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1. An elder with peripheral neuropathies resulting from the chronic
effects of diabetes expresses concern over the ability to have a
satisfying sexual relationship with a partner. Which is the most
beneficial recommendation for the occupational therapist to make
to the elder?
a) Experiment with different positions during sexual expression b
activities
b) Focus on intact senses and areas of intact sensation.
c) Schedule sexual expression activities after rest periods
d) Advise the elder to accept decreased abilities in sexual expres-
sion as a normal part of aging.
2. An individual with amyotrophic lateral sclerosis requires the
use of an environmental control unit (ECU) to access electrical
devices and a personal emergency response system. The indi-
vidual lives alone and self-directs personal care attendants to
perform personal activities of daily living. During instruction to the
individual on the capabilities and use of the ECU, which is most a
important for the occupational therapist to discuss with the client?
a) The ECU's back-up power source and charging instructions
b) Additional assistive technology available
c) Augmentative alternative communication options
d) Funding for assistive technology
3. A nine-year-old child identifies the assembly of a model as the
most desired play activity. The occupational therapist determines
that the child would have difficulty completing the selected model.
Which action is most effective for the therapist to take during the
next intervention session?
a) Allow the child to work on the model and provide maximum
assistance as the child completes the project.
c
b) Explore with the child why completing the model is desired by
the child and provide alternative project choices.
c) Break the project down into accomplishable segments and
instruct the child to complete on segment at a time.
d) Explain to the child several reasons why the selected model is
not the best choice for the child and provide alternative project
choices.
4. A child with myelomeningocele meets the short-term goals of
achieving functional gross grasp and lateral pinch. After several
weeks of occupational therapy, the child does not meet the goals
of demonstrating pincer grasp and three jaw chuck. Consequently,
the therapist modifies the child's intervention plan. Which inter-
vention is best to include in the revised plan?
a) Splint the index finger in 30 degrees PIP flexion and 30 degrees c
DIP flexion to achieve pincer grasp
b) Increase strength of lateral pinch as a basis to develop pincer
grasp and three jaw chuck
c) Teach the child to use gross grasp and lateral pinch for func-
tional activities
d) Teach the child to use ulnar grasp for functional activities
5. An individual attends an outpatient parenting skills group. The
person has a history of serious recurrent depression and is taking
Nardil. The client complains of recurrent headaches and difficulty
focusing during the day (e.g. when helping children with their
homework). Which action is best for the occupational therapist to
make in response to the client's expressed concerns? d
a) Instruct the client in stress reduction techniques
b) Ask the group for suggestions on how to deal with the parenting
stress of homework.
c) Suggest that the individual consult with a nurse practitioner for
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d) Tell the client you will be notifying the psychiatrist of these
complaints.
6. A religious congregation obtained private funding to build a
ramp so that members with disabilities can attend services. The
entrance to the congregation's building has six steps with a rise of
7 inches each. Which is best for the occupational therapist hired
by the congregation to recommend construction of this ramp? c
a) 42 feet long
b) 48 feet long
c) 42 feet long with a 4'x4' landing at the ramp's midpoint
d) 48 feet long with a 4'x4' landing at the ramp's midpoint.
7. A child with juvenile rheumatoid arthritis wears bilateral night
resting splits with wrists in 0 degrees of extension, MPs and IPs
flexed, ulnar deviation of 0 degrees and thumbs in opposition. The
child complains of pain in the wrists upon awakening. No redness
is noted upon removing splints. ROM measurements show ulnar
deviation of 5 degrees. Which action should the occupational ther-
a
apist take in response to this complaint and these observations?
a) Modify the splints at the wrist.
b) Pad the ulnar aspect on the inside of the splints
c) Discontinue the splints and monitor the status of pain for two
weeks
d) Construct volar cock-up splints for use during the day.
8. A 15-year old with asymptomatic HIV attends an outpatient
clinic. The occupational therapy protocol for patients diagnosed
with HIV includes presentation of information on safe sex. The
adolescent's parents refuse to allow this information to be pre-
sented to their child. Which is the best action for the therapist to
take in response to this situation?
a) Ask the patient's opinion and act on the patient's refusal or b
consent.
b) Document that the parents refuse the intervention for their
child.
c) Refer the family to the social worker for counselling.
d) Have the parents sign a waiver that they refused the interven-
tion for their child.
9. An individual who has Parkinson's disease presents with poor
trunk rotation during ambulation and while performing activities
of daily living. According to neurophysiologic frames of reference,
which is the most effective therapeutic intervention for the occu-
pational therapist to use with this person?
a) Facilitation of trunk rotation using neurodevelopmental han- c
dling techniques
b) Slow rolling with the person supine with knees and hips flexed.
c) Engagement in activities of daily living using diagonal patterns
d) Provision of a rolling walker to compensate for limited rotation
and enhance mobility.
10. An individual who had a CVA one year ago continues to
demonstrate unilateral neglect. The individual drives daily to ther-
apy despite several suggestions from the occupational therapist
to discontinue this activity. The therapist has determined that the
client is an unsafe driver. Which is the best action for the therapist
to take in response to this situation? c
a) Report the individual to the department of motor vehicles
b) Suggest that the individual attends a driver training program
c) Report the information to the physician
d) Tell the individual's family that the client is at risk for injuring self
and others while driving
11. Following a left CVA, an individual receives OT services at a
subacute rehabilitation facility. The patient's personal goal is to

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be independent in dressing. The patient demonstrates decreased
memory, poor sequencing skills and ideational apraxia. Which of
the following is the most effective for the therapist to provide when
teaching one-handed dressing techniques to this patient?
a) Step-by-step verbal instructions c
b) Sequenced photographs of the steps in dressing
c) Physical prompts to initiate the steps in dressing.
d) A full length mirror for the client to observe self-dressing per-
formance.
12. An elementary school teacher has been recently diagnosed
with multiple sclerosis (MS). Which adaptation is best for the
occupational therapist to recommend the teacher to use to ac-
commodate for the effects of MS on classroom teaching?
a) Large print written material to compensate for visual impair- d
ments
b) A daily list of tasks to compensate for cognitive deficits
c) A motorized scooter to compensate for decreased endurance
d) A high stool to compensate for lower extremity weakness
13. An occupational therapist conducts an initial home visit to a
family with a premature infant who, at four months and 5 lbs., has
just been sent home. The child has multiple disabilities. Which is
the best primary goal for the therapist to work on with the family
during this first session?
a) Communicate effectively to develop a therapeutic relationship
a
with the family.
b) Teach the family proper body mechanics for lifting the child.
c) Teach the family assertiveness training to develop advocacy
skills
d) Determine whether adaptive aids or positioning equipment is
needed
14. A three-year-old child with left spastic hemiplegia due to
cerebral palsy is evaluated for early intervention services. Dur-
ing the evaluation the occupational therapist observes behaviors
that seem to indicate the presence of visual deficits. Based on
these observations, which action should the occupational thera-
d
pist take?
a) Completion a motor-free visual perceptual assessment
b) Completion a developmental vision assessment
c) Refer the child to an optician
d) Refer the child to an optometrist
15. An occupational therapist constructs a splint for a person who
incurred full thickness facial and anterior neck burns. In which
position should the therapist splint the neck?
a) Neutral a
b) 15 degrees flexion
c) 15 degrees lateral flexion
d) 15 degrees hyperextension
16. An occupational therapist reviews the use of the occupational
therapy department's resources to determine medical necessity
and cost efficiency. Which service management task is the ther-
apist performing?
a
a) Utilization review
b) Retrospective peer review
c) Total quality management
d) Risk management
17. A six-year-old has thumb weakness, noted mostly in poor abil-
ity to perform thumb opposition. During evaluation, which activity
will the therapist most likely observe the child having difficulty b
performing?
a) Holding a penny on the ulnar side of the hand while moving a

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nickel from the palm to the tips of the thumb and the index finger
b) Rotating a pencil 180 degrees
c) Sliding the fingers up and down a pencil while holding the pencil
in a tripod grasp.
d) Moving a ring from pad-to-pad pinch position to the palm
A private practice comprised of five occupational therapists pro-
vides homebased services to a variety of adult clients in a
two-county area. They are expanding their practice to include
home-based services in another county. In addition, this private
practice has recently been awarded the early intervention service
provider contract for all three counties. The practitioners plan to
hire three entry-level occupational therapists and two occupation-
al therapy assistants (OTAs) to fill the service needs of their grow-
ing practice. The OTAs have extensive experience in home-based
service provision. The private practitioners plan to provide all for
c
their new employees with a comprehensive orientation program
and the shadowing of an experienced therapist for two weeks.

18. To ensure the provision of best practice, the new entry-level

occupational therapists will be provided with supervision of their
caseloads. At what level should this supervision be provided?
a) Routine
b) General
c) Close
d) Minimal
A private practice comprised of five occupational therapists pro-
vides homebased services to a variety of adult clients in a
two-county area. They are expanding their practice to include
home-based services in another county. In addition, this private
practice has recently been awarded the early intervention service
provider contract for all three counties. The practitioners plan to
hire three entry-level occupational therapists and two occupation-
al therapy assistants (OTAs) to fill the service needs of their grow-
ing practice. The OTAs have extensive experience in home-based
service provision. The private practitioners plan to provide all for
their new employees with a comprehensive orientation program
d
and the shadowing of an experienced therapist for two weeks.

19. The private practitioners pay for their newly hired occupational
therapists registration for an advanced course on pediatric as-
sessment. Which is the most important outcome of attending this
course for the occupational therapists?
a) Fulfilment of continuing education requirements for indepen-
dent credentialing agencies.
b) Keeping up-to-date on current trends in occupational therapy.
c) Networking with other pediatric professionals
d) Improvement of their professional skills and competence
A private practice comprised of five occupational therapists pro-
vides homebased services to a variety of adult clients in a
two-county area. They are expanding their practice to include
home-based services in another county. In addition, this private
practice has recently been awarded the early intervention service
provider contract for all three counties. The practitioners plan to
hire three entry-level occupational therapists and two occupation-
al therapy assistants (OTAs) to fill the service needs of their grow- a
ing practice. The OTAs have extensive experience in home-based
service provision. The private practitioners plan to provide all for
their new employees with a comprehensive orientation program
and the shadowing of an experienced therapist for two weeks.

