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Quiz Session - Attempts With Random Questions

NBCOT COTA Exam Questions

Page 3 of 40

41.

If a therapist is working to fit a patient with an orthosis that will assist with anti-contracture positioning, what would be an ideal preparatory activity?

  • Discussing the wearing schedule and care for the orthosis

  • Strengthening exercises

  • Coordination exercises

  • Having the patient choose the orthosis color

Correct answer: Discussing the wearing schedule and care for the orthosis

The therapist should educate the patient as to the orthosis' wearing schedule, how to care for the device, and how to don/doff the device. This is not only an appropriate preparatory activity for someone about to receive an orthosis, but it's imperative for success with the device.

Strengthening exercises are not indicated to assist with managing contractures, so this would not be a recommended preparatory activity. Coordination exercises are also not typically indicated to help manage contractures, so this would not be a recommended preparatory activity. Having the patient choose the orthosis color may or may not be possible, based on the facility's resources, but this is not considered a preparatory activity, as it serves no functional purpose.

42.

A therapist is making handouts to remind patients of their precautions after an anterolateral hip replacement. Which of the following should the therapist NOT include?

  • No hip flexion greater than 90 degrees

  • No external rotation

  • No hip extension

  • No movement restrictions

Correct answer: No hip flexion greater than 90 degrees

"No hip flexion greater than 90 degrees" is a hip precaution of the posterolateral approach to a hip replacement.

For an anterolateral hip replacement, precautions may vary. Some surgeons do not use hip precautions, and others have patients refrain from hip external rotation and hip extension.

43.

A therapist is treating a patient who was recently diagnosed with dementia after several months of increasing confusion and memory loss. The therapist doesn't have experience working with this population. She knows home modifications can help but is unsure where to start. 

What home modification should be a priority for this patient?

  • Remove items that may be dangerous

  • Use contrasting colors

  • Install door alarms

  • Move the patient to a safer environment

Correct answer: Remove items that may be dangerous

The first home modification should be to remove items that may be dangerous from the home. If an individual is confused or forgetful, it is important to set up the home so that the patient will be less likely to hurt themselves or others. This may include removing or locking away medicines, chemicals, knives, matches, stove knobs, etc.

Adding contrasting colors is a useful home modification for preventing falls, but this is not as important as removing dangerous items from the home. Door alarms are a good modification to make next, but removing dangerous items is still the priority for this patient. Moving the patient to a safer environment is a potential option for someone with dementia; however, this is only recommended if social supports are largely missing or if the patient's current environment is too unsafe to remedy.

44.

An OTA is trying to develop activities to address the fine pincer grasp of a one-year-old child. What activity is MOST suitable for this?

  • Peeling a sticker

  • Using tongs to move cotton balls

  • Pressing buttons

  • Holding a 5" bead

Correct answer: Peeling a sticker

Peeling a sticker requires opposition of the thumb DIP and another finger tip.

The other activities do not require this grasp and are more advanced, so they are more suitable for older children.

45.

A COTA is working alongside an OTR to fabricate an ulnar drift orthosis for a new patient. What aspects of education should the providers offer to this patient?

Select the three BEST responses.

  • Functional training in orthosis use, including donning and doffing

  • Wearing schedule

  • Performing skin checks

  • Making changes to the orthosis

  • Decorating the orthosis

  • Adding dynamic components to the orthosis

Upon getting a new or adjusted orthosis, all patients (and their caregivers or family, if needed) should be trained in functional use of the orthosis throughout typical daily tasks, including putting the orthosis on and taking it off properly. Patients should also understand the wearing schedule, including how long to wear the orthosis, wearing it in the shower, wearing it at night, and more. Patients and other relevant parties should also know how to perform skin checks to ensure proper hygiene and safety.

Patients should not be instructed how to make changes to the orthosis or add dynamic components to the orthosis, since these both require clinical decision-making and oversight from an OT provider. Patients should also not decorate their orthosis since this can have an impact on hygiene.

46.

Which type of splint is indicated for a flexor tendon injury?

  • Dorsal protection splint

  • Buttonhole splint

  • PIP extension splint

  • Cone splint

Correct answer: Dorsal protection splint

A dorsal protection splint, which is fabricated with the thermoplast on the dorsal side of the arm, is indicated for a flexor tendon injury.

A buttonhole splint (or silver ring) is intended to minimize the PIP hyperextension that results from a swan neck deformity. A PIP extension splint (or silver ring) is intended to minimize the PIP flexion and DIP hyperextension that results from a boutonniere deformity. A cone splint is best suited for spasticity of the hand.

