Pass the OT: Module 5 Quiz
For which patient would you recommend the use of a rocker knife, to use as an adaptive eating utensil? a. Cerebral palsy b. Right below elbow amputation c. Macular degeneration d. Type II diabetes
b. Right below elbow amputation
An OTR® is working with Rachel, a 57-year-old patient who has been diagnosed with Primary Progressive Multiple Sclerosis (PPMS). Rachel has recently been experiencing difficulty with brushing her teeth due to fatigue, decreased strength in her upper extremities, and an intention tremor. Which adaptive strategy would be BEST to recommend to Rachel to make the task of brushing her teeth more manageable a. A weighted electric toothbrush b. Sitting next to the sink and propping her elbow on the countertop during teeth hygiene tasks, while using a light-weight electric toothbrush c. A universal cuff with a manual toothbrush attached d. It is not important to have good oral hygiene if you have MS
b. Sitting next to the sink and propping her elbow on the countertop during teeth hygiene tasks, while using a light-weight electric toothbrush
A patient with left hemiplegia and unilateral neglect is participating in a gardening activity as part of his OT intervention. The OT spreads some soil in front of the patient and asks him to scoop up the soil and place it into a container which has been placed in his midline. The patient only scoops up some of the soil and then stops the activity. What is the BEST remedial strategy the OT can teach this patient in order to support him gaining long-term independence with any activity he is presented with? a. Have the patient visually scan the table for side to side b. Move the soil further to the patient's right side c. Provide hand-over-hand assistance d. Redirect the patient back to the task with verbal commands
a. Have the patient visually scan the table for side to side
A patient with hypertension recently suffered an Ischemic Stroke while brushing his teeth due to an embolus which lodged in his middle cerebral artery. As a result, this patient's right arm has a complete loss of function. What does this MOST likely indicate? a. Hypotonia b. Flaccid paralysis c. Vertebral subluxation d. Atonicity
b. Flaccid paralysis
What sign is unique to Guillain-Barre syndrome (GBS)? a. Tingling sensations b. Symptoms appear quickly c. Need for respiratory support d. Muscle weakness
b. Symptoms appear quickly
According to Occupational Safety and Health (NIOSH) guidelines, what is the maximum weight an OT practitioner should handle before using a lift to assist with patient handling becomes necessary? a. 15 lbs b. 25 lbs c. 35 lbs d. 40 lbs
c. 35 lbs
A patient in inpatient rehab was admitted for R CVA 2 weeks ago. He demonstrates leaning to the right side of his body during upper body dressing at the edge of the bed and neglects dressing the left side of his body. What is this an example of? a. Gravitational insecurity b. Ideational apraxia c. Asomatognosia d. Astereognosis
c. Asomatognosia
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? a. Turkey and cheese sandwich b. Stir-fry vegetable dish over brown rice c. Grilled cheese sandwich d. Microwavable dinner
c. Grilled cheese sandwich
Which device is typically recommended to turn pages and point on a keyboard when a patient's hand function is limited? a. AAC device b. Prone stander c. Head pointer/wand d. Sip and puff
c. Head pointer/wand
According to Rood, what is required for normalization of tone and evocation of desired muscular responses? a. Full AROM b. Desensitization c. Sensory input d. Visual tracking
c. Sensory input
An OTR® is working with Mary, a college student who is recovering from a recent TBI. Mary has a grade 4+ strength (MMT) in both her upper extremities but due to marked intention tremors and postural instability her ability to grasp and manipulate a pen is being affected. As Mary is majoring in creative writing, continuing to write in her journal is an important goal for her. Which writing adaptation would be MOST appropriate to recommend to Mary to help her compensate for her deficits? a. Universal cuff with a pen loop attachment b. Computer keyboard with tilt feature c. Weighted pen and weighted wrist cuffs d. Forearm orthosis balanced on a sling with a built-up marke
c. Weighted pen and weighted wrist cuffs
An OT practitioner has completed an ergonomic evaluation at a busy airport where most of the employees' duties involve heavy manual labor. What are the BEST interventions the OT practitioner can provide to prevent work-related injuries? a. Introduce de-stress workshops for employees b. Teach stretch exercises to be used at the workplace c. Recommend treatment for possible cumulative trauma disorder d. Promote better positioning at work through modifications and weight belts
d. Promote better positioning at work through modifications and weight belts
When determining seating biomechanics requirements and taking into account the patient's stability, postural support, and mobility needs, what would the OTR® FIRST assess? a. Upper extremities b. Trunk c. Head and neck d. Pelvis
d. Pelvis
What type of spoon has a mechanism that keeps the spoon level to prevent spills and can be used to compensate for lack of movement in the forearm? a. Lightweight b. Angled c. Weighted d. Swivel
d. Swivel
A patient with Parkinson's Disease spills his food every time he attempts to scoop with a spoon due to his intention tremor. Which adaptive feeding utensil will provide this patient with more control so he can feed himself without spilling? a. Light weight utensil b. Universal cuff c. Rocker knife d. Weighted utensil
d. Weighted utensil
An OTR® is providing education to the family of a patient who is in the end stage of ALS. What is the MOST IMPORTANT advice the OTR® 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
An OT receives a referral to work on strengthening with a patient who has multiple sclerosis. What type of exercise should the OT provide to this patient? a. Isometric exercise to build muscle tissue. b. High intensity interval strengthening to increase cardiovascular health c. Graded isotonic exercise with as much weight as the patient can handle d. Low load strengthening exercise to increase endurance