20. The supervising occupational therapists meet to plan the

workload of the recently hired OTAs. Which is an appropriate task
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for them to assign to the OTAs?
a) The in-home evaluation of the adult clients instrumental activ-
ities of daily living
b) The determination of long-term goals to include the adult
clients' occupational therapy home care intervention plan
c) The design of home-based sensory integration protocols for
infants and toddlers with sensory processing disorders
d) The administration and interpretation of the Hawaii Early
Learning Profile (HELP) to infants and toddlers
A private practice comprised of five occupational therapists pro-
vides homebased services to a variety of adult clients in a
two-county area. They are expanding their practice to include
home-based services in another county. In addition, this private
practice has recently been awarded the early intervention service
provider contract for all three counties. The practitioners plan to
hire three entry-level occupational therapists and two occupation-
al therapy assistants (OTAs) to fill the service needs of their grow-
ing practice. The OTAs have extensive experience in home-based
service provision. The private practitioners plan to provide all for
their new employees with a comprehensive orientation program d
and the shadowing of an experienced therapist for two weeks.

21. The private practitioners meet with their accountant to plan

fiscally for their expanded practice. How would the accountant
classify the fees that the practice receives from their early inter-
vention contract?
a) Accounts payable
b) Capital assets
c) Productivity standards
d) Accounts receivable
A private practice comprised of five occupational therapists pro-
vides homebased services to a variety of adult clients in a
two-county area. They are expanding their practice to include
home-based services in another county. In addition, this private
practice has recently been awarded the early intervention service
provider contract for all three counties. The practitioners plan to
hire three entry-level occupational therapists and two occupation-
al therapy assistants (OTAs) to fill the service needs of their grow-
ing practice. The OTAs have extensive experience in home-based
service provision. The private practitioners plan to provide all for
their new employees with a comprehensive orientation program
c
and the shadowing of an experienced therapist for two weeks.

22. The accountant asks the private practitioners to present their

budget for anticipated direct expenses of their growing practice.
Which is the most appropriate item to include in this budget
request?
a) The rent and utilities of the practice's primary office
b) An integrated computer system for paperless documentation
by all staff.
c) Staff vacation and sick time.
d) Supplies of items used in in-home therapy sessions.
23. A young adult with a diagnosis of schizophrenia, paranoid
type is scheduled to be discharged from an inpatient setting to
a halfway house and psychosocial clubhouse. The occupational
therapist is assisting the team with the discharge plan. Which is
the most important information for the therapist to provide to the a
team about this person?
a) The person's instrumental ADL skills
b) The possible effects of medication on the person's perfor-
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c) The person's vocational potential
d) The person's social interaction skills
24. Following the performance of a home exercise program pre-
scribed one week ago, an individual with bilateral upper extremity
muscle weakness reports experiencing pain in both shoulders
and elbows. The pain is consistent for up to eight hours. The
individual's occupational therapist is on vacation for two weeks
and a recently hired entry-level therapist has been assigned to
cover the vacationing therapist's caseload. Which is the most
appropriate action for the covering therapist to take in response
to this individual's reporting symptoms? b
a) Stop exercising completely until the primary therapist returns
and can re-evaluate the person's status.
b) Reduce the intensity of exercise by 50% and reassess the
person during the next intervention session.
c) Continue with the current exercise program to develop toler-
ance
d) Advise the individual to take a pain relief medication 30 minutes
prior to exercising
25. A child with spinal muscle atrophy can no longer reach beyond
90 degrees of shoulder abduction and 90 degrees of shoulder
flexion. The parents state that the child can no longer don or doff
a t-shirt. Which is the best approach for the occupational therapist
to recommend the child use for dressing?
a) Place the t-shirt directly on the child's lap, have the child don
the arms first, then don the head of the t-shirt
c
b) Have the child learn to don and doff front-opening shirts instead
of t-shirts
c) Have the child support the elbows on a table at chest height to
don the t-shirt over arms, then don over head.
d) Have the child sit with the trunk well-supported, lean to the right
and don the right arm, repeat to the left and then don the head of
the t-shirt
26. An individual recovering from a CVA has received extensive
motor learning intervention. The client can now transfer a learned
motor skill to different contexts. The client also demonstrates the
ability to successfully motor problem solve during activities in
different contexts. In documenting the client's progress, which
stage of motor learning is most accurate for the occupational b
therapist to document the individual has achieved?
a) Skills acquisition
b) Skill retention
c) Practice context
d) Generalized context stage
27. An occupational therapist provides consultation services to
members of a town chamber of commerce who have expressed
interest in improving their business' accessibility. Which is the
minimum door width that the occupational therapist should rec-
ommend to the chamber members as accessible and not requir-
b
ing modification?
a) 28 inches
b) 32 inches
c) 30 inches
d) 34 inches
28. A client expresses an interest in playing a computer game
with another group member during a leisure skills group. The
occupational therapist reviews the client's cognitive evaluation
and agrees that the game is a good choice for the client's cognitive
level. After 15 minutes of engaging in the computer game, the
client rubs both eyes, looks around, and reports trouble focusing.
Which should the therapist do in response to these observations
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and client statements?
a) Provide verbal encouragement for the client to complete the
game before taking a break.
b) Suggest the client and the other member play a different video
game that is easier for the client. d
c) Discontinue the session and advise the client to select a differ-
ent leisure activity to do with the other member.
d) Suggest the client and the other member talk about the game's
progress in between completing their turns.
29. A 19-year-old with diagnoses of dysthymic disorder and nar-
cissistic personality disorder attends a vocational rehabilitation
program. When the client arrives for the work adjustment group,
the therapist notes that the client demonstrates an unsteady gait,
and slurred speech. The client's breath smells of alcohol. Which
is the best action for the therapist to take in response to these
observations?
a) Follow the program procedures to arrange for transportation to a
bring the client home.
b) Introduce the topic of alcohol's effect on work performance as
the focus of the scheduled group session.
c) Have the client meet with the social worker to discuss treatment
options for potential alcohol abuse.
d) Contact the client's parents to pick the client up to bring the
client home.
30. A toddler with spastic quadriplegic cerebral palsy demon-
strates a consistent gag reflex. Which technique should the oc-
cupational therapist use to help inhibit this reflex?
a) Move a spoon from side to side on the tongue
c
b) Walk a spoon down the tongue, going from proximal to distal
with even pressure
c) Press a spoon down firmly on the center of the tongue
d) Stroke the tongue in a circular motion with a firm object
31. A child with a tactile defensive sensory modulation disorder
attends a private early intervention clinic. The occupational thera-
pist collaborates with the client's parents to develop strategies and
guidelines to help the child handle the symptoms of this disorder
at home. Which is the best recommendation for the therapist to
make to the parents?
a) Avoid the use of swings and other moving equipment during c
play activities
b) Encourage the use of swings and other moving equipment
during play activities.
c) Soften the child's clothing by repeated laundering and remove
clothing tags.
d) Provide a variety of textures in the clothing the child wears
32. A newly hired OTA is instructed by the director of rehabilitation
to supervise two hospital volunteers as they learn how to assist
patients in safely completing bed to wheelchair transfers. The OTA
informs the supervising occupational therapist of the director's
request. Which is the first action the occupational therapist should
take in response to this request?
d
a) Advise the OTA to comply with the request
b) Advise the OTA to refuse the request
c) Observe the OTA to assess service competence in transfer
training
d) Explain to the director of rehabilitation why the request is
inappropriate
33. A single parent is hospitalized for an exacerbation of schizo-
phrenia. Actively psychotic upon admission, the client has been
stabilized on medication. The client is currently not demonstrat-
ing hallucinations or delusions. Residual deficits include several
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negative symptoms and decreased cognitive skills. At the team
meeting, the psychiatrist decides to discharge the client within
48 hours. The client lives with his/her elementary school aged
children. Which is the best recommendation for the occupational
therapist to make during this team meeting?
a) An extension of hospitalization to further evaluate cognitive
skills c
b) A family meeting to discuss the need for the children to assume
home management tasks
c) A home visit to assess the client's safety skills within the home
environment
d) A referral to social services to explore foster care for the
children
34. An individual recovering from hip replacement surgery pre-
pares for discharge home. The client has a secondary diagnosis
of gastric esophageal reflux disease (GERD). Which is the best
bed position for the occupational therapist to recommend to this
client? a
a) Supine with elevation of the shoulders and head
b) Sidelying with neck in neutral
c) Sidelying with elevation of the shoulders and head
d) Supine with the elevation of the hips
35. An occupational therapist designs a dynamic splint for an
individual recovering from tendon repair. At which angle should
the therapist position the outrigger?
a) 45 degrees to the joint b
b) 90 degrees to the joint
c) 60 degrees to the joint
d) 110 degrees to the joint
36. The transition plan for a high school senior with developmental
delay includes a referral to a vocational rehabilitation (sheltered)
workshop job setting. The student has set a goal to live inde-
pendent of family. Which is the best living environment for the
occupational therapist to recommend for this student? d
a) An apartment in a subsidized housing project
b) A group home with case managers available on call
c) A supported apartment with a roommate
d) A group home with daily on-site supervision
37. The parents of a two-year-old child with bilateral congenital
upper extremity amputations express concern to the homecare
occupational therapist about their child's complete disinterest in
toilet training. At which point should the occupational therapist
advise the parent to begin toilet training?
a) When the child indicates discomfort with being wet or soiled
a
b) Immediately, because toileting is a developmentally appropri-
ate task
c) When the child is three years old, as this is the typical devel-
opmental age for toilet training.
d) By placing the child on a "potty" chair for five minutes per hour
each day.
38. A school-aged child who is right-hand dominant complains of
numbness and tingling after writing for more than 15 minutes. A
neurological exam shows no reason for the numbness and tin-
gling. Which action would be most beneficial for the occupational
therapist to recommend to the child?
a) Use a pencil held in a universal cuff to complete writing activ- c
ities
b) Elevate the right upper extremity at night and whenever possi-
ble during the day.
c) Stretch the right upper extremity every 15-20 minutes during
writing activities.
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d) Use a custom-molded pencil grip made of splinting material
when writing
39. An occupational therapist leads a transitional planning group
for high school students with conduct disorders. The school fire
alarm goes off five minutes before the group's scheduled termi-
nation. There have been six false alarms during the past three
days at the school. Several of the students laugh and say, "There it
goes again.". Which is the occupational therapist's best response
to this situation?
b
a) Call the school's main office to determine the validity of this
alarm
b) Escort the students to the nearest fire exit
c) Conclude the group with a discussion about the implications of
false alarms
d) Escort the students back to their homeroom classrooms to
await directions.
40. A clubhouse program hires an occupational therapist as a
consultant. The clubhouse board of directors requests that the
OT consultant focus on the development of evening and weekend
leisure activities. Which recommendations should the therapist
make for the selection and completion of the group activities?
a) Activities to be selected and completed by clubhouse members
according to guidelines provided by the therapist. c
b) Activities to be selected by the therapist with written instructions
provided to the group attendees for activity completion.
c) Activities to be selected by clubhouse members with activity
completion led by the clubhouse members.
d) Activities to be selected by the therapist and completed by the
clubhouse members after demonstration by the therapist.
41. A two-year-old is placed in foster care due to child abuse and
neglect. The child was frequently beaten and locked in a dark
closet. The child is fearful and is suffering from sensory depriva-
tion. Which sensory input is best for the occupational therapist to
recommend the foster parents provide for the child? a
a) Slow rocking
b) Fast rocking
c) Bright lights
d) Upbeat music
42. An occupational therapist advises the parent of an 18-month
old with developmental delays on techniques to facilitate feeding.
The child has a reflexive bite. Which utensil is most beneficial
for the therapist to recommend the parent use when feeding the
child? b
a) A deep-bowled soup spoon
b) A narrow shallow coated spoon
c) A traditional teaspoon
d) A plastic spork
43. During a wheelchair evaluation, an individual with limited
functional mobility expresses concern about the ability to continue
volunteer work at a local church. The church's doorway are 31
inches wide. The client knows (from a recent home remodelling
project) that 32 inches is the minimum width recommended for
wheelchair access. Which recommendation should the occupa-
tional therapist make to the client to most effectively address the
b
client's concerns and functional mobility needs?
a) Have the church widen its doorways to comply with ADA
requirements
b) Order a wheelchair with wraparound armrests
c) Have the client explore alternative volunteer activities in acces-
sible locations
d) Order a customized narrow adult wheelchair
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44. An occupational therapist provides home-based services to a
person recovering from a recent CVA. The individual lives alone
and receives home care Medicare part A benefits. The therapist
arrives at the client's house at the scheduled session time, but
there is no response to the knocking on the door. A neighbour
reports seeing the client leave with a friend. Which is the best
action for the therapist to take in response to this situation?
a) Document that no one answered the door and that the appoint- a
ment will be rescheduled.
b) Call the nurse case manager to report the missed appointment
and the need to reschedule.
c) Document that no one was home and that the appointment will
be rescheduled
d) Document that the client is engaged in community mobility
activities and should be evaluated for discharge.
45. A client with a diagnosis of paranoid schizophrenia is partic-
ipating in an initial evaluation session of a psychiatric day treat-
ment program. Halfway through the completion of an activities
configuration, the client states the referral to this day program is
inappropriate and unnecessary because it was made by an in-
competent psychiatrist. The client becomes visibly upset and loud
when talking about the unfounded referral and the psychiatrist's
incompetence. Which is the best initial action for the occupational
therapist to take in response to the client's statements?
c
a) End the evaluation session and tell the client to call to resched-
ule when feeling better
b) Assure the client of the referring psychiatrist's competence and
advise the client to discuss the concerns with the doctor.
c) Acknowledge that the client appears upset and ask if the client
is able to focus on the remaining evaluation.
d) Contact the day program's chief psychiatrist to report the
client's stated concerns about the referring psychiatrist's compe-
tence.
46. An occupational therapist measures the active range of motion
of an individual's index finger. The measurements are MCP 0-45,
PIP 10-60, and DIP 10-40. Which is most accurate for the therapist
to document as the finger's total active motion (TAM)?
b
a) 62.5 degrees
b) 125.0 degrees
c) 72.5 degrees
d) 145.0 degrees
47. The family of an individual being admitted to a rehabilitation
center offers the occupational therapist a cash gift. The therapist
refuses the money but the family continues to insist that the
therapist take the cash gift. After thanking the family for their
generous gesture, which is the therapist's best response? d
a) Donate the money to the hospital
b) Donate the money to charity
c) Use the money to purchase an item for the OT department
d) Decline the gift.
48. An individual who successfully completed an inpatient drug
rehabilitation program returns to the setting to thank staff mem-
bers for their assistance with recovery. The individual offers to
share personal insights and experiences with the members of
the OT values clarification group scheduled for the next hour.
After thanking the individual, which is the best response for the b
occupational therapist to make in response to this offer?
a) Welcome the individual as a guest to the group to share per-
sonal perspectives on recovery and inspire the group members
b) Inform the individual that former clients cannot visit the group
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c) Ask the individual to prepare a presentation on how values clar-
ification aided in recovery for the next scheduled group session
d) Tell the individual that the therapist will discuss this offer with
the group and afterwards inform the individual regarding the group
decision.
49. A 21-month-old child with severe spastic quadriplegia is eval-
uated by an occupational therapist. The therapist determines that
the child is cognitively intact, exhibiting age-appropriate cognitive
skills despite major sensorimotor deficits. The therapist recom-
mends a play activity to enhance these cognitive abilities and
provide the child with a fun and pleasurable experience. Which
b
is the best object for the therapist to recommend?
a) A multi-colored mobile of objects of interest placed over the
child's stroller
b) A mechanical toy with a chin controlled on/off switch
c) A shape sorter with foam squares, triangles and circles
d) A battery controlled hammock swing
50. An individual recovering from a traumatic brain injury is as-
sessed to be at level VI of the Rancho Level of Cognitive func-
tioning scale. Which should the occupational therapist use to
implement treatment?
d
a) Sensory stimulation activities such as moving to music.
b) Repetitive self-care tasks such as brushing hair.
c) Community re-entry activities such as taking a bus.
d) Simple meal preparation tasks such as making a sandwich
51. An individual with hemiplegia has inadequate ankle dorsiflex-
ion on the affected side. Which of the following equipment is best
for the OT to recommend the person use to compensate for this
deficit and facilitate safe and effective ambulation?
a
A. An ankle foot orthosis (AFO)
B. A wide-based quad cane (WBQC)
C. A narrow-based quad cane (NBQC)
D. A knee-ankle-foot orthosis (KaFO)
52. The parent of two elementary school-aged children re-
ceives home care services due to metastasized bone cancer.
The client is in pain and has poor endurance and decreased
muscle strength. The client requires moderate assistance with
self-care and dressing. Which is the best intervention for the OT
to incorporate into sessions with this parent? d
A. Training in energy conservation techniques for self-care and
dressing.
B. Training in joint protection techniques for self-care and dressing
C. Using biofeedback to reduce the client's pain
D. Exploring play activities for the parent to do with the children
53. An OT working in a school has been asked to recommend
technological devices for a student with severe spastic quadriple-
gia and dysarthria. Which action should the therapist take prior to
recommending specific equipment?
A. Determine access capabilities in collaboration with the speech d
language pathologist
B. Identify funding sources in collaboration with the social worker
C. Obtain family support in collaboration with the psychologist
D. Determine intervention goals in collaboration with the student
54. A patient with a complete injury of the spinal cord at the C5
level completed inpatient rehabilitation which concentrated on in-
creasing independence in ADL. In the discharge documentation,
b
which is most likely for the OT to state the client is able to do?
A. Button buttons using button hook
B. Use mobile arm supports for feeding

