This week focuses on: OT Process, NBCOT® Rules and Regulations, Professional Development, OT Roles, Medicare vs. Medicaid, Professional Standards & Ethics, OT and OTA, Research & Statistics, Frame of Reference and Models
This week focuses on: OT Process, NBCOT® Rules and Regulations, Professional Development, OT Roles, Medicare vs. Medicaid, Professional Standards & Ethics, OT and OTA, Research & Statistics, Frame of Reference and Models
To streamline studying, we have highlighted our most recommended material. If you are limited on time, please review this material first.
Use this meditation to calm your nerves, reduce test anxiety, and to increase your confidence
Final PEOP Video + Case Study
Model of Human Occupation – MOHO
OTPF Song -Occupational Therapy Practice Framework Song
Code of Ethics Song for Occupational Therapy
Unbroken – Motivational Video
Test Taking Body Scan
OT Rex – OT Principles and Standards of Conduct
OT Rex – Models and Theories Overview
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Week 1 Quiz
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If you do not receive above 75% or better on this exam. it is highly recommended that you sign up for a personal tutoring session immediately before taking the actual NBCOT® exam. A personal tutor can significantly help you better understand any problem areas, and do not want to take the actual exam if you have any problem areas. It will significantly jeopardize you from passing.
An OTA helps a CVA patient make a Valentine’s card for her husband and then uses her own money to buy heart candy so the patient has a gift to provide to her husband. What value is demonstrated by the OTA?
A. Altruism. Altruism is the unselfish concern for the welfare of others. This concept is reflected in actions and attitudes of commitment, caring, dedication, responsiveness, and understanding. It is characterized by acts with no apparent benefits for the individual who performs them but that are beneficial to other individuals. Often, people behave altruistically when they feel empathy and a desire to help.
A. Altruism. Altruism is the unselfish concern for the welfare of others. This concept is reflected in actions and attitudes of commitment, caring, dedication, responsiveness, and understanding. It is characterized by acts with no apparent benefits for the individual who performs them but that are beneficial to other individuals. Often, people behave altruistically when they feel empathy and a desire to help.
When a claim is submitted to Medicare for OT services, which of the following scenarios will MOST likely result in Medicare rejecting this claim, denying coverage and payment?
A. Maintaining range of motion for a spastic hemiplegic arm of a patient who had a stroke several years ago.
The term “maintain” is already a red flag because denial of payment happens frequently with therapy that is viewed as “maintenance”. In the case of a patient post-stroke with hemiplegia that he has lived with for years, providing interventions to maintain range of motion for a spastic hemiplegic arm now will not produce quantifiable results in the eyes of third party payers. If a patient has been pre-determined for a certain number of sessions by a third party payer for a rotator cuff tear, then the patient is not had high risk for payment denial unless OT services goes over that number without seeking approval for additional days. For the patient with schizophrenia, the OT is not specifically providing mental health treatment but rather addressing the hip. E-stimulation to the lower back extensors is quantifiable and skilled treatment for postural stability and alignment, thus is not a high-risk treatment for denial.
A. Maintaining range of motion for a spastic hemiplegic arm of a patient who had a stroke several years ago.
The term “maintain” is already a red flag because denial of payment happens frequently with therapy that is viewed as “maintenance”. In the case of a patient post-stroke with hemiplegia that he has lived with for years, providing interventions to maintain range of motion for a spastic hemiplegic arm now will not produce quantifiable results in the eyes of third party payers. If a patient has been pre-determined for a certain number of sessions by a third party payer for a rotator cuff tear, then the patient is not had high risk for payment denial unless OT services goes over that number without seeking approval for additional days. For the patient with schizophrenia, the OT is not specifically providing mental health treatment but rather addressing the hip. E-stimulation to the lower back extensors is quantifiable and skilled treatment for postural stability and alignment, thus is not a high-risk treatment for denial.
Which occupational therapy treatment techniques fall under the level of intervention of Purposeful Activity? Please select the best 3 answers.
Rationale: Purposeful activities are meaningful to the client and goals are written to specifically address these activities. Self-feeding, bowling, housekeeping, and participating in the hobby of building birdhouses are all activities that have meaning for these clients. Goals should be written in the treatment plan addressing these activities, as these are activities the clients want to resume. Providing a sock aid to a woman recovering from a hip fracture is an enabling activity, as the woman may not need the sock aid to dress herself once she has recovered. Applying the hot pack is an adjunctive activity, as it will help prepare the man for participation in therapeutic exercise.
Rationale: Purposeful activities are meaningful to the client and goals are written to specifically address these activities. Self-feeding, bowling, housekeeping, and participating in the hobby of building birdhouses are all activities that have meaning for these clients. Goals should be written in the treatment plan addressing these activities, as these are activities the clients want to resume. Providing a sock aid to a woman recovering from a hip fracture is an enabling activity, as the woman may not need the sock aid to dress herself once she has recovered. Applying the hot pack is an adjunctive activity, as it will help prepare the man for participation in therapeutic exercise.
What type of insurance covers people 65 years and over, who have been on social security for 24 months, and requires a minimum of 5 days/week of services?
C. Medicare Part A
Medicaid provides health coverage for children, pregnant women, parents, seniors, and individuals with disabilities. Blue Cross/Blue Shield PPO is private insurance. Medicare Part A covers patients that are in the acute care setting and need a minimum of 5d/wk of therapy. Medicare Part B covers patients in the outpatient setting that need therapy 3d/wk.
C. Medicare Part A
Medicaid provides health coverage for children, pregnant women, parents, seniors, and individuals with disabilities. Blue Cross/Blue Shield PPO is private insurance. Medicare Part A covers patients that are in the acute care setting and need a minimum of 5d/wk of therapy. Medicare Part B covers patients in the outpatient setting that need therapy 3d/wk.
An OT runs a group to educate new single mothers in positioning strategies for their newborns during feeding to promote newborn health. Which type of intervention/prevention is this?
C. Primary prevention. Primary prevention reduces the incidence of a disease or disorder. Secondary prevention prevents the disease from progressing through early detection.
C. Primary prevention. Primary prevention reduces the incidence of a disease or disorder. Secondary prevention prevents the disease from progressing through early detection.
An OTR® and an entry-level COTA® are working with a group of patients who have been diagnosed with bipolar disorder at an outpatient mental health facility in Lumbock,Texas. What task is the COTA® permitted to perform?
D. Introduce the patients and hand out supplies. Regardless in which state the clinician is practicing, a COTA® can help lead mental health groups, but is prohibited from setting goals and interpreting results from a standardized assessment any patient.
The OT initiates and directs a patient’s evaluation, interprets the data, and develops the intervention plan. In terms of goals, the OTA is responsible for being knowledgeable about the client’s occupational therapy goals, not setting them.
D. Introduce the patients and hand out supplies. Regardless in which state the clinician is practicing, a COTA® can help lead mental health groups, but is prohibited from setting goals and interpreting results from a standardized assessment any patient.
The OT initiates and directs a patient’s evaluation, interprets the data, and develops the intervention plan. In terms of goals, the OTA is responsible for being knowledgeable about the client’s occupational therapy goals, not setting them.
An inpatient who has a complete C8 SCI has been participating in OT for 2 weeks to improve his performance in upper body dressing. The patient is now able to transfer into his wheelchair and don a t-shirt, but he is still unable to reach for the t-shirt, from the closet. Which statement indicates the BEST description for the assessment portion of the SOAP progress note?
B. “The patient is learning techniques and is progressing towards the long-term dressing goal for dressing”.
Low-Cervical Nerves (C5 – C8). The “A” portion of the SOAP note represents the assessment which reflects the patient’s progress, functional limitations, and expected benefits from skilled OT interventions and to justify continuation in rehabilitation. The assessment describes the clinician’s interpretation of the “S” and “O” of the SOAP note and reflects the clinician’s clinical judgement.
B. “The patient is learning techniques and is progressing towards the long-term dressing goal for dressing”.
Low-Cervical Nerves (C5 – C8). The “A” portion of the SOAP note represents the assessment which reflects the patient’s progress, functional limitations, and expected benefits from skilled OT interventions and to justify continuation in rehabilitation. The assessment describes the clinician’s interpretation of the “S” and “O” of the SOAP note and reflects the clinician’s clinical judgement.
An OTA is working with a patient who is recovering from a CVA. One of the patient’s goals, is to improve her cognitive skills. As Valentine’s day is the following day, the patient states that she would like to make a card for her husband. The OTA structures the activity accordingly, to meet the therapeutic goals. During the session, the patient mentions that she always buys a card and a gift for her husband on Valentine’s Day. Later on during the day, the OTA surprises the patient with candy that she had purchased for her, to give to her husband. What core value is this OTA demonstrating in this scenario?
A. Altruism.
Altruism is the unselfish concern for the welfare of others. This concept is reflected in actions and attitudes of commitment, caring, dedication, responsiveness, and understanding. It is characterized by acts with no apparent benefits for the individual who performs them but that are beneficial to other individuals. Often, people behave altruistically when they feel empathy and a desire to help. For the patient participating in the card making activity will address certain OT intervention goals. Receiving candy from the OTA, is however not relevant in terms of the patient’s intervention plan but it will help the patient feel less confined to the hospital and it’s restrictions.
A. Altruism.
Altruism is the unselfish concern for the welfare of others. This concept is reflected in actions and attitudes of commitment, caring, dedication, responsiveness, and understanding. It is characterized by acts with no apparent benefits for the individual who performs them but that are beneficial to other individuals. Often, people behave altruistically when they feel empathy and a desire to help. For the patient participating in the card making activity will address certain OT intervention goals. Receiving candy from the OTA, is however not relevant in terms of the patient’s intervention plan but it will help the patient feel less confined to the hospital and it’s restrictions.
According to AOTA® guidelines, what level of supervision is made directly every 2 weeks with other methods of supervision, such as written or telephonic communication, in the interim?
B. Routine supervision.
Intermediate OTA
Supervision: Routine/general supervision by all level OT or advanced OTA
Supervises: Aides, technicians, volunteers, Level 1 OT students, Level 1 + 2 OTA students
B. Routine supervision.
Intermediate OTA
Supervision: Routine/general supervision by all level OT or advanced OTA
Supervises: Aides, technicians, volunteers, Level 1 OT students, Level 1 + 2 OTA students
In an outpatient clinic, an OTA is working with a 43-year-old patient who is recovering from a right CVA. The patient has been working as a school bus driver for the past ten years and would like to return to work. In the last two treatment sessions, the OTA has seen a decline in the patient’s reaction time and visual acuity. What action should the OTA take next?
B. Report the information to the physician.
It is important to report this information to the physician so that the physician can do further testing. The physician needs to be made aware of the patient’s deficits, so that he/she can assess further assess the patient and discuss the matter with the patient. Besides the patient possibly needing further testing, it is typically the physician’s legal responsibility to report impaired drivers. It is not within the scope of practice, for an OT to make recommendations for driver training in this scenario, or to report the driver to the authorities.
B. Report the information to the physician.
It is important to report this information to the physician so that the physician can do further testing. The physician needs to be made aware of the patient’s deficits, so that he/she can assess further assess the patient and discuss the matter with the patient. Besides the patient possibly needing further testing, it is typically the physician’s legal responsibility to report impaired drivers. It is not within the scope of practice, for an OT to make recommendations for driver training in this scenario, or to report the driver to the authorities.
While transferring a patient from a wheelchair to a raised toilet seat, an entry level OTA is observed locking the wheelchair brakes before the transfer. Which ethical principle did the clinician abide by?
C. Nonmaleficence.
Nonmaleficence. Principle 2. Occupational therapy personnel shall refrain from actions that cause harm. Nonmaleficence “obligates us to abstain from causing harm to others” (Beauchamp & Childress, 2013, p.150). The Principle of Nonmaleficence also includes an obligation to not impose risks of harm even if the potential risk is without malicious or harmful intent.Nonmaleficence relates to avoiding actions that may cause harm.
C. Nonmaleficence.
Nonmaleficence. Principle 2. Occupational therapy personnel shall refrain from actions that cause harm. Nonmaleficence “obligates us to abstain from causing harm to others” (Beauchamp & Childress, 2013, p.150). The Principle of Nonmaleficence also includes an obligation to not impose risks of harm even if the potential risk is without malicious or harmful intent.Nonmaleficence relates to avoiding actions that may cause harm.
At what point is a COTA® permitted to modify intervention techniques?
