Occupational Therapy Assessment and Intervention Exam Preparation Guide
Course Introduction
This course provides an in-depth exploration of assessment techniques and intervention strategies used in the field of occupational therapy. Students will learn to evaluate clients physical, cognitive, emotional, and environmental factors that influence occupational performance, using standardized and non-standardized assessment tools. The course covers evidence-based interventions across the lifespan, including pediatric, adult, and geriatric populations, with an emphasis on promoting functional independence and participation in everyday activities. Through case studies and practical labs, students will gain hands-on experience in developing and implementing individualized intervention plans tailored to diverse client needs and settings.
Recommended Textbook
Pedrettis Occupational Therapy Practice Skills for Physical Dysfunct
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444 Verified Questions
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Chapter 1: The Occupational Therapy Practice Framework
and the Practice of Occupational Therapy for People With
Physical Disabilities
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Sample Questions
Q1) For the 10-year-old client to make her bed,she will need enough hand strength to pull the corner of the bottom sheet to fit.This would be considered under which section of activity demands?
A) Objects and their properties
B) Space demands
C) Sequence and timing
D) Required body structures
E) Required body functions
Answer: E
Q2) The Framework refers to activities that are oriented toward taking care of one's own body as which of the following?
A) ADLs
B) IADLs
C) Performance skills
D) Areas of occupation
E) Context
Answer: A
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Chapter 2: The Occupational Therapy Practice Framework
and the Practice of Occupational Therapy for People With
Physical Disabilities
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Q1) An occupational therapist is working with a 21-year-old client who has suffered a mild traumatic brain injury as a result of a car accident when he was 6.The client is now exhibiting signs of depression and social anxiety.The OT practitioner has identified therapeutic use of self as the most appropriate intervention method at this time.The OT practitioner should do which of the following?
A) Use active listening when the client talks about himself and his injury.
B) Arrange for the client to go to a baseball game, where he can relax and enjoy his favorite team.
C) Simulate meeting new people in the OT clinic so the client feels more at ease in social situations.
D) Provide the client with a list of resources for treatment of depression and social anxiety disorder.
Answer: A
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4
Chapter 3: History and Practice Trends in Physical
Dysfunction Intervention
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Q1) The Rehabilitation Act of 1973,the Individuals with Disabilities Education Act (IDEA)of 1973,and the Americans with Disabilities Act (ADA)of 1990 are all legislation acts that resulted from activists of which model or movement?
A) Arts and Crafts movement
B) Moral treatment
C) Scientific management
D) Medical model
E) Disability rights movement
Answer: E
Q2) The idea that handicrafts could be graded to provide occupation that stimulated mental activity and muscular exercise at the same time stemmed from which founding ideology?
A) Arts and Crafts movement
B) Moral treatment
C) Scientific management
D) Medical model
E) Disability rights movement
Answer: A
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Chapter 4: Application of the Occupational Therapy
Practice Framework to Physical Dysfunction
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Q1) There are several forms of clinical reasoning.Which statement best fits the concept of pragmatic reasoning?
A) This form of reasoning provides a connection between the client's identified problems and the interventions provided, sometimes referred to as critical pathways.
B) This form of reasoning is primarily concerned with the interactions between the client and the therapist, with a focus on understanding the client's point of view.
C) This form of reasoning is focused on the client's explanation or description of the disability experience and how that affects therapeutic interventions.
D) This form of reasoning considers the external demands of the intervention setting, financial resources, and the client's potential discharge placement.
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6
Chapter 5: Evidence-Based Practice for Occupational Therapy
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Q1) Which type of statement reflects what clients and relevant others would like to happen?
A) Objective
B) Specificity
C) Goal
D) Operational
E) Outcome
Q2) "Jane will arrive at work on time." This is an example of which type of objective?
A) Process
B) Intuitive
C) Outcome
D) Specific
E) Reflexive
Q3) What are the two kinds of objectives?
A) Reflexive and systematic
B) Process and outcome
C) Goals and causes
D) Downstream and upstream
E) Scientific and intuitive
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Chapter 6: Health Promotion and Wellness for People With Physical Disabilities
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Sample Questions
Q1) Which assumptions guide health promotion OT service?
A) Client-centered care, empowerment, enablement
B) Client-centered care and client compliance with procedures
C) Client compliance with procedures and therapist expertise
D) All of the above
Q2) All but which of the following statements about health promotion as described in the OT Practice Framework are accurate?
A) The Framework describes health promotion as an appropriate intervention for OT.
B) The Framework describes disability prevention as an appropriate intervention for OT.
C) Disability prevention is included in the Framework.
D) Wellness, as described in the Framework, involves only the lack of disease symptoms.
Q3) All of the following are examples of secondary preventive measures except:
A) Joint protection instruction
B) Energy conservation instruction
C) Ergonomic assessment and modification
D) Work simplification instruction
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Chapter 7: Documentation of Occupational Therapy Services
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Q1) Which term is not a section of a SOAP note?
A) Subjective
B) Objective
C) Analysis
D) Plan
Q2) Narrative reasoning is used __________________.
