Full Practice Test B (error – will not let me edit)

A client who presents with Stage IV Hodgkin Lymphoma has ceased receiving chemotherapy services. As a result of the previously received chemotherapy, the client is experiencing deficits in memory and attention. The client appears anxious and upset secondary to her cognitive impairments and her difficulties with remembering things, along with her prognosis. Which of the following choices is MOST indicated to complete with the client and her family at this stage?

A client who presents with Stage II Hodgkin Lymphoma is currently receiving chemotherapy services. As a result of the chemotherapy, the client is experiencing deficits in memory and attention. The client appears anxious and upset secondary to these new cognitive impairments and her difficulties with remembering things. Which of the following choices is indicated to promote a compensatory response to the cancer-related cognitive impairments?

A right-hand dominant client presents for hospitalization with a deep partial thickness burn to the dorsum of the right hand. The client is status-post 1 day from undergoing split-thickness skin grafting to the affected area. Which of the following is most appropriate to INITIATE during the initial evaluation and intervention process in the acute post-graft stage?

An OT has been treating a client in an outpatient facility who presents for OT services with a diagnosis of De Quervain’s tenosynovitis of the right upper extremity. The client has recently experienced a burn to the right hand during meal preparation, and the burn presents with redness, blistering, and a wet appearance, and the client endorses pain. What should the OT’s FIRST response be in handling this burn?

A client who has experienced chronic pain has been diagnosed with CRPS Type I of the right upper extremity with significant pain, allodynia, and limited ROM as a result. The client also has a past medical history significant for severe peripheral neuropathy with impairments in protective sensation and temperature awareness of the hands. As part of the intervention process, which of the following is MOST appropriate?

A client who has experienced chronic pain has been diagnosed with CRPS Type I of the right upper extremity. The client has a past medical history notable for epilepsy. The OT has administered the COPM as part of the evaluation process to track the client’s improvements in pain and occupational performance. As part of the intervention process, which of the following is MOST appropriate?

A generalist OT is working with a client in the home health setting. The client presents in the early stages of Glaucoma impacting IADL performance and functional mobility. The client also reports that she has recently become concerned about her driving abilities. Which of the following represents the NEXT step for the OT to take in regards to the client’s concerns?

An OT is working with a client in the home health setting. The client presents in the early stages of Glaucoma impacting IADL performance and functional mobility. The client also reports that their difficulty with IADL tasks is further exacerbated by a severe case of diabetic neuropathy of the hands. Given this information, which of the following is MOST appropriate for the OT to implement to maximize safety/independence during IADL tasks or functional mobility?

A client in a community mental health setting presenting with major depressive disorder experiences difficulty with attending her daily thematic group regarding IADL abilities. The client demonstrates limited motivation for participation in therapy sessions and reports that she is able to complete the IADL tasks without difficulties, though based on observation the client demonstrates deficits in these areas. The OT determines the client would benefit from an approach to intervention based on the Model of Human Occupation (MOHO). Based on this information, which of the following subsystems/components of MOHO is MOST appropriate to target with the client during intervention?

A client in a community mental health setting presenting with major depressive disorder experiences difficulty with attending her daily group. The client demonstrates good motivation for participation in therapy sessions and adequate insight into her areas of difficulty. The OT determines the client would benefit from an approach to intervention based on the psychodynamic frame of reference. Which of the following approaches would BEST illustrate an intervention consistent with this approach?

A client in a community mental health setting presenting with major depressive disorder experiences difficulty with attending her daily group. The client demonstrates good motivation for participation in therapy sessions and adequate metacognitive abilities. The OT determines the client would benefit from an approach to intervention based on the cognitive behavioral frame of reference. Which of the following approaches would BEST illustrate an intervention consistent with this approach?

A client who has experienced a diffuse TBI is demonstrating a status/impairments consistent with an RLA IV. The OT is completing the intervention process with the client in an acute care hospital. Which of the following represents the MOST appropriate intervention to implement with the client at this stage?

A client who has experienced a diffuse TBI is demonstrating a status/impairments consistent with an RLA II, and a motor subset score of 3 on the Glasgow Coma Scale. Based on the evaluation process/observation and discussion with the SLP, the client demonstrates difficulty managing their secretions. The OT is initiating the intervention process with the client in the ICU of an acute care hospital. Which of the following represents the MOST appropriate intervention to implement at this stage?

An 8 year-old client in an outpatient facility presents with peripheral nerve compression at the flexor retinaculum. Which of the following functional activities would you expect this client to demonstrate the MOST difficulties with as a result?

An 8 year-old client in an outpatient facility presents with peripheral nerve compression at Guyon’s canal. Which of the following functional activities would you expect this client to demonstrate the MOST difficulties with as a result?

A client who experienced an ischemic cerebellar infarct five months prior presents for OT intervention in a home health setting. The client continues to present with impairments in upper extremity coordination, impaired standing balance, and anosognosia. When addressing ADL and IADL abilities, which of the following interventions would be appropriate to implement with the client at this stage?

A client with an acute ischemic cerebellar infarct presents for OT intervention in an inpatient rehab setting. The client presents with impairments in upper extremity coordination, impaired standing balance, and impaired safety awareness with limitations in metacognitive abilities. When addressing ADL and IADL abilities, which of the following interventions would be appropriate to INITIALLY implement with the client?

An OT in a community mental health setting is working with a client experiencing major depressive disorder. As part of the OT process, the OT is incorporating motivational interviewing techniques. The client has been working with the OT across the course of several weeks, with the ultimate goal to improve financial management. During an intervention session, the client states “With help from my sister, I’ve got my budget laid out for the next two months. Next time we meet, can we review it together?” Which of the following is MOST appropriate as it relates to the role of the OT at this stage?

An OT in a community mental health setting is working with a client experiencing major depressive disorder. As part of the OT process, the OT is incorporating motivational interviewing techniques. During the evaluation the client reported that his ultimate goal is to improve financial management. However, the client states “I know I need to stop spending so much money, but I’m not sure I’m ready to start cutting down just yet”. Which of the following strategies will be MOST appropriate for the OT to include with the client during initial intervention at this stage?

