passing the NBCOT exam

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OTR2013 in Texas

41 months ago

NYMSOT in Saint Louis, Missouri said: 5. A patient in a rehabilitation facility has a complete C8-T1 spinal cord injury. The patient is learning techniques to maximize independence with dressing. Which technique should the OTR teach the patient to use to support progress toward this goal?

a. Put on undergarments ad trousers in bed, then, transfer to a wheelchair to complete upper body dressing.
b. Use a universal cuff with a buttonhook and zipper-pull to fasten front-opening clothing.
c. Wear a wrist driven flexor hinge splint for pulling on and fastening clothing.
d. While supine in bed, put socks and shoes; then put on underpants and trousers by rolling side to side in bed.*

ok, this one I ended up w/ "A" b/c C8-T1 have UE but the LE is weak. since he has weak LE, wouldn't it be better if he put his undergarments & pants in bed then transfer to a WC for UB dressing? I was going between "A" and "D" but thought that "D" was the "2nd best" b/c why would he do socks & shoes first? isn't it a weird patten for a SCI? BUT now that I see "A" it doesn't EXACTLY SPECIFY HOW HE WILL PUT THE TROUSERS ON IN BED WHERE AS "D" STATED SPECIFICALLY "SUPINE IN BED, AND ROLLING SIDE TO SIDE IN BED". can someone clarify and let us hear your critical thinking???? BASICALLY, WHAT IS THE TINY DIFFERENT BETWEEN "A" AND "D'?????

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OTR2013 in Texas

41 months ago

sull in Quincy, Massachusetts said: Ans C Respect the patients wishes and document refusal in medical record

An OTR working in a skilled nursing facility is beginning an initial patient interview. After providing the patient with a brief introduction to OT service the patient refused to participate in an evaluation stating “This is childish, I’m here to get stronger. There is an entire staff that can help me get dressed”. What action should the OTR take based o the response.
a. Provide further discussion about how OT will help improve daily living skills.
b. Assure the patient that strengthening exercises will be included in the intervention*.
c. Respect the patients wishes and document the refusal in the medical record.
d. Advise the patient that an assessment is mandated by the insurance company.

*HEY SULL IN MASSACHUSETTS--->difficult time understanding why "C" would be a choice too? I too, went w/ "B" b/c the pt. is upset and wants to get stronger. so shouldn't we acknowledge the pt's goal by being client-centered and letting him know that strengthening exercises will be incorporated in the intervention, therefore, it would help ease the pt is possibly participating in the eval? there has been answer where I would choose "C" and document the refusal, but in this question, pt complained about wanting to get stronger so that word STUCK in my head.
btw, WHEN do we specifically respect pt wishes, and document refusal in med records? is there something in tromly that mentions it?

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otgrad0612 in Los Angeles, California

41 months ago

1234OTR in Lubbock, Texas said: Hi Everyone,

I just took an passed the OTR exam at the beginning of February. I used the Fleming NBCOT guide, the official NBCOT OTR guide, and the therapy ed course. I have the Fleming book 6th edition with CD & NBCOT official OTR study guide for sale and will throw in the therapy ed course guide book as well (it has an extra test w/ answers provided separately). Please let me know if you are interested. The books are in great shape. Please reply with contact information if you are interested.

By the way. I made a 67, 72, & 70% on the fleming quizzes and took a 100 question NBCOT practice test and made a 502. Honestly, the thing that helped the most was reading through the Fleming book & studying the things I was weak in and then taking the NBCOT practice questions in the official study guide and getting a feeling of how they ask the questions on the real test. The fleming practice exam questions are harder than the NBCOT questions and worded completely different. The Fleming book will help you know what areas you are weak in and what to study. However, knowing how to read the NBCOT questions and know exactly what they are asking will help when answering the questions. Such as, if in the question they suggest a particular setting the answer will be consistent with that setting; if it asks for an intervention the answer will be an intervention, etc.

Hi 1234OTR in Lubbock, Texas,

Could you please email me at otgrad0612@gmail.com
Thanks!

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OT graduate in San Leandro, California

41 months ago

OTR2013 in Texas said: 2. A patient has cerebellar ataxia and will be discharged in 2 days from an inpatient rehabilitation facility to live at home with family. The patient is afraid of falling, especially during BADLs activities in the bathroom. What action is the MOST IMPORTANT for the OTR to take to reduce the patients fear and promote a safe transition to home?
a. assess the home layout to advise the family about modifying potential fall hazards.*
b. Incorporate dynamic balance exercises into each intervention session.
c. Provide the family members with handouts about home safety and fall risks.
d. Recommend the patient and family attend a post discharge fall prevention class

I think they are tricky you with the words usually yes you would do home eval but the way this particular questions is worded WHAT ACTION to REDUCE PATIENTS FEAR and promote SAFE TRANSITION (and keep in mind the patient has fears especially when doing BADLS in the bathroom) so I WOULD PICK ANS B INCORPORATE DYN STAN BAL THEN YOU CAN ASSES THE AT RISK FOR FALLS AND FROM THERE THEN I WOULD GO TO ANS D AS IT WOULD BE ASSESSED THAT DYS STAN BAL IS AT RISK AND HOME EVAL IS NOW NEEDED THIS IS THE OT PROCESS THOUGHT
Any thoughts any one ??

