Johnson (SIMULATION EXAMINATION 2)

Study online at https://quizlet.com/_bqbu66

1. A 4 month-old infant being seen for an OT assessment shows
a strong preference for the left hand when reaching for a rattle
(A) Further observation and evaluation of right-sided dysfunction
at midline. Considering the development of dominance in normal
is indicated. Answer A is correct because infants usually use a
children, the OT practitioner should conclude that:
bilateral approach at this age. Although unilaterally occurs several
a. Further observation and evaluation of right sided is indicated
months later, most children alternate hands in many activities until
b. Development of hand dominance is proceeding in a typical
6 year. This means that this infant should be observed for possible
manner
right-sided dysfunction.
c. Hand dominance will not develop until age 1 year
d. Unilaterally precedes bilaterality in typical development
2. An OT practitioner is evaluating an individual who recently
sustained a cerebrovascular accident (CVA). The sensory portion (B) Receptive aphasia. Individuals with receptive aphasia cannot
of the test would be invalid for an individual with which one of the comprehend spoken or written words and symbols; therefore, they
following impairments? cannot understand verbal directions or consistently respond to
a. Expressive aphasia stimuli. Individuals with receptive aphasia may be able to imitate
b. Receptive aphasia or follow a demonstration, but these techniques do not work for
c. Agnosia sensory evaluation.
d. Ataxia
(C) Has a standard format. Standardization of a test means that
the test is administered in a prescribed manner and that scoring
3. In selecting a standardized test to use with a child, an OT and interpretation of scores are also completed in a prescribed
practitioner can assume that the test: way. The presence of data concerning the test's "norms" and the
a. is valid establishment of reliability and validity (answers A, B, and D) may
b. has normative data be, and often are, provided with standardized tests but are not
c. has a standard format assumed to be part of the test unless this information is included.
d. is reliable The aspects of standardized tests that are always assumed is the
specific and standardized method of administration, scoring, and
interpretation.
4. An OT practitioner is evaluating a client who is unable to
name or demonstrate the use of common household objects. The
practitioner documents this as:
(C) Visual agnosia. Visual agnosia is the ability to recognize com-
a. Apraxia
mon objects and demonstrate their use in an activity.
b. Stereognosis
c. Visual agnosia
d. Alexia
5. An OT practitioner is working with a client diagnosed with
a mild sprain. The client cradles her hand and appears to be
hypersensitive to light touch. The individual also presents with
(B) Reflex sympathetic dystrophy. This diagnosis is typically "a
edema, pain, shiny skin, and excessive dryness of the extremity.
disabling reaction to pain that is generated by an abnormal sym-
Based on this, the OT assumes that the client is MOST likely
pathetic reflex." Signs include pain, edema, coolness of the hand,
suffering from:
and blotchy skin. The level of trauma does not typically correlate
a. neuromas
to the amount of pain that the client is experiencing.
b. reflex sympathetic dystrophy
c. carpal tunnel syndrome
d. desensitization
6. A preschool child with spastic cerebral palsy uses "bunny-hop-
ping" for functional mobility during an OT evaluation. This indi-
(A) STNR. The correct answer is A because the STNR, when
cates that a primitive pattern is being used for mobility. Which of
present, provides the child with bilateral arm extension and hip
the following reflexes is MOST likely being used by the child?
flexion with the head raised (and bilateral arm flexion and hip
a. STNR
extension with the head lowered), which can be used to move
b. ATNR
forward.
c. TLR
d. neck righting reflex
7. An OT practitioner is evaluating a young cabinet maker who
complains of sensory changes over the dorsal thumb and prox-
imal phalanx of the index, long, and half of the ring finger. The
(C) Radial nerve. Injury to the radial in the wrist area causes
practitioner will MOST likely suspect involvement of the:
sensory damage only. This damage occurs to the radial two thirds
a. ulnar nerve
of the dorsum of the hand.
b. median nerve
c. radial nerve
d. brachial plexus

1 / 32
 Johnson (SIMULATION EXAMINATION 2)
Study online at https://quizlet.com/_bqbu66
8. A child has considerable difficulty with a problem solving when
playing with Legos and become frustrated and gives up easily.
This MOST likely indicates a problem in which area of play? (C) Constructional. Constructional play involves building and cre-
a. Sensorimotor ating things. It is in this area of play that children develop a sense
b. Imaginary of mastery and problem-solving skills.
c. Constructional
d. Game
9. An individual who had a stroke is copying a picture of a clock.
The drawing appears as a lopsided circle with a flat side on the left. (B) Left unilateral neglect. This is the inability to respond or orient
The numbers 1 through 8 are written in numerical order around to perceptions from the left side of the body. Evidenced as left
the right side of the clock. The hands are correctly drawn on unilateral neglect, this deficit is also apparent in the draw a man
the clock to represent three o'clock. The individual's performance test, flower copying test, house test, and completing a human
appears to demonstrate: figure or face puzzle. Unilateral neglect is contralateral to the side
a. right hemianopsia of a brain lesion; therefore, left unilateral neglect would result from
b. left unilateral neglect right-sided brain damage. Left neglect occurs most commonly in
c. cataracts in the left eye right hemisphere lesions.
d. bitemporal hemianopia
10.An individual demonstrates the ability to pick up a penny from
a flat surface. This represents which of the following prehension
(C) Tip. Tip prehension is accomplished by flexing the IP joint of
patterns?
the thumb and the PIP and DIP joints of the finger and bringing
a. Lateral
the tips of the thumb and finger together. This type of prehension
b. Palmar
is used to pick up objects such as a pin, nail, or coin.
c. Tip
d. Three-jaw chuck
11.An OT practitioner is informing a childs caregiver about when
developmental milestones of childhood occupations typically oc-
cur. The therapist reports that infants sit without support for a few
minutes by: (C) 8 to 9 months of age. "By 8 to 9 months the infant sits erect
a. 3 to 5 months of age and unsupported for several minutes."
b. 6 to 7 months of age
c. 8 to 9 months of age
d. 13 to 15 months of age
12.Of the following, the MOST important aspect of administering
a standardized test for an OT practitioner is the use of: (C) Stated instructions for administration and scoring. In standard-
a. subjective judgment to determine how best to administer the ized assessments, the instructions to the examiner are detailed
test and fixed so that procedures are followed consistently each time
b. previous experience as a way to gauge test results the test is administered. Following these instructions assures the
c. stated instructions for administration and scoring highest level of reliability and validity possible.
d. practice to learn the best way to administer and score the test
13.As part of an initial evaluation of an individual with carpal
tunnel syndrome, the OTR evaluates light touch sensation using
a cotton ball. After wearing a wrist splint for 2 weeks the patient
(A) A cotton ball. When retesting it is important to use the method
returns for re-evaluation, which the COTA performs. At this time,
used initially in order to make an accurate comparison of status
the MOST appropriate method for re-evaluation of light touch is
before and after treatment. In addition, evaluation results are more
to use:
consistent when the individual who performed the initial evaluation
a. a cotton ball
performs subsequent reevaluations.
b. an aesthesiometer
c. Semmes-Weinstein monofilaments
d. a pin or straightened paper clip
14.An OT practitioner conducting a hard assessment would use
(B) A pinch meter. A pinch meter is used to measure the strength
which instrument to measure the strength of the three-jaw chuck:
of a three-jaw chuck grasp (palmar pinch), in addition to key (later-
a. an aesthesiometer
al) pinch and tip pinch. These tests are performed with 3 trials that
b. a pinch meter
are averaged together and then compared with a standardized
c. a dynamometer
norm.
d. a volumeter
15.Infants and preschool children with musculoskeletal disorders
require ongoing examination of their upper extremity strength,
(C) Observation of play and hand function. The observation of
coordination, and functional abilities. The OT practitioner will ob-
play and hand function is the most appropriate way to obtain as-
tain the majority of assessment information during infancy and
preschool through:
2 / 32
 Johnson (SIMULATION EXAMINATION 2)
Study online at https://quizlet.com/_bqbu66
a. assessments related to the specific diagnosis that determines
hand function sessment information during infancy and preschool ages. "Much
b. dynamometer and pinch meter function of the assessment, during infancy and preschool, centers around
c. observation of play and hand function observation of play and hand function" (p. 609).
d. functional independence measures
16.Which of the following of the following performance compo-
nents are MOST important to consider when analyzing activities
for use with adults with psychosocial problems?
(A) The amount of self-control demands, time management de-
a. The amount of self-control demands, time management de-
mands, self-expression opportunities, and interest in the activity.
mands, self-expression opportunities, and interest in the activity
Components that are primarily within the psychosocial areas and
b. Age appropriateness, prehension patterns required, and the
skills of occupational performance are most important to consider
presence of small pieces that could be mistakenly swallowed
with psychosocial populations.
c. Tactile, kinesthetic, visual and olfactory properties
d. Space requirements, equipment and supply needs, cost and
safety considerations
17.During the evaluation of a child diagnosed with autism, the
child demonstrates craving for tactile stimulation, rubbing objects
on his arms and legs. He also avoids being touched by others, (A) Poor modulation of tactile input. This is the only answer that
The OTRs FIRST interpretation is that this is a sensory integration describes both his hypersensitive and hyposensitive responses
related to: to tactile input. The child with autism may be unpredictable in
a. poor modulation of tactile input terms of response to sensory stimuli, both avoiding and craving
b. hypersensitivity to tactile input stimulation at various times.
c. hyposensitivity to tactile input
d. poor modulation of proprioceptive input
18.An OT practitioner is treating a client who has a swallowing
limitation, partly caused by the inability to receive visual and
olfactory stimulation before eating. This limitation typically occurs
in which stage of the swallowing process? (A) Oral preparatory phase. The oral preparatory phase is typically
a. Oral preparatory phase initiated through the process of looking at and reaching for food.
b. Oral phase
c. Pharyngeal phase
d. Esophageal phase
19.A pre-schooler with a diagnosis of developmental delay is very
withdrawn and passive. While working on toilet skills, the child
reaches out for a toothbrush and starts brushing her hair with it.
(C) Indicating initiative and beginning task-directed behavior. Be-
The OT practitioner recognizes the PRIMARY importance of this
cause this child is very withdrawn, any spontaneous action should
behavior as:
be seen as a very positive sign. It is very important to encourage
a. demonstrating attention-getting behavior
the child in independent exploratory behavior in order to develop
b. a sign of cognitive limitation
task competence and become less withdrawn.
c. indicating initiative and beginning task-directed behavior
d. demonstrating misinterpretation of cues because of a visual
deficit
20.When a new patient is referred for psychiatric services, the
COTA and OTR both review the chart. The OTR then completes
performance measures, and the COTA performs an interview. The (D) View of the problem and an overall goal. The interview is
COTA/OTR team relies on the interview part of the assessment generally the component of the assessment process in which the
to address the individual's: OT practitioner asks about the individual's goals for treatment
a. diagnosis and gains an understanding of the problems from the person's
b. current medications perspective.
c. ability to concentrate and solve the problems
d. view of the problem and an overall goal
21.An OTR observes that an individual on a purees diet has
demonstrated a gurgle or wet voice after swallowing a second
(A) Videofluoroscopy. A videofluoroscopy should be performed
time. The diet had not been difficult for the individual until this
when it is suspected that the individual is aspirating. An individual
instance. The MOST appropriate recommendation for the OTR to
who suddenly has a wet voice when there was no prior difficulty
make is for this person to have a:
may have had a sudden change in medical status causing aspi-
a. videofluoroscopy
ration. He or she should be reevaluated to determine if there is
b. diet change to include thin liquids
aspiration into the larynx or trachea.
c. tracheostomy
d. regular diet

