NBCOT Standards of Practice Questions and Answers
An extremely agitated adult is admitted to an inpatient psychiatric hospital late on a Friday afternoon. Because nursing is short staffed, the nurse on the unit requests that the patient attend an occupational therapy group being led by a COTA® ...
NBCOT Standards of Practice Questions
and Answers
An extremely agitated adult is admitted to an inpatient psychiatric hospital late on a
Friday afternoon. Because nursing is short staffed, the nurse on the unit requests that
the patient attend an occupational therapy group being led by a COTA® that evening.
The COTA® calls the OTR®, who is working at a location far from the unit, for guidance.
The OTR® is unable to return to the unit in time to evaluate the client before the
session. What is the BEST course of action the OTR® would direct the COTA® to take?
- answer Do not allow the patient to attend the group
The COTA®is not permitted to initiate treatment of a client; the OTR® must do the initial
assessment of the client. Allowing the patient to attend a group session would be an
ethics violation and liability risk.
**Allowing the patient to attend the group would not be permitted under the guidelines
for COTA®supervision, which require that an OTR® complete an initial assessment
before the client participates in treatment, including attending a group session. The
OTR® must perform the initial assessment; directing the COTA® to initiate the
assessment violates supervision standards. Allowing the patient to attend the group and
completing the assessment afterward is not be permissible under the guidelines for
COTA® supervision.**
Which of the following actions demonstrates the use of standard precautions during an
ADL session? - answer Washing hands at the start of the session
Hands should be washed at the start of sessions as well as immediately after. They also
should be washed any other times hand washing is indicated, such as when hands are
visibly soiled or when removing gloves.
**Needles should never be recapped, because doing so puts the practitioner at risk for
having a needlestick injury from the used needle. Dirty clothing does not need to be
placed in a biohazard bag; only infectious waste needs to be placed in biohazard bags.
Mops should not be used to clean urine or other body fluids from the floor. Body fluid
spills should be cleaned with disposable products, such as paper towels or other
approved materials.**
A client with hip osteoarthritis has been referred for an occupational therapy
assessment and treatment. What can a COTA® contribute to the assessment and
treatment process? - answer Select and implement therapeutic activities.
COTA®s can select and implement therapeutic activities that meet client goals.
, **OTR®s are responsible for all aspects of occupational service. They decide whether a
client is appropriate for services and what should be evaluated, and they interpret the
results of outcomes to determine whether clients are progressing. COTA®s may assist
with these activities.**
An entry-level COTA® begins working at a long-term care facility and needs direct
continuous supervision. Which statement BEST describes this type of supervision? -
answer The COTA and the supervising OTR® are in the rehabilitation gym, and the
OTR observes the COTA's performance.
Direct supervision offers the OTR firsthand information on the COTA's performance as a
result of in-person observation. Continuous supervision means the COTA is in sight of
the supervising OTR.
In an outpatient setting, a COTA® is setting up electrical stimulation on a client with a
significant cardiac history, including a pacemaker. The OTR® observes the COTA®
perform the client set up. What action should the OTR® take? - answer Stop the
COTA® from proceeding, check the evaluation and treatment plan and, if needed,
review physical agent modalities and appropriate use.
A pacemaker is a contraindication for using electrical stimulation. Thus, this treatment is
inappropriate and should be stopped immediately. Perhaps the COTA® misread the
evaluation and treatment plan or did not have the appropriate understanding of physical
agent modalities; therefore, supervision around this area should occur.
A COTA® in an acute rehabilitation facility has been working with a client for four
consecutive sessions. The COTA® learns that the client has two cats at home for which
the client is the sole caregiver. Which option BEST describes the COTA®'s role in
making pet care a goal? - answer The COTA® can discuss this possible IADL goal
with the OTR® to determine its appropriateness and how to address it as an
intervention.
Ultimately, the OTR® is responsible for creating the intervention plan, but the OTR®
and COTA® partner with the client to develop this plan. After the evaluation is
completed, new information may arise, such as learning that a client is responsible for
pet care at home. The COTA® has valuable client-centered information that can help to
adjust the intervention plan in a meaningful way.
**The COTA® must first collaborate with the OTR; moreover, goals must be added to
progress notes or recertification notes, not to daily treatment notes. The notion that a
COTA® cannot add a goal once the evaluation has been completed is not accurate
because new information about clients often emerges once rapport is developed.**
Under what circumstances is a COTA® allowed to administer the Kohlman Evaluation
of Living Skills to a new patient in an inpatient acute psychiatric hospital? - answer
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