NBCOT COTA Exam || with Complete Solutions.
General Environmental Considerations Definition and Maior Concepts correct answers and
Maior Concepts 1. The environment "the aggregate of phenomena that surrounds individual and
influences (her) development existence" (Mosey, 1996, p. 171). environment which lives, and
exposure to various settings, influences his or her development and adaptation. The environment
facilitate because for adaptation problem-solving strategies to developed. Conversely,
environment can hinder develop- and adaptation impoverished hostile. 5. A person's abilities,
limitations, problems, activities, occupations be fully under- stood without considerations his/her
current and expected environment. 6. Physical/nonhuman environment. Everything nonhuman
(i.e., buildings, objects, tools, devices, animals, trees). Sensory environment. Visual: lighting,
colors, posters all over Auditory: loudness of loudspeakers, class- room noise. c. Tactile: seating
textures. d. Olfactory: pleasant offensive odors. Gustatory: pleasant offensive 8.
Social-cultural/human environment. a. Social roles: organized pattern behavior that characteristic
enerauem defined position social system" (Mosey, 1996, p. 64); for example, student, parent,
worker. Social network: "the of voluntary relationships that make individual's social
environment" (Mosey, 1996, 184). aspects: "the social structures, values norms, and expectations
that accepted shared of people" d. Psychological aspects: environmental character- istics that
affect mood and stress level (e.g., a calming, cheerful envi chaotic, uncomfortable, depressing
setting). 9. The AOTA description environment beyond the physical and social environment to
include concept In the AOTA Practice Framework, context "refere law expected occupant
environment Practice ramework expanded variety interrelated conditions are within and
surrounding the interrelated less tangible physical and sto 15
Definition and Maior Concepts correct answers social environments nonetheless exer influence
performance" (AOTA 2008, Contexts include cultural, personal, tempor virtual. (1) "cultural
context includes customs activity patterns, behavior standards, and tations accepted by the
society of whi client is a member" (AOTA "personal context demos individual such age,
socioeconomic status, educational that not health condition" 2008, p. "temporal context includes
stages time year, time of day and duration activity, history" (AOTA 2008, The virtual context
refers the "enviro in which communication by mea airways or computers absence of cal contact"
(AOTA 2008, 645); exan e-mail, video-conferencing, web-based networking.
Legislation Related to the Environment correct answers Environment 1. Americans with
Disabilities Act (ADA): civil law aimed at allowing full participation in society people with
disabilities. Several sections mandate accessible environie for persons with disabilities. b.
Included are policies dealing with public sevic employment, public accommodations. 2.
Omnibus Budget Reconciliation Act dates that restraints cannot be used without justification,
agreement, and documentation 3. Individuals with Disabilities Education Act (IDEA mandates
that children disabilities geine education in least restrictive and most environment. a. Inclusive
models are be used to enable chil to be taught a regular classIOom. b. Education must prepare
iving and emplovment environme child for indepgnd The role of practitioners environmental ase
ment and modification has increased with mentation of the OBRA, and IDEA. (See 4 more
specific information on OR IDEA.)
,me Role of Occupational Therapy (OT) Practitioners correct answers 2. OT practitioners
advocate for and design environ- ments that use principles of universal design meet physical,
sensory, sociocultural, psychological needs individual. Table 15-1. OT practitioners can help
identify settings and approaches implement the OBRA, and IDEA. porson's environment-living,
vocational, a-whether takes place hospital, nursing school, practitioners familiar with
me Role of Occupational Therapy (OT) Practitioners correct answers practitioners can advocate
for ADA, OBRA, IDEA compliance to enable individuals function independently-and with least
restriction-as possible, their environment.
The Role of the Team correct answers 1. practitioners part of an interdiscipli- nary team that
determines the needs abilities of an individual with disability specific environ- ment. Basis team
construction. a. The facility which the individual disability presently resides and/or participates.
