TEST BANK for Occupational Therapy in Mental Health 2nd Edition by Catana Brown, Virginia C Stoffel, by ACADEMIAMILL

TEST BANK

Occupational Therapy in Mental Health 2nd Edition Brown Test Bank Chapter 1: Recovery Multiple Choice

1. Which of the following best describes recovery? a. Recovery is a personal, holistic process. b. Recovery defines a sense of purpose focused on the limitations of the disability. c. Recovery means being disease-free. d. Recovery is a process where individuals learn to rely on others to achieve their goals. ANS: a Topic: Definitions of Recovery LO: 1.1

2. A client with schizophrenia is working with her occupational therapist on achieving her goal of returning to work. During your last session, she told you that for the first time she was feeling motivated to return to work and was beginning to see a brighter future. Which of the 10 Guiding Principles of Recovery does this best represent? a. Respect b. Strengths and responsibilities c. Hope d. Person-driven ANS: c Topic: Principles of Recovery LO: 1.1

3. During an inpatient group, the occupational therapy group members are asked to identify social supports, including family, friends, community members, and so on, who they find supportive and offer hope and encouragement. Which principle of recovery does this represent? a. Respect b. Relational c. Peer support d. Hope ANS: b Topic: Principles of Recovery LO: 1.1

4. The Substance Abuse and Mental Health Services Administration identifies four dimensions of recovery: health, home, purpose, and community. The ability to engage in meaningful daily activities is an example of . a. Health b. Home

c. Purpose d. Community ANS: c Topic: Dimensions of Recovery LO: 1.2

5. A client with depression has come to the local community center to learn more about health and wellness. Which of the following best describes health, as defined by the Substance Abuse and Mental Health Services Administration? a. Managing one’s disorder(s) and making healthy choices that support physical and emotional wellbeing b. Focusing on the physical aspects of one’s well-being c. Fulfillment of one’s potential through meaningful activities d. Full engagement in one’s community ANS: a Topic: Dimensions of Recovery LO: 1.2

6. Which of the following most accurately defines how an occupational therapist can support someone in recovery? a. The occupational therapist should set goals for the individual based on the individual’s deficit areas. b. The occupational therapist should encourage the individual to maintain medication compliance. c. The occupational therapist should focus on improving client factors. d. The occupational therapist should assess areas of occupation the individual wants to engage in and complete an analysis of occupational performance to identify skills and abilities that support or impede engagement. ANS: d Topic: Dimensions of Recovery LO: 1.1 & 1.2

7. Recovery has not only changed people’s lives but it has changed policy as well. Which of the following U.S. policies has been cited as moving the health system toward a more integrated, holistic model of care addressing physical and behavioral health needs? a. Recovery-to-Practice Act b. Affordable Care Act c. Excellence in Mental Health Act d. Return to Work Act ANS: b Topic: Recovery as a Change Agent LO: 1.4

Chapter 2: The Unfolding History of Occupational Therapy in Mental Health

Multiple Choice

1. A humanistic treatment approach had a major impact on the formation of occupational therapy and is still an important aspect of occupational therapy’s philosophy. Which 19th century theory can this approach be attributed to? a. Moral Treatment b. Arts and Crafts Movement c. Mental Hygiene Movement d. Reductionistic Movement ANS: a Topic: History of Occupational Therapy LO: 2.1

2. Which of the following models was initiated in response to industrialization of society and can be described as “reestablishing harmony between environment, occupation and the person”? a. Moral Treatment b. Arts and Crafts Movement c. Mental Hygiene Movement d. Reductionistic Movement ANS: b Topic: History of Occupational Therapy LO: 2.1

3. Which occupational therapy founder was most closely associated with the development of performance-based tests? a. William Rush Dunton, Jr. b. Eleanor Clarke Slagle c. Susan Tracy d. George Barton ANS: c Topic: Founding of Occupational Therapy LO: 2.2

4. Which occupational therapy founder was most closely associated with habit training? a. William Rush Dunton, Jr. b. Eleanor Clarke Slagle c. Susan Tracy d. George Barton ANS: b Topic: Founding of Occupational Therapy LO: 2.2

5. Habit training can best be described as . a. A well-balanced daily routine that contributes to health and wellness b. A program that encourages highly structured, monotonous daily routines c. A program that requires equal time in each area of work, leisure, and self-care d. A program that teaches specific behavior patterns for completion of activities of daily living ANS: a Topic: Founding of Occupational Therapy LO: 2.2

6. Habit training is still seenTinEoScTcuBpAaN tioKnS alEtL heLraEpR y .pC raO ctM ice today. Which domain of the American Occupational Therapy Association Practice Framework best reflects this concept? a. Areas of occupation b. Performance skills c. Performance patterns d. Client factors ANS: c Topic: Founding of Occupational Therapy LO: 2.3

7. A 10-year-old with anxiety disorder is experiencing difficulty at school. As the occupational therapist at that school, which of the following best describes your role related to this child? a. Promote inclusion and increased understanding of mental health issues in the classroom, at recess, and before and after school activities b. Work on handwriting skills c. Facilitate the development of a productive daily routine d. Engage the child in sensory integration activities ANS: a Topic: Mental Health Settings Where Occupational Therapists Practice LO: 2.4

Chapter 3: Person-Environment-Occupation Model

Multiple Choice

a. b. c. d.

The Person-Environment-Occupation (PEO) model was developed based on the work of other prominent theorists. Environmental press is one of the model’s concepts. Which of the following best describes environmental press? The individual is able to mold or “press” the environment into a structure that is beneficial to him or her. Press is considered to be the supportive aspect of the environment. Press is defined as aspects of the environment that constrain occupational performance. Press consists of aspects of the environment, coupled with the needs of an individual that evoke a specific response.

ANS: d Topic: Development of the PEO Model LO: 3.1

2. a.

Which of the following best describes the Person-Environment-Occupation (PEO) model? It is a transactive model that states a change in one part of the model affects other parts of the model, influencing occupatiT onEaS l pTerBfoArm ceE . LLER.COM NaKnS b. It is a model that focuses on the specific parts of an individual and occupational performance. c. It is a model that describes a relationship between the person, environment, and occupation that is static over time. d. It is a model framed in the concepts of occupational identity, competence, and adaptation. ANS: a Topic: Description of the PEO Model LO: 3.2

The Person-Environment-Occupation (PEO) model describes the person as being composed of spirituality, social and cultural experiences, and observable occupational performance components. Which of these is considered to be at the core of all PEO interactions? Spirituality Social experiences Cultural experiences Observable performance components

a. b. c. d. ANS: a Topic: Description of the model LO: 3.3

According to the Person-Environment-Occupation (PEO) model, the environment is “the context within which occupational performance takes place” and is composed of four environmental elements. Which of the following is an environmental element according to this model? Spiritual Temporal Institutional Virtual

a. b. c. d. ANS: c Topic: Description of the Model LO: 3.3

Which of the following most accurately reflects occupational performance as described by the Person-Environment-Occupation (PEO) model? It is the result of the interaction between volition, habituation, and performance skills. It is the result of the dynamic interaction between the person, environment, and occupation. It is mastery of a task caused by the interaction between volition, habituation, and performance

a. b. c. skills. d. It is mastery of a task caused by the interaction between the person, environment, and occupation. ANS: b Topic: Description of the Model LO: 3.3

Occupational performance is impacted by the congruence between the person, environment, and occupation (PEO). This congruence can best be described as . PEO adaptation PEO fit PEO flow PEO press

a. b. c. d. ANS: b Topic Occupational Performance LO: 3.5

a. b. c. d. ANS: a

You are working with an individual who is 65 years old who started experiencing depression following his retirement. During your initial interview this gentleman tells you about his interest in fishing. He says he loves it and did it often as a child and teenager but had less time to do it while he was working full-time as an accountant. He says the one thing he is looking forward to in retirement is returning to this activity. When you ask what he enjoyed about it he says it was a great way to spend time with his father and now he is looking forward to spending time fishing with his son and grandchildren. This is an example of how impacts occupational performance. Dimension of time Dimension of space Occupational fit Occupational adaptation

Topic: Occupational Performance LO: 3.5 & 3.8

This same gentleman talks about running as his way of getting exercise. He indicates he enjoys running but has been having difficulty with this activity because of arthritic knees. He used to be able to run 5 miles but is now lucky to be able to run one-half mile before he starts to experience pain. This situation is an example of a misfit between . Person and environment Person and occupation Environment and occupation Environment and occupational performance

a. b. c. d. ANS: b Topic: Analyzing Occupational Performance LO: 3.5 & 3.8

A woman in your mental health clinic was telling you about her love for gardening but is unable to engage in this activity at home because she is in an apartment with no balcony. She said she was appreciative that the clinic has a greenhouse and different horticulture classes that allow her to participate in this interest. This is an example of congruence between . Person and environment Person and occupation Environment and occupation Environment and occupational performance

a. b. c. d. ANS: d Topic: Analyzing Occupational Performance LO: 3.8

Chapter 4: Person-Centered Evaluation

Multiple Choice

1. As an occupational therapy practitioner, it is important to gain an understanding of your client as an occupational being before working with that client to develop an intervention plan. Which of the following is the best way to obtain this perspective? a. Review the medical records b. Talk to other members of the interprofessional team c. Complete an evaluation d. Identify the key outcomes you want your client to attain ANS: c Topic: Purpose of Evaluation LO: 4.1

2. As a school-based practitioner, you are working with a 10-year-old boy who has been sharing how he loves school. When he is not there, he is responsible for helping his mom clean-up around the house. He also enjoys computer games and spends a lot of time doing that on the weekends. He states he lives at home with his parents and two siblings, noting he has a good relationship with his family and they all seem to get along. When asked wThE at S heTw ts K toSdE oL wL heEnRh. e gCrO ow BaAnN Ms up, he responds he wants to be a firefighter and begins to tell you about his plans to make his dream come true. According to the Occupational Therapy Practice Framework (OTPF), this scenario is an example of an . a. Analysis of occupational performance b. Occupational profile c. Occupational therapy referral d. Occupational therapy outcome ANS: b Topic: Purpose of Evaluation LO: 4.1

3. After getting a general overview of this boy, you want to use a variety of assessment tools to gain a better understanding of him as an occupational being. According to the Occupational Therapy Practice Framework (OTPF), what is the next step of the evaluation process? a. Analysis of occupational performance b. Occupational profile c. Occupational therapy referral d. Occupational therapy outcomes ANS: a Topic: Purpose of Evaluation LO: 4.1

4. Which of the following is the most important consideration when choosing an assessment for the evaluation process? a. Assure it measures a multitude of constructs b. Ensure it summarizes an occupational history c. Considerations of rapport building d. Consideration of its validity and reliability ANS: d Topic: Purpose of Evaluation LO: 4.3

5. You have identified a plan to complete the evaluation process with your 10-year-old client, but have run up against a few factors that are influencing the process, such as not having enough time to administer your assessment of choice, not being familiar with the assessment a colleague recommended, your client’s priorities being somewhat different than yours, and so on. This has caused you to rethink how you will complete the evaluation and can best be explained by the reality that the evaluation process is . a. Not a linear process b. Highly predictive c. Practitioner-centered d. Client-centered ANS: a Topic: Evaluation as a Process LO: 4.2

6. Which of the following best describes why you should use a practice model during the evaluation process? a. It provides a holistic lens to guide the process and ensure all areas impacting occupational performance have been addressed. b. It provides a valid and reliable method to guide the process. c. It provides a comprehensive look at specific performance skills. d. It provides a way to translate the International Classification of Functioning, Disability and Health to your clients and their families. ANS: a Topic: Using Practice Models LO: 4.5

7. You are evaluating an older adult with dementia who has demonstrated difficulty with communication and self-awareness. Based on this information, what type of assessment tool would be best to use with this client? a. Interview b. Self-report c. Performance-based d. Projective ANS: c Topic: Assessment Methods

LO: 4.6

8. You are working with a young adult in a partial hospital program. You are completing the evaluation process and decide you want to administer a tool that allows the client to share data about his perspective regarding his occupational performance. You decide to administer the Role Checklist to learn more about the client’s perceptions of past, present, and future roles. This represents which of the following assessment methods? a. Interview b. Self-report c. Performance-based d. Projective ANS: b Topic: Assessment Methods LO: 4.6

Chapter 5: Evidence-Based Practice in Mental Health

Multiple Choice

1. As an occupational therapy practitioner, you want a practice grounded in evidence. Which of the following best describes evidence-based practice? a. The judicious use of current best evidence to make decisions regarding your individual clients b. The use of the same well-researched practice guidelines for all your patients c. A practice solely based on outcomes of research studies d. A practice that only applies to occupational therapists, not occupational therapy assistants ANS: a Topic: What Is Evidence-Based Practice? LO: 5.1

2. As a new practitioner, you are committed to engaging in evidence-based practice. In reviewing the literature, you come across the five-step process, or the cycle of evidence-based TiEthStT EoRr. Mith your clients, you identify and practice that can help guide you w hiB sA taN skK. S WEhL enLw kiC ngOw review evidence related to your client’s situation and develop your intervention based on your findings. Which step of this cycle does this best represent? a. Identify the problem b. Identify relevant evidence c. Implement useful findings d. Evaluate outcomes ANS: c Topic: The Process of Using Research in Practice LO: 5.2

3. You are reading a study that is comparing the prevalence and incidence of schizophrenia in urban versus rural areas. Which type of study does this best represent? a. Descriptive research b. Predictive research c. Efficacy research d. Assessment research ANS: a Topic: Types of Research Evidence LO: 5.4

4. You are reading a study that is exploring the relationship between bipolar disorder and socioeconomic status. Which type of study does this best represent? a. Descriptive research b. Predictive research c. Efficacy research d. Assessment research ANS: b Topic: Types of Research Evidence LO: 5.4

5. You are reading a study that is exploring the usefulness of cognitive behavioral therapy on individuals with depression. As you are appraising this study, you are concerned about threats to validity and how they may have impacted the usefulness of the interventions. Which type of study does this best represent? a. Descriptive research b. Predictive research c. Efficacy research d. Assessment research ANS: c Topic: Types of Research EvidenTceESTBANKSELLER.COM LO: 5.4

6. You want to design a study that explores the lived experience of individuals with schizophrenia as it relates to forming new social relationships. Which type of study does this best represent? a. Phenomenological b. Narrative c. Grounded theory d. Descriptive ANS: a Topic: Types of Research Evidence LO: 5.4 & 5.5

7. Based on the data you collect in Question 6, you want to create a new social participation theory. Which type of study does this best represent? a. Phenomenological b. Narrative c. Grounded theory

d. Descriptive ANS: c Topic: Types of Research Evidence LO: 5.4 & 5.5

8. As you are developing your study, you want to make sure the data is trustworthy, an accurate representation of participants’ experience, and free from bias. Therefore, you decide to corroborate your data with those of other researchers to come to a consensus regarding the findings. Which of the four characteristics of trustworthiness does this represent? a. Transferability b. Dependability c. Confirmability d. Credibility ANS: d Topic: Types of Research Evidence LO: 5.5

9. Levels of evidence are one method used to examine the quality of efficacy studies. According to Sacket et al., a study examining the effectiveness of an intervention on one group of individuals without the use of T aE coSnT troBlAgN roKuS pE isLidLeE ntRif. ieC dO asM . a. Level I evidence b. Level II evidence c. Level III evidence d. Level IV evidence ANS: d Topic: Types of Research Evidence LO: 5.6

10. You want to design a study examining the usefulness of Qigong for individuals with depression. You decide to examine and summarize previous randomized controlled trials. This would be considered . a. Level I evidence b. Level II evidence c. Level III evidence d. Level IV evidence ANS: a Topic: Types of Research Evidence LO: 5.6

Chapter 6: Introduction to the Person

Multiple Choice

1. Which of the following best reflects the shared beliefs of occupational therapy and the recovery movement? a. Focus on what matters to someone versus what is the matter with someone b. Focus on steps needed to be perceived as normal c. Focus on the practitioner’s expert knowledge of treatment of mental illness d. Focus on and address someone’s limitations to increase occupational functioning ANS: a Topic: Recovery-Oriented Practice LO: 6.1

2. Which of the following best describes the purpose of the Diagnostic and Statistical Manual of Mental Disorders (DSM)? a. It provides for open and consistent lines of communication between clinicians and researchers. b. It provides a clear description of functional limitations associated with diagnoses. c. It decreases medicalization of problems of daily living. d. It eliminates the need to meeTt E wS ithTtB heApNaK tieSnE t tL oL diE agR no.sC eO hiM m or her. ANS: a Topic: Diagnostic and Statistical Manual of Mental Disorders LO: 6.2

3. Sarah is an individual who works at a local telecommunications company. She has been invited to apply for a supervisory position but her beliefs that she is not good interacting with others is interfering with her following through with the application process. Which of the following performance skills does this best represent? a. Cognition b. Cognitive beliefs c. Sensory processing d. Coping and resilience ANS: b Topic: Identifying Performance Skills LO: 6.4

4. It has been noted that Sarah (from Question 3) has been avoiding her manager who has invited her to apply for the supervisory position. Her manager noted that whenever Sarah is confronted with a difficult situation she becomes withdrawn or changes the subject to something more pleasant. Which of the following performance skills does this best represent? a. Cognition

b. Cognitive beliefs c. Sensory processing d. Coping and resilience ANS: d Topic: Identifying Performance Skills LO: 6.4

5. Tim is a college student who has expressed an interest in playing basketball. He has demonstrated good skills and has been invited to join an intramural basketball team. Despite his performance skills and interests, he still doesn’t participate. Which of the following performance skills does this best represent? a. Time use and habits b. Motivation c. Communication and socialization d. Emotion ANS: b Topic: Identifying Performance Skills LO: 6.4

6. Andre is a high school student who has been diagnosed with anxiety disorder. He is always concerned about his grades and spends most of his time in school and doing homework. When asked about his interests he says he enjoys singing and wants to participate in the school musicals but there is no time because he is always studying. T HE eS saT ysBhA eN wK anStsEhL isLdE aiR ly.scChO edMule to be different but this is the way it has to be in order to succeed in school. Which of the following performance skills does this best represent? a. Time use and habits b. Motivation c. Communication and socialization d. Emotion ANS: a Topic: Identifying Performance Skills LO: 6.4

7. Camilla was recently admitted to the inpatient psychiatric unit because of depression. She recently graduated from college with honors with a degree in accounting but has been unable to find a job. Because of financial constraints she needed to move home with her parents in the suburbs. There are opportunities but not close to her home and she has no way to get to a job because of her lack of transportation. As an occupational therapy practitioner, you are using a holistic approach to evaluate Camilla. Which of the following best describes her barrier to occupational participation? a. Cognition b. Time use and habits c. Coping and resilience d. Environment ANS: d Topic: Recognizing the Individual Nature of Performance Skills LO: 6.5

8. You are working with a new client and want to gather information on her lived experience with mental illness. You informally ask your client to tell you a little bit about herself. In addition, you ask about difficult times in her life, as well as how it has been living with a mental illness. Which approach to gathering narrative information does this best represent? a. Structured interview b. Narrative interview c. Self-assessment d. Creative media ANS: b Topic: Appreciating the Lived Experience LO: 6.6

Chapter 7: Autism

Multiple Choice

Which of the following best reflects the changes that occurred with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition’s (DSM-5’s) description and diagnostic criteria for autism? There is an increased focus on deficits in communication and social interaction deficits. Autism diagnosis must now be made before the age of 2. There is an increased focus on engagement in repetitive patterns of behavior. Asperger’s syndrome has been eliminated.

a. b. c. d. ANS: d Topic: Shifting Conceptualizations LO: 7.2

2. a. b. c.

Which of the following is most accurate regarding the etiology of autism? Researchers have identified a strong heritability of autism with the greatest risk between full siblings. Researchers have identified one genetic cause for autism. Researchers have identifiedT siE mS ilaTriB tiA esNinKbSraEinLfL unEcR tio.nCinOiM ndividuals with autism compared with those without autism. Changes in brain functioning typically begin in early childhood.

d. ANS: a Topic: Etiology LO: 7.3

3. Which of the following is most representative of the course and outcomes of autism? a. Because of recent research, aging in autism is well understood. b. Symptoms of autism are strongly correlated with adaptive functioning. c. Childhood language and intelligence are the strongest predictors of later outcomes. d. Therapeutic intervention has little impact on the course of autism. ANS: c Topic: Prevalence and Course–Course and Outcomes LO: 7.3

4. Which of the following is most reflective of the impact of neurocognitive factors on occupational performance? a. IQ is the best predictor of an individual’s ability to engage in effective daily living skills. b. When working with school-aged children diagnosed with autism, the occupational therapist should work with the child, family, and teachers to increase their understanding of the child’s

c. d.

abilities and recommended task and environmental adaptations to increase occupational functioning. The impact of neurocognitive factors on occupational performance is best assessed through cognitive testing. As individuals with autism age, the gap between their executive functioning and ability to engage in complex daily living tasks often become less apparent.

ANS: b Topic: Impact on Occupational Performance LO: 7.6

5. Sam is a high school student who demonstrates behavioral problems when he is in the crowded school hallway, changing classrooms. As people bump into him and the noise from the others in the hallway gets louder, he becomes angry and often yells. At times he will begin punching those around him. It takes Sam time to calm down and he often misses part of his next class as he works on regulating his emotions. Which of the following best describes what is causing Sam’s behavioral issues? a. Sam is experiencing sensory oversensitivity, which presents when he is in crowded, noisy environments. b. Sam is experiencing executive functioning issues, which present as acting out when he cannot find his way to his next classroom. c. Sam is experiencing social participation issues, which present when he doesn’t socially fit in with his peers. d. Sam is demonstrating behaviors of withdrawal and avoidance, which are common in individuals with autism. ANS: a Topic: Impact on Occupational Performance LO: 7.6

6. You have been working with Sam from Question 5 to establish a coping skills plan to implement when he is changing classes. He has set a goal to successfully transition between classes for 1 day without any angry outbursts. He has set a plan to listen to music to cut down on the hallway noise and he will wait to make the transition until the hallways have started to clear out. He plans to try this out tomorrow and check in with you at the end of the day. Which intervention approach does this best represent? a. Mindfulness meditation b. Social skills training c. Peer-mediated interventions d. Cognitive Orientation to Daily Occupational Performance (CO-OP) ANS: d Topic: Intervention LO: 7.7

7. Another approach to his successful transition from classroom to classroom that you and Sam have discussed is asking one of his classmates to accompany him during the transition periods. Sam would have the opportunity to watch how his classmate handles these transitions and how the classmate interacts with others in the hallway. Which intervention approach does this best represent? a. Mindfulness meditation

b. Social skills training c. Peer-mediated interventions d. Cognitive Orientation to Daily Occupational Performance (CO-OP) ANS: c Topic: Intervention LO: 7.7

8. In addition to intelligence and age, what related feature of autism has the greatest impact on adaptive skills? a. Autism level of severity b. Sensory processing c. Executive function d. Behavioral difficulty ANS: c Topic: Impact on Occupational Performance

9. What has emerged as a significant contributor to delayed diagnosis of autism spectrum disorder among children? a. There are no accurate and reliable diagnostic procedures available to diagnose earlier than 3 years of age. b. Primary health-care providers often provide passive or reassuring responses to concerns initially expressed by parents. c. Parents have difficulty identifying typical compared with atypical behaviors in their toddlers. d. Parents often wait too long, up to 2.7 years, to share developmental concerns with their primary health-care providers. ANS: b Topic: Prevalence and Course

10. What medication has been approved for use with youth with autism spectrum condition? a. Risperidone b. Selective serotonin reuptake inhibitors c. Fenfluramine d. Methylphenidate ANS: a Topic: Medications

Chapter 8: Intellectual Disabilities

Multiple Choice

1. In order for an intellectual disability to be diagnosed, an individual must have an onset of the condition during the developmental period and have both . a. Academic and adaptive functioning deficits b. Communication and intellectual deficits c. Intellectual and adaptive functioning deficits d. Self-care and adaptive functioning deficits ANS: c Topic: DSM-5 Criteria LO: 8.1

2. Adaptive functioning is divided into three skill domains. Activities of daily living, work, safety, and money management represent which of these domains? a. Conceptual skills b. Social skills c. Intellectual skills d. Practical skills ANS: d Topic: DSM-5 Criteria LO: 8.1

3. Severity levels in intellectual disabilities are determined based on a. Adaptive functioning domains b. IQ c. Age of onset d. Level of support required for daily living ANS: a Topic: DSM-5 Criteria–Severity Levels LO: 8.1 & 8.2

4. You are working with a 22-year-old man with an intellectual disability. He has been successful in an office job that consists of structured, repetitive tasks and does not require independent complex problem-solving. He recently moved into his own apartment and has

access to a local social service agency for support with health-care and financial decisions. What level of severity in intellectual disability does this scenario most accurately reflect? a. Mild b. Moderate c. Severe d. Profound ANS: a Topic: DSM-5 Criteria–Severity Levels LO: 8.2

5. A 10-year-old girl on your caseload demonstrates she cannot read and has limited communication skills. You have been told she requires support to complete her activities of daily living and is reliant on others for all forms of problem-solving. What level of severity in intellectual disability does this scenario most accurately reflect? a. Mild b. Moderate c. Severe d. Profound ANS: c Topic: DSM-5 Criteria–Severity Levels LO: 8.2

7. Which of the following is most reflective of an individual with an intellectual disability’s vulnerability to health disparities? a. Health providers are well-trained in addressing health concerns in this population. b. These individuals often have co-existing mental health disorders. c. These individuals experience decreased comorbid health conditions as they age. d. These individuals experience similar life expectancy compared with the general population. ANS: b Topic: Prevalence & Course LO: 8.4

8. It has been proposed that cognition is only one factor that influences ability in individuals with intellectual disability. Therefore, it has been suggested when practitioners are assessing an individual’s ability they should also consider the activity or task, level of participation, available support, and context. This approach can best be described as the . a. Occupational adaptation approach b. Multidimensional human functioning approach c. Combined motor and process approach

d. Reductionistic approach ANS: b Topic: Impact on Occupational Performance–Mental Functions LO: 8.7

9. You are working with a young woman with intellectual disability who is a sophomore in high school and states her long-term goal is to find a job after high school. Which of the following approaches would you recommend to increase the likelihood of securing a job when she graduates? a. Enroll her in a sheltered employment program b. Consider placement to a residential program for support c. Refer her for high school transition planning services d. Enroll in a junior college program to increase work skills ANS: c Topic: Impact on Occupational Performance–Work LO: 8.8

Chapter 9: Attention Deficit-Hyperactivity Disorder

Multiple Choice

1. Maria’s teacher has been concerned about her academic performance because she has difficulty initiating a task, and when she does, she isn’t able to stay focused and complete the task. Maria’s teacher indicates she has not noticed any restlessness or fidgeting. Which subtype of attention deficithyperactivity disorder (ADHD) does this best describe? a. Predominantly inattentive (ADHD-I) b. Predominantly hyperactivity-impulsive (ADHD-HI) c. Combined type (ADHD-C) d. Unipolar type (ADHD-U) ANS: a Topic: DSM-5 Criteria LO: 9.1

2. Pedro has been having difficulty concentrating in class; in addition, he has also been demonstrating difficulty sitting still. He is often in and out of his seat, requiring the teacher to set numerous limits on him throughout the day. Because of this behavior, Pedro has been falling further behind academically and his teacherTisEcS onTcB erA neNdKabSoE utLhL isEaR bi. litC yO toMsucceed in the classroom. Which subtype of attention deficit-hyperactivity disorder (ADHD) does this best describe? a. Predominantly inattentive (ADHD-I) b. Predominantly hyperactivity-impulsive (ADHD-HI) c. Combined type (ADHD-C) d. Unipolar type (ADHD-U) ANS: c Topic: DSM-5 Criteria LO: 9.1

3. As children with attention deficit-hyperactivity disorder (ADHD) transition to adolescence, which behaviors are they most susceptible to because of their desire to be part of a social group? a. Antisocial behaviors and addiction b. Social difficulties c. Disorganization d. Vocational difficulties ANS: a Topic: ADHD Across the Life Span LO: 9.2

4. You are a school-based practitioner who has been seeing George, an 8-year-old, for the past 3 months. George’s teacher notes that he has been having difficulty in the classroom, especially in tasks that

require concentration and multitasking. George has also demonstrated an inability to set a plan to get his work done without the help of his teacher. Which of the following do these behaviors best represent? a. Sensory motor abilities b. Academic functions c. Executive functions d. Daily routines ANS: c Topic: Impact on Occupational Performance LO: 9.4

5. Laura is a 6-year-old whose teacher has been concerned with her classroom behaviors and their potential impact on her academic performance. Laura appears to overreact to unexpected noises and becomes emotional when touched by her classmates, even those she considers to be her friends. She also demonstrates difficulty at recess engaging in activities requiring gross motor actions and in class doing activities that require cutting or manipulating small objects. Which of the following do these behaviors best represent? a. Sensory motor abilities b. Academic functions c. Executive functions d. Daily routines ANS: a Topic: Impact on Occupational Performance LO: 9.4

6. As Laura’s occupational therapy practitioner, you decide you want to focus on her oversensitivity to noise and touch. Which intervention target does this best represent? a. Social play b. Whole school mental health promotion c. Sensory processing needs d. Problem-solving ANS: c Topic: Intervention LO: 9.5

7. Which type of medication is most commonly prescribed for individuals with attention deficithyperactivity disorder (ADHD)? a. Anti-anxiety medications b. Stimulants c. Antidepressants d. Antipsychotics ANS: b Topic: Medication LO: 9.6

8. The diagnosis of attention deficit-hyperactivity disorder (ADHD) is based on the Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria. What is the main source of information the physician, neurologist, psychiatrist, or child development doctor collects in the process of diagnosing ADHD? a. Interview of the child b. Reports of teachers and parents c. Blood tests d. Computerized assessments ANS: b Topic: DSM-5 Criteria Rationale: Although it is important to observe and interview the child as well as use computerized assessments for measuring his attention, the questionnaires on everyday functioning of the child that are completed by both parents and teachers are the primary source of diagnostic information.

