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Quiz Session - Attempts With Random Questions

NBCOT COTA Exam Questions

Page 5 of 40

81.

If an OTA sees a patient who has severe and persistent behaviors that negatively impact their health and these concerns don't respond to environmental adaptations or activity modifications, which healthcare professional should the OTA recommend a referral for?

  • Psychologist 

  • Psychiatrist

  • Speech-language pathologist 

  • Craniosacral therapist

Correct answer: Psychologist

A psychologist provides cognitive and behavioral therapy that takes a non-pharmacological approach to managing behaviors.

A psychiatrist recommends medications for mental health concerns. A speech-language pathologist does work on improving cognitive skills, but generally will not address behavior. A craniosacral therapist is an alternative provider who provides light touch as a way to relieve pressure in the head and neck.

82.

An OTA is working with a 6-year-old who has tactile defensiveness, particularly to light touch. If the therapist is working on incorporating light touch into sessions, what parts of the body should they avoid?

Select the three BEST responses.

  • Palm

  • Face

  • Abdomen

  • Back

  • Neck

  • Ear

The body finds deep pressure calming, while light touch is often received negatively. 

The abdomen/stomach, face, and palmar surfaces of the hand are particularly sensitive to light touch and should be avoided.

83.

An OTA is part of a work hardening program where she educates patients in proper body mechanics in preparation for them returning to work. What are some important points to include in body mechanics education?

Select the three BEST responses.

  • When carrying items, keep them close to your body

  • Face the item you are lifting

  • Keep the back straight and lift with your legs

  • Don't lower your body to the level of your work

  • Jerking motions offer more torque when lifting items wedged in tough spots

  • Balancing on your toes helps level your center of gravity when lifting

Carrying items close to the body allows you to have greater control over them, which prevents you from dropping them and injuring yourself. By facing the item you are lifting, you are avoiding rotational movements, which place someone at the greatest risk for injury. Keeping the back straight allows you to push through your legs rather than engaging your spine, which allows you to better manage a heavy load. 

It's important to lower your body to the level of your work to prevent awkward positioning and muscle strains. Jerking motions are discouraged, since smooth motions place the least strain on the body. It's best to keep the feet flat and not balance on the toes or twist the foot, since flat feet give you a stable base.

84.

What is the MOST common documentation format for writing rehabilitation goals?

  • SMART

  • FEAST

  • RUMBA

  • COAST

Correct answer: SMART

SMART goals dictate that therapists write specific goals that are measurable, attainable (or achievable), relevant (or realistic), and time-allotted. This is the most common format therapists use across all settings.

FEAST is another format for goal-writing that says goals must have a function and include expectations, the action focused on, specific conditions, and a timeline for the goal. The RUMBA format states therapists must write relevant, understandable, and measurable goals that have a behavioral outcome and are achievable. When using the COAST format, therapists must identify the client, occupation of focus, assist level that is needed, specific conditions, and ensure that goals are time-sensitive.

85.

A five-year-old boy is demonstrating a digital-pronate grasp on his writing utensils. What is the expected grasp a five-year-old should use on their writing tools?

  • Dynamic tripod posture

  • Static tripod posture

  • Digital-pronate grasp

  • Palmar-supinate grasp

Correct answer: Dynamic tripod posture

In order to improve writing and grasp of writing tools, it is important that the OTA have an understanding of the expected grasps a child will have at various ages.

A dynamic tripod posture is expected at 4.5 to 6 years of age and involves grasp between the thumb and 2nd and 3rd digits. With this grasp, the child arches the 4th and 5th digits, extends the wrist, and uses smaller digit movements for drawing.

A static tripod posture is expected at 3.5 to 4 years of age and involves grasp between the thumb and 2nd and 3rd digits. With this grasp, the child uses the whole hand for drawing.

A digital-pronate grasp is expected at 2 to 3 years of age and involves grasping using the fingertips but maintaining a pronated position. With this grasp, the child uses their whole arm for drawing.

A palmar-supinate grasp is expected at 1 to 1.5 years of age and involves a grasp with digits in full gross flexion while maintaining a somewhat supinated posture. With this grasp, the child uses their whole arm for drawing.

86.

According to Mosey's taxonomy of groups, what is a thematic group?

  • A group intended to give members the knowledge and skills needed for certain tasks

  • A group that follows a certain theme

  • A group that simulates activities to improve success

Correct answer: A group intended to give members the knowledge and skills needed for certain tasks

A thematic group has a goal of helping members acquire knowledge, skills, and attitudes necessary for the completion of certain activities. 

