NBCOT National Board for Certification of Occupational Therapy 2024-2025 Practice Exam Rev, Exams of Occupational therapy

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NBCOT National Board for Certification of

Occupational Therapy 2024-2025 Practice

Exam Review Questions and Answers

100% Pass | Graded A+

David Mungai [Date] [Course title]

NBCOT National Board for Certification

of Occupational Therapy 2024-

Practice Exam Review Questions and

Answers 100% Pass | Graded A+

1. The director of OT services for a large metropolitan home health agency is conducting a supervisory visit and notices the OTR is writing progress notes on a persona electronic tablet. OT is excited about using tablet and shares with the director that it saves a great deal of time. Most appropriate response from director? a. Applaud the OT for using technology efficiently b. Develop a policy prohibiting the use of personal electronic tablets for note writing c. Ask the OT to describe the use of electronic recording to the other OT at the agency d. Ask home health clients for their opinions regarding electronic record keeping - Answer>> b. Develop a policy prohibiting the use of personal electronic tablets for note writing A patient in a rehabilitation facility has a complete C8-T1 spinal cord injury. The patient is learning techniques to maximize independence with dressing. Which technique should the OTR teach the patient to use to support progress toward this goal? a. Put on undergarments and trousers in bed, then transfer to a wheelchair to complete upper body dressing b. Use a universal cuff with a button-hook and zipper-pull to fasten front-opening clothing c. Wear a wrist-driven flexor hinge splint for pulling on and fastening clothing d. While supine in bed, put on socks and shoes; then put on underpants and trousers by rolling side to side in bed -

a. back-date the entry to correspong to the actial date of the meeting b. insert a summary of the meeting into the margins of the client's medical record. D. Enter the information as a late entry into the client's medical record. - Answer>> D. Enter the information as a late entry into the client's medical record. An OTR who has passed the initial NBCOT exam has decided not to be recerified through NBCOT. Which consequences will result from the OTR decision? a. the OTR will not be allowed to practice OT in the USA b. The OTR practice opportunities and credentials will remain unchanged c. the OTR may practice OT in the state that does not require certification, but the OTR's credential will change d. the OTR may practice OT in a state that does not require certification and the OTR credentials will not change - Answer>> c. the OTR may practice OT in the state that does not require certification, but the OTR's credential will change

6. A COTA decides that a client has returned to the previous level of function and continued OT services are no longer needed. Best way to discharge patient? a. COTA sets a last tx day, provides home exercise program and review progress with the patient while completing the discharge notes b. COTA alerts the OTR and the OTR review the documentation discusses the patient's progress and response to intervention, and collaborates on a last tx day c. COTA notified the OTR who meets with the patient to discuss potential discharge from therapy, the OTR proceeds the discharge d. COTA sets a last tx day, provides a home exercise program and home safety packet, and reports final notes on functional

levels to the OTR - Answer>> b. COTA alerts the OTR and the OTR review the documentation discusses the patient's progress and response to intervention, and collaborates on a last tx day COTA working on an inpatient rehab has had 2 patients fall in last month. OTR has concerns about the COTA's safety awareness during certain interventions. Which approach is the best for the OTR? a. speak with the rehab manager about possible disciplinary action b. review the documentation of the 2 patients who fell and discuss their cases thoroughly with the COTA to determine cause of the falls c. ask the COTA whether more thorough supervision is needed and then proceed to provide close supervision d. collaborate with the COTA to determine potential causes of the falls and provide direct supervision with more deliberate feedback

• Answer>> d. collaborate with the COTA to determine potential causes of the falls and provide direct supervision with more deliberate feedback An OTR is supervising an OT student for Level II FW. The OTR notices that the student did not gather complete info. Regarding a client's Occ. History. Which comment best represents effective feedback? a. "you missed some info when you were recording the client's occ. History b. "in the future, you need to ask better questions about the client's occ. History c. "in the future, you may want to use a checklist to ensure that your occ. History interviews are comprehensive. d. you should practice doing occ. History interviews - Answer>> c. "in the future, you may want to use a checklist to ensure that your occ. History interviews are comprehensive.

b. I have pain when I wake up in the morning. I have arthritis. It usually takes a while before it gets any better. Maybe you should try to exercise in the morning to get things moving like I do c. I realize that you are in pain. Lets try this activitiy and see what happens. If you need to stop, let me know, but I would like to see you push yourself. d. I think we should slowly increase the time you are spending at work-related tasks - Answer>> c. I realize that you are in pain. Lets try this activitiy and see what happens. If you need to stop, let me know, but I would like to see you push yourself.