Chapter 10: Disruptive, Impulse-Control, and Conduct Disorders

Multiple Choice

1. Jackson is a patient at your clinic. When you meet with him for the occupational therapy evaluation you note that he gets annoyed easily, appears to be vindictive toward the doctor who referred him to the clinic, and he repeatedly refuses to do activities you ask him to do as part of the evaluation. When you try to talk to him about intervention options, he becomes defiant, stating he will not be participating in any of those groups. Following your interaction, you go back to revisit the medical record and find this was not a new pattern of irritability and defiance; it has been evident for the past year. Which diagnosis does this best represent? a. Intermittent explosive disorder b. Oppositional defiant disorder c. Antisocial personality disorder d. Conduct disorder ANS: b Topic: Descriptions of the Conditions LO: 10.1

2. The prevalence of disruptive behavior disorders is most similar between adolescent males and females in which of the following? a. Intermittent explosive disorder b. Oppositional defiant disorder c. Antisocial personality disorder d. Conduct disorder ANS: b Topic: Gender Considerations LO: 10.3

3. Which of the following most accurately reflects antisocial personality disorder? a. It is considered chronic. b. Individuals with conduct disorder typically go on to develop antisocial personality disorder. c. Behaviors tend to worsen with age. d. It is responsive to medication. ANS: a Topic: Course LO: 10.4

4. Individuals with disruptive behavior disorders tend to have difficulty in all areas of occupation. Which of the following best explains these difficulties? a. Under-sensitive sensory systems interfere with the individual’s ability to focus on his or her required tasks.

Behavioral management plans are easy to maintain in multiple environments an individual engages in and withstand the inconsistencies in these environments. There are no medications that have been found to be effective in this population. These individuals have difficulty following rules, which impacts school and work performance.

c. d. ANS: d Topic: Impact on Occupational Performance LO: 10.5

5. Steven is a 24-year-old who was referred to you for vocational counseling. He states he wants to work as a welder and has gotten an apprenticeship but has been having difficulty maintaining his temper. He states that when something unexpected happens he gets angry and on several occasions he has yelled at his supervisor. He has gotten two warnings about his behavior. One more and he will be fired. Which of the following would be the most effective strategy Steven could implement? a. Engage in leisure planning group to identify activities to engage in outside of work to help him relax b. Have Steven tell his boss he needs a consistent and rigid schedule to perform most effectively c. Identify coping skills that Steven could use when he feels his temper beginning to rise d. Engage in social skills training to address how to talk to his coworkers ANS: c Topic: Impact on Occupational Performance LO: 10.5 & 10.6

6. Which of the following statements best explains why occupational therapy practitioners need to be aware of medication(s) their patients are taking? a. It is good to have a holistic picture of your patients. b. Side effects may influence occupational engagement and performance. c. If a child is on medication, he or she does not need occupational therapy. d. Medication is highly effective in treating aggressive behaviors and it will be easier for practitioners to work with medicated patients. ANS: b Topic: Medication LO: 10.8

7. You have been asked to work with a second grader with a conduct disorder. While performing a classroom observation, you would expect to see this student . a. Spend time preoccupied with a single toy b. Cry or complain about classmates c. Tattle on his classmates d. Throw or break toys ANS: d Topic: Description of the Conditions

8. You are working with a middle school student who has been diagnosed with oppositional defiant disorder. Which of the following are you most likely concerned about as he transitions to high school? a. Classroom academic demands b. Interactions with new faculty c. Potential exposure to drugs and alcohol d. His transportation ANS: c Topic: Description of the Conditions

9. The type of medications most commonly associated with the treatment of disruptive behavior disorders are . a. Stimulants such as Ritalin b. Neuroleptics such as Risperdal c. Antianxiety drugs such as Diazepam d. Antiseizure drugs such as Tegretol ANS: b Topic: Medications

Chapter 11: Eating Disorders

Multiple Choice

1. You have been asked to evaluate a 15-year-old girl with a potential eating disorder, which is impacting her school performance. When you meet her you are struck that she appears to be of normal weight. As you are completing your evaluation one theme keeps arising, her extreme fear of becoming fat. As you continue to observe her throughout the day, you notice that although she is eating her meals, she disappears shortly thereafter. Staff is concerned that she is purging and you overheard her friends talking about potential laxative abuse. Which eating disorder does this information best represent? a. Anorexia nervosa b. Bulimia nervosa c. Binge eating disorder d. Binging/Purging eating disorder ANS: b Topic: Description of Eating Disorders LO: 11.1

2. Which of the following is the most accurate statement regarding the prevalence and course of eating disorders? a. It is the least prevalent psychiatric condition of young women. b. Bulimia tends to be a chronic health condition. c. Binge eating disorders tend to be more common in younger people compared with other eating disorders. d. Individuals with anorexia have a life span 25 years shorter than the general population. ANS: d Topic: Prevalence and Course LO: 11.2

3. Your colleague asked to consult with you on a new referral he just received. He describes the 13year-old girl as an introvert, very cautious, with a strong drive for perfectionism and need for external validation. Which eating disorder do these personality characteristics best describe? a. Anorexia nervosa b. Bulimia nervosa c. Binge eating disorder d. Binging/Purging eating disorder ANS: a Topic: Predisposing Factors LO: 11.3

4. Which family characteristic is most closely associated with an individual’s sensitivity to develop an eating disorder? a. Rigidity b. Undervaluing of appearance and thinness c. Increased autonomy d. Eating habits organized around overeating ANS: a Topic: Predisposing Factors LO: 11.3

5. According to evidence, which of the following is more reflective of a male’s experience with eating disorders? a. Males experience anorexia more often than bulimia. b. Males interested in diving and swimming are more at risk of developing an eating disorder compared with females. c. Compared with females, males tend to use compulsive exercise to control weight more than purging. d. Male jockeys are less likely to develop an eating disorder compared with female jockeys. ANS: c Topic: Sex Differences LO: 11.4 6. You have been asked to worTkE wS itT h aB1A6N -yK eaSr-EoL ldL mEalR e. wC hoOiM s on the wrestling team. You begin your evaluation by asking him about his interests and how he spends his time. He responds that he doesn’t do a lot because he’s not very good at anything. He states that because he’s not good at things he doesn’t have many friends; he doesn’t think others would want anything to do with someone who can’t do anything but wrestle, and that he actually isn’t very good at wrestling, either. Which of the five key cognitive concepts that impact volition does this best represent? a. Mood intolerance b. Core low self-esteem c. Perfectionism d. Interpersonal problems ANS: b Topic: Impact of Eating Disorders on Occupational Participation LO: 11.5

7. Which of the following best demonstrates the use of dialectical behavioral therapy with an eating disorder population? a. Focus on reduced engagement in unhealthy routines and adoption of healthy routines b. Identification of spiritual support to assist with distress tolerance around eating and meal preparation c. Utilization of mindfulness to assist with emotion regulation and distress tolerance around eating and meal preparation d. Focus on the development of health relationships and supports to assist with distress tolerance around eating and meal preparation ANS: c Topic: Interventions

LO: 11.7

Chapter 12: Personality Disorders

Multiple Choice

1. Which of the following is a characteristic associated with personality disorders? a. Feelings of distress an individual is causing others b. Overly flexible c. Inability to sustain meaningful relationships d. Increased concern about pleasing others ANS: c Topic: Personality Disorders LO: 12.2

2. When working with Adrian, you notice his behavior is a little eccentric. He demonstrates difficulty trusting you and engaging in your recommended intervention. Whenever you make a recommendation, he questions the recommendation and is resistant to engaging. Which of the following best describes Adrian’s situation? a. Paranoid personality disorder b. Avoidant personality disorder c. Borderline personality disorder d. Schizotypal personality T diE soSrdTeB r ANKSELLER.COM ANS: a Topic: Specific Personality Disorders LO: 12.3

3. You are working with Pat on developing interpersonal relationships. During your sessions she demonstrates dramatic and erratic responses to past interpersonal relationships. When you attempt to discuss what happened in these past relationships she becomes intensely emotional about situations that you perceive to be out of proportion to the situation. As her emotions escalate she has difficulty calming down and enters into extreme black and white thinking. In addition, Pat often has difficulty at the end of your sessions, fearful that you are abandoning her and won’t be here when she returns for her next appointment. Which of the following personality disorders best reflects Pat’s situation? a. Paranoid personality disorder b. Avoidant personality disorder c. Borderline personality disorder d. Schizotypal personality disorder ANS: c Topic: Specific Personality Disorders LO: 12.3

Which of the following is associated with the development of personality disorders?

a. Research has identified specific genes related to personality disorders. b. Neuroimaging suggests no biological vulnerability toward these disorders. c. Temperament is a protective factor against the development of personality disorders. d. The baby/parent “fit” is crucial in the development of adaptive personalities. ANS: d Topic: Etiology LO: 12.4

5. Individuals diagnosed with personality disorders tend to experience minimal pleasure in life and demonstrate extreme and persistent responses to everyday situations, interfering with occupational functioning. Which of the four core areas associated with the inner experience and behaviors of personality disorders does this represent? a. Cognition b. Affectivity c. Impulse control d. Interpersonal problems ANS: b Topic: Impact on Occupational Performance LO: 12.7

6. Individuals with personality disorders have difficulty engaging in meaningful roles and activities because of distortions T inEthSeTwBayAtN heKySinEteLrpLreEt R ev.eC ryO daMy situations. Which of the four core areas associated with the inner experience and behaviors of personality disorders does this represent? a. Cognition b. Affectivity c. Impulse control d. Interpersonal problems ANS: a Topic: Impact on Occupational Performance LO: 12.7

7. As an occupational therapy practitioner, you decide to use an intervention that encourages the client to focus awareness nonjudgmentally on the present. Which approach does this best represent? a. Cognitive behavioral therapy b. Dialectical behavior therapy c. Anger management d. Mindfulness meditation ANS: d Topic: Role of occupational therapy LO: 12.8

Chapter 13: Mood Disorders

Multiple Choice

1. Jenny has been experiencing loss of interest in daily activities, increased sleep, and disruption in work and in her relationships with her friends. This has been occurring for the past month. This also occurred several years ago. Jenny reports that this time she feels that the symptoms are worse than the first time. She has never reported any manic or hypomanic symptoms. Which disorder does this best represent? a. Major depression b. Persistent depressive disorder c. Bipolar II disorder d. Hypomania ANS: a Topic: DSM-5 Criteria LO: 13.1 & 13.2

2. LaDonna’s family has brought her into your clinic because of her irritability, rapid speech, and engagement in dangerous and risky behaviors. They have noticed the behaviors for the past week. They are concernT edEbSeT caB usA eN thK isSisEdL ifL feE reR nt.thCaO nM what LaDonna has experienced in the past. During the past several years, she has experienced several episodes of depression and they aren’t sure what is happening now. Which disorder does this best represent? a. Major depression b. Hypomania c. Bipolar I disorder d. Bipolar II disorder ANS: c Topic: DSM-5 Criteria LO: 13.1 & 13.2

3. Which of the following is most reflective of the etiology of mood disorders? a. Having a father with major depression b. Decreased secretion of cortisol c. Early exposure to adverse events resulting in negative attitudes and biases about the self and the world d. Well-regulated circadian rhythms ANS: c Topic: Etiology LO: 13.3

Which of the following best describes the prevalence and course of mood disorders?

a. Depression occurs more frequently in men. b. One in five Americans will experience depression during their lifetime. c. Mood disorders are associated with higher socioeconomic status. d. Symptoms of bipolar disorder typically occur after the age of 25. ANS: b Topic: Prevalence and Course & Gender/Culture Specific Information LO: 13.4 & 13.5

5. Which of the following is the most accurate statement regarding suicide? a. Decreased access to mental health care is a risk factor for suicide. b. Suicide has been linked to lower socioeconomic countries. c. Suicide is the second leading cause of death among 60- to 75-year-olds. d. Alcohol use is a protective factor for suicide. ANS: a Topic: Prevalence and Course LO: 13.4

6. Which of the following areas of occupation are most significantly impacted in adults with major depression? a. Sleep b. Social participation c. Activities of daily living d. Work ANS: d Topic: Impact on Occupational Performance LO: 13.6

7. Which of the following is a consequence of decreased sleep in individuals with bipolar disorder that may impact occupational performance? a. Decreased self-esteem b. Cognitive decline c. Low motivation d. Decreased psychotic symptoms ANS: b Topic: Impact on Occupational Performance LO: 13.6

Chapter 14: Anxiety, Obsessive-Compulsive, and Related Disorders

Multiple Choice

1. Anxiety is described as an adaptive response to threatening situations. Anxiety disorders occur when this response is . a. Prolonged and inappropriate to the actual threat b. Expressed through mild feelings of uneasiness c. Expressed through hyperarousal d. One that includes increased heart rate ANS: a Topic: Description of the Condition LO: 14.1

2. Kim is concerned with her appearance. She spends about 3 hours every morning exercising, putting on makeup, and fixing her hair. She is constantly seeking reassurance from her husband that she looks alright. She is often late to work, and when she is there she frequently compares herself with her coworkers. Which obsessive-compulsive related disorder does this best represent? a. Trichotillomania b. Body dysmorphic disorder c. Obsessive-compulsive disorder d. Hoarding disorder ANS: b Topic: Obsessive-Compulsive and Related Disorder LO: 14.4

3. Which of the following best describes the prevalence of anxiety disorders? a. Men are at higher risk for anxiety disorders than women. b. Females with anxiety disorder are more likely to have a co-occurring substance use disorder. c. Anxiety disorders are more prevalent in non-Western cultures. d. Anxiety disorders are the most common psychiatric disorder in adolescents. ANS: d Topic: Prevalence/Sex Differences/Culture-Specific Information LO: 14.6 & 14.7

4. a. b. c.

Which of the following is most reflective of the course of obsessive-compulsive disorder? It is typically “outgrown” in early adulthood. It may present later in life as social anxiety. It most commonly presents after the age of 40.

d. It is a chronic disorder. ANS: d Topic: Course LO: 14.8

5. Which of the following is most descriptive of the impact of social anxiety on occupational performance? a. Participation in activities such as work or school are negatively impacted. b. It negatively impacts activities of daily living. c. Refusal to participate in activities outside the home increases family relationships. d. Participation in activities away from the primary attachment figure may be negatively impacted. ANS: a Topic: Impact on Occupational Performance LO: 14.9

6. Several factors associated with anxiety and obsessive-compulsive disorders can negatively impact occupational performance. Which of the following is most representative of those factors? a. Anxiety disorders have a lower rate of comorbid physical illness. b. Increased impulsivity and hyperactivity exists. c. Decreased engagement T inEmSeT anB inA gfN uK l aS ctE ivL itiL esEaR nd.rCelO atM ionships exists. d. Anxiety disorders have a high rate of comorbid personality disorders. ANS: c Topic: Impact on Occupational Performance LO: 14.9

Chapter 15: Trauma and Stressor-Related Disorders

Multiple Choice

1. Which of the following is most reflective of trauma? a. Cognitive, physiological, and behavioral changes are common after a traumatic event. b. Traumatic events are always intentional. c. Only those who are the direct recipient of a traumatic event are impacted by trauma. d. Manifestation of trauma is consistent among individuals. ANS: a Topic: Descriptions of Trauma and Stress LO: 15.1

2. Last year Sally’s family was in a car accident. Her oldest daughter was hospitalized for about a month with serious injuries, but following physical rehabilitation she has returned to all her valued occupations. During the time of her daughter’s hospitalization and rehabilitation, Sally complained of tension headaches, anxiety, and at times feelings of being overwhelmed. Those symptoms have now resolved and she feels as if she’s “back to normal.” What type of stress does this best represent? a. Reactive stress b. Acute stress c. Chronic stress d. Traumatic stress ANS: b Topic: Stress LO: 15.1

3. Individuals who experience more positive emotions, feel a sense of self-efficacy, and demonstrate flexibility when adapting to change are more likely to . a. Not experience trauma b. Recover from trauma, stress, or adversity c. Not recover from trauma; predisposing factors do not contribute to resilience and recovery d. Avoid adverse experiences ANS: b Topic: Resilience, Occupational Participation, and Health LO: 15.2

4. Samuel is a 7-year-old whose family experiences economic hardship. He has six siblings, all under the age of 10. His father left the family several years ago and his mother needs to work nights to provide for the family. One night when his mother was at work there was a fire in their apartment. Thankfully Samuel and his siblings all escaped without injury. Samuel’s teacher noted that about a month after the fire he started having difficulty concentrating during class and hadn’t been keeping up with his

homework. This continued for about 5 months and then his school performance started to improve. Which stress-related disorder does this best describe? a. Posttraumatic stress disorder b. Disinhibited social engagement disorder c. Reactive attachment disorder d. Adjustment disorder ANS: d Topic: Adjustment Disorder LO: 15.3

5. Six months ago Taylor witnessed his mother being shot and killed by his father. Since that time he has been re-experiencing the traumatic memory. It is more common that this occurs when watching a violent movie but can also occur when there is no trigger. Because of these flashbacks, he has found himself watching TV less and not spending as much time with his friends as a way to avoid triggers. Taylor often feels guilt about not being able to save his mother and shame regarding his father’s actions. He also tends to have an extreme neurophysiological stress response when confronted with these flashbacks. Which stress-related disorder does this best describe? a. Posttraumatic stress disorder b. Disinhibited social engagement disorder c. Reactive attachment disorder d. Adjustment disorder ANS: a Topic: Posttraumatic Stress Disorder and Acute Stress Disorder LO: 15.4

6. Maddie is 4 years old. She was abandoned by her mother at the age of 1 year and has been in and out of foster homes since that time. The longest she has been in one foster home is about 6 months. Her current foster parents have expressed concern because she will go up to random adult strangers and start talking to them and has even started following them when they end the conversation and leave the environment. Which stress-related disorder does this best describe? a. Posttraumatic stress disorder b. Disinhibited social engagement disorder c. Reactive attachment disorder d. Adjustment disorder ANS: b Topic: Posttraumatic Stress Disorder and Acute Stress Disorder LO: 15.6

7. Which of the following is a key principle of trauma-informed care? a. Assuming decision-making capacity for your client b. Provider support c. Trustworthiness and transparency d. Limited choices ANS: c Topic: Trauma-Informed Care LO: 15.7

Chapter 16: Schizophrenia and Schizoaffective Disorder

Multiple Choice

1. Mariah is a 23-year-old who has been diagnosed with major depression. Last year she began experiencing delusions, as well as disorganized thinking and behaviors. These symptoms remitted with medication but she then began to display flat affect and social withdrawal. Two months ago she once again began to experience delusions and an increase in disorganized thinking. Which of the following disorders is Mariah experiencing? a. Schizophrenia b. Schizoaffective disorder c. Major depression with psychotic features d. Bipolar I disorder ANS: b Topic: Description of the Condition LO: 16.1

2. Which of the following symptom clusters would Mariah’s symptoms of delusions represent? a. Psychotic symptoms b. Negative symptoms c. Disorganized symptoms d. Affective symptoms ANS: a Topic: Symptom Clusters LO: 16.2

3. Keo is demonstrating psychotic-like symptoms, cognitive decline, and increased social isolation. He has not yet met the criteria for schizophrenia. Which of the following best describes what Keo is experiencing? a. Negative symptoms b. Affective symptoms c. Prodromal period d. Late stage symptoms ANS: c Topic: Prevalence and Course LO: 16.4

4. Which of the following is most reflective of gender and cultural differences in schizophrenia? a. Schizophrenia is underdiagnosed in minority groups. b. Schizophrenia is generally more severe for females. c. Men experience more positive symptoms. d. Cultural considerations are vital in distinguishing psychotic experiences. ANS: d Topic: Gender and Cultural-Specific Differences LO: 16.5

5. Cognitive impairments in individuals with schizophrenia impact occupational performance. Which of the following is the most accurate statement regarding cognitive impairments and schizophrenia? a. They are a core symptom of schizophrenia. b. They are more predictive of functional outcomes than symptoms. c. They worsen through time. d. The hallmark cognitive impairment of schizophrenia is difficulty with short-term memory. ANS: b Topic: Impact on Occupational Performance LO: 16.6

6. Overall health and wellness in individuals with schizophrenia negatively impacts occupational performance. Which of the following is most descriptive of the impact on health and wellness on occupational performance? a. Medication can lead to oral side effects such as dry mouth, tardive dyskinesia, and dystonia of the mouth, tongue, head, and neck. b. Individuals with schizophrenia are nonresponsive to interventions focused on lifestyle behaviors. c. Medications can increase the risk of type 1 diabetes and weight gain. d. Individuals with schizophrenia are at lower risk of medical comorbidities. ANS: a Topic: Impact on Occupational Performance LO: 16.6

7. Evidence indicates that early intervention for individuals with schizophrenia should include cognitive remediation. Which of the following best describes a cognitive remediation intervention approach? a. Adapting the cognitive aspects of a task b. Daily living skills training c. Application of behavioral strategies to activities of daily living (ADL) and instrumental activities of daily living (IADL) skills d. Graded and repeated practice of cognitive-oriented task in the context of occupational performance ANS: d Topic: Intervention LO: 16.7

8. Which statement best describes the course of schizophrenia? a. Different individuals will have different experiences, but many individuals will have an improvement through time. b. The course of schizophrenia is one of progressive deterioration. c. Once individuals develop psychotic symptoms, they tend to experience the same symptoms throughout their lifetime. d. Most individuals develop schizophrenia late in life. ANS: a Topic: Description of the ConTdE itiSoT n BANKSELLER.COM Rationale: There is a great deal of heterogeneity in the expression and course of schizophrenia; however, most individuals improve to some degree through time.

9. Individuals with schizophrenia are much more likely to die at a younger age than the general population, and most often that death is attributable to what condition? a. Cardiovascular disease b. Suicide c. Cancer d. Dementia ANS: a Topic: Impact on Occupational Performance Rationale: Individuals with schizophrenia have a life span that is decades shorter than individuals in the general population, with the most common cause of death associated with cardiovascular disease.

