A client's wrist and thumb joints are limited in range of motion, and the client complains of
some mild discomfort that affects the client's caregiving duties at home. The OTR® wants to
facilitate movement, increase circulation, and decrease pain. What would be the MOST
appropriate use of thermal modalities?
A. Use deep heat while stretching the client's stiff joints.
B. Use superficial heat before or during a passive stretch.
C. Use superficial heat or deep heat without stretching the client's stiff joints.
D. Use a different modality for this problem. - ANSWER The right answer is B
Mild heat before or during a passive stretch will give the best results and increase range of
motion and circulation, because the heat will have a soothing effect and decrease
discomfort.
A: Deep heat is indicated for contractures, scarring, pain, and muscle spasms, not for
generalized stiffness.
C: Use of heat should always be paired with some type of movement, stretch, or activity.
D: Heat is indicated when an OTR wants to increase motion and circulation and a client
complains of aching pain.
Retired NBCOT® Question
1
,An OTR® is setting up a booth to promote occupational therapy services at a community-
sponsored health fair. A vendor has donated various therapy equipment and product
brochures for the OTR® to display. When reading one of the brochures, the OTR® identifies a
product promotion that claims to eliminate pain for any condition. What is the BEST course
of action for the OTR® to take regarding this printed information?
A. Display only those products that are supported in occupational therapy literature by
evidence-based research.
B. Post a product disclaimer about the equipment at the booth that is visible to the health
fair attendees.
C. Advise the company representative that the product information and equipment cannot
be displayed at the health fair.
D. Recognize that the claim is invalid and eliminate the printed product endorsement from
the booth. - ANSWER The right answer is D
Practitioners are ethically obligated to report any acts that make false claims and must not
use such products or services in practice to refrain from any actions that may inflict harm.
A: Products do not have to be supported in occupational therapy literature to be
incorporated in practice, though considering the evidence base is important.
B: Product disclaimer is not sufficient to avoid the use of products or services that make false
claims or may potentially inflict harm. The product or service may not be used in practice at
all.
C: The product should be reported to appropriate authorities who can take action with the
company representative.
What is included when using a top-down approach to reduce risks in jobs?
2
,A. Work hardening program to increase endurance
B. Maintaining neutral spine alignment in lifting
C. Involving managers in work
simplification
D. Individual workstation ergonomic assessment - ANSWER The right answer is C
A top-down approach includes systemwide changes and management support of the change
process.
A, B, D: These options are bottom-up approaches that focus on addressing the person's risk
for the job task.
A client with stroke is in inpatient rehabilitation, and at the start of the intervention session
the OTR®; is observing as the client sits at the dining table in a wheelchair. The client's hips
are extended, and the client is leaning on the unaffected left upper extremity. What should
the OTR's FIRST approach be?
A. Reposition the client in the wheelchair with hips flexed at 90° and the upper extremity
resting in the lap
B. Transfer the client to another wheelchair that provides a lap tray for upper-extremity
support.
C. Transfer the client to a standard chair with arms for positioning in posterior pelvic tilt.
D. Complete the Berg Balance Scale to determine the client's postural needs -
ANSWER The right answer is A
3
, Ideal seated posture for a client with hemiparesis is hips flexed at 90° with shoulders over
hips and arms relaxed in lap; the upper extremities should not be used to provide support in
sitting.
B: Clients with hemiparesis need frequent repositioning in sitting to maintain upright
posture; supine positioning does not facilitate the return of muscle strength for sitting and
should not be the first choice.
C: Changing the chair surface does not necessarily improve the client's positioning in the
chair.
D: The Berg Balance Scale is recommended as an evaluation tool for clients with stroke, but
assessment is not the appropriate first approach given the client's current position.
Correcting the client's positioning is first priority.
An OTR® has discontinued occupational therapy services with a client. A month after the
completion of services, the client and the OTR see each other unexpectedly at the local
grocery store. They both express interest in dating the other person. They start dating within
a month of this meeting at the grocery store.
A. This action is illegal and should be reported to the authorities immediately.
B. This action is within the occupational therapy ethical guidelines for the principle of
Nonmaleficence.
C. This action is within the occupational therapy ethical guidelines for the principle of
Beneficence.
D. This action may or may not be ethically appropriate and needs to be investigated further. -
ANSWER The right answer is D
D: Principle 2, Nonmaleficence, states that occupational therapy personnel shall
intentionally refrain from actions that cause harm. Principle 2C states that practitioners shall
4
some mild discomfort that affects the client's caregiving duties at home. The OTR® wants to
facilitate movement, increase circulation, and decrease pain. What would be the MOST
appropriate use of thermal modalities?