An individual with Bipolar Disorder is being seen in a community mental health setting. The client has resided with friends in a dorm apartment for the prior 2 years, but perceives that he lacks the basic IADL living skills such as cooking and financial management to optimally perform in his environment. Based on this information, which of the following subsystems/components of MOHO is MOST appropriate to target with the client during intervention in this scenario?

An OT has been consulted by a corporate client to create an injury prevention program for office workers. The program will consist of the whole workforce with a focus on the prevention of musculoskeletal/cumulative trauma disorders. This represents an example of which type of prevention program?

An OT has been consulted by a corporate client to create an injury prevention program for office workers. One aspect of the program will consist of targeted individualized intervention for workers who have experienced injuries with non-reversable symptoms, with the focus of promoting optimal performance at work within the context of the injury. This represents an example of which type of prevention program?

A individual who has experienced a TBI is being seen for OT services. The evaluation indicated that the client is at Stage VIII of the Rancho Los Amigos Scale. The client scored a 2+/5 on the manual muscle test of the right upper extremity, with the left upper extremity scoring within functional limits based on observations. The client also demonstrates a 1 on the Modified Ashworth Scale of the right upper extremity. The PT treating the client asks for your thoughts regarding the appropriateness of implementing a CIMT approach. What is your response in this scenario?

An OT is working with a 7 year-old child who experiences difficulties with handwriting abilities. To address these noted difficulties, the OT has implemented a motor learning remedial approach with the client. The child is in the cognitive phase of the handwriting instruction. Based on this information, which of the following is MOST appropriate to implement with the client in this stage of motor learning?

A client is being seen for a clinical assessment of swallowing. The client has swallowed his first bite of food, and the OT has checked the client’s mouth to see if any food remains, and checked the client’s voice quality. Upon assessment the client demonstrates a gurgly voice. Based on this information, which of the following is the NEXT step of this process as it relates to the assessment of swallowing?

A client who has experienced an acute CVA is being seen for a clinical assessment of swallowing beginning with pureed textures. The client has swallowed his first bite of food, and the OT has checked the client’s mouth for pocketing and also assessed for the quality of voice, with no signs or symptoms of dysphagia. Which of the following is the NEXT step of this process as it relates to the assessment of swallowing?

An OT is working with a client with a past medical history of diabetes mellitus type II, peripheral neuropathy resulting in diminished protective sensation of the hands, and pacemaker placement, who is in the chronic active stage of arthritis in an outpatient facility. Which of the following is NOT appropriate for the OT to complete with the client at this stage?

An OT is working with a client with a past medical history of diabetes mellitus type II, peripheral neuropathy resulting in diminished protective sensation of the hands, and pacemaker placement, who is in the sub-acute inflammatory stage of arthritis in an outpatient facility. Inflammation in the hands is subsiding and the joints of the wrist, and MCP are slightly warm. Which of the following is MOST appropriate for the OT to complete with the client at this stage?

An OT clinician in the school system is working with an 8 year-old right-hand dominant child with Developmental Coordination Disorder. The child demonstrates impairments in pencil grasp and handwriting abilities due to quickly experiencing muscular tension and fatigue with handwriting tasks. The clinician is using a biomechanical approach with the child when addressing handwriting abilities. Which of the following represents an example of the MOST appropriate intervention to use with the client?

An OT clinician in the school system is working with an 8 year-old right-hand dominant child with neuromuscular impairments along with impairments in executive functioning. The child demonstrates impairments in pencil grasp and handwriting abilities, and the clinician is using a motor learning remedial approach with the child when addressing handwriting abilities. The child is in the associative stage of motor learning. Which of the following represents an example of the MOST appropriate intervention to use with the client?

An OT clinician in the school system is working with an 8 year-old child with neuromuscular impairments along with impairments in executive functioning. The child demonstrates impairments in pencil grasp and handwriting abilities, and the clinician is using a motor learning remedial approach with the child when addressing handwriting abilities. The child is in the cognitive stage of motor learning. Which of the following represents an example of the MOST appropriate intervention to use with the client?

An 85 year-old female has recently experienced an incomplete SCI resulting in central cord syndrome. The client is in an inpatient rehab facility, and is currently preparing for discharge to the home environment. Prior to the injury, the client had been considering the use of a wheelchair due to frequent falls. The client currently ambulates with contact guard assist due to impaired standing balance without the use of an assistive device, though sitting balance is functional. Which of the following is the BEST fit as it relates to the wheelchair that will be indicated for use with the client at this time?

A 61 year-old female has recently experienced a CVA resulting in left-sided hemiplegia. The client has been in an inpatient rehabilitation facility for 4 weeks, and is currently preparing for discharge home. The client currently requires moderate assistance for ambulating short distances using a hemi-walker. Which of the following is the BEST fit as it relates to the wheelchair that will be indicated for use with the client at this time?

You are working with a 10 year-old client. The client demonstrates deficits with in-hand manipulation skills. The evaluation indicates that the highest in-hand manipulation skill attained at this point is the ability to complete complex rotation to consistently rotate writing utensils and toy objects. Based on this information, which intervention makes sense to NEXT implement at this stage with the client to address continued translation skills?

You are working with a 5 year-old client. The client demonstrates deficits with in-hand manipulation skills. The evaluation indicates that the client is able to pick up small items with his fingers and move them to the palm, and move small items from the palm to the fingers, but these are the highest in-hand manipulation skills attained at this point. Which intervention makes sense to FIRST implement at this stage with the client based on this information?

A client who has experienced a Colles’ fracture has achieved full AROM at the wrist, has been completing isometric and isotonic exercises targeted for strengthening the wrist, and is now appropriate and medically cleared to progress to the next step of treatment based on the biomechanical frame of reference. Which of the following is MOST appropriate for the OT to now initiate with the client during OT sessions?

A client being treated for OT after experiencing a Colles’ fracture has been completing static resistive exercises of the affected wrist. The client is ready to progress to the next course of action based on the biomechanical model. Which of the following represents the NEXT step as it relates to appropriate therapeutic exercises for use with this client?

