×

Quiz Session - Attempts With Random Questions

NBCOT COTA Exam Questions

Page 4 of 40

61.

An 81-year-old female presents to OT with worsening osteoarthritis that is preventing her from safely bathing. An OTR completed a home assessment and found that adaptive equipment is the best option for this patient. What adaptive equipment might an OTA recommend for this ADL?

Select the three BEST responses.

  • Anti-scald valves

  • Non-skid mats

  • Shower bench

  • Angled dish

  • Rocker knife

  • Suction-cup dish

Some DME that can assist with showering include grab bars, non-skid mats, tub benches, shower chairs, handheld showers, antiscald valves, long-handled sponges, and soap-on-a-rope. An angled dish, suction-cup dish, and rocker knife are examples of DME, but they are more appropriate for feeding.

62.

What type of environmental modification is appropriate for a child with congenital upper body contractures secondary to arthrogryposis?

  • Placing items on lower shelves

  • Modified writing utensils

  • Weighted eating utensils

  • Pocket doors

Correct answer: Placing items on lower shelves

Placing items on lower shelves will make them more accessible for a child with arthrogryposis. This is an appropriate environmental modification for this child.

Modified writing utensils will likely benefit this patient, but they are not considered an environmental modification. Weighted eating utensils are not only not an environmental modification, but they will not benefit someone with contractures, as weighted utensils are meant to help with incoordination. Pocket doors are not an appropriate environmental modification, as they would be difficult to manipulate by someone with upper body joint contractures.

63.

If a patient recently had shoulder surgery, what type of intervention is best done FIRST?

  • Codman's exercise

  • Differential tendon gliding

  • Blocking exercises

  • Moist heat

Correct answer: Codman's exercise

Codman's exercises are a type of passive range of motion. They are done with the patient bent over at the waist and their involved arm dangling and relaxed completely. Then the patient weight shifts to allow the arm to move in a pendulum motion. 

Differential tendon gliding exercises are used to improve tendon movement and reduce pain. Blocking exercises are used by a clinician in order to obtain movement at a desired joint and block extraneous movement from other joints. Heat is a good modality to use in combination with other treatments, but it will not yield large increases in ROM by itself.

64.

What is NOT an appropriate intervention strategy for spatial neglect?

  • Provide complex activities initially

  • Work on visual scanning skills

  • Use an anchor as a visual reminder on the affected side

  • Provide written directions for tasks

Correct answer: Provide complex activities initially

Spatial neglect is the decreased ability to scan the environment to locate desired items or locations. Appropriate treatment strategies include working on scanning skills and techniques, using an anchor as a visual reminder to scan toward the affected side, and providing written directions to further encourage thorough and accurate scanning (reading the directions). 

Simple scanning activities should be presented initially, progressing to more complex tasks as the patient improves.

65.

A COTA is assisting with providing care for a patient who is experiencing shock. What is the FIRST step the provider should take to treat this?

  • Obtain the patient's history, if they are able to

  • Do a skin check and capillary refill test

  • Check the patient's breathing, circulation, bleeding, and airways

  • Testing the patient's level of consciousness

Correct answer: Obtain the patient's history, if they are able to

Obtaining the patient's history is important, so the providers know what additional steps to take. Therefore, this is always considered the first step when managing shock.

The fourth step in managing shock is doing a skin check and capillary refill test. Therapists should be looking for signs of the nail bed not refilling with blood (evidenced by turning pink) within two seconds. The second step in managing shock is checking the patient's breathing, circulation, bleeding, and airways. The third step in managing shock is testing the patient's level of consciousness.

66.

What part of the body should ultrasound NEVER be used on?

  • Over a growth plate

  • Over a sprain

  • Over tendonitis

  • Over a wound

Correct answer: Over a growth plate

Ultrasound is contraindicated over a growth plate, where new bones are growing. 

Continuous and pulsed ultrasound is indicated for all the other options, including sprains, tendonitis, and wounds. 

67.

When working in an acute care setting, an occupational therapist notes that his patient is on droplet precautions. What illness requires a therapist to use droplet precautions?

  • Influenza

  • Clostridium difficile

  • Shingles

  • Tuberculosis

Correct answer: Influenza

Influenza requires droplet precautions. Tuberculosis and shingles require airborne precautions. Clostridium difficile requires contact precautions.

Droplet precautions are placed to reduce transmission of diseases spread through sputum droplets following coughing, sneezing, etc. Examples of diseases spread through sputum droplets include influenza and pertussis (whooping cough).

Airborne precautions are placed to reduce transmission of diseases spread through the air following coughing, sneezing, etc. Examples of diseases spread through the air include tuberculosis and chickenpox/shingles.

