NCTRC Ultimate 5 — Questions and Answers
Question 1: Which theory of aging posits that older adults who remain active and socially engaged maintain higher life satisfaction than those who withdraw?
- Disengagement theory
- Activity theory (Correct answer)
- Continuity theory
- Socioemotional selectivity theory
Correct answer: Activity theory
Activity theory proposes that maintaining social roles and activities is key to life satisfaction in older adults, directly supporting TR's role in aging populations.
Question 2: A CTRS is completing a functional assessment for a client with a spinal cord injury at C6. Which leisure activity modification is MOST appropriate?
- Eliminate all upper extremity activities
- Use adaptive equipment such as universal cuffs for hand activities (Correct answer)
- Focus exclusively on cognitive leisure activities
- Limit activities to those requiring no equipment
Correct answer: Use adaptive equipment such as universal cuffs for hand activities
Clients with C6 SCI have wrist extension but no hand function; adaptive equipment like universal cuffs enables meaningful upper extremity participation in many activities.
Question 3: Under HIPAA, a CTRS may share a client's protected health information (PHI) without written authorization for which purpose?
- Marketing to the client's family
- Sharing with a local recreation center staff for fun
- Treatment, payment, and healthcare operations (Correct answer)
- Publishing a case study in a professional newsletter
Correct answer: Treatment, payment, and healthcare operations
HIPAA's TPO exception allows sharing PHI without authorization for treatment (including care coordination), payment, and healthcare operations purposes.
Question 4: Which type of facilitation technique involves the therapist gradually reducing assistance as the client gains competency?
- Chaining
- Fading (Correct answer)
- Shaping
- Prompting
Correct answer: Fading
Fading is the systematic, gradual reduction of prompts or assistance as the client demonstrates increasing competency, promoting independence.
Question 5: When a CTRS evaluates a client's leisure lifestyle, which domain is LEAST likely to be addressed?
- Leisure awareness
- Leisure skills
- Leisure resources
- Cardiovascular endurance training (Correct answer)
Correct answer: Cardiovascular endurance training
Leisure lifestyle evaluation addresses awareness, skills, and community resources for recreation — cardiovascular endurance training is a clinical health outcome goal, not a leisure lifestyle domain.
Question 6: A CTRS working in a school setting is part of an IEP team. TR services in this context are MOST likely classified as:
- A related service (Correct answer)
- A primary special education service
- A voluntary extracurricular activity
- A health and wellness elective
Correct answer: A related service
Under IDEA, therapeutic recreation is listed as a related service that supports a student's access to special education and enables participation in school activities.
Question 7: Which ethical principle requires a CTRS to act in the client's best interest, even when the client's stated preference may conflict with their wellbeing?
- Autonomy
- Beneficence (Correct answer)
- Non-maleficence
- Justice
Correct answer: Beneficence
Beneficence means actively promoting the client's good and acting in their best interest — it may sometimes create tension with client autonomy.
NCTRC Ultimate 5
Which theory of aging posits that older adults who remain active and socially engaged maintain higher life satisfaction than those who withdraw?