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NC OT Jurisprudence study materials
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NC OT Jurisprudence practice questions

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Question 1North Carolina Occupational Therapy Practice Act

Under the North Carolina Occupational Therapy Practice Act, which body is responsible for adopting rules that govern the practice of occupational therapy and for issuing licenses to occupational therapists and occupational therapy assistants?

  1. The North Carolina Board of Occupational Therapy Correct answer.
  2. The North Carolina Medical Board
  3. The North Carolina Department of Public Instruction
  4. The North Carolina Board of Nursing

Explanation

The Practice Act creates the North Carolina Board of Occupational Therapy and assigns it responsibility for licensing OT practitioners and adopting rules that carry out the Act. The Medical Board, Board of Nursing, and Department of Public Instruction regulate other professions or school systems and have no licensing authority over occupational therapy practitioners.

Question 2North Carolina Occupational Therapy Practice Act

A person who has completed an accredited occupational therapy educational program and passed the national certification examination applies for a North Carolina license. What must the Board of Occupational Therapy generally verify before granting that license?

  1. That the applicant has completed a doctoral degree in any health field
  2. That the applicant has completed the required supervised fieldwork and meets the education and examination requirements set by the Board Correct answer.
  3. That the applicant is a member of a national professional association
  4. That the applicant has practiced for at least five years in another state before applying

Explanation

Licensure under the Practice Act is based on meeting the Board's established qualifications, which include graduation from an accredited program, completion of required fieldwork, and passing the certification examination. Membership in a professional association and a fixed number of out-of-state practice years are not statutory prerequisites.

Question 3North Carolina Occupational Therapy Practice Act

In North Carolina, which title may a person use only if that person holds a current license issued by the Board of Occupational Therapy?

  1. Rehabilitation technician
  2. Occupational therapy aide
  3. Activities coordinator
  4. Occupational therapist Correct answer.

Explanation

The Practice Act restricts use of the titles occupational therapist and occupational therapy assistant, and abbreviations such as OTR or COTA, to individuals licensed by the Board. Aide, technician, and activities coordinator titles are not protected OT titles and do not imply licensure.

Question 4North Carolina Occupational Therapy Practice Act

An occupational therapy assistant in North Carolina is providing services to a client. According to the Practice Act framework, which statement best describes the required relationship with the supervising occupational therapist?

  1. The assistant may supervise the occupational therapist in selected settings
  2. The assistant may practice independently once licensed, with no therapist involvement
  3. The assistant must be supervised by a physician at all times
  4. The assistant provides services under the supervision of a licensed occupational therapist as defined by Board rules Correct answer.

Explanation

The Practice Act establishes that occupational therapy assistants deliver services under the supervision of a licensed occupational therapist, with the specifics of supervision defined in Board rules. Assistants do not practice independently, are not supervised by physicians for OT purposes, and do not supervise therapists.

Question 5North Carolina Occupational Therapy Practice Act

Which activity falls within the scope of occupational therapy practice as described in the North Carolina Practice Act?

  1. Evaluating and treating clients whose ability to perform daily occupations is impaired Correct answer.
  2. Prescribing controlled substances for pain
  3. Performing surgery to repair a tendon
  4. Diagnosing a fracture on a radiograph

Explanation

Occupational therapy practice centers on evaluation and treatment to help people participate in daily occupations when function is limited by injury, illness, or disability. Medical diagnosis of fractures, prescribing controlled substances, and surgery are outside OT scope and belong to other licensed professions.

Question 6North Carolina Occupational Therapy Practice Act

A licensed occupational therapist in North Carolina wants to renew a license that has been active. What does the Practice Act and Board rules generally require for renewal?

  1. Submitting a new transcript from an accredited program each year
  2. Completion of continuing competence activities and payment of the renewal fee by the deadline Correct answer.
  3. Nothing beyond paying a fee, with no continuing education requirement
  4. Retaking the national certification examination every renewal cycle

Explanation

License renewal under the Board's rules requires timely payment of fees and documentation of continuing competence activities. Practitioners are not required to retake the national examination or resubmit academic transcripts at each renewal.

