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Quiz Session - Attempts With Random Questions

NBCOT COTA Exam Questions

Page 9 of 40

161.

If a COTA is instructed to use the biomechanical/restorative frame of reference to structure sessions for a certain patient, what technique might they consider?

  • Energy conservation

  • Adaptive equipment

  • Compensatory strategies

  • Activity analysis to help reduce activity demands

Correct answer: Energy conservation

Energy conservation is one example of a technique that falls under the biomechanical/restorative frame of reference. Additional strategies according to this frame of reference include graded exercises, occupation-based activities that take metabolic equivalent (MET) levels into consideration, and work simplification techniques.

Adaptive equipment is prescribed using a compensatory lens and, therefore, is considered part of the compensatory/adaptive frame of reference. Compensatory strategies are also considered part of the compensatory/adaptive frame of reference. Activity analysis is a common fixture in OT intervention. However, when it is used to lower activity demands for someone who cannot complete the task naturally, it follows the compensatory/adaptive frame of reference.

162.

An OTA is seeing a patient in a neuro rehab care center to help improve self-care performance. Before the first treatment, she reads that the patient has a lower motor neuron lesion. Which of the following symptoms should she expect to see?

  • Diminished deep tendon reflexes

  • Spasticity

  • Clonus

  • Autonomic dysreflexia

Correct answer: Diminished deep tendon reflexes

Diminished deep tendon reflexes are a symptom of a lower motor neuron lesion.

Upper motor neuron lesions are associated with spasticity, clonus, autonomic dysreflexia, and overly responsive deep tendon reflexes.

163.

Which classification of burn involves the destruction of the nerve along the path it runs?

  • Electrical burn

  • Superficial partial-thickness burn

  • Deep partial-thickness burn

  • Full-thickness burn

Correct answer: Electrical burn

Electrical burns destroy the nerve along its pathway and are most common with fourth-degree burns.

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 5 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.

164.

If a patient with impaired grasp due to severe carpal tunnel syndrome begins to have trouble driving, what adaptation can help them regain independence?

  • Tri-pin

  • Hand controls

  • Pedal extensions

  • Steering wheel ring

Correct answer: Tri-pin

A tri-pin is used when an individual has decreased grip strength and is unable to hold the wheel. The driver places the hand and wrist between the three pins, which allows for adequate control of the steering wheel.

Hand controls are used instead of brake and gas pedals to drive a car without requiring leg use. Pedal extensions provide extra length to the pedals if an individual is unable to reach them, but they will not help if a patient is not able to control the legs for braking and accelerating. Steering wheel rings attach to an upper body prosthesis in order to assist with steering the car's wheel.

165.

A patient who recently has been diagnosed with Parkinson's disease is experiencing dyskinesia for the first time. This can result from many things, but what is it MOST likely attributed to?

  • Medication side effect

  • Pain

  • Poor sleep

  • Their condition is rapidly progressing

Correct answer: Medication side effects

Medications used to treat Parkinson's disease come with associated side effects as the body's response to medication changes during the course of the disease. Dyskinesia can appear in response to the medication's growing inconsistency in managing symptoms. 

The other options may cause some changes in movement but nothing as large-scale as this symptom.

166.

Which documentation phrase BEST demonstrates medical necessity and patient improvement while offering justification for continued skilled care?

  • Progressed in balance

  • Maintained ROM

  • Minimal change

  • Requires repetition

Correct answer: Progressed in balance

When a therapist notes progression in an intervention or skills, there is documented improvement. This helps justify continuing skilled OT care.

The other phrases indicate slow progression and decreased potential for improving occupations and performance skills with OT intervention.

167.

When training an individual in strategies for home management, what strategy would improve carryover of kitchen management?

  • Written directions posted on the refrigerator

  • Hand-over-hand assistance

  • Verbal cueing

  • Task supervision to maintain a safe environment

Correct answer: Written directions posted on the refrigerator 

All the options are appropriate ways of providing cues and assistance with household management. However, hand-over-hand assistance, verbal cues, and task supervision are all done while the therapist is present. Placing written directions in a prominent location is a strategy to improve carryover and provide cues when the therapist is not present.

168.

In regard to occupational therapy documentation, which statement is FALSE?

