
B133. An occupational therapist working for a home care agency
is vacationing and sees a colleague at an all-day concert. Upon
return from the vacation, the therapist notices that this colleague
had billed for a full-day of home visits on the day of the concert.
Which action is best for the therapist to take first in response to
this situation? a
A. Inform the home care supervisor.
B. Contact the state regulatory board.
C. Contact the National Board for Certification of Occupational
Therapy.
D. Ask the colleague to clarify the situation.
B134. A caregiver support meets weekly at a senior center. A new
member attends the group for the third time and listens intently.
The person nods in agreement when others speak, but does not
participate verbally. Which action is most effective for the occu-
pational therapist to take to facilitate the individual's engagement
in the group?
A. Reiterate the group's norm that active participation is expected
c
from all group members.
B. Ask the individual several questions to encourage verbal par-
ticipation.
C. Invite the individual to join in the discussion, if the person would
like.
D. Refer the individual to the center's social worker for individual,
nongroup counseling.
B135. An occupational therapist accepts a job in an after-school
program. The program provides services for adolescents at risk
for mental health problems due to their history of being victims
of abuse. The therapist decides that an activity group to elicit the
adolescents' thoughts and feelings in a safe atmosphere would
be instrumental to their recovery. Which group would be most a
relevant for the therapist to design?
A. A task-oriented group
B. An instrumental group.
C. A topical group.
D. A thematic group.
B136. An elementary school student with hypotonic cerebral palsy
receives school-based occupational therapy to improve fine motor
skills. The child holds a thick marker with a static tripod grasp and
holds a No. 2 pencil with a gross grasp. The occupational therapist
revises the intervention plan based on the child's attained skills.
Which grasp would be best for the therapist to address next in the b
revised occupational therapy intervention plan?
A. Dynamic tripod with the thick marker.
B. Static tripod with a pencil.
C. Lateral pinch with a thick marker,
D. Dynamic tripod with a pencil.
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B137. A young adult with a 10-year history of serious and per-
sistent mental illness is being discharged home in two days.
The client collaborates with the care coordination team to plan
discharge with the client's primary family members. The team
consists of a psychiatrist, a registered nurse, a social worker and
an occupational therapist. The team conducts a pre-discharge
family meeting to provide family members with information to
a
assist them in supporting the client's recovery. Which is the most
relevant information for the occupational therapist to provide to
the client's primary family members at this meeting?
A. Family role activity suggestions and potential adaptations.
B. The therapeutic effects and potential side effects of medication.
C. Advocacy strategies and consumer family resources.
D. Family dynamics information and family support groups.
B138. A Sensory Profile completed by a caregiver indicates that
an elementary school-aged child has modulation impairments
and sensation seeking patterns. The occupational therapist ob-
serves the child frequently wandering, bumping into objects in the
room and fidgeting. Which is the best intervention approach for
the therapist to use to address this child's deficits?
A. Strategies to increase random sensory input and encourage
d
high physical activity at home.
B. An obstacle course which requires diverse movements for
varied proprioceptive and tactile input.
C. Sensory experiences that focus on body awareness and grad-
ing control during play activities.
D. A sensory diet which includes controlled sensory input inte-
grated into the child's daily routine.
B139. An occupational therapist provides home care services to a
neonate with significant developmental delays. Two hours before
the next scheduled home visit, the child's parent informs the
therapist that one of three older children has developed chicken
pox. While the other children do not show signs of chickenpox,
the parent expresses concern that they are contagious. Which
b
therapist's best response to this situation?
A. Cancel the scheduled session and reschedule after two weeks
have passed.
B. Complete the scheduled session using airborne precautions.
C. Complete the scheduled session using standard precautions.
D. Complete the scheduled session using droplet precautions.
B140. An individual with borderline personality disorder incurred
a back injury while working as a stock person for a large ware-
house. The individual attends a work hardening program. The
occupational therapist evaluates the individual and determines
the client's level of productivity is just below the warehouse mini-
mum standards. The individual complains of pain when lifting the
heaviest boxes. The client frequently becomes angry and verbally
c
abusive in response to directions or feedback. Which is the most
important initial focus of the work hardening program for this
individual?
A. An increase in productivity to meet minimum standards.
B. An increase in productivity to exceed minimum standards.
C. The development of affective work behavior skills.
D. The development of strength and ergonomic lifting abilities.
141. An older client with a diagnosis of late onset dementia of
the Alzheimer type lives with family members. On the last three
occasions, the client attended OT sessions with bruises and cuts
on both legs. When asked about this, the client replies that a b
family member caused these injuries. Which is the first action the
occupational therapist should take?
A. Confirm the client's statements with the family

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B. Immediately report potential abuse according to the facility
policy.
