OT CLINICAL SIMULATION TEST
QUESTIONS AND ANSWERS
An OTR® is working with a 53-year-old client who had a myocardial infarction and
underwent open-heart surgery to repair the mitral valve. What precautions should the
OTR® consider in working with this client? - Correct Answers --client should wait 6-8
weeks before resuming sexual intercourse
-lifting limitations are usually 10 lb for 6-12 weeks after open-heart surgery
-perform daily activities using both hands to avoid placing pressure on sternal scar
-educate on sternal precautions
An OTR® working in a hospital receives a referral for an 82-year-old client who has
chronic obstructive pulmonary disease (COPD). The client has been admitted to the
hospital after having the flu and experiencing increased shortness of breath.
What clinical observations or assessments would be indicated for this client? - Correct
Answers --ADL evaluation
-cognitive screening as it relates to the client's ability to remember and carry out skilled
instruction
-oximeter readings
An OTR® working in a hospital receives a referral for an 82-year-old client who has
chronic obstructive pulmonary disease (COPD). The client has been admitted to the
hospital after having the flu and experiencing increased shortness of breath.
Using the COAST method, which occupational therapy goals reflecting a functional,
occupation-based approach would be appropriate for this client? - Correct Answers --
client will independently demonstrate pursed-lip breathing during functional activities in
2 weeks
-client will independently demonstrate pacing and energy conservation techniques
during completion of cooking and laundry tasks within 2 weeks
An OTR® working in a hospital receives a referral for an 82-year-old client who has
chronic obstructive pulmonary disease (COPD). The client has been admitted to the
hospital after having the flu and experiencing increased shortness of breath.
What occupational therapy interventions would allow this client to return home instead
of being transferred to a skilled nursing facility? - Correct Answers --training in breathing
techniques to facilitate independence in ADLs
-education for caregiver or family support system at home
-training in methods to cope with SOB as it will reduce client's fear and anxiety
increasing likelihood client can remain in home
,-energy conservation techniques such as sitting to bathe and dress
Opening Scene: An unemployed medical professional is referred to a partial
hospitalization program after a four-day hospitalization. This adult client recently
experienced a severe episode of a major depressive disorder. The client lives with an
employed spouse and an employed adult child. The family members complain that the
client does not do much to help the family. The referring physician anticipates that the
client, now moderately depressed, will become increasingly less symptomatic as the
antidepressant medication is treated to an adequate dose over the next eight weeks.
The partial hospitalization referral identifies the need for intervention to help the client
participate in meaningful and desired family and community roles.
Section A The occupational therapist meets with the client and family members to
complete the partial hospitalization evaluation process. The client's appearance is
disheveled. The client - Correct Answers -YES:
1. With the client's consent, ask the client's family about their understanding of the
impact of depression on the client's occupational performance
2. Ask the client to describe key symptoms that influence the ability to rest, work, and
complete home management tasks
3. Evaluate the client's cognitive skills and the impact of activity demands on
performance by having the client purchase five items from a list in the partial hospital
consumer-run store.
NO:
Administer the Occupational Performance History Interview (OPHI) to compare past and
present function.
Assess the client's self-esteem.
Provide the client with a notebook to record a daily schedule.
Section B The therapist determines that the client can link fatigue, irritability, and the
ability to concentrate to mood states. The client has difficulty with initiation, attention,
and organization. Activity performance worsens with auditory stimuli and social
demands. Family stress contributes to the client's anxiety, helplessness, low self-
esteem, and shame. As medication is adjusted, the client's symptoms are likely to
fluctuate until a baseline of optimal function is reached.
Which intervention approaches are most effective at this time to help the client manage
symptoms and participate in meaningful family and community roles? - Correct Answers
-YES:
Provide training in effective strategies the client can use to help counter negative
thinking.
Collaborate with the client to determine resources to help family members learn about
depression and its biological foundation.
Collaborate with the client to set up a weekly schedule that includes a balance in activity
demands to enable desired role performance.
Engage the client in a communication skills group to increase assertiveness skills.
NO:
, Refer the client to a local volunteer agency so the client can find ways to help others to
build self-esteem.
