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Quiz Session - Attempts With Random Questions

NBCOT COTA Exam Questions

Page 6 of 40

101.

Which type of occupational therapy personnel is responsible and accountable for all aspects of OT service delivery?

  • Occupational therapist

  • Occupational therapy assistant

  • Occupational therapy aide

  • Director of rehabilitation

Correct answer: Occupational therapist

Occupational therapists are the only ones that do not require supervision when providing services; therefore, OTs are the primary clinicians responsible for therapeutic services provided to patients. 

OTAs require supervision and guidance in the services they provide, and OT aides are not permitted to provide skilled intervention. 

While directors of rehab mentor, guide, and advocate for the rehab department as a whole, they are not directly accountable for the actions of the therapists on their team.

102.

An OTA is providing education on home modifications to allow for wheelchair access. The homeowner is going to widen existing narrow doorways.

What is the ideal doorway and hallway width?

  • 36"

  • 32"

  • 26"

  • 24"

Correct answer: 36"

Doorways should be at least 32 inches wide, but the ideal width is 36 inches. The hallways should be 36" wide to allow self-propulsion without scraping hands on the walls. Wheelchairs are typically 24" to 26" wide.

103.

If a therapist asks patients to sit down and discuss the group afterward, what part of a five-stage group is taking place?

  • Stage V

  • Stage II

  • Stage III

  • Stage IV

Correct answer: Stage V

Stage V is closure, which ends the group by discussing what occurred (potentially what the members completed or learned, etc.).

Stage II is movement, and involves gross motor movement to improve the arousal of participants. Stage III is perceptual-motor and involves perceptual-motor activities designed to assist in relaxation, peacefulness, and centering attention on the group following the movement in Stage II. Stage IV is cognitive, and involves activities to improve cognitive and reasoning skills.

104.

When educating a patient who underwent a hip replacement with a posterolateral approach, what precautions should a COTA mention?

  • Do not bend past 90 degrees, do not pivot at the hip

  • Do not externally rotate the hip, do not extend the hip

  • Do not internally rotate the hip, do not extend the hip

  • Do not externally rotate the hip, do not flex the hip

Correct answer: Do not bend past 90 degrees, do not pivot at the hip

Not flexing the hip past 90 degrees and not pivoting at the hip are two precautions associated with a posterolateral hip replacement. In addition, patients recovering from this surgery should not cross their legs or otherwise adduct the hip, or internally rotate the hip. It's also recommended to sit on raised surfaces (raised chairs and raised toilet seats) to help enforce the "no bending" part of these precautions and to transfer from sitting to standing with the hip slightly abducted and extended.

Not externally rotating the hip and not extending the hip are part of anterolateral hip precautions, so this information is not correct. Not internally rotating the hip is part of posterolateral hip precautions, but not extending the hip is part of anterolateral hip precautions, so the COTA should not present this information to the patient. Not externally rotating the hip is an anterolateral hip precaution. Not flexing the hip at all is not realistic, but not bending that joint past 90 degrees is part of posterolateral precautions. Either way, this combination of information is not correct.

105.

What areas should a hospital-based COTA address with a patient who sustained full-thickness burns to both arms 1 week ago?

  • Range of motion, pain, anti-deformity positioning, psychosocial function

  • Range of motion, pain, sensation, strength

  • Leisure, range of motion, strength, psychosocial function

  • ADL function, range of motion, strength

Correct answer: Range of motion, pain, anti-deformity positioning, psychosocial function

Anti-deformity positioning should be a priority for intervention, especially this early in the plan of care. OTs should also address range of motion, pain, and psychosocial function, as full-thickness burns are extensive and all will be limiting factors if not managed properly.

Sensation and strength should only be incorporated into sessions once the patient's wounds have healed. It's too early to address leisure with this patient, as there are other priority areas. In addition, ADL function may not be possible until the patient has a positioning schedule in place to prevent contractures.

106.

Which of the following is NOT recommended criteria for splinting to address burns?

  • IP joints fully flexed

  • Wrist in 20 to 30 degrees of extension

  • MCPs in 70 degrees of flexion

  • Thumb abducted and extended

Correct answer: IP joints fully flexed

Appropriate splinting for burns is placing the wrist at 20 to 30 degrees of extension, MCP joints in 70 degrees of flexion, IP joints fully extended, and the thumb abducted and extended. So placing the IP joints fully flexed would not be indicated.