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C. The shoes using thick shoelaces
D. Brush teeth using a tenodesis splint
55. An individual presents with intention tremor, dysmetria, de-
creased equilibrium and nystagmus caused by a cerebellar lesion.
The person expressed difficulty with routine tasks. Which inter-
vention is best for the OT to provide?
A. A cone and pegboard activity with wrist weights to control
d
tremors
B. Quick stretch to lateral trunk muscles during a functional activ-
ity
C. A power wheelchair to prevent falls during routine activities
D. UE weight bearing during self-care activities at a sink
56. A middle school-aged child with osteogenesis imperfect re-
ports feelings of low self-esteem, social isolation, boredom, and
lethargy. The OT collaborates with the child to identify the re-
sources for after-school leisure activities to promote socialization
and community participation. Which of the following activities is
d
best for the therapist to explore with the child?
A. Team sports
B. Therapeutic horseback riding
C. Scouting programs
D. Computer clubs
57. An OT interviews an OTA for a position at a high school
for gay and lesbian youth. The position involves the provision of
transitional vocational programming and life skills training. The
OTA uses a wheelchair for mobility and has dysarthric speech.
Which of the following is most relevant for the OT to ask the OTA
A
about during the interview?
A. Verbal group leadership skills
B. Sexual orientation
C. Personal beliefs about homosexuality
D. Accommodations needed due to the evident disabilities
58. A 9-year-old girl with the diagnosis of cystic fibrosis is hospital-
ized in a small rural hospital. Currently, there are no other children
in the hospital and the hospital does not have a pediatric play
area. The head nurse asks the OT to suggest appropriate play
activities that hospital volunteers can provide for the child. Which
c
is the most age appropriate activity for the therapist to suggest?
A. Dressing paper dolls
B. Coloring in coloring books
C. Playing card games
D. Cutting and pasting pictures onto cards
59. After evaluating a client with right-sided weakness and de-
creased motor control an OT decides to use interventions based
on the proprioceptive neuromuscular facilitation (PNF) approach.
When applying PNF principles, which of the following actions
should the therapist have the client do during an intervention
session to increase use of the right upper extremity and hand?
A. Reach overhead with the right hand to retrieve a dish out of a
higher cabinet and set it down on the countertop in front
d
B. Reach to the right side to retrieve an item out of refrigerator at
hip height and place it into the left hand to set it on the countertop
to the left
C. Use both hands together to pour juice out of a heavy pitcher
into a glass on a countertop
D. Take items out of a dishwasher on the right side and reach
across the body to place them in the upper cabinet on the opposite
side.
60. A teenage girl with juvenile rheumatoid arthritis (JRA) identi-
fies a goal of applying her own makeup. Which adaptation is most

