NBCOT Registered Occupational Therapists (OTR) Quiz: Emergency Response
20 questions · exam conditions
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Emergency ResponseQuestion 1 of 20

An occupational therapist is working with a client who has a C6 spinal cord injury on performing dressing tasks in bed. The client suddenly complains of a pounding headache and blurred vision. The therapist observes that the client is sweating profusely on their forehead and has visible goosebumps on their arms.

Which of the following actions should the therapist take FIRST?

Lay the client flat to prevent a syncopal episode from the change in blood pressure.
Immediately check the client's catheter tubing for kinks or blockages.
Sit the client upright as quickly as is safe to help lower their blood pressure.
Locate a blood pressure cuff to obtain a baseline reading before taking further action.
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NBCOT Registered Occupational Therapists (OTR) Quiz

NBCOT Registered Occupational Therapists (OTR) Quiz: Emergency Response

Practice Emergency Response in NBCOT Registered Occupational Therapists (OTR) with focused quiz questions that help you check what you know, review explanations, and build confidence with test-style prompts.

What this quiz covers

This quiz focuses on Emergency Response, giving you a quick way to practice the rules, question types, and explanations that matter most for NBCOT Registered Occupational Therapists (OTR).

How to use this quiz

Try each quiz question before looking at the correct answer. Use the explanations to review missed ideas, then come back to similar questions until the pattern feels familiar.

All questions

Question 1

An occupational therapist is working with a client who has a C6 spinal cord injury on performing dressing tasks in bed. The client suddenly complains of a pounding headache and blurred vision. The therapist observes that the client is sweating profusely on their forehead and has visible goosebumps on their arms.

Which of the following actions should the therapist take FIRST?

  1. Lay the client flat to prevent a syncopal episode from the change in blood pressure.
  2. Immediately check the client's catheter tubing for kinks or blockages.
  3. Sit the client upright as quickly as is safe to help lower their blood pressure. (correct answer)
  4. Locate a blood pressure cuff to obtain a baseline reading before taking further action.
Explanation: The client is exhibiting classic signs of autonomic dysreflexia, a medical emergency common in individuals with spinal cord injuries at T6 or above. This condition causes a rapid, uncontrolled increase in blood pressure. The immediate, highest-priority action is to sit the client upright. This uses gravity to help lower blood pressure and is the first line of defense. Checking for the noxious stimulus (like a kinked catheter) is the next step, but positioning takes precedence. Laying the client flat would dangerously increase their blood pressure. Obtaining a BP reading is important but secondary to the immediate action of sitting the client up.

Question 2

A client in a work-hardening program is lifting a 25-pound crate when he stops, grabs his chest, and complains of a squeezing pain. He appears pale and short of breath. He has a known history of coronary artery disease and has a prescription for sublingual nitroglycerin, which he has with him.

What is the therapist's correct sequence of actions?

  1. Immediately administer a dose of nitroglycerin, wait 5 minutes, then call 911 if pain persists.
  2. Stop the activity, have the client sit down, assist with one dose of nitroglycerin, then call 911.
  3. Have the client take his nitroglycerin, continue with lighter duties, and call 911 only if symptoms worsen.
  4. Call 911 immediately, then have the client rest and take his nitroglycerin while waiting for EMS. (correct answer)
Explanation: The client is showing signs of a potential myocardial infarction (heart attack). Current guidelines recommend calling 911 immediately for any chest pain that is not relieved by rest. While waiting for EMS, the therapist should have the client stop all activity and rest in a comfortable position, and can then assist them in taking their prescribed nitroglycerin. Delaying the call to 911 (A, B) is dangerous. Continuing any activity, even light duty (C), is contraindicated as it increases myocardial oxygen demand.

Question 3

An OTR is using a belt sander with a client in a woodworking shop for a prevocational program. The client is wearing safety goggles. The sanding disk shatters, and a small piece strikes the client in the eye, shattering the lens of the safety goggles. The client is screaming in pain and covering their eye.

What is the MOST appropriate first-aid response by the therapist?

