NBCOT Intervention Management 2 — Questions and Answers
Question 1: An OT is working with a client who has hemiplegia after a stroke. Which intervention approach best supports motor re-learning through task-specific practice?
- Constraint-Induced Movement Therapy (CIMT) (Correct answer)
- Passive range of motion exercises
- Sling immobilization of the affected arm
- Bilateral upper extremity splinting
Correct answer: Constraint-Induced Movement Therapy (CIMT)
CIMT forces use of the affected limb through intensive task-specific practice, promoting cortical reorganization and motor re-learning.
Question 2: When using a compensatory approach for a client with low vision, the OT would most likely recommend:
- Vision restoration exercises
- Increased ambient lighting and high-contrast materials (Correct answer)
- Patching the stronger eye
- Reducing environmental modifications
Correct answer: Increased ambient lighting and high-contrast materials
Compensatory strategies for low vision include environmental modifications such as improved lighting and high-contrast materials to maximize remaining functional vision.
Question 3: A therapist is selecting an orthotic for a client with radial nerve palsy. Which device is most appropriate?
- Resting hand splint in wrist flexion
- Dynamic wrist extension splint (Correct answer)
- Ulnar deviation splint
- Thumb spica splint
Correct answer: Dynamic wrist extension splint
Radial nerve palsy causes wrist drop; a dynamic wrist extension splint positions the wrist in extension and allows functional hand use.
Question 4: Which of the following best describes the 'just-right challenge' principle in OT intervention?
- Providing tasks that are far beyond the client's current skill level
- Offering tasks that match the client's skill level to promote engagement and growth (Correct answer)
- Removing all difficult components from the activity
- Repeating the same task until mastery before advancing
Correct answer: Offering tasks that match the client's skill level to promote engagement and growth
The just-right challenge means grading activities so they are neither too easy nor too hard, optimizing motivation and therapeutic benefit.
Question 5: A child with sensory processing disorder shows tactile defensiveness. Which strategy would an OT FIRST implement?
- Deep pressure and proprioceptive input before light touch tasks (Correct answer)
- Immediate exposure to aversive textures to desensitize
- Avoidance of all tactile input
- Cognitive behavioral therapy for anxiety
Correct answer: Deep pressure and proprioceptive input before light touch tasks
Deep pressure and proprioceptive activities are calming and organizing, preparing the nervous system to tolerate light tactile input.
Question 6: An OT treating a client with COPD focuses on energy conservation. Which technique is MOST appropriate during bathing?
- Standing throughout to maintain strength
- Using a shower bench and pacing activities with pursed-lip breathing (Correct answer)
- Performing a full bath immediately after waking
- Increasing water temperature to relax muscles
Correct answer: Using a shower bench and pacing activities with pursed-lip breathing
A shower bench reduces energy expenditure and pacing with pursed-lip breathing helps manage breathlessness during ADLs.
Question 7: Which frame of reference guides an OT when using gradual exposure and behavioral reinforcement to increase occupational performance?
- Biomechanical frame of reference
- Cognitive-behavioral frame of reference (Correct answer)
- Model of Human Occupation
- Neurodevelopmental Treatment (NDT)
Correct answer: Cognitive-behavioral frame of reference
The cognitive-behavioral frame of reference uses principles such as gradual exposure, reinforcement, and cognitive restructuring to change behavior and improve function.
NBCOT Intervention Management 2
An OT is working with a client who has hemiplegia after a stroke.
Which intervention approach best supports motor re-learning through task-specific practice?