Chapter 17: Substance Abuse and Co-Occurring Disorders

Multiple Choice

1. Yolanda has been consuming excess amounts of alcohol for the past 5 years. She has stated she wants to stop but can’t. She states that when she has tried to stop she gets withdrawal symptoms that are intolerable and she has to take a drink to alleviate the symptoms. Her family reports that she has difficulty keeping a job and her parenting skills have been negatively impacted. Yolanda has received two citations for driving while intoxicated but continues to drink. Which of the following diagnoses best represents Yolanda’s situation? a. Co-occurring disorder b. Substance use disorder c. Multi-substance disorder d. Mood disorder ANS: b Topic: Description of the Disorder LO: 17.1 & 17.2

2. Which of the following is most representative of the prevalence of substance use in the United States? a. One-half of Americans aged 16 and older have consumed alcohol. b. Tobacco use is highest among those 50 to 56 years old. c. Illicit drug use is most common among those 30 to 35 years old. d. Binge-drinking is most common among those 18 to 29 years old. ANS: d Topic: Prevalence of Alcohol and Drug Use LO: 17.3

3. Which of the following best describes a high-risk population for opioid addiction? a. Persons with personality disorders b. Young adults c. Persons being treated for chronic pain d. Persons with conduct disorder ANS: c Topic: Prevalence of Alcohol and Drug Use LO: 17.3

4. Which of the following best reflects the impact of substance use disorders on occupational performance? a. Substance use only impacts the individual diagnosed with a disorder. b. Substance use only results in negative consequences on occupational performance. c. All areas of occupation can be impacted by substance use disorders. d. Healthy environments do not impact substance use and occupational performance. ANS: c Topic: Impact on Occupational Performance LO: 17.6

5. Which of the following most accurately reflects a self-reported barrier to receiving intervention for substance use disorders? a. No social supports to stop using b. Not ready to stop using c. Increased knowledge of treatment resources d. Potential positive impacts on the job ANS: b Topic: Barriers LO: 17.8

6. As an occupational therapy practitioner working with individuals with substance use disorder, you want to use an approach where you establish a rapport with your client and help the individual identify why he or she wants to change the behavior. Which approach does this best represent? a. Cognitive behavioral therapy b. Screening brief intervention and referral to treatment c. Mindfulness meditation d. Motivational interviewing ANS: d Topic: Intervention LO: 17.9

Chapter 18: Neurocognitive Disorders (Dementia)

Multiple Choice

1. Jerry is 70 years old. Recently, he has been demonstrating modest cognitive decline in executive functioning, learning, and memory. He has also demonstrated difficulty with way finding and has become increasingly more irritable. However, he has demonstrated no decline in activities of daily living (ADLs) or instrumental activities of daily living (IADLs). Which of the following best describes this scenario? a. Mild neurocognitive disorder b. Major neurocognitive disorder c. Alzheimer’s disease d. Lewy body disease ANS: a Topic: DSM-5 Criteria LO: 18.1

2. Which of the following best describes the etiology of neurocognitive disorders? a. The neural mechanismTsEthSaT tB coAnN triKbS utE eL toLAElR zh.eC imOeM r’s disease are well known and understood. b. The onset of vascular neurocognitive disorder is often abrupt and presents with a stepwise progression. c. Frontotemporal lobar degeneration manifests with disturbances in motor skills. d. Early symptoms of aphasia is what distinguishes Lewy body disease from Alzheimer’s. ANS: b Topic: Subtypes or Etiologies LO: 18.3

3. Identify the most accurate statement regarding the prevalence, gender, educational, and cultural impact of neurocognitive disorders. a. As the life span increases there is an increase in the number of individuals who experience dementia. b. Individuals with higher educational status have a higher incidence of young onset dementia, impacting their income status. c. African Americans have the lowest prevalence of Alzheimer’s disease. d. Prevalence of dementia is higher in males compared with females. ANS: a Topic: Prevalence, Gender, Educational, and Cultural Impact

LO: 18.4 & 18.5

4. Which of the following is most reflective of the impact of neurocognitive disorders on occupations? a. Activities of daily living (ADL) challenges typically present in the early stages of dementia. b. Individuals decrease engagement in leisure activities that require higher levels of cognitive skills. c. Concerns about instrumental activities of daily living (IADL) performance tends to be the impetus for cognitive evaluation. d. Work tends to be the most challenging occupation in the early stages of dementia. ANS: d Topic: Impact on Occupational Performance LO: 18.6

5. Which of the following reflects the most accurate contribution an occupational therapy practitioner can make to the interdisciplinary team when working with someone diagnosed with a neurocognitive disorder? a. Identify external resouTrE ceSs T avBaA ilaNbKleStE oL suLpE poRr. t tC heOiMndividual or his or her family. b. Administer cognitive screens to monitor cognitive decline. c. Identify the impact of cognitive decline on daily functioning. d. Assist the family in adjusting to the diagnosis. ANS: c Topic: Medical and Interdisciplinary Management LO: 18.7

6. Occupational therapy practitioners can modify tasks and environments based on an individual’s cognitive level to maximize strengths and enable doing. Which intervention approach does this best represent? a. Home environment skill building program b. Cognitive disabilities c. Errorless learning d. Augmentative and alternative communication ANS: b Topic: Interventions LO: 18.8

7. Which of the following best describes the use of medications such as Aricept or Exelon for individuals with neurocognitive disorders? a. They stop the progression of these disorders. b. They slow the progression of these disorders. c. They control agitation and aggression related to these disorders. d. These medications may enhance thinking, memory, and communication. ANS: d Topic: Medication LO: 18.9

Note: For the following questions, choose the option that BEST answers each question.

8. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), a key diagnostic criteria for major neurocognitive disorders is . a. Altered mood and changes in behavior, such as agitation or depression b. Cognitive decline from previous level of performance interfering with daily activities c. Loss of memory with decreased face recognition or prosopagnosia d. Delirium or other mental disorder along with behavioral change ANS: b Topic: DSM-5 Criteria

Neurocognitive disorders can stem from a variety of etiologies including . Vascular disorders and HIV Schizophrenia and bipolar disorders Obesity and metabolic syndrome Hearing loss or macular degeneration

a. b. c. d. ANS: a Topic: Subtypes or Etiologies

10. Which of the following statements are true in regard to neurocognitive disorders? a. Many are reversible when the cause is resolved or eliminated. b. Unlike traumatic brain injury, a static disorder, most neurocognitive disorders are progressive and eventually lead to death. c. Depression and delirium are difficult if not impossible to distinguish from dementia. d. Personal history is a minor piece and laboratory tests are a major piece of the comprehensive medical evaluation.

ANS: b Topic: Course

11. Charlie demonstrated rapid onset of symptoms of dementia with disinhibition, irrational judgment, impulsiveness, and social discord. His symptoms are indicative of . a. Alzheimer’s disease b. Vascular dementia c. Lewy body disease d. Frontotemporal lobar degeneration ANS: d Topic: Frontotemporal Lobar Degeneration

12. Best practice occupational therapy for persons with neurocognitive disorder includes . a. Direct service to the client in a clinical setting b. Family-centered models with service directed at the needs of both the client and caregiver c. Referral to home health to complete IADLs and ADLs Muscles to ensure upright d. Restoration of physicaTl E coSnT diBtiA onNbKySsEtrL enLgE thRen.iC ngOm stability ANS: b Topic: Medical and Interdisciplinary Management

13. The focus of occupational therapy intervention to promote occupational performance is balancing . a. New learning with habits from long-term memory b. Amount of service with type of service in the short term c. Family needs against client needs and preferences d. Cognitive capacity and activity demands and external supports ANS: d Topic: Intervention

Chapter 19: Psychosocial Concerns With Physical Disabilities

Multiple Choice

1. Abe experienced a spinal cord injury 3 years ago. Because of his injury he has had to adjust to changes in the roles and activities that he had participated in for many years. One of those roles was being a member of the softball team. In addition, Abe is no longer able to perform his work as a baggage handler at the local airport. This has also altered his social relationships. Since his accident he has had difficulty getting out in the community because of environmental barriers and has been seeing his friends from work and the softball team less frequently. Lately he has been expressing decreased satisfaction with his life and increased feelings of depression. Which of the following psychological implications related to physical disabilities does this best represent? a. Body image b. Isolation c. Gender role issues d. Cognition ANS: b Topic: Psychological Implications of Physical Disabilities LO: 19.3

2. Abe’s medical record indicates that he had past episodes of depression and was hospitalized for a failed suicide attempt. As an occupational therapy practitioner working with Abe, you are concerned about his reports of increased depression and the potential for another suicide attempt. Which of the following is the greatest concern regarding potential suicidal ideation? a. Increased attention to physical appearance b. Development of symptoms of posttraumatic stress disorder (PTSD) c. Refusal of necessary medical care d. Development of future goals ANS: c Topic: Psychological Implications of Physical Disabilities LO: 19.4

3. A mother is the primary caregiver for her son who has a spinal cord injury. She has recently reported increased fatigue and stress, as well as concerns that she doesn’t think she can continue to provide care for her son. Which of the following best represents this scenario? a. Depression b. Role overload c. Increased satisfaction with altered roles and responsibilities d. Caregiver burnout ANS: d Topic: Effects of Physical Disability on the Family LO: 19.5

4. Which of the following best describes the response of role changes that occurs following an acquired physical disability? a. Excitement at the opportunity to explore new roles b. Relief that a family member can assume the financial responsibilities for the family c. Fear of losing their identity d. Opportunity to reassess sense of self-worth ANS: c Topic: Impact on Occupational Performance LO: 19.6

5. Shifting from a loss perspective to an assets perspective following an acquired physical disability best represents which of the following? a. Identity reconstruction b. Recovery c. Accepting they will never fulfill their life goals d. Accepting that life will always be filled with challenges that weren’t there before ANS: a Topic: The Past, Present, and Future Selves LO: 19.6

6. Abe has been making progress in his rehab sessions and has started to demonstrate signs of positive adaptation. He has started to recognize that he has some control regarding his current situation, has started to gather more information about his disability, and wants to start working on developing a plan to develop new skills that will allow him to explore new roles and activities to participate in. Which factor related to positive adaptation does this best represent? a. Gaining knowledge and communication b. Locus of control c. Social support d. Resilience ANS: b Topic: Factors Related to Positive Adaptation LO: 19.7

7. The ability of an individual with an acquired physical disability to maintain a relatively healthy level of psychological and social functioning, as well as a positive sense of self, can best be described as . a. Generativity b. Positive coping c. Internal locus of control d. Resilience ANS: d Topic: Resilience LO: 19.8

8. One intervention approach that is used with individuals with acquired physical disabilities includes the engagement in physical activities that the individual enjoys to increase strength and endurance while at the same time reducing stress. Which intervention approach does this best represent? a. Cognitive behavioral approach b. Exercise/Physical activity c. Mindfulness meditation d. Self-advocacy ANS: b Topic: Interventions LO: 19.9

Chapter 20: Cognition

Multiple Choice

1. Which of the following best describes cognitive awareness in individuals with lived experience with psychiatric disabilities? a. Individuals with schizophrenia have no awareness of their cognitive impairments. b. Individuals with schizophrenia are aware of their cognitive challenge. c. Individuals with schizophrenia are unable to describe the cognitive challenges they experience. d. Individuals with schizophrenia are aware of strategies they can use to overcome their cognitive impairments. ANS: b Topic: Introduction LO: 20.1

2. Samuel is a 34-year-old who has been referred to you for impairments in cognition, specifically attention. When you meet him, you notice that he is easily distracted and appears to have difficulty focusing on relevant stimuli in the environment. Which aspect of attention does this best represent? a. Automatic and controlled processing b. Selective attention c. Divided attention d. Vigilance ANS: b Topic: Components of Cognition—Attention LO: 20.2

3. Ray is a 21-year-old college student who has been demonstrating an inability to sustain attention for extended periods of time. He states he notices this problem is worse at night when he is trying to study. Because of this inability to sustain attention he has been having difficulty completing assignments and his performance on examinations has been declining. Which aspect of attention does this best represent? a. Automatic and controlled processing b. Selective attention c. Divided attention d. Vigilance ANS: d Topic: Components of Cognition—Attention LO: 20.2

4. Memory used to learn how to perform and interpret a range of motion evaluation as an occupational therapy student can best be described as .

a. Semantic memory b. Episodic memory c. Procedural memory d. Long-term memory ANS: c Topic: Components of Cognition—Memory LO: 20.3

5. You have a client with depression who wants to return to work. After exploring her work-related interests, she indicates she wants to be a peer support specialist at the local psychosocial rehabilitation agency. With your guidance, she develops a plan to achieve her work-related goal. This best exemplifies which of the following skills related to executive function? a. Problem-solving b. Concept formation c. Decision-making d. Metacognition ANS: a Topic: Executive Function LO: 20.4

6. Your client from the previous question has been working on her plan to secure a job as a peer support specialist. As she is explorinTgEwS haTt B shAeN neKeS dsEtoLdLoEinRt. hiC sO roM le, she recognizes that although she knows about mental illness, she is not familiar with psychosocial rehab and will need to engage in education to increase her knowledge and skills in this area. This best exemplifies which of the following skills related to executive function? a. Problem-solving b. Concept formation c. Decision-making d. Metacognition ANS: d Topic: Executive Function LO: 20.4

7. You are working with an adult client who is demonstrating impairments in cognition, which is impacting his ability to live independently. You decide you want to assess his executive functioning in a natural context. In particular, you want to assess his ability to make simple purchases at the grocery store. Which assessment would be the best choice for this scenario? a. Continuous performance test b. Do-eat c. Multiple errands test d. Executive function performance test ANS: c Topic: Assessment LO: 20.5

8. As a school employee, you are asked to work with a 7-year-old who has been having difficulty with school performance. You decide you want to administer an assessment that requires the child to engage in three tasks that assess task performance, executive functioning, and sensory-motor skills. Which assessment would be the best choice for this scenario? a. Continuous performance test b. Do-eat c. Multiple errands test d. Executive function performance test ANS: b Topic: Assessment LO: 20.5

9. You are working with a 54-year-old man who has been exhibiting a decline in cognitive functioning following a traumatic brain injury (TBI). Based on your assessment, you create an intervention plan that includes the client using compensatory strategies such as a day planner to help organize work-related tasks and a checklist to help cue him to what homemaking tasks he needs to complete outside of work. Which model best represents this intervention? a. Cognitive adaptation b. Dynamic interactional approach c. Cognitive remediation d. Cognitive disabilities ANS: a Topic: Intervention Models LO: 20.6 & 20.7

Chapter 21: Cognitive Beliefs

Multiple Choice

1. Which of the following best defines cognitive beliefs according to the Occupational Therapy Practice Framework? a. Beliefs that reside within the client b. Motivation to engage in occupation c. Beliefs that impact an individual’s interaction with the environment and occupations d. Cognitive content that the individual holds as true ANS: d Topic: Cognitive Beliefs and Occupational Performance LO: 21.1

2. Which of the following most accurately reflects the theoretical assumption about the nature of cognitive beliefs? a. Core beliefs are easy to modify with sufficient evidence and experience. b. Core beliefs influence our thoughts, emotions, behaviors, and physiological arousal. c. Core beliefs are facts and rules agreed upon by an individual’s community. d. Core beliefs begin to develoT pE inSeT arB lyAaN doKleSscEeL ncL e.ER.COM ANS: b Topic: The Nature of Cognitive Beliefs LO: 21.2

3. Tanisha is a young woman who has a fear of public transportation. On the occasions when she has needed to take public transportation to get to work she becomes extremely fearful that something bad will happen to her and could result in serious injury. Therefore, she begins to have heart palpitations, shortness of breath, and at times immobility. Which psychiatric disorder does this best describe? a. Depression b. Panic disorder c. Eating disorder d. Schizophrenia ANS: b Topic: Cognitive Beliefs and Psychiatric Conditions LO: 21.3

4. Negative beliefs resulting from judgment from others that an individual with schizophrenia has started to internalize can best be described as . a. Recovery-stigma b. Mental illness-stigma c. Public stigma

d. Self-stigma ANS: d Topic: Cognitive Beliefs, Stigma, and Recovery LO: 21.4

5. Which of the following is most descriptive of therapeutic principles that are shared between cognitive behavioral therapy (CBT) and occupational therapy? a. Intervention is client-centered. b. Intervention is future-oriented. c. Intervention is problem-focused. d. Intervention is continuous. ANS: a Topic: Cognitive Belief-Oriented Practice Models LO: 21.5

6. You are working in an adolescent psych clinic and are looking for an assessment that will allow you to engage in a semi-structured dialogue to assess an individual’s belief in what supports and what interferes with occupational performance. Which assessment would be best in this situation? a. Self-efficacy gauge b. Dysfunctional thought records c. TIC-TOC technique d. Socratic questioning ANS: d Topic: Assessments of Cognitive Beliefs LO: 21.6

7. After working in the adolescent psych clinic for a while, you decide an assessment that examines automatic thoughts related to distressing occupational performance situations would be beneficial for some of your clients. You decide to use an assessment that would have clients identify specific situations, emotions they experience in this situation, automatic thoughts, thought distortions, and alternate thoughts. Which assessment would be best in this situation? a. Self-efficacy gauge b. Dysfunctional thought records c. TIC-TOC technique d. Socratic questioning ANS: b Topic: Assessments of Cognitive Beliefs LO: 21.6

8. You are working with a 27-year-old who demonstrates adequate metacognition but continues to experience disruptive cognitive beliefs. You decide to incorporate a cognitive restructuring intervention that requires the individual to examine irrational beliefs and related emotional and behavioral responses

related to a specific situation that is interfering with his or her occupational performance. Which intervention approach best describes this scenario? a. Socratic questioning b. Self-talk and affirmations c. Behavioral experiments d. Rational emotive behavior therapy ANS: c Topic: Intervention LO: 21.7 & 21.8

Chapter 22: Sensory Processing

Multiple Choice

1. Which of the following best describes the four steps of sensory processing? a. Nervous system detection of a stimulus, hypo- or hyper-response to the stimulus, categorizing the stimulus, and attributing meaning to the stimulus b. Nervous system detection of a stimulus, classifying the stimulus, responding to the stimulus, attributing meaning to the stimulus based on the response c. Nervous system detection of a stimulus, classifying the stimulus, attributing meaning to the stimulus, and responding to the stimulus d. Nervous system detection of a stimulus, attributing meaning to the stimulus, recognizing the stimulus based on the meaning, and responding to the stimulus ANS: c Topic: Overview of Sensory Processing LO: 22.1

2. Which sensory system is best described by the awareness of the body’s position in space? a. Proprioceptive b. Vestibular c. Visual d. Tactile ANS: a Topic: Sensory Modalities LO: 22.2

3. You are working with an individual who has an exaggerated response to the feel of clothing on her torso. Which sensory processing disorder does this best represent? a. Under-responsivity b. Over-responsivity c. Sensory seeking d. Sensation avoiding ANS: b Topic: Sensory Processing Disorders LO: 22.3

4. You are working with a 6-year-old who has been in a series of foster homes since she was 3 months old. She has never stayed in one home for more than 1 year. Therefore, she has not had a stable attachment figure. This has resulted in an impairment in the foster parent effectively soothing and stimulating the child. Her teacher reports that at times this child is hyperaroused and other times withdrawn. You decide your best approach is to work with the teacher and the foster parents on how to

create a predictable environment and work with the child to identify triggers, allowing her to practice managing these triggers in the safe environment of your therapy sessions. Which childhood psychiatric condition does this best represent? a. Attention deficit-hyperactivity disorder b. Autism spectrum disorder c. Developmental trauma disorder d. Intellectual disability disorder ANS: c Topic: Sensory Processing and Children With Psychiatric Conditions LO: 22.4

5. You are working with a 10-year-old who is demonstrating behaviors of sensory processing disorder. You want to administer an assessment that will allow you to get a better understanding of the child’s sensory processing impairments. You choose a behavioral rating scale that is based on sensory integration theory. This assessment will allow you to identify sensory vulnerabilities in the areas of under- and over-responsivity, sensory seeking, and perceptual problems. Based on this scenario, which assessment would you choose? a. Short sensory profile b. Sensory processing measure c. Highly sensitive person scale d. School companion sensory profile ANS: b Topic: Assessments LO: 22.7

6. After assessing the child in Question 5, you decide you want to use an intervention that will help the child identify her level of arousal based on four categories that move from low alertness to hyperarousal. What you like about this intervention is it uses colors and signs to identify each category. Which of the following best reflects this intervention? a. Ayres sensory integration b. Sensory-based interventions c. Zones of regulation d. The alert program ANS: c Topic: Interventions LO: 22.8

7. You decide you want to change intervention approaches. You want to try an approach that is therapist directed, administered in the child’s natural environment, and uses sensory input to organize the child’s arousal level. Which of the following best reflects this intervention? a. Ayres sensory integration b. Sensory-based interventions c. Zones of regulation d. The alert program ANS: b

Topic: Interventions LO: 22.8

8. You are working with an adult who demonstrates a low neurological threshold and an active behavioral response. This individual tends to create environments that reduce sensory input. However, at times she finds herself in an environment she cannot control and begins to demonstrate signs and symptoms of distress. Which quadrant of Dunn’s Model of Sensory Processing does this best represent? a. Sensory sensitivity b. Low registration c. Sensation avoiding d. Sensation seeking ANS: c Topic: Dunn Model of Sensory Processing LO: 22.9

Chapter 23: Coping and Resilience

1. The concept that individuals have a predisposition to stress, which makes an individual more vulnerable to the challenges of daily living and potential mental illness, such as depression or bipolar disorder, can best be defined as . a. Diathesis stress model b. Generalized adaptation syndrome c. Allostasis d. Maladaptive coping syndrome ANS: a Topic: Stress and Coping LO: 23.1

2. You have a client who is currently working in a factory job. He states he is unhappy in this position and currently spends a lot of time outside of work searching online for a new job in hopes he can change careers in the future and find happiness. Which coping strategy does this best represent? a. Cognitive restructuring b. Information seeking c. Wish-fulfilling fantasy d. Emotional expression ANS: c Topic: Coping Theory and ReseT arE chS— TTByApeNs KofSCEoLpiLngER.COM LO: 23.2

3. Which of the following characteristics is most reflective of resilience? a. Avoidance of change to allow for growth and development in one’s current situation b. An individual’s belief he or she can influence his or her life situation c. Realization that change requires help from others d. An individual’s acceptance of his or her current situation ANS: b Topic: Coping Resources and Resilience LO: 23.3

4. Sabrina is a 50-year-old with depression. During a family meeting, her husband expresses his frustration with Sabrina. He believes she could get better if she tried and that her current situation is bringing embarrassment to the family. The husband’s response can best be described as . a. Expressed anxiety b. Expressed emotion c. Expressed negative coping d. Caregiver burden ANS: b Topic: Mental Illness and Coping: Impact on the Individual and Family

LO: 23.4

5. Adam is a 60-year-old who has been referred to occupational therapy because of increased anxiety and decreased ability to engage in valued occupations. During your initial interview he states he has been experiencing a lot of stress during the past year: He retired 6 months ago and his wife passed away a month ago. His children recently moved out of the area and he states he is feeling lost given all the changes he has experienced during the past year. You want to administer an assessment that measures the impact stress has had on him during the past year. Adam appears to have intact cognitive functioning and you decide to use a self-inventory. Based on this information, which assessment would you choose? a. Life events checklist b. Coping responses inventory c. Coping strategies inventory d. Recent life changes questionnaire ANS: d Topic: Assessments LO: 23.5

6. You are working with Emily, a 16-year-old who was recently referred to your outpatient clinic. She appears hyper-reactive to daily events that occur at school and home. You decide you want to administer an assessment that will allow her to rate daily events she encounters and the stress she perceives related to eaT chEoSf T thB esAeN evKeS ntE s. L BL asE edRo.nCthOisMinformation, which assessment would you choose? a. Life events checklist b. Coping responses inventory c. Coping strategies inventory d. Recent life changes questionnaire ANS: a Topic: Assessments LO: 23.5

7. Following your assessment of Emily, you decide you want to use an approach that will allow creative expression to promote insight into herself and the situations she perceives as stressful. Specifically, you decide you want to use an open-ended, exploratory writing activity. Which theoretical framework does this best represent? a. Cognitive behavioral b. Model of Human Occupation c. Psychodynamic-object relations d. Occupation-based approach ANS: c Topic: Interventions LO: 23.6

8. You are working with a young adult who reports difficulty keeping a job. When you ask him what he thinks impacts his job performance, he states he knows he has difficulty “keeping his cool” in stressful situations and often ends up yelling at his boss and coworkers. You decide to implement an approach that incorporates role-play, rehearsal, modeling, and coaching to modify his responses. Which intervention best reflects this approach? a. Psychoeducation b. Interpersonal skills training c. Mindfulness meditation d. Progressive muscle relaxation ANS: b Topic: Additional Interventions LO: 23.7

Chapter 24: Motivation

Multiple Choice

1. This theory of motivation uses interventions such as identifying role models, providing genuine feedback on the client’s performance, and assisting with reinterpretation of negative emotional states. a. Maslow’s hierarchy of needs b. Approach and avoidance model c. Self-efficacy d. Self-determination ANS: c Topic: Theories of Motivation LO: 24.1

2. Which of the following best reflects dysfunctional motivation in individuals with schizophrenia? a. Impairment in rewardTpE roSceTsB siA ngNaKsS soEciLatLeE dR w. ithCO aM dysfunctional dopamine system b. Decreased sensitivity to reinforcements c. Extreme sensitivity to the behavioral activation system (BAS) d. High reward sensitivity and low punishment sensitivity ANS: a Topic: Motivation and Psychiatric Disabilities LO: 24.3

3. Currently you are working with an adult who is non-verbal. He has demonstrated difficulties with motivation and you want to get a better idea on his motivation and how the environment affects his level of motivation. Following your assessment, you decide you want to employ an intervention that incorporates a motivation continuum ranging from exploration to achievement. In particular, you want to expose him to both familiar and new activities of interest. Which intervention does this best represent? a. Behavioral activation system (BAS)/behavioral inhibition system (BIS) b. Remotivation process c. Screening brief intervention and referral to treatment d. Harm reduction approach ANS: b Topic: Interventions Linked to Theory

LO: 24.5 & 24.7

4. You are working with a client in an outpatient clinic for treatment following a stroke. You suspect this individual may be misusing alcohol. You ask her if she drinks alcohol. She says she does, so you implement the Alcohol Use Disorders Identification Test. The results indicate alcohol disorder. You use a scripted intervention to raise the subject of alcohol abuse, provide feedback, enhance motivation for treatment, and negotiate and advise follow-up. Then you refer for treatment. Which intervention does this best represent? a. BAS/BIS b. Remotivation process c. Screening brief intervention and referral to treatment d. Harm reduction approach ANS: c Topic: Interventions Linked to Theory LO: 24.5 & 24.7

5. Which of the following best describes motivational interviewing? a. A collaborative conversation used to strengthen a person’s motivation and commitment to change b. A collaborative conversation to support competence, autonomy, and relatedness c. A collaborative conversation to evaluate the volitional system d. A collaborative conversation to identify the current stage of change ANS: a Topic: Motivational Interviewing LO: 24.6

6. You are using motivational interviewing with your new client. As your client is telling you his story, you are using comments such as “This is what I am hearing . . .” or “What I understand you to say . . .” as a way to get a better understanding of your client’s perception of his situation. Which core skill of motivational interviewing does this best represent? a. Use of open-ended questions b. Reflective listening c. Affirmation d. Eliciting change talk ANS: b Topic: Motivational Interviewing LO: 24.6

7. Which theory of motivation recognizes autonomy as an important source of motivation? a. Maslow’s hierarchy b. Self-efficacy theory c. Self-determination theory d. Transtheoretical model of change ANS: c Topic: Theories of Motivation

8. Stanley has recently been discharged from the hospital after a manic episode of bipolar disorder. He is excited to return to college next semester but fears that his persisting but lower level mania may challenge his success. From a BAS/BIS perspective, which approach would be most useful? a. Help Stanley to develop strategies for slowing down and reducing impulsiveness during study and test taking. b. Provide positive feedback to increase his sense of self-efficacy. c. Make sure Stanley has choices regarding what courses he will take next semester. d. Address Stanley’s stability in housing before he pursues college. ANS: a Topic: Approach and AvoidaT ncEeSMToBdA elN s KSELLER.COM

9. Which assessment would be best for determining if a child is able to persist with a challenging task? a. BIS/BAS scales b. Dimensions of mastery questionnaire c. Goal attainment scaling d. Pediatric volitional scale ANS: b Topic: Dimensions of Mastery Questionnaire

10. After a period of difficulty, partially attributed to her depression, Patricia is experiencing much success at work. Her occupational therapist recognizes that Patricia is ready to move to the next level of the remotivation process and is helping her to prepare for a meeting with her boss in which she intends to ask for a promotion. This suggests that the therapist is working with Patricia on which stage of the remotivation process? a. Exploration b. Competency c. Achievement

ANS: c Topic: Intervention

11. You are working with Judith on her weight loss goal. Although she wants to eat healthier, Judith is having difficulty making changes associated with frequent junk food snacking. Which of the following strategies would be most consistent with a motivational interviewing approach? a. Taking Judith to the grocery store and pointing out healthier snack choices b. Describing the negative health outcomes associated with the junk food Judith likes most c. Suggesting that Judith remove all junk food from her house d. Asking Judith what is one thing she can do to improve her snacking next week ANS: d Topic: Motivational Interviewing

Chapter 25: Emotion

Multiple Choice

1. Which of the following is most reflective of the Modal Model of Emotions? a. It is an interactive process between instinctive and intuitive feelings. b. It is an interactive process between the person and situation. c. It is an interactive process between the person and environment. d. It is an interactive process between quick, basic judgments and experiences. ANS: b Topic: Overview of Emotion LO: 25.1

2. Jason is a 16-year-old who is getting ready to take his driving test. He reports having butterflies in his stomach and feeling jittery. After he recognizes these feelings, he begins the deep breathing activity he learned in occupational therapy and begins to feel better. He was able to calm himself down and pass his driving test. Which of the following does this best exemplify? a. Emotion regulation b. Emotion dysregulation c. Sensory sensitivity d. Sensation seeking ANS: a Topic: Emotional Regulation LO: 25.2

3. Which of the following neurophysiological systems is responsible for slowing the heart rate and stimulating the digestive system? a. Autonomic nervous system b. Sympathetic nervous system c. Endocrine system d. Parasympathetic nervous system ANS: d Topic: The Neurophysiology of Emotion Regulation LO: 25.3

4. a. b. c. d.

Identify the statement that is most reflective of emotion regulation throughout the life span. Eastern cultures support open expression of emotions in a group setting. Optimal development of these skills occurs in adolescence. Intensity and lability of expression and mood in adolescents has been linked to increased prevalence of depression. Emotion regulation is most effectively developed through peer relationships.

ANS: c Topic: Development of Emotion Regulation Through the Life Span LO: 25.4

5. You are working with a 23-year-old male who responds quickly and strongly to what you perceive are low levels of stress. In addition, he has an intense response to emotional stimuli and is slow to return to his emotional baseline. After completing some research on effective interventions with this individual, you decide to employ dialectical behavior therapy. Which disorder does this scenario best represent? a. Depression b. Anxiety c. Substance abuse d. Borderline personality disorder ANS: d Topic: Emotion Dysregulation and Psychiatric Disorders LO: 25.5

6. You decide you want to further assess the young man from Question 5 to get a better sense of his cognitive appraisal skills and ability to suppress emotional expression. You want to use a quick, 5-minute, paper-pencil assessment. Which of the following best fits your need? a. Cognitive Emotion Regulation Questionnaire b. Difficulties in Emotion RegT ulE atS ioT nB ScA alN e KSELLER.COM c. Emotion Regulation Questionnaire d. Emotion Regulation Skills Questionnaire ANS: c Topic: Assessment LO: 25.6

7. As a practitioner using a dialectical behavior approach, there are several working assumptions you must accept. Which of the following best represents one of those assumptions? a. Clients do not fail at Dialectical Behavior Therapy (DBT); it is the treatment that is failing and needs to be modified. b. Clients are responsible for the way things are in their life currently and how they will be in the future. c. Clients do not want to change, even if they say they do. d. Clients’ behavior patterns are best understood by present circumstances. ANS: a Topic: Dialectical Behavior Therapy LO: 25.7

8. Which of the following best distinguishes mindfulness-based occupational therapy from other forms of mindfulness?

a. It recognizes individuals can regulate their emotions by paying attention to present-moment experiences. b. It integrates mindfulness strategies into daily tasks, activities, and routines. c. It incorporates a nonjudgmental philosophy. d. It recognizes that mindfulness takes practice and patience to develop. ANS: b Topic: Mindfulness-Based Occupational Therapy LO: 25.8

Chapter 26. Communication and Social Skills

Multiple Choice

1. You are working with a client who was referred to occupational therapy because of difficulty with social and communication skills, which is negatively impacting her ability to maintain employment. Specifically, she has difficulty with awareness of how she responds to others. For example, she often displays defensiveness and irritation to questions that she perceives as confrontational. Although she has gotten feedback on this she denies it’s a problem and therefore has not been able to modify her response behaviors. Which client factor does this best represent? a. Cognitive skills b. Executive functions c. Emotion perception d. Empathy ANS: d Topic: Client Factors LO: 26.1

2. Miguel is a young man T whEoShT asBrA epNorKteSdEdL iffL icE ulR ty.wCitO hM making friends. He goes to many social events and is able to initiate conversations; however, he has difficulty maintaining conversations because he has difficulty following the conversation, especially if he is talking to a group of people. In these situations, he finds himself getting easily distracted and has difficulty organizing his thoughts to respond to questions. Which client factor does this best represent? a. Cognitive skills b. Executive functions c. Emotion perception d. Empathy ANS: b Topic: Client Factors LO: 26.1

3. You are working in a child and maternal health program and are looking to adopt a theory to guide your practice in the area of social and communication skills. You decide a theory that looks at emotional connections between the child and parent would be best for your practice. One thing you like about the theory is it can guide you in designing a prevention program for at-risk parents, as it will allow you to begin educating parents on how to connect with their children. In addition, you can use it with parents with older children to facilitate the development of coping skills related to emotion regulation issues that interfere with effective communication. Which social skills theory best fits your needs? a. Attachment theory b. Social cognition c. Social learning theory

d. Group development theory ANS: a Topic: Theories Underlying Social and Communication Interventions LO: 26.2

4. You are working with a 19-year-old male who has been described as “manipulative” and egocentric, demonstrating cognitive inflexibility and limited insight into his contributions in his interpersonal difficulties. Which mental health disorder does this best represent? a. Autism b. Schizophrenia c. Dementia d. Personality disorder ANS: d Topic: Communication and Social Skills in Individuals With Mental Illness LO: 26.3

5. You are a school-based practitioner and are looking for an assessment for children with autism. In particular, you want to measure social awareness, cognition, communication, and motivation, as well as restricted interests and repetitive behavior. You decide you want to gather information from the children’s parents and teachers to get a better idea of what areas of communication and socialization are particularly difficult for each child. Which assessment would you choose? a. Social profile b. Social responsiveness scale c. Sensory profile d. Assessment of communication and interaction skills ANS: b Topic: Assessments LO: 26.4

6. You are working in a community mental health center where the occupational therapy practitioners use the Model of Human Occupation as their practice model. You are looking for an assessment that is associated with this model to examine social skills. In particular, you want an assessment that will allow you to observe your client’s social skills in a variety of environments and activities. Which assessment would you choose? a. Social profile b. Social responsiveness scale c. Sensory profile d. Assessment of communication and interaction skills ANS: d Topic: Assessments LO: 26.4

7. You are working in a dementia-care unit. Many of your clients have difficulty with communication because of limited verbal language. You believe the use of visual supports will help your clients communicate their needs, as well as help with sequencing their daily schedules. Which of the following best represents a visual support? a. Communication board b. Picture exchange communication system c. iPad d. Social skills training ANS: a Topic: Interventions LO: 26.5

8. As a school-based practitioner working with children with autism, you decide you want to aid communication in your clients by asking another classmate to assist by acting as a mentor. These classmates will be trained in how to interact with another child, share toys, and engage in strategies to promote interaction. Which intervention does this best represent? a. Augmentative and alternative communication b. Social skills training c. Peer-mediated intervention d. Joint attention training ANS: c Topic: Interventions LO: 26.5

9. Which of the following is one of the steps included in social skills training? a. Discuss resistance/ambivalence b. Mindfulness c. Joint attention training d. Homework ANS: d Topic: Social Skills Training LO: 26.6

Chapter 27: Pain

Multiple Choice

1. Acute pain can best be defined as . a. Pain that has an insidious onset b. Pain that does not serve a biological purpose c. Pain that has no apparent tissue damage d. Pain that is caused by tissue irritation related to an injury or disease ANS: d Topic: Defining Pain LO: 27.1

2. According to the biopsychosocial model, which of the following best represents the perception of pain that signals you to take action? a. Pain b. Nociception c. Suffering d. Pain behavior ANS: b Topic: Biopsychosocial Model LO: 27.2

3. Which of the following is the most desired outcome of a comprehensive pain assessment for occupational therapy practitioners? a. Understanding of how pain impacts occupational engagement b. Understanding of the initial trauma related to the onset of pain c. Understanding of how medication impacts pain d. Understanding of the psychological impact of pain ANS: a Topic: Evaluation LO: 27.3

4. You are working in a pain clinic and you want to get an understanding of the intensity of pain your 10-year-old client is experiencing. You decide to implement an

evaluation that shows pictures of facial expressions depicting various levels of pain intensity. Which evaluation would you choose? a. Visual analog scale b. Verbal rating scale c. FACES scale d. McGill Pain Questionnaire ANS: c Topic: Evaluation LO: 27.4

5. While completing an assessment with an adult experiencing chronic pain, you ask the client to choose one word from a list of 15 descriptors to identify his pain intensity. There is an associated number with that word that will be used as the pain intensity score. Which assessment does this best represent? a. Visual analog scale b. Verbal rating scale c. FACES Scale d. McGill Pain Questionnaire ANS: b Topic: Evaluation LO: 27.4

6. Which classification of medications is effective with acute pain but must be used with caution because of the potential for these drugs to lead to addiction? a. Opioids b. Anticonvulsants c. Muscle relaxants d. Tricyclic antidepressants ANS: a Topic: Interventions LO: 27.6

7. Holly is a 45-year-old who reports low levels of pain when she is at rest, but this increases to moderate levels when she is doing her instrumental activities of daily living (IADLs). Recently she has had to rely on her husband and children to complete these activities. Therefore, her self-esteem has started to diminish and she’s afraid that before long she won’t be able to do anything. She values her role as a homemaker and her goal is to manage her pain so she can complete the activities associated with this role. You decide to focus your intervention on refocusing Holly’s thinking and incorporating activities such as deep breathing, distraction, and relaxation training that she can use

while engaging in her valued role. Which model of practice is most closely associated with your intervention plan? a. Behavioral Model b. Biomechanical c. Model of Human Occupation d. Relaxation and Refocusing Model ANS: d Topic: Interventions LO: 27.7

8. You want to incorporate the biomechanical model to develop interventions for individuals with chronic pain from arthritis. Which of the following interventions is most closely associated with this model? a. Biofeedback b. Cognitive restructuring c. Environmental adaptations d. Reactivation of interests ANS: c Topic: Interventions LO: 27.7

9. A company’s investment in ergonomic assessments and modifications in all areas of the workplace to avoid repetitive motion and other workplace injuries is a good example of . a. Prevention b. Relapse management c. Pain management d. Biomechanical intervention ANS: a Topic: Prevention LO: 27.8

10. Pain is often comorbid with . a. Mood disorders b. Obesity c. Attention deficit-hyperactivity disorder d. Heart disease ANS: a Topic: Defining Pain

11. The primary approach to pain assessment is a. The use of self-report measures b. The use of physiological measures c. Diagnostic testing d. The use of psychological measures ANS: a Topic: Evaluation

12. What is the best scale to use for the measurement of pain intensity? a. Visual analog scale b. Numerical rating scale c. Verbal rating scale d. Pain interference scale ANS: b Topic: Evaluation

13. What type of pain scales are recommended for persons who have difficulties with written language? a. Numerical rating scale b. Visual analog scale c. FACES scales d. Verbal rating scale ANS: c Topic: Evaluation

14. Which standardized evaluation provides information on occupations and participation? a. Pain diaries b. McGill Pain Questionnaire c. Pain rating index d. Brief Pain Inventory ANS: d Topic: Evaluation

15. What percent decrease in pain represents a change that is meaningful to the individual experiencing pain?

a. 10% b. 5% c. 33% d. 25% ANS: c Topic: Evaluation

Chapter 28: Time Use and Habits

Multiple Choice

1. Occupational therapy practitioners believe time use is influenced by multiple factors. One of those factors involves a position one assumes that has associated responsibilities and expectations such as mother or student. Which factor does this best represent? a. Interests b. Physical abilities c. Roles d. Environment ANS: c Topic: Time Use and Occupational Balance LO: 28.1

2. a.

Occupational balance can best be described as . Engagement in a varieTtyEoSfTaB ctA ivN itK ieS s aEnLdLoE ccRu. paCtiO onMs to meet an individual’s occupational needs Engagement in a satisfying pattern of daily occupations Engagement in activities that are familiar and automatic Engagement in activities that give meaning to daily occupations

b. c. d. ANS: a Topic: Time Use and Occupational Balance LO: 28.2

3. Taking a shower is an example of an automatic activity that can also be classified as . a. Occupational balance b. Lifestyle balance c. Habit d. Routine ANS: c Topic: Habits and Routines LO: 28.3

4. When you asked your client about her leisure interests, she states she spends most of her time watching TV or playing computer games. This can best be described as . a. Active leisure b. Passive leisure c. Maladaptive leisure d. Occupational imbalance ANS: b Topic: Time Use in Individuals With Mental Illness

5. Which of the following most accurately represents older adulthood related to time usage? a. Engagement in meaningful activities may increase life satisfaction. b. Older adults demonstrate significantly lower levels of well-being. c. Older adults spend 40% of their time sleeping throughout the day. d. Older adults spend less time in grooming and self-care activities. ANS: a Topic: Time Use Across the Life Span LO: 28.5

6. You are working in a community mental health center and are concerned your clients are experiencing occupational imbalance. You want to adopt an assessment that will allow your clients to report how they spend their time on a typical day. In addition, the clients are asked to identify their level of competence and enjoyment related to the activity, as well as how important it is to them. Which assessment would you choose? a. Assessment of time management skills b. Occupational questionnaire c. Profiles of occupational engagement with severe mental illness d. Engagement in meaningful activity scale ANS: a Topic: Assessment LO: 28.6

7. Following the collection of data of how your clients are using their time, you decide you need to get a better understanding of how meaningful their time usage is. You want to get a better understanding of the satisfaction your clients get from the activities they participate in, if they find the activities challenging, and if the activities are a reflection of who your clients are. In addition, you want an assessment that will give you an overall score of their level of satisfaction so you can measure change. Which assessment would you choose?

a. Assessment of time management skills b. Occupational questionnaire c. Profiles of occupational engagement with severe mental illness d. Engagement in meaningful activity scale ANS: d Topic: Assessment LO: 28.6 & 28.7

8. You are looking for an intervention to use with your clients with serious mental illness to increase occupational balance. You are interested in an approach that incorporates the following: identifying the clients’ need for change and how they are currently spending their time, providing education on the benefits of engagement in meaningful activities, engaging in long-term goal planning, and regularly monitoring and refining plans as needed. Which intervention would you choose? a. Redesigning daily occupations b. The development of habits and routines c. Action Over Inertia d. Supported employment ANS: c Topic: Interventions LO: 28.8

9. Which of the following is the most important consideration for occupational therapy practitioners when working with a client on habit and routine development? a. Focus on multiple activities at one time to support multitasking. b. Ensure a clear understanding of the client’s strengths and limitations. c. Begin training in the clinic to assure clients’ ability to engage in an activity. d. Use temporal variation to avoid rote learning. ANS: b Topic: Interventions LO: 28.8

10. “Occupational balance” is best defined as . a. Having the same amount of hours each day in the “three main areas” of work, leisure, and rest b. A congruence between the individual’s desired level of engagement in activities and his or her actual level of engagement in activities c. Limiting working hours to not more than 8 hours per day d. Being able to fit at least 6 hours of active leisure into each day ANS: b

Rationale: “Occupational balance” can only be defined subjectively as a mix of activities that are satisfying to the individual. Any attempt to objectively define “occupational balance” is problematic and does not respect the fact that different individuals will have different desires for their occupational experiences. Topic: Time Use and Occupational Balance

11. Time use research suggests that, when compared with the general population, individuals with serious mental illness tend to spend less time in what types of activities? a. Home maintenance and self-care activities b. Productivity and active leisure activities c. Passive leisure and rest/sleep activities d. Family and social activities Rationale: Time use research demonstrates that people with serious mental illness are less likely to spend time in productive activities (as many of these individuals are unemployed) and are also less likely to engage in active leisure activities such as sport or active hobbies. ANS: b Topic: Time Use in Individuals With Mental Illness

SpEaLreLdEwRit.h CthOeMgeneral population, 12. Time use research sugTgE esS tsTthBaAt,NcK om individuals with serious mental illness tend to spend more time in what types of activities? a. Home maintenance and self-care activities b. Productivity and active leisure activities c. Passive leisure and rest/sleep activities d. Family and social activities ANS: c Rationale: Time use research suggests that individuals with serious mental illness spend about 1 to 2 hours more than the general population sleeping and are more likely to take naps during the day. They are also more likely to spend more time in passive leisure activities such as watching television or “doing nothing in particular.” Topic: Time Use in Individuals With Mental Illness

13. People with serious mental illness may experience several barriers to engaging in meaningful activities. Which set of descriptors is best reflective of the barriers to meaningful activity that may be experienced by individuals living with serious mental illness? a. Lack of awareness

b. Lack of money, lack of access to activity partners, lack of time structure, and difficulties with motivation and planning c. Symptoms of serious mental illness d. Unwillingness of the person to engage in meaningful activities ANS: b Rationale: Although lack of awareness and symptoms of serious mental illness may have some influence over engagement in meaningful activities, it is lack of money, lack of access to activity partners, lack of time structure, and difficulties that may be present in terms of motivation and planning that have the most significant impact on people’s ability to engage in meaningful activities. Topic: Time Use in Individuals With Mental Illness

14. Supporting individuals with serious mental illness to engage in paid work can be helpful for developing more satisfying patterns of time use. Which of the following best explains this concept? a. It stops people from being a burden on the welfare system. b. Employment stops people from being lazy. c. Not only does employment provide the individual with the opportunity to engage in productive activities, but it also helps to structure time, build social networks, and generally gives the individual more money to spend on enjoyable activities. d. Employment reduces people’s time for leisure, so it helps to create “occupational balance.” ANS: c Rationale: Employment has a range of benefits for individuals with serious mental illness. Most people with serious mental illness want to work and employment in good quality work roles provides money, time structure, status and esteem, a sense of purpose, social connections, and a range of other benefits, all of which can support more optimal patterns of time use. Even though work takes up many hours of people’s days, individuals who are engaged in employment typically report greater involvement in satisfying leisure activities when compared with people who are not employed. Topic: Time Use in Individuals With Mental Illness

Chapter 29: Introduction to the Environment

Multiple Choice

1. The belief that the environment demands mastery, and engagement with the environment results in an adaptive response, represents which of the following models of practice? a. Ecology of Human Performance b. Person-Environment-Occupation c. Occupational Adaptation d. Kawa Model ANS: c Topic: Environmental and Occupational Therapy Practice Models LO: 29.1

2. The belief that occupational performance is a convergence of the individual, occupation, and environment represents which of the following models of practice? a. Ecology of Human PeT rfE orSmTaB ncAeNKSELLER.COM b. Person-Environment-Occupation c. Occupational Adaptation d. Kawa Model ANS: b Topic: Environmental and Occupational Therapy Practice Models LO: 29.1

3. Buildings, green space, objects, and tools are all aspects of which component of the environment? a. Physical b. Social c. Temporal d. Virtual ANS: a Topic: Components of the Environment LO: 29.2

4. Which of the following is not an accurate representation of the virtual component of the environment? a. People with mental illness may have limited access to the virtual environment. b. Social media can contribute to negative mental health outcomes. c. Virtual environments are easily accessible by all populations. d. Excessive use of social media is associated with depression. ANS: c Topic: Components of the Environment LO: 29.2

5. Congress, the judicial system, and policies such as the Americans with Disabilities Act are all related to which of the following components of the environment? a. Physical b. Social c. Temporal d. Virtual ANS: b Topic: Components of the Environment LO: 29.2

6. Identify the following statement that best represents the impact of attitudinal barriers on individuals with mental illness. a. Stigma can impact an individual's willingness to disclose his or her disability to obtain accommodations to increase success in the workplace. b. Stigma can lead to increased complexity in the physical environment. c. Stigma can lead to decreased access to transportation. d. Stigma can lead to decreased choice in many aspects of the community. ANS: a Topic: Environmental Obstacles to Recovery and Empowerment LO: 29.3

Food pantries, soup kitchens, and thrift stores are all examples of . Peer-led organizations Family support Community resources Supportive education

a. b. c. d. ANS: c Topic: Environmental Resources LO: 29.4

8. The belief that people with lived experience of mental illness can support others going through a similar experience is most often seen in which of the following? a. Peer-led organizations b. Family support c. Community resources d. Supportive education ANS: a Topic: Environmental Resources LO: 29.4

Chapter 30: The Public Policy Environment

Multiple Choice

1. Events such as war and mass shootings that lead to legislative activity to increase mental health services can best be described as . a. Public policy b. Focusing events c. Politics d. Regulation ANS: b Topic: Public Policy, Laws, Regulations, and Politics LO: 30.2

2. Rules developed to enforce laws can best be described as a. Public policy b. Focusing events c. Politics d. Regulation ANS: d Topic: Public Policy, Laws, Regulations, and Politics LO: 30.2

3. The movement to divert money from state mental health institutions to support programs such as outpatient services and partial hospitalizations is most closely associated with the . a. National Mental Health Act b. Joint Commission on Mental Illness and Health c. Community Mental Health Centers Act d. National Institutes of Mental Health ANS: c Topic: Consequences of Policy: Deinstitutionalization LO: 30.3

4. You have a client who was recently discharged from a state mental health center to a group home for individuals with mental illness. This is an example of .

a. Transinstitutionalization b. Deinstitutionalization c. Community integration d. Moral treatment ANS: a Topic: Consequences of Policy: Deinstitutionalization LO: 30.3

5. You are working with Lindsay, a 25-year-old who was diagnosed with bipolar disorder 5 years ago. She is the youngest of six children; her mother is deceased and her father retired last year. The family is concerned about how Lindsay is going to support herself as she has been unable to maintain employment. You recommend that Lindsay apply for which of the following? a. Supplemental Security Income b. Social Security Disabled Adult Child c. Social Security Disability Income d. Medicare ANS: b Topic: Policies That Directly Impact Individuals With Psychiatric Disabilities LO: 30.4

6. You are working with Wally, a 55-year-old who has been working as an accountant for the past 30 years. He was diagnosed with dementia approximately 3 years ago. Although he was able to work initially, his cognitive decline has now made continuing in his position impossible. His family is concerned about how they will support themselves without Wally’s income. You recommend that Wally applies for which of the following? a. Supplemental Security Income b. Social Security Disabled Adult Child c. Social Security Disability Income d. Medicare ANS: c Topic: Policies That Directly Impact Individuals With Psychiatric Disabilities LO: 30.4

7. Which of the following best reflects the program developed to meet the nutritional needs of low-income individuals through food assistance and education? a. Supplemental Nutrition Assistance Program b. The Emergency Food Assistance Program c. Food Stamp Program

d. Medicaid Buy-In Program ANS: a Topic: Non-SSA Entitlement Policies LO: 30.5

8. You are working with a 20-year-old diagnosed with a mental illness who wants to find a job as an information technology (IT) troubleshooter. As you work with this individual, your professional assessment is that he has the skills to qualify him for an IT job. He states he’s concerned that no one would hire him because of his mental illness. You educate him on the act that was the first to ban discrimination based on disability. Which act best reflects this scenario? a. Americans with Disabilities Act b. Olmstead Decision c. Triple Aim d. Rehabilitation Act of 1973 ANS: d Topic: Civil Rights Policy LO: 30.6

9. Which of the followinT gEinSitT iaB tiA veNsKthSaE t iL ncLoErpRo. raC teOs M occupational therapy services was developed to address early diagnosis and treatment of severe mental illness? a. Excellence in Mental Health Act b. Occupational Therapy in Mental Health Act c. State Mental Health Block Grants d. Certified Community Behavioral Health Clinics ANS: c Topic: Specific Policy Impacting Occupational Therapy Practice LO: 30.7

Chapter 31: Stigma: Implications for Health and Recovery

Multiple Choice

1. A 43-year-old-man was recently diagnosed with depression. Since his diagnosis, his family has become critical of him, saying he is lazy, stupid, and worthless. His wife mockingly tells her friends that he has a “mental illness” and they should stay away from him because he’s lost his mind. This is an example of . a. Public stigma b. Self-stigma c. Structural stigma d. Family stigma ANS: a Topic: Stigma in the Social Environment LO: 31.2

2. a. b. c.

