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NBCOT test taking tips!Written by Stephanie Shane OTR/L, Founder of “Pass the NBCOT”First of all,?congratulations?for getting through graduate school and fieldwork! ?You have undoubtedly worked and pushed yourself so hard to get to this point. There is just one last hurdle in this marathon, and this worksheet will hopefully help you in passing the National Board for Certification in Occupational Therapy (NBCOT) exam.While some tests are looking to see what you are ABLE to learn, the purpose of the National Board for Certification in Occupational Therapy (NBCOT) is to test your understanding of what you have already learned. The goal of the NBCOT is to use a standardized testing process to create an objective assessment of a test taker's knowledge and skills. In other words, it's more about?what you know?rather than your ability to solve clever puzzles. This is good news for those who are serious about being prepared, because it boils down to a very simple strategy: You can succeed on the NBCOT test and become an Occupational Therapist Registered (OTR) by learning critical concepts on the test so that you are prepared for as many questions as possible. Knowledge, preparation, and mental clarity will help you succeed! Having a good strategy, knowing what and how to study are huge advantages! It is impossible to know and memorize everything for the NBCOT test, the field of possible things is way to huge to cover in a 6-8 week study time.About the NBCOTThe content of the NBCOT Exam (OTR) is divided into four domains intended to represent the most important tasks in occupational therapy: Domain 1 (17% of the Exam): Acquire information regarding factors that influence occupational performance throughout the occupational therapy process.Domain 2 (28% of the Exam): Formulate conclusions regarding client needs and priorities to develop and monitor an intervention plan throughout the occupational therapy process.Domain 3 (45% of the Exam): Select interventions for managing a client-centered plan throughout the occupational therapy processDomain 4 (10% of the Exam): Manage and direct occupational therapy services to promote quality in practice.The NBCOT Exam (OTR) exam consists of three simulation test items and 170 multiple-choice questions (with four possible answers). In a simulation test item, a scene is described and the test taker must select if it is a positive, neutral, or negative action to take. Points are given if it is a positive answer, points are neither given nor counted against you if you give a neutral answer, and points are counted against you if you give a negative answer. Some of the potential answers will be partially correct, and it is the job of the candidate to select the best answer.Scoring the exam takes one week. Raw scores (the number of questions answered correctly) are placed on a scale of 300 to 600 according to a formula that accounts for the relative difficulty of the test version. The minimum passing score on the NBCOT exam (OTR) is 450.Both exams are criterion-referenced. This essentially means NBCOT? has determined a minimum passing score to determine one’s ability, skill, and knowledge to perform as an entry-level practitioner.Getting Started and How to Make the Most out of your Preparation“As you embark on your exam preparation journey, establish a path that is right for you. Keep your eye on the roadmap and take the journey to success.” ~NBCOT.Don’t panic, it is just a test! You have just finished an intensive, multiyear course of study along with fieldwork placements and because of this, you know a lot about occupational Therapy! In addition, you have taken many standardized tests by this point in your academic career and you should have an idea of your specific strengths and weaknesses with regard to this type of testing as well as the type of test preparation that has worked for you in the past. If you have struggled with standardized tests, then perhaps it is worth considering a change in your approach. I wish I could sprinkle some fairy dust to ensure you pass the NBCOT, but the truth is a lot of time and effort needs to go into passing this test. However, there are some tried-and-true techniques that if followed, can go far toward improving your chances of success. When do you want to take your test? If you've already accepted a job, you'll need to do this relatively soon after graduation. If you have busy/stressful post-graduation plans (i.e., wedding, moving, etc) you may want to delay the test a bit. You should also consider what kind of studier you are and what situations will make you more stressed. If you're a perpetual procrastinator, it might be better to take the test earlier just to force yourself to study and keep things fresh in your mind. I recommend deciding on a test date before studying for the test so that you have a deadline and you don’t keep putting the test off.Determine how much you are going to study: I recommend giving yourself between 4-8 weeks to study and 4-8 hours of studying per day 5 days a week. This will determine how much you want to push yourself in a given period. It is important to be consistent while making exam prep your priority. If you need to miss a study session, schedule a time to make it up. Give yourself a 5 or 10 minute break every hour or so. You will have plenty of time for that shopping trip, night out, or weekend at the beach after you take the test. Make a Study Plan: If