1.
A child with myelomeningocele meets the short term goals of achieving functional gross grasp and lateral pinch. After several additional weeks of occupational therapy, the child does not meet the goals of demonstrating pincer grasp and three jaw chuck. Consequently, the therapist modifies the child’s intervention plan. Which intervention is best to include in the revised plan?
Correct Answer
C. Teach the child to use gross grasp and lateral pinch for functional activities
Explanation
The child with myelomeningocele has not been able to achieve the goals of demonstrating pincer grasp and three jaw chuck after several weeks of therapy. Therefore, the therapist modifies the intervention plan to include teaching the child to use gross grasp and lateral pinch for functional activities. This intervention is best because it focuses on utilizing the child's current abilities and strengths to perform functional tasks. By teaching the child to use gross grasp and lateral pinch, they can still engage in activities despite not being able to achieve more advanced grasping techniques.
2.
An occupational therapist works with a survivor of a house fire. The client has burns on both hands that limit thumb mobility. The client identifies a personal goal of being able to pick up and hold cans to enable independent shopping and meal preparation activities. Which movement of the thumb should the goal statement include as desired functional outcome?
Correct Answer
A. Carpometacarpal (CMC) palmar abduction
Explanation
The goal statement should include Carpometacarpal (CMC) palmar abduction as the desired functional outcome. This movement of the thumb allows the client to pick up and hold cans, which is necessary for independent shopping and meal preparation activities.
3.
An occupational therapist works in a program for survivors of domestic violence. Which of the following would the therapist do when using a client-centered approach?
Correct Answer
D. Reflectively parapHrase the participants’ statements to help clarify their feelings
Explanation
In a client-centered approach, the occupational therapist would reflectively paraphrase the participants' statements to help clarify their feelings. This means that the therapist would listen attentively to the participants' comments and then repeat or rephrase what they said in order to show understanding and help them gain insight into their own emotions. This approach focuses on the client's own experiences and feelings, rather than offering concrete suggestions or reinforcing neutral comments. By reflecting and clarifying their feelings, the therapist can support the participants in exploring their emotions and working towards healing and growth.
4.
An individual prepares for discharge home following rehabilitation for a left CVA. Residual difficulties include fair dynamic balance, 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 therapist to recommend to this client?
Correct Answer
B. A rolling walker
Explanation
A rolling walker would be the most effective ambulatory aid to recommend to this client. A rolling walker provides stability and support while allowing the client to move more easily. It would help with the client's fair dynamic balance and decreased upper extremity strength. The rolling walker also offers a larger base of support and may be easier for the client to maneuver compared to a standard walker or a side-stepper walker. This would enable the client to ambulate safely to the senior center located in their apartment building.
5.
An occupational therapist is evaluating a child with developmental delay characterized by hypotonicity. According to the Rood approach, which is the first stability pattern that the therapist should facilitate during intervention?
Correct Answer
C. Neck co-contraction
Explanation
According to the Rood approach, the first stability pattern that the therapist should facilitate during intervention for a child with developmental delay characterized by hypotonicity is neck co-contraction. This is because neck co-contraction helps to provide stability and control in the upper body, which is important for the child's overall development and functional abilities. By facilitating neck co-contraction, the therapist can help improve the child's postural control and stability, which can then support their progress in other areas of motor development.
6.
A child with congenital anomalies has severe developmental 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 child’s visual and auditory awareness?
Correct Answer
C. A button switch that activates a CD player when the switch is pressed
Explanation
The best adaptation for the occupational therapist to use during intervention to develop the child's visual and auditory awareness is a button switch that activates a CD player when the switch is pressed. This adaptation encourages the child to use their motor skills to press the button and activates the CD player, which provides auditory stimulation. It also helps develop the child's visual awareness as they learn to associate the action of pressing the button with the sound produced by the CD player. This adaptation promotes the child's overall development and helps improve their visual and auditory awareness.
7.
An occupational therapist providing home-based occupational therapy services implements a bed positioning plan for a person recovering from a cerebral vascular accident. The person is receiving care from family members and personal care assistants employed by a home care agency. Which action should the therapist take to ensure the accurate implementations of this plan by the client’s caregivers?