  1. Cover the injured eye with a rigid shield (like a paper cup) and have the client cover their uninjured eye as well. (correct answer)
  2. Try to remove any visible fragments of the goggle or disk with sterile tweezers.
  3. Attempt to flush the eye with copious amounts of water or sterile saline.
  4. Apply a pressure dressing to the eye to control any potential bleeding.
Explanation: When you encounter eye injury questions in occupational therapy practice, your priority is protecting the eye from further damage while awaiting medical care. Eye injuries, especially those involving penetrating objects or fragments, require careful handling to prevent worsening the injury. Option A is correct because covering the injured eye with a rigid shield (like a paper cup) protects it from further trauma without applying pressure, while covering the uninjured eye prevents sympathetic eye movement that could worsen the injury. Eyes move together involuntarily, so covering both eyes keeps the injured eye still. Option B is dangerous because attempting to remove fragments with tweezers could push debris deeper into the eye or cause additional tissue damage. Only medical professionals should attempt fragment removal. Option C might seem logical since we flush eyes for chemical exposures, but flushing an eye with potential penetrating fragments could force debris deeper or worsen lacerations. This isn't a chemical burn requiring irrigation. Option D is incorrect because applying pressure to an injured eye can increase intraocular pressure and potentially push fragments deeper, causing more severe damage to internal eye structures. For NBCOT-OTR questions about emergency response, remember the principle of "do no harm." When an eye has potential penetrating injury or embedded fragments, your goal is stabilization and protection, not active intervention. Think: rigid shield (no pressure), minimize eye movement, and get immediate medical help. This same principle applies to other penetrating injuries throughout the body.

Question 4

An OTR is facilitating a craft group in a school-based setting. A 7-year-old child puts a large plastic bead in their mouth and begins to choke. The child is conscious, able to make sounds, and is coughing forcefully.

What is the OTR's most appropriate response?

  1. Immediately perform abdominal thrusts (Heimlich maneuver).
  2. Perform a blind finger sweep of the child's mouth to remove the bead.
  3. Encourage the child to continue coughing while closely monitoring them. (correct answer)
  4. Have the child drink water to try and wash the bead down.
Explanation: When a person is choking but can still cough forcefully, it indicates a partial airway obstruction. A strong cough is the most effective way to clear the airway. The OTR should stay with the child and encourage them to keep coughing. Abdominal thrusts are only indicated for a severe or complete obstruction (i.e., the person cannot breathe, speak, or cough). A blind finger sweep is dangerous as it may push the object further into the airway.

Question 5

An OTR is working with a client with a C6 spinal cord injury on dressing tasks. The client is sitting upright in their wheelchair and suddenly complains of a severe, pounding headache. The OTR observes that the client is sweating profusely above the level of injury and their face is flushed.

What is the OTR's MOST critical immediate response to this situation?

  1. Lay the client down flat to reduce the headache and monitor their vital signs.
  2. Continue with the dressing task, reassuring the client that the symptoms will pass.
  3. Keep the client sitting upright and immediately check for sources of noxious stimuli, such as a kinked catheter tube. (correct answer)
  4. Administer over-the-counter pain medication for the headache and contact the physician at the end of the day.
Explanation: These symptoms are classic signs of autonomic dysreflexia, a life-threatening condition common in individuals with SCI at T6 or above. The immediate response is to place the client in an upright position to help lower blood pressure and then promptly identify and eliminate the triggering noxious stimulus (e.g., full bladder, tight clothing, bowel impaction). Laying the client down would dangerously increase their blood pressure.

Question 6

An OTR is assisting a 78-year-old client to move from a supine to a seated position on the edge of the bed for the first time after a prolonged period of bed rest. Upon sitting up, the client states, "I feel very dizzy and my vision is blurry."

Which action should the OTR take IMMEDIATELY?

  1. Have the client perform ankle pumps and deep breathing exercises.
  2. Safely return the client to a reclining or supine position. (correct answer)
  3. Continue to a standing position quickly to overcome the dizziness.
  4. Take the client's blood pressure while they remain seated.
Explanation: The client's symptoms are indicative of orthostatic hypotension, a sudden drop in blood pressure upon moving to an upright position. The most immediate and safest action is to return the client to a supine or reclining position to restore blood flow to the brain and prevent syncope or a fall. While taking blood pressure is important, ensuring the client's immediate safety by repositioning is the priority.

Question 7

During a session in an outpatient hand therapy clinic, a 55-year-old client is using therapeutic putty. The client stops the activity and reports a sudden, crushing chest pain that is radiating to their left jaw and arm. The client appears pale and short of breath.