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beneficial for the therapist to recommend?
A. Silver ring splints to hold makeup applicators
B. Enlarges soft foam handles on makeup applicators b
C. Long thin handles on makeup applicators
D. A universal cuff to hold makeup applicators
61. An OT conducts a satisfaction survey to evaluate the quality
of OT services in an outpatient program. The questionnaire de-
veloped by the therapist asks respondents to rate their respons-
es to quality statements according to a 4- point Likert scale of
agreement. Which statement best reflects an adequate measure
of satisfaction? a
A. "The amount of time devoted to stress management was ade-
quate."
B. "Setting my own goals was important to me"
C. "My experience in OT help me"
D. "The OT staff was respectful and fair to me"
62. An OT working on an acute psychiatric inpatient unit conducts
a series of groups for clients newly admitted to the unit. Which
group leadership style is most effective for the therapist to assume
when leading these groups?
d
A. Advisory
B. Facilitative
C. Laissez-faire
D. Directive
An individual with degenerative joint disease (DJD) incurred an
injury to the right hand. The client is referred to OT due to
complaints of severe pain, stiffness, and extreme temperature
changes in the hand. The OT referral states that the person has
pitting edema and blotchy, shiny skin. Based on a screening,
the OT determines that the client's presenting symptoms are
consistent with the diagnosis of complex regional pain syndrome
(CRPS) Type 1
d
63. The OT evaluates the client's pain by asking the client which
movements or activities elicit pain. Which of the following is the
therapist assessing?
A. The quality of pain
B. The location of pain
C. The intensity of pain
D. The triggers of pain
An individual with degenerative joint disease (DJD) incurred an
injury to the right hand. The client is referred to OT due to
complaints of severe pain, stiffness, and extreme temperature
changes in the hand. The OT referral states that the person has
pitting edema and blotchy, shiny skin. Based on a screening,
the OT determines that the client's presenting symptoms are
consistent with the diagnosis of complex regional pain syndrome
(CRPS) Type 1 c

64. The OT completes the pain evaluation. What additional eval-

uation methods should the therapist use to assess this client?
A. Vigormeter
B. Dynamometer
C. Volumeter
D. Sphygmomanometer
An individual with degenerative joint disease (DJD) incurred an
injury to the right hand. The client is referred to OT due to
complaints of severe pain, stiffness, and extreme temperature
changes in the hand. The OT referral states that the person has
pitting edema and blotchy, shiny skin. Based on a screening,
the OT determines that the client's presenting symptoms are
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consistent with the diagnosis of complex regional pain syndrome
(CRPS) Type 1

65. The OT plans intervention to address the client's goals to

engage in meaningful occupations. Which physical agent modality
b
(PAM) should the OT use in preparation for functional activity?
A. Transcutaneous electrical nerve stimulator (TENS)
B. Contrast baths
C. Whirlpool
D. None; PAMs are contraindicated for this diagnosis
An individual with degenerative joint disease (DJD) incurred an
injury to the right hand. The client is referred to OT due to
complaints of severe pain, stiffness, and extreme temperature
changes in the hand. The OT referral states that the person has
pitting edema and blotchy, shiny skin. Based on a screening,
the OT determines that the client's presenting symptoms are
consistent with the diagnosis of complex regional pain syndrome
(CRPS) Type 1 d

66. which is the most appropriate activity for OT to recommend for

the person to complete at home?
A. Doint light craft work
B. Playing a table-top game
C. Performing relaxation exercises
D. Manually washing a car
67. An individual with advanced Huntington's chorea is newly
admitted to a skilled nursing facility. The resident weighs 280
pounds and cannot independently transfer. What is the best rec-
ommendation for the OT to make to the resident's direct care staff
to ensure a safe transfer? a
A. A mechanical lift transfer
B. A two-person lift transfer
C. A stand pivot transfer
D. An assisted sliding board transfer
68. The staff of an acute inpatient medical unit consists of an OT
and an entrylevel OTA. The admission rate has increased and the
OT is having difficulty completing evaluations in a timely manner.
Which is the best action for the therapist to take in response to
these practice realities?
A. Evaluate patients screened by nursing staff as appropriate for d
OT
B. Plan intervention based on the PT evaluation
C. Train the OTA to independently complete the evaluation
process
D. Redesign the program to allow more time for evaluation
69. An OT receives a referral to construct a splint for an individual
with ERb's palsy. Which orthosis would be most effective for this
condition?
A. A flail arm splint b
B. An elbow lock splint
C. A figure-of-eight splint
D. A deltoid sling
70. Following medical treatment for a brain tumor, a client is
referred to OT home care services for a functional evaluation.
During the initial interview, the client reports difficulty locating
desired items. For example, at lunchtime the client could not find
a
a can of soup in the pantry. Based upon this selfreport, which
functional ability should the OT evaluate?
A. Visual scanning
B. Visual acuity

