OTA 220 final

Ms. Smith was recently discharged home with the addition of 4 new cardiac meds. She has been able to manage her med regiment without difficulty but now is expressing concerns about her ability to organize and remember when to take them. The OTA should consider which of the following factors when working with Ms. Smith to improve medication management?

what compensatory strategies might be necessary to adhere to the prescribed schedule

While in the inpatient rehab setting, which 3 of the following should be the focus of the early OT treatment plan for the client with upper limb loss?

-Education the client on the use of assistive/adaptive equipment during self-care tasks -increasing the client's ROM and strength -Educating the client on one-handed techniques

Which 3 of the following are cognitive strategies used to enhance motor function?

-Mirror therapy -Provide opportunities -Action observation

An OTA is working with a client who has just had a LT anterior approach THR. Which 3 of the following activities are appropriate treatment activities?

-Practice using a raised toilet seat for toilet transfers -Practice using a shower chair and grab bar for shower transfers -Practice reaching in kitchen cabinets while standing at a rolling walker

Your client has been successful with simple organized visual scanning tasks to address oculomotor control? Which 3 of the following should they progress to next?

-Reading a paragraph with a line guide -Working on a more disorganized scanning task, possibly including standing or ambulation -Reading a recipe

Which of the following would be part of the OT plan of care for a client whois functioning at Level II of the LCFS?

-Sensory stimulation -Education of family members in overstimulation -ROM and positioning

John is a 56 year old with a recent diagnosis of CVA. He has dominant right-sided weakness, with decreased hand grip, right visual inattention, and receptive language deficits. Which 3 of the following might be strategies the OTA could employ at the first self-feeding session.

-Setting the table with a large-handled spoon and U-cuff -Setting the table with plate in midline -Using gestures and few words during the self-feeding session

Working with clients to foster lifestyle modifications is especially important when working with people with chronic diseases. Which 3 of the following are considered lifestyle modifications that OTAs should encourage clients with chronic disease to incorporate into their daily lives?

-Stress management and coping strategies -Physical activity and exercise -Healthy diet choices

the OTA walks into the client's inpatient rehabilitation room on the 3rd day following his UE amputation, and he states, "I am having pain in my fingers event hough I know they aren't there. Is there anything we can do about it?" which 3 of the following would be the best treatment strategy to try for this client?

-Use of TENS -Speaking with the physician regarding this complaint so that she can consider medication management -Use of mirror therapy

A client is referred to the outpatient clinic which a flareup of RA affecting her RT shoulder, left wrist, and both hands. Which 3 OT interventions would you most likely incorporate into her treatment?

-Use of a wrist-hand orthotic -Doing gentle active ROM (AROM) exercises in bed before getting up in the morning -receiving instruction in join protection techniques

Which 3 of the following are tools used to compensate for cognitive deficits?

-Using a smartphone calendar -viewing pictures in the bathroom of the steps for grooming -Putting on noise-canceling headphones while working

a 55 year old client with primary progressive MS would be appropriate for which 3 of the following types of OT services?

-adaptive techniques for ADL tasks -balance and mobility safety during kitchen tasks -Memory adaptations

The OTA is treating a client who is about to begin chemo. Which 3 of the following would the OTA use to explain to the client how chemo is administered and its side effects?

-administered intravenously or through an x-ray machine -causing hair loss and short-term memory problems -administered orally, which would cause impaired balance while standing

A 34 year old client with a 5 year history of brain tumor presented to the emergency dept. with sudden-onset significant LT-sided weakness and neglect impacting his ability to safely move in the home or care for himself. He was referred to home care at the time of disease progression. Which 3 of the following are appropriate treatments?

-left upper extremity strengthening -obtaining a physicians order for NMES for neuromuscular reeducation of the LUE -Visual exercises to attend to midline

A client has a C5 ASIA D SCI/D and is going home with her husband, mother, and sister. What 3 expectations should the OTA educate the family on?

-she can expect to brush her teeth with some assistance from family -She can expect to drive her power w/c independently with alternative controls -She can expect to perform pressure relief independently with use of tilt/recline on her power w/c

Once a client's burned skin is ready for scar management, which 3 of the following are suggested to decrease a scar contracture?

