NBCOT Registered Occupational Therapists (OTR) Quiz: Body Function Impact

An OTR is evaluating a 68-year-old client 3 months post-right CVA. The client lives alone and wishes to resume cooking simple meals. During a performance-based assessment in the clinic kitchen, the client attempts to make toast. They successfully retrieve the bread and toaster but then repeatedly attempt to insert the toaster's electrical plug into a fork from the utensil drawer. When prompted, the client is unable to describe the function of the toaster or the fork.

Based on this observation, the client's difficulty with the cooking task is MOST likely caused by an impairment in which specific cognitive body function?

A 25-year-old with a complete C6 spinal cord injury is in an inpatient rehabilitation unit. During a morning ADL session, while the client is sitting upright in their wheelchair, they suddenly develop a pounding headache, profuse sweating above the level of the injury, and significant nasal congestion. Their blood pressure, taken by the nurse, is found to be 200/110 mmHg.

The client's symptoms are an indication of autonomic dysreflexia. This life-threatening condition is caused by a severe impairment in the function of the:

A client is being seen for rehabilitation following a cardiac event and has a sternotomy. The OTR is instructing the client in adaptive techniques for lower body dressing. The client can visually identify their feet and the clothing items but is unable to guide their foot into their sock without looking. They frequently miss the opening of the sock and report a sensation of 'numbness' in their hands when manipulating items out of their line of sight.

The client's difficulty with this dressing task, despite intact vision, MOST likely points to a deficit in which body function?

Client with bilateral vestibular hypofunction falls when reaching into a dark cabinet. Which impairment explains this?

A client with Alzheimer's puts toothpaste on a mirror. Which body function impairment is most evident?

Flaccid hemiplegia causes shoulder subluxation during wheelchair propulsion. Which impairment is most responsible?

Client with emphysema has O2 sat dropping to 88% while showering. Which body function impairment explains this?

Client with MS has leg buckling after a hot shower. This best reflects which impairment?

A client with multiple sclerosis (MS) reports a significant increase in fatigue and blurred vision that forces them to stop their afternoon work as a data entry clerk. These symptoms are most prominent after their daily routine of taking a warm bath before starting their shift. The symptoms typically resolve after resting in a cool room for about an hour. Standard ophthalmologic exams have been unremarkable.

The OTR should recognize that this client's occupational performance is being impacted by which underlying body function impairment characteristic of MS?

George is a 81-year-old man recovering from a left hip fracture repaired surgically three weeks ago. He lives with his spouse in a condo with elevator access. Medical history includes mild diabetes and chronic low back pain. George reports hip stiffness, pain when bending forward, and reduced leg strength. Body structures involved include the left hip joint and healing tissues; body functions impaired include joint mobility, muscle power, and pain modulation. George's valued occupations include dressing independently, walking to the building's mailroom, and preparing simple lunches. He can walk short distances with a walker but becomes unsteady when turning. He struggles to put on pants and socks and avoids going to the mailroom because carrying items while using a walker feels unsafe. Environmental factors include a cluttered hallway near the entry, a low sofa, and limited seating space in the kitchen. Personal factors include strong desire to avoid burdening his spouse and willingness to practice new techniques.

Gloria is a 73-year-old woman with COPD who lives with her sister in a retirement community. Medical history includes mild osteoporosis. Gloria reports shortness of breath with moderate activity, fatigue after walking to the dining hall, and needing to pause during longer conversations when she is winded. Body structures affected include lungs and airways; body functions impaired include breathing control during activity and endurance. Gloria values participating in a choir and attending community events. She has stopped going to choir because walking there and singing for extended periods leaves her exhausted. Environmental factors include long corridors, limited benches for resting, and scheduled events back-to-back. Personal factors include strong social motivation, embarrassment about needing breaks, and interest in learning ways to conserve energy while staying involved.

A client with post-concussion syndrome is attempting to return to their hobby of reading. They report that after a few minutes, the words on the page seem to 'float' or 'shimmer,' and they develop a headache centered behind their eyes. They find they have to constantly re-read sentences because they lose their place. A standard visual acuity test (Snellen chart) is 20/20.

The client's difficulty with the sustained occupation of reading is MOST likely due to an impairment in which specific oculomotor body function?

A client with chronic fibromyalgia is participating in an energy conservation work-simplification program. The client reports that they consistently stop performing homemaking tasks not because of muscular fatigue, but because of a 'burning, electrical, and widespread' discomfort that becomes intolerable. They state that even the light pressure from their clothing can feel intensely uncomfortable during these flare-ups.

The OTR determines that the client's primary limiting factor for occupational performance is an impairment related to which body function?

A client with a history of alcohol use disorder has been diagnosed with Korsakoff syndrome. The OTR is attempting to teach the client a simple 3-step compensatory strategy for remembering to take medication. On Day 1, the client requires constant verbal cues. On Day 2, the client has no recollection of the previous session or the OTR. When shown the visual aid for the strategy, the client creates a plausible but false story about how they designed it themselves last week.

