NBCOT Wheelchair Seating and Mobility
Exam Prep, (Answered) Solution
A COTA® is assisting the OTR® in providing care to a child with lumbar-level
spina bifida. The child spends the majority of time in a wheelchair and plays
adapted basketball. What does evidence reveal as the most effective occupational
therapy intervention for preventing pressure ulcers? Select the BEST 3 choices.
A. Strategies to increase shear
B. Functional activities
C. Wheelchair seating assessment
D. Weight-shifting training
E. Client prevention education
F. Safe transfer techniques
C. Wheelchair seating assessment
E. Client prevention education
F. Safe transfer techniques
A COTA® works at a skilled nursing facility that provides wheelchairs for clients
who need them. As a result, the facility has a room full of wheelchairs of varying
sizes. The COTA is often expected to find the wheelchair that best fits each new
client, which requires determining whether the seat depth is appropriate for that
client. Where should the front edge of the wheelchair seat be in relation to the
client's hamstrings?
A. 5 to 6 inches proximal to the posterior side of the bent knee
B. 1 to 2 inches proximal to the posterior side of the bent knee
C. At the knee crease on the posterior side of the bent knee
D. 1 to2 inches distal to the posterior side of the bent knee
B. 1 to 2 inches proximal to the posterior side of the bent knee
A COTA® is working in a skilled nursing facility and is on the restraint reduction
team. A long-term resident has recently sustained several falls within a few days,
and the team has been asked to assess the situation. What is the MOST important
consideration during the assessment?
A. The safest intervention that will eliminate all future falls
B. The least restrictive intervention that reduces the need for staff intervention
C. The least restrictive intervention that is also safe
D. The safest intervention that is also not a financial burden to the facilty
C. The least restrictive intervention that is also safe
A COTA® at a skilled nursing facility is working with an older client who appears
to have a large gap between the back of the knees and the front of the seat
cushion. What factors may be interfering with the client's positioning within the
seat? Select the 3 BEST choices.
A. Armrest height
B. Back brace
C. Seat back height
D. Shortened seat depth
, E. Anterior pelvic tilt
F. Fatigue
B. Back brace
D. Shortened seat depth
F. Fatigue
A client sustained a C4 spinal cord injury in a car accident, and the OTR®-®is
recommending a power wheelchair with a sip-and-puff controller. Which of the
following options would be best for providing pressure relief to the buttocks by
changing orientation in space but not body position?
A. Tilt in space
B. Recline
C. Elevating leg rests
D. Pelvic bar
A. Tilt in space
A client who is being seen by both occupational therapy and physical therapy
requires an ankle foot orthosis to prevent foot drop while walking and completing
standing ADLs. In this situation, what is the COTA® responsible for regarding
lower-extremity orthoses?
A. Assisting in evaluation for orthosis necessity
B. Adjusting the orthosis when it does not fit
C. Teaching the client to don and doff the orthosis during dressing
D. Assisting with gait training after orthosis application
C. Teaching the client to don and doff the orthosis during dressing
A COTA® has a client who requires a new wheelchair, so the COTA is assisting
the OTR in selecting the appropriate wheelchair. During this process, it is
important to consider seat width. When considering seat width, what should be
the COTA's MAIN objective?
A. To distribute weight over the widest possible surface while keeping the width
of the chair as narrow as possible
B. To support the client's body in the wheelchair while maintaining the thighs in a
position that is parallel to the floor
C. To maintain proper posture and balance and to provide support and alignment
for the upper extremities
D. To provide for maximal function and support of the back while allowing for
change in body positioning
A. To distribute weight over the widest possible surface while keeping the width of the
chair as narrow as possible
A COTA® is treating a client who, because of increased right leg weakness, has
recently begun using a right footrest to avoid foot drag during wheelchair
propulsion. What would be the benefit of using a heel loop on the footplate of the
wheelchair?