d. Low load strengthening exercise to increase endurance
What type of wheelchair is typically recommended for an individual with a T3 SCI? a. Wheelchair with modified rims b. Tilt in space wheelchair c. Power wheelchair d. Manual wheelchair
d. Manual wheelchair
Dustin is a 19 year old man with a diagnosis of severe ADHD with learning disabilities. He has been referred for a vocational evaluation, completed by a team that includes an OT who completes an evaluation of cognitive and work readiness skills. The OT reports to the evaluation team that Dustin shows deficits in executive function skills, but is able to compensate with adaptations that he learned how to use in high school. The psychologist reports that Dustin's IQ is at the lower end of the average range. Dustin's parents report that when completing jobs around the house, Dustin needs some help to learn new tasks, but is able to work independently once he has learned what to do. What type of program should the team recommend for Dustin? a. Supported Employment b. Word Reconditioning c. Work Hardening d. Transitional Employment
d. Transitional Employment
Melinda is a 53-year-old woman who has been diagnosed with Secondary-Progressive Multiple Sclerosis (SPMS). Melinda enjoys cooking and experimenting with new recipes and is fondly known as being the "master chef of her neighborhood". Her main goal is to continue to be productive in her kitchen, but she reports that cooking is starting to become challenging for her. She attributes her generalized weakness and fatigue, and difficulty keeping her place when reading recipes as factors which are contributing to her poor performance. Based on this information, what is the BEST course of action the OT should take? 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
d. Measure the rate of perceived exertion during different types of tasks
An OT is working with a patient who has been diagnosed with a progressive disease. What is the main goal of OT intervention, in this scenario? a. Educate the patient on ways to incorporate compensatory strategies b. Introduce adaptive equipment the patient can use in the bathroom c. Strengthen the patient's upper body by incorporating isometric exercises d. Encourage the patient to stand at the bathroom sink instead of sitting in their wheelchair while performing grooming activities
a. Educate the patient on ways to incorporate compensatory strategies
A 72-year-old patient who presents with a right hemiparesis is currently receiving OT in an inpatient neurorehabilitation unit. The patient has achieved his goals for BADLs and requires minimal supervision for his IADLs. Based on his progress, he is due to be discharged and is eligible to continue with his rehabilitation in an outpatient setting. His OT intervention plan includes having him participate in a home program but before developing this program, what is the MOST IMPORTANT factor the OT practitioner needs to consider? a. The patient's ability to demonstrate carryover of and adherence to the home program instructions b. How much the patient understands the purpose and measurable outcome of the home program c. The amount of assistance the patient receives in ensuring the program is followed appropriately d. The patient's ability to read the instructions despite limited visual perception
a. The patient's ability to demonstrate carryover of and adherence to the home program instructions
An 89-year-old patient with late stage Alzheimer's Disease cannot reposition himself in his wheelchair and suffers recurrent pressure sores. What type of wheelchair feature would allow nursing home staff to provide pressure relief to the man while he is sitting in his wheelchair without having to reposition him? a. Tilt-in-space b. Pelvic bar c. Elevating leg rests d. Recline
a. Tilt-in-space
What are some of the MOST important goals of vocational rehabilitation in OT? Select the best 3 answers. a. Assist individuals to find new employment b. Maximize levels of function following injury and/or illness to maintain a desired quality of life for the worker c.Facilitate the safe and timely return to work of the patient only if they sustained a work-related injury d. Remediate and/or prevent future injury e. Prevent the negative psychosocial consequences of unemployment f.Advocate for patients who have been injured at work to take as much time as they need to heal before they attempt to return to any form of work
b. Maximize levels of function following injury and/or illness to maintain a desired quality of life for the worker d. Remediate and/or prevent future injury e. Prevent the negative psychosocial consequences of unemployment
Robert is a 69-year- old man with a diagnosis of Parkinson's Disease. He has a severe intention tremor and is frustrated by his difficulty initiating movement. What treatment can the OT provide to Robert to help him with his movement disorder? a. Pulley exercise b. Metronome training c. Neuromuscular Electrical Stimulation (NMES) d. Active assistive range of motion exercises
b. Metronome training
An 81-year-old retired school teacher recently had a CVA and she is currently an inpatient in the medical ward. On meeting the patient to evaluate her needs in terms of OT intervention, the patient begins to cry and states that she is devastated because she cannot use her dominant upper limb to complete her ADLs, and she does not want to be dependent on a caregiver. In this scenario, what is the best action the OT should take? a. Instead of assessing the patient's physical limitations, administer a standardized depression assessment b. Provide active listening in order to build a therapeutic relationship with the patient c. Refer the patient to a psychiatrist d. Document the patient's interaction and inform her primary physician
b. Provide active listening in order to build a therapeutic relationship with the patient