The client's inability to learn the new strategy and their creation of a false memory are characteristic of impairments in which two body functions?

Hector is a 52-year-old IT specialist with major depressive disorder. He lives alone and works hybrid (home and office). Medical history includes mild back discomfort from prolonged sitting. Hector reports difficulty concentrating, forgetfulness, and reduced mental stamina, especially when switching tasks. Body functions affected include attention, working memory, and task initiation; body structures involved include brain systems supporting executive function. He is missing steps when troubleshooting, forgetting to document changes, and struggling to start complex tasks. At home, he leaves dishes undone and forgets to refill prescriptions. Environmental factors include multiple chat notifications, frequent context switching, and limited structure on work-from-home days. Personal factors include high personal standards, worry about job performance, and willingness to use external reminders and routines.

Victor is a 57-year-old chef with early-stage Parkinson's disease. He works in a busy restaurant kitchen and lives with his spouse. Medical history includes mild acid reflux. Victor reports intermittent hand tremor, slowed movements, and stiffness in his fingers, especially during long shifts. Body functions impaired include fine motor coordination, movement speed, and muscle tone regulation; body structures involved include brain systems affecting movement. Occupational demands include fast knife skills, plating delicate garnishes, and quickly fastening apron ties and buttons. He notices he drops small items when rushed and his plating takes longer, which affects teamwork. Environmental factors include time pressure, heat, crowded workspaces, and limited breaks. Personal factors include strong professional identity, concern about coworkers' perceptions, and willingness to try strategies that keep him safe and efficient.

Jamal is a 38-year-old sales representative with major depressive disorder. He travels locally for work and lives with his partner. Medical history includes seasonal allergies. Jamal reports difficulty concentrating, slowed thinking, and low mental energy, especially in the afternoon. Body functions affected include sustained attention, processing speed, and emotional regulation; body structures involved include brain systems supporting motivation and cognition. He struggles to prepare for client meetings, forgets follow-up tasks, and feels overwhelmed by planning routes and schedules. He has reduced participation in leisure activities like playing guitar because he "can't focus long enough." Environmental factors include frequent phone calls, pressure to respond quickly to clients, and working from home with distractions. Personal factors include strong desire to maintain performance, frustration with himself, and willingness to use tools to structure his day.

Maria is a 72-year-old retired librarian who lives alone in a one-story home. Two weeks ago, she fell in her garden and sustained a left hip fracture; she had surgical repair and is now weight-bearing as tolerated with a walker. Her medical history includes osteoarthritis in both knees and mild high blood pressure controlled with medication. She reports hip pain rated 6/10 with movement, stiffness, and limited hip bending and outward rotation. Body structures involved include the left hip joint and surrounding soft tissues healing after surgery; body functions impaired include joint mobility (reduced range of motion), pain, and decreased lower-extremity strength and endurance. Maria's main occupational roles are managing her home, attending church, and caring for her small dog. She is struggling with lower-body dressing, stepping into the tub for bathing, and standing long enough to cook simple meals. She avoids bending to feed her dog and has been sleeping in a recliner because getting in and out of bed increases pain. Environmental factors include a narrow bathroom doorway, a bathtub with a high side, and low kitchen cabinets requiring bending; she has supportive neighbors but no family nearby. Maria is motivated to return to her routines and is worried about losing independence.

Patricia is a 67-year-old woman with COPD who lives with her spouse in a single-level home. Medical history includes mild knee osteoarthritis. Patricia reports fatigue and shortness of breath when doing chores like making the bed, carrying laundry, and walking to the mailbox. Body structures affected include the lungs; body functions impaired include endurance and breathing efficiency. She values caring for her home and attending a weekly book club. She has started skipping book club because she becomes tired getting ready and worries about coughing during discussions. Environmental factors include a long driveway to the mailbox, limited seating in the bedroom for rest breaks, and winter cold that worsens breathing. Personal factors include strong desire to stay socially connected, concern about symptom visibility, and willingness to try pacing and planning.

Martha is a 69-year-old woman with COPD who lives alone in a small house. Medical history includes osteopenia and reflux. She reports shortness of breath during vacuuming, fatigue after showering, and needing to sit to recover after climbing a few steps to her porch. Body structures affected include lungs and airways; body functions impaired include breathing endurance and energy level. Martha values independence and enjoys hosting a weekly card game. She has begun canceling because cleaning the house beforehand leaves her exhausted. She also avoids grocery shopping because pushing a cart and carrying bags triggers breathlessness. Environmental factors include a hilly neighborhood, a porch with steps and no rail, and limited delivery options. Personal factors include pride in self-reliance, mild anxiety about symptoms in front of friends, and willingness to consider pacing and task simplification.