pass the OT Module 5

What type of diagnoses use a power wheelchair,

Any level of SCI MS ALS MD Severe RA CP Systemic lupus erythematosus

Paula is a 63-year-old woman with a diagnosis of rheumatoid arthritis. She has limited upper extremity range of motion and complains that she has difficulty grasping and moving her computer mouse when using her PC to connect with her family over Zoom. What adaptation should be recommended to address Paula's problem? Head pointer Trackball mouse Touch screen Voice commands

Trackball mouse. A trackball mouse positions the trackball on top of the mouse, allowing the user to move the computer cursor by moving the ball with the fingers, rather than sliding the mouse around on the desktop. This adaptation works well for people with limited upper extremity range of motion. Paula does still have upper extremity movement, so she would not need to use voice commands or a head pointer. Using a touch screen would probably be difficult for Paula as she would have to reach forward and up to touch the screen.

Define Transitional work programs

Transitional Work Programs: Transitional work uses the actual work tasks and environments as a form of rehabilitation. The patient is attentding a work conditioning program which would typically be taking place at an OT facility.

What are some diagnoses where the person is unable to propel any type of w/c?

-severe quadriplegic cerebral palsy -severe brain injury -multiple congenital conditions -advanced Alzheimer's disease

What kind of diagnoses use a manual wheelchair

-spinal cord injury particularly mid-thoracic, lumbar, sacral -CVA -multiple sclerosis -muscular dystrophy -arthritis -lower extremity amputations

Before transferring any patient, it is important to determine how much assistance they will need, in order to protect yourself and the patient from injury. How many levels of assistance are there for transferring a patient?

1. Dependent: The patient is unable to assist. 2. Maximum Assist: Maximal assist means that the caregiver performs about 75 percent of the work duringtransfers and the patient performs 25 percent of the work. 3. Moderate Assist: Moderate assist is a level of assist where the patient performs about 50 percent of the worknecessary to move and the caregiver performs about 50 percent. 4. Minimal Assist: Minimal assist means that the patient performs 75 percent of the work to move and the caregiver provides about 25 percent of the work. 5. Contact Guard Assist: With contact guard assist, the caregiver needs to have one or two hands on the patient's body without providing other assistance to perform the transfer. The contact is made to help steady the patient's body or help with balance. 6. Stand-by Assist: During stand-by assist, the caregiver does not touch the patient or provide any assistance, bu the or she may need to be close by for safety in case the patient loses their balance or needs help to maintain safety during the transfer. 7. Independent: The patient can perform the functional task with no help and is safe.

1. Define Limb kinetic apraxia. 2. Ideomotor apraxia 3. Ideational apraxia 4. Verbal apraxia- 5. Constructional apraxia- 6. Oculomotor apraxia 7. Dressing apraxia 8. buccofacial or orofacial apraxia,

1. the inability to make fine, precise movements with an arm or leg 2. the inability to make the proper movement in response to a verbal command 3. the inability to coordinate activities with multiple, sequential movements, such as dressing, eating, and bathing 4. difficulty coordinating mouth and speech movements 5. the inability to copy, draw, or construct simple figures 6. Difficulty moving the eyes on command. 7. (difficulty with the automatic and spontaneous capacity for dressing- donning and doffing clothes) 8. inability to carry out facial movements on command such as licking lips, whistling, coughing, or winking.

What is a corner chair with pelvic straps

A corner chair has a V-shaped backrest that provides support at the back and sides of the user and is made specifically for users who cannot stabilize themselves against gravity. Corner chairs are perfect for children who may need head, trunk and pelvis support for attaining proper sitting alignment and posture. The corner chair will usually have a sturdy base so it can be the same height as a regular chair and be used at a table. Conversely, the base can be removed so the corner chair and child can both be placed on the floor for playing, allowing the child to interact more easily with their contemporaries at the same eye level either at a table setting, or on the floor during playtime. The pelvic straps help prevent the user from pushing or sliding out of the chair.

What is the purpose of an adjustable head pointer?

A helmet that assists individuals with limited hand use in writing, drawing, turning pages, or activating switches and controls. This adaptive device can also help people with limited verbal communication skills to use communication boards.The head piece consists of adjustable lightweight plastic bands for fitting individual head sizes and shapes. The bands are secured with metal hardware and topped with a 19-inch aluminum pointer rod. The bands are padded for comfort. The pointer rod is length and angle adjustable in any direction, and is fitted with a removable pencil holder.

Describe a mechanical soft and nectar thick diet

A mechanical soft diet requires that dry or tough foods be ground up or mashed. Meat is usually ground up and sometimes mixed with liquid or gravy. Vegetables are usually cooked and/or mashed. Meat that is cut into bite sized pieces is not soft enough for a mechanical soft diet and saltine crackers are too dry and hard. Pureed spaghetti would not be necessary. Nectar thick liquids include liquids that have a slight thickness to them, such as tomato juice.

Describe a standing w/c?

A power wheelchair that uses hydraulics to lift the person to a standing position and support the person in standing.

Describe a typing aid Describe a page turner Describe a sip and puff

A strap with a stick attached to use as keyboard and button pusher that can be used on keyboards, typewriters, adding machines, calculators and telephones. People with limited functional hand skills will find this tool helpful to accurately press keys. The Page Turner consists of a large open-ended hand clip that is attached to a long, curved bar. Made of aluminum with a rubber tip for easy flipping of pages. This assistive technology is a form of switch system that sends signals through air pressure by having users sip (inhale) or puff (exhale) through a tube, straw or wand.

What is a tonic bite reflex? Why would a vinyl spoon be helpful?

A tonic bite reflex causes the patient to bite down in a strong, sustained manner in response to stimulation of the teeth and gums. Using a coated spoon minimizes the exposure of the teeth and gums to hard metal or plastic, reducing the stimulation received and reducing the reflexive reaction.

Define a light weight w/c? What type of people would benefit from this w/c and what would be their diagnosis?

A wheelchair that is made with lighter materials and designed to fold for travel. Diagnoses that allow the person to drive and/or travel frequently. spinal cord injury amputations multiple sclerosis arthritis cerebral palsy muscular dystrophy

Anton is a 7th grade student with a diagnosis of severe cognitive impairment. He is non-verbal, prompt dependent, and has limited voluntary AROM due to his cognitive limitations. When Anton eats lunch at school, he holds a spoon with his fingertips. He is not able to manipulate the spoon to position it to scoop food and requires hand over hand assistance with this task. He also displays tremor-like movements as he brings the spoon to his mouth, often spilling food on his shirt. What adaptation would help Anton become more independent in feeding himself at school? A swivel spoon A weighted spoon An angled spoon A coated spoon

A. A swivel spoon. Swivel spoons are designed so that the bowl of the spoon sits somewhat lower than the handle, decreasing the amount of wrist flexion and pronation that is required to scoop food with a regular spoon. A swivel spoon is mounted to the spoon handle with a swivel mount, allowing the bowl of the spoon to swing back and forth. The swinging motion compensates for any tremor that is present, making it easier for the person using the spoon to keep the food in the bowl while lifting it to the mouth. The functions of the swivel spoon should help compensate for Anton's limitations and allow him to feed himself without assistance to scoop food.

A 42-year-old woman who works at a law firm as a paralegal has started experiencing difficulty completing her work , due to eyestrain and blurred vision. She has also started developing frequent headaches and dry eyes. What is the MOST useful adaptation that can be recommended to this patient? Anti-glare screen Word prediction software Wireless mouse Increase font size

A. Anti-glare screen. The patient is demonstrating signs of computer vision syndrome (CVS) or digital eyestrain symptoms. Glare on a digital screen can lead to eyestrain. If there is no way to minimize glare from light sources, consider using a screen glare filter. These filters decrease the amount of light reflected from the screen. Viewing a computer or digital screen often makes the eyes work harder. As a result, the unique characteristics and high visual demands of computer and digital screen viewing make many individuals susceptible to the development of vision-related symptoms. Uncorrected vision problems can increase the severity of computer vision syndrome (CVS) or digital eyestrain symptoms. Viewing a computer or digital screen is different than reading a printed page. Often the letters on the computer or handheld device are not as precise or sharply defined, the level of contrast of the letters to the background is reduced, and the presence of glare and reflections on the screen may make viewing difficult. SymptomsThe most common symptoms associated with CVS or digital eyestrain are: • Eyestrain. • Headaches. • Blurred vision. • Dry eyes. • Neck and shoulder pain. These symptoms may be caused by:• Poor lighting. • Glare on a digital screen. • Improper viewing distances. • Poor sitting posture. • Uncorrected vision problems. • A combination of these factors .Uncorrected vision problems like farsightedness and astigmatism, inadequate eye focusing or eye coordination abilities, and aging changes of the eyes, such as presbyopia, can all contribute to the development of visual symptoms when using a computer or digital screen device.

