OT 828 - Midterm

Rachel, a 78-year-old woman, is referred to an outpatient clinic for occupational therapy. During the initial evaluation, she shows difficulty when pinching and grasping cotton balls and pencils. She also stated that there is pain at the base of her thumb. The occupational therapist assesses the grind test. From the symptoms shown above and the assessment of the grind test, which is most likely the cause of Rachel's orthopedic injury? a. Basilar Thumb Arthritis b. Trigger Finger c. De Quervain's Tenosynovitis d. Dupuytren's Disease

A. Basilar Thumb Arthritis

Sarah Samuels, 71-year-old retired assembly line worker for Whole Foods, sustained a R CVA during a family reunion. Sarah is in acute care rehabilitation and exemplified slurred speech, difficulty swallowing meals, LUE paralysis and altered facial expressions. Which of the following best describes Sarah's neurological impairment?

A. Dysarthria; Aphasia

An occupational therapy student was working with a Client who was a 45-year-old woman with a rotator cuff injury from playing in a volleyball league with some friends. After reviewing the occupational profile of the client, it showed that she was very active with her younger children and has a job that requires full shoulder mobility. The student also knew that the client had a partial rotator cuff tear and she complains of pain when shoulder is moved. The student documents that the client is unable to perform her daily tasks as needed. The student tells the client to keep using her shoulder normally as she has prior to her injury in hope of improvement. What is the appropriate intervention the student should be working on with the client? A. Modifying activities B. Putting shoulder in a sling C. Continue with normal every day activities as student suggested D. Control Swelling

A. Modifying activities

Harley Davidson, a 44-year-old male with Amyotrophic Lateral Schlerosis is being seen for therapy in acute care rehab. Harley expresses to you his desire to walk and do his ADLs independently. During your initial evaluation, Harley reports feeling fatigued, periodic muscle twitches, and shortness of breath when lying down to sleep. Harley can speak on his own and does not require respiratory support to speak. Which of the following best describes Harley's condition?

A. Orthopnea while lying flat; fasciculations

Conner, a 22-year-old male, was referred following a plane crash where he received a T6 complete spinal cord injury 2 weeks ago. His past medical history shows he had a left hip arthroplasty 2 years ago. You complete an occupational profile and note that Conner works as an engineer and spends a majority of his day doing hands-on work. He will begin inpatient therapy this upcoming week. He will be seen also by a physical therapist, a nurse, and a physiatrist. When coming in for his evaluation, Conner complains of an "awful headache, feeling anxious, and sweating a ton." His blood pressure is taken and it is noted at 210/100, which is not his normal. What is this dangerous increase in blood pressure called?

Autonomic Dysreflexia

Victor has sustained a C4 incomplete SCI and has been in the hospital for 5 days. When the Occupational Therapist comes in to evaluate Victor, he appears to be in distress and reports having a pounding headache and blurred vision. Victor is most likely suffering from what SCI complication?

Autonomic Dysreflexia

You are seeing a client with a T3 SCI. Your office is experiencing problems with the air conditioner, making it a very warm 79 degrees. During treatment, your client complains that they have a sudden onset of a pounding headache, is sweating profusely, and their skin is flushing. What is your client suffering from?

Autonomic Dysreflexia

Myles is a 46-year-old male who was recently involved in a wakeboarding accident, resulting in a spinal cord injury. Prior to the accident, Myles had no medical concerns or physical limitations. After the accident, Myles went to an inpatient rehabilitation clinic for 3 months. During his stay he developed a urinary tract infection. You walk in to start your therapy session for the day and you notice that Myles appears to be in pain. You ask him what is wrong and he states that he feels dizzy and has a headache. What do you think could be causing Myles to feel this way? What precaution should you take to avoid further issues?

Autonomic Dysreflexia, Check his blood pressure

Aria, a 40-year-old female, was referred due to a recent discectomy. Her past medical history shows hypotension and high cholesterol, which she takes medication for. You complete an occupational profile and note that Aria is a plumber and spends a majority of her shift getting up and down off of the floor from working on sinks. She has severe pain currently. She wants to return to work as soon as possible, but due to acute post-op precautions, it will take some time for her to get back into plumbing. What acute post-op precautions should she follow?

Avoid BLT

Bob was admitted to the hospital following a compression fracture in his spine at T6 that was sustained from a fall while skiing. Bob is currently on spinal precautions as ordered by the physician and was instructed to wear a TLSO for stability whenever her is out of bed. The physician also placed an order for occupational therapy in order to address deficits in bed mobility and transfers. Upon entering Bob's room for his first session, he states he forgot what he is supposed to do for his spinal precautions. What would you tell him?

Avoid bending, lifting and twisting

Jean is a 55-year-old female college professor and a pioneer in the field of economics who presented with an acute sensory and motor deficit; She experienced a tingling sensation in her hands and feet for the first three days, followed by muscle weakness in her arms and legs. After a week of experiencing the above issues, Jean decided to go to the hospital. Jean's Doctor referred her to Occupational therapy to address energy conservation strategies & how to combat muscle fatigue. Considering the Doctor's prescription, He has advised the occupational therapist to perform exercises to maintain the client's condition using assistive devices. Which diagnoses does the client present?

