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1. An OTR receives a referral  to evaluate a 75 year old female diagnosed with Dementia of the Alzheimer’s type.  The client is demonstrating severe cognitive decline, stage 6, and has a caregiver 24 hours a day.  Which method would be the MOST INFORMATIVE to the OTR to determine the client’s ability to care for self?

1. Direct observation of the client performing a self-care task.
2. Interview
3. Self-report
4. Perform the Assessment of Motor and Process Skills

2. An OTR is developing an exercise program for a client with Reflex Sympathetic Dystrophy in her right hand.  Currently, the client is demonstrating pain, swelling, and stiffness.  Which initial exercise plan would be BEST?

1. Manually manipulate the wrist and hand to increase motion.
2. Gentle active exercise and frequent massage.
3. Protective sensory reeducation
4. Relaxation training

3. An OTR is guiding parents of a premature newborn on how to promote upper and lower extremity range of motion into the daily routine of child care.  What is the BEST task parents can use daily?

1. Diaper change
2. Breast or bottle feeding
3. Playing during bath-time
4. Rocking the baby to sleep

4. An OTR is treating an individual in the acute phase of a burn.  The client has burns on bilateral upper extremities and the neck area.  What is the MAIN goal of positioning during this phase?

1. Assessing scars
2. Educate client and family on pain management techniques
3. Limit edema formation
4. Have client perform active range of motion exercise

5. A client with deficits in stereognosis would have MOST DIFFICULTY with?

1. Identifying coins in his or her pocket
2. Finding the route back to his/her room
3. Identifying a familiar face
4. Determining the distance from the front of the sink to the faucet

6. An OTR/OTA is treating a 7 month old baby with Spina Bifida.  The baby is having difficulty with self-feed. Which intervention would be BEST for the OTR/OTA to address during treatment?

1. Finger feeding portions of a meal
2. Dipping spoon in food
3. Taking food from spoon
4. Hold bottle

 7.  An OTR/OTA is treating a 52 year old female who had a Right-sided CVA 3 weeks ago.  Currently, the client demonstrates difficulty with making automatic postural changes.  Which intervention would be BEST  to address postural adaptation during lower extremity dressing?

1.  When the client is donning pants, ask them to stop and hold with both upper extremities at mid-range to stabilize against gravity
2. Encourage the client to fold clothes in sitting
3. Ask the client to attempt to donn pants with the affected upper extremity to encourage voluntary movement in the involved upper extremity
4. Educate the client on the use of adaptive equipment to decrease risk of falling when performing ADLs

8.  An OTR/OTA is working with a client who has recently had a Myocardial Infarction.  One of the client's goals is to be able to do her laundry independently.  Currently, the client is unable to tolerate standing for more than 1 or 2 minutes.  Which treatment approach is BEST to increase the client's endurance for performing laundry tasks initially?

1. Have the client sort laundry in standing, while increasing the amount of clothes to sort each week.
2. Ask the client to pull laundry out of the washer while standing
3. Ask the client to choose the laundry setting and place soap in washer, while standing
4. Educate the client on energy conservation techniques to implement during laundry tasks

9.  An OTR/OTA is treating a client with chronic low back pain in an inpatient rehabilitation facility.  Which treatment approach is BEST when addressing behavioral methods for chronic pain management?

1. An interdisciplinary approach  addressing physical activity, biofeedback, and distraction.
2. Coordinating with the client and their family to address cultural influences.
3. Education on stress management techniques
4. An interdisciplinary approach incorporating deep breathing and meditation

10.  An OTR/OTA is treating a client with Rheumatoid Arthritis.  The OTR/OTA observes the client carries a heavy purse with her hand.  The OTR/OTA is educating the client on joint protection while carrying her purse.   What is the BEST way to educate the client on joint protection to decrease risk of deformity.

1.  Educate the client on limiting items to place in her purse to decrease the external force.
2. Educate the client on limiting items to place in her purse and encourage her to wear the purse over her shoulder.
3. Encourage use of a belted waist pack to decrease to decrease external force and internal load.
4. Encourage the client to wear her purse across her chest to evenly distribute the force of the load she is carrying.

11.   An OTR is assessing a client’s wheelchair mobility with their new wheelchair.  The client plans to return home with their wheelchair, once he/she finishes the inpatient rehabilitation program.  How should the OTR  FIRST assess the client’s wheelchair mobility?

1. Ask the client to propel their wheelchair through an empty hallway.
2. Assess the client’s trunk balance supported and unsupported to determine how well the client can transfer into and out of the wheelchair.
3. Assess the client’s grip strength to determine if the client can lock and unlock the wheelchair brakes.
4. Ask the client to propel their wheelchair from their bed to the bathroom.

12.   An OTR is evaluating a client with a lesion on the Occipital Lobe.  A client with this type of lesion would have the MOST difficulty with?

1. Visual acuity
2. Auditory reception
3. Visual memory
4. Comprehension

13.   An OTR is assessing a client’s strength and ROM in bilateral upper extremities.  The client is deconditioned and cannot tolerate sitting.  What is the BEST start position to assess the client’s active ROM with shoulder extension?

1. Gravity eliminated position with the client side-lying, arm internally rotated, and therapist supporting elbow during the motion, asking the client to move arm back.
2. Gravity eliminated position with the client side-lying, arm in midposition along the side of body, and therapist supporting arm under the elbow, asking the client to lift arm to the front.
3. Support the client in a sitting position, place the arm at the side internally rotated, and ask the client to move arm back.
4. Support the client in a sitting position, place arm down at side, and ask client to lift arm to the front.