Question 7North Carolina Occupational Therapy Practice Act

Under the North Carolina Practice Act, what is the primary purpose of the licensure system for occupational therapy practitioners?

  1. To protect the public health, safety, and welfare by ensuring competent practitioners Correct answer.
  2. To set salary ranges for OT practitioners
  3. To limit competition among rehabilitation providers
  4. To guarantee employment for program graduates

Explanation

Occupational therapy licensure exists to safeguard the public by confirming that practitioners meet minimum competence and ethical standards. Limiting competition, guaranteeing jobs, and setting salaries are not purposes of the licensing statute.

Question 8North Carolina Occupational Therapy Practice Act

Which individual is required to hold a North Carolina occupational therapy license in order to provide occupational therapy services to clients?

  1. A family member helping a relative practice exercises at home
  2. A student observing therapy sessions as part of a school assignment
  3. A person who evaluates and treats clients to improve their occupational performance for compensation Correct answer.
  4. A hospital volunteer who transports patients to therapy

Explanation

The Practice Act requires licensure for persons who provide occupational therapy services for compensation, which includes evaluating and treating clients to improve occupational performance. Volunteers, observers, and family members who are not delivering OT services for compensation are not subject to the licensing requirement.

Question 9North Carolina Occupational Therapy Practice Act

An occupational therapist licensed in North Carolina is treating a client when a situation arises that is not clearly addressed by the Practice Act or Board rules. What is the most appropriate approach for the therapist?

  1. Defer entirely to the client's physician to decide the OT plan of care
  2. Consult the Board's rules and, when uncertain, seek guidance from the Board before acting Correct answer.
  3. Rely solely on a colleague's informal opinion and proceed
  4. Proceed with any intervention the client requests regardless of scope

Explanation

When the Act and rules are unclear, a licensee should review Board guidance and, if still uncertain, request direction from the Board rather than guessing. Relying on client preference or informal peer opinion does not substitute for the regulatory standard, and the physician does not determine OT scope.

Question 10North Carolina Occupational Therapy Practice Act

An occupational therapy assistant has been directed by the supervising occupational therapist to perform an evaluation and to develop the intervention plan for a new client. How should the assistant respond under the Practice Act framework?

  1. Perform the evaluation but have an aide write the plan
  2. Complete the evaluation and plan independently because the therapist delegated them
  3. Decline to perform the initial evaluation and plan development, which remain therapist responsibilities, and clarify the delegation Correct answer.
  4. Perform the evaluation only after obtaining a physician's written order for it

Explanation

Evaluation and development of the intervention plan are responsibilities of the occupational therapist; assistants contribute to treatment implementation under supervision. An assistant should not accept a delegation that exceeds the role and should clarify responsibilities with the supervising therapist.

Question 11North Carolina Occupational Therapy Practice Act

A client offers to pay an occupational therapist a bonus to skip the required documentation so sessions can start sooner. What does the Practice Act's ethical framework require of the therapist?

  1. Ask the supervising physician to approve the arrangement
  2. Accept the bonus but note it in the client's chart
  3. Accept the bonus and document at the end of the month
  4. Decline the arrangement and maintain required documentation, since accepting payment to omit required records is improper Correct answer.

Explanation

Licensees must maintain records that reflect the services provided and must avoid arrangements that compromise professional obligations. Accepting payment to omit required documentation violates recordkeeping and ethical standards, and documenting the bonus or obtaining physician approval does not cure the violation.

Question 12North Carolina Occupational Therapy Practice Act

An occupational therapist moves to North Carolina and holds an active license in another state. Which statement best describes how the Board generally treats licensure of applicants from other jurisdictions?

  1. The applicant must first obtain a North Carolina physician's sponsorship
  2. Out-of-state licenses are never recognized and the applicant must repeat all education
  3. Any out-of-state licensee may practice immediately without applying to the Board
  4. The Board may grant licensure based on verification of credentials and examination results, subject to its rules Correct answer.

Explanation

The Board evaluates applicants from other jurisdictions by verifying education, examination results, and licensure standing under its rules, which may allow licensure without repeating an entire educational program. Immediate practice without Board action is not permitted, and physician sponsorship is not required.

