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Top Occupational Therapy Test Taking Tips

Written by Stephanie Shane OTR®/L, Founder of “Pass the OT”

Most of the time, students have a difficult time breaking down the question so that they understand what the question is really asking or they have difficulty choosing the correct answer after narrowing down their answers to two choices.

When taking the test, make sure to read the question carefully and pay attention to key words such as “most important, next, and initial.” Also, remember safety first, client centered, and occupation-based. For the most part, you can easily eliminate two choices and decide between the other two answer choices keeping in mind the tips above. Don’t get caught up in the details.

Below are 4 unique tips that could be quite useful to you.

One of the most important things you can do in answering a question is to consider only the information that is in the question. Do not read content into the question that is not there; simply apply what you know in order to answer it.

  • Read each question carefully. Ask yourself, “what is this question really about?”
  • What stage in the occupation process are you in? (i.e., screening, evaluation, intervention, or discharge)
  • What is the paractice setting (i.e., acute, in-patient, outpatient, or home health.
  • What is the condition (i.e distal radius fracture, Parkinson’s, autism)
  • Identify the key words in the question stem (i.e., BEST response, INITIAL action, NEXT step).
  • Decide whether each option is correct or incorrect. Remember that for the MC, each response will be plausible, but only one choice will be correct.

Read, Remember, Deconstruct, and Decide:

  • Read: Focus study on one practice item at a time. Read the item stem without proceeding to the response options.
  • Remember: Remember what the question is asking. Begin to formulate the answer in your head without looking at any of the response options. It may be helpful to write the answer down before proceeding to the next step.
  • Deconstruct: Identify critical information: Age, Condition, Stage of condition, practice setting, and other flags. Which words are bolded? Ask yourself if this info leads you to the original answer you formulated.
  • Decide: Using the key information presented in the stem, read the first option. Write a rationale for why the first option is correct or incorrect. If needed, go back to a source reference and look up the information. Select your response.

Test Question:

  • Read:An inpatient who had a myocardial infarction 2 days ago is beginning Phase 1 of cardiac rehabilitation. Which of the following activities is CONTRAINDICATED for the patient to do during this phase of rehabilitation?
  • Remember: Which of the following activities is CONTRAINDICATED for the patient to do during this phase of rehabilitation?
  • Deconstruct:
    • What is the practice setting? Inpatient
    • What are we told about the client? Myocardial infarction, Phase I
    • Based on the condition, what would we be expecting to see? 1-3 days after MI, monitored low-level activity
    • What flags are raised based on the information being presented in the stem? Avoid isometrics, monitor response to activity
    • Which words are bolded indicating very important actions the OTR® needs to take? CONTRAINDICATED
    • What are your immediate thoughts? Avoid activities that would cause cardiac distress
  • Deconstruct and decide :
    • Ambulate from the bed to the bathroom for BADL.
      • Response option A is incorrect; low level activity is encouraged during phase I.
    • Sit on a chair at the bathroom sink to complete grooming tasks.
      • Response option B is incorrect; energy conservation and pacing is a typical component of phase I cardiac rehabilitation
    • Measure perceived exertion during personal hygiene activities.
      • Response option C is incorrect; the OTR® should teach the patient self-monitoring.
    • Compete isolated maximal isometric contractions to maintain strength for BADL.
      • Response option D is correct; Isometric contractions are contraindicated for patients with cardiac disease.
    • Decide: Compare your choice to the answer key…
    • Compete isolated maximal isometric contractions to maintain strength for BADL.
      • Isometric exercises can affect the cardiovascular system by causing a rapid and sudden increase in blood pressure. This physiological response is contraindicated during this phase of rehabilitation.

When reading a NBCOT® question, keep in mind safety first, client centered, and occupation based. Safety is always the answer if it is there! Client centered goal therapy basically means that you collaborate with your client to set a goal and proceed with therapy (i.e., treat them like a partner in therapy; find out what they perceive their strengths & limitations to be, and what they would like to work on. Build a relationship and base your therapy off of your interactions with the client

During the exam you have access to a white board and marker. I practiced this method during my practice exams and it worked well. My entire board was covered with crossed out ABCD’s. It worked like a charm!

You can also use this technique with your fingers. For example, A is your pointer finger, B is your middle finger, C is your ring finger, and D is your pinky. When you know that an answer choice is not the correct answer, bend flex the finger into your palm. This will eliminate wasted time and help you focus on the best two answer choices.

When reading a question, you can think about the ABCD method for treatment goals and objectives

  • A-audience, Who is it for (i.e., Patient)
  • B-behavior- What are the goals and objectives
  • C-condition details
  • D-degree: time frame to have goals reached.
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