B) Guillain- Barre Syndrome

39. Mary was recently diagnosed with Multiple Sclerosis and is a patient in an inpatient rehab unit after having a recent flareup at home. One symptom she is having is her eyes moving back and forth rapidly causing dizziness and nausea. What is this condition called?

C. Nystagmus

Matthew, a 36 y.o male was rushed to the hospital after a head on auto collision at a four-way intersection driving home from his cousin's slumber party. Matthew was slightly intoxicated which caused a head on collision. Matthew suffered a hairline fracture at the base of his temporal bone. Which Cranial Nerves best associates with his TBI?

CN VII facialis; CN VIII vestibulocochlearis

AS suffered a lower motor neuron injury to the lumbosacral nerve roots within the spinal cord. This resulted in AS not being able to urinate or defecate and he has severe weakness in his lower limbs. What syndrome does AS have?

Cauda equina

Joan is a 78-year-old female whose current residence is in an assistive living facility. Joan's medical history includes weakness in UE, falls, cervical stenosis and no cognitive limitations. Joan has recently fallen in her kitchen resulting in an incomplete SCI. Joan will most likely have which type of cord lesion syndrome?

Central Cord Syndrome

Libby, a 70-year-old female took a fall in her house that caused a C7 incomplete spinal cord injury. After examination, it was seen that she had more weakness in her upper extremities compared to her lower extremities. What type of syndrome would explain this?

Central Cord Syndrome

Trevor, a NASCAR driver, was racing at the INDY 500 when he was suddenly cut off and his car spun out and rammed into the side wall. The paramedics took Trevor to the hospital, but he was in and out of consciousness, but went into a coma while at the hospital. The doctors explained to Trevor's wife that due to the car accident Trevor's brain shifted and rotated. This type of Traumatic brain injury would be classified as ___ based on the biomechanics of the injury.

Closed

Shane is a 30-year-old male touring with the Professional Bull Riding circuit. Last week, while in Las Vegas Shane was unable to ride the full 8 seconds. He was thrown from his bull and the bull stepped on his head. Luckily, Shane was wearing a helmet so there was no opened wound from the injury. However, Shane was unresponsive from the rapid movement of the ride. The emergency medical team rushed Shane to the hospital. After further testing, he was diagnosed with a TBI. His medical records indicate that Shane was in a coma for 6 days and his cerebrum had rotated around his brainstem. Based on this information, what is the proper classification of Shane's TBI?

Closed/ Diffuse

Jessica, a 7-year-old female, was learning to ride her bike without training wheels. When her dad let go, Jessica rode for a few feet and then fell onto her outstretched right hand. Her right wrist swelled up and bruised. Her parents took her to the doctors where they took and x ray which showed dorsal displacement and the broken end of the radius was tilted upward. This type of fractures can be diagnosed as a: a) Smith Fracture b) Colles Fracture c) Bennett's Fracture d) Tuft Fracture

Colles Fracture

A lieutenant in the army, A.M. suffered a TBI while on a tour in Afghanistan. During a routine check point assignment, an IED was detonated, and A.M. suffered what is considered a concussive blast. What form of TBI is this considered to be?

Combat-related

Phillip Moore is a 59-year-old male who traveled to Mexico 6 months ago. He tested positive for the zika virus with mild symptoms of fever and muscle pain. A few weeks later Phillip felt numbness and tingling in his feet and hands and had pain in his legs. His symptoms worsened in which he was paralyzed and had difficulty breathing, swallowing, and speaking. This rare disorder can affect motor and sensory neurons; however, cognition remains intact. What neurodegenerative disease is Phillip suffering from?

Guillain-Barré Syndrome

Rodger is a 60-year-old businessman at a local bank. One morning, Rodger went into work and his coworkers noticed he started to have slurred speech and face droop. They called an ambulance immediately where he was taken to a nearby hospital and got some scans done. The scans showed that Rodger had a ruptured blood vessel. What type of stroke did Rodger have?

Hemorrhage

Elon, a 15-year-old boy was playing football with his school friends and coach after school. Elon was the quarterback while his other teammates played defensive end. With the sound of a whistle from the coach, Elon started to countdown searching for a teammate to pass the ball to. As Elon was about to pass the ball, a teammate from the defensive end aggressively tackled Elon straight to the ground. The coach noticed Elon not getting up and quickly ran to check on him. He noticed that Elon was not moving and was unconscious. Elon woke up 3 days post-accident in acute care and could remember nothing from the accident. From Elon's MRI scan, it showed that he sustained a skull fracture due to the force of the blow, as well as a secondary effect which the Medical Doctor described as "Elon not being able to receive enough oxygen to his brain". Which of the following is most likely the type of secondary effect Elon sustained?