An OT is working with a client with dementia identified to be functioning between an Allen Cognitive Level (ACL) 2-3. The OT is making recommendations to nursing staff regarding appropriate instructions to provide when working with the client. Which of the following recommendations is MOST appropriate for the OT to make to the nursing staff to promote the highest level of functional performance?

An OT is working with a client with dementia identified to be functioning between an Allen Cognitive Level (ACL) 3-4. The OT is making recommendations to nursing staff regarding appropriate instructions to provide when working with the client. Which of the following recommendations is MOST appropriate for the OT to make to the nursing staff to promote the highest level of functional performance?

An OT is engaging a client who is status-post a transhumeral amputation with an upper extremity body-powered prosthesis in controls training. Which of the following options would be represented in this stage of prosthetic training?

An OT is engaging a client with an upper extremity prosthesis in functional training using a myoelectric prosthesis. Which of the following options would be represented in this stage of prosthetic training?

A child being seen for OT services presents with poor dynamic standing balance reactions, though sitting balance remains functional.  Despite the addition of grab bars in the child’s tub/shower combo, the child continues to demonstrate difficulties maintaining a stable base of support during showering. The child’s parents are requesting recommendations from the OT to maximize safety during bathing. Based on this information, which of the following is MOST appropriate to utilize to address the parent’s concerns and optimize safety during the bathing routine?

A child being seen for OT services presents with hypotonia and absent sitting balance reactions. The child also presents with poor head control, and his parents report he frequently demonstrates loss of sitting balance during the bathing routine if not fully supported by the parents while sitting in the bathtub, and demonstrates difficulties maintaining an upright head posture during bathing tasks. The child’s parents are requesting recommendations from the OT to maximize safety during bathing. Based on this information, which of the following is MOST appropriate to utilize to address the parent’s concerns and optimize safety during the bathing routine, while allowing the child to complete the task in at least a semi-seated position?

A client in an outpatient facility presents with peripheral nerve compression at the flexor retinaculum. The evaluation indicated impaired touch perception and localization along the area of cutaneous distribution, though intact protective sensation. Which of the following represents the best INITIAL step to take with the client during OT sessions?

A client in an outpatient facility presents with chronic peripheral nerve compression at the flexor retinaculum. The evaluation indicates loss of protective sensation along the area of cutaneous distribution of the affected nerve. Additionally, the client demonstrates intrinsic weakness with a score of 2-/5 of the musculature innervated by the affected nerve. Which of the following is MOST appropriate for the OT to complete as part of the continued evaluation and intervention planning process?

An OT is working with a client who experiences trigeminal neuralgia. During an assessment using light touch and pin to assess sensation on the forehead, cheek, and chin, the client experiences severe pain in the trigeminal branch distribution. The client reports it has become difficult to eat and complete grooming tasks. Which of the following is MOST appropriate for the OT to complete as part of the evaluation and intervention process?

A client experiences dysphagia during the eating/swallowing process with involvement of the glossopharyngeal nerve. Which of following is MOST likely to occur as a result?

A 20 year-old male client with a generalized anxiety disorder is being seen for OT services in a community mental health setting. The client’s goals are to manage his money, learn basic home living skills, and find employment. The OT is framing the intervention process using Motivational Interviewing techniques. During the beginning of a session, the client states “I’m ready to stop spending so much money and I’ve started to think about how I can do that”. What is the most appropriate response for the OT to take in this scenario?

A 20 year-old male client with a generalized anxiety disorder is being seen for OT services in a community mental health setting. The client’s goals are to manage his money, learn basic home living skills, and find employment. The OT is framing the intervention process using Motivational Interviewing techniques. During the beginning of a session, the client becomes frustrated and states “I think it’s pointless to do the homework you gave me. It’s not working”. What is the most appropriate response for the OT to take in this scenario?

An OT employed in a school system has been asked to create and implement an intervention based on the multi tiered systems of support to address mental health concerns relating to the school setting. Which of the following choices below represents an intervention that can be developed at the Tier 2 level to address these concerns?

An OT is working with a student diagnosed with cerebral palsy with right hemiplegia along with mild cognitive impairment. She has difficulties with maintaining an upright position at her chair and desk during classroom activities. The student also experiences challenges with writing secondary to being unable to stabilize her paper using her right upper extremity, which limits her ability to participate in classroom activities including spelling tests and results in illegible writing on the spelling tests. As a result, the student frequently experiences frustration during class. Which of the following represents an appropriate modification to discuss with the student’s teacher?

An OT has been working with an individual diagnosed with ALS who has now progressed to stage II of the disease process. Which of the following interventions is MOST appropriate for the OT to initiate during this stage?

An OT has been working with an individual diagnosed with ALS who has now progressed to stage III. The client has voiced to the OT that his goal is to preserve his independence to the greatest extent possible throughout the disease process. Which of the following interventions is MOST appropriate for the OT to complete with/recommend for the client during this stage to maximize independence?

An OT clinician is completing an evaluation with an 18-month-old child in early intervention services, and is administering the Peabody Developmental Motor Scales-3 (PDMS-3). The child was born at 32 weeks of gestation. During the assessment the child required assistance for stabilization of the proximal upper extremity when reaching for and grasping various task objects. During the synthesis and interpretation of the assessment, which of the following is MOST appropriate to include?

An OT employed in a school system is completing an evaluation with a 7-year old  student. The student appears to demonstrate significant delays in fine motor abilities which has affected performance in school occupations. The OT has determined it would be beneficial to compare how the child is developing in relation to other children their age. Which of the following is the MOST appropriate assessment for the OT clinician to administer as part of the evaluation process to gather more information regarding the child’s deficit areas?

A 65-year-old female with chronic schizophrenia is being seen in a partial hospitalization program for continued services following a recent hospitalization due to an acute onset of psychosis. The client resides with her niece who acts as the caregiver. The client has been engaging in interventions designed to decrease the intrusiveness of her hallucinations using different coping techniques. Which of the following is MOST appropriate for the OT to complete with the client in this scenario in preparation for discharge from services?

A 35 year-old male with schizophrenia is being seen in a partial hospitalization program for continued services following a recent hospitalization due to an acute onset of psychosis, and the client has now stabilized. The client resides in a residential facility, and experiences frequent hallucinations. Which of the following represents the MOST appropriate option for the OT to initially take in this scenario?