47.

What is an example of pragmatic reasoning in the OT field?

  • Ensuring OT treatment adheres to all relevant legislation

  • Relaying all the risks and benefits of a certain intervention to a patient before providing that treatment

  • Completing an occupational profile to gain insight into your patient's life

  • Using standardized assessments during the evaluation process

Correct answer: Ensuring OT treatment adheres to all relevant legislation

Pragmatic reasoning is defined as the real-world implications that relate to practice. Legislation is a consideration all therapists must be aware of, so ensuring their practice adheres to all regulations is a perfect example of pragmatic reasoning.

If a therapist were to relay risks, benefits, and other objective information about an intervention before providing it, this would be an example of ethical reasoning. This takes the morality of practice into account. Completing an occupational profile to get a better idea of a patient's perspective is an example of interactive reasoning. This covers the relational aspect of OT. Using standardized assessments is an example of procedural reasoning, since this entails the "doing" aspect of OT work.

48.

If a COTA were to participate in program planning, what steps would they need to take?

Select the three BEST responses.

  • Conduct a needs assessment

  • Define the program focus based on assessment results

  • Choose frames of reference to structure the program

  • Support open communication

  • Engage in team-building efforts

  • Form a mission statement

Before planning a program, it's important to conduct a needs assessment. The results of the needs assessment will be used to inform the first step of program planning, which involves determining a focus for the program. The second step of program planning is adopting one or more frames of reference to help address the program focus and meet its members' needs.

While teamwork and open communication are important, they do not describe action items used to help with program planning. Forming a mission statement is more important when starting a business rather than launching a program, so that is not correct.

49.

An OTA is treating a 31-year-old woman for a deep partial-thickness burn to the anterior neck. Their OTR instructs them to educate the patient on anti-contracture positioning. How should the OTA place the patient in bed after their visit?

Select the three BEST responses.

  • Use half-mattress to allow for neck extension

  • Remove pillows from behind the head

  • Leave them with a neck collar or neck extension splint

  • Place them in sidelying with a pillow under their head

  • Place them prone with a pillow on their stomach

  • Keep them upright in a chair to avoid pressure on the neck

Patients with an anterior neck burn should use a half-mattress to allow for neck extension and remove pillows from behind the head, since this can cause further skin irritation. OTAs should also provide patients with a neck collar to assist in maintaining this position. 

The other recommendations do not prevent contractures and can cause more irritation. They also don't allow the patient to be in a functional position.

50.

Splinting is intended to do all the following EXCEPT:

  • Decrease range of motion

  • Provide a position of rest

  • Reduce risk of contracture and injury

  • Promote optimal use for daily tasks

Correct answer: Decrease range of motion

Splinting is intended to improve and maintain joint range of motion, not decrease it.

The other options all describe appropriate splinting use. In some instances, such as repetitive use injuries, splinting is used to maintain a resting position to decrease symptoms and inflammation. Splinting is commonly used to reduce the risk of contractures following injuries such as burns. The goal of splinting is to maintain or increase a joint's range of motion to improve use of the affected part for functional daily activities.

51.

A patient who had a heart attack three months ago has now reached the third and final stage of cardiopulmonary rehabilitation. What OT goals will now be the focus of treatment?

  • Encouraging reentry to IADLs and work

  • Building endurance for walking outdoors

  • Offering education on MET levels and energy conservation

  • Improving independence with ADLs

Correct answer: Encouraging reentry to IADLs and work

The final stage of cardiopulmonary rehabilitation is focused on helping patients maintain the endurance and strength they have built through the cardiac rehab program. Clinicians can also assist with guiding patients in returning to desired activities such as IADLs, work, and hobbies.

The other options are all goals for the initial stages of cardiac rehab, as they are more basic needs.

52.

An OTA is educating a patient in safe transfers. What type of transfer is described when a patient may or may not use an assistive device to rise, turn in another direction, and sit down?

  • Stand-pivot transfer

  • Pop-over transfer

  • Sliding board transfer

  • Mechanical lift transfer

Correct answer: Stand-pivot transfer

A stand-pivot transfer involves transitioning from sit to stand, then turning toward the new surface and returning to sitting.

A pop-over transfer typically involves grasping the handrails of a chair and transferring to the new surface without fully standing. Typically, no assistive device is used.

