×

Quiz Session - Attempts With Random Questions

NBCOT COTA Exam Questions

Page 7 of 40

121.

What factors assist with generalizing skills as part of motor learning theory?

Select the three BEST responses.

  • The patient's ability to generate intrinsic feedback

  • Variable and random conditions

  • Naturalistic settings

  • Structure the environment

  • Focus only on near transfers

  • Never complete very far transfers

Therapists should always consider the patient's capacity to generate their own feedback, since this is what will remain once the therapist is no longer present. Variability, unfamiliar conditions, and natural settings will also help patients transfer the knowledge of their skill to other environments. 

While structuring the environment might be helpful early on, this will not help patients generalize their skills after therapy is over. Therapists should not only focus on near transfers, since this is only done early on in therapy. Very far transfers are the next step once patients have succeeded at smaller transfers, so they should also be included at some point.

122.

Which classification of burn affects the nerve endings and is characterized as a "third-degree burn"?

  • Full-thickness burn

  • Superficial burn

  • Superficial partial-thickness burn

  • Deep partial-thickness burn

Correct answer: Full-thickness burn

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.

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.

123.

What is the MOST common type of shoulder dislocation?

  • Anterior dislocation

  • Posterior dislocation

  • Inferior dislocation

  • There is no data on types of dislocations

Correct answer: Anterior dislocation

Anterior dislocations occur more often than posterior or inferior dislocations and are typically caused by overuse or injury.

124.

An OTA is working with children at a preschool. Some children have developed an interest in scissors, while others have not.

What age should a child be expected to create fringe at the bottom of a paper?

  • 2-3 years

  • 3-4 years

  • 1 year

  • 4-6 years

Correct answer: 2-3 years

At 2 to 3 years, a child can typically manipulate scissors in order to snip along one side of a piece of paper. The child is generally unable to propel the scissors forward to cut further into the paper.

At 1 year, a child is unable to manage scissors. At 3 to 4 years, a child can typically cut along a line as well as cut out uncomplicated shapes. At 4 to 6 years, a child can typically cut out a simple picture, such as the shape of an apple.

125.

A COTA with 10 years of experience just began working in a school and had an initial meeting with the OTR who will be supervising them. During this meeting, the COTA mentioned all of their work experience has been in outpatient pediatrics, so they do not feel they need any supervision, since there are so many similarities between the two settings. 

How should the OTR proceed from here?

  • Evaluate the COTA's abilities and set up a supervision schedule accordingly

  • Provide the COTA with close supervision 2 times per week

  • Heed the COTA's words and offer only minimal supervision

  • Assign the COTA to only complete paperwork and not offer any treatment

Correct answer: Evaluate the COTA's abilities and set up a supervision schedule accordingly

The amount of supervision between these two parties is determined by the OTR. As a result, the OTR must evaluate the COTA's abilities and can set a mutually agreeable supervision schedule from there.

Close supervision entails daily, direct contact, not 2 times per week. So this option is not correct. Minimal supervision would entail meeting only on an as-needed basis. While this may be what the COTA eventually receives, this is not appropriate for any OT provider who has just begun a new role. There is no reason why the OTR should prevent this COTA from providing treatment. The COTA needs supervision while doing so, but should be able to complete all job duties as any new provider would.

126.

An OTA is working with a six-month-old child on fine motor development. What motor task should the baby be able to perform at this age?

  • Grasp an item with one hand and release it into the other hand

  • A one-stage transfer

  • Involuntarily dropping items from the hand

  • Voluntarily releasing items from the hand

Correct answer: Grasp an item with one hand and release it into the other hand

At 0-1 month, infants are unable to release items from the hand; infants at 1 to 4 months demonstrate involuntary dropping of items from the hand. 

Infants who are 5 to 6 months of age will move the opposite hand to grasp onto the item prior to releasing it from the original hand (a "two-stage transfer").

At 6 to 7 months of age, an infant will upgrade this skill and complete grasping with the opposite hand and releasing with the original hand as one fluid movement (a "one-stage transfer").

Voluntary release of items is a skill developed from 7 to 9 months of age.

127.

When working with a patient with vision impairment, what is NOT an appropriate intervention strategy?

  • Use low-contrast written handouts

  • Educate on patching for double vision

  • Use a table lamp to increase brightness

  • Use large print on handouts 

Correct answer: Use low-contrast written handouts

If a patient has visual impairment, any written handouts should use strongly contrasting colors for the print and the background paper. 

The other options are appropriate intervention strategies for vision impairments.

128.

What is the LEAST appropriate response to a client exhibiting physical or verbal aggression?