The other definitions do not describe any sort of group as part of Mosey's taxonomy.

87.

Which term describes an assessment that is used to determine if an individual would benefit from occupational therapy?

  • Screening

  • Referral

  • Intervention

  • Evaluation

Correct answer: Screening

A screening is a short assessment used to identify individuals who would benefit from occupational therapy services and whether they are appropriate for OT intervention.

A referral is an order for occupational therapy and can come from a doctor, teacher, nurse practitioner, physician assistant, etc.

An evaluation is a thorough assessment of an individual's current abilities, goals, and need for OT services. An evaluation provides much more information for a clinician than a screening does, so the clinician can develop an appropriate plan of care.

Intervention refers to the OT treatments provided for an individual. Interventions can take many forms but are generally specifically designed for an individual or group.

88.

Which term describes slow movement that is typical with patients who have Parkinson's disease?

  • Bradykinesia

  • Akinesia

  • Athetosis

  • Dystonia

Correct answer: Bradykinesia

Bradykinesia characterizes a slow speed of movement and slow motor responses.

Akinesia is decreased initiation in regard to motor planning and movement. Athetosis is characterized by writhing muscle movements in the presence of decreased motor control. Dystonia is continual involuntary muscle movement.

89.

When managing difficult behaviors that may present themselves in patients who have dementia, what strategy is LEAST appropriate for successful completion of tasks?

  • Tell them what they need to do

  • Maintain steady eye contact

  • Provide instructions in a clear and concise manner

  • Establish a consistent and familiar daily routine

Correct answer: Tell them what they need to do

Giving orders is not recommended for this population. Instead, therapists should use a friendly, calm tone of voice. 

Maintaining steady eye contact is not usually recommended for the management of difficult behaviors, but it is with this population. Providing instructions clearly and concisely and sticking to a daily routine are strategies recommended to prevent difficult behaviors related to dementia.

90.

An OTA is working with a patient who has endured a neurological injury and is now in a wheelchair. The OTA educates this patient about the potential for skin breakdown at which anatomical site? 

  • Ischial tuberosities 

  • Medial malleolus 

  • Lateral epicondyle 

  • Patella 

Correct answer: Ischial tuberosities

When one is seated in a wheelchair, ischial tuberosities are most prone to skin breakdown, due to prolonged weight-bearing and pressure. It is important to educate the patient about weight-shifting strategies and frequency to reduce the likelihood of skin breakdown. 

The heels and elbows are prone to skin breakdown in the supine position. The knees are prone to skin breakdown in prolonged prone positioning or in side-lying if no pillow or support is provided between the legs/knees.

91.

What is the correct root word for a term describing the diaphragm?

  • Phren-

  • Hepat-

  • Gastr-

  • Gloss-

Correct answer: Phren-

The root word "phren-" means diaphragm. The phrenic nerve innervates the diaphragm.

The root word "hepat-" means liver. The term hepatitis means inflammation of the liver.

The root word "gastr-" means stomach. Gastroenterology is the study of the digestive system.

The root word "gloss-" means tongue. Glossodynia refers to pain in the tongue.

92.

When treating patients with neurological disorders, what should a therapist always consider during the prescription of positioning devices?

  • The provision of pressure reduction devices

  • Power wheelchairs 

  • Upper body use when positioning in bed

  • Visual function

Correct answer: The provision of pressure reduction devices

Pressure reduction will be critical when assisting any patient with positioning, both with and without device(s). This should always be included when choosing and implementing positioning devices.

An individual with a neurological disorder may or may not need a power wheelchair. This depends on their level of function and potential for rehab. Therefore, this is not always a consideration. Not every patient with a neurological disorder needs help with positioning in bed, so this is not always appropriate. Visual function is important to a patient's overall function but does not necessarily always play a part in the use of positioning devices.

93.

Which of the following are factors that an OTA should address before recommending any restraints for a patient?

Select the three BEST responses.

  • Pain

  • Hunger

  • Fear

  • Good engagement

  • Positive motivation

  • Being in a familiar environment

Factors such as pain, hunger, the need to toilet, loneliness, fear, boredom, and an unfamiliar environment can all make someone demonstrate aggression and irritability. By addressing these factors, a therapist can prevent the need for restraints. 

Good engagement, positive motivation, and a familiar environment would all make someone more comfortable and potentially even prevent the need for restraints altogether.

94.

Which of the following does NOT accurately characterize lateral epicondylitis?