*SULL MASSACHUSETTS-->Wow this is a really good thought b/c I thought it was "A" also till I read your critical thinking! and it make total sense too since he still as 2 days till D/C & within those 2 days, the OTR can do some dynamic balance exercies to reduce his fears & promote safe transitions at home! anyway we can find a concrete answer in Trombly?

Well, the question stated that the patient will be discharge home in 2 days... and it also indicated how can the therapist promote a SAFE TRANSITION TO HOME.... The best answer is A because it will promote safety at home and reduce risk of falling again...

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OT graduate in San Leandro, California

41 months ago

OTR2013 in Texas said: ok, this one I ended up w/ "A" b/c C8-T1 have UE but the LE is weak. since he has weak LE, wouldn't it be better if he put his undergarments & pants in bed then transfer to a WC for UB dressing? I was going between "A" and "D" but thought that "D" was the "2nd best" b/c why would he do socks & shoes first? isn't it a weird patten for a SCI? BUT now that I see "A" it doesn't EXACTLY SPECIFY HOW HE WILL PUT THE TROUSERS ON IN BED WHERE AS "D" STATED SPECIFICALLY "SUPINE IN BED, AND ROLLING SIDE TO SIDE IN BED". can someone clarify and let us hear your critical thinking???? BASICALLY, WHAT IS THE TINY DIFFERENT BETWEEN "A" AND "D'?????

The patient at c8-T1 level are independent with ADLs and can preform depression transfers...but may need stand-by assist for floor to wheelchair, vice-versa transfers.. base on this information, B and C are automatically crossed out... Also, wouldn't it be harder to put on shoes and socks while lying supine on bed...? Think about it.. The best choice would be A... Not only would the patient work on dressing, he would also work on transfer. It would probably be easier to put on shoes and socks while seated on a wheelchair, compared to lying supine. Also, a person who has C8-T1 injury has good trunk control, so there is no need to be supine.

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OT graduate in San Leandro, California

41 months ago

OTR2013 in Texas said: NYMSOT in Saint Louis, Missouri said: A client has sustained a TBI 3 months ago and is functioning at level VIII(purposeful appropriate; standby assistance) on the Ranchos los Amigos Scale. The client is participating in a meal preparation task. The client is asked to prepare a vegetable soup using a 5 step printed recipe. The client is able to read the recipe steps aloud but does not act on any of them. When the OTR covers over all but the first step of the recipe, the client follows through with the step. What conclusion can the OTR make about the client based on this observation?
a. Adaptive strategies compensate for attention deficits. *
b. Anchoring techniques improve visual perception.
c. Deficits in executive functioning interfere with performance.
d. Ideational apraxia interferes with task initiation. *

I went w/ answer "A" b/c his attention is the problem. it says "he is able to read the recipe steps aloud, BUT DOES NOT ACT ON ANY OF THEM." & when the OT covers everything BUT THE 1ST STEP, the client FOLLOWS THROUGH w/ the steps. That means he does not have ideational apraxia. Ideational apraxia is "the loss of ability to conceptualize, plan, and execute the complex sequence of MOTOR actions" so to me, he has attention deficits since he was able to follow through w/ the steps ONLY WHEN EVERYTHING WAS COVER EXCEPT FOR THE 1ST STEP..???? (Maybe I missed a tricky word thought, let me know your thoughts!)

Nothing in the question indicate attention problems... The answer is C. The patient has difficulty initiating the task, which is an executive function.

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OT graduate in San Leandro, California

41 months ago

OTR2013 in Texas said: An OTR working in a skilled nursing facility is beginning an initial patient interview. After providing the patient with a brief introduction to OT service the patient refused to participate in an evaluation stating “This is childish, I’m here to get stronger. There is an entire staff that can help me get dressed”. What action should the OTR take based o the response.
a. Provide further discussion about how OT will help improve daily living skills.
b. Assure the patient that strengthening exercises will be included in the intervention*.
c. Respect the patients wishes and document the refusal in the medical record.
d. Advise the patient that an assessment is mandated by the insurance company.

*HEY SULL IN MASSACHUSETTS--->difficult time understanding why "C" would be a choice too? I too, went w/ "B" b/c the pt. is upset and wants to get stronger. so shouldn't we acknowledge the pt's goal by being client-centered and letting him know that strengthening exercises will be incorporated in the intervention, therefore, it would help ease the pt is possibly participating in the eval? there has been answer where I would choose "C" and document the refusal, but in this question, pt complained about wanting to get stronger so that word STUCK in my head.
btw, WHEN do we specifically respect pt wishes, and document refusal in med records? is there something in tromly that mentions it?

The question indicates that the OT gave a BRIEF INTRODUCTION to OT services...Also, it seems like the client is not clear about OT services.. SO i thought the answer is A. If the patient still refuses, then honor their decision, and then do C. Remember, it is our responsibility to advocate and educate regarding our profession... Any thoughts?

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OT graduate in San Leandro, California

41 months ago

OTR2013 in Texas said: ok, this one I ended up w/ "A" b/c C8-T1 have UE but the LE is weak. since he has weak LE, wouldn't it be better if he put his undergarments & pants in bed then transfer to a WC for UB dressing? I was going between "A" and "D" but thought that "D" was the "2nd best" b/c why would he do socks & shoes first? isn't it a weird patten for a SCI? BUT now that I see "A" it doesn't EXACTLY SPECIFY HOW HE WILL PUT THE TROUSERS ON IN BED WHERE AS "D" STATED SPECIFICALLY "SUPINE IN BED, AND ROLLING SIDE TO SIDE IN BED". can someone clarify and let us hear your critical thinking???? BASICALLY, WHAT IS THE TINY DIFFERENT BETWEEN "A" AND "D'?????