3 / 32
 Johnson (SIMULATION EXAMINATION 2)
Study online at https://quizlet.com/_bqbu66
22.A therapist is evaluating an individual with a peripheral nerve
injury for strength, range of motion and endurance. The most (C) Biomechanical FOR. The biomechanical approach is based
appropriate frame of reference on which to base the evaluation on enhancing strength, ROM, and endurance. The biomechanical
is: approach is typically used when impairment does not affect the
a. rehabilitative FOR interact CNS. This approach is primarily used for individuals who
b. neurodevelopmental FOR have had a traumatic injury or illness that has affected the mus-
c. biomechanical FOR culoskeletal system.
d. psychoanalytic FOR
23.An OT practitioner is attempting to decide which type of group
to institute within an acute psychiatric setting. The supervision
OT suggests the directive group treatment approach because it (D) Disorganized psychosis. Directive group treatment is a highly
is MOST appropriate in acute care mental health for individuals structured approach that is used in acute care psychiatry for
with: minimally functioning individuals. This approach is useful for dis-
a. substance abuse problems organized and disturbed functioning with patients with psychoses
b. eating disorders and other neurological disorders.
c. adjustment disorders
d. disorganized psychosis
(B) Observe him in his home during feeding time. "Considering
24.A toddler diagnosed with developmental delays dos not fin-
the context of the child's environments is a critical process in
ger-feed when presented with food in the clinic. The BEST way to
occupational therapy assessments." The reason he does not feed
obtain further information about his feeding skills is to:
himself may be environmental - for instance, his parents may have
a. interview his parents to determine his favorite foods
taught him not to touch food with his fingers or he may not have
b. observe him in his home during feeding time
learned to feed himself because his grandmother always feeds
c. review his chart for food allergies
him. Or the child may not be able to transfer skills learned at home
d. repeat the observation in a quiet area (in order to minimize
to the clinic - that is, he may believe that "the place to eat is home,
distractions)
not the clinic."
(A) Within normal limits. The normal ROM for internal rotation is 70
degrees. Rotation can be assessed with the humerus adducted
against the trunk or with the SH abducted at 90 degrees. If the
humeral movements for IR or ER are observed during the per-
formance of any functional activities, the ROM may be noted as
WFL. The OT practitioner may choose not to perform a formal joint
25.An OT practitioner is assessing the range of motion of an
measurement if the joint is WFL; even though the end of the range
individual who demonstrates internal rotation of the shoulder to
may be lacking a few degrees, because the loss of movement
70 degrees. The practitioner would MOST likely document the
may not be significant to the individual. Hypermobility at a joint is
patient's active range of motion:
motion past the average ROM, which at the SH would be past 70
a. within normal limits
degrees of IR. If hypermobility is a deformity caused by an unsta-
b. within functional limits (WFL)
ble joint as might occur after a surgical repair or a disease process,
c. hypermobility that requires further treatment
then splinting or another form of stabilization or immobilization
d. limited mobility that requires further treatment
can be used to correct the problem. If the practitioner observes
hypermobility during ROM, he/she should compare the ROM to
that on the individual's opposite side in order to assess normal
range. A limitation of IR at the SH would be less than 70 degrees
of motion. If a limitation is apparent, the rehabilitation team may
choose not to treat it unless it interferes with function of the UE.
26.The OT practitioner is evaluating two-point discrimination in (A) Apply the stimuli beginning at an area distal to the lesion pro-
an individual with a median nerve injury. The MOST appropriate gressing proximally. The general guidelines for sensation testing
procedure is to: are that the person's vision should be occluded, the stimuli should
a. apply the stimuli beginning at an area distal to the lesion be randomly applied with false stimuli intermingled (opposite of
progression proximally answer C), a practice trial should be performed before the test,
b. test the involved area first, then the uninvolved area and the unaffected side or area should be tested before the
c. present test stimuli in an organized pattern to improve reliability affected side or area (opposite of answer B). Also, the tested
during retesting individual should be given a specified amount of time in which to
d. allow the individual unlimited time to respond respond; therefore, answer D is incorrect.
27.While in the hospital, a 48-year-old roofing contractor experi-
enced extrapyramidal syndrome after being placed on neuroleptic (B) Avoid use of power tools and sharp instruments. Individuals
medications. The patient is to continue taking the medications experiencing extrapyramidal syndrome, which may cause muscu-
after discharge from the hospital. It is MOST important to advise lar rigidity, tremors, and/or sudden muscle spasms, should avoid
the patient to: using power tools or sharp instruments. All of the above are
a. keep time in the sun as brief as possible possible side effects of neuroleptic medications, but answer B is
b. avoid use of power tools and sharp instruments
4 / 32
 Johnson (SIMULATION EXAMINATION 2)
Study online at https://quizlet.com/_bqbu66
c. get up slowly from a standing, sitting or lying position
most important because it relates to the only side effect the client
d. be aware of the dehydrating effects of caffeinated drinks and
has experienced.
alcohol
28.During an initial visit with a 5 year old child with a suspected
learning disability, the OT observes the child run across the room,
hop around on one foot, pick up a pencil, and draw a stick figure (D) Visual perceptual. Running, hopping, using a tripod grasp,
using a tripod grasp. When asked to complete a four-piece puzzle, drawing a stick figure, and putting together a 10-piece puzzle
the child gives up after several unsuccessful attempts. Which type are all developmentally appropriate skills for a 5-year-old child.
of assessment would MOST effectively address this child's area Although the child cannot put together the 10-piece puzzle, the
of difficulty? gross and fine motor skills that doing a puzzle require have been
a. Fine motor observed. Because gross, fine, and developmental skills appear
b. Gross motor to be appropriate, visual perception should be evaluated.
c. Developmental
d. Visual perceptual
(B) Compares performance with a normal standard. Norm ref-
29.In using an assessment that is "norm referenced" for children, erencing is a term applied to standardized or format tests that
the OT practitioner assumes that the test: have been given to a large number of persons in a specific
a. measures normal behavior of children population called the normative sample. When a child is tested
b. compares performance with a normal standard with a norm-referenced test, the scores are compared with those
c. is valid and reliable of the normative sample: this provides information on how a child
d. should be used with a normal population performs compared with the average performance of the norma-
tive sample.
30.A patient who has had a traumatic brain injury is beginning
OT. The OTR practitioner needs to assess whether this person (C) Have the patient get dressed in a certain way, then change the
can transfer learning from one activity to another in order to plan task at the next session. Giving the patient a functional task then
treatment appropriate way for an T to observe this learning ability changing and observing how he responds will tell the therapist
would be to: how well the patient can transfer learning to new situations. If
a. describe situations that might be unsafe and ask the patient the patient can't perform the activity when it is changed slightly,
how he would respond it suggests there may be difficulty with new learning. If the patient
b. give the patient a simple jigsaw puzzle to solve can perform the activity with many changes and in a different
c. have the patient get dressed in certain way, then change the setting, it suggests that he has more capacity for transfer of
task at the next session learning to new situations.
d. give the patient simple calculations performs
31.The MOST appropriate assessment instrument for the OT
practitioner to use for measuring range of motion of the hand is:
a. a goniometer (A) A goniometer. A goniometer measures available joint move-
b. a dynamometer ment.
c. a pinch meter
d. an aesthesiometer
32.A client experiences chronic pain while engaged in household
chores. Because of this pain, the client avoids actions that require
motor performance. OTR observes a MOTOR response to pain,
as demonstrated by the patient's: (C) Repeated protecting of the joints while moving. An individual's
a. inability to concentrate on tasks because of pain protecting the joints while moving is an example of a motor re-
b. frequent complaints of aching pain sponse associated with chronic pain.
c. repeated protecting of the joints while moving
d. refusal to partake in certain ADL to prevent the accompanying
pain
33.A client who recently started using a wheelchair will be re-
turning to work and OTR is evaluating the client's work place
for accessibility, according to ADA guidelines. The doorway to (A) The doorway width needs to be expanded to have a mini-
the client's office has a clear opening of 28 inches. Which of mum clear opening of 32 inches. According the ADA accessibility
the following recommendations would be MOST appropriate to guidelines, a doorway needs to have a minimum clear opening
facilitate clear passage of the wheelchair through the doorway? of 32 inches with the door open 90 degrees, measured between
a. The doorway width needs to be expanded to have a minimum the face of the door and the opposite stop. In an environmental
clear opening of 32 inches evaluation process, according to ADA guidelines, the doorway
b. The client needs to obtain a wheelchair narrower than 28 rather than the individual's wheelchair needs to be adapted.
inches
c. The doorway width needs to be expanded to have minimum

5 / 32
 Johnson (SIMULATION EXAMINATION 2)
Study online at https://quizlet.com/_bqbu66
clear opening of 45 inches
d. The doorway width is satisfactorily and needs no modification
34.An OT practitioner is administering a standard test to a young
client who suddenly becomes uncooperative and complains that
the test is "too hard." The MOST appropriate response for the OT
practitioner would be to: (C) Follow administration instructions and note changes in behav-
a. switch to easier items to improve the child's self-esteem ior. Although the tester may not deviate from the protocol, changes
b. terminate the session and schedule another session for the on behavior represent important test data and should be recorded.
remainder of the test
c. follow administration instructions and note changes in behavior
d. adapt the remaining test items to ensure success
35.A therapist reviews an individual's chart as part of the screen-
ing process. The psychiatrist has written "observe for side ef-
fects with current anti-anxiety medications." The OT practitioner
(B) Confusion. Medication side effects are observe and reported
is MOST likely to report about which of the following side effects?
by OTs and OT assistants. Antianxiety medications often cause
a. akathisia
confusion.
b. confusion
c. extrapyramidal syndrome
d. tardive dyskinesia
36.An OT practitioner is performing a home management evalu-
ation of an ambulatory individual with cerebral palsy (CP) who is
(A) Safety and stability. Incoordination, tremors, ataxia and
cognitively intact but exhibits and ataxic gait pattern. The PRIMA-
athetoid movements may result from conditions that affect the
RY focus if the evaluation should be on:
CNS, such as Parkinson's disease, CP, multiple sclerosis (MS),
a. safety and stability
and head injuries. "The major problems encountered in ADL per-
b. the individual's ability to reach and bend
formance are safety and adequate stability of gait, body parts and
c. whether the individual has adequate strength to perform home-
objects to complete the task."
making tasks
d. fatigue and endurance level
37.A child avoids playground equipment that requires her feet to
(C) Gravitational insecurity. Gravitational insecurity is described
be off the ground. This behavior MOST likely indicates:
as "excessive fear during ordinary movement activities." The child
a. tactile defensiveness
easily experiences a fear of falling and prefers to keep his or her
b. developmental dyspraxia
feet firmly on the ground. Gravitational insecurity, on the other
c. gravitational insecurity
hand, is associated with the utricle and saccule.
d. intolerance for motion
38.The OT treatment approach that will MOST likely meet the
overall needs experienced by individuals with substance abuse
problems is to:
(A) Assist with skill development in the areas of leisure, cognition
a. assist with skill development in the areas of leisure, cognition
and perception, selfexpression, and ADL. In general, the areas of
and perception, self-expression, and ADL
focus with OT intervention for individuals identified with substance
b. educate the family members about making safety modifications
abuse problems are alternative leisure time use, improved ex-
to the kitchen area
pression of feelings, and the acquiring of social and occupational
c. encourage Alcoholics Anonymous (AA) involvement; provide
roles.
retraining of neglected ADL; explore work-related values
d. make aftercare arrangements for vocational counselling and
AA; provide time management; education for self-care activities
39.Evaluation results for a person with arthritis will MOST accu-
(D) Early morning and again in the afternoon. Individuals with
rately reflect true functional abilities if scheduled:
arthritis should be evaluated at both times to assess the functional
a. early morning (8 to 10 AM)
abilities of the individual during and after morning stiffness. Indi-
b. afternoon
viduals with arthritis have many changes in functional status after
c. late morning (10 to 11 AM)
morning stiffness has disappeared.
d. early morning and again in the afternoon
40.After many months of therapy, a pre-school child with Down
syndrome has begun to demonstrate protective reactions when (B) SH flexion and abduction and elbow extension. Protective
falling forward. Which of the following BEST describes the type of arm reactions allow one to return to a support base or to protect
movement that has been demonstrated? the body when there are environmental changes. Answer B is
a. Shoulder flexion, internal rotation and shoulder adduction the correct answer because the shoulders flex and abduct while
b. Shoulder flexion and abduction and elbow extension the elbows extend during this protective movement. Facilitation of
c. Shoulder internal rotation and elbow extension protective reactions may be a beginning point for the development
d. Shoulder hyperextension and external rotation and elbow flex- of arm extension in treatment.
ion

6 / 32
 Johnson (SIMULATION EXAMINATION 2)
Study online at https://quizlet.com/_bqbu66
41.An OT practitioner in a work-hardening program needs back-
ground information about an individual's work history. The BEST
method for obtaining detailed information about the individual's (B) Examining an analysis of the individual's job. The job analysis
job requirements is: is a detailed description of the physical, sensory, and psychologi-
a. interviewing the individual cal demands of a job. Examples of performance requirements in-
b. examining an analysis of the individual's job clude tasks such as lifting, walking, sitting, standing, and reaching,
c. looking up the individual's job in the Dictionary of Occupational as well as seeing, hearing, and interpersonal skills.
Titles
d. requesting information from the referring physician
42.An OT practitioner is reviewing a patients chart before evalu-
ating the patients chart before evaluating the patient. Based on
the physician's history and physical examination, the practitioner
(A) Procedural reasoning. Reasoning based on corresponding
is able to identify the patient's deficits and assessments that will
an individual's deficits and physical symptoms with a procedure
best assess the problem areas. This form of clinical reasoning is
that may benefit the area is referred to as procedural reasoning.
MOST likely an example of:
Procedural reasoning is the process of identifying a particular
a. procedural reasoning
treatment or procedure.
b. conditional reasoning
c. interactive reasoning
d. narrative reasoning
(B) Lateral trunk stability. An individual who is uncoordinated or
has poor head control would not be able to control the mobile arm
support to bring the hand safely to the mouth without hitting the
43.In assessing if a person is a candidate for using a mobile arm face or some other area. Also poor head control would mean that
support, the OT practitioner would have to determine if the person the individual's head would be out of alignment for the hand to
demonstrate which of the following? reach, or the person would be unable to see properly to control
a. incoordination the mobile arm support. An individual with fair plus (3+) elbow
b. lateral trunk stability flexion would be able to stabilize the elbow on the table to bring the
c. fair plus elbow flexion hand to the mouth and would have enough strength to move the
d. poor head control arm without the mobile arm support. For the mobile arm support
to perform properly, the individual's trunk needs to be stabilized
laterally by his/her own control or with positioning devices to
provide a stable base from which the arm may move.
(D) Adapted teaching techniques. Answer D is correct because
a child with this type of disability characteristically has learning
44.In planning a therapeutic dressing program for a first grade problems that require such teaching methods as "chaining" or
child who is mentally retarded, the therapist's FIRST considera- behavior modification. Answers A, B, and C are of secondary
tion should be the need for: importance because physical coordination may be impaired or
a. adaptive equipment other physical limitations such as abnormal muscle tone or sig-
b. adaptive clothing nificant problems with balance could also be present. These ad-
c. proper positioning ditional problems may require adaptive equipment, clothing, or
d. adapted teaching techniques techniques. However, all aspects of dressing depend on the child's
ability to learn procedures of dressing; therefore, it is necessary
to consider task analysis and teaching approach first.
45.An OT practitioner is selecting treatment activities to see with
a young adult diagnosed with a young adult diagnosed with
schizophrenia, undifferentiated type that would help to increase
the patient's ability to receive, process, and respond to sensory (B) Vestibular stimulation and gross motor exercise. The SI treat-
information. The MOST suitable activities for this patient would ment approach, which aims to improve the reception and process-
include: ing of sensory information within the CNS, uses both vestibular
a. social skills training stimulation and gross motor exercises (answer B).
b. vestibular stimulation and gross motor exercise
c. role-playing
d. discussion group
46.After a radial nerve injury, an individual initially had trace
muscle strength in elbow extension. One week later, strength is (B) Extending the elbow in mid-range 30 to 40 degrees with the
noted to have increased to poor minus. The individual is ready for forearm arm resting on the table surface. Extending the elbow in
which activity? mid-range 30 to 40 degrees while the arm is resting on a table
a. passively self-ranging the injured arm surface would be active assisted ROM with gravity eliminated.
b. extending the elbow in mid-range 30 to 40 degrees with the Muscles with poor minus strength would only be able to move a
forearm resting on the table on the table body part through partial ROM in a gravity eliminated position. The
c. pushing a cup filled with pennies with the back of the hand, with
7 / 32
 Johnson (SIMULATION EXAMINATION 2)
Study online at https://quizlet.com/_bqbu66
arm resting on the table individual would then need assistance to complete the ROM while
d. lifting a book placed on the back of the hand up off the table using what strength is available in the body part.
47.A child has poor independent sitting skills as a result of inad-
(B) Wide-base sitting on the floor while reaching for a suspended
equate postural reactions. The FIRST activity the OTR would use
balloon. The child first practices skills in unsupported sitting on a
to promote the development if independent sitting:
stable surface using a wide base of support. As skills improve, the
a. swinging on a playground swing with a bucket seat
wide base is reduced to a more narrow one. Reaching activities
b. wide-base sitting on the floor while batting a ball
are used to promote postural reactions, because they involve
c. straddling a bolster swing while batting a ball
displacement of the center of gravity and weight shifting.
d. riding a hippity-hop, while hand for support
48.An OT practitioner has been asked to develop a program of
self-awareness activities for a group of substance abusers. A (B) Are structured by the OT practitioner to encourage self-reflec-
graded program to develop an individual's self-awareness MUST tion and feedback. For a graded program designed to develop an
include activities that: individual's self-awareness, the most essential ingredient is the
a. encourage self-awareness opportunity to verbalize one's ideas and feelings and to receive
b. are structured by the OT practitioner to encourage self-reflec- feedback from others in a safe setting. Therefore, it is not the
tion and feedback activities that are graded but the way the OT practitioner structures
c. provide opportunities for the patient to be self-aware the activities to encourage self-reflection and feedback.
d. allow for increasing social interaction
49.An OT practitioner is working with a child who has a mild
spastic cerebral palsy. The evaluation has shown that the child
(D) Removing a nut from a bolt. Answer D describes one type of
has poor in-hand manipulation skills. What type of activity would
in-hand manipulation called rotation. Rotation is the movement of
be BEST for practicing this ability?
an object around one or more of its axes, where objects may be
a. grasping blocks to build a building
turned horizontally or end over end with the pads of the fingers,
b. placing pegs from one pegboard to another
as when one would unscrew a nut from a bolt.
c. carrying a bag of Lego blocks with a handle
d. removing a nut from a bolt
50.An OT practitioner is fabricating a splint for an individual who
has a carpal tunnel syndrome. Which of the following splint fab-
rication techniques should be adhered to in order to allow for
adequate digit motion?
(C) Trim lines of the splint should extend proximal to the MCP
a. Trim line of the splints should extend distal to the MCP crease
crease. Trim lines of a splint that extend proximal to the MCP
b. Trim lines of the splint should extend proximal to the DIP joint
crease allow for adequate MCP digit extension and flexion.
c. Trim lines of the splint should extend proximal to the MCP
crease
d. Trim lines of the splint should extend distal to the ulnar 5th MCP
crease
51.An OT practitioner is beginning training in meal preparation
with a homemaker after a TBI. The activity that should be intro- (C) Pouring a glass of orange juice. Meal preparation is graded
duced FIRST is: from cold to hot foods or beverages and from simple to multiple
a. making a peanut butter and jelly sandwich steps. An individual beginning meal preparation training should
b. preparing a hot cup of tea with sugar start with a cold item involving the least number of steps possible,
c. pouring a glass of orange juice such as pouring a glass of juice or other cold beverage.
d. cooking a grilled ham and cheese sandwich
52.The occupational therapist is developing a treatment plan for a (D) Cognitive planning. Praxis or motor planning refers to the
child with motor planning deficits. The MOST important emphasis ability to attend to and plan a motor act cognitively, based on
of motor planning activities for the child will be on activities that adequate sensory input (answer D). Dr. Ayres referred to this
promote: function as the highest, most complex of children's motor func-
a. automatic movement tions, involving conscious attention that is closely linked to metal
b. reflexes and intellectual functions. Automatic and reflex motor activity, as
c. coordination well as coordination of the motor act, do not require attention or
d. cognitive planning volition; it is enough to have a general goal in mind.
53.An OT practitioner wants to alter the seating arrangement (B) Provide enough chairs around a round table. Circular seating
of a community skills group in order to facilitate communication arrangements generally facilitate the most communication among
amongst the members. The BEST arrangement would be to: members. Rectangular tables can lead to unbalanced commu-
a. provide enough chairs around a rectangle table nications. Difficulties in maintaining comfort and attention are
b. provide enough chairs around a round table problems related to floor seating arrangements. Using available
c. provide enough pillows to sit on the floor chairs and couches frequently provides different seating heights
d. use the couches and chairs that are already in the room often in rectangular or square arrangements.