Which of the following bestTdE esS crT ibB esAnN oK rmSaE lizL atL ioE nR th. eoCryO?M Behavior that deviates from the norm is identified by someone in power and a label is placed on that behavior. It identifies four types of stigma: stereotype awareness, stereotype agreement, naming selfconcurrence, self-esteem decrement. The focus is on skill development and creating opportunities for persons with disabilities to engage in roles. Public stigma is at the core of this model.

d. ANS: c Topic: Theories of Stigma LO: 31.3

3. You are working with Maria, a 29-year-old who was diagnosed with schizophrenia 10 years ago. She has been working hard at her recovery and her current goal is to seek employment. She wants to work at the local day-care center, but when agencies find out she has a mental illness they reject her application because they are fearful she will hurt the children. Maria has tried to get some of her family members to advocate for her but they are hesitant and actually support initiatives to toughen the laws to prevent people with mental illness from working in the human services field. She finds this demoralizing and begins to experience some signs of depression but quickly engages with her peer support specialist to

overcome these feelings and continue working toward her goal. Drawing from your knowledge of public stigma theory, you recognize this scenario best represents which type of stigma? a. Stigma by association b. Structural stigma c. Self-stigma d. Family stigma ANS: c Topic: Theories of Stigma—Public Stigma LO: 31.2, 31.3, & 31.5

4. Which of the following has been identified as a key factor of why someone does not seek out mental health care? a. Lack of awareness that this service is needed b. Stigma c. Decreased knowledge of mental health-care providers d. Insufficient insurance coverage ANS: b Topic: Public Perceptions of People With Mental Illness LO: 31.4

5. You are planning a vacation with a group of college friends. Someone asked if you were going to invite Julia. You said no because she has a mental illness and you don’t feel comfortable around her. Secretly you are thinking that not only does she have mental illness but she is also Hispanic and you are afraid she might get violent because of her mental illness. This can best be described as . a. Social distancing b. Public stigma c. Discrimination d. Structural stigma ANS: a Topic: Stigmatizing Responses LO: 31.4 & 31.5

6. You are a practitioner at a psychiatric rehabilitation facility who has incorporated the Model of Human Occupation as your practice model. You are working with a 34-year-old client who has been exhibiting decreased volition because of increased feelings of discrimination caused by his mental illness. You want to get a better understanding of your client’s subjective experience of the discrimination and stigma he has been experiencing. You decide to choose a self-assessment that examines the areas of

alienation, stereotype endorsement, discrimination experience, and social withdrawal. Based on this information, which assessment would you choose? a. Volitional Questionnaire b. Internalized Stigma of Mental Illness Scale c. Self-Stigma of Mental Illness Scale d. Self-Stigma Scale—Short Version ANS: b Topic: Assessment LO: 31.7

7. The belief that every individual has access to and the right to engage in a variety of activities of his or her choice can best be described as . a. Marginality b. Inclusion c. Occupational justice d. Sanctioned occupations ANS: c Topic: Self-Stigma LO: 31.9

Chapter 32: Families and Family-Focused Practice

Multiple Choice

1. Which of the following is most reflective of why occupational therapy practitioners should have an understanding of the family environment and the impact mental illness has on that environment? a. Recognition that experiences of family members dealing with someone with mental illness are similar allows for the development of standardized family protocols. b. Family members often interfere with an individual with mental illness seeking appropriate treatment. c. Interventions for family members are readily available. d. Recognition that caring for someone with mental illness can be distressing, and this can impact the health and well-being of other family members. ANS: d Topic: Introduction LO: 32.1

2. Carole’s son was diagnosed with schizophrenia 15 years ago. He has been in and out of the hospital five times. When discharged, her son takes his medication regularly and his symptoms are controlled. About a year after discharge, when he is feeling good, he stops taking his medication thinking he doesn’t need it. Slowly, his symptoms of hallucinations and delusions return. He stops caring for himself and can become violent toward his family members. In addition to the stress of watching her son decompensate, Carole also experiences heightened stress at having to hospitalize him. She reports that she never really relaxes because even when her son is on his medication she worries about when he will stop taking his medication and is always on alert watching for the return of symptoms. This can best be described as . a. Objective burden b. Subjective burden c. Family resilience d. Family culture ANS: a Topic: Overview of the Family LO: 32.3

3. Which of the following best explains why it is important to use a life-span developmental perspective when working with a family dealing with mental illness?

a. It alleviates objective burden. b. It alleviates subjective burden. c. It allows the practitioner to consider the roles of different family members. d. It helps identify family resilience. ANS: c Topic: Life Span and Occupations of Families: A Developmental Perspective LO: 32.3

4. Which of the following best represents occupational therapy’s conceptualization of family? a. It is a linear social system. b. There are both shared occupations and coordinated individual activities that occur within a family. c. It is comprised of those who are related and live in the same household. d. The main objective is to establish and sustain the diagnosed individual’s roles and routines. ANS: b Topic: Overview of the Family LO: 32.4

5. You have been working witT hE LaSrrT y,BwAhN oK isS 4E 5 aLnL dE wR as.dC iaO gnMosed with depression 10 years ago. He has had minimal response to treatment. Because his family has been experiencing both subjective and objective burden, you begin to have family sessions with the goal of increasing the family’s health and well-being by facilitating changes within the family unit to increase participation in valued occupations, while still supporting Larry. As you begin working with the family, you want to acknowledge the family’s strengths as well as their vulnerabilities, increase the family’s understanding of mental illness, and connect them with resources that will support all family members. Which framework does this best represent? a. Model of Human Occupation b. Canadian Model of Occupational Performance and Engagement c. Family Development Framework d. Recovery Framework ANS: d Topic: Frameworks for Family-Focused Practice LO: 32.4

6. Which of the following best reflects the role an occupational therapy practitioner should assume when collaborating with a family of someone with mental illness? a. Assume the doctor has explained the mental illness and treatment options. b. Listen without judgment when the family is experiencing frustration.

c. Recognize your expertise in the area of mental illness and how you can effectively help the family navigate through the daily challenges of caring for someone with a mental illness. d. The practitioner should identify the goals for the collaboration and the plan to achieve these goals. ANS: b Topic: Collaboration in Family-Focused Practice LO: 32.5

7. As an occupational therapy practitioner, you decide you want to gather information to generate a family occupational profile. You want to use a tool that will allow the family to identify their occupational choices, co-occupations, family routines, and information regarding the influence of social and physical environmental influences on the family. Which tool would you choose? a. Role checklist b. Involvement evaluation questionnaire c. Occupational performance history interview d. Family burden interview schedule ANS: c Topic: Assessment LO: 32.6

8. You have been asked to work with a family who has been experiencing increased stress and overall decreased occupational engagement. You decide to use an approach that would allow you to provide information about coping and stress management skills and how to use these skills while engaged in meaningful activities and occupations. Which family education approach does this best represent? a. Family psychoeducation b. Family consultation c. Family support group d. Family peer education support group ANS: a Topic: Information Sharing and Education LO: 32.7 & 32.8

9. After working with the family from Question 8, you think they would benefit from talking to other families who have dealt with mental illness. You hope that this type of intervention will not only help the family gain more information related to how to cope with mental illness, but also allow the family to find support from people who have had similar experiences. Which family education approach does this best represent? a. Family psychoeducation

b. Family consultation c. Family support group d. Family peer education support group ANS: d Topic: Information Sharing and Education LO: 32.7 & 32.8

10. Which of the following terms most accurately describes the term “family”? a. Blood relative b. Relative through marriage c. Someone who is part of the person’s social network d. Someone who lives in the same household e. Someone who is known to the person ANS: c Topic: Overview of the Family

11. When a family member is diagnosed with a mental illness, the family can experience feelings of grief, loss, and despair through a prolonged period of time. This emotional response is commonly referred to as . a. The grieving process b. Subjective burden c. Familial depression d. Objective burden e. Emotional burden ANS: b Topic: Emotional Responses

12. Which of the following most accurately describes the term “family resilience”? a. The strength of relationships within families b. How well the family helps the person who is unwell c. The successful coping of families during life transitions, stress, or adversity d. How well a family understands mental illness e. How well family members manage an illness ANS: c Topic: Family Culture as Context

Chapter 33: Sociocultural Perspectives in Mental Health Practice

Multiple Choice

1. Which of the following most accurately reflects the importance of appreciating an individual’s cultural lens? a. Inheritable lenses are fixed and do not allow for appreciation of other cultural lenses. b. Individuals interpret the world through their inherited cultural lens. c. Occupational behavior can best be understood if the practitioner looks through his or her own cultural lens. d. Adopting one cultural lens allows the practitioner to get a more in-depth understanding of the client’s personal identity. ANS: b Topic: Overview of Culture LO: 33.1 & 33.2

2. Identify the most effective sT traEteSgT yB thA atNoK ccS upEaL tioLnE alRth.eC raO pyMpractitioners should adopt when considering mental health literacy. a. Patient education materials should be presented in written form only. b. Written patient education materials should be created at or above a sixth-grade reading level. c. Practitioners should talk to their clients about mental illness clearly, concisely, and using “plain language.” d. Practitioners should use professional medical terms when talking to their clients to better educate them on their mental illness. ANS: c Topic: Health and Mental Health Literacy LO: 33.3

3. Which of the following is the most accurate statement regarding social determinants and mental health? a. Individuals have the ability to change the majority of these determinants. b. They are the main driver of overall health status. c. They have no impact on an individual’s physical and mental health. d. There is no association between poor socioeconomic status and mental illness. ANS: b Topic: Social Determinants of Mental Health

LO: 33.4

4. You want to incorporate a tool into your practice that will help you ensure culturally responsive mental health evaluations and interventions. In particular, you want a tool that will guide you through ensuring you have established your client’s cultural identity, gained understanding of his or her conceptualization of mental health issues, gathered cultural information regarding the client’s psychosocial environment, and considered how culture may impact the relationship between you and your client. Which assessment would you choose? a. DSM-5 Cultural Formulation Interview b. Cultural Competence Assessment Instrument c. Inventory for Assessing the Process of Cultural Competence Among Health-Care Professionals d. Occupational Performance History Interview ANS: a Topic: Impact of Culture on Mental Health Diagnosis LO: 33.6

5. As a practitioner working in a culturally diverse area, you want to approach each client with an open mind and no assumptions. When you’re working with each client, you want to ask questions and gather data to formulate and test hypToE thS esT esBrA egN arK diS ngEtL heLbEeR st . apCpO roM ach to working with each client. Which characteristic of a culturally competent provider does this best represent? a. Culture-specific expertise b. Scientifically minded practice c. Dynamic sizing d. Cultural explanations ANS: b Topic: Culturally Responsive Caring in Mental Health Practice LO: 33.7

6. The organization where you work has adopted a model of cultural competence that stresses all practitioners should ask questions to develop skills for all cross-cultural interactions. This model contends that culture is learned, localized, and patterned and, although it is persistent, it is adaptable. Which model does this best represent? a. Culture-emergent model b. Sunrise model of culturally congruent care c. Multicultural and social justice counseling competencies d. Transcultural health care ANS: a Topic: Models of Cultural Competency From Other Professions

LO: 33.8

7. As an occupational therapy practitioner, you want to incorporate a model of cultural competence that is derived from your profession. After investigation of different models, you choose a model that requires the practitioner to critically examine his or her position within society and privilege associated with that position, gain understanding of his or her clients’ cultural characteristics, and engage in skill building to interact with clients from various cultural backgrounds in a respectful and empathetic manner. Which model does this best represent? a. Kawa River Model b. Model of Human Occupation c. Canadian Model of Occupational Performance and Engagement d. Cultural Competence Conceptual Framework ANS: d Topic: Models of Cultural Competency LO: 33.9

8. You recently completed your professional development plan for the coming year. One of your goals was to become a more culturally responsive practitioner. One of the more difficult activities you want to engage in is exploring your T biE asStoTwBaA rdNcK erS taE inL cuLltE urRal.gC roOuM ps. Which of the five aspects of culturally responsive practice does this best represent? a. Generating cultural knowledge b. Building cultural awareness c. Exploring multiculturalism d. Applying cultural skills ANS: b Topic: Outcomes of Cultural Competency Training for Health-Care Professionals LO: 33.10

Chapter 34: The Neighborhood and Community

Multiple Choice

1. Recently there has been more attention on the influence of neighborhoods and community on mental health. Identify why this is important for occupational therapy practitioners. a. It supports occupational therapy’s belief that physical and social environments can support or interfere with occupational performance. b. It supports occupational therapy’s belief that client factors can support or interfere with occupational performance. c. It supports occupational therapy’s belief that performance skills can support or interfere with occupational performance. d. It supports occupational therapy’s belief that performance patterns can support or interfere with occupational performance. ANS: a Topic: Introduction LO: 34.1

2. How would you define a geographic area that is close to your home and provides opportunities for you to become friends with those who live in this area, as well as provide and receive physical and emotional support from these individuals? a. Community b. Catchment area c. Village d. Neighborhood ANS: d Topic: Definition of Neighborhood and Community LO: 34.2

3. Which of the following most accurately represents the current interest in the relationship between neighborhoods, communities, and mental health? a. The less-than-optimal results of deinstitutionalization require exploration and modification of residential support facilities for people with mental illness. b. It supports the concept of marginalization. c. Historically, the understanding of mental illness has been focused on the individual level; there is now a need to incorporate broader social and ecological perspectives.

d. It supports placing older adults in assisted living facilities. ANS: c Topic: Current Interest in Neighborhoods and Communities LO: 34.3

4. Recent research suggests that engagement in meaningful daily activities may decrease a person’s exposure to unsafe situations. Which of the following best supports this finding? a. It decreases the concern of drug use and dealing in their neighborhood. b. They allow individuals to develop skills and knowledge that can be used to navigate neighborhood conflict. c. Engagement in daily activities increases occupational balance. d. The development of a supportive social network can eliminate harassment and victimization. ANS: b Topic: Relationship of Neighborhood Environment to Occupation LO: 34.4

5. Which of the following has demonstrated the most effectiveness in reducing stigma? a. Interpersonal contact TaEteSriTalBANKSELLER.COM b. Distribution of educational m c. Organized protests d. Social activism ANS: a Topic: Relationship of Neighborhood Environment to Occupation LO: 34.4

6. The neighborhood profile will also provide information related to the potential for the development of a consumer-run business. Which of the following best describes a consumer-run business? a. A business venture developed to achieve social outcomes b. Supportive employment c. A business venture run by a community mental health center d. A business venture run completely by mental health consumers ANS: d Topic: Intervening to Develop Supportive Neighborhood Communities LO: 34.5

7. Using the strength-based approach described by Kretzmann and colleagues to establish occupational therapy practice in the area of community development, you would begin with an assessment of the community. Which of the following should be included in this assessment? a. Identify financial resources that communities could contribute to people with mental illness. b. Identify skills and resources that people with mental illness could contribute to their communities. c. Identify potential residential facilities for people with mental illness. d. Determine how community agencies can prevent re-hospitalization for individuals with mental illness. ANS: b Topic: Dynamic Assessment of Neighborhood and Community Capacity LO: 34.6

8. As a community-based practitioner, you want to create a peer support program to assist your clients with community integration. Which of the following best represents a peer support strategy you could implement? a. Establish a mentor program. b. Establish community accessibility committees. c. Establish reduced transit fare for people with disabilities. d. Establish a supportive education program. ANS: a Topic: Examples of Neighborhood IT ntE erS veTnB tioAnN s KSELLER.COM LO: 34.7

9. Contemporary theories suggest that which of the following may explain the successful acceptance and inclusion of people with mental illness in neighborhood communities? a. The provision of extra resources for people with mental illness b. Strong Neighborhood Watch programs c. Opportunities for prosocial contact with residents with mental illness d. Distance of the local neighborhood from the mental health institution ANS: c Topic: Neighborhood Safety

10. Social capital refers to . a. The wealth of a specific neighborhood or community b. The extent to which residents have access to social services and programs within a neighborhood or community c. Social networks and norms that feature trust, cooperation, and reciprocity d. Economic initiatives to improve the daily lives of vulnerable community residents

ANS: c Topic: Neighborhood Organization and Activism

11. Occupational therapy practitioners engaged in community development focus on . a. Ensuring that people who experience mental health issues have access to meaningful occupational opportunities in neighborhood communities b. Developing mental health services and programs in local neighborhoods as indicated by neighborhood profiles c. Assisting people with mental illness to relocate, where necessary, to inclusive neighborhood communities d. Delivering community-based services to people with mental illness to address their daily living needs ANS: a Topic: Intervening to Develop Supportive Neighborhood Communities

12. Housing First refers to a specific housing approach for people with mental illness who are at risk for homelessness. A defining feature of the approach is . a. A particular focus is on ensuring decent housing conditions b. Ensuring that housing provides thT eE neS edTeB dA leN veK lS ofEsuLpL poErtRt. oC reO sidMents c. Ensuring neighborhood acceptance of the housing d. Housing provided based on individual choice without stipulations for treatment ANS: d Topic: Neighborhood Safety

Chapter 35: The Home Environment: Permanent Supportive Housing

Multiple Choice

1. Occupational therapy practitioners have the opportunity to contribute to the successful housing needs of individuals with mental illness. Which of the following is most reflective of what an occupational therapy practitioner can contribute to addressing these housing needs? a. They access financial resources to assist the individual in paying his or her rent. b. They assist with medication management to reduce the risk of recidivism. c. They make discharge placement decisions to assure the successful transition to permanent supportive housing. d. They assess independent living skills an individual needs to be successful in transitioning to permanent supportive housing. ANS: d Topic: Introduction LO: 35.1

2. Having the ability to make decisions regarding their home is an example of which aspect of the “sense of home” contributing to mental health recovery? a. Control and self-determT inE atS ioT n BANKSELLER.COM b. Right to privacy and freedom c. Place for engaging in daily life d. Rebuilding of sense of identity ANS: a Topic: Home as a Facilitating Context for Recovery LO: 35.2

3. Which of the following best describes the impact of poverty on an individual’s access to housing? a. It limits access to benefits such as the Supplemental Nutrition Assistance Program. b. It increases the risk of trauma and assault. c. It contributes to the “not in my back yard” attitude. d. It interferes with access to the basic needs of daily living. ANS: d Topic: Risk and Impact of Homelessness LO: 35.3

4. Legislation such as the Americans with Disabilities Act and the Olmstead Integration Mandate are examples of . a. An individual’s right to live in the community b. Stigma and discrimination

c. An individual’s right to affordable housing d. Impact of poverty ANS: a Topic: Public Policy Initiatives to Address Barriers to Housing LO: 35.4

5. The Department of Housing and Urban Development’s housing rental assistance program best addresses which of the following? a. Right to live in the community b. Right to affordable housing c. Permanent supportive housing d. Linear continuum paradigm ANS: b Topic: Public Policy Initiatives to Address Barriers to Housing LO: 35.4

6. Omar was diagnosed with schizophrenia 15 years ago. He has been living in a skilled nursing facility for the past 10 years. Recently, he was discharged and moved into his own apartment. He is excited to have the opportunity to be living in the same apartment building as people without mental illness. Which core element of permanent supportive housing does this best represent? a. Separation of housing aT ndEsS erT viB ceAs NKSELLER.COM b. Choice of housing c. Housing integration d. Decent, safe, and affordable housing ANS: c Topic: Core Elements of Permanent Supportive Housing LO: 35.5

7. Omar is also excited because his ability to live in his apartment is not based on his compliance with mental health treatment. Which core element of permanent supportive housing does this best represent? a. Separation of housing and services b. Choice of housing c. Housing integration d. Decent, safe, and affordable housing ANS: a Topic: Core Elements of Permanent Supportive Housing LO: 35.5

8. You want to get a better idea of Omar’s cognition and how it affects his ability to engage in daily activities. You decide to use an assessment that incorporates an interview with Omar, as

well as observations of Omar engaging in a variety of self-care and instrumental activities of daily living (IADL) tasks. Which assessment would you choose? a. Occupational Performance History Interview–II b. Residential Environment Impact Scale c. Allen Diagnostic Modules d. Routine Task Inventory–Expanded ANS: d Topic: Assessments LO: 35.6

9. Which of the following most accurately reflects the contribution an occupational therapy practitioner can make to address the impact of neurocognitive functioning on housing? a. Make recommendations on sensory processing preferences to increase successful home management routines b. Educate housing teams on how to implement life skills training in regards to the cognitive aspects of activities of daily living c. Mediate hoarding behaviors with the use of the Community Clutter & Hoarding Toolkit d. Maintain ability to provide interventions for comorbid health conditions ANS: b Topic: Providing Flexible Supports LO: 35.7

10. Having one’s own housing and a sense of “home” can facilitate recovery for persons with mental illness. Which option best represents one way in which this can happen? a. It simply means you are not in a hospital, and recovery can never happen in a hospital. b. It allows a person to use successful street-dwelling skills in a new environmental context. c. It provides an increased opportunity for privacy and freedom from surveillance. d. It reduces societal impact of homelessness and cost of long-stay residential care. ANS: c Topic: Home as Facilitating Context for Recovery

11. Permanent supportive housing is an alternative approach to addressing the problems associated with what was called the linear continuum approach to housing for persons with mental illness. Which option best identifies key criticisms leveled at the linear continuum approach? a. It was too costly because it required multiple types of housing options as the person moved from one level to another. b. It didn’t meet the needs of persons with mental illness who did not have the necessary independent living skills. c. Families rejected this approach because their loved ones were often placed in housing too far away for them to visit. d. Moving from level to level disrupted interpersonal relationships and adjusting to each new context was stressful. ANS: d Topic: Home as Facilitating Context for Recovery

12. Despite the development of permanent supportive housing, custodial housing settings such as residential care homes, boarding homes, and board and care homes remain part of the mental health system of care. Which option best represents the limitations of such settings for promoting recovery? a. These settings are typically licensed by local governments, but seldom inspected or audited for adherence to standards. b. There is limited availability of individually tailored site-based or community-level occupational opportunities. c. Staffing levels are low and focused mostly on providing basic needs—food, shelter, personal care, and medications. d. Because other residents are persons with mental illness, there is limited opportunity for social interaction. ANS: b Topic: Problems with Custodial Housing

13. Nationally and internationally, public policy initiatives have been utilized to address housing needs for persons with mental illness. In the United States, which public policy initiative resulted from what has been described as a “landmark” Supreme Court decision to ensure community integration for persons with mental illness? a. Americans with Disabilities Act (ADA) b. Olmstead Integration MT anEdS atT e BANKSELLER.COM c. Fair Housing Act d. Money Follows the Person (MFP) ANS: b Topic: The Right to Live in the Community

Chapter 36: Early Intervention: A Practice Setting for Infant and Toddler Mental Health

Multiple Choice

1. Stable and responsive relationships within the context of a cohesive family most often contribute to which of the following? a. Adverse childhood experiences b. Disruption in self-regulation c. Development of a strong sense of self d. Changes in brain architecture associated with chronic conditions such as heart disease ANS: c Topic: Infant and Toddler Mental Health LO: 36.1

2. The philosophy of early intervention programs is best described by which of the following? a. They are services provided to children aged 0 to 10. b. They are services provided under Medicare Part C. c. They are services provided in the hospital. d. They are services for chT ildErS enTaB t rA isN kK foS r cEoL ndLitE ioR ns.tC haOt M may impair their ability to participate in occupations associated with their developmental age. ANS: d Topic: Early Intervention Programs, Mission, and Philosophy LO: 36.2

3. You are an occupational therapy practitioner working in early intervention who has adopted a model of care that focuses on the relationship between the provider and family. You recognize the family is the expert on their child’s habits and routines so you want them to be an active member of the intervention team. Which of the following most accurately reflects this model? a. Primary service provider model b. Family-centered care model c. Individualized family service model d. Dynamic systems model ANS: b Topic: Early Intervention Programs, Mission, and Philosophy LO: 36.2

4. You are working on an early intervention team where the team members engage in more informal communication. Your goals are specific to occupational therapy practice and the only time the team formally discusses their intervention approaches and progress for each child that is

being seen occurs in formal team meetings. Which of the following team approaches does this best represent? a. Multidisciplinary team b. Interdisciplinary team c. Transdisciplinary team d. Interprofessional education collaborative ANS: a Topic: Team Members and Approaches to Teamwork LO: 36.3

5. Which of the following is an important consideration when providing occupational therapy services in early intervention programs? a. Interventions should occur within a clinical setting. b. Interventions should focus on preparatory activities. c. Interventions should focus on adverse childhood experiences. d. Interventions should occur within the context of the child-caregiver relationship. ANS: d Topic: Role of Occupational Therapy LO: 36.4

6. A child has been referred to your early intervention clinic. As you are developing the child’s occupational profile, youTwEaS ntTtoBgAaN thK erSinEfoLrL mE atR io. nC abO ouMt any conditions that may impact his or her developmental outcomes. In addition, you want to gather information on the child’s physical and social environment and how the child interacts within this environment. Which model does this most accurately represent? a. Dynamical systems approach b. Psychobiological attachment theory c. Transactional model d. Sensory processing model ANS: c Topic: Conceptual Practice Models and Theoretical Frameworks LO: 36.5

7. You are working with a child who has a strong negative reaction to touch but does nothing to modify the environment to avoid being touched by others. This is impacting the childparent relationship. His mother states she doesn’t know what to do to calm her son. You decide to increase your understanding of both the child’s and mother’s neurological thresholds and selfregulation strategies in order to develop an intervention strategy to improve the child-parent relationship. Which model does this most accurately represent? a. Dynamical systems approach b. Psychobiological attachment theory c. Transactional model d. Sensory processing model ANS: d Topic: Conceptual Practice Models and Theoretical Frameworks

LO: 36.5

8. You are concerned about the interaction between a 2-year-old child you are treating and her caregiver. In particular, you notice when the child tries to interact with her father, the father does not reciprocate. You want to gather more information about this relationship. You incorporate an assessment that allows you to examine the relationship between the father and child during feeding time. Which assessment does this best represent? a. Ages and Stages Questionnaire b. Assessment of Dimensions of Caregiving, Infant Contributions to the Relationship, and Dimensions of the Caregiving Environment c. Psychosocial and Environmental Stressor Checklist d. Infant and Toddler Sensory Profile 2 ANS: b Topic: Assessments LO: 36.6

9. You are an occupational therapy practitioner working with a child who is preparing to transition out of early intervention. Which of the following most accurately reflects your role in this situation? a. Identify environmental risks that may contribute to developmental delays. b. Wait until the child turns 3 to begin talking about the transition. c. Work with the child andTfE am lyBoA nN deK veSloEpL inL gE neRw.hCabOitM s and routines that will occur SiT following the transition. d. Assess the family’s social/cognitive competence. ANS: c Topic: Transition to Early Childhood LO: 36.7

10. Attending to infant and toddler mental health in early intervention practice is important because of which reason? a. Social-emotional development affects other developmental domains. b. Occupational therapy is the only discipline that can address social-emotional development. c. Little is known about the role of social-emotional development. d. Attention to this domain of development lends itself well to interdisciplinary teaming. ANS: a Topic: Infant and Toddler Mental Health

Chapter 37: Early Psychosis Programs for Adolescents and Young Adults

Multiple Choice

1. Identify the most important reason why early psychosis programs focus on the prodrome and first episode psychosis periods as it relates to occupational therapy. a. It can prevent a full-blown psychotic episode. b. It can prevent the progression of symptoms into a diagnosable mental illness. c. This is the period where the majority of functional decline occurs. d. It allows for the diagnosis of attenuated psychotic symptoms. ANS: c Topic: Overview of Early Psychosis LO: 37.1

2. Evidence suggests that recovery-oriented early psychosis programs result in which of the following? a. No improvements in symptoTmEsS orTfB unAcN tioKnS inE g LLER.COM b. Improvements in symptoms but not functioning c. Improvements in functioning but not symptoms d. Improvements in symptoms and functioning ANS: d Topic: Overview of Early Psychosis LO: 37.2