A home health patient is one month post right CVA with left hemiplegia. The patient completes basic ADL tasks using assistive devices and ambulates in the home with a quad cane. He requires stand-by assistance for balance when walking outdoors on uneven surfaces. One of the patient's goals is to resume his favorite leisure activity of gardening in a small backyard vegetable garden. Which course of action should the OTA select to help the patient work toward his goal? Apply adaptive strategies during graded outdoor gardening tasks Set up a routine maintenance schedule to care for indoor flowers and plants Practice mobility skills for going to and from a community gardening class Participate in building planter boxes to establish a raised garden bed

A. Apply adaptive strategies during graded outdoor gardening tasks.Graded gardening tasks outdoors will allow the patient to progress to performing this leisure activity, and working on outdoor gardening tasks will allow the patient to gain skills in the natural context of the activity as long as the practitioner has deemed the activity is safe for the patient to perform.

Jared is a 19-year-old man with a diagnosis of intellectual disability. He is attending high school until age 21 so that he can receive pre-vocational training in preparation for a supported employment position in the community. What pre-vocational activities can the school-based COTA® work on with Jared while he is still attending high school? Select the best 3 choices. Basic ADL skills related to work - hygiene and grooming, how to dress for work, etc. Time and schedule management Handwriting skills Driver training On-site training in tasks specific to the job Jared wants to apply for Training in community mobility

A. Basic ADL skills related to work - hygiene and grooming, how to dress for work, etc. B. Time and schedule management. F. Training in community mobility. Pre-vocational training involves the development of skills necessary to obtain and hold a job in the community. Even though Jared will be working in a supported employment position, he will still be expected to demonstrate the skills needed to hold a job, including appropriate hygiene, grooming, and clothing. He will also need skills related to time and schedule management, such as how to fill out a time card and how to read a work schedule. He will also need training in how to get to work, such as riding the city bus. On-site training in tasks specific to the job Jared will be working will occur during supported employment, not during pre-vocational training. Handwriting skills would have been addressed with Jared when he was in elementary school. Driver training must be provided by specially licensed driver rehabilitation practitioners.

A COTA® working in an outpatient clinic has been asked to provide in-service training on injury prevention to the employees of a local warehouse. What topics would be appropriate for the COTA® to address during her presentation? Select the best 3 answers. Body mechanics during lifting and carrying Body mechanics during lifting and carrying Muscle conditioning exercises Joint protection techniques Recommendations to adapt specific work stations Stress management techniques Specific compensation techniques

A. Body mechanics during lifting and carrying C. Joint protection techniques. E. Stress management techniques. This presentation is on injury prevention techniques for all employees. The presentation should cover general topics that pertain to all the workers in attendance. These topics could include body mechanics to use while lifting and carrying, joint protection techniques, and stress management techniques. Muscle conditioning, adaptations to work stations, and compensation techniques are done on an individual basis with patients in worker rehabilitation programs and should not be addressed during an in-service presentation.

A 15-year-old student with muscular dystrophy has difficulty typing on a keyboard due to progressive muscle weakness in his hands. What adaptation should the OTA recommend to help him complete typing tasks. Dictation software Large key keyboard Mobile arm support Ergonomic keyboard

A. Dictation software. Since the student's muscle weakness is progressive, he will likely have more difficulty typing in the future. Adaptations to the keyboard will have to be revised as the student loses functional ability in his hands. Dictation software would allow the student to compose written work without requiring him to use his hands to type. The student will be able to use this adaptation even if he loses functional movement in his hands, so this would be the best adaptation.

Wanda is a 72-year-old woman with Parkinson's Disease who receives outpatient occupational therapy. What specific strategies can the COTA® use which will facilitate her participation in the OT sessions and improve the quality of her movements? Select the best 3 answers. A). Give Wanda extra repetitions of specific tasks to help reduce intention tremor B.) Use a stopwatch to time Wanda's tasks to give her incentive to move faster C.) Use rhythmic cues to help Wanda pace her movements D). Have Wanda visualize a fine motor task prior to completing it E.) Have Wanda focus on integrating the steps of a task to improve the flow of the task F.) Encourage Wands to complete exercises independently through the range of motion that she has

A. Give Wanda extra repetitions of specific tasks to help reduce intention tremor. C. Use rhythmic cues to help Wanda pace her movements. D. Have Wanda visualize a fine motor task prior to completing it. Movement in patients who have Parkinson's Disease is often limited by tremor, especially intention tremor that occurs before the patient initiates a movement. Treatment techniques that can help reduce this tremor focus on making movements more automatic and timing movements to reduce uncertainty. Extra repetitions, rhythmic cues, and visualizing tasks meet this requirement. Timing tasks causes the patient stress and actually increases intention tremor. Treatment should also focus on practicing specific steps of a task to improve individual movements, rather than integrating the task right away. Exercises should be graded from active assist through the full range of motion to independent movement.

George is a 68-year-old man with a left ischemic CVA with right hemiparesis. He receives occupational therapy as a part of his rehabilitation program. George displays poor trunk control with resulting slouching to the left side and poor sitting balance. How can the COTA® address George's poor sitting balance during therapy sessions? Select the best 3 choices. A.) Have George practice appropriate sitting posture in front of a mirror B.)Use handling techniques to make sure George's posture is correct before initiating activity Place George in a supine position to work since he cannot sit up straight C.) Provide adaptations to support George in sitting prior to working on movement activities D.) Use dynamic weight-shifting during reaching tasks to practice trunk control during weight shifting E.) Avoid trunk-strengthening exercises until George's postural control improves

A. Have George practice appropriate sitting posture in front of a mirror. B. Use handling techniques to make sure George's posture is correct before initiating activity, E. Use dynamic weight-shifting during reaching tasks to practice trunk control during weight shifting. Occupations while seated should always be completed with the body in correct alignment. Handling techniques and visual feedback, such as working while looking in a mirror, can help facilitate this correct alignment. Dynamic weight-shifting activities can emphasize how the body should feel while in and out of correct alignment, as well as strengthen the core muscles during postural movements. Avoiding positions or activities that strengthen postural control will slow or even hinder progress during treatment.

A patient who has been diagnosed with Parkinson's disease is beginning to demonstrate difficulty transitioning from sitting to standing. Which strategies would be the MOST useful to teach this patient to help them stand up with more ease? Select the 3 best answers. Mental rehearsal of the sequence of movements prior to standing up Using a chair with a low seat and no armrests Using proprioceptive cues, such as gently rocking backward and forward prior to standing up Using auditory cues, such as saying "go" Using deep breathing before standing up Leaning back in the chair before standing up

A. Mental rehearsal of the sequence of movements prior to standing up. C. Using proprioceptive cues, such as gently rocking backward and forward prior to standing up. D. Using auditory cues, such as saying "go".

When working with a patient who is in the Recovery Phase of Guillain-Barre syndrome, which device is the MOST useful to incorporate into their OT intervention plan to promote independence in their ADLs? Mobile arm support Tenodesis splint Universal cuff Theraband

A. Mobile arm support. Recovery phase- starts 6 to 12 months after onset. Recovery begins at the head and neck, progresses proximal to distal. Energy conservation, work simplification, avoidance of overstretching, and overuse of muscles is critical to the patient's recovery. Mobile arm supports may be used to alleviate muscle fatigue, promote active assistive use of upper extremities, and encourage independence with occupations. Because muscle belly tenderness usually decreases in the proximal musculature before it decreases distally, proximal musculature movements can be facilitated first while distal joints continue to be supported by using mobile arm supports.

An OT practitioner is formulating the intervention plan for a patient who recently suffered a CVA and presents with a hemiplegia. The goals of the intervention are to maintain the patient's ROM, prevent contractures and subluxation as well as teach the patient how to perform the activities they identified as being most important, using compensatory techniques. From the activities listed below, which activities are based on a Top-Down approach? Select the best 3 answers. Teaching one handed dressing skills Providing and instructing how to operate a one handed can opener Providing and instructing how to use a tub bench Teaching the patient how to maintain ROM by using passive stretch exercises Providing and instructing how to apply a cone splint to the affected hand Teaching the patient how to position their flaccid arm to prevent subluxation

A. Teaching one handed dressing skills. B. Providing and instructing how to operate a one handed can opener. C. Providing and instructing how to use a tub bench. A, B and C are all compensatory strategies which are part of a Top-Down approach.Top-Down Approach is compensatory- maximize existing skills and adapt activities to allow independence in occupation.

