Retired NBCOT
________ ________ is a strategy used to help clients "look around" the blind spot in their field of view. With ______ ________, the client looks slightly away from their intended target, to bring it into view of the ______ visual field. Once the client has determined the location of the ______ or blind spot in the central visual field, training in looking around the _______ is necessary to help develop _______ _____ skills.
Eccentric viewing. peripheral. scotoma, scotoma eccentric viewing
______ _________ is a technique originally developed for people who are blind, but it can also be helpful for people with low vision who are unsure of their bearings in an unfamiliar environment. These techniques will increase the client's safety in crowded or unfamiliar environments and areas that have poor lighting and uneven walking surfaces.
Sighted guide
An OTR® has developed a prevocational program for clients who have an enduring mental illness. Program modules include assessing the advantages and disadvantages of employment, evaluating work and leisure skills, practicing completion of job applications, and learning to write resumes and cover letters. Which frame of reference reflects the design of this program? Cognitivebehavioral Psychodynamic Model of Human Occupation Dynamic Interactional Model
Solution Solution: The correct answer is A. A cognitivebehavioral frame of reference is commonly applied in social and life skills groups where clients can focus on self-regulation through observational learning and modeling of skills. Clients in the group described in this scenario would be able to engage in observational learning and modeling of completing applications, writing letters, and expanding on work and leisure skills through group activities. B: A psychodynamic frame of reference involves clients projecting feeling that they may be unaware of into art or other activities. The activities are used to express emotions. This frame of reference would not apply practical skills training. C: The Model of Human Occupation focuses on skilled performance of activities in context. Group instruction and practice of skills, as described in this scenario, would not fit within this model. D: The Dynamic Interactional Model focuses on multicontextual tasks and environmental conditions that are similar. Consistent cognitive strategies are used throughout intervention activities. The scenario described here does not apply cognitive strategies to facilitate transfer of skills across contexts.
An inpatient is in the recovery phase of Guillain-Barré syndrome. Currently, the patient uses a wheelchair for mobility and has Fair Plus (3+/5) strength of the upper and lower extremities, and Good (4/5) trunk control. The patient wants to be able to return home to care for a preschool-age child. What should be the PRIMARY focus of the patient's intervention during this phase of recovery? Gross motor movements and energy conservation for completion of PADL Fine motor activities and moderate resistance putty exercises to improve BADL Functional splinting and caregiver training for participation in routine ADL Compensatory strategies and assistive devices for childcare activities
Solution Solution: The correct answer is A. Addressing gross motor movements and energy conservation will allow the client to meet goals while addressing the primary needs of improving mobility, maximizing energy available for preferred activities, and increasing strength throughout upper and lower extremities. B: Upper-extremity strengthening may be components of the intervention plan; however, they are not the primary focus, based on the client's current status and the client's goals. C: Splinting is not indicated for this client with Fair Plus upper-extremity strength. D: The expected recovery from Guillain-Barré syndrome is that clients will regain the majority of their previous strength levels; compensatory strategies are not appropriate because the focus should be on remedial intervention strategies.
An OTR® has just fabricated a dynamic splint for an inpatient who had an MCP joint arthroplasty 4 days ago. The patient is being discharged to home and will have home-health follow-up in several days. What information is MOST IMPORTANT for the OTR® include in the patient's discharge instructions? Call the inpatient OTR® with questions about the splint position or fit. Contact the home health OT with any questions about the splint. Remove the splint for short intervals and elevate the hand if swelling occurs. Contact the home health or inpatient OT if there is an increase in redness around the incision.
Solution Solution: The correct answer is A. Any patient provided with a splint should be given thorough written instructions, which include the contact name and number of the practitioner who fabricated the splint. B, D. The practitioner who fabricated the splint should be the follow-up contact person because that practitioner will be the one who is familiar with the patient's status and the design and purpose of the splint that was fabricated. C: Splint wear schedules should be communicated clearly in both oral and written format, although with a joint arthroplasty, the patient will require continuous splint wear.