you don't want to get overwhelmed, it would be helpful to develop a study strategy or plan. This can include certain things such as establishing a set time to study each day, reviewing certain concepts each day, using specific study tools, studying alone or with a group, and what material you are going to usePlay to your strengths and address your weaknesses: Think about what type of learner you are. Visual learners prefer materials such as pictures, diagrams, and videosYou might be most comfortable focusing on the online tests and your written materials, such as your text book.Verbal learners prefer learning from words, whether written or spoken. You might find repeating the words out loud very useful. Auditory learners prefer listening to reading or watching. You might find a study group in which the members watch a video and then quiz each other with flash cards very useful. Another idea would be to put long lists to music. Kinesthetic or tactile learners tend to prefer a more physical style of learning, whether that’s doing an activity or handling materials. You might want to get together with a study partner to review information on a given topic such as ROM or associating different physical positions of the hand and arm with different pieces of information can help you memorize what you need to know about the various disorders. Most of the time we use some combination of learning styles (i.e., A course lecture often involves listening to the speaker and watching slides while taking notes. A discussion group is often completely auditory in nature). Sometimes stepping outside our usual learning style can be a novel experience that helps you integrate your knowledge. For example, if you usually review information silently, try speaking aloud. If you normally read or outline, try drawing a picture or a flowchart. Eat, Sleep, and Exercise: During this time, I also recommend eating well, sleeping at least 6-8 hours, and exercising at least 3 times a week during this period. It is important to prepare your mind, body, and mental focus before this marathon of an exam. I have been doing yoga for over 10 years and I believe yoga or physical movement can help get rid of test anxiety! Some yoga poses to practice are: tree, Seated Arm Stretch or Seated Twist, Legs up on wall and Forward Bends for 5-7 breaths before the test begins. The following link is something you can do while studying and in the test center. HYPERLINK "" students also say that Ginkgo biloba, Omega Fish Oil, and blueberries help with their focus, clarity, and mental stamina. Take it One Step at a Time: It is easy to get overwhelmed if you think about the entirety of information that could come up on the exam. Focus on just one topic at a time, and set a study schedule that will ensure that you cover all the topics you need to know. Reduce Test Anxiety: If you have test anxiety a brain dump could be useful. This could be done by reflecting or writing down how you feel, where you are, how your body feels, or any other thoughts that your brain is holding onto. This "brain dump" will help to clear out all of the tasks and commitments that occupy the brain and limit its capacity.?Then, find a quiet place to focus your attention on your breath or perhaps on an object. Here is a link to a guided meditation that could be useful. distractions: Create a study environment that is free of email, internet, the cell phone, and other distractions. Set aside a specific area for study, whether it is an entire room or your desk or kitchen table, and study there most of the time. If you are tempted to get online or procrastinate, tell yourself you can do that at your next break.Mimic test conditions: As you work through practice questions, try to mimic test conditions by taking timed tests, not consulting your notes, and practicing your testing strategy. If you need an accommodation, request it: If you have a physical or learning disability and need an accommodation such as extra time or special equipment to take the exam, be sure to allow plenty of time to make those arrangements. Here is a link for more information. . Find a Study Partner: Four reasons why study groups are better than self study1. When you are studying in a group there is a higher chance that most of the things you are uncertain about will pop up. As annoying or embarrassing as this might be, it goes without saying that it is better to focus on your weak points then your stronger ones. This way, there will be a much lower probability that the exam will catch you off guard.2. Secondly, it is often quite difficulty to understand every part of the NBCOT exam. By joining my group calls or working in your own study groups, there will be someone to help you pay attention to the parts you missed and therefore fill in the gaps.?3. Thirdly, through their cooperative but also competitive nature, study groups promote critical thinking and creativity as new questions and explanations within discussions and debates. Thus, this interactive environment ensures a much deeper learning of the material.4. Finally, when you are alone, the temptation to procrastinate is incomparably larger than when in an interactive environment. While being alone, you can always find ways to rationalize postponing the start of your studying. Although taking breaks is important, all of this dipping in and out of your study mood can only make you lose time, and contribute to the build-up of frustration due to being inefficient.HERE