3. Initiatives that focus on public education campaigns, targeted education for high-risk groups, and increasing awareness of cultural contexts represent which core principle of early psychosis programs? a. Promoting recovery b. Increasing public awareness and decreasing stigma c. Family engagement and support d. Practitioner training ANS: b Topic: Core Principles and Components of Early Psychosis Programs LO: 37.2

4. Identify the most important reason for acceptance of a clinical staging approach to early psychosis. a. It predicts the potential progression of symptoms into a full-blown psychosis. b. It predicts potential functional impairments. c. It facilitates reimbursement. d. It helps determine the most effective treatment approach. ANS: d Topic: The Clinical Staging Approach LO: 37.3

5. Identify the most important reason for occupational therapy practitioners to be involved in early psychosis programs. a. They help clients maintain a sense of self through ongoing engagement in meaningful roles and activities. b. They help clients develop performance skills. c. They help identify client factor impairments. d. They help with environmental adaptations. ANS: a Topic: Role of Occupational Therapy LO: 37.4

6. Evidence indicates that individuals at clinical high risk for psychosis displayed patterns of higher scores in low registration, sensation sensitivity, and sensation avoiding and lower scores in sensation seeking. Which model was this research based on? a. Person-Environment-Occupation b. Model of Human Occupation c. Dunn’s Model of Sensory Processing d. Canadian Model of Occupational Performance ANS: c Topic: Models of Practice LO: 37.5

7. You are a practitioner working in an early intervention program using the Model of Human Occupation to guide your practice. You are interested in using an assessment to examine how an individual perceives his own competence in daily occupations and how important these occupations are to the individual. Which assessment would you choose? a. Occupational self-assessment b. Canadian occupational performance measure

c. Structured interview for prodromal syndromes d. Occupational circumstances assessment interview and rating scale ANS: a Topic: Assessments LO: 37.6

8. Which of the following is the most important reason for implementing group interventions when working with adolescents and young adults? a. They are a cost efficient way to deliver interventions. b. They promote social skills functioning in clients. c. They highlight the homogeneity of client issues. d. They can address a broad array of client issues. ANS: b Topic: Interventions LO: 37.7

9. Psychotic disorders typically have their onset during what age range? a. 5 to 15 years old b. 10 to 20 years old c. 15 to 25 years old d. 20 to 30 years old ANS: c Topic: Overview of Early Psychosis

10. In the clinical staging approach to treating first episode psychosis, which stage includes helpseeking, mild symptoms of psychosis, neurocognitive deficits, and mild functional impairment? a. Stage 0–Increased risk of psychosis b. Stage 1–Possible prodrome c. Stage 2–First episode psychosis or mood disorder d. Stage 3–Recurrent or persistent disorder e. Stage 4–Severe, persistent, and unremitting illness ANS: b Topic: Overview of Early Psychosis

11. Which of the following early psychosis interventions has a primary focus on teaching problemsolving skills?

a. Multifamily group b. Case management c. Community integration d. Supported employment ANS: a Topic: Early Psychosis Programs

12. The occupational therapist is the only team member on an early psychosis program team to evaluate which of the following factors? a. Person-Environment-Occupation interaction b. Cognition c. Social skills d. School/employment performance ANS: a Topic: Early Psychosis Programs

13. You are working in an early psychosis program and meet with a new client, Jesus, and his family for an initial interview. In discussions with Jesus and his family, you discover that he tends to stay in his room with the lights dimmed and haT sE drS opTpB edAoN utKoS fE mL anL yE ofRt. heCaO ctM ivities he used to participate in at school. You have reports from his teachers that his grades have been dropping and that Jesus appears to be having difficulty staying awake and focusing in lecture classes but that he becomes somewhat reactive and irritable in his large laboratory class, which is very physically busy and loud. When you perform the adolescent/adult sensory profile with Jesus, which sensory processing pattern are you likely to see? a. High scores in low registration, sensory sensitivity, and sensation avoidance with low scores in sensation seeking b. High scores in low registration and sensation seeking with low scores in sensation avoidance and sensation seeking c. Low scores in low registration and sensory seeking with high scores in sensation avoiding and sensory sensitivity d. Average scores in low registration, sensation seeking, and sensation avoiding but high scores in sensory sensitivity ANS: a Topic: Assessment

Chapter 38: Peer-Led Services

Multiple Choice

1. Which of the following most accurately reflects the concept of peer-led services? a. It allows for a client-centered approach to treatment. b. People with lived experience support others as they move toward recovery. c. It is an occupational therapy approach to care. d. It allows for the mental health professional to guide treatment. ANS: b Topic: Overview of Peer-Led Services LO: 38.1

2. Identify which of the following led to the evolution of peer-led services. a. It was mandated by the Center for Mental Health Services. b. It was mandated by the Substance Abuse Mental Health Service Administration. c. It developed through advocacy of peers dissatisfied with existing mental health services. d. It was an occupational therapy initiative. ANS: c Topic: Historical Context LO: 38.2

3. Which of the following is a key principle for peer-led services? a. Consult with mental health professionals to determine the best approach to recovery. b. Peer support should only occur following formal mental health treatment. c. Peer-led interventions should be highly structured and evidence-based. d. Approaches to mental health care should be respectful and collaborative. ANS: d Topic: Underlying Concepts LO: 38.3

4. Identify the most important benefit of using peer-led services to enhance mental health interventions. a. Peer-support services have increased funding for mental health services.

b. Individuals in recovery benefit from mentorship to develop coping strategies and identify resources to support recovery. c. Individuals in recovery benefit from the services of a counselor to recommend coping strategies and resources to support recovery. d. Individuals in recovery benefit from the services of a case manager for community integration. ANS: b Topic: Overview of Peer-Led Services LO: 38.4

5. A family of a young man diagnosed with autism has established a program to help other individuals with this diagnosis develop skills necessary to transition into valued occupational roles and integrate into the community. At the same time, this organization provides support and education to family members. Which type of peer-led service does this best represent? a. Wellness coaching b. Peer-led organization c. Peer-professional partnership d. Peer mentoring ANS: b Topic: Types of Peer-Led Services LO: 38.5

6. Which of the following best describes the role of an occupational therapy practitioner in peer-led services? a. Provide direct service b. Assume responsibility for development and implementation of peer-led services in an inpatient setting c. Assume responsibility for administration of community peer-led services d. Guide a training program for peer support providers ANS: d Topic: Role of Occupational Therapy LO: 38.6

7. Identify the best contribution an occupational therapy practitioner can make when collaborating with a peer-led organization. a. Develop and implement occupational therapy-led services to promote occupational engagement b. Deliver educational programs to peers related to mental illness c. Collaborate with peer specialists to develop a life skills curriculum

d. Provide a list of mental health professionals who can manage the organization ANS: c Topic: Role of Occupational Therapy LO: 38.6

Chapter 39: Mental Health Practice in Criminal Justice Systems

Multiple Choice

1. Within a justice system, legislators are responsible for which of the following? a. Write new laws and policies to limit crime b. Determine if a law was broken c. Divert offenders from traditional court proceedings and incarceration d. Enforce sentences requiring incarceration ANS: a Topic: Key Elements in Criminal Justice Systems LO: 39.2

2. A court that works with individuals with mental illness who are detained for committing a crime in order to connect them with the resources needed for mental health services best exemplifies which of the following? a. Legislation b. Problem-solving courT tsESTBANKSELLER.COM c. Adjudication d. Forensic psychiatry ANS: b Topic: Problem-Solving Courts LO: 39.3

3. Occupational therapy practitioners may work for agencies that support individuals with transition out of prison by assisting with work-skill development, promoting money management, and increasing life skills. Which of the following does this type of agency best represent? a. Minimum security prisons b. Jails c. Secure psychiatric hospitals d. Community-based justice systems ANS: d Topic: Correctional Institutions LO: 39.4

4. The inclusion of work training programs in the prison system most accurately reflects which of the following occupational science concepts? a. Occupational enrichment b. Occupational deprivation c. Occupational imbalance d. Occupational alienation ANS: a Topic: Occupational Risk Factors LO: 39.5

5. When working in the justice system, it is important to have knowledge in six different key areas. Developing skills to manage environmental stressors and attending to personal safety are examples of which type of knowledge? a. Practical skills b. Professional development c. Interventions d. Judicial systems ANS: a Topic: Key Knowledge and Skills for Practitioners in Justice Settings LO: 39.6

6. The Occupational Circumstances Assessment Interview and Rating Scale is a Model of Human Occupation tool that can be used to help formulate which of the following? a. Cognitive limitations b. Motor impairments c. Communication/Interaction skills limitations d. Occupational profile ANS: d Topic: Assessments LO: 39.7 & 39.8

7. You are working with an individual who is preparing for release from a secure psychiatric hospital. You want to explore the challenges this individual may experience once he’s discharged. Specifically, you are interested in identifying challenges related to completing activities of daily living, instrumental activities of daily living, and obtaining a job. You would prefer an assessment that is associated with the Canadian Model of Occupational Performance. Which assessment would you choose? a. Model of Human Occupation Screening Tool b. Level of Service Inventory

c. Offender Reintegration Scale d. Canadian Occupational Performance Measure ANS: c Topic: Assessments LO: 39.7 & 39.8

8. You are working with an individual who indicated that before being in prison he had difficulty maintaining a job because he didn’t get along with his boss and coworkers. Which of the following interventions would you employ to address this concern? a. Money management b. Social skills development c. Work skills development d. Community leisure activities exploration ANS: b Topic: Occupational Therapy Interventions LO: 39.9

Chapter 40: State Hospitals

Multiple Choice

1. Which of the following most accurately reflects involuntary civil commitment to a state mental health hospital? a. An individual recognizes he or she needs to be hospitalized for his or her psychiatric symptoms. b. The courts order an individual to be hospitalized because the person is a danger to himself or herself, or others. c. The courts order an individual to be hospitalized because he or she has been accused of committing a crime but is not competent to stand trial. d. An individual is accused of civil disobedience. ANS: b Topic: Overview of State Hospitals in the United States LO: 40.1

2. Which of the followinT gEmSoT stBaA ccNuK raS teE lyLrL efE leRct.s C thOeMrole of the occupational therapy practitioner in state hospitals? a. Focus on addiction services b. Focus on vocational services c. Focus on skill development to promote successful community reintegration d. Focus on forensic services ANS: c Topic: The Treatment Team LO: 40.3

3. Identify which of the following best reflects an administrative opportunity for an occupational therapy practitioner working in a state hospital. a. Provide services based on the Recovery Model b. Implement a vocational skills development group c. Advocate for consumer needs on the strategic planning committee d. Serve as a liaison between the state hospital and community mental health center ANS: c Topic: The Role of Occupational Therapy LO: 40.4

4. Daily observations of an individual’s behavior in the milieu and in group therapy can best be described as_ . a. Initial evaluation b. Informal reevaluation c. Formal reevaluation d. Discharge evaluation ANS: b Topic: Evaluation LO: 40.5

5. Which of the following is a consideration occupational therapy practitioners should be aware of when evaluating individuals in a state hospital? a. Individuals may have physical disabilities as well as psychiatric disabilities. b. Individuals who are deaf should be evaluated using written self-assessments. c. Many individuals in state hospitals have lower extremity injuries caused by selfinjurious behaviors. d. Individuals should always be evaluated in the presence of security personnel because of safety concerns. ANS: a Topic: Evaluations LO: 40.5

6. When individuals who have experienced long-term hospitalizations are preparing for discharge, which of the following is the most beneficial intervention approach for occupational therapy practitioners? a. Increasing impulse control b. Establishing medication routine c. Addressing reality orientation d. Developing functional living skills ANS: d Topic: Interventions LO: 40.6

7. Group interventions in state hospitals present opportunities and challenges. Which of the following is the most beneficial aspect of groups for hospitalized individuals? a. It is an efficient way to deliver interventions when staffing is limited. b. It provides opportunities for group members to engage in social participation. c. It allows practitioners to deliver interventions to a larger number of individuals than would be allowed by one-to-one interventions.

d. It allows practitioners to address each client’s individual goals. ANS: b Topic: Limitations of Context LO: 40.7

8. Which of the following research findings supports the use of sensory approaches in inpatient psychiatric facilities? a. It has been shown to reduce the use of seclusion and restraints. b. It has been shown to increase social participation. c. It has been shown to decrease recidivism rates. d. It has been shown to increase staff morale. ANS: a Topic: Sensory Approaches LO: 40.8

9. The best example of a Recovery Model-focused treatment intervention is which of the following? a. Development of the treatment plan based on patient deficits b. Allowing clients to choose the menu during a cooking group c. Treatment team providTiE ngStT hB eA clN ieK ntSwEitLhLaEpR re. esCtaObM lished group schedule d. Purchasing a coat for a client without asking for hi or her preference in style or color ANS: b Topic: Interventions Rationale: Interventions in the Recovery Model are focused on providing individuals with choice, which is focused on strengths supporting them in achieving self-identified goals and empowering them to make decisions and do for themselves. Occupational therapists must help clients maximize individuality and offer choice.

10. Which adjunctive treatment team members work to assist in the development of the worker role in teaching and reinforcing work habits and behaviors? a. Social workers b. Addiction counselors c. Vocational adjustment services d. Certified therapeutic recreation specialists ANS: c Topic: The Treatment Team Rationale: Vocational adjustment services teach basic job-related skills and provide feedback regarding work attitudes, working relationships, and habits. These staff

members work in conjunction with the treatment team to assist and support transition to working within the community upon discharge.

11. The treatment mall approach provides clients with which of the following? a. A decentralized structure of programming that allows the client to have more choice in the programming attended b. Ward-based groups and treatment sessions c. Smaller groups because of lower participation rates d. Social isolation and dependence upon staff ANS: a Topic: Group Intervention Rationale: Treatment malls are based on the psychoeducational model and clients participate in groups designed to assist in improving life skills. They are typically held in locked buildings away from where the clients live and are integrated with other wards for increased social interaction. Typical treatment malls run on a rotational 12-week style in which treatment interventions are altered, offering new selections for patients at designated intervals.

Chapter 41: Supporting Individuals Through Crisis to Community Living: Meeting a Continuum of Service Needs

Multiple Choice

1. Individuals with mental illness may require a variety of services ranging from inpatient care to supporting function in the community. This range of services may best be described as which of the following? a. Continuum of needs b. Transitional care services c. Health-care delivery models d. Accountable care organizations ANS: a Topic: Introduction LO: 41.1

2. Hospital admissions in which the individual agrees to treatment and to stay as long as treatment is deemed nTecEeS ssTarByAisNiK deSnEtiL fieLdEaRs . wC hiOchM of the following? a. Outpatient commitment b. Involuntary commitment c. Emergency hospitalization d. Voluntary admission ANS: d Topic: Inpatient Hospital Admission LO: 41.2

3. A dementia care inpatient program most accurately represents which of the following inpatient mental health settings? a. Acute care b. Inpatient hospital program c. Specialized hospitalization program d. Geriatric hospitalization program ANS: c Topic: Inpatient Mental Health Settings LO: 41.3

4. As an occupational therapy practitioner working in an acute care mental health setting, which of the following intervention strategies that has been shown to increase patient satisfaction and occupational participation after discharge would you want to implement? a. Social skills development b. Incorporating stress management skills while performing everyday tasks c. Vocational skills training d. Cognitive behavioral strategies ANS: b Topic: Inpatient Mental Health Settings LO: 41.4

5. You are an occupational therapy practitioner working in an outpatient setting where clients attend Monday through Friday for 6 hours a day. Your interventions focus on skills related to increasing your clients’ success in independent living, such as money management, cooking, and household management. Which outpatient setting does this best describe? a. Partial hospital program b. Intensive outpatient program c. Residential outpatient program d. Transitional housing program ANS: a Topic: Partial Hospitalization Programs and Intensive Outpatient Programs LO: 41.5

6. Which of the following is a critical determinant of where a person goes after discharge from an inpatient setting? a. Level of social support b. Prehospitalization living situations c. Insurance d. Medication compliance ANS: c Topic: Discharge From Inpatient Care LO: 41.6

7. As an occupational therapy practitioner working in a community mental health center, you adopt an intervention approach that is client-centered and focuses on developing daily living and vocational skills that promote recovery and community integration. Which of the following community approaches would you choose? a. Supportive employment

b. Psychiatric rehabilitation c. Assertive community treatment d. Patient outcomes research team ANS: b Topic: Community Approaches LO: 41.7

8. You are an occupational therapy practitioner working on a case management team that is available to their clients 24 hours a day. Responsibilities include working with clients in a variety of settings and facilitating skill development to increase successful community participation. Because you may find yourself engaging in responsibilities typically associated with social work, it is important you have a strong professional identity and ground your interventions in the philosophy of occupational therapy. Which of the following case management approaches does this best represent? a. Strengths based b. Broker model c. Assertive community treatment d. Psychiatric rehabilitation ANS: c Topic: Community Approaches LO: 41.7

9. As a member of an Assertive Community Treatment (ACT) team, you are working with an individual who currently lives in a skilled nursing facility. She has expressed an interest in getting her own apartment. The team begins to collaborate to help this individual achieve her goal. Based on this individual’s goal, you decide you want to assess which of the following? a. Social skills b. Occupational competence c. Vocational skills d. Activities of daily living/instrumental activities of daily living skills ANS: d Topic: Occupational Therapy Across the Continuum of Needs—Assessment LO: 41.8

10. You are an occupational therapist working in an acute care setting. Which of the following best reflects group interventions in this setting? a. Focus on assisting clients to apply for benefits such as Social Security b. Focus on vocational skills development c. Focus on occupational concerns shared by other patients on the unit

d. Focus on activities of daily living/instrumental activities of daily living skill development ANS: c Topic: Occupational Therapy Across the Continuum of Needs—Interventions LO: 41.9

11. Janelle, a 22-year-old grad student, has come to the emergency department of a community hospital with her family. She is refusing to sign admission forms and will not talk to the doctor on call. The family states that Janelle has been scratching herself with her fingernails. For the last week she has been drinking more than usual and refusing to leave her apartment or eat anything. She has given several of her things away to her roommates. They fear she is suicidal and are asking that she be admitted to the hospital for her safety. Janelle can be admitted against her will based on what criteria? a. Janelle is exhibiting behavior that indicates she is a danger to herself. b. Her family will support and fund her admission so she can get some help. c. Intervening early is important to avoid further decompensation. d. Once Janelle feels better she will realize that admission was necessary. ANS: a Topic: Inpatient Hospital Admission

12. A person who is admitted to an inpatient unit will stay for only a brief time, often only 4 or 5 days, before starting or resuming community-based mental health services. Which of the following is the primary reason for brief admissions in an inpatient unit? a. The doctor wants to reevaluate the person’s medications and make a change that requires stopping one or more of them. b. Inpatient hospital stays can be very expensive and insurance often only pays for a few days. c. The person is experiencing a safety crisis because of an environmental stressor or an increase in the intensity of the symptoms. d. People can simply check themselves out when they want to or when they feel that they no longer need help. ANS: c Topic: Inpatient Hospital Admission

13. Mario was recently readmitted to the inpatient hospital with an acute episode of mania. He has been living in the community with support from a community mental health center for a year, has followed his treatment recommendations, and had finally started to believe he would never go back to the hospital again. Mario is talking in group about his experience, stating he doesn’t understand why he has to start all over. What might be the group leader’s response to Mario’s concerns?

a. The therapist would tell Mario that his recovery process, and his need for mental health services, will probably not follow a linear path. b. The therapist might ask Mario what happened and help him figure it out so he can avoid coming back in the future. c. Mario will be encouraged to identify his triggers and adjust his medications accordingly so he can reduce the recidivism. d. The therapist can discuss how mental illness is a lifelong disease and he will probably need to come into the hospital periodically for the rest of his life. ANS: a Topic: Discharge From Inpatient Care

14. John is a 40-year-old male with the diagnosis of paranoid schizophrenia. He has been homeless for the past 6 months. He has no family support and is dependent on social services for shelter and meals. He has no means of transportation and spends most of his time in a day shelter. The shelter staff wants to connect him with the appropriate case management team. An appropriate case management model to set him up with would be which of the following? a. Broker model b. Assertive Community Treatment c. Stand-alone strengths-based model d. Psychiatric rehabilitatT ioE nS seTrvBiA ceNs KSELLER.COM ANS: b Topic: Assertive Community Treatment and Program for Assertive Community Treatment

Chapter 42: Homeless and Women’s Shelters

Multiple Choice

1. When working with children who are homeless, you recognize that their unstable living environment often interferes with their ability to regularly attend school and limits their access to play activities and social interactions necessary for life skills development. These psychosocial issues, along with their potential exposure to violence, put them at higher risk for which of the following developmental problems? a. Language and fine or gross motor skill delays b. Posttraumatic stress disorder c. Depression d. Issues with sexual orientation ANS: a Topic: Who Are the Homeless? LO: 42.1 & 42.2

2. Which of the following best reflects the purpose of a transitional housing program? a. Provide temporary housing for up to 30 days b. Provide temporary housing for up to 2 years c. Provide long-term independent living accommodations d. Provide long-term residential care ANS: b Topic: Mission and Goals of Homeless Shelters and Transitional Housing Environments LO: 42.5

3. Identify the statement that most accurately reflects staffing patterns in homeless shelters. a. They are staffed by social workers. b. Volunteers often oversee daily functions. c. There is limited staff turnover. d. Staff qualifications are well defined with oversight by local governmental agencies. ANS: b

Topic: Team Members LO: 42.6

4. The administrator at one of your local homeless shelters wants to include occupational therapy services in their program. However, they do not have the funding to support an occupational therapy practitioner. Which of the following would you recommend for the administrator to explore to obtain these services at no or low cost? a. Advocate with the U.S. Department of Housing and Urban Development for specialized funding b. Explore increased funding through the Substance Abuse and Mental Health Services Administration c. Explore partnering with an academic occupational therapy department d. Explore funding through expanded Medicaid services ANS: c Topic: Funding Sources LO: 42.7

5. You are an occupational therapy practitioner working in a transitional living program. Your responsibilities include supporting individuals to locate and obtain housing, connecting individuals with other community resources such as food pantries, and facilitating their application for government entitlements. In addition, you are working with them to develop independent living skills needed to be successful in community living. Which of the following best describes your role in this situation? a. Case manager b. Direct service provider c. Consultant d. Program manager ANS: a Topic: Role of Occupational Therapy LO: 42.8

6. A single mother who has been at the domestic violence shelter for the past month where you work is preparing for discharge. You are working with her on the functional living skills she will need to live successfully in the environment. You are concerned about possible cognitive

impairments that may interfere with her successful community reintegration. You want to employ an assessment where your client will complete four instrumental activities of daily living tasks to assess the level of assistance she will require for functional tasks. Which assessment would you choose? a. Assessment of Motor and Process Skills b. Model of Human Occupation Screening Tool c. Allen Cognitive Level Screen d. Executive Function Performance Test ANS: d Topic: Assessment LO: 42.9

7. While working in a homeless shelter, you have become aware of the multiple challenges faced by the individuals you work with on a daily basis. While exploring approaches to treatment, you decide to adopt an approach that conveys a more accepting attitude and sets realistic expectations. You want to respect and accept the individuals’ choices even if they are not eliminating maladaptive behaviors. Which intervention approach does this scenario best reflect? a. Trauma-informed care b. Situated learning c. Harm reduction d. Person environment occupation ANS: c Topic: Intervention Models and Techniques LO: 42.10

8. You are working with a client on increasing community living skills, specifically grocery shopping. You initiated this treatment by setting up a mock grocery store in your clinic. However, you realized this is not the best way for the individual to develop these skills. You modify the activity and start doing the intervention at the individual’s preferred neighborhood grocery store. This allows the individual to practice and you to role model the activity as well as identify barriers and supports needed for the individual to be successful. Which intervention approach does this scenario best reflect? a. Trauma-informed care b. Situated learning c. Harm reduction

d. Person environment occupation ANS: b Topic: Intervention Models and Techniques LO: 42.10

9. Martha has been homeless for several months and is receiving her disability check at the day center. She is overweight and has limited mobility, type 2 diabetes, and chronic pain that she managed with opiates to which she became addicted. When you evaluate her she asks for help with obtaining food. After reviewing her food management and budgeting skills, it becomes clear that she is spending 90% of her check on pain medication. With verbal cues, she is able to create a budget with half of her check for buying fruits and vegetables each month to supplement the availability of soup kitchens and free meals. Which aspect of this treatment plan is an example of harm reduction? a. She will be eating more fruits and vegetables. b. She will have a schedule of soup kitchens to attend. c. She will go to rehab and end her addiction. d. She will have no more than 50% of her check to spend on her opioid addiction. ANS: d Topic: Intervention Models and TTeE chSnT iqBuA esNKSELLER.COM

10. When an individual who is homeless is evaluated and treated by occupational therapy, which skill area is most likely to be intact? a. Vocational skills b. Instrumental activities of daily living skills c. Social interaction skills d. Activities of daily living skills ANS: d Topic: Homelessness and Functional Impairment

11. Which condition is included in the definition of being chronically homeless? a. Having a disability b. Having a mental illness c. Being homeless for at least 6 months

d. Living in a mobile home ANS: a Topic: Who Are the Homeless?

12. Which of the following is an important consideration for an occupational therapist providing assessments to residents living in a shelter? a. The occupational therapist should practice trauma-informed care by being sensitive to the nature of the questions asked so they are not perceived as intrusive or mandatory for anyone who is being interviewed. b. The occupational therapist can interview the client wherever there is space because shelter clients are used to not having any privacy. c. The occupational therapist should write thorough and detailed notes and summaries because there will be a wide range of trained medical providers who will be familiar with occupational therapy language and rely on the assessment findings in the shelter. d. The occupational therapist should begin with specific assessments for cognition because there is a high incidence of traumatic brain injuries among homeless people. ANS: a Topic: Intervention Models and Techniques

13. An occupational therapist is beginning to provide services to residents within a homeless shelter. The occupational therapist wants to start a program focusing on skills to transition from living in a shelter to independent housing; however, the shelter already offers a program focusing on transitions. What other providers may also be working with individuals regarding their transition into housing? a. Recreational therapist b. Social worker c. Intake staff d. Nurse ANS: b Topic: Funding Sources

Chapter 43 Questions Chapter 43: Wraparound Services: Children and Families

1. Which of the following best reflects wraparound care? a. It is a philosophy of care that is strengths-based and promotes empowerment and hope. b. It is a program focused on developing skills for community integration. c. It is a funding source that supports children and their families. d. It is service based on the medical model of care. ANS: a Topic: Description of the Approach LO: 43.1

2. Identify the following statement that most accurately describes one of the core principles of the wraparound approach. a. It is assumed that individuals receiving services are healthy, productive individuals. b. Wraparound services are discontinued when the client experiences a setback. c. Wraparound services are highly structured and consistently delivered from one community to another. d. The wraparound approach embraces reinvolvement. ANS: d Topic: Foundations and Core Principles LO: 43.1

3. Which of the following is an example of enrollment criteria for a child or adolescent seeking enrollment in wraparound services? a. A physical condition such as cerebral palsy b. A disability that presented fewer than 6 months ago c. A severe emotional disorder condition as diagnosed by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition d. Receiving services from no more than one social service agency ANS: c Topic: Population Served LO: 43.2

4. Although wraparound programs are typically administered by one state- or county-based agency, which of the following best describes how services are delivered in the community? a. They are delivered through the juvenile justice system.