Hypoxia

Michael is a 40-year-old male with a right humeral fracture and has a thermoplastic humeral fracture brace to support the length of the humerus during healing. His past medical history is significant for low blood pressure, which is controlled through medication. You complete an occupational profile and note that Michael works as a football coach and spends 6-8 hours a day standing. He also reports that as long as he doesn't move he experiences no pain. His goal is to "be able to give hand signals to his players." If it is within the first six weeks of the evaluation process, which stage of the evaluation process is he in? a.) Immobilization or Early Mobilization b.) Early Consolidation c.) Late Mobilization d) Late Consolidation

Immobilization or Early Mobilization

Nancy is a 56-year-old female who was referred to occupational therapy with complaints of middle finger pain. During your assessment, you palpate over the middle finger and find tenderness over the A-1 pulley of the digital flexor where a nodule is present. You also observe a painful catching of the middle finger when you ask Nancy to flex and extend the digit. Nancy states she has difficulty with typing on her computer at work and would like to decrease the amount of pain she's been having. The client's past medical history is significant for diabetes and rheumatoid arthritis. Based on the above scenario, which of the following should be the INITIAL treatment for Nancy? A) Splinting the middle finger in neutral to prevent triggering B) Repetitive gripping exercises C) Steroid injection D) Heavy lifting strengthening exercises

Splinting the middle finger in neutral to prevent triggering

James Madison, a 71-year-old retired professional golfer, has been diagnosed with Amyotrophic Lateral Sclerosis. James is currently bedridden, unable to perform any ADLs, and required maximal assistance (FIM 2). Which of the following most appropriately describes James's current stage of rehabilitation?

Stage IV

Patrick a 30 year old male who was in a car crash was diagnosed with a complete C8 spinal cord injury. When the occupational therapist is in the room working with the client during his stay at the hospital, his blood pressure drops to a level that is dangerous when sat up. Client was experiencing dizziness, he was light headed, and his vision was blurry. What should the occupational therapist not do with this client who is experiencing orthostatic hypotension?

Stand the patient up

Your client is a 65 year old male who is recovering from a right hip arthroplasty 3 days ago. The arthroplasty was an anterolateral approach. The client is now weight bearing as tolerable. The client has no other injuries and is eager to be fully independent again. What recommendations would you make to best meet the client's needs? a. No bearing weight on the right side and a rollator walker b. Take precaution crossing your legs and no device c. Take precaution extending the right hip and maneuvering in and out of the car and a cane or reacher device if needed d. No precautions because the client should already be recovered by now

Take precaution extending the right hip and maneuvering in and out of the car and a cane or reacher device if needed

Paul, a 65-year-old male, has been referred to OT services as a result of being diagnosed with amyotrophic lateral sclerosis (ALS). Paul's primary symptoms at the time of his diagnosis included weakness, slight muscle atrophy, low tone, and decreased reflexes in all affected muscle groups. What can you determine is true from this information?

The client is presenting with primarily lower motor neuron signs

Michael James, a 32-year-old male flight attendant was en route to Maui when he started to feel uneasy at the LAX airport. He reported to the airline workers that he felt weak on his right leg and nauseated. The airline workers also started to notice that Michael James began to slur his speech and noticed his mouth drooping on the right side. Quickly, medics were called and zoomed Michael James straight to the nearest emergency hospital. After examination from the Physician Assistant, he reported to Michael James that he had an ischemic stroke and his left cerebral artery was blocked from built-up excess fatty plaques, also known as atherosclerosis. Which ischemic stroke is most likely the cause of Michael James incident?

Thrombosis

Nancy is a 56-year-old female who was referred to occupational therapy with complaints of middle finger pain. During your assessment, you palpate over the middle finger and find tenderness over the A-1 pulley of the digital flexor where a nodule is present. You also observe a painful catching of the middle finger when you ask Nancy to flex and extend the digit. Nancy states she has difficulty with typing on her computer at work and would like to decrease the amount of pain she's been having. The client's past medical history is significant for diabetes and rheumatoid arthritis. Which of the following is MOST LIKELY Nancy's diagnosis? A) Boutonniere Deformity B) Dupuytren's Disease C) Trigger Finger D) Flexor tendon rupture

Trigger Finger

Tina a 35yo mom of two recently underwent spinal surgery less than 48hrs ago. She has no other comorbidities and is in good health. Her occupational therapist has discussed techniques to maintain proper precautions while moving when she needs to. What is the correct way in which Tina should get in and out of bed? a. Rotate her lower body so that her legs are hanging off the bed. b. Push up on her elbows and bend her knees to get to the edge of the bed. c. Use the log roll technique. d. Use the Trendelenburg technique.

Use the log roll technique.

Beatrice is a woman who likes to drink, and she tends to be very uncoordinated when inebriated. Beatrice was taken into police custody on numerous occasions for public intoxication, but on one particular night she had fractured her radius when she had fallen on a sidewalk. Beatrice received a cast, but could only tolerate the cast for just 2 days. Swelling was found around her elbow, her fingers were cold with a bluish hue, and no sensation in the hand was found. Beatrice is known suffer with___________ contracture. a) Funneling b) Volkmann's c) Reverse d) De Quarvain's Tenosynovitis

Volkmann's

Jackie is a 70-year-old female who recently received anterolateral surgery on her left hip. Jack is cognitively stable and has no significant medical history. Prior to surgery, Jackie did not use any adaptive equipment. Luke is the OT who is going to work with Jackie. As Luke looks into her chart before the treatment session, he notes that Jackie is currently partial weight bearing. What ambulatory device should Luke work with and educate Jackie on?

