NBCOT OT Exam Domain Knowledge Flashcards

During a home health evaluation, an OT observes that a 78-year-old man with moderate dementia is at significant risk for falls during toileting. Which environmental modification would MOST directly address this safety concern?

Answer: Install grab bars beside the toilet, raise the toilet seat height, and clear obstacles in the path to the bathroom

Grab bars (stability support), raised toilet seat (easier sit-to-stand), and clear pathways (obstacle removal) are the evidence-based environmental modifications that directly reduce fall risk during toileting.

A 6-year-old child with developmental coordination disorder (DCD) has difficulty learning to ride a bike. The OT decides to use the Cognitive Orientation to daily Occupational Performance (CO-OP) approach. Which technique is CENTRAL to CO-OP intervention?

Answer: Teaching the child a global problem-solving strategy ('Goal-Plan-Do-Check') and guided discovery of task-specific strategies

CO-OP's core mechanism is the global cognitive strategy Goal-Plan-Do-Check, through which the child discovers task-specific strategies via guided discovery rather than being taught movements directly.

An OT is treating a 50-year-old man with a traumatic below-elbow (transradial) amputation. The patient is being fitted for a body-powered prosthesis with a voluntary-opening terminal device. To operate the terminal device, the patient must perform which movement?

Answer: Humeral flexion and/or scapular abduction to activate the control cable and open the hook

Body-powered prostheses use a figure-8 harness and control cable activated by shoulder flexion and/or scapular abduction (biscapular spread) to open the voluntary-opening terminal device.

An OT working in a neonatal intensive care unit (NICU) is implementing developmental care for a 32-week premature infant. Which intervention is MOST aligned with the Neonatal Individualized Developmental Care and Assessment Program (NIDCAP) principles?

Answer: Clustering care activities to minimize disruptions and providing containment (hands-on swaddling) during procedures

NIDCAP principles include individualized, neurodevelopmentally supportive care: clustering cares to reduce stimulation stress and using containment/swaddling during handling to support self-regulation.

An OT is interpreting the results of a sensory evaluation for a 9-year-old child. The Sensory Profile 2 (Dunn's model) shows the child scores in the 'Bystander' quadrant with high registration thresholds and passive self-regulation. Which clinical presentation would you MOST expect?

Answer: The child appears slow to notice sensory stimuli, seems 'in their own world,' and misses social cues and instructions

Dunn's Bystander pattern: high neurological threshold + passive self-regulation = the child does not receive enough sensory information and appears passive, misses stimuli, and seems inattentive.

An OT performing a work conditioning evaluation on a 38-year-old warehouse worker with a lumbar disc herniation needs to assess functional work capacity. Which assessment is MOST appropriate?

Answer: Functional Capacity Evaluation (FCE) including lifting analysis, positional tolerances, and work simulation tasks

An FCE provides a comprehensive, objective measurement of safe functional work capacity including lifting, carrying, positional tolerances, and work-simulated activities — essential for RTW decisions.

An OT is working with a 65-year-old man who had a myocardial infarction 5 days ago. He is in Phase I cardiac rehabilitation and asks when he can resume sexual activity. Using MET-level guidelines for cardiac rehabilitation, which response is MOST appropriate?

Answer: Sexual activity is equivalent to climbing two flights of stairs (3–5 METs) and can typically resume in 4–6 weeks when you can perform this comfortably without symptoms

Sexual activity averages 3–5 METs (equivalent to climbing stairs) and can typically resume 4–6 weeks post-MI when the patient can perform equivalent activities symptom-free, per established cardiac rehab guidelines.