Chapter 43 Questions b. They are delivered through a single community agency. c. They are delivered through the child welfare system. d. They are delivered through coordination of multiple community agencies. ANS: d Topic: Program Administration LO: 43.2

5. You are a care coordinator for the family of a 10-year-old using a wraparound approach. Your first step includes building rapport with the family. As part of this process you invite them to tell their story and then take time to identify strengths and unmet needs. Based on the family’s story, you also begin to identify potential team members. Which phase of care coordination does this best represent? a. Engagement b. Planning c. Implementation d. Transition ANS: a Topic: Phases of Care Coordination LO: 43.3

6. You have continued working with the family from Question 5. Currently, you are working to maintain team participation and continue to address the family’s unmet needs. Which phase of care coordination does this best represent? a. Engagement b. Planning c. Implementation d. Transition ANS: c Topic: Phases of Care Coordination LO: 43.3

7. Which of the following statements best reflects the evidence surrounding the efficacy of the wraparound approach? a. It is a promising approach that would benefit from more research. b. Its individualized nature makes it easy to replicate and study. c. It is a well-researched approach. d. It is highly effective and efficient. ANS: a Topic: Efficacy of Wraparound Programs LO: 43.4

Chapter 43 Questions

8. You are working in a wraparound program and want to evaluate how the program affects change in your clients’ school attendance and performance, social functioning, and symptomatology. Which aspect of program evaluation does this best represent? a. Identification of program components that will be evaluated b. Identification of demographic information of children served in the program c. Efficacy of program as demonstrated through outcome measures d. Plan for program sustainability ANS: c Topic: Program Evaluation LO: 43.6

9. You are the principal investigator on a grant exploring the effectiveness of wraparound services in your community. Part of this study is to explore strategies to continue providing these services after the grant ends. Which aspect of program evaluation does this best represent? a. Identification of program components that will be evaluated b. Identification of demographic information of children served in the program c. Efficacy of the program as demonstrated through outcome measures d. Plan for program sustaTinEaSbT iliB tyANKSELLER.COM ANS: d Topic: Program Evaluation LO: 43.6

10. Which of the following identifies the correct sequence of the wraparound process? a. Planning, implementation, transition, engagement b. Engagement, planning, implementation, transition c. Engagement, implementation, planning, transition d. Implementation, engagement, transition, planning ANS: b Rationale: Engagement must occur first to develop trust, respond to any immediate family crisis needs, explain the wraparound process, and solicit the family “story.” Planning is the second phase in which the family “plan” is developed including identification of team member strengths and identification and prioritization of needs. How the team will move forward to implement the plan must be thoughtfully discussed. The third phase is implementation. During this phase, the plan moves into action and progress is regularly evaluated. The plan may be revised or updated as needed. Successes are celebrated and the team becomes more cohesive. The fourth and final phase is transition. The team plans for the cessation of wraparound care, ensuring that the family has become empowered to address any future challenges that they may face. Informal and

Chapter 43 Questions natural resources are more strongly integrated into the team to ensure success and continued familial support. Commencement celebrations occur. Follow-up is done with the family at an established time frame.

Chapter 44: Occupational Therapy: Serving Service Members and Veterans

Multiple Choice

1. Which of the following is the name of the occupational therapy practitioners whose mission was to rehabilitate injured service members through the use of curative crafts and workshops to help them recapture purposeful lives? a. Civil War practitioners b. World War I reconstruction aides c. World War II rehabilitative aides d. Battlefield aides ANS: b Topic: History of Occupational Therapy in the Military LO: 44.1

2. Which of the following best explains why it is important for occupational therapy practitioners working with active service members to be familiar with military culture? AN SeEnLtaLtiE a. It assists in developmeTnE tS anTdBim plK em onRo.fCefOfeMctive intervention plans. b. It assists in identification of what a service member’s uniform artifacts mean. c. It assists in understanding the cultural differences between each branch of service. d. It assists in understanding the competitive nature required of service members. ANS: a Topic: Military Culture LO: 44.2

3. Identify why service members typically don’t seek out mental health services. a. Mental health services are not available in the armed forces. b. Service members fear they will be involuntarily discharged. c. Service members fear being perceived as weak and unable to perform their military duties. d. Service members fear they will be deployed to a hostile environment. ANS: c Topic: Service Members and Veterans’ Behavioral Health Issues LO: 44.3

4. You are an occupational therapy practitioner providing restorative care in a deployed setting. You focus your interventions on maintaining a military routine and improving coping skills to assist service members in managing combat stress with the ultimate goal of returning the service member to the battlefield. What type of setting does this best represent? a. Combat and Operational Stress Control Unit b. Military Treatment Facility c. Warrior Care and Transition Program d. Veterans Health Administration ANS: a Topic: Continuum of Care for Service Members and Veterans LO: 44.4 & 44.5

5. Identify the intervention that has demonstrated a positive effect on veterans with posttraumatic stress disorder by increasing mood and affect. a. Sensory processing b. Mindfulness-based cognitive therapy c. Group activities d. Leisure exploration programs ANS: d Topic: Interventions LO: 44.5 & 44.8

6. Interventions such as money management, self-care, household management, and community participation can be used to address which of the following challenges faced by veterans? a. Job training b. Posttraumatic stress disorder c. Homelessness d. Funding for mental health services ANS: c Topic: Best Practice: Homeless Veterans Programs LO: 44.6

7. You are working in a Warrior Care and Transition Program and are asked to assess a service member who was recently referred to the program. As you are gathering information for the occupational profile, you notice that he is demonstrating difficulty with communication skills. You want to gather more information on his verbal and nonverbal communication as well as identify strengths and problem areas to better inform your intervention planning. Which assessment would you choose?

a. Functional Status Questionnaire b. Multiple Errands Test c. Patient-Reported Outcomes Measurement Information System d. Assessment of Communication/Interaction Skills ANS: d Topic: Assessment LO: 44.7

8. You are working with veterans who are experiencing symptoms of posttraumatic stress disorder. You want to incorporate an intervention approach that will facilitate the development of healthy coping mechanisms and utilizes activities such as yoga, meditation, and guided imagery. Which approach would you choose? a. Sensory processing b. Mindfulness-based cognitive therapy c. Group activities d. Leisure exploration programs ANS: b Topic: Interventions LO: 44.5 & 44.8

9. Where is it best to treat a service member who is experiencing a stress reaction on the battlefield? a. As close as possible to his or her unit b. Stateside c. Military treatment facility d. Veterans Health Administration ANS: a Topic: A Brief History of Occupational Therapy in the Military

10. What does the Army call the behavioral health unit deployed to war zones in order to prevent or mitigate stress reactions? a. Military treatment facilities b. Combat and operational stress control units c. Intensive outpatient programs d. Outpatient clinic ANS: b Topic: Continuum of Care for Service Members and Veterans

11. What occupational therapy intervention has been used since World War I that Army providers continue to use as the foundation of occupational therapy interventions to rehabilitate physical and mental wounds? a. Behavioral activation b. Purposeful activity c. Think before you act activity d. Mindfulness ANS: b Topic: Continuum of Care for Service Members and Veterans

12. What is the primary goal of behavioral health treatment in a combat setting? a. Stabilize and return the service member to home b. Give the service member as much time as needed to recover c. Return the service member to duty as soon as possible d. Establish a safe environment of care ANS: c Topic: Service Members and Veterans’ Behavioral Health Issues

13. A practitioner has decided to create a group for recently discharged female veterans at a local community center. ThT esEe S vT etB erA anNsKhS avEeLidLeE ntRif. ieC d OanMxiety, sleep disruption, and depression as the main issues impacting their occupational performance. What mindfulness-based strategy might be most helpful in addressing these issues? a. Sleep training b. Hatha yoga c. Exposure therapy d. Psychoanalysis ANS: b Topic: Interventions

Chapter 45 Questions Chapter 45: Integrated Behavioral Health and Primary Care

Multiple Choice

1. Which of the following most accurately reflects the World Health Organization’s perspective of integrated behavioral health care? a. Mental health and substance abuse services should be distinct and separate interventions. b. There is no health without mental health. c. Mental health and substance abuse services are more effective when consolidated into behavioral health services. d. Integrated behavioral health care should only be administered in primary care settings. ANS: b Topic: Understanding Integration–Integration of Primary Care and Behavioral Health LO: 45.1

2. Which statement mostTaEcS cuTraBteAlyNrKeS fleEcL tsLthEeRc. osCt OoM f integrated behavioral health care? a. It is more expensive in the short term but better outcomes may offer cost savings in the long run. b. It is less expensive in the short term but more expensive in the long run. c. Non-integrated care results in lower costs for individuals with severe mental illness. d. Treatment of mental health issues increases overall health-care costs. ANS: a Topic: Challenges of Non-Integrated Care LO: 45.3

3. Which of the following most accurately reflects integrated care? a. Providers communicate but patients continue to receive separate services at different locations. b. Patients’ behavioral health and primary care needs are both part of their routine health care. c. It is a continuum of collaboration between providers to address the patient’s needs. d. Services are integrated into the community where the patient resides. ANS: b

Chapter 45 Questions Topic: Frameworks for Integrating Behavioral Health and Primary Care LO: 45.5

4. The community mental health center where you work wants to adopt a model of practice to enhance its initiative to integrate behavioral health and primary care. Currently, they are exploring a model that outlines a variety of approaches that range from communicating with a local primary care office as needed to full integration and collaboration. Which model does this best describe? a. Four Quadrant Clinical Integration Model b. Collaborative Care Model c. Integrated Care Model d. Six Levels of Collaboration/Integration ANS: d Topic: Frameworks for Integrating Behavioral Health and Primary Care LO: 45.5

5. Victor was diagnosed with bipolar disorder 10 years ago. Recently, he was trained to serve as a liaison between health/social services and the community members to increase access and follow-up with services to address health care and wellness needs. Which of the following best dTeE scS riT beBsAthNisKrS olEeL ? LER.COM a. Community mental health worker b. Patient care technician c. Peer health navigator d. Peer support specialist ANS: c Topic: Health Navigators: A Role for the Mental Health Peer Support Specialist LO: 45.6

6. You are working in an integrated behavioral health and primary care setting. Many of the clients in this practice are middle-aged and you want to take a proactive approach to their health and function. You decide to offer a joint protection and energy conservation workshop open to all the clients in this practice. This intervention approach best represents which of the following? a. Health promotion and prevention b. Chronic disease management c. Primary care management d. Behavioral health management ANS: a Topic: Role of Occupational Therapy LO: 45.7

Chapter 46: Applying Entrepreneurial Skills in Mental Health Practice

Multiple Choice

1. Occupational therapy practitioners believe that occupations contribute to health and wellness. This belief, along with Vision 2025, highlights the responsibility for practitioners to advocate for social and occupational justice. Engaging in entrepreneurial initiatives in mental health allows practitioners to act on this belief and bring Vision 2025 to life. Which of the following is the greatest benefit of engaging in these entrepreneurial initiatives? a. It allows practitioners to establish new businesses. b. It allows practitioners to meet the ethical and moral obligations outlined in the occupational therapy code of ethics. c. It allows practitioners to increase reimbursement for services. d. It allows practitioners to expand their services into the community. ANS: b Topic: Why Be an Entrepreneur in Mental Health Services? LO: 46.3

2. You have established an integrated occupational therapy program at a local retirement community. Your services include providing prevention and health promotion in-services for the residents, staff training on environmental modification to support daily functioning for individuals demonstrating signs of cognitive decline, and direct service for clients with mental health or physical health conditions. This scenario best exemplifies which type of occupational therapy entrepreneurship? a. Private practice b. Traditional practice area c. Community-based practice d. Emerging practice area ANS: c Topic: Contemporary Entrepreneurship in Occupational Therapy LO: 46.4

3. You have been an occupational therapy practitioner in an urban school system. Over the past few years you have noticed increased mental health difficulties in students whose families immigrated to the United States from other countries. You decide to approach one of the local immigration agencies to propose inclusion of occupational

therapy services in these agencies to address these children’s mental health issues. This scenario best exemplifies which type of occupational therapy entrepreneurship? a. Private practice b. Traditional practice area c. Community-based practice d. Emerging practice area ANS: d Topic: Contemporary Entrepreneurship in Occupational Therapy LO: 46.4

4. There are many skills and characteristics required for occupational therapy practitioners to engage in entrepreneurial roles. Evidence indicates the most common characteristic found in successful entrepreneurs is which of the following? a. Effective communication skills b. Passion c. Effective financial management skills d. Self-discipline ANS: b Topic: Characteristics and Skills of Entrepreneurs LO: 46.5

5. Beginning an entrepreneurial initiative is stressful and often requires you to deal with unexpected situations, rethink strategies when things don’t go as planned, and cope with feelings of disappointment and frustration. Which entrepreneurial characteristic does this best represent? a. Motivation b. Self-regulation and self-knowledge c. Making effective decisions and avoiding cognitive traps d. Dealing with adversity and failure ANS: d Topic: Characteristics and Skills of Entrepreneurs LO: 46.5

6. You have decided to explore the potential of proposing the implementation of occupational therapy services at a juvenile detention center. One step in this process is completing a needs assessment. Which of the following best describes the purpose of this needs assessment? a. Allows you to assess your current skill set and what skills you will need to develop b. Allows you to gain information to complete a strategic plan

c. Allows you to develop a network of resources d. Allows you to gain a better understanding of the environment, programs offered within the environment, and potential opportunities for your initiative ANS: d Topic: Process for Becoming an Entrepreneur in Mental Health Practice LO: 46.6

7. When you are writing up the program proposal for the inclusion of occupational therapy services in the juvenile detention center, what is the most important component that should be included in this step of the entrepreneurial process? a. Why you are passionate about this initiative b. How occupational therapy fits with the center’s mission and priorities c. How you will establish a network of resources d. Your self-assessment of your skills and abilities ANS: b Topic: Process for Becoming an Entrepreneur in Mental Health Practice LO: 46.6

8. What is the most common characteristic that entrepreneurs exhibit? a. Business knowledge b. Passion c. Financial knowledge d. Confidence ANS: b Topic: Characteristics and Skills of Entrepreneurs

9. During the 1990s, occupational therapy entrepreneurs were mostly viewed as practitioners in . a. Private practice b. Community practice c. Community-based practice d. Nontraditional practice ANS: a Topic: Contemporary Entrepreneurship in Occupational Therapy

10.

Occupational therapy practitioners can become excellent entrepreneurs because . a. Excellent clinicians are naturally excellent entrepreneurs. b. The process for organizational or community profiles is similar to developing occupational profiles. c. They deal with real-life situations so they know a lot about communities’ needs. d. They are so creative and innovative. ANS: b Topic: History of Entrepreneurship in Occupational Therapy

11. One of the most important actions for an occupational therapy practitioner to do during the initial meeting with a stakeholder of an organization that currently doesn’t have occupational therapy services is to . a. Be clear from the beginning about what occupational therapy can offer b. Engage in active listening c. Share what he or she knows about the organization and community d. Provide an overview of occupational therapy services within other settings ANS: b Topic: Characteristics and Skills of Entrepreneurs

12. Which of the following beliefs about helping people with mental illness did Eleanor Clarke Slagle have that is still relevant today? a. We need to fight poverty before helping the mentally ill. b. The solution is to put the mentally ill to work. c. People with mental illness need to be performing curative occupations. d. Only governmental agencies can make a difference with how the mentally ill are treated. ANS: c Topic: History of Entrepreneurship in Occupational Therapy

13. When writing a proposal for the addition of occupational therapy services to an organization that currently doesn’t have occupational therapy services, it is very important to include . a. A proposed occupational therapy niche that relates to the organization’s mission, vision, and values b. A completed grant application c. Information about occupational justice d. Examples of occupational therapy services in other programs

ANS: a Topic: Process for Becoming an Entrepreneur in Mental Health Practice

Chapter 47 Questions Chapter 47: Introduction to Occupation and Co-Occupation

Multiple Choice

1. Through the years, the definition of occupation has undergone modification but one definition has endured since the beginning of the profession. Which of the following best reflects that definition? a. Occupation consists of self-care, leisure, and productivity. b. Occupation is engagement in everyday life activities. c. Occupation is achieving pleasure through the use of one’s hands and muscles. d. Occupation is a means and end to restoration of occupational lives. ANS: a Topic: Defining Occupation LO: 47.1

2. Temporality is one dimension of occupation. One aspect of this dimension is temporal rupture. Which of the following is the best definition of temporal rupture? a. The passage of time isTpEeS rcT eiB veAdNaK sS toEoLslLoE wR . .COM b. The passage of time is perceived to have quickened. c. A life-changing event distorts time and deconstructs daily life. d. A feeling of expanded time results in discomfort. ANS: c Topic: Dimensions of Occupation LO: 47.2

3. The concept of acting on the environment, reflecting on the meaning of that activity, and developing a sense of future potential and self-actualization best describes which of the following dimensions of an occupation? a. Space and place b. Doing, belonging, and becoming c. Temporality d. Habits, routines, and occupational engagement ANS: b Topic: Dimensions of Occupation LO: 47.2

Chapter 47 Questions 4. You are working with a 32-year-old diagnosed with depression. You are concerned with his level of occupational engagement. You want to administer an assessment that examines his perception of his performance in the areas of self-care, work and leisure, and his satisfaction with his performance. Which assessment would you choose to gather this information? a. Occupational self-assessment b. Interest checklist c. Children’s assessment of participation and enjoyment d. Canadian occupational performance measure ANS: d Topic: Assessments LO: 47.3

5. Which of the following best describes the importance of engagement in activities of daily living? a. They promote positive psychological functioning. b. They provide structure and predictability to one’s daily routine. c. They provide outlets for pleasure and connectedness to others. d. They provide opportunities to contribute to the larger society. ANS: b Topic: Occupations LO: 47.4

6. You are leading a leisure exploration group on an inpatient mental health unit. The activity you have chosen for the group session is to have group members work on a jigsaw puzzle. This activity is most reflective of what aspect of co-occupation? a. Shared emotionality b. Shared intentionality c. Shared physicality d. Shared communication ANS: d Topic: Aspects of Co-Occupation LO: 47.5

7. Engaging in co-occupations can support health and wellness. Based on this belief, you begin to develop groups focused on co-occupation for the psychiatric rehabilitation program where you work. One of those groups is a cooking group. This type of group most accurately represents which aspect of co-occupation in practice? a. Co-occupation as an end b. Co-occupation as a means

Chapter 47 Questions c. Parallel occupation d. Shared emotionality ANS: b Topic: Co-Occupation in Practice LO: 47.6

8. Ed is hospitalized following a suicide attempt. His girlfriend of 5 years supports his recovery but she is at a loss as to how to get close to him again. To facilitate cooccupation between Ed and his girlfriend, the best option for you to suggest is . a. Attend a professional sporting game b. Cook dinner together c. Go the movies d. Introduce him to potential new friends ANS: b Topic: Co-Occupation in Practice

9. The purpose of the DoIT Model is to . a. Provide a framework to guide clinical reasoning around personal experience of time as it is related to occupatTioEnSaT ndBaAcN tiK viS tyELLER.COM b. Encourage practitioners to evaluate the effects of interstitial time on occupational engagement c. Enhance occupational performance and engagement in basic activities of daily living d. Assist with intervention planning for individuals experiencing symptoms associated with mental illness ANS: a Topic: Dimensions of Occupation

Chapter 48: Wellness

Multiple Choice

1. When assessing your client, you ask about his or her housing and neighborhood. In addition, you gather information on access to grocery stores and leisure activities. Which dimension of wellness does this best represent? a. Spiritual b. Social c. Emotional d. Environmental ANS: d Topic: Wellness Defined—Eight Dimensions of Wellness LO: 48.1

2. As part of your assessment, you want to get a sense of your client’s values and sense of purpose. Which dimension of wellness does this best represent? a. Spiritual b. Social c. Emotional d. Environmental ANS: a Topic: Wellness Defined—Eight Dimensions of Wellness LO: 48.1

3. a.

What is the greatest health disparity in individuals with mental illness? People with mental illness have decreased access to quality health care compared with the general population. b. People with mental illness die 15 to 20 years earlier than the general population. c. People with mental illness have substandard housing compared with the general population. d. People with mental illness experience higher levels of substance use compared with the general population. ANS: b Topic: Health Disparities LO: 48.2

4. Evidence from a study at a community mental health center identified the number one reason why people with mental health disorders did not seek medical treatment was . a. Geographical inconvenience b. Decreased knowledge of medical resources c. Fear and anxiety d. Lack of medical insurance ANS: c Topic: Health Disparities—Access to Care LO: 48.2

5. What is the purpose of the Health Passport tool? a. It helps identify environmental barriers that impact access to quality health care. b. It helps identify common co-occurring medical conditions. c. It helps assess the eight dimensions of wellness. d. It helps assess health responsibility. ANS: b Topic: Evaluation LO: 48.4

6. What is the purpose of the Wellness Inventory? a. It helps identify environmental barriers that impact access to quality health care. b. It helps identify common co-occurring medical conditions. c. It helps assess the eight dimensions of wellness. d. It helps assess health responsibility. ANS: c Topic: Evaluation LO: 48.4

7. Occupational therapy practitioners who focus interventions on developing a regular workout routine and healthy eating are addressing which dimension of wellness? a. Financial b. Social c. Occupational d. Physical ANS: d Topic: Interventions LO: 48.5

8. Interventions focused on engagement in leisure activities that bring the client pleasure and satisfaction are addressing which dimension of wellness? a. Financial b. Social c. Occupational d. Physical ANS: c Topic: Interventions LO: 48.5

Chapter 49 Questions Chapter 49: Activities of Daily Living and Instrumental Activities of Daily Living

Multiple Choice

1. You are working with a client who has expressed interest in getting a dog for companionship. Your intervention focuses on identifying the responsibilities of and developing the skills required for pet ownership. This activity best represents which of the following? a. Activities of daily living b. Instrumental activities of daily living c. Basic activities of daily living d. Personal activities of daily living ANS: b Topic: Activities of Daily Living and Instrumental Activities of Daily Living LO: 49.1

2. You are working in a dementia care unit. You want to assess a client’s performance in activities of dT aiE lySlT ivB inA gNbK yS obEsL erL viEnR g. hiC mOoMr her complete a series of activities such as bathing, dressing, and toileting. Which assessment would you choose? a. Katz Index of Independence in Activities of Daily Living Skills b. Functional Independence Measure c. Independent Living Skills Survey d. Kohlman Evaluation of Living Skills ANS: a Topic: Assessment LO: 49.3

3. You are working in an inpatient mental health unit and want to employ a valid and reliable assessment that assesses your client’s ability to complete instrumental activities of daily activity, such as banking and cellphone use. You choose an assessment that utilizes a combination of interview- and performance-based items. Which assessment would you choose? a. Katz Index of Independence in Activities of Daily Living Skills b. Functional Independence Measure c. Independent Living Skills Survey d. Kohlman Evaluation of Living Skills ANS: d Topic: Assessment

Chapter 49 Questions LO: 49.3

4. You are working with a client diagnosed with bipolar disorder who is demonstrating difficulty completing activities of daily living and instrumental activities of daily living. You decide to employ an occupation-based intervention that requires the client to keep a daily record of the activities he or she engages in. This will allow your client to monitor his or her daily routine with the goal of establishing the regularity in the timing of the daily activities. Which intervention would you choose? a. Interpersonal and social rhythm therapy b. Home environment skill-building program c. Cognitive adaptation training d. Assistive technology ANS: a Topic: Interventions LO: 49.4

5. A 24-year-old with a diagnosis of schizophrenia was just referred to your clinic. He lives with his parents, who currently assist him with the completion of his instrumental activities of daily living. During your assessment, he identifies a goal of independently doing his own T laE unSdTryB. AHNeKstS atEesLtL haEtRw.hC enOhMe tries to do it by himself he forgets certain steps of the task. For instance, at times he loads the washer but forgets to turn it on, whereas other times he forgets to add the laundry detergent. You decide to use a laundry app that will remind him of the different steps in doing laundry. Which intervention approach does this best represent? a. Occupation based b. Preparatory methods c. Education d. Advocacy ANS: b Topic: Interventions LO: 49.4

6. Life skills training such as money management, social skills, and home management best exemplifies which intervention approach? a. Occupation based b. Preparatory methods c. Education d. Advocacy ANS: c Topic: Interventions

Chapter 49 Questions LO: 49.4

7. You are working with a client who has required repeated hospitalizations because of not taking her medications. You administer the Performance Assessment of Self-Care Skills and determine she is not able to read the medication information on the pill bottle and that has been interfering with the client knowing which medication is in which pill bottle and how often to take each of the medications. Which of the following is the best intervention to use to address this problem? a. Use a visual scheduler to remind the client when to take her medication b. Create large print labels with the name of the medication and dosage directions to put on the medication bottles c. Use a mobile phone app to remind the client when to take her medication d. Have the client organize her medication in a pillbox ANS: b Topic: Interventions and Assessments LO: 49.3 & 49.5

8. You have a client who is demonstrating difficulty with community mobility. Because of the symptoms related to his schizophrenia, he is no longer able to drive and relies on public transportationT. E YS ouTB wA anNt K toSaE ssLesLsEhR is.aC biO litMy to use public transportation so you choose an assessment that incorporates an item that asks the individual to read a bus schedule. Which assessment would you choose? a. Kohlman Evaluation of Living Skills b. Performance Assessment of Self-Care Skills c. UCSD Performance-Based Skills Assessment d. Milwaukee Evaluation of Daily Living Skills ANS: d Topic: Interventions and Assessments LO: 49.3 & 49.5

9. Which of the following is an activity of daily living? a. Pet care b. Money management c. Bathing d. Sleep ANS: d Topic: Overview of Activities of Daily Living and Instrumental Activities of Daily Living Rationale: Bathing is an activity of daily living. It is a basic life skill typically performed in a habitual manner across the life span.

