NCTRC Individualized Plan of Care 4 — Questions and Answers
Question 1: When documenting a client's functional limitations in the individualized plan of care, the CTRS should focus on:
- The client's diagnosis and medical history
- How limitations affect participation in recreation activities (Correct answer)
- The number of medications the client is taking
- The client's insurance coverage and funding sources
Correct answer: How limitations affect participation in recreation activities
Functional limitations in the plan of care should be framed in terms of how they impact the client's ability to participate in recreational activities, which is within the TR scope of practice.
Question 2: Which of the following BEST describes the purpose of short-term goals in an individualized plan of care?
- To document the client's overall prognosis
- To serve as stepping stones toward achieving long-term goals (Correct answer)
- To identify the client's diagnosis and referral source
- To satisfy insurance billing requirements only
Correct answer: To serve as stepping stones toward achieving long-term goals
Short-term goals are incremental, measurable objectives that build progressively toward the attainment of broader long-term goals.
Question 3: A CTRS is updating a client's individualized plan of care after a significant change in the client's condition. This update should occur:
- Only at the scheduled quarterly review
- As soon as the change is identified and documented (Correct answer)
- After the interdisciplinary team meeting the following month
- When the client requests a change to the plan
Correct answer: As soon as the change is identified and documented
Plans of care must be updated promptly when a significant change in condition occurs to ensure interventions remain appropriate and safe.
Question 4: Which element of a measurable goal specifies HOW WELL the client must perform a task?
- Condition
- Behavior
- Criterion (Correct answer)
- Timeline
Correct answer: Criterion
The criterion component of a measurable goal establishes the standard or level of performance required for the goal to be considered achieved.
Question 5: A client states they are not interested in any of the goals the CTRS has proposed. The BEST response is to:
- Proceed with the goals as written since they are clinically appropriate
- Document the refusal and proceed without a plan of care
- Engage the client in collaborative goal-setting to identify mutually agreeable goals (Correct answer)
- Refer the client to another discipline
Correct answer: Engage the client in collaborative goal-setting to identify mutually agreeable goals
Client-centered practice requires that goals be developed collaboratively to ensure relevance, motivation, and adherence to the plan of care.
Question 6: When selecting interventions for an individualized plan of care, a CTRS should prioritize those that are:
- Most readily available in the facility's activity calendar
- Supported by evidence and matched to the client's goals and preferences (Correct answer)
- Least expensive and easiest to administer
- Familiar to the client regardless of therapeutic value
Correct answer: Supported by evidence and matched to the client's goals and preferences
Evidence-based interventions aligned with individual client goals and preferences reflect best practice in therapeutic recreation planning.
Question 7: A CTRS documents that a client will 'demonstrate improved social skills.' This goal is problematic primarily because it:
- Is too ambitious for the client's current level
- Lacks a measurable criterion and timeline (Correct answer)
- Addresses a domain outside TR scope of practice
- Uses language the client cannot understand
Correct answer: Lacks a measurable criterion and timeline
Effective goals must be measurable, including a specific criterion and timeline, so that progress can be objectively evaluated.
NCTRC Individualized Plan of Care 4
When documenting a client's functional limitations in the individualized plan of care, the CTRS should focus on: