NBCOT Analysis and Interpretation 3 — Questions and Answers
Question 1: An OT administers the Functional Independence Measure (FIM) and scores a client as a '3' on bathing. What does this score mean?
- Client is fully independent
- Client requires moderate assistance; performs 50–74% of the task (Correct answer)
- Client requires total assistance
- Client requires supervision only
Correct answer: Client requires moderate assistance; performs 50–74% of the task
A FIM score of 3 (Moderate Assistance) means the client performs 50–74% of the bathing task independently.
Question 2: When interpreting a client's AMPS (Assessment of Motor and Process Skills) results, a motor ability score of 1.0 logits indicates:
- Above average motor performance for IADLs
- Borderline competence; the client is at risk for difficulty with IADL motor demands (Correct answer)
- Severe motor impairment requiring full assistance
- Normal performance within established norms
Correct answer: Borderline competence; the client is at risk for difficulty with IADL motor demands
An AMPS motor score of 1.0 logit or below is a cut-point indicating the client may struggle with IADL motor demands.
Question 3: A client with TBI demonstrates adequate attention during a structured 1:1 session but fails to complete work tasks in an open office environment. This pattern suggests:
- Malingering and poor effort
- Difficulty generalizing attention skills to complex, real-world environments (Correct answer)
- The structured session results are invalid
- Attention deficits are fully resolved
Correct answer: Difficulty generalizing attention skills to complex, real-world environments
Performance breakdown in complex environments despite success in structured settings indicates difficulty generalizing attentional skills to real-world contexts.
Question 4: On the Allen Cognitive Level Screen (ACLS), a client demonstrates a leather lacing score of 4.6. Which activity is MOST appropriate at this level?
- Independent money management and complex IADL planning
- Simple, structured, repetitive tasks with demonstration (Correct answer)
- Multi-step novel problem-solving tasks
- Tasks requiring abstract reasoning and error self-correction
Correct answer: Simple, structured, repetitive tasks with demonstration
At ACL 4.6, clients benefit from simple, concrete tasks with demonstration and limited novel problem-solving demands.
Question 5: An OT analyzes a client's work samples and finds decreased accuracy on tasks requiring sustained attention beyond 15 minutes. The best interpretation is:
- The client has ADHD and requires medication
- The client has an attention fatigue threshold affecting productivity in extended tasks (Correct answer)
- The work samples are not a valid assessment tool
- The client should be discharged due to lack of progress
Correct answer: The client has an attention fatigue threshold affecting productivity in extended tasks
Decreased accuracy after 15 minutes indicates an attention fatigue threshold that must be addressed in work rehabilitation planning.
Question 6: A pediatric OT interprets a child's Peabody Developmental Motor Scales-2 (PDMS-2) score at the 10th percentile in fine motor skills. What does this mean?
- The child's fine motor skills are above average
- The child performs below 90% of same-age peers, indicating a significant delay (Correct answer)
- The child has no measurable fine motor delay
- Percentile scores are not meaningful for pediatric assessment
Correct answer: The child performs below 90% of same-age peers, indicating a significant delay
A 10th percentile score means the child performs better than only 10% of same-age peers, indicating a significant fine motor delay.
Question 7: An OT uses task analysis to evaluate a client dressing and notes disorganized sequencing, clothing applied in wrong order, and inability to self-correct errors. This pattern primarily indicates a deficit in:
- Strength and range of motion
- Executive function and praxis affecting task organization and error monitoring (Correct answer)
- Visual acuity limiting clothing identification
- Proprioceptive feedback from upper extremities
Correct answer: Executive function and praxis affecting task organization and error monitoring
Disorganized sequencing, incorrect order, and inability to self-correct during ADLs indicate executive function and praxis deficits.
NBCOT Analysis and Interpretation 3
An OT administers the Functional Independence Measure (FIM) and scores a client as a '3' on bathing.
What does this score mean?