NBCOT Wheelchair Seating and Mobility Exam Prep, (Answered)2022 Solution

NBCOT Wheelchair Seating and Mobility Exam Prep, (Answered)2022 Solution A COTA® is assisting the OTR® in providing care to a child with lumbar-level spina bifida. The child spends the majority of time in a wheelchair and plays adapted basketball. What does evidence reveal as the most effective occupational therapy intervention for preventing pressure ulcers? Select the BEST 3 choices. A. Strategies to increase shear B. Functional activities C. Wheelchair seating assessment D. Weight-shifting training E. Client prevention education F. Safe transfer techniques C. Wheelchair seating assessment E. Client prevention education F. Safe transfer techniques A COTA® works at a skilled nursing facility that provides wheelchairs for clients who need them. As a result, the facility has a room full of wheelchairs of varying sizes. The COTA is often expected to find the wheelchair that best fits each new client, which requires determining whether the seat depth is appropriate for that client. Where should the front edge of the wheelchair seat be in relation to the client's hamstrings? A. 5 to 6 inches proximal to the posterior side of the bent knee B. 1 to 2 inches proximal to the posterior side of the bent knee C. At the knee crease on the posterior side of the bent knee D. 1 to2 inches distal to the posterior side of the bent knee B. 1 to 2 inches proximal to the posterior side of the bent knee A COTA® is working in a skilled nursing facility and is on the restraint reduction team. A long-term resident has recently sustained several falls within a few days, and the team has been asked to assess the situation. What is the MOST important consideration during the assessment? A. The safest intervention that will eliminate all future falls B. The least restrictive intervention that reduces the need for staff intervention C. The least restrictive intervention that is also safe D. The safest intervention that is also not a financial burden to the facilty C. The least restrictive intervention that is also safe A COTA® at a skilled nursing facility is working with an older client who appears to have a large gap between the back of the knees and the front of the seat cushion. What factors may be interfering with the client's positioning within the seat? Select the 3 BEST choices. A. Armrest height B. Back brace C. Seat back height D. Shortened seat depth E. Anterior pelvic tilt F. Fatigue B. Back brace D. Shortened seat depth F. Fatigue A client sustained a C4 spinal cord injury in a car accident, and the OTR®-®is recommending a power wheelchair with a sip-and-puff controller. Which of the following options would be best for providing pressure relief to the buttocks by changing orientation in space but not body position? A. Tilt in space B. Recline C. Elevating leg rests D. Pelvic bar A. Tilt in space A client who is being seen by both occupational therapy and physical therapy requires an ankle foot orthosis to prevent foot drop while walking and completing standing ADLs. In this situation, what is the COTA® responsible for regarding lower-extremity orthoses? A. Assisting in evaluation for orthosis necessity B. Adjusting the orthosis when it does not fit C. Teaching the client to don and doff the orthosis during dressing D. Assisting with gait training after orthosis application C. Teaching the client to don and doff the orthosis during dressing A COTA® has a client who requires a new wheelchair, so the COTA is assisting the OTR in selecting the appropriate wheelchair. During this process, it is important to consider seat width. When considering seat width, what should be the COTA's MAIN objective? A. To distribute weight over the widest possible surface while keeping the width of the chair as narrow as possible B. To support the client's body in the wheelchair while maintaining the thighs in a position that is parallel to the floor C. To maintain proper posture and balance and to provide support and alignment for the upper extremities D. To provide for maximal function and support of the back while allowing for change in body positioning A. To distribute weight over the widest possible surface while keeping the width of the chair as narrow as possible A COTA® is treating a client who, because of increased right leg weakness, has recently begun using a right footrest to avoid foot drag during wheelchair propulsion. What would be the benefit of using a heel loop on the footplate of the wheelchair? A. To prevent the foot from sliding backward B. To accommodate for ankle flexion C. To accommodate for preferred knee flexion angle D. To prevent falls during transfers A. To prevent the foot from sliding backward A COTA® is working with a client who has decreased visual acuity. The client is concerned about falling while walking up and down the stairs. Which of the following environmental adaptions is BEST for this issue? A. Railings along the length of both walls of the stairwell B. Strips of various colors at the edge of each step C. Safety grip strips placed on the edge of each step D. A chair lift for the entire length of the stairwell B. Strips of various colors at the edge of each step An OTR®-COTA® team is evaluating a client for a power wheelchair. The