ARE GREAT MOVIE'S TO WATCH WHILE LEARNING ABOUT OCCUPATIONAL PERFORMANCE, AGING, AND MENTAL HEALTH One Flew Over the Cookoo's Nest, On Golden Pond, The Note Book, Away from Her, Cocoon, A Trip To Bountiful, Soul Food, Tuesdays with Morrie, Diving Bell and the Butterfly, My left foot, The Brooke Ellison Story, Chocola, What about Bob, As good as it gets, The Kings Speech, What's Eating Gilbert Grape, Silver Linings Playbook, American Beauty, Girl Interrupted, The Butterfly Effect, Clockwork Orange, Cape Fear, Benny and Joon, Awakenings, Temple Grandin, and Blue Jasmin. Study ScheduleStart off my making a list or taking a practice test so you know you’re strong and weak topic areas. If you had a good Fieldwork Level 2, you shouldn’t need to study those areas in depth. Using that list, create a study schedule based on the topic areas or diagnoses/conditions that you are weak in. According to the NBCOT, there are specific diagnoses, interventions, settings, and service components that are on the test. Below are the diagnoses and conditions.ADHD, Adjustment disorders, alcohol/substance abuse, amyotrophic lateral sclerosis, Alzheimer’s disease, amputation/prosteheses, anxiety disorders, aphasia, apraxia, arthritis/collagen injury, ataxia/incoordination, autism, autonomic dysreflexia, back pain, balance, bipolar disorders, blood pressure/hypertension, body scheme/apraqxia/neglect, burns, cardiopulmonary disease, COPD, Ischemia, Respiratory, carpal tunnel, cognitive dysfunction, cerebral palsy, complex regional pain syndrome, cumulative trauma disorders (i.e., dequervain’s disease, carpal tunnel syndrome, lateral epicondylitis, cubital tunnel syndrome), CVA/hemiplegia, death/dying/hospice, decubitis ulcers, deep vein thrombrosis, dementia/alzheimer’s/memory, depression, desensitization, developmental disorders (i.e., autism, asperger’s, developmental delay, down syndrome), diabetes, distractabilit/ concentration, domestic violence/abuse, child/spousal/elder, dysphagia/swallow, dyspraxia, eating disorders, edema, encephalopathy, falls, fetal alcohol syndrome, fibromyalgia, figure ground, flexibly/flexion, fractures, grasp/grip, guillain barre, hand injury, hemiplegia/hemiparesis, heterotropic ossification, hip/knee/joint replacement, HIV/Aids, hypertonia/spacity, hypotonicity/flaccidity, joints/MCP/PIP, learning disabilities, muscular dystrophy, medications/side effects, motor skills/planning/control, motor skills/planning/control, mental retardation, multiple sclerosis, muscle tone, neurodevelopmental treatment (NDT), nerve injuries/ peripheral neuropathy, normal child development, oral/tongue, OCD, osteoporosis, pain, paralysis, Parkinson’s/tremors, perception, preservation, personality disorder, pervasive developmental disorder, positioning/trunk control, post-polio syndrome, post traumatic stress disorder, postural hypotension, reading disorders, reflexes, ATNR, STNR, Labyrinthine, head righting, ROM/PROM, schizophrenia, SCI (i.e., paraplegia, tetraplegia, quadriplegia), sensation, sensory integrative disorders, sequencing, scar remodeling, hypertophic scar, spasticity, spina bifida, suicidal ideation, tactile defensiveness, tardive dyskinesia, TBI, tenosynovitis/dequervain’s, tonic bite, vision impairments (i.e., low vision), macular degeneration, homonymous hemianopisia, homonymous hemianopsia, work-related injuries, Below are interventions, treatments, and equipment that are on the NBCOT. Activities of daily living (ADL), age-appropriate/graded activity, augmentative communication, assessment tools, assistive/adaptive equipment, assistive devices, adaptive utensils, assistive technology, behavior modification, biomechanical, body mechanics, chaining, forward chaining, backward chaining, client-centered approaches, cognitive-perceptual retraining, community integration, community referrals, compensatory techniques, coping strategies, desensitization, discharge planning, energy conservation, endurance/strength/exercise, environmental modification, ergonomics, goal-setting, graded activities, group dynamics, home program education, joint protection, lifestyle redesign, muscle testing, patient education, positioning, pressure garments, purposeful activity, range of motion exercises, role play, safety, universal precautions, sanitation, sensory reeducation, splint fabrication/modification, strengthening exercises, transfer training/education, wheelchair assessment/modification, wheelchair/functional mobility, work hardening/functional capacity, and work simplification. Below are service componentsCommunication skills, confidentiality, conflict of interest, cultural sensitivity/diversity (i.e., culturally responsive care), COTA/OTR roles and responsibilities, CQI/Performance improvement, discharge planning/documentation methods, documentation responsibilities, evaluation, reevaluation, frames of reference/models of practice, informed consent, insurance authorization/reimbursement, interviewing skills/methods, multidisciplinary team process (i.e., listening), negotiating, conflict resolution (i.e., roles and responsibilities), professional liability, program evaluation, promoting the profession, refusal of service, research methods, reliability, validity, research design, resource management (i.e., time), equipment, supplies, screening, service collaboration, service competencies, and strategic planning/goals.Below are the different settings and or situationsAcute care hospital, adult daycare center, ADA, architectural/environmental