FLORIDA CMLS 2024/25 REVISION QUESTIONS WITH QUARANTEED ANSWERS ALREADY GRADED A+

FLORIDA CMLS 2024/25 REVISION QUESTIONS WITH QUARANTEED ANSWERS ALREADY GRADED A+ A 10-year-old child has memory deficits and mild right hemiplegia secondary to an acquired brain injury 2 months ago. The child requires moderate assistance with self-dressing. Which intervention MOST EFFECTIVELY supports the child's independence with self-dressing? A. Establish a consistent routine and location for the child to dress. B. Have the child assemble dressing picture cards in sequence prior to dressing. C. Provide the child with loose-fitting clothing with few fasteners. - RIGHT ANSWER - A 12-year-old child sustained a severe contusion to the dorsum of the dominant hand several weeks ago. Moderate brawny edema, localized to the area of injury, persists and interferes with the child's ability to use the hand. The OTR plans to use edema reduction techniques as an adjunct to activity. Which standardized method would be MOST BENEFICIAL to use for tracking the effectiveness of these techniques? A. Figure-of-eight circumferential measurements B. Pitting edema measurement scale C. Volumetric measurements - RIGHT ANSWER - A 2-year-old toddler has congenital absence of bilateral upper extremities at the proximal forearm level. The toddler is transitioning from using passive prosthetic devices to using body-powered voluntary opening prostheses. Which activity should the OTR introduce during the FIRST phase of the toddler's prosthetic training program? A. Free-style painting on an upright easel B. Pushing a large therapy ball toward a target C. Scooping food with a spoon D. Stacking one-inch (2.54 cm) blocks - RIGHT ANSWER - A 3-year-old child has arthrogryposis multiplex congenita and uses a wheelchair for mobility. The mobility evaluation team ordered a customized standing powered mobility device for the child, and the OTR will be teaching the child how to use the device. Which client factor is MOST IMPORTANT for the OTR to reevaluate prior to the start of the training sessions? A. Trunk stability B. Cognitive ability C. Fine motor dexterity - RIGHT ANSWER - A 5-year-old child has severe extensor tone and shortened hamstrings secondary to athetoid cerebral palsy. The child typically pushes into extension when in a seated position in the wheelchair, making it difficult for the parents to position the child for feeding. Which method should the OTR advise the parents to use INITIALLY to stabilize the child in the wheelchair? A. Insert a small roll behind the lumbar spine to promote an anterior pelvic tilt. B. Insert a wedge cushion in the chair seat to raise the distal portion of the thighs approximately 3 inches (7.62 cm) higher. C. Place the feet on the footrests with the knees positioned in less than 90° of flexion to pull the ischial tuberosities into a posterior pelvic tilt. D. Secure a lap belt at a 45° angle across the child's hips to stabilize the pelvis. - RIGHT ANSWER - A 6-month-old infant who has Down syndrome and hypotonicity has difficulty maintaining head control when pulled from supine to sitting. The OTR plans to work with the infant on therapeutic ball activities to facilitate isolated neck flexion. How should the OTR INITIALLY grade this activity? A. Grasp the infant's upper arms while moving the ball in angular patterns. B Hold the infant's hands while moving the ball side to side. C. Stabilize the infant's pelvis while slowly rocking the ball in diagonal patterns. D. Support the infant's shoulders and trunk while slowly rocking the ball back and forth. - RIGHT ANSWER - A 6-year-old child who has Down syndrome has been participating in OT to promote visual-motor integration. Standardized tests of visual attention indicate the child scored -1.0 standard deviations from the norm. Based on the hierarchy of visual-skills development, which client factor should be addressed NEXT? A. Visual imagery B. Visual discrimination C. Visual cognition D. Visual memory - RIGHT ANSWER - A 9-year-old student who has a C2 spinal cord injury just received new software for a computer that doubles as an environmental control unit. This allows the student to use a head switch to operate a virtual keyboard displayed on a monitor. The OTR observes that the student's speed and efficiency is slow when operating the switch for writing class assignments. What modifications should be made to the computer to improve the student's ability to complete written communication? A. Attach a sip and puff control to operate the keyboard. B. Install voice recognition software onto the computer. C. Provide practice activities to improve speed and accuracy. D. Enable the word prediction option within the software. - RIGHT ANSWER - A child diagnosed with developmental delay has been participating in OT in a preschool setting. The child has achieved all short- and long-term goals and will be discharged from OT. The OTR is concerned about future functional delays. What action should the OTR take in this situation? A. Recommend a routine reassessment schedule for the child. B. Provide the parent with a checklist to track the child's development. C. Request monthly updates on the child's progress from the teacher. - RIGHT ANSWER - A client developed stage 1 complex regional pain syndrome 8 weeks after sustaining multiple metacarpal fractures. Which biomechanical intervention would be MOST BENEFICIAL to include as part of the intervention during this stage of the condition? A. Asking the client to search for common objects hidden in immersion particles B. Beginning a stress-loading program of vigorous scrubbing exercises C. Teaching the client a program of client-directed massage and active ROM - RIGHT ANSWER - A client had an open reduction internal fixation of a distal radius fracture 3 months ago. The client developed complex regional pain syndrome 2 months after the surgery. Currently, the client has decreased functional use of the dominant upper extremity and is scheduled to begin an 8-week work hardening program. What should be the INITIAL goal of this intervention? A. Demonstrate pain modulation techniques during work activities.Improve work behaviors to increase output based on work demands. B. Increase upper extremity strength for critical job demands. C. Perform critical job tasks within a pre-established reasonable time limit. - RIGHT ANSWER - A client has dysphagia and is beginning an oral motor feeding program. The OTR observes that the client has reduced lingual control when swallowing. Which food is SAFEST to include as part of the client's diet? A. Chopped meat with gravy B. Cooked pasta with melted butter C. Dry oat cereal with milk D. Toasted bread with jam - RIGHT ANSWER - A client has macular degeneration resulting in moderate visual impairment. The client works as a data entry clerk and wants to continue working but is having difficulty seeing the computer screen. What feature should the OTR recommend for the client's work computer to improve accessibility? A. Voice recognition B. Character enlargement C. Optical character recognition D. Braille display and embossing - RIGHT ANSWER - A client has moderate hemiplegia due to a recent CVA. The client requires assistance for transfers and does not have functional motor control of the affected upper extremity. When asked about the lack of upper extremity motor control, the client denies having any problems moving the arm. Which of the following statements should be used in the documentation to describe the client's