Contact precautions are placed to reduce transmission of diseases through touch (physical contact) of surfaces that are contaminated. Examples of diseases spread from touching surfaces include MRSA and C-Diff.

68.

In a social setting, an occupational therapy assistant sees another therapist on a date with a former patient who was discharged eight months ago. What is the MOST appropriate action for the OTA to take?

  • Take no action

  • Report the therapist to AOTA

  • Report the incident to their supervisor

  • Confront the therapist immediately

Correct answer: Take no action

A health care practitioner may not date a current patient. There is no evidence that the therapist and the patient were dating while the person was a patient and, therefore, there is no need to do anything about this situation.

69.

Which of the following are methods for completing a psychosocial assessment?

Select the three BEST responses. 

  • Questionnaires

  • Self-report checklists

  • Clinical observation

  • Interviews with only family

  • Movement testing

  • Coordination testing

Mental health assessments can come in the form of structured or unstructured interviews (to help with the completion of an occupational profile), clinical observations, rating scales, standardized tests, questionnaires, and self-report checklists.

Interviews that only focus on family input might be helpful, but are not comprehensive enough to stand alone. Range-of-motion and coordination testing might be a brief part of the mental health evaluation process if a patient demonstrates difficulty with ADLs, but this will not be a major priority.

70.

An OTA is working with a child development team and providing education to mothers of toddlers on expected development of dressing skills. At what age does a child first demonstrate the ability to pull on shoes and socks correctly and consistently?

  • 4 years

  • 5 years

  • 2 years

  • 3 years

Correct answer: 4 years

At 2 years of age, a child typically starts to help with pushing down pants and pushing their arms through a shirt's armholes. They can also take off their shoes.

At 3 years of age, a child can typically pull on a simple shirt as well as shoes and socks, although they may not don the shoes and socks correctly. They can push down their pants and are beginning to fully fasten closures.

At 4 years of age, a child can typically pull off a shirt and don shoes and socks without assistance, although tying shoes is still difficult.

At 5 years of age, a child can get themselves dressed and undressed and now has the fine motor ability to work knots in lacing.

71.

What behaviors might an OTA expect to see from a patient who has a Rancho Los Amigos Level of IX (Purposeful, Appropriate)?

Select the three BEST responses.

  • Low frustration tolerance

  • Depressed affect

  • Acknowledges the feelings and needs of others

  • Cannot realistically plan or schedule activities

  • Can recognize inappropriate behavior

  • Has superficial awareness of their own condition

Patients who are considered RLA level IX (purposeful, appropriate) will present with symptoms of depression, a low frustration tolerance, and some irritability. They are also able to consider others by acknowledging their needs and feelings. 

Patients who are RLA level VII have trouble planning for the future and have little insight into their own condition. Patients who are RLA level VIII can recognize inappropriate behavior in others, while those who are level IX are able to self-monitor their own behavior. 

72.

What impairment describes the inability to read a familiar language?

  • Alexia

  • Acalculia

  • Agraphia

  • Anomia

Correct answer: Alexia

Alexia is the inability to read a familiar language.

Acalculia is the inability to complete mathematical equations, such as addition and subtraction. Agraphia is the inability to write a familiar language. Anomia is characterized by the inability to recall and verbalize commonly recognized objects, people, etc.

73.

Which classification of burn affects the epidermis and the superficial dermis?

  • Superficial partial-thickness burn

  • Deep partial-thickness burn

  • Full-thickness burn

  • Superficial burn

Correct answer: Superficial partial-thickness burn

A superficial partial-thickness burn is a second degree burn that affects the epidermis and the superficial dermis. This burn heals in 1 to 3 weeks and is characterized by increased pain compared to a superficial burn, as well as redness and blisters.

A deep partial-thickness burn is a second degree burn that affects the epidermis and a greater level of dermis (and thus hair follicles and sweat glands). This burn heals in 3 to 4 weeks and has the potential to affect sensation as well as a greater risk for infection.

A full-thickness burn, or third-degree burn, affects the epidermis, dermis, hair follicles, sweat glands, and nerve endings. This burn requires extensive time to heal and is characterized by a white, waxy, and leathery appearance.

A superficial burn, or first-degree burn, affects the epidermis and heals in 3 to 7 days. The affected area may be slightly painful but will show minimal swelling.

74.

What activity is NOT contraindicated for a 51-year-old patient who is in phase 1 of cardiac rehabilitation?