The individual's needs and her abilities/func tional Geographical location. Funding ity (ie., third-
party payers and/or offices individuals with disabilities). Support caregivers. The should always
include the consumer and caregivers. 4. Professional team members may belong to
Rehabilitation Engineers Society of North America (RESNA) and/or Registry Rehabilitation
Technology Suppliers (NRRTS). Both professional organizations help develop standards
measuring tools to ensure proper design, prescription, and delivery of rehabilitation technology.
available the individual with a disabil-
The Role of the Team correct answers 5. professional team members. Assistive technology
professional (ATP): analzE consumer needs, help select appropriate assistive technology
identified and proid. training in use the b. Computer design provision of efficient technology. c.
trainer: for driving adaptations. subsequent section driver rehabilitation. Nurse: ensure medical
care medication regimes prescribed the doctor. e. Occupational and occupational assistant: refer
section. Physical therapist: mobility difficulties individual encounter the environment. Physician:
and assess services and purchases. Psychologist: assist adjustment indicated. i. Rehabilitation
counselor: assess and advise vocational issues. j. Speech language pathologist: to assess mend
augmentative communication aids. Rehabilitation design equipment assist with modifications
adaptive equipme 1. Seating mobility specialist (SMS): seating, positioning, mobility needs and
appropriate recommendations. Social worker: to obtaining funding. evaluae n. Teacher: children
the school system, help any modifications within classroom setting
The Role of the Team correct answers payer their respective case man- to approve and/or
provide funding for the lividual's needed environmental modifica. dors: provide items requested
therapists and required the individual to function Environmental
individual function Purposes Environmental Evaluation Intervention correct answers Lientify
and prioritize needs, goals, desires, blem areas individual with disability within his/her
environments. huablish the regarding everyday functional activities within his/her environment.
functional use devices being considered lor particular individual facilitate mastery the
environment.
Purposes of Environmental Evaluation and Intervention correct answers Environmental Identify
device's availability, safety, cs. Determine device's frequency 6. Determine funding financial
,resources for equip- ment and/or modifications. a. questionable ethics inter- of the with show
him/ her device order top-of-the-line equipment that is covered his/her insurance, he/she does
financial resources self-pay. Determine environmental constraints. For example, individual be
living in flight walk-up apartment device locked up lobby, opening of vandalism theft. 8.
individual with a disability and device allow reevaluation. Ensure device will for possible
modifica tions, upon reassessment of individual change in found. and everyday Chapter 15
Overall Environmental Evaluation Evaluation of Performance Skills Client Factors*** correct
answers role the occupational contributes to the evaluation process collaboration with the
supervisor. Supervision required. (2) level supervision required mined by experience established
service competence. h. Service competency be established. OTA cannot independently or inter-
evaluation results. Performance are essential when conducting environmental evalua- for they are
allow person function in his/her environment. LUpon establishment service competency, OIA
following areas: Sensory (eg, assess Getermine there impairment discrimi- nation inluence safety
the manipula- devices). driving Visual perceptual processing skills of Test, standardized to assess
visual motor for poten- tial difficulties computer Musculoskeletal skills range of motion,
strength, endurance, assess (1) (4) (5)
Evaluation Performance and Client Factors correct answers physically devices optimal
capability). d. Neuromuscular (eg. coordination, assess person's mically and environmental
manipula- tion). skills (eg., following directions and judg- ment, assess is of limitations and able
to follow recall operation assistive technology wheelchairs) use of f. Psychosocial (e.g., support,
assess if individual ask assis- tance, needed the right person). utilize rhyth-
Contextual Evaluation correct answers manipula- to The contributes evaluation process with OT
supervision. targeted evaluation include: a. Physical considerations. (1) Arrangement furniture.
Accessibility items needed activi- ties safe (3) Housing/workplace Neighborhood characteristics.
Contextual Evaluation correct answers Environment: Intervention the individual with disability
(3) Opportunities for socialization (4) Sociocultural norms, values, and expectations Social roles:
expectations for performance Availability and of transportation. Overall accessibility.