  • Ignore behavior to avoid drawing attention to it

  • Establish boundaries for acceptable behavior

  • Remain objective when outlining why the behavior is problematic

  • Establish consequences for unacceptable behavior

Correct answer: Ignore the behavior to avoid drawing attention to it

Offensive behavior may present itself in clients who have sustained a traumatic brain injury or have other psychosocial limitations. When managing offensive behavior that is physical or verbal, it is important that the therapist establish boundaries for acceptable behavior and work to change it as it happens. This is best for the safety of other patients and staff. 

Ignoring it is not appropriate because the individual needs clear feedback about what is expected and acceptable. The therapist should outline why the behavior is problematic and remain objective so as not to continue to escalate the behavior. The therapist should also establish and discuss consequences for unacceptable behavior.

129.

According to motor learning theory, which of the following is a continuous task?

  • Swimming

  • Playing an instrument

  • Brushing teeth

  • Retrieving luggage at the airport

Correct answer: Swimming

Continuous tasks are ongoing tasks that do not end until the performer decides the task is completed. Swimming is an example of a task that is ongoing until the individual decides to finish.

The other options have more consistent stopping points when the task is completed.

130.

OTAs should educate at-risk patients and their caregivers about areas of the body that are most at risk for pressure ulcers. What body parts should they be sure to mention?

Select the three BEST responses.

  • Sacrum

  • Heels

  • Scapula

  • Nose

  • Jaw

  • Wrist

The sacrum, heels, and scapula are among the most common areas to get pressure sores along with the elbows, ischia, greater trochanter on each hip, heels, and ankles. 

The nose, jaw, and wrist are not considered areas at risk for pressure ulcers.

131.

What is true regarding observation skills during an occupational therapy evaluation?

Select the three BEST responses.

  • Observations must take place during occupational performance.

  • Environmental contexts should be included in context.

  • Providers must avoid any bias based on their own background.

  • Structured tools can decrease the reliability of observations.

  • Observations must have a definite start and end in order to be accurate.

  • OTAs can interpret observations before reporting back to their OTR.

It is critical that observations are ongoing and take place during occupational performance. All contexts should be included in observations to account for sociocultural and physical supports or barriers. OTAs must be aware of their own background to avoid a skewed perspective. 

Structured tools can be used to increase the accuracy of an OTA's observations. OTAs are not able to interpret observations before reporting to the OTR, since they must be objective to allow for unbiased interpretation and analysis. Since the observation process is ongoing, they have no definite start or end.

132.

Which of the following is a function of the parasympathetic division of the autonomic nervous system?

  • Increases peristalsis

  • Increases blood pressure

  • Decreases flow of saliva

  • Elevates heart rate

Correct answer: Increases peristalsis

The parasympathetic division of the autonomic nervous system returns the body to a stable condition, which involves lowering the heart rate and blood pressure as well as increasing peristalsis and saliva.

The sympathetic division of the autonomic nervous system is associated with the "fight or flight" response. Blood pressure and heart rate are increased in preparation for an emergency.

133.

What important aspects should a therapist include in wheelchair mobility training?

Select the three BEST responses.

  • Community mobility

  • Use of brakes and leg rests

  • Basics of wheelchair propulsion

  • Other wheelchair options

  • Keeping pace with others

  • Sleeping in a wheelchair

Therapists should educate wheelchair users on proper sitting posture, pressure relief, use of accessories, wheelchair propulsion, safe use of wheelchair features (brake usage, leg rests, and arm rests), proper transfers, community mobility, and maintenance.

It is not necessary to educate patients on other wheelchair options, since this should be a part of the assessment process, which has already taken place. Keeping pace with others is not a standard part of wheelchair training, but it is something therapists can address if the patient requests it. Sleeping in a wheelchair is not ergonomic, so it is not recommended and should not be a part of standard wheelchair training.

134.

Which is NOT a general intervention strategy for impaired alertness or arousal?

  • Work on fine motor activities

  • Increase environmental demands

  • Work on gross motor skills

  • Provide opportunities for sensory processing and stimulation

Correct answer: Work on fine motor activities

When treating an individual with impaired alertness or arousal, the therapist should aim to increase environmental demands that may be interesting to the patient, work on gross motor skills involving the extremities or entire body, and provide ample opportunities for sensory processing. These strategies are stimulating and promote improved alertness and arousal. 

Fine motor activities are least likely to improve general alertness and arousal in a patient, since they are usually more sedentary.

135.

A 30-year-old patient recently sustained a hip fracture and was given partial weight bearing precautions. What assistive device is the MOST appropriate for an OTA to train them in the use of?

  • Crutches

  • Cane

  • Hemi-walker

Correct answer: Crutches

Patients with partial weight bearing precautions cannot place any more than 25% of their weight on their injured leg. This means crutches are the only appropriate device for them to use while ambulating. 

