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NBCOT 2024 QUESTIONS WITH ALL CORRECT ANSWERS, GRADED A+
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A client who has stage 6 Alzheimer's disease has been unwilling to bathe for over a week. The spouse, who is the primary caregiver, asks the COTA for strategies to support the client in completing bathing activities. Which strategies should the COTA provide to the caregiver to support the client'...

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  • August 3, 2024
  • 48
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers

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  • nbcot

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  • NBCOT
  • NBCOT

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NBCOT
A client who has stage 6 Alzheimer's disease has been unwilling to bathe for over a week. The spouse,
who is the primary caregiver, asks the COTA for strategies to support the client in completing bathing
activities. Which strategies should the COTA provide to the caregiver to support the client's participation
in hygiene activities? - Prepare the bathroom prior to the planned bath time.

Plan to complete all the bathing activities as quickly as possible.

Simplify the steps of bathing into clearly understood stages.

Schedule bathing for the same time every day before breakfast.

Offer the client the choice to either take a bath or a shower.

Help the client understand the importance of a bathing routine.



A 10-year-old child has poor motor control and incoordination of the dominant upper extremity
secondary to a cerebellar brain tumor. One of the goals is to help the child independently complete a
grooming routine. Which assistive device would be MOST BENEFICIAL for the child to use for supporting
this goal? - Hair brush with an extended handle

Nail clippers with a suction cup base

Toothbrush with a contoured grip



A 10-year-old child has spastic quadriplegia and is non-verbal. The child is learning to use an
augmentative and alternative communication (AAC) word completion system for the first time. This
requires the child to use head-turning to activate the control interface. During the initial trial, the child is
able to activate the device, but the voice-output message produced is not understandable. Which
activity should the COTA have the child practice FIRST to refine the skills needed to operate the AAC? -
Providing time-dependent choices using symbols instead of words

Playing with a switch-activated toy to master point and click options

Using the head switch to express simple messages and intentions



A 10-year-old child is undergoing treatment in a pediatric hospital after having an open reduction and
internal fixation of bilateral femur fractures. The discharge planning team indicates the child will be
discharged home in 3 days. Although the child has made progress, several of the intervention goals have
not been achieved. Which action should the COTA take to maximize the child's progress prior to
discharge? - Have the child's parents attend remaining sessions so that they can assist with goal
achievement after discharge.

,Identify the child's current level of participation and barriers influencing the expected outcomes for each
goal.

Increase the frequency and duration of OT sessions to enable more opportunities to work toward unmet
goals.



A 10-year-old child sustained a TBI several days ago and is functioning at Level VI (Confused,
Appropriate) on the Rancho Los Amigos scale. One of the inpatient rehabilitation goals is for the child to
bathe independently. Which approach is MOST EFFECTIVE for facilitating success with bathing tasks
based on the child's current cognitive level? - Have the child follow sequential picture cards for
each bathing task.

Provide intermittent verbal instructions throughout the bathing activity.

Use hand-over-hand assistance for each step of the bathing routine.



A 10-year-old child who sustained a TBI 3 weeks ago has made significant progress in an inpatient
pediatric rehabilitation setting, but mild cognitive and physical deficits persist. The child will be
discharged home to live with family in several days and will be transitioning back to school as soon as
possible. What role does the inpatient OT team have in supporting the child's transition back to school? -
Communicate with the special education team regarding the child's needs.

Complete the initial paperwork for services under section 504 of the IDEA.

Provide the IEP team with unmet goals to carry over in the school environment.



A 14-year-old adolescent with a progressive neurological condition has Good (4/5) functional strength of
proximal upper extremities and Poor (2/5) strength distally. This interferes with the adolescent's ability
to independently self-feed. Which assistive device would be MOST BENEFICIAL for the adolescent to use
for maximizing independence while eating? - Swivel spoon with an extended handle

Universal cuff with hook-and-loop strap

Utensil with a large built-up foam grip



A 15-year-old student in high school has autism spectrum disorder. The transition plan recently was
updated to include the student's long-term independent living objective. After completion of high
school, the student wants to move out of the parents' home and live alone in an apartment. Which
intervention would be MOST BENEFICIAL to promote progress toward this objective? - Assist the
student in advocating for personal care supports.