Kathleen, an 88-year-old woman who is healthy and active, lives with her daughter and son-in-law in a single-story house. Recently, Kathleen has started to experience difficulty getting up from the toilet and her daughter is concerned that her elderly mother will lose her balance and injure herself. The most appropriate recommendation at this stage, is to suggest increasing the height of the toilet. For an elderly person, what is the BEST height of a toilet seat, measuring from the floor to the seat top? a. 15 inches b. 16 inches c. 18 inches d. 21 inches
c. 18 inches
A 68-year-old senior male is being fitted for a wheelchair. He states that he frequently wears heavy jackets during the year because he lives in Alaska. He requires no lateral external supports for his torso and has a hip width of 18 inches. What seat width should the OT recommend? a. 16 inches b. 18 inches c. 20 inches d. 22 inches
c. 20 inches
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? a. 12 feet b. 16 feet c. 24 feet d. 36 feet
c. 24 feet
For a 13-year-old patient who has a progressive condition which is causing him to lose his vision, what is the BEST adaptation that can be recommended to help him continue to use his computer despite his poor vision? a. A recommendation for a modified, smaller keyboard b. A recommendation for a voice recognition input program c. A recommendation for a screen reading program d. A recommendation for single-switch scanning with a keyboard on the screen
c. A recommendation for a screen reading program
An OT is providing a wheelchair consultation to a Japanese woman who is 83 years old, 93 pounds, who recently had a mild right CVA, and lives with her husband and two sons. The OT determines that a standard narrow adult chair would be most suitable for this patient. What are the dimensions of this chair? a. 16" wide x 16" deep x 18.5" high b. 18" wide x 18" deep x 20" high c. 14" wide x 16" deep x 18.5" high d. 16" wide x 16" deep x 19.5" high
d. 16" wide x 16" deep x 19.5" high
A newly admitted patient recently had a mild CVA and has goals of upper and lower body dressing. When asked to perform upper and lower body dressing, the patient states that she does not want the OT to look at her naked due to privacy and religious reasons. What action should the OT take next? a. Ask if the patient feels more comfortable with a female therapist b. Educate the patient on the importance of OT and why the current OT needs her to perform the dressing evaluation c. Ask if the patient would like to work on a different task d. Ask if the patient will don and doff larger clothing over her own clothing
d. Ask if the patient will don and doff larger clothing over her own clothing
A 74-year-old man has vertigo caused by an inner ear condition. He often complains of feeling dizzy and will sometimes state that the room is spinning. Which activity would be best for the OT to include during intervention? a. Look back and forth multiple times b. Throw a basketball into a hoop while standing c. Play ping pong while standing d. Catch and throw a ball into a hoop while seated
d. Catch and throw a ball into a hoop while seated
A patient with dementia is observed brushing his teeth with a comb and then later on, eating his meal with a toothbrush. This behavioral disturbance is not attributed to agnosia, as the patient is able to correctly name the items which he misused. What disorder is this patient's behavior indicative of? a. Limb-kinetic apraxia b. Ideomotor apraxia c. Functional movement disorder d. Conceptual apraxia
d. Conceptual apraxia
While observing a patient shower in the hospital bathroom, the patient closes the shampoo by capping it on the wrong end of the tube. What diagnosis does this patient most likely have? a. Visual perception b. Dressing apraxia c. Ideomotor apraxia d. Constructional apraxia
d. Constructional apraxia
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? a. Due to the cerebellar CVA, the patient is seen to show constructional apraxia b. Visual perceptual deficits may be affecting the patient's ability to recognize items c. The patient was unable to see the socks due to left side neglect d. 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
A 64-year-old patient who has been admitted to an inpatient rehabilitation facility following a middle cerebral arterial stroke, is due to be discharged. The patient currently presents with left-sided weakness and anosognosia. He refuses to use any mobility aids despite having had 3 falls during his stay at the facility. The plan is for the patient to return to live with his wife and daughter who have agreed to take care of his needs at home. What goals are the MOST IMPORTANT for the family to accomplish during the final sessions of this patient's OT intervention, before he returns home? a. Cognitive strategies using errorless approach, dynamic standing balance, and caregiver training for functional transfers b. Fall prevention and recovery with family, multi-modal cueing techniques, and visual scanning to improve environmental awareness c. Self-monitoring to manage activity tolerance, scapular stabilization during upper body exercises, and positioning techniques for safe self-feeding d. Fall prevention and recovery with family, cognitive strategies, and patient and family education regarding patient's awareness of deficits
d. Fall prevention and recovery with family, cognitive strategies, and patient and family education regarding patient's awareness of deficits
When using the Carr & Shepherd approach, how are movement patterns practiced? a. In isolation to focus on each specific muscle b. During composite strengthening exercises c. By moving through range of motion in each movement plane d. In the context of tasks
d. In the context of tasks
A patient who suffered a mild CVA is demonstrating difficulty with impulse control by blurting out inappropriate comments. The OT suspects that the patient's executive functioning may have been affected by the CVA. In order to confirm this, the OT has to assess the patient's executive functioning by assessing specific cognitive skills which are part of a person's executive function. Which skills should be assessed? a. Attention to one task b. Spatial relations c. Short term memory d. Initiation and planning
d. Initiation and planning