8 / 32
 Johnson (SIMULATION EXAMINATION 2)
Study online at https://quizlet.com/_bqbu66
(C) Have the individual trace lines across the page with the
right index finger from the left to the right side. A person who
54.An individual with right unilateral neglect is able to track from follows a line when wheeling a wheelchair is focusing on midline
the left side to the midline of the body on paper and pencil tasks. positioning, not crossing the midline. Placing objects commonly
The BEST treatment activity for this person to work on crossing used on the unaffected side is a compensatory technique that
the midline to improve writing would to be: does not involve crossing the midline. The individual with midline
a. have the individual practices wheeling a wheelchair following a problems would need cueing to avoid starting at the midline when
taped line in the floor attempting to lay cards out from the right to left side. Also, the
b. place commonly used self-care items on the left side person would have difficulty accurately completing a sequencing
c. have the individual trace lines across the page with the right task on the neglected side, making it difficult to complete the
index finger from the left to the right side midline crossing successfully. However, when tracing a line across
d. place playing cards in a horizontal row from right to the left in the page, the individual receives the same proprioceptive input
sequence from the movement, and uses the same amount of space in the
visual field, as when writing on paper. This task makes the transfer
of skills easier when performing writing
(C) Have the individual trace lines across the page with the
right index finger from the left to the right side. A person who
55.An individual with right unilateral neglect is able to track from follows a line when wheeling a wheelchair is focusing on midline
the left side to the midline of the body on paper-and-pencil tasks. positioning, not crossing the midline. Placing objects commonly
The BEST treatment activity for this person to work on crossing used on the unaffected side is a compensatory technique that
the midline to improve writing would be to: does not involve crossing the midline. The individual with midline
a. Have the individual practice wheeling a wheelchair following a problems would need cueing to avoid starting at the midline when
taped line on the floor. attempting to lay cards out from the right to left side. Also, the
b. Place commonly used self-care items on the left side. person would have difficulty accurately completing a sequencing
c. Have the individual trace lines across the page with the right task on the neglected side, making it difficult to complete the
index finger from the left to the right side. midline crossing successfully. However, when tracing a line across
d. Place playing cards in a horizontal row from right to left in the page, the individual receives the same proprioceptive input
sequence from the movement, and uses the same amount of space in the
visual field, as when writing on paper. This task makes the transfer
of skills easier when performing writing
56.To promote play skills and self-expression in a child who is
withdrawn, an OT practitioner should FIRST select activities that:
a. promote open-ended symbolic play, such as using action fig- (A) Promote open-ended symbolic play, such as using action
ures, puppets and dolls figures, and dolls. Toys that elicit feelings and expression can be
b. provide a defined structure, such as simple craft activities with used to promote beginning play skills and beginning interaction
instructions and communication skills. Inherit in open-ended play is the fact
c. promote social interaction, such as game of tag with peers that there is no right or wrong way - that failure is not possible.
d. provide a means of tension release, such as leather tooling or
wedging clay
57.An OT practitioner is working with an individual with amy-
otrophic lateral sclerosis (ALS) who is no longer able to ambulate
(A) Meal preparation techniques using a wheelchair. As the dis-
for kitchen or home management activities. Which of the following
ease progresses, individuals with ALS lose the strength required
interventions BEST addresses the goals of independence in meal
for ambulation and begin to use wheelchairs. Therefore, the de-
preparation for this individual?
velopment of meal preparation skills using a wheelchair, such as
a. Meal preparation techniques using a wheelchair
transportation of items, addressing work heights, using adaptive
b. Training in the use of adapted cooking equipment
equipment (answer A encompasses answer B), and safety issues,
c. Simple cooking activities while standing at the counter for
is the best answer.
gradually increasing amounts of time
d. Begin with cold meals and progress to hot meals
58.An individual with Alzheimer's disease has difficulty following
multiple step instructions. Which method will the OT practitioner
instruct the caregiver to use when presenting instructions?
(A) Give one- or two-step instructions frequently repeated. The
a. Give one or two-step instructions frequently repeated
best method to use with an individual with Alzheimer's disease is
b. Provide three-step instructions with gestures for demonstration
short instructions of one to two steps keeping them to the point
c. Write instructions down that are over three steps for the indi-
and repeating them frequently.
vidual
d. Have individual verbally repeat instruction after the therapist
gives them
59.An individual with a cognitive disability has recently joined a
sheltered workshop setting and has been referred to for assign-
ment to the appropriate group. The individual demonstrates the
9 / 32
 Johnson (SIMULATION EXAMINATION 2)
Study online at https://quizlet.com/_bqbu66
ability to copy demonstrated directions presented one step at a
time and visualizes an end product. However, the individual is
unable to recognize errors and may not be able to correct them
when they are pointed out. The MOST appropriate group for this (B) Assembling packets that include a knife, fork, spoon, and
individual is the one involved with: napkin based on a sample. This individual is functioning at Allen's
a. sorting plastic utensil into separate containers Cognitive Level 4. Individuals functioning at this level are able
b. assembling packets that include a knife, fork, spoon, and napkin to copy demonstrated directions presented one step at a time.
based on sample They find it easier to copy a sample than to follow directions or
c. selecting matching shoelace from a mixed pile and lacing them diagrams.
onto a display card
d. gluing labels to cans and placing them in the appropriate
container according to color
60.When providing occupational therapy for children who have
been diagnosed with a terminal illness, the PRIMARY focus for (B) Play and self-care activities. "When providing OT care for
OT intervention would be: children with terminal illness, the underlying principle is to add
a. educational activities quality to their remaining days. There are 2 performance areas
b. play and self-care activities that OTs should address in children with terminal illness: (1) play
c. socialization activities activities and (2) ADL."
d. motor activities
61.The goal for an adolescent with anorexia is to improve
self-concept. Which component of a meal preparation activity
BEST addresses this goal?
(D) State strengths and limitations regarding performance in the
a. Participate in a nutrition group and plan a healthy meal
activity. Self-concept is defined as the value of one's physical and
b. Develop a budget and shop for ingredients with three other
emotional self. Stating one's strengths and limitations about one's
group members c. Delegate tasks and prepare the meal with three
own performance is a reflection of an individual self-concept.
other group members
d. State strengths and limitations regarding performance in one
activity
62.In establishing long term goals for an individual with T4 para-
plegia in a rehabilitation setting, the OT practitioner would MOST
likely predict that the patient will attain what level of independent
with bathing, dressing, and transfers? (A) Complete independence with self-care and transfers. An in-
a. complete independence with self-care and transfers dividual with T4 paraplegia will have sufficient trunk balance and
b. independence with self-care and minimal assistance with trans- UE strength and coordination to complete self-care and transfers
fers independently.
c. minimal assistance with self-care and moderate assistance with
transfers
d. dependence with both self-care and transfers
63.A therapist is working with an individual who was admitted to
an inpatient psychiatric program for major depression. This indi-
vidual is also diagnosed with stage 4 acquired immunodeficiency
(A) Restore and maintain functional performance of self-chosen
syndrome (AIDS). The BEST general focus of treatment at this
occupations that enhance competent performance of valued oc-
point would be to:
cupational roles. The depression is likely to be in reaction to
a. restore and maintain functional performance of self-chosen
the individual's AIDS disease and major loss of functioning at
occupations that enhance competent performance of value oc-
stage 4. Stage 4 of AIDS generally means severe physical and
cupational roles
neurological changes. Because the change of function can be
b. increase physical endurance and maintain desired self-care
broad, answer A is the most comprehensive approach. Answers
task
B, C, and D are to restrictive to be a "major focus". Also, restoration
c. facilitate resolution of current and anticipated losses though the
of work is typically unrealistic at stage 4 of AIDS.
grieving process
d. restore and maintain functional performance of the individual's
primary work role
64.An older adult with diabetes is working on a macramé project
as a way of increasing standing tolerance. The MOST relevant (C) Texture of the cords she will be using. Coarse materials like
safety factor for the OT practitioner to take into consideration is jute may shred and give splinters or injure the skin on hands
the: and fingers. This is particularly important for individuals with di-
a. length of the cords she will start with abetes who frequently have poor sensation and circulation in
b. thickness of the cords she will be using their extremities. Skin damage must be avoided since healing is
c. texture of the cords she will be using compromised.
d. type of surface she will be standing on

10 / 32
 Johnson (SIMULATION EXAMINATION 2)
Study online at https://quizlet.com/_bqbu66
65.The OT practitioner is selecting activities for an 8-year-old
child with Duchenne's muscular dystrophy. Which of the follow- (D) Reinforcement of competence. According to Erikson, an
ing developmental issues is MOST important to consider when 8-year-old is usually at the stage of industry versus inferiority,
identifying activities for this child? during which he or she develops a sense of competency. For a
a. Establishment of basic trust client who is expected to lose motor function gradually, a treatment
b. Freedom to use his initiative plan that will provide him with an ongoing sense of competence
c. Development of self-identity (possibly in other areas) is especially relevant.
d. Reinforcement of competence
66.The OT practitioner working in partial hospitalization program
needs to select a game that allows group members equal op-
portunities to win and can be played by individuals functioning at
(C) Games of chance. Because winning a game of chance is
various levels. The game type the BEST suits this purpose is:
based essentially on luck. Individuals functioning at various func-
a. games of strategy
tional levels have "equal" opportunities to win.
b. hobbies
c. games of chance
d. competitive games
67.An OT practitioner is working with a man diagnosed with schiz-
ophrenia. He states that his main goal is to have a girlfriend. Which
of the following statements is the MOST appropriate example of
a short term goal?
a. The client will develop a friendship with a female within 6 (D) During 1 to 2 conversations with female group members, the
months client will make eye contact for 8 to 10 seconds, two times in each
b. After each group session, the client will identify the ways in half-hour socialization group. The short-term goal that describes
which his disability has interfered with his thinking processes. appropriate verbal and nonverbal interactions with female peers
c. The client will initiate appropriate, casual greetings when be- is the best answer.
ginning casual conversations with female staff.
d. During one to two conversations with female group members,
the client will make eye contact for 8 to 10 seconds, two times in
each half-hour socialization group.
68.An OT practitioner is working with a client in a work program
setting. What is the FIRST step to achieving the program objective
of preventing reinjury within a work program? (B) Learning proper body mechanics. Learning proper body me-
a. performing a prework screening chanics (along with achieving a good fitness level) is one of the
b. learning proper body mechanics first steps to reducing the risk of reinjury in a work program.
c. participating in work hardening
d. engaging in vocational counselling
69.When planning a therapeutic program for a child who has
deficits in visual discrimination, the FIRST step is to provide
matching activities that require: (D) The ability to recognize objects. Answer D is correct because
a. discrimination among the colors of objects a child must be able to recognize an object before he/she can
b. discrimination among the shapes of objects discriminate among its specific visual attribute.
c. discrimination among the positions objects
d. the ability to recognized objects
70.An OT practitioner is fabricating a splint for a client who has
rheumatoid arthritis. Which of the following splints is MOST ap-
propriate for the purpose of resting the joint, decreasing of pain,
and preventing contractures? (D) A volar resting splint. A volar resting splint is indicated for acute
a. a protective MP joint splint synovitis of the wrist, fingers and thumb.
b. a wrist stabilization splint
c. an ulnar drift positioning splint
d. a volar resting splint
71.An OT practitioner is using a visual perceptual frame of refer-
ence. Which of the following would be the FIRST step in planning
(B) Visual attention skills. According to Todd, answer B is correct
a program for a child with visual perceptual problems?
because development of visual attention skills should be worked
a. Visual memory skills
on first because they prepare and provide foundation skills for
b. Visual attention skills
other aspects of visual perception.
c. General visual discrimination skills
d. Specific visual discrimination skills
(C) Modify the environment to protect the infant from excessive
and/or inappropriate sensory stimulation prior to direct interven-
11 / 32
 Johnson (SIMULATION EXAMINATION 2)
Study online at https://quizlet.com/_bqbu66
72.An OT receives a consult for an infant in the neonatal intensive
tion. Neonatal Abstinence Score (NAS) infants have multiple sen-
care unit (NICU) with a history of maternal drug abuse during
sory needs often resulting in poor self-regulation and behavioral
pregnancy. Using a sensory integrative approach, what is the
organization. Answers C and D both incorporate SI approaches;
FIRST action the OT should take?
however, answer C best demonstrates an initial intervention to
a. Determine the mother's current medical status, parental in-
promote neurobehavioral organization required to tolerate direct
volvement and support systems.
handling. Answers A and B are important in determining ap-
b. Recommend a social work referral to address social concerns,
propriate treatment plans for the infant and family. However, a
provide emotional support and community program information
social work referral should be made after initial assessments are
and make a referral to the department of human services.
completed, to make the most appropriate recommendations for
c. Modify the environment to protect the infant from excessive
social service involvement if needed. Although identifying ma-
and/or inappropriate sensory stimulation prior to direct interven-
ternal medical status and treatment compliance issues are of
tion.
great importance for an OT to best determine educational and
d. Assess motor and behavioral skills to identify areas of develop-
disposition recommendations, it is not the OT's primary sensory
mental delay in order to educate family and medical staff of nec-
intervention focus.
essary positional and environmental strategies for skill acquisition
73.After one session with a new patient in a psychosocial treat-
ment setting, it has become apparent that the patient is highly
distractible and cannot complete a magazine collage in a group. (D) Position the patient so she is facing a blank wall. One way to
The BEST approach for the OT practitioner to take is to: modify the environment for an individual who is easily distracted
a. speak slowly and softly to the patient is to position him or her facing a blank wall (answer D), thereby
b. coax and praise the patient until she completes the task lessening possible distracters.
c. ask the rest of the group member to stop talking
d. position the patient so she is facing a blank wall
74.An OT practitioner is instructing an individual with left hemiple-
gia how to remove a t-shirt. The correct sequence is:

a.
(1) remove shirt from unaffected arm;
(2) remove shirt from affected arm;
(3) gather shirt up at the back of the neck; and
(4) pull gathered back fabric off over head.