response? A. "Client is a fall risk due to ideational apraxia." B. "Client requires maximum assistance during transfers." C. "Client is in denial about current physical impairments." D. "Client demonstrates behaviors consistent with anosognosia." - RIGHT ANSWER - A client has severe low vision secondary to diabetic retinopathy. The client wants to independently cook family meals. Which client factor would be MOST IMPORTANT to assess prior to engaging the client in a cooking activity? A. Muscular endurance B. Muscle tone C. Tactile discrimination D. Visual field function - RIGHT ANSWER - A client sustained a radial head fracture 2 months ago and is participating in OT. After completing exercise and a functional activity, ice is applied to the area of injury for 20 minutes. How long after the ice is applied does the client continue to benefit from the analgesic effect of the ice? A. Approximately 30 minutes after removal of the ice B. Five to 10 minutes or until the redness disappears from the skin surface C. Two times the length of time of the ice application D. Until the client feels a burning sensation in the affected area - RIGHT ANSWER - A client who has COPD is participating in an ADL session as part of an outpatient pulmonary rehabilitation program. The client reports a several-day history of right shoulder discomfort. Low grade pain is constant during the day and worsens at night. Nonprescription analgesics do not relieve the symptoms. Pulse oximetry indicates oxygen saturation of 89%. What action should the OTR take based on this report? A. Administer a physical agent modality to relieve the shoulder pain. B. Advise the client to increase the frequency of pursed lip breathing during activity. C. Complete a sensory and motor assessment to determine the cause of the shoulder pain. D. Contact the referring physician to report the client's symptoms. - RIGHT ANSWER - A patient had a coronary artery bypass graft one week ago. The patient will be discharged from the inpatient rehabilitation unit to live at home with family. One of the patient's goals is to resume homemaking and childcare tasks. The cardiologist is allowing the patient to resume an activity level of no more than 1.5 metabolic equivalent (METs) units. Which activity represents a maximum allowable MET-level activity for this patient? A. Moving laundry from the washer to the dryer B. Assisting a young child with bathing and dressing C. Grooming while standing at a bathroom sink D. Standing under warm water in the shower - RIGHT ANSWER - A patient has schizophrenia and is undergoing inpatient treatment. One of the goals is to assess the patient's ability to live independently. During a meal preparation group activity, the patient has difficulty following written instructions for a recipe and indicates that the noise level of the group is too high to complete the assigned tasks. What action should the OTR take based on the patient's responses? A. Evaluate the patient's meal preparation skills individually at another time. B. Ask the group to work more quietly during the remainder of the activity. C. Document the patient's inability to concentrate long enough to cook safely. D. Move the patient apart from the rest of the group to complete assigned tasks. - RIGHT ANSWER - A patient in a rehabilitation facility has a complete C8-T1 spinal cord injury. The patient is learning techniques to maximize independence with dressing. Which technique should the OTR teach the patient to support progress toward this goal? A. Put on undergarments and trousers in bed; then, transfer to a wheelchair to complete upper body dressing. B. Use a universal cuff with a buttonhook and a zipper-pull to fasten front-opening clothing. C. Wear a wrist-driven flexor hinge orthosis for pulling on and fastening clothing. D. While supine in bed, put on socks and shoes; then, put on underpants and trousers by rolling side-to-side in bed. - RIGHT ANSWER - A patient in a rehabilitation facility has moderate cognitive impairment secondary to an acquired brain injury. The patient is currently dependent on caregivers for dressing. As part of a dressing session, the OTR plans to use backward chaining techniques to engage the patient in the task of putting on a sock. What action represents this approach as part of an initial session with this patient? A. Ask the patient to cross one leg over the other in preparation to put the sock on the foot. B. Hand the patient the sock and ask the patient to pull the sock over the toes. C. Place the sock over the patient's foot and have the patient pull the sock up from the ankle. D. Provide a picture of the end goal and have the patient arrange sequential picture cards of each step of the task. - RIGHT ANSWER - A patient is undergoing inpatient treatment to stabilize symptoms associated with the manic phase of bipolar disorder. As part of a meal preparation group, the patient is assigned to "set the table for the meal." The patient becomes highly distracted and wants to be involved in a more challenging activity. What action should the OTR take to support the patient's success during this task? A. Assign the patient to a more challenging meal preparation task. B. Partner the patient with another patient to complete the task. C. Provide additional structure to continue with the assigned task. - RIGHT ANSWER - A patient who had a recent total hip replacement is preparing for discharge from a rehabilitation unit to live at home with a spouse. The patient is independent in all ADL except for putting socks and shoes on the involved extremity. The OTR has instructed the patient in the use of appropriate equipment to assist with this task, but the patient states the equipment is more trouble than it is worth and refuses to use the device. The patient's spouse is willing to assist the patient each day. How should the OTR respond to this situation? A. Evaluate the spouse's ability to safely put socks and shoes on the patient. B. Reemphasize the importance of becoming totally independent with self-care. C. Respect the patient's choice and document discontinuation of therapy. D. Suggest alternative devices that may be more appealing to the patient. - RIGHT ANSWER - A patient who has attention and sequencing deficits has a goal of preparing meals independently. The patient can now make a sandwich with minimal verbal cues. What should the OTR ask the patient to prepare NEXT to progress the treatment? A. Fruit salad following written instructions B.Hot soup using directions provided on the can C. Instant iced tea following written instructions - RIGHT ANSWER - A patient who has depression has been taking an antidepressant for 3 weeks. The patient has also been participating in a daily OT group. During the most recent group activity, the patient reported having more energy despite still feeling depressed. Based on this report, what precautions should the OTR take when preparing intervention sessions? Ensure the activity environment provides structure and allows for continuous observation. A. Avoid gross motor activities that may exacerbate medication side effects. B. Use sedentary activities to avoid the potential for disruptive hyper-manic outbursts. C. Minimize the use of fine motor activities to avoid frustration due to cogwheel rigidity. - RIGHT ANSWER - A patient who has Guillain-Barré syndrome is in an acute rehabilitation program. The patient has quadriparesis and currently requires maximum assistance for BADL. The OTR is developing intervention goals for the patient to achieve by the