Walker

Noah, a 15-year-old male, was referred to OT following a football injury that caused a L1 incomplete spinal cord injury 3 weeks ago. You complete an occupational profile and note that Noah is a high school student who also works at the local movie theater on the weekend. Noah has been complaining of severe pain that affects his occupational engagement, which causes him to be limited in his activity and be depressed. What are ways that OT can treat pain?

b. Splinting and making modifications to activities

Justin, a 75-year-old male, was having trouble with his daily activities due to stiffness, pain, and loss of range of motion in his hip. His doctor decided he would need a hip replacement surgery and ended up having an anterolateral approach. As the occupational therapist you are seeing Justin post-surgery and need to educate him on the precautions he needs to follow. Which of the following are you going to tell Justin: a) No hip flexion beyond 90 degree and no hip external rotation b) No hip internal rotation and no hip extension c) No hip adduction past neutral, no hip flexion beyond 90 degrees and no hip internal rotation d) No hip extension and no hip external rotation

d) No hip extension and no hip external rotation

Adie is a 30-year-old male that was involved in a car accident 3 months ago and has suffered a spinal cord injury. Before the injury, he was living alone, but after the accident he has moved back in with his parents, so they can be his primary caregivers. When Adie was in acute care, the occupational therapists provided Adie splits for his wrist and hand and worked on daily range of motion and strengthening exercises. He also practiced eating and grooming exercises with assistive devices, so he can be more independent in his ADL's. The occupational therapists educated Adie's parents on bed sore management, lower body dressing techniques, and schedules for emptying Adie's catheter bag. Adie's long-term goal is to be able to drive a car again. Based off the information given, where is Adie's spinal cord injury most likely located?

b. C5 - C8

April O'Neil is an air traffic controller who loves what she does. April is happy to return to work after she received months of therapy due to multiple golf-ball sized chunks of ice had hit her on the head. April was in the middle of her shift when it began to hail. April had worked with an occupational therapist as she most likely performed what functional approach?

Proprioceptive Neuromuscular Facilitation Approach

Colin is a 20-year-old male who recently got in an ATV accident resulting in a mid-shaft fracture to his right humerus. The doctor sets Colin's arm and puts him in a brace but monitors him for wrist and hand numbness and weakness. What injury is the doctor also monitoring Colin for?

Radial Nerve Palsy

Alexander is a 24-year-old male who sustained a high tetraplegia spinal cord injury; he is in the acute phases of the injury and requires an external breathing device. Even though Alexander knows his injuries are serious, he is highly motivated & ready for treatment. During the evaluation session, the OT explained to Alexander that his injuries require him to use a wheelchair that allows him to control the dials with his mouth since he has lost all motor function below his neck. Using your clinical reasoning, what level of spinal cord injury does the client exhibit?

A) C1

Your client is now expressing difficulty with ADL's in the home such as cooking and bathing particularly with reaching things that are high above his head what are some techniques you could have your client implement in the home? A. Suggest that the client move commonly used items in the kitchen that are far out of reach, to counter level or lower cabinets that are easily accessible. B. Recommend the client purchase a long handled shower brush to make cleaning spots such as his back easier and more accessible. C. Tell the client he just needs to wait it out and he will eventually be able to do things normally again. D. A and B

A. Suggest that the client move commonly used items in the kitchen that are far out of reach, to counter level or lower cabinets that are easily accessible. C. Tell the client he just needs to wait it out and he will eventually be able to do things normally again. D. A& B

Bob G., a 55-year-old male is seeking occupational therapy services with complaints of general weakness in his extremities and occasional muscle cramps in his legs. The client states, "Sometimes I trip over things around the house because my legs are too weak for me to pick them up." During the initial evaluation of the client, the therapist observes muscle fasciculations (twitching) of the calf and biceps brachii muscles bilaterally. The therapist also notes the client has absent reflexes bilaterally. The client's sensation of the upper and lower extremities, as well as cognition are fully intact. Which of the following is most likely the diagnosis for this client?

Amyotrophic Lateral Sclerosis (ALS)

Lisa, a 63 year old woman, has recently fractured the olecranon in right elbow after falling inside her home. She is experiencing acute pain and has visible signs of swelling. At this stage of the injury, what is the first thing you should do as an OT? a) Passively range the client's right elbow b) Assist the client in finding ways to relieve pain c) Assist with ADLs regardless of pain levels d) Refuse to work with the client until you have personally spoken to the physician

Assist the client in finding ways to relieve pain

Stormy Daniels was provided ownership of an oil well that resides on one of her family's land. Stormy never worked, and typically spends time either at the beach or eating foods with very high sodium and trans-fat levels. Stormy got into an argument with her boyfriend, and found herself with difficulty breathing. Stormy made her way to a hospital where she discovered that she experienced a stroke. The next day, Stormy was on her way to use the restroom and her mother noticed that Stormy would clumsily walk into walls on one side of her body. What condition is Stormy most likely to experience with her gait

Ataxia

Carol Hughes, a 25-year-old female was injured in a car accident resulting in T6 spinal cord injury. Carol has normal upper body movement, but her motor control and sensation from her abdomen down were affected. She reports to her therapist feeling nauseous and having a pounding headache. The therapist checks Carol's blood pressure and it is excessively higher than her normal blood pressure. The main symptoms that carol is experiencing are an indication of what type of condition?