b.
(1) remove shirt from affected arm;
(D) (1) gather shirt up at the back of the neck; (2) pull gathered
(2) remove shirt from unaffected arm;
back fabric off over head; (3) remove shirt from unaffected arm;
(3) gather shirt up at the back of the neck; and
and (4) remove shirt from affected arm. Answers A, B, and C are
(4) pull gathered back fabric off over head.
examples of incorrect sequences that would result in failure to
remove the shirt successfully.
c.
(1) gather shirt up at the back of the neck;
(2) pull gathered back fabric off over head;
(3) remove shirt from affected arm; and
(4) remove shirt from unaffected arm.

d.
(1) gather shirt up at the back of the neck;
(2) pull gathered back fabric over head;
(3) remove shirt from unaffected arm; and
(4) remove shirt from affected arm.
75.An OT practitioner is working with a patient who has recently
experienced a traumatic amputation of his right upper extremity
at the short below-elbow level. Which of the following areas of
patient education would the practitioner work on FIRST in the OT (B) Training in residual limb wrapping. Residual limb wrapping
intervention program? would help prepare the residual limb by shrinking and shaping it
a. Training to put on and take off the prosthesis to fit in the prosthesis.
b. Training in residual limb wrapping
c. Activities to teach grasp and prehension functions
d. Training to resume vocational activities
76.A homemaker who sustained a CVA with subsequent left
hemiparesis is returning home to live with her husband and chil-
dren. To enable the individual to carry out her prior responsibility of

12 / 32
 Johnson (SIMULATION EXAMINATION 2)
Study online at https://quizlet.com/_bqbu66
meal preparation, which item would MOST likely to recommended
for stabilization when cutting a potato?
a. A piece of non-skid backing under the cutting board (D) A cutting board with two nails in it. The potato is placed on the
b. A plate guard around the edge of the board nails to hold it in place while working.
c. A rocker knife
d. A cutting board with two nail in it
77.An individual confides to the OT practitioner that he is con-
cerned that lower extremity flaccidity may cause problems during
sexual activity. The BEST strategy for the OT practitioner to rec- (B) Use pillow to prop up body parts into desired position. An
ommend is: individual with low tone may benefit from supportive positioning
a. use a side lying position devices such as pillows, towels, or bolsters that can help to pre-
b. use of pillows to prop up body parts into the desired position vent overstretching and fatigue.
c. incorporate slow rocking into movements
d. avoid movements that elicit a quick stretch
78.In order for an individual sitting in a wheelchair to achieve
maximal pelvic stability, the seat belt should be positioned:
(C) Inferior to the anterior superior iliac spine. A seat belt placed
a. inferior to the ischial tuberosity
across the lap inferior to the ASIS prevents the hips from being
b. superior to the iliac crest
extended into a posterior pelvic tilt.
c. inferior to the anterior superior iliac spine
d. superior to the posterior superior iliac spine
79.An OT practitioner is treating a patient who has difficulty main-
taining attention to a task but is aware of the problem. The best
example of a strategy that the OT can teach the patient to control
effects of attention deficits would be:
a. simplifying the instructions given to accomplish the task so only (B) Learning the self-monitoring technique of asking oneself if
one step is presented at a time any part of the task has been missed. Teaching the client to
b. learning the self-monitoring technique of asking oneself if any self-monitor is an example of a strategy to control the tendency
part of the task has been missed to miss details involved in the task process.
c. providing practice is shape and number cancellation work-
sheets
d. removing unnecessary objects from around the task area to
decrease distractions
(D) A long-handled bath sponge. A person with a total hip arthro-
plasty needs to avoid hip flexion of 80 degrees or more, hip
80.Which of the following pieces of adapted equipment would the adduction with internal rotation at the knee or ankle, and lifting the
OT practitioner MOST likely recommend a client continue to use knee higher than the hip during self-care or home management
at home after a total hip arthroplasty? activities. A wire basket attached to the walker would not allow
a. A wire basket attached to a walker the person to come close to a counter without having to step
b. A padded foam toilet seat 1 inch in height sideways, which causes hip adduction to either move toward or
c. A short-handled bath sponge away from the counter. A padded toilet seat of 1 inch height or a
d. A long-handled bath sponge short-handled sponge would be inadequate in that it would cause
the person to flex the hip past 80 degrees while performing of
self-care activities.
81.The MOST effective way to adapt a chair to inhibit a child's
extensor tone and allow the child to maintain a sitting position is
to use: (B) A seat belt placed at a 45-degree angle at the hips. A seat belt
a. lateral trunk supports correctly placed at a 45 degree angle to the child's hips would
b. a seat belt placed at a 45-degree angle at the hips inhibit extensor tone
c. a wedge-shaped seat that is higher in the front
d. a lapboard
(A) Textured material, rubbing, taping, and prolonged contact.
Sensory desensitization helps the individual recalibrate altered
82.Which of the following sequence of method is MOST appro-
sensory perceptions and improve sensibility. This type of program
priate to achieve sensory desensitization?
is initiated when light-touch sensation is intact. The above listed
a. Textured material, rubbing, tapping, and prolonged contact
modalities are used as graded tactile stimuli. Treatment is most
b. Massage, facilitory electrical stimulation and a progressive
successful when carried out and controlled by the individual. With
desensitization program
a severe injury such as burn, it is also necessary to train the
c. Pressure, percussion, vibration, icing and edema massage
individual in protective precautions. Any techniques that provide
d. Visual compensation and functional use of the extremity
an ungraded or nonspecific level of touch, such as message,
pressure, percussion, or electrical stimulation, would be tolerated

13 / 32
 Johnson (SIMULATION EXAMINATION 2)
Study online at https://quizlet.com/_bqbu66
with difficulty by a person with hypersensitivity, because much of
the input is facilitory and would be interpreted as painful. Visual
compensation and functional use of the extremity are techniques
used with individual who have impaired sensation.
83.An OTR is implementing cognitive rehabilitation interventions
with a client and has given the client the task of finding telephone
numbers of a specific people in the phone book. The client has
also been given a card with a series of questions written on it
(D) A problem-solving task with a "self-talk" cueing strategy. Find-
including, "Do I understand what I am supposed to do?" and "Do
ing phone numbers is a task that requires some problem solving
I have all the information I need?" and "Is this the best way to do
and the cards are a strategy for providing cues for questioning
this?" This intervention is MOST accurately described as:
oneself about the process of problem solving.
a. a self-management task with an environment cue
b. a task to improve visual scanning
c. a memory task with external aid
d. a problem-solving task with a "self-task" cueing strategy
84.An individual with joint changes that limit finger flexion would (D) Built-up handles. Built-up handles, without adding extra
be MOST comfortable using utensils with: weight, allow a comfortable grasp that regular utensils do not
a. regular handles provide. A weighted handle would cause more rapid fatigue and
b. weighted handles strain to the joints. An arthritic person most likely has adequate
c. a universal cuff attachment grasp and release with a built-up handle, making it easier to use
d. built-up handles than a universal cuff.
85.An IT practitioner is working with an elderly woman with a
diagnosis of depression and dementia during the clean-up portion
of a cooking activity. The patient begins to dry the plates and
(B) Put the dried dishes away and begin to hand her wet dish-
utensils she has already dried. The OTR should:
es. Compensating for mistakes helps to increase the sense of
a. tell the client that the same dishes and utensils are being
self-worth and integrity of individuals with dementia. This ap-
redried
proach is preferable to drawing attention to errors, especially in
b. put the dried dishes away and begin to hand the client wet
situations in which safety is not an issue.
dishes
c. ask the client to stop the activity because it seems too difficult
d. ask the client to describe what she is doing
86.An OT practitioner is instructing a client to perform stand-to-sit
chair transfers after a total hip replacement. Before sitting down
from a standing position, the OTR FIRST instructs the client to:
a. extend the operated leg forward, reach back for the armrests,
(A) Extend the operated leg forward, reach back for the armrests,
and slowly sit, while attempting to not lean forward
and slowly sit, while attempting to not lean forward. By extending
b. extend the non-operated leg forward, while gradually flexing the
the operated leg forward, reaching back for the armrests, slowly
operated side, reaching back for the armrests, and slowly sit, while
sitting, and attempting to not lean forward, an effective and safe
attempting to not let lean forward
transfer can be accomplished.
c. flex the operated leg, then flex the non-operated leg, reach back
for the armrest and slowly sit, while attempting to not lean forward
d. never perform stand to sit transfers with a client with a new total
hip replacement until 2 weeks after surgery
87.An OT practitioner is educating a client with a cumulative trau-
ma disorder about common work-related risk factors. The OTR
explains to the client that many of the PRIMARY risk factors are: (A) Repetition, high force, and awkward joint postures. Repe-
a. repetition, high force, and awkward joint postures tition, high force, and awkward joint postures are work-related
b. progressive resistive exercise, joint mobilization and weight- risk factors that are frequently associated with cumulative trauma
bearing disorders.
c. inflammation, swelling, and pain
d. fatigue, muscle cramps and paresthesias
88.A client is experiencing acute right upper extremity and hand
lymphedema after a recent mastectomy. The client's primary
complaint is joint stiffness. The INITIAL techniques the OTR can
implement to alleviate joint stiffness would MOST likely be: (A) Contrast baths, active and passive ROM, and massage. Con-
a. contrast baths, active and passive range of motion and retro- trast baths, AROM and PROM, and massage are all initial tech-
grade massage niques considered for the prevention or relief of joint stiffness.
b. ultrasound, electrical stimulation, and dynamic splinting
c. resistive exercises, weight-bearing and lifting
d. joint mobilization, serial casting and dynamic splinting

14 / 32
 Johnson (SIMULATION EXAMINATION 2)
Study online at https://quizlet.com/_bqbu66
89.Which of the following BEST describes how an OT practitioner
would document a normally developing infant's first steps?
a. "The infant uses a narrow base of support and low arm guard
(D) "The infant uses a wide base of support and high arm guard
position and takes big steps."
position and takes short steps." Answer D is correct according to
b. "The infant uses a wide base of support and is independent in
Case-Smith. "The infant's first efforts toward unsupported move-
stopping and turning."
ment through walking are often seen in short erratic steps, use of
c. "The infant uses a narrow base of support and low arm guard
a wide based gait, and arms held in a high guard."
position."
d. "The infant uses a wide base of support and high arm guard
position and takes short steps."
90.An individual reports that back pain during sexual activity is so
severe that it prevents any enjoyment. The BEST strategy for the (D) Identify alternative methods for meeting sexual needs that
therapist to recommend is: don't cause pain. Because the individual's pain cannot be seen
a. use a side lying position or felt by the sexual partner, communication is particularly impor-
b. time sexual activity for periods of high energy tant. The couple can discuss alternate positions and methods for
c. do not discuss pain with sexual partner because it may be a achieving sexual fulfillment that are acceptable to them and that
"turn off" do not cause pain, such as alternate positions, masturbation, and
d. identify alternative methods for meeting sexual needs that don't fantasy.
cause pain
91.The OTR instructs a client with chronic neck pain to use
psychosocial pain management techniques. Which if the following
BEST represents psychosocial strategies commonly used by OT
(A) Biofeedback, distraction, and relaxation techniques. Biofeed-
practitioners?
back, distraction, and relaxation techniques are all examples of
a. biofeedback, distraction and relaxation techniques
measures that are implemented to manage pain.
b. specific skill training
c. strength and endurance building techniques
d. cognitive retraining techniques
92.An OT practitioner is providing instruction to caregivers in
long term care facility concerning assisting a resident whose
severe attention span deficits impair the ability to participate in (C) Hand-over-hand assistance. In this method, the caregiver
self-feeding. The OT practitioner is MOST likely to recommend places one hand over the resident's hand and provides assistance
which method? while guiding the resident's hand through the steps of the task,
a. Demonstration of feeding process for the resident guiding the hand from the food up and into the resident's mouth.
b. Providing verbal feedback to the resident about how he or she This method provides maximum assistance while still allowing the
is progressing person to feel involved and connected to the task.
c. Hand-over-hand assistance
d. Chaining
(C) When the child has achieved a maintenance level of func-
93.An OTR has been working in a medical setting with a 6 year old
tioning. Because this child may never be considered completely
child who has had a traumatic brain injury. At what point should
recovered (answer D) or may refuse OT services because of his
the OTR recommend discharge?
head injury (answer A), discharge should be discussed when
a. When the child refuses to attend OT
the child is no longer making significant progress. Transition to
b. When the child is ready to make the transition to first grade
the 1st grade (answer B) is an educational consideration that is
c. When the child has achieved a maintenance level of functioning
not directly relevant to the provision of services under a medical
d. When the child is considered to be completely recovered
model.
94.A child is on a pureed diet because of an inability to chew food.
The MOST effective for the OTR to facilitate the childs ability to
chew would be to:
a. encourage the child to remove food from the spoon with his
teeth (C) Increases the management of texture by slowly increasing
b. stimulate the management of texture by using vegetable or beef texture of food with a baby food grinder. This method offers a
soup gradual increase in texture that encourages chewing
c. increase the management of texture by slowly increasing tex-
ture of food with a baby food grinder
d. stimulate biting and chewing by placing a raisin between a
childs teeth
95.When working clients who experience low back pain, it is
important to practice functional techniques such as lifting and
carrying. Which of the following BEST represents a correct lifting
method?