An OT is working with a client with Duchenne Muscular Dystrophy. The client demonstrates impairments in sitting posture in their current wheelchair due to the presence of an anterior pelvic tilt and lumbar lordosis, resulting in discomfort while sitting in the wheelchair. Which of the following options is MOST appropriate to address this noted impairment?

An OT is working with a 16 year-old client with Duchenne Muscular Dystrophy. The client demonstrates significant difficulty with control and efficiency during joystick use when maneuvering their power wheelchair. Which option represents the MOST appropriate course of action for the OT to take as it relates to these concerns?

During a cooperative group a client decides that he does not want to participate in the group. Instead, he acts out and screams at another one of the members.  He ends up disrupting the group and an argument ensues between the members.  As a result, the project is unfinished, and the members are angry and agitated.  What is the OT’s BEST response in this situation?

During a thematic group focused on financial management and budgeting, the OT notes that a client does not want to participate in the group. Instead, the client sits quietly and does not participate in the budgeting task. What is the OT’s BEST response in this situation?

A client has experienced a C4 ASIA A SCI. During the wheelchair evaluation process the OT notes that the client demonstrates impaired cardiovascular endurance impacting functional activity tolerance. Which of the following represents the MOST appropriate modification to maximize independence with wheelchair propulsion and management for this client?

A client presents with a CVA with occlusion of the right posterior cerebral artery. Which of the following is MOST likely to be observed as an area of deficit for this client during functional activities?

An OT is working with a 7-year-old child with developmental coordination disorder who experiences difficulties with donning and doffing his shirt, pants, and shoes, due to identified impairments in motor control. Per parent report, the child becomes easily frustrated each morning during the dressing process and as a result requires a large amount of assistance with the tasks. The OT is framing the intervention process using the behavioral frame of reference. Which of the following components of intervention is MOST appropriate to include as part of the intervention process?

An 8-year-old child with a spinal deformity is being seen for OT services. The child requires the use of an orthosis and is wheelchair bound, though the child is able to propel the wheelchair. Based on the results of the evaluation, the client experiences difficulties with dressing tasks. Which of the following recommendations is MOST appropriate to maximize independence/safety with dressing tasks?

A client presents to an outpatient facility with acute stenosing tenosynovitis of the first dorsal extensor compartment of the wrist. The physician’s order indicated to fabricate a splint for the client. After the splinting process, the OT notes that the trim lines of the splint appear to be high on the radial border and low on the ulnar border of the forearm. Which of the following MOST likely represents the cause of this?

A client presents to an outpatient facility with chronic stenosing tenosynovitis of the first dorsal extensor compartment of the wrist, status-post release. During the occupational profile, the client reports a new onset of numbness along the dorsal aspects of the thumb, second, and third digits, in addition to the radial half of the 4th digit. Given this information, which of the following is the MOST appropriate response from the OT?

A client diagnosed with C-diff is being seen for OT services for an ADL session. Upon entering the client’s room, the OT performed hand hygiene, donned his gown, then donned his gloves. Upon exiting the client’s room, the OT first removes his gloves, then his gown, then completes hand hygiene using an alcohol-based hand sanitizer immediately prior to proceeding to the next room. Which of the following statements below is MOST appropriate?

An OT is working with a client who has been diagnosed with a history of latent TB. Which of the following options below best represents the precautions that should be taken with this client during treatment?

An OT in a psychosocial clubhouse is running an afternoon job readiness group with three of the clubhouse members who will soon be participating in transitional employment in a retail setting. Which of the following is MOST appropriate for the OT to include as part of the process with these members?

An OT is working with a 61-year-old client with moderate intellectual disability at an Adult Day Center. The case manager at the Adult Day Center reports that the client’s caregiver had inquired about options for the client to make a form of income and would like to discuss potential opportunities. Which of the following represents the MOST appropriate step for the OT to take next in this scenario?

An OT in the school system has been asked to screen a 5.5-year-old child suspected by the child’s teacher to experience developmental delays affecting handwriting. The teacher reports that the child appears to be holding his writing utensils in an atypical manner. Based on observation, the child presents with a quadrupod grasp, is able to copy letters in upper-case and lower-case, and can print their own name. Letter formation, legibility, and speed all appear to be within the expected developmental range based on observation. Which of the following represents the NEXT appropriate step to take in this scenario?

An OT in the school system is working with a 6-year-old child experiencing developmental delays affecting handwriting. The child presents with delayed visual-motor and fine motor skills based on results of administration of the Beery VMI. In addition, clinical observations appear to indicate that the child functions at the level of a typically developing 3-year-old child in regard to handwriting skills. Which of the following would be MOST appropriate to initially implement as part of the intervention process with this child?

An OT is working with a client with a past medical history of diabetes mellitus type II with peripheral neuropathy resulting in slightly diminished light touch perception though intact protective sensation and temperature awareness of the hands, and epilepsy, who is in the chronic active stage of rheumatoid arthritis in an outpatient facility. Which of the following is MOST appropriate for the OT to complete with the client at this stage?

An OT is working with a client with a past medical history of diabetes mellitus type II, peripheral neuropathy resulting in slightly diminished light touch perception though intact protective sensation and temperature awareness of the hands, and pacemaker placement, who is in the sub-acute inflammatory stage of rheumatoid arthritis in an outpatient facility. Inflammation in the hands is subsiding and the joints of the wrist, and MCP are slightly warm. Which of the following is NOT appropriate for the OT to complete with the client at this stage?

A client who has experienced a diffuse TBI is demonstrating a status/impairments consistent with an RLA IV. The OT is completing the evaluation process with the client in an acute care hospital. Which of the following represents the MOST appropriate form of assessment to use with the client at this stage?

A client who has experienced a diffuse TBI is demonstrating a status/impairments consistent with an RLA II, and a motor subset score of 3 on the Glasgow Coma Scale. Based on the evaluation process/observation and discussion with the SLP, the client demonstrates difficulty managing their secretions. The OT is initiating the intervention process with the client in the ICU of an acute care hospital. Which of the following is NOT appropriate to implement at this stage?

