COTA Boards Exam 2 Questions and Solutions

COTA Boards Exam 2 Questions and Solutions A COTA® is working in an outpatient clinic with a child with ADHD. The client reports having difficulty keeping the bedroom neat and tidy without the mother's assistance. On the basis of this condition, which activity demand related to cleaning one's room would be problematic for the client? A. The mother's expectation that food not be eaten in bedrooms B. Drawers that are not designated for specific types of clothing C. A small wastepaper basket D. Lack of space under the client's bed The right answer is B According to AOTA (2008, pp. 634), "Activity demands include the specific objects and their properties used in the activity, the physical space requirements of the activity, the social demands, sequence and timing, the required actions or skills needed to perform the activity, and the required body functions and structures used during the performance of the activity." The lack of designated drawers for different types of clothing may prevent the client from keeping the room neat and tidy. Why might a client with early-stage dementia appear less spontaneous when performing daily routines? A. The client may be compensating for memory loss. B. The client may be compensating for decreased orientation. C. The client may be compensating for decreased spatial orientation. D. The client may be compensating for decreased temporal organization. The right answer is A The client may be aware of memory loss at this stage and compensate by becoming rigid in routines so that the client still appears to others to have intact memory skills. A COTA® is working with a child with ADHD who is transitioning from elementary school to middle school and discussing the child's concerns with the educational team. Given the child's condition, with which occupation might the child need support? A. Meeting a new friend B. Initiating a routine C. Listening to instructions or conversations D. Forming a bond with more than one teacher The right answer is C Children with ADHD typically have difficulty paying attention to details and may miss important information that is conveyed verbally, such as with instructions or conversations. A COTA® in a private clinic is discussing with other practitioners potential peers who can be paired or grouped with a 3-year-old client. The client has autism, and the goals include improving play and social skills. Which potential peer has appropriate characteristics to consider when choosing peers to partner with this client? A. A child of the other gender, to promote gender diversity and exposure to children of that gender B. A child with the same diagnosis who has not been paired with another child during therapy sessions C. A child with the same diagnosis and developmental level as the client D. A slightly older child with a slightly higher developmental level than the client The right answer is D Peers of different ages and different developmental statuses can promote different types of play and leisure behaviors and can advocate a multitude of play skills. A COTA® in an adult day treatment program decides to use a group intervention with clients with schizophrenia who live in a supported living environment with 24-hour supervision. The COTA believes that a sensorimotor approach would help the clients reach their goal to increase independence in overall function and goal-directed activity in the home context. What would be an appropriate group activity that uses the sensorimotor approach? A. Discussing task performance B. Exercising to music C. Using a sensory room D. Baking cookies The right answer is B Exercising to music is used in sensorimotor approaches to enhance motor learning and sensory functioning. It can be used by the COTA to improve skills for daily living and has been recommended as an evidence-based approach for people with schizophrenia. A COTA® is working in the burn unit of a hospital. A client has undergone skin grafting to close wounds on the dorsum of the hand. What occupational therapy treatment is MOST appropriate for the 5 to 7 days post skin graft? A. Instruct client in AROM of the wrist and hand but limit PROM until the staples are removed B. Fabricate and fit the client with a safe position splint over the dressings C. Involve the use of the grafted hand in ADLs that involve resistive grasp D. Perform PROM to the wrist and hand but instruct the client to limit use of the hand outside of occupational therapy treatment sessions The right answer is B Splinting the hand in the safe position allows the graft to take and the wound to heal and prevents deformities. A COTA® is working on dressing in early intervention with a 2-year-old who has a developmental delay. The child is able to take off socks and put legs through pant holes when pants are held up. What is the next area of dressing the COTA® should address? A. Lace shoes. B. Put on mittens. C. Remove coat. D. Put on socks. The right answer is C At age 2, a child should be able to doff a coat after fasteners have been unfastened; the child should also be able to remove shoes if not tied; begin to help with pulling down pants; and locate armholes in shirt. A COTA® is gathering information to support the OTR®; in developing a functional behavior analysis plan for a child with autism who demonstrates severe behavioral problems. Which approach adheres to the essential elements of creating a comprehensive behavioral support plan? A. The behavioral plan must be applied at least half of the school day. B. The plan must include one intervention strategy that is effective for the child's needs. C. The elements of the plan must reflect the values and resources of the child and the person providing support. D. The plan must contain only standardized assessments of behavior. The right answer is C The four essential components of a comprehensive behavioral support plan are (1) a functional assessment of behavior, (2) use of multiple interventions, (3) application of the plan throughout the day, and (4) elements that reflect the values and resources of the child and the person providing support. A COTA® chooses to incorporate the use of a variety of experiences, different media, and novel instructional materials during a handwriting intervention session. Which model of practice is guiding the COTA®'s intervention? A. Neurodevelopmental B. Acquisitional C. Sensorimotor D. Biomechanical The right answer is C A sensorimotor approach to handwriting would include the incorporation of a variety of sensory experiences, different media, and novel instructional materials during a handwriting intervention session. It would also include offering the child multiple different writing tools, writing surfaces, and positions for writing. Which activity would a client with age-related macular degeneration likely have difficulty performing? A. Reading printed material B. Engaging in functional mobility C. Seeing well at nighttime D. Tolerating glare from lights The right answer is A Difficulty reading printed material is a characteristic feature of age-related macular degeneration because of the gradual loss of ability to see clearly and development of a dark or empty area in the center of the vision. A COTA® has been teaching visual scanning techniques to a patient who has a CVA. When documenting progress, what information is BEST to include in the Objective section of a SOAP note? A. The patient's ability to use the techniques and level of assistance needed during a specific dressing activity B. Improvements noted in the patient's participation during ADLs when using the newly learned techniques C. Modifications needed to increase the patient's understanding of the specific techniques D. Family members' observations of the patient using the techniques during activity The right answer is A The Objective section provides concise information that reports what was observed and what occurred in the session; reporting the assistance levels and the techniques used for dressing is appropriate for the Objective section. A client scores an Allen Cognitive Level (ACL) of 4.0 with the Allen Cognitive Disability Framework. A COTA® is working with the client in an adult day treatment center. A. Any project with mostly familiar steps; no more than two steps of the task should require new learning. B. A project that is unstructured; the client should be given opportunities to find and revise errors. C. A project that is set up with a model final product; simple instructions should be provided, along with supervision. D. A project that encourages relatively independent planning and organizing to complete; none of the steps should require new learning. The right answer is C A person with an ACL of 4.0 can perform only simple tasks and will have difficulty with problem solving. A model with clear instructions should be provided along with supervision for cues and guidance when needed. Which part of original Medicare covers stays at hospitals and inpatient rehabilitation facilities? A. A B. D C. B D. C The right answer is A Medicare Part A covers stays at these facilities. A 7-year-old child presents with amelia. The OTR® recommends the use of a myoelectric hand. What type of terminal device would be appropriate? A. Externally powered prosthesis B. Body-powered prosthesis C. Passive prosthesis D. Hook prosthesis The right answer is A A myoelectric hand is paired with an externally powered prosthesis, which involves the placement of an electrode to pick up electromyographic signals to move the electric hand.