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Quiz Session - Attempts With Random Questions

NBCOT COTA Exam Questions

Page 8 of 40

141.

An OTA is assigned to treat an 85-year-old male diagnosed with a generalized neurocognitive disorder. What should be the long-term focus of treatment?

  • Maintaining quality-of-life by adapting activities and modifying the environment

  • Educating the patient about how to slow the disease

  • Reminiscence therapy

Correct answer: Maintaining quality-of-life by adapting activities and modifying the environment

Activity and environmental modifications can be used to maintain quality of life for those with neurocognitive disorders such as dementia and traumatic brain injury.

It would not be appropriate to educate the patient directly on how to slow the progression of their condition. Instead, therapists should educate caregivers and family about how to best assist their loved one. Reminiscence therapy might be part of treatment for those with dementia, but it is not appropriate for all neurocognitive disorders and should not be the focus of either treatment.

142.

Which type of splint is appropriate for a brachial plexus injury?

  • Flail arm splint

  • Elbow brace

  • Tenodesis splint

  • Ulnar drift splint

Correct answer: Flail arm splint

A flail arm splint helps support the affected arm from the shoulder down in someone who has a brachial plexus injury.

An elbow brace prevents compression at the elbow, which helps someone with cubital tunnel syndrome. A tenodesis splint encourages wrist extension in individuals with spinal cord injuries at the C6-C7 levels. An ulnar drift splint prevents subluxation of the wrist and MCPs, which occurs due to rheumatoid arthritis.

143.

Assessment of visual skills is often a necessary part of an OT evaluation, particularly when the patient has experienced a recent CVA or TBI. What visual skill is characterized by the ability to see clearly at various distances?

  • Visual acuity

  • Visual field

  • Topographical disorientation

  • Scanning

Correct answer: Visual acuity

Visual acuity describes the ability to clearly see at various distances.

Visual field describes an individual's peripheral vision in the upper and lower quadrants on both the right and left. Topographical disorientation is when someone struggles to navigate the space around them. Scanning involves the ability to search for and locate specific information in the environment. Scanning is often formally tested in written form via a letter cancellation test.

144.

Regarding cerebral vascular accidents, which condition resolves within 24 hours?

  • Transient ischemic attack

  • Cerebral infarction

  • Cerebral hemorrhage

  • Cerebral arteriovenous malformation

Correct answer: Transient ischemic attack

A transient ischemic attack (TIA) is often considered a "mini stroke" as an individual initially presents with stroke symptoms, but they resolve within 24 hours.

A cerebral infarction is a blockage in the artery that is caused by a blood clot. A cerebral hemorrhage is bleeding in the brain that results from high blood pressure or an aneurysm. A cerebral arteriovenous malformation is a twisted mass of blood vessels that is present at or around birth.

145.

Which type of amputation involves removing the entire arm as well as the clavicle and scapula?

  • Forequarter amputation

  • Shoulder disarticulation

  • Above-elbow amputation

  • Elbow disarticulation

Correct answer: Forequarter amputation

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

A shoulder disarticulation includes the entire arm only, ending with the humerus.

An above-elbow amputation originates on the humerus.

An elbow disarticulation originates at the distal elbow.

146.

An OTA is collaborating with an SLP to provide oral motor intervention for a patient. Which of the following is a type of position that may assist with oral motor weakness?

Select the three BEST responses.

  • Chin tuck

  • Head turn

  • Head tilt

  • Neutral neck

  • Elevated shoulders

  • Protracted scapula

The chin tuck, head turn, and head tilt are all positions that assist with oral motor dysfunction. 

Neutral neck, elevated shoulders, and protracted scapula are not proven to assist with this type of motor dysfunction.

147.

During intervention for cardiac rehab, the heart rate is monitored. They are unable to get a pulse in the most common site due to the placement of wires and lines, so the OTA must palpate the side of the patient's face.

What site is this?

  • Temporal

  • Radial

  • Brachial

  • Carotid

Correct answer: Temporal

A temporal pulse is palpated on the face, between the ear and eye.

A radial pulse is palpated on the radial side of the wrist, below the thumb. A brachial pulse is palpated via the brachial artery above the anterior elbow. A carotid pulse is palpated via the carotid arteries on the front of the neck.