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 OTR® include in the intervention planning for Leslie, 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
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? a. Counting change back to the patron b. Picking up one item at a time with 1 hand and scanning the bar code c. Bagging the purchases in the shopping bag d. Standing at the cash register during the entire shift
d. Standing at the cash register during the entire shift
Wyatt is a 52-year-old male patient who is in the early stages of Amyotrophic Lateral Sclerosis. Wyatt reports that his main goal is to independently finish a meal. Even when he is hungry, he cannot continue to feed himself as he becomes easily fatigued and does not have the strength in his arms to continue taking food to his mouth. What adaptation is the BEST to help Wyatt compensate for his UL weakness and fatigue so that he can remain independent when eating? a. A rocker knife and a tenodesis splint b. A table tray lowered to the level of the patient's abdomen c. Dycem mat and weighted utensils d. Suspension sling or mobile arm support
d. Suspension sling or mobile arm support
A patient who has been diagnosed with fibromyalgia presents with pain and decreased AROM of her upper extremities and knees, bilaterally. Her symptoms have a significant impact on her ability to perform her ADLs, especially in the morning. She especially struggles to wash her hands, brush her teeth, comb her hair, and apply her makeup. What is the FIRST aspect of OT intervention that should be addressed in order to help this patient groom herself in the mornings? a. Select assistive devices to help improve functional performance b. Engage the patient in a passive ROM and strengthening program to preserve joint integrity c. Engage the patient in an active ROM and strengthening program to preserve joint integrity d. Teach the patient a variety of joint protection strategies for grooming
d. Teach the patient a variety of joint protection strategies for grooming
An OT who works at an acute care hospital receives a referral to evaluate a newly admitted patient with a diagnosis of Guillain-Barre syndrome. When planning the structure of the assessment for this patient, what factor would have the MOST impact on the patient's ability to participate in the evaluation process? a. The patient's expected muscle strength b. The patient's expected range of motion c. The patient's expected cognitive skills d. The patient's expected endurance
d. The patient's expected endurance
An OT is working with a patient who suffered a R CVA and has subsequently been transferred to a senior nursing facility as they currently need moderate assistance with all their BADLs. When teaching the caregivers in the facility handling techniques and methods of assisting this patient, what is the BEST strategy to use to ensure that there is carry over? a. Have the nursing staff and caregivers write down details about the patient's ADLs needs b. Verbally explain techniques to implement, then provide a detailed worksheet to the nursing staff and caregivers c. Have the nursing staff and caregivers watch an occupational therapy session d. Verbally explain techniques, then watch the nursing staff and caregivers implement them
d. Verbally explain techniques, then watch the nursing staff and caregivers implement them
A physical therapist is planning on opening up a new rehabilitation clinic and will include occupational therapy, physical therapy, and speech therapy services. An occupational therapist is hired as an ADA and ergonomic consultant. What should the OT suggest as the maximum height for the kitchen counter tops in the rehabilitation kitchen? a. 36 b. 48 c. 38 d. 28
a. 36
Wanda is a 59-year-old woman with severe kyphosis and osteoporosis. Her mobility has declined and she must be fitted for a wheelchair. What adaptations should the OT recommend to support Wanda's upper body, considering her conditions? a. A custom wheelchair back and a butterfly chest harness b. A custom wheelchair back and a pelvic support c. A custom wheelchair back and lateral supports d. A power wheelchair with a custom seating system
a. A custom wheelchair back and a butterfly chest harness
A patient is seen in his home after having a middle cerebral artery stroke 6 weeks ago. The patient is modified independent in most ADLs and IADLs using assistive devices for grooming and ambulation. In order to resume gardening, which modification would be the most necessary? a. Adaptive strategies during graded outdoor gardening tasks b. Routine maintenance care from a professional gardener c. A raised garden box and planter d. Mobility skills training to get to the garden level
a. Adaptive strategies during graded outdoor gardening tasks
While working with a patient who has been diagnosed with MS, the patient complains of a "stiff and sore neck". What should the OT practitioner NOT recommend in this scenario? a. Apply a hot pack to their neck b. Yoga c. Massage d. Rest
a. Apply a hot pack to their neck
An OTR® is educating a patient on proper body mechanics. He has chronic lower back pain. He works as a library technician and as part of his daily tasks, he is required to lift and carry books and place them on the shelves. Which techniques would be beneficial for the OTR® to teach the patient to help him cope with the demands of his job? Select the 3 best answers. a. Bend the knees and keep the back straight, when unpacking new books from a box b. Hold the books below waist level with elbows extended c. Keep feet together while lowering the books onto the lower shelves d. Maintain spinal alignment when holding the books e. Carry the books at chest height with elbows fully flexed f. Extend the lumbar spine slightly while carrying heavier books
a. Bend the knees and keep the back straight, when unpacking new books from a box d. Maintain spinal alignment when holding the books e. Carry the books at chest height with elbows fully flexed
