Advanced Practice Multiple Choice WEC 2 Test

D (AMD) (Macular degeneration is an eye disease that results in vision loss. The progression of this disease ultimately affects an individual's central visual field. The peripheral vision is unlikely to be damaged. A main difference between diabetes and glaucoma and that from macular degeneration is that it affects central vision and often leads to a defined central blind spot.)

Catherine, a 70 year old female retired librarian expresses that about a week ago she noticed decreased vision in her right eye associated with a black spot near the center of her vision. The spot does not move away with both far and near vision. She expresses that she has a hard time reading as sentences appear wavy and blurry. Catherine's peripheral vision is normal. What diagnosis does Catherine most likely have? A cataracts B glaucoma C diabetic retinopathy D aged- related macular degeneration

C (Long cane) (According to Riddering (2011), a long cane can help someone with lower limb neuropathy and contrast sensitivity. Albert is able to hold the long cane which will provide him with tactile information to his hands about his environment. This includes upcoming curbs, potholes, ramps, etc. This is appropriate as Albert's neuropathy has only affected his lower limbs and not his hands.)

Albert is a 76 year old male who has been having difficulty getting around his front yard and to his mailbox. Due to his diabetes, he has lower limb peripheral neuropathy. He states that he has to look down a lot to see where his feet are when walking. He also struggles with deciphering contrast. This has caused him to stumble and run into objects a few times. Which adaptive equipment could best help Albert in these areas of difficulty? A) Eye glasses B) Sunglasses C) Long cane D) Walker

B (Improverished) (According to Riddering (2011), habits are part of performance patterns and should be considered when evaluating an individual's community mobility. Habits are defined as impoverished when they hinder or negatively impact an individual's ability to adequately perform a task. In Dennis' case, his habit of looking down and walking quickly to get to his destination is impoverished because it causes him to bump into others and may ultimately cause him to stumble and fall.)

Dennis is a 71-year-old man who has been living with glaucoma for over 7 years now and has lost all peripheral vision and increased sensitivity to glare. He lives with his wife of 49 years and has lived in the same home for the last 39 years. He is very familiar with his home environment and has been able to manage since his vision loss, however, he has difficulty navigating when out in the community. He often bumps into people because he keeps his head down and walks faster than he processes his surroundings. He does, however, keep sunglasses in his front shirt pocket at all times and automatically puts them on when the glare is bothering him which helps him navigate better. Dennis' habit of walking quickly with his head down is an example of a ______________ habit. A. Maladaptive B. Impoverished C. Adaptive D. Useful

B (28 to 50 ft-c) (Rationale: If there is too much contrast between the task and the surrounding areas is can stress the eyes. The illuminance between the task items, equipment, horizontal work surface, and surrounding areas should be minimized)

What is the recommended illumination level for a computer workstation? a) 50 to 100 ft-c b) 28 to 50 ft-c c) 30 to 43 ft-c d) 61 to 91 ft-c

A (Acuity) (The Snellen chart is used to measure acuity. Although, it can measure someone's ability to read at specific distances and may be used to measure for legal blindness or referral to low vision rehab, its universal role is measuring acuity.)

A Snellen chart uses symbols, words, or letters that an individual must read from a specified distance. This type of chart is used to measure A. Acuity b Legal blindness c. Reading distances d. Referral for low vision rehab

C (Vocational eval) (Vocational evaluations include assessing the client's physical, psychological, intellectual, and emotional well being to determine how they may best complete their vocational duties. A general vocational evaluation is, "a comprehensive assessment to evaluate a person's potential to do any type of work.")

A comprehensive process that systematically uses work, real or simulated, as the focal point for vocational assessment and exploration to assist individuals in their vocational development can best be defined as: A) Work assessment B) Vocational assessment C) Vocational evaluation D) General vocational evaluation

D (Cataracts) (Choices A, B, and C are listed as the three progressive eye diseases that account for most low vision in older adults (Warren, 2011). While cataracts can contribute to low vision, they are correctable with surgery and are not listed as one of the three most responsible for low vision disease in older adults.)

All of the following chronic progressive eye diseases account for most of the low vision disease in older adults Except: A- Age-related macular degeneration B- Open angle glaucoma C- Diabetic retinopathy D- Cataracts

B (She should be provided with an electric stapler and set up a reminder method for taking standing/stretching/movement breaks every 30 minutes.) (As mentioned in Table 14.5, the strategies in choice B are methods to combat the ergonomic risk factors of contact stress and static posturing. Occupational therapists should make recommendations that focus on ways to eliminate or reduce risk factors including using excessive force, repetition, awkward/static posturing, contact stress, excessive vibration, and cold temperatures)

An occupational therapist completing an ergonomic evaluation at a high school history teacher's worksite notices that she uses the side of her fist to punch her stapler repetitively and she remains seated in the same position for extended periods of time. Which of the following suggestions for improvement should the OT recommend? A) She should have the students staple their own papers and utilize a standing workstation. B) She should be provided with an electric stapler and set up a reminder method for taking standing/stretching/movement breaks every 30 minutes. C) She should request an assistant and set up a reminder method for taking standing/stretching/movement breaks every 30 minutes. D) She should be provided with an electric stapler and a more comfortable chair at her workstation.