Correct Answer
C. Post pictures of desired positions next to the headboard of client’s bed
Explanation
To ensure the accurate implementation of the bed positioning plan by the client's caregivers, the therapist should post pictures of the desired positions next to the headboard of the client's bed. This visual aid will provide clear and easy-to-understand instructions for the caregivers, allowing them to accurately replicate the desired positions. Verbal directions may be forgotten or misunderstood, and written directions may not be as effective as visual cues in ensuring accurate implementation. Requiring each caregiver to demonstrate the replication of the desired positions may not be practical or necessary in this situation.
8.
An individual is evaluated for a repetitive stress disorder. The individual complains of numbness and tingling of the thumb, index, middle, and radial half of the ring finger and aching pain in the proximal forearm. The client states that these symptoms are not evident at night. The occupational therapist notes a positive Tinel’s sign. Which site should be the therapist document as the location of this sign for this client?
Correct Answer
D. Forearm
Explanation
The individual's symptoms of numbness and tingling in the thumb, index, middle, and radial half of the ring finger, along with aching pain in the proximal forearm, suggest the presence of a repetitive stress disorder. The fact that these symptoms are not evident at night further supports this diagnosis. The positive Tinel's sign, which is a tingling sensation felt when tapping over a compressed nerve, indicates nerve compression or irritation. Given the location of the symptoms and the positive Tinel's sign, the therapist should document the forearm as the site of the Tinel's sign for this client.
9.
An adult diagnosed with bipolar disorder has been taking lithium for five years. Prior to a weekly occupational therapy vocational planning group, the client reports noticeable functional changes 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 contacts the psychiatrist to describe the client’s concerns. Which symptom would the therapist most likely report as indicative of this problem?
Correct Answer
B. Gross hand tremors
Explanation
The therapist would most likely report gross hand tremors as indicative of a possible lithium overdose. Hand tremors are a common side effect of lithium and can occur at therapeutic levels but are more likely to be seen at toxic levels. This symptom is important to report to the psychiatrist as it may indicate that the client's lithium levels need to be monitored and adjusted to prevent further complications.
10.
A client with traumatic below-elbow amputation of the dominant right arm has participated in occupational therapy for prosthetic training. The therapist prepares a discharge plan that incorporates recommendations to facilitate independence in meal preparation and feeding. Which method is best for the therapist to recommend the client use to cut meat?
Correct Answer
D. Hold a regular fork in the terminal device and hold a regular knife in the left hand
Explanation
The client with a below-elbow amputation of the dominant right arm can best facilitate independence in meal preparation and feeding by holding a regular fork in the terminal device and holding a regular knife in the left hand. This method allows the client to use their non-dominant hand to hold the knife for cutting while using the terminal device to hold and manipulate the fork for eating. Holding a regular fork in the terminal device provides a secure grip, and using a regular knife in the left hand allows for better control and precision in cutting meat.
11.
During a classroom screening, an 8-year-old is observed holding a pencil with tight grip. The student appears to rely heavily on visual cues to assist during both fine and gross motor tasks. During gross motor activities, the student moves in an uncoordinated manner. The occupational therapist uses a sensory integrative frame of reference to interpret evaluation of data. Which impairment should the therapist document as needing further evaluation?
Correct Answer
B. Proprioceptive system dysfunction
Explanation
The correct answer is Proprioceptive system dysfunction. The student's tight grip on the pencil and reliance on visual cues suggest difficulty with proprioception, which is the sense of body position and movement. This can affect both fine motor skills, like holding a pencil, and gross motor skills, leading to uncoordinated movements. The occupational therapist would document this as needing further evaluation to assess the extent of the proprioceptive system dysfunction and develop appropriate interventions.
12.
An occupational therapist develops a task group for the newly admitted patients of a psychiatric inpatient unit of a busy city hospital. The therapist considers several activities to use for the group’s first session. Which activity is best for the therapist to present to the group members?