barriers, assisted living facilities, automobile, bathing/bathroom, classroom, clinic, cooking, community-based, consultant, daycare facility, dressing, eating/dining, grooming/hygiene, groups (i.e., inpatient/outpatient), group home, home-based, IDEA, independence, inpatient rehab facility, interests, job elements, leisure, long-term care facility, occupation, playground, play/leisure activities, prison/confinement facility, school-based, skilled nursing facility, toileting, treatments-new/unfamiliar, volunteers, wellness programs, workplace, and writing/prewriting. You can also jot down specific things you know you need to review. Here is an example of a seven week study schedule. Week 1:Occupational Therapy Process, NBCOT rules and regulations (continuing education and certification), Research (i.e., cohort, p-value, inter vs. intra-reliability, evidence based practice, randomized control trial, case study), Code of ethics, OT vs. Cota (in relation to group activities) Week 2: Pediatrics (i.e., school, child development such as dressing, assessments, feeding, toileting, social interaction), Sensory processing, Handwriting/Grasp, IEP’s . etc, reflexes), and Spina Bifida, Down Syndrome, Cerebral PalsyWeek 3: Hands (i.e., Flexor Tendon, Dequarvians) Splints, Fractures, MMT, musculoskeletal, Heart Disease (Mets), Pulmonary, COPDWeek 4: Burns, Pain, PAMS, Arthritis, Spinal Cord Levels (i.e., tenodesis grasp), Prosthetics/Amputations, Hip/knee Replacements, Rancho Levels, TBI, Vision adaptations, ContraindicationsWeek 5: CVA (i.e., adaptive equipment, dysphagia), Wheelchair (i.e., Ramps/Seatbelt/Lapboard/Accessories/transfers), Community Mobility, Worker’s Comp, Driver’s and Vocational Rehab, ergonomics, Neuromuscular (i.e. Rood vs. NDT vs. PNF) and Diseases (i.e. Parkinson’s), apraxia, neurodegerative Diseases (i.e., Guillan Barre)Week 6: Psychotic Disorders (i.e., Borderline Personality, Anxiety, Schizophrenia, Depressive, Bipolar II, Eating Disorders), Mental Health/Groups, Allen Cognitive Levels, Dementia CBT, Week 7: Overall Review with focus on pediatrics, Hands, ACL, Mental Health, adaptive equipment, etc. Once you have a study schedule I would read the chapters in the Rita Book, study guides, AOTA website, etc., Monday through Thursday. On Friday take as many questions as you can, even take a full length timed test if you have enough time. Then on Saturday review the answers you got wrong. If you have more time, Review the questions you got wrong AGAIN. If you are starting to read something that you know very well, skip it and move on. Don’t waste your time on things you already know, focus on the areas that are difficult for you. You can always jot down or make a flashcard on the material you need help remembering. If you feel you are week in a specific area, for example SCI, you might want to volunteer at a SCI clinic for a day for observation. By seeing a C6 SCI patient and observing their daily routines, you will be able to understand the diagnoses better and have an easier time with retention for answering questions on the exam. Past clients have mentioned to me that they have seen the most questions on Mental Health including Allen’s Cognitive Level, Schizophrenia, Eating Disorders, Bipolar, Clubhouse/home health, burns, conversion disorders, reasonable accommodations, job demands, FCE, and occupational rehabilitation. They also saw many questions in pediatrics including development, school, and transition to school to work. Lots of hands, splints, SCI, and CVA, and dysmetria. . They have seen a question on cohort, p value, vocational rehabilitation, standards of practice, COTA, and wheelchair, transitions. Practice TestsOne of the best ways to prepare for this exam is through repetition, repetition, and repetition! This can be done by taking practice tests. Answering questions correctly is good way to study for the exam because it also gets you familiar with the type of test. It is helpful to become comfortable with reading an exam question, identifying the stem of a question, and synthesizing the information to determine the best answer. I recommend taking one day to take a test and the next day to review your answers. If you don’t have time to answer 200 questions, try to take 50 or 100. By taking these tests, you are learning what areas you need to study up on more and the style of the test questions. Rather than focusing on your score, focus on what you know and what you don’t know. ?Reviewing your answers is one of the most important parts to studying for this exam. Focus and pay attention to WHY your answer is wrong. What are these questions telling you? Specific material you don’t know (i.e., specifics about precautions, diagnoses, equipment)Practice Domains you are unfamiliar withFaulty reasoning/second guessingNot taking enough time/taking too much timeChanging your answer and going against your first instinctsOne Week Before The TestAs you get closer to the exam date, make a final list of things to review. What do you need to review based on your analysis of your last test result? This should include things that you have less interest in or are consistently week in (i.e., nerves in the hand, feeding and swallowing, ACL). It might be helpful to make a 1 page review of the main concepts and concentrate on that during the final days before the test. Also try to get some good sleep, eat a healthy diet that keeps the blood sugar from spiking and decreasing if possible. The