NATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY (NBCOT®) EXAM 2022

NATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY (NBCOT®) EXAM. 1. A 5 year old child who has mild developmental delay is learning to self-dress. Most recently, the child has mastered putting on and taking off a coat, as well as buttoning and unbuttoning it. From the dressing tasks listed, which should the child learn to do next based on the typical development sequence for dressing?: Pulling up a jacket zipper would be the next dressing skill the child should learn. 2. An entry level OTR who works in a long-term care facility is screening a resident who has ALS and uses a wheelchair. The resident's UE functional strength is Trace (1/5) on the left and Poor Minus (2-/5) on the right. The resident wants to eat meals in the facility dining room but is embarrassed about frequently dropping assistive eating devices and having several inci- dences of coughing while eating. What care coordination task should the OTR complete FIRST?: Coordinate with the multi-disciplinary team to identify specific feeding and swallowing objectives. 3. An entry level OTR who works in a long-term care facility is screening a resident who has ALS and uses a wheelchair. The resident's UE functional strength is Trace (1/5) on the left and Poor Minus (2-/5) on the right. The resident wants to eat meals in the facility dining room but is embarrassed about frequently dropping assistive eating devices and having several inci- dences of coughing while eating. What symptom is the resident most at risk for experiencing during a meal?: Variation in voice quality or loss of voice after swallowing, which is a symptom of dysphagia. 4. Which factor is MOST IMPORTANT to determine when considering if the resident would benefit from a mobile arm support?: Amount of upper extremity passive joint mobility 5. At a minimum, what information should the OTR document to increase the likelihood of additional authorized visits?: Functional problem statements indicating the need for skilled services 6. How should the OTR respond to the client's concerns about splinting?: - Encourage full participation in daily tasks by collaborating on ways to modify typical daily activities 7. Your patient had a CVA several weeks ago. Which task oriented approach would be most beneficial to include as part of the intervention plan for maxi- mizing the client's physical abilities?: Constraint-induced movement therapy is a task-oriented approach to motor acquisition. 8. For a patient who had a CVA several weeks ago, which type of activity should be included as part of the INITIAL intervention to REMEDIATE the client's motor impairment?: Weight bearing through the affected upper extremity prior to an activity 9. Which assessment should be included as part of the initial evaluation and can be administered by the COTA?: COPM 10. What is contraindicated during phase I of cardiac rehab?: Isometric exer- cises can cause a rapid and sudden increase in blood pressure 11. AOTA: Publishes Standards of Practice for Occupational Therapy and the Reference Manual of official Documents of the AOTA. 12. NBCOT: Responsible for issues related to certification and certification renew- al 13. ACOTE: responsible for accreditation of OT education standards in support of the practice standards set forth by the AOTA 14. Negligible Correlation: 0 - .2 15. low correlation: .2 - .4 16. moderate correlation: .4 - .6 17. high correlation: .6 - .8 18. .8 - 1.0: very high correlation 19. Constructional Apraxia: have difficulty constructing/assembling objects 20. A client has Poor minus (2-/5) functional strength of the dominant UE. What is the most effective method for grading an activity to improve the client's muscular strength?: Increasing the amount of time an isometric contrac- tion is held 21. What is the PRIMARY purpose for completing a dysphagia screening for an inpatient who had a right CVA several days ago?: To observe the patient's oral motor control and determine a need for further evaluation. A screening is not used for diagnostics or treatment planning - it allows the OTR to quickly detect the presence of a deficit and determine if an in-depth evaluation is needed. 22. An OTR is preparing to interview an outpatient who has a TBI and is functioning at Rancho Level VII. What charcteristic of an individual's cog- nitive behavioral function is typically included in the description of this level?: Consistent orientation to time and space. Patients at this level frequently display robot-like behaviors and require minimal assistance for routine ADL. 23. Cognitive Behavioral Therapy: The individual can change their behavior by first challenging their negative assumptions (cognitions) relating to trigger events. 