Sociocultural considerations. independent function. (5) Community resources available.
individual's network relation ships between individual disability
Home Evaluation General Considerations*** correct answers General Considerations OTAS
perform home assessments and make adap- tations, modifications, and recommendations to
anticipated dwelling to increase safe, independent functioning with OT supervision 2. an
individual with disability discharged to home from facility, evaluation should be discharge The
person's current status (abilities and and risks in home determine need for home modifications
adapta-
Overall Characteristics of the Home correct answers good private one-family, family,
apartnment, walk-up, elevator access. 2. Protection from weather/environmental changes.
Presence and of driveway. 4. Level which person lives. Entrance dwelling wheelchair raimp.
level entrance, 6. Number of entrances that are accessible the vidual, Some buildings allow
residents to delivery because has ramp. 7. Steps: the number present outside dwelling, inside
, dwelling, laundry room, the mailbox, Railings: location and number railings outside and facing
entrance door; presence railings for interior a. Interior should inches ease grasp. railings should
those who walk: 34-38 inches, depending on height. Railings should inches in diameter nonskid
surfaces.
home tions. Overall Characteristics of the Home of correct answers Door sills: identify where
they present, entrance to dwelling bedroom doors, bathroom doors, kitchen doorway. 10.
Elevators: doorway, type operation. IL. Hallways: width hallway entrance. 12. Doorways: width
entrance measure door frame; frame frame Doorways: of opening for entrance d and throughout
dwelling that opened. a. Space accommodate door swing must be minimum inches needed for
using walkers. minimum inches needed using wheelchairs. 14. Type(s) door handles: handles
functional knobs. 15. Identification objects obstrucin doorways pathways. of pets: can obstacles
safety concerns vision, problems, who require assistive devias 17. Carpeting: wall wall th height
of 18. Electrical cords: placed flow traic good condition or frayed, overloaded underng carpeting.
Presence of firm chair the dwelling height. 20. Light accessibility from varios (standing chair).
inches Telephones: number phones, location Lype (e.g., cordless, cell, push button rotaryl gency
numbers telephone. Presence working smoke detectors. 23. Presence heaters wood-buming 24.
Presence emergency call system gency exit
Bedroom Considerations correct answers size of bed, height floor to mattress, ape mattress
wheeled frame or not, posi- ae bed (against the wall freestanding). the from which the individual
with sability enters/exits. 3Ahiliy change location, if needed. LAessibility dothes and dresser
drawers. Suficient available for bedside commode, Considerations anded
Bathroom Considerations bathrooms correct answers Considerations Number bathrooms home.
location of bathroom(s) relative to bedroom. room, kitchen, and living spaces impor- individual.
Width of bathroom doorway. of bathing the individual with disability peforms (ie. sponge bath)
previ- ously and currently. of shower/tub: separate stall, glass door with curtain-enclosed tub
shower, fashioned claw-legged tub.
Bathroom Considerations correct answers Presence and location grab bars for toilet and
bath/shower (the soap dish and towel bar are bars). home rental, landlord's agreement to grab
bars to installed needed. 7. Height of sink, and toilet. Presence a mat or surface in shower/tub. 9.
Presence of throw outside shower. 10. Availability handheld 11. Presence of antiscald valves
and/or faucets. Location of toilet paper holder.
Kitchen Considerations correct answers Considerations old Location preparation that ual uses
most frequently (i.e., oven, microwave, stove). Presence of countertop the stove and sink,
between stove and refrigerator. Accessibility of food, pots, pans, prepara- tion materials.
Direction opening refrigerator, cabinetry, and/ or pantry doors. Presence of charged extinguisher.