time the patient transitions to the next level of care. Which task would be MOST REALISTIC to include as part of a short-term goal in this treatment plan? A. Patient will be able to self-feed with modified independence using adaptive equipment. B. Patient will use adaptive strategies to complete showering and personal hygiene after set-up. C. Patient will be able to independently complete self ROM exercises of bilateral upper extremities. D. Patient will complete a sliding board transfer with contact guard assistance. - RIGHT ANSWER - A patient who has myasthenia gravis and Fair minus (3-/5) strength of the dominant extremity wants to be as independent as possible during meals. The patient is not able to complete self-feeding despite having a universal cuff, plate guard, and an elongated straw. Which intervention would be MOST BENEFICIAL for promoting progress toward the patient's goal? A. Adaptations to the universal cuff and eating utensils B. Instruction in the use of a mobile arm support C. Training on how to facilitate a tenodesis grasp D. Upper extremity strengthening and endurance exercises - RIGHT ANSWER - A patient who has Parkinson's disease is participating in OT to increase independence with self-feeding. During a session, the OTR notes that the bolus of food becomes pocketed between the patient's teeth and cheek. What does this indicate? A. Necessity to take a drink of water to clear the mouth B. Preparation for the oral stage of swallowing C. Risk factor for potential aspiration of food D. Too large a piece of food placed in the mouth - RIGHT ANSWER - A resident of a skilled nursing facility who has mild cognitive decline secondary to Alzheimer's disease wants to bake a cake for a teenage grandchild's birthday, an activity the resident has done every year since the grandchild was born. During which step of the activity would the resident benefit from using environmental adaptations to optimize independence with this task? A. Accurately reading the recipe ingredients from the box of mix B. Cracking the eggs and adding them into the bowl of cake mix C. Pouring pre-measured liquid ingredients into the mixing bowl D. Responding appropriately to the sound of the oven timer - RIGHT ANSWER - A school-age child has a profound hearing impairment. The child demonstrates normal postural reactions for walking, running in place, and skipping, but is unable to maintain balance when moving in various directions on a platform swing. What conclusion can the OTR make based on these observations? A. Conflicting sensory input is inhibiting appropriate vestibular reactions. B. Low muscle tone prevents the child from responding to transitional movements. C. Persistent primitive reflexes are interfering with transitional movement patterns. D. The child lacks anticipatory control required for higher-level motor skills. - RIGHT ANSWER - A school-based OTR is evaluating a 6-year-old child who has mild developmental delay. The child was recently adopted. Social history indicates the child has been in multiple foster homes for the past 3 years. The teacher reports the child is frequently deceitful, rarely interacts with peers, becomes aggressive when told to follow rules, and is beginning to hide food and objects belonging to other students. During the evaluation, the OTR should observe the child for further signs of which of the following diagnoses? A. Attention deficit hyperactivity disorder (ADHD) B. Failure to thrive C. Prader-Willi syndrome D. Reactive attachment disorder - RIGHT ANSWER - A student in elementary school has an emotional and behavioral disorder. The student becomes frustrated when asked to complete cognitively and physically challenging tasks and does not participate in classroom activities unless directed to do so by an adult. Which method would be MOST BENEFICIAL to include as part of the intervention for promoting the student's academic success and social interaction within the school environment? A. Engaging the student in interactive curriculum-based competitive games B. Having the teacher use a behavior modification program with the student C. Including the student in a coping skills and stress management class D. Involving the student in a structured goal-oriented activity group - RIGHT ANSWER - A student in kindergarten has a pervasive developmental disorder. The student has difficulty transitioning from free play to snack time during the school day. Which option is a representational transition strategy for the teacher to use at the end of free play activity to increase predictability for the student and minimize behavior problems associated with imposed transition times? A. Ask the student, "What do we do every day after free play?" B. Hand the student a cup and say, "Time for a snack." C. Have the student look at a posted schedule of daily activities. D. Physically guide the student to the snack table. - RIGHT ANSWER - A student in kindergarten has cerebral palsy and recently transitioned to a new school. The student is unable to maintain an unsupported standing position and depends on a wheelchair for seating and mobility. An OTR is transferring the student to and from a stander for classroom activities. After moving the student from the wheelchair into the stander, what action should the OTR take NEXT? A. Adjust lateral trunk supports to snuggly conform to the student's torso. B. Fasten the chest strap to prevent the student from slipping downward. C. Position the student's feet shoulder width apart to improve weight bearing. D. Secure the pelvic band to adequately stabilize the student's pelvis. - RIGHT ANSWER - A verbal kindergarten student has difficulty with social skills secondary to autism spectrum disorder. During play-based activity in the classroom, a peer offers the student a toy and the student begins to cry and flap arms. What action should the OTR take NEXT to support the child's development of social skills? A. Plan to partner the student with a designated peer mentor. B. Model the expected behavior of accepting a toy from a peer. C. Teach the student the age-appropriate verbal response. - RIGHT ANSWER - A workers' compensation case manager referred a client to a work hardening program. The client had a surgical repair of a work-related rotator cuff injury 8 weeks ago and has been on medical leave due to pain and decreased ROM. What information is MOST IMPORTANT for the OTR to gather from the client prior to establishing the intervention plan? A. Perceptions of current abilities for resuming job tasks B. Comprehensive medical and psychological history C. Impact of injury on current BADL routines D. Risk factors associated with typical work tasks - RIGHT ANSWER - A young adult client recovering from cardiomyopathy is being evaluated in outpatient cardiac rehabilitation. The client achieved independence with BADL during inpatient cardiac rehabilitation. Since discharge, the client relies on friends and family for assistance with all ADL. During the evaluation, the client walked slowly on a treadmill at 2.0 miles per hour for 20 minutes with normal cardiovascular response. What interpretation can the OTR make based on the client's performance during this portion of the evaluation? A. Client is appropriately relying on assistance to help conserve energy during the day. B. Client is demonstrating malingering behaviors with caregivers at home. C. Client is following appropriate activity guidelines for ADL during this phase of recovery. D. Client may not have a clear understanding of current physical