Autonomic Dysreflexia

Your client is a 23-year-old college football player who has recently undergone rotator cuff surgery and is now 5 weeks post-op. He just recently was cleared to have his sling removed 3 days ago and is eager to begin therapy and return back to participating in practices for upcoming game in the Fall. What therapy intervention would be the most appropriate for the client to work towards their goal? A. Have the client work on overhead, full extension exercises, to begin stretching out the muscles after being in a sling for 5 weeks. B. Have the client work on exercises such as towel slides and supinated banded, pull-aparts, reminding the client to never go past the point of pain. C. Tell the client he most likely will not be practicing for a long time since recovery is a lengthy process and tell him to find a more realistic goal. D. Have the client work on strengthening his unaffected side more and learn how to function using only is unaffected shoulder.

B. Have the client work on exercises such as towel slides and supinated banded, pull-aparts, reminding the client to never go past the point of pain.

Jim was diagnosed with a T6 complete SCI following an MVA. He still has good motor control of his upper limbs and torso but has poor trunk control due to the level of his injury. He currently uses a manual wheelchair for mobility and can independently perform his pressure-relief. When you walk into his room for his therapy session, he states that he forgot what his physician told him about how often he should be performing pressure relief while up in his wheelchair. What is the optimum frequency for SCI pressure relief while seated in a wheelchair?

B. Intervals of 2 minutes every hour

Allison, a 35 -year-old female, is not able to extend the wrist and fingers at the metacarpophalangeal joints. The client also states that she is having numbness and tingling of the hand, and she is experience pain. The therapist reviews her occupational profile and indicates the need of a splint to support the wrist and hand for it to heal. This wrist drop condition is caused by what nerve damage. A. Median nerve B. Ulnar nerve C. Radial nerve D. Axillary nerve

Radial nerve

Julie is a 30-year-old female who was in a car accident on her way to pick up her husband from the airport who had been gone for a few weeks due to work. She was hit on the driver side from a truck that ran a red light. When Julie woke up in the hospital, she had no idea what had happened that caused her to be in the hospital. She was diagnosed with a TBI. The TBI caused her to lose her memory of recent events previous to the accident. She didn't remember where she was going, the accident, or where her husband had been. What is Julie experiencing?

B. Post Traumatic amnesia

60-year-old client Bob presents in OT to work on using adaptive equipment since he had a left posterolateral hip arthroplasty and is unable to dress his lower body and complete his self-care routine due to balance issues. At this time Bob is only able to ambulate with a walker with about 10% of the weight on his left leg. Working with the client it is important to follow his weight-bearing precautions. What weight-bearing status does Bob fall under? A. Non-weight bearing B. Touchdown (toe touch) weight bearing C. Partial weight bearing D. Weight Bearing as tolerated

B. Touchdown (toe touch) weight bearing

Rachel, a 78-year-old woman, is referred to an outpatient clinic for occupational therapy. During the initial evaluation, she shows difficulty when pinching and grasping cotton balls and pencils. She also stated that there is pain at the base of her thumb. The occupational therapist assesses the grind test. From the symptoms shown above and the assessment of the grind test, which is most likely the cause of Rachel's orthopedic injury?

Basilar Thumb Arthritis

Nickie is a 35-year-old female post-surgery for a T4 incomplete spinal cord injury. You complete an occupational profile and note that Nickie and is a single mother of a 7-month old baby and before her injury spent 6-8 hours a day carrying her child. Though her mother and siblings often visit to help take care of the child when she is at work, she reports fatigue but otherwise no pain. Her goal is to "Carry her baby again." Which of these is impairments is NOT a common complication of SCI?

Bursitis

Millie, a 48-year-old female, was referred following a CVA that affected the left hemisphere of her brain 1 day ago. Her past medical history shows hypertension, diabetes mellitus, and atrial fibrillation. You complete an occupational profile and note that Millie works as a child psychiatrist and enjoys playing with her cats and bunnies. She is currently in acute care and will be transferred to inpatient rehab once she is stable. Which of the following do strokes in one hemisphere of the brain NOT affect/lead to?

C. Complete, permanent memory

Kate is a 40-year-old female who was diagnosed with Huntington's disease 5 years ago. Her husband, Jack was taught by the occupational therapist that he needs to ask his wife simple yes or no questions and make sure there is no clutter around the house to reduce Kate's risk of falling. Recently, Jack has noticed that Kate has been unable to start tasks. In the mornings, he does things like puts together an outfit for her to get dressed or puts toothpaste on her toothbrush, to help her start her day. They have also agreed that Kate can no longer drive the car because she has been having difficulty turning the wheel. During mealtimes, Kate has had difficulty eating by herself because the chorea has worsened and has difficulty swallowing. Jack told the occupational therapist his new observations of Kate and the occupational therapist suggested using a stable chair for Kate while she eats and other energy conservation techniques he could use. What new stage of Huntington's disease is Kate experiencing?