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C. Spatial relations
D. Topographical orientation
71. A patient has been discharged from a rehabilitation facility six
months ago. A staff therapist who works at the facility sees the
former patient and the senior therapist who treated the patient in
a dating situation. The senior therapist confirms involvement in a
personal relationship with the former patient. Which is the staff
c
therapist's best response to this situation?
A. Report the therapist to the NBCOT
B. Advise the facility director
C. Do nothing
D. Report the therapist to the OT supervisor
72. An adult is hospitalized in the recovery phase of Guillain-Barre
Syndrome. The patient complains of tingling aching and weak-
ness in both hands causing difficulty in grasping grooming sup-
plies. The patient requests relief from the hand symptoms. Which
action should the OT take to address the patient's concerns?
A. Provide soft tissue massage to both hands prior to grooming
activities d
B. Apply hot packs to both hands and complete stretching exer-
cises prior to grooming activities
C. Refer the client to a neurologist for follow-up of possible con-
dition regression
D. Educate the patient about sensory deficits and related adaptive
ADL strategies
73. A child with ADHD and conduct disorder attends an after-
school program that utilizes sensory-integrative and behavioral
management approaches to achieve intervention goals. snacks
are provided and occasionally used as rewards. A parent insists
that a child not be given any foods containing sugar. Which is the
OT's best response to this request?
A. Discontinue providing sugary snacks but continue their use as
c
rewards in the behavioral management program
B. Provide the parent with recent research that refutes the link
between sugar and problem behaviors
C. Discontinue providing sugary snacks for the child to comply
with the parent's request
D. Inform the parent that the therapist will discuss the issue with
the program's administrator to determine the best course of action
74. An individual with myasthenia gravis is being discharged home
after a hospitalization for the treatment of pneumonia. The per-
son's spouse has expressed concern about caregiving responsi-
bilities and the client's ability to function in the home. Which is the
most beneficial recommendation for the OT to make address the
spouse's concerns and the client's needs?
A. The extension of client's length of stay to allow for caregiver
d
training
B. The extension of client's length of stay to provide intervention
to develop ADL skills
C. A referral for the client to an adult day care program to relieve
caregiver stress and to develop functional skills
D. A referral to a home care agency for a functional evaluation and
home assessment
75. An OT becomes aware of the practice of a colleague who
teaches an energy conservation class to persons with arthritis.
This colleague has been sending the names of class participants
to a vendor who sells adaptive equipment. Which action is best
b
for the OT to take in response to the situation?
A. Ignore the situation for it does not harm anyone
B. Speak to the therapist privately and tell him/her this action is
unethical
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C. Advise the therapist to disclose this practice and if he/she
refuses to report the therapist to the state regulatory board.
D. Report the therapist's unethical behavior to the state regulatory
board
76. An OT providing home-based OT services implements a bed
positioning plan for a person recovering from a cerebral vascular
accident. The person is receiving care from family members and
personal care assistants employed by a home care agency. Which
action should the therapist take to ensure the accurate implemen-
tation of this plan by the client's caregivers?
A. Provide verbal step-by-step directions of the desired positions
c
to the client's caregivers
B. Post written step-by-step directions of the desired positions on
the wall by the client's bed
C. Post pictures of the desired positions next to the headboard of
the client's bed
D. Require each caregiver to demonstrate the replication of the
desired positions
77. A young adult with a 10-year history of bulimia nervosa partici-
pates in an outpatient vocational exploration group and completes
a vocational interest inventory. This evaluation identifies four pos-
sible areas for a career. Which career choice is best for the OT to
advise the client to explore further? a
A. Web designer
B. Dietitian
C. Athletic trainer
D. Fashion designer
78. An OT develops a task group for the newly admitted patients
of a psychiatric inpatient unit of a busy city hospital. The therapist
considers several activities to use for the group's first session.
Which activity is best for the therapist to present to the group
members?
A. Planning a weekend pizza party for the patients and their b
visitors
B. Decorating styrofoam cups and planting cuttings in them
C. Publishing a weekly newsletter about city attractions for pa-
tients on the unit
D. Painting a large mural to cover one wall of the day room
79. An individual is evaluated for a repetitive stress disorder.
The individual complains of numbness and tingling of the thumb,
index, middle, and radial half of the ring finger and aching pain in
the proximal forearm. The client states that these symptoms are
not evident at night. The OT notes a positive TInel's Sign. Which
site should the therapist document as the location of this sign for d
this client?
A. The wrist
B. The Guyon's canal
C. The elbow
D. The forearm
80. A client with a right below-elbow amputation begins prosthetic
training with body-powered myoelectric prosthesis. The OT col-
laborates with the client to begin training in the use of the terminal
device to grasp and release objects. Which elbow position is best
for the therapist to place the client's elbow during grasp and
release activities?
a
A. Flexed at 90 degrees with neutral degrees of pronation or
supination
B. Flexed at 90 degrees and pronated 60 degrees
C. Flexed at 120 degrees and with neutral degrees of pronation
or supination
D. Flexed at 90 degrees and supinated 60 degrees
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81.During an early intervention planning meeting, an OT explains
the results of a play assessment to the parents of an 18-month-old
toddler with multiple developmental disabilities. The child has
been assessed as delayed by 6-8 months in all developmental
parameters. Which intervention approach is most effective for the
therapist to recommend using first to develop the toddler's play
skills?
A. The use of toys that encourage creative and imaginative play
B. The use of toys that are visually and auditorily stimulating.
C. Participation in a small parallel play group with other toddlers
D. Engagement in activities that use sensorimotor skills prereq-
uisite to play
82. A two-year-old child receives home care early intervention
services. The OT intervention plan includes a goal to develop the
child's pincer grasp. Which is the most appropriate activity for the
OT to work on with the child during the intervention session?
a
A. Finger-feeding of O-shaped cereal
B. Picking up marbles
C. Drawing with jumbo crayons
D. Stacking one-inch cubes
83. An OT works with an individual with chest and UE burns.
During the intervention session, the client expresses vague fears
about personal safety at home and asks the therapist to advocate
for an extension in the discharge date. According to the medical
record, the client had incurred the burns during a cooking acci-
dent. Which is the therapist's best initial response to the client's
stated concerns?
d
A. Encourage the client to speak to the social worker about
discharge plans
B. Assure the client that pre-discharge fears are normal and
expected
C. Document the client's concerns and recommend an extension
of the length of stay
D. Invite the client to expand upon the nature of these concerns
84. The OT employed at a day treatment center for clients with
psychiatric disorders is conducting a leisure planning group. The
members of the group decide to take a day trip to the local
sculpture garden. Which side effect of psychotropic medications is
most important for the therapist to discuss preventive precautions
c
for with the group?
A. Orthostatic hypotension
B. Akathisia
C. Photosensitivity
D. Tremors
85. A child with mild spastic diplegia wants to participate in neigh-
borhood activities with peers. The family's main goal for the child is
to ride a bicycle. Which bicycle is best for the OT to recommend?
A. A hand-propelled bicycle with hand brakes b
B. A foot-propelled bicycle with hand brakes
C. A foot-propelled bicycle with foot brakes
D. An adapted tricycle with foot brakes
86. An OT receives a referral from a physician that outlines a spe-
cific course of treatment. Following the evaluation of the person,
the therapist believes that a different course of treatment would be
more beneficial. Which course of action is best for the therapist to
take? a
A. Contact the physician and discuss the alternative treatment
B. Provide the prescribed treatment on a three to four-week trial
C. Combine the prescribed treatment with the therapist's preferred
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D. Provide the treatment the therapist believes would be more
beneficial for the person
87. A woman with a complete SCI at the C5 level has given birth
to her first child. The client seeks suggestions on methods to
facilitate independent and safe parenting. Which of the following
is most beneficial for the OT to recommend the mother use to help
her independently feed her child? a
A. A pillow to support the mother's arms during breastfeeding
B. Bottles with pre-measured formula
C. Bottles that have molded easy to grip shapes
D. A sling to support the infant's head during breastfeeding
88. During a classroom screening, an 8-year-old is observed
holding a pencil with a tight grip. The student appears to rely
heavily on visual cues to assist during both fine and gross motor
tasks. During gross motor activities, the student moves in an
uncoordinated manner. The OT uses a sensory integrative frame
of reference to interpret evaluation data. Which impairment should b
the therapist document as needing further evaluation?
A. Vestibular processing dysfunction
B. Proprioceptive system dysfunction
C. Hyporesponsive tactile system
D. Hyperresponsive tactile system
89. An individual with borderline personality disorder is admitted
to the hospital following a suicide attempt. After attending an
OT orientation group, the patient tells the OT, "You are the only
therapist who has ever been really helpful". The patient asks to
meet with the therapist privately on a regular basis instead of the
assigned primary individual therapist. Which action is best for the
therapist to take in response to the patient's request? a
A. Refer the patient to the assigned primary individual therapist
B. Agree to meet with the patient since a positive therapeutic
connection has been expressed
C. Tell the patient that an OT provides only occupation-based
group treatment
D. Explain that this type of manipulative behavior is not acceptable
90.
91.
92.An entry-level OT is hired to work on an acute psychiatric
unit. The OT supervisor orients the therapist to hospital poli-
cies and procedures. Which are the most important policies and
procedures for the supervisor to include in the initial orientation
session? a
A. Crisis intervention
B. Reimbursement
C. Employee benefits
D. Group program scheduling
93. An OT evaluates a client using Allen Cognitive Level (ACL)
Screen. The client successfully completes three running stitches.
Which step should the therapist take next?
A. Demonstrate the whip stitch and ask the client to imitate this
and complete three stitches
B. Demonstrate the single cordovan stitch and ask the client to a
imitate this and complete three stitches
C. Demonstrate the double cordovan stitch and ask the client to
imitate this and complete three stitches
D. Document that the person demonstrates a cognitive level con-
sistent with Level 3 of the Cognitive Disabilities model
94. During an OT session, a veteran recovering from bilateral
traumatic lower extremity amputations expresses several con-

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cerns about having a changed body and questions its sexual ap-
peal. Which response is best for the therapist to take in response
to the client's concerns?
A. Refer the client to the primary care physician
B. Ask open ended questions to explore the concerns further b
C. Reassure the client that the concerns are a normal part of the
recovery process
D. Explain that positioning can compensate for changes in func-
tional mobility.
95. An older adult who is recovering from a cerebral vascular acci-
dent attends OT two times per day. The intervention environment
is highly structured and not over-stimulating yet the OT observes
that the client's mood often changes abruptly. Within one session,
the client will laugh and then become tearful with no apparent
precipitant. Which is most accurate for the OT to document the d
client is exhibiting in the client's daily progress note?
A. Early Alzheimer's disease
B. Anhedonia
C. A response to auditory hallucinations
D. Emotional lability
96. A large general hospital in an urban area initiates several
quality improvement committees that include OTs. Which of the
following does participation in these committees provide to the
OTs?
d
A. The ability to develop personal performance skills
B. The capability to enhance leadership skills
C. The power to promote OT services
D. The opportunity to improve overall service deliver
97. An adolescent student with Duchenne muscular dystrophy
and depression is being evaluated for a power wheelchair. Which
is the most important area to be considered during the OT eval-
uation of the student to determine the student's readiness for the
wheelchair? c
A. Level of interest
B. Fine motor skills
C. Cognitive skills
D. Postural control
98. An individual incurred a SCI at the C5 level. During an OT
session focused on developing the ability to feed independently
using adaptive equipment, the OT notes that the client is flushed
and sweating excessively. The client requests that the session end
early due to a pounding headache. Which action is best for the OT
to take first in response to this situation?
A. End the session and call the transporter to return the client to
b
the client's room
B. Empty the client's filled catheter bag and maintain the client's
upright position
C. Return the individual to the unit and report symptoms to the
head nurse
D. Stop the session and recline the individual in the wheelchair for
a rest break
99. An OT and an OTA co-lead a work adjustment group. One
member has become progressively more dependent on the OTA
for directions, praise, and input throughout the group activities.
Which action should the group leaders initially take in response
to these behaviors?
c
A. Schedule several individual sessions with the OTA and group
member to examine the issues of dependency and transference
B. Inform the attending psychiatrists that the group is exhibiting
signs of dependency and transference
C. Have the OTA work with the person during group sessions to
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develop independence in task completion
D. Have another therapist co-lead the group with the OT and
reassign the OTA to another group
100. The parents of an 8- month old child bring their child to
a free community health development screening program. The
occupational therapist evaluates the moral motor development of
the child and determines that the child's development is within
normal limits. When documenting this determination, which is
b
most likely for the therapist to state the child demonstrates?
a) Rotary Chewing
b) Diagonal jaw movements
c) Effective masucation
d) Cup drinking with firm jaw
101. An elder diagnosed with dementia, Alzheimer's type was
recently admitted to a skilled nursing facility (SNF). The OTA
working with the resident reports to the occupational therapist that
during the morning care session, the OTA observed bruises on
the resident's back and upper arms. Which action is best for the
b
occupational therapist to initially take?
a) Talk to the resident to obtain more information.
b) Follow facility procedures for investigating resident safety.
c) Contact the resident's family to obtain more information.
d) Contact the state office for adult protective services.
102. An occupational therapist assesses a retired carpenter and
war veteran who was recently admitted to an acute psychiatric
unit due tan exacerbation of post-traumatic stress disorder. the
individual is observed to initiate interactions with others during
structured task but is withdrawn when not engaged on a task.
Which activity is best for the therapist to recommend to the in- c
dividual?
a) Writing thoughts and feelings in a daily journal.
b) Engaging in meditation when alone in a hospital room.
c) Assisting another patient with a woodworking project.
d) Writing about personal experiences in the units newspaper.
103. Upon evaluating a client for a wheelchair, the occupational
therapist determines that a standard narrow adult chair would
be suitable for the individual. Which dimensions most accurately
identify this chair?
b
a) 18" wide x 18" deep x 20" high
b) 16" wide x 16" deep x 20" high
c) 16" wide x 16" deep x 18.5" high
d) 14" wide x 16" deep x 18.5" high
104. An adult is referred to occupational therapy treatment for
chronic back pain that hinders the satisfactory performance of
home maintenance tasks. The occupational therapists in the de-
partment have little experience with back pain, while the physical
therapist in the rehabilitation department have extensive experi-
ence in this area. Which action is the best choice for the occupa-
b
tional therapist to take in response to this situation.
a) Refer the patient to physical therapy.
b) Co-treat the person with physical therapy.
c) Give the patient the option to work in occupational or physical
therapy.
d) Review a video on treatment of back pain.
105. A six year-old child with difficulties in figure-ground percep-
tion is being discharged from occupational therapy services. In
the discharge plan, which should the therapist recommend for this
a
child?
a) Use a different solid-colored folder to hold materials for each
class subject.

