NBCOT COTA Exam Questions

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1.

Falls, and injuries related to falls, are a major public health concern for the elderly. Therefore, fall prevention education is an important aspect of occupational therapy intervention. Which of the following is NOT considered something that places someone at risk for falling?

  • Hypervigilance

  • Medication side effects

  • Dementia

  • Presbyopia

Correct answer: Hypervigilance 

Medication side effects, dementia, and presbyopia (decreased visual acuity) can all place someone at risk for falling. 

Hypervigilance has not been identified as a factor that increases fall risk.

2.

What is considered an advantage of group intervention?

  • The ability to learn from other group members

  • Getting feedback from a therapist

  • Being able to tolerate a lack of control due to the presence of other people

Correct answer: The ability to learn from other group members

In an appropriate group setting, discussion and experiences with other members can help patients learn and grow.

Patients can get feedback from their therapist in both group and individual settings. If patients struggle to release control, group settings will often worsen this concern. 

3.

Which of the following is an intrinsic hand muscle innervated by the median nerve?

  • Abductor pollicis brevis

  • Flexor digitorum superficialis

  • Flexor digitorum profundus

  • Flexor pollicis longus

Correct answer: Abductor pollicis brevis

The abductor pollicis brevis is an intrinsic hand muscle innervated by the median nerve. Other intrinsic hand muscles innervated by the median nerve are the opponens pollicis, the superficial head of the flexor pollicis brevis, and the radial side of the lumbricals.

The flexor digitorum superficialis, the flexor digitorum profundus, and the flexor pollicis longus are all extrinsic muscles of the hand innervated by the median nerve.

4.

Cultural sensitivity is an important part of a therapist's job. What are some sociocultural considerations that a therapist should be aware of?

Select the three BEST responses.

  • An individual's social network

  • Community resources

  • Social roles and expectations

  • Financial status

  • Individual goals

  • Work status

An individual's social network, their community resources, and social roles/expectations are just a few sociocultural considerations a therapist should account for. Additional sociocultural considerations include opportunities for socialization, and sociocultural norms, values, and expectations. 

Financial status, work status, and individual goals are not sociocultural in nature.

5.

Which of the following is NOT an intervention strategy for unilateral body neglect?

  • Focus on dressing tasks

  • Design intervention to include tasks requiring both arms/hands

  • Provide assistance to the affected side to improve participation

  • Offer sensory stimulation to the affected limb

Correct answer: Focus on dressing tasks

Unilateral body neglect is inattention toward an affected side/limb following a neurological event. As the individual may forget to use the affected limb during activities, appropriate treatment interventions include providing tasks that require the use of both arms/hands, providing extrinsic assistance to the affected side so that it participates fully, and increasing sensory opportunities for the affected limb during intervention.

While dressing tasks might be one of the primary indications that someone has neglect and should be worked on during sessions, this is not directly remedying the neglect.

6.

If a patient presents with osteogenesis imperfecta, what interventions might an OTA implement?

Select the three BEST responses.

  • Weight bearing activities

  • Activity modification

  • Positioning

  • Passive range of motion

  • Diet recommendations to help gain weight

  • Functional splinting

Weight bearing activities assist those with osteogenesis imperfecta in growing stronger bones. Since this diagnosis is permanent, activity modification will help patients function. Positioning for those with OI will also help prevent injury and promote function. 

Passive range of motion is not recommended, since this can cause fractures. Gaining weight can worsen pressure on bones and place these patients at a greater risk of fractures, so diet education should surround weight control. Splints may be recommended for those with OI, but they should keep patients in protective positions (to prevent injury) rather than placing them in functional positions.

7.

If a patient demonstrates difficulty performing a motor task when asked to, what impairment do they have?

  • Ideomotor apraxia

  • Ideational apraxia

  • Aphasia

Correct answer: Ideomotor apraxia

Ideomotor apraxia, also known as motor apraxia, involves a loss of kinesthetic memory, which leads to an inability to execute purposeful movements. This would cause someone to struggle with carrying out a certain action when asked, but they would still be able to complete this movement spontaneously.

Ideational apraxia involves inappropriate use of objects to complete a task. For example, someone with ideational apraxia might place olive oil in their coffee instead of a typical addition like milk or sugar. Aphasia involves language deficits. Someone with Broca's aphasia presents with a loss of expressive language, while someone with Wernicke's aphasia usually demonstrates poor receptive language. 

8.

What is NOT an appropriate preparatory activity for a patient who underwent surgery to treat breast cancer 1 week ago?