Night Before The TestAt the end of your studying period, there is only so much more information your brain cells can take in. Since this is more of a critical thinking test than a memorization/regurgitation test, cramming is not going to help. Make sure you have all your documents that the testing center requires such as your Authorization to Test (ATT) letter and IDs, in one place and ready to go for the morning. Do something relaxing the night before the test (i.e., yin yoga class, massage, or a warm bath) and get a good night’s sleep. The Morning Of The TestEat a good breakfast with high protein such as eggs, oatmeal, cheese, nuts, honey sticks or 100% juice for natural energy. It is recommended to avoid sugary cereal, pancakes, or waffles with syrup so you don’t get a sugar crash as you are in the middle of the test. The testing center may be variable in regards to temperature so it would be helpful to wear layers and something comfortable. Try to maintain your focus and mental clarity through deep breaths or meditation, stretches, exercise, and intention statements (i.e., I can pass this test!). You will need to arrive 30 minutes prior to your scheduled testing time with two forms of identification, and your name and signature must match what’s on your ATT letter. Getting to the test site early will give you time in case you get lost, find parking, check in, eat a snack, and go to the bathroom. It will also give you time to go over your study guides, flash cards or notes on things you are weak on again. It may take some time to show your forms of Identification, fill out admission paperwork, and put your belongings in a locker. First of all, find a way to relax before the test. Be prepared for the majority of questions to NOT be anything you studied for. Some of the test questions might be judgment questions and strange situations that require quick thinking and clinical reasoning skills. If you are having test anxiety, you might want to do some deep breathing exercises and stretches to remain calm and focused. ?During The TestAs you take this 200 question exam in 4 hours go through each question while focusing on every word. Resist the urge to second guess your answers, simply use your good critical thinking skills. Sometimes you just need to pick the least offensive answer if you really don’t know the answer. Mark the ones you are unsure of and if there is time at the end, go back when you go through all 200. If you don't know the question, don't panic as some of the questions are "test questions". If you are taking an afternoon test – avoid caffeine, eat a light healthy lunch with plenty of protein, do some alerting exercises such as ankle pumps, chair push-ups, shoulder rolls, head rolls, shoulder shrugs.Don't forget to check the time, as you will see time will fly as you are taking the test and if you don't watch the clock you might have 40 questions to go with less than a half hour of time left. Once you are back to the questions you marked, go over them again, reread the question and try and focus on the main points of the question to see if it triggers something from your study. Try and rationalize each answer. Don't doubt yourself as your first choice might be the right answer.?Don’t be afraid to take breaks, however the best time to take a break is during the test taking tutorials because each tutorial is 10 minutes long and it does not count against your time. Do not be afraid to walk away from the computer during the test either. Taking a break might motivate you to continue going on and remain focused. An example might be if you take 3 ten minute breaks or after 50 questions. No matter if you take breaks or not, make sure to manage your time wisely because you do not want to run out of time! There are 4 hrs for the exam, = 240 minutes1 minute / Multiple choice= 170 minutes3 case scenarios= 30/35 minutes= 35/40 minutes to spare for reviewWhen taking the test, make sure to read the question carefully and pay attention to key words such as "most important, next, and initial."?Also, remember safety first, client centered, and occupation-based. For the most part, you can easily eliminate two choices and decide between the other two answer choices keeping in mind the tips above. Don't get caught up in the details. Don’t freak out if you don’t know one of the answers. Instead of becoming flustered, take a breath, collect yourself, and move on. Don’t overthink it. READ what the question is asking you (i.e., “what should you do FIRST?”) There might be very difficult questions that come out of nowhere, but there could also be “give away questions.” Only an answer if: You misread the question or another question triggers the answer.Test Tip #1One of the most important things you can do in answering a question is to consider only the information that is in the question. Do not read content into the question that is not there; simply apply what you know in order to answer it. Read each question carefully. Ask yourself, “what is this question really about?”What stage in the occupation process are you in? (i.e., screening, evaluation, intervention, or discharge)What is the practice setting (i.e., acute, in-patient, outpatient, or home health. What is the condition (i.e distal radius fracture, Parkinson’s, autism)Identify the key words in the question stem (i.e., BEST response, INITIAL action, NEXT step). Decide whether each option is correct or incorrect. Remember that for the MC, each response will be