15 / 32
 Johnson (SIMULATION EXAMINATION 2)
Study online at https://quizlet.com/_bqbu66
a. Keep both knees straight, flex the back and keep object an
arm's length away from the body
b. Bend both knees, keep the back straight, and bring object close (B) Bend both knees, keep the back straight, and bring object
to the body when lifting close the body when lifting. Bending with both knees while keeping
c. Keep both knees and back straight and bring object close to the the back straight and the object close to the body will prevent low
body when lifting back bending and strain.
d. Bend one knee while keeping the other leg straight and keep
the object an arm's length away from the body
96.An individual with Guillain-Barre syndrome complains of pain
during passive range of motion to the shoulder. Which is the
MOST important technique for the OT practitioner to use while (B) Proceed only to the point of pain. Care must be taken to
performing PROM with this individual? avoid fatigue and irritation of inflamed nerves when working with
a. work proximal to distal individuals with Guillain-Barre syndrome, so ranging only to the
b. proceed only to the point of pain point of pain is the most important concept in this question.
c. limit the number of repetitions to 10
d. gently encourage the individual to work through pain
97.A 3 year old child with a diagnosis of mental retardation is
dependent in all areas of dressing. If the OT practitioner uses a
developmental approach with this child, which skill should FIRST
be addressed? (C) Removing pants. Answer C is correct because, according to
a. Putting on garments with the front and back of clothing correctly most developmental scales, children first learn to remove gar-
placed ments, especially socks.
b. Putting on a t-shirt
c. Removing pants
d. Buttoning and tying bows
98.In a long term care facility, an elderly resident with dementia
repeatedly asks for her mother and becomes increasingly upset.
The MOST therapeutic strategy for responding to this resident is
to:
a. use reality orientation; explain that the person's mother has
(D) Respond to the emotional tone expressed by the words; pro-
been dead a long time
vide extra attention and reassurance.
b. set limits: firmly tell the person to stop asking for her mother
c. therapeutic "fibbing": tell the person that her mother will be
coming shortly
d. respond to the emotional tone expressed by the words: provide
extra attention and reassurance
99.An OT practitioner is planning treatment for individuals with a
variety of personality disorders who have inaccurate perceptions
of others and unrealistic perceptions of themselves. The treatment
method that might BEST address these problem areas is a:
a. small group that provides a wide range of craft activities from
(D) Cooperative group activity that both provides and elicits con-
which the members are encouraged to select
sistent and accurate feedback about interactions within the group.
b. session focused on understanding and changing the individ-
ual's way of relating with the therapist
c. social skills training program completed in small groups
d. cooperative group activity that both provides and elicits consis-
tent and accurate feedback about interactions within the group
100. An auto mechanic is currently in a work hardening program
after being in a car accident that left him with numerous upper and
lower extremity impairments. The ultimate goal for this individual
is to return to full employment as an auto mechanic. Which of
the following BEST represents a work hardening activity for this
(B) Working on a mock car engine.
individual?
a. lifting weights
b. working on a mock car engine
c. visiting the work site garage
d. preparing a light lunch at mealtime
101. An individual with ALS and mild dysphagia becomes ex-
tremely fatigued at breakfast, lunch, and dinner. Which is the
FIRST intervention the OT practitioner should considering rec-

16 / 32
 Johnson (SIMULATION EXAMINATION 2)
Study online at https://quizlet.com/_bqbu66
ommending?
a. Speak with the physician about tube feedings
b. Sit in a semi reclined position during meals (C) Eat 6 small meals a day.
c. Eat six small meals a day
d. Substitute pursed foods for liquids
102. An individual with MS reports extreme frustration because
her house is so dirty. When she does attempt to clean it, she is too
exhausted to do anything else afterward. She does not think she
can afford to pay someone else to clean. Which of the following
strategies is MOST appropriate for this individual? (D) Alternative tasks that require standing with those that can be
a. Convince the individual to hire a house cleaner performed sitting.
b. Prescribe activities that will increase strength
c. Use the largest joint available for the task
d. Alternative tasks that require standing with those that can be
performed sitting
103. An OT practitioner is fabricating a dynamic splint for a butcher
who sustained a low level radial nerve injury while slicing lunch-
meat at the deli where he works. The OTR explains to the client
that a dorsal dynamic splint for this type of nerve injury should: (D) Provide wrist extension, MCP extension, and thumb exten-
a. provide wrist extension, MCP flexion and thumb flexion sion.
b. prevent wrist extension, MCP extension, and thumb extension
c. prevent wrist extension, MCP flexion and thumb flexion
d. provide wrist extension, MCP extension, and thumb extension
104. While working with child who has a neuromuscular disorder,
the OT practitioner places the child in a sitting position on thera-
peutic ball, starts moving the ball and asks the child to reach for
a toy while sitting on the moving ball. The primary purpose of this
activity is MOST likely: (B) Facilitating postural reactions.
a. increasing upper extremity strength
b. facilitating postural reactions
c. decreasing tactile defensiveness
d. improving visual perception
105. A client with hemiplegia and her spouse are working on toilet
transfer training activities with the OT practitioner. The BEST way
for the OT practitioner to teach the couple to perform transfers will
be:
a. only to the unaffected side of the client's body (C) To both sides of the client body.
b. only to the affected side to the client's body
c. to both sides of the client body
d. only to the side of the body from which the client will be
approaching the toilet
106. An OT practitioner is preparing for the discharge of a pread-
olescent child with limited strength and endurance. Which of the (A) Mount lever handles on doors and faucets. For children with
following home adaptations is MOST important to recommend? reduced strength and endurance, using less complex movements
a. mount lever handle on doors and faucets and less force results in energy conservation. Lever handles
b. remove all throw rugs require less energy the knob handles on doors, faucets, and
c. install non-skid pads on steps appliances.
d. mount a table top easel for written home work
107. An OT practitioner is fabricating a static splint to prevent
further injury, reduce pain, and encourage proper positioning.
Which if the following would BEST address these goals?
a. a resting pan splint for a client after a TBI who has been (A) A resting pan splint for a client after a TBI who has been
unresponsive in the intensive care unit for 3 weeks, yet grimaces unresponsive in the ICU for 3 weeks, yet grimaces with passive
with passive digit extension digit extension. This type of static splint appropriately positions
b. a dynamic extension splint for a client with radial nerve injury the wrist and digits in a functional position in order to prevent
sustained after skiing accident the development of contractures while providing protection for the
c. an articular splint after surgical repair of PIP joint for a burn hand.
injury
d. a spring coil splint for a client with a median nerve injury
sustained in a boating accident

17 / 32
 Johnson (SIMULATION EXAMINATION 2)
Study online at https://quizlet.com/_bqbu66
108. A child with poor balance is unable to put on and remove
lower extremity clothing. Which of the following approaches would
BEST address this functional problem? (A) Teach the child to dress in a side lying position. The side lying
a. teach the child to dress in a side lying position position eliminates the need for the child to maintain balance in
b. add loops to the waistbands of pants and skirts order to dress the LEs.
c. use Velcro fasteners in place of zippers
d. teach the child to dress in standing position
109. An OTR is on the treatment team for patients with lower
extremity amputations in a rehabilitation hospital. The PRIMARY (C) Providing a program to enhance occupational performance in
role of the OT in the management of lower extremity amputation ADL, work, and leisure. The role of the OT on the LE management
is: team is to address occupational performance in areas of function:
a. fabricating artificial limbs ADL, such as self-care, functional mobility, community mobility;
b. providing therapeutic exercise, wound care, pain management work or productive activities, such as home management and
and gait training vocational activities; and leisure activities. The OT may address
c. providing a program to enhance occupational performance in performance components such as endurance, pain management,
ADL, work, and leisure and soft tissue integrity to achieve the overall aim of maximizing
d. assessing the client's social environment and making recom- occupational performance.
mendations
110. An OT practitioner who is leading a stress management
group explains to the members that stressors can be MOST
accurately described as the:
(C) Precipitating conditions and events that elicit stress reactions.
a. process by which individuals adjust to daily stressful events
The conditions and events that elicit stress reactions are known as
within their environments
stressors (answer C). Stressors can be either short term or long
b. bodys reactions to threat, often described as "fight or flight"
term.
c. precipitating conditions and events that elicit stress reactions
d. process of "fit" between the individual and his or her environ-
ment
111. An individual demonstrate a left visual field cut as a result of a
CVA and demonstrates difficulty crossing the midline during many
selfcare activities. Which of the following interventions would best
(D) Weaving on a wide frame loom. Use of and attention to the
represent a REMEDIAL approach to addressing this deficit area?
entire loom area is essential for weaving on a frame loom. The
a. Placing self-care supplies to the individual's right side
shuttle must slide across the entire width of the loom, which
b. Patient and family education regarding the effects of visual field
involves crossing the midline.
loss
c. Verbal and tactile cueing to look to the right side
d. Weaving on wide frame loom
112. Which of the following is the BEST instruction to impart to
a caregiver regarding how to propel a wheelchair down a steep
ramp? (B) Tip the wheelchair backward and guide it down the ramp
a. tip the wheelchair backward and guide it down the ramp back- forwards. This is the recommended technique for going down a
wards steep ramp. The individual sitting in the wheelchair can also help
b. tip the wheelchair backward and guide it down the ramp for- to control the wheels, if capable of doing so, by a grasping the
wards hand rims.
c. allow the patient to propel the wheelchair independently
d. obtain the assistance of a second individual
113. A child with athetoid cerebral palsy is learning to use aug-
mentative communication and is frustrated because it takes so
long to produce a sentence. Which of the following is the BEST
(C) Word prediction software. Word prediction software anticipates
solution for this problem?
the word desired and increases the speed of input by decreasing
a. a larger monitor
the number of keystrokes required.
b. a voice output tool
c. word prediction software
d. masking inappropriate keys
114. A 78 year-old individual who is ambulating in the home
informs the OT practitioner that improving balance is a major (C) Describe how using a shower chair improves safety. Informing
concern. Although the patient took showers in the past, now his the patient of various options is the first response. By describing
fear of falling limits him to sponge baths. The OT practitioner tells the shower chair and how it make showering safer, the OT prac-
the individual that it is wise to avoid situations in which the risk titioner is conveying the concept that occupational performance
of falling is high. Which of the following should the OT practitioner is based on the interaction of performance contexts (physical
advise the individual to do NEXT?

18 / 32
 Johnson (SIMULATION EXAMINATION 2)
Study online at https://quizlet.com/_bqbu66
a. try the bathtub instead of the shower
b. purchase a shower chair environment) and performance components (balance) and that
c. describe how using a shower chair improves safety there are methods to ensure safety.
d. stretchy fabric clothing with tie closures in the back
115. The goal for an elderly person with Parkinson's disease is to
dress herself independently. The BEST adaptation to compensate
for this person's physical deficits would be: (A) Velcro closures on front-opening clothing. Velcro closures on
a. Velcro closures on front-opening clothing front-opening clothing would require the least amount of dexterity,
b. Large buttons on front-opening clothing which becomes increasingly difficult with Parkinson's disease.
c. Larger clothing slipped on overhead with no fasteners
d. Stretchy fabric clothing with tie closures in the back
116. The BEST way for an OT practitioner to utilize sensory
stimulation for the child with tactile defensiveness is to:
a. apply light touch stimulation such as tickling on the abdomen (C) Allow child to self-apply tactile stimuli to maximize child's toler-
for desensitization ance. Tactile defensiveness is an overreaction or negative reaction
b. avoid all forms of tactile stimulation to accommodate child's to sensations of touch. Answer C is correct. "Generally, tactile
preferences stimuli that are actively self-applied by the child are tolerated much
c. allow child to self-apply tactile stimuli to maximize child's toler- better than stimuli that are passively received, as when being
ance touch by another person."
d. avoid all deep pressure tactile stimuli to decrease defensive-
ness
117. An individual consistently confuses white glue with white
grout during a tile activity. Which of the following actions would
be consistent with an activity adaptation approach?
a. Review with the individual the difference between glue and (B) Replace the white glue with blue glue. Activity adaptations
grout enable the individual to become more functional in his/her task
b. Replace the white glue with blue glue performance.
c. Avoid the use of white tiles
d. Complete the last step of the activity (applying grout) for the
individual has learned how to apply grout
118. A third grade student receives direct OT services provided
(B) Obstacle courses. This child should be exposed to situations
through the public school system. Which of the activities should
that require problem solving by challenging to the child to move his
the OT practitioner recommend to the gym teacher to BEST
or her body in relaxation to objects in the environment. Although
consolidate the child's skills in spatial organization and motor
all of the answers involve motor planning in response to the
planning?
environment to some degree, running obstacle courses clearly
a. relay races
emphasizes the spatial element the most. Obstacles also consist
b. obstacle courses
of static items and therefore facilitate success in adjustment (mo-
c. the balance beam
tor planning) more easily than moving objects.
d. freeze tag
119. A patient who is being discharged from a rehabilitation center
to home has Parkinsons disease and is at risk for aspiration.
(B) Seating the patient upright on a firm surface with the chin
When instructing the primary caregiver in proper positioning dur-
slightly tucked. The best position for feeding an individual with
ing feeding, the OT practitioner should recommend:
a swallowing disorder is upright and symmetrical, with the chin
a. feeding the patient in bed in a supine position
slightly tucked. "Correct positioning normalizes tone, thereby facil-
b. seating the patient upright on firm surface with the chin slightly
itating quality motor control and function of the facial musculature,
tucked
jaw and tongue movement, and the swallow process, all of which
c. positioning the patient in a semireclined position in reclining
minimize the potential for aspiration."
chair
d. feeding the patient in bed in a side lying position
120. An OT practitioner is educating a middle-aged roofer who is
recovering from full-thickness burn about hypertrophic scarring.
The OTR should FIRST inform the client that:
a. the depth of the wound and location and the patient's race and
age can all influence scar formation (A) The depth of the wound and location and patient's race and
b. full-thickness wounds typically heal without significant scar age can all influence scar information.
formation
c. surgical intervention eliminates all risk of hypertrophic scarring
d. hypertrophic scars involving the joints do not interfere with
range of motion

