Post-Test: 170 Questions-3 Clinical Simulations

Clinical Simulation 1 Background Information:

• A 66 year-old male client who recently experienced a C8 ASIA B SCI has been transferred to an inpatient rehabilitation unit to receive intensive OT and PT services. Per the chart review, the client must adhere to spinal precautions, though is not required to don a brace.
• An entry-level OT is completing the evaluation process with the client.

Clinical Simulation 1A: As it relates to the level of SCI the client has experienced, which of the following are CORRECT?

• The OT begins the evaluation process with the client.

Clinical Simulation 1B: As it relates to the OT evaluation and intervention planning process, which of the following are appropriate to perform?

• The OT begins the intervention process with the client.

Clinical Simulation 1C: As it relates to the OT intervention process at this setting, which of the following are appropriate to perform?

• The OT considers the pieces of adaptive equipment, durable medical equipment, and modifications that will be necessary to promote safety and independence during the client’s occupational performance.

Clinical Simulation 1D: As it relates to equipment recommendations in preparation for discharge, which of the following are appropriate and necessary?

Clinical Simulation 2 Background Information:

• An OT working in a pediatric outpatient facility has received a referral to evaluate and treat a child presenting with apparent deficits in sensory processing, feeding, eating, and swallowing abilities, and motor control.
• Following the initial screening, the OT considers the use of standardized assessments as part of the evaluation process.

Clinical Simulation 2A: As it relates to standardized assessment procedures and examples, which of the following are CORRECT?

• The OT administered the PDMS-2, and the child scored 2.0 standard deviations below the mean in the fine motor subtest.
• The OT also administered the Sensory Profile, and further demonstrates advanced training in the Sensory Integration Approach and administered the Sensory Integration and Praxis Test (SIPT). Based on the results, deficit areas include vestibular and proprioceptive processing, tactile defensiveness, and praxis.
• The OT continues in the evaluation process to address the possible deficit areas inclusive of feeding, eating, and swallowing.

Clinical Simulation 2B: As it relates to the assessment process for the child’s feeding, eating, and swallowing abilities, which of the following are appropriate?

• Based on the results of the evaluation process, the child presents with concerns of aspiration. A video-fluoroscopic swallow study was completed in collaboration with the speech-language pathologist. The child demonstrates signs of aspiration with certain textures of foods, and in collaboration with the speech-language pathologist, it has been recommended that the child be placed at Level III: Dysphagia Advanced on the Dysphagia Diet.

Clinical Simulation 2C: As it relates to recommended food items on the Dysphagia Advanced Diet (Level III), which of the following are appropriate and recommended?

• The OT is beginning to address the child’s deficits in sensory processing through the Sensory Integration Approach.
• Along with the previously noted deficit areas in sensory processing, the child appears to demonstrate deficits in effective righting and equilibrium reactions. As part of the intervention process, a therapist-initiated experience has been used to facilitate participation on a platform swing to provide vestibular input, with the child appearing to tolerate this well, though the OT is aware of potential autonomic responses to be aware of.

Clinical Simulation 2D: As it relates to the continued use of the swing to promote use of the Sensory Integration Approach, which of the following are appropriate?

Clinical Simulation 3 Background Information:

• An OT in a hospital-owned outpatient facility has been approached by the rehab director to discuss the possibility of creating and implementing the use of aquatic therapy with clients diagnosed with arthritis, based on an article that the director reviewed. The OT notes that the article the rehab director has reviewed is a case series study. The OT is not trained or educated on the use of the treatment and is unsure of the efficacy of the intervention.
• The OT will be following the EBP process in order to determine the efficacy of the intervention with the defined population.

Clinical Simulation 3A: As it relates to the EBP process that the OT will follow in this scenario, which of the following are appropriate?

• The OT searches available literature databases for relevant and recent evidence in preparation to appraise the literature. The OT takes into account the Levels of Evidence, and initially finds articles that are at Level III and Level IV on the levels of evidence.

Clinical Simulation 3B: Which of the following would be classified as a Level III or Level IV based on the Levels of Evidence?