Correct Answer
B. Decorating styrofoam cups and planting cuttings in them
Explanation
Decorating styrofoam cups and planting cuttings in them is the best activity for the therapist to present to the group members. This activity promotes creativity and engagement, as the patients can decorate the cups according to their preferences and then plant cuttings in them. It also provides a sense of responsibility and nurturing, as the patients will need to take care of the plants. Additionally, this activity can be therapeutic and calming, as it allows the patients to focus on a task and connect with nature.
13.
The occupational therapist plans the client’s early mobilization program. Which is the most appropriate exercise routine for the occupational therapist to use within the limits of a dorsal block splint?
Correct Answer
C. Active extension / Passive flexion
Explanation
The most appropriate exercise routine for the occupational therapist to use within the limits of a dorsal block splint is active extension / passive flexion. This means that the client will actively extend their affected joint while the therapist assists with passive flexion. This exercise routine allows for movement and stretching of the joint while still providing support and protection with the dorsal block splint.
14.
A person fell and sustained bilateral Colle’s 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 therapist monitors the client for overextension. Which behavior indicates overextension?
Correct Answer
C. Complaints of pain in the wrist extensors
Explanation
Complaints of pain in the wrist extensors indicate overextension. When a person overextends their wrists during resistive exercises, it can put excessive strain on the wrist extensor muscles, leading to pain and discomfort. This suggests that the client may be pushing themselves too hard and potentially causing harm to their wrists. The therapist should closely monitor the client's technique and provide guidance to prevent overextension and ensure a safe and effective exercise session.
15.
A two-year-old child receives home care early intervention services. The occupational therapy intervention plan includes a goal to develop child’s pincer grasp. Which is the most appropriate activity for the occupational therapist to work on with the child during an intervention session?
Correct Answer
A. Finger-feeding of O-shaped cereal
Explanation
The most appropriate activity for the occupational therapist to work on with the child during an intervention session is finger-feeding of O-shaped cereal. This activity specifically targets the development of the child's pincer grasp, which is an important fine motor skill. By picking up and manipulating the small cereal pieces using their thumb and index finger, the child can improve their ability to grasp and manipulate objects using their fingers. This activity also provides sensory input and can help improve hand-eye coordination.
16.
In measuring the ROM of a client’s elbow, the occupational therapist records a flexion measurement of 145°. Which is the most accurate for the therapist to document based on this measurement?
Correct Answer
D. Normal elbow ROM
Explanation
Based on the measurement of 145° for flexion of the client's elbow, the most accurate documentation for the therapist would be "Normal elbow ROM." This is because a flexion measurement of 145° falls within the typical range of motion for a healthy elbow joint.
17.
An adult diagnosed with multiple sclerosis (MS) over 10 years ago experiences exacerbation of symptoms. The individual’s principle complaint is decreased strength and endurance. The person can ambulate short distances within a cane in the home and uses a wheelchair outside of the home. The client asks for suggestions to enable independent home maintenance. Which is the best positioning recommendation for the occupational therapist to suggest the person use during meal preparation?
Correct Answer
B. Sitting at the kitchen table
Explanation
Sitting at the kitchen table is the best positioning recommendation for the individual during meal preparation. This allows the person to have a stable surface to work on and provides support for decreased strength and endurance. Sitting in the wheelchair with a tray table may not provide enough stability and may limit the person's ability to reach items on the table. Leaning against the counter while standing or leaning against a tall stool while standing may not provide enough support for the individual's decreased strength and endurance.
18.
A person is 5 days post coronary artery bypass graft (CABG). The patient expresses anxiety about performing any type of activity and reports chest pain during ambulation. The cardiologist has approved activities at a metabolic equivalent (MET) level of 2-3. Which activity is best for the occupational therapist to use when initiating intervention with this person?
Correct Answer
A. Grooming while standing at the sink
Explanation
Grooming while standing at the sink is the best activity for the occupational therapist to use when initiating intervention with this person because it allows the patient to gradually increase their activity level while still being within the approved MET level of 2-3. Standing and grooming at the sink requires more energy expenditure compared to sitting activities like grooming or sponge bathing, but it is still a relatively low-intensity activity that is suitable for a person who is 5 days post CABG and experiencing anxiety and chest pain during ambulation. Performing light housework may be too strenuous at this stage of recovery.
19.