A 48-year-old client diagnosed with a 25-year history of schizophrenia with impairments in auditory processing and a history of intermittent auditory hallucinations is receiving services in a community mental health setting due to difficulties in occupational performance in his role as a janitor through supported employment. The client’s job coach reports that he has not been completing some of the duties of his job such as vacuuming and cleaning the toilets. Based on Dunn’s Model of Sensory Processing, which of the following is the MOST appropriate course of action to address this concern?

An OT is working with a child in the school system. Based on administration of the Sensory Profile School Companion, the child presents with a sensory sensitivity processing pattern. Based on Dunn’s Model of Sensory Processing, which of the following is the MOST appropriate intervention to address this sensory processing pattern?

A client who has experienced a CVA one week prior is being seen for an ADL session. The client presents with hemiparesis of the affected upper extremity with a MMT score of 3-/5 proximally and distally, and impaired standing balance requiring maximal assistance for functional standing balance during ADLs, though sitting balance is functional. The client also presents with ideomotor apraxia impacting their performance with ADLs. Which of the following represents the BEST intervention strategy to implement with the client at this time?

A client who has experienced a CVA one week prior with occlusion of the MCA is being seen for an ADL session. The client presents with hemiparesis of the affected upper extremity with a MMT score of 3-/5 proximally and distally, and impaired standing balance requiring maximal assistance for functional standing balance during ADLs, though sitting balance is functional. Which of the following represents the BEST intervention strategy to implement with the client at this time?

An OT is working with a client who has recently experienced a motor vehicle crash. As a result, the client sustained a C8 ASIA A SCI. The client has worked with the OT for an initial two ADL sessions and the OT is now working with the client for a third ADL session. The client’s ability to stabilize himself during sitting has begun to improve. Which of the following interventions would be MOST appropriate to include during the ADL treatment session with the client at this time?

An OT is working with a client who has recently experienced a motor vehicle crash. As a result, the client sustained a T8 ASIA A SCI. The client has progressed past the initial stage of the intervention process and demonstrates an improved ability to maintain an upright seated position. Which of the following interventions would be appropriate to now INITIATE during an ADL treatment session with this client?

A client has experienced a proximal humeral fracture and is receiving OT services in an outpatient facility, with the fracture being treated non-operatively. The client is in the sixth week status-post experiencing the fracture. The client is a carpenter and expresses a desire to return to work as soon as possible. Which of the following should typically be completed at this stage of the client’s recovery?

A client presenting with a proximal humeral fracture with a comorbidity of diabetes mellitus and significant body habitus is receiving OT services in an outpatient facility, with the fracture being treated non-operatively. The client is entering the third week of recovery status-post experiencing the fracture. Which of the following should typically be INITIATED at this stage of the client’s recovery for the affected shoulder?

An OT in a SNF is using a motor learning approach with a right-hand dominant client who has recently experienced a CVA with residual motor deficits. The client presents with left hemiparesis, with a MMT score of 3-/5 of the affected left upper extremity proximally and distally. During the evaluation, the client appears to present with poor volition and motivation for participation in therapy services. Which of the following represents the BEST approach for the OT to initially take in this scenario?

An OT is framing the intervention process with a client who has experienced a CVA with residual motor deficits using principles of motor learning. The OT is using a shaping approach with the client. Which of the following techniques is representative of this approach?

An OT is working with a client diagnosed with schizophrenia in a community mental health setting. During administration of the Allen Cognitive Level Screen Leather Lacing Tool, the client demonstrated the ability to complete 3 whipstitches in consecutive holes, but is unable to fix a twisted lace error without removing the stitch. Based on performance during the assessment, which of the following is MOST appropriate to recommend to the client and relevant others?

An OT is working with a client diagnosed with schizophrenia in a community mental health setting. During administration of the Allen Cognitive Level Screen Leather Lacing Tool, the client demonstrated the ability to complete 3 cordovan stitches while only requiring one orienting verbal cue. Based on performance during the assessment, which of the following is MOST appropriate to recommend to the client and relevant others?

An OT is working with a client with dementia identified to be functioning between an Allen Cognitive Level (ACL) 1-2. The OT is making recommendations to nursing staff regarding appropriate instructions to provide when working with the client. Which of the following recommendations is MOST appropriate for the OT to make to the nursing staff to promote the HIGHEST level of functional performance?

An OT is working with a client with dementia identified to be functioning between an Allen Cognitive Level (ACL) 4-5. The OT is making recommendations to nursing staff regarding appropriate instructions to provide when working with the client. Which of the following recommendations is MOST appropriate for the OT to make to the nursing staff to promote the HIGHEST level of functional performance?

An OT and a prosthetist are working with a 49-year-old client who has experienced a right short trans-radial amputation. It has been determined that a body-powered prosthesis is the best fit for the client. Which of the following is MOST appropriate to initiate during the initial phase of the prosthetic training program with the client?

An OT and a prosthetist are working with a 49-year-old client who has experienced a right short trans-radial amputation. The client demonstrates a history of uncontrolled diabetes mellitus, resulting in a non-healing wound requiring the amputation, and the client has largely been non-compliant with medical care. The client’s goal is to continue his employment as a retail worker when using the prosthesis. Which of the following types of prostheses is MOST indicated for this client?

An OT is working in a community mental health setting with individuals suffering from schizophrenia and bipolar disorders between the ages of 25-35. The clients currently function at an ego-centric cooperative level based on Mosey’s continuum and would benefit from a group to continue to improve social functioning while responding to one another’s social-emotional needs. Which of the following groups would be the MOST appropriate to run with these clients?

An OT is working in a community mental health setting with individuals suffering from schizophrenia and bipolar disorders. The clients are functioning at an egocentric-cooperative level. The OT decides to develop a group using the psychodynamic frame of reference. Which of the following groups would be the MOST appropriate?

An OT is evaluating a client in an acute hospital setting with a diagnosis of Guillain-Barre Syndrome (GBS) who is status-post 4 weeks from his initial diagnosis. Which of the following components of the evaluation process would be MOST indicated with the client at this stage?