An OT practitioner is treating a patient who recently sustained a C6 spinal cord injury. The patient has active wrist extension but no hand function. What can the OT practitioner recommend to assist this patient in picking up and holding objects independently? Tenodesis splints A universal cuff A reacher Gripping aids

A. Tenodesis splints. If a patient has active wrist extension, the fingers will passively flex and the index finger will contact the thumb. This is called tenodesis action. Tenodesis splints support this action by bracing the thumb and providing a dynamic assist to the wrist, allowing the patient to use the tenodesis action to grasp objects.

A COTA® is working with a 28-year-old inpatient who has recently been diagnosed with Relapsing-Remitting MS. The patient has identified his main goals as maintaining as much of his function as possible so that he remains independent in his ADLs & IADLs, and can continue playing his guitar with his local folk band. At this stage of his disease, the patient only presents with fatigue and minor coordination difficulties, as demonstrated when seated at the basin, shaving. What strategies should the COTA® teach this patient to help him safely perform his desired activities so that he can achieve his goals, for as long as possible? A). Use seated positions as much as possible during fine motor tasks and arrange materials and tools so that they are easily accessible B). Follow principles of body mechanics by distributing the weight of objects over large surface areas and hold them with arms out at shoulder level C.) Arrange items so that they are easily accessible in the kitchen and keep weighted tools inside a hip pouch D.) Have band members carry his guitar and play the guitar with it lying on a table

A. Use seated positions as much as possible during fine motor tasks and arrange materials and tools so that they are easily accessible. The goal in this scenario is energy conservation through environmental modification

An elderly male patient who has chosen to age at home, was recently prescribed a manual wheelchair to help him with his mobility after he had to undergo a unilateral ankle disarticulation secondary to uncontrolled type 2 diabetes, which resulted in him developing unhealed diabetic foot ulcers. When assessing the patient's home for wheelchair access, it was identified that he has great difficulty maneuvering his manual wheelchair in smaller spaces, especially his bathroom. This therefore makes it difficult for him to access the toilet and bathtub. What modifications to the bathroom, are the MOST appropriate to recommend for this patient so that his needs are met, and he can remain safe and independent in his ADLs? Select the 3 best answers. A). Widen the doorway to 32 - 36" clearance B). Remove the bathtub and create a wheel-in shower room with open access to the toilet and shower C.) Install a shower curtain to shield the rest of the room from water spraying during showering and a floor drain to make cleaning the shower room easier. D). Recommend the patient to relocate to a SNF E). A caregiver can sponge-bath the patient in his bed and he can use a commode for toileting F.) Install countertops 34 to 36″ in height for easy access for the patient's wheelchair

A. Widen the doorway to 32 - 36″ clearance. B. Remove the bathtub and create a wheel-in shower room with open access to the toilet and shower. C. Install a shower curtain to shield the rest of the room from water spraying during showering and a floor drain to make cleaning the shower room easier. A. Commonly, doorways are measured at about 23 to 27 inches; this would not be wide enough for a wheelchair user to fit through. Conventional doorways are not always accessible for either electric power chair or manual wheelchair use, so it's generally necessary to modify or widen the bathroom doorway. Residential disabled bathrooms should be between 32 (min) to 36″ wide so that any size wheelchair or walker can easily move through the doorway. B. A stand-alone shower area is generally best for those in a wheelchair. It is much easier to maneuver the wheelchair and is much safer than having to transfer to a tub and back again. C. A movable shower curtain can shield the rest of the room from water spraying during showering and a floor drain makes it easy to clean his room. D. Moving to a SNF is not appropriate as there are more suitable options for the patient had it been deemed necessary for him to relocate for safety reasons. For example, assisted living. A skilled nursing home is normally the highest level of care for older adults outside of a hospital. The Principle of Autonomy should also be considered. The patient has chosen to age at his home, and as this is his choice, it must be respected. Autonomy expresses the concept that practitioners have a duty to treat the patient according to the patient's desires. Often, respect for Autonomy is referred to as the self-determination principle. However, respecting a person's autonomy goes beyond acknowledging an individual as a mere agent and also acknowledges a person's right "to hold views, to make choices, and to take actions based on [his or her] values and beliefs" (Beauchamp & Childress, 2013, p. 106). Individuals have the right to make a determination regarding care decisions that directly affect their lives. In the event that a person lacks decision-making capacity, his or her autonomy should be respected through involvement of an authorized agent or surrogate decision maker. E. A caregiver is not considered a modification and will prevent the patient from being independent in his ADLs. F. Countertops should be installed 34 to 36″ in height for those who are able to stand, and 30 to 32″ for full-time wheelchair users. Allow for a clear space underneath the countertop and handicap sink that is 29″ high x 32 to 36″ wide.countertop and handicap sink that is 29″ high x 32 to 36″ wide.

How do you measure foot rest length?

Affects the support of both the feet and the thighs and the clearance of the footplates and the ground. The footplate must be about 1 to 2 inches off the ground to permit adequate ground clearance.

What age is diagnosed with PD? What does PD increase the risk for? What is dysfunctional in PD Akinesia and bradykinesia are common symptoms in PD, what are these terms?

After age 55 Pneumonia which is fatal. Voluntary and involuntary movement Akinesia- Difficulty initiating movment Bradykinesia- slowness in maintaining movement

Define the following terms, Agnosia, astereognosis, visual agnosia, and apraxia

Agnosia- inability to understand/interpret significance of sensory input. B. Astereognosis. - inability to identify objects through touch. C. Visual agnosia- inability to recognize people and objects. D. Apraxia- inability to carry out specific motor tasks in absence of sensory/motor impairment. Report a Problematic Question

Define akinesia Dyspnea Define Dementia

Akinesia- Inability to initiate movement Dyspnea- Short labored breathing Dementia- State of detoriating personality and intellectual abilities including memory problem solving skills language thinking that interferes with daily functioning

Define Asomatognosia. List the four symptoms of Asomatognosia

Asomatognosia is a disturbance of body schema. Resulting from a disturbance in the normal awareness of one's own body, typically characterized by one or more of the following symptoms: 1. A tendency to ignore or neglect one side of the body 2. A failure to recognize or difficulty in identifying a specific part of the body (usually a limb or part of a limb) 3. Difficulty in differentiating the right from the left side of the body 4. Recognizing an impairment in a part of the body (anosognosia)

What is the depth of a junior standard wheelchair?

B. 16 inches. The depth of a wheelchair is measured by measuring the length of the patient's femur from the posterior portion of the buttocks to the popliteal fossa and then subtracting 2 inches. This allows the posterior crease of the knee joint to clear the edge of the wheelchair seat. The depth of 16 inches is based on average measurement data for adults. Since the difference in data between adults and teenagers is not significant, the depth of 16 inches is also used for junior standard wheelchairs.

An OT practitioner is working with a patient who has been diagnosed with Parkinson's disease. The patient's main concern is that he is beginning to become easily fatigued when using his computer and they have stated that they would like to continue using a standard keyboard. What is the BEST adaptation, the OT practitioner can recommend to help this patient conserve his energy while continuing to use their computer as it is currently set-up? A screen enlargement program A word prediction program to save keystrokes A screen reading program A switch access with a scanning program

B. A word prediction program to save keystrokes.A word prediction program to save keystrokes will help a patient who becomes fatigued from typing. Word prediction programs reduce the number of keystrokes necessary to transcribe a word by using the first one to three letters that are typed to predict the target word. Based on what letters of the word have been typed, these programs first presents a list of choices or guesses as to the desired target word. The proposed word list is then dynamically changed as more letters are typed, thus increasing the accuracy of the predictions. Word prediction was originally developed for people with physical disabilities to decrease the number of keystrokes needed to input text. Today, word prediction is fairly common as an integrated feature of texting and email apps for smartphones and tablet computers (e.g., iPads).

Luanne is a 74-year-old patient who has been diagnosed with Parkinson's disease. Her daughter is enquiring about what she can do to keep her mother safe and allow her to age-in-place. Luanne is an independent woman who lives alone in an apartment. She is currently ambulatory and does not require any assistive devices. Which recommendations are the MOST important to recommend at this stage? Select the best 3 answers. A). Change door levers into round door knobs B.) Install grab bars near the toilet, tub and shower C). Remove throw rugs and clutter D.) Replace heavy silverware with plastic ware E). Recommend chairs that are stable and have arm rests F.) Recommend a caregiver assists Luanne with her ADLs

B. Install grab bars near the toilet, tub and shower.C. Remove throw rugs and clutter.E. Recommend chairs that are stable and have arm rests. Parkinson's disease impacts both motor and nonmotor skills throughout the disease process. Symptoms like fatigue, gait difficulties, cognitive or vision changes can impact the person's ability to stay safe at home independently. Gait difficulties due to mobility changes related to freezing of gait, shuffling steps, or posture changes can increase fall risk for people living with Parkinson's. Most falls take place in the bathroom because of difficulty getting on and off the toilet and in and out of the tub; difficulty seeing due to poor lighting; slipping on wet surfaces; tripping on throw rugs; or getting dizzy while standing from the toilet to the sink.