B (Tertiary Prevention) (Tertiary prevention involves helping the client regain maximum functioning in the workplace and prevent further injury)

An occupational therapist helping a client regain functioning in her wrist so that she can go back to her desk job, and providing her with information on proper wrist positioning when at the computer, would be an example of which type of prevention? A. Primary Prevention B. Tertiary Prevention C.Secondary Prevention D. None of the above

C (Tactile cues) (Rationale: According to our textbook, the main areas of intervention to enhance participation for individuals with visual deficits include magnification, lighting, contrast, and organization.)

An occupational therapist is collaborating with a client to create an intervention for improved participation in ADLs and IADLs. According to our textbook, there are 4 main areas in which interventions should focus. Which of the following is NOT one of those areas? A - Contrast B - Lighting C- Tactile cues D - Organization

C (Functional Capacity Evaluation) (Rationale: "A functional capacity evaluation is an objective assessment of an individual's ability to perform work-related activity" (Ha, Page & Wietlisbach, 2018, p. 340). The occupational therapist will use task analysis while the client is participating in work related activities to determine the clients' ability to engage in work-related tasks, their work capacity, and readiness for return to work. Prior to completing a functional capacity evaluation, the occupational therapist will complete a review of medical records, conduct an interview, complete musculoskeletal screening, and evaluate the client's physical performance abilities)

An occupational therapist working in an outpatient rehabilitation center receives a referral for John, who was injured while working 3 months ago. The referring physician has requested the occupational therapist to perform an assessment to determine the client's ability to participate in work-related activities. The occupational therapist will also conduct an interview with client and review medical records to form a recommendation. The occupational therapist is completing which of the following? a. work performance evaluation b. return to work assessment C. functional capacity evaluation D. functional task evaluation

C (Job demand analysis) (Only answer C describes physical demands of the job. Answer A and B refer to assessment of a person's readiness to return to specific work or to general workforce. Answer E describes the evaluation of the workstation taking under consideration the risk of injury.)

Assessing actual physical requirements of the job is called A) Specific vocational evaluation B) General vocational evaluation C) Job demand analysis D) Ergonomic evaluation

A (An opthamologist will perform a surgical procedure replacing the lens of the eye) (Technologic advances now allow for ophthalmologists to perform a minimally invasive surgical procedure and it has a short recovery period. It imposes virtually no limitations on activities postoperatively. It is extremely common and easy on the patients preceding without complications. The surgery entails removal of the lens and it is replaced with an artificial lens.)

Based on the previous question (cataracts), how can Terrence's diagnosis be treated? A) An opthamologist will perform a surgical procedure replacing the lens of the eye B) The occupational therapist will recommend an eye exam for a stronger eyeglass prescription C) anti-VEGF drugs will be injected the cavity of the eye D) There is no treatment for his diagnosis

B (Assist her in finding a volunteer position, potentially in the hospital, and work with her on skills she will need to be successful.) (Betty would benefit from seeking a volunteer position, as she is not able to return to competitive employment due to her disabilities (Ha, Page, Wietlisbach, 2018, p. 370). She expresses her desire to return to work, and her desire to help others to give herself more meaning in life. The occupational therapist can work with Betty to identify her strengths and build her confidence to allow her to be successful in a volunteer role. Although ADLs and visual-based activities may be important, they are not her main priority.)

Betty, a 62-year-old married female, was employed as a registered nurse (RN) for 39 years before she sustained injuries in a traumatic accident one year ago that has left her paralyzed from the waist down. She lost some of her vision in the accident, has minor cognitive deficits, and she requires assistance for many of her ADLs due to vision loss, weakness, and fatigue. During occupational therapy treatment she expresses her desire to return to work in the hospital, but she knows she is not physically capable of performing her job demands. She has been granted permanent disability, and she feels that her life is meaningless. She states she still has a desire to help others, even if she can't take care of herself. As an occupational therapist what would be the best possible intervention plan to help improve Betty's emotional status and increase her sense of well-being and meaning in life. A) Have a serious talk with Betty and tell her she needs to accept her new physical limitations and enjoy not having to work anymore, she can just relax everyday if she wants to. B) Assist her in finding a volunteer position, potentially in the hospital, and work with her on skills she will need to be successful. C) Work with Betty on her ADL's so she does not have to rely on her husband for assistance. D) Perform vision related activities that will help Betty adapt to life with low vision.

A ( Turn to early when driving and hit a curb) (Binocular vision pertains to the eye's ability to use both eyes to focus on an object and create a single picture. Binocular vision impacts visual field and depth perception (Riddering, 2011). An individual with binocular vision deficits, therefore, will have difficulty judging distances and determing exact locations of objects, such as where a curb ends and the road begins to make a turn while driving. )

Binocular vision deficits may cause an individual to: A. Turn to early when driving and hit a curb B. Develop a headache when watching a movie C. Be unable to distinguish colors in a painting D. Wake up in the mornings with eye pain

B (Open angle glaucoma) (Open-angle glaucoma is the most common form, the anatomy of the eye is normal (Mogk, 2011). However, the eye does not drain its fluid as efficiently as it produced the fluid, which leaves excess fluid in the eye (Mogk, 2011). Due to the increased fluid, it produces swelling of the eye which raises the pressure inside the eyeball (Mogk, 2011). As a result of the increased pressure in the eye gradually damage occurs to the optic nerve causing vision loss, mainly in peripheral vision)