  • Pursed lip breathing

  • Isometric exercises

  • Arm circles

  • Breath holding

Correct answer: Pursed lip breathing

Pursed lip breathing is not contraindicated for someone in phase 1 of cardiac rehabilitation (the acute phase). In fact, pursed lip breathing is one of several techniques that patients can use to manage dyspnea. Patients in this phase of cardiac rehab can also be instructed to practice dyspnea control postures and diaphragmatic breathing techniques.

Isometric exercises place undue strain on the heart and are contraindicated for someone in phase 1 of cardiac rehabilitation. Arm circles are done with both shoulders at 90 degrees of abduction, which is considered a lateral arm movement. This type of movement stretches the chest muscles, which can cause tension on surgical wounds. This is contraindicated because it can impact the healing process. Breath holding also places undue strain on the heart and lungs, and is contraindicated for someone in phase 1 of cardiac rehabilitation.

75.

What might be included in a contextual assessment as part of a wheelchair evaluation?

Select the three BEST responses.

  • Doorways

  • Hallways

  • Restrooms

  • Socioeconomic status

  • Wheelchair control mechanisms

  • The ability of the wheelchair to interact with other medical equipment

A contextual evaluation should include an assessment of physical environments as well as building characteristics, such as accessibility, doorways, hallways, restrooms, workspace design, parking, and more. 

Socioeconomic status, wheelchair control mechanisms, and the wheelchair's interaction with other medical equipment do not fall under a contextual assessment, but they should be assessed in other parts of the evaluation.

76.

What is the difference between transference and countertransference?

  • Transference is an emotional response and reaction expressed by the patient to the therapist; countertransference is a similar reaction that is expressed by the therapist to the patient.

  • Transference is a strong emotional response from one patient to another; countertransference is an emotional response from the therapist to the patient.

  • Transference is the act of patients transferring their life story to their therapists; countertransference is the act of therapists relaying their knowledge to patients.

Correct answer: Transference is an emotional response and reaction expressed by the patient to the therapist; countertransference is a similar reaction that is expressed by the therapist to the patient.

Transference is an unconscious response that a patient has to a therapist. This response is based on the same reaction they have to another relationship in their life (e.g., parent, significant other, sibling). Countertransference involves this same unconscious response being directed from the therapist to the patient. This response is similarly based on a significant person in the therapist's life.

77.

Why might a COTA write a discharge note?

  • The patient is referred to another clinic

  • Their patient is sick

  • The patient moves across town

  • The patient needs a higher frequency of therapy

Correct answer: The patient is referred to another clinic

If the patient is referred to another clinic, they will not be treated at their current location, and their therapist must write a discharge note.

If a patient is sick, this might lead them to cancel a therapy session. So, the COTA would need to write a cancelation note, not a discharge note. If the patient moves across town, this would not impact their services, so the COTA would not need to write a discharge note. If the patient needs a higher frequency of therapy, the provider should consult with their supervising OTR about modifying the plan of care. This does not require a discharge note.

78.

An OTA is working with a three-month-old infant. The mother is concerned that the infant is not yet grasping small objects, but is only looking at them.

What should the OTA tell the mother is typical for this age?

  • This behavior is normal. It is expected that a three-month-old will only look at interesting objects.

  • The baby should be able to interact with objects using a raking grasp.

  • The baby should be able to interact with objects using a pincer grasp.

  • The baby should be able to interact with objects using a cylindrical grasp.

Correct answer: This behavior is normal. It is expected that a three-month-old will only look at interesting objects.

At 3 months old, an infant will direct their focus on an interesting object but will not try to grasp it.

At 6 months old, the infant uses extended digits to reach for the object and rake it toward themselves. At 10 months old, the infant uses a pincer grasp, picking up small objects between the finger pads. The thumb is beginning to demonstrate DIP flexion at this stage. A far more mature grasp is a cylindrical grasp, which is not expected until 2 to 3 years of age.

79.

Which characteristic of group design explains how the group will proceed?

  • Method

  • Rationale

  • Purpose

  • Quality assurance

Correct answer: Method

The method is the plan of execution and includes information on when and where the meetings will be held and what the group sessions will entail.

The rationale details the benefits of the group to potential participants. The purpose describes the group's desired goals as a whole and the reasoning behind its development. Quality assurance involves auditing to determine the level of benefit participants are receiving and whether the group is meeting goals.

80.

What is NOT considered a part of a patient's intervention plan?

  • Outside test results

  • Long-term goals

  • Frequency and duration

Correct answer: Outside test results

While therapists might make brief mention of scores/results from outside tests (e.g. tests performed by other disciplines), this is not an integral part of an OT's intervention plan. 

Therapists should always be sure to include short-term goals, long-term goals, frequency and duration, as well as intervention methods that will be used in treatment.

×