-silicone -massage -paraffin

John is recovering from Guillian-Barre syndrome. While checking his muscle strength in his R wrist extensors, the OTA notices that the muscle contracts but the joint does not move. What muscle grade should be assigned to the client's wrist extensors?

1

What are the 4 cancer gradings?

1. well differentiated (low grade) 2. Moderately differentiated (intermediate grade) 3. Poorly differentiated (high grade) 4. Undifferentiated (high grade)

Mary is a 60-year-old woman who had a LT CVA and is attending outpatient OT services. During functional muscle testing of her RT arm, the OTA notices that the client can raise her arm all the way up but that it falls down immediately. What muscle grade is the client exhibiting?

3

Ms. Thorton has sustained a full-thickness burn. She does not recall the event and appears lethargic. What is the first thing the OT/R should do when Ms. Thorton is seen at the burn center for treatment?

Fabricate and apply a hand orthotic

At initial eval and assessment of a client with a significant burn, what is the primary focus the OTA should have to develop an appropriate treatment plan?

A full understanding of the client's prior and current functioning and ADLs

A client has a history of breast cancer with bil mastectomies and chemo. She has recently noticed that is it getting difficult to button her shirt and to perform her favorite leisure activity of knitting. Which 3 of the following are appropriate treatments that the OTA can provide?

A, C, D -Fluido-therapy for the hands while performing FM manipulation of objects -task practice of knitting -Issue built-up eating utensils

A client who has had a RT CVA displays limited movement in the LT wrist extensors. Using the Rood approach, which techniques is considered effective to facilitate LT wrist extension?

Fast brushing over the wrist extensor muscles

Regarding OT and total knee replacements, which of the following statements is accurate?

OT can assist with encouraging knee mobility during ADLs and IADLs

What types of therapy interventions would you have a client with HD participate in?

Upper extremity exercises, balance tasks, and therapy in the pool

A client who presents with a communication impairment characterized by difficulty articulating messages correctly in the absence of muscle weakness likely has

Apraxia

A client with a diagnosis of radial nerve palsy has been referred for a custom orthosis. He presents with inability to extend the wrist and fingers. This loss of motion makes it difficult for him to release objects from his hand after gripping. The goal of the orthosis would be to:

Assist with function by providing wrist and finger extension while awaiting nerve return.

Jennifer is a client you have been working with in the hospital and was admitted with a new diagnosis of CVA. The client just began to increase her participation in therapy and you note that she is not paying attention to her LT side as much. What is the next course of action?

Discuss this new finding with the OT/R to determine whether a new TX plan needs to be implemented.

A young adult with Duchenne MD might use which item on his power w/c for controlling the mouse on his computer?

Bluetooth mouse control through the joystick

An older woman with SMA type 4 adult-onset has always exercised as part of her daily routine, and she is nervous about continuing and doing damage to her muscles. What should the OTA tell her about exercises?

Do as much physical activity as is comfortable without over doing it

When a client sustained a full-thickness burn circumferentially to an extremity, what is the biggest concern?

Compartment syndrome

A client has rheumatoid arthritis in the inflammatory stage in her RUE. During this phase, the OT/R established a goal for reducing pain and stiffness. The PAMs for addressing this goal would be:

Contrast baths

The OTA is treating an older male client with LGMD who is having significant difficulty with self-care at home. What types of problems might he be having?

EMG or nerve conduction tests, blood work, and genetic testing

A client has been referred for a custom orthosis; however, during initial assessment, she is found to have decreased ROM, edema, and impaired sensation in her wrist and hand. Which 3 of the following are precautions when fitting this orthosis?

Decreased ROM Edema Poor skin integrity

When adhering to posterior approach hip precautions after a THR, which of the following would be the most appropriate OT treatment?

Crossing legs to reach one's shoes

A client has UE spasticity after a stroke. The shoulder will most likely be which of the following fixed positions?

External rotation and abduction

Client sustained a TBI due to a motorcycle accident and a pelvic fracture. The physician ordered NWB on the RT lower extremity. Fred is currently functioning at Level IV of the LCFS, with poor memory, poor safety awareness, and balance deficits. What challenges would the OT/R expect to have in working on ADLs with Fred?