Establish a routine with the client to include food shopping and paying the family's bills
so that the client can assume an active home maintainer role.
Section C The client actively participates in an occupational therapy (OT) intervention
program to facilitate effective self-management of major depression and develop the
requisite skills for successful occupational role performance. The client can now identify
the effect of depression on functioning and is improving at evaluating the physical,
social, emotional, and cognitive demands of desired activities. However, the client has
difficulty self-structuring activities to meet desired goals and often sets unrealistic
expectations for activity performance. The client's subsequent inability to successfully
complete desired tasks exacerbates the client's symptoms. The therapist seeks
evidence for interventions to help the client successfully grade and/or modify activity
engagement according to activity demands.
Which evidence is relevant for the therapist to use as a basis for modification of the
client's intervention - Correct Answers -YES:
A systemic review of studies which examined the efficacy of intervention programs
focused on the development of skills for activity engagement and role participation.
A randomized control trial (RCT) study that tested the hypothesis that people with
depression who use a day planner will manage a routine better than people who do not
use a planner.
NO:
A single subject case study describing the course of occupational intervention for a
client with depression.
A comparative study of the reported self-esteem of persons with depression versus
those with schizophrenia.
A longitudinal study of people with depression who have resumed the role of worker.
Web-based blogs describing the outcomes of experimental approaches for persons with
depression.
Section D The therapist meets with the client to discuss a revised intervention plan that
will be relevant to the client's current status and consistent with evidence-based
practice. The client reports that family members continue to repeatedly complain about
the client's poor contributions to maintaining the household. Because the client is
unemployed, they expect the client to food shop, prepare the family's meals, and clean
the house. The client reports feeling criticized by family members, embarrassed at being
incompetent, and burdensome to others.
Which of the following actions are best to include in an intervention plan focused on
developing the client's ability to assume a home maintainer role? - Correct Answers -
YES:
Use a weekly planner to record one home management task to be completed each day
of the week.
Work with the client to break down cleaning tasks into subtasks and structure ways to
accomplish them over the course of several days.
QUESTIONS AND ANSWERS
An OTR® is working with a 53-year-old client who had a myocardial infarction and
underwent open-heart surgery to repair the mitral valve. What precautions should the
OTR® consider in working with this client? - Correct Answers --client should wait 6-8
weeks before resuming sexual intercourse
-lifting limitations are usually 10 lb for 6-12 weeks after open-heart surgery
-perform daily activities using both hands to avoid placing pressure on sternal scar
-educate on sternal precautions
An OTR® working in a hospital receives a referral for an 82-year-old client who has
chronic obstructive pulmonary disease (COPD). The client has been admitted to the
hospital after having the flu and experiencing increased shortness of breath.
What clinical observations or assessments would be indicated for this client? - Correct
Answers --ADL evaluation
-cognitive screening as it relates to the client's ability to remember and carry out skilled
instruction
-oximeter readings
An OTR® working in a hospital receives a referral for an 82-year-old client who has
chronic obstructive pulmonary disease (COPD). The client has been admitted to the
hospital after having the flu and experiencing increased shortness of breath.
Using the COAST method, which occupational therapy goals reflecting a functional,
occupation-based approach would be appropriate for this client? - Correct Answers --
client will independently demonstrate pursed-lip breathing during functional activities in
2 weeks
-client will independently demonstrate pacing and energy conservation techniques
during completion of cooking and laundry tasks within 2 weeks
An OTR® working in a hospital receives a referral for an 82-year-old client who has
chronic obstructive pulmonary disease (COPD). The client has been admitted to the
hospital after having the flu and experiencing increased shortness of breath.
What occupational therapy interventions would allow this client to return home instead
of being transferred to a skilled nursing facility? - Correct Answers --training in breathing
techniques to facilitate independence in ADLs
-education for caregiver or family support system at home
-training in methods to cope with SOB as it will reduce client's fear and anxiety
increasing likelihood client can remain in home
,-energy conservation techniques such as sitting to bathe and dress
Opening Scene: An unemployed medical professional is referred to a partial
hospitalization program after a four-day hospitalization. This adult client recently
experienced a severe episode of a major depressive disorder. The client lives with an
employed spouse and an employed adult child. The family members complain that the
client does not do much to help the family. The referring physician anticipates that the
client, now moderately depressed, will become increasingly less symptomatic as the
antidepressant medication is treated to an adequate dose over the next eight weeks.