abilities for ADL. - RIGHT ANSWER - A young adult inpatient has transient moderate vertigo secondary to an inoperable brain tumor. The patient is typically able to ambulate and complete BADL independently. The OTR is evaluating the home set-up in preparation for the patient's discharge to live alone in a multi-level home. In addition to installing grab bars in the hallways, bathrooms, and stairs, which feature should be a priority for the patient to have in the home by the discharge date? A. Environmental control unit for in-home monitoring B. Shower chair or tub bench in the shower or bathtub C. Non-skid strips on edges of stair stepsRamp to the main entrance of the home - RIGHT ANSWER - An 18-month-old child is hypotonic and cannot fully extend the neck and trunk against gravity. Which position would be MOST EFFECTIVE to place the child in to facilitate antigravity movement and promote hand usage? A. Fully upright in a standing frame B. Prone on a 45° wedge positioned on the floor C. Seated upright on a large therapy ball D. Straddle-sit position on a bolster - RIGHT ANSWER - An 8-year-old child had an acquired brain injury 3 weeks ago and is an inpatient in a children's hospital. The child has a tracheostomy, is on medication to stabilize seizure activity, and is functioning at Level II (Generalized Response) on the Rancho Los Amigos scale. At least one member of the child's family spends each day and most nights at the hospital with the child. What type of controlled sensory stimulation can the OTR teach the family to do to benefit the child at this stage of the rehabilitation process? A. Change the child's position from supine lying to supported sitting intermittently throughout the day. B. Rub the child's extremities with lotion while providing verbal cues about position and body awareness. C. Pass a cotton ball saturated with ammonia or artificial vanilla under the child's nose for 2-5 seconds three to five times per day. D. Ask the child to clap hands or move the arms and legs to t - RIGHT ANSWER - An 8-year-old child has sensory modulation deficits and is participating in outpatient OT. While spinning in the tire swing, the child begins to show mild signs of autonomic activation. How should the OTR INITIALLY respond to this observation? A. Begin to slowly rotate the swing in the opposite direction. B. Remove the child from the swing immediately. C. Guide the swing into slow linear movements. D. Stop the swing to initiate intense tactile stimulation. - RIGHT ANSWER - An 8-year-old child who has moderate spastic hemiplegia has difficulty maintaining a stable sitting posture when playing table-top games. Which adaptive positioning MOST EFFECTIVELY represents a task-ready position for supporting the child's engagement in these activities? A. Trunk and head in midline with shoulders slightly anterior to the pelvis B. Posterior pelvic tilt with trunk in forward flexion and neck slightly flexed C. Torso supported in a slight recline with knees at 90° and feet flat on the floor - RIGHT ANSWER - An adolescent sustained a 50% total body surface area burn 3 months ago. The adolescent recently developed heterotopic ossification of both elbows as a secondary complication. Evaluation indicates the adolescent is able to actively flex both shoulders from 0° to 100° and both elbows from 45° to 90°. The adolescent currently requires assistance with feeding. Which compensatory strategy would be MOST BENEFICIAL for improving the adolescent's independence with self-feeding? A. Elevate the surface on which the plate and eating utensils are placed. B. Provide the adolescent with elongated and angled eating utensils. C. Train the adolescent to use a table-mounted mobile arm support. - RIGHT ANSWER - An adult client has chronic schizophrenia and is functioning at Allen Cognitive Level 4 (Goal-Directed Actions). The client currently resides in a group home. One of the intervention goals is for the client to participate in meal preparation activities with other residents. What preparation should the OTR make in advance of the group to support the client's success during this activity? A. Ask the client to list meal preparation task preferences. B. Determine the client's typical mealtime habits and routines. C. Engage the client in the meal planning process. D. Plan a meal that does not require the use of a stovetop or oven. - RIGHT ANSWER - An adult client who has an upper extremity transhumeral amputation of the dominant extremity is learning to use a myoelectric prosthesis. During a bedside dressing assessment, the OTR observes that the client is using exaggerated trunk movements to operate the prosthesis. How should the OTR grade the activity to facilitate the client's ability to control the prosthesis? A. Advise the client to use the nondominant extremity as an assist during the task. B. Have the client practice controls training and isolated movements in front of a mirror. C. Initiate a program of resistive strengthening and endurance exercises for the residual limb. D> Teach the client ways to practice a variety of movement patterns without the prosthesis. - RIGHT ANSWER - An entry-level OTR is evaluating a client who has persistent swelling of the non-dominant extremity after undergoing a mastectomy 4 weeks ago. The swelling interferes with the ability to complete fine motor tasks and does not decrease with the use of elevation, ice, or active ROM exercises. The OTR notes the client's affected upper extremity is firm to the touch and there is no pitting of the skin. Results of a volumetric test indicate the affected upper extremity displaces 20 mL of water more than the non-affected extremity. The client has full functional active ROM of bilateral upper extremities. Based on these results, which action should the OTR take to MOST EFFECTIVELY manage the client's edema? A.Identify options for providing the client with manual edema mobilization. B. Initiate a program of retrograde massage as an adjunct to functional activities. C. Obtain circumferential measurements for ordering a custo - RIGHT ANSWER - An initial screening of a 33-month-old child indicates the child has an emerging ability to use objects for solitary pretend play, expresses discomfort by crying, and uses a tripod grasp when copying simple shapes and constructing basic three-dimensional block designs. The parents report the child independently uses the bathroom, helps with dressing, and self-feeds, but occasionally is a picky eater. Which skills appear delayed based on these findings? A. Fine motor B. Sensorimotor C. Social-emotional - RIGHT ANSWER - An inpatient had a recent TBI and is functioning at Level IV (Confused, Agitated) on the Rancho Los Amigos scale. The patient is dependent on staff for meal set-up and requires moderate assistance to eat a meal. One of the intervention goals is for the patient to be independent with self-feeding. During a self-feeding session, which mealtime environment would support INITIAL progress toward this goal? A. Dining room with other patients who have similar functional abilities B. OT clinic during a scheduled mealtime group with other patients C. Patient's room with the patient seated fully upright in a bedside chair - RIGHT ANSWER - An inpatient has a complete C7 tetraplegia and is scheduled to begin transfer training. Innervation of which muscle groups would be the BEST indicator of the patient's potential for achieving independence with wheelchair transfers to even surfaces without the use of assistive equipment? A. Biceps