Canes require someone to place around 75% of their weight on the injured leg, so this wouldn't help someone maintain these precautions. Hemi-walkers take all the weight off the injured leg, so this does not help with the rehabilitation process. 

136.

A 61-year-old patient just participated in a wheelchair evaluation to assist with improved community mobility. Their new COTA has been tasked with recommending a wheelchair cushion to ensure the patient avoids pressure ulcers, as they have a history of ulcers on the sacrum and have some difficulty shifting weight on their own. This patient has intact sitting balance.

What cushion should this therapist recommend?

  • Air-filled cushion

  • Honeycomb cushion

  • Contoured foam cushion

Correct answer: Air-filled cushion

Given that this patient is in need of pressure relief and has no concerns related to sitting balance, they are a good fit for an air-filled cushion. These cushions are lightweight, which also helps with air flow and maintains skin integrity.

A honeycomb cushion does not offer even pressure distribution, so that will increase this patient's risk of pressure ulcers.

A contoured foam cushion makes it difficult for the person using it to shift weight. Since this patient already has trouble shifting weight, this cushion will cause them to be more dependent on others for this purpose. A contoured foam cushion is not a good fit for this patient.

137.

What is an appropriate anti-contracture positioning for a patient who has a burn to the volar aspect of the hand?

  • Palm extension splint

  • Functional hand splint 

  • Wrist cock-up splint

  • Neutral wrist splint

Correct answer: Palm extension splint

A palmar contracture can occur following a burn to the volar aspect of the hand. To reduce the risk of a palm contracture, a palmar extension splint is recommended to maintain positioning.

A functional hand splint with the MPs at 90 and IPs extended is recommended to reduce the risk of claw hand deformity following a burn to the dorsal hand.

A wrist cock-up splint is recommended to reduce the risk of wrist flexion contractures following a burn to the volar wrist.

Neutral wrist positioning is recommended to decrease the risk of wrist extension contracture following a burn to the dorsal wrist.

138.

Knowledge of medical terminology is necessary for competency in reading and writing medical documents. Which term is NOT related to the heart?

  • Sternotomy

  • Tachycardia

  • Bradycardia

  • Cardiomegaly

Correct answer: Sternotomy

Sterno- means "sternum" and -otomy means "surgery" or "cutting", so sternotomy is a surgical cut through the sternum, which happens for a range of reasons other than heart surgery.

Tachy- means "fast" and cardio- means "heart", so tachycardia is a term that means fast heartbeat.

Brady- means "slow" and cardio- means "heart", so bradycardia is a term that means slow heartbeat.

Cardio- means "heart" and megaly- means "enlargement", so cardiomegaly is a term that means enlarged heart.

139.

What wheelchair dimensions are appropriate for the following patients?

Select the three BEST responses.

  • A 40-year-old man of average size in a wheelchair with an 18" seat width

  • An 8-year-old of average size in a wheelchair with a 14" seat width

  • A toddler of average size in a wheelchair with a 12" seat width

  • A 30-year-old woman of average size in a wheelchair with a 24" seat width

  • A 15-year-old girl of average size in a wheelchair with 15" of seat depth

  • A 50-year-old woman of average size in a wheelchair with a seat height of 19.5"

The ideal seating dimensions for an average adult wheelchair are: 18 inches wide, 16 inches deep, and 20 inches tall. Ideal dimensions for an average children's wheelchair are: 14 inches wide, 11.5 inches deep, and 18.75 inches tall. Sufficient seating for an average "tiny tot" wheelchair includes the following dimensions: 12 inches wide, 11.5 inches deep, and 19.5 inches tall. According to these figures, a seat width of 18" inches is appropriate for an average 40-year-old, as is a seat width of 14" for an average 8-year-old and a seat width of 12" for an average toddler. 

The other dimensions are ill-fitting and would not be appropriate for such patients.

140.

An OTA is educating new parents on expected developmental skill progression, specifically for dressing. At what age can a child first be expected to participate in dressing by beginning to pull off shoes and socks and extending their arms to help with putting a shirt on?

  • 1 year

  • 2 years

  • 3 years

  • 4 years

Correct answer: 1 year

At 1 year of age, the child begins to participate in dressing, removing shoes and socks and extending their limbs out when the parent begins to put clothes on.

At 2 years of age, a child can also help pull down pants, take off a coat, and identify the armholes on a shirt. At 3 years of age, a child can doff and don shoes and socks and remove their own pants, but may need a little help with shirts. At 4 years of age, a child can typically dress themselves with the exception of difficult fasteners and shoelaces.

×