C. Call the police to report elder abuse.
D. Administer a cognitive evaluation before taking further action.
142. A client with a lower brain stem injury is referred to occu-
pational therapy. During the evaluation, which reflex would the
person most likely demonstrate?
A. Tonic Lumbar c
B. Body on body righting
C. Tonic Labyrinthine
D. Labyrinthine righting
143. Ten members of a community reintegration group are not
working well together and show decreased levels of trust. The oc-
cupational therapists goal is to enhance the level of cohesiveness
in the group. To begin the next group session, which is the best
action for the therapist to take?
A. Read inspirational phrases to increase motivation b
B. Verbally review the goals and purposes of the group
C. Have each person contribute a line about childhood memories
to group poem
D. Ask each person to talk about silly mistakes to provide some
levity
144. An individual with developmental disabilities scores a Level
5 on the Allen Cognitive Level Test. Which activities should the
occupational therapist include in the intervention plan to help
meet the clients functional needs?
A. Community mobility activities such as taking a bus c
B. Home management activities such as preparing a food shop-
ping list
C. Self care activities such as brushing teeth
D. Leisure activities such as completing a 50 piece puzzle
145. An occupational therapist observes that an 18 month old
child is not able to creep more than a few steps. When the child
looks up, both hips and knees flex and the child ends up W sitting
with both arms extended and propped forward. When document-
ing this observation, which is most accurate for the occupational
therapist to report the child is demonstrating.
A. Typical development of locomotion skills b
B. The influence of the symmetrical tonic neck reflex (STNR)
resulting in delayed gross motor skills
C. An obligatory asymmetrical tonic neck reflex (ATNR) resulting
in delayed gross motor skills
D. An intact tonic labyrinthine reflex which facilitates balance
responses
146. An occupational therapist provides caregiver training to the
spouse of an individual with cerebellar cortical degeneration. The
focus of the session is on community mobility using a wheelchair.
The individual is dependent upon the spouse's assistance for
mobility. Which of the following is most effective for the therapist
to recommend the spouse do when descending a steep grade?
A. Go down backwards with all wheelchair wheels maintaining
a
contact with the ground surface
B. Tilt the wheelchair backward to its gravitational balance point
and then go down forward
C. Tilt the wheelchair backward to its gravitational balance point
and then go down backward
D. Push forward as on flat surfaces but lean body back for extra
drag
147. An adult has been referred to occupational therapy. The
individual demonstrates decreased ROM in the dominant hand

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secondary to a nerve injury. Active thumb ROM for the IP and MP
is within normal limits. Active ROM of the IPs of all four fingers
is 0° - 60°. The individual wants to be able to hold a knife, spoon
and fork. Which utensils are best for the therapist to recommend
to this person?
a
A. Utensils with cylindrical foam handles, 1½" in diameter
B. Standard utensils with no adaptation
C. Utensils with custom-built handles made of low temperature
thermoplastic splinting material
D. Utensils held in a universal cuff
148. The population of an urban homeless shelter includes in-
dividuals with histories of chronic alcohol abuse who are at risk
for developing peripheral neuropathy. The occupational therapist
consulting at this shelter monitors the residents' status to ensure
early detection of this problem. Which is the most important ob-
served status change for the therapist to report? b
A. Progressive deterioration in visual acuity
B. Progressive deterioration of sensorimotor functions of the lower
extremities
C. Rapid onset of intention tremors D. Rapid loss of sensorimotor
functions of the facial and neck muscles
149. A middle school student with learning disabilities exhibits
no behavioral problems in the classroom. However, whenever
the class is in a line waiting to switch classrooms, the student
becomes agitated and often pushes classmates. The occupation-
al therapy consultant advises the teacher that this behavior ma
be indicative of an underlying problem. Which of the following is
d
most accurate for the therapist to identify as a potential disorder
warranting further evaluation?
A. Gravitational insecurity
B. A conduct disorder
C. Antisocial tendencies
D. Tactile defensiveness
150. The occupational therapist plans the clients early mobiliza-
tion program. Which is the most appropriate exercise routine for
the occupational therapist to use within the limits of a dorsal block
splint?
c
A. Active flexion /passive extension
B. Active flexion/active extension
C. Active extension/ passive flexion
D. Passive flexion/passive extension
151. The occupational therapist meets with the client to ensure
compliance with the prescribed splinting protocol. Which is the
most important outcome of this session?
A. The clients adherence to a written split wearing schedule
c
B. The clients ability to independently don and doff the splint
C. The clients understanding of the purpose(s) and procedure(s)
of the splint protocol
D. The completion of functional training in the use of the splint
152. The client is now seven weeks post operation. Which are
the most appropriate interventions activities for the occupational
therapist to use with this client?
A. Home management activities such as doing laundry b
B. Light activities of daily living such as grooming
C. Strengthening exercises using high resistance theraband
D. Passive exercises using a dynamic splint
153. During an intervention session in a school, the occupational
therapist observes a young child turn the pages of a book. The
therapist identifies this behavior as an example of an in-hand
manipulation task. Which task should the occupational therapist

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document the child is capable of performing?
A. Shift
B. Simple rotation a
C. Translation
D. Translation with stabilization
154. A rehabilitation hospital is interested in starting a driver re-
habilitation program. Which must the occupational therapist hired
to develop this program do first?
A. Determine the cost of commercially available driving rehabili-
d
tation program
B. Develop admission criteria for program participants
C. Develop a marketing plan to obtain referrals
D. Learn the states driving laws and requirements
155. An individual recovering from hepatitis, type C has de-
creased upper and lower extremity muscle strength and hyper-
tension. Six months ago the client had an angioplasty and is
very fearful of having a heart attack. Which should the occupa-
tional therapist instruct the client to perform to increase muscle
a
strength?
A. Isotonic exercises
B. Isometric exercises
C. Contract-relax exercise
D. Muscle contractions and holds
156. During a home care intervention planning meeting, the
team discusses a client with a right CVA. The physical therapist
states the individuals ambulatory status is now within functional
limits. Physical therapy services will be discontinued because
the person is no longer homebound. The occupational therapist
reports that the individual is frequently confused during home
management task performance and becomes extremely anxious
when community activities are discussed. Which recommenda-
tion should the therapist make? b
A. Refer the individual to a psychiatrist for a mental status evalu-
ation
B. Continue OT services as the person should continue to be
considered homebound
C. Discontinue OT services as they are non reimbursable since
the person is no longer considered home bound.
D. Contact the physician to discuss the need for OT services on
an outpatient basis and for psychosocial counselling.
157. An older adult with Parkinsons disease has a secondary
diagnosis of depression. During home based occupational ther-
apy service provision, the client exhibits increased confusion and
disorientation. Which action is best for the home care occupa-
tional therapist to advise the clients primary caregiver to take in
response to the clients change in status? d
A. Obtain an evaluation from a neurologist to determine if demen-
tia has begun
B. Seek support from a caregivers respite program
C. Discuss placement alternatives with social worker
D. Contact the clients psychiatrist for a medication evaluation
158. An adult with amyotrophic lateral sclerosis frequently coughs
and chokes when eating finely chopped foods and drinking thin
liquids. The speech pathologist and occupational therapist collab-
orate and recommend a videofluoroscopy procedure. Which be-
havioral information would be most relevant for the occupational
a
therapist to include on the referral?
A. The client demonstrates minimal limitations in cognitive level
B. The client is able to consume chopped foods and apple juice
with no difficulty
C. The client demonstrates only oral stage problems during eating
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D. The client cannot tolerate therapy focused on improving feeding
and swallowing skills
159. An adult recently diagnosed with scleroderma receives oc-
cupational therapy services to deal with the functional changes
caused by this disease. Which recommendation is best for the
occupational therapist to make to this individual?
b
A. Dress in lightweight clothing for thermal comfort
B. Dress in layers for neutral warmth
C. Use pull-on clothing to ease donning and doffing
D. Use Velcro/or a button hook to ease fastening
160. An individual is status post carpal tunnel release. When
the occupational therapist conducts a sensory test for sharp/dull
(pain), the person reports dull as sharp on the palmar surface
of the thumb and index finger. All other responses were correct.
Which is accurate for the therapist to document about the individ-
uals sensation?
c
A. Impaired for pain along C5 and C6 dermatomes
B. Hypersensitive along the ulnar nerve distribution of the palmar
surface of the hand
C. Hypersensitive along the median nerve distribution of the
thumb and index fingers
D. Absent for pain along the median nerve distribution
161. The family of a two year old in a spica cast asks the occu-
pational
therapist to modify the childs car seat. The child cannot fit safely
in the car
seat due to the cast. Which action is best for the therapist to take
in response to this request?
A. Pad the area between the car seat and the childs back with a
b
pillow to accommodate for the lack of hip flexion.
B. Recommend the family purchase a car seat designed for a child
with a spica cast
C. Cut down the sides of the car seat to allow the cast to hang out
of the sides of the car seat
D. Tell the family to use the current car seat and tighten up the
straps to hold in the child
162. A level II fieldwork student's first assigned case is an indi-
vidual with right hemiplegia. The supervising therapist reminds
the student that primitive reflexes can emerge when someone
incurs a CVA. The therapist demonstrates this point by rotating the
clients head to the right and stating that the observed response
demonstrates a subtle asymmetrical tonic neck reflex (ATNR).
The therapist asks the student to describe the clients reaction that
c
resulted in the therapists interpretation. Which is most accurate
for the student to state the client is exhibiting based on this
observation.