A. When it is indicated to meet the needs of the patient.
Interventions do not always go as planned. They should be modified as needed. They should be modified based on the patients needs. The COTA® is responsible for being knowledgeable about the patient’s occupational therapy goals. The OTA selects, implements, and makes modifications to therapeutic activities and interventions that are consistent with demonstrated competency levels, client goals, and the requirements of the practice setting.
A. When it is indicated to meet the needs of the patient.
Interventions do not always go as planned. They should be modified as needed. They should be modified based on the patients needs. The COTA® is responsible for being knowledgeable about the patient’s occupational therapy goals. The OTA selects, implements, and makes modifications to therapeutic activities and interventions that are consistent with demonstrated competency levels, client goals, and the requirements of the practice setting.
When OT practitioners share a similar experience in a “story telling” format while problem solving, what type of reasoning is being used?
A. Narrative reasoning.
Narrative reasoning is a central mode of clinical reasoning in occupational therapy. Clinicians reason narratively when they are concerned with disability as an illness experience, that is, with how a physiological condition is affecting a person’s life. In this paper, narrative reasoning is contrasted with propositional reasoning, and two kinds of narrative thinking are examined. The first is the use of narrative as a mode of speech that can be contrasted with biomedical discourse, in which disability is framed as physical pathology. The second involves the creation rather than the telling of stories. Clinicians try to “emplot” therapeutic encounters with patients, that is, to help create a therapeutic story that becomes a meaningful short story in the larger life story of the patient.
A. Narrative reasoning.
Narrative reasoning is a central mode of clinical reasoning in occupational therapy. Clinicians reason narratively when they are concerned with disability as an illness experience, that is, with how a physiological condition is affecting a person’s life. In this paper, narrative reasoning is contrasted with propositional reasoning, and two kinds of narrative thinking are examined. The first is the use of narrative as a mode of speech that can be contrasted with biomedical discourse, in which disability is framed as physical pathology. The second involves the creation rather than the telling of stories. Clinicians try to “emplot” therapeutic encounters with patients, that is, to help create a therapeutic story that becomes a meaningful short story in the larger life story of the patient.
An OT asks the OTA to complete a bathing evaluation with a patient who he is due to be discharged. When the OTA arrives at the patient’s room, the patient informs the OTA that they just completed a shower with the nurse. What should the OTA do next, in this scenario?
B. Complete a simulated bathing task. In order to be discharged, the OTA needs to see certain skills, even if the patient completed them in advance with the nursing staff.
B. Complete a simulated bathing task. In order to be discharged, the OTA needs to see certain skills, even if the patient completed them in advance with the nursing staff.
Which of the following defines an OTA’s service competency?
A. The demonstrated ability to use an identified intervention task in a safe and effective manner with a similar outcome as the OT.
Service competency does not mean that the OTA will perform the task in exactly the same manner as the OT, only that the outcomes will be similar. The supervising OT’s view of the OTA’s performance is subjective, whereas the OTA’s ability to achieve a similar outcome as the OT is objective. The amount of continuing education the OTA has had can influence service competency, but does not define it. Similarly, an OTA may only require general supervision but may not demonstrate the same types of outcomes as the OT in certain areas.
A. The demonstrated ability to use an identified intervention task in a safe and effective manner with a similar outcome as the OT.
Service competency does not mean that the OTA will perform the task in exactly the same manner as the OT, only that the outcomes will be similar. The supervising OT’s view of the OTA’s performance is subjective, whereas the OTA’s ability to achieve a similar outcome as the OT is objective. The amount of continuing education the OTA has had can influence service competency, but does not define it. Similarly, an OTA may only require general supervision but may not demonstrate the same types of outcomes as the OT in certain areas.
Richard is a 65-year-old male who was diagnosed with Progressive Supranuclear Palsy 4 months ago. He lives with his eldest daughter and grandson in a one-story home. Recently, Richard has been falling due to his impaired gait and balance. His family reports that lately he has been demonstrating general apathy, a poor appetite and a need to take long rest periods throughout the day. It has been determined that Richard would benefit from using a power wheelchair. He has shown progress in the functional use of the wheelchair but the COTA® has noticed that Richard’s posture is becoming progressively worse, especially during meals. Using a top-down approach, what PRIMARY factor should the clinician consider before recommending any positional adaptations and supports for the wheelchair to improve Richard’s posture?
C. Behavioral and mental status leading to decreased social participation.
It is essential to consider the patient’s motivation as it may affect goal-directed behavior especially if the patient has had a recent change in condition or when dealing with a chronic condition. The value of social participation at meal times should be considered prior to treating for positional adaptations and supports that target the underlying deficit associated with the symptoms of Supranuclear Palsy (rigidity, stiffness, eye gaze, swallowing).
Progressive supranuclear palsy (PSP) is an uncommon degenerative neurological disorder that causes progressive impairment of balance and walking; impaired eye movement, especially in the downward direction; abnormal muscle tone (rigidity); speech difficulties (dysarthria); and problems related to swallowing and eating (dysphagia). Affected individuals frequently experience personality changes and cognitive impairment. Symptoms typically begin after age 60 but can begin earlier. The exact cause of PSP is unknown.
Top-down approach: Although condition-specific treatments are essential to target adaptation to specific skills, a top-down approach with community interventions should be initiated concurrently to improve client-centered social integration. It is beneficial to identify a client’s real-world routines, patterns, and responsibilities to help build a meaningful treatment plan. Goals for vision-based treatments should be centered on function rather than remediation to accurately reflect the occupational therapy scope of practice and client-stated objectives.
https://www.aota.org/Publications-News/otp/Archive/2018/community-vision.aspx
https://www.aota.org/~/media/Corporate/Files/Secure/Practice/Manage/value/SNF-Evaluation-Checklist-Quality-Measures.pdf
Pass the OT Study Materials – Module 1: “Bottom-Up and Top-Down Approaches”
https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Progressive-Supranuclear-Palsy-Fact-Sheet
https://rarediseases.org/rare-diseases/progressive-supranuclear-palsy/
C. Behavioral and mental status leading to decreased social participation.
It is essential to consider the patient’s motivation as it may affect goal-directed behavior especially if the patient has had a recent change in condition or when dealing with a chronic condition. The value of social participation at meal times should be considered prior to treating for positional adaptations and supports that target the underlying deficit associated with the symptoms of Supranuclear Palsy (rigidity, stiffness, eye gaze, swallowing).
Progressive supranuclear palsy (PSP) is an uncommon degenerative neurological disorder that causes progressive impairment of balance and walking; impaired eye movement, especially in the downward direction; abnormal muscle tone (rigidity); speech difficulties (dysarthria); and problems related to swallowing and eating (dysphagia). Affected individuals frequently experience personality changes and cognitive impairment. Symptoms typically begin after age 60 but can begin earlier. The exact cause of PSP is unknown.
Top-down approach: Although condition-specific treatments are essential to target adaptation to specific skills, a top-down approach with community interventions should be initiated concurrently to improve client-centered social integration. It is beneficial to identify a client’s real-world routines, patterns, and responsibilities to help build a meaningful treatment plan. Goals for vision-based treatments should be centered on function rather than remediation to accurately reflect the occupational therapy scope of practice and client-stated objectives.
https://www.aota.org/Publications-News/otp/Archive/2018/community-vision.aspx
https://www.aota.org/~/media/Corporate/Files/Secure/Practice/Manage/value/SNF-Evaluation-Checklist-Quality-Measures.pdf
Pass the OT Study Materials – Module 1: “Bottom-Up and Top-Down Approaches”
https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Progressive-Supranuclear-Palsy-Fact-Sheet
https://rarediseases.org/rare-diseases/progressive-supranuclear-palsy/
An OTA is working with a patient with right side neglect during a meal preparation activity. The patient is unable to see the salt and pepper shaker which is located to the right of his hand. The OTA educates the patient to turn his head to the right in order to locate the items. Which frame of reference did the OTA use during this intervention?
C. Compensatory. This frame of reference states that patients who will not regain functional skills can compensate by using adaptive equipment or techniques to complete tasks in a different way. By teaching the patient to look to the right to compensate for his right side neglect, the OTA is using the compensatory frame of reference.
C. Compensatory. This frame of reference states that patients who will not regain functional skills can compensate by using adaptive equipment or techniques to complete tasks in a different way. By teaching the patient to look to the right to compensate for his right side neglect, the OTA is using the compensatory frame of reference.
A retired surfer recently sustained an injury to his left upper limb, and he is now receiving OT intervention at the outpatient rehab unit. The OTA decides to incorporate a surfing task to increase range of motion because the patient loves surfing and is motivated to participate in this leisure activity. What cognitive process has the OTA incorporated into treatment according to the Model of Human Occupation (MOHO)?
D. Volition.The definition of volition is the cognitive process in which a person decides on a particular course of action. Within MOHO, volition refers to the motivation for occupation. The patient is motivated to participate in surfing, so the OTA has utilized the patient’s volition to increase his participation in a range of motion activity.
D. Volition.The definition of volition is the cognitive process in which a person decides on a particular course of action. Within MOHO, volition refers to the motivation for occupation. The patient is motivated to participate in surfing, so the OTA has utilized the patient’s volition to increase his participation in a range of motion activity.
A 16-year-old female who has been diagnosed with anorexia nervosa has recently been admitted to the inpatient psychiatric unit for intervention. As part of a multidisciplinary program, the patient has been participating in a social skills group. When documenting the patient’s participation and progress, using the SOAP format, what information should the OTA document under the “A” section?
C. Patient appears to use appropriate judgement when role-playing various tasks that involve social skills.
The assessment section summarizes and interprets the observations of the patient’s performance, allowing the therapist to determine conclusions based on the patient’s performance. Any specific observations or evidence should be reported in the objective section of the note.
C. Patient appears to use appropriate judgement when role-playing various tasks that involve social skills.
The assessment section summarizes and interprets the observations of the patient’s performance, allowing the therapist to determine conclusions based on the patient’s performance. Any specific observations or evidence should be reported in the objective section of the note.
According to Rood, what is required for normalization of tone and evocation of desired muscular responses?
C. Sensory input. This is one of the 4 basic principles of the Rood frame of reference. Sensory input may be manipulated in treatment through facilitation techniques such as brushing and inhibition techniques such as neutral warmth.
C. Sensory input. This is one of the 4 basic principles of the Rood frame of reference. Sensory input may be manipulated in treatment through facilitation techniques such as brushing and inhibition techniques such as neutral warmth.
Jonathan, a 19-year-old male who currently resides with his mother, sustained a T10 spinal cord injury 6 months ago from a gunshot wound. Jonathan is having difficulty propelling a manual wheelchair due to a chronic shoulder injury from when he played high school baseball. If the OTA is applying the PEOP FOR to assess Jonathan’s need for a powered wheelchair, which of the following are examples of environmental factors?
D. Jonathan’s power wheelchair and his relationship with his mother.
Environmental factors, according to the PEOP Frame of Reference, are extrinsic factors and include:
•Built environment and technology- physical
•Natural Environment- geographic, air quality, climate, terrain
•Culture and values– customs, values, beliefs, and behaviors that affect interpretation and meaning of occupations/life
•Social Support- Social interactions and relationships, societal values, and attitudes
•Social and Economic Systems – access to health care, policies and procedures, and monetary resources
D. Jonathan’s power wheelchair and his relationship with his mother.
Environmental factors, according to the PEOP Frame of Reference, are extrinsic factors and include:
•Built environment and technology- physical
•Natural Environment- geographic, air quality, climate, terrain
•Culture and values– customs, values, beliefs, and behaviors that affect interpretation and meaning of occupations/life
•Social Support- Social interactions and relationships, societal values, and attitudes
•Social and Economic Systems – access to health care, policies and procedures, and monetary resources
A COTA® is due to renew her State license. How many continuing education units (CEUs) do they need to accrue during a renewal cycle, in order for their license renewal to be approved?
A. It depends on the licensure requirements of the state where the OTA lives.
The number of continuing education units needed depends on the licensure requirements of the state where the COTA® lives. Each state sets its own license renewal requirements. While the state may receive input from the national certification board or the American Occupational Therapy Association, the state has the final say on license requirements.
A. It depends on the licensure requirements of the state where the OTA lives.
The number of continuing education units needed depends on the licensure requirements of the state where the COTA® lives. Each state sets its own license renewal requirements. While the state may receive input from the national certification board or the American Occupational Therapy Association, the state has the final say on license requirements.
According to the NBCOT® regulations, what is the minimum number of Professional Development Units (PDUs), a COTA® has to accrue during a 3-year renewal cycle?