6. Presence of and/or
Fall Prevention and Management Falls Etiology, Prevalence, Prognosis*** correct answers
Etiology, Prevalence, Prognosis unintentional causing one make unexpected contact ground
floor. and fall injury are major health concern 1or the elderly. figures follow FTovided the need
for ỢT practitioners to be active the prevention falls. These statistics will be the NBCOT
General Environmental Considerations Definition and Maior Concepts correct answers and
Maior Concepts 1. The environment "the aggregate of phenomena that surrounds individual and
influences (her) development existence" (Mosey, 1996, p. 171). environment which lives, and
exposure to various settings, influences his or her development and adaptation. The environment
facilitate because for adaptation problem-solving strategies to developed. Conversely,
environment can hinder develop- and adaptation impoverished hostile. 5. A person's abilities,
limitations, problems, activities, occupations be fully under- stood without considerations his/her
current and expected environment. 6. Physical/nonhuman environment. Everything nonhuman
(i.e., buildings, objects, tools, devices, animals, trees). Sensory environment. Visual: lighting,
colors, posters all over Auditory: loudness of loudspeakers, class- room noise. c. Tactile: seating
textures. d. Olfactory: pleasant offensive odors. Gustatory: pleasant offensive 8.
Social-cultural/human environment. a. Social roles: organized pattern behavior that characteristic
enerauem defined position social system" (Mosey, 1996, p. 64); for example, student, parent,
worker. Social network: "the of voluntary relationships that make individual's social
environment" (Mosey, 1996, 184). aspects: "the social structures, values norms, and expectations
that accepted shared of people" d. Psychological aspects: environmental character- istics that
affect mood and stress level (e.g., a calming, cheerful envi chaotic, uncomfortable, depressing
setting). 9. The AOTA description environment beyond the physical and social environment to
include concept In the AOTA Practice Framework, context "refere law expected occupant
environment Practice ramework expanded variety interrelated conditions are within and
surrounding the interrelated less tangible physical and sto 15
Definition and Maior Concepts correct answers social environments nonetheless exer influence
performance" (AOTA 2008, Contexts include cultural, personal, tempor virtual. (1) "cultural
context includes customs activity patterns, behavior standards, and tations accepted by the
society of whi client is a member" (AOTA "personal context demos individual such age,
socioeconomic status, educational that not health condition" 2008, p. "temporal context includes
stages time year, time of day and duration activity, history" (AOTA 2008, The virtual context
refers the "enviro in which communication by mea airways or computers absence of cal contact"
(AOTA 2008, 645); exan e-mail, video-conferencing, web-based networking.
Legislation Related to the Environment correct answers Environment 1. Americans with
Disabilities Act (ADA): civil law aimed at allowing full participation in society people with
disabilities. Several sections mandate accessible environie for persons with disabilities. b.
Included are policies dealing with public sevic employment, public accommodations. 2.
Omnibus Budget Reconciliation Act dates that restraints cannot be used without justification,
agreement, and documentation 3. Individuals with Disabilities Education Act (IDEA mandates
that children disabilities geine education in least restrictive and most environment. a. Inclusive
models are be used to enable chil to be taught a regular classIOom. b. Education must prepare
iving and emplovment environme child for indepgnd The role of practitioners environmental ase
ment and modification has increased with mentation of the OBRA, and IDEA. (See 4 more
specific information on OR IDEA.)
,me Role of Occupational Therapy (OT) Practitioners correct answers 2. OT practitioners
advocate for and design environ- ments that use principles of universal design meet physical,
sensory, sociocultural, psychological needs individual. Table 15-1. OT practitioners can help
identify settings and approaches implement the OBRA, and IDEA. porson's environment-living,
vocational, a-whether takes place hospital, nursing school, practitioners familiar with
me Role of Occupational Therapy (OT) Practitioners correct answers practitioners can advocate
for ADA, OBRA, IDEA compliance to enable individuals function independently-and with least
restriction-as possible, their environment.
The Role of the Team correct answers 1. practitioners part of an interdiscipli- nary team that
determines the needs abilities of an individual with disability specific environ- ment. Basis team
construction. a. The facility which the individual disability presently resides and/or participates.
