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Enhanced NBCOT Exam Prep with TrueLearn Random Test 2 and OTR Prepathon.
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Enhanced NBCOT Exam Prep with TrueLearn Random Test 2 and OTR Prepathon.
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Enhanced NBCOT Exam Prep withTrueLearn Random Test 2 and OTR
Prepathon.
An OTR is treating a client with complex regional pain syndrome (CRPS) in the
dominant hand. The client is very protective of the hand secondary to pain and edema
and becomes nauseated when the hand is touched. What is the therapist's BEST
response to this situation?
A. Avoid touching the hand and promote use of the non-dominant hand
B. Provide a structured exercise program that includes the shoulder
C. Do not initiate therapy until the pain and edema has resolved
D. Avoid movement of shoulder and focus specifically on the hand function -
\B
A continuous, severe burning pain that is often out of proportion to the severity of the
injury characterizes complex regional pain syndrome (CRPS). Although the hand is the
affected area, CRPS often triggers shoulder pain and stiffness; therefore, the shoulder
must be incorporated into an exercise program in order to maintain or prevent shoulder
dysfunction.CRPS is treated by reducing sympathetic stimulation and is most
responsive in the early stages with the first goal of intervention to reduce pain and
hypersensitivity.
An OTR is working with a client with hemiparesis of the dominant upper extremity
following a cerebrovascular accident (CVA). The client has significantly low tone in the
upper extremity and no functional use. Which is BEST for the OTR to address when
working with this client?
A. Risk of joint and soft tissue injury during activities of daily living (ADLs) and bed
mobility
B. Constraint-induced movement therapy to decrease learned non-use
C. Weight-bearing through the upper extremity and use for support
D. Using supported reach tasks and moving objects across a table -
\A
During the low tone stage, joints are at an increased risk for injury due to instability and
are more likely to become misaligned. With low tone, the muscles do not provide the
typical or normal stabilization around the joints, increasing the opportunity for
misalignment to occur. In order to protect the unstable joints, the OTR must address the
risk, maintenance, and protection of the joints and soft tissues during activities of daily
living (ADLs) and bed mobility.
,An OTR is planning group intervention utilizing a cognitive-behavioral frame of
reference. Which intervention is MOST appropriate to utilize during group activities?
A. Use open-ended questions to obtain understanding
B. Provide feedback for members to help one another
C. Explore client feelings through movement activities
D. Practice and rehearse techniques learned in group -
\D
The cognitive-behavioral frame of reference promotes that the best strategy for change
is reinforcements. Change occurs when behavior is reinforced in some way. Practice
and rehearsal of technique learned, or role-playing, allows clients to practice newly
learned behaviors in a safe, therapeutic, and supportive environment.
A 14-year-old client is working with a OTR to expand his social engagement and
participation with peers. He presents with challenges connecting with peers and making
friends. The client has indicated a personal goal to increase social engagement and
friendships. What is the BEST way for the OTR to gain a perspective on the client's
needs?
A. Use a parent report to determine targeted areas to improve social engagement
B. Use a client report to determine the youth's feelings and experiences in context
C. Use parent report to determine cognitive and social engagement skills
D. Use standardized testing to determine targeted areas to improve cognitive skills and
work preferences -
\B
During a chart review, an OTR notes the client has experienced extensor tendon injury
in zone I of the hand. Which BEST describes what the client is experiencing?
A. Mallet deformity
B. Clawhand deformity
C. Complex regional pain
D. Finger contractures -
\A
Mallet deformity is the result of a disruption of the terminal extensor tendon and
manifests itself as distal interphalangeal (DIP) extensor lag, specifically in zone 1 of the
hand. A mallet finger is characterized by flexion of the DIP joint resulting in the finger
losing the ability to extend the distal phalanx.
Clawhand deformity is the result of high level ulnar nerve involvement resulting in the
hyperextension of the metacarpophalangeal (MCP) joints of the ring and small fingers.
The hyperextension is the result of the overaction of the extensor digitorum communis
that results in a clawing appearance of the hand.
Answer C: Complex regional pain syndrome is not unique to this injury and is a group of
disorders that involve pain and dysfunction with the severity out of proportion to the
,initiating event. Complex regional pain syndrome can develop with any injuries and is
not specific to hand injuries.