An OT has been requested to meet with the management of a lumber yard, to help with minimizing work-related injuries and work absences. The OT is permitted to execute all of the following actions EXCEPT? a. Bill for services under the medical insurance of employees b. Ensure they comply with OSHA-proposed medical standards c. Help reduce workers' compensation d. Ensure they comply with the requirements of the American with Disabilities Act
a. Bill for services under the medical insurance of employees
An OT leads a wellness group for seniors who attend a community center. The members of the group have all adopted pets recently and are attending the group to find out how they can best look after their pets. What should the focus of the group be on when teaching the group members about pet care? a. Body mechanics to use when lifting the new pets and their pet supplies b. Ideal furniture for pets c. How to find pet websites for socialization d. Ways to maximize bonding with new pets
a. Body mechanics to use when lifting the new pets and their pet supplies
What technique is not encouraged during recovery from a CVA according to the Neurodevelopmental Treatment frame of reference? a. Compensation b. Placing and holding c. Weight bearing d. Tapping and joint compression
a. Compensation
Joe, a former navy pilot, is a 72-year-old senior who recently had a CVA. As he is building a model airplane, he puts the wheels in the cockpit instead of on the wheel mounts. What should the OT document in her notes, in terms of what Joe demonstrated during the session? a. Constructional apraxia b. Lateral neglect c. Stuffing apraxia d. Unilateral neglect
a. Constructional apraxia
While observing a patient with a R CVA participating in a craft activity, the OT notices that the patient has great difficulty copying a 2-dimensional drawing. Which disorder is this behavior MOST likely indicative of? a. Constructional apraxia b. Visual agnosia c. Ideational apraxia d. Unilateral neglect
a. Constructional apraxia
An OT receives an order to evaluate a 78-year-old man with a diagnosis of right cerebellar CVA. What would the OT expect to observe as she completes this evaluation? a. Difficulty walking to the closet and reaching for clothing with the right hand b. Difficulty holding a spoon to feed self with the left hand c. Difficulty noticing art supplies placed on the left side of a table during a project d. Difficulty saying the correct word when speaking
a. Difficulty walking to the closet and reaching for clothing with the right hand
A woman demonstrates difficulty determining the distance between her arm and the counter while attempting to pick up her coffee cup. This problem is an example of what condition? a. Dysmetria b. Apraxia c. Astereognosis d. Agnosia
a. Dysmetria
What is the best seating recommendation for a 10-year-old boy with cerebral palsy who leans backwards because he is unable to sit in an upright position? a. Corner chair with pelvic straps b. Crushed cushion insertion c. Flat ring cushion d. U-shaped abductor pommel seat
a. Corner chair with pelvic straps
A patient who has recently been diagnosed with Parkinson's disease is experiencing difficulty eating due to her fatigue and bradykinesia. What type of adaptation is the BEST to introduce to this patient during this stage of her disease to help her conserve her energy during meals? a. A metal spoon b. A built-up handle spoon c. A weighted spoon d. A coated spoon
b. A built-up handle spoon
A patient with Parkinson's disease fatigues very quickly while using a standard keyboard to operate a computer. Which of the following choices would be the best option to recommend if the patient prefers to continue using the standard keyboard? a. A screen enlargement program b. A word prediction program to save keystrokes c. A screen reading program d. A switch access with a scanning program
b. A word prediction program to save keystrokes
A patient with Guillain-Barre has been referred for OT intervention. The OT is planning on performing an ADL assessment, however, upon entering the patient's room, the OT sees the nursing staff finishing up bathing and dressing with the patient. What is the best course of action the OT should take in this scenario? a. Complete the Functional Independence Measure (FIM) b. Ask the patient to simulate dressing and bathing tasks c. Caregiver training so the patient is ready for discharge d. Determine the best adaptive equipment to make ADLs easier
b. Ask the patient to simulate dressing and bathing tasks
A patient who is recovering from a recent CVA is performing her morning ADL routine. During the session, the patient is asked to perform her self-care tasks whilst looking at her reflection in a large mirror to ensure that she is sitting upright. While focusing on the mirror, the patient reaches into her cosmetic bag to retrieve her toothpaste but is unable to identify which item in the bag is the tube of toothpaste. The patient's tactile sensation is intact, therefore the OT rules out a sensory deficit. Based on this information, what type of disorder does this patient most likely have? a. Apraxia b. Astereognosis c. Aphasia d. Agraphesthesia
b. Astereognosis
An OT is working on dressing with a patient who has Parkinson's disease. What is the best dressing modification for this patient if he shows increased difficulty in gross motor coordination, impaired balance, and postural instability? a. Dress while sitting on a bench b. Dress while sitting in a chair with arms c. Dress while supine on bed d. Use of grab bar to grab while not sitting
b. Dress while sitting in a chair with arms
A patient is asked to place her sandwich on a placemat in the middle of the table, but instead places the sandwich on the edge of the table and the sandwich falls to the floor. Based on this information, what can the OT determine? a. Intention tremors b. Dysmetria c. Dysdiadochokinesia d. Dyssynergia
b. Dysmetria
An OT is using the Brunnstrom approach while working with a patient who is recovering from a right CVA. The patient must stand up from an armchair to pull up his pants. What facilitation technique should the OT use to help the patient push up from the chair using both arms? a. Have the patient push on the chair with his affected arm while the OT supports the elbow and shoulder b. Have the patient push on the chair with his unaffected arm while the OT taps on the triceps of the affected arm to elicit a response c. Have the patient push on the chair with his unaffected arm and bear weight on his unaffected leg as he stands d. Have the patient pronate both forearms and hands, pushing up and forward as he stands up