Results from a manual muscle test indicate that a client who is in Stage II of amyotrophic lateral sclerosis has Good Minus (4−/5) strength of the intrinsic muscles. The client reports that by the end of a meal, it becomes extremely difficult to hold and manipulate eating utensils. Which assistive device will be MOST EFFECTIVE for the client to use during self-feeding at this stage of the disease process? Foam tubing to build up handles of eating utensils Standard universal cuff with elasticized strap Lightweight plastic eating utensils with contoured grip Wrist support with palmar pocket for inserting utensils
Solution Solution: The correct answer is A. Built-up utensils will allow the client to use less grasp strength throughout the meal and will be effective in compensating for the decreased intrinsic muscle strength. B, D: The client has Good Minus strength in the intrinsic muscles and should be encouraged to continue using available grasp strength. Using a device that eliminates the need for the client grasp such as a universal cuff or palmar pocket wrist support would potentially decrease muscle strength. C: Decreasing the weight of the utensil would decrease the muscle strength needed to lift the utensil; however, the client is still required to use prolonged grasp strength to hold the utensil and would still fatigue with the task.
A client has a unilateral transradial amputation. The client will be fitted with a prosthetic device in 1 month. One of the client's goals is to be independent with BADL as soon as possible. The client refuses to use the uninvolved hand for toileting tasks, citing cultural reasons. What INITIAL action should the OTR® take in this situation? Talk with the client about using alternative strategies. Have the client practice the task using assistive devices. Revise the client's long-term goals based on cultural limitations. Focus on other tasks that are not impacted by cultural restrictions.
Solution Solution: The correct answer is A. Cultural factors can affect a client's reaction and adjustment to disability and may require time for the client to adjust to the change in body image. Talking with the client allows the practitioner to help the client understand the importance of the prosthetic training program and the role that uninvolved hand use will have in completing basic ADLs. B: Assistive devices may not be needed to complete the task and will still require the client to use the uninvolved hand during toileting. C: The client has a goal to be independent with basic ADLs as soon as possible, so changing the long-term goals to accommodate the cultural limitations will not facilitate meeting the client-centered goals. D: Avoiding the issue that is causing the client conflict will not be beneficial to the client progressing to the prosthetic training program. Therapeutic intervention should facilitate this area of need and adjustment for the client.
A school-based OTR® has evaluated a 4-year-old child who has cerebral palsy. Results of the Peabody Developmental Motor Scales Second Edition (PDMS-2) indicate the child is functioning at a 2-year-old developmental level. Which environment is MOST CONDUCIVE for conducting the initial play assessment based on this information? In the classroom with peers and familiar developmental toys In an isolated room with access to age-appropriate computer games At the community playground with sliding, swinging, and climbing opportunities In a therapy room with the OTR® providing the child with a selection of toys
Solution Solution: The correct answer is A. Play is most meaningful when it occurs in context; therefore, the classroom with peers and familiar toys is most appropriate for an initial play assessment. A child's activities cannot be accurately observed unless they occur within the environment where the child plays. B, C, D: Play is most meaningful when it occurs in context; therefore, observing the child's play in an isolated room, at a community playground that may not be familiar, or in a therapy room does not provide a familiar context for the child. A child's activities cannot be accurately observed unless they occur within the environment where the child plays.
A client had a complete median nerve laceration at the wrist of the dominant hand 3 weeks ago. Which intervention activity should be included as part of the INITIAL phase of the client's sensory reeducation program? Instruction in visual compensatory strategies to use during daily tasks Application of deep pressure, rubbing, and tapping of the involved digits Desensitization by rubbing the fingertips with a variety of textures Identification of familiar objects hidden in a bucket of uncooked rice
Solution Solution: The correct answer is A. Safety is a primary focus early on in the intervention for a client with total sensory loss, and the client must be able to compensate for lost sensation. B, C, D: With a complete median nerve laceration, the client will have total loss of sensation, and the client may not be a candidate for sensory reeducation.