What is the OTR's PRIORITY action?

  1. Ask the client if they have a history of heartburn or indigestion.
  2. Stop the activity, have the client rest, and activate emergency medical services (EMS). (correct answer)
  3. Check the client's grip strength to see if the symptoms are related to the exercise.
  4. Offer the client a glass of water and encourage them to take deep breaths.
Explanation: The client's symptoms are classic signs of a myocardial infarction (heart attack), which is a medical emergency. The priority is to stop all activity and immediately activate EMS (e.g., call 911). Delaying medical care to gather more information or attempt minor interventions could have life-threatening consequences.

Question 8

A client is receiving a hot pack treatment on their lower back to manage chronic pain. Five minutes into the treatment, the client reports that the pack feels like it is burning their skin. The OTR checks and notices a well-defined area of bright red skin under the hot pack.

What is the OTR's IMMEDIATE course of action?

  1. Add several more layers of towels and continue the treatment.
  2. Remove the hot pack and inspect the client's skin. (correct answer)
  3. Tell the client that intense warmth is expected and a normal part of the treatment.
  4. Document the client's complaint and lower the temperature for the next session.
Explanation: Any report of burning or excessive heat during a thermal modality application must be addressed immediately to prevent tissue damage. The first and most critical step is to remove the source of heat (the hot pack) and carefully inspect the skin for signs of a burn. Ignoring the client's report or simply documenting it without action is negligent.

Question 9

During a feeding session, an OTR is working with an adult client who has dysphagia following a stroke. After the client takes a spoonful of pureed food, they begin to cough weakly, their voice sounds wet and gurgly, and the OTR notices a bluish tint around their lips.

What is the OTR's IMMEDIATE response?

  1. Offer the client a drink of thin liquid to help clear their throat.
  2. Stop the feeding immediately and encourage the client to cough forcefully. (correct answer)
  3. Have the client lie down flat to prevent further aspiration.
  4. Continue the feeding using smaller spoonfuls.
Explanation: The client is showing clear signs of aspiration (food entering the airway). The immediate priority is to stop feeding to prevent more food from being aspirated and to attempt to clear the airway. Encouraging a cough is the first step. Offering liquids, continuing feeding, or laying the client flat would all increase the risk of further aspiration and respiratory compromise.

Question 10

An OTR is conducting a bedside session in an acute care hospital when a "code blue" (cardiac arrest) is announced for the OTR's patient. The code team rushes into the room.

What is the OTR's most appropriate role during this acute medical emergency?

  1. Immediately leave the room to avoid getting in the way of the medical team.
  2. Begin performing chest compressions over the code team leader.
  3. Provide a concise report to the code team leader about the patient's activity and status just prior to the event. (correct answer)
  4. Go to the nursing station to find the patient's paper chart for the team.
Explanation: The OTR has unique and valuable information about what the patient was doing immediately before the cardiac arrest. Providing a brief, relevant report (e.g., "We were working on sitting at the edge of the bed when he became unresponsive") gives the medical team important context. The OTR should then step back but remain available if needed. Leaving the room, taking over medical procedures, or searching for a chart are not the OTR's primary role in this situation.

Question 11

An OTR is fabricating a thermoplastic orthosis for a client. The client, who has a severe but undocumented latex allergy, develops hives, wheezing, and reports their throat feels like it is closing after their arm comes into contact with latex gloves that the OTR had been wearing earlier in the session.

What is the OTR's most critical FIRST step?

  1. Document the adverse reaction in the client's medical record.
  2. Apply a cold compress to the client's arm to reduce the hives.
  3. Activate emergency medical services and ask if the client has an epinephrine auto-injector. (correct answer)
  4. Remove all latex materials from the immediate area and monitor the client's breathing.
Explanation: Wheezing and the sensation of the throat closing are signs of anaphylaxis, a severe, life-threatening allergic reaction. This is a medical emergency that requires immediate intervention. The OTR's first priority is to activate EMS (call 911 or the facility's emergency response team) and inquire about an epinephrine auto-injector, which the OTR may be able to assist the client in using. All other actions are secondary to obtaining immediate medical help.