A) To help the therapist understand the client's disabilities, impairments, and performance contexts
B) To evaluate the meaning that occupational performance limitations might have on the client
C) When addressing practical realities associated with delivery of OT services
D) To determine the most appropriate therapy intervention to address the client's occupational performance needs
Q3) Which term below is not an example of skilled terminology?
A) Analyze
B) Maintain
C) Facilitate
D) Design
E) Adapt
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Chapter 8: Documentation of Occupational Therapy Services
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Q1) Pick the best answer to explain what is wrong with using the following statement as the objective part of a note: "The client has decreased grip strength of the right hand,which limits his ability to open a jar."
A) It should be in the subjective portion of the note.
B) It does not state what interventions are planned.
C) It is not an objective measurement.
D) It is an interpretation of an objective measurement, rather than an objective measurement.
Q2) What is the most compelling reason for the therapist to fill out all sections of the Medicare 700 form?
A) Because it makes the therapist appear thorough
B) Because failure to complete a section on the form could result in a technical denial
C) Because supervisors want all the sections completed so they will pass an audit
D) Because filling in all sections makes the need for therapy seem more justified
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Chapter 9: Infection Control and Safety Issues in the Clinic
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Q1) When working with a client who has a hyperalimentation device for nutritional support,the occupational therapist should ensure that catheter connections are secure before and after intervention.What potentially life-threatening condition can result from a disrupted connection?
A) Blood clot
B) Gastrointestinal reflux
C) Air embolus
Q2) Standard precautions for infection control recommend the use of protective clothing (e.g.,gowns,gloves,masks)_________________.
A) When working with all clients
B) Only when working with patients who are diagnosed with infectious diseases
C) When splashing of body substances is likely
D) Only when the therapist has an infectious condition (e.g., cold, flu)
Q3) To reduce the risk of cross-contamination,the occupational therapist should wash his or her hands before and after treating each client for at least:
A) 5 seconds
B) 10 seconds
C) 15 seconds
D) 20 seconds
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Page 11
Chapter 10: Infection Control and Safety Issues in the Clinic
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Q1) An OT practitioner is working with a client with a history of chronic obstructive pulmonary disease who has been admitted to the hospital with pneumonia.The client begins to experience some shortness of breath while seated at a table completing a meal preparation activity.Which of the following is the correct dyspnea control position to use for the client?
A) Client bends deeply at the waist, resting the chest on the thighs.
B) Client sits upright with arms relaxed at the sides of the body.
C) Client bends forward slightly at the waist, leaning the forearms on the table.
D) Client leans back against the chair backrest with arms resting in the lap.
Q2) In addition to teaching the client to use dyspnea control postures,the occupational therapist also teaches the client to use pursed-lip breathing to reduce shortness of breath while performing activities of daily living.Which of the following best describes pursed-lip breathing?
A) Inhaling slowly through pursed lips, then exhaling through the nose
B) Inhaling through pursed lips, then exhaling slowly through the nose
C) Inhaling slowly through the nose, then exhaling through pursed lips
D) Inhaling through the nose, then exhaling slowly through pursed lips
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Chapter 11: Activities of Daily Living
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Q1) The use of a wrist-driven flexor hinge splint may benefit a client with muscle function from spinal cord levels __________.
A) C6
B) C5
C) C4
D) A and B
Q2) Stabilizing an extremity to reduce incoordination and enable a client to perform activities of daily living (ADLs)is a common practice for clients with which of the following conditions?
A) Rheumatoid arthritis
B) Central nervous system (CNS) disorders
C) Temporary orthopedic disorders such as fractures
D) Quadriplegia
Q3) IADL skills needed for client safety and independence alone at home include all but which of the following?
A) The ability to retrieve a simple meal
B) The ability to ambulate independently
C) The ability to employ safety precautions
D) The ability to take medications.
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Page 13
Chapter 12: Activities of Daily Living
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Q1) An occupational therapist is working with a patient with low vision in her home.Which environmental modification would be contraindicated?
A) Improve lighting by opening blinds and curtains.
B) Simplify figure-ground perception.
C) Use magnifiers with lights.
D) Maximize contrast for the task.
Q2) Stabilizing an extremity to reduce incoordination to enable a client to perform activities of daily living (ADLs)is a common practice for clients with which of the following conditions?
A) Rheumatoid arthritis
B) Central nervous system (CNS) disorders
C) Temporary orthopedic disorders such as fractures
D) Quadriplegia
Q3) The use of a wrist-driven flexor hinge splint may benefit a client with muscle function from which spinal cord level(s)?
A) C6
B) C5
C) C4
D) A and B
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Chapter 13: Mobility
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Q1) Why might a rigid frame chair be preferable for individuals with paraplegia who are manually propelling the wheelchair?
A) They are more lightweight than folding chairs.
B) They are more energy efficient during propulsion.
C) They are more easily folded and stored.
D) They are more sturdy and do not need to be replaced as often.
Q2) It is recommended that wheelchair footplates clear the floor by a minimum distance of ________________.