A. 36.
The NBCOT® certification requires at least 36 Professional Development Units (PDUs) accrued during the 3-year renewal cycle for both Registered Occupational Therapists and Certified Occupational Therapy Assistants.
A. 36.
The NBCOT® certification requires at least 36 Professional Development Units (PDUs) accrued during the 3-year renewal cycle for both Registered Occupational Therapists and Certified Occupational Therapy Assistants.
An OTA has been working with a 57 year old patient who has been recovering in an inpatient unit after undergoing a right total hip arthroplasty. The patient wants to practice ambulating to the bathroom with a single-point cane. The OTA knows that the patient has been placed on partial weight-bearing precautions for the next two weeks and advises the patient to use a wheelchair or a front-wheeled walker instead. What core value is most associated with this scenario?
C. Prudence.
Prudence which is using clinical and ethical reasoning skills.
Prudence: Occupational therapy personnel use their clinical and ethical reasoning skills, sound judgment, and reflection to make decisions to direct them in their area(s) of practice.
C. Prudence.
Prudence which is using clinical and ethical reasoning skills.
Prudence: Occupational therapy personnel use their clinical and ethical reasoning skills, sound judgment, and reflection to make decisions to direct them in their area(s) of practice.
A patient who has COPD complains of shortness of breath while walking up stairs, performing her grooming routine, and cooking in her kitchen. Which subjective information would the OTA most likely write down in her SOAP note,which would indicate to the OTA that this patient needs education regarding her disease?
D.”I wake up in the morning and rush to get my clothes on, wash my teeth, and make breakfast. Then I am exhausted”
The first section of the SOAP note format is the S which contains subjective information obtained from the patient. In order for this part to include subjective information, documenting what the patient said regarding complaints of fatigue, is necessary.
Based on the information which the patient gave you, it is clear that you need to educate the patient about COPD and the need for her to learn to use strategies to help her cope with her ADLs. Strategies include: energy conservation, pacing, and slowing down.
D.”I wake up in the morning and rush to get my clothes on, wash my teeth, and make breakfast. Then I am exhausted”
The first section of the SOAP note format is the S which contains subjective information obtained from the patient. In order for this part to include subjective information, documenting what the patient said regarding complaints of fatigue, is necessary.
Based on the information which the patient gave you, it is clear that you need to educate the patient about COPD and the need for her to learn to use strategies to help her cope with her ADLs. Strategies include: energy conservation, pacing, and slowing down.
Which frame of reference aims to make people as independent as possible despite any residual impairment. The patient is encouraged to focus on their remaining abilities so that they can attain their highest level of functioning in their desired occupational performances?
A. Rehabilitative frame of reference.
The Rehabilitative FOR is a comprehensive approach to treatment in which the ultimate outcome is for the person to become as independent as possible despite any residual dysfunction. The primary focus of this frame of reference is adaptation to facilitate independence. This FOR is used with patients whose underlying impairments are unlikely to be remediated or with patients who lack motivation to participate in remediation. The theoretical basis of this FOR is that the patient must focus on his/her remaining abilities, despite any disabilities, to attain his/her highest level of functioning in the desired occupational performance.This FOR includes concepts of adaptation, compensation, and environmental modifications. It uses the method of teaching compensatory or functional methods, and makes use of assistive equipment and environmental modifications to restore function.
https://ottheory.com/therapy-model/rehabilitative-frame-reference
A. Rehabilitative frame of reference.
The Rehabilitative FOR is a comprehensive approach to treatment in which the ultimate outcome is for the person to become as independent as possible despite any residual dysfunction. The primary focus of this frame of reference is adaptation to facilitate independence. This FOR is used with patients whose underlying impairments are unlikely to be remediated or with patients who lack motivation to participate in remediation. The theoretical basis of this FOR is that the patient must focus on his/her remaining abilities, despite any disabilities, to attain his/her highest level of functioning in the desired occupational performance.This FOR includes concepts of adaptation, compensation, and environmental modifications. It uses the method of teaching compensatory or functional methods, and makes use of assistive equipment and environmental modifications to restore function.
https://ottheory.com/therapy-model/rehabilitative-frame-reference
Rose is a 45 year old woman who has a permanent limitation in shoulder AROM due to repeated rotator cuff injuries. Following the guidelines established under the Americans with Disabilities Act, what reasonable accommodation should the OTA recommend to Rose’s employer to allow Rose to continue to perform her job as a waitress in a restaurant that is a part of a national restaurant chain?
B. Allow Rose to place her coffee pot on a separate, lower hot plate after the coffee is brewed.
Since Rose’s limitation involves the rotator cuff, she will have difficulty reaching up to the top of the coffee maker to lift her full coffee pot. Eliminating this step by lowering the hot plate where Rose keeps her pot is the most reasonable and cost effective accommodation listed. Purchasing a new coffee maker is an unnecessary expense for the restaurant. Providing a step stool is unreasonable because it causes a safety risk for both Rose and the other employees. Asking another waitress to pour Rose’s coffee implies that Rose is not capable of performing her job duties and therefore not eligible for reasonable accommodations under the ADA.
B. Allow Rose to place her coffee pot on a separate, lower hot plate after the coffee is brewed.
Since Rose’s limitation involves the rotator cuff, she will have difficulty reaching up to the top of the coffee maker to lift her full coffee pot. Eliminating this step by lowering the hot plate where Rose keeps her pot is the most reasonable and cost effective accommodation listed. Purchasing a new coffee maker is an unnecessary expense for the restaurant. Providing a step stool is unreasonable because it causes a safety risk for both Rose and the other employees. Asking another waitress to pour Rose’s coffee implies that Rose is not capable of performing her job duties and therefore not eligible for reasonable accommodations under the ADA.
What frame of reference is used when a patient uses a raised toilet seat during recovery from a hip replacement?
B. Rehabilitative frame of reference.
Rehabilitative frame of reference: The focus is on what the patient can do, rather than on what they cannot do, and it utilizes adaptation, compensation, and modification in order to facilitate the patient’s ability to participate in the desired activities. The rehabilitative approach looks at functional problems from a top-down approach and can be utilized regardless of the extent of the patient’s deficits because it does not require the restoration or development of missing skills, but instead focuses on maximizing independence where the patient is now in the recovery process.
B. Rehabilitative frame of reference.
Rehabilitative frame of reference: The focus is on what the patient can do, rather than on what they cannot do, and it utilizes adaptation, compensation, and modification in order to facilitate the patient’s ability to participate in the desired activities. The rehabilitative approach looks at functional problems from a top-down approach and can be utilized regardless of the extent of the patient’s deficits because it does not require the restoration or development of missing skills, but instead focuses on maximizing independence where the patient is now in the recovery process.
An OTA is working with a patient who has severe cognitive deficits. Using a functional skill training approach, what is the MOST appropriate method to teach this patient how to comb his hair?
C. Repetition of the task sub-steps with gradually fading cues.
When using a functional skill training approach, the OTA should be focused on helping the patient master a task. Repeated practice with cueing is key.
A) Focused on caregiver training.
B) Using instructional cue cards is a compensatory approach.
D) Focuses on underlying performance components.
C. Repetition of the task sub-steps with gradually fading cues.
When using a functional skill training approach, the OTA should be focused on helping the patient master a task. Repeated practice with cueing is key.
A) Focused on caregiver training.
B) Using instructional cue cards is a compensatory approach.
D) Focuses on underlying performance components.
An OTR® and COTA® are collaborating in order to evaluate a patient who was recently admitted to a post-acute rehabilitation facility due to an exacerbation of Multiple Sclerosis. Which task is the COTA® able to complete as part of the process of collecting information for the evaluation?
B. Administer a standardized test to determine the patient’s cognitive function. COTA® contributes to the evaluation by helping to gather data, administer parts of the evaluation, and reporting observations. However, they cannot assess, analyze, nor interpret results of assessments
B. Administer a standardized test to determine the patient’s cognitive function. COTA® contributes to the evaluation by helping to gather data, administer parts of the evaluation, and reporting observations. However, they cannot assess, analyze, nor interpret results of assessments
An OTA is working with a young college student who has Onychophagia which is placing her at high risk for contracting infections such as Covid-19. This behavior occurs mostly when the patient is studying, and her goal is therefore to develop strategies to help her stop this behavior. Using the MOHO approach, what is the BEST way to help this patient achieve her goals?
D. Help the patient identify leisure activities that can be incorporated into her daily routine.
The patient has Onychophagia, otherwise known as compulsive nail biting. This is often a sign of stress/anxiety. Taking healthy steps, such as getting active, to manage stress and anxiety is the best approach in this scenario. Leisure is “non obligatory activity that is intrinsically motivating and engaged in during discretion time, time that is not committed to obligatory occupations such as work, self-care, or sleep” (OTPF-3 (Parham & Fazio, 1997, as cited in the Occupational Therapy Practice Framework, p. S21).
A, B, and C are strategies associated with the Cognitive Behavioral approach for anxiety management. https://www.unk.com/blog/3-instantly-calming-cbt-techniques-for-anxiety/ Occupational Therapy Practice Framework: Domain and Process (3rd Edition). Am J Occup Ther 2017;68(Supplement_1):S1-S48. doi: 10.5014/ajot.2014.682006.
D. Help the patient identify leisure activities that can be incorporated into her daily routine.
The patient has Onychophagia, otherwise known as compulsive nail biting. This is often a sign of stress/anxiety. Taking healthy steps, such as getting active, to manage stress and anxiety is the best approach in this scenario. Leisure is “non obligatory activity that is intrinsically motivating and engaged in during discretion time, time that is not committed to obligatory occupations such as work, self-care, or sleep” (OTPF-3 (Parham & Fazio, 1997, as cited in the Occupational Therapy Practice Framework, p. S21).
A, B, and C are strategies associated with the Cognitive Behavioral approach for anxiety management. https://www.unk.com/blog/3-instantly-calming-cbt-techniques-for-anxiety/ Occupational Therapy Practice Framework: Domain and Process (3rd Edition). Am J Occup Ther 2017;68(Supplement_1):S1-S48. doi: 10.5014/ajot.2014.682006.
Stacy has just been admitted into a skilled nursing facility after experiencing complications following a recent total knee replacement. The OT and OTA enter her room in order to conduct an initial evaluation. Upon entering the room, Stacy states firmly, “I do not want OT services, please leave”. Despite the patient’s request, the clinicians return multiple times throughout the day attempting to persuade Stacy to accept their services. Which principle are the clinicians most likely violating, in this scenario?
C. Autonomy. The Code of Ethics Principle of Autonomy reads as follows: “Occupational therapy personnel shall respect the right of the individual to self-determination, privacy, confidentiality, and consent.” (Occupational Therapy Code of Ethics, 2015). Actions taken that respect a patient’s right to privacy and decision making while receiving occupational therapy services reflect this principle, including respecting a patient’s right to refuse a treatment session due to illness.
C. Autonomy. The Code of Ethics Principle of Autonomy reads as follows: “Occupational therapy personnel shall respect the right of the individual to self-determination, privacy, confidentiality, and consent.” (Occupational Therapy Code of Ethics, 2015). Actions taken that respect a patient’s right to privacy and decision making while receiving occupational therapy services reflect this principle, including respecting a patient’s right to refuse a treatment session due to illness.
An OTR® has asked a COTA® who is the primary therapist treating a patient, to help prepare information for the patient’s monthly care plan meeting. Which tasks are the COTA® permitted to perform in preparation for this meeting? Select the best 3 choices.
B. Use a goniometer to measure the patient’s current range of motion.
D. Write a progress summary that includes objective information.
F. Administer a standardized test that the COTA® has been trained to administer by the OTR®.Using a goniometer to measure the patient’s current range of motion; writing a summary about the patient’s progress that includes objective information, and administering a standardized test which the COTA® has been trained to administer by the OTR®, are within the COTA®’s scope of practice.
A. Revising the patient’s treatment goals, and making changes as necessary – only the OT® is permitted to establish the patient’s treatment goals.
B. Using a goniometer to measure the patient’s current range of motion can be performed by the COTA®. The OTR® determines which assessment tasks can be implemented by the COTA®.
C. It is the OT®’s responsibility to establish the plan of care and treatment goals. The OT® is responsible for making modifications to the intervention plan throughout the intervention process. It is not within the COTA®’s scope of practice to modify an existing plan of care.