An OT practitioner is working with a professional bodybuilder who sustained an injury to his lower back when a competitor played a prank on him while he was in training. The patient is currently attending regular OT sessions where he is participating in a work conditioning program. At this stage, the patient is able to complete tasks which are classified as medium work. What is the NEXT step in grading this patient's OT sessions? Progress to lifting no more than 50 pounds at a time Progress to lifting no more than 100 pounds at a time Progress to lifting no more than 125 pounds at a time Continue with lifting the same weight but move the OT sessions to the patient's gym where he usually trains

B. Progress to lifting no more than 100 pounds at a time .Heavy work- involves lifting no more than 100 pounds at a time

For a patient with which diagnosis, would you recommend the use of a rocker knife? Cerebral palsy Right below elbow amputation Macular degeneration Type II diabetes

B. Right below elbow amputation. A rocker knife allows a patient to cut food by rocking the knife, rather than using the knife to saw through food. This eliminates the need to use a fork to hold the food in place while cutting, so only one hand is needed to use a rocker knife. The design of the rocker knife makes it ideal for patients who only have the use of one hand, such as the patient with a right below elbow amputation.

Roger is a 75-year-old man who had a left anterior cerebral artery CVA 6 months prior. He lives in a skilled nursing facility and receives physical and occupational therapies. Roger has significant cognitive impairments and wanders throughout the facility. He had achieved upright ambulation with a merry walker, but the physical therapist now notices that Roger is walking with his head and trunk bent forward. This causes Roger to run into people and objects. With consideration to what's going on in PT sessions, what can the OTA incorporate into treatment to help Roger improve his posture as he moves about the facility? A). Alerting activities to help Roger register and orient to his surroundings so that he doesn't run into things B.) Simple, functional, and repetitive standing activities emphasizing postural adjustments that help Roger compensate for decreased sensation in his lower extremities C.) ADL activities adjusted to accommodate for Roger's cognitive level D.) Adaptations to Roger's merry walker to compensate for his forward posture

B. Simple, functional, and repetitive standing activities emphasizing postural adjustments that help Roger compensate for decreased sensation in his lower extremities. One of the symptoms of an anterior cerebral artery CVA is cortical sensory loss in the lower extremities. This means that Roger may not be fully aware of where his legs are as he is walking. His perception of his balance may be altered. Since Roger has significant cognitive impairments and cannot process what is happening, he keeps walking and compensates for the sensory impairment by leaning forward. Simple, repetitive standing activities that incorporate correct posture and basic postural adjustments will help Roger's muscles to automatically adjust his posture while walking to compensate for limited sensation, without having to think about it too much. The activities should be completed in standing rather than walking until Roger begins to display automatic postural adjustments. Once this is accomplished, postural control can be addressed while walking.

Wade is a 47-year-old man who is recovering from a MVA in which he sustained multiple injuries. He wants to drive again but needs further rehabilitation, including driver rehabilitation, before he can get his driver's license reinstated. What activities can the COTA® work on with Wade in the clinic to help him prepare for driver's rehabilitation? Select the best 3 choices. Therapeutic activities to address fine motor skills Therapeutic exercises to improve neck and shoulder range of motion Visual motor tracking with an emphasis on reaction time ADL skills so that Wade can dress appropriately for driver's rehabilitation Pre-vocational skills as Wade plans to drive himself to work Strengthening exercises to improve Wade's ankle/foot control and grip strength

B. Therapeutic exercises to improve neck and shoulder range of motion C. Visual motor tracking with an emphasis on reaction time F. Strengthening exercises to improve Wade's ankle/foot control and grip strength The underlying skills for driving can be addressed in the clinical setting, before driver's rehabilitation begins. Activities to address these skills include range of motion exercises to improve head, neck and shoulder mobility, strengthening to ensure hands and feet are in condition for operating vehicle controls, and visual motor tracking skills to insure adequate visual reaction time during driving. Other tasks like ADL skills, fine motor skills, or pre-vocational skills could be addressed in the clinic, but would not directly apply to driver's rehabilitation.

Define Broca Apahasia

Broca's is also called Expressive or non-fluent aphasia. People with this pattern of aphasia may understand what other people say better than they can speak. People with this pattern of aphasia struggle to get words out, speak in very short sentences and omit words. A person might say, "Want food" or "Walk park today." A listener can usually understand the meaning, but people with this aphasia pattern are often aware of their difficulty communicating and may get frustrated.

What is the depth of an adult narrow standard wheelchair? 12 inches 14 inches 16 inches 18 inches

C. 16 inches. The depth of a wheelchair is measured by measuring the length of the patient's femur from the posterior portion of the buttocks to the popliteal fossa and then subtracting 2 inches. This allows the posterior crease of the knee joint to clear the edge of the wheelchair seat. The depth of 16 inches is based on average measurement data for adults.

A patient who recently had a total hip replacement lives in a one-story house with his wife and two dogs. For mobility, he is now required to use a standard wheelchair however, there is a 2-foot vertical rise at the entrance to his home. What is the recommended ramp length needed in order for this patient to access his house? 12 feet 16 feet 24 feet 36 feet

C. 24 feet. 1 foot is equal to 12 inches. ADA recommends a 1:12 slope, which means that for every 1 inch of vertical rise, 12 inches of ramp length is required. In this scenario the vertical rise is 2-foot which equals 24-inch. The minimum ramp length would therefore be 24 inches X 12 = 288 inches. To convert 288″ to foot measurements, divide 288 by 12 which equals 24 feet. Or simply put, the ratio is 1:12. The vertical rise is 2 feet which means that the calculation is simply 2:24. Make you are using the scale of measurement. View this website for more information. http://www.adawheelchairramps.com

A COTA® is working with a Physical Therapist on a 2-person transfer of an obese male inpatient who requires Maximal Assist. The patient is recovering from a recent anterior cerebral arterial stroke and is being transferred from a sitting position at the edge of his bed into a wheelchair. The patient presents with paralysis of his contralateral lower extremity and MMT scores of 3 and 3+ in his trunk and upper extremities, respectively. In order to stabilize himself while seated at the edge of the bed, the patient requires moderate use of his upper extremities. What part of the transfer setup is MOST IMPORTANT to ensure a safe patient transfer without compromising the safety of the clinicians? A.) Ensure the gait belt fits snugly around the patient's trunk under the axilla B. Have the patient shift his weight forward while pushing with both arms to lift his hips in a semi-squat position C. Both clinicians position the patient upright and centered, with the front clinician blocking the patient's knees and feet D. Allow the patient to lead the count to coordinate the timing of the transfer

C. Both clinicians position the patient upright and centered, with the front clinician blocking the patient's knees and feet. Max Assist: Patient does 25%, Caregivers do 75%. The question asks what part of the set-up is the "MOST IMPORTANT" in terms of ensuring a safe transfer, and keeping the clinicians out of harm's way. By positioning the patient upright and centered, with the front clinician blocking the patient's knees and feet, the clinicians are applying proper body mechanics which is the is the most important aspect for their safety. This step comes after positioning the wheelchair, locking the brakes, and securing the gait belt, then the clinicians should follow proper body mechanics to maintain the integrity of their spine, in order to safely support and move the patient. A gait belt should be used at all times if you have access to one. if you don't have access to one, use the patient's pants or belt. A. The gait belt should fit snugly around the waist and not move up the trunk. B. With a MMT of 3+, the patient will likely not have enough upper extremity strength to lift his hips. When the clinicians shift the patient's weight forward, it will make it easier to passively lift his hips while the front clinician blocks his knees. The clinicians will direct and move the body towards the transfer surface. D. Confusion and slow-processing is expected with anterior cerebral arterial stroke. Therefore, the team of clinicians should lead the count. Early, Mary Beth. (2013) Physical dysfunction practice skills for the occupational therapy assistant (3rd Edition). St. Louis, Mo. : Elsevier/Mosby, pp 316-317.Pass the OT study material - Cerebral Vascular Accident,