C. Mid Stage

Emmet is a 72-year-old male who had a stroke 2 days ago. The occupational therapist is working with him in the hospital setting and notices that he is having difficulties in swallowing. His ability to drink and or eat by mouth is affected post-stroke. What neurological impairment is Emmet experiencing?

D. Dysphagia

Molly was playing with her kids when she suddenly collapsed. Her husband was nearby and called 911 which an ambulance came and rushed Molly to the hospital. When she arrived, the doctors did a quick exam and rushed her into surgery to restore blood flow in her artery due to a blood clot being stuck because the artery was too small for the clot to pass through. The type of stroke Molly has is?

D. Embolism

Lana, a 21-year-old swimmer is training for the upcoming Olympics in 2024. At practice, Lana was walking to her swim lane when she slipped on water and fell forward onto the pavement. Lana was rushed to the hospital where an MRI was administered. Of the MRI, the scan showed a lesion at the anterior pole of the frontal lobe from Lana's fall. Which of the following is most likely the type of traumatic brain injury Lana sustained?

Focal Injury

Ollie, a 66-year-old male was referred following a TBI after receiving a GSW to the head in a drive-by shooting 2 weeks ago. His past medical history shows hypertension, high cholesterol, and obesity. You complete an occupational profile and note that Ollie works as a mechanical engineer and enjoys playing with his grandkids and reading books. He is currently in inpatient rehab. Which of the following is NOT a neurological event that can occur from a TBI?

Decreased intracranial pressure

Trevor, a NASCAR driver, was racing at the INDY 500 when he was suddenly cut off and his car spun out and rammed into the side wall. The paramedics took Trevor to the hospital, but he was in and out of consciousness, but went into a coma while at the hospital. The doctors explained to Trevor's his wife that due to the car accident Trevor's brain shifted and rotated. This type of injury is.

Diffuse Injury

Marshall is a 57 year old male who is experiencing decreased ROM in his left ring finger. He notices that he is unable to fully extend this finger and has recently discovered a nodule on his palm. Marshall is of Northern European descent and is currently taking medication for epilepsy. What condition does he most likely have? a) Dupuytren's Disease b) Trigger Finger c) de Quervain's Tenosynovitis d) arthritis

Dupuytren's Disease

What is the best FIRST course of action for an occupational therapist who has a nonsurgical patient with a shoulder injury?

Educate the client

Jessie is a 45-year-old female who was diagnosed with MS when she was 32. Over the years, Jessie has done a great job of keeping herself healthy and managing her symptoms. She has been managing her pain well, she exercises daily, and has made modifications in her home to make her daily activities easier. What symptom of MS is the most common and is one of the primary reason clients with MS are referred to occupational therapy?

Fatigue

An SCI independent of its severity is an emotionally traumatic event. You as an Occupational therapist are seeing Nickie during the acute phase treatment, which of these is NOT a good example of the positive facilitation of coping skills throughout the continuum of care.

Focus solely on the client's reactions

12. Lisa, a 60-year-old female, who suffers from spinal stenosis. Prior to the onset of her diagnosis, Lisa was a Zumba instructor, teaching classes at the local YMCA three times a week. She would often move heavy equipment around the facility, as she believed this also helped keep her in shape. Lisa began experiencing intense pain in her vertebra which led her doctor to suggest surgery. After her laminectomy, Lisa is able to return home where she lives by herself. She has been properly educated on the precautions and how to log roll out of bed. Which of the following is the most appropriate answer choice for Lisa to follow spinal precautions? A. Lisa should reach slowly into the backseat to pick up her pocketbook before going into the grocery store B. Lisa should use a step stool to put her groceries onto the higher shelves and reach down to pick up the bags from the counter C. Lisa should sit down and bring her foot to her body by crossing her legs to but her shoes on D. Lisa should sit in her most comfortable chair that is really soft and allows her to move around the most

Lisa should sit down and bring her foot to her body by crossing her legs to but her shoes on

Sarah a 24-year-old female has come to her doctor because she has been having changes in her daily life. Sarah tells her doctor that she has been having weakness, sensory changes, dysphagia, dizziness, spasticity, and fatigue. She also mentions that at times she has pain and bladder issues. The doctor does a neurological examination, has Sarah get an MRI and analyzes the cerebrospinal fluid that was taken. From this information, it is most likely that the doctor will diagnosis Sarah with:

Multiple Sclerosis

Chance, a 68-year-old male, was referred following a posterolateral right hip arthroplasty 2 weeks ago. His past medical history shows he already had a left hip arthroplasty 10 years ago. You complete an occupational profile and note that Chance works as a financial advisor and spends 8 hours/day in front of a computer working. He will begin outpatient therapy this upcoming week. He is advised of precautions that he must follow for 3 months' post op. What acute post-op precautions does he NOT have to follow based on that type of arthroplasty he had performed?