  • Golfer's elbow

  • Repetitive use of wrist extensors

  • Repetitive microtrauma

  • Overuse of extensor carpi radialis brevis

Correct answer: Golfer's elbow

Golfer's elbow is characteristic of medial epicondylitis, as it is caused by repetitive use of the wrist flexors.

Repetitive use of the wrist extensors is characteristic of lateral epicondylitis.

Repetitive microtrauma can cause degenerative changes to the tendon's origin, leading to lateral epicondylitis.

Extensor carpi radialis brevis is an example of one of the major wrist extensors that can be overworked and can lead to lateral epicondylitis.

95.

What is NOT an appropriate method of pressure relief for the wheelchair-bound patient?

  • Relying on transfers for times of pressure relief

  • Wheelchair push-ups

  • Weight shifts leaning from side to side

  • Setting a timer as a weight shift reminder

Correct answer: Relying on transfers for times of pressure relief 

Although an individual will get pressure relief when performing transfers, they must perform pressure relief movements at much more frequent intervals. 

Pressure relief can be done through wheelchair push-ups and with weight shifting within the wheelchair. Setting a timer on a phone or watch as a reminder to perform pressure relief is a good idea. Pressure relief movements help to decrease the likelihood of skin breakdown.

96.

What is NOT a part of education-based interventions for lymphatic disease?

  • Blood pressure monitoring

  • Self-bandaging

  • Skin and nail care

  • Infection management

Correct answer: Blood pressure monitoring

Blood pressure monitoring is not part of education provided to individuals with lymphatic disease. Pressure, as it pertains to compression garments, is an important consideration for individuals with lymphatic disease, but not blood pressure.

Individuals with lymphatic disease must practice self-bandaging outside of sessions for maximal gains. Skin and nail care should be attended to, as these are important parts of the lymphatic system and need to be maintained properly to avoid injury. Infection management is also important for patients to know about, since even minor wounds can lead to infection and other complications if you have lymphatic disease.

97.

Which of the following upper extremity conditions is the result of median nerve injury?

  • Ape hand deformity

  • Dupuytren's disease

  • Skier's thumb

  • De Quervain's syndrome

Correct answer: Ape hand deformity

Ape hand deformity is characterized by IP flexion in the digits and atrophy of the thenar eminence and is caused by a median nerve injury.

Dupuytren's disease is the thickening of the fascia within the hand that causes the affected fingers to form flexion contractures. It is not known what causes the fascia to thicken.

Skier's thumb is an injury to the ulnar collateral ligament of the MCP joint of the thumb.

De Quervain's syndrome is characterized by pain in the radial styloid and affects comfortable use of the thumb for functional tasks. It is caused by inflammation of the tendons in the thumb, the abductor pollicis longus, and the extensor pollicis brevis.

98.

What are the goals of seating and positioning systems?

Select the three BEST responses.

  • Improving posture

  • Assisting with pressure relief

  • Helping properly align the trunk and joints

  • Allowing more blood flow to the brain

  • Increasing happiness

  • Allowing all people to assume the same neutral position

Seating and positioning systems help in many ways, including improving posture, offering more stability and comfort, enhancing pressure relief to maintain skin integrity, allowing proper alignment of the trunk/upper body/lower body, decreasing a person's risk for injuries such as decubiti and contractures, improving sitting tolerance and endurance, allowing for more visual readiness during ADLs, and generally improving participation. 

More blood flow to the brain is not a goal of seating and positioning systems. Seating and positioning systems do not directly address emotional health, so improving happiness is not a benefit. Positioning is very person-specific, so not everyone may be able to assume neutral. This will vary based on the person and their wheelchair. 

99.

Which modality transfers heat through conduction?

  • Hot packs

  • Fluidotherapy

  • Laser

  • Ultrasound

Correct answer: Hot packs

There are four types of heat transfer: conversion, radiation, convection, and conduction.

  • Conversion: Ultrasound transfers heat through conversion.
  • Radiation: Laser transfers heat through radiation.
  • Convection: Fluidotherapy transfers heat through convection.
  • Conduction: Hot packs and paraffin transfer heat through conduction.

100.

The rotator cuff muscles work together to control:

  • Humeral head positioning

  • Shoulder stability

  • Scapular winging

  • The coracoacromial arch

Correct answer: Humeral head positioning

The rotator cuff muscles (subscapularis, infraspinatus, supraspinatus, and teres minor) maintain the stability and positioning of the humeral head within the glenoid fossa (together, the glenohumeral joint). 

The rotator cuff does indirectly stabilize the shoulder, though this is not its main purpose. These muscles also do not control scapular winging or the coracoacromial arch.

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