Preparatory Selection - Nbcot Registered Occupational Therapists Otr

1. Which preparatory technique is most appropriate to calm an overaroused client before participating in self-care?

   Calming sensory input (deep pressure, slow rocking, dim light). Inhibitory inputs modulate sensory processing to decrease hyperactivity and promote relaxation.

2. Which preparatory technique is typically used to increase tissue extensibility before stretching a stiff joint capsule?

   Moist heat or ultrasound (thermal) immediately before stretch. Thermal agents enhance collagen extensibility, allowing for more effective stretching of stiff tissues.

3. Identify the best preparatory technique to improve performance when pain is the main limiter during a functional task.

   Analgesic modality (e.g., TENS or cold/heat as indicated). Pain modulation enables greater engagement in activities by alleviating discomfort barriers.

4. Which preparatory technique is most appropriate to reduce pain during movement for osteoarthritis before ADL training?

   Superficial heat (moist heat/paraffin) for pain and stiffness. Thermal therapy alleviates joint pain and improves mobility by increasing blood flow and reducing viscosity.

5. Which preparatory technique is most appropriate to reduce edema in an acute ankle sprain before activity?

   Cryotherapy (cold pack/ice) with elevation and compression. Applies RICE principles to minimize swelling and inflammation in acute injuries, facilitating safer activity participation.

6. Which preparatory technique is contraindicated over an area with impaired sensation (absent protective sensation)?

   Superficial heat (hot pack/paraffin) due to burn risk. Impaired sensation prevents detection of excessive heat, increasing the risk of thermal injury.

7. Which preparatory technique is most appropriate to maintain ROM and prevent contracture in a client with prolonged immobility?

   Positioning and prolonged low-load stretch (splinting as needed). Sustained positioning counteracts adaptive shortening in muscles and connective tissues.

8. Which preparatory technique is most appropriate to increase safety before transfers when the client has poor trunk control?

   Core activation and seated balance training before transfer practice. Strengthens trunk musculature and proprioception to provide a stable base for safe transfers.

9. Which preparatory technique is most appropriate to reduce spasticity briefly before functional task practice?

   Prolonged stretch/weight bearing with slow rhythmic movement. These methods inhibit hyperactive reflexes and muscle tone through sustained proprioceptive input.

10. Which preparatory technique is contraindicated for a client with a known deep vein thrombosis in the affected limb?

    Massage and vigorous heat; avoid techniques increasing embolus risk. Such interventions may dislodge thrombi, potentially leading to pulmonary embolism.

11. Which preparatory technique is contraindicated over a malignant tumor site?

    Thermal modalities and ultrasound over the tumor region. These methods may accelerate metabolic activity and cell proliferation in neoplastic tissues.

12. Which preparatory technique is most appropriate to soften scar tissue to support later scar mobilization?

    Heat (e.g., moist heat) followed by gentle scar mobilization. Thermal application increases tissue pliability, facilitating effective manual mobilization.

13. Identify the safest preparatory technique for desensitization of a hypersensitive residual limb after amputation.

    Graded desensitization (textures, tapping, vibration as tolerated). Progressive sensory exposure habituates neural responses, reducing hypersensitivity without overwhelming the system.

14. Which preparatory technique is contraindicated directly over a pacemaker or implanted defibrillator site?

    Electrical stimulation (TENS/NMES) over the implant area. Electrical currents can disrupt the function of cardiac implantable devices.

15. Which preparatory technique is most appropriate before handwriting when the primary issue is finger stiffness?

    Paraffin or moist heat to hand, then brief ROM before writing. Thermal and mobility interventions enhance joint flexibility and reduce resistance to movement.

16. Which option is the safest preparatory choice when skin is fragile and at high risk for tearing?

    Avoid adhesive tape and friction massage; use gentle positioning. Minimizes shear forces and adhesion-related trauma to vulnerable integument.

17. Which preparatory technique is most appropriate to improve joint proprioception before balance-related functional tasks?

    Weight bearing, closed-chain input, or joint approximation. These activities stimulate mechanoreceptors to enhance kinesthetic awareness and stability.

18. Which preparatory technique should be avoided over an area of active bleeding or severe bruising?

    Heat and vigorous massage; use cold if appropriate. These interventions may exacerbate hemorrhage by promoting vasodilation and mechanical disruption.

19. What is the safest preparatory technique to decrease pain and muscle guarding before gentle ROM in acute inflammation?

    Cryotherapy for analgesia and reduced metabolic demand. Cold therapy provides pain relief and decreases inflammation without risking further tissue damage in acute conditions.

20. Which preparatory technique is most appropriate to reduce nausea/vertigo symptoms before functional mobility training?

    Vestibular habituation or gaze stabilization as clinically indicated. These exercises desensitize the vestibular system to motion, mitigating symptoms during activity.

21. Which option best matches the goal of improving sitting tolerance for a client with low back pain before work tasks?

    Heat and gentle trunk mobility, then graded postural endurance. Prepares spinal tissues and builds endurance to sustain upright postures comfortably.

22. Which preparatory technique is most appropriate to address orthostatic hypotension risk before standing ADLs?

    Gradual position changes with compression and LE pumping exercises. These measures support venous return and blood pressure stability during postural transitions.

23. Which preparatory technique is most appropriate to reduce hand edema after stroke before grasp-and-release practice?

    Retrograde massage and elevation with gentle AROM. Facilitates fluid mobilization and reduces swelling through gravitational and manual assistance.

24. Which preparatory technique is most appropriate to improve alertness and arousal before a task for a lethargic client?

    Alerting sensory input (cold, brisk brushing, upbeat music). Stimulatory sensory modalities activate the reticular activating system to enhance wakefulness.

25. Which preparatory technique best facilitates muscle activation in a weak muscle prior to strengthening tasks?

    Neuromuscular electrical stimulation (NMES) or vibration/tapping. These techniques promote neural excitation and muscle recruitment to enhance voluntary control.

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