b. Have the patient push on the chair with his unaffected arm while the OT taps on the triceps of the affected arm to elicit a response
What is the most common cause of an intention tremor? a. Dopamine deficiency b. Parkinson's disease c. Brainstem lesion d. Cerebellar lesion
d. Cerebellar lesion
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? a. Solid seat insert b. Chest harness c. Cup holder d. Amputee axle
d. Amputee axle
What are the 3 main purposes of using the Dynamic Lowenstein Occupational Therapy Cognitive Assessment (DLOTCA)? a. Identifies cognitive abilities and limitations of people with neurological disabilities, identifies learning potential and provides a starting point from which to begin intervention appropriate to the specific patient being tested b. Identifies cognitive abilities and limitations of people with mental health problems, identifies learning potential and provides a starting point from which to begin intervention appropriate to the specific patient being tested c. Identifies cognitive abilities of people with neurological and developmental disabilities, identifies learning potential and provides a starting point from which to begin intervention appropriate to the specific patient being tested d. Identifies cognitive limitations of people with neurological and physical disabilities, identifies learning potential and provides a starting point from which to begin intervention appropriate to the specific patient being tested
a. Identifies cognitive abilities and limitations of people with neurological disabilities, identifies learning potential and provides a starting point from which to begin intervention appropriate to the specific patient being tested
An OT is establishing a treatment plan for a patient with a degenerative disease. What skill areas should the OT be sure to include in the plan? a. Improving patient safety and providing caregiver education b. Transferring in and out of the bathtub c.ADL retraining d. Improving bilateral upper extremity strength
a. Improving patient safety and providing caregiver education
Joshua, a 55-year-old male who has been diagnosed with Huntington's Disease (HD), has progressed to the middle stage of the disease. In addition to his functional limitations, Joshua has started losing weight at an alarming rate and the OT practitioner needs to prioritize addressing this issue. What is the MOST likely cause for Joshua's weight loss? Select the best 3 answers. a. Increased energy expenditure b. Gastroenteritis c. Impaired mobility d. Dysphagia e. Poor postural control f. Anorexia Nervosa
a. Increased energy expenditure d. Dysphagia e. Poor postural control
A patient with a diagnosis of a CVA is eating dinner. When a staff member comes to remove the patient's plate, she notices that the patient has only eaten the food on the right side of the plate. The staff member points out the remaining food to the patient and the patient responds that she did not know the food was there. What condition is this scenario most likely indicative of? a. Left unilateral neglect b. Right hemianopsia c. Bitemporal hemianopia d. Cataracts in the left eye
a. Left unilateral neglect
A 29-year-old male recently sustained a T2 SCI after being struck by a car while riding his motorcycle. During a wheelchair evaluation the patient states that he would like to continue to drive, play sports, and go to parties with his friends. Which type of wheelchair would be the MOST suitable to recommend as a primary wheelchair for this patient? a. Lightweight standard manual wheelchair b. Powered wheelchair c. Lightweight sports wheelchair d. Tilt-in-space wheelchair
a. Lightweight standard manual wheelchair
Which neuromuscular rehabilitation approach uses spiral and diagonal patterns, exercises agonists and antagonists, and follows a distal-to-proximal sequence? a. PNF b. Rood c. Moro d. NDT
a. PNF
An OT is assisting a patient who suffered a R CVA and subsequently presents with Pusher Syndrome, transfer from their bed to their wheelchair. In this scenario, what strategy would BEST support this patient with performing this transfer? a. Provide a mirror to prompt the patient to sit upright before attempting a transfer b. Provide auditory cues to prompt the patient to sit upright before attempting a transfer c. Ask the patient to verbalize what they are doing as they transfer to another surface d. Instruct the patient to lean to their weaker side
a. Provide a mirror to prompt the patient to sit upright before attempting a transfer
A 36-year-old patient who has been diagnosed with Relapsing-Remitting MS, is working with the OT on gaining independence in upper body dressing. Using the compensatory FOR, how could the OT help this patient achieve her goal of being independent in dressing? a. Provide the patient with a button hook to help with her impaired fine motor skills b. Help the patient with lower body dressing and have her complete upper body dressing herself c. Practice donning and doffing loose fitted clothing d. Help the patient to begin upper body dressing and allow her to finish without assistance
a. Provide the patient with a button hook to help with her impaired fine motor skills
An OT is working with a patient who has recently had a mild CVA. Upon observation, the OT notices the patient's right ankle appears to be inverted and may need an ankle splint. What is the best course of action the OT should take? a. Refer the patient to his/her physician b. Refer the patient to a podiatrist c. Refer the patient to a physical therapist d. Recommend a brace the patient can use
a. Refer the patient to his/her physician
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? a. Tenodesis splints b. A universal cuff c. A reacher d. Gripping aids
a. Tenodesis splints
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.