• Through the literature review, the OT notes that there appears to be a scarcity of Level I evidence relating to the topic.
• With approval and guidance from the rehab director, the OT heads a research study regarding the use of aquatic therapy as a form of intervention with clients diagnosed with arthritis. The OT assembles a research team consisting of occupational therapists and occupational therapy assistants. The ultimate goal is to create a Research study consistent with a Level I study based on the levels of evidence.
• The OT has identified the problem of interest, completed the literature review, and has chosen the frame of reference.

Clinical Simulation 3C: The OT is continuing the Research Process: What should occur in the immediate next steps of the process?

• The OT has completed the Randomized Control Trial, with greater than 80% follow-up of participants. The experimental group received aquatic therapy in conjunction with simultaneous interventions to address strength, endurance, and pain, whereas the control group received traditional interventions to address strength, endurance, and reduction of pain.
• The OT notes that during the analysis of the results of the study, .05 was set as the cut-off value for testing statistical significance between the control group and experimental group, with the p-value of the study being .053.

Clinical Simulation 3D: Which of the following are true/appropriate based on the previous information regarding the RCT?

An OT is working with an individual with a diagnosis of dementia. According to the client’s family, the client previously enjoyed activities such as crafting and painting. After completing a battery of assessments, the client is determined to be functioning at an Allen Cognitive Level 4.6. Based on this, which of the following recommendations is most appropriate to include for a client at this level?

A client with a diagnosis of arthritis with an acute exacerbation is being seen in an outpatient therapy facility. The client presents with acute inflammation and pain, with hot and red joints and stiffness. Which of the following is CONTRAINDICATED as part of the intervention process at this stage?

A client has experienced a low laceration to the median nerve, and is presenting for OT services in the immediate post-operative phase following a repair to the nerve. Which of the following is appropriate to include with the client as part of this phase?

A client with DeQuervain’s has been completing isotonic exercises of the affected hand and wrist to improve strength. 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?

A 30 year-old client in an outpatient facility presents with a positive froment’s sign following damage to a peripheral nerve. Which of the following functional activities would you expect this client to demonstrate the MOST difficulties with?

An OT is making recommendations for a client who has recently underwent a right total hip arthroplasty. The OT has instructed the client that a supine bed position for sleeping is optimal following a hip replacement. The client insists that she is not able to rest unless she sleeps on the right side. What should the OT’s recommendation be to this client?

An OT is writing a SOAP note following a session completed with a client focused on ADL tasks. As part of the SOAP Note, the OT has written the following: “Client would benefit from the use of a Long-Handled Sponge during completion of LB bathing to assist in bathing bilateral lower extremities to promote improved safety”. Which of the components of the SOAP Note will this information be included?

A client who presented with full thickness burns 3 days ago is being seen for intervention during the pre-graft phase of the burn recovery process. The client presents with burns to the dorsum of both hands with possible extensor tendon exposure. Which of the following is the MOST appropriate option to include as part of the intervention process with this client?

A 45 year-old male experienced a TBI 30 days ago and is functioning between a RLA Level VI-VII. He has currently just been admitted to an inpatient rehabilitation unit. After assessing the client, the OT meets with the client’s wife to discuss treatment planning options and her role in relation to ADLs and IADLs. Which of the following is MOST appropriate considering the client’s RLA Level?

A 4 year-old client who experiences Down Syndrome is hypotonic in the mouth, legs, arms, and hands. An OT is treating the client secondary to deficits with self-feeding and eating. The OT has included establishing a proximal base of support and control during feeding and eating as the first aspect of the intervention process. Which of the following is appropriate to include as the NEXT step towards working on the goal of improved self-feeding?

A 2 year old child is being seen for OT early intervention services in the home environment. The OT is in the process of creating updated goals for the client in collaboration with his family. Which of the following goals is appropriate to create in this scenario?

An OT is completing an evaluation with a client who has experienced a CVA in an acute care facility. The client lives alone at home, with the closest family member residing three hours away. The OT determines that the client requires continued skilled OT services, though the client becomes significantly fatigued following approximately 10 minutes of activity during the evaluation process and requires maximal assistance during the evaluation for mobility and ADLs. Which of the following discharge options is MOST appropriate for this client?