D. If the COTA® is the primary therapist treating the patient, she is able to write a progress summary for the care plan meeting, as long as the summary is approved and co-signed by the OTR®. The COTA® is allowed to give recommendations to the OTR® regarding changes to the patient’s treatment goals and frequency, but the final decision regarding changes to the treatment plan can only be made by the OTR®. I.e. The COTA® can collaborate with the OTR® to come up with an intervention plan by giving input and recommendations for the patient’s intervention.
E. Decreasing the patient’s treatment frequency based on his/her progress can only be established by the OTR®. She is solely responsible for determining the patient’s need for continuing, modifying, or discontinuing OT services.
F. Administering a standardized test that the COTA® has been trained to administer by the OTR®.
The role of the OTA is described as contributing to the process through implementing assessments delegated by the OT and providing reports of the patient’s abilities and the OTA’s observations in a manner consistent with state and federal law, regulatory requirements, and AOTA official documents.
Practice acts may differ from state to state, and they supersede AOTA official documents, so occupational therapy practitioners should check their state practice act for what role the OTA may take in the evaluation process in their state. In addition, OTA involvement in the evaluation process is limited when using assessments which require training to administer that is available only to OTs e.g. Sensory Integration Praxis Test or the Assessment of Motor and Process Skills. Evaluating the patient is the primary responsibility of the OT, and analyzing and interpreting all evaluation data must be carried out by the OT. However, if permitted by the relevant state practice act, the OTA may administer some standardized assessments, once service competency has been demonstrated.
https://www.oregon.gov/otlb/Documents/OTA%27s%20role%20in%20the%20Evaluation%20Process%20by%20Mashelle%20Painter.pdf
https://ot.unm.edu/common/docs/fieldwork/articles/Guidelines%20for%20OT%20supervision.pdf
B. Use a goniometer to measure the patient’s current range of motion.
D. Write a progress summary that includes objective information.
F. Administer a standardized test that the COTA® has been trained to administer by the OTR®.Using a goniometer to measure the patient’s current range of motion; writing a summary about the patient’s progress that includes objective information, and administering a standardized test which the COTA® has been trained to administer by the OTR®, are within the COTA®’s scope of practice.
A. Revising the patient’s treatment goals, and making changes as necessary – only the OT® is permitted to establish the patient’s treatment goals.
B. Using a goniometer to measure the patient’s current range of motion can be performed by the COTA®. The OTR® determines which assessment tasks can be implemented by the COTA®.
C. It is the OT®’s responsibility to establish the plan of care and treatment goals. The OT® is responsible for making modifications to the intervention plan throughout the intervention process. It is not within the COTA®’s scope of practice to modify an existing plan of care.
D. If the COTA® is the primary therapist treating the patient, she is able to write a progress summary for the care plan meeting, as long as the summary is approved and co-signed by the OTR®. The COTA® is allowed to give recommendations to the OTR® regarding changes to the patient’s treatment goals and frequency, but the final decision regarding changes to the treatment plan can only be made by the OTR®. I.e. The COTA® can collaborate with the OTR® to come up with an intervention plan by giving input and recommendations for the patient’s intervention.
E. Decreasing the patient’s treatment frequency based on his/her progress can only be established by the OTR®. She is solely responsible for determining the patient’s need for continuing, modifying, or discontinuing OT services.
F. Administering a standardized test that the COTA® has been trained to administer by the OTR®.
The role of the OTA is described as contributing to the process through implementing assessments delegated by the OT and providing reports of the patient’s abilities and the OTA’s observations in a manner consistent with state and federal law, regulatory requirements, and AOTA official documents.
Practice acts may differ from state to state, and they supersede AOTA official documents, so occupational therapy practitioners should check their state practice act for what role the OTA may take in the evaluation process in their state. In addition, OTA involvement in the evaluation process is limited when using assessments which require training to administer that is available only to OTs e.g. Sensory Integration Praxis Test or the Assessment of Motor and Process Skills. Evaluating the patient is the primary responsibility of the OT, and analyzing and interpreting all evaluation data must be carried out by the OT. However, if permitted by the relevant state practice act, the OTA may administer some standardized assessments, once service competency has been demonstrated.
https://www.oregon.gov/otlb/Documents/OTA%27s%20role%20in%20the%20Evaluation%20Process%20by%20Mashelle%20Painter.pdf
https://ot.unm.edu/common/docs/fieldwork/articles/Guidelines%20for%20OT%20supervision.pdf
When does the discharge planning process begin for any patient who has been referred for OT services?
A. Day 1.
Planning for a successful discharge from therapy services begins at admission. In order to establish clear goals for your patient, you need to have a wholistic picture of your patient’s needs during their period of OT intervention, as well as their possible needs post-discharge. By starting to plan for your patient’s discharge right away, you will be ensuring that your patient will be able to transition smoothly to the next stage of their recovery.
A. Day 1.
Planning for a successful discharge from therapy services begins at admission. In order to establish clear goals for your patient, you need to have a wholistic picture of your patient’s needs during their period of OT intervention, as well as their possible needs post-discharge. By starting to plan for your patient’s discharge right away, you will be ensuring that your patient will be able to transition smoothly to the next stage of their recovery.
What is the best description for the Ecology of Human Performance FOR?
B. The interrelationship of person and context and which tasks fall within the person’s performance range.
A person’s occupational performance is viewed in relation to the context in which activity occurs. Activity is selected and adapted based on physical, social, temporal and cultural contexts.In theory and in practice, context (as an area of concern to occupational therapists) has not received the same attention as performance components and performance areas. The Ecology of Human performance serves as a framework for considering the effect of context. Context is described as a lens from which persons view their world. The interrelationship of person and context determines which tasks fall within the person’s performance range. The Ecology of Human Performance framework provides guidelines for encompassing context in occupational therapy theory, practice, and research.
B. The interrelationship of person and context and which tasks fall within the person’s performance range.
A person’s occupational performance is viewed in relation to the context in which activity occurs. Activity is selected and adapted based on physical, social, temporal and cultural contexts.In theory and in practice, context (as an area of concern to occupational therapists) has not received the same attention as performance components and performance areas. The Ecology of Human performance serves as a framework for considering the effect of context. Context is described as a lens from which persons view their world. The interrelationship of person and context determines which tasks fall within the person’s performance range. The Ecology of Human Performance framework provides guidelines for encompassing context in occupational therapy theory, practice, and research.
Which FOR would be best to use when working with a woman recovering from a traumatic brain injury?
Neurodevelopmental Treatment and Proprioceptive Neuromuscular Facilitation are frames of reference that were developed to address neurological conditions such as a traumatic brain injury (TBI). The Dynamic Interactional Approach was designed for people with cognitive dysfunction, which often occurs as a result of TBI. The Model of Human Occupation is a frame of reference that can be used with clients of any diagnosis. Psychodynamic Theory is a frame of reference that primarily pertains to people with mental health disorders, while Sensory Integration is a frame of reference developed for use with children and adults who have neuropsychological conditions that include sensory processing dysfunction.
Neurodevelopmental Treatment and Proprioceptive Neuromuscular Facilitation are frames of reference that were developed to address neurological conditions such as a traumatic brain injury (TBI). The Dynamic Interactional Approach was designed for people with cognitive dysfunction, which often occurs as a result of TBI. The Model of Human Occupation is a frame of reference that can be used with clients of any diagnosis. Psychodynamic Theory is a frame of reference that primarily pertains to people with mental health disorders, while Sensory Integration is a frame of reference developed for use with children and adults who have neuropsychological conditions that include sensory processing dysfunction.
A 6-year-old child who presents with difficulty organising and interpreting sensory information in order to appropriately plan and execute functional tasks, has been referred for OT intervention. Which FOR would be best for the OTA to incorporate in the child’s treatment plan?
B. Sensory integration.The Sensory Integration (SI) frame of reference focuses on how the interaction between the sensory systems including auditory, vestibular, proprioceptive, tactile, and visual systems, provides integrated information that contributes to a child’s learning and adaptive behaviors. Improved sensory processing provides a foundation for enhanced attention and academic ability. Responding adaptively to the environment enhances the intake and combining of sensory information
B. Sensory integration.The Sensory Integration (SI) frame of reference focuses on how the interaction between the sensory systems including auditory, vestibular, proprioceptive, tactile, and visual systems, provides integrated information that contributes to a child’s learning and adaptive behaviors. Improved sensory processing provides a foundation for enhanced attention and academic ability. Responding adaptively to the environment enhances the intake and combining of sensory information
Which model would a COTA® use when working with a patient who is motivated to explore the world and exhibit mastery in a new environment?
D. Occupational Adaptation. Occupational Adaptation is a complex series of steps and factors that occur when the person is faced with an occupational challenge that takes place within one’s environment and within one’s role capacity. It involves 1) the person, 2) the occupational environment, 3) the interaction or process that takes places between the person and environment. This process depicts how a person can respond adaptively and masterfully when engaged in occupations.
D. Occupational Adaptation. Occupational Adaptation is a complex series of steps and factors that occur when the person is faced with an occupational challenge that takes place within one’s environment and within one’s role capacity. It involves 1) the person, 2) the occupational environment, 3) the interaction or process that takes places between the person and environment. This process depicts how a person can respond adaptively and masterfully when engaged in occupations.
A patient who works as a custodian for a local high school reports having difficulty lifting chairs, mopping, and performing other janitorial duties due to tightness in his right wrist and fingers. The physician diagnosed the patient with having a non-displaced distal radius fracture to his right-dominant upper extremity. How should the OTA incorporate the biomechanical approach in the first intervention to help the patient with his job tasks?
D. Incorporate gentle range of motion exercises.
The biomechanical approach using range of motion will help loosen the patient’s joints. In the first session the OTA can use gentle range of motion exercises to mobilize the patient’s joints.
D. Incorporate gentle range of motion exercises.
The biomechanical approach using range of motion will help loosen the patient’s joints. In the first session the OTA can use gentle range of motion exercises to mobilize the patient’s joints.
Application of this FOR/Model requires a collaborative relationship between the patient and the OTA. The OTA understands the issues and options presented by the patient’s needs and goals by asking the appropriate questions. Factors in their personal performance capabilities/constraints and the environmental enablers/barriers that are central to their occupational performance are identified, and this in turn leads to the development of a realistic and sequenced intervention plan. Which FOR/Model is being described?
A. Person-Environment-Occupation-Performance (PEOP).
Person-Environment-Occupation-Performance model (PEOP). Occupational performance is emphasized in the PEOP model and involves three components: (1) characteristics of the person (including physiological, psychological, motor, sensory/perceptual, cognitive, or spiritual), (2) features of the environment (including cultural, social support, social determinants, and social capital, physical and natural environments, health education and public policy, assistive technology), and (3) characteristics of the activity, task, or role. When people perform occupations, they also interact with environment. Thus, there are reciprocal consequences; that is, a person’s goals and intentions influence his/her occupational performance, and the action changes his/her environment and his/her characteristics at the same time. The interaction between the person and environmental components positively or negatively influences occupational performance. When there is a person-environment fit in supporting the valued occupation, success in occupational performance eventually leads to participation and well-being. In addition, the PEOP model is a client-centered model; that is, client must actively set goals and participate in determining a plan that promotes occupational performance.
https://ottheory.com/therapy-model/person-environment-occupation-performance-model-peop
A. Person-Environment-Occupation-Performance (PEOP).
Person-Environment-Occupation-Performance model (PEOP). Occupational performance is emphasized in the PEOP model and involves three components: (1) characteristics of the person (including physiological, psychological, motor, sensory/perceptual, cognitive, or spiritual), (2) features of the environment (including cultural, social support, social determinants, and social capital, physical and natural environments, health education and public policy, assistive technology), and (3) characteristics of the activity, task, or role. When people perform occupations, they also interact with environment. Thus, there are reciprocal consequences; that is, a person’s goals and intentions influence his/her occupational performance, and the action changes his/her environment and his/her characteristics at the same time. The interaction between the person and environmental components positively or negatively influences occupational performance. When there is a person-environment fit in supporting the valued occupation, success in occupational performance eventually leads to participation and well-being. In addition, the PEOP model is a client-centered model; that is, client must actively set goals and participate in determining a plan that promotes occupational performance.
https://ottheory.com/therapy-model/person-environment-occupation-performance-model-peop
Which of the following is the best example of an OT intervention which is based on the ecology of human performance model?
A. Working within a person’s home to modify it for their needs.
Ecology of Human Performance: A focus on the person choosing appropriate tasks within the environment. The environment can be temporal, physical, social, and cultural. How does the context affect the person’s occupational performance. Examples include:
Working within a person’s home to modify it for their needs; In acute care teaching person to select correct self-care tools; ability to choose to sit and knit then gather and prepare a station with necessary tools, lighting, etc.