• Answer>> An OTR is working with an adult client with sensory processing difficulties who finds it uncomfortable to commute to a job via train because of the noise of the train and of other passengers talking. Which environmental modification would be appropriate? a. encourage the client to obtain a driver's license and avoid train b. petition the train to set off a section of silence c. recommend the use of noise-cancelling headphones with a device that plays music or books the client enjoys d. get a closer job - Answer>> c. recommend the use of noise- cancelling headphones with a device that plays music or books the client enjoys

1. An OTR is working to establish a therapeutic relationship with a client in a skilled nursing facility. Which consideration is the MOST important in establishing an effective relationship? a. The OTR has the power to determine the goals b. The client is an informed equal in the relationship c. The OTR is solely responsible for any positive outcomes d. The client is expected to follow the OTR advice - Answer>> b. The client is an informed equal in the relationship

2. A client with a herniated lumbar disk was referred to OT. The OTR completes an initial eval. And develops an intervention plan. Which task can the OTR assign to the COTA? a. Write up the initial eval. b. Alter the initial plan to address pain c. Do a complete reeval. Of strength d. Educate the client in proper body mechanics - Answer>> d. Educate the client in proper body mechanics
3. According to the Standards of Practice for OT, what is the role of the COTA in the screening process a. Completing the screening process b. Initialing the screening process c. Analyzing and interpreting screening results d. Providing observations to the OTR - Answer>> d. Providing observations to the OTR
4. A COTA who spend 2 years working on the ortho. Unit of an acute care hospital is now working on the neuro. Floor. How is appropriate supervision best described? a. The OTR and COTA decide to set up supervisory visits on an as-needed basis b. The COTA requires minimal supervision owing to his or her 2 years of experience c. The OTR and COTA agree that close supervision is best at this time d. The OTR and COTA decide that continuous supervisor is needed. - Answer>> c. The OTR and COTA agree that close supervision is best at this time
5. A supervising OTR hires two newly graduated COTA's who have different learning styles. One prefers visual learning, and the other prefers hands on learning. Which approach is the best way for the OTR to supervise both COTAS

d. Allow the patient to attend the group with the understanding that the OTR will complete the eval on returning to the unit. - Answer>> b. Do no allow the patient to attend the group

8. An entry-level COTA begins working at a long-term care facility and needs direct continuous supervision. Which statement BEST describes this type of supervision? a. The COTA and supervising OTR are in the rehab. Gym, the OTR observes the COTA's performance b. The COTA and OTR meet at the end of the day to discuss the COTA's caseload and review documentation c. The supervising OTR is in the facility but in another area d. The COTA emails or texts the OTR questions throughout the day as needed, and the OTR reviews the COTA's documentation regularly. - Answer>> a. The COTA and supervising OTR are in the rehab. Gym, the OTR observes the COTA's performance
9. According to the Standards of Practice for OT, which task can the COTA complete in the eval. Process? a. Respond to the initial referral request b. Interpret and document the eval results c. Perform delegated assessments using current tools d. Make recommendations to other professionals - Answer>> c. Perform delegated assessments using current tools A COTA has been assigned to treat a new patient. The OTR has evaluated this patient but has not yet written the documentation. How should the COTA proceed? a. Do not treat the patient and document in the chart that intervention is on hold pending completion of eval. b. Review the chart to understand the patient's conditions and ask the patient what needs to be addressed as part of treatment c. Co-treat with the physical therapist to gain info on reason for admission and special issues, and document accordingly

d. Discuss with the OTR reason for admission, precautions, and goals, and proceed, documenting the supervisory visit. - Answer>> d. Discuss with the OTR reason for admission, precautions, and goals, and proceed, documenting the supervisory visit.

