PRACTICE QUESTIONS Flashcards by Taylor Hooker

Which one of the four categories of child development does the skill “take turns” belong? 
A)	Personal/social
B)	Adaptive/ fine motor
C)	Motor behavior
D)	Language

A) Personal/social

How well did you know this?

Not at all

Perfectly

Which of the following is NOT an example of a TR department’s risk management plan?
A) Requiring TR student interns to complete their own client assessments.
B) Requiring employees to park on hospital premises
C) Conducting peer reviews by trained professionals
D) Incorporating family into the assessment procedure

A) Requiring TR student interns to complete their own client assessments.

How well did you know this?

Not at all

Perfectly

Which of the following activities is MOST LIKELY to teach social skills to a group of at-risk youth?
A) Bingo
B) Volleyball, b/c it involves both cooperation and competition
C) Role plays of asking someone for assistance
D) Discussion of appropriate leisure skills in a variety of situations

C) Role plays of asking someone for assistance

How well did you know this?

Not at all

Perfectly

All of the following may be found in a TR department’s policy and procedure manual, EXCEPT
A) Instructions for checking out and driving agency vehicles
B) Treatment protocols for disability groups served by the department.
C) Guidelines for prescribing meds.
D) Information about staff recruiting, hiring, supervision and firing.

C) Guidelines for prescribing meds.

How well did you know this?

Not at all

Perfectly

The CTRS wants clients w/ severe intellectual disabilities to be able to freely choose their preferred leisure experiences. When the CTRS uses a variety of tactile, auditory and gustatory objects from which the client chooses, it is called… 
A)	Reality orientation
B)	Remotivation
C)	Assertiveness training
D)	Sensory stimulation

D) Sensory stimulation

How well did you know this?

Not at all

Perfectly

The CTRS uses the Transtheoretical Model of Behavior change in organizing her documentation on client behavior change. What are the “stages” of behavior change that she observes and documents on?
A) Thought, affect, behavior, evaluation
B) Rapid behavior change, slowed behavior change and maintained behavior change
C) Precontemplation, contemplation, preparation, action, maintenance, and termination
D) Preparation, action, evaluation, and new action

C) Precontemplation, contemplation, preparation, action, maintenance, and termination

How well did you know this?

Not at all

Perfectly

Visualization can be helpful to clients because they can…
A) Use imaginary practice sessions for upcoming stressful situations.
B) Express their feelings without retribution from the group
C) Relax at their own pace
D) Only reveal to the group what they want to reveal

A) Use imaginary practice sessions for upcoming stressful situations.

How well did you know this?

Not at all

Perfectly

When using behavior modification w/ a female child who is emotionally disturbed, the CTRS teaches her separate hygiene behaviors (brushing teeth, combing her hair) and then combines them all together in a morning wake up routine. What behavior modification technique is the CTRS using?
A)	Shaping
B)	Modeling
C)	Extinction
D)	Chaining

D) Chaining

How well did you know this?

Not at all

Perfectly

The CTRS requires that all of her employees actively participate in diversity training on a regular basis. She is trying to ensure their…
A)	Prejudices
B)	Cultural competence
C)	Attitudinal awareness
D)	Recertification through NCTRC

B) Cultural competence

How well did you know this?

Not at all

Perfectly

People w/ chronic pain may benefit from time management sessions because…
A) They tend to be the busiest people
B) They tend to be complainers and procrastinators
C) It would help them identify their goals for spending their least painful time constructively
D) It would help them develop a beneficial exercise routine at a local community center

C) It would help them identify their goals for spending their least painful time constructively

How well did you know this?

Not at all

Perfectly

Which of the following is NOT appropriate in the TR department’s Written Plan of Operation?
A) The mission, vision, and goals of the unit
B) Comprehensive and specific program protocols
C) The listing of assessments, evaluation and their administrative procedures
D) Individual clients’ treatment and program plans

D) Individual clients’ treatment and program plans

How well did you know this?

Not at all

Perfectly

A TR facilitation technique that focuses on taste, touch, sight, smell, hearing and bodily movement, and is often combined w/ reminiscence and remotivation is called…
A)	Sensory overload
B)	Aromatherapy
C)	Sensory stimulation
D)	Sensory integration

C) Sensory stimulation

How well did you know this?

Not at all

Perfectly

The CTRS is teaching clients w/ panic disorders to breathe from their diaphragms, rather than their chests because…
A) Diaphragmatic breathing exchanges a greater volume of air
B) Diaphragmatic breathing can leave the individual light headed
C) Chest breathing is harder to learn
D) The activity analysis showed that more people would be successful

A) Diaphragmatic breathing exchanges a greater volume of air

How well did you know this?

Not at all

Perfectly

One of the primary components of a job description is the listing of…
A)	Past work experiences
B)	Job duties to be performed
C)	References
D)	Education institutions attended

B) Job duties to be performed

How well did you know this?

Not at all

Perfectly

The CTRS is working w/ teenagers in a psychiatric inpatient program that is oriented toward Freudian psychology. One of the activities the CTRS would recommend for the clients based on “sublimation of sexual urges” is…
A)	Crafts
B)	A dance
C)	Gymnastics
D)	Tennis

B) A dance

How well did you know this?

Not at all

Perfectly

Which one of the following activities in MOST LIKELY to aid a client in increased physical endurance?
A)	Leisure resource discussion group
B)	Video games
C)	Walking
D)	Yoga

C) Walking

How well did you know this?

Not at all

Perfectly

Which of the following is the LEAST likely way for a CTRS to improve her continuing professional competence?
A) Attend hospital grand rounds
B) Present in-service training sessions to her colleagues
C) Read brochures about services at similar facilities
D) Attend national conferences

C) Read brochures about services at similar facilities

How well did you know this?

Not at all

Perfectly

Which method of behavioral observation and recording is the CTRS using when she wants to record how often a behavior occurs during consecutive time periods?
A)	Frequency or tally
B)	Duration
C)	Interval
D)	Instantaneous time sampling

C) Interval

How well did you know this?

Not at all

Perfectly

Which method of behavioral observation and recording is a CTRS using when she wants to record how long a client’s outburst lasts?
A) Frequency or tally
B) Duration
C) Interval
D) Instantaneous time sampling

B) Duration

How well did you know this?

Not at all

Perfectly

The best direct way to promote the value of TR services within a facility is to…
A) Provide in-service trainings to other disciplines
B) Attend hospital grand rounds
C) Create and post an activity calendar on the unit
D) Create a multidisciplinary assessment

A) Provide in-service trainings to other disciplines

How well did you know this?

Not at all

Perfectly

Which method of behavioral observation and recording is the CTRS using when he notes how many times the client uses negative self-statements?
A) Frequency or tally
B) Duration
C) Interval
D) Instantaneous time sampling

A) Frequency or tally

How well did you know this?

Not at all

Perfectly

One method to increase inter-rater reliability in observations is to…
A) Improve the construct validity of the instrument
B) Use clearly defined and non-overlapping categories
C) Support the results w/ extensive interviews
D) Purchase and compare similar interest inventories

B) Use clearly defined and non-overlapping categories

How well did you know this?

Not at all

Perfectly

All of the following are true statements about chronic pain EXCEPT…
A) Chronic pain is defined as pain that lasts more than 6 months
B) No major organic disorder can be found to explain chronic pain
C) Typical onset of chronic pain is the age of 41
D) Chronic pain forms a cycle of lack of activity, then continued pain

C) Typical onset of chronic pain is the age of 41

How well did you know this?

Not at all

Perfectly

Reality orientation is a technique used to combat what symptom(s)? 
A)	Lack of assertiveness
B)	Irresponsibility and immaturity
C)	Chronic fatigue or stress
D)	Confusion

D) Confusion

How well did you know this?

Not at all

Perfectly

Using the following scenario, Client A is displaying which of the following types of behavior? During a discussion on the value of leisure, Client A said, “We need to change topics. I don’t like this one. I think it’s for sissies like the rest of you guys.” Client B said, “I feel like I’m benefiting from this discussion and I would like to continue.” Client C said, “I’ll go along with whatever the majority thinks.” A) Assertive B) Nonassertive (passive) C) Aggressive D) Noncommittal

C) Aggressive

All of the following may be part of the department’s risk management plan, EXCEPT… A) Acceptable staff/client rations for certain types of programs B) Qualifications and special certifications needed by staff C) Marketing brochures for fund raising purposes D) Procedures for reporting emergencies, crises, and critical incidents

C) Marketing brochures for fund raising purposes

``` The CTRS brought a wedding album, rice, a bridal veil and a ring pillow to the session to trigger older adults to talk about their past experiences about weddings. What technique was the CTRS employing in this session? A) Remotivation B) Reality orientation C) Reminiscence D) Relaxation response ```

C) Reminiscence

The modality of Remotivation includes all of the following EXCEPT… A) Warm, caring, concerned, environment B) Confrontation with other members of peer group C) Personal recollections of the topic of the day D) Connections between past and present reality

B) Confrontation with other members of peer group

``` Which of the following medications is classified as an opioid? A) Vicoden B) Dexadrine C) Tegretol D) Naproxen ```

A) Vicoden

One of the principles in ATRA’S Code of Ethics is Beneficience. This concept means… A) All individuals should receive identical services B) All clients have the basic right of self-determination C) At best, provide benefit; at worst, do no harm D) That confidentiality is expected in almost all situations

C) At best, provide benefit; at worst, do no harm

A CTRS is interested in determining a patient’s leisure interests. From the following options, the CTRS should choose which assessment? A) Leisure Diagnostic Battery (LDB) B) Leisurescope C) BANDI-RT D) Comprehensive Evaluation in Recreation Therapy Scale (CERT)- Psych

B) Leisurescope

The head of the TR department in a center that treats individuals who are addicted to opioids is likely to assure compliance with which external accreditation standards? A) Agency for Healthcare Research and Quality (AHRQ) B) Rehabilitation Accreditation Commission (CARF) C) Joint Commission (JCAHO) D) Health Care Financing Administration (HCFA)

B) Rehabilitation Accreditation Commission (CARF)

When appraising research for evidence-based practice, all of the following are appropriate questions EXCEPT: A) Do the results apply to my clients or situation? B) Do the benefits outweigh any harm, costs, and/or inconveniences that are involved in the intervention? C) What other factors need to be considered when applying this evidence? D) Does the study report confidence intervals?

D) Does the study report confidence intervals?

``` To be classified as legally blind, a person must have visual acuity no better than… A) 20/20 B) 10/200 C) 20/200 D) 10/100 ```

C) 20/200

``` Biofeedback, meditation, autogenic training and progressive muscle relaxation are examples of what kind of TR facilitation technique? A) Relaxation training B) Tai chi C) Guided imagery D) Sensory stimulation ```

A) Relaxation training

The CTRS is instructed to prepare a zero-based budget for the upcoming fiscal year. This means that the CTRS… A) Adds a certain percentage to last year’s budget to calculate this year’s budget B) Receives no salary raise for the upcoming year C) Builds this year’s budget from scratch D) Must negotiate with other departments to get more money in the budget

C) Builds this year’s budget from scratch

The primary reason the American Therapeutic Recreation Association was created in 1984 was to… A) Provide services to veterans returning from the Vietnam War B) Provide workshops and conferences for members to get CEUs C) Create the national certification examination for TRSs D) Respond to concerns and issues of TRSs working in clinical facilities

D) Respond to concerns and issues of TRSs working in clinical facilities

The difference between an operational budget and a capital budget is that an operational budget… A) Includes large expenditures of any kind over $500 B) Covers all revenues and expenditures, except personnel C) Covers day-to-day revenues and expenditures for a 1 year period D) Has line-items that can be vetoed by the agency president

C) Covers day-to-day revenues and expenditures for a 1 year period

1. Using the following scenario, Client B is displaying which of the following types of behavior? ``` During a discussion on the value of leisure, Client A said, “We need to change topics. I don’t like this one. I think it’s for sissies like the rest of you guys.” Client B said, “I feel like I’m benefiting from this discussion and I would like to continue.” Client C said, “I’ll go along with whatever the majority thinks.” A) Assertive B) Nonassertive (passive) C) Aggressive D) Noncommittal ```

A) Assertive

``` One of the major long-term effects of repeated use of inhalants is… A) Extreme thirst B) A strong reaction to sunlight C) Bruising of the forearms D) Improved sight acuity ```

A) Extreme thirst

Alcoholism is characterized by… A) Physical dependence on alcohol and interruptions in typical life functions B) Drinking 3-7 drinks per day C) Spending more than 20% of income on alcoholic beverages D) Repeated intoxication in public

A) Physical dependence on alcohol and interruptions in typical life functions

Accreditation standards for ambulatory health care, behavioral health care, home care and hospitals come from which of the following organizations? A) Agency for Healthcare Research and Quality (AHRQ) B) Commission on Accreditation of Rehabilitation Facilities (CARF) C) Joint Commission (JCAHO) D) Health Care Financing Administration (HCFA)

C) Joint Commission (JCAHO)

``` Feelings of overwhelming dread or impending doom w/ increased uneasiness are characteristics of… A) Somatoform disorders B) Schizophrenia C) Anxiety disorders D) Multiple personality disorders ```

C) Anxiety disorders

In order to teach adults appropriate social skills, the CTRS task analyzes the skill of “beginning a conversation with a new person.” All of the additional techniques would be appropriate to teach social skills, EXCEPT: A) Demonstration by the CTRS B) Practice and repetition by the client C) Practice with feedback from peers in the group D) Paper and pencil test

D) Paper and pencil test

``` Managed care has shifted the responsibility of determining the services a patient needs from the providers of services to the… A) State governments B) Payers of service C) Patient D) Middle class ```

B) Payers of service

``` In a prospective payment system of health care, the hospital knows that a specific amount will be paid by the insurance company for a particular surgery, regardless of the… A) Skill of surgeon B) Ethnicity of the patient C) Actual cost of surgery D) Intended outcomes ```

C) Actual cost of surgery

Which of the following is MOST likely to produce positive attitudes toward individuals with disabilities? A) Increased exposure to and contact w/ individuals w/ disabilities B) Special discount rates to events and attractions C) Segregated or specialized services for individuals w/ disabilities D) Negative terminology and extensive classification systems

A) Increased exposure to and contact w/ individuals w/ disabilities

The organization that provided personnel standards for the TRS is… A) National Therapeutic Recreation Society (NTRS) B) American Therapeutic Recreation Association (ATRA) C) National Council for Therapeutic Recreation Certification (NCTRC) D) Joint Commission (JCAHO)

C) National Council for Therapeutic Recreation Certification (NCTRC)

``` All of the following are examples of passive body language, EXCEPT A) Erect body posture B) Dropped head C) Little eye contact D) Hands kept in the lap ```

A) Erect body posture

Which of the following federal acts defined TR as a related area of service and was responsible for allowing more people with disabilities to be served by CTRSs? A) 1973 Rehabilitation Act B) Smith-Sears Veterans Rehabilitation Act C) Individuals w/ Disabilities Education Act D) White House Conference on Handicapped Individuals Act

C) Individuals w/ Disabilities Education Act

``` In the process of developing an assessment instrument, the CTRS observes and rates the client. Then the 1st CTRS has another CTRS observe and rate the client on the same functional behaviors. The ratings are then compared, with nearly a perfect coefficient. What instrument characteristic is being determined? A) Validity B) Reliability C) Usability D) Practicality ```

B) Reliability

``` To receive the full benefits of a leisure experience, most CTRSs believe that the experience should be… A) Spontaneous B) Motivational C) Intrinsically motivated D) Challenging ```

C) Intrinsically motivated

If a client assessment produces results that are reliable, it means that… A) The content of the assessment matches the content of the intervention program B) The same client will receive about the same score if given the assessment twice C) Clients are placed into the most appropriate programs to meet their needs D) 2 different assessments will produce the same results over time.

B) The same client will receive about the same score if given the assessment twice

A CTRS who works at a residential facility for at-risk youth, uses Piaget’s Cognitive Theory of Development to develop age-appropriate activities. For the 2-7 year olds, he specifically focuses on… A) Advanced language skills B) Development of abstract reasoning C) Symbolic play such as playing house or using puppets D) Group consensus about the rules of games

C) Symbolic play such as playing house or using puppets

Which of the following agencies is responsible for developing standards for facilities that serve individuals w/ spinal cord injuries, chronic pain and traumatic brain injuries? A) ATRA B) Joint Commission (JCAHO) C) Centers for Medicare and Medicaid Services (CMS) D) Rehabilitation Accreditation Commission (CARF)

D) Rehabilitation Accreditation Commission (CARF)

All of the following would be principles of effective time management, EXCEPT… A) Minimize time wasters B) Procrastinate at least once a day C) Create an ongoing list of goals and priorities D) Keep an organizer or calendar close at hand

B) Procrastinate at least once a day

If a facility does not meet standards and is not accredited by the Joint Commission (JCAHO) what is likely to be the result? A) Medicare, Medicaid and private insurance companies will not pay for services B) The administration will seek accreditation by CARF C) Staff’s wages will be garnished until the problem is corrected D) Nothing, accreditation by the Joint Commission (JCAHO) is not mandatory

A) Medicare, Medicaid and private insurance companies will not pay for services

One of the basic principles of assertiveness training is… the basic principles of assertiveness training is… A) If allowed, people will tend to be aggressive toward one another B) That the majority of people need significant amount of training in social skills C) That each individual should be able to stand up for his/her rights, while acknowledging the rights of others D) That most stress is experienced when trying to work with others

C) That each individual should be able to stand up for his/her rights, while acknowledging the rights of others

A CTRS who works with older adults in a long-term care facility, uses Erikson’s Theory of Psychosocial Development to develop age and stage appropriate programs. Specifically she provides programs that help clients to… A) Increase co-morbidities and secondary conditions B) Become more community-minded and less self-focused C) Meet their own needs through intrinsically motivated leisure D) Reconcile limits and losses associated with aging and mortality

D) Reconcile limits and losses associated with aging and mortality

All of the following assist individuals in coping w/ stress, EXCEPT their… A) Attitudes of feeling challenged instead of threatened B) Feelings of having adequate resources to deal with the situation C) Type A personalities D) Adequate social support networks

C) Type A personalities

Which of the following best represents the theory of recreation substitutability? A) The activity does not matter, it’s the experience that counts B) The second string squad often plays as well as the first string squad C) Unable to do one activity, the person chooses another that provides similar satisfactions and benefits D) There is no substitute for a person’s favorite leisure activity so it must always be available

C) Unable to do one activity, the person chooses another that provides similar satisfactions and benefits

Stress management involves a variety of techniques, activities and interventions designed to… A) Reduce unfamiliar stress B) Cope more effectively with distress and add more positive stress (eustress) C) Increased the individual’s capacity to take on and handle more stress D) Aid individuals who have recently suffered severe and significant losses

B) Cope more effectively with distress and add more positive stress (eustress)

One of the most important ways in which CTRSs help clients develop independent and satisfying leisure lifestyles is by teaching them… A) As many leisure activities as possible B) How to make positive leisure choices for self-involvement C) How to access public transportation and leisure facilities D) The concepts of self-determination and intrinsic motivation

B) How to make positive leisure choices for self-involvement

``` The Comprehensive Evaluation in Recreation Therapy – Physical Disabilities (CERT-PD) measure which of the following sensory abilities EXCEPT A) Visual acuity B) Ocular pursuit C) Depth perception D) Taste perception ```

D) Taste perception

``` Which of the following is NOT assessed as part of a cognitive assessment for older adults? A) Memory B) Communication skills C) Problem-solving skills D) Safety awareness ```

B) Communication skills

Title II in the Americans w/ Disabilities Act of 1990 (and later amendments) concerns discrimination with regard to… A) Recreation services and facilities B) Employment C) Education D) Both physical and programmatic services

D) Both physical and programmatic services

Using the following scenario, Client C is displaying which of the following types of behavior? ``` During a discussion on the value of leisure, Client A said, “We need to change topics. I don’t like this one. I think it’s for sissies like the rest of you guys.” Client B said, “I feel like I’m benefiting from this discussion and I would like to continue.” Client C said, “I’ll go along with whatever the majority thinks.” A) Assertive B) Nonassertive (passive) C) Aggressive D) Noncommittal ```

B) Nonassertive (passive)

``` Which of the following is listed as a related service under the Individuals w/ Disabilities Education Act of 2004? A) Therapeutic recreation B) Personal (exercise) training C) Science education D) Medicaid ```

A) Therapeutic recreation

The CTRS is leading a group of elderly clients who are disoriented using Validation Therapy. Which phase is being used when the CTRS says, “Sometimes I feel very lonely and when I do, I go looking for a friend. Do you ever feel lonely, Mrs. Jones? A) Birth of the Group—Creating Energy B) Life of the Group—Verbal Interaction C) Movement & Rhythm D) Closing of the Group with Anticipation for the Next Meeting

B) Life of the Group—Verbal Interaction

Which of the following statements is NOT a suggested principle for structuring inclusionary programs? A) Exempt the person w/ the disability from rules that require physical or intellectual skills B) Rotate positions and roles of the participants within the activity or program C) Role model positive, accepting behavior as the leader of he activity or program D) Accent positive attributes and skills of all participants.

A) Exempt the person w/ the disability from rules that require physical or intellectual skills

What is the primary feature that distinguishes “therapeutic recreation” from “recreation?” A) Setting in which interventions take place B) Purposeful nature of intervention to bring about behavioral change C) Nature of the selected experiences to facilitate outcomes D) Extent of time leaders prepare for interventions and follow-up after intervention

B) Purposeful nature of intervention to bring about behavioral change

The term “continuity of care” means that the… A) The treatment team strives to provide predictable, connected, meaningful programs to clients B) Client is transitioned from clinical to community settings C) Client is involved in inclusive recreation services in the community with non-disabled peers D) Specialist serves as a case manager throughout the client’s length of stay at the facility

A) The treatment team strives to provide predictable, connected, meaningful programs to clients

Which of the following statements are true about persons qualifying for services under the Individuals w/ Disabilities Education Act of 2004? A) All individuals aged 5-21 with disabilities qualifies for services B) All individuals pre-school to age 21 with disabilities and with need qualify for services C) Only individuals with cognitive, emotional and physical disabilities from pre-school to 21 qualify for services D) Only individuals with cognitive and physical disabilities who have an IQ above 85 qualify for services

B) All individuals pre-school to age 21 with disabilities and with need qualify for services

Which question below addresses client evaluation? A) How consistent are the services being delivered to clients? B) How many programs did the client attend? C) Was the specialist effective and efficient in delivering intervention services to the client? D) What proposed outcomes were achieved as the result of the client’s involvement in the program?

D) What proposed outcomes were achieved as the result of the client’s involvement in the program?

“Accessible” facilities become “usable” when the person with a disability can… A) Expect to receive special treatment and services B) Function as independently as possible C) Socialize w/ individuals with similar disabilities D) Enter through the front door and use the restroom area

B) Function as independently as possible

``` The CTRS tracks the number of times a client responds appropriately to another peer, in order to monitor the effects of the social skills program. This type of observation is being recorded through the ___________ method. A) Tally B) Duration C) Interval D) Instantaneous time sampling ```

A) Tally

Utilization review in hospitals in the process of … A) Recruiting, interviewing and hiring new specialists from various disciplines B) Changing from retrospective payments to managed care C) Evaluating the most efficient and effective use of resources D) Making sure all professionals attend professional conferences in their discipline

C) Evaluating the most efficient and effective use of resources

The purpose of an assessment protocol is to… A) Make sure every client has the same diagnosis and treatment plan B) Increase sensitivity to cultural minorities C) Align the TR assessment w/ the occupational therapy assessment D) Increase the reliability of the assessment administration

D) Increase the reliability of the assessment administration

What piece of legislation mandates program accessibility in public accommodations? A) Americans w/ Disabilities Act of 1990 B) Section 504 of the 1973 Vocational Rehabilitation Amendments C) Architectural Barriers Act of 1968 D) Public Law 94-142 of 1975

A) Americans w/ Disabilities Act of 1990

``` The CTRS wants the client to gain upper body strength so that he can propel his wheelchair for longer distances. The CTRS would MOST LIKELY use… A) Weight training B) Wheelchair basketball C) Tai Chi D) Anaerobic exercise ```

A) Weight training

According to Healthy People 2020, individuals w/ disabilities are more likely to experience poorer health than their non-disabled counterparts because of the following EXCEPT: A) Inaccessibility of health care facilities B) Inaccessibility of physical fitness area and facilities C) Lack of social support D) Improved health care monitoring

D) Improved health care monitoring

The Functional Assessment of Characteristics for TR – Revised (FACTR-R) measures which of the following? A) Leisure functioning B) Decision-making skills C) Prerequisite skills related to leisure participation D) Leisure skills typically needed to live in the community

C) Prerequisite skills related to leisure participation

A “leisure lifestyle” means that the individual… A) Is unemployed and is “at leisure” for most of the day B) Has developed a daily pattern of leisure involvement C) Participates in a variety of leisure activities D) Is independent in most if not all of daily activities

B) Has developed a daily pattern of leisure involvement

Which of the following is NOT assessed as part of a social skills assessment for youth in psychiatric treatment? A) Tell me how you would introduce yourself to a youth you didn’t know B) Where is a good place to meet other kids w/ common leisure interests? C) How would you ask someone to go bowling with you? D) When was the last time you played a game for more than 30 minutes?