A. Working within a person’s home to modify it for their needs.
Ecology of Human Performance: A focus on the person choosing appropriate tasks within the environment. The environment can be temporal, physical, social, and cultural. How does the context affect the person’s occupational performance. Examples include:
Working within a person’s home to modify it for their needs; In acute care teaching person to select correct self-care tools; ability to choose to sit and knit then gather and prepare a station with necessary tools, lighting, etc.
Which FOR uses a remedial approach and therefore assumes patients are able to acquire the voluntary motor skills necessary to perform their desired human occupation. The main goals of this FOR are preventing deterioration and maintaining existing movements for occupational performance, restoring movements for occupational performance, and compensating/adapting for loss of movements in occupational performance
D. Biomechanical.
The theoretical base of biomechanical frame of reference (FOR) is considered as a remedial approach focusing on impairments that limit occupational performance. This FOR assumes clients are able to acquire the voluntary motor skills necessary to perform the desired human occupation, meaning that the underlying impairment is amenable to remediation. It also assumes that engaging in occupation and therapeutic activities has the potential to remediate the underlying impairment, and results in improvement in occupational performance. The goals are to prevent deterioration and maintain existing movements for occupational performance, to restore movements for occupational performance, and to compensate/adapt for loss of movements in occupational performance. Individuals who have limitations in performing occupations due to limitations in movements, inadequate muscle strength, loss of endurance, or other biomedical conditions are suitable to use this FOR. The goals are to prevent limitation of range of motion, to move the target body part through full range of motion, either passively or actively appropriately, and to position the body to prevent contractures and edema. Assessment includes assessing the performance components on movements, strength and endurance. Some assessments associated with this FOR include standardized objective tests of occupational performance, pain scales, examination of skin/wounds, sensory testing, etc. Interventions associated with this FOR include ADL retraining, work hardening, static and dynamic orthoses, active, active assistive, passive range of motion exercises, nerve gliding, etc. The variety of interventions aims to amend underlying impairment and result in enhanced occupational performance in desired occupations.
https://ottheory.com/therapy-model/biomechanical-frame-reference
D. Biomechanical.
The theoretical base of biomechanical frame of reference (FOR) is considered as a remedial approach focusing on impairments that limit occupational performance. This FOR assumes clients are able to acquire the voluntary motor skills necessary to perform the desired human occupation, meaning that the underlying impairment is amenable to remediation. It also assumes that engaging in occupation and therapeutic activities has the potential to remediate the underlying impairment, and results in improvement in occupational performance. The goals are to prevent deterioration and maintain existing movements for occupational performance, to restore movements for occupational performance, and to compensate/adapt for loss of movements in occupational performance. Individuals who have limitations in performing occupations due to limitations in movements, inadequate muscle strength, loss of endurance, or other biomedical conditions are suitable to use this FOR. The goals are to prevent limitation of range of motion, to move the target body part through full range of motion, either passively or actively appropriately, and to position the body to prevent contractures and edema. Assessment includes assessing the performance components on movements, strength and endurance. Some assessments associated with this FOR include standardized objective tests of occupational performance, pain scales, examination of skin/wounds, sensory testing, etc. Interventions associated with this FOR include ADL retraining, work hardening, static and dynamic orthoses, active, active assistive, passive range of motion exercises, nerve gliding, etc. The variety of interventions aims to amend underlying impairment and result in enhanced occupational performance in desired occupations.
https://ottheory.com/therapy-model/biomechanical-frame-reference
Which frame of reference is used when working on strengthening, range of motion, and endurance, with a patient who is recovering from a work related injury?
B. Biomechanical Frame of Reference. This frame of reference is used with patients who have deficits in range of motion, strength, and endurance. It is the oldest known frame of reference for physical disabilities.
B. Biomechanical Frame of Reference. This frame of reference is used with patients who have deficits in range of motion, strength, and endurance. It is the oldest known frame of reference for physical disabilities.
An OTA is working with a patient with right-sided neglect during a meal preparation activity. The patient is unaware of the salt and pepper shakers which are located on his right side. The OTA educates the patient to turn his head to the right, when he needs to locate these items. Which frame of reference is the OTA using during this intervention?
C. Compensatory. Patients can regain independence using compensation when they cannot fully recover from their diagnosis. Patients will adapt to their environment through modifications to substitute for loss of function.
C. Compensatory. Patients can regain independence using compensation when they cannot fully recover from their diagnosis. Patients will adapt to their environment through modifications to substitute for loss of function.
An OTA working in an acute care setting, is working on a patient’s discharge plan. The OTA provides modification recommendations for the patient’s home to ensure the patient’s safety at home. What frame of reference is the OTA using?
A. Occupational Adaptation. This frame of reference addresses the ability of a person to adapt to the environment so he or she can participate in meaningful occupations. Part of the adaptation process include person, environment, and the interaction between the two. Providing recommendations to a patient regarding modifications to the patient’s home to allow for safe, independent function is an example of occupational adaptation.
A. Occupational Adaptation. This frame of reference addresses the ability of a person to adapt to the environment so he or she can participate in meaningful occupations. Part of the adaptation process include person, environment, and the interaction between the two. Providing recommendations to a patient regarding modifications to the patient’s home to allow for safe, independent function is an example of occupational adaptation.
Using the compensatory approach, what is the best intervention for a patient who wants to perform lower body dressing following a RCVA?
B. Dress your left side first.
The stroke dressing technique – Always dress your weak side first and when undressing take the clothes off the weak side last. Using the compensatory approach, the patient should be taught to complete lower body using the stroke dressing technique (dress your weak side first and when undressing take the clothes off the weak side last). A right CVA would affect the patient’s left side so dressing the weaker left side first should be taught.
B. Dress your left side first.
The stroke dressing technique – Always dress your weak side first and when undressing take the clothes off the weak side last. Using the compensatory approach, the patient should be taught to complete lower body using the stroke dressing technique (dress your weak side first and when undressing take the clothes off the weak side last). A right CVA would affect the patient’s left side so dressing the weaker left side first should be taught.
A patient with Parkinson’s disease is currently functioning at level 3 and is starting to require some help with bathing and grooming. Using the model of role acquisition, what can the OTA provide in the intervention to help this patient?
A. Help the patient acquire specific skills needed to function in her environment.
Lifestyle performance model: Intervention focuses on enhancing the environment and the patient’s needs
Psychoanalytic and Psychodynamic theory: Intervention should help improve a patient’s self-identity and improve interpersonal relationships
Biomechanical Frame of Reference: Intervention focuses on range of motion, strength, endurance, and restoring functional skills
A. Help the patient acquire specific skills needed to function in her environment.
Lifestyle performance model: Intervention focuses on enhancing the environment and the patient’s needs
Psychoanalytic and Psychodynamic theory: Intervention should help improve a patient’s self-identity and improve interpersonal relationships
Biomechanical Frame of Reference: Intervention focuses on range of motion, strength, endurance, and restoring functional skills
An OTA enters the room of a patient with a degenerative disease. The patient asks the OTA if she is her physical therapist. The OTA states to the patient, “No, I am your Occupational Therapist.” What code of ethics is the OTA following?
D. Veracity.
Occupational therapy personnel shall provide comprehensive, accurate, and objective information when representing the profession. Veracity is based on the virtues of truthfulness, candor, and honesty. The Principle of Veracity refers to comprehensive, accurate, and objective transmission of information and includes fostering understanding of such information (Beauchamp & Childress, 2013). Veracity is based on respect owed to others, including but not limited to recipients of service, colleagues, students, researchers, and research participants. In communicating with others, occupational therapy personnel implicitly promise to be truthful and not deceptive. When entering into a therapeutic or research relationship, the recipient of service or research participant has a right to accurate information.
http://ajot.aota.org/
D. Veracity.
Occupational therapy personnel shall provide comprehensive, accurate, and objective information when representing the profession. Veracity is based on the virtues of truthfulness, candor, and honesty. The Principle of Veracity refers to comprehensive, accurate, and objective transmission of information and includes fostering understanding of such information (Beauchamp & Childress, 2013). Veracity is based on respect owed to others, including but not limited to recipients of service, colleagues, students, researchers, and research participants. In communicating with others, occupational therapy personnel implicitly promise to be truthful and not deceptive. When entering into a therapeutic or research relationship, the recipient of service or research participant has a right to accurate information.
http://ajot.aota.org/
An OTA is working with a patient who has severe cognitive deficits. Using a functional skills training approach, the MOST appropriate method to use in order to teach the patient to comb his hair would be?
C. Repetition of the task sub-steps with gradually fading cues. When using a functional skill training approach, the OTA should be focused on helping the patient master a task. Repeated practice with cueing is key.
C. Repetition of the task sub-steps with gradually fading cues. When using a functional skill training approach, the OTA should be focused on helping the patient master a task. Repeated practice with cueing is key.
An OTR® asks the COTA® to assist in preparing for a patient’s care plan meeting. Which task is the COTA® permitted to perform for this meeting?
A. Measure the patient’s active ROM using a goniometer.
Occupational Therapy Assistants are able to deliver OT services under the supervision & in partnership with an OT. Specific Roles of a Certified Occupational Therapy Assistant includes performing designated assessments to contribute to the evaluation, if directed by the occupational therapist and deemed competent. The interpretation of assessment results and the overall evaluation is the responsibility of the occupational therapist.
B. The OT is responsible for determining the need for continuing, modifying, or discontinuing occupational therapy services.
C. The OT interprets the information provided by the OTA and integrates that information into the evaluation and decision-making process.
D. The OT is responsible for determining priorities of goals
A. Measure the patient’s active ROM using a goniometer.
Occupational Therapy Assistants are able to deliver OT services under the supervision & in partnership with an OT. Specific Roles of a Certified Occupational Therapy Assistant includes performing designated assessments to contribute to the evaluation, if directed by the occupational therapist and deemed competent. The interpretation of assessment results and the overall evaluation is the responsibility of the occupational therapist.
B. The OT is responsible for determining the need for continuing, modifying, or discontinuing occupational therapy services.
C. The OT interprets the information provided by the OTA and integrates that information into the evaluation and decision-making process.
D. The OT is responsible for determining priorities of goals
Which of the following is the BEST example of the assessment section of a SOAP note for a 28-year-old male patient, who has received treatment for overuse of his rotator cuff and will shortly be discharged?
D. Pt. has improved significantly in his ability to work at the computer by using periodic stretch breaks.
S: Subjective-a quote from the patient
O: Objective-what happened during the session
A: Assessment- OT perspective on the session
P: Plan-what is your plan for the next session
D. Pt. has improved significantly in his ability to work at the computer by using periodic stretch breaks.
S: Subjective-a quote from the patient
O: Objective-what happened during the session
A: Assessment- OT perspective on the session
P: Plan-what is your plan for the next session
An OTA serving on the board of her local historical society has been made aware that a complaint has been filed against an iconic historic home open for tours because the entrance is not wheelchair accessible. The complainant requests that a ramp be installed at the front entrance of the home. What information can the OTA give the board about the best response to this complaint?
A. The ADA requires historic sites to provide accessible entrances but alternate entrances may be used if changing the front entrance of the site alters the historic significance of the site. Since installing a wheelchair ramp to the front entrance of the home would compromise the historic significance of the home, the historical society is allowed to make alternative arrangements under Title III of the ADA, such as installing the ramp on a side or back entrance instead of on the front.
A. The ADA requires historic sites to provide accessible entrances but alternate entrances may be used if changing the front entrance of the site alters the historic significance of the site. Since installing a wheelchair ramp to the front entrance of the home would compromise the historic significance of the home, the historical society is allowed to make alternative arrangements under Title III of the ADA, such as installing the ramp on a side or back entrance instead of on the front.
A patient presents with a hemiplegia, following a recent CVA. Using the compensatory approach, what is the best method you can teach this patient, for independent upper body dressing?
A. The general rule is to use your unaffected arm to dress the affected side first. To undress, take the garment off the unaffected side, then remove it from the affected side. http://www.strokeassociation.org/STROKEORG/LifeAfterStroke/RegainingIndependence/Dressing-Tips-for-Stroke-Survivors_UCM_310116_Article.jsp#.XDEEvFUzbIU’ defer onload=’
When dressing, use your strong arm to dress your weak side first. When undressing, pull your strong arm or leg out of your clothing first.
I.e: Always dress your weak side first and when undressing take the clothes off the weak side last.