A ten-year-old with congenital anomalies wears bilateral ankle-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 beast footwear recommendation for the therapist to make for the child to wear?
Correct Answer
C. Running shoes with Velcro shoe closures
Explanation
The best footwear recommendation for the therapist to make for the child to wear is running shoes with Velcro shoe closures. This option allows the child to independently don and doff the shoes without needing to tie laces, which the child cannot do. Additionally, running shoes provide good support and stability for the child's feet, which is important considering the child wears bilateral ankle-foot orthoses. Velcro closures make it easier for the child to put on and take off the shoes, promoting independence and convenience.
20.
A patient is recovering from a right total hip placement (posterolateral incision, cementless fixation). Which is the best type of bed-to-wheelchair transfer for the occupational therapist to teach the patient to use?
Correct Answer
B. Stand-pivot transfer to the non-surgical side
Explanation
The best type of bed-to-wheelchair transfer for a patient recovering from a right total hip placement with a posterolateral incision and cementless fixation is a stand-pivot transfer to the non-surgical side. This transfer allows the patient to maintain weight-bearing precautions on the surgical side while using the non-surgical side for support during the transfer. It helps to minimize stress and strain on the surgical hip, promoting proper healing and reducing the risk of complications.
21.
A nine-year-old child identifies the assembly of a model as the most desired play activity. The occupational therapist determines that the child would have difficulty completing the selected model. Which action is most effective for therapist to take during next intervention session?
Correct Answer
C. Break the project down into accomplishable segments and instruct the child to complete one segment at a time
Explanation
The most effective action for the therapist to take in the next intervention session is to break the project down into accomplishable segments and instruct the child to complete one segment at a time. This approach allows the child to still engage in their desired play activity while also addressing their difficulty in completing the model. By breaking the project into smaller, manageable tasks, the child is more likely to experience success and build confidence in their abilities. This approach also promotes problem-solving skills and helps the child develop strategies for completing tasks independently.
22.
An individual with Parkinson’s disease exhibits difficulty moving from sitting in a chair to standing. Which technique is best for the therapist to recommend the person use to help successfully complete this functional mobility activity?
Correct Answer
C. Sit at the edge of the chair and rock back and forth before rising
Explanation
Rocking back and forth while sitting at the edge of the chair can help the individual with Parkinson's disease to shift their weight and generate momentum before rising. This technique can assist in overcoming the difficulty in initiating movement and provide the necessary momentum to stand up from a seated position.
23.
A client participates in occupational therapy for intervention following a rotatory cuff injury. The therapist provides progressive resistive exercises. When grading these exercises, which of the following is best for the therapist to increase?
Correct Answer
A. The amount of resistance provided with stronger level of therapy band
Explanation
The therapist should increase the amount of resistance provided with a stronger level of therapy band. This is because progressive resistive exercises involve gradually increasing the resistance to challenge the muscles and promote strength and endurance. By increasing the resistance provided by the therapy band, the therapist can ensure that the client is continually challenged and making progress in their rehabilitation.
24.
The parents of a school-aged child with Rett syndrome ask the occupational therapist for activities to do at home to help their child regain lost skills. Which of the following should the therapist include in the home program for the parents to do with their child?
Correct Answer
D. Perform passive ROM to prevent contractures
Explanation
Performing passive range of motion (ROM) exercises can help prevent contractures in children with Rett syndrome. Rett syndrome is a neurodevelopmental disorder that affects motor skills and causes a loss of purposeful hand skills. Contractures, or the permanent shortening and tightening of muscles, can occur if the child does not have adequate movement and stretching of their joints. By performing passive ROM exercises, the parents can help maintain joint mobility and prevent contractures from developing. This can ultimately support the child in regaining lost skills and improving their overall function.
25.
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 individual’s sensation?
Correct Answer
C. Hypersensitive along the median nerve distribution of the thumb and index fingers
Explanation
The individual's report of dull as sharp on the palmar surface of the thumb and index finger suggests hypersensitivity along the median nerve distribution. This is because the median nerve innervates the thumb and index fingers, and the abnormal sensation indicates an exaggerated response to sharp stimuli in this area. The other options, such as impaired for pain along C5 and C6 dermatomes or hypersensitivity along the ulnar nerve distribution, do not accurately explain the individual's specific sensory findings.