D) When was the last time you played a game for more than 30 minutes?

All of the following are examples of physical benefits of leisure participation EXCEPT… A) Potential counteragent to negative lifestyle choices B) Reduction of secondary disabilities C) Improved health indicators such as bone density and joint mobility D) Increase in high blood pressure and heart disease

D) Increase in high blood pressure and heart disease

``` Which of the following activities is MOST LIKELY based on competition? A) Scrabble B) Dancing C) Dramatic theatre D) Running ```

A) Scrabble

Which of the following is an example of a “structure” indicator in TR services? A) Proportion of TRSs to other therapists B) Outcomes of clients who receive TR services C) Frequency of interactions between clients and therapists D) Client achievement of social interaction skills objectives

A) Proportion of TRSs to other therapists

As the level of intellectual disability increases from mild to severe/profound, the CTRS should expect to see increased… A) Social and intellectual skill development B) Compensation for skill deficits C) Need for transportation D) Secondary physical limitations and sensory impairments

D) Secondary physical limitations and sensory impairments

Time management is the practice of… A) Structuring time to focus on important activities and minimizing unimportant activities B) Fitting more activities into a person’s schedule C) Reducing the number of commitments on your time D) Keeping track of events and appointments in a personal calendar

A) Structuring time to focus on important activities and minimizing unimportant activities

Typical treatment for decubitus ulcer includes… A) Increased cardiovascular exercise B) A prescription for blood pressure medication C) Bed rest and antibiotics D) Daily stress management classes

C) Bed rest and antibiotics

Which of the following is an example of as “outcome” indicator in TR services? A) Proportion of TRSs to other therapists B) Proportion of clients who receive TR services C) Proportion of clients treated according to TR protocols D) Client achievement of social interaction skills objectives

D) Client achievement of social interaction skills objectives

``` The client is showing signs of disorientation, confusion and memory loss. After the CTRS completes the assessment and meets with the treatment team, he/she should use which of he following intervention techniques? A) Resocialization B) Remotivation C) Reality orientation D) Refocusing ```

C) Reality orientation

``` The CTRS provides many active games and sports to adolescents with emotional disturbances to allow for the release of disorganized and pent-up emotions. The CTRS adheres to which of the following theories of play? A) Custodial B) Psychoanalytical C) Compensatory D) Catharsis ```

D) Catharsis

``` The CTRS designed a program to assist older adults with intellectual disabilities to share their previous life experiences after reading poetry about children. The CTRS was using a technique known as… A) Reality orientation B) Remotivation C) Teach back D) Cognitive restructuring ```

B) Remotivation

A client’s sense of control may be increased through all of the following EXCEPT… A) Asking what type of community event the person would like to attend B) Giving the client an important role in planning to attend an event C) Asking the client to take part in the meal preparation D) Placing the sign-up sheet in the main activity room so all can find it

D) Placing the sign-up sheet in the main activity room so all can find it

``` The CTRS, in an assertiveness training session, teaches clients to avoid being persuaded by others into doing something against their wishes, by repeating a concise statement of refusal. The CTRS is teaching clients the technique of… A) Clouding B) Broken record C) Compromise D) Defusing ```

B) Broken record

An advantage of calling someone’s references before hiring him is that the supervisor can… A) Ask the reference to compare qualifications of several applicants B) Ask about personal issues such as family status, drug and alcohol history, and religion C) Verify information from the resume or interview D) Orient the employee to hospital procedures and introduce staff of different departments

C) Verify information from the resume or interview

In order to benefit from aerobic exercise, individuals need to reach and stay within their target heart rate for at least twenty minutes. This formula for calculating target heart rate is… A) age minus 20, times 1.5 B) 60 to 75% of normal maximum heart rate C) weight minus 15, plus age D) 40% of normal maximum heart rate

B) 60 to 75% of normal maximum heart rate

The Centers for Medicare and Medicaid Services (CMS) monitors quality assessment and performance improvement in facilities that… A) Serve individuals covered by the federal government’s health insurance program B) Use the TR Accountability Model C) Adhere to the ATRA’s Standards of Practice D) Are located in low-income, urban areas

A) Serve individuals covered by the federal government’s health insurance program

In the following exchange, Client A was showing which of the following behavioral styles? ``` A: “You guys must cover for me when the head nurse comes and asks why I wasn’t in group therapy this morning. B: “Okay, whatever you say.” C: “No, I can’t do that for you, because that would be lying.” A) Aggressive B) Passive C) Assertive D) Emotive ```

A) Aggressive

Which of the following is an example of a program based on the principle of “normalization?” A) Older adults with sensory deficits are taken to a playground B) Female teenagers with intellectual disabilities play video games and listen to music C) Youths in juvenile detention attend programs on vacationing overseas D) All children w/ disabilities are registered for community recreation programs

B) Female teenagers with intellectual disabilities play video games and listen to music

``` The CTRS employs and activity that focuses on the client’s thoughts. What is this kind of therapy called? A) Cognitive therapy B) Behavior therapy C) Affective therapy D) Gestalt therapy ```

A) Cognitive therapy

Which of the following in an example of intrinsically motivated leisure? A) The client joins a quilters club for her own enjoyment B) The client’s incentive for joining the running club is trophies C) The client learns golf so he can play golf with his colleagues D) The client joined the fitness center because many of his friends are members

A) The client joins a quilters club for her own enjoyment

``` The CTRS has clients discuss whether their daily behavior reflects their statements that their own personal health is of high importance. The specialist is using which of the following TR facilitation techniques? A) Bibliotherapy B) Remotivation C) Resocialization D) Values clarification ```

D) Values clarification

``` The CTRS is aware that clients, like the rest of the American population, are apt to be more overweight and obese, and he realizes this puts them at risk of not having a healthy and satisfying leisure lifestyle. To find out more information about this trend as well as ways to reverse it, the CTRS should read documents at which of the following web sites? A) www.toofatforhealth.org B) www.healthpeople.gov C) www.takebackyourtime.org D) www.recreationtherapy.com ```

B) www.healthpeople.gov

The CTRS is leading a group of elderly clients who are disoriented using Validation Therapy. Which phase is being used when the CTRS says, “Mr. Smith did you remember to bring the poem you wanted to share with us? You did. Great! O.K. let’s listen to Mr. Smith’s poem.” A) Birth of the Group—Creating Energy B) Life of the Group—Verbal Interaction C) Movement and Rhythm D) Closing of the group w/ Anticipation for the next meeting

A) Birth of the Group—Creating Energy

``` In developing a leisure lifestyle, an individual often selects leisure experiences in which they can expect reasonable success, based on past experiences and past success. This is based on the concept of… A) self-determination B) ecological development C) perceived competence D) optimal functioning ```

C) perceived competence

``` When a CTRS provides an accepting and understanding attitude to a client and, as a result, that positive involvement reduces the client’s feelings of loneliness and worthlessness, and helps the client to take responsibility to alter irresponsible behavior, the CTRS is probably using what therapy? A) Psychoanalytic B) Behavior C) Reality D) Rational emotive ```

D) Rational emotive

``` Medicare Part A provides for all of the following health services EXCEPT… A) in-patient hospital care B) skilled nursing in long-term care C) hospice care D) outpatient rehabilitation services ```

D) outpatient rehabilitation services

``` Which of the following activity titles seem MOST appropriate to help clients develop social skills? A) Bingo B) Interaction skills for adults C) Low-cost activities for children D) Volleyball ```

B) Interaction skills for adults

The CTRS is leading a group of elderly clients who are disoriented using Validation Therapy. In which phase does the CTRS serve refreshments and plays an upbeat song? A) Birth of the Group—Creating Energy B) Life of the Group—Verbal Interaction C) Movement and Rhythm D) Closing of the group w/ Anticipation for the next meeting

D) Closing of the group w/ Anticipation for the next meeting

The CTRS met one of her client’s relatives in a local restaurant and let them know that his prescriptions had recently been changed to better control his behavior. The CTRS violated provisions in the… A) Medicaid and Medicare regulations B) Older Americans Act of 1965 and its reauthorizations C) Health Insurance Portability and Accountability Act (HIPAA) of 1996 D) Patient Privacy Act (PPA) of 2010

C) Health Insurance Portability and Accountability Act (HIPAA) of 1996

``` Considering the typical leisure patterns of adolescents, which activity is MOST LIKELY to be appropriate? A) Community folk and social dance club B) Square dancing C) Computer and video games D) Crossword puzzles ```

C) Computer and video games

``` The Analysis part of a SOAP note contains what types of information? A) Assessment B) Activity recommendations C) Interpretation of data D) Revision in the treatment plan ```

C) Interpretation of data

In Rational Emotive Therapy, the focus is placed on… A) Irrational self-statements that interfere w/ a person’s ability to see reality objectively B) Reducing stress by eliminating emotions that are not rational C) Paying attention to the physiological responses to stress D) Clarifying what the person thinks or feels about his/her family members

A) Irrational self-statements that interfere w/ a person’s ability to see reality objectively

An advantage of SOAP notes over narrative notes is they… A) Are completed only by select members of the treatment team B) Contain more subjective information about the client C) Are more structured and organized D) Require behavioral observation

C) Are more structured and organized

``` When he is upset or things do not go his way, the client lashes out at people, often making very caustic remarks and sometimes striking them. A TR facilitation technique that is MOST LIKELY to help the client is called… A) Journaling B) Reality therapy C) Resocialization D) Anger management ```

D) Anger management

Which of the following is a formative program evaluation question? A) What unanticipated events or outcomes occurred in this program that were not part of the program plan? B) Did the sequence of activities appear to be logical and appropriate? C) How much time will be allotted for the program next time it is offered? D) Are there enough resources for the remainder of the program?

D) Are there enough resources for the remainder of the program?

``` If a person believes that he/she does not have the right skills to complete a leisure experience, and then generalized this inadequacy to all other leisure behaviors, this person is exhibiting which of the following? A) Leisure efficacy B) Learned helplessness C) Attributional leisure response D) Extrinsic motivation ```

B) Learned helplessness

When is it most appropriate to use structured observations for client assessment? A) When actual behavior is of concern B) When the person’s perceptions of behaviors are important C) When the person acts out in public D) Rarely, interviews are always the better choice for client assessment purposes

A) When actual behavior is of concern

Which of the following is NOT appropriate to document in the TR department’s written plan of operation? A) The philosophy of the TR department B) Comprehensive and specific program descriptions C) Description of assessment tools and assessment protocol D) The treatment plans and progress notes

D) The treatment plans and progress notes

Meditation is the practice of… A) Resolving domestic violence conflicts B) Attempting to mindfully focus on one thought at a time C) Chanting mantras while in a yoga position D) Making clients responsible for their own behaviors

B) Attempting to mindfully focus on one thought at a time

Knowing the payer mix of the agency is important because it… A) Influences how external accreditation agencies review the various departments B) Requires an extensive knowledge of insurance company forms C) Influences how the agency gets reimbursed for services D) Shortens the patient’s length of stay

C) Influences how the agency gets reimbursed for services

Which of the following is an example of a probe that could be used during a client assessment? A) “My name is Reginald and I’d like to learn as much as I can today about your leisure” B) “To summarize your comments thus far…” C) “And now let’s move to the 3rd section of the assessment” D) “Tell me about your artistic ability”

D) “Tell me about your artistic ability”

``` The process by which a nongovernmental agency or association grants recognition to an individual who has met certain predetermined qualifications specified by that agency or association is called… A) licensure B) accreditation C) certification D) registration ```

C) certification

``` Biofeedback can help individuals learn to modify all of the following bodily functions, EXCEPT… A) Muscle tension B) Skin surface temperature C) Blood pressure D) Rapid eye movement ```

D) Rapid eye movement

``` The process by which qualified individuals are listed on an official roster maintained by a governmental or non-governmental agency is called… A) licensure B) accreditation C) certification D) registration ```

D) registration

Which of the following represents the highest level of cross-cultural competence? A) Being aware that one is lacking knowledge about another culture B) Learning about clients’ cultures and providing culturally specific interventions C) Automatically providing culturally congruent care to clients of diverse cultures D) Not being aware that one is lacking knowledge about another culture

C) Automatically providing culturally congruent care to clients of diverse cultures

The CTRS wants to assess whether her clients follow the American College of Sports Medicine guidelines for physical activity involvement. She asks which of the following questions? A) Do you, on average, exercise for 30 minutes per day at least 5 days a week? B) Do you participate in at least 4 physical leisure activities per week? C) Do you achieve a resting heart rate of at least 100 beats per minute? D) How many miles do you walk in one day, on average?

A) Do you, on average, exercise for 30 minutes per day at least 5 days a week?

Managed care is an effort on behalf of insurance companies to… A) increase patient’s length of stay B) control costs of caring for clients C) reduce the paperwork involved in client care D) decrease the number of preferred provider organizations (PPOs)

B) control costs of caring for clients

The Health Insurance Portability and Accountability Act (HIPAA) of 1996 and its updates provide which of the following for health care recipients? A) States must have ‘reciprocity’ for employee health insurance plans B) Information about an individual’s health care is protected from unwarranted disclosure C) All recipients must have access to the results of quality improvement efforts on their health care providers D) Health insurance policies must be transferable between employment settings

B) Information about an individual’s health care is protected from unwarranted disclosure

``` Which of the following types of activity often is used in stress management programs? A) Progressive muscle relaxation B) Remotivation C) Social skills training D) Trust building ```

A) Progressive muscle relaxation

For a service to be reimbursable, in many instances insurance companies require the therapist to provide what information or evidence? A) Assessment tools sanctioned by JCAHO, HCFA or CARF B) Source-oriented medical records C) Physician’s orders D) Risk management plan for the activity

C) Physician’s orders

An “optimal experience” (commonly called a peak experience of flow) is more likely to happen when… A) the person’s skills are adequate for the challenge B) the individual is surrounded by loved ones C) it is preceded by pleasant emotions and positive regard D) the person is highly skilled at the activity

A) the person’s skills are adequate for the challenge

Which of the following assessments would be located in the category of Leisure Attitudes and Barriers? A) Leisure Motivation Scale (LMS) B) BANDI-RT C) Therapeutic Recreation Index (TRI) D) Global Assessment of Functioning (GAF)

A) Leisure Motivation Scale (LMS)

Evaluation is conducted on a specific individual programs in order to… A) provide systematic information for future program decisions B) provide systematic information on client regression C) increase validity and reliability of client assessment procedures D) develop individual client treatment plans

A) provide systematic information for future program decisions

Which of the following is an important premise of Reality Therapy? A) The specialist helps the client stay oriented to time, person and place B) The client is responsible for all of his or her behavior C) The specialist helps the client explore connections between past experiences and present actions D) The specialist helps the client focus on stopping irrational thoughts

B) The client is responsible for all of his or her behavior

Which of the following is NOT a condition of informed consent? A) Person is capable of making health care decisions B) Person is acting voluntarily without coercion or deceit C) Person has immediate access to health care records D) Person is provided simple yet complete information about the procedures, risks, benefits and alternatives

C) Person has immediate access to health care records

``` The client says that involvement with her family is very important to her, but spends an inordinate (excessive) amount of time at work, usually bringing home a large pile of work to do in the evenings and on the weekends. The CTRS may use what type of therapeutic technique to help her review her priorities and behaviors? A) Values clarification B) Reality orientation C) Assertiveness training D) Bibliotherapy ```

A) Values clarification

``` Cataracts involves the clouding of the cornea of the eyeball and is the leading cause of… A) falls in the elderly B) blindness C) glaucoma D) nearsightedness ```

B) blindness

Which of the following is an appropriate program evaluation question to ask clients? A) How satisfied were you with the qualifications of the staff? B) What did you learn from your participation in the program? C) How do you spend time with your family? D) How satisfied were you with the activity analysis of the program?

B) What did you learn from your participation in the program?

Which of the following is the BEST example of a receptive communication dysfunction? A) Inability to transform experiences into language B) Inability to comprehend the written or spoken word C) Inability to express oneself through actions or language D) Inability to distinguish nuances in spoken language

B) Inability to comprehend the written or spoken word

``` The process by which an agency or organization evaluates and recognizes a program of study or an institution as meeting certain predetermined qualifications or standards is called________. A) licensure B) accreditation C) certification D) registration ```

B) accreditation

Which of the following might be an outcome indicator assessed through a continuous quality improvement program? A) Qualifications of the TR staff B) Environment in which treatment is provided C) Intervention strategies employed by the CTRS D) Changes in client’s functional capacity

D) Changes in client’s functional capacity

In the following exchange, Client B was showing which of the following behavioral styles? A: “I want you both to cover for me when the head nurse comes and asks why I wasn’t in group therapy this morning.” B: “Okay, whatever you say.” C: “No, I can’t do that for you, because that would be lying.” A) Aggressive B) Passive C) Assertive D) Emotive

B) Passive

“Clinical indicators” are used in quality improvement to… A) evaluate the degree of client satisfaction with services received B) compare one discipline’s outcomes compared to other disciplines C) measure how well the targets were achieved D) provide a basis for evidence-based practice

C) measure how well the targets were achieved

In the following exchange, Client C was showing which of the following behavioral styles? A: “I want you both to cover for me when the head nurse comes and asks why I wasn’t in group therapy this morning.” B: “Okay, whatever you say.” C: “No, I can’t do that for you, because that would be lying.” A) Aggressive B) Passive C) Assertive D) Emotive

C) Assertive

``` The process of comparing the quantity of services provided with the amount of resources such as staff and time used is called… A) market segmenting B) risk management C) productivity measure D) analysis of care ```

C) productivity measure

Why does “thought stopping” help reduce stress reactions in people who have obsessive or phobic thoughts? A) Thoughts precede emotions which precede physiological responses B) It punishes them for their negative thoughts C) It isolates them from the group before they can be hurt D) It shows them they have value and worth

A) Thoughts precede emotions which precede physiological responses

One of the primary tenets of the Health Insurance Portability and Accountability Act (HIPAA) of 1996 and later rules is that individual health information: A) must be kept private and confidential B) must be kept electronically so it can be shared with other providers C) should be part of the individual’s medical record D) should be checked annually for medical errors

A) must be kept private and confidential

Which of the following is the BEST example of using guided visualization as a facilitation technique in TR? A) Having a person with cancer imagine good cells chomping on cancerous cells B) Asking a group to role play what they might do when a stranger approaches C) Asking a group of clients to express their feelings through any visual art medium D) Asking a client to paint a picture of her future leisure

A) Having a person with cancer imagine good cells chomping on cancerous cells

Which statement describes an intent or purpose common to both systems planning and quality improvement plans? A) Each describes the relationship of the comprehensive program to individual treatment plans B) Each outlines the relationship between the agency and departmental procedures C) Both define the components of department programs D) Each provides a systematic method to evaluate service delivery

D) Each provides a systematic method to evaluate service delivery

One example of a “trigger” within the Activities section on the MDS 3.0 would be when the individual… A) prefers more or different activity choices than are now being offered B) rarely receives visits from family or friends C) is completely independent on his/her leisure pursuits D) is ready for discharge to his/her home

A) prefers more or different activity choices than are now being offered

One document within a written plan of operation is the department’s or unit’s scope of care. The scope of care specifies… A) the comprehensive goals and program areas of the department B) methods of treating groups of clients C) the treatment protocols for specific diagnostic groups D) how the CTRS should interact with the clients

A) the comprehensive goals and program areas of the department

``` In assessment the most significant source of information is usually the… A) client B) care giver C) medical records D) team members ```

A) client

``` The following is an example of which one of the following health care delivery systems? The focus of care is on the improvement of knowledge for the world of work. A) Medical B) Custodial C) Milieu D) Education and Training ```

D) Education and Training

``` A CTRS is nonjudgmental, nondirective and provides an accepting atmosphere allowing the clients to assume the same positive self-regard the CTRS has shown to the client. The CTRS is using _____________ therapy. A) gestalt B) reality C) rational emotive D) person centered ```

D) person centered

``` From assessment results, the CTRS determines that the client has an inability to assert himself with peers or to follow through with commitments. He also lacks receptive communication skills. Which of the following TR programs would be MOST appropriate for this client? A) Leisure planning B) Social skills training C) Leisure values and attitudes D) Leisure resources ```

B) Social skills training

All of the following areas of a TR department’s written plan of operation may have specific, written policies and procedures, EXCEPT… A) obtaining physician’s orders for treatment of clients B) employee hiring and firing procedures C) how CTRSs apply for recertification D) procedures for obtaining supplies from the dietary department

C) how CTRSs apply for recertification

Which of the following is of primary importance for the CTRS to consider when selecting an intervention program that will produce a specific client outcome? A) Resources necessary to offer the experiences B) Staff skills needed to lead the activity C) Functional requirements of the activity D) Risk management protocols for the experience

C) Functional requirements of the activity

``` According to Maslow, all humans are striving to achieve _______________ but first must fulfill other essential needs. A) self-actualization B) ego esteem needs C) a sense of love and belonging D) safety/security ```

A) self-actualization

A CTRS is interested in determining behaviors that relate to a person’s ability to successfully integrate into society using his/her social interaction skills. From the following options, the CTRS should choose which assessment? A) Leisure Diagnostic Battery (LDB) B) Leisurescope C) BANDI-RT D) Comprehensive Evaluation in Recreational Therapy Scale (CERT) – Psych

D) Comprehensive Evaluation in Recreational Therapy Scale (CERT) – Psych

``` Which one of the four categories of child development does the skill “heeds his/her name” belong? A) Personal/social B) Adaptive/fine motor behavior C) Motor behavior D) Language ```

A) Personal/social

``` The Global Assessment of Functioning (GAF) is a numeric scale used by clinicians and physicians in what type of setting? A) Long-term care B) Physical rehabilitation C) Mental health D) Pediatric health care ```

C) Mental health

A CTRS is looking for program ideas for adolescent substance abusers. The BEST resource for the CTRS is… A) the Therapeutic Recreation Journal B) state recreation conferences C) chemical dependence conference D) other TR professionals who work in chemical dependency

D) other TR professionals who work in chemical dependency

In order for charting-by-exception to be effective, what first must be accomplished? A) Standards of care must be predefined so exceptions can be identified B) The patient must be medically stable and coherent C) Reimbursement for services has to be standardized hospital-wide D) All health care professionals must agree to a single-page assessment form

A) Standards of care must be predefined so exceptions can be identified

Which of the following examples typify the theory of self-efficacy? A) The client believes he is efficient in most leisure activities B) The client believes her life would change completely if she could live by herself C) The client hates to lose so tried extremely hard to excel so he can win D) The client believes he can master kayaking since he excels at canoeing

D) The client believes he can master kayaking since he excels at canoeing

``` Most video games use which of the following social interaction patterns? A) Intragroup B) Multilateral C) Interindividual D) Extraindividual ```