An OTR® is providing early intervention services to a 24-month-old child who has a pervasive developmental disorder. The parents' goal is for the child to be able to participate in age-appropriate activities with peers. Which of the following contexts is BEST for promoting progress toward this goal? Organized play group in a community playground Backyard of the child's home with siblings Group session in the occupational therapy clinic with other children Tumbling group for preschoolers in a community gymnasium
Solution Solution: The correct answer is A. The environment is important for supporting a child's play actions; the child perceives the interactions within various environments, then learns to act on those interactions. A play group that is organized will allow the child to be in a natural play environment while learning to adapt to or accommodate peers in interactions. B: The backyard of the child's home and the child's siblings are a comfortable context for the child and will not require adaptation or accommodation of the child's interactions. C: The occupational therapy clinic is not a natural play environment for a child and does not set the child up to interact with age-appropriate peers. D: An activity group such as a tumbling group will not allow for as much peer-to-peer interaction as an organized play group. Moreover, the child will not perceive much control within a tumbling group that is likely directed by a class instructor.
An OTR® is providing consultative services to develop a new occupational therapy department as part of a comprehensive rehabilitation program for a rural regional medical center. When reviewing the impact of the macroenvironment on the organization, what MUST the OTR® consider? Local and national legislative acts and regulatory policies that affect service delivery models Internal resource availability, and service delivery goals of the organization Corporate culture, supply availability, and organizational staffing policies that relate to quality care Organization's vision statement, governance, and internal auditing processes and procedures
Solution Solution: The correct answer is A. The macroenvironment includes the external environment including policy, funding, and political services that impact provision of services. B: These factors would be part of the micro level because they are internal to the organization itself and not related to the broad external environment factors. C: These factors would be part of the mezzo level of factors influencing delivery of services because these factors are the environment external to the organization itself. D: The organization itself is considered the micro level of factors influencing delivery of services.
An inpatient rehabilitation facility has table tennis available in the community room for the patients to use for a leisure activity. One of the inpatients who has a C7 tetraplegia wants to play this game with the other patients. Which adaptation would be MOST BENEFICIAL for enabling the patient to participate in this game? Fasten hook-and-loop straps to secure the paddle to the hand. Hold the paddle with a natural tenodesis grasp pattern. Wear a short opponens splint to stabilize the thumb for grasping. Attach foam padding to build-up the handle of the paddle.
Solution Solution: The correct answer is A. This adaptive method will compensate for the patient's limited grasp and dexterity, allowing the patient to engage in the table tennis game. B: The patient will have limited grasp and dexterity to maintain a tenodesis grasp on the paddle during the dynamic interaction of the game. C: The patient has full movement at the thumb, so a splint to support the thumb is not indicated; the partial intrinsic muscle innervation is the reason for limited grasp. D: Increasing the handle size will not compensate for the patient's partial innervation of the intrinsic hand muscles.
During a standardized assessment of developmental motor skills, a 5-year-old child is unable to stack 1-inch (2-cm) cubes as per the standardized instructions. Based on this finding, the OTR® plans to include intervention activities for increasing the child's motor control. Which goal related to this objective would be MOST ACHIEVABLE within a 60-day time period? After playing with toys, the child will clean up the play area by placing five small toys in a container with minimal verbal cues. The child will consistently fasten the bottom three buttons of a front-opening shirt when prompted during dressing activities. The child will score at age level when asked to stack blocks during readministration of the fine motor skills assessment. The child will throw a bean bag onto a target with 90% accuracy from 4 feet (1.2 m) away.
Solution Solution: The correct answer is A. This goal is linked to the child's acquisition of hand skills through engagement in occupational activities and is a reasonable goal in the given time frame. B: Goals must be feasible for the child to accomplish given the current status of hand function. If the child is having difficult stacking 1-inch cubes, it is likely the child is unable to button, and achieving this goal within the 60 days is not reasonable. C: This goal is not relating the acquisition of the child's hand function to engagement in occupational activities, which is necessary in all goals for children developing hand skills. D: This goal does not relate to the development of the child's hand skills in relation to occupational engagement (throwing bean bags at a target is not a direct occupational performance task).
A school-aged child has myelomeningocele resulting in symptoms associated with an upper motor neuron bladder. The child is participating in a bowel and bladder program to learn to manage self-toileting tasks. Despite completing intermittent catheterization as recommended, the child continues to have only partial control of bladder function. Frequent bladder leaks result in skin irritation of the perineum and odor. In addition to recommending a follow up evaluation with the child's primary care provider and teaching personal hygiene skills, what action should the OTR® take? Advise the child to wear an absorbent incontinence pad or a youth-size disposable diaper. Suggest restricting the child's fluid intake during the day to limit urine production. Recommend the child apply manual pressure on the abdomen while emptying the bladder. Educate the parent and child about alternative means of collecting the child's urine.