Question 12

A client was recently fitted with a custom thermoplastic resting hand orthosis. During a follow-up visit, the client reports that their fingers feel numb and tingly. The OTR removes the orthosis and observes that the fingers are pale and cool to the touch compared to the other hand.

What is the OTR's BEST immediate action?

  1. Instruct the client to wear the orthosis for shorter periods and build up tolerance.
  2. Document the client's report and modify the orthosis during the next scheduled visit.
  3. Discontinue use of the orthosis immediately and modify it to relieve pressure. (correct answer)
  4. Add extra padding to the areas where the client feels numbness.
Explanation: The signs of numbness, tingling, pallor, and cool skin indicate neurovascular compromise, likely due to excessive pressure from the orthosis. This is a serious adverse event that could lead to tissue damage. The immediate action is to discontinue all use of the orthosis. The OTR must then identify the areas of pressure and modify the orthosis before the client can safely wear it again. Delaying this action is unsafe.

Question 13

An OTR is using a fluidotherapy machine for a client's hand. The client, who has some sensory deficits, does not report any discomfort, but when the OTR removes the hand after the prescribed time, they observe significant redness and the formation of several small blisters.

What is the MOST appropriate first-aid response for this type of burn?

  1. Apply ice directly to the blistered area to reduce swelling.
  2. Cool the burn with cool running water, then cover with a sterile, non-stick dressing. (correct answer)
  3. Puncture the blisters with a sterile needle to drain the fluid and prevent infection.
  4. Apply butter or a thick antibiotic ointment and wrap the hand tightly.
Explanation: This is a second-degree (partial-thickness) thermal burn. The standard first-aid procedure is to cool the area with cool (not ice-cold) water for 10-20 minutes to stop the burning process. After cooling, the area should be covered with a sterile, non-stick dressing to protect it and prevent infection. Applying ice, butter, or ointments, and breaking blisters are all contraindicated and can cause further tissue damage or increase infection risk.

Question 14

During a work-conditioning session, a client is lifting a 20-pound crate from the floor to a shelf. They suddenly cry out, drop the crate, and report a sharp, stabbing pain in their lower back. The client is unable to stand up straight due to the pain.

What is the OTR's most appropriate INITIAL response?

  1. Encourage the client to slowly attempt to touch their toes to stretch the muscle.
  2. Apply a hot pack to the area to help relax the muscle spasm.
  3. Stop the activity and help the client into a position of comfort, such as lying on their back with knees bent. (correct answer)
  4. Have the client repeat the lift using proper body mechanics to correct their form.
Explanation: The client has likely sustained an acute musculoskeletal injury. The immediate priority is to prevent further harm and reduce pain. This involves stopping all activity and assisting the client into a position that minimizes strain on the lower back, such as supine with knees bent or side-lying with a pillow between the knees. Attempting to stretch, apply immediate heat (ice is usually preferred for acute injuries), or repeat the activity would be unsafe and could worsen the injury.

Question 15

A home health OTR arrives at the house of an elderly client who lives alone for a scheduled appointment. The OTR knocks and rings the doorbell, but there is no answer. The OTR can hear the television on inside and a faint moaning sound. The door is locked.

What is the OTR's MOST appropriate course of action?

  1. Try to find an unlocked window to enter the home and assess the client.
  2. Call the client's emergency contact number listed in the chart.
  3. Leave a note on the door and call the office to report a missed visit.
  4. Call 911 to request a wellness check due to a potential medical emergency. (correct answer)
Explanation: The combination of a missed appointment, a client who lives alone, and sounds of distress from inside the home constitutes a potential emergency. The most appropriate and safest action is to call 911 for a wellness check. Emergency services are equipped to enter the home and provide medical assistance. Calling the emergency contact first would delay a potentially time-sensitive medical response. Attempting to enter the home is unsafe and a liability for the therapist.

Question 16

An OTR is applying a multi-layer compression bandage to a client's arm to manage lymphedema. After the wrapping is complete, the client states, "My fingers are starting to feel like pins and needles and they look a little blue."

Which action must the OTR take IMMEDIATELY?