No hip external rotation

You see Mr. Smith is a 60-year-old-male, postoperatively for a left thumb CMC arthroplasty at the hand clinic. You provide him a hand-based thumb spica orthosis, which is used to provide some pain relief and help Mr. Smith do a functional pinch. As another part of his intervention, you educate him on protecting his joints and different types of adaptive devices for him to perform his ADLs. What is most likely Mr. Smith's hand condition? a. Osteoarthritis b. Trigger Finger c. Tendinitis d. Smith Fracture

Osteoarthritis

Devin is a 30 year old male who sustained an L2 spinal cord injury from a motorcycle accident. Devin is independent with most of his daily activities with the use of adaptive equipment. Devin has full function in his upper extremities but experiences some weakness in his lower extremities. Based on this information, Devin is thought to have what type of paralysis?

Paraplegia

Jacob, 24-year-old, was in a car accident that caused a spinal cord injury at L1. The physician did tests on Jacob after his surgery and found that he has sensory and motor function in his arms, shoulders, and fingers. When the lower extremities were tested, Jacob had limited sensory but no motor function. From the information provided we can conclude that Jacob is considered ______ and has a ______ L1 spinal cord injury.

Paraplegia, incomplete

Billy is a 60-year-old male who was referred to occupational therapy for recent falls. When Billy enters the clinic, the therapist notices Billy has festinating (freezing) gait. During the interview with the client, he complains of tremors when trying to feed himself and fill out his checkbook. His wife is also present and states Billy has trouble sleeping at night and has been displaying early signs of dementia. Which of the following is most likely Billy's diagnosis?

Parkinson's Disease

Paul, a 65-year-old male, has been referred to OT services as a result of being diagnosed with amyotrophic lateral sclerosis (ALS). Paul's primary symptoms at the time of his diagnosis included weakness, slight muscle atrophy, low tone, and decreased reflexes in all affected muscle groups. Which of the following would be unexpected for Paul at this time?

Paul will most likely recover with OT services

lieutenant in the army, A.M. suffered a TBI while on a tour in Afghanistan. During a routine check point assignment, an IED was detonated, and A.M. suffered what is considered a concussive blast.

Primary

Hulk Hogan, a 55-year-old male, was referred to occupational therapy in acute care rehab following his initial diagnosis of Multiple Sclerosis. While completing an occupational profile, you discover Hulk's joy of playing racquetball and billiards pool. Hulk states his main goals include a return home, independence in his ADLs, and a return to recreational smoking. Hulk's current symptoms include cognitive and physical fatigue, dizziness, and a short attention span. During your evaluation, Hulk expresses his MS symptoms have significantly worsened and there has been no point of recovery. Which of the following stages of Multiple Sclerosis is Hulk experiencing?

Primary Progressive

Your client is 3 weeks post-operation for a left total knee replacement. This is a new client for you, as her previous therapist has decided not to work with her due to unknown reasons. The client reports she feels fine and is ready to return to work as soon as possible because she is the only source of income for her household. Upon evaluation, you notice that the client is not using her crutches to assist with ambulation. You also notice that the area of operation seems to be red, swollen, warm, and the client winces in pain when it is palpated. Choose the most appropriate answer for what you should do next. A. Write up a discharge plan because the client needs to go back to work and says she feels okay B. Reassess the surgery site and communicate with the doctor that an infection may be present C. Educate the client on how to properly use the crutches and why she should use them D. Talk with the client about other options for a source of income since she has a role of providing for her family

Reassess the surgery site and communicate with the doctor that an infection may be present

During which stage of recovery do therapists consider activity demands, contexts, patterns of performance, and integration of skills in order to help clients reach goals for quality of life and participation in meaningful roles?

Rehabilitation and reentry to the community phase

Client is a 50 year old male who came into clinic due to pain in his left shoulder. He has worked for Amazon in their packaging facility for the past 30 years and started to notice that whenever he lifts his arm above his head there is a shooting pain. The clinician recommends an MRI which determined that the client has a torn rotator cuff. What is most likely that cause of the injury?

Repetitive use

John is a 46-year-old man who is referred to an outpatient hand clinic for occupational therapy. The occupational therapy student evaluates John and notices the signs of inflammation that consists of redness, swelling, and pain in his hands, as well as abnormal body posture. The occupational therapy student proceeds to question John if he experiences morning hand stiffness, fatigue, and pain. John replied "yes" to all. From the evaluation, which is most likely the cause of John's pain?

Rheumatoid Arthritis

John is a 46-year-old man who is referred to an outpatient hand clinic for occupational therapy. The occupational therapy student evaluates John and notices the signs of inflammation that consists of redness, swelling, and pain in his hands, as well as abnormal body posture. The occupational therapy student proceeds to question John if he experiences morning hand stiffness, fatigue, and pain. John replied "yes" to all. From the evaluation, which is most likely the cause of John's pain? a. Idiopathic Osteoarthritis b. Rheumatoid Arthritis c. Extensor Tendon Injury d. Flexor Tendon Injury

Rheumatoid Arthritis

You are a member of the interprofessional team collaborating on a discharge plan for Patrick. Patrick is a 55 year old who lives alone. He is diagnosed with a CVA in which caused weakness to his left side. Patrick was administered tPA within an hour of the stroke occurring. His physician has cleared Patrick medically for discharge. Based on this information, it is likely Patrick had what type of stroke?