A. Use deep heat while stretching the client's stiff joints.
B. Use superficial heat before or during a passive stretch.
C. Use superficial heat or deep heat without stretching the client's stiff joints.
D. Use a different modality for this problem. - ANSWER The right answer is B
Mild heat before or during a passive stretch will give the best results and increase range of
motion and circulation, because the heat will have a soothing effect and decrease
discomfort.
A: Deep heat is indicated for contractures, scarring, pain, and muscle spasms, not for
generalized stiffness.
C: Use of heat should always be paired with some type of movement, stretch, or activity.
D: Heat is indicated when an OTR wants to increase motion and circulation and a client
complains of aching pain.
Retired NBCOT® Question
1
,An OTR® is setting up a booth to promote occupational therapy services at a community-
sponsored health fair. A vendor has donated various therapy equipment and product
brochures for the OTR® to display. When reading one of the brochures, the OTR® identifies a
product promotion that claims to eliminate pain for any condition. What is the BEST course
of action for the OTR® to take regarding this printed information?
A. Display only those products that are supported in occupational therapy literature by
evidence-based research.
B. Post a product disclaimer about the equipment at the booth that is visible to the health
fair attendees.
C. Advise the company representative that the product information and equipment cannot
be displayed at the health fair.
D. Recognize that the claim is invalid and eliminate the printed product endorsement from
the booth. - ANSWER The right answer is D
Practitioners are ethically obligated to report any acts that make false claims and must not
use such products or services in practice to refrain from any actions that may inflict harm.
A: Products do not have to be supported in occupational therapy literature to be
incorporated in practice, though considering the evidence base is important.
B: Product disclaimer is not sufficient to avoid the use of products or services that make false
claims or may potentially inflict harm. The product or service may not be used in practice at
all.
C: The product should be reported to appropriate authorities who can take action with the
company representative.
What is included when using a top-down approach to reduce risks in jobs?
2
,A. Work hardening program to increase endurance
B. Maintaining neutral spine alignment in lifting
C. Involving managers in work
simplification
D. Individual workstation ergonomic assessment - ANSWER The right answer is C
A top-down approach includes systemwide changes and management support of the change
process.
A, B, D: These options are bottom-up approaches that focus on addressing the person's risk
for the job task.
A client with stroke is in inpatient rehabilitation, and at the start of the intervention session
the OTR®; is observing as the client sits at the dining table in a wheelchair. The client's hips
are extended, and the client is leaning on the unaffected left upper extremity. What should
the OTR's FIRST approach be?
A. Reposition the client in the wheelchair with hips flexed at 90° and the upper extremity
resting in the lap
B. Transfer the client to another wheelchair that provides a lap tray for upper-extremity
support.
C. Transfer the client to a standard chair with arms for positioning in posterior pelvic tilt.
D. Complete the Berg Balance Scale to determine the client's postural needs -
ANSWER The right answer is A
3
, Ideal seated posture for a client with hemiparesis is hips flexed at 90° with shoulders over
hips and arms relaxed in lap; the upper extremities should not be used to provide support in
sitting.
B: Clients with hemiparesis need frequent repositioning in sitting to maintain upright
posture; supine positioning does not facilitate the return of muscle strength for sitting and
should not be the first choice.
C: Changing the chair surface does not necessarily improve the client's positioning in the
chair.
D: The Berg Balance Scale is recommended as an evaluation tool for clients with stroke, but
assessment is not the appropriate first approach given the client's current position.
Correcting the client's positioning is first priority.
An OTR® has discontinued occupational therapy services with a client. A month after the
completion of services, the client and the OTR see each other unexpectedly at the local
grocery store. They both express interest in dating the other person. They start dating within
a month of this meeting at the grocery store.
A. This action is illegal and should be reported to the authorities immediately.
B. This action is within the occupational therapy ethical guidelines for the principle of
Nonmaleficence.
C. This action is within the occupational therapy ethical guidelines for the principle of
Beneficence.
D. This action may or may not be ethically appropriate and needs to be investigated further. -
ANSWER The right answer is D
D: Principle 2, Nonmaleficence, states that occupational therapy personnel shall
intentionally refrain from actions that cause harm. Principle 2C states that practitioners shall
4
