NBCOT Intervention Management 5 — Questions and Answers
Question 1: An OT is treating a client with spinal cord injury (C6 complete). Which functional outcome is MOST realistic for this level of injury?
- Independent ambulation without assistive devices
- Independent manual wheelchair propulsion and adapted ADLs using tenodesis (Correct answer)
- Full hand dexterity for fine motor tasks
- Independent transfers without equipment
Correct answer: Independent manual wheelchair propulsion and adapted ADLs using tenodesis
C6 SCI preserves wrist extension, enabling tenodesis grasp and adapted independence in manual wheelchair propulsion and many ADLs with appropriate equipment.
Question 2: Which splint is indicated for a client with swan neck deformity of the finger?
- Mallet finger splint (DIP extension splint)
- Silver ring or oval-8 splint to block PIP hyperextension (Correct answer)
- Buddy strap to the adjacent finger
- Dynamic MCP flexion splint
Correct answer: Silver ring or oval-8 splint to block PIP hyperextension
A ring splint blocks PIP hyperextension while allowing PIP flexion, directly addressing the swan neck deformity pattern.
Question 3: A therapist is using the Allen Cognitive Levels (ACL) to guide intervention planning. A client scoring at Level 3 would MOST likely need:
- Minimal cueing for complex instrumental ADLs
- Repetitive step-by-step cuing and a highly structured, simplified environment (Correct answer)
- Independent goal setting and problem solving
- Group-based insight therapy
Correct answer: Repetitive step-by-step cuing and a highly structured, simplified environment
ACL Level 3 indicates manual actions are possible with repetition; clients require step-by-step cuing and simplified structured environments for safety.
Question 4: An OT in a work hardening program is grading a client's lifting tolerance after a lumbar injury. Which principle BEST guides activity progression?
- Increase weight maximally from day one to rebuild strength quickly
- Gradually increase load, repetitions, and duration based on the client's pain and tolerance (Correct answer)
- Avoid all lifting until the client is pain-free
- Progress only when imaging shows complete tissue healing
Correct answer: Gradually increase load, repetitions, and duration based on the client's pain and tolerance
Work hardening uses progressive grading of physical demands based on functional tolerance, following the principle of gradual loading to restore work capacity safely.
Question 5: Which of the following is the BEST example of a preparatory method in the OT intervention continuum?
- Practicing meal preparation in the clinic kitchen
- Hot pack application to reduce muscle stiffness before functional activity (Correct answer)
- Role-playing a job interview
- Community outing to practice money management
Correct answer: Hot pack application to reduce muscle stiffness before functional activity
Preparatory methods such as hot pack application prepare the client's body for functional performance but are not occupational in nature themselves.
Question 6: An OT is working with a client who has schizophrenia in a supported employment program. This intervention is BEST aligned with which model?
- Biomechanical model
- Individual Placement and Support (IPS) model within the recovery model (Correct answer)
- Neurodevelopmental Treatment
- Developmental frame of reference
Correct answer: Individual Placement and Support (IPS) model within the recovery model
The IPS model supports rapid placement in competitive employment with ongoing support, reflecting the recovery model's emphasis on community participation and client choice.
Question 7: A client with rheumatoid arthritis asks about joint protection during kitchen tasks. Which principle should the OT emphasize FIRST?
- Maximize joint stress during tasks to build strength
- Distribute weight across larger joints and avoid sustained pinch or tight grip (Correct answer)
- Use only the dominant hand for all tasks
- Perform tasks as quickly as possible to minimize time in painful positions
Correct answer: Distribute weight across larger joints and avoid sustained pinch or tight grip
Joint protection principles for RA include distributing load across larger, more stable joints and avoiding sustained pinch grip to reduce stress on vulnerable small joints.
NBCOT Intervention Management 5
An OT is treating a client with spinal cord injury (C6 complete).
Which functional outcome is MOST realistic for this level of injury?