Question 13North Carolina Occupational Therapy Practice Act

A supervising occupational therapist assigns an unlicensed aide to carry out a treatment activity with a client. Which principle governs this assignment under the Practice Act framework?

  1. Aides may perform treatment only if they hold a national certification
  2. Aides may perform any activity the therapist delegates as long as the client consents
  3. Aides may assist with tasks that do not require the judgment of a licensed practitioner, and the therapist retains responsibility for the services Correct answer.
  4. Aides may perform treatment independently once they have one year of experience

Explanation

Unlicensed aides may perform supportive tasks that do not require the professional judgment of a licensed practitioner, and the supervising therapist remains accountable for the care delivered. Delegation does not expand the aide's authority, and experience or certification does not create independent practice rights.

Question 14North Carolina Occupational Therapy Practice Act

During a home health visit, an occupational therapist suspects that a client is being abused by a caregiver. What does North Carolina law expect of the therapist?

  1. Wait until the next scheduled reassessment to document the concern
  2. Report the suspicion to the appropriate adult protective services authority as required by law Correct answer.
  3. Confront the caregiver and resolve the matter privately
  4. Keep the suspicion confidential because of the therapist's duty to the client

Explanation

North Carolina law imposes mandatory reporting duties on health care providers, including occupational therapy practitioners, who suspect abuse, neglect, or exploitation of a disabled or older adult. Confidentiality does not bar a report required by law, and private confrontation or delay is inappropriate.

Question 15North Carolina Occupational Therapy Practice Act

An occupational therapist is asked to sign a plan of care that includes interventions the therapist believes are outside the scope of occupational therapy practice. What is the most appropriate action?

  1. Delegate the decision to an occupational therapy assistant
  2. Sign the plan but add a verbal disclaimer to the client
  3. Decline to authorize interventions outside OT scope and discuss appropriate alternatives with the care team Correct answer.
  4. Sign the plan because another provider requested it

Explanation

A licensee is accountable for services authorized under their license and should not approve interventions that fall outside the scope of occupational therapy. Discussing alternatives with the team addresses the client's needs without misrepresenting the therapist's authority, and an assistant cannot make that scope determination.

Question 16North Carolina Occupational Therapy Practice Act

A licensed occupational therapist is convicted of a felony unrelated to health care. What is the Board's authority regarding the license under the Practice Act?

  1. The Board has no authority because the conviction was unrelated to practice
  2. The Board may take disciplinary action, including suspension or revocation, after following its procedures Correct answer.
  3. The license is automatically void with no hearing required
  4. The Board must refer the matter to the Medical Board for a decision

Explanation

The Practice Act authorizes the Board to discipline licensees for specified conduct, including certain criminal convictions, using established procedures that provide notice and an opportunity to be heard. The Board retains discretion rather than acting automatically, and it does not defer to the Medical Board on OT licensure.

Question 17North Carolina Occupational Therapy Practice Act

An occupational therapist who is the subject of a Board complaint is asked to respond to the Board's inquiry. What does the Practice Act framework generally require of the licensee?

  1. Cooperate with the Board's investigation and provide the requested information Correct answer.
  2. Destroy records that are not favorable to the licensee
  3. Have a colleague respond on the licensee's behalf without disclosure
  4. Ignore the inquiry until a formal hearing is scheduled

Explanation

Licensees are expected to cooperate with Board investigations and provide accurate information in response to inquiries. Ignoring the Board, having another person respond without disclosure, or altering records obstructs the process and can itself become grounds for discipline.

Question 18North Carolina Occupational Therapy Practice Act

An occupational therapist wants to advertise services and include the credential OTR/L in marketing materials. Which statement reflects the Practice Act's requirements?

  1. The therapist must remove all credentials from advertising to avoid regulation
  2. The therapist may use the protected title and credential because the therapist holds a current license Correct answer.
  3. The therapist may advertise only with the Board's prior approval of each advertisement
  4. The therapist may use any credential regardless of licensure status

Explanation

Use of protected OT titles and credentials is lawful for individuals who hold a current North Carolina license. Unlicensed persons may not use those titles, and the Act does not require prior Board approval of each advertisement.