26.
A patient who is status-post left frontal lobe ischemia has difficulty bearing weight through the right lower extremity during reaching activities (e.g. standing at a sink during morning self-care routine). The occupational therapist implements a Motor Relearning Program (MRP). Which is the bet intervention for the therapist to provide according to this approach?
Correct Answer
D. Verbal and visual feedback while practicing reaching
Explanation
The Motor Relearning Program (MRP) focuses on retraining the central nervous system to improve motor function. Providing verbal and visual feedback while practicing reaching activities helps the patient to better understand and integrate sensory information, enhancing their motor learning and performance. This intervention can improve the patient's ability to bear weight through the right lower extremity and perform reaching activities more effectively. Therapeutic handling, a stool to sit on, and joint compression may have their own benefits but they are not specific to the MRP approach in addressing the patient's difficulty.
27.
An individual recovering from a head trauma exhibits a motor pattern indicative of being influenced by symmetrical tonic neck reflex (STNR). Which is most likely for the occupational therapist to observe the client having difficulty with during functional mobility?
Correct Answer
B. Moving from lying supine to sitting
Explanation
The symmetrical tonic neck reflex (STNR) is a primitive reflex that is typically present in infants and should disappear by the age of 6-9 months. This reflex is characterized by the extension of the head causing the arms to straighten and the legs to flex, and the flexion of the head causing the arms to bend and the legs to extend. In the case of an individual recovering from a head trauma, the presence of the STNR can interfere with functional mobility, particularly when transitioning from lying supine to sitting. This is because the extension of the head during this movement can cause the arms to straighten, making it difficult for the individual to lift themselves into a sitting position.
28.
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?
Correct Answer
A. Firm seats are needed to provide stability
Explanation
Firm seats are needed to provide stability because they offer better support and prevent individuals from sliding or falling out of the wheelchair. The firmness of the seat helps distribute the weight evenly, ensuring proper balance and stability for the user. This is especially important for individuals with central nervous system dysfunction who may have limited control over their body movements. A firm seat also promotes proper posture and alignment, reducing the risk of developing musculoskeletal issues.
29.
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?
Correct Answer
A. Proprioception
Explanation
Given that the injury is to the anterior spinal artery at the T12 level, it is likely that the individual has retained proprioception. Proprioception refers to the sense of the position and movement of our body parts. The anterior spinal artery supplies blood to the anterior part of the spinal cord, which includes the pathways responsible for proprioception. Therefore, despite the injury, the individual may still have intact proprioceptive sensation.
30.
An individual recently had a left transfemoral amputation as a result of complications of diabetes. The client is 2 years status-post a right transtibial amputation as a result of same precipitant. The client is referred to OT for preprosthetic interventions. The referral notes that the complications of neuromas and phantom limb pain are present in left residual limb. Which intervention is best for occupational therapist to implement during first session?
Correct Answer
C. Upper extremity strengthening with empHasis on the triceps
Explanation
The client has complications of neuromas and phantom limb pain in the left residual limb. These complications are specific to the lower extremity. Therefore, the best intervention for the occupational therapist to implement during the first session would be upper extremity strengthening with emphasis on the triceps. This intervention focuses on the upper extremities, which are not affected by the complications in the lower extremity.
31.
During an intervention session, a client complains of dry mouth due to prescribed medications. What is the most effective strategy for the occupational therapist to suggest to the client to manage this side effect?
Correct Answer
D. Sip water
Explanation
Sipping water is the most effective strategy for managing dry mouth caused by prescribed medications. Water helps to hydrate the mouth and stimulate saliva production, providing relief from dryness. Sucking on ice or hard candies may provide temporary relief, but they do not address the underlying issue of dehydration. Drinking iced tea may actually worsen dry mouth due to its diuretic effect. Therefore, sipping water is the best recommendation to manage this side effect.
32.
An adult with persistent balance difficulty and a history of recent falls (two in the last 3 months) receives home care occupational therapy services. During the initial session, which client factors are most important for the occupational therapist to consider?