Also, D would not be correct since it is sequentially not correct.

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OTR/L new grad in New York, New York

41 months ago

OT graduate in San Leandro, California said: Well, the question stated that the patient will be discharge home in 2 days... and it also indicated how can the therapist promote a SAFE TRANSITION TO HOME.... The best answer is A because it will promote safety at home and reduce risk of falling again...

i think the answer is definitely to do the home eval for 2 reasons #1 with cerebellar ataxia there's not much you can do to improve balance especially not in 2 days, and #2 doing the home eval is the most pro active response to ensure a safe return home, the other choices kind of leave it up to the family to read the brochure and to attend the class on fall prevention with no way of knowing how much of the information will be retained and applied. So the word "action" in the question is definitely a key word leading you pick the answer that is most proactive, and of course you would also have to know that with cerebellar ataxia balance will not improve in 2 days.
It's important to find key words in the question as they're always hints to lead you to the right answer.

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OT - New Grad in SF, California

41 months ago

OT graduate in San Leandro, California said: The patient at c8-T1 level are independent with ADLs and can preform depression transfers...but may need stand-by assist for floor to wheelchair, vice-versa transfers.. base on this information, B and C are automatically crossed out... Also, wouldn't it be harder to put on shoes and socks while lying supine on bed...? Think about it.. The best choice would be A... Not only would the patient work on dressing, he would also work on transfer. It would probably be easier to put on shoes and socks while seated on a wheelchair, compared to lying supine. Also, a person who has C8-T1 injury has good trunk control, so there is no need to be supine.

I agree with with answer A for the same reasons. I considered D, but it doesn't make sense to put socks and shoes on while in bed, then put on underpants and trousers by rolling side to side in bed. The obvious problem is the pt will already have his shoes on before he even puts on his pants, right? Also, Pedretti states that undergarments (and pants) should be donned while in bed, then transfer to a w/c to complete UE dressing.

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OT - New Grad in SF, California

41 months ago

1. An OTR and an entry - level COTA are employed in a an outpatient setting. Several clients on the OTR caseload are due for their 90-day plan of care recertification update as required by Medicare. The OTR learns that these clients have been scheduled for reevaluations appointments on a day when the OTR must be on personal leave time and will be away from the facility. How should the OTR respond to this finding?

a. Ask the administrator to provide line-of site supervision while the COTA completes the scheduled evaluations.
b. Continue with the current plan and schedule a comprehensive assessment for a date soon after the scheduled leave time. *
c. Discuss the clients current progress with the COTA and select appropriate evaluations for the COTA to complete.
d. Use progress notes from the clients previous session to update the plan of care prior to taking the scheduled leave.

This is a tough one. I agree with answer B, but answer C also makes sense as COTA's can perform an eval, but they cannot interpret results. The only issue I have with answer B is that the assessement will be completed after the scheduled leave time, which means the OT may not meet the 90 day deadline. Thoughts?

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Krystina01 in Orland Park, Illinois

41 months ago

OTR2013 in Texas said: ok, this one I ended up w/ "A" b/c C8-T1 have UE but the LE is weak. since he has weak LE, wouldn't it be better if he put his undergarments & pants in bed then transfer to a WC for UB dressing? I was going between "A" and "D" but thought that "D" was the "2nd best" b/c why would he do socks & shoes first? isn't it a weird patten for a SCI? BUT now that I see "A" it doesn't EXACTLY SPECIFY HOW HE WILL PUT THE TROUSERS ON IN BED WHERE AS "D" STATED SPECIFICALLY "SUPINE IN BED, AND ROLLING SIDE TO SIDE IN BED". can someone clarify and let us hear your critical thinking???? BASICALLY, WHAT IS THE TINY DIFFERENT BETWEEN "A" AND "D'?????

I would think that choice A isn't correct bc I would be confused to why he would need to t/f back to the w/c to do UE dressing. But that was my reasoning. But then again choice D- rolling side to side when supine seems like it would take a lot of effort also. Not sure.

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Krystina01 in Orland Park, Illinois

41 months ago

OTR2013 in Texas said: An OTR working in a skilled nursing facility is beginning an initial patient interview. After providing the patient with a brief introduction to OT service the patient refused to participate in an evaluation stating “This is childish, I’m here to get stronger. There is an entire staff that can help me get dressed”. What action should the OTR take based o the response.
a. Provide further discussion about how OT will help improve daily living skills.
b. Assure the patient that strengthening exercises will be included in the intervention*.
c. Respect the patients wishes and document the refusal in the medical record.
d. Advise the patient that an assessment is mandated by the insurance company.

*HEY SULL IN MASSACHUSETTS--->difficult time understanding why "C" would be a choice too? I too, went w/ "B" b/c the pt. is upset and wants to get stronger. so shouldn't we acknowledge the pt's goal by being client-centered and letting him know that strengthening exercises will be incorporated in the intervention, therefore, it would help ease the pt is possibly participating in the eval? there has been answer where I would choose "C" and document the refusal, but in this question, pt complained about wanting to get stronger so that word STUCK in my head.
btw, WHEN do we specifically respect pt wishes, and document refusal in med records? is there something in tromly that mentions it?