Christina is a 52 year-old woman she recently went to her ophthalmologist with complaints of severe headaches and patchy blindness in her peripheral vision while navigating within her environment. She expressed how she always had normal vision (20/20), but with her progression in age it is slowly declining. She has a history of eye disease in her family and always has her eye pressure tested on annual eye exams. Usually, her eye pressure is slightly higher than average, but not high enough to be diagnosed with an eye condition. This year when she had her eye pressure tested it was reported at an unsafe level. What eye condition does Christina have? A) Diabetic Retinopathy B) Open-angle Glaucoma C) Severe Low Vision D) Age-related Macular Degeneration

A (Legal Blindness) (Legal blindness requires than an individual sees a visual field difference which is less than 20 degrees in one eye from another on the Snellen chart. Additionally, the individual must have a 20/200 or less in order to qualify as legally blind. A near normal range would be 20/30-20/60 where as a normal is 20/20.)

Elizabeth mentions to her work friends that seeing her computer has been more difficult and even with her corrective lenses she thinks she is going blind. She says that at her last doctor visit her visual field is 20 degrees less in one eye than another. Additionally, they said the results of the Snellen chart measured less than 20/200 in her best eye. What level of visual impairment does this classify as? A. Legal Blindness b. Normal range c. Near normal D. None of the above

D (20/200) (Rationale: In the 1930s, the US government created the term legal blindness for citizens to receive government services and benefits. To qualify as legally blind, an individual must have a best corrected visual acuity of 20/200 or less in the better eye or a visual field of 20 degrees or less in the better eye)

For an individual to qualify as legally blind, they must have a best corrected visual acuity of? A) 20/20 B) 20/60 C) 20/100 D) 20/200

D (Moderate low vision) (In order to accurately depict vision as a range of abilities, the World Health Organization (WHO), created 7 sub categories in order to differentiate ranges of vision based on Snellen chart results. They include normal vision (20/12-20/20), near normal vision (20/30-20/60), moderate low vision (20/80-20/160), severe low vision (20/200-20-400), profound low vision (20/500-20-1000), near blindness (20/1250-20/2500), and total blindness (no light and no perception)

George is a 75 year old man who just received a Snellen chart vision score of 20/160 in his right eye at his annual eye doctor exam. He is now unable to drive because of his impaired vision, which cannot be corrected by treatment or eye glasses. According to the World Health Organization, which category of vision loss does he fall under? A- Severe Low Vision B- Low Vision C- Near Blindness in the affected eye D- Moderate Low Vision

A (Contrast sensitivity) ( Contrast sensitivity can impact safe and independent functioning within the home and community. As contrast sensitivity declines with age, it is important to address daily contexts and environments. In an effort to increase contrast within such environments, modifications and adaptations are made to enable safe and effective participation within daily occupations.)

Henry is a 75 year old male who reports increased difficulty differentiating the street from the curb when stepping out of his vehicle. Most recently, Henry sustained a hip fracture as a result of a fall when stepping out of his vehicle and missing the curb. Henry also reports difficulty using his watch which has a grey background and dark grey numbers. Which of the following is Henry having difficulty with? A) Contrast sensitivity B) Visual acuity C) Saccades D) Depth perception

A (Charles Bonnet Syndrome) (Rationale: Charles Bonnet Syndrome is a type of syndrome that 20-30% of people with vision loss share. It is similar to phantom pain in an amputated body part. The individual may see lifelike images in their environments that are not there. The are usually repetitive images of common objects and are not threatening. Clients have stated that it is similar to seeing a still picture or watching a silent movie. These images are colorful and may move, but will not emit any sound. This does NOT mean that the individual is hallucinating or that their cognition is declining. This occurs when the nerves serving the unseeing areas of the retina do not receive any input and they fire off independently which causes the brain to perceive the message as visual, but also recognizes that the visual images are not real. This is different from hallucinations because when people hallucinate they generally have normal sight, believe the images are real, and interact with those images. Individuals with Charles Bonnet Syndrome are visually impaired, know the images are not real, and do not interact with them but rather perceive them as a still picture or silent movie.)

James is 80 years old and has visual impairments. One concern he has is he will continuously see a tree in his living room. The tree is fairly large, and he sees bright orange and yellow leaves on the tree. James does not interact with this image and knows that this image is not real. Although he knows that there is no tree in his living room, he is becoming worried that he is hallucinating or that his cognition is declining. What condition is James experiencing? A) Charles Bonnet Syndrome B) Diabetic Retinopathy C) Alhiezhimer's Disease D) Uveitis

A (Access to bedroom and bathroom on 1st floor of home) ("Aging in place" occurs when adults want to age where they currently live. Accessible bedrooms and bathroom are a major recommendation for universal design technique for adults aging in place. The other options are recommendations for adaptive equipment for a specific individual needs. )

James is an 80-year-old male who lives alone with some supervision from a part time home aide. His children would like to make some modifications to their father's home to improve safety and prevent serious injury. Using universal design strategies and considering a home plan for '"aging in place" which of the following is the best accomodation for James? (Defining universal design, n.d., pp. 38) A) Access to bedroom and bathroom on 1st floor of home B) Installing a ramp to all entrances of the home C) Prescribing a wheelchair D) Keyless entry to his home