11. According to the Standards of Practice for OT, which best describes the role of the COTA in client outcomes? a. Develops a transition plan b. Contributes to discontinuation plan - however unable to Ind. Discontinue a client from OT. c. Reduces the intensity of services d. Interprets achieved outcomes - Answer>> b. Contributes to discontinuation plan - however unable to Ind. Discontinue a client from OT.
12. Which statement Best describes how a COTA assists with performing an OT eval? - Answer>> a. The COTA may perform delegated assessments and provide reports of a client's capabilities to the OTR
13. Under what circumstances is a COTA allowed to administer the Kohlman Eval. Of Living Skills to a new patient in an inpatient acute psychiatric hospital? a. After an OTR has directed the COTA to initiate the eval process b. When the OTR is unavailable to administer the assessment c. When the OTR is in the room while the COTA administers the assessment d. When the COTA has demonstrated competence in administering the assessment to the OTR - Answer>> d. When the COTA has demonstrated competence in administering the assessment to the OTR

17. An OTR who supervised an OT assistant student in the student's final level II fieldwork in an acute psychiatric hospital hires the student for a COTA position. The student plans to sit for the NBCOT exam in 2 weeks. How should the OT supervise the COTA? a. Supervise the new employee as a COTA/L because the employee has completed all courses and fieldwork b. Always provide direct, face-to-face supervision for the new employee c. Supervise the employee consistent with national and state guidelines on uncertified employees d. Ask the new employee to initiate an OT assessment. - Answer>> c. Supervise the employee consistent with national and state guidelines on uncertified employees
18. A client with hip osteoarthritis has been referred for an OT assessment and treatment. What can the OTR have a COTA contribute to the assessment? a. Identify whether the client will need OT b. Decide which eval should be completed c. Select and implement therapeutic activities d. Interpret from the outcome if client can engage in occupations - Answer>> c. Select and implement therapeutic activities
19. An OTR has just begun working on the cardiology unit of an acute care hospital and will be responsible for supervising the COTA that has been working there for 5 years. What is the best level of supervision? a. Continuous b. Minimal c. Routine d. Close - Answer>> b. Minimal
20. An OTR in a home health setting is working with a client in the kitchen and hears a heated argument between the client's spouse

and one of the client's children in the next room. The client begins to cry, indicating that the arguing is causing stress. a. Confront the people in the next room b. Call the medical social worker and report the incident c. Drive the client to a shelter d. Try to resolve the conflict - Answer>> b. Call the medical social worker and report the incident

2. An OTR is conducting a group for older adult clients on prep. For driving cessation. Several group members express a fear of using public transportation because they have never done so. a. Referrals to a psychologist to address issues of fear and anxiety b. Driving evals. To ensure that the clients can continue to drive for as long as possible. c. Travel training to practice use of public transportation with the clients until they feel comfortable on their own d. Simulation of public transportation by driving the clients along the same routes used by the transit system - Answer>> c. Travel training to practice use of public transportation with the clients until they feel comfortable on their own
3. Older women who are members of an ethic minority and live on lower incomes have been identified as using public transportation more than most people in their age cohort. How might this reliance on public transportation influence the engagement in community occupations of this population? a. Participation in community occupations will be limited by the hours of transportation service and the cost to use it b. Access to taxi services will expand this population's access to community occupations. c. Public transportation offers access to more geographic areas than does a private automobile - Answer>> a. Participation in community occupations will be limited by the hours of transportation service and the cost to use it

c. Activities that do not require too many choices d. Activities that allow for self-expression - Answer>> d. Activities that allow for self-expression

8. An OTR is evaluating a 16-year old adolescent with major despression and suicide precautions in an inpatient facility. Which source of info. Will best enable the OTR to document the intensity, severity, and duration of these symptoms? a. Observation during occupational performance b. A life events inventory of the client c. Interviews with caregivers d. Interviews with roommates in the facility - Answer>> b. A life events inventory of the client
9. During an OT eval., which approach would pose the biggest barrier to engaging in a client-centered process with an adult client who is able to converse? a. Paying attention to the meaning of nonverbal cues b. Being directive c. Being too empathetic with the client d. Asking too many closed-ended questions - Answer>> d. Asking too many closed-ended questions
10. An OTR works with elderly clients with low vision. A client with macular degeneration is referred after substantial symptom progression and loss of vision. The client's spouse states that for the past 3 months, the client has uncharacteristically refused to participate in social activities, is frequently irritable and uncommunicative, and is unwilling to perform personal care or routine risks. a. Consider exporing assisted living alternatives b. Insist that the client resume accompanying the spouse to bridge club and prepare a snack to share with the club c. Encourage the client to consult a mental health provider

d. Advise the client and spouse to seek professional counseling to adjust to the inevitable changes in the marriage - Answer>> c. Encourage the client to consult a mental health provider