The individual's needs and her abilities/func tional Geographical location. Funding ity (ie., third-
party payers and/or offices individuals with disabilities). Support caregivers. The should always
include the consumer and caregivers. 4. Professional team members may belong to
Rehabilitation Engineers Society of North America (RESNA) and/or Registry Rehabilitation
Technology Suppliers (NRRTS). Both professional organizations help develop standards
measuring tools to ensure proper design, prescription, and delivery of rehabilitation technology.
available the individual with a disabil-
The Role of the Team correct answers 5. professional team members. Assistive technology
professional (ATP): analzE consumer needs, help select appropriate assistive technology
identified and proid. training in use the b. Computer design provision of efficient technology. c.
trainer: for driving adaptations. subsequent section driver rehabilitation. Nurse: ensure medical
care medication regimes prescribed the doctor. e. Occupational and occupational assistant: refer
section. Physical therapist: mobility difficulties individual encounter the environment. Physician:
and assess services and purchases. Psychologist: assist adjustment indicated. i. Rehabilitation
counselor: assess and advise vocational issues. j. Speech language pathologist: to assess mend
augmentative communication aids. Rehabilitation design equipment assist with modifications
adaptive equipme 1. Seating mobility specialist (SMS): seating, positioning, mobility needs and
appropriate recommendations. Social worker: to obtaining funding. evaluae n. Teacher: children
the school system, help any modifications within classroom setting
The Role of the Team correct answers payer their respective case man- to approve and/or
provide funding for the lividual's needed environmental modifica. dors: provide items requested
therapists and required the individual to function Environmental
individual function Purposes Environmental Evaluation Intervention correct answers Lientify
and prioritize needs, goals, desires, blem areas individual with disability within his/her
environments. huablish the regarding everyday functional activities within his/her environment.
functional use devices being considered lor particular individual facilitate mastery the
environment.
Purposes of Environmental Evaluation and Intervention correct answers Environmental Identify
device's availability, safety, cs. Determine device's frequency 6. Determine funding financial
,resources for equip- ment and/or modifications. a. questionable ethics inter- of the with show
him/ her device order top-of-the-line equipment that is covered his/her insurance, he/she does
financial resources self-pay. Determine environmental constraints. For example, individual be
living in flight walk-up apartment device locked up lobby, opening of vandalism theft. 8.
individual with a disability and device allow reevaluation. Ensure device will for possible
modifica tions, upon reassessment of individual change in found. and everyday Chapter 15
Overall Environmental Evaluation Evaluation of Performance Skills Client Factors*** correct
answers role the occupational contributes to the evaluation process collaboration with the
supervisor. Supervision required. (2) level supervision required mined by experience established
service competence. h. Service competency be established. OTA cannot independently or inter-
evaluation results. Performance are essential when conducting environmental evalua- for they are
allow person function in his/her environment. LUpon establishment service competency, OIA
following areas: Sensory (eg, assess Getermine there impairment discrimi- nation inluence safety
the manipula- devices). driving Visual perceptual processing skills of Test, standardized to assess
visual motor for poten- tial difficulties computer Musculoskeletal skills range of motion,
strength, endurance, assess (1) (4) (5)
Evaluation Performance and Client Factors correct answers physically devices optimal
capability). d. Neuromuscular (eg. coordination, assess person's mically and environmental
manipula- tion). skills (eg., following directions and judg- ment, assess is of limitations and able
to follow recall operation assistive technology wheelchairs) use of f. Psychosocial (e.g., support,
assess if individual ask assis- tance, needed the right person). utilize rhyth-
Contextual Evaluation correct answers manipula- to The contributes evaluation process with OT
supervision. targeted evaluation include: a. Physical considerations. (1) Arrangement furniture.
Accessibility items needed activi- ties safe (3) Housing/workplace Neighborhood characteristics.
Contextual Evaluation correct answers Environment: Intervention the individual with disability
(3) Opportunities for socialization (4) Sociocultural norms, values, and expectations Social roles:
expectations for performance Availability and of transportation. Overall accessibility.