D (All of the above) (The reason John may be experiencing fatigue and back pain could be because of his poor working posture. Because he prefers to work at a higher level, this results in a kyphotic posture as he is hovering over his desk. Sitting with his feet on the casters of the chair results in an increased amount of pressure on the back of his legs. Adjusting the height of the chair will allow for John to better align with his workstation to decrease the chance of poor posture and allow for his feet to be on the floor to decrease pressure. Providing a backrest with lumbar support and and a waterfall design for the seat pan will decrease the amount of pressure on the back of his legs and lower back)

John works as an assistant for a large business corporation in New York City. His job requires him to work at a desk for an eight hour shift with a one hour long break period. He is able to move around the office and take additional small breaks as needed. John is currently sitting in a standard office chair that has minimal seat cushioning and little back support. John keeps his chair on the highest level because he prefers to be up high when working at his desk. This results in John resting his feet on the casters of the chair. Recently, John has been complaining of fatigue and lower back pain resulting from poor posture. What ergonomic suggestion would be the most beneficial for John? A) Adjust the seat height B) Provide a backrest with lumbar support C) Choose a waterfall design for the seat pan D) All of the above

D (A & B only. The seat pan should NOT be deep. This compromises lower extremity circulation)

Joseph works as a help desk representative where he interacts with technicians via telephone while seated at a desk. During a worksite evaluation, what should the occupational therapist look for in the design of the chair to promote comfort and support? A) The chair should be easily adjustable for height, backrest position, and seat pan tilt B) Joseph's feet should be supported by the floor or a foot rest while seated C)The seat pan should be deep to support lower extremity circulation D) A & B only

B (Refer to a certified orientation and mobility specialist) (A certified orientation and mobility specialist (COMS) is highly skilled in helping an individual with visual impairment to use their residual senses to determine their location in their environment to be able to safely navigate from one place to another. Referral to any one of these specialities, aside from a COMS, is not indicated by the situation)

Josephine, a 79-year-old widow with macular degeneration, and her occupational therapist are working on community mobility. In this particular session, the therapist and her are navigating from Josephine's apartment to the bus stop two blocks away. The therapist notes that she frequently veers off the sidewalk and into oncoming traffic. She does not appear to hear the cars or use any other senses to recognize that she is on the road. The therapist decides this is out of her scope of practice, and that she needs to refer to another speciality. What does she do next? A) Refer to physical therapy B) Refer to a certified orientation and mobility specialist C) Refer to an optometrist D) Refer to a certified low vision therapist

C (DOT defines overall level of work as HEAVY when 20-50 lbs of force are frequently exerted. Frequency is defined as ⅓ to ⅔ of the day. Assuming that Lamar works a 7.5 hour work day, unloads for 90 minutes each day and has a minimum of 3 feed customers per hour (5 -10 minutes to load each vehicle = 15-30 min/hour x 6 = 75 -180 minutes per day) , this means he performs heavy work for 165 - 270 minutes per day. That translates to 2.75 to 4.5 hours of exerting force between 20- 50 lbs which is between ⅓ and ⅔ of the work day. Values can be found in Tables 14.1 and 14.2 of our text)

Lamar works in farm supply store in Iowa unloading 50 lb sacks of feed between trucks and the stockroom. In between the 90 minute long daily deliveries he also loads feed into customer's vehicles at the rate of between 3 and 5 customers per hour. He wrenched his back and filed a workman's compensation claim. After receiving 10 weeks of occupational therapy services Lamar feels ready to go back to work but in spite of improved body mechanics and work conditioning he is fearful of experiencing another injury. He would like to be placed on light duty for 3 months. As an occupation therapist how do you understand Lamar's pre-injury physical demand frequencies and overall level of work per DOT? A.Overall Level: Very Heavy, Physical Demand Frequency: Constantly, B.Overall Level: Heavy, Physical Demand Frequency:Constantly C.Overall Level:Heavy, Physical Demand Frequency: Frequently D. Overall Level: Very Heavy, Physical Demand Frequency: Frequently

B (Glaucoma) (Rationale: Glaucoma has a distinctive pattern of vision loss which begins by reducing an individual's vision in the mid-peripheral field and then progresses toward the center and the periphery. If untreated, glaucoma can leave the affected eye with a narrow tunnel of vision, or without any vision. Glaucoma has no symptoms so it is advised individuals older than 40 years old should have eye examinations every two to three years)

Mike is a 74-year old retired teacher. He enjoys gardening with his wife during his free time. Recently, he noticed he is having trouble navigating around his environment, especially his outdoor garden. Mike is having persistent difficulty with his peripheral vision as he is having trouble scanning his garden when looking for vegetables to pick. He went to his eye doctor and complained of having "tunnel like" vision. What common eye disease does Mike present with? A) Diabetic Retinopathy B) Glaucoma C) Cataracts D) Macular Degeneration

A (Worksite eval) (A worksite evaluation is, "an on the job assessment to determine whether an individual can return to work after the onset of a disability or whether a person can benefit from reasonable accommodations to maintain employment". )

Mr. Johnson recently injured his back while attempting to lift a heavy load at work. He is the third person this month to suffer a back injury at work. The owner of the company then hired an occupational therapist to complete an on the job assessment to determine if Mr. Johnson is able to return to work and if the therapist can make any work modifications or recommendations. The occupational therapist is most likely completing a: A) Worksite evaluation B) Work hardening program C) Specific vocational evaluation D) Vocational assessment