I think for this question its in the 1st domain- evaluating and collecting information about the pt, and the question with the strengthening has to do with intervention.

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Krystina01 in Orland Park, Illinois

41 months ago

Irish_OT in Tenafly, New Jersey said: was just browsing the forums......

Don't sweat it to the people that failed the test. I used Therapy Ed's prep material and sat for a test prep course. I passed the first try and barely studied - I swear it was all the pointers I got in the prep course. I cannot emphasize enough ---- take a prep course!!! seriously. More than half of those in attendance were people who had failed in previous attempts. Most people pass after they take a prep course.

Yes, it's a financial investment , but so is taking the test multiple times.
Keep trying....You can do it!!
:)

Can you tell me more about the prep course. Do they go through specific ways to read the questions and what to look for in selecting the right answers? Or is it more of a review through the book? thanks.

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sull in Quincy, Massachusetts

41 months ago

Hi OTR 2013 in Texas I see where your coming from with answer B but it doesn't say anything about him wanting to get stronger in the question it states in the question a brief introduction of what OT is and after that the patient decides He doesn't want anything to do with OT and that is why he doesn't want to participate in the OT eval We as clinicians have to respect that and document it It is not our role to for a lack of a better way to say this "shove ideas or examples of how and why OT would be good" as He already got an introduction to that and in the introduction it would already be mentioned why OT would be good for him, and he still refused to participate. We need to respect that decision and by respecting that, that is client centeredness as those are his wishes

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OT-dude in Cypress, Texas

41 months ago

This was on facebook nbcot website. Anybody care to explain the right answer.

OTR Exam Prep: An OTR is evaluating the effectiveness of an OT home program for clients who have been diagnosed with an anxiety disorder. Which qualitative measure would be MOST BENEFICIAL to use as part of this evaluation process?

A. Retrospective record reviews to measure the percentage of clients who attained occupation-based goals
B. Semi-structured interviews in order to gather information from the clients about their current functional level
C. Occupational role checklists administered at the start and then several months after completion of the program
D. Standardized, norm-referenced or criterion-referenced occupation-based assessments

Stop reading here because I'm about to tell you the correct answer if you are trying to figure it out. According to NBCOT, the answer is C. I do not understand why the answer is not B. Is it become it is semi-structured, thus making it more quantitative. What if it was an unstructured interview? Thank you.

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Krystina01 in Orland Park, Illinois

41 months ago

wow I also thought B.

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OTwestcoast

41 months ago

OTdude-

I agree, this is tricky, especially because C is including what to do after eval, and the question asks about eval. In this case, they are not referring to an initial eval- if they said that, then answer B makes more sense. However, C makes sense to me because the question asks about evaluating effectiveness of a program, and being able to perform various roles seems a more holistic/top down and general approach that would address how effective a home program is, rather than assessing the individual's initial function. Despite making it tricky, they include the fact that they will then reassess roles later for a comparison, which would be necessary for evaluating effectiveness of a program.

OT-dude in Cypress, Texas said: This was on facebook nbcot website. Anybody care to explain the right answer.

OTR Exam Prep: An OTR is evaluating the effectiveness of an OT home program for clients who have been diagnosed with an anxiety disorder. Which qualitative measure would be MOST BENEFICIAL to use as part of this evaluation process?

A. Retrospective record reviews to measure the percentage of clients who attained occupation-based goals
B. Semi-structured interviews in order to gather information from the clients about their current functional level
C. Occupational role checklists administered at the start and then several months after completion of the program
D. Standardized, norm-referenced or criterion-referenced occupation-based assessments

Stop reading here because I'm about to tell you the correct answer if you are trying to figure it out. According to NBCOT, the answer is C. I do not understand why the answer is not B. Is it become it is semi-structured, thus making it more quantitative. What if it was an unstructured interview? Thank you.

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OT-dude in Cypress, Texas

41 months ago

OTwestcoast said: OTdude-

I agree, this is tricky, especially because C is including what to do after eval, and the question asks about eval. In this case, they are not referring to an initial eval- if they said that, then answer B makes more sense. However, C makes sense to me because the question asks about evaluating effectiveness of a program, and being able to perform various roles seems a more holistic/top down and general approach that would address how effective a home program is, rather than assessing the individual's initial function. Despite making it tricky, they include the fact that they will then reassess roles later for a comparison, which would be necessary for evaluating effectiveness of a program.

What's confusing me is the word qualitative. With that in mind, I was thinking interviews are more qualitative than checklists. I see your point with answer C with it being more top-down and holistic approach though.

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OTwestcoast

41 months ago

OT - New Grad in SF, California said: I agree with with answer A for the same reasons. I considered D, but it doesn't make sense to put socks and shoes on while in bed, then put on underpants and trousers by rolling side to side in bed. The obvious problem is the pt will already have his shoes on before he even puts on his pants, right? Also, Pedretti states that undergarments (and pants) should be donned while in bed, then transfer to a w/c to complete UE dressing.

Exactly, go with the obvious. It doesn't make sense to put underwear and pants over shoes. Have you ever tried doing that? Especially while in sidelying or supine? People typically get dressed UE while sitting up, so doing it in the w/c is what the individual would probably prefer to do, and has the capability at this level.