D) Extraindividual

``` Understanding facial expressions, customs, appropriate dress and the like are important considerations for improving a CTRS’s… A) performance reviews B) scope of practice C) clinical supervision D) cultural competence ```

D) cultural competence

Which of the following is NOT a rule for activity modification? A) Keep the activity and action as close as possible to the original or traditional activity as possible B) Modify only aspects of the activity that need adapting C) Individualize the modifications D) Use assistive technology wherever possible to ease the physical requirements of the activity

D) Use assistive technology wherever possible to ease the physical requirements of the activity

``` Neurological functions necessary for survival (ex.- breathing, digestion, heart rate) are located in what section of the brain? A) Brainstem B) Cerebellum C) Frontal lobe D) Occipital lobe ```

A) Brainstem

The term “branding” in marketing and public relations means that A) a product or service is differentiated from other similar products or services B) all company trademarks are copyrighted C) a company focuses on the one product or service that sells the best D) all employees are responsible for ‘selling’ the product or service

A) a product or service is differentiated from other similar products or services

A baby born with fetal alcohol syndrome will most likely have which of the following symptoms or characteristics? A) Intellectual disability, facial abnormalities, and stunted growth B) Enlarged heart, chemical tolerance, and bowed legs C) Stunted growth, heart disease and short stature D) Facial abnormalities, tendency to weep and stunted growth

A) Intellectual disability, facial abnormalities, and stunted growth

``` After the client assessment has been completed, the next step in the programming process is to A) write treatment summaries B) analyze activities C) identify the problem(s) D) develop goals and objectives ```

C) identify the problem(s)

``` The anatomical term “carpal” refers to which area of the body? A) Abdominal cavity B) Wrist C) Thigh D) Buttocks ```

B) Wrist

``` Educating others about a particular issue on behalf of another person is called A) education for all B) advocacy C) wellness promotion D) attitude adjustment ```

B) advocacy

``` Which of the following is a likely secondary condition to osteoporosis? A) Muscle wasting B) Hip fracture C) Osteoarthritis D) Hypertension ```

B) Hip fracture

Using a holistic approach to TR services means that the CTRS A) provides integrated services based in the community B) addresses social, physical, cognitive, and emotional functioning in leisure C) is part of a transdisciplinary treatment team D) uses activity analysis to assess the characteristics of leisure activities

B) addresses social, physical, cognitive, and emotional functioning in leisure

``` In the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), the diagnosis of depression would be categorized under A) Axis I B) Axis II C) Axis III D) Axis IV ```

A) Axis I

``` Which of the following is an appropriate area for assessing affective functioning? A) Dual communication skills B) Safety awareness C) Emotional regulation D) Leisure attitudes ```

C) Emotional regulation

``` A CTRS is most likely to teach which of the following skill sets to individuals w/ panic disorders? A) Relaxation B) Cognitive dissonance C) Reality orientation D) Sensory stimulation ```

A) Relaxation

``` A CTRS wants to assess a patient’s/client’s ability to control anger. The CTRS should assess behavior from which of the following domains? A) Cognitive B) Physical C) Emotional D) Social ```

C) Emotional

The two most widely used, evidence-based treatments for post-traumatic stress disorder are A) therapeutic exposure and cognitive reframing B) biofeedback and dream analysis C) escalation and progressive muscle relaxation D) modeling and stress management

A) therapeutic exposure and cognitive reframing

In 1953, what organization was formed to identify and resolve different philosophies held by members of the Hospital Recreation Society, the Recreation Therapy Section and the National Association of Recreation Therapists? A) Council for the Advancement of Hospital Recreation (CAHR) B) American Therapeutic Recreation Association (ATRA) C) National Therapeutic Recreation Society (NTRS) D) American Association of Recreational Therapy (AART)

A) Council for the Advancement of Hospital Recreation (CAHR)

Which of the following is a FALSE statement about self-efficacy? A) People are born with or without self-efficacy and it rarely changes during one’s life course. B) Self-efficacy involves one’s perceptions about his/her capabilities to attain a goal. C) As a person gains mastery in one area, self-efficacy may spread to other areas as well. D) To improve self-efficacy, it is better to start with simpler, smaller tasks that can be more readily accomplished.

A) People are born with or without self-efficacy and it rarely changes during one’s life course.

Which of the examples below illustrates using the principles of evidence-based research in therapeutic recreation? A) The CTRS uses results from a Therapeutic Recreation Journal article to most efficiently create a stress management program. B) The CTRS collects evidence over 12 months to show the attendance rates of clients. C) The CTRS attends a research forum at a national conference. D) The CTRS calls colleagues to see how their aquatic programs are designed.

A) The CTRS uses results from a Therapeutic Recreation Journal article to most efficiently create a stress management program.

``` The purpose of the conjunctiva in the human eye is to… A) provide color to the iris B) sense and react to light C) refract light as it enters the eye D) protect the eye from irritants ```

D) protect the eye from irritants

``` A client holds two opposing beliefs; one is that work is the most important thing in life and the second is that most enjoyment comes from leisure activities. Because this client feels this is a problem, the CTRS might employ which of the following intervention techniques w/ this client? A) Values clarification B) Reality orientation C) Remotivation D) Cognitive restructuring ```

A) Values clarification

Society generally devalues individuals with disabilities, reinforcing negative attitudes by doing all of the following EXCEPT A) using offensive terminology w/ regard to people w/ disabilities B) treating them as helpless and victimized C) labeling them as social burdens D) treating them as equals

D) treating them as equals

``` Two clients ran away during a community outing. After contacting the police, the CTRS complete which form? A) Incident report B) Revised treatment plan C) Discharge/referral summary D) Liability summary ```

A) Incident report

``` All of the following would be considered leisure constraints EXCEPT A) freedom of choice B) lack of leisure partners C) inability to make decisions D) fear of stigma ```

A) freedom of choice

Which of the following is an example of using “displacement” as a defense mechanism? A) Not remembering that the event occurred. B) Attributing the action or behavior to another person C) Using a subordinate as the scapegoat D) Not acknowledging the magnitude of a stressful event

B) Attributing the action or behavior to another person

Presbyopia is a visual condition common in older individuals that results in A) loss of elasticity of the lens and inability to focus on an object B) an astigmatism of unequal portions C) cataracts D) glaucoma

A) loss of elasticity of the lens and inability to focus on an object

Which type of facility has the highest bed occupancy rate of all long-term care facilities? A) Nursing homes B) State facilities for individuals w/ developmental disabilities C) Psychiatric hospitals D) Physical medicine and rehabilitation centers

C) Psychiatric hospitals

``` In which of the following steps does the CTRS collect feedback for the improvement of future programs? A) Assessment B) Program planning C) Program implementation D) Program evaluation ```

D) Program evaluation

In the Leisure Ability Model, the purpose of functional intervention services is to A) provide co-treatment with other therapies at the most basic, functional levels B) acquaint clients with available and appropriate community services C) bring clients up to the baseline of their peers’ average functional level D) increase the physical capabilities of the clients

C) bring clients up to the baseline of their peers’ average functional level

A strategic plan is a method of… A) projecting needs and activities of an organization in the future B) continuous quality improvement C) protocol development and implementation D) resource utilization

A) projecting needs and activities of an organization in the future

``` Which of the following sets of standards was established by the field of therapeutic recreation to address quality of service delivery? A) Accreditation standards B) Certification standards C) Education standards D) Standards of practice ```

D) Standards of practice

CTRSs and activity personnel typically complete which section of the MDS 3.0 assessment? A) Section A Functional Abilities and Wellness B) Section C Activity Interests and Participation C) Section F Preferences for Customary Routine and Activities D) Section K Activities of Daily Living and Leisure Experiences

C) Section F Preferences for Customary Routine and Activities

``` A disability that is present a birth is described as A) congenital B) adventitious C) traumatic D) acquired ```

A) congenital

What is likely to happen if the assessment instrument is NOT administered in a reliable way to clients? A) Client placement into programs will likely be wrong B) Clients will improve their functional abilities more quickly C) The activity analysis will yield faulty results D) The client’s length of stay will be reduced

A) Client placement into programs will likely be wrong

``` Which of the following terms means that medication has been delivered directly to the spinal cord? A) Intravenously B) Intramuscularly C) Subcutaneously D) Intrathecally ```

D) Intrathecally

Reliability, as a measurement characteristic, asks which of the following questions? A) Does the manual include directions for administering, scoring and interpreting results? B) Does the instrument match the programs offered to clients? C) Does the instrument yield accurate information about the client? D) Is the instrument measuring what it is intended to measure?

C) Does the instrument yield accurate information about the client?

If the client does not understand the language used on the assessment or becomes fatigued, what is likely to happen? A) The CTRS will gain insight into the sitting tolerance of the client. B) The CTRS still will be able to use the assessments from other disciplines to build a treatment plan. C) Nothing, most CTRSs do not use assessment scores anyway. D) The assessment score will not be reflective of the person’s skills, attitudes and knowledge.

D) The assessment score will not be reflective of the person’s skills, attitudes and knowledge.

``` A CTRS selects the Comprehensive Evaluation in Recreation Therapy Scale (CERT-Psych) to measure behavior of a client as observed in group activities. Which assessment characteristic has the CTRS considered in making this selection? A) Validity B) Reliability C) Usability D) Practicability ```

A) Validity

``` Once the CTRS has met the sitting requirements for and passed the NCTRC exam, she must renew her certification every year and recerify every _____ year(s) to remain certified. A) 10 B) 5 C) 6 D) 2 ```

B) 5

The CTRS knew that by adhering to the assessment protocol she was… A) decreasing the content validity of the assessment results B) increasing the likelihood of false positives C) matching the content of the assessment with the content of the program D) reducing error and increasing confidence in the assessment results

D) reducing error and increasing confidence in the assessment results

In 1983, a cost-cutting Medicare hospital payment system was initiated that included A) a retrospective payment system B) direct reimbursement for TR services C) the Center for Medicare and Medicaid Services (CMS) D) diagnostic-related groups (DRGs)

D) diagnostic-related groups (DRGs)

The CTRS wants to assess clients for placement into a leisure education program. The CTRS should make sure the instrument is valid and measures which of the following? A) social skills, leisure activity skills, leisure resources and leisure awareness B) functional limitations, social skills, and physical abilities C) leisure interests, functional limitations, leisure awareness and leisure resources D) decision-making skills, small group and large group interaction skills and leisure resources.

A) social skills, leisure activity skills, leisure resources and leisure awareness

The “saggital plane” divides the human body… A) with a horizontal line through the abdomen B) from front to back C) with a vertical line (left from right) D) into 4 equal sections

C) with a vertical line (left from right)

``` A common secondary condition for individuals w/ visual impairments is A) inability to memorize lists of words B) obesity C) impaired concentration skills D) high cholesterol ```

B) obesity

Client documentation and program documentation are importance because they allow for all of the following EXCEPT A) increased communication among staff members B) a higher degree of accountability C) patient autonomy D) adherence to professional and external standards

C) patient autonomy

``` The medical term “NPO” is the abbreviation for A) idiopathic diagnosis B) nothing by mouth C) normal parameters of oxygen D) normal postoperative outpatient ```

B) nothing by mouth

Which of the following is typical behavior expected during a manic episode for someone who has been diagnosed w/ bipolar disorder? A) ability to focus for long periods of time B) increased need for sleep and rest C) decreased sexual drive D) extreme irritability

D) extreme irritability

The CTRSs created agency-specific assessments on their own. One CTRS’s assessment results in a score that then is used to place clients into TR programs, while the other CTRS’s results in open-ended comments that are more difficult to analyze. The second CTRS’s assessment will more likely result in A) faulty program placement decisions and inability to show client outcomes B) better validity of assessment results C) better reliability of assessment results D) improved ability to report accurate results to the treatment team

A) faulty program placement decisions and inability to show client outcomes

``` Which of the following is NOT a possible means of transmission of HIV? A) Donating blood B) Unprotected sexual intercourse C) Sharing drug injection paraphernalia D) Mother to fetus ```

A) Donating blood

``` Which of the following activities would most likely help an adolescent with an intellectual disability to improve concentration? A) Watching television B) Plant care C) Crossword puzzle D) Videogame ```

D) Videogame

58. Which of the following statements reflect the current emphasis of external accreditation agencies in reviewing therapeutic recreation services for quality improvement purposes? A) The effectiveness of TR services is determined by the achieved client outcomes B) The most important criteria for proving effectiveness of TR services is the availability of facilities and adequacy of equipment. C) The crucial element in TR quality assurance is the interaction established between the CTRS and the client. D) Linkages w/ community agencies is the prime factor in determining quality care in TR services.

A) The effectiveness of TR services is determined by the achieved client outcomes

Given the goal statement below, which of the following is the most appropriate TR program. “Goal: To teach clients skills in negotiating physical environmental barriers.” A) Friday night bingo club B) Big brother/ big sister program C) Leisure awareness discussion group D) Wednesday night community re-integration trip to local mall

D) Wednesday night community re-integration trip to local mall

``` Visual deficits are the result of injury in what portion of the human brain? A) Braintstem B) Cerebellum C) Frontal lobe D) Occipital lobe ```

D) Occipital lobe

The major purpose of conducting an activity analysis is to make sure the selected activities… A) fit the program goals and client characteristics B) are compatible w/ agency goals and staff abilities C) are both social and physical in nature D) are documented and evaluated on a timely basis

A) fit the program goals and client characteristics

Health can be defined, not just as the absence of illness, but as… A) a higher level of disease process B) exercising 3 days a week for at least 30 minutes at a time C) a sense of physical, mental and social well-being D) minimal deviation from normal functioning

C) a sense of physical, mental and social well-being

A CTRS is working with a group of adolescents who have mild intellectual disabilities and hopes to improve their interactions with each other. She has decided to use positive reinforcement for each good interaction that occurs with the group. The first thing the CTRS should do is… A) determine how often the target behavior currently occurs B) determine what is a reinforcer C) reward each client whenever a good interaction occurs D) describe the target behavior

D) describe the target behavior

The medical/clinical model of healthcare… A) involves total care of the individual, including sleeping, eating and hygiene B) focuses on establishing a therapeutic community among clients C) centers on the physician as the primary decision-maker for client care D) provides services to client often living independently

C) centers on the physician as the primary decision-maker for client care

``` A common secondary condition got individuals w/ severe arthritis is… A) spina bifida B) contractures C) enlarged bones D) aphasia ```

B) contractures

Which of the following is an example of a transdisciplinary treatment team? A) Each team member independently assess and plans interventions for the client B) Each team member is responsible for collaborating w/ others on identifying common goal areas; then selects the best intervention within his/her discipline. C) Each team member works across disciplinary boundaries to develop goals and plans and often co-treats clients D) Each team member is cross-trained in each other’s discipline and there are virtually no boundaries between disciplines

C) Each team member works across disciplinary boundaries to develop goals and plans and often co-treats clients

The federal agency that provides regulations to reduce workplace hazards and dangerous conditions is called the… A) Occupational Safety and Health Administration B) Department of Health and Human Services C) Department of Homeland Security D) Employment and Job Site Security Bureau

A) Occupational Safety and Health Administration

What are the likely consequences of having inadequate resources and staff per activity? A) Risk to clients is increased B) The difficulty can be increased C) More content can be covered D) Less time is needed to reach targeted goals

A) Risk to clients is increased

The Current Procedural Terminology (CPT) codes created by the American Medical Association describe A) reimbursable intervention units B) recommendations for weekly physical activity C) protocols for the treatment of post-traumatic stress disorder D) risk management procedures used by most hospitals

A) reimbursable intervention units

In problem-oriented record keeping, the abbreviation SOAPIER, stands for A) subjectivity, objectivity, assess, plan, implement, evaluate, revise B) subjective data, objective data, analysis, plan, interventions, evaluation, revisions C) sources, objects, adjectives, protocols, initiatives, expressions, resolutions D) nothing, it simply means to completely (saturate) the topic

B) subjective data, objective data, analysis, plan, interventions, evaluation, revisions

``` Aging women, as compared to men, are cared for in long-term care facilities at the rate of A) 4 women to 3 men B) 10 women to 9 men C) 1 woman to 2 men D) 2 women to 1 man ```

A) 4 women to 3 men

``` If a person with osteoporosis engages in weight bearing activity that is too strenuous, he or she is put at a higher risk for A) bone fracture B) contractures C) depression D) vestibular resistance ```

A) bone fracture

``` The CTRS documented how the client met her initial goals and objectives after 2 weeks. What form of documentation was the CTRS using? A) Assessment summary report B) Progress notes C) Transition summaries D) Discharge summaries ```

B) Progress notes

``` The CTRS works with an educator from a local university to research the impact of exercise on substance abuse patients in an outpatient recovery program. The CTRS is adhering to which principle of the ATRA Code of Ethics? A) Confidentiality and privacy B) Justice C) Veracity D) Competence ```

D) Competence

The CTRS teaches the client, who has been recently diagnosed with glaucoma, to make which of the following adaptations during activity involvement? A) Use eye drops frequently B) Periodically scan the entire area from side to side C) Use a light background and dark print D) Participate in activities only during the day or in areas with bright

B) Periodically scan the entire area from side to side

``` The CTRS may need to describe specific behavioral cues that help describe the client’s behavior. The client’s _______ can be described using words such as lively, neutral, blunted, flat, stable, labile, defensive, calm, sad, hostile, guarded, distant, evasive, cooperative and open. A) speech B) mood and affect C) social distancing D) movement ```

B) mood and affect

``` One of the primary programming considerations for children with hearing impairments that should be included in the activity analysis of all TR activities is: A) balance B) atrophy C) visual requirements D) peripheral vision ```

A) balance

Recreation participation programs are MOST appropriate for clients who need to A) improve physical endurance B) learn new leisure and recreation skills C) practice social skills in an unstructured environment D) become more aware of the role leisure plays in their lives

C) practice social skills in an unstructured environment

What is an advantage of asking open-ended questions of clients for a program evaluation? A) The answers are easily quantifiable B) The clients are able to expand on their answers C) The specialist needs to be skilled in interviewing people D) There is no advantage to open-ended questions

B) The clients are able to expand on their answers

``` Intellectual disability occurs in approximately what percent of the population in the US? A) 1% B) 10% C) 20% D) 30% ```

A) 1% According to the World Health Organization, up to 3% or almost 200 million people of world’s population have intellectual disabilities. Largest disability population in the world.

``` All of the following have an impact on how client documentation is required, EXCEPT A) external accreditation standards B) agency guidelines and procedures C) legal requirements D) activity analysis ```

D) activity analysis

``` All of the following documents should be evaluated and updated on a regular basis EXCEPT A) job announcement B) performance appraisal C) job description D) written plan of operation ```

A) job announcement

Which of the following statements about leisure’s impact on coping with stressful life events is TRUE? A) Leisure activities often intensify the harmful effects of negative life events B) Leisure activities often have the effect of eliminating optimism and hope about the future C) Leisure activities often disrupt one’s ability to cope with stress D) Leisure activities may be used following negative life events to attain new goals

D) Leisure activities may be used following negative life events to attain new goals

``` The CTRS checks each piece of recreation equipment each week during a routine maintenance and safety check. The CTRS is involved in what kind of action? A) Client management B) Quality achievement C) Environmental assessment D) Risk management ```

D) Risk management

If the CTRS makes an error while writing in the client’s chart, he should A) use white correction fluid over the error and then write the correction in the ink B) report the mistake to his boss, and begin on a clean new page C) cross out the error, write “error” above it and initial it D) learn to always chart in pencil so mistakes can be easily erased and corrected

C) cross out the error, write “error” above it and initial it

``` 76. How often must an individual’s Individualized Education Program be updated according to the Individuals w/ Disabilities Education Act of 2004? A) Weekly B) Quarterly C) Semi-Annually D) Annually ```

D) Annually

``` In systems program design, a performance measure (PM) is the same as a(n) A) assessment item B) outcome statement C) enabling objective D) mission statement ```

B) outcome statement

``` An adult with intellectual disability has the ability to participate in some general recreation programs within the regular community-based recreation program. When the CTRS helps the client enroll in one of these programs, which of the following mainstreaming principles is being applied? A) Advocacy B) Deinstitutionalization C) Least restrictive environment D) Discharge planning ```

A) Advocacy

Which of the following is NOT a factor in selecting an activity for client participation? A) Activities must have a direct relationship to the client goal B) Non-traditional activities make the intervention more fun for clients C) A single activity or session is not likely to produce a desired behavioral change D) Consider the types if activities in which people will engage when they have the choice

B) Non-traditional activities make the intervention more fun for clients

Activity Analysis is the process of… A) examining client characteristics to best place them into programs B) examining the activity components to identify inherent characteristics C) evaluating the effects of the activities/programs on the clients D) evaluating the resources/equipment needed to implement the activities

B) examining the activity components to identify inherent characteristics

``` Which one of the four categories of child development does the skill “sits leaning forward on hands” belong? A) Personal/social B) Adaptive/fine motor C) Motor behavior D) Language ```

C) Motor behavior

Which of the following is NOT a benefit resulting from completing an activity analysis? A) a better comprehension of the client’s activity interests and preferences B) a rationale or explanation for the therapeutic benefits of activity involvement C) information for selecting a leadership or facilitation technique D) a greater understanding of the complexity of activity requirements for client participation

A) a better comprehension of the client’s activity interests and preferences

Which of the following is an example of clinical supervision? A) Overseeing clients on a community out-trip B) Overseeing clients during an in-house discussion group C) Helping a junior professional become a better practitioner D) Performing personnel evaluations on staff at least once per year

C) Helping a junior professional become a better practitioner

In 2001, the World Health Organization revamped its classification of human functioning and disablement. Called the International Classification of Functioning, Disability and Health (ICF), it promotes A) better medical care in 3rd world countries B) viewing human functioning and disablement from a biopsychosocial model of health C) more active treatment for those with severe disabilities and terminal illnesses D) therapeutic recreation as one of the three services that promote quality of life

B) viewing human functioning and disablement from a biopsychosocial model of health

Many private hospitals followed the federal government in adhering to a prospective payment system. This means that… A) hospitals receive the same fee for each diagnostic-related group (DRG) they treat B) insurance companies will pay whatever hospitals charge for a service C) individuals pay 80% of health care charges D) psychiatric services are available to individuals within their own community

A) hospitals receive the same fee for each diagnostic-related group (DRG) they treat

``` 6. What is the most common adult social interaction pattern? A) Intragroup B) Multilateral C) Interindividual D) Extraindividual ```

A) Intragroup

Which of the following is a TRUE statement about the aging process? A) Individuals with less education tend to outlive those with more education B) Women tend to outlive men C) Ethnic minority members tend to outlive Caucasians D) Individuals who are single tend to outlive those with families

B) Women tend to outlive men

Which of the following is the BEST example of a client outcome measure, collected as part of the TR department’s quality improvement efforts? A) Change in client’s health status or well-being B) Change in client’s attendance at programs C) Development of a baseline for expected client behavior D) Development of one-to-one treatment programs

A) Change in client’s health status or well-being

``` An older female has been admitted as a client to a psychiatric facility for treatment of severe depression. She says her daughter has taken care of her home and needs for the last 5 years. She has no interest in making her own decisions about leisure involvement. The client may be exhibiting… A) learned helplessness B) infantile expressive skills C) extrinsic behavior D) aggressive behavior ```

A) learned helplessness

The difference between a vision statement and a statement of purpose for an organization is that a vision statement is A) never put into operation B) created solely by the top level managers C) far-reaching and translates values into a desired future D) is for the immediate future and is directly translated into operational goals

C) far-reaching and translates values into a desired future

``` When an agency has decided to use the Functional Independence Measure (FIM), the CTRS may be called upon to assess which of the following sections? A) Self-care B) Mobility C) Home skills D) Social/cognition ```

D) Social/cognition

``` When a person believes that his/her culture is superior or better than other cultures, it is called… A) superiority complex B) ethnocentrism C) egotism D) cultural delusion ```