148.

You are working in a pediatric home care agency and begin treating a two-year-old whose chart says he demonstrates "severe gross motor delays." Which of the following gross motor activities would a two-year-old NOT be expected to achieve yet?

  • Demonstrates a symmetric tonic neck reflex

  • Rolls to the side and pushes up to seated position

  • Controlled release of items into a small container

  • Seldom falls when walking

Correct answer: Demonstrates a symmetric tonic neck reflex

A child begins to demonstrate a symmetric tonic neck reflex at 4 to 6 months, but this should be integrated by the age of one year. Therefore, a two-year-old should not demonstrate this reflex. 

The other options are all characteristic of a child at two years of age (and potentially even younger).

149.

What is managed care?

  • A way to reduce costs while providing quality care

  • The act of coordinating multiple services for a single patient

  • Codes that are attached to specific medical services

Correct answer: A way to reduce costs while providing quality care

HMOs and PPOs are managed care organizations that focus on lowering the cost of care and utilization of medical services while still offering quality services. 

Coordinating multiple services for one patient is referred to as case management or care management. Codes attached to medical services are known as procedure codes. 

150.

Which approach to treating cognitive-perceptual deficits focuses primarily on providing extrinsic verbal cues during task performance?

  • Information Processing Approach

  • Compensatory/Adaptive/Functional Approach

  • Neurofunctional Approach

  • Dynamic Interactional Approach

Correct answer: Information Processing Approach

The Information Processing Approach focuses on providing verbal cues to increase an individual's problem solving and awareness of their performance.

The Compensatory/Adaptive Approach emphasizes repetition for task proficiency as well as modification to tasks, items, or the environment to reach maximum independence. The Neurofunctional Approach is based on learning theory and focuses on realistic, practical life skills training for individuals who have had a neurological event. The Dynamic Interactional Approach focuses on helping an individual transfer skills learned therapeutically into real-life situations and environments.

151.

Which ambulation aid requires a person to slightly lift the device with each step using both arms?

  • Standard walker

  • Hemi-walker

  • Rolling walker

  • Multiple-wheeled walker

Correct answer: Standard walker

A standard walker only has two front wheels (rather than four found on a rolling walker) and is used by lifting the walker in order to propel it forward.

A hemi-walker provides stability for an individual with hemiparesis who cannot adequately grasp a typical walker. This walker requires the use of only one arm. A rolling walker has four wheels that propel forward easily without any lifting. A multiple-wheeled walker (such as a rollator) has three or four wheels, depending on the style, and is easily propelled. These walkers have brakes as well as a seat and a storage compartment (under the seat).

152.

A fibers are the largest nerve fibers, and they send quick impulses. What type of A fiber sends sensory information related to light and deep touch?

  • Beta

  • Alpha

  • Gamma

  • Delta

Correct answer: Beta

Beta nerve fibers send sensory information related to light and deep touch.

Alpha nerve fibers send information about body awareness and somatic motor functions. Gamma nerve fibers send motor planning information to the muscles for movement. Delta nerve fibers send sensory information related to pain, temperature, and touch.

153.

Which of the following is NOT an acceptable reason for discharge from occupational therapy?

  • The clinician thinks the patient is more appropriate for a different level of care

  • The patient declines further intervention

  • The patient has met their goals

  • The patient's progress has slowed or hit a functional plateau

Correct answer: The clinician thinks the patient is more appropriate for a different level of care

It is not the sole decision of a therapist to determine whether a patient is suitable for their current level of care. A therapist can document their concern and bring this matter to the treatment team during meetings or one-on-one. But this is typically a group decision and therapy should be continued until there is no longer a valid medical need. 

The other options are all appropriate reasons to discharge a patient from OT.

154.

Which of the following is NOT a type of ergonomic work program?

Select the three BEST responses.

  • Vocational programs

  • Prevocational programs

  • Transitional employment programs

  • Ergonomic survey

  • Manager and employee training

  • Job site analysis

Vocational programs, prevocational programs, and transitional employment programs all focus on obtaining and continuing success in work roles. They do not focus on ergonomics.