A 55-year-old patient has been admitted to an inpatient facility following a recent R-CVA. The patient is demonstrating certain behaviors that suggest he may have hemispatial neglect. To further assess the patient's spatial awareness, the OT practitioner performs a paper and pencil cancellation task. Which observation from the observations below would confirm that this patient has hemispatial neglect? A. Randomly eliminating the items on the paper B. Crossing out items only on the left side of the paper C. Crossing out items only on the right side of the paper D. Consistently squinting one of his eyes

C. Crossing out items only on the right side of the paper. Hemispatial neglect, also known as unilateral spatial neglect, is a condition in which a patient fails to respond to stimuli on the side of space opposite to the side of the brain lesion. Hemispatial neglect is common following unilateral brain damage, particularly of the right hemisphere (Right CVA). Patients with neglect often fail to be aware of or acknowledge items on their contralesional side (the left side for patients with right brain damage) and attend instead to items towards the same side as their brain damage—their ipsilesional side. Their neglect may be so profound that they are unaware of large objects, or even people, in extra-personal space. Neglect may also extend or be confined to personal space, with patients failing to acknowledge their own contralesional body parts in daily life. In this scenario, the patient suffered a R-CVA which has resulted in a left hemispatial neglect. Therefore, they would only attend to the items they are aware of, which are on their right side.Cancellation tasks are popular clinical and scientific tools for identifying spatial neglect, with neglect patients tending to miss targets on the contralesional side of the test. Typically, the individual is shown a piece of paper with a cluttered array of items, and asked to mark all of the target items, while ignoring other distractors. The prevalence of these tests stems from many factors including the ease of describing the task to participants in a clinical situation and speed of administration (a couple of minutes). A. This would most likely be displayed when there is a deficit with attention. D. The patient has corrective lenses which were recently updated. Therefore, he would likely not have difficulty with acuity.

A patient who is recovering from a recent CVA presents with a flaccid hemiplegia and an acquired expressive and receptive aphasia. The patient has indicated that she wants to be able to continue to feed herself as she did before her stroke. Using a universal cuff has been recommended to help this patient achieve her goal. The education and training on the use of the universal cuff will therefore be the focus of the session. What method would be BEST for teaching this patient how to use this type of adaptive equipment? A). Showing the patient donning the cuff and going through the motions of hand-to-mouth feeding B). Printing out step-by-step visual demonstrations from the U-Cuff manufacturer, with written instructions removed C). Demonstrate active use of the equipment during a regular scheduled meal and allow the patient to return the demonstration D.) Provide verbal cues and hand-over-hand assist for improved motor planning

C. Demonstrate active use of the equipment during a regular scheduled meal and allow the patient to return the demonstration.Expressive or receptive aphasia, or global aphasia (both expressive and receptive) can occur after stroke and impairs one's ability to express or understand language. Reading and writing can be affected as well. During OT intervention, it is best to have the patient perform the actual task in the appropriate environment and time of the day. In this way, the clinician can isolate other factors that will help determine the type of support the patient will need to perform the task successfully, based on the effects of aphasia on comprehension. A. A combination of demonstration and return demonstration would be more effective. B. It is more appropriate to start with a demonstration first. D. This would be more appropriate if apraxia is suspected.

An COTA® is providing education to the family of a patient who is in the end stage of ALS. What is the MOST IMPORTANT advice the COTA® should give the family at this stage of the patient's disease? A). Daily participation of the patient in a home exercise program aimed at maintaining strength and AROM B.) Encouraging the patient to complete their ADLs as independently as possible and only offering assistance when absolutely necessary C.) Encouraging the family to carry out passive ROM exercise and pressure relief to prevent contractures and decubitus ulcers from developing D.) Recommend the patient's family request a formal SLP home health evaluation to assess the patient for dysphagia

C. Encouraging the family to carry out passive ROM exercise and pressure relief to prevent contractures and decubitus ulcers from developing.As the ALS progresses to its final stages, almost all voluntary muscles will become paralyzed. The patient will most likely be bedridden and total assistance will be required. A and B. ALS is a progressive disease. Already in the late stage, mobility is extremely limited and assistance is needed in carrying out most personal needs. Maintaining strength and AROM is not possible. D. As the mouth and throat muscles become paralyzed, it becomes impossible to talk, eat, drink or swallow. Eating and drinking is therefore done via a feeding tube.

A COTA® is treating a 30-year-old inpatient with Guillain-Barre Syndrome whose onset of symptoms began 6 months ago. The patient's UE strength measures 3+/5 and LE strength measures 4/5. The patient uses a standard wheelchair for mobility and is working on ambulation using a FWW with stand-by assist. She has managed to walk up to 15 feet with the use of her walker and bilateral ankle-foot orthoses. The patient's goal is to return home to resume caring for her twin sons who are starting kindergarten in a few weeks. What interventions would be MOST IMPORTANT to focus on during this phase of recovery? A). Fine motor coordination and hand strength for managing fasteners for dressing B). Standing tolerance to perform light meal prep at the kitchen counter C). Energy conservation and gross motor movements to complete preferred basic activities of daily living D).Compensatory strategies and assistive devices to drive the children to school

C. Energy conservation and gross motor movements to complete preferred basic activities of daily living.Although some people can take months and even years to recover, most people with Guillain-Barré syndrome experience this general timeline: - After the first signs and symptoms, the condition tends to progressively worsen for about two weeks - Symptoms reach a plateau within four weeks - Recovery begins, usually lasting six to 12 months, though for some people it could take as long as three years. This patient is therefore in the recovery phase. The patient's primary focus is returning home to care for her children. Therefore, energy conservation and gross motor movements will allow the patient to maximize the energy available to perform preferred activities and gradually gain tolerance to utilize the upper and lower body for mobility needs.

During a treatment session, a patient who has had a CVA successfully makes a peanut butter and jelly sandwich. What therapeutic activity would be BEST for the next treatment session in order to work on developing cooking skills with this patient? Turkey and cheese sandwich Stir-fry vegetable dish over brown rice Grilled cheese sandwich Microwavable dinner

C. Grilled cheese sandwich. The activity analysis skill here is grading; the OT recognizes the success of a multi-step cold meal and appropriately upgrades the task to require more complex steps. A: The turkey and cheese sandwich is too similar to the original task and would likely not provide a sufficient challenge. B: A microwavable dinner is typically a single-step process and therefore is not an appropriate upgrade. D: A stir-fry dish is more complex and involves making two separate items to combine, which may be a desired task at a later time. Report a Problematic Question

Jake is a 53-year-old patient who was diagnosed with MS in his late 20s. For community mobility he has been using a mobility scooter which he is skilled at operating. Recently, however, Jake was run over when he was crossing the road resulting in him sustaining a TBI and fractured right upper limb. Jake is currently functioning at Rancho Los Amigos level 6 (Confused, Appropriate.) and has identified that his main goal is to purchase a new scooter as soon as possible so that he can regain his independence. While Jake is waiting for the finances to purchase a new scooter, what is the MOST appropriate mobility aid he should be using at this stage of his recovery? Rented mobility scooter Electric wheelchair Manual wheelchair Write a letter of motivation to Jake's insurance to fast track his claim

C. Manual wheelchair. While an electric scooter or wheelchair would be the most appropriate mobility aid for a patient with MS, it is not safe for Jake to operate an electric mobility aid at this stage at his current cognitive level of functioning. At Rancho Los Amigos level 6, Jake would most likely still be hospitalized and would not need a mobility aid for getting around the community. At Rancho Los Amigos VI - Confused, Appropriate, the patient will typically:• Attends to task for about 30 minutes but may be distracted by noisy environments• May be impulsive, do things without thinking first• Unaware of impairments, safety risk. Will be aware of hospitalization due to injury but may not have insight into existing problems. Will be more aware of physical problems than cognitive problems-may associate problems with being in the hospital and may have the expectation that problems will go away upon return home

Jorge is a 26-year-old man with a C6 spinal cord injury. The OTA wants to teach Jorge how to use a universal cuff to scoop food with a spoon. How should the spoon and the universal cuff be positioned to allow Jorge to scoop food? A). The universal cuff should be placed on the volar surface of the hand and the spoon placed in the ulnar side of the pocket B.) The universal cuff should be placed on the dorsal surface of the hand and the spoon placed in the ulnar side of the pocket C.) The universal cuff should be placed on the volar surface of the hand and the spoon placed in the radial side of the pocket D.) universal cuff should be placed on the dorsal surface of the hand and the spoon placed in the radial side of the pocket

C. The universal cuff should be placed on the volar surface of the hand and the spoon placed in the radial side of the pocket. The universal cuff should be positioned to most closely simulate how a person with normal movement would hold a spoon to scoop food. Placing the cuff on the volar surface of the hand with the spoon in the radial side of the pocket most closely simulates grasping a spoon to scoop food.