Solution Solution: The correct answer is A. Using an incontinence pad or disposable diaper will provide the child with skin protection by having the pad absorb any leaked urine, and the pad may also minimize odors associated with leaking. B: Restricting fluid intake will make the child susceptible to bladder infections and is not an appropriate recommendation. Note that fluid restriction prior to bowel program sessions will prevent bladder distention; however, it should not be a daily practice. C: Because the child has an upper motor neuron bladder, the training program is focused on developing an automatic response for voiding. Pressure on the abdomen would be a method used for lower motor neuron bladders where the bladder requires assistance to empty because of low tone. D: The child is currently using the least restrictive method of catheterization, and modifying the catheterization schedule or assistive devices to protect from accidents is more beneficial than seeking a more restrictive method that requires surgical intervention.
A student in the third grade with a learning disability has attended school-based occupational therapy for several years to improve visual-perceptual skills for completing curriculum-based school work. The latest update report to the parents indicates the student is not making progress toward the stated Individualized Education Program (IEP) goals. This report is similar to the previous two reports. What action should the OTR® take NEXT to address the lack of progress? Continue occupational therapy intervention knowing that developmental progress due to maturity is still possible. Discuss alternative classroom modifications and adaptations with the student's teacher. Request the special education team schedule an interim meeting to modify the student's IEP. Send a letter to the student's parents informing them that occupational therapy is no longer beneficial to their child.
Solution Solution: The correct answer is B. The student's response to occupational therapy intervention and teacher data is important in implementing an effective intervention plan. The intervention plan appears to need modification on the basis of the student's response. A: The practitioner must continuously gather data to inform the intervention decisions on the basis of student response and teacher data. Continuing occupational therapy intervention without any modification at this point would indicate that the practitioner is not attending to this information. C: The intervention plan is modified before changing the goals in the IEP because the goals may not be the problem; rather, the practitioner may not have implemented the right intervention yet or the student's status has changed and requires modification of the intervention. D: Discontinuing occupational therapy services is not the appropriate response without gathering more information. The practitioner must collect necessary systematic data to inform intervention decisions and support the best outcomes for the student.
A client is recovering from an exacerbation of rheumatoid arthritis and is participating in outpatient occupational therapy. The initial evaluation indicates decreased active ROM of bilateral wrists and hands, bilateral ulnar drift, moderate edema, and a pain rating of 7 out of 10 on the visual analog scale. The client currently depends on the spouse to assist with all ADL, but has a goal to increase independence with self-care tasks. Which of the following statements would be BEST to include as a short-term goal in the client's intervention plan? Control MCP joint ulnar deviation by the end of the second session using bilateral hand-based splints during self-feeding. Increase active ROM of the digits to within functional limits for independence with grooming by the sixth occupational therapy session. Subjective report of pain during dressing tasks will decrease by 2 levels on a visual analog scale within 2 weeks. Verbalize daily use of joint protection techniques during oral hygiene tasks within 2 weeks.
Solution Solution: The correct answer is C. A client reducing pain levels during dressing directly incorporates the evaluation results and client's goals for a measurable, objective outcome. A: Splints should be used with rheumatoid arthritis to support function, and providing hand-based splints during self-feeding may interfere with task performance. B: Increasing AROM is contraindicated with rheumatoid arthritis because of pulling that may occur on the joint, thereby increasing joint deformity. Supporting task performance with splinting or assistive devices would be a more appropriate intervention outcome. D: A variety of teachinglearning techniques are needed to ensure the behavioral changes necessary to incorporate joint protection. Verbalizing may be one method, but client demonstration of techniques would be a better measure.
Based on the outcomes of a needs assessment for a retirement community, an OTR® plans to offer a program to promote the residents' adjustment and support participation in the community. What information should the OTR® gather as the FIRST step toward implementing this program? Capacity of the community to offer a variety of social and leisure programs Public transportation options available to residents of the community Performance patterns, skills, and client factors of potential participants Volunteer opportunities available in the community for elder residents
Solution Solution: The correct answer is C. A community profile is created to give the practitioner information about the participants, their condition, and the context. The engagement in occupation is understood through performance skills, performance patterns, and client factors. A: The community capacity to offer social and leisure programs is determined through the needs assessment so the OTR® has this information already. B: Public transportation options are determined through the needs assessment so the OTR® has this information already. D: Volunteer opportunities are determined through the needs assessment so the OTR® has this information already.