and wrist extensors B. Deltoids and biceps C. Deltoids and shoulder depressors D. Triceps and shoulder depressors - RIGHT ANSWER - An inpatient has apraxia and hemiplegia secondary to having a subarachnoid hemorrhage 2 weeks ago. The OTR is using an errorless completion technique to teach the patient compensatory methods for increasing independence with BADL. Which intervention represents this technique? A. Asking the patient to describe anticipated difficulties prior to starting a BADL task B. Guiding the patient's hand through a difficult part of a BADL activity C. Providing verbal feedback about observed difficulties at the completion of a BADL task D. Repeating the same prompt until the patient can perform a specific component of the BADL task - RIGHT ANSWER - An inpatient has hemiplegia secondary to a CVA 6 weeks ago. The OTR has been using the Functional Reach Test to monitor progress related to the patient's dynamic balance. The results from this test administered at the time of the patient's admission to the facility 3 weeks ago and a reevaluation at 6 weeks are indicated in the table below:What conclusion can the OTR make about the patient's progress based on these results? Measurement at 3 weeks: Affected Side: 13.9 cm (3.8) Unaffected Side: 15.4 cm (6.7) Measurement at 6 weeks: Affected side: 17.6 cm (4.8) Unaffected Side: 18 cm (4.9) A. Dynamic balance for functional tasks has improved, and the patient is ready for discharge. B. Improvements are noted and should be compared to the patient's current functional abilities. C. Balance is comparable on both sides, and the patient is now at low risk for falls during activity. - RIGHT ANSWER - An inpatient recovering from Guillain-Barré syndrome has Fair plus (3+/5) to Good minus (4-/5) strength in both lower extremities. The patient typically completes stand-pivot transfers with minimal assistance. During one transfer, the patient sways backward and falls back into the wheelchair seat. What should the OTR instruct the patient to do to avoid this occurrence when the patient repeats the transfer? A. Position the feet shoulder width apart and perpendicular to the transfer surface. B. Scoot forward to position the hips evenly in the middle of the wheelchair seat. C. Shift trunk weight forward, bringing both shoulders over the thighs. D. Use both hands to push down on the wheelchair arm rests. - RIGHT ANSWER - An inpatient sustained a 50% total body surface area burn 3 days ago involving primarily the torso and bilateral upper extremities. Medical records indicate the patient is currently in a medically induced coma and has full-thickness burns on the dorsum of both hands. The OTR is scheduled to begin a program of ROM and preventive positioning at the patient's bedside. Which precaution should the OTR take when completing passive ROM of the patient's hands during this phase of medical care? A. Maintain the wrist in 45°-70° extension while completing isolated movement to each IP joint. B. Extend and flex the wrist while holding the patient's fingers in composite flexion .C. Stabilize the wrist in neutral while moving the IP joints of each finger into an intrinsic-minus position. - RIGHT ANSWER - An inpatient who has an L1 spinal cord injury is preparing for discharge from a rehabilitation unit to home. The patient's home has a wheelchair-accessible bathroom with a bathtub that has a wall-mounted showerhead and shower curtains. Which home modification should the OTR recommend for this patient? A. Replace the shower curtain with a tub-mounted sliding door. B. Place a shower chair with suction feet in the bathtub. C. Use a tub-transfer bench for getting into and out of the bathtub. D. Fasten a removable grab bar to the side rim of the bathtub. - RIGHT ANSWER - An inpatient with mild hemiplegia wants to be able to use a disposable razor for facial shaving. During one of the grooming sessions, the patient sustains a superficial cut to the chin and begins to bleed. What action should the OTR take based on this occurrence? A. Ensure standard precautions are used when attending to the patient. B. Have the patient complete the task using an electric razor. C. Identify process improvements to prevent recurrence. D. Use sterile procedures when attending to the patient. - RIGHT ANSWER - An older adult client has been diagnosed with early stage dementia. The client lives alone in an apartment. One of the client's goals is to remain in the current apartment as long as possible. During an aging in place assessment, the OTR determines that the client has difficulty remembering the sequence of steps for securing the locks on a door. Which option would be MOST EFFECTIVE for supporting long-term aging in place? A. Engage the client in repetitive drills using blocked practice to facilitate carry-over of learning. B. Identify a programmable environmental control device that can be used in the client's home. C. Post visual reminders on each door of the home to indicate the need to lock the door. D. Provide a checklist the client can use to check in-home security at the end of each day. - RIGHT ANSWER - An older adult outpatient client has hemiplegia of the dominant extremity after having a CVA 2 weeks ago. Results from a motor evaluation administered one day ago indicate mild upper extremity weakness and decreased fine motor dexterity when compared to the nondominant extremity. The client acknowledges the results but declines services, stating that the deficits do not interfere with day-to-day activities. What action should the OTR take in this situation? A. Administer a standardized ADL assessment to ensure the client's functional skills are within normal limits. B. Document the client's response, indicating that additional services and follow-up are not medically necessary. C. Provide the client with a medium resistance therapy band to use for strengthening the upper extremity at home. D. Respect the client's decision and schedule a reevaluation in one month to reassess client factors. - RIGHT ANSWER - An OTR and an entry-level COTA are employed in an outpatient setting. Several clients on the OTR caseload are due for their 90-day plan of care recertification update as required by Medicare. The OTR learns that these clients have been scheduled for reevaluation appointments on a day when the OTR must be on personal leave time and will be away from the facility. How should the OTR respond to this finding? A. Ask the administrator to provide line-of-sight supervision while the COTA completes the scheduled evaluations. B. Continue with the current plan and schedule a comprehensive assessment for a date soon after the scheduled leave time. C. Discuss the clients' current progress with the COTA and select appropriate evaluations for the COTA to complete. D. Use progress notes from the clients' previous session to update the plan of care prior to taking the scheduled leave. - RIGHT ANSWER - An OTR has been working with a child on in-hand manipulation skills for 13 weeks. Reports indicate consistent progress toward both short- and long-term goals for the first 12 weeks. During week 13, the OTR observes a decline in the child's ability to perform previously mastered tasks. When writing the weekly progress note, what information is MOST IMPORTANT for the OTR to include? A. Objective reports of the child's performance during specific tasks B. Changes that will be made to the treatment plan and intervention C. Subjective impressions of the child's continued rehabilitation potential D. Plans to meet with