A) 2 inches
B) 1 inch
C) 0.25 to 0.5 of an inch
D) 4 inches
Q3) Which ambulation aid is the most appropriate for a client who has minor balance problems?
A) Forearm crutches
B) Single point cane
C) Front-wheeled walker
D) "Pick-up" walker
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15
Chapter 14: Mobility
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Sample Questions
Q1) You are an occupational therapist with advanced training in driving evaluation.You are working with a client with paraplegia.After completion of a thorough predriving assessment,you determine that your client can safely drive with appropriate vehicle modifications.Which of the following are appropriate modifications for the individual with paraplegia?
A) Left foot accelerator, spinner knob
B) Hand controls for accelerator and brake, hand-operated parking brake
C) Pedal extensions
D) High-technology electronic controls and power equipment
Q2) You are an occupational therapist working with an individual with T1 spinal cord injury.Your client has paralysis of both legs.Upper extremity function is fully intact,but your client has limited upper trunk stability.Which of the following is the most appropriate type of transfer to use to maintain safety and maximize your client's independence in functional mobility?
A) Bent pivot transfer
B) Sliding board transfer
C) Stand pivot transfer
D) Transfer with mechanical lift
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Chapter 15: Work Evaluation and Work Programs
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Q1) Which one of these risk factors is not usually included on an ergonomics checklist used by the ergonomics team?
A) Repetitions of task
B) Lunch break and break times
C) Use of vibration
D) Employee pay scale and benefits
Q2) _______ addresses "human performance and well-being in relation to one's job,equipment,tools,and environment."
A) Anthropometry
B) Ergonomics
C) Industrial hygiene
D) OSHA
Q3) "Primary" prevention of workplace injuries ______________.
A) Emphasizes early identification and intervention of workers and risk factors
B) Helps protect healthy workers against targeted conditions
C) Occurs after a worker suffers nonreversible injury, illness or disease
D) Is not addressed by occupational therapists
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Chapter 16: Work Evaluation and Work Programs
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Q1) The state Department of Rehabilitation refers many clients to OT for help with the transition from school to work.What would be an appropriate goal for a student with paraplegia who wants to be a teacher?
A) Increase upper extremity strength to within normal limits
B) Independence with using a computer and a projector to put lessons on the board.
C) Independent with all dressing skills
D) Any goal made collaboratively with the student, rehabilitation counselor, and the OT practitioner
Q2) The ABC candy company requires workers to perform packaging of 1-pound boxes at a standing workstation.What is the best height for this type of workstation?
A) 34-37 inches: slightly below elbow
B) 37-43 inches: above elbow height
C) 28-35 inches: heavy work
D) This task should be done while sitting.
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18
Chapter 17: Americans With Disabilities Act and Related
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Sample Questions
Q1) An OT practitioner is working in a public school with a child who uses a wheelchair for all mobility.He tells the OT practitioner that he cannot get into a toilet stall in the bathroom because the stall is too small.What should the OT practitioner do?
A) Perform an accessibility audit of the bathroom and make recommendations to the school principal to provide wheelchair access under the ADA.
B) Tell the student to file a complaint with the Department of Justice in Washington,
C) Ask the principal if the student can use the teachers' bathroom, which is larger.
D) There is nothing that the OT practitioner can do in this situation.
E)C.
Q2) A neighborhood restaurant needs to comply with ADA requirements to accommodate customers with disabilities.What is the first priority under Title III regulations?
A) Provide parking for the disabled and access into the restaurant.
B) Make the restrooms accessible for all people.
C) Make restaurant tables accessible to wheelchair users.
D) Make the menus more accessible for persons with visual limitations.
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Chapter 18: Leisure Occupations
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Q1) An occupational therapist from the Midwest (where the population is predominantly white)is moving to southern California (where the population is an ethnic mix with a large segment being Mexican).What should the occupational therapist do to improve her knowledge and application of culturally appropriate occupations for her new clientele?
A) Gather examples of successful activities that she did in the Midwest and box them up to take to her new job.
B) Review manual muscle testing so that when assigning an embroidery project, the occupational therapist will know that the proper hand muscles are working.
C) Research leisure interests and occupations by ethnicity using books, articles, and the Internet.
D) Learn Mexican recipes because most clients she will be treating will be Mexican and will enjoy cooking groups.
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Chapter 19: Americans With Disabilities Act and Related
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Q1) The Air Carrier Access Act of 1986 (ACAA)prohibits discrimination against people with disabilities by air carriers.However,airlines may exclude someone from flying if
A) The person's disability results in an appearance that would offend someone
B) There is a risk of affecting the safety of the flight
C) There are other people with disabilities on the flight already and the staff would be inconvenienced
D) They did not give prior notice of special needs to preboard
Q2) What year did Congress pass the Americans with Disabilities Act (ADA)?
A) 1973
B) 1990
C) 2002
D) 1969
Q3) At which stage of the hiring process can an employer give a functional capacity assessment?