A (Work Hardening) (The answer is work hardening, A, because work hardening is a multidisciplinary approach, often incorporating occupational, physical, and vocational services. These programs often incorporate simulated work activities that take place in environments similar to the individual's natural work environment. Additionally, work hardening can include psychosocial treatment as well)

Mr. Rhodes has been receiving occupational therapy and physical therapy services following an injury that occurred at his job as a mechanic. The therapy he is receiving has been focused on education, strengthening, and performing activities in a simulated work environment. Despite the rehabilitative program it is unlikely that he will be able to continue in the position that he has held for the last twenty years, and has been working with a vocational counselor to explore other career possibilities. He has been experiencing increased stress due to his fear that he will no longer be able to provide for his family if he is unable to return to his job. What type of program is Mr. Rhodes participating in? A. Work hardening B. Work conditioning C. Work simplifying D. Work training

B (Work Conditioning; Work conditioning is defined as the physical conditioning alone, which covers strength, aerobic fitness, flexibility, coordination, and endurance generally involving a single discipline.)

Mr. Smith received occupational rehabilitation to improve his lower back pain sustained from excessive lifting while on the job. The goal of the rehabilitation was to maximize his function and enable him to return to work as quickly and safely as possible. During this phase of the rehabilitation process activities focused on physical conditioning, which aimed to improve Mr. Smith's strength, aerobic fitness, flexibility, coordination, and endurance. A) Work hardening B) Work conditioning C) Industrial rehabilitation D) Industrial conditioning

B (The evaluation should be scheduled during the normal hours of the worker) (The first step of ergonomic evaluation is to make an appointment with the worker to be assessed and the supervisor during regular working hours to get the best understanding of the actual work that needs to be completed in the particular workstation. Answer C is not correct because the evaluation will not be complete with just on side of information. Answer A is not correct because the OT and the worker do not require any witness. They require the presence of the supervisor to complete the evaluation.)

Mr. Thompson works in the factory. He complains of shoulder pain. His employer decided to hire an occupational therapist to evaluate Mr. Thompson's workstation. The OT made and appointment after hours when the factory is quiet so he can talk to Mr. Johns and his employer in a quiet environment since there will be a lot of educational points that need to be explained. The evaluation and the meeting will be incomplete and not appropriate because: A) There need to be more witnesses during the meeting B) The evaluation should be scheduled during the normal hours of the worker C) First meeting should be one- on -one, only the therapist and the worker D) B and C

A (Face the likely direction of the object and visually search the floor with a horizontal search pattern. If she does not find the earring she should take a step back and repeat the procedure with a larger left to right scan.) (When a client has a central field deficit an occupational therapist can teach the client visual scanning techniques to help them quickly scan the environment. Scanning is a useful technique if a client is trying to locate a lost or dropped object. The client should face the likely direction where the object landed, and visually search the area directly in front with a horizontal search pattern. If he/she cannot locate the item they should take a step back and repeat the procedure with a larger left-to-right scan. If the item is still not located the client can slight turn and keep repeating the steps until it is found.)

Pam is a 74 year old woman diagnosed with AMD, which affects her central field. She was attempting to put on a pair of earrings and she dropped them on the floor of her bedroom. The occupational therapist taught Pam techniques to help her locate an item if she dropped it. What would the technique look like when Pam performs it to find the lost earring? A) Face the likely direction of the object and visually search the floor with a horizontal search pattern. If she does not find the earring she should take a step back and repeat the procedure with a larger left to right scan. B) Call the nearest family member and ask them to search the ground for her because she is unable to see the floor of her bedroom. C) Bend down on hands and knees and circle the area until it is found. Hands can be moved in a circular movement on the floor to see if she can feel the earring. Keep circling until the earring is felt. D) Use a handheld telescope while sitting in the chair near the area where the earring dropped. Scan the ground in a vertical direction until the earrings are found.

D (Age- related macular degeneration) (AMD affects the central field of vision which decreases visual acuity. Poor visual acuity will affect individuals ability to see fine detail (Mogk, 2011). In most cases, individuals with AMD are able to walk around since there peripheral vision has not been compromised. Additionally, being Caucasian and older than 65-years-old increases one's risk for AMD, compared with glaucoma where the prevalence is highest in African American individuals. Diabetic retinopathy is associated with diabetes, and this case does not indicate the client has it (Mogk, 2011)

Regina is a 74-year-old caucasian woman living in an assisted living facility due to a recent hip replacement and early signs of Parkinson's disease. However, she is able to ambulate around the facility with a walker. Throughout the day many groups are formed by staff members to help keep the residents engaged with various activities. Regina is having trouble participating in these activities due to central vision loss causing her to have difficulties reading directions, choosing appropriate colors for painting activities, and trouble identifying family members when showing other residents her family photo books. Considering these visual issues, what is Regina's diagnosis? A) Cataracts B) Diabetic Retinopathy C) Blindness D) Age- Related macular degeneration

D (Both A & B; Risk factors to look for when completing an ergonomic evaluation include: forceful exertions, repetition, awkward or static posturing, contact stress, excessive vibrations, and cold temperatures)

Sally is a novice OT tasked with evaluating work-related musculoskeletal disorders. She is looking to assess ergonomic risk factors, in order to develop an education and prevention program. To complete a workstation evaluation, which of the following risk factors should be included on her evaluation? A) Forceful exertions, repetition, and awkward or static posturing B) Contact stress, excessive vibrations, and cold temperatures C) Only A D) A and B

C (Severe low vision) (Rationale: Severe low vision indicates the beginning acuity levels that make up legal blindness. Individuals with severe low vision are able to read with magnifiers, however their reading performance is typically slower than normal. Individuals with severe low vision will experience difficulties with ADLs, such as feeding and grooming, as well as IADLs, such as meal preparation, financial management, shopping, and housekeeping. These individuals may also need to depend on others for transportation as their functional mobility may be impacted.)