  • Clinicians should never handwrite notes; electronic notes are the only acceptable format

  • Clinicians writing notes by hand should only use black or blue ink

  • Occupational therapy documentation is considered a part of the medical record

  • Documentation should clearly state whether it is an evaluation or a daily treatment note

Correct answer: Clinicians should never handwrite notes; electronic notes are the only acceptable format

This is false. While handwritten notes are falling out of favor compared to electronic medical records and digital systems, they are still an acceptable way to document. Both types of documentation are considered part of the medical record. 

When making handwritten notes, a clinician should only write in black or blue ink. All electronic or handwritten documentation should clearly state whether the note is an evaluation, daily treatment note, or another type.

169.

An OTA just began treating a 55-year-old male with diabetes after he had a below-the-knee amputation on the left leg. The patient has not received his prosthetic yet. What might the OTA include in treatment?

Select the three BEST responses.

  • Desensitization

  • AROM of the uninvolved joints

  • Skin care and hygiene training

  • AROM of the involved joints

  • PROM of the uninvolved and involved joints

  • Community reintegration

OTAs who treat patients before they receive a prosthetic should include desensitization, AROM of the uninvolved joints, wrapping, ADL training, skin care education, and counseling as needed to adjust to the new surgery. The OTA should also include education on managing diabetes, since this will help with wound healing and prevent further complications. 

AROM and PROM of the involved joints is not recommended at this point in the treatment plan, since the prosthetic is not there yet. Community reintegration is also not necessary at this point in the plan of care.

170.

What criteria have been met if a patient is considered independent in a task?

Select the three BEST responses.

  • They can implement a full course of action.

  • They can account for potential mistakes.

  • They can avoid safety hazards in novel and familiar scenarios.

  • They need added time to complete the task.

  • They only need verbal cues.

  • They only need someone to watch in case they need help.

Patients who are considered independent are able to fully execute a motor plan, consider any errors that arise, and predict/avoid safety risks in any situation. 

If patients need additional time to complete the task, they are considered modified independent. If a patient needs verbal cues but no physical assistance, they cannot be considered independent. If they need someone to watch, they are considered needing stand-by assist.

171.

Which of the following motivators is LEAST appropriate to increase patients' participation in an activity?

  • A preferred snack

  • Praise

  • Ability to succeed

  • Choice of activity

Correct answer: A preferred snack

Food, especially candy, is motivating for children. But, it should not be the primary motivator for participation, since someone can develop an unhealthy food relationship. 

Praise, the ability to succeed, and providing choices about what activities to engage in are more appropriate and favored motivators.

172.

Which term describes agencies and companies that cover the majority of costs for health care services?

  • Third-party payers

  • Vendors

  • Providers

  • Veterans Health Administration

Correct answer: Third-party payers

Third-party payers include insurance companies that pay the majority of the cost of health care services.

Vendors are companies that provide equipment. Providers are the health care practitioners such as occupational therapists or therapy assistants. The Veterans Health Administration provides federal health care benefits for veterans and their dependents. It is a large system but does not provide the majority of reimbursements for health care in the U.S.

173.

It is not uncommon for people to have difficulty responding to feedback, especially in the workplace. If a patient with mental health concerns is to receive ADA accommodations, what alternatives might be put into place for providing negative feedback?

Select the three BEST responses.

  • Have the employee prepare their own work appraisal

  • Provide positive reinforcement

  • Offer on-site crisis intervention to help with self-esteem and comfort

  • Offer less predictability surrounding feedback

  • Encourage the employee to independently fix their negative behaviors

  • Eliminate unnecessary distractions

If an employee creates their own work appraisal and assesses their performance, they can then compare this to that of their supervisor for a more fluid conversation. Providing positive reinforcement will help with many aspects of this employee's work performance and satisfaction. On-site crisis intervention can offer many services that give employees assistance with accommodations, emotional support, and building confidence. 

Employers should strive to offer more, not less, predictability and structure surrounding feedback. Employees should work with their supervisors to collaboratively fix negative behaviors. Eliminating unnecessary distractions can help employees better manage time constraints and productivity, but this will not necessarily help them accept negative feedback.

174.