  • Donning compression garments

  • Sensory re-education

  • Activity modification

  • Energy conservation

Correct answer: Donning compression garments

Compression garments will eventually be used to prevent lymphatic buildup (which can lead to lymphedema) in any patient recovering from breast cancer surgery. But these garments will only be helpful after the patient's surgical wounds have healed. They are not ideal at this phase in their recovery.

Sensory re-education is an important intervention for patients who experience peripheral neuropathy after cancer surgery. This can also help patients experience less sensitivity in the area(s) that were operated on.

Since this patient underwent breast cancer surgery, their upper body movement will be somewhat limited for the first few weeks. Therefore, activity modification will help them remain functional in their chosen occupations until they regain range-of-motion.

Anyone who is recovering from major surgery will benefit from energy conservation, so this is an ideal technique to help the patient get through sessions and other preferred activities.

9.

Which of the following is NOT a contraindication for heat therapy?

  • Chronic injuries

  • Postsurgical repairs

  • Impaired sensation

  • Impaired vasculature

Correct answer: Chronic injuries

Chronic injuries are not a contraindication for heat. However, heat is contraindicated for acute injuries, as it may worsen inflammation in the area of injury. Cryotherapy (ice packs or ice massage) is recommended to treat acute injuries.

Other conditions where heat usage is contraindicated include postsurgical repair, impaired sensation, and impaired vasculature.

10.

An occupational therapy evaluation reveals adhesive capsulitis of the shoulder. Which motion is MOST limited?

  • External rotation

  • Abduction

  • Extension

  • Flexion

Correct answer: External rotation

Adhesive capsulitis is also referred to as frozen shoulder and is characterized by very limited active and passive range of motion within the glenohumeral joint. External rotation is most affected, although other shoulder movements—abduction, internal rotation, and flexion—are also limited.

11.

Which condition is characterized by a painful and inflamed radial styloid and can be confirmed with Finkelstein's test?

  • De Quervain's syndrome

  • Dupuytren's disease

  • Ape hand deformity

  • Skier's thumb

Correct answer: De Quervain's syndrome

De Quervain's syndrome is characterized by a painful and inflamed radial styloid and affects comfortable use of the thumb for functional tasks. It is caused by inflammation of the tendons in the thumb, the abductor pollicis longus, and the extensor pollicis brevis. A Finkelstein's test can be used to confirm the condition.

Dupuytren's disease is the thickening of the fascia within the hand that causes the affected fingers to form flexion contractures. It is not known what causes the fascia to thicken.

Ape hand deformity is characterized by IP flexion in the digits and atrophy of the thenar eminence. It is caused by a median nerve injury.

Skier's thumb is an injury to the ulnar collateral ligament of the MCP joint of the thumb.

12.

Which peripheral nerve injury is characterized by sensory changes along the ulnar nerve pathway in the hand and is caused by compression of the ulnar nerve?

  • Guyon's canal

  • Carpal tunnel syndrome

  • Pronator teres syndrome

  • Radial nerve palsy

Correct answer: Guyon's canal

Guyon's canal is caused by compression of the ulnar nerve at the wrist and is characterized by sensory changes and weakness along the ulnar nerve pathway in the hand.

Carpal tunnel syndrome is caused by compression of the median nerve at the wrist and is characterized by sensory changes in the 1st-4th digits.

Pronator teres syndrome is caused by compression of the median nerve within the pronator teres (in the forearm) and is characterized by sensory changes in the 1st-4th digits as well as pain in the forearm.

Radial nerve palsy is caused by compression of the radial nerve, resulting in decreased ability to perform wrist extension (wrist drop) or thumb and MP extension.

13.

What must be included when a COTA trains a patient on the use of an electrical assistive technology device (ATD)?

  • Following directions when charging batteries

  • Not having a backup system to test someone's emergency management skills

  • Avoiding using surge protectors due to added complexity

  • Keeping electrical cords visible for easier location

Correct answer: Following directions when charging batteries

Electrical ATDs need power in order to be functional, so patients should understand how to charge batteries properly to ensure safe use of their device.

It is important for patients to have a backup system for their ATD, so this education should also be included. Surge protectors should be encouraged to avoid circuit malfunctions that will not only impact device charging, but also the patient's home.

Electrical cords that help charge electrical ATDs should be secured and safely installed for the integrity of the cord and the safety of the patient. Patients who have visual concerns that prevent them from locating the cord should be instructed on other options to help with easier location, such as adding colored tags or labels to the cord.

