Purple Book NBCOT, Complete Answered Rationales Test Bank 2022. An OT is preparing to evaluate a toddler who has UE orthopedic concerns. How will the OT MOST likely obtain the majority of the initial assessment data? a. measurement tools that assess visual-motor skills. b. dynamometer and pinch meter readings. c. Observation of a child during activities in the child-care center. d. Functional independence measures. -Answer- C. observation of a child during activities in the child-care center. Through observation of the child, the OT can collect information about the child's motor performance skills and participation in activities that require UE/hand skill. Naturalistic observation is a method of ecologic assessment which is a "primary mechanism for obtaining data relevant to the child's performance context." The other answer choices are all appropriate choices after the child is old enough for these assessments. During an initial eval, the OT suspects that a child has somatodyspraxia. In what area should the OT focus on the eval? a. ability to print or write b. reading competency c. math calculations d. new motor task planning -Answer- D. New motor task planning Somatodyspraxia is described as a deficit in learning new motor skills, planning new motor actions, and generalizing motor plans. Inability to print or write is termed dysgraphia. Dyslexia means dysfunction in reading, and dyscalculia is the term for inability to perform mathematics. An OT working in a long-term care facility needs to eval the long-term memory of a resident. Which of the following methods is BEST for evaluating memory of personally experienced events (declarative memory). a. show the person a series of objects and ask him to recall the objects within 60 seconds b. ask the individual how he spent New Years. c. have the individual state the place, date, and time. d. ask the client to remember to bring a specific item to the next therapy session. -
Answer- B. ask the individual how he spent New Years Declarative memory is one aspect of long term memory and includes conscious memory of events, knowledge, or facts. It is commonly assessed through verbal interviews and informal testing such as asking a question about a persons recall of personal events. Working memory refers to the temporary storage of information while one is attending to it (answer A). Prospective memory involves the ability to remember intentions or activities that will be required in the future (answer D). Knowing time, date, and place is orientation. A child avoids playground equipment that requires her feet to be off the ground. What does this behavior MOST likely indicate? a. difficulty modulating proprioception b. somatodyspraxia c. gravitational insecurity d. bilateral integration/sequencing deficits. -Answer- C. Gravitational insecurity. gravitational insecurity is described as fear response to movement. Tactile defensiveness (answer A) is a term used to describe discomfort with various textures with unexpected touch. Somatodyspraxia interferes with development of bodyscheme and awareness. Bilateral integration relates to ability to coordinate, sequence, and execute motor actions quickly and efficiently. When the OT suspects tactile defensiveness as a rational for a child's challenges, in what area of participation should the OT focus on FIRST? a. play behavior b. dressing habits c. social skills d. leisure interests -Answer- b. dressing habits Children with tactile defensiveness are bothered by tactile aspects of ADLs including specific types of clothing. The child may avoid wearing certain clothes. Conversely, some children may never take their shoes off to avoid tactile stimulation. Play behavior and social skills could be affected secondarily as a result of intolerance to certain textures or human touch. Knowledge of the child's dressing habits will give the OT key information at the start of the evaluation process. An OT is working with an individual with schizophrenia who is in the process of preparing to move from a state hospital to a group home. During a baking group, the client becomes agitated and leaves the room when another client uses the electric hand mixer to mix the cake batter, and again when two clients begin to argue loudly about which type of icing to use. How would the OT BEST describe this behavior? a. low registration b. sensory avoiding c. sensory seeking d. a hearing impairment -Answer- b. sensory avoiding The individual's actions are indicative of sensory avoiding behavior, characterized by low threshold to stimuli perceived as noxious, followed by an active response such as leaving the room. Individuals with sensory avoiding behavior may become distressed in situations in which they cannot control the environment. An individual with low registration, sensory seeking behavior, or a hearing impairment would not have difficulty with the auditory stimulation. During a self-care eval of an individual who recently sustained a brain injury, the OT instructs the individual to comb his hair immediately after he washes his face. The individual washes his face quickly, but then the therapist must give him several reminders to comb his hair. The OT is MOST likely to identify this as a deficit in what