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OT-dude in Cypress, Texas

41 months ago

OT-dude in Cypress, Texas said: What's confusing me is the word qualitative. With that in mind, I was thinking interviews are more qualitative than checklists. I see your point with answer C with it being more top-down and holistic approach though.

But then the word beneficial comes into play, These tricky tricky people!!!!!!

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OTwestcoast

41 months ago

OT-dude in Cypress, Texas said: What's confusing me is the word qualitative. With that in mind, I was thinking interviews are more qualitative than checklists. I see your point with answer C with it being more top-down and holistic approach though.

The Role Checklist is purely qualitative. There are no norms, since everyone's answer differs/is individual, and comparisons of responses are not relevant.

They are looking to evaluate a program- so I think key here is the before and after component included as part of the eval. This probably falls under "business" section, of studying (in Rita's book).

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OTwestcoast

41 months ago

Really glad to read everyone's comments here. I am struggling with therapy Ed (Rita's) practice tests... Happy to hear that passing NBCOT is still possible even if getting less than stellar (haha) scores on those practice questions! I didn't use NBCOT guides or tests, and am wondering how helpful that would be? They are very expensive! I did read through Case-Smith and Trombly.

Does anyone know of a resource good for the official roles OT/ OTA (more detailed than Therapy Ed), or for some of the more ethical-based questions? We all have our own common sense and perception of ethics, and the Code of Ethics to guide in general, but it would be helpful to see NBCOT's official way of approaching practical situations, and since what you see or are advised in fieldwork may not line up with NBCOT's approach. Suggestions?

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OTwestcoast

41 months ago

OTwestcoast said: Really glad to read everyone's comments here. I am struggling with therapy Ed (Rita's) practice tests... Happy to hear that passing NBCOT is still possible even if getting less than stellar (haha) scores on those practice questions! I didn't use NBCOT guides or tests, and am wondering how helpful that would be? They are very expensive! I did read through Case-Smith and Trombly.

Does anyone know of a resource good for the official roles OT/ OTA (more detailed than Therapy Ed), or for some of the more ethical-based questions? We all have our own common sense and perception of ethics, and the Code of Ethics to guide in general, but it would be helpful to see NBCOT's official way of approaching practical situations, and since what you see or are advised in fieldwork may not line up with NBCOT's approach. Suggestions?

I'm going to answer my own question - Willard & Spackman. Still think there should be or wonder if there is another good resource with practical examples.

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sull in Quincy, Massachusetts

41 months ago

The official AOTA web site has the official OT code of ethics and OT/COTA Roles
hope that helps :))

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OT-dude in Cypress, Texas

41 months ago

NYMSOT in Saint Louis, Missouri said: 6. An OTR working in a skilled nursing facility is beginning an initial patient interview. After providing the patient with a brief introduction to OT service the patient refused to participate in an evaluation stating “This is childish, I’m here to get stronger. There is an entire staff that can help me get dressed”. What action should the OTR take based o the response.

a. Provide further discussion about how OT will help improve daily living skills.
b. Assure the patient that strengthening exercises will be included in the intervention*.
c. Respect the patients wishes and document the refusal in the medical record.
d. Advise the patient that an assessment is mandated by the insurance company.

I'll post more questions from NBCOT exam 8 later. Any responses would be great.

So it seems the overall consensus on this answer is either B or C. I'm going to stick with answer B being the best answer. First off, the services will be client-centered due to the patient looking to receive strengthening exercises. If the patient said he does not want therapy services, then you go with answer C. In this scenario, he has yet to actually DECLINE or NOT want services. He just said one aspect of it (self-dressing) is not important for him. Due to that, that's not a reason to completely just discharge him from services.

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OT-dude in Cypress, Texas

41 months ago

NYMSOT in Saint Louis, Missouri said: A client has sustained a TBI 3 months ago and is functioning at level VIII(purposeful appropriate; standby assistance) on the Ranchos los Amigos Scale. The client is participating in a meal preparation task. The client is asked to prepare a vegetable soup using a 5 step printed recipe. The client is able to read the recipe steps aloud but does not act on any of them. When the OTR covers over all but the first step of the recipe, the client follows through with the step. What conclusion can the OTR make about the client based on this observation?

a. Adaptive strategies compensate for attention deficits. *
b. Anchoring techniques improve visual perception.
c. Deficits in executive functioning interfere with performance.
d. Ideational apraxia interferes with task initiation. *

This question was really frustrating me. I believe I picked answer D when I first took this test, which I now believe may be wrong. In therapy-ed, impaired attention "includes difficulty with sustained attention and selective attention in additional to dividing and alternating between two tasks". With that in mind, the client was then able to perform the first step of the 5 step task once the therapist compensated for him by covering the other 4 steps. Therefore, my pick now would be answer A.

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Sahil in Edison, New Jersey

41 months ago

can anyone tell,whether these books sufficient for preps.or not.
Please give me your phone number if you want to discuss with regarding the books. Thanks
Sahil Sethi

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sam115530 COTA exam in Edison, New Jersey

41 months ago

Anybody want to study with me for cota exam please email me at sam115530@yahoo.com

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otgrad2012 in Langhorne, Pennsylvania

41 months ago

Hello,

Happily I just found out that I passed!
Reading these posts have been helpful, but sometimes overwhelming and depressing. I'll try to give my $.02 as to what worked for me

First of all, I used these books

1. NBCOT official study guide - $68 purchased from NBCOT
Although this is a rip-off, it's necessary to see the official questions (150 total) from NBCOT.
2. Rita C-F study guide -$92 purchased directly from TherapyEd or AOTA with membership. Don't buy from amazon, where it's super expensive
3. Johnson's OT Review- Dont know current cost. This one is outdated, before the exam added the clinical sim. section, but it's useful with 800 questions available on CD (if you have Windows).