Following weight-bearing precautions with toilet transfers

When introducing AE or devices to a client with dementia, it is best to introduce it to them no later than:

GDS stage 4

Client is a new to outpatient clinic. He sustained TBI after falling from a ladder 6 months ago. He lives with his wife and 7 year old son. He is only interested in outpatient therapy to work on his goals to return to driving and his job as a manager of the service department of a car dealership. The eval shows deficits in problem solving skills, sequencing, abstract reasoning, mild FM deficits in the LT hand, and mild memory deficits. How would the OT/R address the clients goal or returning to work?

Give him a crate of equipment to sort and organize on a shelf to simulate a task that he might do at work to encourage participation in therapy sessions.

Which orthotic would you recommend for a client with osteoarthritis of the thumb? CMC joint?

Hand-based orthotic with the thumb abducted in a position of comfort

Jon has a C7 ASIA D SCI/D and is regaining "gross strength" in his RT hand and fine motor strength in his LT hand. Which of the most accurate ex. of how he can use his RT hand?

Hold a water bottle with his RT hand

What would be an appropriate goal for a cancer survivor?

Increasing independence in mobility with or without an assistive device

Gladys had a TBI 4 weeks ago and is now at home and receiving out patient OT services. She has difficulty with recent memory and new learning. She is oriented to time by using a calendar and clock for direction. Gladys is still demonstrating some confusion. At what level of the LCFS is Gladys functioning?

Level VI-Confused, appropriate response

A client with MS has severe dysarthria and mild cognitive deficits. The family has noted the client has difficulty spelling words with the communication device that utilizes a keyboard. Which 3 of the following might be included as the next options for the client?

Picture-based board using familiar items Board with common words and phrases Word prediction on current device

Which of the following is an example of utilizing a multimodal approach to communication during a session?

Providing written instructions in conjunction with verbal instructions and further supplementing with a demonstration of the task

It is your first visit with a client who has age-related macular degeneration. You begin with:

Reviewing goals and ensuring the client understands the diagnosis

You are covering a relatively new client for a coworker you neglected to tell you anything about the client except that she has a CVA. After talking with her, she appears to have impaired speech, impulsiveness, and impaired problem-solving ability. Where might her CVA have been located?

Right hemisphere

A client with LT homonymous hemianopsia demonstrates poor awareness of her LT side. Where should treatment begin?

Scanning tasks to increase attention to the left

When teaching self-ROM exercise to a client who has had a CVA, is it important that the OT/R instruct the client to NOT:

Stretch the shoulder beyond 90 degrees of flexion

The OT/R is working with a client who has LT hemiparesis and is functioning at Level VII of the LCFS. Which of the following strategies would be appropriate for working on UB dressing?

Teach hemi-dressing techniques in the context of dressing

Brad has a C6 SCI/D. His daughter would like to assist with stretching her father's UE's and LE's during evenings and weekends. What mechanism would the OTA emphasize protecting during stretching?

Tenodesis: Flexing the wrist while extending the fingers

Mark experienced a recent MI (heart attack) but was cleared medically by his physician for OT services. During an OT session, he began having nausea, shortness of breath, extreme fatigue, and chest pain. What action should the OTA complete in response to these symptoms?

The OTA should stop intervention immediately and notify nursing staff because these are signs and symptoms of exercise intolerance, as well as possible signs of a heart attack

Clients who present as a GDS stage 6 may demonstrate which of the following characteristics?

They wander for self-stimulation

A client was referred to the clinic for a dynamic orthosis 2 weeks after surgically repaired nerves which were damaged when he has sustained a gunshot injury to the arm. In this situation, a dynamic orthosis is used:

To compensate for loss of motion and improve function

A client has recently been diagnosed with myasthenia gravis, and is having difficulty with IADL tasks, specifically with putting away groceries and retrieving items from higher shelves and in the closet. Which items and techniques might the OTA offer?

Using a reacher and dressing stick in the kitchen and bedroom

A client with dementia presents as a DGS stage 5. During the day program, this client may demonstrate which of the following characteristics?

they may use different grasps for different objets