A) Pre-offer stage
B) Post-offer stage
C) During the medical exam
D) During the interview
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Chapter 20: Leisure Occupations
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Q1) Jeri's story was used as the case study in the Leisure Occupations chapter.Jeri was described as a 29-year-old,newly married woman who was in a traffic accident that resulted in a traumatic head injury,a broken wrist,and a broken leg.Before the accident she enjoyed scrapbooking,going to the nearby lake to boat and fish,playing with and caring for her dogs,and shopping.Jeri continues rehabilitation as an outpatient for the residual problems resulting from her head injury as well as for continuing problems using her dominant hand because of the healed wrist fracture (cast removed 2 weeks ago).She needs minimal assistance for safety because of poor balance and decreased judgment.Which intervention would be the best occupational therapy choice to assist her in engaging in her favorite leisure occupations?
A) A large button switch to listen to music
B) Use of adapted scissors to cut shapes that were glued to sturdy paper
C) Instruction in the using a rocker knife with her nondominant hand to cut meat
D) Teaching her to ride a hand-cycle racing bike
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Chapter 21: Occupation-Based Functional Motion Assessment
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Q1) Which of the following is a reason that assumptions can be made regarding lower extremity strength during functional activities?
A) The dependency of the distal joints on the more proximal joints for positioning
B) The complexity of motor patterns requiring gross and fine motor skill
C) The stereotypical movement patterns that occur due to the joints and relative arrangement of the muscle
D) The variety of patterns of movement that can be assumed
Q2) Which of the following cannot be assessed using the occupation-based functional motion assessment?
A) Motor control
B) Sensation
C) Range of motion (ROM)
D) Muscle strength
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23
Chapter 22: Joint Range of Motion
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Q1) When ROM is being measured,which is not a purpose of the therapist being in the proper position?
A) Making the client more comfortable
B) Ensuring accurate placement of the goniometer
C) Protecting the therapist's back
D) Giving the patient more time to move
E) Supporting the limb at the level of its center of gravity
Q2) When joint motion is limited by the length of a muscle that crosses two joints,it is called ________________.
A) Passive instability
B) Joint stiffness
C) Passive insufficiency
D) Joint weakness
E) Joint shortening
Q3) When the joint is moved solely by an outside force,it is called ______________.
A) Functional range of motion (ROM)
B) Active ROM
C) External ROM
D) Passive ROM
E) Active-assistive ROM
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Chapter 23: Joint Range of Motion
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Q1) An OT practitioner has measured a client's passive thumb metacarpophalangeal (MP)flexion.The recorded ROM is -30 to 0 to 35.What does this tell the therapist?
A) That the joint has normal hyperextension and normal flexion
B) That the joint has limited hyperextension and limited flexion
C) That the joint has abnormal hyperextension and limited flexion
D) That the joint has abnormal hyperextension and normal flexion
Q2) An OT practitioner is evaluating a 58-year-old client who sustained a stroke that resulted in hemiplegia of his right arm 3 months ago.While beginning to assess ROM,the therapist observes that the client's right wrist and hand are swollen and tender.The client reports having fallen in his bedroom the previous day.With regard to the wrist and hand,the therapist should do which of the following?
A) Measure active ROM and passive ROM.
B) Measure passive ROM only.
C) Measure active ROM only.
D) Defer measurements until a later time.
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25
Chapter 24: Evaluation of Muscle Strength
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Q1) In what plane is the MMT for grades F- and higher performed?
A) Horizontal plane
B) Gravity-minimized plane
C) Vertical plane
D) Gravity-assisted plane
E) Gravity-eliminated plane
Q2) The amount of resistance applied to a muscle should not depend on which of the following?
A) The cross-sectional size of the muscle
B) The age of the client
C) The relative power of the muscle
D) The gender of the client
E) The strength of the therapist
Q3) Which of the following does not belong with the others?
A) Good
B) Normal
C) 4
D) Moderate resistance
E) B and D
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Page 26
Chapter 25: Evaluation of Muscle Strength
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Q1) An OT practitioner is screening a client's wrist extension strength.The client is able to actively extend the wrist partially against gravity.Because of a joint limitation,the client's forearm cannot be placed in neutral rotation.What is the appropriate muscle grade?
A) 0
B) 1
C) 2
D) 3
Q2) An occupational therapy (OT)practitioner is testing a client's wrist flexion strength.The client is able to flex the wrist to 50 degrees against gravity.What should the therapist do next in the assessment?
A) Apply resistance.
B) Reposition the client to test in the gravity-minimized plane.
C) Assist the client into full wrist flexion and then apply resistance.
D) Flex the wrist passively to assess available range of motion.
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Chapter 26: Evaluation of Sensation and Intervention for Sensory Dysfunction
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Q1) Which of these is not an example of protective sensory reeducation?
A) Using a screwdriver for 30 minutes without any gloves
B) Softening the amount of force used when gripping objects
C) Moisturizing the skin regularly to keep it supple
D) Checking for blisters or cuts
Q2) Why is it important to test temperature sensation before applying heat or cold modalities in the clinic?