During an evaluation at an outpatient facility, an OT is evaluating a client and assessing two-point discrimination with the Foley Gauge applied in a parallel manner to the longitudinal axis over the volar fingertip of the 4th digit. The client reports feeling the Gauge only on the radial half of the 4th digit. Which of the following conclusions can be drawn from this scenario?

You are working with an adult client who experiences neuromuscular impairments affecting trunk and oral musculature, which has resulted in limitations with feeding, eating, and swallowing, with noted deficits in oral sensory awareness and facial/oral musculature strength. Which of the following is most appropriate to include as a compensatory approach to address the client’s eating and swallowing abilities?

You are working with a client who presents with a C6 ASIA A SCI. You are providing education on pressure relief strategies, with one of the client’s goals being to facilitate improved independence with pressure relief to the greatest extent possible while seated in a wheelchair. Which of the following choices would be appropriate to implement with this client?

An OT is assessing the severity of upper extremity spasticity in a client with cerebral palsy. Which of the following techniques should be utilized to achieve the most accurate results during the assessment?

A client who experienced a TBI presents with difficulties performing a supine to sit movement pattern. Which of the following is MOST likely impaired based on this information?

A client being seen in an acute care setting presents with oral apraxia of speech. The OT and Speech Language Pathologist are collaborating with nursing staff to improve the client’s abilities to communicate during his stay at the hospital. Which of the following is MOST appropriate to achieve this goal?

A client is being seen for an OT evaluation in an outpatient facility with his wife present. During development of the occupational profile, the client’s wife reports that during sleep the client gasps frequently and appears to have periods of briefly holding his breath. As a result, the sleeping patterns of both the client and his wife have been disrupted. Which of following is the NEXT step the OT should take in this scenario?

An OT is writing a SOAP note following a session completed with a client focused on ADL tasks. As part of the SOAP Note, the OT has written the following: “Dyspnea appears to impact the client’s abilities to complete lower body bathing with greater independence”. Which of the components of the SOAP Note will this information be included?

A client just diagnosed with De Quervain’s Tenosynovitis is entering the first week of treatment for OT services at an outpatient hand clinic. Which of the following is MOST appropriate to initiate with the client during this stage of the healing process?

A client diagnosed with Klumpke’s paralysis is being seen for an evaluation in an outpatient therapy center. In regards to this diagnosis, which of the following options would you expect a client to present with the most difficulties in as it relates to the completion of oral hygiene?

You are working with a client who has recently experienced a CVA. You note during the evaluation that the client appears to be experiencing ideomotor apraxia. Which of the following actions would lead you to this conclusion?

A client presents with chronic insomnia which has affected his sleeping patterns and subsequently affects performance in daytime occupations. The client presents with anxiety about his lack of sleep and a fear of staying awake all night. Which of the following is MOST appropriate to implement during the OT intervention process with the client to address this concern?

A client has recently experienced a right-hemispheric CVA, presenting with impairments in contralateral sensation, strength, and postural malalignment. The client also presents with apparent deficits in noticing items in the left visual field. During the intervention process the client demonstrates a lack of understanding for the need to utilize compensatory strategies. Which of the following diagnoses does the client MOST likely present with?

An OT has recently completed the cover-uncover test with a client in an outpatient therapy facility. Which of the following diagnoses does this client likely present with?

A client who experienced an ASIA A C6 SCI is being educated on strategies to complete UB Dressing. Which of the following techniques is MOST appropriate for the client to utilize to promote independence with the task?

A client is engaging in a session focused on the performance of lower body dressing. The client is not able to stand independently due to poor balance, though the client presents with good strength and coordination of the lower extremities. The client also presents with poor safety awareness. Which of the following positions should the OT recommend to promote safety during the task?

A client is receiving OT services in an outpatient facility. The client receives 8 minutes of therapeutic exercise, 8 minutes of therapeutic activities, and 23 minutes of self-care ADL retraining. Which of the following is appropriate for the OT to bill in regards to timed minutes and units of service?

Which of the following types of scales does the measurement of a client’s range of motion represent?