A resident in a long term care facility has a severe elbow contracture. The OTR® has just finished applying a bivalved splint to provide low load prolonged stress to the affected elbow. What MUST the OTR® do as part of the care plan for maximizing the effectiveness of this splinting intervention? Supplement the splint wear schedule with high brief-load stretches for 12 minutes at least 3 times per day. Advise the resident that the stretch will be uncomfortable but needs to be tolerated for at least several hours at a time. Provide nursing staff with specific instructions for a graded daily splint-wearing schedule. Ensure the evening nursing shift has documented orders to apply the splint just before the resident goes to sleep.
Solution Solution: The correct answer is C. An extremely tight elbow will require a graded splint wear schedule for maximum comfort, and staff education is essential to ensure compliance with a proper wear schedule. A: High brief-load stretches throughout the day do not achieve elongation of tissues over time and are not beneficial in this situation. B: The resident should not be uncomfortable while wearing the splint because the splint should place a slight stress that is tolerable for the resident over a significant amount of time. D: Low-load stress needs to be applied for a duration of 68 hours frequently so applying the splint just before sleep will not be the optimal wear schedule. Initially, the resident will likely only tolerate 34 hours of splint wear, so use during the daytime will be necessary for optimum progress.
An OTR® is providing intervention in the home of a client who is recovering from Guillain-Barré syndrome. The client ambulates independently using a walker, but becomes unsteady when tired. What should the OTR® include as part of the intervention for supporting the client's safety at home? Talk with family members about providing contact-guard assistance whenever the client is engaged in daily tasks. Advise the client to complete self-care tasks while seated in a wheelchair in the home bathroom. Problem-solve with the client to identify and eliminate existing fall risks within the home. Teach the client diaphragmatic breathing techniques to use during functional ambulation at home.
Solution Solution: The correct answer is C. Providing safety strategies for proper use of a walker within the home is the most effective intervention strategy because it allows the client to identify situations that could be modified for better safety. A: The client is independent using a walker and contact-guard assistance is not indicated and may lead to loss of occupational function for the client. B: The client should be allowed to perform as many tasks with the use of the walker as possible to maintain the client's independence. D: Respiratory control is not typically a cause of fatigue for a client with Guillain-Barré syndrome, and breathing techniques would not improve steadiness with ambulation.
A newly certified OTR® wants to provide occupational therapy coverage on an "as-needed basis" at a medical center burn unit. What should the OTR® expect the facility to provide in order to promote continuity of care for these services based on best practice standards? Funds to attend professional development classes to learn about evidence-based burn care Availability of burn-care protocols currently used for patients with thermal injuries Options for establishing service competence for completing clinically based processes and procedures on the unit Written communication from the primary therapist in advance of the coverage date outlining patient care routines
Solution Solution: The correct answer is C. Service competency will support that the newly certified OTR® and existing practitioners in the burn unit are performing functions similarly and achieving the same outcome. A: Continuity of care is not ensured with practitioners attending professional development classes because practitioners will implement practice in their own way. Services competency ensures teaching, training, and evaluation of practitioner on the basis of skills delivery. B: Providing burn-care protocols does not ensure continuity of care because practitioners may interpret the protocols in their own way. Service competency ensures teaching, training, and evaluation of a practitioner. D: Written routines or protocols may provide guidance for the new OTR® in typical practice approaches in the unit, but they will not ensure continuity of care.
A client who has Trace (1/5) lower-extremity muscle strength and Good (4/5) upper-extremity muscle strength is learning safe transfer techniques. Which transfer device would be MOST BENEFICIAL for the client to use when transferring from a standard wheelchair to a variety of surfaces? Hydraulic lift Lift seat Sliding board Transfer disc
Solution Solution: The correct answer is C. Sliding board transfers are useful for a person who has trace muscle strength in the lower extremities and good upper-extremity muscle strength. A, B: The client is able to participate more fully in the transfer by positioning the lower extremities; a power lift is not needed, and using a power lift may decrease the client's independence over time. D: With trace lower-extremity muscle strength, the client would not be able to use a transfer disc because this device supports the client for getting into position for the transfer only.