A. The general rule is to use your unaffected arm to dress the affected side first. To undress, take the garment off the unaffected side, then remove it from the affected side. http://www.strokeassociation.org/STROKEORG/LifeAfterStroke/RegainingIndependence/Dressing-Tips-for-Stroke-Survivors_UCM_310116_Article.jsp#.XDEEvFUzbIU’ defer onload=’
When dressing, use your strong arm to dress your weak side first. When undressing, pull your strong arm or leg out of your clothing first.
I.e: Always dress your weak side first and when undressing take the clothes off the weak side last.
Which type of reasoning allows a patient and an OTA to work collaboratively and focuses on the patient as a person? By using this type of reasoning, the clinician can begin to understand the person better, and can appreciate the disability or illness as experienced by the patient.
D. Interactive reasoning. Interactive reasoning is a strategy used by the OTA to understand the patient as a person. This type of reasoning takes place during face-to-face interactions between the clinician and patient.
There are 3 different types of reasoning used when solving problems in day-to-day practice.
1. Procedural reasoning guides the therapist in thinking about the patient’s physical performance problems.
2. Interactive reasoning is used when the therapist wants to understand the patient as a person.
3. Conditional reasoning is used to integrate the other two types of reasoning as well as to project an imagined future condition or situation for the person.
Interactive reasoning is used for at least eight reasons or purposes, as follows:
1. To engage the person in the treatment session (Mattingly, 1989, identified six such strategies)
2. To know the person as a person (Cohn, 1989)
3. To understand a disability from the patient’s point of view (Mattingly, 1989)
4. To finely match the treatment goals and strategies to this patient with this disability and this experience. Therapists call this process individualizing treatment (Fleming, 1989),
5. To communicate a sense of acceptance, trust, or hope to the patient (Langthaler, 1990),
6. To use humor to relieve tension (Siegler, 1987),
7. To construct a shared language of actions and meanings (Crepeau, 1991),
8. To determine if the treatment session is going well (Fleming, 1990)
D. Interactive reasoning. Interactive reasoning is a strategy used by the OTA to understand the patient as a person. This type of reasoning takes place during face-to-face interactions between the clinician and patient.
There are 3 different types of reasoning used when solving problems in day-to-day practice.
1. Procedural reasoning guides the therapist in thinking about the patient’s physical performance problems.
2. Interactive reasoning is used when the therapist wants to understand the patient as a person.
3. Conditional reasoning is used to integrate the other two types of reasoning as well as to project an imagined future condition or situation for the person.
Interactive reasoning is used for at least eight reasons or purposes, as follows:
1. To engage the person in the treatment session (Mattingly, 1989, identified six such strategies)
2. To know the person as a person (Cohn, 1989)
3. To understand a disability from the patient’s point of view (Mattingly, 1989)
4. To finely match the treatment goals and strategies to this patient with this disability and this experience. Therapists call this process individualizing treatment (Fleming, 1989),
5. To communicate a sense of acceptance, trust, or hope to the patient (Langthaler, 1990),
6. To use humor to relieve tension (Siegler, 1987),
7. To construct a shared language of actions and meanings (Crepeau, 1991),
8. To determine if the treatment session is going well (Fleming, 1990)
An OTA is working with a pediatric patient when they observe a bruise on the patient’s arm. When the OTA asks the patient about the bruise, the patient replies “Mommy squeezes my arm when I’m naughty.” What should the OTA do next?
B. Follow the facility’s policy regarding contacting and reporting suspected abuse to child services. Federal law mandates that healthcare workers must report suspected abuse to the local child and family services agency. The facility where the OTA works should have a policy in place regarding reporting suspected abuse. The OTA should follow this policy to report the suspected abuse.
B. Follow the facility’s policy regarding contacting and reporting suspected abuse to child services. Federal law mandates that healthcare workers must report suspected abuse to the local child and family services agency. The facility where the OTA works should have a policy in place regarding reporting suspected abuse. The OTA should follow this policy to report the suspected abuse.
An OTR® and COTA® work together at a local mental health facility for patients dealing with substance abuse. They receive 4 new patient referrals on the same day. In order to get started seeing patients quickly, how can the COTA® help the OTR®?
A. Review the patients’ medical charts and copy pertinent records. The COTA® is allowed to review medical records as a provider of health care services within the facility and she can copy pertinent information to expedite the evaluation process for the OTROTA involvement in the evaluation process is limited when using assessments such as the Sensory
Integration Praxis Test or the Assessment of Motor and Process Skills, which require training to administer that is available only to OTs.
.
The COTA® cannot complete evaluations, unless specifically delegated by the OTR®. If permitted by the relevant state practice act, the COTAOTA involvement in the evaluation process is limited when using assessments such as the Sensory
Integration Praxis Test or the Assessment of Motor and Process Skills, which require training to administer that is available only to OTs.
may administer some standardized assessments once service competency has been demonstrated. Service competency is defined as the ability of the OTA to obtain the same or equivalent results as the supervising OT in evaluation and treatment. The OTA’s involvement in the evaluation process is limited when using assessments such as the Sensory Integration Praxis Test or the Assessment of Motor and Process Skills, which require training to administer that is available only to OTs.
A. Review the patients’ medical charts and copy pertinent records. The COTA® is allowed to review medical records as a provider of health care services within the facility and she can copy pertinent information to expedite the evaluation process for the OTROTA involvement in the evaluation process is limited when using assessments such as the Sensory
Integration Praxis Test or the Assessment of Motor and Process Skills, which require training to administer that is available only to OTs.
.
The COTA® cannot complete evaluations, unless specifically delegated by the OTR®. If permitted by the relevant state practice act, the COTAOTA involvement in the evaluation process is limited when using assessments such as the Sensory
Integration Praxis Test or the Assessment of Motor and Process Skills, which require training to administer that is available only to OTs.
may administer some standardized assessments once service competency has been demonstrated. Service competency is defined as the ability of the OTA to obtain the same or equivalent results as the supervising OT in evaluation and treatment. The OTA’s involvement in the evaluation process is limited when using assessments such as the Sensory Integration Praxis Test or the Assessment of Motor and Process Skills, which require training to administer that is available only to OTs.
Which job duties can an OTA perform in an inpatient clinic? Select the best 3 choices.
A. Prepare the clinic area for treatment sessions
C. Assess a meal time feeding group
E. Continue adaptive equipment training with patients
OTAs who work in inpatient settings work under direct or intermittent supervision from OTs. They are able to perform the following job duties from the answer choices according to occupational therapy practice guidelines and state licensure laws:
-Prepare the clinic area for treatment sessions. OTAs provide treatment to patients and can certainly prepare for those sessions.
-Assess a mealtime feeding group. This task falls under the category of ADL assessment. OTAs are allowed to complete ADL assessments according to the practice guidelines.
-Continue adaptive equipment training with patients. While the OTA would not be able to initiate adaptive equipment training, as this is a decision the OT has to make, the OTA can continue training with supervision from the OT.
Treatment cannot be initiated prior to the OT evaluation in any clinical setting. Establishing short-term treatment objectives and discharging patients from occupational therapy are both functions the OT must complete.
A. Prepare the clinic area for treatment sessions
C. Assess a meal time feeding group
E. Continue adaptive equipment training with patients
OTAs who work in inpatient settings work under direct or intermittent supervision from OTs. They are able to perform the following job duties from the answer choices according to occupational therapy practice guidelines and state licensure laws:
-Prepare the clinic area for treatment sessions. OTAs provide treatment to patients and can certainly prepare for those sessions.
-Assess a mealtime feeding group. This task falls under the category of ADL assessment. OTAs are allowed to complete ADL assessments according to the practice guidelines.
-Continue adaptive equipment training with patients. While the OTA would not be able to initiate adaptive equipment training, as this is a decision the OT has to make, the OTA can continue training with supervision from the OT.
Treatment cannot be initiated prior to the OT evaluation in any clinical setting. Establishing short-term treatment objectives and discharging patients from occupational therapy are both functions the OT must complete.
A COTA® is working with a 72-year-old patient whose main goal is to resume driving. Using the Person Environment Occupational Performance Model (PEOP), what are the best treatment interventions that the COTA® should use when treating this patient? Select the best 3 answers.
A. Educate the patient on car adaptations and safety so he can return to driving around his community
C. Map out directions for how the patient can get from his house to his senior softball game every Thursday
E. Provide the patient with a seat cushion he can use to sit more comfortably while driving
The Person Environment Occupational Performance (PEOP) emphasizes the essential interaction between the person, performance of a desired meaningful occupation, and the context in which the person engages in the occupation. This model helps describe the experiences of an individual and population and explains the impact of the key components of this model on health, wellness, and quality of life. Recommending and providing simple adaptations and written maps to places the 72-year-old man drives to frequently follow this frame of reference.
A. Educate the patient on car adaptations and safety so he can return to driving around his community
C. Map out directions for how the patient can get from his house to his senior softball game every Thursday
E. Provide the patient with a seat cushion he can use to sit more comfortably while driving
The Person Environment Occupational Performance (PEOP) emphasizes the essential interaction between the person, performance of a desired meaningful occupation, and the context in which the person engages in the occupation. This model helps describe the experiences of an individual and population and explains the impact of the key components of this model on health, wellness, and quality of life. Recommending and providing simple adaptations and written maps to places the 72-year-old man drives to frequently follow this frame of reference.
Using the Model of Human Occupation (MOHO) frame of reference, what should a COTA® focus on when working with a patient with dyslexia?
C. Exploring volition, habituation, and capacity for performance.
The Model of Human Occupation is dynamic and context is dependent. Personal occupational choices and engagement in occupation shape the individual.
The model centers around 3 elements are inherent to humans:
If the COTA® is using MOHO during treatment, she should focus on these three elements.
C. Exploring volition, habituation, and capacity for performance.
The Model of Human Occupation is dynamic and context is dependent. Personal occupational choices and engagement in occupation shape the individual.
The model centers around 3 elements are inherent to humans:
If the COTA® is using MOHO during treatment, she should focus on these three elements.
The local YWCA asks an entry-level OTA to lead a wellness group on essential oils. What is the best course of action for the OTA if she is not very knowledgeable in this subject area?
C. The OTA should tell the YWCA that she is not a specialist in this subject area and should recommend an alternative treatment specialist.If the OTA only has basic understanding of an alternative treatment such as essential oils, she needs to disclose this information to the group. It is best to refer the YWCA to an alternative treatment specialist.
C. The OTA should tell the YWCA that she is not a specialist in this subject area and should recommend an alternative treatment specialist.If the OTA only has basic understanding of an alternative treatment such as essential oils, she needs to disclose this information to the group. It is best to refer the YWCA to an alternative treatment specialist.
An OTA is working with a woman who sustained a TBI a month ago. Premorbidly, she was a keen baker and spent many hours in her kitchen inventing new recipes. She has stated that her goal is to be able to return to her kitchen as soon as possible. The woman is currently residing in a group home and to start the process of resuming baking, she would like to make scones for the other residents. What frame of reference should the OTA use when working with this patient, to help her achieve her goal?
D. Occupational Adaptation. This frame of reference is a complex series of steps and factors that occur when the person is faced with an occupational challenge. Occupational adaptation takes place within one’s environment and within one’s role capacity. It involves 1) the person (the woman), 2) the occupational environment (the kitchen in the group home), 3) the interaction or process that takes places between the person and environment (making scones). This process depicts how a person can respond adaptively and masterfully when engaged in occupations.
D. Occupational Adaptation. This frame of reference is a complex series of steps and factors that occur when the person is faced with an occupational challenge. Occupational adaptation takes place within one’s environment and within one’s role capacity. It involves 1) the person (the woman), 2) the occupational environment (the kitchen in the group home), 3) the interaction or process that takes places between the person and environment (making scones). This process depicts how a person can respond adaptively and masterfully when engaged in occupations.
An OTA is working in the inpatient department in a rural community hospital with a 72-year-old male patient who recently fell and fractured his right hip. When working with this patient, which tasks adhere to the principle of Beneficence? Select the best 3 choices.
A. Referring to an optometrist when the elderly patient begins to have trouble reading a newsletter about “home safety”.
C. Terminating therapy when the patient’s insurance coverage no longer covers it.
D. Incorporating therapeutic practices that are evidence based and are in lined with the patient’s goals.
The principle of Beneficence states that occupational therapy practitioners shall demonstrate a concern for the well being of service recipients and provide services that are in the patient’s best interests. This includes providing evidence-based treatment techniques, referring patients to other health care providers when health problems that might affect safety are observed, and terminating therapy when a patient’s insurance no longer covers services. Respecting a patient’s right to refuse treatment falls under the principle of Autonomy. Protecting the patient with dementia falls under the principle of Nonmaleficence. Refusing a gift from a patient falls under the principle of Justice.