Question 19North Carolina Occupational Therapy Practice Act

A supervising occupational therapist is developing a supervision plan for an occupational therapy assistant in a setting where the therapist is frequently off-site. What consideration is most consistent with Board rules on supervision?

  1. Supervision may be provided by any licensed health professional on site
  2. Supervision is unnecessary once the assistant has passed the national examination
  3. Supervision can be entirely indirect with no direct contact if the assistant is experienced
  4. The plan should ensure the level and frequency of supervision required by Board rules, including any required direct contact and availability of the therapist Correct answer.

Explanation

Board rules define supervision requirements, including the amount of direct and indirect supervision and the availability of the supervising therapist, which the plan must satisfy. Experience, examination passage, or the presence of another health professional does not substitute for supervision by the occupational therapist.

Question 20North Carolina Occupational Therapy Practice Act

An occupational therapist practicing in North Carolina is asked to treat a client using a technique the therapist has never been trained in but that is within the broad scope of occupational therapy. What is the most appropriate response?

  1. Perform the technique because it falls within the general scope of OT
  2. Perform the technique and document that it is experimental
  3. Refuse to treat the client and discharge them without referral
  4. Perform the technique only after obtaining the competence needed through appropriate training or consultation Correct answer.

Explanation

Scope of practice defines the boundaries of the profession, but a licensee must also be competent in the specific intervention before using it. Obtaining training or consultation ensures competence, while performing an unfamiliar technique or discharging without referral fails the client.

Question 21North Carolina Occupational Therapy Practice Act

An occupational therapist in North Carolina is considering a business arrangement in which the therapist would receive payment for each referral of a client to a particular durable medical equipment supplier. How does this arrangement relate to the Practice Act's ethical standards?

  1. It is acceptable if the client is informed of the arrangement
  2. It is acceptable if the payments are small
  3. It raises a conflict of interest and is inconsistent with the licensee's ethical obligation to act in the client's interest Correct answer.
  4. It is permissible because equipment suppliers are not regulated by the Board

Explanation

Accepting payment for referrals creates a conflict of interest that can compromise the licensee's duty to act in the client's best interest and may also implicate other laws. Client disclosure or a small payment amount does not remove the underlying ethical problem.

Question 22North Carolina Occupational Therapy Practice Act

A person who is not licensed in North Carolina provides occupational therapy services to clients for a fee while representing themselves as an occupational therapist. What is the most accurate description of this conduct under the Practice Act?

  1. It is lawful if the clients sign a waiver acknowledging the lack of licensure
  2. It is unlicensed practice and use of a protected title, both of which the Act prohibits Correct answer.
  3. It is lawful if the person practices under the general supervision of a physician
  4. It is lawful if the person holds certification from a national organization

Explanation

The Practice Act prohibits both practicing occupational therapy without a license and using protected OT titles without authorization. National certification, physician supervision, or client waivers do not create an exception to the licensure requirement.

Question 23North Carolina Occupational Therapy Practice Act

An occupational therapist employed by a school system provides services to students with disabilities. Which statement best describes how the Practice Act interacts with the therapist's school-based role?

  1. The therapist is exempt from licensure while working in a public school
  2. The therapist must hold a North Carolina OT license and also comply with applicable education law requirements for school services Correct answer.
  3. The therapist's license is suspended automatically during the school year
  4. The therapist may practice in schools only under a teacher's license

Explanation

Licensure under the Practice Act applies across practice settings, including public schools, and school-based therapists must also follow the education laws and procedures that govern services to students with disabilities. There is no school exemption from OT licensure, and a teaching license is not a substitute.

Question 24North Carolina Occupational Therapy Practice Act

An occupational therapist is employed by a telehealth company and provides services to a client located in North Carolina while the therapist is physically located in another state. Which principle governs whether the therapist needs North Carolina licensure?

  1. Licensure is required only if the client travels to the therapist's state
  2. Telehealth services are exempt from state licensure laws
  3. The therapist must be licensed in North Carolina because the client is located in North Carolina and the services are delivered there Correct answer.
  4. Licensure is determined solely by the state where the therapist is physically located

Explanation

Licensure generally follows the location of the client receiving services, so a practitioner delivering OT to a client located in North Carolina must hold a North Carolina license, subject to Board rules on telehealth. The therapist's physical location or an exemption for telehealth does not remove that requirement.