Right hemispheric Ischemic Stroke

A 60-year-old male has been having right shoulder pain for about 6 months. The client notices that his right shoulder is very weak compared to his left shoulder and his pain level (8) is at the highest peak when he performs an overhead activity. The client is having difficulty performing activities of daily living above the shoulder level such as combing his hair, putting on his shirt, and bathing when trying to reach his back. The client is scheduled for a magnetic resonance imaging (MRI) next week. What is the most likely cause of this client's shoulder pain? A. Shoulder Impingement B. Adhesive Capsulitis C. Rotator cuff tear D. Frozen shoulder

Rotator cuff tear

Jimmy, a 56 year old, was painting his house and was on a small ladder. Jimmy is a healthy man with a medical history only consisting of high blood pressure, which he is able to control with medications. While on the ladder, Jimmy lost his balance and fell on the outstretched hand, with radial deviation. When admitted to the hospital, the doctor presumes Jimmy will have what type of fracture?

Scaphoid fracture

Client is an 17 year old male who came into clinic due to the immense pain he has in his right hand. He is a high school student who plays football and recently was tackled to the ground during a game, where he landed on his hand. Clinician determined that the ulnar side was the most injured. What kind of injury did the client sustain?

Skier's Thumb

Alana Thompson had stayed up late one evening to study for her occupational therapy exam with her classmates. Alana wanted to teach her friends about her father's difficulties with arm flexion and extension. When Alana would pull on her father's arm that is typically in a flexed position, his arm would extend in small degrees at a time without it him being in pain. Alana mentioned this is called the cogwheel affect for what related condition of a stroke?

Spasticity

Wanda is a 78-year-old female that has been complaining of lower back pain. When asked about her pain level, she rates it as an 8 out of a 10. She also mentions that she has tingling feeling in her feet and has been getting frustrated because she cannot pick up her knitting needles well to knit sweaters for her grandchildren. Looking at Wanda's medical history, she has already had surgery in the past for degenerative disc disease and disc herniations. What is most likely the cause for Wanda's lower back pain? a. Arthritis b. Spinal stenosis c. Sciatica d. Chance fracture

Spinal stenosis

George is a 25-year-old male with lower back pain. He has no prior past medical history. You complete an occupational profile and note that George is a warehouse worker who spends up to 8 hours a day standing and lifting boxes up to 4. He also reports that any time he bends down he feels a 6 on the pain scale. His goal is to "Get back to work." Which of these DO NOT represent good body mechanics, that George should practice? a.) When lifting a heavy object add more central support by lowering one knee on the floor (half kneeling) so that the body is close to and facing the object. Keeping the weighted mass as close to the body's center of gravity as possible. b.) When standing to cook or wash dishes, place one foot on the shelf under the sink or on a low stool to achieve posterior tilt. c.) To sit lower the body by flexing the knees without bending the spine. Place hands on the chair's armrest to guide the descent and provide support through the transition. d.) When lying in bed the ideal posture to decrease pressure to the spine is to lie prone with the knees bent. And log rolling to come to a seated position.

When lying in bed the ideal posture to decrease pressure to the spine is to lie prone with the knees bent. And log rolling to come to a seated position.

Tina, a 35yo mom of two, recently underwent spinal surgery, less than 48hrs ago. She has no other comorbidities and is in good health. Her occupational therapist has discussed techniques to maintain proper precautions while moving when she needs to. When discussing interventions, what would Tina's occupational therapist choose to be the most important before being discharged? a. Precaution guidance and adaptation of certain ADL's. b.Light upper arm exercises with 10lb weights. c. Massage therapy for the pain. d. 45min sitting breaks throughout the day.

a. Precaution guidance and adaptation of certain ADL's.

Your client is a 65 year old male who is recovering from a right hip arthroplasty 3 days ago. The arthroplasty was an anterolateral approach. The client is now weight bearing as tolerable. The client has no other injuries and is eager to be fully independent again. Which of the following interventions would you be most likely to focus on right now for this client's treatment? a. Safety and precautions education, introducing appropriate assistive devices, and implementing adaptive techniques for ADLs. b. Massage, yoga, and swimming exercises to reduce pain and regain strength. c. Educating the client on how to walk up and down the stairs with their assistive devices. d. Pendulum exercises.

a. Safety and precautions education, introducing appropriate assistive devices, and implementing adaptive techniques for ADLs.

Loretta is a 78-year-old female who just recently had a reverse shoulder arthroplasty. Loretta has had a history of chronic shoulder arthritis and recently suffered a large rotator cuff tear resulting in her needing the surgery. What is the main reason why the physician would choose to do a reverse arthroplasty instead of a total shoulder arthroplasty?

bad rotator cuff

Ben is a 60-year-old male who was diagnosed with ALS two years ago. Some of the symptoms that Ben is currently experiencing is severe weakness in some of the muscles in his legs, increased difficulty with ADLs, and constant fatigue. Ben is currently using a walker to get around his home. In what stage of ALS is Ben currently in?

c. phase 3