The Rita book is the main bible, along with your own course notes. The practice exams are ridiculously specific, but if you can handle most of these questions or understand the rationales, you should be fairly well prepared for the real exam. Most people don't really score too well, so I think if you can get above 60% and ultimately get near 70%, then you're in good stead.

The main textbooks:
1. Pedretti (Trombley would be good if you studied with that. it's referenced a lot in the question rationales)
2. Case Smith
3. My course notes from mental health. Dr. Cara (of Cara & McRae) was my professor. Also my notes from neuro rehab. I think the Zoltan book would've been really helpful, as they're are many questions on stroke rehab.

I thought I probably would need ~8 weeks to study. It becomes very draining after week 5 or 6 though. My opinion now is that if you are a very focused self-starter in studying, you can probably prep in 4-5 weeks. But this mean treating it like a full time job, with a steady schedule of 6-8 hours of real studying/ day. If you have some other "life stuff" going on, then I think you need to give yourself the 8 weeks or more. I pretty much had nothing else going on, and I looked over materials 7 days week,

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otgrad2012 in Langhorne, Pennsylvania

41 months ago

cont.-->
but I had a hard time really being super focused, but I probably avg. 6-7 hours of real studying/ day.

Study with whatever worked best for you during your tedious school years. Remember you already got thru many tough classes, so you have all your + study habits. Try to review what's fairly familiar to you, and really study and semi-memorize what was hard for you.
These areas need to be nearly memorized: hand nerve distribution/ injuries- Splints. Spinal nerve levels C1-L4 [emphasis on C tho]. Rancho los amigos levels, Allen Cog. levels. Assist. dev. for specific deficits. Pediatric reflexes and major dev. milestones [esp. dressing, feeding].

I spent the last half of my schedule doing as many exam questions as I could find using Rita and Johnson electronic questions, and the 150 NBCOT paper Qs. These were great because they had timers, and you could create indiv. tests on specific content areas. It's important to get used to testing at the rate of 1 min/ 1 question. And to do 3 Clinical sims/ 30 min. I feel that this exam is challenging for students where English is secondary lang. It's word heavy reading all the context blurbs, and you don't have enough time, so get used to doing the questions on timer.

My best tip for the actual exam day: They allow you scratch paper. I wrote a Q. time schedule. The clock runs backwards from 4:00 (4 hours). I listed 3:30 - after 3 clinical sims. You can break the questions down in groups of 60 afterwards, or whatever works for you. 2:30 after Q. 1-60/ 1:30 after Q. 61-120/ :40 min after Q 121-170. Then you have that bank of time to review and to use on bathroom breaks etc. I can't do math backwards on the fly, so it helped me to always have a reference where I needed to be

OT grad 2012 in Langhorne, Pennsylvania said: Hello,

Happily I just found out that I passed!

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otgrad2012 in Langhorne, Pennsylvania

41 months ago

I am selling my NBCOT official study guide
I will also include the Johnson review and CD (I'm keeping the Rita study guide b/c I believe it'll be useful for future reference to have everything listed in one ref. book)

I am currently in Philly area.
please email me at:
camgirlla@gmail.com
You can email me if you have any specific Qs either.

Good luck and keep pushing forward in your studies. It's super tedious, but something we all just have to get thru and will!

OT grad 2012 in Langhorne, Pennsylvania said: cont.-->
but I had a hard time really being super focused, but I probably avg. 6-7 hours of real studying/ day.

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otgrad2012 in Langhorne, Pennsylvania

41 months ago

OT grad 2012 in Langhorne, Pennsylvania said: I am selling my NBCOT official study guide
I will also include the Johnson review and CD (I'm keeping the Rita study guide b/c I believe it'll be useful for future reference to have everything listed in one ref. book)

Forget to mention that I purposefully did not circle any of the answers or write in the NBCOT guide. It's nearly new condition.
The Johnson book has highlighting.

*In my last week, i gave in & took NBCOT practice exam 8. Yes it's costly, but what I did was take the 4 hr option, and copy/paste the questions so I would have them to study. You only get a score, and you don't know which ones you got wrong, but if I was to pay that much, I wanted to be able to review the Qs. As others have stated, the Rita Qs are much more difficult/ specific and not quite like the actual NBCOT Qs. so you must get the study guide and it's helpful to do their practice exams. But i will say i found the actual exam easier than practice. Practice exam 7 seemed super hard, a lot of quant. stats. While taking exams, it's most important to focus on the Q. rationales, even for the ones you get right; Do not focus too much on your scores, I know it's hard for all you A types out there!

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i like spring in New York, New York

41 months ago

Hi, i just found out that i failed my first attempt, planning to retake in april, does the therapy ed review course help?

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otgrad2012 in Langhorne, Pennsylvania

41 months ago

By chance, is English not your native language? Pak sounds like a Korean surname.
Are you ok timewise on the exam or do you run out? Doing as many practice tests as you've done, and going over all the rationales. I really tried to analyze every NBCOT question as to the scope of what they were asking. You want to try to get patterns on the wording and scope of their questions and learn to read them very carefully.