List the categories of work

Categories of Work: • Medium work- involves lifting no more than 50 pounds at a time with frequent lifting or carrying of objects weighing up to 25 pounds. If someone can do medium work, we determine that he or she can also do sedentary and light work .• Heavy work- involves lifting no more than 100 pounds at a time with frequent lifting or carrying of objects weighing up to 50 pounds. If someone can do heavy work, we determine that he or she can also do medium, light, and sedentary work .• Very heavy work- involves lifting objects weighing more than 100 pounds at a time

An OTA observes a 7-year-old child with CP leaning forward in his wheelchair. As the child is at risk of falling out of his wheelchair, what is the best seating adaptation the OTA can provide for this patient Chest harness Inflatable ring cushion Wedge-shaped insert cushion Offset the axle

Chest harness Chest harness is an anterior trunk support Typically has a soft component that crosses the trunk or chest and attaches to the wheelchair in four places with straps. Also referred to as chest harnesses or H straps. They are used to promote trunk extension and/or limit forward trunk movement. Inflatable ring cushion provides support for the bottom and prevents ulcers Wedge-shaped insert cushion is an inflatable, dynamic cushion that activates intrinsic trunk muscles to support the spine. The wedge shape encourages proper posture and alignment while sitting at a desk or table.

In a clubhouse model, patients learn vocational skills by doing what?

Completing jobs to take care of the everyday needs of the clubhouse. In the clubhouse model, each patient takes on a work task to help keep the clubhouse maintained and running efficiently, just like a real cooperative work environment. Report a Problematic Question

An OTA is working with a patient who has difficulty wrapping/closing her fingers around standard cutlery as the joints in her hands are painful due to arthritis. What is the BEST adaptive utensil for this patient? Cylindrical foam attached to utensil Universal cuff Weighted utensil Swivel spoon

Cylindrical foam attached to utensil. Cutlery with built-up handles allows the patient to grasp the handle of the utensil without having to wrap their fingers tightly around the handle for a stable and secure hold. Handles that are enlarged and/or contoured make it easier to grip. Helpful for patients who have pain in their hands which makes forming a tight grip difficult.

If a patient who has been diagnosed with Parkinson's picks up a comb to brush her teeth during the morning grooming routine, what would this be a sign of? Visual agnosia Constructional apraxia Ideomotor apraxia Conceptual apraxia

D. Conceptual apraxia.Conceptual apraxia is characterized by a difficulty in selecting an adequate tool for a specific action. The patient typically demonstrates poor knowledge of tool function and tool-object association, suggesting impaired conceptual knowledge of tool use. They may use the wrong tool for the task or may associate the wrong tool with the object to be acted on Visual Agnosia is diagnosed if the client is unable to name four out of five objects Constructional apraxia is characterized by an inability or difficulty to build, assemble, or draw objects. Ideomotor apraxia is an inability to carry out a motor act on verbal command or imitation (knows what they want to do).

Charles, a 68-year-old widow and former broadcast journalist was diagnosed with Stage I Parkinson's disease, 2 years ago. He currently presents with mild hypertonicity and minor tremors which are not affecting his mobility and therefore at this stage, he does not require the use of any adaptive devices for mobility. Charles lives with his son who is invested in keeping his father mobile and functional. During a recent home visit, Charles's son asks the home health COTA® for suggestions on how he can help his father remain mobile so that he can continue to safely walk to his favorite café for breakfast. The COTA® suggests a community, age-in-place program to support this goal. Which type of program would BEST help Charles maintain his mobility and independence? A.) A group Bridge Game at the local senior community center B.) A water aerobics class at the local YMCA in a shallow pool C.) Volunteering hosting senior charity events D.) A Tango dance class at a local community center

D. A Tango dance class at a local community center.People with Parkinson's Disease benefit from rhythmic auditory stimulation that enhances functional movement patterns associated with abnormal gait patterns, rigidity, incoordination, postural control and hypertonicity due to decreased dopaminergic production. Any type of movement-based therapy associated with following a rhythm would be helpful for balance, coordination, and mobility. A. This activity focuses on attention, problem-solving, social interaction and fine-motor skills. B. Water aerobics would be somewhat challenging for Charles as he would have to move against resistance. This activity is mostly beneficial for strengthening and cardiopulmonary efficiency. C. Hosting an event would not address his mobility needs.

A patient with Myasthenia Gravis who is currently residing at a long-term care facility, is receiving OT intervention for dysphagia and difficulty with self-feeding. What additional supports can the OTA provide to the nursing staff to promote assisted self-feeding for this patient? A). Have all the nursing staff watch a feeding session with the patient B.) Ask the nursing aides to write a detailed report about the patient's mealtime skills C.) Give a detailed verbal explanation to the nursing aides about what the patient can and cannot do D.) Allow the nursing aides to participate in an interactive observation feeding session and provide them with instructional handouts

D. Allow the nursing aides to participate in an interactive observation feeding session and provide them with instructional handouts. All the other options are passive learning approaches while interactive sessions with supplemental handouts promotes carryover.

A 42-year-old man is a bilateral above-the-knee amputee as a result of a car accident. He uses a lightweight manual wheelchair for mobility. In order for this man to use his wheelchair independently, what adaptation is necessary to prevent the wheelchair from tipping backwards?

D. Amputee axle. An amputee axle can be adjusted on the wheelchair to compensate for the person's center of gravity, which tends to raise in height after a bilateral lower extremity amputation.

An OT practitioner is working with a patient who is recovering from a recent CVA and as a result presents with dysphagia and unilateral neglect. The OT session is taking place in the dining room of the inpatient rehab facility and the OT is focusing their intervention on teaching the patient techniques to compensate for their unilateral neglect during meal times. Suddenly, the OT practitioner notices that the patient appears to be choking on her food. What action should the OT practitioner take FIRST in this scenario? Check the patient's mouth and by using a sweeping movement with your finger, remove any visible food Immediately administer the Heimlich maneuver Call 911 Ask the patient, "Are you choking?"

D. Ask the patient, "Are you choking?".Firstly it is important to ascertain if the patient is choking and if they are able to clear their airway by themselves before initiating further action which would require helping them to clear their airway When assisting a conscious adult or a child who is older than 1 year, the following steps should be taken: 1. Ask the patient, "Are you choking?" If the patient can speak or cough effectively, do not interfere with the patient's own attempts to expel the object. 2. If the patient is unable to speak, cough, or breathe, check the mouth, and remove any visible foreign object. 3. If the patient is unable to speak or cough, position yourself behind the patient. Clasp your hands over the patient's abdomen, slightly above the umbilicus but below the diaphragm .4. Use the closed fist of one hand, covered by your other hand, to give three or four abrupt thrusts against the person's abdomen by compressing the abdomen in and up forcefully (also known as the Heimlich maneuver). Continue to apply the thrusts until the obstruction becomes dislodged or is relieved, or the person becomes unconscious. It is no longer recommended that a rescuer perform a finger sweep to remove the object. 5. Seek medical assistance.

5-days ago, a 43-year-old male truck driver was admitted to the inpatient department after he suffered a cerebellar CVA. During a lower body dressing assessment, the patient dons his shoes and then attempts to don his socks over his shoes. Which statement MOST ACCURATELY describes the possible reason why this patient is presenting with these difficulties? Due to the cerebellar CVA, the patient is seen to show constructional apraxia Visual perceptual deficits may be affecting the patient's ability to recognize items The patient was unable to see the socks due to left side neglect Due to ideational apraxia, the patient is not able to conceptualize the steps of the task

D. Due to ideational apraxia, the patient is not able to conceptualize the steps of the task.The patient cannot perform the task correctly due to ideational apraxia as the patient has difficulty with sequencing the steps correctly of donning shoes/socks.If dressing apraxia was an option, then that would be the correct answer but as it is not stated as an answer choice, ideational apraxia is correct. Dressing apraxia is seen as the inability to plan the effective motor actions required during the complex perceptual task of dressing one's upper and lower body. The classification of dressing impairment as a form of apraxia can be seen as an extension of an ideational apraxia disorder. (Pedretti's Occupational Therapy - E-Book (Occupational Therapy Skills for Physical Dysfunction (Pedretti)) (p. 641). Kindle Edition.)

An OTA is working with a patient who recently had a stroke. In order to eat his lunch, the OTA will need to add a thickening agent to make the food a pudding-consistency thereby allowing it to remain on the spoon in a soft mass. What is the name of this texture? Liquid consistency Nectar consistency Solid foods Spoon-thick liquids

D. Spoon-thick liquids. Spoon-thick or "pudding" consistency are terms used to describe a liquid that is as thick as a pudding.

