OTR Client Evaluation 3 — Questions and Answers
Question 1: Which assessment approach is MOST consistent with a top-down evaluation framework in occupational therapy?
- Testing isolated muscle strength before observing task performance
- Observing the client perform daily tasks and then analyzing underlying deficits (Correct answer)
- Administering neurological reflex tests first
- Measuring passive range of motion as the initial step
Correct answer: Observing the client perform daily tasks and then analyzing underlying deficits
A top-down approach begins with observing occupational performance and then identifies underlying performance skill deficits that interfere.
Question 2: The OTR uses the Kohlman Evaluation of Living Skills (KELS) with a psychiatric inpatient. This assessment focuses on:
- Cognitive endurance during work tasks
- Basic living skills needed for community survival (Correct answer)
- Upper extremity motor coordination
- Leisure participation patterns
Correct answer: Basic living skills needed for community survival
The KELS evaluates basic living skills such as self-care, safety, money management, transportation, and telephone use to determine readiness for community living.
Question 3: During evaluation, an OTR observes that a client consistently neglects objects on the left side of space. The MOST appropriate tool to formally assess this finding is:
- Trail Making Test
- Catherine Bergego Scale (CBS) (Correct answer)
- Jebsen-Taylor Hand Function Test
- Wolf Motor Function Test
Correct answer: Catherine Bergego Scale (CBS)
The CBS is a standardized observational scale specifically designed to assess unilateral spatial neglect in functional activities.
Question 4: When interpreting standardized assessment scores, a standard score of 85 on a norm-referenced test falls approximately at which percentile?
- 2nd percentile
- 16th percentile (Correct answer)
- 50th percentile
- 84th percentile
Correct answer: 16th percentile
A standard score of 85 is one standard deviation below the mean (100), which corresponds to approximately the 16th percentile.
Question 5: The OTR administers the Nine-Hole Peg Test (9HPT). What construct does this test PRIMARILY measure?
- Grip strength
- Fine motor dexterity and finger coordination (Correct answer)
- Upper extremity proprioception
- Visual-motor integration
Correct answer: Fine motor dexterity and finger coordination
The 9HPT measures fine motor dexterity by timing how quickly a person places and removes nine pegs from a pegboard.
Question 6: A client reports difficulty managing money and using public transportation. According to the OTPF, these are examples of which occupational domain?
- Activities of daily living (ADLs)
- Instrumental activities of daily living (IADLs) (Correct answer)
- Rest and sleep
- Social participation
Correct answer: Instrumental activities of daily living (IADLs)
Financial management and community mobility are IADLs, which are more complex activities that support independence in daily life.
Question 7: An OTR evaluates a client with low back pain using the Oswestry Disability Index. This tool measures:
- Pain quality and location
- Functional disability related to pain (Correct answer)
- Spinal range of motion
- Nerve conduction velocity
Correct answer: Functional disability related to pain
The Oswestry Disability Index quantifies how low back pain affects functional performance across ten life domains.
OTR Client Evaluation 3
Which assessment approach is MOST consistent with a top-down evaluation framework in occupational therapy?