Correct Answer
D. Sensory functions and sensory organization of balance
Explanation
The most important client factors for the occupational therapist to consider in this scenario are sensory functions and sensory organization of balance. This is because the client has persistent balance difficulty and a history of recent falls, indicating a potential issue with their balance and coordination. By assessing their sensory functions and sensory organization of balance, the occupational therapist can identify any sensory deficits or impairments that may be contributing to their balance difficulties. This information will then guide the development of an appropriate treatment plan to address these specific issues and improve the client's balance and overall functional mobility.
33.
An individual with moderate intellectual disability moves into a group home. An initial goal established for the resident is the development of socially acceptable table manners. The occupational 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?
Correct Answer
D. Rewards for socially appropriate behaviors
Explanation
The best intervention technique for the therapist to include in the design of the group home dining experience is rewards for socially appropriate behaviors. By providing rewards for socially acceptable table manners, the therapist can reinforce and encourage the resident to engage in these desired behaviors. This positive reinforcement approach will motivate the individual to develop and maintain socially acceptable table manners, ultimately achieving the goal of the intervention.
34.
An elementary school teacher has been recently diagnosed with multiple sclerosis (MS). Which adaptation is best for the occupational therapist to recommend the teacher use to accommodate for effects of MS on classroom teaching?
Correct Answer
D. High stool to compensate for LE weakness
Explanation
The best adaptation for the occupational therapist to recommend the teacher use to accommodate for the effects of MS on classroom teaching is a high stool to compensate for lower extremity (LE) weakness. This would provide support and stability for the teacher while reducing the strain on their legs, allowing them to continue teaching while minimizing the impact of their weakness. Large print written material would be more suitable for visual impairments, a daily list of tasks for cognitive deficits, and a motorized scooter for decreased endurance.
35.
An occupational therapist plans individual and group activities for a child with oppositional defiant disorder. Which is most important for the therapist to address during group activities?
Correct Answer
B. Child's ability to attend to complete a task
Explanation
The most important aspect for the therapist to address during group activities for a child with oppositional defiant disorder is their ability to attend to complete a task. This is crucial because children with this disorder often struggle with staying focused and completing tasks, which can hinder their participation and progress in group activities. By addressing and improving their ability to attend and complete tasks, the therapist can help the child engage effectively in the group activities and enhance their overall development and functioning.
36.
An individual with spinal cord injury at C7 reports noticeable 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 client’s observations?
Correct Answer
A. Integrate weight shifting into daily activities
Explanation
Integrate weight shifting into daily activities. This is the most effective action to recommend because weight shifting helps to relieve pressure on the ischial tuberosity, which can prevent the development of pressure ulcers. By incorporating weight shifting into daily activities, the individual can regularly relieve pressure on the affected area, reducing the risk of skin breakdown and promoting overall skin health. This recommendation is based on the understanding that pressure ulcers are a common complication for individuals with spinal cord injury, particularly at the ischial tuberosity, and that regular weight shifting is a key preventative measure.
37.
In an acute inpatient psychiatric facility, an occupational therapist designs a therapeutic activity group for individuals with poor orientation to reality. What is the best activity choice for therapist to provide in this group?
Correct Answer
B. The assembly of wooden toys for a children’s unit
Explanation
The assembly of wooden toys for a children's unit would be the best activity choice for individuals with poor orientation to reality in an acute inpatient psychiatric facility. This activity provides a concrete and tangible task that can help individuals focus and engage in a meaningful way. It also allows for the development of fine motor skills and can provide a sense of accomplishment and satisfaction. Additionally, working with toys designed for children can evoke positive emotions and memories, which can help improve mood and overall well-being.
38.
The occupational therapist administers the Allen Cognitive Level (ACL) Screen to an individual. During this evaluation, the most complex behavior the individual can perform is to do the three running stitches, imitating the therapist’s example. Based upon these results, the therapist selects an activity to use for intervention that is consistent with the individual’s functional level. According to the Cognitive Disabilities Model, which activity is best for the therapist to use when implementing intervention with this patient?
