NBCOT Intervention Management 4 — Questions and Answers
Question 1: An OT is working with a child diagnosed with developmental coordination disorder (DCD). Which intervention has the strongest evidence?
- Passive stretching and resting splints
- Task-oriented approaches such as CO-OP (Cognitive Orientation to Occupational Performance) (Correct answer)
- Sensory integration therapy alone
- Eliminating participation in sports and physical activities
Correct answer: Task-oriented approaches such as CO-OP (Cognitive Orientation to Occupational Performance)
CO-OP uses metacognitive strategy training and task analysis, and is the most evidence-based approach specifically for children with DCD.
Question 2: When fabricating a static progressive splint, what is the OT's PRIMARY goal?
- Immobilize the joint completely to prevent contracture
- Apply a low-load prolonged stretch to increase passive range of motion (Correct answer)
- Provide dynamic resistance during active movement
- Prevent edema by elevating the extremity
Correct answer: Apply a low-load prolonged stretch to increase passive range of motion
Static progressive splints apply incrementally increased sustained stretch to remodel connective tissue and improve passive ROM.
Question 3: A client with unilateral neglect following a right hemispheric stroke is working on ADLs. Which cuing strategy is MOST appropriate initially?
- Placing all items on the right (non-neglected) side
- Verbal and visual cues to direct attention to the left side (Correct answer)
- Covering the right visual field to force left gaze
- Providing no cues to encourage spontaneous recovery
Correct answer: Verbal and visual cues to direct attention to the left side
Verbal and visual cueing directs the client's attention to the neglected side, facilitating exploration and safe engagement in ADLs.
Question 4: An OT working with a client with major depressive disorder in a community mental health setting would MOST appropriately use which intervention?
- Passive activities that require minimal engagement
- Behavioral activation by scheduling meaningful and pleasurable occupations (Correct answer)
- Isolation from social contexts to reduce stimulation
- Exclusively pharmacological management referrals
Correct answer: Behavioral activation by scheduling meaningful and pleasurable occupations
Behavioral activation counters depression by reintroducing meaningful and pleasurable activities, improving mood and restoring occupational engagement.
Question 5: Which assessment tool would an OT use to evaluate a client's perception of their occupational performance and satisfaction with that performance?
- Functional Independence Measure (FIM)
- Canadian Occupational Performance Measure (COPM) (Correct answer)
- Mini-Mental State Examination (MMSE)
- Assessment of Motor and Process Skills (AMPS)
Correct answer: Canadian Occupational Performance Measure (COPM)
The COPM is a client-centered outcome measure that captures the client's self-perception of performance and satisfaction across self-care, productivity, and leisure.
Question 6: A therapist is using the Kawa (River) Model in intervention planning. This model is PRIMARILY used to:
- Measure biomechanical deficits
- Understand the client's life flow and contextual factors from a cultural perspective (Correct answer)
- Guide splint fabrication
- Calculate functional independence scores
Correct answer: Understand the client's life flow and contextual factors from a cultural perspective
The Kawa Model uses the metaphor of a river to explore how life circumstances and context shape occupational engagement, especially across cultures.
Question 7: When implementing a home modification program for an older adult at risk for falls, the OT would FIRST:
- Install grab bars in all bathrooms without assessment
- Conduct a comprehensive home safety evaluation to identify specific hazards (Correct answer)
- Recommend the client move to assisted living
- Prescribe a cane without gait assessment
Correct answer: Conduct a comprehensive home safety evaluation to identify specific hazards
A comprehensive home safety evaluation identifies the specific fall hazards and functional limitations that guide individualized modification recommendations.
An OT is working with a child diagnosed with developmental coordination disorder (DCD).
Which intervention has the strongest evidence?