Encourage the student to identify a meal preparation goal.

,Help the student develop routines for daily living.



A 17-month-old child who has fetal alcohol syndrome recently developed skills for maintaining an
upright sitting position for several minutes at a time while unsupported. Which intervention activity
would support the NEXT level of motor development while sitting? - Ask the child to lean to one
side to reach for a toy while straddling a cylindrical bolster.

Encourage the child to throw a ball while seated cross-legged on a platform swing.

Have the child raise both arms above the head in rhythm to music while sitting on the floor.



A 2-year-old child has hypotonia resulting in developmental delay. Currently, the child has good head
control, can roll from supine to prone, and shifts weight from side to side in prone. One of the
intervention goals is for the child to master movement in a quadruped position. Which facilitation
activity is MOST BENEFICIAL to include as part of the initial intervention for progressing toward this goal?
- Have the child reach for a toy with alternating hands while lying in prone over a therapy ball that
is 31 inches (78.74 cm) in diameter.

Place the child in a hands-and-knees position on the floor while providing stabilization at the pelvis.

Position the child in prone on a wedge cushion on the floor to provide joint approximation on propped
arms.



A 2-year-old child with Down syndrome has an oral-motor deficit resulting in ineffective chewing skills.
The child is not eating solid food but is able to safely swallow liquids from a bottle with a standard
nipple. One of the intervention goals is to improve the child's oral-motor control for chewing solid food.
Which type of solid food texture should be introduced to the child at the start of a feeding program? -
Finely chopped

Fork mashed

Smooth pureed



A 4-year-old child has age-appropriate motor skills, but communication, social play, and ADL skills are at
a 2-year-old level. Which technique would be MOST BENEFICIAL to use with the child for promoting
cognitive development for self-dressing? - Allowing the child to play dress-up while offering visual
cues as needed

Having the child use a doll to practice putting on and taking off clothing

Rewarding the child for each piece of clothing properly donned each morning

Using a dressing board for training the child to button, zipper, and snap

, A 4-year-old child has moderately poor visual-spatial skills and difficulty integrating both sides of the
body. Which activity would be MOST BENEFICIAL to include as part of the intervention for promoting
initial improvement of these skills? - Carrying dishes from table to sink

Swinging on a suspension swing

Pushing a toy cart through a maze

Playing with small interlocking blocks



A 4-year-old child has poor motor coordination and limited trunk control secondary to Dandy-Walker
syndrome. In preparation for a play session, the COTA positions the child in a standing frame that has a
contoured head support, an attached tray table, and an adjustable foot support. When the child is in a
full upright position, the child's head falls into forward flexion. Which action should the COTA take to
facilitate the child's ability to participate in the play session? - Remove the head support from the
stander.

Place the stander in a slightly reclined position.

Tilt the tray table to a 45° incline in relation to the torso.



A 4-year-old child has spastic quadriplegic cerebral palsy and is dependent on caregivers for all aspects of
bathing. The child's parents indicate that it is becoming difficult to wash the child in the home bathtub
and ask the COTA about available equipment options that would make this task more manageable.
Which equipment should the COTA recommend placing in the tub to support safe bathing? - Bath
transfer bench with a nonskid seating surface

Hammock chair with suction feet and head support

Trunk support ring with a molded back and adjustable legs



A 4-year-old child with Rett syndrome has characteristic excessive hand wringing and hand-to-mouth
patterns. The neurologist ordered a right volar long arm immobilization orthosis to control the negative
effects of these movements, and the COTA fabricated the orthosis 2 weeks ago. During a follow-up
appointment, the parents report difficulty adhering to the prescribed wear schedule because the child
removes the orthosis when the parents are not in line of sight. After inspecting the child's skin and
ensuring an effective fit, which action should the COTA take to support better compliance with the wear
schedule? - Change the orthosis to a circumferential clamshell design.

Provide the parents with a stockinette to place over the orthosis.

Replace the hook and loop straps with riveted snap closures.

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