Correct Answer
C. Sanding wooden bookends
Explanation
Based on the information provided, the individual's most complex behavior is imitating the therapist's example of doing three running stitches. This suggests that the individual has a moderate cognitive impairment and is at a lower functional level. Sanding wooden bookends would be the most appropriate activity for intervention because it requires a moderate level of cognitive ability and motor skills. The other activities listed, such as sorting laundry and planning a three-course meal, may be too complex for the individual's current cognitive level.
39.
An adult with arthritis of both hands has ulnar drift of myofascial pain syndrome (MPS) during finger extension and flexion and at rest. The patient also has lengthening of the central slips of the extensor digitorum communis tendons of the right index and middle fingers. Which of the following should the occupational therapist report the person is exhibiting?
Correct Answer
D. Boutonniere deformities
Explanation
The occupational therapist should report that the person is exhibiting Boutonniere deformities. This is indicated by the ulnar drift of myofascial pain syndrome during finger extension and flexion and at rest, as well as the lengthening of the central slips of the extensor digitorum communis tendons of the right index and middle fingers. Boutonniere deformities occur when there is a flexion deformity at the proximal interphalangeal joint and hyperextension at the distal interphalangeal joint.
40.
An occupational therapist provides services to a homeless shelter, which includes residents who are HIV positive. The therapist conducts several activity groups. Which should the therapist do while working with this population?
Correct Answer
A. Wash hands before and after each group session
Explanation
The therapist should wash their hands before and after each group session when working with a population that includes residents who are HIV positive. This is important to maintain proper hygiene and prevent the spread of any potential infections or diseases. By washing their hands, the therapist can minimize the risk of transmitting any pathogens and ensure the safety and well-being of both themselves and the residents. Wearing latex gloves during groups or when handling food may not be necessary unless there is a specific reason to do so, and implementing transmission-based precautions may not be needed unless there is a known risk of transmission.
41.
A person recovering from skin grafting due to full thickness burns is prescribed splints to immobilize the grafted areas in anti-deformity positions. Which splint-wearing schedule is best to include in splinting protocol for first 72 hours post-surgery?
Correct Answer
D. On at all times, except for dressing changes
Explanation
After skin grafting surgery, it is important to keep the grafted areas immobilized in anti-deformity positions to promote proper healing and prevent complications. The best splint-wearing schedule for the first 72 hours post-surgery is to keep the splints on at all times, except for dressing changes. This means that the splints should be worn continuously to provide constant support and protection to the grafted areas, except when they need to be temporarily removed for dressing changes to ensure proper wound care. This schedule allows for consistent immobilization and minimizes the risk of deformities or complications during the initial healing period.
42.
An elementary school student is referred to occupational therapy to improve fine motor skills. The student is having difficulty drawing simple shapes (i.e. circle, square, and triangle) and cutting a straight line with scissors. Which of the following activities is best to help develop the arches of the hand and increase hand strength to improve the student’s ability to grasp a writing utensil or scissors?
Correct Answer
D. Chair push-ups before tabletop activities
43.
An elder with peripheral neuropathies resulting from the chronic effects of diabetes expresses concern over the ability to have a satisfying sexual relationship with a partner. Which is the most beneficial recommendation for the occupational therapist to make to the elder?
Correct Answer
B. Focus on intact senses and areas of intact sensation
Explanation
The most beneficial recommendation for the occupational therapist to make to the elder is to focus on intact senses and areas of intact sensation. This suggestion acknowledges the concerns of the elder while also providing a practical solution. By focusing on areas of the body that still have sensation, the elder can explore different ways to experience pleasure and maintain a satisfying sexual relationship with their partner. This recommendation takes into account the specific challenges posed by peripheral neuropathies resulting from diabetes and offers a proactive approach to addressing the elder's concerns.
44.
A client with chronic depression and a spouse attend a discharge meeting with the occupational therapist following the client’s six-week hospitalization for a major depressive episode. They state that they have few activities in common and spend little time together. The client retired two months ago and the spouse continues to work full time. Which of the following should the therapist encourage this couple to do first to address this concern?
Correct Answer
C. Explore activities enjoyed together and alone
Explanation
The therapist should encourage the couple to explore activities that they can enjoy both together and individually. This will help them to find common interests and also have their own personal hobbies, which can improve their overall relationship and well-being. It is important for them to have a balance between shared activities and individual pursuits, especially considering the client's recent retirement and the spouse's full-time work. Delaying planning activities until the depression is resolved may not be beneficial as engaging in enjoyable activities can actually aid in the recovery process.