A. Referring to an optometrist when the elderly patient begins to have trouble reading a newsletter about “home safety”.
C. Terminating therapy when the patient’s insurance coverage no longer covers it.
D. Incorporating therapeutic practices that are evidence based and are in lined with the patient’s goals.
The principle of Beneficence states that occupational therapy practitioners shall demonstrate a concern for the well being of service recipients and provide services that are in the patient’s best interests. This includes providing evidence-based treatment techniques, referring patients to other health care providers when health problems that might affect safety are observed, and terminating therapy when a patient’s insurance no longer covers services. Respecting a patient’s right to refuse treatment falls under the principle of Autonomy. Protecting the patient with dementia falls under the principle of Nonmaleficence. Refusing a gift from a patient falls under the principle of Justice.
An OTA is explaining the difference between Medicare Part A and Medicare B to a patient who is recovering from a stroke. Which statements from the list below, explain Medicare A.
Select the 3 best choices
D. Medicare A covers occupational therapy as a single service if continued service is medically necessary
E. Medicare A is covered for inpatient hospital stays if determined to be medically necessary by a patient’s physician
F. People age 65 and older are covered by Medicare A
Medicare A
|
D. Medicare A covers occupational therapy as a single service if continued service is medically necessary
E. Medicare A is covered for inpatient hospital stays if determined to be medically necessary by a patient’s physician
F. People age 65 and older are covered by Medicare A
Medicare A
|
An OTA is assessing the AROM of a patient who was recently involved in a MVA. The OTA has decided to use a goniometer in order to record this patient’s baseline measurements. Using the SOAP note format, under which part of the SOAP acronym should the results be documented?
D. “O”- objective
The SOAP note (an acronym for subjective, objective, assessment, and plan) is a method of documentation employed by health care providers to write out notes in a patient’s chart.
D. “O”- objective
The SOAP note (an acronym for subjective, objective, assessment, and plan) is a method of documentation employed by health care providers to write out notes in a patient’s chart.
Which of the following settings is subject to the Medicare Part B therapy “cap”?
D. There is no longer a therapy cap.
Medicare Part B covers outpatient therapy, including physical therapy (PT), speech-language pathology (SLP), and occupational therapy (OT). Previously, there were limits, also known as the therapy cap, how much outpatient therapy Original Medicare covered annually. However, in 2019, the therapy cap was removed.
Original Medicare covers outpatient therapy at 80% of the Medicare-approved amount. If your total therapy costs reach a certain amount, Medicare requires your provider to confirm that your therapy is medically necessary. If Medicare denies coverage because it finds your care is not medically necessary, you can appeal.
Outpatient therapy includes therapy received:
• At therapists’ or doctors’ offices
• At Comprehensive Outpatient Rehabilitation Facilities (CORFs)
• At skilled nursing facilities (SNFs), when you are there as an outpatient or are otherwise ineligible for a Medicare-covered stay
• And, at home through therapists connected with home health agencies, when you are ineligible for Medicare’s home health benefit
D. There is no longer a therapy cap.
Medicare Part B covers outpatient therapy, including physical therapy (PT), speech-language pathology (SLP), and occupational therapy (OT). Previously, there were limits, also known as the therapy cap, how much outpatient therapy Original Medicare covered annually. However, in 2019, the therapy cap was removed.
Original Medicare covers outpatient therapy at 80% of the Medicare-approved amount. If your total therapy costs reach a certain amount, Medicare requires your provider to confirm that your therapy is medically necessary. If Medicare denies coverage because it finds your care is not medically necessary, you can appeal.
Outpatient therapy includes therapy received:
• At therapists’ or doctors’ offices
• At Comprehensive Outpatient Rehabilitation Facilities (CORFs)
• At skilled nursing facilities (SNFs), when you are there as an outpatient or are otherwise ineligible for a Medicare-covered stay
• And, at home through therapists connected with home health agencies, when you are ineligible for Medicare’s home health benefit
Which occupational therapy treatment techniques fall under the level of intervention of Purposeful Activity? Select the best 3 choices.
C. Retraining a woman with a traumatic brain injury in self-feeding skills
E. Helping a woman with rheumatoid arthritis increase endurance during light housekeeping tasks
F. Setting up an activity of building a bird house for a man recovering from Guillain-Barre Syndrome
Purposeful activities are meaningful to the client and goals are written to specifically address these activities. Self-feeding, housekeeping, and participating in the hobby of building bird houses are all activities that have meaning for these clients. Goals should be written in the treatment plan addressing these activities as these are activities the clients want to resume. Providing a sock aid to a woman recovering from a hip fracture is an enabling activity, as the woman may not need the sock aid to dress herself once she has recovered. Applying the hot pack and setting up the home exercise program are adjunctive activities, as both of these interventions prepare the patients for occupational performance.
C. Retraining a woman with a traumatic brain injury in self-feeding skills
E. Helping a woman with rheumatoid arthritis increase endurance during light housekeeping tasks
F. Setting up an activity of building a bird house for a man recovering from Guillain-Barre Syndrome
Purposeful activities are meaningful to the client and goals are written to specifically address these activities. Self-feeding, housekeeping, and participating in the hobby of building bird houses are all activities that have meaning for these clients. Goals should be written in the treatment plan addressing these activities as these are activities the clients want to resume. Providing a sock aid to a woman recovering from a hip fracture is an enabling activity, as the woman may not need the sock aid to dress herself once she has recovered. Applying the hot pack and setting up the home exercise program are adjunctive activities, as both of these interventions prepare the patients for occupational performance.
Which intervention technique is an example of tertiary prevention?
A. A water exercise program for people with multiple sclerosis.
Tertiary prevention focuses on people who have already been affected by a disease. The goal is to improve their quality of life by reducing disability, limiting or delaying complications, and restoring function. This is done by treating the disease and providing rehabilitation. The objective of tertiary prevention is to maximize the remaining capabilities and functions of an already disabled patient.
3 levels of prevention:
1. Primary prevention—those preventive measures that prevent the onset of illness or injury before the disease process begins. An educational program for senior citizens on safety at home is an example of primary prevention.
2. Secondary prevention—those preventive measures that lead to early diagnosis and prompt treatment of a disease, illness or injury to prevent more severe problems developing. Treatment for oral motor skills for a 2-year-old through a birth-to-three program and adapting the home of a man recovering from a total hip replacement are examples of secondary prevention.
3. Tertiary prevention—those preventive measures aimed at rehabilitation following significant illness. At this level health services workers can work to retrain, re-educate and rehabilitate people who have already developed an impairment or disability.
A. A water exercise program for people with multiple sclerosis.
Tertiary prevention focuses on people who have already been affected by a disease. The goal is to improve their quality of life by reducing disability, limiting or delaying complications, and restoring function. This is done by treating the disease and providing rehabilitation. The objective of tertiary prevention is to maximize the remaining capabilities and functions of an already disabled patient.
3 levels of prevention:
1. Primary prevention—those preventive measures that prevent the onset of illness or injury before the disease process begins. An educational program for senior citizens on safety at home is an example of primary prevention.
2. Secondary prevention—those preventive measures that lead to early diagnosis and prompt treatment of a disease, illness or injury to prevent more severe problems developing. Treatment for oral motor skills for a 2-year-old through a birth-to-three program and adapting the home of a man recovering from a total hip replacement are examples of secondary prevention.
3. Tertiary prevention—those preventive measures aimed at rehabilitation following significant illness. At this level health services workers can work to retrain, re-educate and rehabilitate people who have already developed an impairment or disability.
Leonard is a 79 year-old patient who is currently receiving rehabilitation services in a skilled nursing facility. His insurance requires that he receives OT and PT at a minimum of 5 days per week. With the information provided, what insurance type does Leonard most likely carry?
C. Medicare Part A – covers patients that are 65 years of age or older and have received social security benefits for 24 months. Part A will pay for occupational therapy services in the acute care setting if the patient needs therapy a minimum of 5 days per week.
Medicare Part B covers patients who require outpatient therapy in an outpatient or long term care setting. Medicaid provides health coverage for children, pregnant women, parents, seniors, and individuals with disabilities who meet certain income requirements. Blue Cross/Blue Shield PPO is private insurance with its own eligibility requirements.
C. Medicare Part A – covers patients that are 65 years of age or older and have received social security benefits for 24 months. Part A will pay for occupational therapy services in the acute care setting if the patient needs therapy a minimum of 5 days per week.
Medicare Part B covers patients who require outpatient therapy in an outpatient or long term care setting. Medicaid provides health coverage for children, pregnant women, parents, seniors, and individuals with disabilities who meet certain income requirements. Blue Cross/Blue Shield PPO is private insurance with its own eligibility requirements.
Which frame of reference would be best to use when working with a woman recovering from a traumatic brain injury?
C.
Neurodevelopmental Treatment is a frame of reference that were developed to address neurological conditions (specifically the central nervous system) such as traumatic brain injury (TBI). Psychoeducation is a frame of reference commonly used in psychiatric settings and although TBI can result in psychiatric symptoms, it is not necessarily considered a psychiatric diagnosis. Psychodynamic Theory is a frame of reference that primarily pertains to people with mental health disorders, while Sensory Integration is a frame of reference developed for use with children and adults who have neuro-psychological conditions that include sensory processing dysfunction.
C.
Neurodevelopmental Treatment is a frame of reference that were developed to address neurological conditions (specifically the central nervous system) such as traumatic brain injury (TBI). Psychoeducation is a frame of reference commonly used in psychiatric settings and although TBI can result in psychiatric symptoms, it is not necessarily considered a psychiatric diagnosis. Psychodynamic Theory is a frame of reference that primarily pertains to people with mental health disorders, while Sensory Integration is a frame of reference developed for use with children and adults who have neuro-psychological conditions that include sensory processing dysfunction.
An OTA is treating a patient with carpal tunnel syndrome for the last time in a hand therapy clinic. The patient has met all her goals and reports decreased pain in her carpal tunnel region. The patient asks if she can continue to come into the clinic to receive paraffin because she likes how it makes her hands feel soft. If the OTA says yes, what ethical principle would she be violating?
D. Beneficence. The definition of Beneficence in the Occupational Therapy Code of Ethics states that occupational therapy personnel shall demonstrate a concern for the well-being and safety of the recipients of their services. This includes termination of occupational therapy services when they are no longer beneficial. If the OTA continues to bill for services that are no longer necessary, she is putting the patient at risk for having services denied by her insurance company, causing a financial burden and affecting her well-being.
D. Beneficence. The definition of Beneficence in the Occupational Therapy Code of Ethics states that occupational therapy personnel shall demonstrate a concern for the well-being and safety of the recipients of their services. This includes termination of occupational therapy services when they are no longer beneficial. If the OTA continues to bill for services that are no longer necessary, she is putting the patient at risk for having services denied by her insurance company, causing a financial burden and affecting her well-being.
An OTA is giving an in-service training on Medicare reimbursement guidelines for durable medical equipment (DME). In which scenario would Medicare approve payment for the DME?
C. A walker for a person who cannot ambulate in the home independently.This is the only item that Medicare considers to be durable medical equipment (DME). DME requires that the item must be medically necessary and reasonable to treat an illness or when a patient has a decline in function
Medicare Part B covers medically necessary durable medical equipment (DME) if the patient’s doctor prescribes it for them to be used in their home.
DME that Medicare covers includes, but isn’t limited to:
– Blood sugar monitors
– Canes
– Commode chairs
– Continuous passive motion devices
– Continuous Positive Airway Pressure (CPAP) devices
– Crutches
– Hospital beds
– Oxygen equipment & accessories
– Patient lifts
– Pressure-reducing support surfaces
– Traction equipment
– Walkers
– Wheelchairs & scooters
A sock aid, grab bars, and a reacher are used for self-help and are not therefore covered by Medicare.
https://www.medicare.gov/coverage/durable-medical-equipment-dme-coverage
C. A walker for a person who cannot ambulate in the home independently.This is the only item that Medicare considers to be durable medical equipment (DME). DME requires that the item must be medically necessary and reasonable to treat an illness or when a patient has a decline in function
Medicare Part B covers medically necessary durable medical equipment (DME) if the patient’s doctor prescribes it for them to be used in their home.