What is the PRIMARY benefit of using the SETT (Student, Environment, Task, Tools) Framework to guide assistive technology (AT) evaluation and service delivery in a school-based setting? Helps to reduce the incidence of learned helplessness and low self-esteem among students who have communication deficits Meets specific standardized assessment requirements as outlined in the Individuals With Disabilities Education Improvement Act of 2004 Promotes educational team collaboration regarding students' AT needs throughout the school day Provides a method for prioritizing students' occupational therapy intervention activities based on hierarchy of scores
Solution Solution: The correct answer is C. The SETT allows for collaboration and communication among educational team members to support good decision making to determine the AT needs of a student. A: The SETT is used to determine AT needs of a student, not just communication needs, and does not address learned helplessness or self-esteem of a student. B: The SETT is a framework and does not meet standardized assessment criteria. D: The SETT is a framework that results in qualitative information about a student's needs and does not provide a score.
An OTR® has completed the Allen Diagnostic Module with a client who has dementia. Results indicate that the client is functioning at a 4.6 level (Goal-Directed Actions). Based on this information, which strategy would MOST effectively promote the client's success during a grooming task? Demonstrate and ask the client to imitate the OTR®'s movements. Guide the client through the physical movements of the task. Lay out the items needed for the task prior to the start of the session. Use verbal praise during each task to encourage on-task behavior.
Solution Solution: The correct answer is C. Visual cues are significant at Level 4. Keeping items in plain view and minimizing clutter in the environment will facilitate this client's performance of self-care tasks. A: Imitation of the practioner's actions occurs at Level 3; this client is functioning at a higher level than that. B: Guiding the client through the physical actions of an activity is required at Level 2; this client is functioning at a higher level than that. D: At Level 5, clients are more aware of the social and physical consequences of their action, and verbal praise may be a more useful strategy. A client functioning at Level 4 will not be receptive to verbal praise.
A client is attending occupational therapy for conservative management of acute carpal tunnel syndrome. What information would be MOST BENEFICIAL to provide the client during the initial stage of the intervention process? Methods for immobilizing the hand, importance of taking anti-inflammatory medications, and typical work restrictions Handouts illustrating therapy putty exercises, proper wear and care of a resting hand splint, and methods for completing contrast baths Instructions for upper-extremity strengthening using therapy bands, fine motor activities, and stress-loading exercises Techniques for managing edema, illustrations of tendon glide exercises, and methods for modifying daily activities
Solution Solution: The correct answer is D. Controlling edema, initiating tendon glides, and making recommendations for modifying daily activities are all strategies that are indicated in the early nonoperative management of carpal tunnel syndrome. A: The hand does not require immobilization in conservative management of carpal tunnel syndrome; the wrist may be immobilized in neutral to minimize median nerve compression. B: A resting hand splint is not indicated in conservative management of carpal tunnel syndrome; the wrist may be immobilized in neutral to minimize median nerve compression. C: Stress loading is not indicated at any stage of carpal tunnel syndrome management.
A student in kindergarten has dyspraxia and frequently falls when playing at recess and during gym class. When completing at-desk art and writing activities, the student often reverses numbers and letters and holds the pencil with an immature grasp. What should be the INITIAL focus of intervention sessions with this student? Identifying assistive devices for improving handwriting legibility Using parquetry activities for improving visualspatial and visualmotor skills Engaging in fine motor games to increase pinch and grip strength Providing a just-right challenge during gross motor play activities
Solution Solution: The correct answer is D. Improving the child's safety during recess and gym class should be the first priority of the intervention plan, so addressing gross motor play skills is most appropriate. Providing the just-right challenge will allow the child to participate in tasks that do not overwhelm yet are also not so simple that the task is routine or uninteresting. This challenge will allow the child to develop praxis with gross motor play. A: Identifying assistive devices for handwriting may be a component of the intervention but should not be the initial focus of the intervention plan; improving the child's safety with play is most important. B: The scenario does not suggest that visualspatial or visualmotor skills are interfering with the child's ability to engage in gross motor play or with the child's ability to complete handwriting activities. C: Implementing hand strengthening for improving handwriting may be a component of the intervention but should not be the initial focus of the intervention plan; improving the child's safety with play is most important.