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b) Use a toothbrush and comb that are the same colors as the
counter.
c) Wear clothing with bold colors and loud patterns.
d) Place all school books and handouts on the desk while com-
pleting homework.
106. An occupational therapist is working with a child presenting
with sensory-seeking behavior and under reactivity to touch and
movement. the child has an unusually high activity level, inability
to self-calm, motor impulsivity and frequent touching and handling
of items in the environment. Using Ayres classic sensory integra-
tive (SI) approach which would be most effective for the therapist
to use with this child to facilitate an adaptive response?
d
a) A pre-determined schedule of sensory activities designed by
the occupational therapist
b) The child's passive participation in a variety of vestibular and
proprioceptive experiences.
c) Use of a sensory void environment to promote selfregulation.
d) Individualized therapeutic activities based on the interest of the
child.
107. A non-English speaking individual with a recent left-sided
CVA comes to occupational therapist for the first evaluation ses-
sion. The assigned therapist cannot communicate verbally with
the person. Which action is best for the therapist to take first?
a) Perform a screening to determine the specific areas to evalu-
b
ate.
b) Seek out a translator to assist with the evaluation.
c) Communicate with the individual using nom-verbal communi-
cation.
d) Evaluate the individual according to established protocols.
108. Which is the most effective approach for an occupational
therapist to use when giving directions for a task to an individual
with schizophrenia who is experiencing auditory hallucinations?
a) Written directions for making vanilla pudding. a
b) Verbal step-by-step directions for making a leather link belt.
c) General verbal directions for the completion of a group collage.
d) Demonstration of steps during a swing dance class.
109. As the result of a trauma 10 months ago, a 13-year=old
incurred a unilateral below-elbow amputation. Due to a recent
growth spurt, the adolescent is being re-evaluated for a new
prosthesis. During the evaluation, the adolescent angrily tells the
occupational therapist that a prosthesis is "annoying to have to
wear every day". The adolescent reports not liking "the claw" and
as result often takes off the current prosthesis. However, the ado-
lescent acknowledges that the prosthesis is "needed sometimes"
to perform bilateral activities. WHich action is best for the therapist
b
to take in response to this adolescent's statements?
a) Refer the adolescent to the child psychologist to deal with
adjustment to disability.
b) Work on developing unilateral skills for completion of meaning-
ful activities .
c) Refer the adolescent to a prosthetist for a prosthesis with a
cosmetic hand.
d) Recommend the adolescent attend a teen amputee support
group.
110. An occupational therapist conducts an after-school transition
skill group with adolescents with a diversity of disabilities. One of
the student's behaviors is very different than in prior groups (e.g.
difficulty focusing when typically serving as the group initiator,
making statements that are relevant to the topic at hand). The
therapist smells a strong alcohol content on the student's breath.
Which action should the therapist take in response to this situa-
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tion?
a) Directly ask the student if the student has been drinking.
b) Initiate a group discussion about the effects of substance abuse
on occupational performance.
d
c) Proceed with the group and report suspicious of alcohol use at
the nexttransistion planning team meeting.
d) Call for a school aide to escort the student to the school's
on-site health care facility.
111. An occupational therapist uses behavior modification tech-
niques to help shape the behavioral responses of students with
behavioral disorders. Which action is most consistent with this
intervention approach?
a) Provide frequent positive reinforcement for all desired behavior.
b) Reprimand the students every time an understandable behav- a
ior occurs.
c) Allow each student enough time for self-correction of the be-
haviors.
d) Encourage the teaching staff to tell the students which behav-
iors are correct and incorrect.
112. During a home visit, a client who had incurred CVA reports
difficulty finding objects during BADL, and IADL. The client re-
ports that the directions family members provide (e.g. look on the
refrigerator's door, look in the medicine cabinet) are not helpful.
Which cognitive perceptual ability should the occupational thera-
d
pist further evaluate?
a) Stereognosis
b) Organization
c) Spatial relations
d) Visual closure
113. An occupational therapist is treating an eight-month-old with
mild developmental delay. the child exhibits normal cognitive de-
velopment. The child has developed adequate static sitting bal-
ance but has poor dynamic sitting balance. The therapist imple-
ments intervention by positioning the child and having the child
find a toy that is covered with a cloth. Which positioning and toy
placement are most beneficial for the therapist to use with this
child?
a
a) Sit the child between the therapist's extended leg and alternate
blacing the covered toy to the child's right and left side.
b) Sit the child in a child seat and alternate placing the covered
toy to the child's right and left side.
c) Lay the child in a prone position and place the covered toy in
front of the child.
d) Lay the child in on the right side and place the covered toy to
the left of the child.
114. A child with moderate spastic cerebral palsy works on ambu-
laton with a walker in physical therapy. The occupational therapy
evaluation reveals problems in lower extremity dressing, transi-
tional skills, self-feeding and grasp and release skills. TO facilitate
the attainment of the child's ambulation goal, which activity is
best for the occupational therapist to include in OT intervention
session?
a) Rolling in and out of prone and supine while on mat, with b
minimal hands-on facilitation.
b) Donning and doffing shoes and socks in bench sitting with one
leg externally rotated and placed on the opposite knee.
c) Self-feeding with elbows supported on a cut-out table at waist
height, using a spoon with a built-up handle.
d) Practicing grapes and release of small objects while wearing
bilateral soft splints to support a more functional hand position.

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115. A co-worker in the therapy department complains exces-
sively during working hours of personal problems. The co-worker
does not respond to colleagues' statements that this is disruptive
to their work. Which action is best for the occupational therapist
to take in response to this situation? d
a) Call the employee assistance program for the co-worker.
b) Talk with the co-worker using a client-centered approach.
c) Tactfully and firmly redirect the co-worker to work issues.
d) Inform the department supervisor of the situation.
116. A five-year-old is referred to occupational therapy. Upon the
completion of a standardized test evaluation, the occupational
therapist determines that the child demonstrates age-appropriate
cognitive and fine motor skills. Which activity would the child be
able to complete at this developmental level? c
a) Cutting long thin strips with scissors.
b) Holding and snipping with scissors.
c) Cutting simple figure shapes with scissors.
d) Opening and closing scissors in a controlled fashion.
117. An occupational therapist provides recommendations for
play activities that a parent with a complete spinal cord injury at
the C=7 level can do with children, age eight and ten. WHich is
the best adapted activity for the therapist to recommend?
c
a) An arts and crafts project using mouthstick brush to paint.
b) A woodworking project using a universal cuff to hold tools.
c) A hoard game using a tenodesis grasp to move game pieces.
d) A computer game using a typing stick to keyboard.
118. An individual recently lost significant functional abilities due
to postpolio syndrome. The occupational therapist works with
the individual to develop compensation skills for performing daily
tasks. During a meal preparation session, the person angrily
throws all of the adaptive equipment onto the floor. At the next
meeting, which defense mechanism should the therapist report d
the individual appears to be demonstrating?
a) Acting out
b) Passive-aggressive behavior
c) Reaction formation
d) Displacement
119. An occupational therapist works with a patient with diabetes
and a below-knee (BK) amputation to learn how to effectively
perform home management tasks while wearing a BK prosthesis.
When taking laundry from a front-loading washer and placing it
into a top loading dryer, the patient reports feeling weak, dizzy
and somewhat nauseous. The occupational therapist notices that
the patient is sweating profusely and is unsteady when standing.
Which is the best immediate course of action for the therapist to b
take in response to the patient's complaints and these behaviors?
a) Return the person to the unit of care due to an insulin reaction.
b) Administer orange juice for developing hypoglycemia.
c) Call a nurse to administer an insulin reaction for developing
hyperglycemia.
d) Have the patient sit down until the orthostatic hypotension
resolves.
120. A child with spastic quadraplegic cerebral palsy has in-
creased tone and flexor synergies in both upper extremities. The
child receives Botox injections into both biceps. In designing play
activities to use during intervention, which is most important for
b
the occupational therapist to include as an activity performance
characteristic?
a) Reaching overhead and to both sides in supine.
b) Bilateral upper extremity weight- bearing in sitting and in prone.

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c) Grasp and release of objects in supported sitting.
d) Transitions into and out of sitting supine and prone.
121. A person recovering from hip replacement surgery wants to
begin meal preparation. The client refuses to use the walker that
was ordered by the physician. The physician is unavailable for
consultation. Which is the best initial action for the occupational
therapist to take in response to this situation?
a) Work on meal preparation activities with the client sitting at a
table. a
b) Work on meal preparation activities with the client standing
without the walker.
c) Delay working on meal preparation activities until the physician
can be contacted.
d) Tell the client the walker must be used until the physician
changes the order.
122. The occupational therapist determines the Allen Cognitive
Level (ACL) Screen to an individual. During this evaluation, the
most complex behavior the individual can perform is to do the
three running stitches, imitating the therapist's example. Based
upon these results, the therapist selects an activity to use for
intervention that is consistent with the individual's functional level.
According to the Cognitive DIsabilities model, which activity is c
best for the therapist to use when implementing intervention with
this patient?
a) Exercises that require the imitation of another's posture.
b) Sorting laundry by matching the colors of clothing items.
c) Sanding wooden bookends.
d) Planning a three-course meal
123. A skilled nursing facility (SNF) wants to provide an activities
program to meet the needs of each resident. The occupational
therapist asked to write a job description for the position of an
activities program director and delineate the qualifications needed
for that position. Which should the occupational therapist recom-
mend for this position?
a) An OTA who receives general supervision from an occupational
d
therapist.
b) An OTA who receives close supervision from an occupational
therapist.
c) An OTA who receives routine supervision from an occupational
therapist.
d) An OTA who does not require supervision from an occupational
therapist.
124. An occupational therapist works with adolescents who have
been victims of child abuse. Treatment can be carried out in
groups or on an individual basis. WHich of the following would
indicate to the therapists that intervention should be provided on
an individual basis rather than in groups?
c
a) The adolescent wants more socialization experiences.
b) The adolescent could benefit from feedback from peers.
c) The adolescent desires greater control over the environment.
d) The adolescent needs an opportunity to gain situational per-
spective.
125. A house painter is referred to occupational therapy after a
re-occurrence of rotator cuff tendinitis. The physician prescribes
a conservative intervention approach. Which recommendations is
best for the occupational therapist to make to the individual?
c
a) Continue performing above shoulder activities to build rotator
cuff strength.
b) use an extension handle in the paint roller when painting
ceilings.