Question 25North Carolina Occupational Therapy Practice Act

An occupational therapist discovers that a colleague has been documenting treatment sessions that did not occur. What is the most appropriate course of action consistent with the Practice Act's standards?

  1. Ignore the conduct because it is the colleague's responsibility
  2. Report the falsification through appropriate channels, such as the employer and the Board, and avoid participating in the false documentation Correct answer.
  3. Confront the colleague and agree to keep the matter private if the records are amended
  4. Correct the colleague's records personally without notifying anyone

Explanation

Falsifying treatment records is a serious violation that undermines client care and public trust, and licensees should report such conduct to the employer and the Board. Ignoring the conduct, altering records unilaterally, or agreeing to silence does not meet the licensee's professional obligations.

Question 26North Carolina Occupational Therapy Practice Act

Under the North Carolina Occupational Therapy Practice Act, which body is responsible for administering licensure and enforcing the Act for occupational therapy practitioners?

  1. The North Carolina Board of Occupational Therapy Correct answer.
  2. The North Carolina Medical Board
  3. The Division of Health Service Regulation
  4. The Department of Public Instruction

Explanation

The Practice Act creates a dedicated occupational therapy board that issues licenses, adopts rules, and disciplines licensees. Other boards and agencies regulate different professions or facilities and do not administer occupational therapy licensure.

Question 27North Carolina Occupational Therapy Practice Act

An occupational therapy assistant practicing in North Carolina must practice under what arrangement to remain within the Practice Act?

  1. Supervision provided by a registered nurse
  2. A separate independent caseload approved by the Board
  3. Direct on-site supervision at all times in every setting
  4. Supervision by a licensed occupational therapist Correct answer.

Explanation

Occupational therapy assistants deliver services under the supervision of a licensed occupational therapist, who retains responsibility for the plan of care. The Act does not permit assistants to practice independently.

Question 28North Carolina Occupational Therapy Practice Act

Which document does the Practice Act require an occupational therapist to obtain before initiating occupational therapy intervention with a client?

  1. A second opinion from another licensed therapist
  2. A notarized treatment agreement from the client
  3. A referral or order as required by the practice setting and Board rules Correct answer.
  4. A signed consent for billing from the payer

Explanation

The Act and Board rules address the referral or order requirements that must be in place before treatment begins, with specifics depending on the setting. Payer billing forms and notarized agreements are not licensure requirements.

Question 29North Carolina Occupational Therapy Practice Act

An occupational therapist is completing continuing competence requirements for license renewal in North Carolina. Which statement best describes the Act's approach to continuing competence?

  1. Continuing education is voluntary and has no effect on renewal
  2. Competence is verified solely by the employer, not the licensee
  3. Licensees must satisfy continuing competence requirements set by the Board as a condition of renewal Correct answer.
  4. Only occupational therapy assistants must document continuing competence

Explanation

The Board establishes continuing competence requirements that licensees must meet to renew. Responsibility rests with the individual licensee, not the employer, and applies to both occupational therapists and assistants.

Question 30North Carolina Occupational Therapy Practice Act

A person uses the title occupational therapist in North Carolina without holding a license. What is the Board's authority in this situation?

  1. The Board must refer the matter to local law enforcement and take no other action
  2. The Board may only issue a warning letter with no further consequence
  3. The Board has no jurisdiction because no client was harmed
  4. The Board may investigate and pursue enforcement action for unlicensed practice Correct answer.

Explanation

Using a protected title without a license constitutes unlicensed practice, which the Board is empowered to investigate and address through its enforcement authority. Harm to a client is not required for a violation to exist.

Question 31North Carolina Occupational Therapy Practice Act

An occupational therapist is issued a license by the North Carolina Board. Which statement best describes the legal effect of that license?

  1. It grants permanent authority that cannot be revoked
  2. It authorizes practice subject to the Act and Board rules and is subject to discipline Correct answer.
  3. It authorizes practice in any state without further licensure
  4. It transfers supervisory responsibility to the Board

Explanation

A license is a privilege to practice that remains conditioned on compliance with the Act and Board rules and is subject to disciplinary action. It is not permanent, portable across states, or a transfer of supervisory duty.