14.  An OTR is treating a child with Attention Deficit Hyperactivity Disorder in a school setting.  Currently, the child is disruptive in the classroom, frequently throws his belongings, and leaves the classroom without permission.  The OTR is educating the client’s teacher on tactics to aid in increasing the child’s attention and behavior in the classroom.  What is the BEST method for the OTR to educate the teacher on to increase the structure of the classroom environment?

1. Each time the student acts out, send the student to the principal’s office
2. Have the teacher explain directions and rules prior to classroom activity, with reminders during the activity
3. Educate the teacher on allowing the student to pass out items for class activities, to help the student expend their energy
4. Ask the teacher to post a schedule for the day for the students to ensure they are informed of what to expect during classroom time

15.  An OTR or OTA is instructing a client with a recent bilateral lower extremity amputation how to use a sliding board to transfer onto a toilet.  The OTR or OTA should first instruct the client to:

1. Instruct the client to remove one wheelchair armrest to initiate the transfer
2. Ensure the brakes are locked
3. Instruct the client to place the sliding board between the buttocks and knee
4. Place the wheelchair parallel to the toilet

16.   An OTR/OTA is treating a client who recently had a right upper extremity amputation at the shoulder joint, due to a chronic infection.  The right UE is the client’s dominant side.  Currently, the client has a dressing over the incision to allow for wound healing.  During the preprosthetic phase, the OTR/OTA is addressing activities of daily living to educate the client on unilateral activity.  The OTR/OTA should:

1.  Massage the wound to aid in desensitization for dressing tasks
2. Educate the client on wrapping the limb as part of preparation for hygiene and dressing tasks
3. Introduce adaptive equipment that may be beneficial for bilateral activity
4. Educate the client on one-handed techniques to assist the left upper extremity with the dominant role

17.   An OTR/OTA is treating a child with Autism.  The OTR/OTA is addressing a play task that will address sequencing, memory, and motor planning.  The BEST intervention would be:

1. Have child swing in a linear motion
2. Design an obstacle course in a circular pattern
3. Have child swing in a spinning motion
4. Design an obstacle course in a line pattern

18.  An OTR/OTA, in an inpatient rehabilitation facility, is treating a client who recently had an exacerbation of Multiple Sclerosis.  The client is unable to tolerate standing during ADL tasks due to fatigue and weakness.  The client is determined to remain independent.  The BEST intervention during the ADL portion of OT treatment would be:

1. Educate the client on performing grooming tasks from a wheelchair level
2. Educate the client on sliding transfers to the toilet
3. Introduce adaptive equipment to assist with dressing tasks
4. Provide information to the client on energy conservation techniques

19.  An OTR is assessing  visual perception skills during the initial evaluation of a client who recently had a right Cerebral Vascular Accident.  The client is demonstrating symptoms of unilateral visual neglect of the sensory type.  A client demonstrating this deficit during a self-care task would MOST LIKELY:

1. Demonstrate the correct use of a comb, but with clumsiness
2. Bump into the toilet, prior to a toilet transfer
3. Have difficulty performing a cancellation task
4. Over reach for items near the sink

20.  An OTR/OTA is addressing handwriting skills for a child who is in the 2^nd grade.  Upon observation, the OTR/OTA notices the child is able to grasp a pencil and hold it in a functional position for writing.  The NEXT step in the assessment process is:

1.  Ask the client to copy letters and numbers
2. Have the client sit unsupported on the mat to assess postural control
3. Ask the client to imitate shapes on paper
4. Determine if the client’s feet can touch the floor, while seated comfortably back in their chair

21.  An OTR is evaluating an individual’s performance with IADL motor skills.  During a meal planning task, the clinician would MOST LIKELY be concerned with:

1. The client’s ability to retrieve items from a refrigerator bilaterally without dropping
2. The client initiating the task by reading the directions
3. The client separating the ingredients on the counter according to the directions
4. The client’s ability to stabilize balance while retrieving items from the refrigerator

22.   An OTR is measuring passive shoulder flexion ROM while an individual is sitting.  The BEST placement of support the therapist can provide to the client is:

1. Distal to the glenohumeral joint
2. Proximal and distal to the glenohumeral joint
3. Proximal to the lateral epicondyle of the humerus
4. Proximal and distal to the scapula

23.   An OTR is assessing the manual muscle strength on an individual who demonstrates mild hypertonicity when performing elbow flexion.  What muscle grade is the MOST informative when establishing a plan of care to assist in documenting progress for self-feed:

1. Triceps muscle, to address stabilization
2. Deltoid muscle, to compensate at the shoulder level for the activity that cannot be performed smoothly below
3. Biceps muscle, to address lifting of the eating utensils
4. Pectoralis Major, to assist in rotation of the arm to reach for food

24.  An OT practitioner is addressing cylindrical grasp with a client who recently had a CVA and is trying to gain greater control in his right hand.  The BEST initial intervention would be:

1. Ask client to stimulate placing a cereal box on a shelf above shoulder level, with the OT practitioner for support.
2. While client is standing, have him transport a coffee cup to a shelf at or below hip level.
3. While the client is standing, address reaching for a cup from a neutral level.
4. Address grasping a cup from a neutral level, with minimal support at the top of the cup from the OT practitioner.

 Here are the sample question answers.