In reading a client's medical chart, the COTA® notes that the client has a history of
postprandial orthostatic hypotension. What activity precautions should the COTA give the
client?
A. Limit standing to 30 minutes while completing an occupation such as cooking.
B. Avoid a positional change from lying down to standing within 30 minutes of eating a meal.
C. Take several minutes to move from lying down to sitting and then to standing after being
in bed all night.
D. Avoid leaning the head too far forward, for example, bending over to tie shoes while
sitting. - ANSWER B
A newly certified COTA® is working a first job on an inpatient rehabilitation unit. The OTR®
instructs the COTA to teach a bath bench transfer to a patient while the OTR goes to another
room to evaluate a new patient. The COTA never completed a bath bench transfer before.
What ethical principles should guide the student in this situation? Select the 3 BEST choices.
A. Autonomy
B. Veracity
C. Beneficence
D. Nonmaleficence
E. Fidelity
F. Justice - ANSWER C, D, F
A client with advanced amyotrophic lateral sclerosis (ALS) presents with a stiff forward-
flexed neck that is at risk for developing a contracture and impairing social participation.
Which intervention would the COTA® use to BEST prevent a contracture?
1
,A. A physical agent modality, such as diathermy or ultrasound, to minimize contractures
B. Caregiver training on gentle neck stretching and how to help the client don a soft cervical
collar
C. A home exercise program of isometric neck exercises in all planes
D. Patient and caregiver education on proper positioning at rest and during functional tasks -
ANSWER B
A COTA® is working with a client who has sustained a low ulnar nerve injury to the hand. The
client has been instructed in visual protection of the hand. Over the weekend, the client
experiences burns to the injured hand. What area of the hand would have been burned?
A. Thenar side of the hand
B. Thumb and index fingers
C. Hypothenar side of the hand
D. Index and middle fingers - ANSWER C
A COTA® is working with a 2½-year-old child on age-appropriate fine motor skills. Which
activity would be most appropriate to support development?
A. Unbuttoning large buttons
B. Lacing a shoe
C. Cutting out shapes with scissors
D. Drawing shapes - ANSWER A
The COTA®'s next client has macular degeneration in both eyes. To prepare the treatment
environment for this client, which course of action should the COTA® take?
A. Close the blinds and the curtains
2
,B. Sit directly in front of the client
C. Increase lighting and avoid glare
D. Place dark objects on a black table - ANSWER C
A 4-year-old child with arthrogryposis is being evaluated for ADLs. The child needs to use
utensils that are angled to be able to put food into the mouth. Which characteristic of clients
with this condition provides the rationale behind the use of these adapted utensils?
A. Joint contractures in the arms and hands
B. Spasticity in the arms and hands
C. Hypotonia in the arms and hands
D. Decreased sensation in the arms and hands - ANSWER A
A client with a learning disability is interested in exploring work opportunities after high
school graduation. The client has difficulty sequencing more than three-step directions and
lacks attention to detail. Which option would be considered a component of the student's
transitional program plan?
A. Completion of a transition-related evaluation by a vocational rehabilitation counselor to
identify the student's strengths, weaknesses, and interests
B. Completion of a job site analysis with physical demands to determine the feasibility of the
client's performing specific tasks
C. Provision of written directions to complete a three-step task and use of samples to
promote problem solving
D. Situational observation, interview, and activity analysis to determine a match between the
client's abilities and expected performance - ANSWER D
A COTA® is working on postoperative discharge plan for a school-age child with
neurofibromatosis. The COTA® recommends that the parents move the child's clothes from
the top drawer so that the child can access them independently. Why might the COTA® make
this recommendation?
3
, A. Children with neurofibromatosis have weakened shoulder girdles and reduced upper-
extremity strength.
B. Children with neurofibromatosis are of short stature and have skeletal anomalies.
C. Children with neurofibromatosis have decreased sensation and often drop things.
D. Children with neurofibromatosis have difficulty initiating routines. - ANSWER B
To facilitate participation in familiar daily living tasks by clients with dementia, what would
be an appropriate INITIAL stage of intervention?
A. Recommend home modifications.
B. Provide caregiver education.
C. Develop strategies to simplify familiar tasks.
D. Establish appropriate daily routines. - ANSWER C
Because information-processing speed may affect a driver's on-road performance, which is
the BEST compensatory approach the COTA® can use?
A. Discuss with the supervising OTR® the client's driving cessation.
B. Instruct the client in proper visual search patterns and efficient scanning techniques.
C. Limit driving to familiar areas, simple traffic scenes, and roads with reduced speed limits.
D. Educate the client in rules of the road and signs of the road. - ANSWER C
A COTA® is working with a client with traumatic brain injury who is displaying decorticate
rigidity. What clinical characteristics can the COTA expect to find? Select the 3 BEST choices.
A. Upper extremities are flaccid, with internal rotation.
B. Upper extremities are spastic, with external rotation.
C. Upper extremities are flaccid, with external rotation.
4
postprandial orthostatic hypotension. What activity precautions should the COTA give the
client?
