NBCOT Occupational Performance and Client Factors 5 — Questions and Answers
Question 1: A client with multiple sclerosis reports fatigue that worsens throughout the day and limits her ability to complete household tasks. According to the OTPF, fatigue is classified under which category of client factors?
- Body structures
- Mental functions
- Neuromusculoskeletal functions (Correct answer)
- Global mental functions
Correct answer: Neuromusculoskeletal functions
Fatigue related to neuromuscular conditions is classified under neuromusculoskeletal and movement-related functions in the OTPF body functions.
Question 2: During a home evaluation, an OT notices a client with Parkinson's disease freezes at doorway thresholds when walking. Which occupational performance area is MOST affected by this freezing of gait?
- Rest and sleep
- Work
- Functional mobility within IADLs (Correct answer)
- Social participation
Correct answer: Functional mobility within IADLs
Freezing of gait impairs functional mobility, which is classified as an IADL in the OTPF and is essential for independent home navigation.
Question 3: A therapist is applying the Person-Environment-Occupation (PEO) model. A client has limited hand function (person) and works in an office requiring extensive typing (occupation). The OT modifies the workstation with adaptive equipment. Which PEO component is PRIMARILY being addressed?
- Person
- Occupation
- Environment (Correct answer)
- Person-Occupation fit
Correct answer: Environment
Modifying the workstation addresses the physical environment component of the PEO model to improve occupational performance fit.
Question 4: An OT evaluates a child using the Sensory Integration and Praxis Tests (SIPT). The child has difficulty with bilateral coordination, sequencing new motor tasks, and constructional play. These findings MOST suggest a deficit in which area?
- Tactile discrimination
- Dyspraxia (Correct answer)
- Gravitational insecurity
- Auditory language processing
Correct answer: Dyspraxia
Dyspraxia is characterized by difficulty planning and executing novel motor tasks, including bilateral coordination and construction activities.
Question 5: A client with chronic pain avoids social gatherings and has withdrawn from her volunteer role at church. According to the OTPF, which occupation is MOST directly affected?
- Leisure
- Education
- Social participation (Correct answer)
- Rest and sleep
Correct answer: Social participation
Social participation encompasses engagement with community, family, peers, and friends, including roles like volunteering and attending social events.
Question 6: An OT documents that a client 'requires minimal assistance for lower body dressing, needing only verbal cues for sequencing.' Using the Functional Independence Measure (FIM), what level BEST describes this performance?
- FIM Level 4 — Minimal Assistance (Correct answer)
- FIM Level 5 — Supervision
- FIM Level 3 — Moderate Assistance
- FIM Level 6 — Modified Independence
Correct answer: FIM Level 4 — Minimal Assistance
FIM Level 4 (Minimal Assistance) indicates the client performs 75% or more of the task but requires physical or verbal assistance for the remainder.
Question 7: An OT working with a client post-hand surgery notes the client has full passive ROM but limited active ROM due to extensor tendon adhesions. This discrepancy between active and passive ROM MOST directly reflects an impairment in which client factor?
- Joint mobility — passive range
- Muscle power functions (Correct answer)
- Sensory functions of the hand
- Muscle tone functions
Correct answer: Muscle power functions
When passive ROM is preserved but active ROM is limited, the deficit lies in muscle power functions — the ability to generate force through voluntary muscle contraction despite tendon restrictions.
NBCOT Occupational Performance and Client Factors 5
A client with multiple sclerosis reports fatigue that worsens throughout the day and limits her ability to complete household tasks.
According to the OTPF, fatigue is classified under which category of client factors?