19 / 32
 Johnson (SIMULATION EXAMINATION 2)
Study online at https://quizlet.com/_bqbu66
121. An OT practitioner is instructing a person with arthritis how
to maintain range of motion while performing household activities.
Which of the following activities MOST effectively accomplishes
(D) Use dust mitt to keep fingers fully extended. Using dust mitts
this?
"keeps fingers straight and prevents the static contraction and
a. use short strokes with the vacuum cleaner
potentially deforming forces of holding a dust cloth."
b. keep elbow flexed when ironing
c. keep lightweight objects on low shelves
d. use dust mitt to keep fingers fully extended
122. Which of the following is the FIRST step an OT practitioner
should take when initiating a safe wheelchair transfer?
a. have the patient scoot forward to the front of the seat (D) Lock the brakes. Brakes should be locked first to stabilize the
b. position foot plates in the up position wheelchair.
c. swing away the leg rests
d. lock the brakes
123. An individual has been referred to OT following open heart
surgery and a period of prolonged bedrest. After the individual is (D) Walking at 1 mph. The MET value for sitting at the edge of the
able to tolerate sitting unsupported at the edge of the bed, the bed is 1.3, and the MET value for walking is 1.2 mph is 2. Although
NEXT activity the OT practitioner should introduce is: it is unrealistic to expect the entry-level practitioner to memorize
a. peeling potatoes while seated a MET table, several factors can help the therapist assess the
b. wheelchair propulsion at 1.2 mph demand of any given task. For example, UE activity work produces
c. taking a shower a greater cardiovascular response than LE work.
d. walking at 1 mph
124. An OT practitioner is running a discharge planning group
in which individuals discuss their personal feelings and concerns
about returning to the community. Which of the following would be
the BEST method to facilitate this process?
(A) Patients write fears and concerns on index cards. The OT
a. Patients write fears and concerns on index cards. The OT prac-
practitioner collects and reads the cards to the group for discus-
titioner collects and reads the cards to the group for discussion
sion. This method allows for anonymity by having each patient
b. Patients write fears and concerns on index cards and then take
write down their concerns without including their names, thereby
turns reading their cards to the group
eliminating any fear of embarrassment.
c. Patients each take a turn verbalizing their fears and concerns
to the group
d. The psychologist speaks to the group about discharge fears in
general
125. A sixth grader with a diagnosis of athetoid cerebral palsy
needs an adapted computer for communication. Her upper ex-
(A) Single pressure switch firmly mounted within easy reach. A
tremity control is poor because of fluctuating muscle tone. The
child with fluctuating muscle tone lacks stability and demonstrates
BEST way for her to operate her computer is to use a:
extraneous movement; therefore, deliberate motor action is most
a. single pressure switch firmly mounted within easy reach
effectively executed on a securely mounted device using simple
b. lightweight keyboard placed at midline
movement patterns.
c. low-resistance mouse and pad
d. mercury-switch headband set to respond to minimal movement
126. An individual with chronic obstructive pulmonary disease
(COPD) with low endurance is taught to modify his bathing tech- (C) Using a bath chair and a hand-held shower with tepid water.
niques for carryover after discharge. The BEST bathing method The best bathing method for a person with COPD considers
would be: the energy demands of the task as well as the effect of water
a. tub bathing method with hot water temperature in light of the person's functional status. A person
b. standing for a quick shower with COPD has difficulty breathing when the environment is hot
c. using a bath chair and hand-held shower with tepid water or humid or when there is a high degree of steam.
d. tub bathing using lukewarm water
127. Which of the following would be the BEST cup for the OT
practitioner to recommend using when working with an individual (A) A vacuum feeding cup. Individuals with impulsive behavior or
who tend to drink too quickly? poor judgment often attempt to drink too quickly. The rate of intake
a. a vacuum feeding cup can be limited by using a drinking spout with a small opening,
b. a "nosey cup" (cut out for the nose) pinching a straw, or using a vacuum feeding cup with a control
c. a mug with two handles button.
d. a cup with a large drinking spout
128. The OTR is organizing a group picnic outing to a park. The
most important precaution for the OTR to implement for those
group members taking neuroleptic medications is to:
20 / 32
 Johnson (SIMULATION EXAMINATION 2)
Study online at https://quizlet.com/_bqbu66
a. encourage the use of PABA-free sunblock and hats
b. encourage members to move slowly when changing positions (A) Encourage the use of PABA-free sunblock and hats. Individ-
from sitting to standing uals taking neuroleptic medications are prone to photosensitivity
c. encourage members to use an antiperspirant and wear light and need protection from the sun. A PABA-free sunblock is recom-
colored clothing mended because this reduces the chance of an allergic reaction
d. take along such low-calorie snacks as carrot sticks and celery to the sunblock.
sticks
129. To avoid overstimulation when handling a stable, 12 week
premature infant in the NICU setting, an OT practitioner must
FIRST: (A) Provide gentle human touch to enable the infant to slowly re-
a. provide gentle human touch to enable the infant to slowly spond to intervention. Although all answers are possible examples
respond to intervention of applied calming techniques, the tactile system is the first to
b. establish a calm state by utilizing the infant's musical mobile develop and the most sophisticated in the young NICU patient.
c. swaddle the infant in a blanket and cuddle to provide contain- Therefore, answer A is the most suitable for initial interaction
ment and warmth to assist with self-regulation contact.
d. establish a bond through visual orientation to the therapist's
face
130. An individual with complete C7 quadriplegia demonstrates
fair+ strength in the wrist extensors. Which of the following in-
terventions will MOST effectively increase strength in the wrist
extensors? {a (d)} (A) A craft activity using increasingly heavy hand tools.
a. a craft activity using increasingly heavy hand tools Progressive resistive exercise is the most effective method for
b. mildly resistive activities that are halted as soon as the individ- increasing strength in a muscle with fair+ strength.
ual begins to fatigue
c. electric stimulation to the wrist extensors
d. moderate resistance during active range of motion to the wrist
131. Which of the following activities would be BEST to promote
prewriting skills with a child in preschool or kindergarten?
a. maneuvering through obstacles and focusing on making turns (D) Drawing lines and shapes using shaving cream, sand, or finger
b. having the child create his or her own books in specific topics' paints. The best activity to encourage prewriting would be drawing
c. rolling clay into a ball lines in different sensory media.
d. drawing lines and shapes using shaving cream, sand or finger
paints
132. The OTR is teaching a student how to perform range of
motion exercises with a patient who has quadriplegia. In order to
encourage the development of tenodesis, the OTR must be sure
(C) Extension during finger flexion and flexion during finger ex-
to position the patient's wrist in:
tension. The method used to maintain tenodesis in the hand of
a. the neutral position during finger flexion and extension
a person with quadriplegia is to keep the wrist extended during
b. flexion during finger flexion and extension
finger flexion and flexed during finger extension. This allows the
c. extension during finger flexion and extension and flexion during
finger flexor tendons to shorten so tenodesis action can occur.
finger extension
d. flexion during finger flexion and extension during finger exten-
sion
133. An OT practitioner is performing an assistive technology
intervention with a client who is has severe limitations of motor
function resulting from CP. The FIRST function of the OT in this
(B) Identify the abilities, needs, and life goals of the client. Identi-
process is to:
fying the abilities, needs, and life goals of the client occurs before
a. identify the most appropriate commercially available forms of
any other steps in the process in order to make a match between
assistive technology
the client's abilities, environmental demands, and the appropriate
b. identify the abilities, needs, and life goals of the client
technology to carry out desired daily occupations.
c. select the appropriate method of accessing the technology
d. modify the assistive technology device to meet the needs if the
client
134. During and oral motor evaluation, an OT practitioner asks the
client to stick out her tongue. Next, the client is asked to move her
(C) Protrusion and lateralization. Protrusion is the motion of stick-
tongue from side to side. The two functions that the OT practitioner
ing the tongue out of the mouth in a forward manner, and lateral-
is attempting to facilitate are:
ization involves the movement of the tongue from side to side.
a. protrusion and humping
b. lateralization and tipping

21 / 32
 Johnson (SIMULATION EXAMINATION 2)
Study online at https://quizlet.com/_bqbu66
c. protrusion and lateralization
d. lateralization and humping
135. An OT is running a group for individuals who have difficulty
managing anger. Based in a cognitive-behavioral frame of refer-
ence, which of the following steps would the OT BEGIN with?
a. Discuss the benefits of alternative beliefs about anger and (B) Develop awareness about what produces anger and how
responses to anger the clients respond to anger. All of the answers are steps in
b. Develop awareness about what produces anger and how the the cognitive-behavioral process. Treatment begins, however, with
client respond to anger developing awareness of what produces anger and how individ-
c. Role play a situation that presents minimal difficulty to group uals respond.
participants
d. Role play a situation that present significant difficulty to group
participants
136. When adapting toilet for use by a child with poor postural
control, the OT practitioner should pay PRIMARY attention to (C) Can the child's feet reach the floor? A relaxed position during
which of the following issues? toilet use is essential to success in elimination training. The seat
a. Can the toilet paper be reached without a major weight shift? should below enough so the child's feet can be used to help with
b. Is the flush handle easy to manipulate? postural stability. In addition, a seat design featuring a wide base,
c. Can the childs feet reach the floor? back support will give the child's sense of comfort and security.
d. Is a non-skid mat placed in the floor to prevent slipping?
137. A client is having difficulty getting around within her home as
a result of low vision. The MOST appropriate strategy to improve
accessibility would be to:
(B) Provide strong color contrast at key areas to identify steps,
a. instruct the client to sit while performing ADL
pathways, etc. Using contrast is a key environmental adaptation
b. provide strong color contrast at key areas to identify steps,
strategy for people with visual impairments. The more contrast,
pathways, etc.
the easier it is to locate objects, steps, entrances, and pathways,
c. recommend the client arrange to get assistance when moving
thereby improving accessibility by maximizing remaining vision
within her home
d. recommend training in white cane use, for identifying obstacles
in the home
138. A patient with neurological deficits has been unable to carry
over skills learned previously in therapy and has exhibited no
(B) Recommendations of environmental adaptations and assis-
capacity to learn new information. The MOST appropriate in-
tance for ADL. A patient who exhibits no capacity for new learning
tervention approach to improve ADL functioning for this patient
will be unable to benefit from therapy interventions that require
would be:
the ability to transfer learning (answers A, C, and D). A compen-
a. repetitive practice of simple ADL under therapist guidance
satory approach of adapting the environment and recommending
b. recommendation of environmental adaptations and assistance
assistance for safe performance of daily activities is the MOST
for ADL
appropriate intervention.
c. ADL training in the familiar home environment
d. forward or backward chaining techniques
139. Inpatient OT treatment groups for individuals with schizo-
phrenia are MOST appropriate when they provide the opportunity (C) Practice social and life skills. Answer C is correct because
for group members to: practicing life skills is essential for learning and has been found
a. disclose themselves in the groups to be helpful in improving functional performance. Structured,
b. develop insight into their feelings supportive milieus with an emphasis on enhancing positive social
c. practice social and life skills and life skills have been found to be helpful.
d. deal with expression of anger
140. A second grade child has a diagnosis of muscular dystrophy.
The child operates a manual wheelchair, but his mobility is slow
because of muscle weakness. The OT should consider a powered (B) Child's speed over long distances becomes less than that of
wheelchair when the: a walking person. This child should be considered for a power
a. child starts junior high school and will be expected to switch wheelchair when the current means of locomotion proves less
classrooms several times daily efficient and slower than locomotion by walking. Because the
b. child's speed over long distances becomes less than that of a child will be experiencing progressive muscle weakness, energy
walking person conversations is of primary importance.
c. child's home can be made accessible for a power wheelchair
d. child becomes unable to propel a manual wheelchair
141. An elderly man admitted to the hospital after a car accident.
He sustained a right pelvic fracture and verbalizes extreme pain
with ambulation. The orthopedic doctor has recommended that
22 / 32
 Johnson (SIMULATION EXAMINATION 2)
Study online at https://quizlet.com/_bqbu66
the patient perform "toe touch only" weight bearing on his right
foot for 6 to 8 weeks. The OT should instruct the patient to use a (A) Transferring on and off a commode seat. The patient will most
walker when performing which of the following activities? likely utilize a walker to transfer on and off a commode seat. In
a. transferring on and off a commode seat this case, the assistive device (the walker) will permit the patient
b. working on bed mobility to adhere to the mandated toe touch precautions, while providing
c. performing self-feeding balance, decreasing pain and encouraging safe transfers.
d. working on distal lower extremity dressing
142. An individual with depression is ready to return to the job
held before taking a leave of absence. Which of the following is
the FIRST action the OT practitioner should take?
a. perform a job analysis (A) Perform a job analysis. Job analysis identifies essential func-
b. request reasonable accommodation tions of a particular job.
c. emphasize activities that promote a sense of self efficacy
d. encourage the individual to participate in a weekly support
group
143. A 1-year-old child is working on increasing neck flexor
strength. At this time, the child can maintain head alignment when
tilted backward from an upright supported sitting position, to a
(C) By tilting backwards up to 60 degrees while rocking. By low-
45-degree incline, but loses control when tilted further back. The
ering the child backwards from the sitting position, the child is
NEXT important step in the intervention is to work on head and
required to activate increasing degrees of antigravity control in the
head neck alignment:
neck musculature. As the child's strength increases, the degree of
a. in a sidelying position while batting a toy
incline can be increased.
b. in a prone position while watching a peek a boo game
c. by tilting backwards up to 60 degrees while rocking
d. in a supine position, while watching an overhead mobile
144. An individual with c8 quadriplegia is most likely to require
which of the following in order to perform self-feeding?
(D) No assistive devices. A person with SCI at the C8 level would
a. total assistance
have full UE function and would be able to perform self-feeding
b. support of the upper extremity against gravity
independently without using equipment.
c. a universal cuff
d. no assistive devices
145. A resident of a long term care facility has been referred to the
OT practitioner because of difficulties with eating. The FIRST step
of intervention the OT performs with this resident at mealtime is
to:
(D) Position the person in an upright posture, make sure head
a. provide skid-proof placemats, plate guard, and utensils with
is flexed slightly and in midline. Making sure that the resident is
built up handle
correctly positioned is the first step in addressing eating problems.
b. observe for swallowing after each bite of food
Improper posture can result in difficulties with swallowing.
c. instruct the caregivers about a special eating setup for the
resident
d. position the person in an upright posture, make sure head is
flexed slightly and in midline
146. An OT practitioner is working on sequencing skills with a
young patient who is s/p TBI. The MOST effective activity to
promote development of these skills is: (B) Stringing beads for a necklace, following a pattern. This is the
a. leather stamping using tools in a random design only activity of those listed that requires the individual to follow a
b. stringing beads for a necklace, following a pattern sequence in order to achieve the desired outcome.
c. putting together a 20 piece puzzle
d. playing Concentration
147. The spouse of an individual being treated for bipolar disorder
describes the frustration he experiences in regard to the ups
and downs of his wife's condition. The support group that the OT
(C) National Alliance for the Mentally Ill. This is a support group
practitioner would MOST likely refer this individual to is:
that is open to clients and families and focuses on education and
a. Al-Anon
support related to all mental illness.
b. family therapy
c. National Alliance for the Mentally III
d. Recovery, Inc
148. By using an interest checklist that includes a report of both
(A) Use of time. By comparing interests and actual participation
interests and actual participation in activities, an OT practitioner
reported, the OT practitioner may identify discrepancies between
will MOST likely collect information on client's:
23 / 32
 Johnson (SIMULATION EXAMINATION 2)
Study online at https://quizlet.com/_bqbu66
a. use of time
interests and actual play and leisure behavior. This information
b. developmental level
can help address the client's use of time and facilitate temporal
c. mood and affect
organization.
d. communication skills
149. An OT practitioner working in an acute care hospital is
writing a progress note in the chart for a treatment session hold
earlier that day. Medical documentation should include which of (A) Concise objective information. All medical documentation
the following? should be accurate, concise, and objective. Personal opinions and
a. concise objective information statements that are speculative, judgmental, or subjective are not
b. speculative and judgmental information appropriate to be included into the patient's chart.
c. objective and speculative information
d. subjective information and personal opinions
150. A young child with a diagnosis of spina bifida has been
referred for an assessment. When collecting the initial data by
interviewing the child's mother, the OT should focus PRIMARILY
(A) The mother's concerns and goals for her child. The caregiver's
on:
concerns are essential in planning effective intervention within the
a. the mother's concerns and goals for her child
context of the family.
b. medical management
c. equipment needs
d. the physical layout of the home
151. The treatment environment in which an OTR would be MOST
likely to emphasize discharge planning for addressing mental
health problems would be a(n): (C) Acute care hospitalization. The emphases of acute care hos-
a. club house pitalization are symptom, reduction, medications, and discharge
b. community mental health center planning.
c. acute care hospitalization
d. quarterway house
152. When a therapist reevaluates a client's treatment plan, the
(D) Are easily accomplished by the client. Answer D is correct be-
therapist would be MOST likely to change activities when the
cause activities which are easily accomplished offer no challenge
activities:
and, therefore, will not enhance learning of skills and develop-
a. continue to provide some degree of challenge
ment of competence. During the process of reassessment, such
b. the activities reflect the client's priorities
activities require changing through the process of grading to make
c. the activities help to achieve help to achieve the client's goals
them somewhat more difficult.
d. are easily accomplished by the client
153. An OT practitioner should discontinue OT services when
which of the following has taken place?
a. The goals have been met and the individual can no longer
benefit from OT services (A) The goals have been met and the individual can no longer
b. The goals have not been met and the individual could benefit benefit from OT services. Discontinuation of OT should occur
from continued services when an individual has met the goals and further progress is not
c. The goals have been met but the individual could benefit from anticipated within the therapeutic environment.
continued services
d. The individual feels that he or she has not made gains despite
objective measures to the contrary
154. A school-age child with fine-motor difficulties is ready for
discharge from outpatient OT services. Which of the following is
the MOST important to focus? (B) The child's writing, dressing, and self-feeding skills. Because
a. The child's interests and hobbies the child was being treated for difficulties with fine motor skills,
b. The child's writing, dressing and self-feeding skills discharge criteria should focus on fine motor function.
c. The child's academic achievement
d. The availability of the child's parents for follow up services
155. An OT practitioner in a psychosocial setting is documenting
a client's responses to an activity. Which of the following is the
(C) "The client independently selected one of six craft designs
most OBJECTIVE statement?
presented." The notation of the client's response to treatment
a. "the client did not want to finish her stenciling activity"
that contains the MOST objective information is answer C. The
b. "the client was hostile to another client in the activity group"
notations that address the client's wants and hostility are interpre-
c. "the client independently selected one of six craft designs
tations of behavior versus directly observable response. The use
presented"
of the word "appropriate" reflects the OT practitioner's judgment.
d. "the client demonstrated an appropriate level of frustration
tolerance during most of the activity"