plausible, but only one choice will be correct. Test Tip #2Read, Remember, Deconstruct, and Decide:Read: Focus study on one practice item at a time. Read the item stem without proceeding to the response options. Remember: Remember what the question is asking. Begin to formulate the answer in your head without looking at any of the response options. It may be helpful to write the answer down before proceeding to the next step.Deconstruct: Identify critical information: Age, Condition, Stage of condition, practice setting, and other flags. Which words are bolded? Ask yourself if this info leads you to the original answer you formulated. Decide: Using the key information presented in the stem, read the first option. Write a rationale for why the first option is correct or incorrect. If needed, go back to a source reference and look up the information. Select your response. NBCOT Question: Read: An inpatient who had a myocardial infarction 2 days ago is beginning Phase 1 of cardiac rehabilitation. Which of the following activities is CONTRAINDICATED for the patient to do during this phase of rehabilitation? Remember: Which of the following activities is CONTRAINDICATED for the patient to do during this phase of rehabilitation?Deconstruct: What is the practice setting? InpatientWhat are we told about the client? Myocardial infarction, Phase IBased on the condition, what would we be expecting to see? 1-3 days after MI, monitored low-level activityWhat flags are raised based on the information being presented in the stem? Avoid isometrics, monitor response to activityWhich words are bolded indicating very important actions the OTR needs to take? CONTRAINDICATEDWhat are your immediate thoughts? Avoid activities that would cause cardiac distressDeconstruct and decide : A. Ambulate from the bed to the bathroom for BADL.Response option A is incorrect; low level activity is encouraged during phase I.B. Sit on a chair at the bathroom sink to complete grooming tasks.Response option B is incorrect; energy conservation and pacing is a typical component of phase I cardiac rehabilitationC. Measure perceived exertion during personal hygiene activities.Response option C is incorrect; the OTR should teach the patient self-monitoring.D. Compete isolated maximal isometric contractions to maintain strength for BADL.Response option D is correct; Isometric contractions are contraindicated for patients with cardiac disease.Decide: Compare your choice to the answer key...D. Compete isolated maximal isometric contractions to maintain strength for BADL.Isometric exercises can affect the cardiovascular system by causing a rapid and sudden increase in blood pressure. This physiological response is contraindicated during this phase of rehabilitation.When reading a NBCOT question, keep in mind safety first, client centered, and occupation based. Safety is always the answer if it is there! Client centered goal therapy basically means that you collaborate with your client to set a goal and proceed with therapy (i.e., treat them like a partner in therapy; find out what they perceive their strengths & limitations to be, and what they would like to work on. Build a relationship and base your therapy off of your interactions with the clientTest Tip #3!During the exam you have access to a white board and marker. I practiced this method during my practice exams and it worked well. My entire board was covered with crossed out ABCD’s. It worked like a charm!You can also use this technique with your fingers. For example, A is your pointer finger, B is your middle finger, C is your ring finger, and D is your pinky. When you know that an answer choice is not the correct answer, bend flex the finger into your palm. This will eliminate wasted time and help you focus on the best two answer choices. Test Tip # 4! An OTR or COTA is educating a client with chronic obstructive pulmonary disease how to incorporate pursed lip breathing with self care tasks. The?MOST EFFECTIVE?breathing technique to incorporate during a dressing task to decrease symptoms of dyspnea is:A. Promote the client to breathe in when lifting legs into pantsB. Encourage the client to breathe out when pulling a shirt overheadC. Reinforce a daily self care routine be performed in sittingD. Emphasize the use of a pulse oximeter during lower body dressingFirst, determine the areas of the stem of the exam question. The stem of the question is how the problem is presented to the exam candidate. Therefore, there are many key words that comprise the stem and it is not localized in one area. An OTR or COTA is?educating?a client with?chronic obstructive pulmonary disease?how to incorporate pursed lip breathing?with self care tasks. The?MOST EFFECTIVE?breathing technique?to incorporate during a?dressing task?to?decrease symptoms of dyspnea?is:Next, think about or visualize this example and the possible answer or technique you would employ in practice. Do you see it in the answer choices? Then, eliminate the incorrect answer choices. Sometimes the incorrect choices may seem obvious to rule out, as they have distinctive qualities that do not apply to or contradict the stem of the question.1. Promote the client to breathe in when lifting legs into pants2. Encourage the client to breathe out when pulling a shirt overhead3. Reinforce daily self care routine be performed in sitting; this is considered an energy conservation technique.4. Emphasize the use of a pulse oximeter during lower body dressing; this is