A) To avoid burning the client
B) To know whether to adjust the thermostat in the room
C) To know whether to put a blanket on the client
D) To find out whether the client prefers heat over cold or vice versa
Q3) Why is stereognosis important for hand function?
A) Without stereognosis our hands would not be able to sweat.
B) Without it we could not discriminate cold from hot.
C) Without it we could not identify an item with our vision occluded.
D) Without it we could not discern sharp items from dull items.
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Chapter 27: Evaluation of Sensation and Intervention for Sensory Dysfunction
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Q1) What does sensory reeducation require?
A) Specialized and standardized equipment
B) 30-minutes sessions
C) 10- to 15-minute sessions
D) Clients to be experiencing hypersensitivity
Q2) Which statement below is not true?
A) Proprioception and pain are aspects of musculoskeletal sensation.
B) Proprioception is the awareness of joint position.
C) Proprioception encompasses joint position, muscle stretch, and deep vibration.
D) Following cerebrovascular accident and with other neurological disorders, proprioception is usually intact.
Q3) Superficial fine touch receptors include which of the following?
A) Pacinian corpuscles
B) Ruffini's corpuscles
C) Meissner's corpuscles
D) Golgi tendon organs
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29
Chapter 28: Eating and Swallowing
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Q1) The hypoglossal nerve (XII)is active during what stages of the swallow?
A) Oral preparatory and pharyngeal stages
B) Oral preparatory and oral stages
C) Oral and pharyngeal stages
D) Pharyngeal and esophageal stages
Q2) Videofluoroscopy is an example of what type of swallowing assessment?
A) Oral motor assessment
B) Bedside sensory assessment
C) Instrumental assessment
D) Clinical assessment
Q3) A wet or gurgly vocal quality after an individual swallows is indicative of what?
A) Poor vocal fold control when talking
B) Poor respiratory support and a weak voice
C) Material collecting in the larynx
D) Nasal congestion
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Chapter 29: Evaluation and Treatment of Visual Deficits
Following Brain Injury
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Q1) Which of the following conditions could create cloudy vision in one eye after a traumatic brain injury?
A) Vitreous hemorrhage
B) Cataract
C) Optic nerve injury
D) Retinal detachment
Q2) All but which of the following could directly or indirectly result from a head injury?
A) Cataract
B) Diabetic retinopathy
C) Corneal scarring
D) Vitreous hemorrhage
Q3) Occlusion is used with the client with paralytic strabismus to __________.
A) Reestablish binocular use of the eyes
B) Prevent secondary contracture
C) Eliminate the double image
D) Improve focus
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31
Chapter 30: Evaluation and Pain Management
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Q1) Which of the following best defines pain?
A) An objective experience that is either acute or chronic
B) An unpleasant sensory and emotional experience, usually associated with actual or potential tissue damage
C) A physical disability with an emotional component
D) A negative sensation that always disrupts normal occupations
E) All of the above
Q2) What are the four distinct domains of the biopsychosocial model of pain?
A) Nonmalignancy, trauma, disease, and fear
B) Muscular weakness, noxious stimuli, nervous system syndrome, and chronic illness
C) Nociception, pain, suffering, and pain behavior
D) Arthritis, fibromyalgia, cancer, and headaches
Q3) What assessments are appropriate for an occupational therapist to use with clients,such as Catalina,who report pain?
A) Visual analog scale
B) Occupational profile
C) Numeric pain intensity scale
D) Activity diaries
E) All of the above
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Page 32
Chapter 31: Evaluation and Pain Management
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Q1) An occupational therapy (OT)practitioner has received an order to evaluate a middle-aged man because of shoulder pain that is impeding his ability to go back to work. The OT practitioner observes guarded movement,bracing,posturing,rubbing,and facial grimacing.These are examples of which of the following?
A) Asymmetry of the spine
B) Pain behaviors
C) Myasthenia gravis symptoms
D) Hypochondriasis
E) All of the above
Q2) For which of the following pain interventions does the occupational therapist need post-professional education to ensure competency?
A) Adaptive equipment
B) Splinting
C) Relaxation training
D) Physical agent modalities (PAMs)
E) All of the above
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Chapter 32: Orthotics
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Q1) An OT practitioner is working with a client experiencing proximal upper extremity weakness as a result of polymyositis.The client wants to be able to feed himself while sitting up in his wheelchair.The therapist has set up a MAS ,but the client is having difficulty flexing his elbow enough to reach his hand to his mouth.Which adjustment can the therapist make to facilitate this motion?
A) Lower the semireclining mount on the wheelchair upright.
B) Move the rocker arm more distally on the forearm support.
C) Roll the semireclining mount outwardly.
D) Move the rocker arm more proximally on the forearm support.
Q2) A 54-year-old woman is fitted with a wrist splint for night wear because of carpal tunnel syndrome.At a return visit the client reports that she has less numbness and tingling at her volar thumb and index and middle digits,but she has increased pain at the radial dorsal side of her hand. The OT practitioner should consider which of the following possibilities?
A) The client has been using her hand too much.
B) The client has not been wearing her splint.