11. An adolescent hospitalized for suicidal ideation and depression is meeting with an OTR for discharge planning. What aspect of the discharge plan is MOST urgent? a. Provide client education on the effects of prescription medication b. Review the contract for safety procedures the client will follow when thoughts of suicide commence c. Contact the client's school system to see if a suicide prevention program is in place d. Reinforce the need for follow-up OT treatments to monitory progress - Answer>> b. Review the contract for safety procedures the client will follow when thoughts of suicide commence
12. An OTR is assessing a client with bulimia. The client has become preoccupied with hiding purging behaviors from friends and family. While developing an occupational profile with the client, the OTR notices that the client's bulimia has evolved, and that the client has replaced all other activities with the bulimia. a. Teach the client relaxation strategies to provide relief from the stress caused by the bulimia b. Recommend social activities to encourage the client to interact with friends and family in a more positive way c. Provide the client with leisure's activities that will create more balance and offer the client more control over the client's life d. Assign the client small-group activities with other clients to provide the client with info. About the health impact of bulimia. - Answer>> c. Provide the client with leisure's activities that will create more balance and offer the client more control over the client's life

d. Conflict resolution sessions between the spouse and client - Answer>> a. Training the spouse to provide simple, one-step directions and avoid abstractions

4. Which statement best describes an important consideration for OTR's working with clients with dementia and their caregivers? a. Providing a variety of new occupations creates a sense of well- being for the caregiver and care recipient b. A brief respite from caregiving benefits the caregiver but is detrimental to the care recipient c. Everyday occupation is central to a caregiver's sense of well- being d. Psychologically resisting the inevitability of chronic illness improves satisfaction with caregiving. - Answer>> c. Everyday occupation is central to a caregiver's sense of well-being
5. Believing that treatment was not medically necessary, a third- party payer has denied payment for OT services. What step should OT take to appeal the denial of payment? a. Write an appeal letter that explains the client's need for the OT services that were provided b. Correct technical errors in previously submitted documentation c. Write an appeal letter that requires reconsideration of previously submitted documentation d. Ask the payer whether a different intervention would better fit the payment guidelines - Answer>> a. Write an appeal letter that explains the client's need for the OT services that were provided
6. During the OTR initial interview, a client with stage 2 Parkinson's disease explains the importance of the client's role of head of household and expresses a fear of being dependent on his or her children. The client's chief complaints are tremors and fatigue, which are starting to affect the client's performance of higher-level ADL and IADL tasks.

a. Energy conservation education, such as delegating tasks to family members to reduce fatigue b. Stress management skills, because stress tends to exacerbate symptoms such as tremors c. Activity and environmental modifications for home management skills to successfully maintain the client's role d. Therapeutic exercise to improve balance, which will enhance the client's participation in higher-level tasks. - Answer>> c. Activity and environmental modifications for home management skills to successfully maintain the client's role

7. A client with middle-stage dementia has been wandering outside the house in the middle of the night. The client's caregivers have been using monitoring devices and recently added door alarms, but usually are too late. Weather is beginning to get cold, and the caregivers do not want to the client to get frostbite. What is the next intervention for the client? a. Install bed rails to keep the client from climbing out of bed b. Place the client in a nursing home c. Conceal the doorknobs so that the client cannot open the door d. Move the client's bed into one of the caregivers room - Answer>> c. Conceal the doorknobs so that the client cannot open the door
8. An OTR is working with a client with Alzheimer's disease (AD) in a skilled nursing facility. The client's adult child, who is the client's primary caregiver, appears to be stressed and fatigued and has asked the OTR for advice about how to best manage the parent's progressive decline in function. What would be the best approach? a. Refer the caregiver to a physician for treatment b. Refer the caregiver to the social worker for community resources c. Provide the caregiver with education about the progression of AD