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c) Sleep with the shoulder extended and adducted.
d) Sleep with the shoulder fully flexed and adducted.
126. An occupational therapist implements intervention in a
preschool program for children with tactile defensiveness. In the
prior intervention session, the children had responded favorably
when the therapist had rolled a large ball over their bodies as
they lay supine on a mat. Which intervention method should the
therapist use next?
a
a) Roll the large ball with increased pressure across the children's
bodies.
b) Bounce the ball across the children's bodies.
c) Have the children jump into a pool filled with small balls.
d) Roll the large ball, as in the prior session, with the children
prone.
127. The parent of a newborn infant has bilateral shoulder weak-
ness and is referred to occupational therapy for training in en-
ergy conservation techniques for the performance of parenting
and home management tasks. Which adaptation(s) is/are most
effective for the occupational therapist to recommend the parent
use? b
a) A top-loading washer and dryer for clothing care.
b) A streamer, streamer basket and/or crock pot for meal prepa-
ration.
c) A front pack carrier for holding the infant.
d) Cloth diapers and the use of a weekly diaper care service.
128. A 14-year-old with spastic quadraplegia cerebral palsy and
intellectual disability begins high school. The occupational thera-
pist determines that the adolescent's academic needs are being
adequately addressed by the use of the equipment and strategies
that the adolescent has acquired during the middle school years.
Which recommendation is best for the therapists to make to the
individualized education planning team?
a) Adaptation of the middle school strategies and equipment to b
the adolescent's highschool classes.
b) The development of a transition plan with the adolescent for a
desired post-school life.
c) The development of peer relationships through engagement in
extracurricular activities.
d) A referral to the local center for independent living for commu-
nity-based activities.
129. An occupational therapist provides services to a homeless
shelter which includes residents who are HIV positive. The ther-
apists conduct several activity groups. Which should the therapist
do while working with this population?
a
a) Wash hands before and after each group session.
b) Always wear latex gloves during groups.
c) Wear latex gloves when handling food.
d) Implement transmission-based precautions.
130. A client with chronic depression and a spouse attend a
discharge meeting with the occupational therapist following the
client's six-week hospitalization for a major depressive episode.
They state that they have few activities in common and spread
little time together. The client retired a few months ago and the
spouse continues to work full time. Which of the following should
the therapist encourage this couple to do first to address this c
concern?
a) Immediately participate in one activity together.
b) Become involved in their own individualized activities during the
day.
c) Explore activities enjoyed together and alone.
d) Delay planning activities until the depression is totally resolved.
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131. Two months ago a child received full thickness circumferen-
tial burns of both upper extremities. The child shows progressively
decreasing ROM of the right elbow with a 25° loss to date with
stiff endpoint. The child complains of increased pain in the elbow.
Which actions should the occupational therapist take first in re-
c
sponse to this change in status.
a) Begin use of a continuous passive motion device.
b) Apply heat prior to active ROM
c) Contact the child's physician
d) Splint the child's elbow in static splints.
132. An occupational therapist conducts a communication skill
group in a wellness program for a large accounting company. In
this mature level group what should the therapist do?
a) Help to develop the group norms b
b) Participate as a member.
c) Actively resolve group conflicts.
d) Maintain a leader role.
133. When performing a chart audit for on-site accreditation visit,
an occupational therapist realizes that a date of service was
documented wrong. Which actions are best for the therapist to
take?
a) Use a whiteout to remove the incorrect date of service, and
then initial and the date correction.
c
b) Write the correction date over the incorrect date and then write
the rehabilitation department director's initial.
c) Put a single line through the incorrect date, write the correct
date of service and then initial and the date the correction.
d) Meet with the rehabilitation department director to discuss the
need to correct this documentation.
134. A patient incurred a traumatic upper extremity amputation.
During the pre-prosthetic treatment, the occupational therapist
molds the contours of the residual limb to shape it in preparation
for a prosthesis. Which method is most effective for the occupa-
tional therapist to use? a
a) Wrapping
b) Percussion
c) Shrinking
d) Massage
135. An individual receives treatment for major depression on an
inpatient psychiatric unit. The patient has received an electrocon-
vulsive treatment (ECT) at 8 am. At 2 pm, the patient walks into the
occupational therapy department stating a desire to participate in
the leisure skills group. Which is the occupational therapist's best
response?
a) Encourage the client to select one of three structured leisure
a
activities to complete.
b) Call nursing staff to escort the client back to the client's room
so that the client can rest.
c) Commend the client's motivation but remind the client that rest
is recommended for 24 hours after ECT.
d) Have the client complete a leisure history questionnaire to
enable individualized treatment.
136. An occupational therapist designs an activity group program
for twelve adults with multiple physical disabilities and/or illness
who attend a day hospital family respite program. Which method is
most effective for the therapist to use to determine the members'
needs upon which to base the program? b
a) Interview family caregivers
b) Interview each member
c) Interview day hospital staff
d) Research the program's population characteristics.
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137. An occupational therapist leads a work at a vocational reha-
bilitation program for persons with traumatic brain injuries. One
member begins to make sexually suggestive comments to other
group members. The therapist redirects the client to the work in
progress but the member continues to make sexually suggestive
statements. Which is the therapist's best initial response to this
situation?
a) Explain to the client that such statements are not tolerated at
b
work and call security to have the client removed from the group.
b) Explain to the client that such statements are not tolerated at
work and the client must stop or leave the group.
c) End the group before the situation escalates and reschedule
the group to meet without disruptive client.
d) Set the client up at a different workstation so the client is not in
contact with other group members and cannot disrupt the group's
work.
138. A carpenter recovering from injuries incurred during a fall
from a ladder has decreased strength in the triceps bilaterally.
The most recent manual muscle test indicated that the tricep
muscle strength is 3. The occupational therapist provides the
individual with a tabletop wood project to complete. To develop
triceps muscle strength, how should the therapist position the
table top when the person sand the project?
a) At a 45° incline angled so that the individual's hands are above
the elbows when the elbows are flexed.
b) At the individual's waist height so that the individual's hands
and elbows are on the same plane when the elbows flex.
c) At the individual's chest height so that the individual's hands
and elbows are on the same plane when the elbows flex.
d) At a 45° incline angled so that the individual's hands are below
the elbows when the elbows are flexed.
139. An occupational therapist provides home-based early in-
tervention evaluations. A referral for an 18-month-old child notes
that the child is able to finger feed effectively but is not able to
use a spoon or suck a straw. The occupational therapist puts
together supplies to bring to the child's home and plans activities
to use during the developmental evaluation. Which development
b
age is most important for the therapist to consider when selecting
objects and activities to bring to the evaluation session?
a) 6-9 months
b) 9-12 months
c) 12- 18 months
d) 18-20 months
140. An occupational therapist is instructing a patient who had a
left CVA on how to lock the brakes on a wheelchair. The patient is
right-handed and the right upper extremity has partial paralysis.
Based on motor learning theory, which is the best intervention
approach for the therapist to use when instructing the person to
a
lock the right brake?
a) Practice with the left hand first and then with the right.
b) Show the person how to use an extension brake.
c) Practice the locking motions with both hands simultaneously.
d) Have the patient use the left hand to assist the right hand.
141. An occupational therapist develops a protocol for a tropical
group to be implemented on an acute impatiens unit for individ-
uals recovering from substance abuse. Which intervention focus
is best for the occupational therapist to identify for this topical c
group?
a) The improvement of self-esteem.
b) The development of coping skills.

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c) The identification of leisure pursuits.
d) The practice of assertive behaviour.
142. An adult incurred several lacerations to the extrinsic flexor
tendons in Zone V of the hand. The tendons were surgically
repaired and have healed. The surgeon's most recent orders have
upgraded to active ROM without restrictions. The occupational
therapist is preparing for discharge and performs a final evalu-
ation, which reveals limitations in active finger flexion 10-20° of
full active ROM in the MCP, PIP and DIP joints of all fingers. The
b
therapist collaborates with the patient to prepare a home program.
Which intervention is most important for the therapist to include
in this program?
a) Use of resting splint.
b) Tendon gliding exercises
c) Weight-bearing activities
d) Home management tasks
143. A child with moderate Klumpke's paralysis on the right side
wants to cut meat. The child holds the fork with the right and the
knife in the left hand and practices with therapy putty. TO begin
cutting which is the best way to configure the therapy putty?
a
a) Flattened and placed directly on the table.
b) Rolled and placed on a plate on the table.
c) Flattened on a plate that rests on a non-skid mat.
d) Flattened and placed on a plate on the table.
144. During an occupational therapy intervention session, a client
with a left CVA demonstrates extinction to the right and a tendency
to ignore items on the right side. When documenting this behavior
what should the therapist report?
b
a) Agnosia
b) Unilateral inattention
c) Poor sight/ Left discrimination
d) Poor visual scanning
145. An individual with post-polio syndrome receives an occupa-
tional therapy re-evaluation of functional status. How should the
therapist initiate sensorytesting with this client?
a) Demonstrate the test with the individual's vision occluded. c
b) Proceed proximal to distal
c) Demonstrate the test with the client's vision not occluded.
d) Proceed distal to proximal
146. An occupational therapist is working with a preschool student
who was born with congenital cytomegalovirus (CMV) infection.
As a result, the child has difficulty seeing. THe child enjoys playing
with classmates but has difficulty when the play activity is highly
dependent on vision. Which of the following actions is best for the
therapist to recommend for improving the child's play experiences
d
with classmates?
a) Train a personal assistant to provide verbal cues during play
activities
b) Have the child read books in Braille aloud to the classmates
c) Train a classmate to guide the child during play activities.
d) Incorporate three-dimensional objects into play activities.
147. Upon screening, an eight-month-old child demonstrates a
positive downward parachute reflex. Which action should the
occupational therapist take next in response to this observed
behavior?
a
a) Document that the child exhibits normal reflex development.
b) Document that the child exhibits a developmental delay.
c) Evaluate the protective extension downward reflex.
d) Evaluate the standing reflex.