24. If a client presents with a boutonniere type deformity, what is the most likely cause?: Rupture or lengthening of the central slip of the EDC 25. Rupture of the flexor digitorum superficialis tendon or lengthening of the lateral slips of the EDC may result in...: swan neck deformity 26. An OTR who receives a referral for a 5 yr old with PDD should first gather background information on the child by:: discussing the child's history with the caregiver to identify the child's present level of performance in different occupational roles 27. When considering the readiness of a client for a power wheelchair, the OTR should primarily be concerned with: Cognitive ability, to ensure that the individual has the awareness, problem solving, and decision making capabilities to learn how to consistently and safely operate the chair 28. agoraphobia: a morbid fear of open spaces (as fear of being caught alone in some public place) 29. During an OT session at an outpatient facility, the client states that being injured has caused considerable stress at home. The client often feels frus- trated and angry and reports a concern for having to physically discipline her children. The FIRST action that the OTR should take is to:: further explore the situation since the child may be at risk. Gathering specific information about the client's comment is critical due to the seriousness of the accusation. Therapists are required by law to report any situation where abuse is suspected. Documentation occurs after all information is obtained from the individual. More information is needed before any action is taken. 30. According to SI frame of reference, tx is most effective when:: a child directs his or her actions within an environment structured by an OTR that pro- vides the just-right challenge. The child's skills and abilities are facilitated in an environment where the child is directing their participation in activities 31. An individual who is referred to OT to increase socialization and develop leisure skills sits alone, despite the active involvement of the other group members. To increase the individual's involvement in the group, the OTR's MOST APPROPRIATE FIRST action would be to: review the goals and purpose of the group with the individual. In order for the individual to become involved in a group process, the group norms and expectations must first be explained to the client. 32. The BEST position in which to feed an 8-month old with severe hypotonia is: semireclined with the neck in neutral and head at midline. This will promote cor- rect alignment of body parts during feeding and requires minimal active muscular control 33. An individual has difficulty conceptualizing and organizing future events, and is experiencing decreased feelings of competence. The BEST treatment intervention is to have the individual:: prioritize short term goals with a high chance of success. Feelings of competence are enhanced by successful progres- sion toward achievable goals 34. A 15 month old child with motor delays is able to get into a sitting postition, but does not pull up to standing. Which developemental milestone is the OTR MOST LIKELY to emphasize next?: Creeping - The Developmental Frame of Reference suggests that once a child has achieved the developmental skill of sitting, the next skill to achieve is creeping. 35. Before recommending purchase of adapted switches for a 3 year old with severe cerebral palsy, the OTR must FIRST:: determine goals - considering how a new piece of equipment will fit into a person's occupational roles should be the first consideration for identifying equipment needs 36. When positioning an individual with flaccid hemiparesis in a wheelchair, an OTR using NDT would place the affected arm in:: a supported position, with the scapula protracted and the arm forward to inhibit abnormal patterns of movement and inhibit synergistic posturing and help to maintain scapular mobility for normal movement patterns 37. An OTR is working on pencil grasp with an 8 yr old. The child consis- tently uses a palmer grasp. The MOST EFFECTIVE activity to facilitate the development of a more mature pencil grasp pattern is:: stringing small beads would be most effective way to improve functional coordination and use of intrinsic muscles of the hand. This activity would also promote a more refined distal fingertip control. Distal control in intrinsic muscle strength and coordination are important components of a mature pencil grasp. 38. When learning one-handed dressing techniques, an individual with right hemiplegia, aphasia, and ideational apraxia would MOST LIKELY benefit from which of the following treatment approaches?: Tactile cueing for initiating dress because ti uses the individual's existing strengths to minimize the functional deficits resulting from aphasia and ideational apraxia 39. To maximize independence in feeding, an individual with a complete C-5 quadriplegia will most likely benefit from a:: plate guard, a wrist-hand orthosis with a utensil slot, bent angled utensils, and a long straw with a straw holder. A wrist-hand orthosis would compensate for the absence of wrist extensors/flexors. Bent angled utensils aid in maximizing self-feeding skills by compensating for the absence of radial and ulnar deviation. A plate guard provides a barrier against which the individual could push food to get the food onto a fork. 40. C5: will have the following movements: elbow flexion, forearm supination, shoulder external rotation, should abduction to 90 degrees. 