45.
A seven-year-old child with spina bifida at the C7 level receives home-based occupational therapy services. Which ability is most relevant for occupational therapist to focus on during intervention?
Correct Answer
A. Dressing lower body
Explanation
Given that the child has spina bifida at the C7 level, which affects the lower body, it is most relevant for the occupational therapist to focus on dressing the lower body during intervention. Spina bifida at this level can result in paralysis or weakness in the lower limbs, making it challenging for the child to independently dress their lower body. By addressing this ability, the occupational therapist can help the child gain independence and improve their overall functional skills.
46.
An occupational therapist implements an activity program at a hospital that provides long-term care to elderly persons with severe and persistent mental illnesses (SPMI). The occupational therapist uses a sensorimotor approach to guide the program design. Which activity is best for the therapist to incorporate into a group?
Correct Answer
D. Keeping balloons afloat while music plays
Explanation
The activity of keeping balloons afloat while music plays is the best choice for the occupational therapist to incorporate into a group. This activity engages both the sensorimotor skills and the cognitive abilities of the elderly persons with severe and persistent mental illnesses. It requires hand-eye coordination and physical movement to keep the balloons in the air, while also providing auditory stimulation through the music. Additionally, the activity promotes social interaction and group participation, which can have therapeutic benefits for the individuals in the long-term care setting.
47.
An individual with a body mass index (BMI) of 35 is joining a community-based wellness program conducted by an occupational therapist. When formulating an individualized wellness plan, which condition should the occupational therapist take into consideration as an increased risk for this person?
Correct Answer
B. Hyperthermia during exertion
Explanation
An individual with a BMI of 35 is considered obese, which puts them at an increased risk of hyperthermia during exertion. Obesity can impair the body's ability to regulate temperature, leading to overheating during physical activity. This can be dangerous and potentially lead to heat-related illnesses such as heat exhaustion or heat stroke. Therefore, the occupational therapist should consider hyperthermia during exertion as an increased risk for this person when formulating their wellness plan.
48.
The client is now seven weeks postoperation. Which are the most appropriate intervention activities for the occupational therapist to use with this client?
Correct Answer
B. Light activities of daily living such as grooming
Explanation
The client is now seven weeks postoperation, indicating that they have had enough time to recover and regain some level of function. Light activities of daily living, such as grooming, are appropriate intervention activities for the occupational therapist to use with this client at this stage. These activities will help the client regain independence and improve their functional abilities. Home management activities such as doing laundry may still be too physically demanding, while strengthening exercises using high resistance theraband and passive exercises using a dynamic splint may not be necessary or appropriate at this point in the client's recovery.
49.
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 child?
Correct Answer
B. Cutting complex figure shapes
Explanation
The child with developmental delay has already mastered cutting simple figure shapes with scissors. To further challenge and develop their skills, the occupational therapist should introduce cutting complex figure shapes. This will help the child improve their fine motor skills, hand-eye coordination, and problem-solving abilities. By gradually increasing the difficulty level, the therapist can support the child's progress and promote their overall development in scissor skills.
50.
An occupational therapist meets with the patient with fibromyalgia who has had difficulty meeting intervention goals. The patient complains of being hurt and frustrated in attempts to resolve pain and fatigue issues. Which is the most effective technique for the therapist to use to help patient increase insight into this situation?
Correct Answer
B. Reflect the patient's verbal expressions back to the patient
Explanation
Reflecting the patient's verbal expressions back to the patient is the most effective technique for the therapist to use to help increase the patient's insight into the situation. By doing so, the therapist validates the patient's feelings and experiences, showing empathy and understanding. This technique can help the patient feel heard and understood, which can contribute to building a therapeutic relationship and increasing insight into their pain and fatigue issues. Offering a variety of options for pain management, referring the patient to a specialized pain management center, and repeating the patient's exact words back to them may also be helpful strategies, but reflecting the patient's verbal expressions back to them is the most effective technique in this context.