area? a. working memory b. judgement c. hearing d. abstraction -Answer- a. working memory working memory is the temporary storage of information while one is working with it or attending to it. It includes the ability to recall information immediately after exposure. It also allows one to focus conscious attention and keeps track of information as one is performing an activity. Judgment is the ability to make realistic and safe decisions and would not be needed for this task. Because the person performed the first request, hearing would seem intact. Abstraction is the ability to extrapolate information from an idea to generalize to another situation and would not be needed to follow this direction. A supermarket employee with OCD takes an hour to stock 24 soup cans on the shelf because once he has placed the cans on the shelf, he removes them and starts over stating "all the labels were not lined up exactly in the same direction." Which of the following methods would be MOST effective to evaluate this individual's work performance? a. on-site observation of performance skills b. formal cognitive assessment c. verbal interview focusing on the requirements of the job. d. task evaluation using a "clean" medium such as a puzzle. -Answer- A. on-site observation of performance skills Individuals with OCD often experience difficulties with work. Observation in situational context is likely to be more useful in fully understanding their behavioral success and is the preferred approach for assessing work function of people with psychiatric disabilities. There is nothing to suggest the individual has a cognitive deficit or need for cognitive evaluation. Interview is more useful for assessing an individual's readiness for work, occupational development, and interests. Task evaluation with a clean medium may be indicated for individuals with OCD of the washing type. However, this individual has OCD of the checking type. An OT has been working with an individual who is recovering from a TBI. A standard pivot transfer has been successfully demod in the gym. The MOST appropriate way to assess generalization of this new learning would be to have the patient perform which activity? a. identify potential hazards in the patient's bathroom at home that could make transferring unsafe. b. select an appropriate tub bench and nonskid mat for the patient's bathroom at home. c. attempt a standard pivot transfer from wheelchair to bed in the patient's hospital room. d. attempt a sliding board transfer from wheelchair to tub. -Answer- C. Attempt a standard pivot transfer from the wheelchair to bed in the patient's hospital room. Giving the individual a functional task, then changing it, and observing the response will tell the therapist how well the patient can transfer learning to new situations. Generalization of skill is seen when the learner is able to spontaneously perform the task in different environments. None of the other answers assess the ability to transfer learning. An OT is working with an individual with depression who is cognitively intact but demoing difficulty carrying out self-care and other ADL tasks. The OT, who has no advanced certifications, would like to identify a standardized assessment to measure ADL performance. Which is the MOST appropriate tool for this purpose? a. Bay Area Functional Performance Eval. b. Routine Task Inventory- Expanded. c. Kohlman Evaluation of Living Skills. d. Assessment of Motor and Process Skills. -Answer- c. Kohlman Evaluation of Living Skills the KElS combines interview items with simulated performance to obtain information about 17 living skills in the areas of self-care, safety and health, money management, transportation, telephone use, and work and leisure. The AMPS assesses motor and process skills, sometimes embedding a task that is in an ADL category. In order to administer the AMPS, one must have special training. Therefore, the OT could not use this immediately. The routine task inventory uses observation to assess 14 different ADL aspects and is based on the cognitive disabilities model which would not be appropriate for this client. The bay area functional performance eval was designed to measure performance skills such as memory, organization, attention, motivation, and frustration tolerance. Although it can help the OT develop conclusions about ADL performance, it is not actually an ADL evaluation tool. An OT is conducting a perceptual function screening with an individual who has had a CVA. Which of the following informal screening activities would the therapist ask the individual to perform in order to identify the presence of agnosia? a. demonstrate common gestures such as waving. b. name objects through touch only c. identify or demonstrate the use of common household objects. d. read a paragraph and explain its meaning. -Answer- c. identify or demo the use of common household objects visual agnosia is the inability to recognize common objects and demo their use in an activity. Asking the individual to demo common gestures such as waving is a technique to screen for apraxia or the inability to perform purposeful movement on command. Answer B is asking the individual to perform stereognosis. Asking the individual to read