the parents and contact the physician - RIGHT ANSWER - An OTR has completed a contrast sensitivity and lighting test with a client who has low vision. The client has high contrast threshold and low contrast sensitivity. What conclusions can the OTR make based on these findings? A. The client is a good candidate for Braille training. B. The client will require magnification during fine motor tasks. C. The position of lighting impacts the client's ability to see objects. D. The use of fluorescent lighting is best for seeing objects clearly. - RIGHT ANSWER - An OTR has completed a manual muscle test of a client who has a brachial plexus injury. Results of the evaluation indicate the injury impacted the posterior branch of the brachial plexus. What is the classic functional deformity associated with this injury? A. Claw hand B. Benedictine hand C. Drop wrist D. Ape hand - RIGHT ANSWER - An OTR has completed a self-feeding reevaluation of a resident in a long term care facility. Results indicate the resident would benefit from using eating utensils inserted in a universal cuff instead of using utensils with built-up handles. The OTR provides the assistive eating utensils and assesses the resident's ability to use the utensils. What additional action should the OTR take to support the resident's long-term independence with self-feeding? A. Advise the resident to use the universal cuff during several meals and then reassess. B. Educate the direct-care staff about the prescribed assistive devices and meal set-up. C. Schedule several mealtime sessions to train the resident how to don and doff the cuff. - RIGHT ANSWER - An OTR has completed a utilization review of services provided to patients who completed inpatient rehabilitation after having a CVA. Results indicate that within one week after discharge, 80% of the patients who were discharged to home required additional adaptive devices and durable medical equipment as determined by home health OT. What action should the OTR take based on the outcome of this study? A. Recommend including predischarge home evaluation visits as part of the discharge planning for patients in this diagnostic group. B. Compile a list of equipment that patients in this diagnostic group should purchase prior to discharge to home. C. Develop a home accessibility survey for patients to complete at discharge and several weeks after discharge. - RIGHT ANSWER - An OTR has completed an initial screening of an inpatient who had a prefrontal right hemispheric CVA 2 days ago. The patient responded appropriately to interview questions but was unable to carry out each of the following verbal commands: • "Cross your legs."• "Raise your arm above your head."• "Wave goodbye."What do the results of this screening suggest? A. Global aphasia B. Ideomotor apraxia C. Decreased attention D. Premotor perseveration - RIGHT ANSWER -... An OTR is about to administer a standardized developmental screening to a 6-month-old infant born at 34 weeks gestation. What method should the OTR use to calculate the infant's corrected age prior to administering the test? A. Subtract the day, month, and year of the infant's birth date from the date of testing. B. Subtract the infant's measurement of prematurity from the infant's chronological age. C. Subtract the month and year of testing from the month and year of the infant's birth date. D. Subtract the number of weeks of full-term gestation from the actual weeks of gestation. - RIGHT ANSWER - An OTR is developing a home program for a client who has a moderate hemiplegia. Observation results indicate the client lacks active upward rotation of the scapula and external rotation of the humerus of the involved upper extremity. Which type of exercise is CONTRAINDICATED to include in the client's home program? A. Bearing weight on the affected forearm placed on a table, then turning the trunk away from the supported position B. Clasping both hands to reach upward beyond 90° of shoulder flexion C. Cradling both arms at chest level to abduct and adduct the shoulders D. Using a hand-over-hand movement to slide a dust cloth across the tabletop - RIGHT ANSWER - An OTR is developing a Patient Intervention Comparison Outcome (PICO) question as part of the evidence-based practice process for an outpatient client who completed chemotherapy treatment for breast cancer 9 months ago. The client's goal is to return to work, but the client reports debilitating fatigue limiting ability to perform job duties. The client asks the OTR if attending a work hardening program in addition to outpatient therapy would be an added benefit. In this situation, what is the Intervention (I) component of the clinical question? A. Outpatient therapy B. Chemotherapy treatment C. Debilitating fatigue - RIGHT ANSWER - An OTR is evaluating a client who is in stage II of amyotrophic lateral sclerosis. During a mealtime assessment in the client's home, the OTR observes that the client has mild bulbar involvement impacting the ability to swallow and finish eating a meal. What should the OTR advise the caregivers to include as part of the client's mealtime routine? A. Arrange for meals to take place in a relaxed and unhurried atmosphere. B. Position the client during meals in a chair that semi-reclines 30° to 40°. C. Prepare the client foods that have a thin, liquid consistency. D. Provide the client with a nosey cup for drinking liquids. - RIGHT ANSWER - An OTR is evaluating an adult client who is diagnosed with focal hand dystonia of the nondominant hand. Symptoms interfere with the client's employment as a professional musician. What information would be MOST IMPORTANT for the OTR to gather prior to establishing an intervention plan? A. Movement patterns the client uses during work B. Amount of assistance the client needs during BADL C. Grip and pinch strength measurements of both hands D. Sensory mapping using monofilament instruments - RIGHT ANSWER - An OTR is evaluating an outpatient client who has a wound on the dorsal surface of the hand. The OTR removes the alginate dressing, measures the size of the wound, inspects the condition of the tissue at the margins, and looks for signs of infection. What additional information is MOST IMPORTANT for the OTR to collect for the comprehensive assessment of the wound? A. Amount and type of exudate B. Debridement plan to remove slough and eschar C. Progression schedule for transitioning to a less absorbent dressing type - RIGHT ANSWER - An OTR is interpreting the results of a standardized developmental assessment administered to a school-age child. Results indicate the child achieved a percentile score of 16 on the assessment. What does this score indicate? A. Eighty-four percent of the children in the normative group scored higher. B. Sixteen percent of the children in the normative group scored higher. C. The child passed 16% of the items on the test. D. The child passed 84% of the items on the test. - RIGHT ANSWER - An OTR is leading an educational group for inpatients admitted to a behavioral health unit. Which method represents a cognitive-behavioral approach the patients can use to effectively manage anxiety in daily living? A. Replace distorted thoughts and fears with positive ones. B. Use journaling activities to express feelings and thoughts. C. Engage in a hobby or leisure activity to divert attention from stress. - RIGHT ANSWER - An OTR is preparing to complete a vocational-readiness assessment with an adult client who has chronic schizophrenia. The client wants to work with a