NBCOT Exam Questions and Answers Rated A

NBCOT Exam Questions and Answers Rated A What meal size/frequency is recommended for Alzheimer's patients? small, frequent (as opposed to 3 large meals) Thromboangilitis Obliterans; Name major symptoms and (related to this) what should you be careful with in order to maintain safety? aka Buerger's disease; results in diminished temperature sense, paresthesias, pain, and cold extremities; make sure to educate patient and/or family members in maintaining water temperature and other temperature-related issues When someone is experiencing auditory hallucinations, what type of directions are best to use? (written, demonstration, verbal) written directions with a structured, expected outcome are best to reinforce reality and to provide concrete feedback verbal directions are hardest to follow and demonstration may include distracting factors (ex: demonstration of a dance step may include background music, which may be distracting) What symptoms might an individual experiencing hypoglycemia be exhibiting? dizziness, nausea, profuse sweating, shakiness Describe biofeedback and what kinds of pain it may be useful for. Biofeedback is a technique you can use to learn to control your body's functions, such as your heart rate. n essence, biofeedback gives you the power to use your thoughts to control your body, often to help with a health condition or physical performance. Biofeedback is often used as a relaxation technique. While in a group therapy session, an individual experiences an active hallucination. What is best for the OT to do; redirect the client back to the task or provide reassurance to the client that the hallucination is not real? Why? Redirect the client back to the task. This can help the person focus on reality. Explaining that a hallucination is not real would not be helpful because it is a real sensory experience for the client. What are the 3 categories of transmission-based health precautions? In what cases would they be required? contact precautions: intended to prevent transmission of infectious agents which are spread by direct/ indirect contact with the patient or the patient's environment also apply where the presence of excessive wound drainage, fecal incontinence, or other discharges from the body that suggest an increased potential for extensive environmental contamination and risk of transmission droplet precautions: intended to prevent transmission of pathogens spread through close respiratory or mucous membrane contact with respiratory secretions; (e.g., mumps, rubella, pertussis, influenza) because these pathogens do not remain infectious over long distances in a healthcare facility, special air handling and ventilation are not required to prevent droplet transmission airborne precautions: prevent transmission of infectious agents that remain infectious over long distances when suspended in the air (e.g., rubeola virus [measles], varicella virus [chickenpox], M. tuberculosis, and possibly SARS Describe standard precautions hand hygiene; personal protective equipment (PPE; gloves, gowns, mouth/nose/eye protection); respiratory hygiene/cough etiquette; patient placement; patient-care equipment and instruments/devices; care of the environment; textiles and laundry; worker safety What are some symptoms of a myocardial infarction? significant substernal pain, extreme discomfort in the epigastric area (upper belly), indigestion, nausea, sweating Akathisia; symptoms and possible causes a syndrome characterized by unpleasant sensations of inner restlessness that manifests itself with an inability to sit still; most likely a side effect of medications, such as anti-psychotic meds Akinesia; symptoms and possible causes loss of voluntary movement; negative symptom of schizophrenia; also a symptom of Parkinson's disease Pseudo-parkinsonism; symptoms and possible causes behaviors similar to symptoms of advanced Parkinson's disease (e.g., rigidity, pill-rolling tremors, masked face, shuffling gait); side effect of medications Tardive dyskinesia; symptoms and possible causes a disorder resulting in involuntary, repetitive body movements; irreversible neurological condition caused by prolonged use of neuroleptic medications "tardive," meaning they have a slow or belated onset Orthostatic hypotention; who most commonly experiences it? (age-related group) If an SCI patient were experiencing it, for example, what might an OT do to remedy the situation? head rush or dizzy spell; blood pressure suddenly falls when standing up suddenly or stretching; prevalent among elderly and those with low BP it is caused by blood pooling in lower extremities upon a change in body position; therefore, the client should be seated and immediately reclined - this will return BP to a normal range Describe symptoms of heat stroke. What are some first aid approaches for it? high body temperature, lack of sweating, nausea/vomiting, flushed skin, rapid breathing, racing heart rate seek immediate medical help; take immediate action to cool the person down while waiting for medical assistance The Omnibus Budget