14.

A risk management team is called in to review and assist a hospital therapy department. What is an area this team would NOT cover?

  • Showing the team how to do chart audits

  • Effective communication within the team and with clients

  • Ensuring staff education is up-to-date

  • Equipment maintenance

Correct answer: Showing the team how to do chart audits

This is not an area that risk management covers. The other options are all areas that risk management teams assess, address, and provide education on.

15.

An OTA asks their OTR about fabricating a splint for a patient with concerns surrounding tone. What types of splints might be used to help manage tone?

Select the three BEST responses.

  • Cone splint

  • Resting hand splint

  • Functional hand splint

  • Silver rings

  • Dorsal protection splint

  • Hand-based thumb splint

Cone splints, also known as spasticity splints, are used to help manage hypertonicity. Resting hand splints, also known as functional hand splints, are used to help manage flaccidity. 

Silver rings are used to help manage Boutonniere deformities that occur in individuals who have arthritis. Dorsal protection splints are ideal for those with flexor tendon injuries, since they block off and protect the site of the injury while it heals. A hand-based thumb splint is a good recommendation for patients with CMC arthritis.

16.

What principles should an OTA follow if they are measuring sensation as part of a biomechanical evaluation?

Select the three BEST responses.

  • Have the patient close their eyes during the testing

  • Testing should be done on the uninvolved side first

  • Apply stimuli to the back of the limb and front of the limb

  • When testing proprioception, the patient positions their limb

  • When testing kinesthesia, the patient moves their limb

  • Two-point discrimination is measured with a dynamometer

Therapists should demonstrate how the sensory testing will occur while the patient has their eyes open, then complete it with the patient's eyes closed. Sensory testing should also be done on the uninvolved side first by applying stimuli to the volar and dorsal aspects of the limb. 

When testing proprioception, it's important that the OTA places the patient's extremities in a certain position so the patient can mimic that positioning with the other limb. When testing kinesthesia, the OTA should move the limb and have the patient respond by saying how it is positioned. Two-point discrimination is measured with a paper clip, Boley Gauge, or Disk-Criminator. A dynamometer is used to measure grip strength.

17.

What concept presides during the associated stage of learning?

  • How best to perform a new skill

  • What is the skill is

  • How can the skill be applied in other situations

  • When to complete the skill

Correct answer: How best to perform a new skill

The associated stage is characterized by developing the ability to consistently perform the new skill. The individual will learn how best to perform a skill to ensure consistent results.

The cognitive stage is characterized by learning a new skill. An individual must determine the desired skill, plan how to learn the new skill, and begin to practice the skill.

The autonomous stage is characterized by the ability to utilize the skill across environments and situations and modify it according to variations in the environment. The goal is still to maintain a high consistency of performance.

When to complete a skill is not a consideration in the stages of motor learning.

18.

What is a method of direct communication used for OTA-OTR supervision?

Select the three BEST responses.

  • Co-treatment

  • Observation

  • Modeling

  • Telephone communication

  • Text messaging

  • Written communication

Direct communication requires face-to-face contact between both parties, so some acceptable examples are co-treatment, modeling, discussion, instruction, and observation. 

Telephone communication, text messaging, and other written communication are all considered indirect methods of supervision.

19.

In the autonomous stage of motor learning, what decision does the learner contemplate?

  • How the skill can be applied to other situations

  • How best to perform a new skill

  • What the desired skill is

  • The same decisions are contemplated in all stages of motor learning

Correct answer: How the skill can be applied to other situations

The autonomous stage is characterized by a high-level understanding of the skill that allows someone to use the skill across environments and situations and to modify it according to the environment. The goal is still to maintain a high consistency of performance.

The associated stage is characterized by a developing ability to consistently perform the new skill. The individual will learn how best to perform a skill to ensure consistent results.

The cognitive stage is characterized by the learning of a new skill. An individual therefore must determine what the desired skill is, plan how to learn the new skill, and begin to practice it.

20.

An OTA is working with a 20-year-old female patient who has begun demonstrating self-mutilating behaviors. What areas can the OTA address when providing intervention?

  • Problem-solving skills

  • Academic performance

  • Productive leisure

Correct answer: Problem-solving skills

OTAs can assist with self-mutilation by providing intervention focused on emotion regulation, stress management, alternative coping skills, CBT or DBT, sensory approaches, problem-solving skills, and communication skills. 

Academic performance is not an area that an OTA would address. While OTAs can address productive leisure, it would not help reduce the occurrence of self-mutilating behaviors.