An OT employed in a school system is completing an evaluation with a 5-year old kindergarten student. The student appears to demonstrate significant delays in fine motor abilities which has affected performance in school occupations. The student also demonstrates significant difficulties following instructions and requires maximal cueing for engagement in tasks throughout the school day due to cognitive limitations. Which of the following is the MOST appropriate assessment for the OT to administer as part of the evaluation process to gather more information regarding the child’s deficit areas?

An OT is working with a child who is about to begin kindergarten. The child is 5 years old and experiences developmental delays, performing dressing at the level of a 2.5 to 3 year-old. Which of the following choices represents an example of an appropriate FIRST priority for the focus of treatment?

A client who has experienced a peripheral nerve injury is being seen for an occupational therapy evaluation. During development of the occupational profile the client reports he resides alone in his home environment and is responsible for all ADLs and IADLs. Which of the following is MOST important for the OT to first assess as part of the evaluation process?

An OT is leading a Tier 2 group based on the multi-tiered systems of support in a school systems setting. Each student in the group is developing typically though presents at-risk for the development of mental health concerns. As part of the group, the students are involved in selecting and engaging in a long-term task, and the OT provides facilitative leadership. Based on this information, the students in this group must be at LEAST what age range?

A client diagnosed with schizophrenia is being educated on strategies to use during IADL tasks to account for deficits in memory and concentration. The client first practices the strategies in a quiet laundromat, then practices the strategies in a crowded grocery store. Which of the following options is this approach consistent with?

A client presents with peripheral neuropathy affecting touch sensation of bilateral hands. The client lives alone and is responsible for all ADLs and IADLs. The client’s main concern is to improve ease of completion during dressing tasks. Which of the following is most important to FIRST implement as part of the OT intervention implementation process with this client?

An OT is assessing upper extremity range of motion of a client with Parkinson’s Disease. The client demonstrates resistance manifested by an increase in tone noted throughout the entire movement pattern. Which of the following forms of hypertonicity does this represent?

Which of the following represents an example of the principles of Universal Design?

An OT is completing a session with a client involving LB Dressing. The OT is instructing safety methods for completing the task while sitting at edge of bed. During the session, the client notes he is concerned about going home and being able to safely navigate around the house while managing a walker. What aspect of the SOAP note should the OT include the client’s concerns?

The parents of a child being screened for occupational therapy services expresses concerns that their child is delayed in bathing skills. The child is 8 years-old and requires a substantial amount of assistance for washing and drying themselves. Which of the following choices represents the child’s skills in this occupation as it relates to typical development?

A 6.5 month-old child is being seen by an occupational therapist to address possible development delays. As you observe the child grasping a teether, you note that she picks up the teether with her left hand and holds the object at midline, then simultaneously grasps the teether with her right hand while releasing the teether with her left hand. Which of the following statements is correct regarding the OT’s assessment of this release pattern?

An OT in an acute care facility is evaluating a client who experienced a TBI. During a screening of vision, the client appears to present with impairments in lateral eye movements. Which of the following cranial nerves is MOST likely affected in this scenario?

One of the main goals of therapy during the proliferative phase of wound healing will be to:

A client who presents with a peripheral nerve injury is being treated through a sensory re-education process, through graded discrimination training. Through the use of the tactile sense, the client is able to differentiate between a nut and a bolt. Which of the following represents the next step of progression in this training process?

An OT is working with a client diagnosed with CRPS. The OT is utilizing the McGill Pain Questionnaire to assess the client’s perception of the affective dimensions of pain. Which of the following words will the client MOST likely utilize to describe his pain under this dimension?

An OT is working with a client diagnosed with schizophrenia, framing the intervention process through the Cognitive Disabilities Model. The client functions at a level IV based on the model. Which of the following BEST describes the highest level of environmental awareness the client will attend to during completion of tasks?

An OT is leading a school assembly at a middle school focused on health promotion. As part of the assembly, the entire student body is present and receives strategies to support healthy eating and sleeping habits. Based on the multi-tiered system of support, which of the following levels does this intervention represent?