Sally is an 80-year-old woman who lives in the suburbs with her husband, Henry, who is a retired pilot. Sally handles the majority of the household chores including bill paying, grocery shopping, and cooking. Recently, she has been having trouble reading the labels on cleaning supplies at home and while attempting to pick up items at the supermarket. She is unable to read her mail and recipes without the use of a magnifier. She is also having trouble driving, as evident from being pulled over by the police for running a stop sign. Sally is seeking OT services due to her difficulty with these tasks. According to the World Health Organization, which of the following subcategory describes the level of Sally's deficit? A - Profound low vision B - Moderate low vision C - Severe low vision D - Near blindness

A (Primary Prevention Program) (Rationale: A primary prevention program focuses on protecting health workers in a specific population from acquiring a certain injury/condition (Ha, Page & Wietlisbach, 2018). Sally was hired to provide education to new employees hired specifically to work in the dock loading area. Since these employees have not yet sustained an injury, and Sally's primary role is to educate them and provide services with a focus on protect them from sustaining an injury, Sally is providing a primary prevention program.)

Sally, an occupational therapist, was recently hired as a consultant in her town's Pepsi Co. plant. The plant has noticed an increase in workers compensation claims being filed in the last 6 months, primarily from dock workers loading and unloading trucks. The dock workers are responsible for lifting and stacking boxes weighing about 50lbs. each. The injured workers are already receiving medical care elsewhere, therefore Sally will not be working with them. Sally will only be working with new employees hired to work in the dock loading area to educate them on proper lifting techniques to prevent the occurrence of injuries in the future and reduce the number of workers compensation claims being filed. What type of injury prevention program was Sally hired to provide to the new employees? a. Primary Prevention Program b. Secondary Prevention Program c. Tertiary Prevention Program d. General Prevention Program

A (Wrist stay straight) (Whenever possible, avoid awkward positions, and "choose tools shapes that allow the wrist to stay straight and the elbow to stay bend and close to the body during use." Figure 14.9 on page 352 demonstrates hand tools designs for optimal wrist posture.)

Steven is a 35 year-old line worker at a local factory. He is responsible for tightening a screw that a machine cannot reach. Lately, Steven has been complaining of pain in his right thumb CMC joint. When observed, Steven's wrist was in an ulnar deviated position while he was tightening the screw. What is the optimal position of the wrist while using hand tools? A) The wrist to stay straight B) The wrist should have slight extension C) The wrist should be flexed slightly D) None of the above

D (Cataracts) (A cataract commonly occurs with advancing age. It is a cloudiness of the lens of the eye. Symptoms from a cataract include clouded vision, dulled colors, blurred visual details, and can give a glare. Cataracts cannot be corrected by eyeglasses because the natural lens has become less transparent and thicker.)

Terrence is a 72-year-old male and is currently receiving occupational therapy services at a skilled nursing facility for a hip replacement. During treatment the occupational therapist notices he has difficulty locating items within his visual field, his clothes appear to be stained, and his room remains dim due to complaints of glare. He also complains of clouded and blurred vision. He wears bifocal glasses, but they have not been helpful. The occupational therapist notices his eyes are slightly grayish white. Due to his symptoms, what is most likely Terrence's diagnosis? A) Glaucoma B) Legal blindness C) Macular degeneration D) Cataracts

A (Sedentary) (Exerting anything more than 10 lbs. is not considered a sedentary level of work. Jobs are considered sedentary if walking and standing are required occasionally but all other sedentary criteria are met)

Terry's is a 34 year old male who works the front desk at a medical office. His job entails exerting up to 10 lbs. of force periodically. He also spends most of his days sitting at his desk, but he occasionally gets up to walk or stand for brief periods of time. What overall level of work is Terry demonstrating? a) Sedentary b) Light c) Medium d) Heavy

A (Primary prevention) (The answer is primary prevention, A, because primary prevention focuses on interventions that are relevant to all employees in order to prevent the occurrence of injury or work-related conditions. Secondary prevention identifies individuals who are at risk for developing a condition in order to minimize problems. Tertiary prevention is for individuals who have already suffered an injury or developed a condition, and interventions will focus on improving function and preventing further problems from occurring.)

The level of prevention that is considered "universal" where education on prevention can be provided to all individuals is called ______________. When applied to the workforce, interventions would focus on targeting all employees from acquiring work related injuries or conditions. A. Primary Prevention B. Secondary prevention C. Universal prevention D. Tertiary prevention

D (FCE) (The purpose of a functional capacity evaluation is to analyze how the worker performs the job and to determine if they are able to meet the job requirements. Other terms for this process include: physical capacity evaluation, work tolerance screening, and work capacity assessment.)