Reconciliation Act (OBRA) of 1987 declared that nursing home residents have what rights? The right to freedom from abuse, mistreatment, and neglect; The right to freedom from physical restraints; The right to privacy; The right to accommodation of medical, physical, psychological, and social needs; The right to participate in resident and family groups; The right to be treated with dignity; The right to exercise self-determination; The right to communicate freely; The right to participate in the review of one's care plan, and to be fully informed in advance about any changes in care, treatment, or change of status in the facility; and The right to voice grievances without discrimination or reprisal. In what cases may physical restraints be provided in a SNF or medical setting? when it is recognized as being medically necessary and temporary for lifesaving treatment When an OT has determined that a client is an unsafe driver, what is the best action for the therapist to take in response to this situation? report the information to the physician When working with an individual with a swallowing disorder, an OT elicits a swallowing reflex by providing sensory input to what area of the mouth, and with what instrument? to the inferior faucial arches with a chilled dental examination mirror Indirect vs. direct therapy in treatment of dysphagia direct therapy: utilizes bolus with modification of consistency, amount, and pacing of solids and liquids indirect therapy: does not involve bolus - thermal (cold) stimulation provides sensory input to the inferior faucial arches via a chilled dental examination mirror to elicit a swallow reflex. - reflex facilitation - strengthening, facilitation, and coordination of oral movements - airway adduction procedures - positioning to maintain the trunk/head/neck in correct postures Supraglottic swallow technique voluntarily close/protect the airway during food intake Mendlesohn's maneuver voluntarily prolonging the rise of the larynx by prolonging tongue contraction Bite reflex; how to test? pathological response? - Tested by lightly place tongue depressor between the upper and lower teeth - Normal response: no reaction - Pathological response: a reflexive bite Jaw jerk; how to test? pathological response? - Tested by firmly tap 1-2 time the center of the mandible - Normal response: no reaction - Pathological response: reflexive jaw closure/opening response Rooting reflex; how to test? pathological response? - Tested by lightly stroking from the corner of the mouth along the cheek in a direction toward the ear. - Normal response: no reaction. - Pathological response: head turning and tongue protrusion toward the direction of the stimulus What occurs in swallowing? - Laryngeal elevation when larynx rises to approximate the epiglottis and protect the airway - Soft-palate elevation when soft palate rises to close off the naso-pharynx to prevent food/liquid from entering the nasal cavity - Pharyngeal peristalsis when peristaltic waves of muscle contraction propel food through the pharynx What does an oral motor evaluation involve? 1) ROM, strength, and tone of the lips, cheeks, and tongue 2) Extra- and intra-oral sensation 3) Dentition (integrity of teeth, denture fit, etc.) 4) Oral control of bolus 5) The presence of a swallow reflex: 6) Airway protection via: 7) Relaxation of the esophageal sphincter 8) Primitive reflexes 9) Cranial nerve testing 10) Objective testing (Modified Barium Swallow/Videofluoroscopy, FEES, etc.) Blocked practice vs. random practice blocked practice involves repeated performance of the same motor skill random practice involves the performance of several tasks in random order to encourage the reformulation of the solution to the presented motor problem Utilization review a plan to review the use of resources within a facility to determine medical necessity and cost efficiency; often a component of a continuous quality improvement (CQI) or a performance assessment and improvement (PAI) system Total quality management the creation of an organizational culture that enables all employees to contribute to an environment of continuous improvement Risk management a process that identifies, evaluates, and takes corrective action against risk; and plans, organizes and controls the activities and resources of OT services to decrease actual or potential losses Retrospective review involves the auditing of medical records by third-party payers to ensure appropriate care was rendered Describe orthosis and prosthesis. How are they different? Orthosis: External device that provides stability, support, correction, or prevent a deformity. The plural is Orthoses. Prosthesis: Device that is either external or implanted which meant to replace a missing limb and provide. The plural is Prostheses. Difference: A prosthesis is meant to replace limbs while orthoses are meant to improve or support a limb. What kind of activities does OT train amputees to adapt to? Standing tolerance and balance while performing ADLs UE strengthening Prosthetic tolerance Incorporating prosthesis into body activities