Evaluation and Interventions
A religious congregation obtained private funding to build a ramp so that members with disabilities can attend services. The entrance to the congregation’s building has six steps with a rise of 7 inches each. Which is best for the OT hired by the congestion to recommend for construction of this ramp?
A. 42 feet long with a 3’ x 3’ landing at the ramp’s midpoint
B. 48 feet long with a 3’ x 3; landing at the ramps midpoint
C. 48 feet long with a 5’ x 5’ landing at the ramps midpoint
D. 42 feet long with a 5’ x 5’ landing at the ramps midpoint
D. 42 feet long with a 5’ x 5’ landing at the ramps midpoint
A child with spastic quadriplegic cerebral palsy has increased tone and flexor synergies in both upper extremities. The child receives Botox injections into both biceps. In designing play activities to use during intervention, which is most important for the OT to include as an activity performance characteristic?
A. Reaching overhead and to both sides in supine
B. Bilateral upper extremity weight bearing in sitting and prone
C. Grasp and release of objects in supported sitting
D. Transitions into and out of sitting, supine, and prone
B. Bilateral upper extremity weight bearing in sitting and prone
The OT administers the Allen Cognitive Level 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 on 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?
A. Sorting laundry by matching the colors of clothing items
B. Exercises that require the imitation of another’s posture
C. Sanding wooden bookends
D. Planning a three-course meal
C. Sanding wooden bookends
A caregiver support group meets weekly at a community 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 occupational therapist to take to facilitate the individual’s engagement in the group?
A. Refer the individual to the center’s social worker for individual, nongroup counseling
B. Invite the individual to join in the discussion if the person would like
C. Ask the individual several questions to encourage verbal participation
D. Reiterate the group’s norms that active participation is expected from all group members
B. Invite the individual to join in the discussion if the person would like
An individual with bilateral knee replacements and cataracts is newly admitted to a SNF. The individual retains some residual vision. During the initial evaluation, which is the most effective placement for the occupational therapist to use when presenting materials to the person?
A. To the side of the person, no direct lighting
B. Directly in front of the person, at tabletop level
C. Directly in front of the person at eye level
D. To the side of the person, with strong direct light
A. To the side of the person, no direct lighting
An OT advises the parent of an 18-month with developmental delays on techniques to facilitate feeding. The child has a reflexive bite. Which utensil is most beneficial for the therapist to recommend the parent use when feeding the child?
A. A deep-bowled soup spoon
B. A traditional teaspoon
C. A narrow shallow coated spoon
D. A plastic spork
C. A narrow shallow coated spoon
A person with a traumatic brain injury is assessed to score a 6 on the Glasgow Coma Scale. Which should the OT use to initiate intervention with this person?
A. Demonstrated directions
B. Sensory stimulation
C. Hand-over-hand assistance
D. Verbal cues
B. Sensory stimulation
A home care OT plans intervention for an individual with agoraphobia with panic attacks. The OT plans to use a cognitive-behavioral approach. Which approach is best for the therapist to use with the client during the initial intervention session?
A. A token reward system
B. Behavioral extinction
C. Relaxation techniques
D. Systematic desensitization
C. Relaxation techniques
Several adolescents with behavior problems attend a school-based after-school program. They work at an egocentric-cooperative level in a group dealing with issues related to school performance and peer pressure. Which of the following would be most likely for the OT to observe the participants doing in the group?
A. Focusing on the group tasks rather than the feelings of the participants
B. Actively taking on roles such as energizer, coordinator, or opinion giver
C. Making decisions with minimal to no supervision from the group leader
A. Focusing on the group tasks rather than the feelings of the participants
A 6-year old child has thumb weakness that is most evident in the child’s poor ability to perform thumb opposition. During evaluation, which activity will the therapist most likely observe the child having difficulty performing?
A. Separating two pieces of paper
B. Picking up coins
C. Turning a pencil over to erase
D. Rolling a piece of clay into a ball
C. Turning a pencil over to erase
A woman with a complete spinal cord injury at the C5 level has given birth to her first child. The client seeks suggestions on methods to facilitate independent and safe parenting. Which of the following is most beneficial for the OT to recommend the mother use to independently feed her child?
A. Bottles with premeasured formula
B. A sling to support the infants head during breastfeeding
C. Bottles that have molded easy to grip shapes
D. A pillow to support the mother’s arm during breast feeding
D. A pillow to support the mother’s arm during breast feeding
A preschool aged child is hypersensitive to touch. The OT decides to use the SI frame of reference to help the child develop the ability to adequately modulate sensory stimuli. Which technique is best for the therapist to use initially with this child?
A. Firm pressure where the child can see the source of the stimuli
B. Lightly moving touch to the child’s abdomen and the extremities
C. Quick icing where the child cannot see the source of the stimuli
D. Fast brushing to the child’s arms in a direction opposite of hair growth
A. Firm pressure where the child can see the source of the stimuli
An OT implements an activity program at a hospital that provides long-term care to older adults with serious mental illnesses. The OT uses a sensorimotor approach to guide the program design. Which activity is best for the therapist to incorporate into a group?