C) The new splint is not helping her carpal tunnel syndrome symptoms.
D) The new splint is pressing on the radial digital nerve near the anatomical snuffbox.
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Chapter 33: Orthotics
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Q1) Clients with which condition would likely not be appropriate candidates for an MAS?
A) Cervical spinal cord injury
B) Cerebral palsy
C) Poliomyelitis
D) Muscular dystrophy
E) Guillain-Barré syndrome
Q2) When the occupational therapist is deciding which splint style and design to choose,the individual needs of the client must be considered.The therapist should consider all of the following except __________________.
A) Cognitive ability to don and apply the splint correctly
B) Ability of the caretaker to assist with applying the splint
C) Sensory dysfunction and fragile skin
D) Constant full time wear for optimal results
E) Compliance with the therapy program
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Chapter 34: Traditional Sensorimotor Approaches to Intervention
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Q1) You are planning your daily intervention for a client who sustained an RCVA and now has left hemiparesis.You are considering using PNF to increase the client's left upper extremity strength and range of motion.Your client's past medical history also includes a transient ischemic attack,hypertension,and active rheumatoid arthritis with substantial inflammation and pain in both shoulders and wrists.You choose
A) Forceful use of PNF diagonal 1 flexion with resistance to increase strength of left shoulder flexion, adduction, external rotation, supination, and finger flexion
B) Forceful use of PNF diagonal 1 extension with resistance to increase strength of left shoulder extension, abduction, internal rotation, pronation, and finger extension
C) Forceful use of PNF diagonal 2 extension with substantial resistance to increase range of motion for dressing activities of daily living.
D) Resistive use of PNF patterns is not an appropriate intervention for this client at this time
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Chapter 35: Degenerative Diseases of the Central Nervous System
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Q1) Which form of multiple sclerosis is the most common and features repeated episodes in which the client has a loss of function and then the function returns?
A) Secondary-progressive
B) Primary-progressive
C) Relapsing-remitting
D) Progressive-relapsing
Q2) Your next client,a 71-year-old woman,has been diagnosed with Alzheimer's disease and has moderate memory loss for recent personal experiences and is having problems managing her finances.Using the four-stage classification method,identify the stage in which your client is at this time.
A) 1: Very mild to mild cognitive decline
B) 2: Mild to moderate decline
C) 3: Moderate to moderately severe decline
D) 4: Severe cognitive decline
Q3) What are the three classic clinical symptoms of Parkinson's disease?
A) Resting tremor, spasticity, rigidity
B) Resting tremor, impaired voluntary movement, rigidity
C) Spasticity, impaired postural reflexes, decorticate posture
D) Spasticity, choreiform movements, impaired postural reflexes
Page 37
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Chapter 36: Cerebrovascular Accident Stroke
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Q1) The subcategories of care of pets,home management,and shopping are included in which area of occupation?
A) Education
B) Social participation
C) Leisure
D) IADLs
E) ADLs
Q2) A 10-year-old client is making her bed.She needs two sheets and a pillowcase to do this task.She prefers flannel sheets.This would be considered under which section of activity demands?
A) Objects and their properties
B) Space demands
C) Sequence and timing
D) Required body structures
E) Required actions
Q3) Which is the most common form of stroke?
A) Ischemic
B) Embolic
C) Thrombotic
D) Hemorrhagic
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Chapter 37: Spinal Cord Injury
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Q1) The person with C6 quadriplegia may be able to assist in transfers by locking the elbows in extension and performing shoulder _________________.
A) Depression, extension, and adduction
B) Depression, external rotation, and adduction
C) Adduction and elbow flexion
D) Horizontal abduction and humeral adduction
Q2) The patient has a C6 quadriplegia.We can anticipate that he or she has innervation of which of the following?
A) Deltoids, latissimus, biceps, radial wrist extensors
B) Latissimus, serratus, biceps, triceps
C) Deltoids, biceps, triceps, hand intrinsics
D) All of the above
Q3) The patient has a C5 quadriplegia.We can anticipate that he or she has innervation of which of the following?
A) Upper trapezius, deltoids, biceps, levator scapulae, wrist flexors
B) Latissimus, deltoids, biceps, supinators, pronators
C) Upper trapezius, diaphragm, levator scapulae, biceps, and supinators.
D) A and B
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Chapter 38: Spinal Cord Injury
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Q1) While working with Rick,you notice that he begins to perspire profusely,complains of a severe headache,and looks flushed.He is showing signs of _____,and you should _____.
A) Postural hypotension; tip the wheelchair back for a few minutes
B) Autonomic dysreflexia; elevate his legs
C) Malingering; continue intervention and ignore complaints
D) Autonomic dysreflexia; seek medical assistance
Q2) When being trained to use the tenodesis wrist-hand orthosis or flexor hinge hand splint,Rick should be taught to perform palmar prehension by doing which of the following?
A) Flexing the wrist
B) Extending the wrist
C) Flexing the fingers
D) Extending the fingers
Q3) A primary intervention aim for Rick would be to increase the strength of which of the following?