client lives at home with a caregiver. After the intake interview, the team is concerned that Medicare Part B will not reimburse the cost of the wheelchair. Which client statements support the client's eligibility? Select the 3 BEST choices. A. "I have diabetes and arthritis, which make it difficult for me to walk." B. "I don't have enough room to move the wheelchair between rooms in my home." C. "I use my cane when I am at home." D. "I am unable to do any of my daily activities without help from my daughter." E. "My doctor quit accepting Medicare last month." F. "I am unable to push myself in a wheelchair because of my arthritis." A. "I have diabetes and arthritis, which make it difficult for me to walk." D. "I am unable to do any of my daily activities without help from my daughter." F. "I am unable to push myself in a wheelchair because of my arthritis." The COTA® assisted with evaluating a client who recently sustained an L2 spinal cord injury with lower-extremity paralysis. The evaluation found that the client's upper-extremity function is intact. During treatment, what would be the MOST appropriate way to teach the client to complete functional transfers? A. Dependent transfer B. Sliding board transfer C. Bent pivot transfer D. Stand pivot transfer B. Sliding board transfer An OTR® is working with a client who is interested in getting a power wheelchair. The client asks the OTR about the benefits of a reclining-back over a tilt-in-space wheelchair. What would be the MOST appropriate response to this question? A. A reclining-back wheelchair is best for someone who has a custom contoured seating system. B. A reclining-back wheelchair is beneficial for a person who has excessive extensor tone. C. A reclining-back wheelchair is advantageous when a person has a diagnosis of orthostatic hypotension. D. A reclining-back wheelchair is a good idea for someone who is concerned with shearing of the skin. C. A reclining-back wheelchair is advantageous when a person has a diagnosis of orthostatic hypotension. A COTA® has a client who came into the clinic with a wheelchair that was borrowed from a relative. The client asks whether it would be possible to use the wheelchair permanently to save money. After consulting with the OTR®, both the COTA and the OTR agree that the wheelchair is too tall for the client. How did they reach this conclusion? A. They observed that the client is sliding out of the chair. B. The client is complaining about pain in the ischial tuberosity. C. The client has to lean out of the chair to propel it. D. They observed that the client's feet do not touch the floor. D. They observed that the client's feet do not touch the floor. A client has been using a wheeled walker for many years but has begun to complain that arthritis in the right hand is making it difficult to grasp the walker for any extended period of time, making functional ambulation difficult. Which recommendation would BEST help maintain this client's mobility? A. Use a wheelchair for the majority of functional activities. B. Add bilateral forearm troughs to the current walker. C. Add a padded grip to the right side of the walker. D. Use a cane on the left side during all activities. C. Add a padded grip to the right side of the walker. A COTA® is working with a client who recently sustained a right-sided cerebrovascular accident with left-sided paresis. The OTR® wrote a goal for functional transfers, and the COTA is assisting the client with a wheelchair-to-bed transfer. What instructions would the COTA give the client BEFORE initiating the transfer? A. Shift weight into an anterior pelvic tilt, place the right hand on the wheelchair armrest, and point the heels away from the bed. B. Shift weight into an anterior pelvic tilt, place the right hand on the COTA's back, and point the heels toward the bed. C. Shift weight into an anterior pelvic tilt, place the right hand on the wheelchair armrest, and point the heels toward the bed. D. Shift weight into a posterior pelvic tilt, place the right hand on the wheelchair armrest, and point the heels toward the bed. C. Shift weight into an anterior pelvic tilt, place the right hand on the wheelchair armrest, and point the heels toward the bed. A frail older adult client who uses an ultra lightweight manual wheelchair with a foam cushion comes to the clinic is complaining of low back pain. The client's caregiver indicates that the skin on the client's coccyx is very pink, and there is concern about skin breakdown. The OTR®-COTA® team observes that the client's seated position is stable without supports, the client's upper extremities rest on the armrests without the shoulders hiking, the feet rest on the foot plates bilaterally, and the hips are at a 45° angle, which keeps the knees higher than waist level. The client indicates that this sitting posture is usual and is maintained most of the day. What intervention would the OTR®-COTA® team try INITIALLY to relieve the client's pain and protect the skin? A. Add an adjustable-tension back support so that the client can lean back further B. Lower the footrests so that the thighs are level with the seat of the chair and the feet rest flat on the footrests C. Replace the client's foam cushion with a gel cushion for better support