A 65-year-old patient presents to an orthopedic clinic with a script for an orthosis. What health concern might they have that warrants an OTA and OTR to fabricate this orthosis?

Select the three BEST responses.

  • Ulnar drift

  • Swan neck deformity

  • Boutonniere deformity

  • Osteoarthritis

  • Neuralgia

  • Neuropathy

Individuals with ulnar drift might benefit from an ulnar drift splint. Those with a swan neck deformity might be fitted for silver rings, hyperextension blocks, or digital dorsal splints. Someone who presents with a boutonniere deformity might need PIP extension splints. 

Splints are not usually recommended for those with osteoarthritis, neuralgia, or neuropathy.

175.

Which is NOT an appropriate intervention strategy for motor apraxia?

  • Use specific verbal cues

  • Decrease the complexity of the task

  • Provide hand-over-hand assistance

  • Use visual cues

Correct answer: Use specific verbal cues

Motor apraxia is decreased motor planning for performing a task or skill. When treating an individual with motor apraxia, the therapist should not use specific verbal cues related to performance, but instead should generalize feedback and cues. 

The rest of the options are valid tips for addressing motor apraxia.

176.

An OTA just got assigned to work with a patient who has MRSA. How can this therapist best educate this patient to prevent spreading the condition?

  • Avoid communal bathing or swimming areas

  • Offer resting hand splints to allow for function and prevent contractures

  • Wash their hands as little as possible

Correct answer: Avoid communal bathing or swimming areas

Communal areas such as spas, saunas, or swimming pools can spread MRSA to uninfected individuals, so they should be avoided. Resting hand splints are not indicated for MRSA, since this is a bacterial infection that does not cause contractures. Patients should not be educated to wash their hands as little as possible, since good hand hygiene can actually help prevent the spread of this infection.

177.

If a patient experienced an occipital stroke due to a blockage in the posterior cerebral artery, what impairments might they have?

  • Vision loss or changes

  • Hearing loss or changes

  • Impaired or absent sensation

  • Poor attention and focus

Correct answer: Vision loss or changes

The occipital lobe primarily carries out visual functions.

The temporal lobe primarily carries out auditory functions. The parietal lobe is responsible for processing sensory information. The frontal lobe is responsible for executive functions, such as attention.

178.

Which type of amputation is also known as a below-knee amputation?

  • Transtibial amputation

  • Transfemoral amputation

  • Hemipelvectomy

  • Hip disarticulation

Correct answer: Transtibial amputation

A transtibial amputation is also known as a below-knee amputation and originates at the tibia and fibula.

A transfemoral amputation is also known as an above-knee amputation and originates at the femur.

A hemipelvectomy involves removal of the entire leg as well as half of the pelvis.

A hip disarticulation is amputation of the entire leg, including the full femur.

179.

A client goes to open the door but instead bangs their hand into the wood instead of grasping the doorknob. What symptom are they experiencing?

  • Dysmetria

  • Dyssynergia

  • Intention tremor

  • Dysdiadochokinesia

Correct answer: Dysmetria

Dysmetria is decreased accuracy when reaching toward an item, such as reaching to brush the dog but landing the brush on his nose rather than his neck.

Dyssynergia is difficulty moving each part of a limb cohesively. For example, when reaching, they move the shoulder first, then the elbow, then the hand all separately rather than in one motion. An intention tremor is a tremor that occurs with attempts at active movement, such as reaching to grasp a glass. Dysdiadochokinesia (DDK) is the inability to quickly alternate movements, such as alternating supination and pronation between the arms.

180.

What strategies might an OTA use for an 85-year-old woman with dementia who has just begun wandering in her assisted living facility? 

Select the three BEST responses.

  • Use door alarms and personal monitoring devices

  • Install deadbolt locks at all doors

  • Hide all exits with mirrors and other obstructions

  • Animal therapy

  • Pastoral care visits

  • Limit external noises

Door alarms, personal monitoring devices, and deadbolt locks can all prevent wandering. It's also recommended to hide all exits with full-length mirrors, wallpaper, blinds, stop signs, and other camouflaging obstructions. 

Animal therapy and pastoral care visits might be of solace to those with dementia, but this will not necessarily prevent wandering. Limiting external noises can assist with reducing aggression, but this will also not directly help with wandering behaviors.

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