An OT employed in a school system has been consulted to complete a screen with a first-grade student to determine the need for occupational therapy services. The teacher reports that the child demonstrates difficulties with handwriting, playtime at recess, and engaging in other school-related occupations throughout the day. Which of the following is MOST appropriate for the OT to complete as part of the screen with this client?

An OT is working with a child who experiences deficits with feeding and eating due to poor oral motor control, and the child presents with a tongue thrust. Which of the following choices represents an appropriate recommendation to facilitate optimal performance and safety with feeding and eating?

An OT is working with a client diagnosed with schizophrenia, framing the intervention process through the Cognitive Disabilities Model. During intervention sessions, the client is able to follow a new recipe to make different meals, but frequently burns items when using the stove and oven to cook. Which of the following levels is this client MOST likely functioning at based on the Cognitive Disabilities Model?

An OT is planning to use autogenic training as a relaxation strategy for an individual with generalized anxiety disorder. Which of the following represents an example of the implementation of this strategy?

A long-term care resident in a skilled nursing facility presents with advanced dementia. The OT is working with nursing staff to make recommendations regarding appropriate strategies to use with this client to reduce problem behaviors. Which of the following is the MOST appropriate recommendation for the OT to make?

A client presents with incoordination of the upper extremities which has affected her performance during self-feeding. As a result, the client has recently experienced social isolation due to being embarrassed to eat with friends and family in social and public settings. Which of the following is MOST appropriate to recommend the client use to promote reduced spillage during mealtime routines with friends and family?

An OT is discussing DME needs with an 85 year-old client’s responsible medical party, who expresses concern regarding being able to afford the recommended DME. Which of the following will the OT explain is covered under Medicare services?

A male client who was recently in a car injury must don a CTLSO brace according to physician’s orders, along with adhering to spinal precautions. The OT is working with the client to implement techniques and strategies to promote improved independence with self-care tasks. Which of the following is most appropriate to recommend for this client to improve independence during ADLs?

An OT is writing a SOAP note following a session completed with a client focused on ADL tasks. As part of the SOAP Note, the OT has written the following: “treatment sessions will continue to address increasing independence during completion of ADLs including LB task components with education on use of adaptive equipment”. Which of the components of the SOAP Note will this information be included?

An OT is working with a child to address difficulties with feeding and eating. The child exhibits a tonic bite reflex, along with oral hypersensitivity. Given this information, which of the following options would be the BEST tactic to use with this child during the intervention implementation process?

An OT is working in a preschool setting with a 4.5 year old child, assessing the child’s abilities as they relate to the development of handwriting skills. Which of the following abilities represents the HIGHEST level of progression regarding handwriting skills for a typically developing child of this age?

Which of the following does NOT represent one of the fundamental approaches of motivational interviewing?

An OT is working with a client who has experienced a TBI with resulting memory impairments. The OT is instructing the client on strategies to assist with completion of a light meal preparation task. Which of the following is MOST appropriate to utilize to promote learning with this client?

A client abducts the shoulder to reach for a cup of coffee located on a table beside the client. Which of the following planes of movement does this motion occur in?

A client with COPD with a recent acute exacerbation is being seen for OT services in a home health setting. During a light meal preparation task, the client rates their exertion as a 9 on the Borg Perceived Rate of Exertion Scale. What is the OT’s NEXT appropriate response to take in this scenario?

During a session focused on self-feeding a client suddenly becomes quiet and motions for the universal choking sign. The therapist quickly asks the client “are you choking”, and the client begins to cough. What should the therapist’s NEXT response be in this scenario?

An OT is writing a progress note for a client who experienced a CVA. As part of the note, the OT writes the following: The client’s RUE hemiparesis continues to interfere with ADL performance”. What portion of the SOAP Note will this statement be included in?

An OT is treating a client recovering from COVID-19 who presents with shortness of breath, dyspnea, and increased respiratory rate with light activity. Which of the following represents the MOST appropriate goal to create in collaboration with the client as part of the intervention planning process?

A client is engaging in a treatment session focused on lower body dressing. The OT sets up the task for the client and remains within close sight, with the client then completing all aspects of lower body dressing requiring no physical assistance though requiring 1 verbal cue from the OT for safety. How will the OT grade the client’s performance of this task?