A. Increased flexor tone of the right upper extremity
B. Increased extensor tone of the left upper extremity
C. Increased extensor tone of the right upper extremity
D. Increased extensor tone in both upper extremities
163. An individual with a spinal cord injury at C-7 reports no-
ticeable redness on the ischial tuberosity during self examination
with a mirror. Which action is most effective for the occupational
therapist to recommend in response to clients observations?
A. Integrate weight shifting into daily activities a
B. Use a tilt in space wheelchair
C. Use an angled foam cushion
D. Self direct caregivers to assist with weight shifting at least once
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164. A graduate student with an anxiety disorder reports feeling
confused about the future. During the OT evaluation, the client
relates decreased feelings of competence for a chosen field of
study and overall poor personal causation. Which is the best initial
action for the therapist to take in response to the client's stated
concerns? d
A. Administer a vocational inventory
B. Provide activities related to the clients chosen field of study
C. Refer the client to the state office of vocational and educational
services
D. Establish short term goals with high potential for attainment
165. An occupational therapist completes a cognitive screening
for a person with chronic schizophrenia, undifferentiated type.
The therapist uses Allens cognitive disabilities model to guide the
evaluation process. During the screening, the person is able to
initiate the whipstitch but cannot imitate the single cordovan stitch.
Based upon these results, the occupational therapist determines
that further evaluation is indicated. Which ability is most relevant c
for the therapist to assess?
A. Performance of multi-step tasks using overt trial and error
problem-solving
B. Performance of multi-step tasks using analytical reasoning
C. Performance of simple tasks independently using visual cues
D. Performance of simple tasks with long-term repetitive training
166. An occupational therapist works with a child with pervasive
developmental disabilities in order to improve self-care skills. In
teaching the child to brush teeth, the therapist places the tooth-
brush in the child's hand and guides it to the mouth. To help
the child learn to complete the activity the therapist uses the
somatosensory system. Which of the following is most effective
b
for the therapist to use next during intervention with this child?
A. Tell the child to brush up and down
B. Provide hand-over-hand assistance to brush the child's teeth
C. Touch the child's hand to prompt hand-to-mouth movements
D. Instruct the child to follow a pictorial sequence card depicting
tooth-brushing
167. A pre-school aged child with recurring headaches and de-
creased gross and fine motor skills is hospitalized on an acute
care unit for a diagnostic work-up. Just prior to the occupational
therapy evaluation, the parents are told that their child has cancer.
The parents are upset when they bring their child to the evaluation
session. Which are the best actions for the therapist to take in
response to this situation?
A. Recommend the parents speak to their spiritual advisor or the a
social worker and proceed with the OT session
B. Cancel the OT session and recommend the parents peak to
their spiritual advisor or the social worker
C. Spend the OT session providing support to the parents and
addressing the parents' acceptance of the diagnosis
D. Recommend the parents speak to their spiritual advisor or the
social worker and reschedule the OT session for later in the week
168. After six months of rehabilitation for a T-2 spinal cord injury, a
patient is being discharged. The occupational therapist conducts
a home visit to evaluate accessibility. The individual lives with
two roommates in an apartment in a private home. The doorway
measurements currently range from 30-32 inches throughout the
a
apartment. The patients landlord is amenable to making changes
in the apartment bus has no financial resources. Which rec-
ommendation is best for the therapist to make for independent
accessibility in the apartment?
A. Install offset hinges on ail doors

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B. Remove doorframes of doorways less than 32 inches and
install wider frames
C. Remove all doors except for the apartment entrance door
D. Remove all doorframes and install 36 inch wide doorframes
169. An individual recovering from myasthenia gravis has fair
minus (F-) muscle strength in both upper extremities. The occu-
pational therapist develops an intervention plan to include the goal
of increasing muscle strength. According to the biomechanical
approach, which should the therapist work on with the patient
b
during intervention?
A. Compete active ROM with gravity, decreased
B. Complete active ROM against gravity
C. Incomplete active ROM against gravity
D. Complete active ROM against gravity and slight resistance
170. A high school student with a diagnosis of borderline person-
ality disorder and a history of self-abusive behaviors attends a
transitional school-to-work program co-lead by an occupational
therapist and an occupational therapy assistant (OTA). During
the vocational skills group, the student expresses feelings of
hopelessness about the future and questions the point of partic-
ipating in the program. The student asks to leave the group due
to being too tired to concentrate as a result of sleepless nights.
The occupational therapist asks the OTA to assume leadership of
the group while the therapist addresses the student's concerns.
a
Which action is best for the therapist to take in response to the
student's statements?
A. Pull the student aside from the group and ask if the student is
feeling self-destructive
B. Allow the student to leave the group after reminding the student
to relay concerns to the guidance counselor
C. Support the validity of the student's feelings and encourage the
student to remain in the group
D. Remind the student that in a work setting the norm is to work
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