B) ethnocentrism

The State Technical Institute’s Leisure Assessment Process (STILAP) assessment differs from other activity inventories or leisure interest scales because it… A) focuses on physical activities such as sports and large group games B) assesses barriers to community integration C) looks at the entire community environment to which the client is to return D) translates activity skills into leisure competencies

D) translates activity skills into leisure competencies

Which of the following is NOT a method for an active CTRS to be recertified by NCTRC? A) Receiving a passing grade in university level coursework B) Completing a second internship in a different setting C) Attending professional workshops that awards CEUs for participation D) Writing and publishing education articles in professional journals

B) Completing a second internship in a different setting

Which of the following is NOT a characteristic of an effective group? A) Each person monitors someone else’s progress toward accomplishing the task B) Have a unifying relationship C) Seek a share and common goal D) Work together to meet individual and group needs

A) Each person monitors someone else’s progress toward accomplishing the task

The CTRS wrote the following note in a client’s chart. Which of the following documentation principle was violated? “Mrs. Sullivan appeared to be lethargic and depressed.” A) Add adequate descriptions to explain motivations B) Be consistent and explain exceptional behavior C) Observe behavior, then write it down D) Focus on client behavior, rather than interpretations of behavior

D) Focus on client behavior, rather than interpretations of behavior

When individuals with disabilities are categorized and labeled (e.g., “the retarded,” “the disabled”), it shows… A) Misconceptions about professionalism B) The underlying attitudes held towards individuals with disabilities C) Inadequate information about health and illness D) Religious beliefs toward perceived differences

B) The underlying attitudes held towards individuals with disabilities

``` Which of the following is an example of the condition part of a behavior objective? A) With level 4 minimal assistance B) The client will plan a weekend trip C) After the completion of the program D) Two out of three times ```

C) After the completion of the program

Which of the following is NOT a true statement about the majority of individuals with intellectual disabilities? A) They are more easily suggestible than individuals w/ higher intelligence B) They are more passive in their thoughts than individuals w/ higher intelligence C) They are more judgmental than individuals w/ higher intelligence D) They are more concrete in their thinking than individuals w/ higher intelligence

C) They are more judgmental than individuals w/ higher intelligence

The CTRS on a physical medicine and rehabilitation unit plans on providing a clinic on adapted tennis. Which of the following would NOT be a consideration for modification? A) Available facilities B) Necessary equipment and materials needed C) Number of qualified staff D) Decision-making skills

D) Decision-making skills

Reimbursement for TR services is dependent on all of the following EXCEPT… A) Insurance contracts B) Local managed care agreements C) The square footage of the activity area D) Documentation of client outcomes

C) The square footage of the activity area

Which of the following is the BEST example of a receptive communication dysfunction? A) Inability to transform experiences into language B) Inability to comprehend the written or spoken word C) Inability to express oneself through action or language D) Inability to distinguish regional accents in spoke language

B) Inability to comprehend the written or spoken word

``` A CTRS should use which of the following resources to find successful, proven methods of achieving positive client outcomes through actual TR services? A) Therapeutic Recreation Journal B) An introduction to TR textbook C) Adapted Activities Quarterly D) ATRA newsletter ```

A) Therapeutic Recreation Journal

``` Which of the following terms means that medication has been delivered under the tongue? A) Sublingually B) Intramuscularly C) Subcutaneously D) Intrathecally ```

A) Sublingually

``` The CTRS is treating a divorced parent who has custody of 2 children. The lawyer of the non-custodial parent calls seeking information regarding the status of the custodial parent. The CTRS refuses to give information. The CTRS is adhering to which principle of the ATRA Code of Ethics? A) Confidentiality and privacy B) Justice C) Veracity D) Competence ```

A) Confidentiality and privacy

For individuals with substance dependence problems, the term tolerance means that the person… A) Needs more of the substance to achieve intoxication B) Is more open-minded and accepting of diverse opinions C) Shows emotional distress during substance withdrawal D) Willingly accepts more limitations within his/her life

A) Needs more of the substance to achieve intoxication

Which of the following is the best approach to use with individuals who are kinesthetic learners? A) Drawings on a chalkboard or white board B) Verbal recordings of instructions C) Materials that provide tactile stimulation D) Charts, signs and posters w/ clear instructions

C) Materials that provide tactile stimulation

High-quality patient documentation focuses on “behavioral language.” Which of the following is NOT an example of a behavioral statement? A) The client was 15 minutes late to the TR program B) The client stated that she was bored during the social skills program C) The patient verbalized her appreciation for TR services D) The patient appeared distraught and upset

D) The patient appeared distraught and upset

``` A CTRS is working w/ a person who is quadriplegic as a result of a recent diving accident. The CTRS suggests that she try playing Ping-Pong instead of tennis, which she previously enjoyed. The CTRS is using which of the following TR principles? A) Aging-in-place B) Substitutability C) Least restrictive environment D) Continuity of care ```

B) Substitutability

In Section O of the MDS 3.0, all of the following conditions must be present to be considered concurrent therapy EXCEPT… A) 2 or more residents are engaged in different tasks B) the director of nursing must be present C) the residents must be in direct line-of-sight of the therapist or assistant D) student interns must be in direct line-of-sight of therapist, if providing treatment

B) the director of nursing must be present

Universal design of facilities means that the built environment is… A) usable to the greatest extent possible by everyone B) free of stairways and curb cuts C) available at those facilities which persons with disabilities frequent D) specific to the age of the individuals who go there

A) usable to the greatest extent possible by everyone

A halfway house is used primarily for individuals who… A) need a balance of supervision and independence B) are alcoholics C) have intellectual disability D) have been diagnosed for at least 2 years

A) need a balance of supervision and independence

The Family and Medical Leave Act (FMLA) provides which of the following for eligible employees? A) Payment for adoption services for foreign born child(ren) B) Payment for funeral expenses for family members C) Unpaid, job-protected leave for a specified family and medical reasons D) 6 weeks of paid vacation per year

C) Unpaid, job-protected leave for a specified family and medical reasons

``` Given the goal statement below, which of the following is the most appropriate TR program. “Goal: To provide opportunities for self-expression.” A) Open gym for volleyball practice B) Outdoor bocce ball game C) Open time in the woodworking room D) Art instruction in quilting ```

C) Open time in the woodworking room

``` The term “muscular strength” refers to A) Repeated submaximal effort B) The range of motion within a joint C) The ability to change direction without losing balance D) A single maximum effort ```

D) A single maximum effort

``` On an activity analysis form, the items about interaction patterns (such as unilateral, intraindividual, etc.) would best fit under the component of: A) Physical B) Mental C) Emotional D) Social ```

D) Social

Which of the following is NOT a requirement of the Health Insurance Portability and Accountability Act (HIPAA) of 1996 and later rules? A) Give patients notice about how their health information will be used B) Make a good faith effort to ensure patients understand their rights C) Obtain written authorization from the patient for purposes other than treatment, payment or operations D) Perform research on evidence-based practice and best practice of health care

D) Perform research on evidence-based practice and best practice of health care

Validity, as a measurement characteristic, asks which of the following questions? A) Is the instrument measuring what it is intended to measure? B) Will the same results happen if the instrument is given a 2nd time? C) Does the manual include directions for administering, scoring and interpreting results? D) How consistent are the results from one client to another?

A) Is the instrument measuring what it is intended to measure?

Which of the following is an example of an interpersonal constraint to leisure participation? A) Lack of self-determination of the individual B) Lack of interest in the activities being offered C) Lack of transportation to recreation facilities D) Lack of leisure partners

D) Lack of leisure partners

Which of the following in NOT an example of inclusive recreation programming? A) Community reintegration programs for outpatients B) Leisure skills instruction for independent participation C) Ensuring universal design in leisure facilities and programs D) Anger management training for inpatients w/ substance addictions

D) Anger management training for inpatients w/ substance addictions

Glaucoma is the result of excessive pressure building up within the… A) Aqueous humor of the anterior chamber of the eye B) Synovial joint of the neck C) Tympanic membrane in the ear D) Eustachian tube

A) Aqueous humor of the anterior chamber of the eye

According to the Leisure Ability Model of TR services, the program service categories include… A) Functional intervention, leisure education and recreation participation services B) Therapy and recreation services C) Leisure education, counseling and recreation services D) Inpatient, outpatient and community services

A) Functional intervention, leisure education and recreation participation services

Three early professional organizations for TR (HRS, NART & RTS) formed the National Council for the Advancement of Hospital Recreation (CAHR). What was the major accomplishment of CAHR in 1956? A) A combined professional philosophy for the entire field B) The creation of the National Voluntary Registration Plan for TR personnel C) The creation of the National Therapeutic Recreation Society D) The first standards of practice for TR practitioners

B) The creation of the National Voluntary Registration Plan for TR personnel

``` The content of the assessment must match the content of the… A) Activity analysis B) Program C) Treatment plan D) Quality improvement plan ```

B) Program

An individual with a moderate hearing impairment would MOST likely need which of the following services or adaptations? A) Community mobility training B) Well-lit rooms with bright colors C) Amplification devices in some situations D) Personal assistants to take care of daily needs

C) Amplification devices in some situations

One of the problems with client assessment in TR services is that… A) There are too many assessments from which to select B) Clients are too diverse to be assessed C) Assessments that are validated for practice are difficult to find and use D) The information they gather is often in conflict with that of other treatment team members

C) Assessments that are validated for practice are difficult to find and use

``` When choosing an assessment instrument, the CTRS first needs to determine the instrument’s… A) Reliability B) Validity C) Stability D) Purpose ```

D) Purpose

The custodial/long-term care model of healthcare… A) Involves total care of the individual, including sleeping, eating and hygiene B) Focuses on establishing a therapeutic community among clients C) Centers on the physician as primary decision-maker for client care D) Provides service to clients often living independently

A) Involves total care of the individual, including sleeping, eating and hygiene

Muscular dystrophy results in which of the following activity limitations? A) Loss of muscle function B) Decrease in hand-eye coordination C) Decrease in attention span D) Improved respiration and resting heart rate

A) Loss of muscle function

``` The CTRS wants to start a walking program for clients who meet the criteria for entering the program. With which of the following disciplines is the CTRS most likely to collaborate on the treatment team? A) Personal trainer B) Occupational therapy C) Physical therapy D) Outpatient therapy coordinator ```

C) Physical therapy

``` Almost all models of TR service delivery start with the step of… A) Assessment B) Goal development C) Program evaluation D) Quality improvement ```

A) Assessment

Within the Individuals w/ Disabilities Education Act of 2004, and updated in 2011, Part C now includes individuals with… A) Developmental delays aged 2 and under B) Autism spectrum disorder, including Asperger’s Syndrome C) Mental illnesses as long as they are in school D) Traumatic brain injury, regardless of age

A) Developmental delays aged 2 and under

One mistake in assessment many CTRSs make is to A) Improve the reliability of their assessment instrument B) Use the results of the assessment to place clients into programs C) Use an assessment that was intended for a different purpose D) Interview clients asking the questions in the same way every time

C) Use an assessment that was intended for a different purpose

``` Which method of behavioral observation and recording is the CTRS using when she records how long a certain behavior lasts? A) Frequency or tally B) Duration C) Interval D) Instantaneous time sampling ```

B) Duration

Which of the following questions would NOT be appropriate when documenting a client’s participation in a TR program? A) Did the client attend voluntarily? B) Did the client merely observe the activity? C) Was the client actively participating in the session? D) Did the client attend all therapies on Tuesday?

D) Did the client attend all therapies on Tuesday?

Dementia typically results in which of the following activity limitations? A) Decrease in amounts of aphasia B) Increased likelihood of blood disorders C) Memory loss D) Increase in executive functioning

C) Memory loss

``` A person who has a hearing capacity of less than 120 decibels (db) is considered to… A) Have normal hearing B) Be slightly hearing impaired C) Be moderately hearing impaired D) Be deaf ```

D) Be deaf

``` The medical term “VO” is the abbreviation for… A) Verbal order B) Halitosis C) Ventilator only D) Vital organism ```

A) Verbal order

Which of the following components is missing from the discharge summary? “Pt. was referred to TR program due to the lack of appropriate social skills at peer level and complaints of boredom. Pt. participated in Social Skills Training programs on a weekly basis and Leisure Opportunities programs on a daily basis for 5 weeks. Pt. enrolled in 2 community-based leisure programs. CTRS will follow-up in 3 weeks to monitor client progress in community.” A) Major client goals or problems B) Services received by client C) Client attainment of goals D) Plans for post-discharge involvement

C) Client attainment of goals

``` Which of the following are NOT typical characteristics of someone who has been diagnosed w/ schizophrenia? A) Though disorder B) Dysmorphia C) Blunted or flat affect D) Social withdrawal ```

B) Dysmorphia

In this excerpt of a client’s treatment plan, which of the following, if any, was MOST likely identified as the client’s problems? 1.“Enroll pt. in leisure planning class Tuesdays and Thursdays. Focus on taking responsibility and decision-making.” 2. “Enroll pt. in Social Singles Club weekly. Focus on initiating and maintaining conversations w/ peers.” A) A lack of knowledge of leisure resources and lack of social partners. B) A lack of conversational abilities and decreased concentration skills. C) A lack of repertoire of activity skills and inability to identify leisure value system. D) None of the above

D) None of the above

``` The condition called Phenylketonuria (PKU- is a rare condition in which a baby is born without the ability to properly break down an amino acid called phenylalanine) is associated with… A) Schizophrenia B) Cerebral vascular accident C) Barbiturate addiction D) Intellectual disability ```

D) Intellectual disability

``` The CTRS places a client in a team sport to introduce cognitive challenges. What higher level intellectual requirement is needed to be successful in a team sport like soccer? A) Memorization of rules B) Coordination of body parts C) Concentration D) Application of strategies ```

D) Application of strategies

If an individual experiences a stroke on the right side of his/her brain, the typical effects include… A) Lack of depth perception, intuition and nonverbal participation B) Inability to remember past events and to read C) Inability to communicate and organize thoughts D) Increased lability and control

A) Lack of depth perception, intuition and nonverbal participation

When a physician or case manager creates a master list of client deficits and develops a plan of action focused on these deficits, this is called… A) A problem-oriented medical record B) A clinical pathway C) The case load of the physician on staff D) A diagnostic protocol

A) A problem-oriented medical record

``` The CTRS wants to develop a stress management program. He first reviews the Therapeutic Recreation Journal, the Annual in Therapeutic Recreation and the American Journal of Recreation Therapy to determine what is known about the design and effects of stress management programs in therapeutic recreation so he can apply that information to build the program he provides clients. The CTRS is performing what task? A) A field review B) A research study C) Evidence-based practice D) A meta-analysis ```

C) Evidence-based practice

``` In which of the 4 domains does the statement below fall under? “To wait to interrupt until appropriate conversational opportunity occurs.” A) Cognitive B) Affective C) Physical D) Social ```

D) Social

``` Which of the following are examples of secondary conditions? A) Osteoporosis and hip fracture B) Spinal cord injury and heart disease C) Dementia and losing track of time D) Arthritis and scoliosis ```

A) Osteoporosis and hip fracture

``` In which of the 4 domains does the statement below fall under? “To improve ability to locate facilities on a map.” A) Cognitive B) Affective C) Physical D) Social ```

A) Cognitive

Which of the following is an appropriate goal for a client who lacks awareness of personal resources? A) The client will identify 4 assets within him/herself that complement their leisure lifestyle. B) The client will name 3 leisure resources in the community. C) The client will learn 3 new leisure activities within the next 3 months. D) The client will register for one community program within 1 month.

A) The client will identify 4 assets within him/herself that complement their leisure lifestyle.

``` Neuroleptics are a class of prescription medications for which of the following disorders? A) Agoraphobia B) Tardive dyskinesia C) Schizophrenia D) Neuropathy ```

C) Schizophrenia

``` In the U.S., which of the following is among the most participated in? A) Basketball B) Swimming C) Inline skating D) Bowling ```

D) Bowling

``` In using a service marketing approach to promote her community based program, the CTRS focuses on which of the following? A) Relationships to clients B) The price point for programs provided C) Quality of the programs provided D) The staff that provide services ```

C) Quality of the programs provided

``` When a person experiences stress, which of the following physiological reactions occur? A) Blood pressure lowers B) Pupils (eyes) become dilated C) Respirations decreases D) Blood rushes to the hands and feet ```

B) Pupils (eyes) become dilated

The top 2 leading causes of death in the U.S. are… A) Obesity and strokes B) Heart disease and cancer C) Heart disease and sexually-transmitted diseases D) Vehicular accidents and gunshot wounds

B) Heart disease and cancer

``` The client’s goal is to develop appropriate competitive skills. The CTRS selects table games like checkers and tic tac toe to initiate intervention. At what social interaction level has the CTRS begun intervention? A) Extraindividual B) Aggregate C) Interindividual D) Unilateral ```

C) Interindividual

``` In which of the following steps does the CTRS use modalities and facilitation techniques to improve the delivery of programs? A) Assessment B) Program planning C) Program implementation D) Program evaluation ```

C) Program implementation

Which of the following is a TRUE statement about alcoholism? A) More males than females are diagnosed with alcoholism B) Onset is usually in a person’s mid-to late-20s C) Alcoholism is genetically inherited from grandparents D) Mortality and morbidity rates are lower for individuals w/ alcoholism

A) More males than females are diagnosed with alcoholism

``` A client receives a token every time he responds appropriately to a request from a staff member. This approach is called… A) Behavior management B) Behavior modification C) Behavior therapy D) Milieu therapy ```

B) Behavior modification

The program evaluation is designed at the same time the program is planned so that the… A) CTRS will know how and when to collect information as the program progresses B) Client will know from the activity calendar when activities are offered C) Treatment team can collect information about the continuity of care D) Activities are analyzed for their physical, social/affective, and intellectual requirements of clients

A) CTRS will know how and when to collect information as the program progresses

Which of the following is an example of having an internal local of control? A) The client is motivated to participate to receive approval from staff B) After a game, prizes are given out randomly C) The client wants to improve her artistic ability D) The clients look forward to receiving prizes after bingo

C) The client wants to improve her artistic ability

Which of the following is a FALSE statement about implementing TR programs for clients? A) The CTRS should know several different facilitation techniques in order to select the most appropriate one for a particular group B) The facilitation technique selected by the specialist depends upon the abilities, limitations and needs of the clients. C) Each client will vary in the amount he/she may benefit from a particular type of facilitation technique D) There is no research to support the use of facilitation techniques in TR.

D) There is no research to support the use of facilitation techniques in TR.

Which of the following is a TRUE statement about autonomic hyperreflexia (autonomic dysreflexia)? A) It is often felt as an “aura” before the experience of a seizure B) Common in people with spinal cord injuries, it is a rapid and uncontrolled elevation in blood pressure. C) It is common among individuals with schizophrenia and can be controlled through medication D) It is associated with excessive dopamine in the limbic brain center and eventually causes death

B) Common in people with spinal cord injuries, it is a rapid and uncontrolled elevation in blood pressure.

``` Which set of standards governs the delivery of programs and services in the profession regardless of setting or population? A) Critical pathways B) Codes of Ethics C) Plan of operations D) Standards of Practice ```

D) Standards of Practice

``` Which of the following s the best test for agility? A) A timed obstacle course B) Repetitious weight lifting C) Chin ups D) Core strength training ```

A) A timed obstacle course

``` The CTRS works in a youth correctional facility. At the beginning and ending of each session, he counts the number of scissors and rulers to make sure that all recreation supplies are accounted for. The CTRS is involved in what kind of action? A) Equipment management B) Risk management C) Environmental assessment D) Quality achievement ```

B) Risk management

In the Therapeutic Recreation Outcome Model, the purpose of TR is to… A) Provide diversional leisure activities for enjoyment and entertainment B) Plan and implement community inclusion services under the ADA C) Improve the clients leisure lifestyle D) Improve the client’s quality of life by increasing functional capacity and health status

D) Improve the client’s quality of life by increasing functional capacity and health status

Facilities that provide adult day care, assisted living, behavioral health and employment and community services are MOST LIKELY to seek accreditation from… A) Joint Commission (JCAHO) B) National Committee for Quality Assurance (NCQA) C) Centers for Medicare and Medicaid Services (CMS) D) Rehabilitation Accreditation Commission (CARF)

D) Rehabilitation Accreditation Commission (CARF)

What role does a good assessment play in providing intervention programs to clients? A) It ensures that clients are placed in the right programs for their needs B) It shows the client what his/her leisure interests are C) It provides feedback to the therapist about how well the program is going D) It is the basis for quality improvement

A) It ensures that clients are placed in the right programs for their needs

If the client assessment cannot distinguish between those who need the program and those who do not, what is likely to happen to the clients? A) They are likely to receive the wrong program, a diversional program or no program at all B) They will receive both functional intervention and leisure education programs C) They are more likely to benefit from community integration programs D) They are more likely to efficiently reach their outcomes and achieve an early discharge

A) They are likely to receive the wrong program, a diversional program or no program at all

The primary role of the CTRSs working with individuals who have autism is to… A) Have them learn a variety of leisure skills that their peers might know B) Improve their visual acuity C) Teach them how to adapt activities on there own D) Improve their ADLs

A) Have them learn a variety of leisure skills that their peers might know

Which of the following is an example of a self-fulfilling prophecy? A) The client enjoyed every minute of the self-awareness activity B) The client felt great joy at helping other people, especially older adults C) The client fails to score a point, just as he predicted earlier D) The client always knew she wanted to be a TRS

C) The client fails to score a point, just as he predicted earlier

One of the MOST important aspects of a client/therapist relationship is for the CTRS to… A) Have an unconditional positive regard for the client B) Let the client know he/she is always right C) Establish a position of authority with the client D) Establish a relationship with the client’s family

A) Have an unconditional positive regard for the client

``` The CTRS wants to start a garden group that clients can independently attend and organize. The best group format would be… A) Instructional class B) Clubs and special interest groups C) Drop-in center D) Out-trips ```

B) Clubs and special interest groups

Which of the following organizations allows for chapter affiliation by local groups of TRSs? A) National Therapeutic Recreation Society (NTRS) B) American Therapeutic Recreation Association (ATRA) C) Recreation Therapy Sections (RTS) D) National Council for Therapeutic Recreation Certification (NCTRC)

B) American Therapeutic Recreation Association (ATRA)

Which of the following is an example of extinction that is meant to reduce a certain behavior? A) Taking a client to the zoo when they are afraid of animals B) Taking away a favorite toy when the client misbehaves C) Talking to the client about antecedents, behaviors and consequences D) Applying the principle of negative reinforcement

B) Taking away a favorite toy when the client misbehaves

``` The CTRS was offered free tickets for patient to attend a special performance of a play during the afternoon, but instead chose to have the patients/clients pay and attend a night performance. The CTRS was demonstrating which of the following mainstreaming principles? A) Integration B) Normalization C) Least restrictive environment D) Deinstitutionalization ```

B) Normalization

``` The CTRS is working with a group of chemically dependent teens. The goal of the program is “to gain an understanding of the importance of leisure.” The CTRS decides to use an activity called “20 Things I Love to Do.” This is an example of… A) Reality therapy B) Assertiveness C) Values clarification D) Bibliotherapy ```

C) Values clarification

``` A person who had a brain injury and now has problems speaking is considered to have… A) Autism B) An aneurysm C) Aphasia D) An occlusion ```

C) Aphasia

The CTRS on a mental health unit plans on providing instruction on coping skills for clients. Which of the following would NOT be a consideration? A) Number of participants B) Types of equipment and materials needed C) Increase in behavioral prompts D) Level of social interaction skills

C) Increase in behavioral prompts

``` Alzheimer’s type dementia is caused by… A) Biological changes to the brain B) Getting older C) Not engaging in intellectual activities as one ages D) Environmental pollutants and toxins ```

A) Biological changes to the brain

A client outcome is the… A) Client’s heightened awareness of leisure as a substitute for work B) Observed changes in the client’s status as a result of interventions C) End result of an activity analysis D) Point at which activity and client assessment intersect

B) Observed changes in the client’s status as a result of interventions

``` Children w/ visual or hearing impairments are often found to have significantly reduced _________ in comparison with their seeing or hearing peers. A) Intelligence B) Parental supervision C) Academic achievement D) Physical fitness ```

D) Physical fitness

Which of the following are typical parts of a client treatment plan? A) Assessment results, goals and objectives, interventions and reevaluation schedule B) Client deficits, statements, behaviors, and plans for change C) Current status, past status, and future status D) Strengths, plan of action and discharge plan

A) Assessment results, goals and objectives, interventions and reevaluation schedule

``` Paralysis on one side of the body is called… A) Paraplegia B) Hemiplegia C) Monoplegia D) Quadriplegia ```

B) Hemiplegia

``` ATRA’s Standards for the Practice of TR document is divided into 2 sections of… A) Assessment and program planning B) Clinical and community guidelines C) Direct practice and management D) Inpatient and outpatient care ```

C) Direct practice and management

``` The CTRS sends in forms reporting participation in continuing education activities to NCTRC every 5 years. The CTRS is adhering to which principle of the ATRA Code of Ethics? A) Confidentiality and Privacy B) Justice C) Veracity D) Competence ```

D) Competence

``` The dividing vertebrae between being classified as a paraplegic and a quadriplegic is… A) C8, T1 B) T12, L1 C) T1, T2 D) T5, T6 ```

C) T1, T2

``` In promoting their long-term care facility, the CTRS suggested her management team capitalize on the bond and affinity that current residents have with staff. The CTRS is promoting which kind of marketing? A) Product marketing B) Services marketing C) Relationship marketing D) Public relations ```

C) Relationship marketing

``` Which of the following medications is classified as an adjuvant (a substance that enhances the body's immune response to an antigen)? A) Elavil B) Demerol C) Percodan D) Feldene ```

A) Elavil

``` Which of the following is the most difficult of all documentation methods to easily interpret and extrapolate information from? A) Problem-oriented records B) Focus charting C) Narrative records D) SOAP notes ```

C) Narrative records

In a facility that uses the Health Protection/ Health Promotion model of TR, what would be the intent of service delivery? A) Helping clients become more competent and able to select enjoyable activities B) Helping people overcomes barriers to health that interfere with their leisure C) Promoting human happiness through primary and secondary efforts D) Empowering the client to achieve only those goals that improve their leisure lifestyle

B) Helping people overcomes barriers to health that interfere with their leisure

The major components of the Optimizing Lifelong Health through TR service delivery model are… A) Diagnosis/assessment, treatment, education, and prevention/health promotion B) Functional intervention, leisure education and recreation participation C) Prescriptive activities, recreation and leisure D) Selecting, optimizing, compensating and evaluating

D) Selecting, optimizing, compensating and evaluating

Which question is the BEST formative evaluation concern? A) How does the 2nd day of the program need to be changed from the first day? B) Are the interventions appropriate for the content? C) What were the total resource costs of program delivery? D) Was staff adequately prepared to deliver the services to this group of clients?

A) How does the 2nd day of the program need to be changed from the first day?