A client presents with impairments in strength following a recent bout of pneumonia. The client is able to actively flex her elbows against gravity to 100 degrees. Which of the following MMT scores will the OT grade the client’s elbow flexion strength?

An OT is writing a SOAP note following a session completed with a client focused on ADL tasks. The client reported “I am so excited about my grandson coming to visit me this week”. Which of the components of the SOAP Note will this information be included?

An OT is working with a client in an outpatient setting who is experiencing an acute flare-up of rheumatoid arthritis. The client presents with weakness of the lumbrical muscles and pain and acute inflammation at the MCP joints. Which of the following represents the MOST important component of the acute stage of intervention with this client?

A child with a sensory processing disorder does not respond to sensory input. The child appears to have a limited awareness of environmental cues, demonstrates a flat affect, and appears disconnected from their surroundings. Based on this information, all of the following are appropriate intervention tactics to use with this child, EXCEPT?

An OT is completing an evaluation with a client who has experienced a peripheral nerve injury. The client winces and reports pain when being touched over the hand by a cotton ball. The OT documents that the client is likely experiencing which of the following?

A client diagnosed with Bipolar Disorder is receiving supportive services for prevocational training in a psychosocial clubhouse setting. Which of the following types of employment is the client MOST likely participating in?

An OT is working with a client in the pre-contemplation stage of change based on the transtheoretical model of change. Which of the following strategies will be MOST appropriate for the OT to include with the client at this stage?

Which of the following represents a CONTRAINDICATION for the use of continuous mode therapeutic ultrasound?

A client with a diagnosis of Carpal Tunnel Syndrome has been referred for an evaluation and treatment at an outpatient facility. The OT has completed a review of the client’s medical history, a brief interview and observation of the client, and has developed the occupational profile. Which of the following is the most appropriate NEXT step for the OT to complete?

An OT employed at an outpatient pediatric therapy facility is leading a group session focused on modulation of behavior during play activities consisting of children who are between the ages of 7 and 9 who present with ADHD, though cognition is typically developed. Which of the following options is MOST appropriate to implement during the session to facilitate age-appropriate play for these clients?

You are working with a child who has a retained tonic labyrinthine supine reflex. This affects the child’s participation with the completion of dressing. Which of the following options represents an appropriate recommendation to make to the parents of a child with this retained reflex?

An entry level OT is part of an interdisciplinary team working with a client diagnosed with Borderline Personality Disorder. The client is being treated from a Dialectical Behavior Therapy perspective. The OT will likely be involved in all of the following components of this approach EXCEPT:

A 5 year-old child diagnosed with autism is being seen for occupational therapy services. The child is functioning developmentally at a 3 year-old level. In regards to dressing, he is able to don a pullover shirt with minimal assistance, and is able to don his socks. All of the following represent an appropriate next dressing task that should be implemented into treatment sessions EXCEPT?

A client who has experienced a TBI is functioning at a Rancho Los Amigos Level III.  The client presents with an immature tonic labyrinthine reflex. Which of the following is the MOST appropriate option to include as part of occupational therapy treatment with this client?

A client presents for a wheelchair evaluation. The evaluation determines that the client has good trunk control, is ambulatory using a walker, and will mainly use the wheelchair for community outings and appointments. What type of wheelchair seat cushion will best fit this client’s needs?

A client who presents with a flexible deformity of a right pelvic obliquity has been referred for OT services as it relates to seating and positioning needs. Which of the following is MOST appropriate for the client’s seating surface secondary to the presence of the obliquity?

Which of the following is MOST appropriate to implement as part of the intervention process for a client in the late stages of Parkinson’s Disease?

A client who experienced a CVA demonstrates impairments consistent with unilateral neglect, flaccidity of the affected LUE, and pain consistent with symptoms of thalamic pain. The client also demonstrates impairment of cognition and appears to lack an awareness of his deficits. The client currently requires maximal assistance with all ADLs based on the initial evaluation. Which of the following goals is MOST appropriate to create with this client as part of the intervention planning process?