Donna, a 60-year-old inpatient with Amyotrophic Lateral Sclerosis, has been working with an OTR® on her BADLs. While seated in her wheelchair, Donna is able to sponge bath herself at the sink from her midsection down, but her movements are slow and labored and she requires a significant amount of time to complete the task. Her next goal is to be able to wash her face and neck with the appropriate setup. To help Donna achieve this goal, she will need to be trained in using a mobile arm support. Which movements does Donna need to demonstrate in order for her to be considered a candidate for this assistive device? a. The ability to flex the elbow of the dominant upper extremity against gravity without additional resistance b. The ability to stabilize the trunk laterally with some movement from the neck and shoulder c. The ability to have at most 100 degrees of passive shoulder flexion and abduction d. The inability to stabilize the head against gravity for an extended period of time
b. The ability to stabilize the trunk laterally with some movement from the neck and shoulder
When a patient has been diagnosed with ideomotor apraxia, both transitive and intransitive gestures are used as part of the assessment. What is the distinction between transitive and intransitive gestures? a. There is no distinction between transitive and intransitive gestures, as they are both gestures b. The distinction between transitive and intransitive gestures is based on whether or not an action involves the use of an object c. Transitive gestures involve sequencing of tool use and intransitive gestures involve selecting the correct tool for the task d. Intransitive gestures are illustrator gestures whereas transitive gestures are adaptor gestures
b. The distinction between transitive and intransitive gestures is based on whether or not an action involves the use of an object
If a patient has SCI C3, what kind of wheelchair do they need? a. They need a power wheelchair with chin, breath controls and mouth stick b. They need a power wheelchair equipped with portable respirator with chin or breath controls c. They need a manual wheelchair d. They need tilt 'n' Space
b. They need a power wheelchair equipped with portable respirator with chin or breath controls
An OT has been referred to work with a 20-year-old patient with Huntington's chorea. What physical symptoms might the OT observe from the patient during the screening? a. Muscle weakness and fatigue b. Uncontrollable movements of twitching, clumsiness, and difficulty walking c. Spasticity of all four limbs d. Impaired sensation to touch
b. Uncontrollable movements of twitching, clumsiness, and difficulty walking
An OT is consulting with an 88-year-old patient who has been diagnosed with a degenerative joint disease. The woman reports that when she attempts to open any jar, she has difficulty maintaining her grasp on the lid to turn it as the jar tends to move around. What is the most cost-effective adaptation that the OT can recommend to this patient, at this stage of her disease? a. Leave the lids on the jars loose and keep them in the refrigerator b. Use a non-skid mat to hold a jar in place while turning the lid c. Purchase an electric jar opener d. Ask a family member to open jars and place the contents of the jars in easy-to-open plastic containers
b. Use a non-skid mat to hold a jar in place while turning the lid
An OT practitioner is working with a patient who has Parkinson's disease and associated cognitive impairments. The focus of the session on improving the patient's independence when eating a meal. Which strategy would be the BEST to use in this scenario to help the patient achieve their goal? a. Provide bigger size utensils b. Use sectioned dishes c. Use low contrast place settings d. Use handling techniques to align the jaw
b. Use sectioned dishes
A patient with a C5 SCI who has met all their occupational therapy goals, is preparing to be discharged to live at home with caregiver assistance. What type of device should be recommended for this patient to maximize their independence during self-care activities at home? a. Power wheelchair with head control b. Wheelchair-mounted mobile arm supports c. Electronic aid to daily living d. Custom-fitted tenodesis splint
b. Wheelchair-mounted mobile arm supports
An OTR® 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
3 days ago, a patient diagnosed with Guillain-Barre Syndrome was admitted to the ICU of the main hospital. Currently, the patient is ventilated, and she has muscle weakness in both upper limbs (Poor Minus) and paralysis of her lower extremities. What would the focus of OT intervention be, at this stage? a. Strengthening and resistance exercises, and coping strategies to deal with the long-term effects of the disease b. Gradually working on performing ADLs, and education on progressive resistance exercises c. Caregiver education on passive range of motion, positioning, and training in low-tech assistive devices d. Exercises to prevent muscle atrophy due to disuse, and respiratory exercises
c. Caregiver education on passive range of motion, positioning, and training in low-tech assistive devices
A 67-year-old female inpatient who presents with a mild right CVA, demonstrates significant deficits in her trunk control and balance. Today's OT session is structured to encourage active trunk rotation and functional use of both her upper limbs. The patient is participating in a laundry activity which requires her to fold towels on a table which has been placed on her left side, and then to move the folded towels onto another table on her right side. Which sitting position would provide the patient with the most stability so that she can maximize using her upper limbs for this activity? a. Complete the laundry task by having the patient sit on the edge of the chair while the OT practitioner provides anticipatory support behind the patient b. Change the structure of the activity to having the patient fold the towels on a small table placed in front of her c. Complete the laundry task by having the patient sit all the way back on the chair d. Complete the laundry task by having the patient sit on a wobble cushion
c. Complete the laundry task by having the patient sit all the way back on the chair
A patient's daughter calls to report that her mother, a 55- year-old woman who recently sustained a TBI as a result of a MVA, is acting "strangely". According to the daughter, her mother has gradually resumed cooking basic meals for the family and insists on clearing the dishes from the table but when it comes to loading the dishwasher, she appears to become confused and is unable to complete the task. The daughter describes her mother's confusion in terms of her not being able to correctly insert the plates in the slots of the dishwasher and place the utensils in the utensil holder. The mother's frustration tends to result in her breaking dishes which makes cleaning up stressful for both mother and daughter. Based on this information, what disorder is this patient most likely demonstrating? a. Conceptual apraxia b. Ideational apraxia c. Constructional disorder d. Functional movement disorder
c. Constructional disorder
