1. A child demonstrates disruptive behavior due to a low sensory threshold. What specific strategy
should the OT suggest to the teacher for a field trip to the zoo?
A. Allow the child to lead the group to reduce anxiety
B. Seat child at front of bus and use earmuffs to dampen noise
C. Provide a weighted blanket only during lunch time
D. Have the child wear sunglasses inside the reptile house
Correct Answer: B. Rationale: Low sensory threshold means the child overreacts to stimuli. The
front of the bus reduces visual chaos, and earmuffs dampen auditory input, preventing overload.
2. An OT suspects tactile defensiveness is the reason for a child's dressing challenges. What area of
participation should be addressed first?
A. Fine motor manipulation of buttons
B. Dressing Habits
C. Balance while standing on one leg
D. Visual perceptual skills for matching socks
Correct Answer: B. Rationale: Tactile defensiveness directly impacts the sensory experience of
clothing touching skin. "Dressing Habits" addresses the sensory routines and aversions first.
3. A patient with CRPS is experiencing severe pain that limits work and self-care. Which PAM is
best to manage this specific pain profile?
A. Fluidotherapy
B. Transcutaneous Electrical Nerve Stimulation
C. Paraffin wax bath
D. Ultrasound at 3.0 MHz
Correct Answer: B. Rationale: TENS uses electrical impulses to block pain signals at the spinal cord
level (gate control theory), specifically indicated for neuropathic pain like CRPS.
4. A college student with substance abuse is admitted after an overdose. What area should the OT
focus on first during evaluation?
A. Vocational exploration
B. Leisure skills
,C. Financial budgeting
D. Cooking safety
Correct Answer: B. Rationale: In early recovery, healthy leisure skills replace the time and routine
previously occupied by substance use, providing natural coping mechanisms.
5. An OT observes a child who is awkward with gross motor tasks and can skip forward but not
backward. What condition is the OT specifically looking for?
A. Sensory Modulation Disorder
B. Developmental Dyspraxia
C. Hypotonia
D. Visual Processing Delay
Correct Answer: B. Rationale: Dyspraxia involves difficulty planning novel motor tasks. Skipping
backward requires new motor planning, unlike the already-learned forward pattern.
6. A patient with ALS and mild dysphagia is extremely fatigued during meals. What is the first
intervention to implement?
A. Thicken all liquids to nectar consistency
B. Eat six small meals a day
C. Use a chin tuck for every swallow
D. Eliminate all solid foods
Correct Answer: B. Rationale: Fatigue reduces coordination for safe swallowing. Smaller, frequent
meals preserve energy for airway protection and reduce respiratory effort during eating.
7. An OT is developing a measurement plan for students with ASD to track social participation
changes. What is the most likely strategy?
A. Peabody Developmental Motor Scales
B. Goal Attainment Scaling
C. Visual Motor Integration Test
D. Sensory Profile
Correct Answer: B. Rationale: GAS is individualized to each student's specific social goals (e.g.,
initiating play), allowing measurement of small, meaningful changes in participation.
8. A child with CP has limited postural stability but is developmentally ready for toilet training.
What element should be considered first?
A. Visual schedule for toileting
,B. Utilization of foot supports
C. Elastic waistbands on pants
D. Verbal cues for clean-up
Correct Answer: B. Rationale: Postural stability is prerequisite for toileting. Foot supports provide a
fixed base of support, freeing the child's hands and attention for the task.
9. A parent with mild intellectual disability needs help developing positive parenting skills during
feeding. What intervention will most likely help?
A. Lecture on child development stages
B. Encourage problem solving about how to respond when baby is fussy
C. Referral to a parenting book
D. Passive stretching for the infant
Correct Answer: B. Rationale: Problem-solving in context addresses real-time challenges. This
cognitive strategy builds practical reasoning skills specific to the parent's unique situation.
10. An OT plans a meal prep activity for a client with attentional and organizational deficits. What
is the most appropriate first activity for sequencing?
A. Making a gourmet meal from a video
B. Baking cookies following a recipe
C. Chopping vegetables without instructions
D. Setting a table with mismatched dishes
Correct Answer: B. Rationale: Baking cookies follows a concrete, step-by-step written sequence. It
provides external structure for organization and requires sustained attention for short bursts.