  1. Elevate the client's arm above their head and reassess in 15 minutes.
  2. Remove the bandages completely and check capillary refill in the fingers. (correct answer)
  3. Inform the client that this is a normal sensation as the fluid begins to move.
  4. Document the client's complaint and loosen the top layer of the bandage slightly.
Explanation: Paresthesia ('pins and needles') and cyanosis (bluish discoloration) are red flags for neurovascular compromise due to excessive compression. The bandage is too tight and is cutting off circulation and/or compressing nerves. The only safe and immediate action is to remove the bandages completely to restore blood flow and nerve function, followed by a thorough neurovascular assessment. Delaying removal or minimizing the client's complaint could lead to permanent tissue damage.

Question 17

An OTR is working with a client in their room at a skilled nursing facility when the fire alarm begins to sound. The OTR's client is non-ambulatory and uses a wheelchair for mobility. The OTR does not see or smell smoke in the immediate vicinity.

According to the R.A.C.E. fire safety protocol (Rescue, Alarm, Confine, Extinguish/Evacuate), what is the OTR's primary responsibility at this moment?

  1. Leave the client to find the source of the fire and a fire extinguisher.
  2. Immediately transfer the client from the wheelchair to their bed.
  3. Close the client's room door and wait for further instructions from facility staff. (correct answer)
  4. Wheel the client to the elevator to evacuate the building as quickly as possible.
Explanation: Since the alarm is already sounding ('A' is complete) and there is no immediate danger in the room ('R' is not immediately needed), the next step is to 'Confine' the fire by closing the door to the room. This helps prevent the spread of smoke and fire. The OTR should then prepare to evacuate the client according to the facility's emergency plan, which typically involves horizontal evacuation to a safer area, not using elevators. Leaving the client is abandonment.

Question 18

An OTR is working with a client with Type 1 diabetes on a morning ADL routine. The client becomes increasingly confused, shaky, and pale. They report feeling weak and their skin is cool and clammy to the touch. The client is conscious and able to follow simple commands.

What is the MOST appropriate initial action for the OTR to take?

  1. Help the client administer their scheduled dose of insulin.
  2. Provide the client with a fast-acting source of sugar, such as orange juice. (correct answer)
  3. Have the client lie down and rest until the symptoms resolve on their own.
  4. Call 911 immediately without providing any other intervention.
Explanation: The client is exhibiting classic signs and symptoms of hypoglycemia (low blood sugar). Since the client is conscious and able to swallow, the standard first-aid protocol is to provide 15-20 grams of a fast-acting carbohydrate, such as juice, glucose tablets, or hard candy. Administering insulin would be extremely dangerous as it would lower blood sugar further. While calling 911 may become necessary if the client does not improve or loses consciousness, providing sugar is the correct initial step.

Question 19

An OTR is conducting a cooking activity in a rehabilitation kitchen with a client who has a known seizure disorder. During the activity, the client suddenly stops, their eyes become fixed, and they begin to experience tonic-clonic movements. The client is standing next to a countertop with several sharp utensils.

What is the OTR's MOST appropriate INITIAL action?

  1. Insert a padded tongue depressor into the client's mouth to prevent them from biting their tongue.
  2. Guide the client safely to the floor and move nearby objects, such as utensils and stools, away from them. (correct answer)
  3. Firmly hold the client's arms and legs to restrict their movements and prevent self-injury.
  4. Immediately call the client's emergency contact to inform them of the seizure.
Explanation: The primary goal during a seizure is to ensure the person's safety. Guiding the client to the floor and clearing the area of hazardous objects minimizes the risk of injury. This action takes precedence over all others. Restraining the person or putting objects in their mouth can cause serious injury. Calling for medical help (e.g., activating facility emergency response) is a priority, but securing the immediate safety of the client comes first.

Question 20

A client sustained a minor fall during an OT session. The client was assessed, found to have no apparent injuries, and their physician was notified. The client was able to continue with a modified session.

Following the immediate management of the situation, what is the OTR's primary professional responsibility regarding this event?

  1. Avoid documenting the fall to prevent legal complications for the facility.
  2. Complete a facility-specific incident report detailing the event objectively. (correct answer)
  3. Verbally inform the next therapist who sees the client about what happened.
  4. Only document the fall in the daily note if the client later complains of pain.
Explanation: Regardless of the severity of the outcome, any adverse event, including a fall, must be formally documented through an incident report. This is a crucial component of risk management, patient safety, and quality improvement for the facility. Documentation should be objective, factual, and completed in addition to the regular therapy note. Failure to report the incident is unethical and violates professional standards.