A. Line dancing using pictures of feet on the floor as visual for dance steps
B. Keeping balloons afloat while music plays
C. Exercising along with a video routine
D. A sing-along using songbooks and recorded music
B. Keeping balloons afloat while music plays
To develop social interaction skills, an OT implements a group program for students with autism spectrum disorder. Which group is best for the therapist to include in this program?
A. Topical group
B. Developmental group
C. Directive group
D. Task-oriented group
B. Developmental group
An occupational therapist provides intervention to develop independent feeding skills in an 18-month-old child with significant developmental delays. The child has mastered the ability to hold a spoon and bang in on the tray of the high chair. The child can also hold and suck on a cracker. Which activity is best for the therapist to provide next during intervention?
A. Scooping food and bringing it to the mouth
B. Bringing a filled spoon to the mouth
C. Finger-feeding soft foods
D. Taking cereal from a spoon held by the therapist
C. Finger-feeding soft foods
An elementary school teacher has been recently diagnosed with multiple sclerosis (MS). Which adaptation is best for the OT to recommend the teacher to use to accommodate for the effects of MS on classroom teaching?
A. The use of anchoring techniques to compensate for scanning deficits
B. A daily list of tasks to compensate for cognitive deficits
C. A high stool to compensate for lower extremity weakness
D. A motorized scooter to compensate for decreased endurance
C. A high stool to compensate for lower extremity weakness
An adolescent incurred a spinal cord injury at the C6 level. During a family caregiver education session, the OT instructs family members in the provision of passive range of motion to the patient’s wrist and fingers. Which method of PROM should the therapist teach the family members to perform?
A. Flex and extend the fingers with the wrist in a neutral position
B. Flex the fingers with wrist extension and extend the fingers with wrist flexion
C. Flex the fingers with the wrist flexed
D. Extend the fingers with the wrist extended
B. Flex the fingers with wrist extension and extend the fingers with wrist flexion
An OT plans a task-oriented activity group for adolescents recently diagnosed with anorexia nervosa. Which is the best activity for the therapist to include in the initial session of this group?
A. Composing lyrics and melody for a group song
B. Performing low impact aerobic exercises
C. Baking cookies for the residents in a homeless shelter
D. Making cards to send to veterans in a local hospital
A. Composing lyrics and melody for a group song
An individual with borderline personality disorder is admitted to the hospital following a suicide attempt. After attending an occupational therapy orientation group, the patient tells the OT, “ You are the only therapist who has ever been really helpful.” The patient asks to meet with the therapist privately on a regular basis instead of the assigned primary individual therapist. Which action is best for the therapist to take in response to the patient’s request?
A. Agree to meet with the patient since a positive therapeutic connection has been expressed
B. Refer the patient to the assigned primary individual therapist
C. Tell that patient that an OT provides only occupation-based group treatment
D. Explain that this type of manipulative behavior is not acceptable
B. Refer the patient to the assigned primary individual therapist
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 OT take in response to these statements?
A. Document objective data about the complaints in the person’s chart
B. Notify the client’s primary care physician that the person exhibited evidence of paranoia
C. Notify the primary care physician that the person may need an audiological evaluation
D. Collaborate with the program director to remove groups from the client’s program plan
C. Notify the primary care physician that the person may need an audiological evaluation
An OT measures a person for a wheelchair. 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 dimension should the therapist recommend?
A. 16 inches wide by 18 inches deep
B. 18 inches wide by 18 inches deep
C. 18 inches wide by 20 inches deep
D. 18 inches wide by 16 inches deep
D. 18 inches wide by 16 inches deep
During a home visit, a client who had incurred a CVA reports difficulty finding objects during BADL and IADL. The client reports that the directions family members provide (e.g., look on the refrigerator’s door, look in the medicine cabinet) are not helpful. Which cognitive perceptual ability should the OT further evaluate?
A. Organization
B. Stereognosis
C. Visual closure
D. Spatial relations
C. Visual closure
In an acute inpatient psychiatric facility, an OT designs a therapeutic activity group for individuals with poor orientation to reality. Which is the best activity choice for the therapist to provide to this group?
A. Structured verbalizations of personal assets and limitations
B. The assembly of wooden toys for a children’s unit
C. Guided imagery for stress management
D. A discussion of the effects of hospitalization on occupational roles
B. The assembly of wooden toys for a children’s unit
An occupational therapist and a COTA co-lead a work adjustment group. One member has become progressively more dependent on the COTA for directions, praise, and input throughout the group activities. Which action should the group leaders initially take in response to these behaviors?
A. Inform the attending psychiatrist that the group member is exhibiting signs of dependency and transference
B. Have another therapist co-lead the group with the occupational therapist and reassign the COTA to another group
C. Schedule several individual session with the COTA and group member to examine the issues of dependency and transference
D. Have the COTA work with the person during group sessions to develop independence in task completion
D. Have the COTA work with the person during group sessions to develop independence in task completion
An OT works in a school system with a child with developmental delays. One of the goals of treatment is to develop prewriting 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 be the focus for the implementation of intervention?
A. Palmar supinate grasp
B. Static tripod grasp
C. Digital prone grasp
D. Dynamic tripod grasp
D. Dynamic tripod grasp