NBCOT Therapeutic Use of Occupations and Activities 5 — Questions and Answers
Question 1: A pediatric OT wants to use a cooking activity to address executive function deficits in an adolescent with TBI. Which task demand MOST directly targets executive function?
- Sequencing recipe steps independently and self-monitoring for errors (Correct answer)
- Measuring ingredients with adaptive utensils to accommodate grip weakness
- Selecting preferred foods to increase intrinsic motivation
- Using a microwave rather than stovetop to reduce safety risk
Correct answer: Sequencing recipe steps independently and self-monitoring for errors
Sequencing and error monitoring directly engage planning, organization, and self-regulation — core executive function components.
Question 2: A client with COPD is learning energy conservation during home management tasks. The BEST example of work simplification is:
- Sliding heavy items along the counter rather than lifting them (Correct answer)
- Resting for 30 minutes after every 5 minutes of activity
- Avoiding all housekeeping tasks until dyspnea fully resolves
- Performing all chores in a single morning session to preserve afternoon energy
Correct answer: Sliding heavy items along the counter rather than lifting them
Work simplification reduces the physical effort of a task by changing the method, such as sliding instead of lifting to minimize exertion.
Question 3: When using occupation-based intervention versus a preparatory method, the OT should recognize that:
- Occupation-based intervention contextualizes skill application in meaningful daily tasks, which can enhance motivation and carryover (Correct answer)
- Preparatory methods are always more effective because they isolate the specific deficit being treated
- Occupation-based intervention is contraindicated in acute care due to safety concerns
- Both approaches have identical outcomes and the choice depends solely on therapist preference
Correct answer: Occupation-based intervention contextualizes skill application in meaningful daily tasks, which can enhance motivation and carryover
Occupation-based interventions embed skill practice in meaningful contexts, promoting generalization and client engagement beyond preparatory exercises.
Question 4: A client with rheumatoid arthritis asks the OT how to best protect her joints while gardening. The therapist should recommend:
- Using long-handled tools and padded grips to distribute joint load and avoid sustained pinch (Correct answer)
- Avoiding gardening entirely until the disease is in remission
- Wearing compression gloves during gardening to increase grip strength
- Performing gardening only on high-pain days to build pain tolerance
Correct answer: Using long-handled tools and padded grips to distribute joint load and avoid sustained pinch
Joint protection principles include using larger joints, distributing force, and using ergonomic tools to reduce stress on vulnerable joints.
Question 5: An older adult in a skilled nursing facility refuses to participate in a morning ADL group, stating she has 'always bathed at night.' The OT's BEST response is to:
- Adjust the bathing schedule to align with her lifelong routine and habits (Correct answer)
- Explain the therapeutic rationale for morning bathing and encourage compliance
- Document the refusal and defer bathing until the client is more cooperative
- Transfer the client to a self-care independence program requiring morning bathing
Correct answer: Adjust the bathing schedule to align with her lifelong routine and habits
Respecting established habits and routines is a client-centered principle that supports autonomy, dignity, and occupational engagement.
Question 6: During a hand therapy session, the OT uses a peg board activity to improve pinch strength. To make this activity MORE occupation-based, the therapist should:
- Replace the peg board with a task the client performs at work, such as sorting small parts on an assembly line (Correct answer)
- Increase the resistance of the peg board to simulate maximum grip loading
- Have the client perform the peg board task while standing to add postural challenge
- Time the peg board task to establish a performance benchmark for documentation
Correct answer: Replace the peg board with a task the client performs at work, such as sorting small parts on an assembly line
Replacing a simulated task with an actual work task transforms preparatory activity into an occupation-based intervention with real context.
Question 7: A therapist is designing a group intervention for adults with depression using the lifestyle redesign model. Which activity selection BEST reflects this approach?
- Collaboratively identifying and experimenting with daily routines that promote health and personal meaning (Correct answer)
- Teaching symptom management techniques through structured psychoeducation lectures
- Providing individual task practice focused on remediating specific performance skills
- Selecting activities solely based on normative developmental expectations for adults
Correct answer: Collaboratively identifying and experimenting with daily routines that promote health and personal meaning
Lifestyle redesign centers on co-creating health-promoting occupational patterns and routines tailored to the individual's values and life context.
NBCOT Therapeutic Use of Occupations and Activities 5
A pediatric OT wants to use a cooking activity to address executive function deficits in an adolescent with TBI.
Which task demand MOST directly targets executive function?