This is known as a systematic process for observing, measuring, analyzing and recording a person's physical abilities to perform work-related activity: A) Work study B) Job requirement analytics C) Anthropometry D) Functional capacity evaluation

C (Uvea) (The eyeball consists of three layers. The outermost layer is the sclera, which is the anterior surface. The middle layer, otherwise known as the vascular layer is known as the uvea. It includes the choroid posteriorly, which supplies nutrients to the retina and removes its waste. The uvea also is composed of the ciliary body anteriorly which produces aqueous fluid that fills the front of the eye. The iris which is the colored part of the eye is also included in the uvea. The innermost layer is the retina)

This layer of the eye is also referred to as the vascular layer. The components of this layer work to supply nutrients to the retina and removes wastes, produces aqueous fluid, and contains the iris. What layer of the eyeball is this? A) Sclera B) Retina C) Uvea D) Lens

C (FCE) (Functional capacity evaluations are defined by Ha, Page, Wietlisbach (2018) as, "an objective assessment of an individual's ability to perform work-related activity" (p. 340). These evaluations may be conducted by a number of disciplines, including occupational therapists, and are used for many reasons including setting goals, determining readiness to return to work, assess residual work capacity, determine disability status, and screen for physical compatibility before hiring a candidate)

This type of evaluation, conducted by an occupational therapist, is an objective assessment of the client's ability to perform work-related activities and may be used to set goals, determine readiness to return to work, or screen physical compatibility as part of the hiring process? A) Vocational evaluation B) Job demand analysis C) Functional capacity evaluation D) Industrial evaluation

B (Low physical effort) (According to the principles of universal design, low physical effort is a design that can be used efficiently and comfortably with a minimum of fatigue. This principle recommends guidelines such as allowing the user to maintain a neutral body position, use reasonable operating forces, minimize repetitive actions and minimize sustained physical effort.)

This type of universal design principle allows an individual to maintain a neutral body position, uses reasonable operating forces, and minimizes repetitive actions. A) Tolerance for error B) Low physical effort C) Perceptible Information D) Flexibility in Use

C (DR) (Rationale: Diabetic retinopathy (DR) can affect the entire retina and can cause levels of vision loss, or total blindness. DR is the only common eye disease that can cause varying patterns of vision loss due to it impacting the blood vessels supporting the retina. Individuals with DR often complain of double vision, decreased contrast sensitivity and color discrimination, poor night vision, and fluctuations in vision resulting from fluctuating glucose levels)

Vincent is a 57-year-old Caucasion man who was diagnosed with Type 1 Diabetes 9 years ago. He is married, has three adult children, and two dogs. He likes to work on his motorcycle in his spare time. Vincent recently went to his ophthalmologist and is complaining of spotty areas of vision loss, which makes it difficult to scan his environment for tools and not to trip over his dog's food bowls. He also noted that he is having trouble driving at night and complains of occasional double vision. This eye disease may require laser treatment or surgery in advanced cases. What does Vincent present with? A) Glaucoma B) Wet Macular Degeneration C) Diabetic Retinopathy D) Cataracts

C (They involve the entire visual field and cause a general decrease in acuity) (All four diseases affect different structures in the eye. Diabetes affects the retina and can cause any level of blindness resulting in decreased acuity. Cataracts affect the lens of the eye and blurs details throughout the visual field. Retinopathy of prematurity is a congenital eye disease that affects the retina resulting in myopia and anisometropia decreasing visual acuity. Uveitis is an inflammation of the uvea that impacts the entire field of vision resulting in decreased visual acuity. Although the diseases affect different structures in the eye, they all involve the entire visual field and cause a general decrease in acuity)

What do diabetes, cataracts, retinopathy of prematurity, and uveitis have in common? A) They all only affect one's central vision B) They all affect the retina C) They involve the entire visual field and cause a general decrease in acuity D) They involve the peripheral field and cause difficulty with contrast sensitivity

A (Trailing) (According to Riddering (2011), trailing is when a person places their small finger side of their hand on the wall to guide them through the room. Their hand should be slightly flexed and not stiff in order to avoid injury.)

What is it called when a client runs their small finger alongside the wall while walking in order to navigate their environment? A) Trailing B) Auditory use C) Protective technique D) Sighted guide

C (Service review) (Rationale: According to Ha, Page and Wietlisbach (2018), the three main roles of Occupational therapists in transition planning are transition related evaluation, service planning, and service implementation)

What is not the three main roles of Occupational therapists in transition planning? A) Transition related evaluation B) Service planning C) Service review D) Service implementation

B (Work hardening is a comprehensive, formal and multidisciplinary program that rehabilitate an injured worker. The rehabilitation team may include occupational and physical therapists, vocational and psychological counselors, exercise physiologists, dieticians, addiction counselors, etc. The program consists of intake evaluation, job site evaluation, graded activity, work simulation, strength and cardiovascular training, education, and goal setting. Work conditioning covers strength and cardiovascular training, flexibility, coordination and endurance. It may be implemented through one professional discipline ( i.e., physical therapy, occupational therapy, exercise physiologist, athletic trainer)

What is the difference between work hardening and work conditioning? A) Physical therapists conduct work conditioning while occupational therapists conduct work hardening. B) Work hardening is a formal, multidisciplinary program to prepare for return to work through graded activities and work simulation while work conditioning is accomplished through a single discipline and focuses on physical conditioning. C) Work hardening uses actual job equipment while work conditioning uses pegs, cones and arm bikes. D) Work hardening takes place in a 4 week inpatient setting while work conditioning is performed on an outpatient basis.