The partial hospitalization referral identifies the need for intervention to help the client
participate in meaningful and desired family and community roles.
Section A The occupational therapist meets with the client and family members to
complete the partial hospitalization evaluation process. The client's appearance is
disheveled. The client - Correct Answers -YES:
1. With the client's consent, ask the client's family about their understanding of the
impact of depression on the client's occupational performance
2. Ask the client to describe key symptoms that influence the ability to rest, work, and
complete home management tasks
3. Evaluate the client's cognitive skills and the impact of activity demands on
performance by having the client purchase five items from a list in the partial hospital
consumer-run store.
NO:
Administer the Occupational Performance History Interview (OPHI) to compare past and
present function.
Assess the client's self-esteem.
Provide the client with a notebook to record a daily schedule.
Section B The therapist determines that the client can link fatigue, irritability, and the
ability to concentrate to mood states. The client has difficulty with initiation, attention,
and organization. Activity performance worsens with auditory stimuli and social
demands. Family stress contributes to the client's anxiety, helplessness, low self-
esteem, and shame. As medication is adjusted, the client's symptoms are likely to
fluctuate until a baseline of optimal function is reached.
Which intervention approaches are most effective at this time to help the client manage
symptoms and participate in meaningful family and community roles? - Correct Answers
-YES:
Provide training in effective strategies the client can use to help counter negative
thinking.
Collaborate with the client to determine resources to help family members learn about
depression and its biological foundation.
Collaborate with the client to set up a weekly schedule that includes a balance in activity
demands to enable desired role performance.
Engage the client in a communication skills group to increase assertiveness skills.
NO:
, Refer the client to a local volunteer agency so the client can find ways to help others to
build self-esteem.
Establish a routine with the client to include food shopping and paying the family's bills
so that the client can assume an active home maintainer role.
Section C The client actively participates in an occupational therapy (OT) intervention
program to facilitate effective self-management of major depression and develop the
requisite skills for successful occupational role performance. The client can now identify
the effect of depression on functioning and is improving at evaluating the physical,
social, emotional, and cognitive demands of desired activities. However, the client has
difficulty self-structuring activities to meet desired goals and often sets unrealistic
expectations for activity performance. The client's subsequent inability to successfully
complete desired tasks exacerbates the client's symptoms. The therapist seeks
evidence for interventions to help the client successfully grade and/or modify activity
engagement according to activity demands.
Which evidence is relevant for the therapist to use as a basis for modification of the
client's intervention - Correct Answers -YES:
A systemic review of studies which examined the efficacy of intervention programs
focused on the development of skills for activity engagement and role participation.
A randomized control trial (RCT) study that tested the hypothesis that people with
depression who use a day planner will manage a routine better than people who do not
use a planner.
NO:
A single subject case study describing the course of occupational intervention for a
client with depression.
A comparative study of the reported self-esteem of persons with depression versus
those with schizophrenia.
A longitudinal study of people with depression who have resumed the role of worker.
Web-based blogs describing the outcomes of experimental approaches for persons with
depression.
Section D The therapist meets with the client to discuss a revised intervention plan that
will be relevant to the client's current status and consistent with evidence-based
practice. The client reports that family members continue to repeatedly complain about
the client's poor contributions to maintaining the household. Because the client is
unemployed, they expect the client to food shop, prepare the family's meals, and clean
the house. The client reports feeling criticized by family members, embarrassed at being
incompetent, and burdensome to others.
Which of the following actions are best to include in an intervention plan focused on
developing the client's ability to assume a home maintainer role? - Correct Answers -
YES:
Use a weekly planner to record one home management task to be completed each day
of the week.
Work with the client to break down cleaning tasks into subtasks and structure ways to
accomplish them over the course of several days.