``` Which method of behavioral observation and recording is the CTRS using when she checks the activity room at 9:00, 11:00, 1:00 and 3:00 to see how many patients are watching television? A) Frequency or tally B) Duration C) Interval D) Instantaneous time sampling ```

D) Instantaneous time sampling

Clients are most likely to achieve optimal experience when… A) The activity challenge and skills level are nearly equal B) They are trying a novel activity C) The activity is similar to what they have experienced before D) Stress is low and challenge is high

A) The activity challenge and skills level are nearly equal

``` What method of behavioral observation and recording is the CTRS using when he wants to know how many times the client attends TR programs? A) Frequency or tally B) Duration C) Interval D) Instantaneous time sampling ```

A) Frequency or tally

The Americans with Disabilities Act of 1990 allows full and equal access by persons with disabilities to… A) Any place of public accommodation B) State and federal buildings funded through public taxes C) Almost any public accommodation, but excludes recreation facilities D) Any recreation facility, whether public, private or commercial

A) Any place of public accommodation

Which of the following is NOT a requirement of the Health Insurance Portability and Accountability Act (HIPAA) of 1996 and later rules? A) Enforce polices and procedures to protect patient information B) Designate a person to oversee adherence to the rules C) Allow children to make their health care decisions for themselves D) Secure patient records to that a minimal number of people have access

C) Allow children to make their health care decisions for themselves

All of the following things affect people’s attitudes toward individuals w/ disabilities EXCEPT A) Characters portrayed in movies B) Fairy tales and childhood stories C) Etiological concerns (cause of disease/abnormal functions) D) Television advertisements

C) Etiological concerns (cause of disease/abnormal functions)

The CTRS wants to apply the principles of Arousal, Novelty and Diversity in her plan for a leisure skills instruction program. Which of the following is she most likely to incorporate? A) Relating the content to the participant’s lives B) Fading prompts as participants gain skills C) Allowing time for repetition and practice D) Offering a variety of activities and materials within the program

D) Offering a variety of activities and materials within the program

Which of the following may be an effect of having a spinal cord injury on a person’s leisure lifestyle? A) The person will have ill health and not be physically active B) The person’s range of leisure options will be larger than average C) The person’s range of activities may be limited by physical accessibility D) The person will be able to maximize choice and be self-determined

C) The person’s range of activities may be limited by physical accessibility

``` 32. Which of the following recreation activities is the best treatment modality for improving social skills? A) Bingo with prizes B) Aquatic therapy C) Yoga instruction D) Cooperative games ```

D) Cooperative games

``` In which of the following steps does the CTRS examine how the content and process of the activity will contribute to the accomplishment of client objectives? A) Assessment B) Program planning C) Program implementation D) Program evaluation ```

B) Program planning

Units or facilities that are especially designed for individuals w/ moderate to advanced dementia include which of the following design considerations? A) Mazes for wandering, bright colors, no signage, heavy security doors B) Minimal clutter, no more than 10 residents per unit, 1 large bedroom for 10 C) Clusters of residences, meaningful wandering path, positive and secure outdoor space D) Walking paths through the community, well-lit areas and large activity spaces

C) Clusters of residences, meaningful wandering path, positive and secure outdoor space

The discrepancy between the mental age (MA) and the chronological age (CA) for persons with intellectual disability… A) Becomes less noticeable with age B) Becomes more noticeable with age C) Influences the quality of the materials used in recreation equipment D) Determines the facility to be used

B) Becomes more noticeable with age

One of the primary criteria for selecting client assessments for use in TR programs is that… A) The content of the assessment matches the content of the intervention program B) It improves the expertise of the specialist C) The inter-rater reliability is high D) It requires specialized training just for TRSs

A) The content of the assessment matches the content of the intervention program

All of the following are important ways to ensure that the assessment results translates into the right program placement to work on a client’s identified problems, EXCEPT A) Use an assessment that produces reliable sources for the intended population B) Train all CTRSs and interns on the correct use of the assessment C) Document a standardized protocol for the administration, scoring and interpretation of the assessment D) Improve the construct validity of the assessment instrument

D) Improve the construct validity of the assessment instrument

A CTRS may work with a person who has recently experienced an extensive thermal burn, by providing which of the following types of sessions? A) Leisure resource utilization B) Adjustment to disability C) Leisure awareness D) Assistive devices and adaptive techniques

B) Adjustment to disability

Which of the following is NOT a purpose of community reintegration programs? A) To go to more theaters and other public venues B) To reduce stigma associated with disability C) To practice in a real-world setting the skills that have been learned in treatment D) To gain familiarity with community resources

A) To go to more theaters and other public venues

Which of the following provides example behaviors from an individual with oppositional defiant behavior? A) Extreme levels of hyperactivity and distractibility B) Interruptive social behaviors that are more apparent to others than the individual C) Behaviors that violate the rights of others and major age-appropriate societal norms D) Negative, hostile behaviors toward others

D) Negative, hostile behaviors toward others

What effect has clients’ shortened lengths of stay had on client assessment? A) It is now a much easier task because clients are more focused on their own treatment B) The connection between gathering a baseline of information and measuring for outcomes has been strengthened C) Assessments need to be concise and administered more quickly following admission D) The effect has been minimal because TRSs have always been known for efficient assessments

C) Assessments need to be concise and administered more quickly following admission

Older adults often need an extended rest period following physical exertion because they… A) Are less motivated to continue to exercise B) Require longer to return to a state of homeostasis after an activity C) Fail to properly warm up prior to the exercise D) Tend to overexert during physical activities

B) Require longer to return to a state of homeostasis after an activity

Which of the following is a FALSE statement about the disadvantages of unstructured interviews? A) Individual CTRS in the department may not use the same questions B) There is too much room for interpretation that limits reliability C) They increase reliability at the expense of validity D) They are too difficult to score consistently

C) They increase reliability at the expense of validity

Consider the following 2 interview questions/statements to be used in a client assessment. 1. “Tell me how you would go about finding transportation to get to an athletic event downtown.” 2. “Tell me about your family.” Interview question/statement 1 is better than 2, because it… A) Focuses on the specific content of TR programs B) Requires less short-memory from the client C) Requires less time for the client to answer D) Takes more time to analyze and interpret the answer for placement into programs

A) Focuses on the specific content of TR programs

``` The first major textbooks with the term “therapeutic recreation” in the titles were published in the: A) 1890s B) 1910s C) 1940s D) 1970s ```

D) 1970s

When intervention sessions are planned, what are the primary factors to consider? A) The time constraints of the therapists and support staff B) The number of clients served on the unit and space available C) The case load and grand rounds of the physician on staff D) The patient’s need and nature of the program

D) The patient’s need and nature of the program

``` A CTRS in a correctional institution may emphasize programming based on improving the individual’s self-efficacy in coping with high-risk situations that trigger re-incarceration. An example of a program title suited for this purpose is… A) Relapse Prevention Strategies B) Total Body Workout C) Competitive Volleyball D) Bibliotherapy ```

A) Relapse Prevention Strategies

Medicare is a federal health insurance program that does NOT include which of the following? A) Individuals who are first- or second-generation Native Americans B) Individuals 65 or older C) Individuals under age 65 with certain disabilities D) Individuals with end-stage renal disease

A) Individuals who are first- or second-generation Native Americans

One of the most common conditions associated with myasthenia gravis is… A) gout B) high blood sugar C) muscle contractures in elbows and knees D) drooping eyelids

D) drooping eyelids

Muscular dystrophy advances from proximal to distal in the extremities, meaning that… A) Jumping is one of the last skills to be lost B) Hand and finger function remains intact longer C) the person loses muscle from front to back D) the person loses muscle from feet to head

B) Hand and finger function remains intact longer

Which of the following is the most difficult interpersonal constraint for a CTRS to overcome? A) Lack of free activities in the community B) Lack of accessible facilities C) Lack of participant skill D) Lack of participant interest

D) Lack of participant interest

Given the goal statement below, which of the following is the most appropriate TR program? “Goal: To increase clients’ dyad cooperation skills.” A) Volleyball instruction clinic B) Backgammon tournament C) Leisure resource information exchange group D) Ballroom dancing instruction

D) Ballroom dancing instruction

``` 53. In implementing an exercise program for aging individuals, the CTRS becomes aware that the planned activity is too strenuous for the participants. The CTRS inadequately analyzed the __________ requirements of the activity for the given populations. A) Social B) Emotional C) Physical D) Cognitive ```

C) Physical

When a hospital or health care agency receives accreditation from the Joint Commission (JCAHO) among other things, it means A) The hospital will receive Medicare payments more easily B) Professionals working in the agency will get direct reimbursement for services C) The client will receive a lower quality of care D) Client assessment must be completed with 12 hours of admission

A) The hospital will receive Medicare payments more easily

The CTRS uses the Information Seeking and Health Spectrum Model to develop therapeutic recreation programs for persons who utilize outpatient services at a physical medicine and rehabilitation center. She provides information to clients that is related to… A) Adaptations and modifications for leisure participation B) Prevention of substance addictions C) Improvement of short-term and long-term memory D) Optimal arousal and focus

A) Adaptations and modifications for leisure participation

In long-term care, skilled nursing units or facilities means that the patients have… A) Medical needs that require additional amount of nursing or other therapies B) Federal or private insurance coverage C) Contagious conditions that threaten the general public D) Multiple conditions, often called poly-trauma

A) Medical needs that require additional amount of nursing or other therapies

A CTRS is responsible for administering the MDS 3.0 to her residents. She knows the first step is to… A) Determine whether the resident can indicate a preference B) Discuss the residents’ needs with the interdisciplinary treatment team C) Assess the resident’s leisure preferences and interests D) Create a variety of activities of interest to the residents

A) Determine whether the resident can indicate a preference

The therapeutic milieu model of healthcare… A) Involves total care of the individual, including sleeping, eating and hygiene B) Focuses on establishing a therapeutic community among clients C) Centers on the physicians as the primary decision-maker for client care D) Provides services to clients often living independently

B) Focuses on establishing a therapeutic community among clients

``` Teenscope is a useful assessment to place adolescent clients into which types of therapeutic recreation programs? A) Treatment B) Social skills C) Leisure resources D) Leisure skills ```

D) Leisure skills

``` According to the National Institutes of Health, which condition occurs more frequently than diabetes, heart disease and cancer combined? A) Macular degeneration B) Osteoarthritis C) Brain concussions D) Pain ```

D) Pain

``` The overall content covered by the Leisure Diagnostic Battery (LDB) includes… A) Leisure participation history B) Leisure interests C) Attitudes toward leisure and work D) Perceived freedom in leisure ```

D) Perceived freedom in leisure

Chronic pain has been characterized as pain that… A) Results from surgical or medical procedures B) Cannot be reduced with medications C) Cannot be reduced through meditation D) Is prolonged and persistent

D) Is prolonged and persistent

``` In medical terminology, NKDA means… A) No known diagnostic algorithms B) Sodium phosphate C) Above knee amputation D) No known drug allergies ```

D) No known drug allergies

``` In which of the 4 domains does the following statement fall under? “To express anger in a positive manner.” A) Cognitive B) Affective C) Physical D) Social ```

B) Affective

The CTRS will most likely to work with which of the following disciplines to provide medical play to hospitalized children? A) Physical therapy B) Occupational therapy C) Nursing D) Child life-Child life specialists are pediatric health care professionals who work with children and families in hospitals and other settings to help them cope with the challenges of hospitalization, illness, and disability.

D) Child life- Child life specialists are pediatric health care professionals who work with children and families in hospitals and other settings to help them cope with the challenges of hospitalization, illness, and disability.

When the physician or treatment team creates a master list of patient/client deficits and develops a plan of action focused on these deficits, it is called which of the following? A) Problem-oriented medical records (POMR) B) Source-oriented medical records (SOMR) C) Client deficit planning D) Quality improvement

A) Problem-oriented medical records (POMR)

``` The process by which an agency of the government grants permission to persons meeting predetermined qualifications to engage in a given occupation is called… A) Licensure B) Accreditation C) Certification D) Registration ```

A) Licensure

``` 53. Which of the following is the BEST method of reducing the likelihood of decubitus ulcers? A) Drinking plenty of fluids B) Using stool softeners C) Yoga and other stretching exercises D) Change in positioning ```

D) Change in positioning

In the treatment protocol, the outcome criteria refers to… A) Measurable changes brought about in a patient as a direct result of the intervention B) How the assessment is conducted C) The timing of the treatment evaluation D) Steps taken and services provided by the CTRS to complete a protocol

A) Measurable changes brought about in a patient as a direct result of the intervention

``` Which social interaction pattern focuses on action with an object in the environment, requiring no contact with another person? A) Intragroup B) Multilateral C) Interindividual D) Extraindividual ```

D) Extraindividual

``` Chronic users of cocaine may experience all of the following EXCEPT… A) Depression B) Periods of excessive sleep C) Hypertension D) Respiratory and/or cardiac failure ```

B) Periods of excessive sleep

What is likely to happen when the content of the assessment does not match the content of the programs designed for client participation? A) The assessment is likely to be more valid than reliable B) The assessment will not lead to proper program placement and clients will not reach their goals C) Outcomes will be better defined and less ambiguous D) The assessment will have less cultural bias and increased sensitivity

B) The assessment will not lead to proper program placement and clients will not reach their goals

An individual who has a panic disorder experiences… A) Maladaptive behaviors in response to social situations B) Persistent, abnormally intense fears C) “free-floating” anxiety which tends to pervade all areas of life D) sudden, periodic attacks of intense anxiety

D) sudden, periodic attacks of intense anxiety

The CTRS knew that she could not program for and measure outcomes for self-esteem, but she still wanted a program in this area and have clients achieve measurable outcomes. What outcomes would be more appropriate than “improve self-esteem?” A) Improve self-concept B) Verbalize 2 positive statements about self C) Decrease negative thoughts about self D) Increase self-image

B) Verbalize 2 positive statements about self

``` After each out-trip the CTRS is required to perform an 11-point checklist on the van. What is the purpose of this task? A) Vehicle registration inspection B) Quality improvement C) Vehicle evaluation D) Risk management ```

D) Risk management

All of the following may be questions that the CTRS uses to improve clarity and completeness to a narrative note EXCEPT… A) How did I first become aware of the problem? B) What has the client said about the problem that is not significant? C) Is this the same problem that was exhibited last week? D) What is the plan for dealing with the problem?

B) What has the client said about the problem that is not significant?

According to the World Health Organization’s International Classification of Functioning, Disability and Health (ICF), services are needed at each of the following levels… A) Community, state, regional and national B) Body part, the whole person, and the person’s social context C) Medical, rehabilitation, and long-term care D) Functional intervention, leisure education and recreation participation

B) Body part, the whole person, and the person’s social context

In a TR program accredited by Joint Commission (JCAHO), the goal would be to… A) Improve health care quality and patient safety B) Improve baseline, functional abilities of all clients C) Discharge all clients to their own homes/communities D) Reduce errors and improve confidence

A) Improve health care quality and patient safety

``` Which of the following is NOT an example of a chronic health condition? A) Heart disease B) Diabetes mellitus C) High blood pressure D) Vehicular accident ```

D) Vehicular accident

``` There are how many vertebrae in the cervical region of the human spine? A) 3 B) 5 C) 7 D) 9 ```

C) 7

Which of the following may be used as a technique to motivate employees on a long-term basis? A) Make them boss for the day B) Ask them to do more with fewer resources C) Encourage their donations to the agency’s charity fund D) Encourage cross training into new areas of job responsibility

D) Encourage cross training into new areas of job responsibility

While a medical model of health care focuses on the pathology of a person, the salutogenic model of health focuses on… A) Lifestyle factors that support, enhance and produce health B) Social relationships that need to be terminated prior to full recovery C) Total lifestyle environment to which the patient will return D) Direct reimbursement of services

A) Lifestyle factors that support, enhance and produce health

``` The medical term “qid” is the abbreviation for… A) white blood count B) 4 times a day C) quadriceps D) within normal limits ```

B) 4 times a day

``` 53. Which one of the four categories of child development does the skill “asks why” belong? A) Personal/social B) Adaptive/fine motor C) Motor behavior D) Language ```

D) Language

``` Which part of the SOAP progress note is the following statement, “Schedule pt. for social interaction program?” A) S-Subjective B) O-Objective C) A-Assessment D) P-Plan ```

D) P-Plan

The Centers for Medicare and Medicaid Services (CMS) is the governmental agency responsible for… A) Building collaborative initiatives between private and public hospitals B) Ensuring that patients within these programs pay their bills in a timely manner C) Reporting medical errors to the American Medical Association D) Regulatory review of hospitals that bill for federally insured recipients

D) Regulatory review of hospitals that bill for federally insured recipients

``` Operant conditioning is a form of learning that stems from which type of psychology? A) Behavioristic B) Humanistic C) Instrumental D) Psychoanalytic ```

A) Behavioristic

``` The CTRS manager submitted a report to the executive director, that the activity room had a leak in the ceiling that was causing the floor tiles to ripple and be uneven. The CTRS was practicing risk management with regard to… A) Facilities B) Equipment C) Clients D) Staff ```

A) Facilities

C) Automatically providing culturally congruent care to clients of diverse cultures

A client states: “I don’t want to try this activity because I don’t think I can do it.” Which of the following statements is an example of a CTRS response using reflective listening technique? A) “Would you like to explore alternative activities?” B) “How do you feel about this activity?” C) “Why don’t you try the activity; most clients enjoy it.” D) “Do you think that you lack the skills to participate?”

D) “Do you think that you lack the skills to participate?”

``` Cognitive disorders are associated with all of the following EXCEPT… A) aging B) infection C) substance abuse D) spinal cord injury ```

D) spinal cord injury

When a CTRS is designing an aquatic therapy program for individuals with multiple sclerosis, the MOST important concern should be… A) intensity and duration of the swimming class B) availability of adaptive equipment C) number of clients in the group D) clients’ premorbid leisure interests

A) intensity and duration of the swimming class

An individual with bipolar disorder will MOST likely exhibit which of the following patterns of behavior? A) Minor disturbances in sleep and libido B) Cycles of mood swings from mania to depression C) Explosive anger followed by depression D) Intermittent interference with social interactions

B) Cycles of mood swings from mania to depression

``` Which of the following behaviors is characterized by passivity and dependence on others? A) Defensiveness B) Learned helplessness C) Under controlled behavior D) Passive-aggressive behavior ```

B) Learned helplessness

``` The education and human services delivery system is MOST often used with persons who have… A) severe developmental disabilities B) acute medical conditions C) geriatric conditions D) acute psychological concerns ```

A) severe developmental disabilities

Listed below are 4 steps a CTRS takes to select an assessment instrument: (1) identify the criteria to be assessed, (2) identify the purpose of the assessment process, (3) select the assessment instrument and (4) determine the criteria for establishing the reliability of the assessment instrument. ``` What of the following correctly orders these steps from first to last? A) 1, 2, 3, 4 B) 2, 1, 4, 3 C) 2, 3, 1, 4 D) 3, 1, 4, 2 ```

B) 2, 1, 4, 3

``` All of the following observations may be used to assess the affective domain EXECPT… A) length of attention span B) amount of self-disclosure C) expressions of self-valuation D) statements about the future ```

A) length of attention span

``` In which section of a SOAP progress note would the following statement be found: “Attended all scheduled therapeutic recreation treatment sessions, remained on task for 30 minute treatment sessions, and correctly followed 3-step directions without cuing or prompts?” A) Subjective B) Objective C) Assessment D) Plan ```

B) Objective

As a general rule, progress notes should be written at which of the following times? A) When the client assessment is completed B) On a regulatory scheduled basis C) A minimum of 3 times during treatment prior to discharge D) A minimum of once per week

B) On a regulatory scheduled basis

``` Which of the following intervention technique is MOST appropriate for a 1-year old child diagnosed as “failing to thrive”? A) Massage therapy B) Relaxation therapy C) Sensory stimulation D) Hydrotherapy ```

C) Sensory stimulation

``` An adaptive device that would be appropriate for a client with minor impairment of fine motor skills is… A) a universal cuff B) an electronic page turner C) a mouth stick D) a built-up paint brush ```

D) a built-up paint brush

An 8-year old male who is being treated for a brain injury in a hospital is referred to the TR program. The CTRS notices the boy’s inability to concentrate when playing games and difficulty understanding simple oral or written directions. On the basis of these observations, the CTRS’s BEST course of action would be too… A) report these findings to the team and request a neuropsychological exam B) suspect that the client is mentally retarded and simplify all activities C) administer a series of IQ tests to determine deficit areas of learning D) implement solitary activities to reduce the client’s level of frustration

A) report these findings to the team and request a neuropsychological exam

``` A Saturday morning program for youth-at-risk in a community center must be modified because of high staff absenteeism. Typically, clients rotate through concurrent activities during a 2-hour period. The CTRS director will need to modify which of the following aspects of program planning? A) Goal-oriented programming B) Sequence of events and time frame C) Supply needs D) Client safety ```

B) Sequence of events and time frame

Which of the following would be the MOST effective technique to promote the value of a TR services program within an agency? A) Giving a presentation to volunteer groups B) Publishing an article in a scholarly journal C) Participation in local professional meetings D) Submitting quarterly progress reports to the administration

D) Submitting quarterly progress reports to the administration