An individual s/p experiencing a CVA will be discharged shortly from an inpatient rehab stay. The OT has written a goal stating “the client will complete lower body dressing in a seated position edge of bed with independence before discharge”. What conclusion can be made regarding the specific condition for this task based on the COAST goal writing method?

A client who is receiving Home Health services under Medicare Part A alerts the OT that she plans to attend weekly church services on Sunday mornings with transportation provided by her son. She asks the OT how this will affect her eligibility for Home Health Services. Which of the following is an appropriate course of action for the OT to take?

An OT has completed a research study regarding the effectiveness of CIMT on upper extremity function with clients who have experienced a stroke. The OT used a true experimental design for the study. During the analysis of the results, .05 was set as the cut-off value for testing statistical significance. The OT concluded that the p-value of the study was .051. Which of the following statements is correct regarding the conclusions that can be drawn from this study?

An OT notes that a client’s wound is producing serous exudate. How will this present?

An OT is working with a child who is in fourth-grade who has a diagnosis of autism. The child demonstrates outbursts that seem to be preceded by a bell in the classroom ringing. The OT works with the child’s teacher to implement a consequence intervention approach to address this. Which of the following options represents this approach?

An OT is utilizing an errorless learning approach to teach life and social skills to a client with schizophrenia. Which of the following skills is MOST conducive to training using an errorless learning approach?

A client presents with adhesive capsulitis. Based on the patterns of impairment associated with this diagnosis, which of the following components of functional activities would you expect the client to present with the MOST difficulties in as it relates to driving?

A client presents with a swan neck deformity. Which of the following options is indicated as a splinting mechanism to address this deformity?

A client presents with Rheumatoid Arthritis and inflammation at the MCP joints in the acute stage, and the client reports pain at the MCP joints. According to the client’s chart review, she also presents with a comorbidity of Raynaud’s Syndrome. Which of the following techniques to reduce pain is BEST for use during intervention with the client in this stage?

An OT plans to use a cognitive behavioral frame of reference with a client diagnosed with acute schizophrenia to guide cognitive restructuring. Which of the following is the MOST important determining factor of the successful use of this frame of reference?

An OT is working with a client with major depressive disorder. The client reports to the OT that he believes he is unproductive during each day which results in increased feelings of hopelessness. The OT instructs the client to record his behavior on an hourly basis for 5 days. Which of the following strategies does this represent?

A client who has experienced a recent bout of pneumonia is being seen for OT services in a skilled nursing facility. The OT is instructing the client on techniques for the completion of an upper extremity Home Exercise Program. During the chart review the OT noted that the client also presents with diabetic retinopathy and presbycusis. Which of the following methods of instruction will be MOST effective to utilize for this client to promote performance?

A client who recently experienced a TBI is being seen in an inpatient rehabilitation setting. The client presents with deficits in attention, memory, and executive functioning abilities. The OT is initially addressing the client’s metacognitive status as part of the intervention process. Which of the following represents a metacognitive component of intervention that the OT may engage the client in?

A Home Health OT is studying the differences between symptoms of Insulin Reaction and Ketoacidosis in order to be equipped to assist clients with diabetes in the event of a medical emergency. Which of the following symptoms would indicate that a client may be experiencing a reaction to Insulin?

A client who has experienced a recent CVA is engaging in performance of upper body dressing hemi-dressing strategies, and is in the acquisition phase of the learning process. Which of the following examples would result in the highest level of contextual interference present during the task?

An individual s/p experiencing a CVA will be discharged shortly from an inpatient rehab stay. The OT has written a goal stating “the client will complete lower body dressing in a seated position edge of bed using a sock-aid and Reacher as indicated before discharge”. What conclusion can be made regarding the assist level for this task based on the COAST goal writing method?

An OT is working with a client in an inpatient rehab facility. The client has requested that his wife be present during all sessions, which is permissible by the facility standards. The OT suspects that the client is magnifying his limitations which has been exacerbated by his wife, and the client is not making progress at the rate initially expected. The client also complains that the treating OTA “hasn’t been helping me out at all”. Which of the following is MOST appropriate for the OT to complete in this scenario?