A. To prevent the foot from sliding backward
B. To accommodate for ankle flexion
C. To accommodate for preferred knee flexion angle
D. To prevent falls during transfers
A. To prevent the foot from sliding backward
Exam Prep, (Answered) Solution
A COTA® is assisting the OTR® in providing care to a child with lumbar-level
spina bifida. The child spends the majority of time in a wheelchair and plays
adapted basketball. What does evidence reveal as the most effective occupational
therapy intervention for preventing pressure ulcers? Select the BEST 3 choices.
A. Strategies to increase shear
B. Functional activities
C. Wheelchair seating assessment
D. Weight-shifting training
E. Client prevention education
F. Safe transfer techniques
C. Wheelchair seating assessment
E. Client prevention education
F. Safe transfer techniques
A COTA® works at a skilled nursing facility that provides wheelchairs for clients
who need them. As a result, the facility has a room full of wheelchairs of varying
sizes. The COTA is often expected to find the wheelchair that best fits each new
client, which requires determining whether the seat depth is appropriate for that
client. Where should the front edge of the wheelchair seat be in relation to the
client's hamstrings?
A. 5 to 6 inches proximal to the posterior side of the bent knee
B. 1 to 2 inches proximal to the posterior side of the bent knee
C. At the knee crease on the posterior side of the bent knee
D. 1 to2 inches distal to the posterior side of the bent knee
B. 1 to 2 inches proximal to the posterior side of the bent knee
A COTA® is working in a skilled nursing facility and is on the restraint reduction
team. A long-term resident has recently sustained several falls within a few days,
and the team has been asked to assess the situation. What is the MOST important
consideration during the assessment?
A. The safest intervention that will eliminate all future falls
B. The least restrictive intervention that reduces the need for staff intervention
C. The least restrictive intervention that is also safe
D. The safest intervention that is also not a financial burden to the facilty
C. The least restrictive intervention that is also safe
A COTA® at a skilled nursing facility is working with an older client who appears
to have a large gap between the back of the knees and the front of the seat
cushion. What factors may be interfering with the client's positioning within the
seat? Select the 3 BEST choices.
A. Armrest height
B. Back brace
C. Seat back height
D. Shortened seat depth
, E. Anterior pelvic tilt
F. Fatigue
B. Back brace
D. Shortened seat depth
F. Fatigue
A client sustained a C4 spinal cord injury in a car accident, and the OTR®-®is
recommending a power wheelchair with a sip-and-puff controller. Which of the
following options would be best for providing pressure relief to the buttocks by
changing orientation in space but not body position?
A. Tilt in space
B. Recline
C. Elevating leg rests
D. Pelvic bar
A. Tilt in space
A client who is being seen by both occupational therapy and physical therapy
requires an ankle foot orthosis to prevent foot drop while walking and completing
standing ADLs. In this situation, what is the COTA® responsible for regarding
lower-extremity orthoses?
A. Assisting in evaluation for orthosis necessity
B. Adjusting the orthosis when it does not fit
C. Teaching the client to don and doff the orthosis during dressing
D. Assisting with gait training after orthosis application
C. Teaching the client to don and doff the orthosis during dressing
A COTA® has a client who requires a new wheelchair, so the COTA is assisting
the OTR in selecting the appropriate wheelchair. During this process, it is
important to consider seat width. When considering seat width, what should be
the COTA's MAIN objective?
A. To distribute weight over the widest possible surface while keeping the width
of the chair as narrow as possible
B. To support the client's body in the wheelchair while maintaining the thighs in a
position that is parallel to the floor
C. To maintain proper posture and balance and to provide support and alignment
for the upper extremities
D. To provide for maximal function and support of the back while allowing for
change in body positioning
A. To distribute weight over the widest possible surface while keeping the width of the
chair as narrow as possible
A COTA® is treating a client who, because of increased right leg weakness, has
recently begun using a right footrest to avoid foot drag during wheelchair
propulsion. What would be the benefit of using a heel loop on the footplate of the
wheelchair?
A. To prevent the foot from sliding backward
B. To accommodate for ankle flexion
C. To accommodate for preferred knee flexion angle
D. To prevent falls during transfers
A. To prevent the foot from sliding backward