A) Triceps, finger extensors, and finger flexors
B) Biceps, pectoralis major, and wrist extensors
C) All of the above plus hand intrinsics
D) All of the above plus wrist flexors
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Chapter 39: Disorders of the Motor Unit
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Q1) The motor unit is the elementary functional unit of the peripheral nervous system.What are its four elements?
A) The cell body of the motor neuron in the anterior horn of the spinal cord; the axon of the motor neuron, which travels via spinal nerves and peripheral nerves to muscle; the neuromuscular junction; and the muscle fibers innervated by the neuron
B) The spinal nerve, the peripheral nerve, the neuromuscular junction, and the muscle fibers
C) The cell body of the motor neuron in the posterior spinal cord, the dorsal root, the peripheral nerve, and the muscle fibers
D) The synaptic junction, the anterior spinal cord, the neuromuscular junction, and the muscle fibers
Q2) Which of the following is a disorder of the neuromuscular junction?
A) Postpolio syndrome
B) Muscular dystrophy
C) Guillain-Barré syndrome
D) Myasthenia gravis
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Chapter 40: Disorders of the Motor Unit
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Q1) During a Backpack Awareness Day event,occupational therapy (OT)students educated middle school-aged children about carrying the correct amount of weight and wearing their backpacks correctly to prevent injury of which peripheral nerve?
A) Brachial plexus
B) Axillary nerve
C) Median
D) Long thoracic
Q2) What interventions are appropriate for an occupational therapist to use with clients who have postpolio syndrome (PPS)?
A) Psychological counseling
B) Pain management
C) Exercise designed to work the muscles at maximum capacity with frequent, intermittent periods of rest
D) Diet recommendations and cooking groups
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Chapter 41: Arthritis
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Q1) Rheumatoid arthritis can result in significant psychological stressors because of pain,changed body image,and uncertainty about the course of the disease.Major depression can result in approximately what percentage of the cases?
A) 40%
B) 20%
C) 10%
D) None of the above
Q2) In osteoarthritis nodes or bony enlargements are commonly seen at the distal interphalangeal joints.What are these nodes called?
A) Mallet finger nodes
B) Bouchard's nodes
C) Boutonnière deformity nodes
D) Heberden's nodes
E) None of the above
Q3) A common hand deformity in rheumatoid arthritis includes which of the following?
A) Metacarpophalangeal (MP) ulnar deviation and wrist ulnar deviation
B) MP radial deviation and wrist ulnar deviation
C) MP ulnar deviation and wrist radial deviation
D) MP radial deviation and wrist radial deviation
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Page 43
Chapter 42: Arthritis
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Q1) An OT practitioner is working with a 55-year-old client with osteoarthritis.She has pain at the base of her thumb at the carpometacarpal (CMC)joint and nodes at several of the distal interphalangeal (DIP)joints.She reports attending a yoga class the previous evening that required weight bearing on her hands.Her pain increased after the class and still persists during her OT appointment.What should the OT practitioner tell the patient?
A) Continue the yoga class to increase strength.
B) Avoid any activity that causes pain for more than 1 to 2 hours after completion.
C) Review joint protection principles.
D) B and C.
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44
Chapter 43: Hand and Upper Extremity Injuries
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Q1) Explain why the tip of the thumb flexes when trying to grasp a piece of paper between the thumb and index finger in a client who has ulnar nerve paralysis.
A) Because the flexor pollicis longus substitutes for the absent adductor pollicis muscle
B) Because the extensor pollicis longus is absent in ulnar nerve injuries
C) Because the index flexor tendons are absent in ulnar nerve injuries
D) Because the thumb opponens pollicis is absent in ulnar nerve injuries
Q2) Why is surgery required for neurotmesis?
A) Because it would take too long to wait for the nerve to regenerate
B) Because the nerve is contused
C) Because there is a complete laceration of both nerve and fibrous tissues
D) Because nerve fibers distal to the injury degenerate, despite the fact that the internal organization of the nerve is intact
Q3) What does digital clawing indicate?
A) Weakness or absence of the extensor muscles
B) Weakness or absence of the intrinsic muscles of the hand
C) Weakness or absence of the flexor muscles of the hand
D) Flexor tenosynovitis
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Chapter 44: Low Back Pain
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Q1) In working with Pilar,the occupational therapist will teach her the concepts of body mechanics,which include ___________________.
A) Avoiding twisting movements, holding objects close to the body, lifting with the legs
B) Teaching her tasks and positions that move her body out of balance to challenge and strengthen the low back muscles
C) Forceful dynamic stretching of the upper and lower back
D) Balancing on one leg while reaching overhead
E) All of the above
Q2) Low back pain may be a result of which of the following?
A) Poor conditioning
B) Improper use of the back
C) Obesity
D) Smoking
E) All of the above
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Chapter 45: Hand and Upper Extremity Injuries
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Q1) Positive Phalen's test is associated with which of the following?
A) Cubital tunnel syndrome
B) Radial tunnel syndrome
C) Carpal tunnel syndrome
D) Trigger finger
Q2) Which of the options below is an accessory motion?