An OT is treating a client in the inpatient rehab wing of a hospital setting with a diagnosis of Guillain-Barre Syndrome (GBS) who is status-post seven weeks from his initial diagnosis. Which of the following components of the intervention process would be appropriate to INITIATE with the client at this stage?

An OT is working with a 25-year-old client diagnosed with obsessive compulsive disorder in a community mental health setting. Which of the following is the MOST appropriate intervention to include with the client at this setting?

An OT is working with a 25-year-old client with major depressive disorder admitted to an acute psychiatric hospital following a suicide attempt. Which of the following is the MOST appropriate intervention to use with the client based on a MOHO approach?

An OT is completing an evaluation with a 5-year-old child diagnosed with Level 3 (severe) autism spectrum disorder. As part of the evaluation process, the OT administered the PDMS-3 with the child. Which of the following statements below is CORRECT regarding the evaluation process and administration of this assessment?

An OT is working with a client with Parkinson’s Disease to promote occupational performance during IADL tasks and social participation. The OT is directly addressing process performance skills during an intervention. Which of the following is MOST appropriate for the OT to complete with the client during the intervention?

A client with a history of a TBI 2 years prior continues to have difficulties with approaching her peers to initiate and sustain socially appropriate actions due to deficits in attention and concentration. The client is aware and embarrassed of her difficulties. Which of the following would be MOST appropriate to complete with the client as part of the intervention process?

Which of the following descriptions below represents the manifestation of impairment in the client factor category of specific mental functions?

An OT is working with a LTC resident in a SNF. During completion of the most recent progress note, the client appears to be functioning at their baseline and appears to have reached their maximum functional potential with skilled OT services, and as a result the OT plans a discharge date for the client. Upon informing the client’s daughter of this information, the daughter becomes upset and requests that the OT keep the client on caseload. What is the MOST appropriate response for the OT to take in this scenario?

A pediatric OT is reading the results of an RCT completed with clients with Level II Autism Spectrum Disorder regarding use of video modeling in OT sessions to improve motor skills compared to traditional interventions. The study used the outcome measure of the PDMS-3 with normative comparison, and found a difference between the experimental and control group with a p-value of .034. Which of the following represents the NEXT step the OT should take in this scenario?

An OT is working with a 58-year-old client receiving hospice services due to metastatic breast cancer. The client and spouse report that they strongly desire to address performance in bathing and dressing tasks. Which of the following is the MOST appropriate response for the OT to take in this scenario?

Johnny is a 2-year-old child who is being seen for early intervention services. Johnny functions developmentally at a 7-month-old level from a fine motor control perspective. Which of the following goals is MOST appropriate to develop for this child?

A 42 year-old client with neuromuscular impairments status-post a TBI is being seen for OT services in an inpatient rehab setting. The client is functioning at an RLA Level VIII, presents with a Modified Ashworth Scale score of 1 of the upper extremities, and poor trunk/UE motor control. Which of the following is appropriate to INITIALLY complete with the client?

An OT is engaging a client who has experienced a CVA in a session designed to address meal preparation and clean-up skills to improve fine motor control and precision of the affected upper extremity. The OT is framing the process using a motor learning approach, with the client in the associative stage of motor learning. Which of the following is MOST appropriate to include with the client during the session?

An OT is framing the intervention process in an outpatient facility with a 66-year-old client who experienced an ischemic CVA 3 weeks prior using the motor learning approach, in the stage of skill acquisition of motor skills during IADL tasks. Which of the following represents the most appropriate part-task training intervention at this time?

An OT is treating a client in the inpatient rehab wing of a hospital setting with a diagnosis of Guillain-Barre Syndrome (GBS) who is status-post seven weeks from his initial diagnosis. Which of the following components of the intervention process would be appropriate to INITIATE with the client at this stage?

A client has recently experienced a burn to the upper extremity, with a split-thickness skin graft taken from the thigh. The OT is part of the wound care team addressing the client’s wounds at the hospital. The donor site presents with a minimal amount of clear, thin, and watery fluid. Which of the following options is the MOST appropriate course of action to take as part of the wound management process?

An OT is working with a client in an outpatient facility who recently underwent a Dupuytren’s fasciectomy in the initial evaluation process. The client has expressed concerns about the wound healing process. The client’s wound presents with exudate that is clear, pink, thin, and watery, and the wound bed is beefy and red. Which of the following represents the MOST appropriate response for the OT to take in this scenario?

A client who is a single father has experienced a proximal humeral fracture and is receiving OT services in an outpatient facility, with the fracture being treated non-operatively. The client has been attending OT services for over 12 weeks. Which of the following is MOST appropriate to include during intervention at this time?

A client has experienced a proximal humeral fracture and is receiving OT services in an outpatient facility, with the fracture being treated non-operatively. The client is in the sixth week status-post experiencing the fracture. The client is a carpenter and expresses a desire to return to work as soon as possible. Which of the following should typically be completed at this stage of the client’s recovery?

A client who is employed as an assembly line worker in a factory presents with cervical spinal stenosis status-post a recent laminectomy with upper and lower extremity motor and sensory impairments. After undergoing a course of work hardening, it has been determined that the client has reached their maximum functional potential with very limited progress made. Which of the following is MOST appropriate to complete at this time?

An OT is working with a 25-year-old client in a halfway house using the psychodynamic approach. Which of the following is MOST appropriate to utilize?

An OT is working with a group of individuals in a halfway house. During the completion of the group a client becomes angry at another member and begins to storm out of the room. The therapist guides the client to instead promote verbal expression of their affect. This response from the therapist is MOST likely guided by which of the following frames of reference?

An OT is working with a client with a history of COPD, who continues to smoke on a daily basis. When using the Expanded Chronic Care Model to guide the intervention process, which of the following is MOST appropriate to complete with the client?

During a discussion-based group focused on concurrent parenting concerns, the OT notes that a client consistently interrupts other members and speaks at length, which limits the ability of the other group members to contribute. What is the OT’s BEST response in this situation?

An OT is leading a task-oriented group in a community mental health setting. A client who has been identified as growing up in an emotionally abusive household frequently tries to please others and avoids conflict. Which of the following Models of Practice/Frames of Reference and approach is MOST appropriate for the OT to use with the client in this scenario?