If you want to directly email me: camgirlla@gmail.com

Pak928 in Philadelphia, Pennsylvania said: Hi, I've taken the exam 3 times and failed. The closest I came to passing was 8 points the second time I took it.

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OT-dude in Cypress, Texas

41 months ago

Has anybody taken Test 7 and fail yet still pass the NBCOT exam? In my opinion, test 7 was very difficult.

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JV in Quezon City, Philippines

41 months ago

Hello,

I'm an OT from the Philippines, and I'll be taking the NBCOT this coming April. Any tips on how to ace the exam?

I took the Castaldy exam, and got 65%, 61%, and 71% respectively. I also took the castle exam Test 7 and got 480 score. According to the Castle report, I need to brush up with Professional Standards as well as OT interventions.

Any pieces of advice would greatly be appreciated. Thank you.

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otgrad2012 in Langhorne, Pennsylvania

41 months ago

Not sure if this was posted a few pages back, this is the top 10 list of textbooks NBCOT uses
[I did NOT want to purchase any more textbooks, BUT my only wish was that I had a splint text with tons of pictures, Pedretti did not have enough of all the various splints]

Fundamentals of Hand Therapy: Clinical Reasoning and Treatment Guidelines for Common
Diagnoses of the Upper Extremity. Cooper C. (2007)

Introduction to Splinting: A Clinical-Reasoning and Problem Solving Approach. (3rd ed.).
Coppard BM, Lohman H. (2007)

*Occupational Therapy for Children (6th ed.). Case-Smith J, O’Brien J. (2009)

The Occupational Therapy Manager (4th ed.). McCormack G, Jaffe EG, Goodman-Lavey M
(eds). (2003)

*Occupational Therapy for Physical Dysfunction (6th ed.). Vining-Radomski, M, Trombly-
Latham C. (2008)

*Pedretti’s Occupational Therapy: Practice Skills for Physical Dysfunction (6th ed.). McHugh-
Pendleton H, Schultz-Krohn W (eds). (2006)

Psychosocial Occupational Therapy: A Clinical Practice (2nd ed.). Cara E, MacRae A. (2005)

Screening Adult Neurologic Populations: A Step-by-Step Instruction Manual (2nd ed.).
Gutman SA, Schonfeld AB. (2009)

Stroke Rehabilitation: A Function-Based Approach (2nd ed.). Gillen G, Burkhardt A. (2004)

Vision, Perception, and Cognition: A Manual for the Evaluation and Treatment of the Adult
with Acquired Brain Injury (4th ed.). Zoltan B. (2007)

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OT-dude in Cypress, Texas

41 months ago

Question from Test 7:

A 3 year old has spastic cerebral palsy. The child's parents are learning techniques to use when dressing the child. How should the parents position the child to MOST EFFECTIVELY to inhibit muscle tone before putting on the child's shoes and socks?

A. Facing upward on the parent's lap with the child's hips and knees in flexion
B. Prone on the floor flexing the child's knee to 90 degree one at a time.
C. Side-lying on the bed with the child's hips and knees fully extended
D. Supine on a firm surface with the child's hips and knees fully extended.

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dharmamom in Los Gatos, California

41 months ago

OT-dude in Cypress, Texas said: Question from Test 7:

A 3 year old has spastic cerebral palsy. The child's parents are learning techniques to use when dressing the child. How should the parents position the child to MOST EFFECTIVELY to inhibit muscle tone before putting on the child's shoes and socks?

A. Facing upward on the parent's lap with the child's hips and knees in flexion
B. Prone on the floor flexing the child's knee to 90 degree one at a time.
C. Side-lying on the bed with the child's hips and knees fully extended
D. Supine on a firm surface with the child's hips and knees fully extended.

Hi OT Dude. I think B is the best answer. This position would provide better postural stability during dressing for parents learning new dressing techniques. Flexion of hips and knees is the best position for breaking up extensor tone to allow for easier dressing. What did NBCOT say it was?

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OT-dude in Cypress, Texas

41 months ago

dharmamom in Los Gatos, California said: Hi OT Dude. I think B is the best answer. This position would provide better postural stability during dressing for parents learning new dressing techniques. Flexion of hips and knees is the best position for breaking up extensor tone to allow for easier dressing. What did NBCOT say it was?

Unfortunately, they don't provide the correct answers to these exams.

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dharmamom in Los Gatos, California

41 months ago

OT-dude in Cypress, Texas said: Unfortunately, they don't provide the correct answers to these exams.

Good to know. So what do you think the correct answer is?

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OT-dude in Cypress, Texas

41 months ago

dharmamom in Los Gatos, California said: Good to know. So what do you think the correct answer is?

I picked answer B also for your same reasoning, but I'm just not certain on it. To me, it just seems like an awkward position to put shoes on somebody.

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OT-dude in Cypress, Texas

41 months ago

An OTR fabricated a forearm-based thermoplastic thumb spica splint for an outpatient one week ago. On a follow-up visit, the OTR removes the splint and notes small, red, elevated, inflamed papules on the client’s forearm. What INITIAL action should the OTR take in response to these findings?
A. Change the splint to a prefabricated splint
B. Discontinue the use of the splint and contact client’s referring physician
C. Line the splint with a 1/16 inch (1.5 mm) absorbent padding
D. Modify the splint wear times and educate the client about proper hygiene

I chose B. What are your takes?