11. A child with under-reactive sensory processing is referred to OT. Based on SI theory, what
characteristics should intervention activities have?
A. Predictable and Boring
B. Slow and repetitive
C. Arhythmic and Unexpected
D. Silent and stationary
Correct Answer: C. Rationale: Under-reactive children need high-intensity, novel input to register
sensation. Arhythmic and unexpected stimuli (e.g., sudden changes in movement) alert the
nervous system.
, 12. A flight attendant with a low-back injury is in work hardening. After simulating distributing
magazines successfully, what should the OT ask them to simulate next?
A. Sitting on a static airplane seat
B. Serving from the beverage cart
C. Folding blankets while standing still
D. Walking down the aisle with no load
Correct Answer: B. Rationale: Serving from a cart involves dynamic twisting, pushing/pulling, and
reaching overhead—significant upgrades in biomechanical demand compared to magazines.
13. A patient with LUE flaccidity sits with the arm dangling over the side of the W/C. What
positioning strategy should be introduced first?
A. Placing the arm in a lap tray
B. Positioning the UE on the table with Dycem
C. Using a resting hand splint 24/7
D. Tying the sleeve to the armrest
Correct Answer: B. Rationale: Flaccid arm is at risk for traction injury and edema. Supporting the
arm on a table with Dycem prevents downward pulling and provides sensory feedback.
14. A 6-year-old with CP is discharged home. What instructions should the OT give the family for
maintaining correct jaw control while feeding from the side?
A. Push the jaw backward forcefully
B. Jaw opening and closing are controlled with your index and middle finger, place your thumb on
the child's cheek
C. Only feed pureed foods to avoid jaw movement
D. Hold the nose to encourage mouth closing
Correct Answer: B. Rationale: This technique (jaw stability) provides external stability to the
mandible, allowing for graded lateral tongue movements and safe bolus manipulation.
15. A patient with hemiparesis and mild perceptual deficits wants to button a shirt. What is the
best way to do this?
A. Button from the top down while looking in a mirror
B. Lay the shirt flat and button before donning
C. Get the shirt all the way on, then line up the buttons and holes, and begin buttoning from the
bottom
D. Use Velcro replacements only
should the OT suggest to the teacher for a field trip to the zoo?
A. Allow the child to lead the group to reduce anxiety
B. Seat child at front of bus and use earmuffs to dampen noise
C. Provide a weighted blanket only during lunch time
D. Have the child wear sunglasses inside the reptile house
Correct Answer: B. Rationale: Low sensory threshold means the child overreacts to stimuli. The
front of the bus reduces visual chaos, and earmuffs dampen auditory input, preventing overload.
2. An OT suspects tactile defensiveness is the reason for a child's dressing challenges. What area of
participation should be addressed first?
A. Fine motor manipulation of buttons
B. Dressing Habits
C. Balance while standing on one leg
D. Visual perceptual skills for matching socks
Correct Answer: B. Rationale: Tactile defensiveness directly impacts the sensory experience of
clothing touching skin. "Dressing Habits" addresses the sensory routines and aversions first.
3. A patient with CRPS is experiencing severe pain that limits work and self-care. Which PAM is
best to manage this specific pain profile?
A. Fluidotherapy
B. Transcutaneous Electrical Nerve Stimulation
C. Paraffin wax bath
D. Ultrasound at 3.0 MHz
Correct Answer: B. Rationale: TENS uses electrical impulses to block pain signals at the spinal cord
level (gate control theory), specifically indicated for neuropathic pain like CRPS.
4. A college student with substance abuse is admitted after an overdose. What area should the OT
focus on first during evaluation?
A. Vocational exploration
B. Leisure skills
,C. Financial budgeting
D. Cooking safety
Correct Answer: B. Rationale: In early recovery, healthy leisure skills replace the time and routine
previously occupied by substance use, providing natural coping mechanisms.
5. An OT observes a child who is awkward with gross motor tasks and can skip forward but not
backward. What condition is the OT specifically looking for?
A. Sensory Modulation Disorder
B. Developmental Dyspraxia
C. Hypotonia
D. Visual Processing Delay
Correct Answer: B. Rationale: Dyspraxia involves difficulty planning novel motor tasks. Skipping
backward requires new motor planning, unlike the already-learned forward pattern.