Sociocultural considerations. independent function. (5) Community resources available.
individual's network relation ships between individual disability
Home Evaluation General Considerations*** correct answers General Considerations OTAS
perform home assessments and make adap- tations, modifications, and recommendations to
anticipated dwelling to increase safe, independent functioning with OT supervision 2. an
individual with disability discharged to home from facility, evaluation should be discharge The
person's current status (abilities and and risks in home determine need for home modifications
adapta-
Overall Characteristics of the Home correct answers good private one-family, family,
apartnment, walk-up, elevator access. 2. Protection from weather/environmental changes.
Presence and of driveway. 4. Level which person lives. Entrance dwelling wheelchair raimp.
level entrance, 6. Number of entrances that are accessible the vidual, Some buildings allow
residents to delivery because has ramp. 7. Steps: the number present outside dwelling, inside
, dwelling, laundry room, the mailbox, Railings: location and number railings outside and facing
entrance door; presence railings for interior a. Interior should inches ease grasp. railings should
those who walk: 34-38 inches, depending on height. Railings should inches in diameter nonskid
surfaces.
home tions. Overall Characteristics of the Home of correct answers Door sills: identify where
they present, entrance to dwelling bedroom doors, bathroom doors, kitchen doorway. 10.
Elevators: doorway, type operation. IL. Hallways: width hallway entrance. 12. Doorways: width
entrance measure door frame; frame frame Doorways: of opening for entrance d and throughout
dwelling that opened. a. Space accommodate door swing must be minimum inches needed for
using walkers. minimum inches needed using wheelchairs. 14. Type(s) door handles: handles
functional knobs. 15. Identification objects obstrucin doorways pathways. of pets: can obstacles
safety concerns vision, problems, who require assistive devias 17. Carpeting: wall wall th height
of 18. Electrical cords: placed flow traic good condition or frayed, overloaded underng carpeting.
Presence of firm chair the dwelling height. 20. Light accessibility from varios (standing chair).
inches Telephones: number phones, location Lype (e.g., cordless, cell, push button rotaryl gency
numbers telephone. Presence working smoke detectors. 23. Presence heaters wood-buming 24.
Presence emergency call system gency exit
Bedroom Considerations correct answers size of bed, height floor to mattress, ape mattress
wheeled frame or not, posi- ae bed (against the wall freestanding). the from which the individual
with sability enters/exits. 3Ahiliy change location, if needed. LAessibility dothes and dresser
drawers. Suficient available for bedside commode, Considerations anded
Bathroom Considerations bathrooms correct answers Considerations Number bathrooms home.
location of bathroom(s) relative to bedroom. room, kitchen, and living spaces impor- individual.
Width of bathroom doorway. of bathing the individual with disability peforms (ie. sponge bath)
previ- ously and currently. of shower/tub: separate stall, glass door with curtain-enclosed tub
shower, fashioned claw-legged tub.
Bathroom Considerations correct answers Presence and location grab bars for toilet and
bath/shower (the soap dish and towel bar are bars). home rental, landlord's agreement to grab
bars to installed needed. 7. Height of sink, and toilet. Presence a mat or surface in shower/tub. 9.
Presence of throw outside shower. 10. Availability handheld 11. Presence of antiscald valves
and/or faucets. Location of toilet paper holder.
Kitchen Considerations correct answers Considerations old Location preparation that ual uses
most frequently (i.e., oven, microwave, stove). Presence of countertop the stove and sink,
between stove and refrigerator. Accessibility of food, pots, pans, prepara- tion materials.
Direction opening refrigerator, cabinetry, and/ or pantry doors. Presence of charged extinguisher.
6. Presence of and/or
Fall Prevention and Management Falls Etiology, Prevalence, Prognosis*** correct answers
Etiology, Prevalence, Prognosis unintentional causing one make unexpected contact ground
floor. and fall injury are major health concern 1or the elderly. figures follow FTovided the need
for ỢT practitioners to be active the prevention falls. These statistics will be the NBCOT