not considered a breathing technique.? However, emphasizing the use of a pulse ox can be done in addition to pursed lip or diaphragmatic breathing.If or when you are left with two remaining answer choices, apply those answer choices to the stem of the question. Synthesizing this information requires you to comprehend the exam question. Decreasing symptoms of shortness of breath would require the client to breathe in or out during exertion?Choose the best answer by reducing the information presented to you in the question and theremaining answer choices.Correct Answer:Answer 2:?Breathing out during exertion can decrease SOB and does not cause an increased strain on the lungs or cardiovascular system.In summation, taking practice exam questions is a great way for one to become familiar and comfortable with the format of the NBCOT? Certification Exam, as well as help one identify areas they need to become more familiar with to aid their success in passingTest Taking Tip #5When reading a question, you can think about the ABCD method for treatment goals and objectivesA=audience, Who is it for (i.e., Patient)B-behavior- What are the goals and objectivesC-condition detailsD-degree: time frame to have goals reached. Test Taking Tip #6Timing is important when taking the NBCOT because you want to make sure you answer all 170 questions in the 4 hour time span. Practice taking timed tests so that you know how to answer questions quickly. It should take you on average 1.5 minutes to answer each question. Test Taking Tip #7 Clinical Simulation TipsThese are questions that new OT’s will faceThese questions consist of opening info + section info which leads to multiple choice questionsYou will make a decision on an action – is it a screening or evaluationThere will be a list of options to choose from – once you click an answer…you can’t change itRead the question slowlyPick an answer which results in a feedback box for the scenarioPoints are given for “positive” decisionsNever click anything that seems “negative” because points are deducted for these answersIf there are 8 answers 1/3 of the answers will be + , - , and neutralOnly click on the + answers – do not click unless you are 95% positive that the answer is correctRead words of the question: – initial and sub-acute – don’t do a home evaluation because that is after rehab. Instead you are in the stage of tx planning …incorporate safety into txTest Taking Tip #8/ Random TipsDo not choose family as an answer unless the adult has cognitive dysfunction. It could be an answer for a peds question and/or dementiaMedicare doesn’t pay for raised toilet seat but it does pay for a 3-in-1 commodeMake sure you know what Medicare covers and what it doesn’t coverNever call family for HIPPAA…family is not a part of any answers except for the description aboveWould a SCI C6 patient use a manual or power chair? Manual because they have wrist extensionWhat must an OT do? Answer what must be done…must = mustAlways pick an answer that is occupational basedIndependence in ADL’s and IADL’s with ADL’s being the most important Select positive active choices*Never choose documentation or team meetings as an answer if there is a more active answer If the question talks about sensory processing – the answer should not be “working on strength” because it does not answer the needsWith any progressive disease, don’t build physical skills. For example, ALS…do not pick an answer that states “build physical skills”Do not give a patient with dementia (79 y/o) a baby doll because it is developmentally inconsistentEliminate answers that include contraindications such as hip precautions A physical threat is the only time a person would be removed from a therapy sessionHand Protocols or NICU won’t be on the exam because it is to specialized and not found in most textbooksIf there is chronic pain in the question, it trumps everything else and pain must be in the answerAs an OT – we do skilled interventions including grading activities and changing activitiesFamily can only do unskilled interventionsThere will be questions what is abnormal at 8 months – know child development especially the charts and infant reflexesSoup is harder to control than apple juice for dysphagiaMake sure you know myelomeningocele and spina bifida “Get use to it” – this is a bad phrase to tell a parentUnderstand group development – parallel, project, cooperative, mature. Mature group is college levelWhat must be done prior to discharge? A person can’t be d/c without family support.Grade an activity down and let the child choose between 2 things to increase motivationOutpatient pain in wrist, if a pt has JRA…you would want to support the wristKeep hands away from mouth – 30 degrees flex on elbow*Ethical situations – neglect and abuseKnow ContraindicationsPhysical disabilitiesPt can follow simple commands – open eyes and wiggle toes, the next level is hand over handIf the question talks about pain, then the answer must include pain. Pain always trumps everything else*Must take care of pain and ROM before working on strength*Language is L CVA, Emotion is R CVAKnow what hemianopsia is Functional mobility = movement of bodyMotor control theory = learn by doingCyanotic = DVT is very serious…this is an emergencyTonic-clonic seizure = never put rag in mouth of client (old school) instead move everything out of way so pt doesn’t get hurt, can’t position pt while in seizureErgonomics – position in static movement >> move periodicallyC7 – need