B (Steroids) (According to the readings, the most often and effective medication used to control uveitis is steroids and is prescribed in the form of injections, drops, or oral medication based on where it is located in the eye.)

What is the most common and effective medication used to control uveitis? A insulin B steroids C penicillin D ibuprofen

D (Both B & C) (OTs in the workplace will observe a work space and analyze the demands of the job in relation to the worker. They will determine if the demands are a threat to the individual's musculoskeletal system and create/design/educate how to reduce the demand of the task. )

What is the role of an occupational therapist in work programs? A) To train the workers how to do their job B) Identifying and analyzing the problems at the workplace C) Design appropriate assessments and interventions to solve workplace problems D) B and C

D (aging) (Aging has been determined to be the single best predictor of a person developing low vision, with at least two-thirds of all individuals over age 65 having low vision. For each decade that passes after age 60, chances of developing low vision increase. The other factors listed are not indicated to increase chances of developing low vision.)

What is the single biggest predictor of developing low vision? A) Race B) Genetics C) Lifestyle D) Aging

D (Contrast sensitivity) (Contrast sensitivity is the ability to differentiate between shades of light and dark, that also help to distinguish between similar colors. Visual field is the ability to see in one single area without turning one's head or eyes. Light modulation allows one to adapt to changing light, such as from light to dark. Glare modulation is how an individual is able to adjust to light reflecting from different surfaces)

What term best describes the ability to distinguish between similar shades of light and dark? A) Visual Field B) Glare modulation C) Light modulation D) Contrast Sensitivity

C (Both indoors and outdoors) (As discussed by Riddering (2011), glare is attributed as a significant factor impacting ADL performance for individuals with glaucoma. When determining the cause of glare, assessments should be done both indoors and outdoors, in a variety of weather conditions.)

When completing a vision assessment, glare should be assessed A) Indoors B) Outdoors C) Both indoors and outdoors D) None of the above

D (Modify and adapt) (Although all of these approaches can be used with older adults with eye conditions, modify and adapt approach is the PRIMARY approach due to the chronic and progrssive nature of many eye diseases that cause low vision for older adults. This approach will make it easier for older adults to complete their daily activities even when their vision progressively becomes worse.)

Which intervention approach is the PRIMARY approach to use with older adults who have chronic and progressive eye conditions/diseases? A) Create/promote B) Establish/restore C) Maintain D) Modify and adapt E) Prevent

A (Ergonomics) (Rationale: Ergonomics addresses human performance and well-being in relation to one's job, equipment, tools, and environment)

Which of the following addresses human performance and well-being in relation to one's job, equipment, tools, and environment? A) Ergonomics B) Worksite evaluations C) Job demands analysis D) None of the above

D (Angle of light) (The three lighting factors that should be considered are contrast, glare, and quantity. Lighting is an important factor for completing job tasks. Bright lighting should be avoided as it causes discomfort. While angle of light should be considered, it is not listed as the three basic lighting factors)

Which of the following is not a basic lighting factor that should be considered for performance of work. A) Contrast B) Glare C) Quantity D) Angle of light

C (Visual acuity) (Visual acuity is the sharpness of vision that is measured by the ability to perceive letters or numbers at a given distance (Riddering, 2011). Decreased distance visual acuity may hinder an individual's ability to anticipate obstacles in their pathway while walking (Riddering, 2011). Limitations in both near and distance visual acuity can restrict an individual's participation within their given environments)

While assessing Steve's mobility the occupational therapist notes that he had limited ability to visually anticipate obstacles in his pathway. What visual factor is limiting Steve's ability to notice obstacles while navigating within his environment? A) Visual field B) Glare C) Visual acuity D) Contrast sensitivity

A (Detach the telephone from the wall and move it within the admin assistant's primary work zone.) (In this case, the telephone is in the tertiary work zone which is typically where items that require seldom access should be situated. Objects that require repetitive access, such as the telephone, should be placed within forearm's length from the person's normal sitting position.)

You are an OT assigned to make ergonomic modifications to the computer workstation of an administrative assistant that claims she has neck and shoulder pain on her left side. She sits at her desk to do computer work and take phone calls for most of the day. You notice that the telephone is attached on the wall about an arm's reach away and slightly higher from her normal sitting position. This forces her to abduct her left arm approximately 120 degrees to pick up the telephone. With this knowledge, what modification would you recommend? A) Detach the telephone from the wall and move it within the admin assistant's primary work zone. B) Boost up her chair so she won't have to reach so high C) Switch the phone for a cordless model D) Use a downward tilting keyboard tray

C (General vocational eval) (A general vocational evaluation is used to evaluate a person's potential to complete any type of work. This evaluation is used for individuals who have never worked, cannot return to their prior job, or cannot return due to their injury. The key works identified in the question are "explore other interests" and "clients potential")

You are an OT evaluating a client who has sustained a TBI after a severe fall in NYC. Your client has been an ironworker for the last 20 years, however, his wife does not want him to continue his career after his recovery. She would like for him to find a job that is less demanding and dangerous. What assessment would be most beneficial to use to explore other interests and evaluate your clients potential? A) Specific vocational evaluation B) Functional capacity evaluation C) General vocational evaluation D) Job demand analysis