A sliding board transfer uses a sliding board placed between two surfaces, which the patient uses to slide across and over to the new surface. 

A mechanical lift transfer uses a device such as a Hoyer lift and dependently transfers a patient to another surface.

53.

What is NOT an appropriate strategy to improve sleep quality?

  • Sleep in on weekends

  • Use light-blocking curtains

  • Go to sleep when you feel tired

  • Do not watch TV in the bedroom

Correct answer: Sleep in on weekends

In order to improve sleep habits, the therapist can educate the client about sleep restriction training. This means the individual should develop a consistent wake-up time and should avoid sleeping in on the weekends or napping during the day. 

Light-blocking curtains may be appropriate to achieve a darker environment, and the therapist should recommend removing (or not using) the TV in the bedroom. The therapist should also provide instructions to simply go to bed when one is feeling tired.

54.

If a person overtly engages in trial-and-error thinking along with problem solving to learn new things, what level are they according to Claudia Allen's Cognitive Disabilities Model?

  • Level V - Exploratory Actions

  • Level III - Manual Actions

  • Level IV - Goal-Directed Actions

Correct answer: Level V - Exploratory Actions

At level five, a person uses trial-and-error and problem solving to engage in the learning process for new concepts. 

At level three, a person begins to use their hands to interact with objects and will begin to perform different tasks after receiving long-term training focused on repetition. At level four, a person has established routines and struggles to cope with new or unfamiliar events. Someone at this level can also carry out simple tasks from start to finish, though they rely heavily on visual cues to do so.

55.

Which type of amputation involves removing the entire finger (distal to metacarpal)?

  • Ray amputation

  • Hemipelvectomy

  • Forequarter amputation

  • Syme's amputation

Correct answer: Ray amputation

A hemipelvectomy involves removing the entire leg as well as half of the pelvis. 

A forequarter amputation includes the entire arm as well as the clavicle and scapula.

Syme's amputation involves amputating the foot at the point of the ankle.

56.

What phase of disability adjustment is characterized by decreased verbal communication and physical ability?

  • Shock

  • Anxiety

  • Denial

  • Externalized anger

Correct answer: Shock

Shock is the first response an individual exhibits to a traumatic event and may involve decreased verbal communication and physical ability.

The anxiety phase involves a rising understanding of how significant the event or disability is. Anxiety is accompanied by racing thoughts and nervousness. Denial involves an individual downplaying how significant the event or disability is, as well as developing high expectations that may not be achievable. Externalized anger involves negative behavioral changes toward others in response to the event.

57.

All the cranial nerves go to the head and neck EXCEPT which one?

  • Cranial Nerve 10

  • Cranial Nerve 6

  • Cranial Nerve 9

  • Cranial Nerve 11

Correct answer: Cranial Nerve 10

The tenth cranial nerve is the vagus nerve, which goes down to the thorax and abdomen to provide innervation to the stomach and other digestive organs. 

Each of the other nerves remains within the head and neck.

58.

When completing a wheelchair assessment, what part of the body should be measured first?

  • Pelvis

  • Lower body

  • Trunk/torso

Correct answer: Pelvis

The correct order for measuring body parts to fit someone for a wheelchair is as follows: pelvis, lower extremities, trunk/torso, upper extremities, head/neck, and feet. This sequence is recommended because patients must have proximal stability before they can achieve distal mobility.

59.

An adult is demonstrating minimal alertness and the OTA checks their heart rate to determine if they need help. What heart rate would indicate the patient is bradycardic?

  • 52 beats per minute

  • 60 beats per minute

  • 65 beats per minute

  • 80 beats per minute

Correct answer: 52 beats per minute

Bradycardia is indicated when an individual exhibits a heart rate of less than 60 beats per minute. The normal range for heart rate in adults is 60-100 beats per minute.

60.

The occupational therapist is assisting with splinting for a patient with rheumatoid arthritis deformities in the hand. Which deformity of rheumatoid arthritis results in PIP flexion and DIP hyperextension?

  • Boutonniere deformity

  • Swan neck deformity

  • Ulnar deviation

  • Heberden's nodes

Correct answer: Boutonniere deformity

A boutonniere deformity is characterized by PIP flexion and DIP hyperextension.

A swan neck deformity is characterized by PIP hyperextension and DIP flexion.

Ulnar deviation involves gravitation and shift of the hand toward the ulnar side of the wrist due to MCP and wrist subluxation.

Heberden's nodes are bone spurs located on a digit's DIP, which are more common in osteoarthritis.

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