6. A patient with ALS and mild dysphagia is extremely fatigued during meals. What is the first
intervention to implement?
A. Thicken all liquids to nectar consistency
B. Eat six small meals a day
C. Use a chin tuck for every swallow
D. Eliminate all solid foods
Correct Answer: B. Rationale: Fatigue reduces coordination for safe swallowing. Smaller, frequent
meals preserve energy for airway protection and reduce respiratory effort during eating.
7. An OT is developing a measurement plan for students with ASD to track social participation
changes. What is the most likely strategy?
A. Peabody Developmental Motor Scales
B. Goal Attainment Scaling
C. Visual Motor Integration Test
D. Sensory Profile
Correct Answer: B. Rationale: GAS is individualized to each student's specific social goals (e.g.,
initiating play), allowing measurement of small, meaningful changes in participation.
8. A child with CP has limited postural stability but is developmentally ready for toilet training.
What element should be considered first?
A. Visual schedule for toileting
,B. Utilization of foot supports
C. Elastic waistbands on pants
D. Verbal cues for clean-up
Correct Answer: B. Rationale: Postural stability is prerequisite for toileting. Foot supports provide a
fixed base of support, freeing the child's hands and attention for the task.
9. A parent with mild intellectual disability needs help developing positive parenting skills during
feeding. What intervention will most likely help?
A. Lecture on child development stages
B. Encourage problem solving about how to respond when baby is fussy
C. Referral to a parenting book
D. Passive stretching for the infant
Correct Answer: B. Rationale: Problem-solving in context addresses real-time challenges. This
cognitive strategy builds practical reasoning skills specific to the parent's unique situation.
10. An OT plans a meal prep activity for a client with attentional and organizational deficits. What
is the most appropriate first activity for sequencing?
A. Making a gourmet meal from a video
B. Baking cookies following a recipe
C. Chopping vegetables without instructions
D. Setting a table with mismatched dishes
Correct Answer: B. Rationale: Baking cookies follows a concrete, step-by-step written sequence. It
provides external structure for organization and requires sustained attention for short bursts.
11. A child with under-reactive sensory processing is referred to OT. Based on SI theory, what
characteristics should intervention activities have?
A. Predictable and Boring
B. Slow and repetitive
C. Arhythmic and Unexpected
D. Silent and stationary
Correct Answer: C. Rationale: Under-reactive children need high-intensity, novel input to register
sensation. Arhythmic and unexpected stimuli (e.g., sudden changes in movement) alert the
nervous system.
, 12. A flight attendant with a low-back injury is in work hardening. After simulating distributing
magazines successfully, what should the OT ask them to simulate next?
A. Sitting on a static airplane seat
B. Serving from the beverage cart
C. Folding blankets while standing still
D. Walking down the aisle with no load
Correct Answer: B. Rationale: Serving from a cart involves dynamic twisting, pushing/pulling, and
reaching overhead—significant upgrades in biomechanical demand compared to magazines.
13. A patient with LUE flaccidity sits with the arm dangling over the side of the W/C. What
positioning strategy should be introduced first?
A. Placing the arm in a lap tray
B. Positioning the UE on the table with Dycem
C. Using a resting hand splint 24/7
D. Tying the sleeve to the armrest
Correct Answer: B. Rationale: Flaccid arm is at risk for traction injury and edema. Supporting the
arm on a table with Dycem prevents downward pulling and provides sensory feedback.
14. A 6-year-old with CP is discharged home. What instructions should the OT give the family for
maintaining correct jaw control while feeding from the side?
A. Push the jaw backward forcefully
B. Jaw opening and closing are controlled with your index and middle finger, place your thumb on
the child's cheek
C. Only feed pureed foods to avoid jaw movement
D. Hold the nose to encourage mouth closing
Correct Answer: B. Rationale: This technique (jaw stability) provides external stability to the
mandible, allowing for graded lateral tongue movements and safe bolus manipulation.
15. A patient with hemiparesis and mild perceptual deficits wants to button a shirt. What is the
best way to do this?
A. Button from the top down while looking in a mirror
B. Lay the shirt flat and button before donning
C. Get the shirt all the way on, then line up the buttons and holes, and begin buttoning from the
bottom
D. Use Velcro replacements only