An OT in a psychosocial clubhouse is running an afternoon group with three of the clubhouse members who have a goal to participate in supported employment in a retail setting. Which of the following is most appropriate for the OT to FIRST include as part of the process with these members?

An OT employed in a community mental health setting is scheduled to lead an afternoon thematic group with individuals who experience generalized anxiety disorder. Shortly before the group is set to begin, the director requests that the OT include a new individual in the afternoon group. What is the MOST appropriate response for the OT to take in this scenario?

An OT is working with a 29-year-old-client with Autism Spectrum Disorder in an Adult Day Center. The OT has been consulted to help determine appropriate activities in which the client may engage. Which of the following assessments is MOST appropriate to administer at this time?

A 55-year-old female employed as a restaurant server and retail worker is status-post 6 weeks from experiencing a slight non-displaced fracture of the proximal ulna. She also developed a deep anterior compartmental syndrome. Which of the following activities/movements would be MOST appropriate to complete with the client during the intervention process to address the noted areas of impairment?

A client presents with acute tendonitis of the tendons originating at the common flexor tendon wad. Which of the following is MOST appropriate to complete with this client?

A 72-year-old client with moderate cognitive impairment and a history of a stage I sacral ulcer is residing in a LTC facility and has been referred to OT services for a positioning evaluation. Which of the following is MOST appropriate to recommend for the client at this time?

An 80 year-old client with traditional Medicare who experienced a CVA 1 year prior continues to demonstrate cognitive, perceptual, and motor control deficits with limited ability to ambulate, though the client is able to self-propel a wheelchair with supervision. The client and his spouse live in a suburban area with limited family and limited financial support, and are exploring alternative options for transportation to/from appointments within the community. Which of the following represents the MOST appropriate first step for the OT to take in order to directly assist the client in this scenario?

An OT is evaluating a client’s home and making recommendations for modifications to improve access to the home environment. The client is wheelchair bound at baseline, and has limited funds. Upon taking home measurements, the OT notes that the entryway width to the client’s bathroom is 30 inches, and the entryway to the bedroom is 32 inches. Which of the following represents the MOST appropriate recommendation to make that is consistent with ADA standards?

A client presents with a 6-month history of tendinosis of the tendons originating at the common extensor tendon wad, with a comorbidity of Raynaud’s syndrome and remote pacemaker placement. Which of the following is MOST appropriate to complete with this client?

A client who has experienced a trans-radial amputation of the left upper extremity is being seen in a skilled nursing facility for OT services 10 days post-operatively. The client also presents with a history of a left-hemispheric CVA 5 months prior, resulting in Wernicke’s aphasia, hemiparesis, and recently developed spasticity of the right upper extremity. The client appears to be experiencing pain behaviors, though it is difficult to differentiate if the source is phantom pain of the residual limb or the client’s spasticity. What is the MOST appropriate intervention to address the client’s pain in this scenario?

A client experiences neurotmesis of the radial nerve resulting from a fracture to the humerus status-post repair of the nerve. Which of the following splints is appropriate to fabricate for the client in the sub-acute stage after the repair?

A 59-year-old client with a history of an ischemic MCA CVA 6 months prior presents with increased spasticity of the affected upper extremity. Which splint is MOST appropriate to fabricate to address the spasticity and promote an antideformity position at the wrist and hand?

A client presents with an acute olecranon fracture and is being seen by OT services for fabrication of a long-arm splint. Which of the following splints is MOST appropriate to fabricate for this client?

A 64-year-old client with early onset dementia in the moderate to severe stages presents with an acute distal radius fracture. Which of the following BEST represents the splinting material that would be appropriate for this client?

A client presents to an outpatient facility with chronic stenosing tenosynovitis of the first dorsal extensor compartment of the wrist status-post release. Which of the following represents the MOST appropriate type of splint the client should be provided with initially?

An OT is working with an older adult client in the home health setting, who has a comorbidity of Diabetes Mellitus. The client has been provided with a pre-fabricated wrist support to compensate for pain caused by OA. The OT receives a call from the client one day prior to the next OT session reporting moderate discomfort with the splint wear. Which of the following represents the MOST appropriate approach for the OT to take?

A client who resides in a long-term care facility through hospice services presents with severe hypertonicity and fixed contractures of the wrist and digits with a score of 4 on the Modified Ashworth Scale. Which of the following splints is MOST appropriate to use with the client?

An OT is working with a client experiencing arthritis with a history of medical non-compliance, with active synovitis at the MCP joints. During the occupational profile the client reports she enjoys cooking, crafting, sewing, and gardening. Which of the following is the MOST appropriate intervention to include with the client at this time?

An OT in an inpatient rehab setting is working with a client with a history of medical non-compliance preparing for discharge to home health services after experiencing a CVA, with subsequent proximal weakness and subluxation of the affected shoulder. When completing caregiver education, which of the following is MOST appropriate to consider in this scenario?

An OT is working with a client who has experienced a CVA with hemiparesis of the affected upper extremity and moderate cognitive deficits. Which of the following is MOST appropriate as it relates to the intervention process with this client?

An OT is working with a client in an inpatient rehab setting status-post 1 week from undergoing a unilateral mastectomy without reconstruction. The client recently completed chemotherapy services just prior to the mastectomy. During the evaluation the client presented as guarded and reported a fear of moving, general anxiety, and uncertainty regarding participation in the inpatient rehab process. Which of the following is the most appropriate FIRST step for the OT to take as part of the intervention process?

A client receiving OT services on the medical floor of an acute care hospital presents with a hemoglobin level of 8 g/dL. The client has expressed a desire to complete bathing during the OT session on this date. Which of the following is the MOST appropriate course of action for the OT to take in this scenario?

An 82-year-old client who experienced a myocardial infarction is being seen for the initial OT sessions in acute care. Which of the following is MOST appropriate for the OT to complete with this client during the initial evaluation or intervention process?

A client status-post 1 week from experiencing a trans-radial amputation presents for OT services in an outpatient center. The client demonstrates a history of non-compliance with medical services. Which of the following is MOST likely to be initiated with the client as part of the intervention process at this time?