A 4-year-old child with bilateral congenital limb deficiencies at the transhumeral level was recently fitted with new prostheses. Which activity should be introduced FIRST as part of the prosthetic program with the child? Self-feeding using standard eating utensils Coloring pictures in an oversized coloring book Stacking 1-inch (2.54-cm) wooden blocks Pushing an 18-inch- (45-cm-) diameter exercise ball
Solution Solution: The correct answer is D. Once an individual is fit with a prosthetic, use training should begin so the client can understand how to operate and control the prosthetic. The client is able to implement practice with pre-positioning the limb to more effectively approach an object, such as pushing a ball. A, B: Functional training occurs after the client has gained concepts of control and use of the prosthetic as through pre-positioning and prehension control. C: Prehension training occurs after the client is successful with pre-positioning the prosthetic in preparation for grasp or interaction with an object.
An OTR® is setting up a booth to promote occupational therapy services at a community-sponsored health fair. A vendor has donated various therapy equipment and product brochures for the OTR to display. When reading one of the brochures, the OTR identifies a product promotion that claims to eliminate pain for any condition. What is the BEST course of action for the OTR to take regarding this printed information? Display only those products that are supported in occupational therapy literature by evidence-based research. Post a product disclaimer about the equipment at the booth that is visible to the health fair attendees. Advise the company representative that the product information and equipment cannot be displayed at the health fair. Recognize that the claim is invalid and eliminate the printed product endorsement from the booth.
Solution Solution: The correct answer is D. Practitioners are ethically obligated to report any acts that make false claims and must not use such products or services in practice to refrain from any actions that may inflict harm. A: Products do not have to be supported in occupational therapy literature to be incorporated in practice, though considering the evidence base is important. B: Product disclaimer is not sufficient to avoid the use of products or services that make false claims or may potentially inflict harm. The product or service may not be used in practice at all. C: The product should be reported to appropriate authorities who can take action with the company representative.
A client has central vision loss secondary to macular degeneration. The OTR® plans to teach the client eccentric viewing techniques to compensate for the client's visual loss. What should the OTR® teach the client as the FIRST step of this process? Head positioning for optimal viewing Methods for using a magnification device Scanning exercises across the full field of vision Strategies for increasing blind spot awareness
Solution Solution: The correct answer is D. The first step in eccentric viewing techniques is increasing the client's awareness of the central scotoma, or blind spot. A: The client must first increase awareness of the blind spot before determining the best viewing position for the chosen target. B: The client will learn to track and view through a magnification device once the client has increased awareness of the blind spot and identified best eccentric viewing positions. C: The client practices scanning once the client has increased awareness of the blind spot and practiced using optical devices such as magnifiers.
A home health client has hemiplegia secondary to having had a CVA 1 month ago. The client completes BADL using assistive devices and ambulates in the home with a quad cane. The client requires stand-by assistance for balance when walking outdoors on uneven surfaces. One of the client's goals is to resume a favorite leisure activity of gardening in a small backyard vegetable garden. Which task would be MOST BENEFICIAL to have the client complete as part of the initial intervention for progressing toward the client's goal? Apply adaptive strategies during graded outdoor gardening tasks. Set up a routine maintenance schedule to care for indoor flowers and plants. Practice mobility skills for going to and from a community gardening class. Participate in building planter boxes to establish a raised garden bed. Solution
Solution: The correct answer is A. Graded gardening tasks outdoors will allow the client to progress to performing this leisure activity, and working on outdoor gardening tasks will allow the client to gain skills in the natural context of the activity as long as the practitioner has deemed the activity is safe for the client to perform. B: The client's problem area is in walking outdoors on uneven surfaces, so providing a schedule of indoor activity would not effectively address the client's problem. C: Mobility skills for accessing a community gardening class may not generalize to improved mobility skills in the client's own outdoor garden. Practicing task performance in context would be most beneficial. D: The client's problem area is in walking outdoors on uneven surfaces, so raising the garden bed height would not effectively address the client's problem.