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148. The occupational therapist wishes to compare the results
of an evaluation of lateral pinch to the norms. Which is the best
positioning for the therapist to place the individual in when using
the pinch meter?
a) Forearm in neutral and pinch meter placed on the DIP joint.
b
b) Forearm in neutral and pinch meter placed on the middle
phalanx.
c) Forearm in pronation and pinch meter placed on the DIP joint.
d) Forearm in pronation and pinch meter placed on the middle
phalanx.
149. An elementary school-aged child is referred to occupational
therapy by a pediatrician. The pediatrician has ruled out attention
deficit disorder and notes that the child demonstrates poor school
performance and unexplained clumsiness. The occupational ther-
apist screens the child and determines that the child is a candi-
date for a sensory processing evaluation. Which skills are more
a
likely to have been observed to be intact during the screening and
needing no further evaluation?
a) Fine motor coordination.
b) Sequencing motor tasks
c) Initiation of activities.
d) Ocular pursuits.
150. A seven-year-old with complete spina bifida at the T10 level
attends outpatient OT weekly. The child's parent reports that the
child is losing bladder control. Upon re-evaluating the child, the
occupational therapist notes that the child shows minimal de-
crease in strength of bilateral lower and upper extremities and
an increase in the equinovarus position of the feet. The therapist
d
contracts the physician to report the child's change in status may
indicate which of the following?
a. Shunt malformation
b. A recent growth spurt
c. Arnold-Chiari formation
d. tethered cord
151. An occupational therapy assistant (OTA) recently attended
a two-day splinting workshop. The OTA asks the supervising
occupational therapist for a caseload that includes more clients
that require splinting interventions. Which action is best for the
occupational therapist to take in response to this request?
a. Decline the request because splinting ia an advanced practice c
skill
b. Ask the OTA to give a splinting in-service to demonstrate
acquired knowledge
c. Establish the OTA's service competency in splinting
d. Distribute the department's caseload to meet the OTA's request
152. An occupational therapist works with the new foster parent
of a twoyear-old child diagnosed with major developmental delays
and severe hypotonia. The therapist advises the foster parent
to position the head in midline during feeding. Which additional
positioning recommendations for feeding are best for this child? c
a. Sitting with hips and knees at 90°flexion, neck in neutral
b. Sitting with hips and knees at 90° flexion, neck in extension
c. Semi-reclined with neck in neutral
d. Semi-reclined with neck in extension
153. During an intervention session focused on developing home
management skills, a client made a grocery list. The client
grouped needed items together to make shopping easier and
listed eggs separately from all of the other items. When explaining b
how the list was composed, the client stated, "Eggs break, they
should be on top". Which of the following is the most accurate for
the occupational therapist to report that the client's approach to
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this task represents?
a. Diminished insight
b. Concreteness
c. Anosognosia
d. Poor sequencing
154. A client with a traumatic below-elbow amputation of dominant
right arm has participated in occupational therapy for prosthetic
training. The therapist prepares a discharge plan that incorporates
recommendations to facilitate independence in meal preparation
and feeding. Which method is best for the therapist to recommend
the client use to cut meat?
a. Hold a regular knife in the terminal device and hold a regular
d
fork in the left hand
b. Hold a knife with built-up handle in the terminal device and hold
the plate with the left hand
c. Use a one-handed technique with a rocker knife in the left and
hold the plate with the terminal device
d. Hold a regular form in the terminal device and hold a regular
knife in the left hand
155. An occupational therapist working for a partial hospital pro-
gram arranges the seats for a topical group. The room is small
and there are eight people in the group. Two of the members have
been diagnosed with schizophrenia, paranoid type. Which is the
best arrangement of the room for this composition?
a. Eight chairs placed around a table with assigned seats and the
therapist at the front of the room d
b. Nine chairs placed in a circle, with assigned seat and the
therapist between the two persons with schizophrenia
c. Two semi-circles of four chairs facing the therapist, with the two
patient with schizophrenia, in front row
d. Nine chairs placed in a circle, with no assigned seats for the
patients or therapist
156. A client exhibits residual difficulties in a variety of perceptual
skills. Which procedure should the therapist include in the evalu-
ation of the client's proprioception?
a. The therapist positions one extremity and asks the patient to
duplicated the position with the contralateral extremity
b. The therapist moved one extremity and asks the patient to a
duplicate the movement with contralateral extremity
c. The therapist demonstrates the desired position and asks the
person to replicate the position in mirror fashion
d. The therapist shows the client a picture of a position and asks
the client to replicate the position with each extremity
157. An occupational therapist implements a transitional program
for a high school student with a history of numerous school-relat-
ed failures. Which is the most important principle of intervention
for the therapist to use with this student?
a. Utilize activities that are typically at developmental level of a
middle school student to ensure successful completion
b
b. Grade an activity of interest into achievable steps to facilitate
successful completion
c. Introduce several activities during each session and change
them frequently to decrease boredom
d. Terminate the activity during a treatment session when there is
difficulty with activity completion to eliminate frustration
158. An elementary school-aged child incurred burns, lacerations,
and a femur fracture in a motor vehicle accident and was hos-
pitalized for three weeks. During outpatient occupational therapy
d
sessions, the parent expresses concern that the child has begum
wetting bed daily. Which professional is most relevant for the
occupational therapist to advise the parent to contract?
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a. A rehabilitation nurse to develop a bladder control program
b. A child life therapist for intervention for developmental delays
c. A psychiatric occupational therapist for behavior management
strategies
d. A clinical social worker to explore potential regression issues
159. The occupational therapist administers a standardized cog-
nitiveperceptual assessment to the client. The client demon-
strates difficulty performing the first two tasks of the evaluation.
Which is the most appropriate action for the therapist to take?
a. Continue the evaluation and provide verbal cued during task
c
performance
b. Continue the evaluation and model each evaluation task
c. Continue the evaluation according to the established adminis-
tration protocol
d. Discontinue the evaluation to avoid frustrating the client
160. During the evaluation, the occupational therapist observes
that the client has difficulty dealing with increasing amounts of
stimuli. This is observed in all modalities. Based on this obser-
vation, which cognitive perceptual dysfunction does the therapist
record as present when reporting the client's evaluation results? d
a. Inability to abstract
b. Poor organizational skills
c. Poor semantic memory
d. Generalized attention deficit
161. The occupational therapist uses a neurofunctional approach
to remediate the client's cognitive dysfunction. Which is most
appropriate for the occupational therapist to include in the inter-
vention program?
a
a. Functional activities in their real contexts
b. Client education on strategies to remediate deficits
c. Tabletop activities to practice remediation strategies
d. Computer games to develop performance component skills
162. During an intervention session using a transfer of training
approach, the occupational therapist gives the client a list of
items commonly found in a closet and asks the client to separate
the items into grooming and dressing items. Which skill is the
occupational therapist working on? a
a. Categorization
b. Sequencing
c. Problem solving
d. memory
163. The occupational therapist re-evaluates the client prior to
discharge from the rehabilitation center. The client exhibits resid-
ual cognitive deficits in problem solving. To develop requisite
problem solving skills for independent functioning at home, which
ability should the occupational therapist work on with the client
c
during OT intervention?
a. Performing routine morning self-care
b. Making a shopping list of grocery staples
c. Washing the family's laundry
d. Reading a bedtime story to the client's children
164. An elderly person has lost significant functional vision over
the last four years and complains of blurred vision and difficulty
reading. The patient frequently mistakes images directly in front,
especially in bright light. When walking across a room, the patient
is able to locate items in the environment using peripheral vision d
when items are located on both sides. Based on these findings,
which visual deficit should the occupational report the client is
exhibiting?
a. Glaucoma

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b. Presbyopia
c. Hemianopsia
d. Cataracts
165. The director of an occupational therapy driver rehabilitation
program must determine if the program is meeting its objectives.
Which of the following is most important for the director to mea-
sure during the evaluation of the program outcomes
a. Participants' satisfaction with program services
d
b. Family members' satisfaction with program services
c. The effect of program participation on participants' automobile
insurance premiums
d. The percentage of participants who successfully return to dri-
ving
166. An individual with an incomplete C6 spinal cord injury has a
secondary diagnosis of thromboangiitis obliterans. The occupa-
tional therapist conducts a pre-discharge home evaluation of the
client's rented apartment. Which is the most important area for the
therapist to assess?
a. The apartment's electrical capacity for an environmental control c
unit
b. The apartment's electrical capacity for an emergency call sys-
tem
c. The apartment's water temperature
d. The landlord's willingness to modify the bathroom
167. An occupational therapist receives a referral to evaluate an
individual's executive functioning following a mild cerebral vascu-
lar accident. Which are the most relevant foci for this evaluation?
a. The person's attention and memory d
b. The person's job interests and efficacy
c. The person's spatial relations and praxis
d. The person's initiation and planning
168. An occupational therapist is evaluating a child with devel-
opmental delay characterized by hypotonicity. According to the
Rood approach, which is the first stability pattern that the therapist
should facilitate during intervention?
c
a. roll over
b. quadruped
c. neck co-contraction
d. prone on elbows
169. A person recovering from skin grafting due to full thickness
burns is prescribed splints to immobilize the grafted areas in
antideformity positions. Which splint wearing schedule is best to
include in the splinting protocol; for the first 72 hours post-surgery
d
a. One hour on, with 10 minutes off
b. Four hours on, with 20 minutes off
c. Eight hours on, with 30 minutes off
d. On at all times, except for dressing changes
170. A child with tactile defensiveness is receiving intervention
from an occupational therapist using a sensory initiative ap-
proach. Which method is most effective for the therapist to use
when introducing tactical stimuli to the child?
a. Provide deep touch and firm pressure where the child can see
the stimuli
a
b. Apply the stimuli in the direction opposite of hair growth with
vision occluded
c. Apply light touch across the face and abdomen with vision
occluded
d. Provide light brushing across the palmar surface of the extrem-
ities with the child eatching

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