A client who experienced neurotmesis of the ulnar nerve just proximal to the wrist is status-post isolated repair of the nerve. Which of the following is appropriate to complete with the client during the initial weeks of OT evaluation and intervention?

A client in an outpatient facility presents with a chronic history of peripheral nerve compression at Guyon’s canal. Semmes Weinstein testing indicates the ability to feel the red monofilament along the area of cutaneous distribution of the affected nerve. Which of the following is MOST appropriate for the OT to complete as part of the evaluation and intervention process with this client?

A client in acute care is status-post a non-elective posterior hip hemiarthroplasty. The client resides at home with family and completes BADLs with supervision due to dementia with moderate cognitive decline. Which of the following is MOST appropriate to complete with the client at this time?

An OT enters the room of a client status-post a posterior hip replacement. The client is finishing up toileting with the CNA and is completing perineal hygiene by wiping from behind in sitting. The client reports “that’s the only way I can do it”. Which of the following is the MOST appropriate initial step for the OT to take in this scenario?

A 50-year-old previously independent client with a history of right chronic rotator cuff impingement and diabetes mellitus experienced superficial partial thickness burns of the upper extremities proximally and distally, with a prolonged healing time of the burns. During the evaluation the client demonstrated right scapular hiking with shoulder elevation. Which of the following treatments is MOST appropriate to include with the client as part of the outpatient intervention process?

A 6-year-old child with gravitational insecurity is being seen for OT services. The child’s parents report that he becomes easily frustrated, and his resistance to play activities has resulted in difficulties with interacting with peers during school and church social activities. Which of the following is MOST appropriate for the OT to include as part of the initial intervention process using Ayres’ Sensory Integrative approach?

A client who has recently experienced a CVA presents with deficits in eating and swallowing. The client is currently at Level 2 on the Dysphagia Diet. Which of the following represents the MOST appropriate intervention to complete using a direct rehabilitative approach?

A 4-year-old child with Down Syndrome has been referred for OT services due to difficulties with eating and swallowing resulting from neuromuscular impairments. Evaluation indicates deficits in the oral prep, oral, and pharyngeal stages of swallowing. Which of the following is MOST appropriate to promote initial performance in the home environment with eating and swallowing?

A client who experienced a CVA one-week prior presents with deficits in eating and swallowing. The evaluation revealed impairments in normal functioning of cranial nerve X. Which of the following techniques is MOST appropriate to complete with the client at this time to address this area of impairment?

An OT in the school system has just completed an evaluation of a child with a speech articulation disorder, also suspected of possible delays in handwriting abilities. The child’s parents are adamant that the child receive special education and OT services due to their identified and suspected impairments. The child scored .5 standard deviations below the mean on the Minnesota Handwriting Assessment. Which of the following represents the MOST appropriate response for the OT to take in this scenario?

An OT has been working with a child in the school system for approximately four months. The child is demonstrating limited progress towards their goals, and the OT perceives that the child would benefit from modification to the goals. Which of the following is the MOST appropriate step for the OT to take in response to this scenario?

An OT is administering the Beery VMI with a 6-year-old child with ADHD. Approximately three-fourths of the way into the assessment, the child becomes visibly frustrated with their performance and begins to demonstrate emotional lability. Which of the following represents the MOST appropriate response for the OT to take in this scenario?

When completing an evaluation with a 5-year-old child with motor and sensory processing impairments being seen for OT services in an outpatient facility, which of the following would provide the MOST ecologically valid information to the clinician?

An OT with specialized training in sensory integration techniques is working with an 11-year-old child with level II Autism Spectrum Disorder (ASD). The child experiences somatodyspraxia impacting performance during all ADLs, and has demonstrated limited progress during prior therapy services according to parent report. Which of the following is MOST appropriate to complete with the child as part of the evaluation or intervention process?

An OT is working with a 6-year-old child diagnosed with Down Syndrome. The child demonstrates mild hypotonia and slouches when sitting during ADLs such as feeding-eating-swallowing, brushing teeth, and dressing. Which of the following interventions would be most appropriate to trial FIRST to address the child’s noted deficit areas?

An OT is working with a 6-year-old child diagnosed with intellectual disability who experiences difficulty with sequencing the steps of donning a shirt. When structuring the intervention process with the child, which of the following is MOST appropriate?

An OT is working with a 10 year-old child who has experienced a TBI in the pediatric ICU. The child is functioning at an RLA III. The child is beginning to develop hypertonia and is demonstrating the return of primitive reflexes, including the tonic labyrinthine reflex and the ATNR. Which of the following is MOST appropriate to complete with the child as it relates to bed positioning?

A 7-year-old child with DCD has been referred to OT due to difficulties with motor coordination and ADLs. His parents have expressed concerns about his struggles with fine and gross motor activities. If using a motor learning approach to address the deficits in motor control affecting occupational performance, which of the following would be MOST appropriate?

A caregiver notes that a child with poor insight and self-awareness consistently uses too much toilet paper when completing toileting tasks. Which of the following represents the MOST appropriate recommendation for this child?

A 6-year-old child with spastic hemiplegic cerebral palsy and intact volition/cognition presents with difficulty with bilateral integration affecting performance during ADLs, IADLs, and school-related tasks. The child has been on caseload for 6 months and has made very limited functional progress. Which of the following is MOST appropriate to complete with the child at this time?

A child experiences impairments in the sitting tilting reflex. When working with the child in the school system, which of the following is MOST appropriate to complete?

An OT is working with a 6-year-old child who experiences delays in handwriting abilities. During structured observation, the child experiences difficulties adjusting along the shaft of the writing utensil within the hand to attain a proper grasp on the utensil. Based on this information, which of the following would be MOST appropriate to assess using a bottom-up approach to determine client factors and performance skills contributing to the difficulties in handwriting?

An OT is working with a 5-year-old child born prematurely with a history of intraventricular hemorrhage, and resulting visual-perceptual impairment. The child’s parents have expressed concerns about the child’s ability to manipulate the buttons on their clothing. Which of the following is MOST appropriate for the OT to initially complete in this scenario?