A 25 year-old patient who has spastic diplegic cerebral palsy wants to work as a store clerk at a local shoe store. What task, without incorporating any compensatory strategies, would be the greatest challenge for him, in this line of work? Counting change back to the patron Picking up one item at a time with 1 hand and scanning the bar code Bagging the purchases in the shopping bag Standing at the cash register during the entire shift

D. Standing at the cash register during the entire shift.Spastic diplegia affects bilateral lower extremities more than the upper extremities. The patient may have difficulty with weight bearing, and maintaining postural control against gravity. He is therefore likely to become easily fatigued with static postures.

Melinda, a 53-year-old woman, who has been diagnosed with Secondary-Progressive Multiple Sclerosis (SPMS) has been referred for OT intervention as an outpatient. Melinda's main difficulties are coping with her generalized weakness and fatigue, and keeping her place while reading her favorite cooking magazines. This is affecting her ability to follow recipes which is making meal prep time longer than it should be. What action should the COTA® take in response to Melinda's concerns? A.) Assess the patient's ability to read B.) Provide education on the expected symptoms of the patient's type of MS C.) Work on adaptations to compensate for fine motor deficits, for turning the pages D.) Measure the rate of perceived exertion during different types of tasks involved in meal prep

D. Measure the rate of perceived exertion during different types of tasks involved in meal prep.It is important to gather information about fatigue levels and the patient's activity patterns to support a plan to develop strategies on managing fatigue. In terms of the difficulties experienced with reading, eye movement abnormalities are common in MS. Most eye movement abnormalities associated with MS are due to brainstem or cerebellar lesions and result in symptoms of visual fatigue, blurred vision, diplopia and oscillopsia. The predominant abnormalities of efferent ocular function encountered in MS include internuclear ophthalmoplegia (INO), saccadic abnormalities, nystagmus, abnormalities of the vestibulo-ocular reflex (VOR) and smooth pursuit abnormalities. A. It is unlikely that the patient is exhibiting problems with executive functioning as she is able to comprehend what she is reading .B. Addressing the patient's concern is using a client-centered approach and validates the patient, therefore, education does not deal with the patient's stated problem. C. There is no indication of a problem with fine-motor skills.

Leslie, a 77-year-old former seamstress, has been receiving occupational therapy services in a skilled nursing facility for an acute exacerbation of multiple sclerosis. Yesterday, during her afternoon therapy session, the resistance level on the ergometer hand bike was upgraded, and today Leslie is complaining of a moderate level of perceived exertion with dressing this morning. Previously, she has not reported changes in her level of fatigue during self-care activities. What should the COTA® include in Leslie's intervention plan for tomorrow? A.) Recommend asking a caregiver to assist the patient with her dressing in the mornings B.)Continue using the ergometer hand bike at the current resistance level and monitor the patient's response to the activity C.) Focus only on basic self-care goals and discontinue exercises D.) Reduce the resistance level of the ergometer hand bike to the previous level

D. Reduce the resistance level of the ergometer hand bike to the previous level. Returning to the previous, tolerable exercise level will assist the patient in managing fatigue, a common symptom with multiple sclerosis. B. Since the patient had reported fatigue, the clinician should discontinue the exercise at that level. A and C. These are not consistent with the patient's current functional abilities. Early, Mary Beth. (2013) Physical dysfunction practice skills for the occupational therapy assistant (3rd Edition). St. Louis, Mo. : Elsevier/Mosby, pp 518-519.

An OT practitioner is working with Rachel, a 29-year-old patient who was recently diagnosed with Multiple Sclerosis. Rachel is newly married, and her role as a housewife requires her to maintain a clean home and complete all the household chores. Rachel's main issue which is preventing her from fulfilling this role, is her level of fatigue. What is the BEST strategy the OT practitioner can teach Rachel so that she can learn to manage her fatigue? Rachel should take frequent rest breaks throughout the day, resting when she becomes fatigued Rachel should take a long rest break in the morning so that she has enough energy in the afternoon to perform her chores Rachel should learn to live with feeling fatigued as this will be an ongoing symptom of her disease Rachel should take frequent rest breaks throughout the day, resting before she becomes fatigued

D. Rest throughout the day before becoming fatigued With MS fatigue, it is more effective to rest before an activity to "bank" energy rather than waiting to become overly fatigued and then trying to recover. It is important for the patient to plan her day, with scheduled breaks throughout the day.

What is Parkinson's Disease?

Degenerative neurologic disease that usually affects the elderly population and has three main symptoms - Tremors -Ridgity -Bradykinesia

What kind of condition would benefit from this w/c and what diagnoses may they have/

Diagnoses that prevent the person from standing without total support. -cerebral palsy -spinal cord injury -multiple sclerosis -amyotrophic lateral sclerosis -muscular dystrophy

Define Dyskinesia,

Dyskinesia- refers to a movement disorder characterized by involuntary muscle movements. These movements can include twitching, tremors, and athetoid movements. A person with dyskinesia may have some or all of these characteristics. Dyskinesia is often a symptom of a systemic neurological disorder, such as Parkinson's Disease or Huntington's Chorea.

Why is it important to implement aspiration precautions for people that are post CVA and working on feeding interventions What are some methods to prevent aspiration during eating?

Dysphagia post CVA is common and protecting the patients' airways is the first priority, so it is important to implement aspiration precautions first. Making sure the patients are sitting upright in their chairs/wheelchairs • Implementing postural changes that improve swallowing. For example, a chin tuck. • Adjusting the rate of eating and size of bites; avoiding rushed or forced eating.• Alternating solid and liquid boluses. • Varying the placement of food in a patient's mouth according to the type of deficit. For example, food may be placed on the right side of the mouth if left facial weakness is present. • Determining the food viscosity beforehand that is best tolerated by each individual. Ideally a trained dysphagia clinician (such as a speech therapist) should be consulted.

How do you measure seat height?

Footrests should have 2 inches of clearance from the floor. Standard height = 19″- 20″Hemi-height = 17.5″Super-low = 14.5″* The cushion selected for a wheelchair will affect this measurement.

Define Global Apashia

Global aphasia. This aphasia pattern is characterized by poor comprehension and difficulty forming words and sentences. Global aphasia results from extensive damage to the brain's language networks. People with global aphasia have severe disabilities with expression and comprehension.

Describe Gullian- Barre Syndrome

Guillain-Barré syndrome (GBS) is a rare neurological disorder in which your immune system mistakenly attacks part of the peripheral nervous system—the network of nerves located outside of the brain and spinal cord. GBS can range from a very mild case with brief weakness to nearly devastating paralysis, leaving you unable to breathe independently. Can also lead to sensory loss and muscle atrophy

What are hand controls, pedal extender and automatic car door opener?

Hand controls are a type of assistive technology that enables drivers to operate the brake and gas pedals without using their feet. pedal extenders: Pedal extensions (also referred to as pedal extenders) are bolt on devices that bring the pedals of the vehicle closer to the driver, providing more space between short-stature drivers and the steering wheel. automatic car door opener automatic door openers require the user to push a button to open the door.

What is the purpose of a honeycomb cushion, foam cushion, contoured cushion, and air cushion.

Honeycomb cushions are not recommended if positioning or weight distribution are a major concern. Foam cushions offer limited pressure relief. Contoured cushions are used for patients with a posterior pelvic tilt. air cushions are an excellent option for individuals who have had past issues with pressure related sores and ulcers as they are Excellent weight distribution • Lightweight • Washable ROHO cushions are widely used air filled cushions. Most ROHO cushions format their air cells in different contours and in a gradation of heights. These contours are designed to ensure that areas at higher risk of skin breakdown are given focused protection.

Describe Huntington's disease

Huntington's disease (HD) is an inherited disorder that causes nerve cells (neurons) in parts of the brain to gradually break down and die. The disease attacks areas of the brain that help to control voluntary (intentional) movement, as well as other areas. People living with HD develop uncontrollable dance-like movements (chorea) and abnormal body postures, as well as problems with behavior, emotion, thinking, and personality.

Differentiate ideomotor, ideational, and conceptual apraxia

Ideomotor apraxia- Interference with the transmission of impulses from the brain to the motor center resulting in the inability to translate an idea into motion (Knows what they want to do but are unable to do it. Ideational apraxia- Inability to formulate a plan to complete the requested command. Conceptional Apraxia: the patient is typically unable to understand the concept of tools and/or how to use them correctly.