107.

Which of the following is NOT a muscle of shoulder extension?

  • Teres minor

  • Latissimus dorsi

  • Teres major

  • Posterior deltoid

Correct answer: Teres minor

The teres minor is part of the rotator cuff and functions in external rotation of the shoulder, not extension.

The latissimus dorsi, teres major, and posterior deltoid all assist with shoulder extension.

108.

Each person goes through a series of stages when they are adjusting to death, dying, and disability. Which of the following is NOT one of these stages?

  • Defusion

  • Bargaining

  • Denial

Correct answer: Defusion

The stages are as follows: denial, anger, bargaining, depression, and acceptance. 

Defusion is not one of the stages someone experiences as they are adjusting to major life events.

109.

An OTA began treating a laborer for pain in and around the elbow. He describes his workstation to the OTA, who then makes recommendations to improve its ergonomics. What should the OTA tell their patient is the appropriate workbench height for performing light work while standing?

  • Immediately below the elbow

  • Above the elbow 

  • 4-6 inches below the elbow

  • At the knee

Correct answer: Immediately below the elbow

Regarding standing work, the preferred workbench position for light work is immediately below the elbow. 

The preferred workbench height for precision work is above the elbow. The preferred workbench position for heavy work is 4 to 6 inches below the elbow. A workbench at knee height would not be appropriate at all and would cause strain to the back if the laborer was standing.

110.

An OTA is treating a 10-year-old child with cerebral palsy. What is part of their role in intervention for this child?

Select the three BEST responses.

  • Recommend and adjust equipment and assistive technology

  • Recommend community agencies for this child and their family

  • Focus on play-based activities to improve occupational engagement

  • Improve handwriting skills

  • Decrease the presence of tremors

  • Enhance coordination

Children with cerebral palsy can benefit from AT/equipment recommendations and community agencies and resources. Children do best with play-based interventions that focus on skill areas specific to the patient's goals. 

Treatment should not necessarily focus on handwriting skills, tremors, or coordination, rather it should focus on the child's specific needs.

111.

What type of therapy group emphasizes group interaction rather than project completion?

  • Project/associative groups

  • Mature groups

  • Egocentric-cooperative groups

Correct answer: Project/associative groups

Members who are part of project/associative groups are encouraged to work together on short-term tasks where the focus is on their cooperation more than the task itself. 

Mature groups focus more on the creation of an end product. Egocentric-cooperative groups involve 5-10 members choosing a long-term task for the group to complete. The task is more so the focus for egocentric-cooperative groups.

112.

The occupational therapy assistant must educate a patient and assist in anti-contracture positioning after a burn. What position is MOST appropriate to reduce the likelihood of contracture after a burn to the anterior neck?

  • Lie supine without any pillows

  • Lie supine with two pillows to support the neck

  • Chin-to-chest position

  • Whatever position is most comfortable for the patient

Correct answer: Lie supine without any pillows

After a burn to the anterior neck, a contracture can occur in neck flexion unless proper positioning precautions are taken. Lying supine without pillows allows more neck extension and prevents prolonged neck flexion.

The other positions are inappropriate because they all promote neck flexion and, therefore, neck flexion contractures. A patient will feel most comfortable in a position with some neck flexion, so the therapist must educate the patient to promote neck extension.

113.

When treating a person with a new onset of disability, it is important for the therapist to recognize the phases of adjustment to disability. What phase involves an individual accepting the changes and developing a positive outlook regarding the future?

  • Adjustment

  • Acknowledgment

  • Depression

  • Denial

Correct answer: Adjustment

Adjustment is the final stage and involves an individual accepting the changes and developing a positive outlook on how to return to necessary and desired roles and activities.

Acknowledgment involves the initial feelings of acceptance of changes related to disability. An individual may seek to establish an identity and new desires following the disability.

Depression describes the grief experienced when the individual realizes what has been lost following an event or disability. They may experience sorrow and devastation and may seclude themselves from others. 

Denial involves an individual downplaying how significant the event or disability is, as well as developing high expectations that may not be achievable.

114.

What is a palpation site that therapists can use to take a patient's pulse?

Select the three BEST responses.

  • Popliteal

  • Radial

  • Temporal

  • Cardiac

  • Ulnar

  • Occipital

The popliteal (behind the knee), radial (at the wrist on the side of the thumb), and temporal (at each side of the forehead) are all viable places to take a pulse. 