A) Joint distraction
B) Extension
C) Flexion
D) Abduction
Q3) Which of the following best defines axonotmesis?
A) An injury in which nerve fibers distal to the site of injury degenerate but the internal organization of the nerve remains intact
B) Contusion of the nerve without Wallerian degeneration
C) Complete laceration of both nerve and fibrous tissues
D) An injury in which surgical intervention is typically required
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Chapter 46: Burns and Burn Rehabilitation
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Q1) The extent of burn injury is classified by which of the following?
A) Burn severity scale
B) Dermal damage score
C) Total body surface area percentage
D) Skin viability test
E) Burn intensity grade
Q2) Which is not true about splinting in the treatment of burns?
A) Splints do not need to be worn at all times to prevent contractures.
B) Splints can maintain correct positioning of joints.
C) Splints can protect compromised tissues to promote healing.
D) Splints can reverse scar contractures of mature scars.
E) Splints should not compromise function whenever possible.
Q3) Revascularization,reepithelialization,and contraction of a burn wound occur in which phase of wound healing?
A) Emergent
B) Inflammatory
C) Proliferation
D) Maturation
E) Remodeling
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Page 48
Chapter 47: Burns and Burn Rehabilitation
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Q1) An OT practitioner is evaluating the ROM of a client with an acute full thickness burn to the dorsum of the hand.The therapist is concerned about the integrity of the extensor tendons and should take which of the following actions?
A) Measure passive composite finger flexion.
B) Measure active composite finger flexion.
C) Measure metacarpophalangeal (MP) flexion with the interphalangeal joints in extension.
D) Refrain from performing all hand joint measurements until the burn has healed.
Q2) An OT practitioner is treating a client with burns to the chest and upper extremities sustained 6 weeks ago.The client is exhibiting new stiffness and deep pain in the elbow at the end of elbow flexion range.The therapist suspects development of heterotopic ossification and should take which of the following actions?
A) Discontinue all elbow ROM until pain resolves.
B) Initiate dynamic elbow flexion splinting.
C) Have client perform active elbow ROM exercises within pain-free range.
D) Perform more aggressive passive stretching into elbow flexion.
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Chapter 48: Amputations and Prosthetics
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Q1) What is the leading cause of lower extremity amputation?
A) Peripheral vascular disease (PVD)
B) Motor vehicle accidents
C) Gunshot wounds
D) Osteogenic sarcoma
E) Chronic infection
Q2) A client practicing stacking small blocks would be in what phase of prosthetic training?
A) Preprosthetic
B) Control
C) Use
D) Functional
E) Repetitive
Q3) Which is not part of a myoelectric prosthesis control system?
A) Motor
B) Cable
C) Battery
D) Electrode
E) Amplifier
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Page 50
Chapter 49: Amputations and Prosthetics
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Q1) An OT practitioner is working with a client who had a unilateral below-knee amputation 2 weeks ago and wants to be able to resume living alone as soon as possible.To meet this goal,the therapist should:
A) Alter the client's preexisting performance patterns.
B) Encourage the client to focus on his former sense of self.
C) Discourage the client's independent process skills.
D) Adapt the client's activity demands.
Q2) An OT practitioner is doing functional unilateral myoelectric prosthetic training with a client who wants to be able to cut vegetables for meal preparation.What should the therapist teach the client?
A) To use packaged precut vegetables so that cutting is not necessary
B) To use a cutting board and a one-handed rocker knife
C) To use the terminal device to hold the knife and the sound hand to hold the vegetable
D) To use the sound hand to hold the knife and the terminal device to hold the vegetable
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Chapter 50: Oncology
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Q1) A cancer with staging of III __________________.
A) Has a primary tumor greater than 5 cm, no invasion of adjacent tissues, no lymph involvement and no metastases
B) Has a primary tumor of 5 cm or less, no invasion of adjacent tissues, positive regional lymph involvement and no metastases
C) Has a primary tumor greater than 5 cm or less, no invasion of adjacent tissues, no lymph involvement, and distant metastases are present
D) Has a primary tumor with invasion to adjacent tissues, positive regional lymph involvement, and no metastases
Q2) A malignant tumor of the lung is classified as a ______________.
A) Lymphoma
B) Sarcoma
C) Carcinoma
D) Leukemia
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Chapter 51: HIV Infection and Aids
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Q1) OT intervention that is delivered to a community,group,or individual with developmentally appropriate content intended to provide information on reducing the risk of HIV infection through safer sex practices and abstinence would best be described as an example of ____________.
A) Primary prevention
B) Secondary prevention
C) Tertiary prevention
D) nonOT prevention
Q2) All of the following statements about HIV/AIDS OT assessment and intervention are true with the exception of the following:
A) Observing universal precautions when working with HIV positive clients is not recommended because it may interfere with therapeutic rapport.
B) OT may need to address the psychosocial aspects of HIV, including loss of friends as a result of the illness.
C) OT may need to address real or perceived discrimination experienced by the client.
D) Most clients with HIV/AIDS have an altered worker role.
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