Question 32North Carolina Occupational Therapy Practice Act

Which statement accurately describes the scope of occupational therapy practice as defined under the North Carolina Practice Act?

  1. It is limited to hand therapy and upper extremity rehabilitation
  2. It is restricted to clients who have a documented physical disability
  3. It covers only services delivered in hospital inpatient settings
  4. It includes evaluation and treatment to develop or restore functional performance in daily life activities Correct answer.

Explanation

Occupational therapy addresses functional performance in daily occupations across a range of populations and settings. It is not confined to a single body area, a single setting, or a single disability category.

Question 33North Carolina Occupational Therapy Practice Act

An occupational therapy practitioner is asked to release a client's records. Which statement best reflects the Act's treatment of client records?

  1. Records belong to the client and must be surrendered on any verbal request
  2. Records must be maintained and released consistent with law and Board rules governing confidentiality Correct answer.
  3. Records may be destroyed immediately when a client stops attending
  4. Records may be shared freely with any interested third party

Explanation

The Act and Board rules impose duties to maintain records and to protect client confidentiality while permitting release consistent with law. Records are not surrendered on any verbal request and are not freely shared with third parties.

Question 34North Carolina Occupational Therapy Practice Act

An occupational therapist wants to provide services to a client located in North Carolina while the therapist is physically in another state. Which statement is most accurate under the North Carolina Practice Act?

  1. The therapist generally must hold a North Carolina license or other authorization recognized by the Board to serve that client Correct answer.
  2. The therapist may serve the client if a North Carolina assistant supervises remotely
  3. The therapist may practice freely because the therapist is not physically in North Carolina
  4. The therapist needs only a license from the state where the therapist is located

Explanation

North Carolina regulates practice directed at clients located within the state, so practitioners generally need North Carolina licensure or Board-recognized authorization. The therapist's physical location does not exempt the practitioner, and an assistant cannot supply the missing authorization.

Question 35North Carolina Occupational Therapy Practice Act

A licensed occupational therapist is the subject of a Board investigation and is asked to provide a written response. Which statement best describes the therapist's obligation?

  1. The therapist should direct the Board to contact the employer instead
  2. The therapist should alter records to clarify the clinical reasoning
  3. The therapist should respond truthfully and cooperatively within the time allowed by the Board Correct answer.
  4. The therapist should ignore the request until a formal hearing is scheduled

Explanation

Licensees are expected to cooperate with Board investigations and to provide truthful information. Ignoring the Board, altering records, or deflecting the inquiry to an employer can itself become grounds for discipline.

Question 36North Carolina Occupational Therapy Practice Act

An occupational therapist is developing a supervision plan for an occupational therapy assistant in a new setting. Which approach best complies with the Act and Board rules?

  1. Set supervision frequency based on the assistant's preference
  2. Delegate supervision entirely to an unlicensed aide in the same building
  3. Determine the supervision level the rules require for the setting and document the supervisory arrangement Correct answer.
  4. Use the least restrictive supervision level because the assistant has several years of experience

Explanation

Supervision must satisfy the level and documentation required by the Act and Board rules for the particular setting and client needs. Experience, aide availability, or personal preference does not override those requirements.

Question 37North Carolina Occupational Therapy Practice Act

An occupational therapist is offered payment by a durable medical equipment supplier for each client referred to that supplier. Which statement best describes this arrangement under the Act?

  1. Accepting payment for referrals may constitute improper conduct subject to discipline Correct answer.
  2. The arrangement is acceptable if the therapist discloses it to clients
  3. The arrangement is acceptable if the equipment is clinically appropriate
  4. The arrangement is acceptable because referrals are part of case management

Explanation

Kickbacks and fee-splitting for referrals create conflicts of interest and can violate the Act's ethical standards and other law. Disclosure, clinical appropriateness, or routine case management does not cure the underlying financial conflict.

Question 38North Carolina Occupational Therapy Practice Act

An occupational therapist documents an evaluation that was actually performed by an unlicensed aide. What is the primary concern under the Act?