Answer D: Contractures result in tissue shortening due to lack of passive motion and
are not unique to this zone of the hand.
A client presents with severe rheumatoid arthritis of both shoulders and hips and is
limited in his ability to perform self-care activities. He lives at home with his wife. He
expressed that he has not been able to help his wife with homemaking tasks and would
like to avoid being a burden to his wife. He would like to be able to dress himself and
complete his own bathing and grooming. Which of the following assistive devices is
MOST appropriate for the client?
A. Button hook
B. Long-handled sponge
C. Built-up handle toothbrush
D. Mounted nail clipper -
\B
An OTR is making an early intervention home visit to a family in a rural community. The
grandmother, mother, and mother's sister are present during the session, and the
grandmother is bottle-feeding the 8-month-old infant when the OTR arrives. The OTR's
goal for the child is to work with the family on further developing the child's motor skills.
What INITIAL action should the OTR take in the session with this family?
A. Wait until the child finishes eating for the mother to begin therapy with the child in
order to work on motor skill development
B. Re-schedule the child's therapy session due to concern that motor activities are
contraindicated after bottle-feeding
C. Focus the treatment session on feeding skills to incorporate the natural routine and
habits of the family
D. Engage the caregivers in conversation about the child and the progress made since
the last therapy visit33.8% of Users Answered Correctly -
\D
A client is beginning phase 2 of cardiac rehabilitation in an outpatient setting. After
assessing the client's risk factors and cardiovascular response to exercise, the OTR
develops the intervention plan to incorporate discontinuous exercise. Which is the BEST
benefit for this recommendation?
A. Multiple muscle groups are utilized
B. Completion of 40 minutes of exercise
C. Specific muscle groups are targeted
D. Mimics home exercise programs -
\A
Discontinuous exercise allows the patient to stay on one piece of equipment for one-half
or one-third of the allotted time and provides an opportunity for multiple muscle groups
to be utilized, boredom to be minimized, and exposure to a variety of equipment.
, Discontinuous exercise provides a broader rehabilitation program secondary to focusing
on multiple muscle groups.
An OTR is working with a patient who had a cerebrovascular accident on increasing
his/her functional hand use. What is the MOST BENEFICIAL activity to develop radial-
ulnar dissociation needed to increase in-hand manipulation skills?
A. Watering a plant using a spray bottle
B. Wearing a serpentine splint at night
C. Playing a card game of Go-Fish
D. Completing a 100-piece puzzle -
\A
Watering a plant using a spray bottle deliberately separates the radial side of the hand
(the thumb, second, and third digits) from the ulnar side (fourth and fifth digit) of the
hand to practice working on the dissociation of the hand to improve hand use.
Working in an acute care setting, an order is received for acute post-operative repair of
boxer's fracture of the right dominant upper extremity. The patient has been immobilized
post-operatively with gauze and ace wrapping. The surgeon has ordered an
occupational therapy evaluation and treatment including splinting. What is the MOST
appropriate plan of treatment, including the most appropriate splint fabrication and the
most appropriate approach to post-operative edema control for this patient.
A. Forearm-based resting hand splint with wrist extension at 20 degrees, begin active
and passive tendon glides to promote wrist and digit mobility, positioning, and/or light
massage to promote edema control
B. Forearm-based ulnar gutter splint with 4th and 5th metacarpophalangeal joint flexed
to 60 degrees, begin active and passive tendon glides for wrist and digit mobility,
positioning, and/or light massage to promote edema -
\B
According to current research and evidence-based practice, ulnar gutter splints with
mild wrist extension and metacarpophalangeal joint flexion to 60 degrees, if possible, is
recommended. Early mobilization through tendon gliding and range of motion is
indicated to promote early return to active sports in athletes with boxer's fracture.
An OTR is working with a kindergarten classroom teacher in developing seating options
for all students in her classroom. The teacher shared that her students are seated on
the floor during several academic instruction times. They are positioned in a circle and
often students struggle with keeping their hands to themselves and their bodies in their
own space. What type of chair might the OTR recommend to the teacher?
A corner chair
B Infant sitter
C cube chair
D Howda Hug Chair -
\C
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