Ergonomic surveys, job site analyses, manager and employee training, educational seminars, and exercise/stretching programs are all types of work programs. 

155.

The occupational therapy evaluation denotes that a patient has a median nerve impairment. Which muscle would NOT be affected?

  • Opponens digiti minimi

  • Abductor pollicis brevis

  • Opponens pollicis

  • Flexor digitorum superficialis

Correct answer: Opponens digiti minimi 

The opponens digiti minimi is innervated by the ulnar nerve and controls opposition of the fifth finger.

The abductor pollicis brevis, opponens pollicis, and the flexor digitorum superficialis are all innervated by the median nerve.

156.

Before selecting an intervention to address chronic lower back pain in a 41-year-old male, the COTA should ask questions to explore if which of the following causes are contributing factors to the pain?

Select the three BEST responses.

  • Heavy lifting

  • Poor seated posture

  • Poor standing posture

  • Not lifting with enough force

  • Bending over in isolated incidents

  • Raking leaves

Heavy lifting and poor posture (both while seated and while standing) are some of the leading causes of lower back pain. Other causes of low back pain include poor sleeping posture and repetitively bending over using poor body mechanics. 

Not lifting with enough force may not be an effective way to lift items, but it typically does not lead to lower back pain or injury. When done with poor body mechanics, an isolated incident of bending over will not necessarily lead to chronic low back pain, but it may cause an acute injury if it is combined with excessive force. The act of raking leaves is not necessarily a contributing factor to lower back pain, but this activity may lead to lower back pain if it is done with poor body mechanics.

157.

A therapist summarizes feedback and recommendations for improved task performance at the end of a session. What type of feedback is this?

  • Delayed feedback

  • Inherent feedback

  • Concurrent feedback

  • Terminal feedback

Correct answer: Delayed feedback

Delayed feedback is not immediately provided following completion of a task. An example is a therapist educating a patient at the end of a session, stating, "Keep reaching back for the chair when you go to sit."

Inherent feedback is feedback obtained intrinsically when practicing a skill. An example of inherent feedback is recognizing that you put your arm through the neck hole of a shirt.

Concurrent feedback is provided during performance of the task. An example is a therapist instructing a patient to keep an upright posture while reaching.

Terminal feedback is provided following the completion of a particular entire task. This feedback differs from delayed feedback as it is provided before moving on to a new task, whereas delayed feedback is typically provided at the end of a session, potentially following completion of several therapeutic tasks.

158.

An OTA is shadowing an OTR to learn more about the orthosis fabrication process. The OTR educates the OTA about the benefits of orthoses and how to modify them to suit a range of patient needs.

What is NOT considered a purpose of orthoses?

  • To improve skin integrity

  • To increase ROM

  • To restrict ROM

Correct answer: To improve skin integrity

Orthoses do not help address a person's skin integrity. In fact, improper orthosis use can cause skin breakdown, particularly if patients do not follow the wearing schedule and care instructions.

Depending on the orthosis and the person's abilities, orthoses can either increase ROM (to improve a patient's function) or restrict ROM (to protect them from injury while healing).

159.

An OTA is told by her supervisor to rewrite a daily note so that its wording reflects skilled intervention and justifies medical necessity. What should the OTA avoid using in order to justify skilled services?

  • Maintained

  • Downgraded

  • Facilitated 

  • Challenged 

Correct answer: Maintained

Maintained is a term that does not display the need for skilled therapy, as it implies that an individual has not improved but has merely maintained the skills they had prior to treatment. 

The other terms imply skilled therapy is necessary for the improvement of occupations and performance skills.

160.

What aspects of a home can be changed without much effort to make it safer?

Select the three BEST responses.

  • Removing clutter from walkways

  • Hiding and securing exposed wires and cords

  • Adding task lighting

  • Widening door frames

  • Changing a tub to a walk-in shower

  • Installing thermostats for improved temperature control

Therapists can quite easily help patients remove clutter from walkways, secure exposed wires and cords, and add task lighting to make a home safer. 

Other home modifications include widening door frames, remodeling a bathroom to include a walk-in shower, and installing a thermostat. However, these options will take more time and energy, and often require assistance from a professional.

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