What are some safety tips for the kitchen for people with PD?

Install cabinet handles rather than knobs to make it easier to open and close cupboard doors. • Store commonly used items in easily accessible drawers to avoid the need to reach or bend over to find them. • Place items used for cooking, such as spices, pots and pans, near the stove to avoid reaching over the stove, which may cause burns. • Use a single handle sink faucet, which is easier to control and turn on and off.

What are some tips for people with TD to avoid falls?

Install grab bars near the toilet, tub and shower: no location should require use of towel racks, faucets or soap dishes as grab bars .• Ensure the toilet has an elevated seat and arm rests or grab bar within easy reach. • Add a sturdy bench with back support to the tub or shower for safety. • Make seating available to perform tasks such as brushing teeth or shaving. • Place light switches near the door to avoid walking into a dark area. • Keep floors unwaxed and debris free.

What disease has 3 primary symptoms of fatigue, pin and needles sensation in the feet and sensitivity to heat What is Muscular Dystrophy

MS (Multiple Sclerosis). It characterized by the destruction of the myelin sheath of neurons in the CNS degenerative inherited neuromuscular disorder characterized by loss muscle atrophy and progressive muscle weakness

How do you measure seat depth?

Measure from the posterior portion of the buttocks to the popliteal fossa and then subtract 2 inches. Measure both legs and take the greatest length.

How do you measure back height?

Measure from the seat surface (including the cushion) upward to one of the following, depending on trunk control, activity level, strength and size of the person: 1. Mid back to 1-2 inches below the scapula. 2. Mid scapula or axilla. 3. Top of the shoulder.

How do you measure seat width?

Measure the widest point across the hips and thighs and then add 2 inches.

What is a nosy cup?

Nosey cup- This is a flexible drinking cup that also has a space cut out of it to fit a person's nose. This is a simple and effective way to improve the independence of those who are limited in their ability to tilt their head back while drinking. With the space cut out for the nose, there is no need to tilt their head back while using this cup. The flexibility of the cup can control the flow of the fluid as well, to promote safe swallowing.

List the steps of OT process

Referral Screening Evaluation D/C

How do you measure armrest height?

Shoulders should be neutral with arms hanging at the sides and elbows flexed to 90 degrees. -Armrests that are too low will encourage leaning forward .-Armrests that are too high will cause shoulder elevation.

A 35-year-old airport shuttle driver sustained an injury to his left upper limb resulting in an above-elbow amputation of that limb. In order for this patient to return to work, what type of adaptation needs to be added to the vehicle? Hand controls Pedal extender Automatic car door opener Spinner knob

Spinner knob. Adaptation for patients who only have use of one hand. A steering spinner or steering knob is a small rotating handle which is fitted onto the steering wheel, to enhance one-handed control of the steering wheel. It gives the driver far greater control when manuvevering the vehicle, however they also have the effect of making the steering super-sensitive at high speeds and it is essential that the driver is correctly trained in how to drive with a spinner. There are a variety of shapes and sizes available, and they are generally selected according to what hand function the driver has. They are made up of a base which is clamped to the steering wheel, and the spinner handle. These come with the option of having a quick release system where the handle can easily be removed from the base, thus only leaving the base on the steering wheel.

For a pt with PD list the sequences steps for standing

Standing up from a sitting position, requires the individual to sequence 4 actions: 1. Shifting the body forward so that the buttocks are close to the edge of the chair 2. Placing the feet flat on the floor so that the heels are well back 3. Leaning the trunk forward 4. Standing up quickly while thinking of leaning "for-ward and up" in an arc of movement .A common problem is that people with PD fail to lean far enough forward when standing up. As a result, the line of center of gravity falls too far posteriorly in relation to the feet, and the loading moments of force on the hips and knees are increased. This problem makes rising very difficult. A downward gaze and loss of momentum due to akinesia further increase the difficulty in performing this task. With hypokinesia, mental rehearsal of the sequence prior to its performance as well as the use of verbal cues, such as counting or saying the action out loud, may enable this task to be performed more easily. With akinesia, the use of proprioceptive cues, such as gently rocking backward and forward prior to the movement, or auditory cues, such as saying "go," can be of use.

What is a suction plate?

The base of the plate that promotes independent feeding and prevents spills.

What is the purpose of a swivel utensil, rocker knife, weighted utensil, and universal cuff

The rocker knife is a knife with a rounded blade attached to a large, easy-grip handle directly above the blade. Knives with the blade positioned at right-angle to the handle allow a stronger grip to be maintained during cutting as the wrist remains in a neutral position. Rocker blades cut food using a rocking motion, rather than the traditional sawing motion. Swivel utensil- has a pivoting joint between the head and the handle of the utensil, helping to keep the head of the utensil horizontal as it is brought towards the mouth. The swivel mechanism of these utensils is engineered to stay level thus keeping the spoon bowl or fork tines level which reduces spills. Weighted utensil-It helps to reduce/dampen a tremor which in turn enables the patient to have more control over the utensil. With more control, the utensil can reach the patient's mouth more efficiently (smoother movement with less spillage) universal cuff- Designed to give people with limited grip, hand strength, or dexterity, controlled use of items such as eating utensil, toothbrush, writing tools, and other small items.

Describe the Rood approach What are some proprioceptive techniques used to stimulate muscles. What are some exteroceptive techniques to stimulate in the muscle according to Rood apporach

The rood approach is using muscle stimulation techniques for pts with neuromuscular dysfunction to increase their chances of participating in therapeutic exercises. Proprioceptive techniques include joint compression, positioning, joint distraction, reflexes, stretch and resistance. Exteroceptive techniques include stroking brushing, icing, warmth, pressure, and vibration in order to achieve optimal muscular action.

When would a person need a universal cuff versus built up handles during feeding.

Universal cuffs are for someone who has no active grasp. Built up handles are for when the hand/finger muscles are weak but some grasp is present.

Define Wernicke's Aphasia- Define hemianopsia-

Wernicke's aphasia. People with this pattern of aphasia (also called fluent or comprehensive aphasia) may speak easily and fluently in long, complex sentences that don't make sense or include unrecognizable, incorrect, or unnecessary words. They usually don't understand spoken language well and often don't realize that others can't understand them. hemianopsia- a clinical term used to describe the loss of one half of a vertical visual field.

Define work conditioning.

Work Conditioning- A program of physical exercise and endurance training designed to help a person regain the physical capabilities necessary to return to work. The grading of the OT program should increase the amount of weight the patient is required to lift. Progressing from medium to heavy work is the recommended progression in this scenario.

What is the maximum height for a counter top according to ADA Guidelines?

a section of counter at least 36 inches long and not more than 36 inches above the floor will make the counter accessible

Define ALS What are some symptoms of ALS The age range for ALS What is another name for ALS

amyotrophic lateral sclerosis. A progressive neurodegenative disease of the nerve cells around the brain and spinal cord that control voluntary movement. As motor neurons degenerate they can no longer send impulses to the muscle fibers that result in muscle movement. Muscle weakness (Arms and legs) Speech difficulty (dysarthria) Swallowing (dysphagia) Difficulty breathing (Dyspnea) 40-70 Lou Gherig's Disease

Define the terms intention tremor, dysmetria, dyssnergia, and Dysdiadochokinesia

intention tremor- worsening of action tremor as the limb approaches a target in space dysmetia- over or undershooting a target d/t an inability to control motor movement. Common in cerebellar disorders. Dyssnergia- breakdown/decomposition in movement resulting in joints being moved separately to reach a desired target Dysdiadochokinesia- impaired ability to perform rapid alternating movements

List the seat width and height for a standard adult, narrow adult, slim adult, and wide width adult chair.

standard adult seat width- 16, seat height- 19.5 narrow adult seat width- 16 inches, seat height- 19.5 inches slim adult seat width- 14 inches, seat height- 19.5 wide width adult seat width- 20 inch, seat height- 19.5

What are some early symptoms of MS? What is Relapsing MS

• Trouble seeing • Sensitivity to heat• Numbness, especially in the feet • Weakness • Fatigue • Difficulty thinking clearly • Depression • Needing to urinate urgently • Trouble with balance• Lack of coordination Relapsing-remitting MS is marked by relapses that last at least 24 hours. During a relapse, symptoms get worse. A relapse will be followed by a remission. During a remission, symptoms partly or completely go away. Since the relapsing-remitting type of MS has variable symptoms with expected function to be higher than that of other types, a combination of environmental modification and compensation techniques would support the patient's goals. Seated positions and taking advantage of gravity-assisted work, such as pouring a drink from the edge of a table, will require less demand on the patient's energy levels and coordination.