41. What technique helps to normalize tone and promote sensory feedback in a pt who had a CVA with resulting hypertonicity?: weight bearing/joint compression is an inhibitory technique described in both Rood's and Bobath's theories 42. The parents of a 6 month old who has mild spasticity have been in- structed in a positioning program for home. The BEST way to assess the effectiveness of the intervention program is to:: have the parents demonstrate correct positioning 43. Based on a child's performance, a school-based OTR believes that pro- gram modifications in the IEP are needed. The first course of action the OT should take should be to:: Prepare a summary of the additional needs for the multidisciplinary team 44. Based upon the initial evaluation results of a patient with a brain tumor, independence in upper body dressing is established as a short-term goal. After 2 weeks of treatment the patient is not progressing as quickly as expected. The FIRST thing the OTR should do is:: contact the physician to discuss the patient's progress. It may be appropriate to modify the patient's plan but the OTR should FIRST discuss this with the physician 45. An OTR emplyed by a multi-state entertainment theme park corporation can FIRST enhance the corporation's awareness of their role in assuring parks accessibility and ADA compliance by:: identifying barriers which inhibit customer use. Determine occupational needs of the organization. The first step of the process would be to identify the needs and issues surrounding parks accessibility and ADA compliance. 46. An OTR working in a long-term care facility is asked to recommend seat- ing approaches for the residents in the dining program. The BEST approach to meet the needs of the entire group would be to:: assess the resident's needs and strengths. Determine occupational needs of the program. 47. When does Asymmetric Tonic Neck Reflex disappear?: 4 months 48. When does the stepping reflex disappear?: 2 months 49. When does palmar grasp reflex (spontaneous grasp of adult fingers) disappear?: 3-4 months 50. When can a child lift self by arms when prone?: 2 months 51. When can child sit alone?: 6-7 months 52. When can child crawl?: 7 months 53. When can child pull to stand?: 8 months 54. WHen can child stand alone?: 11 months 55. When can child build a tower of 2 cubes?: 13 months 56. Reaching at 3 months: Voluntary reaching gradually improves in accuracy. It does not require visual guidance of arms and hands, but rather a sense of movement and location. 57. Reaching at 9 months: Infant can redirect reaching to obtain a moving object that changes direction. 58. When can a baby roll from tummy to back and back to tummy?: 4-5 months 59. What is the primary purpose of the chin tuck?: To prevent food secretion from entering the larynx below the level of the vocal chords 60. A client who has motor deficits secondary to the onset of Huntington's disease is participating in OT. One of the client's goals is to be independent with dressing. Which intervention activity is BEST to include as part of the initial intervention plan?: Educate the client and caregivers about methods for adapting the fasteners on the client's clothing. HD is a progressive neurodegenerative disorder. Symp- toms include choreo-athetoid movements and alterations in behavior and cognitive functions. A client in the early stages would benefit most from learning techniques to compensate for motor deficits. 61. A 5-year-old child who has mild developmental delay is learning to self-dress. Most recently, the child has mastered putting on and taking off a coat, as well as buttoning and unbuttoning it. From the dressing tasks listed, which should a child learn to do NEXT based on the typical develop- mental sequence for dressing?: Pulling up a jacket zipper 62. Minimum width of a hall for a wheelchair: 36 in 63. Minimum clear width for a wheelchair is inches for a door.: 32 64. If wheel chair ramp changes direction the minimum size of the landing is:: 5' by 5' 65. Wheel chair hand rail height: 33" to 36" 66. Standard wheelchair width: 24-27" 67. Phase I Cardiac Rehab: Acute care -3-5 day hospital stay for uncomplicated MI -initiate activity once stable for 24hrs -low intensity (2-3 METs) progressing to 3-5 METs by discharge -lifting restricted for 6 wks -monitored low level physical activity -self-care -reinforcement of cardiac & post-surgical precautions -energy conservation education -graded activity 68. Phase II Cardiac Rehab: Pt. is out of the hospital and goes to a rehab center. Target HR during rehab is 10bpm below the rate of ischemic change. Subacute (outpatient) rehab; most payers allow 36 visits (3x/wk for 12 wks); for pts at risk for arrhythmias or angina that benefit from ECG monitoring; 30-60 min session with warm up and cool down; gradually weaned to self-monitoring; exit point is 9 METS (5 METS for most daily activities); strength training after 3 wks of rehab, 5 wks post-MI, or 8wks post-CABG; elastic bands or 1-3 lb weights, to mod loads of 12-15 reps 69. Phase III Cardiac Rehab: Community exercise program, post phase II rehab; entry level criteria is 5 METs, clinically stable angina, and arrhythmias controlled with meds; progress to self-regulation; 50-85% capacity 3-4 times/wk for 45 min sessions; discharge in 6-12 mo; 5 wks post-surgical or MI; 3 wks post-PTCA; no evidence of unstable s/s; resistance with 50% or more of 1 RM, 1-5 lb weights, RPE 11-13; RPP prescribed by ETT 70. Fine Motor Development 8 month: mouths toys, accurately reaches for toys, transfers toys hand to hand, bangs objects together, grasps small objects in fingertips 71. Gross Motor Development 8 months: sits independently, rolls, stands with support, and crawls on belly 72. When does the Moro Reflex disappear?: 3-4 months 73. symmetric tonic neck reflex: onset: 4-6 months, disappears: 8-12 months Stimulus: place infant in the crawling position and extend the head Response: Flexion of the hips and knees *Breaks up total extensor posture 74. When should head lag stop when lifting the baby up to sitting from a lying down position?: 6 months 75. equilibrium reactions: stimulus: displace center of gravity by tipping support surface, response: righting of head/trunk/limbs