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dharmamom in Los Gatos, California

41 months ago

OT-dude in Cypress, Texas said: An OTR fabricated a forearm-based thermoplastic thumb spica splint for an outpatient one week ago. On a follow-up visit, the OTR removes the splint and notes small, red, elevated, inflamed papules on the client’s forearm. What INITIAL action should the OTR take in response to these findings?
A. Change the splint to a prefabricated splint
B. Discontinue the use of the splint and contact client’s referring physician
C. Line the splint with a 1/16 inch (1.5 mm) absorbent padding
D. Modify the splint wear times and educate the client about proper hygiene

I chose B. What are your takes?

That is a tricky one. It really depends on why the client is wearing a spica splint. Sometimes spica splints are worn post operatively after repair of a thumb tendon/ligament or a joint repair. If this was the case you wouldn't want to discontinue the splint as it could jeopardize the repair and you would want to consult with the MD before discontinuing the splint. The red papules could be due to heat rash or an allergic reaction, but probably not an infection.

I think C is the best answer. I would also reevaluate within a few days and instruct the person to call right away if the rash seems to be getting worse.

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OTR2013 in Texas

41 months ago

OT-dude in Cypress, Texas said: Question from Test 7:

A 3 year old has spastic cerebral palsy. The child's parents are learning techniques to use when dressing the child. How should the parents position the child to MOST EFFECTIVELY to inhibit muscle tone before putting on the child's shoes and socks?

A. Facing upward on the parent's lap with the child's hips and knees in flexion
B. Prone on the floor flexing the child's knee to 90 degree one at a time.
C. Side-lying on the bed with the child's hips and knees fully extended
D. Supine on a firm surface with the child's hips and knees fully extended.

I picked "A--face upward on lap w/ child's hips/knees in flexion" read page 503 in Case Smith (6th ed). I don't see how "B" putting him in Prone, on his tummy, can help ease of putting on sock and shoes even if you flexed knee in 90 degree? explain.

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OTR2013 in Texas

41 months ago

OT-dude in Cypress, Texas said: An OTR fabricated a forearm-based thermoplastic thumb spica splint for an outpatient one week ago. On a follow-up visit, the OTR removes the splint and notes small, red, elevated, inflamed papules on the client’s forearm. What INITIAL action should the OTR take in response to these findings?
A. Change the splint to a prefabricated splint
B. Discontinue the use of the splint and contact client’s referring physician
C. Line the splint with a 1/16 inch (1.5 mm) absorbent padding
D. Modify the splint wear times and educate the client about proper hygiene

I chose B. What are your takes?

I picked "B" b/c it is not in our scope of practice to know what these small red elevated inflamed papules are suppose to be. it's the doctor's area to assess it. due to the fact that the OT made the splint 1 week ago, came back and something happen to the pt's forearm, the doctor should be notified, INITIALLY.

and isn't "C" mainly for a pt. who is sweating at night time wearing a splint?? that's when you would put the lining inside the splint for absorbent? I can't remember exactly where I read it, but that's what jumped to my mind when I read answer "C" correct me if that's completely wrong.

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dharmamom in Los Gatos, California

41 months ago

OTR2013 in Texas said: I picked "A--face upward on lap w/ child's hips/knees in flexion" read page 503 in Case Smith (6th ed). I don't see how "B" putting him in Prone, on his tummy, can help ease of putting on sock and shoes even if you flexed knee in 90 degree? explain.

Uh oh! Maybe I should take a study break. Got prone & supine mixed up:0 Hope I don't do that on the test. Both hip and knee should be flexed to break up extendor tone. (If knees are flexed in supine so are hips)
Think you & OT-dude are right, A is the best answer.

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dharmamom in Los Gatos, California

41 months ago

OTR2013 in Texas said: I picked "B" b/c it is not in our scope of practice to know what these small red elevated inflamed papules are suppose to be. it's the doctor's area to assess it. due to the fact that the OT made the splint 1 week ago, came back and something happen to the pt's forearm, the doctor should be notified, INITIALLY.

and isn't "C" mainly for a pt. who is sweating at night time wearing a splint?? that's when you would put the lining inside the splint for absorbent? I can't remember exactly where I read it, but that's what jumped to my mind when I read answer "C" correct me if that's completely wrong.

My first impulse was the same - it's not OTs role to diagnose skin conditions. But then again you wouldn't want to DC a post op spica splint without consulting the referring MD. We are supposed to recognize & respond appropriately to decubitus ulcers how are the papules different? Heat rash is caused from excess heat & the resulting sweat. Seems like addressing this would also be in the OT scope of practice. Too bad you don't have the official answer to this one.

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BTOT in Fort Lauderdale, Florida

41 months ago

Mon108OT in Galveston, Texas said: I am selling the following books:
OT Examination Review by Caryn Johnson
NBCOT OTR Official Study Guide
Therapy Ed's NBCOT Review and Study Guide + Course Manual
The NBCOT Official study guide and Therapy ED books have little to no writing in them. The Johnson book has heavy writing throughout but has the CD Rom with practice exams.
I am dying to get rid of these books and I'm offering a great price for them. Please contact moloving @aol.com if you are interested put NBCOT Stuff in the subject line. Thanks!!

HI, are you still selling the OT Examination Review by Caryn Johnson and
NBCOT OTR Official Study Guide? If so, how much for each? You can also reach me at btot149@gmail.com

Thanks!

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