DME that Medicare covers includes, but isn’t limited to:
– Blood sugar monitors
– Canes
– Commode chairs
– Continuous passive motion devices
– Continuous Positive Airway Pressure (CPAP) devices
– Crutches
– Hospital beds
– Oxygen equipment & accessories
– Patient lifts
– Pressure-reducing support surfaces
– Traction equipment
– Walkers
– Wheelchairs & scooters
A sock aid, grab bars, and a reacher are used for self-help and are not therefore covered by Medicare.
https://www.medicare.gov/coverage/durable-medical-equipment-dme-coverage
An OTA is working at a skilled nursing facility when a new rehab director looks into their personnel file and notices that their license has expired. In this situation, what would you expect the rehab director to do NEXT?
A. Ask the OTA if they have renewed their license. Determine if they are aware that it is their responsibility to renew their license, by the expiration date.
It is important talk to the OTA. Just because a new license is not present in the OTA’s personnel file does not mean that they didn’t renew it. The rehab director should find out if the OTA renewed their license and, if yes, should request a copy for the file. The rehab director should only contact the state licensing agency if the OTA has not renewed their license and is not legally permitted to practice.
A. Ask the OTA if they have renewed their license. Determine if they are aware that it is their responsibility to renew their license, by the expiration date.
It is important talk to the OTA. Just because a new license is not present in the OTA’s personnel file does not mean that they didn’t renew it. The rehab director should find out if the OTA renewed their license and, if yes, should request a copy for the file. The rehab director should only contact the state licensing agency if the OTA has not renewed their license and is not legally permitted to practice.
The requirement that communities must provide accommodations for wheelchairs along with other transportation services for the disabled is derived from what law?
D. Americans with Disabilities Act (ADA) provides the disabled, including those with mental impairment, access to employment and the community. Communities must provide transportation services for the disabled, including accommodation for wheelchairs. Public facilities (schools, museums, physician’s offices, post offices, and restaurants) must be accessible, with ramps and elevators as needed. HIPAA addresses the rights of the individual related to privacy of health information. OAA provides improved access to services for older adults and Native Americans, including community services (meals, transportation, home health care, adult day care, legal assistance, and home repair). OBRA provides guidelines for nursing facilities, such as long-term care facilities
D. Americans with Disabilities Act (ADA) provides the disabled, including those with mental impairment, access to employment and the community. Communities must provide transportation services for the disabled, including accommodation for wheelchairs. Public facilities (schools, museums, physician’s offices, post offices, and restaurants) must be accessible, with ramps and elevators as needed. HIPAA addresses the rights of the individual related to privacy of health information. OAA provides improved access to services for older adults and Native Americans, including community services (meals, transportation, home health care, adult day care, legal assistance, and home repair). OBRA provides guidelines for nursing facilities, such as long-term care facilities
Which frame of reference examines the occupational outcomes of a person’s skills, occupational demands, and environmental supports or barriers?
A. Person-Environment-Occupation-Performance Model (PEOP). This frame of reference states that the interaction between a person’s abilities, environmental factors, and the demands of occupation influences performance outcomes.
A. Person-Environment-Occupation-Performance Model (PEOP). This frame of reference states that the interaction between a person’s abilities, environmental factors, and the demands of occupation influences performance outcomes.
Which of the following scenarios provides the best intervention example for the ecology of human performance model?
A. Working with a patient in his home to modify it for his needs. The Ecology of Human Performance frame of reference states that a person’s occupational performance is viewed in relation to the context in which activity occurs. Holding a therapy session with a person in his home to help modify the environment is a good example of the application of this frame of reference.
A. Working with a patient in his home to modify it for his needs. The Ecology of Human Performance frame of reference states that a person’s occupational performance is viewed in relation to the context in which activity occurs. Holding a therapy session with a person in his home to help modify the environment is a good example of the application of this frame of reference.
What frame of reference is used when a patient uses a raised toilet seat during recovery from a hip replacement?
B. Rehabilitative frame of reference.
Rehabilitative frame of reference: The focus is on what the patient can do, rather than on what they cannot do, and it utilizes adaptation, compensation, and modification in order to facilitate the patient’s ability to participate in the desired activities. The rehabilitative approach looks at functional problems from a top-down approach and can be utilized regardless of the extent of the patient’s deficits because it does not require the restoration or development of missing skills, but instead focuses on maximizing independence where the patient is now in the recovery process.
B. Rehabilitative frame of reference.
Rehabilitative frame of reference: The focus is on what the patient can do, rather than on what they cannot do, and it utilizes adaptation, compensation, and modification in order to facilitate the patient’s ability to participate in the desired activities. The rehabilitative approach looks at functional problems from a top-down approach and can be utilized regardless of the extent of the patient’s deficits because it does not require the restoration or development of missing skills, but instead focuses on maximizing independence where the patient is now in the recovery process.
Which of the following is exemplified by participating in Halloween, wearing costumes, and handing out candy to young kids?
B. Cultural context.
This looks at the society the characters live in and at how their culture can affect their behavior and their opportunities. Customs, beliefs, activity patterns, behavioral standards, and expectations accepted by the society of which a person is a member. The cultural context influences the person’s identity and activity choices.
A. Virtual context refers to ‘interactions that occur in simulated, real time, or near real time situations absent of physical contact’ (American Occupational Therapy Association (AOTA), 2014: S9). Occupations that occur in a virtual context, however, still require physical interaction with devices.
C. Temporal context is the experience of time as shaped by engagement in occupations. It includes stage of life, time of day or year, duration or rhythm of activity, and history.
D. Personal context reflects an individual’s internal environment derived from his or her gender, values, beliefs, cultural background, or state of mind. Personal context refers to demographic features of the individual, such as age, gender, socioeconomic status, and educational level, that are not part of a health condition.
Occupational Therapy Practice Framework: Domain and Process (3rd Edition). https://pdfs.semanticscholar.org/f7bc/7b466c299301ede325ad8c938f950fd39a48.pdf
B. Cultural context.
This looks at the society the characters live in and at how their culture can affect their behavior and their opportunities. Customs, beliefs, activity patterns, behavioral standards, and expectations accepted by the society of which a person is a member. The cultural context influences the person’s identity and activity choices.
A. Virtual context refers to ‘interactions that occur in simulated, real time, or near real time situations absent of physical contact’ (American Occupational Therapy Association (AOTA), 2014: S9). Occupations that occur in a virtual context, however, still require physical interaction with devices.
C. Temporal context is the experience of time as shaped by engagement in occupations. It includes stage of life, time of day or year, duration or rhythm of activity, and history.
D. Personal context reflects an individual’s internal environment derived from his or her gender, values, beliefs, cultural background, or state of mind. Personal context refers to demographic features of the individual, such as age, gender, socioeconomic status, and educational level, that are not part of a health condition.
Occupational Therapy Practice Framework: Domain and Process (3rd Edition). https://pdfs.semanticscholar.org/f7bc/7b466c299301ede325ad8c938f950fd39a48.pdf
A new therapy aide is hired to work in the rehab department. Is an entry-level OTA allowed to supervise this aide?
A. Yes, once the entry-level OTA shows service competency to a supervising OT.
Entry-level OTAs are allowed to supervise aides, technicians, and volunteers once they show service competency in this area to a supervising OT.
A. Yes, once the entry-level OTA shows service competency to a supervising OT.
Entry-level OTAs are allowed to supervise aides, technicians, and volunteers once they show service competency in this area to a supervising OT.
Every morning a patient with COPD wakes up at 5am and performs certain tasks in a specific order. He first goes to the bathroom, then washes his face, and then he drinks a glass of water with lemon. How would you describe this behavior?
C. Routine.
A routine is a customary or regular course of procedure , when ADLs, chores, or duties must be done regularly or at specified intervals. This patient follows a specific routine in the morning.
The behavior is not a ritual because the patient does not do it for psychological reasons, but does it because it is a part of his regimen of physical self-care.
C. Routine.
A routine is a customary or regular course of procedure , when ADLs, chores, or duties must be done regularly or at specified intervals. This patient follows a specific routine in the morning.
The behavior is not a ritual because the patient does not do it for psychological reasons, but does it because it is a part of his regimen of physical self-care.
An entry level OTA is working in a hand therapy clinic. She has been asked to supervise an OT student who is completing her level-I fieldwork rotation. Is this OTA permitted to supervise the OT student, in this scenario?
A. Yes, entry-level OTs and OTAs can supervise a level-I fieldwork student.
The AOTA Standards describe the goal of Level I Fieldwork “to introduce students to the fieldwork experience and develop a basic comfort level with an understanding of the needs of clients.” Level I Fieldwork is not intended to develop independent performance, but to “include experiences designed to enrich didactic coursework through directed observation and participation in selected aspects of the occupational therapy process. “Qualified personnel for supervision of Level I Fieldwork may include, but are not limited to, academic or fieldwork educators, occupational therapy practitioners initially certified nationally, psychologists, physician assistants, teachers, social workers, nurses, physical therapists, social workers, etc. The supervisors must be knowledgeable about occupational therapy and cognizant of the goals and objectives of the Level I Fieldwork experience. Entry Level OTA can supervise aides, techs, volunteers, level 1 FW students. OTAs must have 1 year of experience before supervising a level-II fieldwork student.
https://www.aota.org/Education-Careers/Fieldwork/LevelI.aspx
https://www.aota.org/Education-Careers/Fieldwork/Answers.aspx
A. Yes, entry-level OTs and OTAs can supervise a level-I fieldwork student.
The AOTA Standards describe the goal of Level I Fieldwork “to introduce students to the fieldwork experience and develop a basic comfort level with an understanding of the needs of clients.” Level I Fieldwork is not intended to develop independent performance, but to “include experiences designed to enrich didactic coursework through directed observation and participation in selected aspects of the occupational therapy process. “Qualified personnel for supervision of Level I Fieldwork may include, but are not limited to, academic or fieldwork educators, occupational therapy practitioners initially certified nationally, psychologists, physician assistants, teachers, social workers, nurses, physical therapists, social workers, etc. The supervisors must be knowledgeable about occupational therapy and cognizant of the goals and objectives of the Level I Fieldwork experience. Entry Level OTA can supervise aides, techs, volunteers, level 1 FW students. OTAs must have 1 year of experience before supervising a level-II fieldwork student.
https://www.aota.org/Education-Careers/Fieldwork/LevelI.aspx
https://www.aota.org/Education-Careers/Fieldwork/Answers.aspx
A patient with chronic heart failure lost his job as a warehouse worker and has been depressed for over 6 months. The patient would like to receive mental health services but he only receives Social Security Disability Income and does not think he can afford it. What is the best advice the OTA can give this patient?
C. Advise the patient to sign up for Medicare Part B
The OTA should advise the patient to sign up for Medicare Part B. People who receive Social Security Disability Income (SSDI) are eligible for Medicare and can receive Medicare Part B benefits for a monthly premium payment. Medicare Part B covers mental health services. A person must be eligible for Supplemental Security Income (SSI) before they can sign up for Medicaid.
C. Advise the patient to sign up for Medicare Part B
The OTA should advise the patient to sign up for Medicare Part B. People who receive Social Security Disability Income (SSDI) are eligible for Medicare and can receive Medicare Part B benefits for a monthly premium payment. Medicare Part B covers mental health services. A person must be eligible for Supplemental Security Income (SSI) before they can sign up for Medicaid.
An OTA is working in the rehab department of a new rehabilitation facility and sees several employees from an organization reviewing the quality of care to provide accreditation. What organization are these employees most likely from?
C. Commission on Accreditation of Rehabilitation Facilities (CARF). This accreditation focuses on quality and outcomes for rehabilitation facilities.
C. Commission on Accreditation of Rehabilitation Facilities (CARF). This accreditation focuses on quality and outcomes for rehabilitation facilities.
A COTA® has shown service competency and can complete a part of the Barthel Index in order to measure a patient’s independence in BADLs. What is the most appropriate method for conducting the evaluation?
C. Ask the questions the same way they are worded in the instruction manual. The Barthel Index is a standardized assessment tool. A standardized evaluation needs to be conducted exactly the way it is intended to be completed by following the exact steps and verbalizing the statements as they are written in the instruction manual. This will ensure the reliability and validity of the assessment tool.
C. Ask the questions the same way they are worded in the instruction manual. The Barthel Index is a standardized assessment tool. A standardized evaluation needs to be conducted exactly the way it is intended to be completed by following the exact steps and verbalizing the statements as they are written in the instruction manual. This will ensure the reliability and validity of the assessment tool.