Mr. Smith, a 62-year-old patient who has been diagnosed with secondary-progressive MS, has recently been admitted to an inpatient rehab facility due to an exacerbation of his MS. He lives with his spouse who is also his primary caregiver. In terms of assistance, Mr. Smith has only needed minimal assistance for transferring to and from his power scooter which he has been using for in-home and community mobility. Lately however, he has had a significant decline in his function and currently needs moderate assistance for his BADLs, bed mobility, and transfers. To ensure that the patient's wife will be able to cope with taking care of her husband's needs once he is discharged, what is the best way to prepare her for this transition? a. Provide a 1-on-1 session with the caregiver on how to safely perform sliding board transfers using the therapist for practice b. Devise a list of current durable medical equipment needs for the home which includes raised toilet seats, a tub transfer bench, and manual wheelchair c. Coordinate with the caregiver, to establish a schedule for her to participate in the patient's therapy sessions d. Explore the option of assistive technology, focusing on remote access controls for energy conservation
c. Coordinate with the caregiver, to establish a schedule for her to participate in the patient's therapy sessions
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
An OT is working with an older adult patient with a cognitive disability and auditory defensiveness. What treatment strategy would help this patient the most as he participates in occupational therapy activities in the facility? a. Therapeutic listening b. Sound bingo c. Earplugs or headphones d. Passive range of motion to relax the nervous system
c. Earplugs or headphones
Betsy, a 36-year-old owner of a poodle dog rescue, is currently in the recovery phase of Guillain-Barre syndrome. Her main goal at this stage is to return to work and in order to achieve this, she would have to be able to pick up small dogs from the floor and place them on a counter. During her therapy sessions, Betsy has been working towards achieving her goal and she has progressed to being able to lift 5-pound weights from the floor onto a counter top. What is the NEXT STEP in grading this activity so that Betsy can ultimately achieve her long-term goal? a. Have the patient coordinate and manage 2 small therapy dogs by lifting and placing them onto a counter 3 times within 15 seconds b. Have the patient lift, carry, and transport 10 pounds across 10 feet to the counter c. Have the patient repeatedly lift 10 pounds from the floor to the counter 3 times independently d. Have the patient initiate pacing strategies while lifting 50 pounds from the floor to the counter 3 times
c. Have the patient repeatedly lift 10 pounds from the floor to the counter 3 times independently
An OTR® is assessing a patient for a work hardening program using a Functional Capacity Evaluation. What is likely included in this Functional Capacity Evaluation (FCE).? a. The worker's compensation insurance plan and coverage b. Work simulation activities for 3 to 5 weeks with goals to improve physical capacity c. Positional tolerance activities such as reaching, standing, stooping, and grasping d. The individualized education program report
c. Positional tolerance activities such as reaching, standing, stooping, and grasping
William, a 72-year-old male who has Parkinson's disease, is receiving OT services in a rehabilitation facility. William is usually able to perform transfers with minimal assistance. During the session, however, when transferring from his wheelchair to the plinth, he started to sway backward which resulted in him falling back into the wheelchair. What strategy should the OTR® teach William to prevent this from happening during future transfers? a. Enlist the assistance of a physical therapist assistant to perform a 2-person transfer b. Scoot forward to the edge of the seat with hips positioned midline c. Shift upper body forward with the shoulder girdle over the quadriceps d. Push down with both hands on the wheelchair armrests
c. Shift upper body forward with the shoulder girdle over the quadriceps
An OT practitioner is working with a patient who presents with a hemiplegia after suffering a CVA. The intervention plan is based on a specific approach which utilizes a training program that focuses on repeatedly performing a functional task to engage the neuromuscular and musculoskeletal system. Which approach is being described in this scenario? a. Proprioceptive Neuromuscular Facilitation b. Neurodevelopmental Treatment c. Task Oriented Approach d. Carr & Shepherd's Motor Relearning Programme
c. Task Oriented Approach
An OT is evaluating a male patient who sustained a left CVA two days prior. The OT notices that the patient sits with his head turned toward his left side and he does not seem to notice the OT until the OT moves to his left side. When the OT tests the patient's peripheral vision, he does not report seeing the visual stimulus until the stimulus is on his left side. What can the OT conclude from this information? a. The patient has right hemiparesis b. The patient has aphasia c. The patient has a right visual field cut d. The patient has left side neglect
c. The patient has a right visual field cut
Betsy, a 57-year-old widow, who has Stage I Parkinson's disease is working with a OTR® on fall prevention. Betsy has recently had 2 falls while working in her kitchen and walking in her living room rendering her a high risk for falling. Despite recommendations for increased assistance, she wants to age in place. When reviewing her case during a staff meeting, what information is MOST IMPORTANT to share with the team? a. The patient's ability to bend, stoop, and lift loose rugs and move furniture b. The completed form of the ADA Readily Achievable Barrier Removal checklist c. The patient's understanding of the environmental barriers in her home d. The recommendations of footwear and clothing adaptations the patient may require
c. The patient's understanding of the environmental barriers in her home
An OT is working with a patient who is recovering from a CVA. OT intervention is focused on using functional tasks to improve a specific type of active movement of the patient's shoulder. Incorporated into the session are activities which include drinking from a mug, buttoning a shirt, and eating a meal. What is the specific shoulder movement the OT is trying to elicit? a. To work on external rotation b. To work on supination c. To work on internal rotation d. To work on pronation
c. To work on internal rotation
A patient is in the plateau stage of Guillain-Barre Syndrome and is demonstrating frustration with performance in self-care activities despite having some gains in upper extremity function. What should the OT do NEXT in response to the patient? a. Redirect the patient with an activity of interest b. Continue with the session as the patient is demonstrating confusion as a common symptom c. Use empathetic listening to the patient's concerns and feelings d. Refer the patient to the physician to check if medication needs to be changed
c. Use empathetic listening to the patient's concerns and feelings
