OT NBCOT OT Exam Domain Knowledge 3

Question 1

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?

Accepted Answer

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

Answer

Place signs on all doors to help the client orient to room locations

Answer

Recommend a commode at the bedside to eliminate bathroom navigation

Answer

Educate the caregiver to accompany the client to the bathroom at all times

Question 2

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?

Accepted Answer

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

Answer

Practicing bike-riding skills in progressively more challenging environments using repetition

Answer

Providing manual guidance and hand-over-hand assistance to shape the movement pattern

Answer

Sensory integration activities to improve vestibular and proprioceptive processing needed for balance

Question 3

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?

Accepted Answer

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

Answer

Wrist extension to mechanically extend the hook fingers

Answer

Elbow flexion of the sound limb to provide power transfer

Answer

Shoulder internal rotation and depression to open the terminal device

Question 4

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?

Accepted Answer

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

Answer

Providing vigorous tactile stimulation to promote sensory system development

Answer

Maintaining a bright, stimulating environment to support visual system maturation

Answer

Encouraging maximal alert wakefulness periods to promote social interaction

Question 5

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?

Accepted Answer

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

Answer

The child is constantly moving, seeking intense sensory experiences to meet high thresholds

Answer

The child overreacts to ordinary sounds and textures with emotional meltdowns

Answer

The child actively avoids sensory input by withdrawing from group activities and wearing minimal clothing

Question 6

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?

Accepted Answer

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

Answer

DASH questionnaire only to capture self-reported upper extremity function

Answer

Modified Oswestry Disability Index to quantify pain-related disability

Answer

Standard isometric strength testing of lumbar extensors via dynamometer

Question 7

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?

Accepted 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

Answer

Sexual activity requires 8–10 METs and should be avoided for 6 months after MI

Answer

Sexual activity is safe to resume immediately as it requires less than 1 MET

Answer

The OT cannot address this topic; only the cardiologist can provide sexual activity guidelines