landscaping company. What performance skills should the OTR INITIALLY evaluate to provide information about the client's current work behaviors? A. Lifting capacity and endurance B. Memory and physical stamina C. Strength and adaptability D. Time management and social skills - RIGHT ANSWER - An OTR is preparing to use a goniometer to measure active flexion of a client's elbow. The client is positioned in supine with the shoulder in neutral and the forearm supinated. On which anatomical landmark should the OTR align the axis of the goniometer to accurately measure this motion? A. Olecranon process B. Acromion process C. Medial epicondyle of the humerus D. Lateral epicondyle of the humerus - RIGHT ANSWER - An OTR is providing consultative services to a medical equipment vendor. The vendor asks the OTR to assist in the selection of a new wheelchair for a customer who has severe physical disabilities. When providing this type of service, what information is MOST IMPORTANT for the OTR to use as the basis for the selection criteria? A. Seating system that the customer is currently using B. Allowable reimbursement from third-party payers C. Prescription written by the customer's primary physician D. Mobility requirements and habits of the intended user - RIGHT ANSWER - An OTR is providing home-based services to an older adult client who is recovering from a hip fracture. The client's only social support is a neighbor who is willing to assist the client with home management tasks. During a home visit, the client asks the OTR to contact the neighbor to discuss the client's progress. What INITIAL action should the OTR take based on this request? A. Ask the client what type of information should be shared with the neighbor. B. Determine if the client has completed a release of information form for the neighbor. C. Prepare a list of homemaking tasks the client can safely complete to give to the neighbor. - RIGHT ANSWER - An OTR is removing electrodes from a client who has just received iontophoresis. Within several minutes of removing the electrodes, what should the OTR do to the skin surface that came in contact with the electrodes? A. Wipe the area with an alcohol pad. B. Vigorously massage the area. C. Apply a lotion with a neutral pH.D. Rub an analgesic lotion into the area. - RIGHT ANSWER - An OTR is scheduled to evaluate a young adult admitted to the neurological unit of an acute care hospital 2 days ago. Medical records indicate the patient has a history of epilepsy and hydrocephalus and was hospitalized after having multiple seizures, severe headaches, high fever, and alterations in mental status. What additional information would be MOST IMPORTANT for the OTR to obtain from the records prior to beginning the initial evaluation of this patient? A. Activities that prompt the onset of seizures B. Presence of an external ventricular drain C. Guidelines for isolation precautions - RIGHT ANSWER - An OTR is speaking to a support group for parents who have young adult-age children with mild-to-moderate developmental delay. The parents want to learn strategies for helping prepare their children for transition from living at home to working and living independently in the community. The young adults are independent with self-care, and they have graduated from a high school special education program. In addition to talking to the parents about promoting independence with cooking and homemaking, which topics would be MOST IMPORTANT to include for supporting an initial transition plan? A. Effective budgeting strategies B. Leisure skill development alternatives C. Social skills training opportunities D. Transportation options and availability - RIGHT ANSWER - An OTR is using manual muscle testing to evaluate the wrist strength of a client who has a peripheral neuropathy. When the client is seated upright with the forearm supported in neutral, the client has 30° of active wrist extension. The client has full passive ROM of the wrist. When the forearm is placed in midposition on its ulnar border, the client is able to actively extend the wrist to 70° and maintain the position against slight resistance. What muscle grade for wrist extension should the OTR record in the client's chart? A. Poor (2/5) B. Fair (3/5) C. Good (4/5) - RIGHT ANSWER - An OTR is using the systematic evidence-based practice process to guide clinical decision making. The OTR has searched the literature for relevant information and has determined the best evidence related to a specific clinical question. What is the NEXT step in the evidence-based practice process? A. Integrate the evidence with clinical experience, client preferences, and the practice setting. B. Modify clinical practice guidelines and distribute them to colleagues in the therapy department. C. Summarize pertinent information to engage clients in selecting preferred intervention options. - RIGHT ANSWER -... An OTR is working on pre-feeding activities with an inpatient who had a recent TBI and is functioning at Level III (Localized Response) on the Rancho Los Amigos scale. Which technique would be MOST EFFECTIVE when providing graded stimulation of the patient's cranial nerves? Gently rub the patient's tongue using a cotton swab saturated with salty and sweet flavorings. A. Hold strong-smelling cooking extracts, such as artificial vanilla, close to the patient's nose for 2-5 seconds. B. Place a small piece of the patient's favorite sweet food on the patient's tongue. C.Use soft candy items as rewards for positive responses to voice commands. - RIGHT ANSWER - An OTR places an 8-month infant in a sitting position and observes for arm extension while gently pushing the infant off balance to the front, back, and each side. Which automatic reaction is the OTR screening when following this procedure? A. Protective response B. Body on body righting C. Equilibrium reaction - RIGHT ANSWER - An OTR receives a referral from an occupational health physician that reads, "45-year-old welder with wrist pain. X-rays negative. Evaluate and treat." History and initial screening results are as follows: • Insidious onset of pain on dominant right hand • No history of direct trauma • Positive Finklestein's test • Negative Phalen's sign • Negative Tinel's sign at the wrist • Full active ROM all digits bilateral hands • Pain with resistance to thumb abduction and extension • Tenderness along the abductor pollicis longus and extensor pollicis brevis • Sensation of fingertips on all digits is 4 mm Which diagnosis is consistent with the screening results and the client's history? A. Carpal tunnel syndrome B. De Quervain's tenosynovitis C. First CMC joint arthritisD. Trigger thumb - RIGHT ANSWER - An OTR who works in a Medicare-funded inpatient rehabilitation unit is completing an evaluation of a patient who had bilateral total knee arthroplasties 3 days ago. The patient is in generally good health, plans to live independently at home, and wants to resume volunteer work in the community. The patient currently requires OT services to increase independence in bathing, dressing, and toileting. What MUST the OTR consider when scheduling the patient for OT? A. Availability of caregivers to participate in daily sessions for caregiver education and training B. Impact of the patient's prior level of function on frequency and duration of sessions C. Minimum number of therapy hours required for reimbursement by the third party payor D. Patient's physical endurance for completing activities according to a clinical pathway - RIGHT ANSWER - An OTR working in a rehabilitation setting is completing an initial evaluation for a patient who underwent surgery for resection of a brain tumor 3 days ago. The patient currently requires minimal assistance to complete self-care due to apraxia, impaired executive function, and decreased balance. The patient lives at home with a spouse who works outside the home. The patient's priority is to be able to stay home alone while the spouse is at work. Which INITIAL action should the OTR take to acquire more information related to the patient's priority? A. Determine the amount of assistance family is able to provide the patient after discharge. B. Assess the patient's neurobehavioral responses during simple meal preparation. C. Observe the patient's ability to complete typical routines for toileting. - RIGHT ANSWER - An OTR working in a skilled nursing facility is beginning an initial patient interview. After the OTR provides the patient with a brief introduction to OT services, the patient refuses to participate in an evaluation, stating, "This is childish. I'm here to get stronger. There's an entire staff that can help me get dressed." What action should the OTR take based on this response? A. Provide further discussion about how OT will help improve daily living skills. B. Assure the patient that strengthening exercises will be included in the intervention. C. Respect the patient's wishes and document the refusal in the medical record. - RIGHT ANSWER - An OTR working in a skilled nursing facility routinely submits requests for reimbursement under Medicare Part A. Based on the Prospective Payment System (PPS), what is the PRIMARY factor used for determining reimbursement for patient services? A. Current procedural terminology B. Diagnostic-related groups C. International classification of diseases D. Resource utilization group categories - RIGHT ANSWER - An OTR working in an inpatient rehabilitation setting is completing an initial evaluation with a young adult who recently underwent a transfemoral amputation. The patient's responses during the evaluation indicate the patient is extremely angry, has a sense of panic, and is fearful about current physical limitations. The patient does not believe participation in OT will improve functional abilities. Which action would be MOST BENEFICIAL for the OTR to take prior to finalizing the intervention plan for this patient? A. Arrange a meeting with the patient and the patient's relevant others to discuss goal-setting. B. Complete a standardized assessment to obtain objective information on the patient's coping skills. C. Consult with the interprofessional team to determine behavioral objectives for this patient. - RIGHT ANSWER - An OTR working in an outpatient hand clinic has completed range of motion measurements with a client who dislocated the PIP joint of the second digit 8 weeks ago. The joint is in alignment and the injury is stable.The results of ROM testing are indicated in the chart below: MCP: AROM, PROM (0-90) PIP: AROM (0-30), PROM (0-40) DIP: AROM (0-20), PROM (0-30) What is the PRIMARY reason for this client's limitation in range of motion? A. PIP and DIP joint stiffness B. Adhesion of the flexor tendon C. Extrinsic extensor tendon tightness - RIGHT ANSWER - An OTR working in an outpatient setting has completed an initial evaluation with a client who has early stage Parkinson's disease. The client has mild motor symptoms, scored within normal limits on the Montreal Cognitive Assessment (MoCA), and reports independence with ADL and IADL. Scores of the Performance Assessment of Self-Care Skills (PASS) - Clinic Version are as follows:What does the discrepancy between the results of the PASS and the subjective report suggest about the client? PASS Subtest Medication Management: Independence: 2/3 Safety: 1/3 Adequacy: 1/3 A. Intentional masking of changes in cognitive capacity B. Confabulation during report of occupational abilitiesC. Impaired self-awareness of performance errors - RIGHT ANSWER - An OTR works as part of a multidisciplinary spina bifida team at a university-based orthopedic children's hospital. A 2-year-old child, who lives in a rural community 90 miles (144 km) from the clinic, has a routine appointment with the clinic team every 2 months. During one of the clinic appointments, the OTR completes a developmental screening. Results indicate a 2-3 month delay in upper body motor development. What action should the OTR take based on the screening outcomes? A. Advise the child's parents to schedule an appointment with a developmental pediatrician. B. Initiate a referral to an early intervention program in the family's community. C. Schedule the child for a comprehensive developmental assessment during the next clinic visit. - RIGHT ANSWER - An OTR, who works in an intensive care unit, is monitoring the mean arterial pressure of an adult patient as part of an assessment of basic vital signs. Which option represents a normal range for mean arterial pressure in an adult patient? A. 70 - 110 mmHg B. 40 - 60 mmHg C. 10 - 35 mmHg - RIGHT ANSWER - As part of the evaluation process, an OTR administers the Hawaii Early Learning Profile to an 11-month-old infant who is at risk for developmental delay. What is the PRIMARY purpose of using this type of assessment? A. To establish an age-equivalent developmental score to use as a baseline measure B. To determine the infant's level of performance using a defined set of skills C. To measure the infant's participation in developmental tasks relative to a normative group - RIGHT ANSWER - The OT staff in an inpatient setting has developed a continuous quality improvement initiative to measure the percentage of intervention goals achieved. Results suggest that although patient improvement was evident in the documentation, the goals of the original intervention plan were not always achieved by the time of discharge. What should the OT staff investigate NEXT based on these findings? A. Relationship of intervention goals to the presenting occupational performance deficits B. Consistency in therapy minutes allocated for daily OT treatment sessions C. Extent to which each intervention plan reflected patients' perceived needs - RIGHT ANSWER - Where on the human hand is two-point discrimination MOST refined? A. Dorsum of the hand B. Center of the palm C. Volar fingertips D. Radial side of the index finger - RIGHT ANSWER - Which is the TYPICAL phase of wound healing associated with the formation and breakdown of collagen resulting in scar formation? A. Remodeling B. Inflammatory C. Proliferation - RIGHT ANSWER - Which mealtime task would be MOST DIFFICULT for a 20-month-old toddler who was recently diagnosed with Rett syndrome? A. Maintaining head control when sitting in a child's high chair B. Completing hand-to-mouth patterns for self-feeding C. Swallowing flavored juices from a standard baby bottle - RIGHT ANSWER - Which of the following clinically focused research project topics is an example of qualitative research methodology? A. Assessing the outcomes of a life skills training group to identify the change in job retention rates for clients who have a substance use disorder B. Conducting focus groups with individuals who have sustained a spinal cord injury in order to develop a theory of adjustment C. Engaging kindergarten-age students who have learning disabilities in a sensory integrative program to improve academic performance D. Using gardening activities to improve grip strength outcomes for clients who have mild hemiplegia - RIGHT ANSWER -