  1. The evaluation was completed outside the client's home
  2. The evaluation was not performed by a qualified licensee as the Act requires Correct answer.
  3. The documentation used an outdated evaluation template
  4. The aide was not paid at the licensed rate

Explanation

Evaluations and other services reserved to licensees must be performed by qualified practitioners. Crediting an aide's work as the therapist's own evaluation misrepresents who provided the service and violates licensure and documentation standards.

Question 39North Carolina Occupational Therapy Practice Act

A client asks an occupational therapist to continue treatment that the therapist believes is no longer clinically indicated. What does the Act expect the therapist to do?

  1. Continue treatment indefinitely because the client requested it
  2. Continue the plan unchanged until the payer denies authorization
  3. Transfer the client to an aide to continue the same treatment
  4. Exercise professional judgment and adjust or discontinue services based on clinical findings Correct answer.

Explanation

Licensees are expected to exercise independent professional judgment and to modify or end services that are no longer clinically justified. Client preference, aide delegation, or payer decisions do not replace the therapist's clinical responsibility.

Question 40North Carolina Occupational Therapy Practice Act

An occupational therapist suspects that a client is being abused by a caregiver. What does the Act require of the therapist?

  1. Keep the suspicion confidential because of the therapy relationship
  2. Investigate the allegation personally before reporting
  3. Report only after obtaining the caregiver's permission
  4. Report the suspicion as required by North Carolina law governing abuse and neglect Correct answer.

Explanation

Practitioners are required to report suspected abuse or neglect in accordance with North Carolina law, and confidentiality does not bar a legally mandated report. Personal investigation or caregiver consent is not a prerequisite to reporting.

Question 41North Carolina Occupational Therapy Practice Act

An occupational therapist is asked to sign a plan of care that includes interventions the therapist considers outside the scope of occupational therapy. What is the most appropriate action under the Act?

  1. Sign the plan and document that the therapist disagrees
  2. Modify the plan without informing the other professionals involved
  3. Sign the plan because another licensed professional developed it
  4. Decline to sign and address the concern through appropriate clinical and administrative channels Correct answer.

Explanation

A therapist should not sign off on services that fall outside the scope of occupational therapy practice. The appropriate response is to decline and raise the concern through proper channels rather than signing with a disclaimer or making unilateral changes.

Question 42North Carolina Occupational Therapy Practice Act

An occupational therapist is convicted of a felony unrelated to health care. Which statement best describes the Board's authority?

  1. The Board may act only if the felony involved a client
  2. The Board has no authority because the conviction is unrelated to practice
  3. The Board may take disciplinary action based on the conviction Correct answer.
  4. The Board must wait for the employer to terminate the therapist

Explanation

The Act authorizes the Board to discipline licensees based on criminal convictions, and the Board's authority is not limited to convictions involving clients or to employer action. A conviction can support discipline even when it is not directly related to health care.

Question 43North Carolina Occupational Therapy Practice Act

An occupational therapist wants to advertise services using the credential OTR/L. Which statement is most consistent with the Act and Board rules?

  1. The therapist may use the credential only in clinical, not public, materials
  2. The therapist may use the credential if it accurately reflects the license held Correct answer.
  3. The therapist may use the credential if the employer approves it
  4. The therapist may use any credential that appears in national advertising

Explanation

Advertising must be truthful and credentials must accurately reflect the license the practitioner actually holds. Employer approval or common national usage does not authorize misleading credential use, and the same accuracy standard applies to public-facing materials.

Question 44North Carolina Occupational Therapy Practice Act

An occupational therapist is considering delegating a treatment activity to an unlicensed aide. Which factor is most important in deciding whether the delegation is permissible?

  1. Whether the payer reimburses for aide-delivered services
  2. Whether the aide has worked in the clinic the longest
  3. Whether the client has consented to treatment by the aide
  4. Whether the task is a routine activity that may lawfully be delegated with appropriate supervision Correct answer.

Explanation

Delegation to unlicensed personnel is limited to tasks that may lawfully be delegated and must occur under appropriate supervision by the therapist. Seniority, client consent, or reimbursement does not expand what may be delegated.