Chapter 49 Questions

10. Which of the following is an instrumental activity of daily living? a. Grooming b. Money management c. Sleep d. Eating ANS: b Topic: Intervention Rationale: Money management is an instrumental activity of daily living. It supports daily life and is more complex than activities of daily living.

11. Within Interpersonal and Social Rhythm Therapy, individuals learn to monitor their routines and strive for regularity. This emphasis on scheduling makes it most appropriate for persons with which of the following diagnoses? a. Bipolar disorder b. Dementia c. Anxiety d. Depression ANS: a Topic: Intervention Rationale: Persons with bipolar disorder may experience bipolar episodes with the disruption of typical routines. Therefore, Interpersonal and Social Rhythm Therapy works best for individuals in this population.

12. Which of the following is an approach consistent with cognitive adaptation training? a. Reinforcement and verbal praise for preferred behaviors b. Posting of checklists in key areas around a client’s home to ensure the client completes all of the steps of the task in order c. Creating a daily exercise regimen d. A work group where clients come together to complete a craft ANS: b Topic: Intervention Rationale: Posting checklists is the activity most consistent with cognitive adaptation training (CAT). CAT uses environmental supports such as checklists to help cue and sequence activities of daily living and instrumental activities of daily living activities.

Chapter 50: Occupational Therapy’s Role in School Mental Health

Multiple Choice

1. Identify the federal initiative that was the first to draw attention to the mental health needs of students. a. Education of All Handicapped Children Act b. Individuals with Disabilities Education Act c. President’s New Freedom Commission on Mental Health d. World Health Organization ANS: b Topic: Overview of School Mental Health—Legislation and Policies LO: 50.1

2. Which of the following is most reflective of a public health approach to school mental health? a. Teachers should address the mental health needs of students. LE b. School psychologists T shEoS ulT dB adAdNreKssStE heLm enRta.l C heOaM lth needs of students. c. All school personnel should address mental health needs of students. d. Parents should address the mental health needs of their children. ANS: c Topic: Overview of School Mental Health—Public Health Approach LO: 50.1

3. Which of the following most accurately reflects mental health in children and youth? a. Children with disabilities are at greater risk of experiencing mental health challenges than nondisabled peers. b. Positive mental health in children is reflected in good behavior in school. c. Mental health challenges are reflective of severe disorders. d. Technology increases mental health in children and youth. ANS: a Topic: The Mental Health Continuum in Children and Youth LO: 50.2 & 50.3

4. You are working with children in the school system and notice several have decreased social skills. Which of the following interventions has demonstrated the most effectiveness in promoting social competence? a. Arts and crafts b. Small group activities c. Individual social skills training d. Activities that utilize the students’ character strengths and talents ANS: b Topic: Occupational Therapy in School Mental Health LO: 50.4

5. As an occupational therapy practitioner working in the schools, identify the most positive aspect of integrated services. a. They allow you to work with students in private rooms to cut down on distractions and interruptions. b. They allow you to work with students in their classrooms. c. They allow you to integrate private practice interventions with school-based interventions. d. They allow you to work in the natural contexts beyond the classroom that they engage in throughout the day. ANS: d Topic: Integrated Services anT dE ScShToB olASN etKtiS ngEsLLER.COM LO: 50.5

6. Observation of a child’s emotional response to various activities, as well as what activities the child participates in throughout the day, best exemplifies which step of theoccupational therapy process in school mental health? a. Awareness b. Assessment c. Appraisal d. Action ANS: c Topic: The Occupational Therapy Process LO: 50.6

7. You are working with a child who has been demonstrating difficulty in activities that occur outside of the classroom. You want to gather information from the child’s teacher to get a better understanding of the child’s strengths and needs in activities that occur in nonacademic functional tasks. Which assessment would you choose? a. School Function Assessment

b. Recess Environmental Scan c. Cafeteria Environmental Scan d. School Setting Interview ANS: a Topic: Assessments LO: 50.7

8. Which of the following approaches best reflects the contribution an occupational therapy practitioner can make when working with students with intensive mental health needs? a. Handwriting Without Tears b. In-depth counseling c. Medication recommendations d. Sensory processing evaluation and intervention ANS: d Topic: Tier 3: Individualized Intensive Mental Health Interventions LO: 50.8 & 50.9

Chapter 51: Student: Adult Education

Multiple Choice

1. Which of the following best justifies the need for supported education for adults with mental illness? a. It helps divert students to community colleges, which is a better fit for their educational needs. b. It provides opportunities for students to address issues of occupational imbalance. c. Mental health concerns on college campuses continue to increase. d. It allows students to look at alternatives to formal postsecondary education. ANS: c Topic: Need for Supported Education With the Mental Health Population LO: 51.2

2. You are an occupational therapy practitioner employed by the local university in the role of a supported education specialist. Your approach to supporting your students includes offering groups focuT seEdSoT nB tiA mN eK mS anEaL geLmEeRn. t aCnO dM establishing productive study habits. You also offer individual sessions focused on addressing barriers to successful classroom performance. Which model does this best represent? a. Self-contained classroom b. Onsite service model c. Mobile support model d. Combined models ANS: b Topic: Supported Education Models LO: 51.3

3. You are an occupational therapy practitioner employed by a community college. You have created a specialized curriculum for people with mental illness who have been out of school for at least 5 years. The goal of your program is to facilitate foundational academic, social, and psychological skills needed to be successful in postsecondary education. Which model does this best represent? a. Self-contained classroom b. Onsite service model c. Mobile support model d. Combined models ANS: a

Topic: Supported Education Models LO: 51.3

4. Practitioners who work with students to identify the responsibilities of engaging in the student role and establishing a daily schedule that incorporates those responsibilities are addressing which domain of the occupational therapy practice framework? a. Performance skills b. Performance patterns c. Contexts and environments d. Client factors ANS: b Topic: The Role of Occupational Therapy in Supported Education—Occupational Therapy Practice Framework LO: 51.6

5. You are working with a student to develop her competence with an online learning system to increase her ability to access course information and submit assignments. Which domain of the occupational therapy practice framework does this best represent? a. Performance skills b. Performance patterns c. Contexts and environments d. Client factors ANS: c Topic: The Role of Occupational Therapy in Supported Education—Occupational Therapy Practice Framework LO: 51.6

6. You have based your supported education practice on the Person-EnvironmentOccupation (PEO) model. As you interview a client, you ask questions about his comfort level in interacting with professors and his level of interest with current courses. Which aspect of the PEO model does this represent? a. Person b. Environment c. Occupation d. Occupational performance ANS: a Topic: The Person-Environment-Occupation Model and Supported Education LO: 51.7

7. In this supported education model, students attend a specialized curriculum to obtain foundational skills needed to enter higher education. a. Onsite services model b. Mobile support model c. Self-contained classroom model d. The Person-Environment-Occupation model ANS: c Topic: Supported Education Models Rationale: The self-contained classroom model is intended for students who have been out of school for a lengthy amount of time and need to build certain skills before entering postsecondary education.

Chapter 52: Work as Occupation

Multiple Choice

1. Which of the following best describes occupational therapy’s view on work? a. It is not restricted to paid employment. b. It is restricted to paid employment. c. It is any activity that occurs outside the home. d. It is any activity that provides economic resources essential for well-being. ANS: a Topic: Work, Workplaces, Mental Health, and Well-Being LO: 52.1

2. According to the Model of Human Occupation, when working with individuals with mental illness who want to return to the worker role it is important to explore personal factors, such as values and interests related to work, along with their beliefs about their abilities to be successful in this role. Which subsystem does this best represent? a. Habituation b. Performance skills c. Environmental factors d. Volition ANS: d Topic: Vocational Development and Work Transitions LO: 52.2

3. According to the Model of Human Occupation, an individual who has demonstrated success in the worker role and takes pride in his job and being employed is said to have a positive . a. Occupational competence b. Occupational identity c. Habituation subsystem d. Personal causation ANS: b Topic: Vocational Development and Work Transitions LO: 52.2

4. An individual’s work history that has been disrupted because of mental illness is an example of what type of work participation barrier? a. Person-related b. Vocational and mental health service-related c. Employer and workplace-related d. Systems-related ANS: a Topic: Disruptions to Vocational Development and Work Participation LO: 52.3

5. The risk of losing medical coverage and housing subsidies if an individual returns to work is an example of what type of work participation barrier? a. Person-related b. Vocational and mental health service-related c. Employer and workplace-related d. Systems-related ANS: d Topic: Disruptions to Vocational Development and Work Participation LO: 52.3

6. Which of the following legislative initiatives prohibits governmental and nongovernmental employers from discriminating against qualified individuals with a disability who can perform the essential functions of the job with or without reasonable accommodations? a. The Rehabilitation Act of 1973 b. The Americans with Disabilities Act of 1990 c. The Ticket to Work and Work Incentives Improvement Act d. The Gioia Model of Vocational Recovery ANS: b Topic: Policies to Support Work Participation LO: 52.4

7. You are looking for a Model of Human Occupation assessment that explores how physical and social factors, task demands, and daily job functions support or interfere with the person’s success in the workplace. Which assessment would you choose? a. Worker role interview b. Vocational profile c. Work environment impact scale d. Assessment of work performance

ANS: c Topic: Assessments LO: 52.5

8. Based on evidence accumulated over the past 20 years, which of the following work rehabilitative initiatives demonstrates the best outcomes? a. Train-then-place approach b. Place-then-train approach c. Prevocational training approach d. Skills training approach ANS: b Topic: Interventions to Promote Work Participation LO: 52.6

9. One approach to vocational rehabilitation is to place individuals in time-limited jobs in mainstream workplaces at the prevailing wage. These jobs offer onsite training and job coaching. Which of the following best reflects this approach? a. Transitional employment b. Social enterprises c. Supported employmenT d. Train-then-place employment ANS: a Topic: Interventions to Promote Work Participation LO: 52.6

Chapter 53: Volunteer and Service Occupations

Multiple Choice

1. Bringing a meal to a friend who is recovering from surgery is an example of which of the following? a. Formal volunteerism b. Informal volunteerism c. Community volunteerism d. Volunteer exploration ANS: b Topic: Overview of Volunteer and Service Opportunities LO: 53.1

2. According to the evidence, which group of individuals benefits most from volunteering? a. Those with physical limitations b. Those with limited soT ciE alSinTteBrA acNtiK onSsELLER.COM c. Those who have difficulty regulating emotions d. Those who are socially active ANS: b Topic: Benefits of Volunteering and Providing Service to Others—Evidence-Based Practice LO: 53.2

3. The first step an occupational therapy practitioner should do when working with someone who wants to engage in a volunteer activity is to identify an individual’s volunteer interests, values, and beliefs. In addition, he or she should gather information regarding an individual’s work, training, and volunteer history. Which of the following best describes this process? a. Analysis of occupational performance b. Initial assessment c. Developing an occupational profile d. Performance skills assessment ANS: c Topic: Evaluation LO: 53.4

4. The next step of the evaluation process is to assess the individual’s occupational performance in volunteer activities. One approach to gather this information is to use an assessment that evaluates self-care, safety and health, community mobility, and work and leisure. Which assessment would you choose to gather this information? a. Executive Function Performance Test b. Kohlman Evaluation of Living Skills c. Occupational Performance History-II d. Cognitive Performance Test ANS: b Topic: Evaluation LO: 53.4

5. You want to assess your client’s level of engagement in leisure, social, and instrumental activities. Which assessment would you choose? a. Canadian Occupational Performance Measure b. Cognitive Performance Test c. Activity Card Sort d. Occupational Circumstances Assessment Interview and Rating Scale ANS: c Topic: Evaluation LO: 53.4

6. An occupational therapy practitioner is facilitating a volunteer workshop. The agenda includes discussion on the benefits of volunteering, exploring community volunteer opportunities, and having a panel present on their volunteer experiences. What type of intervention approach does this best represent? a. Education b. Training c. Advocacy d. Groups ANS: a Topic: Intervention LO: 53.5

7. Working with a client to develop strategies to request accommodations in a volunteer setting is an example of which intervention approach? a. Education b. Training

c. Advocacy d. Groups ANS: c Topic: Intervention LO: 53.5

8. Having a client engage in volunteer activities for the purpose of developing performance skills as a step to achieve the ultimate goal of returning to work best exemplifies which of the following? a. Skills training b. Education c. Community integration d. Volunteering as an intervention ANS: d Topic: Volunteering as an Intervention LO: 53.6

Chapter 54: Social Participation

Multiple Choice

1. You are working with an individual with mental illness who has identified social activities he plans to regularly participate in. Which stage of recovery does this best represent? a. Moratorium b. Awareness c. Preparation d. Rebuilding ANS: d Topic: Stages of Recovery LO: 54.1

2. Identify the most effective way occupational therapy practitioners can promote social participation among individuals at a psychiatric rehabilitation center. a. Have a group of indivT idE uaSlsTpBlA anNaKnS dE imLpLleEmRe. ntCaOTMhanksgiving party for everyone at the center b. Have a group of individuals work on their own arts and crafts projects in a leisure development group c. Facilitate a psychotherapy group d. Facilitate a life skills development group ANS: a Topic: Recovery and Social Participation—Evidence-Based Practice LO: 54.2 & 54.3

3. Adopting a recovery-oriented approach for increasing social participation requires an attitude shift for most mental health providers. Which of the following most accurately reflects this shift? a. Accepting the mental health provider is the expert in developing interventions for social participation b. Accepting that consumers are partners in their own care and should have input in developing interventions for social participation c. Accepting that not all consumers require medication to improve social participation d. Accepting a directive approach in developing social skills is the most effective way to increase social participation

ANS: b Topic: Recovery Oriented Service Provisions LO: 54.3

4. When employing the recovery philosophy of care, which of the following is something practitioners should consider while administering an assessment to measure social participation? a. The whole assessment should be administered to maintain the tool’s reliability and validity. b. It is acceptable to administer subscales of an assessment that the practitioner deems important. c. It is acceptable to administer subscales of an assessment that the family deems important. d. It is acceptable to administer subscales of an assessment that the consumer deems important. ANS: d Topic: Evaluations LO: 54.4

5. You are looking for anTaEsS seTssBmAeN ntKtS haEt L exLaE mR in.eC s tOhM e functional ability of your client in a community mental health center. You want an assessment that asks the client to identify the role he assumes in the areas of work, education, and residence; the level of support he receives in the specified roles; and the quality of performance of these roles. Which assessment would you choose? a. Multnomah Community Ability Scale b. Mental Health Recovery Star c. Multidimensional Scale of Independent Functioning d. Satisfaction with Daily Occupations ANS: c Topic: Evaluations LO: 54.4

6. You are looking for an assessment that asks the client to rate his or her performance and level of satisfaction in the areas of work, leisure, domestic, and self-care activities. Which assessment would you choose? a. Multnomah Community Ability Scale b. Mental Health Recovery Star c. Multidimensional Scale of Independent Functioning d. Satisfaction with Daily Occupations ANS: d

Topic: Evaluations LO: 54.4

7. Identify the benefit most closely associated with patient and family support group participation. a. Increase in overall functioning and decrease in hospitalizations b. Greater sense of independence in both patients and family members c. Increased self-confidence d. Skills acquisition ANS: a Topic: Interventions LO: 54.5

8. Which of the following is the best explanation of why people with psychosis interact more effectively through social media? a. There is no pressure for the person to participate. b. There is less reliance on social cues. c. It reduces negative beliefs about social participation. d. It decreases levels of distress when interacting with others. ANS: b Topic: Interventions LO: 54.5

9. Identify one of the benefits of participating in a community arts program. a. Increase in overall functioning and decrease in hospitalizations b. Greater sense of independence in both patients and family members c. Being recognized for what they can do versus their diagnosis d. Reduced blood pressure ANS: c Topic: Interventions LO: 54.5

Chapter 55: Leisure and Play

Multiple Choice

1. Which of the following is most reflective of participation in leisure and play? a. Participation relies on an external locus of control. b. Participation requires a strong sense of internal motivation. c. Participation may contribute to a sense of mastery over the environment. d. Participation is a concept that is easily defined within occupational therapy. ANS: c Topic: Defining Leisure and Play LO: 55.1

2. You are a school-based practitioner leading a play exploration group. The children are allowed to choose which activities they want to engage in. One child chooses coloring and becomes so engrossed in the activity that she doesn’t realize the group session has ended. Which of the following does this scenario best represent? a. Engagement b. Partial engagement c. Flow d. Disengagement ANS: c Topic: Factors Affecting Leisure and Play LO: 55.2

3. You are working with an adult diagnosed with schizophrenia. When asked about her engagement in leisure activities, she states she doesn’t do much because she doesn’t have any friends and doesn’t want to do things alone. She has tried to get involved in social activities at her church but no one talks to her. This makes her feel left out and she has stopped going. Therefore, she says she often feels bored and lonely. Which of the following does this scenario best represent? a. Occupational balance b. Occupational engagement c. Occupational alienation d. Occupational deprivation ANS: c Topic: Factors Affecting Leisure and Play LO: 55.2

4. An 8-year-old has been excluded from a classmate’s birthday party because the mother hosting the party is fearful that the child has a mental illness and doesn’t want him around the other children. Which external barrier to occupational participation does this best represent? a. Poverty b. Stigma c. Symptoms d. Emotional ANS: b Topic: Factors Affecting Leisure and Play—Occupational Deprivation LO: 55.2 & 55.3

5. You are working in early intervention and want to assess a child’s level of playfulness. In particular, you want to observe the child during periods of free play to examine intrinsic motivation, internal control, and the child’s ability to suspend reality. Which assessment would you choose? a. Children’s Assessment of Participation and Engagement b. Knox Preschool Play Scale c. Pediatric Interest ProfT ileESTBANKSELLER.COM d. Test of Playfulness ANS: d Topic: Assessments LO: 55.4

6. You are working with an adult who reports limited leisure participation. You decide to administer an assessment that allows the individual to identify her past, present, and future level of interest in a variety of activities. Which assessment would you choose? a. Activity Card Sort b. Modified Interest Checklist c. Leisure Motivation Scale d. Leisure Satisfaction Measure ANS: b Topic: Assessments LO: 55.4

7. When planning leisure interventions, it is important to complete an activity analysis on the activities you will be presenting to your client to assure which of the following? a. It is age appropriate. b. It is offered in the right environment. c. It addresses barriers to participation. d. It is the “just-right challenge.” ANS: d Topic: Interventions LO: 55.5

8. Children with attention deficit-hyperactivity disorder (ADHD) often lack interpersonal empathy toward their playmates. Identify the best approach an occupational therapy practitioner should take during an intervention to facilitate the development of empathy. a. Help the child identify feelings of his or her playmates b. Establish an inviting environment with many play options c. Assure parental involvement d. Assure the “just-right challenge” ANS: a Topic: Play-Based Interventions for Attention Deficit-Hyperactivity Disorder LO: 55.6

9. Identify one of the most beneficial reasons for using social media as a leisure intervention for adults with mental illness. a. It is a mechanism to provide social support and connectedness. b. It provides opportunities for supported socialization. c. It provides opportunities for successful experiences. d. It provides opportunities for spontaneity. ANS: a Topic: Interventions for Adults LO: 55.7 & 55.8

10. Identify one of the most beneficial reasons for using arts and crafts as a leisure intervention for adults with mental illness. a. They are a mechanism to provide social support and connectedness. b. They provide opportunities for supported socialization. c. They provide opportunities for successful experiences. d. They provide opportunities for spontaneity. ANS: c

Topic: Interventions for Adults LO: 55.7 & 55.8

11. Flow is when an individual feels _. a. Overly challenged and unable to perform the activity b. Disengaged and bored c. Optimally engaged and adequately challenged d. Side effects from his or her medication ANS: c Topic: Factors Affecting Leisure and Play

Chapter 56: Rest and Sleep

Multiple Choice

1. Which of the following best describes the importance of sleep for occupational participation? a. It is the foundation for all our waking occupations. b. It is a shared construct. c. It is a repeatable experience. d. It has cultural meaning. ANS: a Topic: Introduction LO: 56.1

2. Increased sleep debt can impact which of the following? a. Melatonin production b. Circadian rhythm c. Cognition d. Zeitgebers ANS: c Topic: The Physiology of Sleep and the Role of Sleep in Health and Growth LO: 56.2 & 56.3

3. The introduction of lifestyle changes, such as decreased nicotine and caffeine intake in the evening, maintaining a regular bedtime routine, and maintaining an effective sleep environment are examples of which of the following? a. NREM sleep b. REM sleep c. Spatial contexts of sleep d. Temporal contexts of sleep ANS: d Topic: The Context of Sleep LO: 56.4 & 56.5

4. a.

Which of the following best describes children experiencing increased sleep debt? Increased drowsiness

b. Increased hyperactivity c. Decreased REM sleep d. Increased NREM sleep ANS: b Topic: Sleep Across the Life Span LO: 56.6

5. Sensations of falling just before falling asleep and the experience of dreams when an individual is awake are symptoms of which of the following? a. REM sleep debt b. NREM sleep debt c. Hypnic myoclonia sleep debt d. Hypnagogic sleep debt ANS: a Topic: Sleep Across the Life Span LO: 56.7

6. You are working with an adolescent who describes her daily routine as playing video games, going to her part-time job during the day, watching TV in the evening until 1:00 a. m., and waking up betT wEeeSnT9B:0A0NaK ndS1E0L:0L0EaR .m..CthOeMnext morning. Her family is concerned about this routine because it is not a normal sleep pattern. Which sleep disorder does this best represent? a. Insomnia b. Parasomnias c. Circadian rhythm sleep disorders d. Sundowning ANS: c Topic: Sleep Disorders LO: 56.8

7. You are working with a client diagnosed with dementia who functions best in the morning. Staff complains that in the evening your client demonstrates increased confusion and anxiety, resulting in her pacing throughout the evening and making it difficult for the staff to assist her to bed. Which of the following does this best represent? a. Insomnia b. Parasomnias c. Circadian rhythm sleep disorders d. Sundowning ANS: d Topic: Populations at Special Risk for Sleep Disorders

LO: 56.9

8. You are working with an adult whose family is concerned he is sleeping too much. You want to use an assessment to gather information on the individual’s perspective and satisfaction on his sleep patterns. Which assessment would you choose? a. Insomnia Severity Index b. Oviedo Sleep Questionnaire c. Patient Health Questionnaire d. Sleep Disturbance Scale for Children ANS: b Topic: Assessments LO: 56.11

9. You are working with a client who reports difficulty sleeping. It has gotten so bad that he dreads bedtime because he knows he will toss and turn for an hour before he falls asleep and wake up a few hours later, unable to fall back to sleep. He states he knows these feelings of dread and the anxiety associated with it is further complicating his ability to fall asleep. You decide to use an intervention that incorporates mindfulness and education about sleep and sleep hygiene in the hopes that your client will begin to see sleep as a positive activity. WThE icS hT apBpA roNaK chStE oL slL eeEpRd. isC orOdM ers does this best represent? a. Pharmacological b. Cognitive therapy c. Environmental adaptations d. Bedtime routine ANS: b Topic: Intervention LO: 56.12

10. When working with a client experiencing sleep disturbances, you want to make sure that she has a good pillow and mattress, as well as recommend the use of a sleep mask to block out light. Which approach to sleep disorders does this best represent? a. Pharmacological b. Cognitive therapy c. Environmental adaptations d. Bedtime routine ANS: c Topic: Intervention LO: 56.12

11.

The gradual accumulation of a lack of sleep is called a. Sleep apnea b. Insomnia c. Sleep disorder d. Sleep debt ANS: d Topic: The Role of Sleep in Health and Growth

12.

Extreme sleep debt in children displays the same symptoms as a. Cognitive delay b. Hyperactivity c. Insomnia d. Night terrors ANS: b Topic: Sleep Across the Life Span

Chapter 57: Spiritual Occupation

Multiple Choice

1. Which of the following best reflects how occupational therapy defines spirituality? a. Religious beliefs b. Religious affiliations c. How a person seeks and expresses meaning and purpose d. Cultural beliefs ANS: c Topic: Introduction LO: 57.1 2. The Canadian Model of Occupational Performance and Engagement places spirituality at the core of which of the following domains? a. Person b. Environment c. Occupation d. Occupational performT anEcS e TBANKSELLER.COM ANS: a Topic: Introduction LO: 57.1 3. The ability to make decisions about what spiritual beliefs and practices to adopt is referred to as which of the following? a. Volition b. Occupational performance c. Personal causation d. Spiritual agency ANS: d Topic: Religion and Spirituality in Mental Health Practice LO: 57.2 4. Evidence indicates that religious and spiritual practices impact which of the following? a. Negative impact on mental health outcomes b. Positive impact on mental health outcomes c. Increased delusions d. Increased depressive symptoms ANS: b Topic: Religion and Spirituality in Mental Health Practice

LO: 57.2 5. As an occupational therapy practitioner, you choose to engage your clients in activities such as painting, poetry, and dancing as a way of discovering meaning in life and relationships. These activities can best be identified as which of the following? a. Nature-based occupations b. Creative occupations c. Social occupations d. Religious occupations ANS: b Topic: Spiritual Occupations LO: 57.3 6. You are working with a client who states she feels at peace when communing with nature, but hasn’t been engaged in nature-based occupations for a long time because of work commitments. Through collaboration with your client you establish a weekly routine that incorporates one nature-based activity. Which of the following best reflects a nature-based activity? a. Sketching nature scenes b. Mindfulness c. Establishing new friendships d. Gardening ANS: d Topic: Spiritual Occupations LO: 57.3 7. Which of the following is most reflective of an occupational therapy practitioner’s approach to working with an individual who engages in a specific religious practice? a. Obtain a thorough knowledge of the individual’s religious practice b. Collaborate with the appropriate religious personnel when providing treatment c. Recognize and respect the significance and meaning this practice has for the individual you are working with d. Avoid the topic of spirituality in practice, as it is not your domain ANS: c Topic: Spiritual Occupations LO: 57.3

8. You have been working on an inpatient mental health unit for the past 5 years. Because of the increased acuity of your patients and work-related stress, you and your colleagues have started to experience burnout. You decide you want to incorporate an evidence-based intervention that has been found to help reduce job burnout. Which of the following interventions would you choose? a. Journaling b. Prayer c. Yoga

d. Mindfulness ANS: d Topic: Mindfulness and Reflective Practices LO: 57.5 9. You are working with a client who values regular religious participation; however, this person has not been attending religious services for the past 6 months because of symptoms of depression. You are looking for an evidence-based intervention that addresses time use as a way to increase occupational balance and community engagement that you hope will facilitate your client’s return to regular religious service participation. Which intervention approach would you choose? a. Action Over Inertia b. Mindfulness Living Programs c. Cognitive Behavioral Therapy d. Disabilities and Faith Program ANS: a Topic: Evidence Based Practice—Enabling Religious Attendance LO: 57.5