An OT is working in a home health setting with a client who has experienced an ASIA A T12 SCI. The client has a ramp at his home, although it does not meet ADA requirements, and has a steep grade. The client has asked the OT to provide his wife with training on how to best maneuver his wheelchair on the ramp, and on the curbs outside his house adjoining the sidewalk. Which of the following is MOST appropriate for the OT to recommend?

An OT is treating an SCI client insured by Medicare who is preparing for discharge to the home environment from inpatient rehab. The client and his wife express concern that Medicare will not pay for certain DME, and that he cannot afford the pieces of recommended adaptive equipment. Based on this information, which of the following is MOST appropriate for the OT to complete?

A client who underwent a posterolateral hip replacement is preparing for discharge to his home environment on the 4th postoperative week. The OT is completing a home evaluation with the client, and making recommendations to the client and his wife. Which of the following is MOST appropriate for the OT to consider?

An OT is working with a client receiving home health services. A neighbor occasionally helps the client with care throughout the day when his wife has to be away for brief periods of time. During the second week of OT home health, the client states that he doesn’t need OT services anymore. The client is adamant in his statement. Which of the following is the MOST appropriate course of action for the OT to take?

An OT is working with a client who has experienced an ASIA A T12 SCI. The client has good motor control of the upper extremities and good trunk stability. It has been determined that the client would benefit from a light-weight custom manual wheelchair. Which of the following are appropriate measurements for the OT to make?

An OT is treating a client who has experienced a CVA for the first session post-evaluation. An OT aide will be assisting the OT in the session. At the start of the session, the client is in bed. As it relates to the OT Aide’s role in the intervention process, which of the following is MOST appropriate in this scenario?

A client with a trans-radial amputation has been provided with a myoelectric prosthesis. The OT is in the use training process with the client. Which of the following activities is MOST appropriate during this stage?

A client is being seen at an outpatient occupational therapy center for occupational performance deficits related to damage of the long thoracic nerve. Based on the occupational profile the OT notes the client is a carpenter. Which of the following options would you MOST likely observe the client experiencing difficulties with?

A client presents with adhesive capsulitis. Based on the patterns of impairment associated with this diagnosis, which of the following would you expect the client to present with the MOST difficulties in?

You are working with a client who has experienced a left-hemisphere CVA, and the client is demonstrating motor return in the RUE. You are using a PNF approach with the client, and are using diagonal patterns to facilitate improved use of the RUE. Which of the following represents a functional example of the D2 flexion or extension patterns using the RUE?

An OT is completing interventions in an outpatient facility with a 7 year-old child. The OT gathered information from the child’s parents during the evaluation process that lead the OT to suspect the child may be experiencing impairments of smooth pursuit eye movements. Which of the following activities did the child’s parents MOST likely report difficulties with?

An OT is treating a client who experienced burns on an inpatient rehab unit. The client has skin tightness of the shoulder and hand affecting range of motion secondary to scar formation. The client also presents with significant edema of the hands and forearms. Which of the following is MOST appropriate for the OT to complete with the client during the intervention process?

An OT is working with a client who demonstrates left-sided unilateral neglect, and the client requires maximal multi-modal cues to attend to the left hemi-body and environment. The client also demonstrates deficits in spatial relations, and anosognosia. However, the client demonstrates the ability to initiate ADLs. Which of the following is MOST appropriate for the OT to complete with the client as part of the intervention process at this initial stage?

A client has experienced damage to the musculocutaneous nerve. Which of the following options would the client demonstrate the MOST impairments in?

You are working with a 35 year-old client who recently experienced an ankle fracture. The client had been using crutches for mobility for a little over one month. As a result, the client has experienced compression of the axillary nerve. Based on this information, which of the following interventions is MOST appropriate to include with this client?

The mean for a given norm-referenced assessment is 100, and the standard deviation is 15. The results of the assessment for a single participant indicate that the participant has scored within 1 standard deviation below the mean. Which of the following statements is TRUE regarding the participant’s standard score on the assessment?

An OT employed in an acute care hospital is completing interventions with a 69 year-old male client who has experienced a C6 ASIA A SCI 5 days ago. As it relates to the client’s needs in the acute care setting, which of the following is MOST appropriate to complete?