24 / 32
 Johnson (SIMULATION EXAMINATION 2)
Study online at https://quizlet.com/_bqbu66
156. An OT practitioner providing home-based care to an indi-
(C) To teach the caregiver how to lift and turn the client safely.
vidual with AIDS learns from his caregiver that he has become
Individuals unable to move themselves and those with sensory
too weak to turn himself in bed. What is the MOST important
loss are susceptible to the development of decubiti. Skin damage
modification to the treatment plan for the OT practitioner to rec-
results from pressure on the skin over a prolonged period of
ommend?
time. The skin over body prominences is particularly prone to the
a. to begin a strengthening program
development of decubitus ulcers. Frequent position changes are
b. to begin a bed mobility program
essential for these individuals to prevent skin breakdown and the
c. to teach the caregiver how to lift and turn the client safely
risk of serious infection.
d. to provide an environment control unit to the client
157. A preteen with a diagnosis of spastic cerebral palsy is enjoy-
ing computer assisted learning while making significant progress
in written communication, but he complains of general fatigue, (A) The time he spends at the computer. Since computer work
body aches, and eye strain. Based on this information, which requires very little active movement, and LE, trunk, and neck are
area would be most relevant for the OT practitioner to reassess generally held in a static position, it is essential to assess how
FIRST? much time the child spends in this position. The OT practitioner
a. The time he spends at the computer needs to instruct the child to take regular breaks and maintain
b. The size of the computer screen proper positioning while at the computer to avoid further strain.
c. The challenge level of the learning program
d. His control of the keyboard
158. During OT treatment, a child has a seizure. The MOST
important actions for the OT practitioner during the seizure are
(C) Ease the child to a lying position, remove or pad nearby
to:
objects, loosen clothing. The most important action to take is to
a. check breathing and administer mouth to mouth resuscitation
protect the child during the seizure by preventing injuries which
if necessary
can occur from falling or hitting objects during movements. Other
b. attempt to restrain the child's movement to prevent injury
protective measures include loosening clothing that is restrictive
c. ease the child to a lying position, remove or pad nearby objects,
and placing a blanket or cushion underneath the child if possible.
loosen clothing
d. take no actions except observation of the child
159. An individual will be performing sliding board transfers with
assistance from family members upon discharge. When order-
ing the wheelchair, which features will be MOST important to (C) Swing-away footrests and removable armrests. After swinging
include? away the footrests and removing the armrests, the individual can
a. one-arm drive and low backrest perform a sliding board transfer without being blocked by the
b. reclining backrest and elevating footrests wheelchair.
c. swing-away footrests and removable armrests
d. elevating footrests and removable armrests
160. A child short-term goal is to "demonstrate increased manip-
ulation skills by opening a 3 inch screw top jar independently." The
MOST important tool the OTR will need to reassess the childs
(B) A 3-inch screw-top jar. Since the goal was written as a func-
progress is:
tional behavioral objective, the OTR should reassess the child for
a. a goniometer
functional progress made in performance areas.
b. a 3-inch screw top jar
c. a dynamometer
d. a developmental fine motor assessment
161. A patient is about to be discharged after completing a reha-
bilitation program following a total hip replacement. In assessing
the home environment, the OT practitioner takes into consid- (C) Marking the end of each step with high contrast tape. Difficulty
eration the patients poor visual acuity. The MOST appropriate in seeing contrast and color are 2 forms of decreased visual acuity
adaptation to ensure that the client can go up and down the stairs that cannot be addressed by corrective lenses. Two effective envi-
safely is: ronmental adaptations to these deficits are increasing background
a. installing a stair glide contrast and increasing illumination. Using tape or paint to make
b. installing hand rails in both sides of the steps the edge of each step contrast sharply with the rest of the step is
c. marking the end on each step with high contrast tape an inexpensive way to adapt the environment for the patient.
d. instructing the patient to take only one step at a time when going
up or down
162. Which of the following is the MOST important precaution
(A) Practice regular skin inspection. Children with LE paralysis
to emphasize to parents when discharging a child with lower
resulting from myelomeningocele usually experience impaired LE
extremity paralysis as a result of myelomingocele?
sensation, placing them at risk for developing decubitus ulcers or
A. practice skin inspection
burns due to contact with hot water or objects.
B. avoid feeding the child chewy foods that may cause choking

25 / 32
 Johnson (SIMULATION EXAMINATION 2)
Study online at https://quizlet.com/_bqbu66
C. monitor apnea episodes
D. avoid situations that can stimulate tactile defensiveness
163. The family of an individual with paraplegia is moving into a
new apartment and they need to select a surface for the living
area. Finances are limited, but they are looking for the surface
that will be easiest for maneuvering a wheelchair. Which of the
(A) Linoleum floor. Linoleum floors are the easiest and least ex-
following is the MOST appropriate surface for this situation?
pensive surface over which to maneuver a wheelchair.
a. linoleum floor
b. short pile carpeting
c. deep pile carpeting
d. several area rugs
164. An OT practitioner is writing a daily SOAP note in order to
document treatment for a client in the rehabilitation unit. Which of
the following documented statements BEST describes an objec-
(D) "Patient stated that he likes to read sports magazines." This
tive basis for judgment?
statement provides a basis for an objective judgment on what the
a. "patient enjoys reading photography magazines"
patient likes because it has been made by the patient.
b. "patient likes news magazines"
c. "patient obviously likes to read sports magazines"
d. "patient stated that he likes to read sports magazines"
165. An individual who is being discharged in one week is func-
tioning at Allen's Cognitive level 4 and needs to take 2 different
psychotropic medications twice daily. Which of the following is the
(B) Instruct the client to take "one white and one blue pill" with
MOST appropriate discharge recommendation?
the morning and evening meals. Cognitive disabilities' levels of
a. instruct the client to take medication at 9 AM and 9 PM
function distinguish the types of assistance an individual needs
b. instruct the client to take "one white and one blue pill" with the
to safely complete everyday tasks. Cognitive level 4 functioning
morning and evening meals
involves having a routine goal in mind. Linking medications with
c. instruct the caregiver to remind the client to take medication
meals helps the goal become routine.
twice daily
d. instruct the caregiver to place pills into client's hands at the
designated times
166. An elderly has Alzheimer's disease and is about to be dis-
charged to home, where she lives with her husband. She does
(B) Strategies the husband can use to prevent the patient from
not always recognize her children, shows a tendency to wander,
wandering. Although wandering, incontinence, and failure to rec-
and has frequent episodes of incontinence. Which of the following
ognize family members (answers A, C, and D) are all issues,
is the MOST important item for the OT practitioner to include in
wandering is the only potentially dangerous one. Because the
the family discharge planning conference?
patient's dementia is advanced, most of the discharge planning is
a. strategies the patient can use for incontinence
directed toward the husband. Discussion with the patient will have
b. strategies that the husband can use to prevent the patient from
no effect on her ability to manage her incontinence. At this point,
wandering
environmental adaptation will be more effective than attempting
c. strategies that the patient can use to prevent wandering
to change the patient's behavior.
d. reality orientation techniques to increase recognition of her
children
167. An OT practitioner is working with an individual who has
identified alcohol abuse as a contributing factor to the depression
that he has been experiencing. The practitioner is discussing
discharge plans with this individual. At discharge, the MOST (B) Self-help groups. Self-help groups are supportive and edu-
appropriate type of group to refer this individual to is a(an): cational and focus on personal growth around a single major life
a. advocacy group disrupting problem.
b. self-help group
c. support group
d. psychotherapy group
168. Several clients are about to be discharged from an inpatient
psychiatric unit to a variety of community programs. Which of
the following areas is MOST important to address in a discharge
(C) Relapse prevention. Relapse prevention, symptom identifica-
planning group?
tion and reduction, and medication management are the areas
a. developing ADL routines
that are emphasized in discharge planning groups.
b. self-awareness
c. relapse prevention
d. social skills

26 / 32
 Johnson (SIMULATION EXAMINATION 2)
Study online at https://quizlet.com/_bqbu66
169. An OT manager is preparing the OT staff for a visit from
an accrediting agency. The accrediting agency that surveys the
inpatient and comprehensive outpatient rehabilitative programs is
(C) CARF. The Commission on Accreditation of Rehabilitation
BEST represent by which of the following:
Facilitates (CARF) is the regulatory agency for the provision of
a. AOTA
rehabilitation services.
b. JCAHO
c. CARF
d. NBCOT
170. An OT practitioner working in a drug and alcohol rehabil-
itation center is educating clients about discharge options. The
PRIMARY expectation for becoming a member in a self-help
group for alcohol problem is:
(B) Members share their experiences and struggles with alcohol
a. members are encouraged to tell the other members their names
use. Shared experiences can build feelings of understanding,
and where they live and work
hope, and acceptance among the members of a self-help group.
b. members share their experiences and struggles with alcohol
use
c. members are required to attend a set number of meetings
d. members are encouraged to give advice to others
171. Adults with mental retardation can be offered with a variety
of work alternatives. Which if the following MOST likely involve
simple assembly or sorting and packaging tasks with supervision
and subcontracted piecework? (D) A sheltered workshop. Sheltered workshops are designed to
a. an adult activity center help individuals master basic work skills.
b. supervised employment
c. job coaching
d. sheltered workshop
172. An OTR is a team member of a work hardening program.
Which of the following would BEST represent the goal that an OT
practitioner would document regarding this type of program?
(C) Work simulation to increase strength and endurance for nec-
a. ADL retraining to increase the ability to perform household skills
essary work-related skills. Work stimulation is considered to be a
independently
primary goal of work hardening, in addition to increasing produc-
b. progressive resistive exercise to increase endurance for self-
tivity and feasibility through work-simulated activities. OTs typical-
care skills
ly measure and assess a client's overall physical ability to perform
c. work simulation to increase strength and endurance for neces-
the requirements of a particular job.
sary work related skills
d. vocational retraining to increase the ability to re-enter the job
market
173. In establishing a wellness program for older adults, the OT
(B) Increase physical activity and fitness. Wellness programs
practitioner is MOST likely to incorporate activities that:
focus on developing personal control of behaviors through ed-
a. improve weakness following a CVA
ucational approaches and active participation in activities that
b. increase a physical activity and fitness
promote health, such as increasing level of physical activity to
c. improves social skills for depressed elders
improve physical fitness.
d. increase independent performance
174. An OTR working as a consultant to a health care facility to
assist the facility in achieving compliance with the Americans with
Disability Act, title III. The PRIMARY focus of the OTs efforts would
be to make recommendations about:
a. improving accessibility in building access, building interiors, and (A) Improving accessibility in building access, building interiors,
rest rooms and rest rooms. Title ill of the ADA addresses accessibility of
b. modifying equipment, providing assistive aids, and training in facilities used by the public and focuses on removal of structural
adaptive so a disabled person can perform a particular job barriers to allow access to the premises and use of the facilities,
c. providing education to persons who hire personnel concerning including, parking areas, walks, ramps, entrances, etc.
non-discriminatory behaviors and procedures regarding persons
with disabilities
d. assistive technology systems to facilitate job performance of
disabled employees
175. A fall prevention program is being implemented by an OT
who works in life-care retirement community. The BEST way to
implement this type of program at the primary level of prevention
would be to:

27 / 32
 Johnson (SIMULATION EXAMINATION 2)
Study online at https://quizlet.com/_bqbu66
a. develop a protocol for environmental modification to reduce fall
risks in the life-care retirement community
(A) Develop a protocol for environmental modification to reduce
b. observe ADL performance to identify those residents at highest
fall risks in the life-care retirement community. Developing a pro-
risk for falls
tocol for environmental modification of general hazards to reduce
c. make recommendations for wheelchair positioning for those
falls throughout the community is an example of a primary pre-
who have had at least one fall
vention strategy.
d. provide intervention to improve balance for those residents who
demonstrate the need
176. Which of the following activities would be MOST appropriate (A) Stocking the shelves at a local grocery. OT interventions for
for vocational skills training for high school students with severe the transition from school to adult life should focus on real-life
learning disabilities? functional activities in actual work settings. Working in the natural
a. stocking shelves at a local grocery setting affords students opportunities to develop skills necessary
b. packaging items in a local sheltered workshop for success in community jobs. Working in a sheltered workshop
c. cleaning the school cafeteria after lunch in their own school environment does not provide real-life settings
d. reading want ads and role playing interviews for job training.
177. The OT is leading a grooming group for female clients in
a psychosocial treatment setting. Which if the following options
(A) Use disposable cotton swabs and have clients bring their own
BEST complies with universal precautions?
cosmetics. Universal precautions are related to the prevention of
a. use disposable cotton swabs and have client bring their own
the spread of infection. Using disposable cotton swabs and having
cosmetics
clients use their own cosmetics would be effective in reducing the
b. use disposable gloves when combing the client's hair
risk of infection.
c. wash and dry makeup brushes between uses
d. avoid bringing cosmetics in glass containers to the group
178. A COTA and OTR have effectively worked together for the (A) A mutual process. The supervisory process is one that re-
past 5 years. Which of the following BEST describes the supervi- quires the attention of both parties involved. The COTA needs to
sory process between a COTA and supervising OTR at this level? develop his/her own role and identity within the institution and
a. mutual process profession. In addition, the OTR supervisor needs to provide the
b. evaluative process COTA with opportunities for growth and development. As part
c. counselling process of this relationship, ongoing evaluation and counseling may take
d. learning process place to enhance leaning and role development.
179. An OTR has been working in the area of mental health for 3
(D) Intermediate-level OTR with routine supervision. Supervision
years and continues to meet with her supervisor every other week.
is the oversight required of an OT and may be at 1 of 4 levels
This therapist has mastered basic role function, begun specializa-
based on the expertise of the professional. This therapist sees the
tion and participates in the education of other personnel. Based
supervisor every other week, indicating a routine or general level
on the AOTA document, Occupational therapy roles, this OTR is
of supervision which is appropriate for an intermediate-level prac-
functioning as an:
titioner. An intermediate therapist will have gained skill mastery,
a. entry-level OTR with close supervision
begun to specialize, and have the ability to participate in education
b. intermediate-level OTR with minimal supervision
of others. However, he or she has not yet gained the refinement
c. advanced-level OTR with general supervision
of special skills to be considered advanced.
d. intermediate-level OTR with routines supervision
180. An advanced-level COTA who has worked at an independent (B) Yes, as long as state regulations allow autonomous practice
living center for the past 7 years has been offered the position and the COTA recognizes situations that require consultation with
of director of the program. There are no funds to pay for OTR or referral to an OTR. OT plays a significant role working with
supervision. According to the AOTA, can the COTA accept the consumers in the independent living movement by working both
position? with individuals and their environments. According to the AOTA
a. only if the COTA can find some way to fund OTR supervision position statement The Role of Occupational Therapy in the In-
b. yes, as long as state regulations allow autonomous practice dependent Living Movement, AOTA "supports the autonomous
and the COTA recognizes situations that require consultation with practice of the advanced COTA practitioner in the independent
referral to an OTR living setting." In this situation it would be the responsibility of
c. no, the COTA cannot work in this practice setting without OTR the COTA to recognize and seek out OTR consultation when
supervision appropriate. However, this does not supersede state regulations
d. only if the COTA relinquishes use of the credentials "COTA" when they prohibit autonomous practice by the COTA.
181. An individual with advanced lung cancer is about to be
discharged from an acute care setting to home. She is depressed,
although she remains ambulatory and independent in basic activ- (D) Recommend hospice OT. OT in hospice care focuses on role
ities of daily living; she tries very quickly and no longer participates performance, the components of which are quality of life, focus
in most of her life roles. Which of the following is the BEST action and control, and adaptation. This type of intervention may bring
for the OT practitioner to take? quality and meaning to the individual's remaining days.
a. provide her with a home program
b. recommend home health OT

28 / 32
 Johnson (SIMULATION EXAMINATION 2)
Study online at https://quizlet.com/_bqbu66
c. recommend discontinuation of OT services
d. recommend hospice OT
182. While practicing wheelchair-to-tub transfers in individual's
external catheter is dislodged and urine spills onto the floor. The
therapist notes that the urine appears to have blood in it. Which (D) An exposure has occurred; put on gloves, clean up the spill
one of the following response is the MOST appropriate? with paper towels, put the soiled paper towels in a plastic bag,
a. an exposure has not occurred; clean up the area with paper seal the bag, disinfect the area, and finish the patient's session
towels and resume treatment as quickly as possible with whatever time is still left. The Occupational Safety and Health
b. an exposure has occurred; close off the area until it can be Administration (OSHA) has identified materials that require uni-
disinfected and resume treatment as quickly as possible versal precautions to include blood, semen, vaginal secretions,
c. an exposure has occurred; clean up the spill with towels, place CSF, synovial fluid, pleural fluid, any body fluid with visible blood,
towels in the dirty laundry bin and resume treatment as quickly as any unidentifiable body fluid, and saliva from dental procedures.
possible Items OSHA has identified as not needing universal precautions
d. an exposure has occurred, put on gloves, clean up the spill with include feces, nasal secretions, sputum, sweet, tears, urine, and
paper towels, out the soiled paper towels in a plastic bag, seal the vomitus.
bag, disinfect the area and finish the patient's session whatever
time is still left
183. An OT manager is attempting to find a way to have financial
success in the department while ensuring patient satisfaction.
(D) Interdisciplinary care improvement teams. Healthcare pro-
Which of the following is MOST likely to be implemental to assess
fessionals who are part of an interdisciplinary care improvement
patient flow, develop critical pathways and cut costs?
team work together to "address such issues as patient flow, the
a. quality improvement
discharge process, patient outreach, and promotion and cost-ef-
b. peer review teams
ficiencies."
c. cost accounting
d. interdisciplinary care improvement teams
184. A client uses a wheelchair and is independent in transfers
and basic ADL. With continued OT intervention, he is expected
to be able to function independently in the community. The MOST (B) Transitional living center. Transitional living centers "provide
appropriate community living option for him, at this time, would be temporary living arrangements for individuals who are in a tran-
a(n): sitional phase between hospital or institution and independent
a. cradle-to-grave home community living. Professional staff, including OTs, assist the res-
b. transitional living center idents in gradually assuming responsibility in self-maintenance."
c. adult day program
d. clustered independent living arrangement
185. An OT is establishing a department in a rural long-term
care facility. When developing the policies and procedures for
(A) Uniform Terminology for Occupational Therapy. Uniform Ter-
documentation in the facility, which of the following documents
minology is a document that defines OT in relationship to perfor-
would be MOST useful?
mance areas and performance components. This document pro-
a. Uniform Terminology for Occupational Therapy
vides a common language for OTs to use to describe individuals
b. Occupational Therapy Code of Ethics
and their performance abilities.
c. Occupational Therapy Standards of Practice
d. Occupational Therapy Roles
186. An OT practitioner is coordinating a cooking group, as a part
of the competency training program for leading the group, the OTR
must demonstrate an awareness of the policies and procedures
(A) Infection control plan. An infection control plan most likely
that relate to the storage and maintenance of a staple products,
includes appropriate techniques and procedures for storing and
as well as food handling. This policy will MOST likely be part of
handling foods within the OT department. Such plans specify the
the facility's:
shelf lives of certain foods, standards for storage of food, use of
a. infection control plan
hair nets, and cooking temperatures and times.
b. risk management plan
c. emergency procedures plan
d. environmental survey plan
187. A physician's referral for OT services may be required by
(B) Federal and state governmental agencies and third-party pay-
which of the following:
ers. AOTA (included in answers A, C, and D) does not require
a. AOTA, federal and state governmental agencies
physician referral for the provision of OT services. Federal, state,
b. federal and state governmental agencies and third-party pay-
and local government agencies; third-party payers; regulatory
ers
and state agencies; and individual facilities may require physician
c. third-party payers, individual facilities and AOTA
referral.
d. AOTA, third-party payers and state governmental agencies

29 / 32
 Johnson (SIMULATION EXAMINATION 2)
Study online at https://quizlet.com/_bqbu66
188. An OT practitioner is graduating from an OT program and
is seeing employment. An OT job description would MOST likely
contain: (D) The title of the job, organizational relationships, essential job
a. the title of the job, post experience required and job require- functions, and the job requirements. Job requirements usually
ments contain the title of the job, organizational relationships, essential
b. a summary of primary job functions, references and job require- job functions, work performed, job requirements, and environ-
ments mental risks. Items that are not required but may complement an
c. the organizational relationships, personality characteristics de- individualized job description are personality characteristics, past
sired in a job candidate and accomplishments of the candidates experience requirements, and accomplishments.
d. the title of the job, organizational relationships, essential job
functions and the job requirements
189. When working within a school system to assist the main-
streaming of a child with spina bifida into a regular classroom,
(D) The OT problem solves with the teacher. Answer D is correct
the OT consults with the classroom teacher. The nature of this
because the consultation relationship in the school is based on
"consultation" relationship is BEST characterized by the following
a shared relationship with the school staff for whom the OT is
statement:
hired to consult. Answer D reflects one of the essential tenets of
a. the OT teaches the teacher
consultation - that the consultee, by sharing in problem solution,
b. the OT provides therapy to the child
will become committed to a child's program.
c. the OT directs he teacher
d. the OT problem solves with the teacher
190. The OT department has been asked to provide information
to the hospital administration regarding the cost effectiveness of
(D) Productivity evaluations. "Productivity is the ratio between the
services provided. Which of the following methods would MOST
output and the resources expended to obtain the desired out-
effectively obtain this information?
put." High productivity is often associated with costeffectiveness.
a. outcomes measurements
Analysis of productivity data can contribute to program develop-
b. utilization review
ment, improving staff effectiveness and containing costs.
c. program evaluation
d. productivity evaluations
191. An OT practitioner works with an entry-level COTA on an
(B) Evaluate clients who are admitted on the weekends. The
inpatient psychiatric unit. They each work 4 days a week, over-
primary role of the COTA is to implement treatment such as that
lapping schedule only on Mondays. It would be inappropriate for
described in answers A, C, and D. AOTA guidelines about OT
the OTR to ask the COTA to:
roles (AOTA, 1993) indicate that a COTA may not independently
a. lead the daily craft group
evaluate patients. Depending on the site and its policies, the
b. evaluate clients who are admitted on the weekends
COTA may be able to begin the process of assessment by making
c. assist individuals in carrying out their ADL on Saturday and
contact with the client and collecting data that the OTR would use
Sunday mornings
in performing the evaluation.
d. lead a leisure planning group on Saturday afternoon
192. A new COTA works in a busy rehabilitation department. Half
of the department's OT staff, including the supervisor, is out with
the flu. The COTA observes an aide carrying out a session of
training in ADL with a patient who is scheduled for discharge the (D) Discuss her concerns with an OTR who is present. Although
next day. The MOST responsible action for the COTA to take is to: the COTA's own supervisor is absent, an OTR present would
a. allow the aide to finish so the patient will be prepared for become the acting supervisor for the COTA for the day. The COTA
discharge should always discuss concerns with the supervisor first.
b. terminate the aide and complete the session herself
c. bring the issue to the attention of the facility administrator
d. discuss these concerns with an OTR who is present
193. A COTA and OTR jointly decide to discharge an individual
after the goal of independence has been achieved. However, they
are instructed by the facility administrator to continue treating,
(C) Inform the administrator they are unable to provide services
or at least billing, the individual for two sessions per day for the
to individuals who can no longer benefit form OT. Answers A,
next week, because his insurance will allow it. What is the most
B, and D involve falsifying documentation, financial exploitation
appropriate action for the OT practitioners to take?
of insurance carriers, and inaccurate recording of professional
a. continue to work on activities the individual particularly enjoys
activities, and are violations of the Code of Ethics. It is unethical to
twice a day whenever possible
bill for services not rendered or to provide services to individuals
b. discontinue treatment but continue to bill as directed by the
who can no longer benefit. In this case, the individual reached his
administrator
full potential for independence in self-care and no longer requires
c. inform the administrator they are unable to provide services to
OT services.
individuals who can no longer benefit from OT
d. compromises with the administrator and agree to drop in and
check on the individual once a day and bill accordingly
30 / 32
 Johnson (SIMULATION EXAMINATION 2)
Study online at https://quizlet.com/_bqbu66
194. A clinical manager of an OT department is reviewing ster- (B) Any equipment that has come into contact with body fluids
ilization policies based in universal precautions. The manager must been sterilized before using the equipment again. OSHA has
revealed that this policy will MOST likely state that: set out strategies to protect individuals from potential exposure
a. all equipment is to be sterilized annually to HIV and hepatitis B virus. This situation would be an example
b. any equipment that has come into contact with body fluid must of an engineering control. These controls are to modify the work
be sterilized before using the equipment again environment to reduce risk of exposure. Other examples are using
c. all equipment is to be sterilized at the end of each day sharps containers, eyewash stations, and biohazard waste con-
d. all equipment is to sterilized after each use tainers.
195. An OT practitioner in private practice is preparing to act as a
(A) Negotiate the contract. Many OT practitioners have moved into
consultant to a community agency. The FIRST step would be to:
consultation roles. The first step in the consultation process should
a. negotiate the contract
include negotiation of a contract. This immediately establishes the
b. establish trust
general terms of agreement and a focus of the activities that are
c. assess the environment
to be completed by the therapist.
d. identify problems
196. A manager of an OT department is attempting to increase
the visibility of the OT department within the setting. This type of
promotion is commonly done through internal marketing. In order (B) A presentation to physicians. Answer B, a presentation to
to market internally, the OT manager would MOST likely employ physicians, is correct because this is an example of internal mar-
which of the following? keting. Other internal marketing strategies are site-based open
a. a community newsletter houses, progresses notes, service reports and in-service for nurs-
b. a presentation to physicians ing staff.
c. a local community workshop
d. a booth at a local health fair
197. A research question has been identified and a literature
review completed by an OT practitioner. The NEXT step for the
(A) Refine the question and develop the background. Once the
OT researcher is to:
question has been identified, a review of the literature should
a. refine the question and develop the background
occur. The next step in research is to refine the question and
b. decide on methodology
develop the background
c. establish boundaries for the study
d. collect and analyze data
198. An OTR/COTA team need to report discharge information
and document the information in the patient's chart. At what level
does the COTA participate in making discharge recommenda-
tions?
a. an entry-level COTA may perform the task independently (C) A COTA contributes to the process but does not complete the
b. an intermediate-level COTA may perform the task independent- task independently.
ly
c. a COTA contributes to the process but does not complete the
task independently
d. a COTA cannot perform the task
199. On the way to lunch, an OT practitioner is stopped by a
patient's spouse and questioned for 15 minutes about the pa-
tient's progress. What is the MOST appropriate action for the
OT practitioner to take when determining how the patient will
be treated and charged for the scheduled one hour treatment
session?
a. charge the patient for an additional 15 minutes of treatment for (D) Treat the patient as scheduled and charge for the 1 hour of
the time spent with family member direct time spent with the patient.
b. reduce the patient's therapy to 45 minutes and charge for 1 hour
to treatment cover the time spent with the family member
c. reduce patient's therapy to 45 minutes and charge patient for
45 minutes of treatment
d. treat the patient as scheduled and charge for the 1 hour of direct
time spent with the patient
200. While preparing for his first presentation at a professional
conference, an OT realizes he does not have the name of the
author of an article containing critical information he planned n
photocopying and distributing. Which of the following is the MOST
appropriate action for the OT to take?
a. distribute the handout and apologize for not having the author's

31 / 32
 Johnson (SIMULATION EXAMINATION 2)
Study online at https://quizlet.com/_bqbu66
name
b. show the handout with an overhead projector and apologize for
not having the author's name (C) Use the handout only as resource while developing the pre-
c. use the handout only as resource while developing the presen- sentation.
tation
d. refrain from using the handout in any way

32 / 32