A. Limit standing to 30 minutes while completing an occupation such as cooking.
B. Avoid a positional change from lying down to standing within 30 minutes of eating a meal.
C. Take several minutes to move from lying down to sitting and then to standing after being
in bed all night.
D. Avoid leaning the head too far forward, for example, bending over to tie shoes while
sitting. - ANSWER B
A newly certified COTA® is working a first job on an inpatient rehabilitation unit. The OTR®
instructs the COTA to teach a bath bench transfer to a patient while the OTR goes to another
room to evaluate a new patient. The COTA never completed a bath bench transfer before.
What ethical principles should guide the student in this situation? Select the 3 BEST choices.
A. Autonomy
B. Veracity
C. Beneficence
D. Nonmaleficence
E. Fidelity
F. Justice - ANSWER C, D, F
A client with advanced amyotrophic lateral sclerosis (ALS) presents with a stiff forward-
flexed neck that is at risk for developing a contracture and impairing social participation.
Which intervention would the COTA® use to BEST prevent a contracture?
1
,A. A physical agent modality, such as diathermy or ultrasound, to minimize contractures
B. Caregiver training on gentle neck stretching and how to help the client don a soft cervical
collar
C. A home exercise program of isometric neck exercises in all planes
D. Patient and caregiver education on proper positioning at rest and during functional tasks -
ANSWER B
A COTA® is working with a client who has sustained a low ulnar nerve injury to the hand. The
client has been instructed in visual protection of the hand. Over the weekend, the client
experiences burns to the injured hand. What area of the hand would have been burned?
A. Thenar side of the hand
B. Thumb and index fingers
C. Hypothenar side of the hand
D. Index and middle fingers - ANSWER C
A COTA® is working with a 2½-year-old child on age-appropriate fine motor skills. Which
activity would be most appropriate to support development?
A. Unbuttoning large buttons
B. Lacing a shoe
C. Cutting out shapes with scissors
D. Drawing shapes - ANSWER A
The COTA®'s next client has macular degeneration in both eyes. To prepare the treatment
environment for this client, which course of action should the COTA® take?
A. Close the blinds and the curtains
2
,B. Sit directly in front of the client
C. Increase lighting and avoid glare
D. Place dark objects on a black table - ANSWER C
A 4-year-old child with arthrogryposis is being evaluated for ADLs. The child needs to use
utensils that are angled to be able to put food into the mouth. Which characteristic of clients
with this condition provides the rationale behind the use of these adapted utensils?
A. Joint contractures in the arms and hands
B. Spasticity in the arms and hands
C. Hypotonia in the arms and hands
D. Decreased sensation in the arms and hands - ANSWER A
A client with a learning disability is interested in exploring work opportunities after high
school graduation. The client has difficulty sequencing more than three-step directions and
lacks attention to detail. Which option would be considered a component of the student's
transitional program plan?
A. Completion of a transition-related evaluation by a vocational rehabilitation counselor to
identify the student's strengths, weaknesses, and interests
B. Completion of a job site analysis with physical demands to determine the feasibility of the
client's performing specific tasks
C. Provision of written directions to complete a three-step task and use of samples to
promote problem solving
D. Situational observation, interview, and activity analysis to determine a match between the
client's abilities and expected performance - ANSWER D
A COTA® is working on postoperative discharge plan for a school-age child with
neurofibromatosis. The COTA® recommends that the parents move the child's clothes from
the top drawer so that the child can access them independently. Why might the COTA® make
this recommendation?
3
, A. Children with neurofibromatosis have weakened shoulder girdles and reduced upper-
extremity strength.
B. Children with neurofibromatosis are of short stature and have skeletal anomalies.
C. Children with neurofibromatosis have decreased sensation and often drop things.
D. Children with neurofibromatosis have difficulty initiating routines. - ANSWER B
To facilitate participation in familiar daily living tasks by clients with dementia, what would
be an appropriate INITIAL stage of intervention?
A. Recommend home modifications.
B. Provide caregiver education.
C. Develop strategies to simplify familiar tasks.
D. Establish appropriate daily routines. - ANSWER C
Because information-processing speed may affect a driver's on-road performance, which is
the BEST compensatory approach the COTA® can use?
A. Discuss with the supervising OTR® the client's driving cessation.
B. Instruct the client in proper visual search patterns and efficient scanning techniques.
C. Limit driving to familiar areas, simple traffic scenes, and roads with reduced speed limits.
D. Educate the client in rules of the road and signs of the road. - ANSWER C
A COTA® is working with a client with traumatic brain injury who is displaying decorticate
rigidity. What clinical characteristics can the COTA expect to find? Select the 3 BEST choices.
A. Upper extremities are flaccid, with internal rotation.
B. Upper extremities are spastic, with external rotation.
C. Upper extremities are flaccid, with external rotation.
4