Cardiac, ulnar, and occipital are not locations where a pulse can be found.

115.

If a therapist is using the RADAR approach, what should they do FIRST?

  • Routinely ask

  • Respond

  • React

  • Reassure

Correct answer: Routinely ask

As occupational therapists and assistants build rapport with their patients, they can routinely and consistently ask patients if they are experiencing abuse. The other options are not part of the RADAR method.

116.

A COTA working in a skilled nursing facility (SNF) is accused of negligence towards their patient, who fell last week and sustained an injury. Which of the following are NOT considered negligent?

Select the three BEST responses.

  • Taking responsibility for any harm done to a patient

  • Having personal malpractice insurance to protect yourself against claims

  • Asking your institution to assume liability for environmental problems that led to patient injury

  • Failing to do what another clinician would have done in the same situation

  • Doing what another provider would not have done in the same situation

  • Not taking responsibility for any harm done to a patient

Having personal malpractice insurance to protect yourself against claims is best practice for all therapists, so this is not considered negligent. Taking responsibility for any harm done to a patient is the ethical option, so this is also not considered negligent. Institutions typically assume liability for environmental problems (e.g., missing railings, dim walking pathways, broken grab bars) that led to patient injury, so asking them to do so is not negligent.

Negligence involves failing to do what another clinician would have done in the same situation, doing what another provider would not have done in the same situation, and not taking responsibility for harming a patient.

117.

What is NOT considered a factor that leads to silent aspiration?

  • A person coughing excessively, which causes food to enter the lungs

  • A person coughing too lightly, which prevents the bolus from being expelled from the esophagus

  • The bolus entering the lungs with no outward signs or symptoms

Correct answer: A person coughing excessively, which causes food to enter the lungs

Silent aspiration occurs when a bolus enters the lungs without any indication and a bolus enters the lungs and causes respiratory distress but no cough. Silent aspiration also happens when a person coughs too weakly to expel the bolus from the esophagus. A person coughing excessively may also lead to food entering the lungs. However, this is more obvious and referred to as aspiration instead of silent aspiration.

118.

A third-party payer is conducting an assessment of a clinical plan of care prior to approving treatment services. The payer is conducting a:

  • Prospective review

  • Retrospective review 

  • Peer review 

  • Utilization review

Correct answer: Prospective review

A prospective review is used to review and assess the need for a specific plan of care prior to the intervention occurring.

A retrospective review is used to review and assess an intervention after it has occurred to determine the appropriateness of the treatment provided.

A peer review involves review of treatment provided by one individual by their peers. An example might be charts audited by clinicians at a facility to ensure documentation demonstrates skilled care.

A utilization review assesses whether the intervention provided was actually needed. This type of review places strong emphasis on reviewing intervention to assist with managing the cost of health services provided.

119.

After a CVA, a patient may be unable to understand what the hospital staff and their family are saying to them. What is this impairment called?

  • Wernicke's aphasia

  • Broca's aphasia

  • Global aphasia

  • Anomia

Correct answer: Wernicke's aphasia

Wernicke's aphasia (receptive) is the decreased comprehension of verbal language.

Broca's aphasia (expressive) describes an inability to verbally express oneself. Global aphasia is a combination of Broca's and Wernicke's aphasia, including decreased verbal expression and comprehension. Anomia is characterized by the inability to recall and verbalize commonly recognized objects, people, etc.

120.

Which of the following statements are TRUE about work programs?

Select the three BEST responses.

  • Vocational and transitional employment programs utilize job coaches.

  • Vocational and supported programs are often considered a long-term goal.

  • Patients can no longer be part of a vocational program if they have returned to their old job.

  • Vocational programs are required to be accredited.

  • Patients will never be discharged from a vocational program.

  • A patient might be discharged from a work program if they are compliant.

Vocational programs, supported employment programs, and transitional employment programs all use job coaches to help patients better adjust. These same programs are also considered the long-term goal for most patients with disabilities who want to work. Patients might be discharged from a vocational program if they have declined services, are non-compliant, have met their goals, have returned to a previous work role, or demonstrate limited potential for improvement.

Vocational programs are not required to be accredited, but they are often part of larger organizations (such as hospitals) that are accredited.  A patient who is compliant would not be discharged from a work program (or any program, for that matter) for that reason.

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