``` Which 1 of the 4 categories of child development does the skill “plays simple nursery games” belong? A) Personal/Social B) Adaptive/fine motor C) Motor behavior D) Language ```

A) Personal/Social

When using active listening with a client, it is important for the CTRS to do which of the following? A) Reflect the feeling tone the client communicates B) Respond immediately to the client’s statement C) Nod his/her head and speak to the client frequently D) Ask questions so the client will know the CTRS is listening

A) Reflect the feeling tone the client communicates

Which of the following is the BEST example of an efficacy research study conducted in a physical rehabilitation setting? A) Client skills at discharge are compared with their skills at admission B) The CTRS tracks client attendance at TR programs C) 2 CTRSs evaluate the inter-rater reliability of their observational tool D) Peer reviews are conducted on the adherence to ATRA Standards of Practice

A) Client skills at discharge are compared with their skills at admission

``` Which of the following statements is TRUE about the following objective? “When given a choice of 3 activities, the client will verbalize his favorite leisure activity to participate with friends.” A) The condition is missing B) The behavior is missing C) The criterion is missing D) The objective is complete as is ```

C) The criterion is missing

``` In medical terminology, MVA means… A) more ventricular reaction B) military vehicle accident C) major ventricular arteries D) motor vehicle accident ```

D) motor vehicle accident

``` In which of the following steps does the CTRS gather data for service quality improvement? A) Assessment B) Program planning C) Program implementation D) Program evaluation ```

D) Program evaluation

``` From assessment results, the CTRS determines that the client has a lack of knowledge of community leisure facilities and programs, and is unaware of other people who participate in her leisure interests. Which of the following TR programs would be the MOST appropriate for this client? A) Leisure planning B) Social skills training C) Leisure values and attitudes D) Leisure resources ```

D) Leisure resources

``` The following is an example of which 1 of the following health care delivery systems? This model is based on the philosophy that mental illness is the product of unhealthy interactions with one’s environment. A) Medical B) Custodial C) Milieu D) Education and training ```

C) Milieu

Most facilities utilize treatment teams in order to… A) provide better documentation of services B) receive community support for programs C) shorten the client’s length of stay at the facility D) bill clients at a higher rate

C) shorten the client’s length of stay at the facility

``` The CTRS wants to create an activity area that clients can come to and complete their own art projects, work on puzzles, or have conversations with others. The best program format would be… A) Instructional class B) Clubs and special interest groups C) Drop-in center D) Out-trips ```

C) Drop-in center

Which of the following would improve the reliability of the results of an assessment tool? A) Replace all close-ended items with open-ended items B) Shorten the length of the assessment C) Remove all items that were ambiguous to the clients D) Limit the time the client has to complete the assessment

C) Remove all items that were ambiguous to the clients

The 1st kind of prescription medication offered for pain is… A) weak opioids B) strong opioids C) NSAIDS (nonsteroidal anti-inflammatory drugs) D) adjuvants

C) NSAIDS (nonsteroidal anti-inflammatory drugs)

The purpose of client assessment is to… A) provide feedback on the effectiveness of an intervention program B) place clients in programs based on their needs C) improvement communication b/w members of treatment team D) evaluate client performance in TR programs

B) place clients in programs based on their needs

``` The 4 basic measurable functions of health (blood pressure, pulse, respiration and temperature) are called… A) vital signs B) health signs C) normal health signs D) normal functioning ```

A) vital signs

``` The CTRS is most likely to work with which of the following disciplines to provide sensory stimulations to individuals with dementia? A) Physical therapy B) Occupational therapy C) Nursing D) Child life ```

B) Occupational therapy

``` When a client has broken her clavicle, she has a broken… A) collarbone B) neck C) hip D) leg ```

A) collarbone

The purpose of client assessment in TR is to… A) identify a client’s leisure interests B) make appropriate referrals to various professionals C) gather information to develop an individual treatment plan D) list the client’s strengths and weaknesses

C) gather information to develop an individual treatment plan

Which of the following is most likely to produce error in a client’s assessment score? A) Lack of confidence in the CTRS B) Inconsistent administration of the assessment tool C) Computerizing the assessment process D) Following an assessment protocol

B) Inconsistent administration of the assessment tool

Which of the following are typical parts of a diagnostic protocol? A) Assessment, planning, implementation, evaluation B) Subjective, objective, analysis, planning C) Comprehensive program descriptions and specific program descriptions D) Client problems, assessment criteria, process criteria and outcomes criteria

D) Client problems, assessment criteria, process criteria and outcomes criteria

The CTRS runs a community-based disability management program for individuals diagnosed with diabetes. Which of the following is NOT a programming consideration for these individuals? A) Monitor blood glucose before and after exercise B) Teach participants about diet and nutrition C) Teach participants stress management D) Use large print materials with high contrast lettering

D) Use large print materials with high contrast lettering

``` Alcohol is classified in which of the following categories of drugs? A) Stimulants B) Depressants C) Hallucinogens D) Narcotics ```

B) Depressants

``` An older person who does not have static or dynamic balance is at great risk for… A) falls B) loss of muscle strength C) loss of flexibility D) loss of endurance ```

A) falls

Using a strengths-based approach to TR programming means the CTRS… A) focuses on the abilities of the clients B) measures precisely the clients’ functional deficits C) provides upper-body strengthening and conditioning programs D) focuses on the clients’ former leisure lifestyles

A) focuses on the abilities of the clients

``` The statement that identifies the agency’s basic values and beliefs and thus defines how it wants to be perceived by the public is called… A) mission statement B) scope of care statement C) marketing statement D) external monitoring statement ```

A) mission statement

For each of the standards in the ATRA Standards of Practice, what elements are included as measurement criteria? A) structure, process, and outcomes B) assessment, planning, implementation and evaluation C) rating scales from 1 (very poor) to 10 (excellent) D) self-reporting and peer review

A) structure, process, and outcomes

TR programs for individuals with acute schizophrenia disorders are MOST appropriate when they focus on goals to improve or increase… A) social interaction and motor behaviors B) integration into community rec activities C) adaptive responses to addictive behaviors D) manipulative behaviors of the client

A) social interaction and motor behaviors

Unlike a municipal hospital, a private, for-profit hospital usually… A) specializes in 1 or a limited number of disorders B) is operated by a governmental entity, such as a county C) serves only children D) serves individuals on a long-term basis

A) specializes in 1 or a limited number of disorders

The four axes of the Diagnostic and Statistical Manual IV-TR are… A) physical, social, emotional and intellectual B) clinical disorders, medical disorders, personality disorders, and psychosocial problems C) anxiety disorders, affective disorders, substance abuse and psychomotor disorders D) schizophrenia, bi-polar, substance abuse and depression

B) clinical disorders, medical disorders, personality disorders, and psychosocial problems

The national voluntary professional registration program that preceded the National Council for Therapeutic Certification was administered by the… A) National Therapeutic Recreation Society (NTRS) B) American Therapeutic Recreation Association (ATRA) C) American Association of Recreational Therapy (AART) D) Council for the Advancement of Hospital Recreation (CAHR)

A) National Therapeutic Recreation Society (NTRS)

Medicare Part B provides for all of the following health services EXCEPT… A) prescription meds B) doctors’ office visits C) out-patient rehab services D) medically necessary physical and occupational therapy

A) prescription meds

The primary purpose of a TR service model is to… A) provide data for comprehensive program development B) serve as a guide for the development of programs offered to clients C) provide a standard by which programs can be evaluated D) distinguish b/w services provided within various settings

B) serve as a guide for the development of programs offered to clients

``` The director of the TR department conducted a study on the effectiveness of the previous marketing efforts done for TR services. The action taken by the director is called a marketing ___________. A) audit B) research schema C) audience D) tool ```

A) audit

What is the purpose of the Health Protection/Health Promotion Model? A) Independent leisure functioning B) Facilitating healthy self-actualization C) Attaining highest level of health D) Reducing blocks to quality of life behaviors

C) Attaining highest level of health

Which of the following is NOT a result of chronic stress? A) Adrenal glands secrete corticoids that inhibit digestion B) Cellular tissue repair is made more quickly C) Reproduction system is impaired D) Immune system is weakened

B) Cellular tissue repair is made more quickly

In the Leisure Ability Model, which of the following would be considered an appropriate goal for functional intervention? A) To improve time-on-task B) To learn about inexpensive leisure resources in the community C) To improve group-entry skills D) To participate in a fitness activity of her choice

A) To improve time-on-task

``` A person who has a(n) __________ disorder may have limited, inflexible behaviors that inhibit his/her ability to interact with others and deal with certain aspects of his/her environment. A) circulatory B) attention deficit C) nervous D) orthopedic ```

B) attention deficit

``` Patients have the right to have the treatment plan explained to them. According to the ATRA Code of Ethics, this principle is called? A) Confidentiality and privacy B) Justice C) Veracity D) Informed consent ```

D) Informed consent

Quality assurance/continuous quality improvement is… A) a method of comprehensive program evaluation for future program enhancement B) a method for implementing in-service staff training C) required in all clinical and community agencies D) the 1st step in designing a comprehensive program

A) a method of comprehensive program evaluation for future program enhancement

Using an ecological perspective for TR programming means the CTRS… A) focuses on the interactions b/w clients and their environments B) teaches clients to reduce, reuse and recycle C) reuses supplies as much as possible D) coordinates services with other members of the transdisciplinary team

A) focuses on the interactions b/w clients and their environments

A treatment plan should be entered into the medical chart after… A) seeing the patient once B) conferring with the physician C) the patient/legal guardian has agreed to the treatment plan D) the patient has been in the hospital for a week

C) the patient/legal guardian has agreed to the treatment plan

``` 1 example of a mood disorder is the diagnosis of… A) psychosis B) bipolar personality C) paranoia D) organic brain syndrome ```

B) bipolar personality

``` In implementing a leisure ed. program for 4-year old children, the CTRS becomes aware that the activity requires abstract thought, which the clients are not capable of. The CTRS inadequately analyzed the ______ requirements of the activity for the given population. A) social B) emotional C) physical D) cognitive ```

D) cognitive

``` Which social interaction pattern is displayed in singles tennis? A) Intragroup B) Multilateral C) Interindividual D) Extraindividual ```

C) Interindividual

For individuals with disabilities from preschool to the age of 21, a transition plan for services must be in place while they are in school, as required by what piece of federal legislation? A) Rehabilitation Act of 1978 B) Americans with Disabilities Act of 1990 C) New Freedom Initiative of 2000 D) Individuals with Disabilities Education Act of 2004

D) Individuals with Disabilities Education Act of 2004

The medical term “oriented x3” is the abbreviation for… A) can go as high as 3 times tables in math skills B) recognizes 3 objects C) oriented to person, place and time D) can have three visitors at a time

C) oriented to person, place and time

``` Which part of the SOAP progress note is the following statement? “Patient states: Don’t bother me.” A) S- Subjective B) O- Objective C) A- Assessment D) P- Plan ```

A) S- Subjective

Networking is helpful to TR specialists because… A) expertise and ideas are shared to improve the quality of programs B) each professional can claim a unique set of skills C) clients are not likely to know more than one TRS D) individuals with disabilities are likely to receive fewer services in the future

A) expertise and ideas are shared to improve the quality of programs

``` In which of the 4 domains does the following statement fall under? “To ask for assistance when needed.” A) Cognitive B) Affective C) Physical D) Social ```

D) Social

``` In which of the 4 domains does the following statement fall under? “To improve ability to locate leisure resources.” A) Cognitive B) Affective C) Physical D) Social ```

A) Cognitive

Which statement describes the purpose of evidence-based practice? A) Method of designing critical pathways B) Process to control medical bills through reduction of services C) Means of conducting near-patient research D) Method to enhance client care through application of research results

D) Method to enhance client care through application of research results

The Americans with Disabilities Act includes provisions specifically regarding… A) employment, government services, and recreation B) public transit, government services, and recreation C) employment, public entities, telecommunications and public accommodations D) employment, recreation and public accommodations

C) employment, public entities, telecommunications and public accommodations

``` The CTRS says to the client, “Let’s stay in the present and take responsibility for your actions.” This specialist is using which type of “therapy” approach? A) Gestalt therapy B) Rational-emotive therapy C) Cognitive therapy D) Reality therapy ```

D) Reality therapy

According to Healthy People 2020, individuals with disabilities are much more likely to experience all of the following EXCEPT… A) reduced use of tobacco B) increased incidence of obesity C) fewer diagnostic and preventative tests D) high blood pressure

A) reduced use of tobacco

``` The CTRS asked clients who had recently experienced strokes to identify their highest priorities, set goals and develop an action plan for their leisure. The technique is called… A) goal orientation B) self-actualization C) time management D) remotivation ```

C) time management

High-quality documentation is important for all of the following reasons EXCEPT to… A) show the patient’s leisure history B) provide data for quality improvement C) improve communication among staff members D) provide professional accountability for services rendered

A) show the patient’s leisure history

Which of the following is a likely result of a profession having and adhering to protocols? A) More people are likely to enter the field B) The specialist can provide better services that are more similar to others provided around the country C) Clients will need to stay in treatment facilities longer to receive the full benefits of the protocol D) Insurance companies are more likely to deny payment for services in the protocol

B) The specialist can provide better services that are more similar to others provided around the country

``` Observation of overt behavior and the learning of new behavior is a focus of _________ theory. A) psychoanalytic B) cognitive-behavioral C) behavioristic D) growth ```

C) behavioristic

``` All programs in TR should be based on… A) resources B) client need C) client interests D) clinician skill ```

B) client need

The CTRS in a long-term care facility plans on designing a program that maximizes interaction b/w residents. Which of the following would be a PRIMARY consideration in developing and modifying this program? A) Existing social skills of the residents B) Available facilities C) Necessary equipment and materials D) Number of qualified staff

A) Existing social skills of the residents

``` The CTRS bases her intervention programs on the notion that all clients desire to interact effectively with their physical and social environments and to view themselves as skilled in their quest for a happy and fulfilling life. She is basing her intervention programs on the theory of… A) competence-effectance motivation B) trust-building C) flow D) social psychology of leisure ```

A) competence-effectance motivation

Given the goal statement below, which of the following is the most appropriate TR program? “Goal: To increase clients’ independent community skills.” A) Vacation planning seminar B) Instructions on taking the bus C) Problem solving discussion group D) Social skills functional intervention program

B) Instructions on taking the bus

``` Which part of the SOAP note focuses on the CTRS’s interpretation of the client’s actions and verbalizations? A) S- Subjective data B) O- Objective data C) A- Analysis D) P- Plan ```

C) A- Analysis

Which of the following is an appropriate way to resolve conflicts in communication and achieve compromise? A) Being aggressive in order to manipulate or intimidate B) Negotiating and coming to an agreement C) Giving in to avoid unpleasantness D) Avoiding the unpleasant person or situation

B) Negotiating and coming to an agreement

In the classical pattern of multiple sclerosis, the person experiences alternating intervals of… A) episodes of symptoms and remission B) short mania and longer term depression C) athetosis and ataxia D) muscle atrophy and hypertonia

A) episodes of symptoms and remission

``` The CTRS was interacting with the client and said, “You said you wanted to become more physically active but you refused to come to exercise class today.” The CTRS was using which of the following communication techniques? A) Teach back B) Summarization of feeling C) Confrontation D) Request for clarification ```

C) Confrontation

Inclusive recreation means that individuals with disabilities… A) attend segregated services before attending other programs B) are mixed w/ individuals with dissimilar disabilities C) are denied access to community programs because special programs are created D) attend rec programs of choice and have equal and joint participation

D) attend rec programs of choice and have equal and joint participation

The CTRS evaluated the 16-week summer programming sessions at 4-week, 8-week and 12-week intervals to gather which of the following types of program evaluation information? A) Instantaneous time sampling B) Quality assurance health care monitoring C) Formative D) Summative

C) Formative

1 reason that client assessment is important to TR service delivery is it… A) empowers clients to prepare for life changes B) relates directly to program evaluation C) helps clients achieve their goals by being placed in the most appropriate programs D) analyzes which programs are the best for certain groups of clients

C) helps clients achieve their goals by being placed in the most appropriate programs

``` The definition of intellectual disability adopted by the American Association on Intellectual and Developmental Disability (AAIDD) suggests that there is a relationship b/w intellectual functioning and which of the following? A) Social skills B) Physical skills C) Lability D) Adaptive behavior ```

D) Adaptive behavior

All of the following are ways to establish rapport w/ clients in an assessment interview, EXCEPT… A) introduce yourself and explain your department B) provide answers for client C) refer to the client by name D) use body language that signals you are listening

B) provide answers for client

1 reason that individuals older than 65 experience increased pain is that they… A) have more body parts failing B) are unable to report it adequately C) are often unable to speak or gesture D) experience more side effects from numerous prescribed meds

B) are unable to report it adequately

The client was discharged from the clinical facility b/c it was determined that he was not making further progress in his rehabilitation efforts and the “bed space” could be better utilized for an incoming patient. Which of the following committees or departments would make this recommendation? A) Professional standards review organization (PSRO) B) Utilization review C) Medical records review D) Risk management review

B) Utilization review

``` There are how many vertebrae in the thoracic vertebrae of the human spine? A) 8 B) 10 C) 12 D) 14 ```

C) 12

Which of the following is NOT part of the NCTRC fieldwork requirements (academic path)? A) The on-site fieldwork supervisor must be a CTRS at the beginning of the internship B) The university supervisor must be a CTRS C) A 14-week fieldwork requirement must be completed D) The fieldwork placement must be completed at 2 different agencies (clinical and community)

D) The fieldwork placement must be completed at 2 different agencies (clinical and community)

``` Those groups of clients known to not benefit from participation will be identified in which part of a protocol? A) Etiology B) Diagnostic criteria C) Inclusion criteria D) Risk management considerations ```

B) Diagnostic criteria

A CTRS should observe all of the following procedures when transferring an individual w/ a physical disability EXCEPT… A) standing w/ their feet together B) asking how and what type of assistance is needed C) maintaining a firm grasp on the individual through all points of the transfer D) keeping the majority of the individuals weight as close as possible to the CTRS’s own body

A) standing w/ their feet together

An assessment protocol increases the likelihood that the assessment will… A) be administered the same way every time it is given B) psychometrically sound C) focus on more than leisure and activity interests D) be reliable for a wide variety of clients

A) be administered the same way every time it is given

``` The CTRS is a supervisor of a large TR department in a community mental health center. When staff cutbacks were ordered in the TR department by the center’s administrators, she ignored the memos and continued to staff the units on regular schedules. The conflict resolution strategy employed by the CTRS is called ________. A) avoidance B) defusion C) containment D) confrontation ```

A) avoidance

The 1st step in the assessment implementation process is for the CTRS to… A) interpret results for client placement into programs B) analyze or score the assessment results C) administer the assessment to the client D) review the assessment protocol

D) review the assessment protocol

The basic premise behind “managed care” in the health care industry is… A) positive client outcomes produced at a low cost B) less focus on the individual, more focus on the diagnosis C) sustaining a person’s life at all costs D) the insurance companies will pay whatever the clinical facility charges for services

A) positive client outcomes produced at a low cost

``` The Leisure Competence Measure (LCM) parallels the format of which of the following client assessments? A) Functional Independence Measure (FIM) B) Rancho Los Amigos Scale C) Brief Leisure Rating Scale (BLRS) D) Leisure Barriers Inventory (LBI) ```

A) Functional Independence Measure (FIM)

``` The drug Librium is most often used to treat which of the following disorders? A) Chronic angina B) Anxiety C) Muscle stiffness D) Arrhythmias ```

B) Anxiety

Which of the following assessments was designed to coincide w/ the Functional Independence Measure (FIM)? A) Leisure Diagnostic Battery (LDB) B) Comprehensive Evaluation in Recreational Therapy Scale (CERT) –Psych C) Leisure Competence Measure (LCM) D) Leisure Activities Blank (LAB)

C) Leisure Competence Measure (LCM)

Evidence-based practice means that the… A) CTRS selects interventions based on research findings and professional expertise B) client needs to see evidence before participating C) client is at the center of the treatment D) client will be involved in inclusionary programs

A) CTRS selects interventions based on research findings and professional expertise

An individual’s responses or scores on the MDS 3.0 may link to a “trigger” that requires a Care Area Trigger (CAT) to be completed. This means that… A) an individual will receive a more in-depth assessment in this area B) the CTRS must complete an interview w/ the family C) the assessment was completed incorrectly D) the information from the assessment is neither valid or reliable

A) an individual will receive a more in-depth assessment in this area

``` The CTRS wants to teach clients new leisure activities they can do for low- to no-cost in their home. The best group format would be… A) Instructional class B) Clubs and special interest groups C) Drop-in center D) Out-trips ```

A) Instructional class

``` The CTRS is asked to submit an annual budget that assumes she starts w/ no dollars and asks her to justify each dollar she then requests. This type of budgeting is called… A) zero-based budgeting B) zero-sum score budgeting C) revenue and expense budgeting D) NIL (No Income or Losses) budgeting ```

A) zero-based budgeting

``` Diabetic retinopathy is a condition that often results in… A) amputation of lower limbs B) higher blood sugar levels C) blindness D) dark spots on the field of vision ```

C) blindness

The results from any assessment should give the CTRS a clear indication of… A) the programs in which the client should be placed B) the client’s leisure interests C) the validity of the tool D) how successful the client has been in achieving the program outcomes

A) the programs in which the client should be placed

Which statement correctly identifies the criteria of an accessible parking space? A) Accessible parking spaces are closest to the building entrance B) Accessible parking may be distributed in a parking lot if greater access is achieved C) Parking spaces and aisles are level with a slop no greater than 1:20 Parking spaces are at least 96 inches wide w/ adjacent access aisle of 68 inches

B) Accessible parking may be distributed in a parking lot if greater access is achieved

Which of the following is NOT a principle of activity analysis? A) Analyze the activity as it is normally engaged in B) Analyze the activity with regard to the minimal level skills required for basic, successful participation C) Complete the activity analysis at least 24 hours before leading the activity D) When completing an activity analysis, rate the activity as compared to all other activities

C) Complete the activity analysis at least 24 hours before leading the activity

``` Which 1 of the 4 categories of child development does the skill “walks with help” belong? A) Personal/social B) Adaptive/fine motor behavior C) Motor behavior D) Language ```

C) Motor behavior

The CTRS in a facility for at-risk youth plans on designing an anger management skills program. Which of the following would be a PRIMARY consideration in developing and modifying this program? A) Available facilities B) Necessary equipment and materials C) Existing emotional control of the youth D) Existing physical abilities of the youth

C) Existing emotional control of the youth

A person-centered approach to TR means that… A) despite differences, we accept that each individual is a unique person B) we encourage age-appropriate behaviors and activities C) we can reduce the impact of the self-fulfilling prophecy D) we encourage clients to think of themselves first, others second

A) despite differences, we accept that each individual is a unique person

Which of the following is the BEST example of public advocacy? A) Speaking on behalf of a patient during a treatment team meeting B) Going to a city council meeting to support additional community access C) Talking with a patient’s family about rights and responsibilities D) Making a bulletin board of patient’s artwork

B) Going to a city council meeting to support additional community access

Down Syndrome, the best-known form of chromosomal intellectual disability, is characterized by… A) short stature and enlarged rib cage and upper arms B) flat, broad face and small ears and nose C) increased urinary tract infections and sexual dysfunction D) lowered IQ and osteoporosis

B) flat, broad face and small ears and nose

In the Leisure Ability Model, which of the following would be considered an appropriate goal under leisure awareness? A) To improve taking personal responsibility for leisure B) To improve cooperative leisure skills C) To actively participate in a conversation for 5 minutes D) To learn about activity opportunities

A) To improve taking personal responsibility for leisure

The 3 major characteristics of intellectual disability are… A) subaverage intellectual functioning, impairment in at least 2 adaptive skill areas and evident before age 18 B) subaverage intellectual functioning, lack of physical coordination skills and extraordinary facial features C) subaverage social, intellectual and physical functioning within community expectations D) subaverage functioning in home, community, and school environments