to develop tenodesis – fingers flexion and wrist extension*Don’t pick documentation or team mtg if other active choices availableKnow wheelchair movement – turning radius and door width because it is easy to write questions on thisBipolar disorder cannot do anything long term – need self cares/self esteemA shelter workshop is run like a business – vocational skills – will staple papers and separate boltsIf you wouldn’t say it that way, it is the wrong answerTop 5 reflexes of the 25 reflexesWrist extension for C7 spinal cord injuryNeed a tenodesis splint for C6 and C7Know what OTA’s can do, OTA can assess if there is competency*observe cognitive fxn to understand what is happening*Ask client if they are feeling suicidalCooking, exercise, and body image is bad for anorexia – looking for emotional supportQuestion talks about outside and sun and drugs – photosensitivity*Know side effects of medicines in mental illness*Don’t choose answer about reporting to staff*ALWAYS USE STANDARD PRECAUTIONS INCLUDING: wash hands and gloves for bodily fluids*The only time you separate pt from a group is if he/she threatens other members *Domestic abuse – people are fragile, have low self esteem, and can only do small tasks *Job coaching – Transitional employment program – real job for psychiatric disorderStudy professional standardsIf someone wants to read his/her medical record, the physician in charge will have to sit with them …Melanoma is serious so take a serious stand…it looks like a irregular and uneven edged circle (mole) If the questions describes a violation – the answer will be the most seriousA drunk pt is a safety riskQuality improvement = better service to clients*There are a lot of questions about ethicsPHD = researcher, OTD does not equal researcherYou have to decide if it is an ethical dilemma or violation…an ethical dilemma you have to get more information, a violation requires an extreme actionUnderstand Medicaid and Medicare questions. Know what they pay for and what they do not pay forAlways call or report abuse*Professional competence – improve knowledgeAfter the Exam:If you have any complaints tell the staff before you leave the building. This can include a shaky monitor or the noise in the room was not addressed. You will most likely be really exhausted and you might be second guessing your answers. Instead of torturing yourself afterwards try to “breath, trust, and let go!” When you walk out and the test is over, realize that there is nothing that can be done at this point. The NBCOT now scores the test every week so there is less of a waiting period. Check out this link for when the NBCOT scores the test. matter what the results may be, realize that you worked very hard and you will be a great OT!Study Options and OpportunitiesBelow are some helpful study options, books, and materials that you might find useful: TherapyEd National OT Review & Study Guide for the NBCOT Exam?by Rita P. Fleming-Castaldy: This is the bible for this exam with practice tests and rationale. It is by far the best book to purchase for studying the Exam and taking practice tests. Occupational Therapy Examination Review Guide (Johnson). This book has a CD with 200 computer questions similar to NBCOT questions. There are explanations of the reasoning’s behind the answers at the conclusion of the test. You can also choose to break down your score into how you did by question, domain, or area of practicePreparing For The Occupational Therapy National Board Exam: 45 Days And Counting?by Rosanne DiZazzo-Miller and Joseph Pellerito Jr: This is a great reference with worksheets that help you organize the mountains of information you will need to commit to memory and extra practice questions you will want days before the big examNBCOT Examination Readiness Tool (cost=free!) . This allows you to rate your strengths in the areas tested by the exam. AOTA Exam Prep: . This is a fantastic website to help you prepare for the test by providing practice multiple-choice and clinical simulation tests that focus on your specific study needs. Some of the questions are actual retired NBCOT exam questions. Study Guides: Therapy Ed and Pass the NBCOT have great study guides that have comprehensive information that goes over important study areas such as activity groups, code of ethics, feeding, hand and upper extremity disorders/injuries, burns, and many more!!!?Flashcards or study cards: Research says one of the best ways to remember information is through REPETITION, REPETITION, REPETITION!!!?You can make flashcards based on the information you are trying to learn or you can buy a set from Pass the NBCOT in order to help you retain necessary NBCOT information.Quizlet: . This website offers study materials on all the necessary subjects. Just type the subject you are looking to learn about and you will instantly find tons of questions and answers for free! Muscle Charts: Although muscles are not on the NBCOT there might be questions that question your knowledge. Here are some useful charts! Tests: Castle Worldwide offers more online Practice Tests similar to the NBCOT. Textbooks and Course Notes Study Groups or a Study Partner: Studying in a group, with a partner, or being tutored by “Pass the NBCOT” will help you set goals, test you on concepts, cover material out loud, and review things that you may have problems with. Exam Preparation Courses such as Therapy Ed or Pass the NBCOT ................
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