Question 45North Carolina Occupational Therapy Practice Act

An occupational therapist is employed by a school system and provides services to students with disabilities. Which statement best describes how the Act applies?

  1. The therapist may practice under the school principal's supervision instead of a license
  2. The therapist must hold a North Carolina license and comply with the Act while also meeting school-based requirements Correct answer.
  3. The therapist is exempt from licensure because schools are public entities
  4. The therapist needs only a teaching license to provide occupational therapy

Explanation

School employment does not exempt a practitioner from occupational therapy licensure, and the therapist must comply with the Act in addition to education-specific requirements. A teaching license or principal supervision does not substitute for occupational therapy licensure.

Question 46North Carolina Occupational Therapy Practice Act

An occupational therapist is asked by a colleague to co-sign documentation for services the colleague did not provide. What is the most appropriate response under the Act?

  1. Co-sign as a professional courtesy if the colleague is licensed
  2. Decline, because co-signing would misrepresent who provided the services Correct answer.
  3. Co-sign if the colleague agrees to document the arrangement later
  4. Co-sign after reviewing the client's chart

Explanation

Signing documentation for services another practitioner did not provide misrepresents the record and exposes both parties to discipline. Courtesy, chart review, or a promise of later documentation does not make the record accurate.

Question 47North Carolina Occupational Therapy Practice Act

An occupational therapist discovers that a colleague has been documenting treatment sessions that did not occur. What is the most appropriate action under the Act?

  1. Report the conduct through appropriate channels, which may include the Board Correct answer.
  2. Confront the colleague privately and take no further action if the records are corrected
  3. Ignore the conduct because it is the employer's responsibility
  4. Document the concern in the client's record and continue treating

Explanation

Falsified documentation is a serious violation that implicates licensure standards and client safety, and practitioners are expected to report such conduct through appropriate channels. Private correction, employer deference, or a note in the chart does not adequately address the falsification.

Question 48North Carolina Occupational Therapy Practice Act

An occupational therapist is negotiating an employment contract that includes a clause requiring the therapist to provide services in a manner the therapist believes conflicts with the Act. What is the best course of action?

  1. Refuse to agree to the conflicting term and resolve the conflict before signing Correct answer.
  2. Sign the contract and follow the employer's direction as a condition of employment
  3. Sign the contract and comply with the Act only when observed
  4. Sign the contract and rely on the employer to obtain any needed waivers

Explanation

A contract cannot require conduct that conflicts with the Practice Act, and licensees remain personally accountable for compliance. Signing while intending selective compliance, following employer direction, or relying on waivers does not excuse a violation.

Question 49North Carolina Occupational Therapy Practice Act

An occupational therapist is asked to supervise more assistants than the therapist can reasonably oversee. What is the most appropriate response under the Act?

  1. Accept the assignment and delegate supervision duties to an aide
  2. Accept the assignment and document that supervision was limited
  3. Ensure that supervision can be provided at the required level before accepting the assignment Correct answer.
  4. Accept the assignment because the assistants are experienced

Explanation

Supervising therapists must be able to provide supervision at the level the Act and rules require, and accepting an assignment that makes adequate supervision impossible risks noncompliance. Documenting limited supervision, delegating supervision to an aide, or relying on assistant experience does not satisfy the requirement.

Question 50North Carolina Occupational Therapy Practice Act

An occupational therapist licensed in another state moves to North Carolina and begins treating clients there before applying to the North Carolina Board. Under the North Carolina Occupational Therapy Practice Act, which statement best describes the status of this practice?

  1. The therapist may practice for up to 90 days while the application is pending, provided the out-of-state license is active.
  2. The therapist is practicing without a North Carolina license, which the Act prohibits and the Board may act against. Correct answer.
  3. The therapist may practice indefinitely because licensure in another state satisfies the Act's credential requirement.
  4. The therapist may practice only under the direct supervision of a North Carolina licensee until the license is issued.

Explanation

Under the North Carolina Occupational Therapy Practice Act, a person must hold a current North Carolina license issued by the Board before practicing occupational therapy in the state. An active license from another jurisdiction does not by itself authorize practice in North Carolina, and the Act does not create a grace period for applicants. Practicing without the required license exposes the therapist to Board disciplinary action.