A) subaverage intellectual functioning, impairment in at least 2 adaptive skill areas and evident before age 18

Which of the following best represents the Activity Therapy model of TR service delivery? A) The focus of programs in on activity skills acquisition B) Similar disciplines, such as art, music, dance and recreation therapy are housed in one department C) The philosophy is “All recreation is therapeutic” D) The focus of programs is on improving the functional independence of clients

B) Similar disciplines, such as art, music, dance and recreation therapy are housed in one department

``` Which of the following conditions is genetic, produces gradually wasting muscle, w/ accompanying weakness and deformity? A) Spina bifida B) Multiple sclerosis C) Muscular dystrophy D) Osteoarthritis ```

C) Muscular dystrophy

The Centers for Medicare and Medicaid Services requires that the MDS 3.0 assessment be conducted w/… A) all individuals in mental health facilities B) all individuals in long-term care facilities C) qualified individuals in physical medicine facilities D) individuals over the age of 65 w/ a confirmed medical disability

B) all individuals in long-term care facilities

Active treatment means that intervention is… A) delivered in the least restrictive environment B) provided to all clients, regardless of ability and/or interest C) based on reasonable expectation of improving the client’s condition and reducing future care D) based on the American College of Sports Medicine’s (ACSM’s) recommendation for physical active leisure

C) based on reasonable expectation of improving the client’s condition and reducing future care

``` 1 of the primary precautions for programming for individuals w/ hearing impairments is a secondary condition of… A) balance deficits B) lowered intelligence C) obesity D) astigmatism ```

A) balance deficits

``` All of the following are examples of leisure barriers measured in the Leisure Barrier Inventory, EXCEPT… A) time, money, and transportation B) poor self-concept C) availability of leisure partners D) understanding of leisure as a concept ```

B) poor self-concept

A client was rated by his physician as having a 61-70 score on the Global Assessment of Functioning (GAF). The CTRS knew this might mean the client would benefit from the following services? A) Activities of daily living and community integration B) Decision-making, problem solving and coping skills C) Functional improvement, time management and stress management D) Health prevention and stress coping

B) Decision-making, problem solving and coping skills

Mental illness may be considered any disorder that… A) is congenital and transient B) results from lower intellectual capacity and lower adaptive behavior C) results in abnormal behavior that can be seen as bizarre, unusual and irritating D) exhibits alteration of thought, mood or behavior so that the individual has difficulty meeting daily living requirements

D) exhibits alteration of thought, mood or behavior so that the individual has difficulty meeting daily living requirements

Listed below are the 4 steps to “thought stopping.” 1) Imagine the thought, 2) Unaided thought interruption, 3) Aided thought interruption and 4) Though substitution. ``` Which of the following correctly orders these steps from first to last? A) 1, 2, 3, 4 B) 1, 3, 2, 4 C) 4, 3, 1, 2 D) 4, 3, 2, 1 ```

B) 1, 3, 2, 4

``` Of the 5 major life areas (vocational, family, spiritual, social, leisure and legal), leisure often is the __________ impacted by the use of substances. A) last B) second C) first D) third ```

C) first

In a facility that adopts the Health Protection/Health Promotion model, what is the primary purpose of the intervention? A) To provide therapist-directed experiences w/ clients B) To motivate clients to function independently in the community C) To promote behaviors that enable clients to move toward mastery of their own health D) To enhance leisure decision-making so clients develop self and leisure awareness

C) To promote behaviors that enable clients to move toward mastery of their own health

Typical experiences of individuals w/ new spinal cord injuries include… A) heightened ability to cope w/ stress, fewer leisure options and lowered self-esteem B) decreased helplessness, fewer employment opportunities and better relationships C) loss of ability and skills, disruption of relationships, and dependence on others D) higher risk for infections, lowered intellectual ability and lowered self-esteem

C) loss of ability and skills, disruption of relationships, and dependence on others

``` Asking the question, “How stable is the instrument over a give period of time?” is an example of looking at the assessment’s… A) concurrent validity statistics B) test-retest estimates C) Cronbach’s alpha D) internal consistency estimates ```

B) test-retest estimates

The federal law (and later amendments) that dictates currently the specifications for barrier free design is the… A) Architectural Barriers Act of 1968 B) Americans With Disabilities Act of 1990 C) Mandatory Inclusion Act of 1992 D) Barrier Free Environments Act of 2012

B) Americans With Disabilities Act of 1990

Which organization oversees the accreditation of physical medicine programs? A) Joint Commission (JCAHO) B) Rehabilitation Accreditation Commission (CARF) C) American Therapeutic Recreation Association (ATRA) D) Centers for Medicare and Medicaid Services (CMS)

B) Rehabilitation Accreditation Commission (CARF)

When a client has a “lack of leisure awareness,” it means she… A) knows very few leisure skills B) has severe cognitive deficits C) does not understand the importance of leisure D) has developed a meaningful and satisfying leisure lifestyle

C) does not understand the importance of leisure

``` During client assessments, the CTRS makes sure to respect the client’s viewpoint, allows the client to finish his/her thoughts before speaking again, and asks for clarification when she does not understand an answer. The CTRS is using the technique known as… A) values clarification B) active listening C) cognitive restructuring D) non-violent communication ```

B) active listening

Substance addictions are likely to affect a person’s leisure lifestyle in which of the following ways? A) Improved social relationships w/ friends and family B) Reduced need for coping and anger management skills C) Improved energy and intrinsically motivated leisure involvement D) Reduced enjoyment from non-addiction activities

D) Reduced enjoyment from non-addiction activities

``` The “day-to-day behavioral expression of one’s leisure-related attitudes, awareness and activities revealed within the context and composite of the total life experience” is a person’s… A) leisure lifestyle B) recreation well being C) quality of life D) leisure well being ```

A) leisure lifestyle

``` Which of the following activities has been proven to be most effective w/ improving psychological states? A) soothing music B) building bird houses C) physical exercise D) joining a social club ```

C) physical exercise

Which of the following should the CTRS do before she interviews the client for the TR assessment? A) Decide which behaviors are pertinent to the TR assessment B) Perform an activity analysis on likely activities of interest C) Review medical records to obtain background information D) Interview the clients’ family members

C) Review medical records to obtain background information

``` One leadership principle the CTRS should follow when working w/ autistic children is to… A) establish eye contact B) use lengthy activities C) play a lot of active games D) change activities quickly ```

A) establish eye contact

All of the following are true statements about client assessment in TR EXCEPT assessments should be… A) selected or developed based on a specific purpose B) able to gather necessary information in a logical and straightforward manner C) able to be completed by clients within a short time frame D) able to produce results that are as valid and reliable as possible

C) able to be completed by clients within a short time frame

1 of the major DISADVANTAGES of using interviews in client assessment is… A) unless the scoring system is in place ahead of time, they are difficult to score and analyze B) they are less likely to get correct information than observations C) that clients often lie about their leisure participation patterns prior to admission D) they reduce personal contact b/w the client and the CTRS

A) unless the scoring system is in place ahead of time, they are difficult to score and analyze

``` When an individual has mild to strong cravings for a substance and believes the substance is necessary to maintain an optimal state of well-being, it is called… A) drug abuse B) psychological dependence C) physical dependence D) tolerance ```

B) psychological dependence

The Fox Activity Therapy Social Skills Baseline assessment was developed for use with which population? A) Older adults in nursing homes B) Adults w/ developmental disabilities C) Adults w/ mental health disturbances D) Disabled children in inclusion programs

B) Adults w/ developmental disabilities

In the mental illness diagnosis classification system used by the American Psychiatric Association, Axes I and II describe… A) physical disorders related to mental illness B) unrelated symptoms C) categories and conditions of mental illness D) social support networks that can be used by the client

C) categories and conditions of mental illness

The CTRS wants to assess clients’ sensory abilities in functional areas such as visual acuity, depth perception, auditory acuity, and tactile sensation. The best assessment instrument for this use might be the… A) Global Assessment of Functioning (GAF) B) Comprehensive Evaluation in Recreation Therapy- Physical Disabilities (CERT-PD) C) FOX Assessment D) Functional Assessment of Therapeutic Recreation Skills

B) Comprehensive Evaluation in Recreation Therapy- Physical Disabilities (CERT-PD)

``` In which of the following steps does the CTRS develop intervention protocols? A) Assessment B) Program planning C) Program implementation D) Program evaluation ```

B) Program planning

The CTRS wants to assess clients’ stress management skills. Which of the following questions is most appropriate? A) Can you feel the breath going in and out of your body? B) When is the last time you experienced stress? C) How do you handle stress when you experience it? D) Are you aware of stress?

C) How do you handle stress when you experience it?

``` Because of efforts to reduce the amount of time individuals spend in in-patient acute care, they are often moved more quickly to… A) group homes B) halfway houses C) rehabilitation units or hospitals D) health clinics ```

D) health clinics

The CTRS wants to assess social skills. Which of the following questions is most appropriate? A) What do you like to do when you’re alone? B) What do you do for fun? C) How would you greet someone you do not know? D) Do you enjoy dual sports?

C) How would you greet someone you do not know?

The CTRS took client medical records home so she could finish her charting for the week. The CTRS is in violation of which law? A) Health Insurance Portability and Accountability Act (HIPAA) B) Americans with Disabilities Act (ADA) C) Consumer Health Protection Act D) Health Maintenance Organization Act

A) Health Insurance Portability and Accountability Act (HIP

Which of the following is NOT a way for clients to improve their health and well-being? A) Exercise to the point of exhaustion once per day B) Break patterns of unsatisfying or destructive behaviors C) Maximize positive and pleasant experiences D) Reflect on positive occurrences in their lives

A) Exercise to the point of exhaustion once per day

1 of the most typical ways to receive direct reimbursement for TR services is by “time units.” This means that the patient is charged… A) per time intervals (e.g., per 15 minutes) B) as part of the per diem rate C) by the procedures performed D) by the hospital’s daily bed rate

A) per time intervals (e.g., per 15 minutes)

``` The client has been diagnosed with schizophrenia and admitted as an inpatient. The CTRS should be aware of which of the following possible complications of schizophrenia? A) Difficulty participating in groups B) Increased resting heart rate C) Autonomic dysreflexia D) Grand mal seizures ```

A) Difficulty participating in groups

The client has been diagnosed w/ heroin addiction and admitted as an inpatient. The CTRS should be aware of which of the following possible complications of heroin addiction? A) Exposure to HIV (Human Immunodeficiency Virus) B) Blunted feelings C) Rapidly alternating periods of mania and depression D) Decreased pain tolerance

A) Exposure to HIV (Human Immunodeficiency Virus)

``` Continually striving to upgrade one’s knowledge and skills necessary to practice proficiently is the definition of… A) in-service training B) continuing professional competence C) quality improvement D) clinical supervision ```

B) continuing professional competence

``` Which part of the SOAP progress note is the following statement? “Patient turns away when others try to talk with him/her and attends to a craft or a book.” A) S- Subjective B) O- Objective C) A- Assessment D) P- Plan ```

B) O- Objective

Which of the following is NOT a principle of activity selection to address client outcomes? A) Activities must have a direct relationship to the client goal B) Consider the types of activities in which people will engage when they have choice C) Program to the client’s outcomes and priorities D) Provide large group entertainment activities as often as possible

D) Provide large group entertainment activities as often as possible

Which of the following are NOT minimal expectations of all TRSs? A) Read professional journals, attend professional conferences and network B) Retain professional certification and join appropriate professional organizations C) Study external accreditation documents and professional standards D) Maintain professional knowledge as it was at graduation

D) Maintain professional knowledge as it was at graduation

In a leisure skills acquisition class, which of the following activities is usually most appropriate for an adolescent male w/ a recent thoracic spinal cord injury? A) Building remote-controlled model airplanes B) Plant care C) Pilates D) Crossword puzzles

A) Building remote-controlled model airplanes

Debriefing a TR activity or session is important because it allows clients time to… A) socialize w/ peers so the specialist can make additional systematic observations B) analyze the intent of the activity and draw conclusions about their own behavior C) think about the purpose of the activity and how it related to their past D) take control of the activity and decide what rules and regulations will be followed

B) analyze the intent of the activity and draw conclusions about their own behavior

``` It is the responsibility of every CTRS to advocate for the leisure rights of individuals with disabilities because leisure is a(n)… A) privilege B) option C) right D) challenge ```

C) right

Which of the followings is NOT a characteristic of an outcome-oriented intervention? A) All clients receive all services B) Systematic design occurs before implementation C) Programs area based on individual client need D) Outcomes have relevance and importance to the client

A) All clients receive all services

Which of the following statements indicates that the client is at the precontemplation stage of behavior change? A) I’ll check out the fitness center when the weather gets nicer. B) I’m glad I asked my friend to go to the fitness center w/ me next week. C) I don’t need to go to a fitness center; I’m in pretty good shape. D) I wonder what the hours of the fitness center are?

C) I don’t need to go to a fitness center; I’m in pretty good shape.

Which of the following is an example of a multi-disciplinary treatment team? A) Each team member independently assesses and plans interventions for the client B) Each team member is responsible for collaborating with others on identifying common goal areas; then selects the best intervention within his/her discipline C) Each team member works across disciplinary boundaries to develop goals and plans and often co-treats clients. D) Each team member is cross-trained in each other’s discipline and there are virtually no boundaries between disciplines.

A) Each team member independently assesses and plans interventions for the client

``` In a leisure resources session, the CTRS, asked the client, “How would you locate a fitness center in your hometown?” The CTRS’s question is at what level of Bloom’s Cognitive Taxonomy? A) Knowledge B) Comprehension C) Evaluation D) Analysis ```

B) Comprehension

Which of the following is an appropriate strategy for working with individuals with intellectual disabilities? A) Present the activity in small steps B) Speak loudly and enunciate words clearly C) Provide a high degree of stimulation through all 5 senses D) Move through the activity quickly to keep their attention

A) Present the activity in small steps

Which of the following is a TRUE statement about evidence-based practice? A) It has been practiced by TRSs since the early 1990s B) It decreases accountability for services provided C) The specialist depends on theory-based programming and systems design D) Client outcomes are more likely to be achieved when best practices are used

D) Client outcomes are more likely to be achieved when best practices are used

Which of the following client descriptions BEST demonstrates the custodial or long-term care model of service delivery? A) Individuals in acute psychiatric care B) Day camp participants C) Residents in a state mental health facility D) Individuals in a physical medicine and rehabilitation center

C) Residents in a state mental health facility

``` In a leisure awareness session, the CTRS asked the client, “What skills and abilities contribute to your ability to have fun?” The CTRS’s question is at what level of Bloom’s Cognitive Taxonomy? A) Knowledge B) Comprehension C) Application D) Analysis ```

D) Analysis

``` In which of the 4 domains does the following statement fall under? “To improve decision-making skills related to leisure involvement.” A) Cognitive B) Affective C) Physical D) Social ```

A) Cognitive

``` The largest federal 3rd party payer in the U.S. is… A) Medicare B) Blue Cross/Blue Shield C) State Farm Insurance D) Medicaid ```

A) Medicare

``` The CTRS used a paper and pencil leisure education activity for a chronic mental health group. During the beginning of the activity, the CTRS realized that the clients could not read. The CTRS did not adequately analyze the __________ requirements of the activity. A) Cognitive B) Affective C) Physical D) Administrative ```

A) Cognitive

The purpose of Healthy People 2020 is to… A) establish benchmarks for monitoring the health of U.S. citizens B) document an exercise plan that all citizens can easily follow C) document nutrition and exercise plan according to individuals’ race, age and gender D) provide a cross-country comparison for monitoring the health of the US versus other countries

A) establish benchmarks for monitoring the health of U.S. citizens

Problem-oriented medical records have which of the following advantages over source-oriented medical records? A) An unrestricted style and format B) Improved ability to track problem areas and successes C) Record of behavior change over time D) Decreases need for staff communication

B) Improved ability to track problem areas and successes

During a leisure education discussion group, the client sits slumped in his chair with his arms folded and legs crossed. Using non-verbal communication cues, the CTRS assumes that the client is… A) actively engaged in the activity B) becoming overtly aggressive to other patients/clients C) disinterested and unengaged in activity D) demonstrating a “closed” position to further communication

D) demonstrating a “closed” position to further communication

``` The Americans w/ Disability Act requires that public and commercial access be provided in what order of priority? 1) Public sidewalks, parking or public transportation, 2) Areas where goods and services are made available to the public, 3) Access to and usability of restroom facilities and 4) Any other features necessary to provide access to the goods, services, facilities, privileges, advantages or accommodations of a place of public accommodation. A) 1, 2, 3, 4 B) 3, 2, 1, 4 C) 4, 3, 2, 1 D) 3, 1, 4, 2 ```

A) 1, 2, 3, 4

When serving a program evaluation function, the assessment tool or procedure and its results may be used to… A) plan appropriate programs for client needs B) provide an accurate and valid diagnosis for client treatment C) monitor the continuing behavior of clients D) ask for input from other therapists on the treatment team

C) monitor the continuing behavior of clients

``` According to the Transtheoretical Model, if the client has developed a plan of action with intentions for implementation within the next month, he is at what stage of behavior change? A) Precontemplation B) Contemplation C) Preparation D) Action ```

C) Preparation

A marketing audit is a vital step in designing a marketing plan for a TR department b/c it… A) describes what past marketing efforts and effects have been B) evaluates the target audiences and in information they seek C) critiques what others have done in that area D) establishes goals and objectives for implementation

A) describes what past marketing efforts and effects have been

Which of the following examples demonstrates the concept of “flow?” A) The client got so involved in painting a sunset, she lost track of time. B) The client, after trying a number of activities, decides he likes archery the best. C) The client has 3 cats and 2 dogs and volunteers at the animal shelter 2x a week. D) The client likes to travel to new places at least 2x a year.

A) The client got so involved in painting a sunset, she lost track of time.

The major difference between an acute care hospital and a physical rehab center is the… A) types of professionals found on the treatment team B) patient’s/client’s readiness for outpatient programs C) patient’s/client’s medical stability and need for care D) level of professional accountability required by external accreditation standards

C) patient’s/client’s medical stability and need for care

Which of the following is NOT criteria for selecting “important aspects of care” to monitor during quality assurance reviews? A) Programs that serve large numbers of clients B) Programs that put clients at risk of serious consequences C) Programs that occur on an annual basis D) Programs, that in the past have produced problems for staff or clients

C) Programs that occur on an annual basis

``` A client’s symptoms of irritability, pallor, trembling, blurred vision, perspiration, fatigue, confusion and headache, may be indicators of… A) traumatic brain injury B) diabetic coma C) heart attack D) post-traumatic stress syndrome ```

B) diabetic coma

``` In medical terminology, AROM means… A) about the room once B) asynchronous range of motion C) active range of motion D) higher than average ```

C) active range of motion

``` Which of the following statements is TRUE about the following objective? “After completion of the Social Skills Program, the client will introduce herself to 1 other peer, using the 5 step procedure as instructed.” A) The condition is missing B) The behavior is missing C) The criterion is missing D) The objective is complete as is ```

D) The objective is complete as is

Which of the following is a TRUE statement regarding pain? A) Pain medications cause addictions B) Young children do not experience pain C) If a child can be distracted, he is not in pain D) Slightly less than half of hospitalized children experience pain

D) Slightly less than half of hospitalized children experience pain

A written plan of operation for a TR department is most similar to a… A) policy and procedure manual B) description of the department’s quality performance initiatives C) personnel maintenance record D) summary of all departmental risk management activities for the past 5 years

A) policy and procedure manual

In the Leisure Ability Model, which of the following would be considered an appropriate goal under leisure resources? A) To improve taking personal responsibility for leisure B) To gain an understanding of the effects of disability or illness on leisure behavior C) To provide leisure opportunities that allows the client freedom to voluntarily participate D) To locate a low-cost fitness activity in the community

D) To locate a low-cost fitness activity in the community

Which of the following is a team-building strategy for personnel within a TR department? A) Establish goals that are to be accomplished as a group B) Implement policies without staff input C) Keep the information flow to a minimum D) Make unilateral decisions

A) Establish goals that are to be accomplished as a group

``` A typical secondary condition to osteoarthritis is… A) anxiety B) decubitus ulcers C) obesity D) joint pain ```

D) joint pain

In health care, the term “capitation” means the health care provider… A) agrees to a preset dollar amount per person and to not ask for further reimbursement B) is reimbursed only for expenses that the client can pay for C) must itemize all charges on the bill and relate each to a specific diagnosis code D) is a member of a fee-for-service organization that agrees on charges prior to admission

A) agrees to a preset dollar amount per person and to not ask for further reimbursement

``` A __________ is a document kept within a client’s medical record that specifies the actions to be taken on behalf of and by the client in order to reach his goals. A) critical pathway B) written plan of operation C) protocol D) treatment plan ```

D) treatment plan

``` The medical term “ad. lib.” is the abbreviation for… A) as patient can tolerate B) give freedom liberally C) as often as possible D) daily ```

A) as patient can tolerate

``` Individuals w/ spina bifida may be susceptible to a secondary condition called… A) cleft palate B) decubitus ulcers C) hip fracture D) synovial distension ```

B) decubitus ulcers

In calculating the price to be charged the client in a fee-for-service arrangement, the CTRS should consider which of the following costs? A) Direct costs, indirect costs and uncollectibles (individuals unable to pay) B) Department budget, divided by the number of TR programs C) Department budget, divided by the number of TR staff D) Staff salaries, facility rental, overhead costs

A) Direct costs, indirect costs and uncollectibles (individuals unable to pay)

``` Interventions targeted for a specific client are described in a… A) clinical or critical pathway B) written plan of operation C) treatment protocol D) treatment plan ```

D) treatment plan

The TRS who knows about personal choice, self-efficacy and personal causation would do the following while facilitating programs for clients? A) Call the community facility to makes arrangements and pay for tickets B) Post a calendar with the month’s events listed on a weekly basis C) Help participants finish their projects before leaving the activity room D) Ask participants to help plan next week’s activity session

D) Ask participants to help plan next week’s activity session

Which of the following is an example of “subjective” data that may be recorded in a progress note? A) The client has a prominent odor late in the day B) The client’s sister said, “He doesn’t really look forward to getting out.” C) The client seems really happy during TR activities D) The client appears depressed and withdrawn

B) The client’s sister said, “He doesn’t really look forward to getting out.”

A “good” progress note allows for… A) considerations of physical, social, intellectual and emotional aspects B) demonstration of a clear relationship b/w goals, objectives and plan of action C) an information update from the assessment and treatment plan D) all of the above

D) all of the above

In the TR Service Delivery Model, as the client gains in ability to make rational choices and becomes independent, the CTRS… A) reduces control over the intervention B) provides a greater number of community reintegration activities C) focuses to a greater degree of the client’s functional abilities D) switches focus to quality of life

A) reduces control over the intervention

What is likely to be the nature/role of CTRS in an acute care setting where the medical model is the mode of operation? A) Design recreation participation programs for evening/weekend participation B) Conduct one-to-one sessions with clients using leisure as a diversionary tool C) Prepare individualized treatment programs based on physician’s orders D) Plan leisure education sessions so clients gain an awareness of leisure and life satisfaction

C) Prepare individualized treatment programs based on physician’s orders

For which group of clients is recreation participation programs most suited? A) Clients who need to improve physical well-being and health B) Clients who need to develop new leisure time skills C) Clients who need to develop functional skills D) Clients who need to practice interaction skills in supervised situations

D) Clients who need to practice interaction skills in supervised situations

``` During a planning session for a community outing, the CTRS told the group that each person was a team member and was responsible for making decisions and helping to plan the outing. The CTRS was using which of the following types of leadership style? A) Autocratic B) Democratic C) Laissez-faire D) Motivational ```

B) Democratic

Which of the following is the BEST example of self-advocacy by someone w/ a mental illness? A) Responding to a newspaper article saying that mental health services are a waste of money w/ facts about recovery B) Going to a supermarket to buy groceries C) Joining a weekly support group for individuals w/ mental illness D) Bringing toys to a children’s residential facility during the annual Holiday Toy Drive

A) Responding to a newspaper article saying that mental health services are a waste of money w/ facts about recovery

The CTRS can make which of the following assumptions about clients in a day care center for older adults? A) They are in need of acute medical care B) They have or can arrange transportation and have a reasonable level of health C) They live below the income poverty level D) They need reality orientation and remotivation training activities

B) They have or can arrange transportation and have a reasonable level of health

In 2001, the World Health Organization defined quality of life as… A) return to health after a lengthy period of illness or disability B) a person’s perception of their overall health and well-being C) the achievement of homeostasis D) a major factor in ratings of patient satisfaction w/ health care services

B) a person’s perception of their overall health and well-being

The client, a 13-year old boy, has been diagnosed w/ autism. The CTRS should be aware of which of the following possible side effects of autism on leisure activity participation? A) Reduced tolerance for heat B) Inability to stay awake during activities C) Strong need for multiple play partners D) Inability to communicate preferences

D) Inability to communicate preferences

Focus charting is used when the treatment team wants to… A) show similarities and differences b/w clients B) use a critical care map of client progress C) follow the diagnostic protocol D) emphasize an event, behavior or circumstance in clients’ records

D) emphasize an event, behavior or circumstance in clients’ records

The Functional Assessment of Characteristics for Therapeutic Recreation – Revised (FACTR-R) makes which of the following assumptions about physical functional abilities such as vision, hearing, ambulation and bowel/bladder control? A) Individuals w/ severe impairments in these areas may not be appropriate for TR services. B) TRSs should not be measuring these areas. C) Functional abilities are prerequisite to leisure decision-making. D) Some functional abilities are not amenable to improvement, but are important considerations for TR programming.

D) Some functional abilities are not amenable to improvement, but are important considerations for TR programming.

Which of the following would be typical topics for specific program evaluation questions? A) Content of the assessment and content of the program B) Seasonal program offerings and timing of events C) Validity and reliability of the specific program evaluation questions D) Appropriateness of program content and process for clients who participated

D) Appropriateness of program content and process for clients who participated

Which of the following example demonstrates the concept of “learned helplessness?” A) The client plans on her calendar to do at least 1 fun thing per week. B) The client has repeatedly failed and doesn’t want to try any more. C) The client has trouble remembering to ask for help D) The client learned that asking for help is not a weakness

B) The client has repeatedly failed and doesn’t want to try any more.

``` In what document would the CTRS be MOST likely to find information on staff benefits? A) Quality improvement records B) Policy and procedure manual C) Intern manual D) Personnel files ```

B) Policy and procedure manual

One of the principles in ATRA’s Code of Ethics is Informed Consent. This concept means… A) all client data must be verified by a 3rd party prior to any treatment B) insurance companies have the right to limit the amount of payment for any service C) clients have the right to know the benefits and risks prior to participation D) clients’ photographs cannot be taken w/ their permission

C) clients have the right to know the benefits and risks prior to participation

``` The client receives treatment and was not informed of risks involved and the treatment results in some unwanted side effect or injury, then the client can bring a lawsuit against the CTRS. The CTRS could be found… A) guilty of negligence B) having a breach of confidentiality C) to be harmful to all D) guilty of malfeasance ```

D) guilty of malfeasance

Substance-related disorders are categorized according to which Axis in the Diagnostic and Statistical Manual IV-TR? A) Axis I- Clinical Disorders B) Axis II- Personality Disorders, Mental Retardation C) Axis III- Acute Medical Conditions D) Axis IV- Psychosocial and Environmental Problems

A) Axis I- Clinical Disorders

``` The CTRS was interviewing the client and said, “I’m not sure what you mean by that. Can you explain it to me?” The CTRS was using which of the following communication techniques? A) Teach back B) Summarization of feelings C) Confrontation D) Request for clarification ```

D) Request for clarification

Obsessive-compulsive disorder is categorized to which Axis in the Diagnostic and Statistical Manual IV-TR? A) Axis I- Clinical Disorders B) Axis II- Personality Disorders and Mental Retardation C) Axis III- Acute Medical Conditions D) Axis IV- Psychosocial and Environmental Problems

B) Axis II- Personality Disorders and Mental Retardation

``` During an assessment interview, the client stated, “I hate physical activities. They just wear me out. But my sister just loves to be involved in sports.” The CTRS responded, “You don’t like exercise, while your sister does.” The CTRS was using which of the following communication techniques? A) Probe B) Summarization C) Redirection D) Confrontation ```

B) Summarization

Which of the following is an example of an interdisciplinary treatment team? A) Each team member independently assesses and plans interventions for the client B) Each team member is responsible for collaborating w/ others on identifying common goal areas; then selects the best intervention within his/her discipline C) Each team member works across disciplinary boundaries to develop goals and plans, and often co-treats clients D) Each team member is cross-trained in each other’s discipline and there are virtually no boundaries between disciplines

B) Each team member is responsible for collaborating w/ others on identifying common goal areas; then selects the best intervention within his/her discipline

``` The CTRS wants to help clients w/ mental health issues to increase physical flexibility. What activity is most appropriate for this purpose? A) Yoga B) Volleyball C) Softball D) Core training ```

A) Yoga

``` Which of the following activities is most appropriate for improving clients’ knowledge of the benefits of leisure? A) Social interaction skill instruction B) Knowledge of leisure resources C) Leisure awareness D) Leisure interest exploration ```

C) Leisure awareness

TR services are often included in a facility’s per diem rate which means that services are… A) directly billable in 15-minute increments B) part of one daily charge for allowable costs C) established on a case-by-case basis D) discounted for large groups negotiated by the insurance company

B) part of one daily charge for allowable costs

``` A CTRS wants to assess a patient’s/client’s ability to follow simple directions. The CTRS should assess behavior from which of the following domains? A) Cognitive B) Physical C) Emotional D) Social ```

A) Cognitive

Which of the following is NOT a primary symptom of substance abuse disorders? A) Inability to distinguish healthy and non-healthy eating B) Difficulty withdrawing or eliminating the substance from one’s routine C) Continued choice to use the substance despite problems associated w/ use D) Change in the individuals’ tolerance for the substance

A) Inability to distinguish healthy and non-healthy eating

Spina bifida typically results in which of the following activity limitations? A) Paralysis below the lesion B) Increased likelihood of blood disorders C) Decreased attention span D) Increased motor activity in the lower extremities

A) Paralysis below the lesion

``` The Diagnostic and Statistical Manual of Mental Disorders IV-TR classifies which type of disorders? A) Mental illness B) Intellectual disability C) Cognitive impairments D) Learning disabilities ```

A) Mental illness

Clinical supervision is different than managerial supervision in that it… A) can only come from CTRSs B) involves mentoring about practice situations and wisdom C) must be sanctioned by NCTRC D) can only occur in clinical facilities

B) involves mentoring about practice situations and wisdom

According to the Health Protection/Health Promotion model, prescriptive activities help the client… A) adjust to multiple medications B) recover from a threat to his/her health C) reintegrate into the community D) alleviate the long-term effects of disability and/or disease

B) recover from a threat to his/her health

In which of the following situations does the individual likely have cataracts? A) The client needs glasses only for near-vision reading. B) The client experiences loss of central vision and has to turn from side to side to see an item directly in from of him. C) The client’s vision is blurred and she has trouble seeing things distinctly. D) The client has difficulty seeing at night, often seeing “stars” around bright lights.

C) The client’s vision is blurred and she has trouble seeing things distinctly.

The ATRA Standards of Practice says that quality client assessment is characterized by… A) data, action and response B) leisure interests, health and well-being, and future intentions C) functional abilities that impact leisure involvement D) systematic collection of comprehensive and accurate data to design an individualized treatment plan

D) systematic collection of comprehensive and accurate data to design an individualized treatment plan

The most recent and the most preferred national standards for accessibility are contained within the… A) Joint Commission’s (JCAHO) standards manual B) Accessibility Guidelines of America C) Department of the Interior’s park and natural areas guidelines D) Americans w/ Disabilities Act

D) Americans w/ Disabilities Act

The CTRS working in a psychiatric facility for adults needs an assessment instrument that has the capability of monitoring clients in the three areas of general performance, individual performance, and group performance. Which of the following published assessment instruments would be MOST suitable? A) Leisure Diagnostic Battery (LDB) B) Comprehensive Evaluation in Recreation Therapy Scale (CERT-Psych) C) Self-Leisure Interest Profile (SLIP) D) Leisure Activities Blank (LAB)

B) Comprehensive Evaluation in Recreation Therapy Scale (CERT-Psych)

Which federal legislation attempts to equalize mental health services w/ other medical services? A) Mental Health Parity and Addiction Equity Act B) Americans w/ Disabilities Act C) Equity Healthcare for All Americans Act D) Equal Illness, Equal Healthcare Act

A) Mental Health Parity and Addiction Equity Act

After administering the Leisure Diagnostic Battery (LDB), the CTRS scored the client’s sub-scales and found that the client had an external locus of control, among other findings. Which of the following client statements would confirm these assessment results? A) “I am a very goal-oriented person.” B) “I want you to make that decision for me.” C) “I am saving money to go on a vacation next month.” D) “I followed up on our conversation and I’m entering that writing contest next week.”

B) “I want you to make that decision for me.”

A clinical CTRS and a community CTRS are conducting a marketing analysis to set-up a joint outpatient TR rehab program. Which statement identifies a factor that would be considered an opportunity to promote this joint venture? A) PT and OT are currently contracting their services in the community B) A private health care company is providing in-home care in the area C) Patient length of stay in inpatient rehab is continuing to decrease D) An ADA survey is presently being conducted in the community

C) Patient length of stay in inpatient rehab is continuing to decrease

When an assessment is norm-referenced, it means that the assessment was/is… A) interpreted based on the average scores for that person’s peer group B) based on a normal population’s average scores C) references using the major tests in the TR literature D) based on scores of normal behavior expected within that developmental life stage

A) interpreted based on the average scores for that person’s peer group

A CTRS who works w/ 3 to 5 year olds in a preschool program, uses Erikson’s Theory of Psychosocial Development to improve the age-appropriateness of his programs. Specifically he teaches the children to… A) know when to take action and when to use self-restraint B) play games that require intragroup and social interaction skills C) meet their own needs through intrinsically motivated play D) recognize their own strengths and weaknesses

A) know when to take action and when to use self-restraint

Which of the following is a question that addresses content validity? A) How accurately does current content reflect future content? B) How closely related are items on a single assessment? C) How consistent are scores over different parts of the assessment? D) How adequately does the sample of assessment items represent the totality of the content to be measured?

D) How adequately does the sample of assessment items represent the totality of the content to be measured?

``` A CTRS has been hired as Director of TR Services at the local rehab center to start a new program of services and wants to provide the highest quality services available. She reviews which TR standards to assure program compliance? A) ATRA Standards of Practice B) Joint Commission (JCAHO) standards C) NCTRC certification standards D) ATRA Code of Ethics ```

A) ATRA Standards of Practice

Which of the following is NOT a benefit of evidence-based practice? A) Helps focus intervention programs on client outcomes B) Improves relative consistency from program to program C) Eliminates need for program evaluation data D) Help determine the content of client assessments

C) Eliminates need for program evaluation data

The intent of the federal initiative called Healthy People 2020 is to… A) heighten awareness of the overall health of Americans, including those w/ disabilities B) ensure that Americans understand that eating fast food is the prime predictor of obesity C) monitor the increasing amount of time Americans are spending on exercising D) monitor the effects of low-carbohydrate diets on the obesity of Americans

A) heighten awareness of the overall health of Americans, including those w/ disabilities

``` The CTRS has eight 4-year old children who had behavioral problems (like kicking, biting and spitting on others) compete with each other on 2 bowling teams. Instead of realizing the children had difficulty interacting in the ________ interaction pattern and having them practice skills at that level, she had them participating in an activity that required a _________ interaction pattern, and thus, the children became aggressive and the activity failed. A) Aggregate, intergroup B) Intraindividual, extraindividual C) Aggregate, interindividual D) Cooperative, competitive ```

A) Aggregate, intergroup

Which statement best describes an outcome of completing activity analysis? A) Activities are referenced according to their difficulty B) The amount of time necessary for the client to acquire the skill is determined C) The skills necessary to perform the activity are identified D) The types of adaptations needed by clients are determined

C) The skills necessary to perform the activity are identified

``` In which of the following steps does the CTRS place the client into the most appropriate programs? A) Assessment B) Program planning C) Program implementation D) Program evaluation ```

A) Assessment

``` While teaching adolescents with mild intellectual disability the card game of “Pinochle,” the CTRS found that the rules were too complicated for the clients to be successful. The CTRS had inappropriately analyzed and planned the activity in which of the following domains? A) Physical B) Emotional C) Social D) Cognitive ```

D) Cognitive

All of the following must be protected under the Health Insurance Portability and Accountability Act (HIPAA) 1996 and its updates EXCEPT… A) individually identifiable demographic information B) the individual’s past, present or future physical or mental health or condition C) the provision of health care to the individual D) some employment records for some groups of individuals

D) some employment records for some groups of individuals

“Frontloading” an activity mean that the TRS… A) plans the activity well in advance of it’s delivery B) explains the intended outcomes at the beginning of the activity C) places all the materials and props at the front of the room D) uses an icebreaker to facilitate group introductions

B) explains the intended outcomes at the beginning of the activity

People who are intrinsically motivated in their leisure tend to… A) avoid situations in which they are challenged to demonstrate a certain skill level B) seek challenges equal to their competence C) avoid situations which may result in negative feedback about their performance D) seek situations that are easily accomplished or quickly won

B) seek challenges equal to their competence

``` During a leisure planning session, a client said, “We used to take lots of vacations as a family, usually for 2-3 weeks at a time.” The CTRS responded, “Tell me more about your vacations.” The CTRS was using which of the following communication techniques? A) Probe B) Summarization C) Clarification D) Confrontation ```

A) Probe

``` The client received burns in a house fire that affected all 3 layers of skin as well as muscle tissue. She does not feel pain as the nerve fibers and pain receptors have been destroyed. The client’s burns are classified as… A) intensive B) first-degree C) second-degree D) third-degree ```

D) third-degree

Which of the following statements represents the MOST assertive response to the question, “Where would you like to eat dinner tonight?” A) “We can go wherever you want” B) “I don’t care where we eat, you always choose anyway” C) “I’d like to try that new Italian restaurant by the mall” D) “You should known where I want to eat by now”

C) “I’d like to try that new Italian restaurant by the mall”

A CTRS working in a psychiatric facility needs to find information about specific mental illnesses and conditions. Which of the following references would be MOST appropriate? A) Physicians’ Desk Reference B) Diagnostic and Statistical Manual-IV-TR C) TR and the Nature of Disabilities D) Comprehensive Accreditation Manual for Behavioral Health Care

B) Diagnostic and Statistical Manual-IV-TR

``` The client tends to blame others when something goes wrong and has a difficult time accepting responsibility for her actions. What therapeutic recreation facilitation technique is MOST LIKELY to be helpful for this client? A) Reality therapy B) Anger management C) Resocialization D) Validation therapy ```

A) Reality therapy

A facility that provides comprehensive services for individuals w/ physical disabilities on an inpatient and outpatient basis is called a… A) community mental health center B) physical medicine and rehabilitation center C) sheltered workshop D) homebound program

B) physical medicine and rehabilitation center

In human anatomy, the scapula performs what function? A) It produces extension and flexion of the upper leg B) It forms the shoulder joint where many bones and muscles originate C) It forms the elbow joint with the humerus proximally D) It serves as the foundation for speech

B) It forms the shoulder joint where many bones and muscles originate

``` When assessing a child’s ability to remain seated during a 30-minute activity, the CTRS would look for which of the following behavioral characteristics? A) Duration of behavior B) Frequency of behavior C) Intensity of behavior D) Rate of the behavior ```

A) Duration of behavior

The client, a 10-year old boy, has been diagnosed with attention-deficit/hyperactivity disorder (ADHD). The CTRS should be aware of which of the following possible side effects of ADHD? A) Decreased ability to follow directions B) Blunted feelings C) Above average organizational skills D) Loss of personal sense of identity

A) Decreased ability to follow directions

``` The Joint Commission (JCAHO) identifies 3 categories of outcome measures: health status, patient perceptions of care and client performance outcomes. The CTRS reports on clients’ functional improvement, which falls in which of the following outcome categories? A) Health status B) Patient perceptions of care C) Client performance outcomes D) None of the above ```

C) Client performance outcomes

The symptoms of anorexia nervosa are… A) refusal to eat, loss of hair and frequent vomiting B) binge eating, depression, and weighing constantly C) secretive behavior, hyperactivity, and depression D) growth of fine body hair and loss of 25% body weight

D) growth of fine body hair and loss of 25% body weight

``` The MDS 3.0 is an assessment completed for individuals in which type of setting? A) Correctional institutions B) Adult day care centers C) Outpatient rehabilitation programs D) Nursing homes ```

D) Nursing homes

``` Where is the latissimus dorsi muscle located in the human body? A) leg B) neck C) abdomen D) mid-back ```

D) mid-back

Current research has shown that the most common TR services billed for reimbursement include… A) client assessment, leisure education and community re-entry B) client assessment, social skills training and ADLs C) stress management, group activities and outpatient services D) values clarification, leisure education and functional skills training

A) client assessment, leisure education and community re-entry

All of the following are considered disadvantages of reviewing medical records instead of interviewing or observing the client EXCEPT… A) reducing redundancy for the client B) potential inaccuracy of the data C) limited amount or kinds of data D) reducing personal contact w/ the client

A) reducing redundancy for the client

Muscle atrophy is caused by which of the following situations? A) Lack of intelligence B) Lack of physical activity C) Excessive calorie intake compared to energy expenditure D) Steroids or human growth hormones

B) Lack of physical activity

``` After the client assessment has been completed, the next step in the programming process is to… A) write treatment summaries B) analyze activities C) identify the problem(s) D) develop goals and objectives ```

C) identify the problem(s)

``` A client in a substance abuse program, states, “I am looking forward to going home but worry if I can maintain my sobriety.” He is expressing emotions at what level of the Krathwohl’s Affective Taxonomy? A) Responding B) Valuing C) Organization D) Characterization ```

D) Characterization

The purpose of quality improvement activities is to… A) gather client input into the improvement of programs B) increase communication w/ other members of the treatment team C) increase documentation of TR services D) improve the effectiveness of client services

D) improve the effectiveness of client services

``` In which of the 4 domains does the following statement fall under? “To increase standing tolerance to 15 minutes.” A) Cognitive B) Affective C) Physical D) Social ```

C) Physical

Individuals w/ intellectual disabilities may have an unrealistic view of “self” for all of the following reasons EXCEPT… A) lack of exposure to peer groups B) parents may be overprotective C) difficulty in exploring and testing their own limits D) biological changes in the brain

D) biological changes in the brain

``` A client in a stroke rehab program, states, “I really like to spend time with my family and have 2 activities planned for this weekend.” She is expressing emotions at what level of the Krathwohl’s Affective Taxonomy? A) Responding B) Valuing C) Organization D) Characterization ```

B) Valuing

``` Spina bifida is a condition in which the spinal column… A) was injured by traumatic force B) is injured posthumously C) collapses upon itself D) has failed to develop completely ```

D) has failed to develop completely

Which of the following is NOT a characteristic of “high performance teams” of people working in a health care environment? A) Decisions are made by group members B) Each person shares in the responsibility for success C) Each person works in his/her “work solo” D) Responses to requests are timely and efficient

C) Each person works in his/her “work solo”

``` Which part of the SOAP progress note is the following statement, “The client lacks adequate knowledge of community resources to be able to function independently.” A) S- Subjective B) O- Objective C) A- Assessment D) P- Plan ```

C) A- Assessment

Which of the following is an example of “objective” data that may be recorded in a progress note? A) The client stated, “I really got a lot out of this program!” B) The client’s family said that the client was progressing with the outpatient therapy. C) It appears the client is depressed. D) The client goes to his room immediately following all sessions.

D) The client goes to his room immediately following all sessions.

``` According to the Transtheoretical Model, if the client has been walking three miles every other day in order to increase his physical activity levels, he is at what stage of behavior change? A) Precontemplation B) Contemplation C) Preparation D) Action ```

D) Action

Compare the 2 progress notes written below: 1 Friday, 12/11 – Pt. seemed withdrawn on community outing Friday night. 2 Friday, 12/11 – While pt. was attending community outing Friday night, she conversed only once with other pts. for approximately 1 minute. Pt. remained alone in the corner of the van during transit, and stayed at a separate table during most of the night. Progress note 2 is better written than progress note 1 b/c it… A) states more consistent information B) relies on professional judgments C) states behavior rather than conclusions D) uses less professional jargon

C) states behavior rather than conclusions

In establishing an environment that embraces multiculturalism, the CTRS would… A) make sure all ethnic holidays are on the activity calendar B) introduce signage that includes both English and Spanish and possibly French C) recognizes people’s differences while establishing a sense of unity D) follow the agency directives w/ regard to nondiscrimination toward foreigners

C) recognizes people’s differences while establishing a sense of unity

``` An insurance carrier’s cost control method of paying a prearranged amount for specific service, no matter what the actual cost of those services might be is called… A) third-party reimbursement B) prospective payment C) cost allocation D) unit cost ```

B) prospective payment

The best indication that pain is present is… A) regression to child-like behaviors B) self-report of the client C) swelling and redness in the area D) a similar occurrence in the past 24 hrs.

B) self-report of the client

The CTRS might use each of the following to assess leisure interests of a client EXCEPT… A) administering an activity interest inventory to the client B) interviewing the client regarding her leisure interests C) interviewing the family and/or significant others regarding the client’s leisure interests D) administering the Functional Independence Measure (FIM)

D) administering the Functional Independence Measure (FIM)

Which of the following is NOT an appropriate question for a cognitive assessment for older adults in long-term care? A) What day of the week is it today? B) How would you find someone to play cards with while here in the facility? C) How often do you talk with family members? D) What leisure activities do you like to do before you became a resident here?

C) How often do you talk with family members?

The CTRS should use which of the following activities to improve the dynamic balance of youth w/ hearing impairments? A) standing on one foot, w/ arms outstretched B) leisure education C) running D) tumbling

D) tumbling

What is a primary outcome of completing a task analysis? A) Behaviors needed to complete a skill are listed in a teaching sequence B) A hierarchy of skills used in an activity are prepared C) Each behavioral area exhibited in an activity is compared w/ one another D) The time necessary for intervention is determined

A) Behaviors needed to complete a skill are listed in a teaching sequence

``` While leading a reminiscing group at the long-term care facility, the CTRS was unprepared to console/counsel a patient when he talked about a traumatic and difficult childhood. The CTRS had inappropriately planned and analyzed the activity in which of the following domains? A) Physical B) Emotional C) Social D) Cognitive ```

B) Emotional

Which of the following documents most directly justifies reimbursement for TR services? A) Client assessment, treatment protocols, and quality improvement documents B) Flow charts and trend analysis C) Utilization review documents, treatment protocols and risk management studies D) Policy and procedure manuals

A) Client assessment, treatment protocols, and quality improvement documents

``` The CTRS observes the client’s ability to complete a 5-minute walking endurance test. What functional behavior is being assessed? A) Cognitive B) Physical C) Social D) Emotional ```

B) Physical

A major advantage to knowing the stages of behavior change in the Transtheoretical Model is that the CTRS can… A) provide a variety of leisure resources to the clients B) focus on the concerns at each stage C) motivate clients to learn more leisure activities D) increase attendance at TR programs

B) focus on the concerns at each stage

The first step in a person changing a negative behavior to a positive behavior is… A) recognizing the problem behavior B) reappraising the stressors that caused the original incident C) coping with the negative consequences of the original behavior D) believing the negative behavior can be changed

A) recognizing the problem behavior

The punishment model for corrections may adhere to the following moto… A) “An eye for an eye” B) “There is hope for everyone” C) “A stitch in time saves nine” D) “Do unto others as you would have them do unto you”

A) “An eye for an eye”