Occupational Therapy for Physical Dysfunction
Midterm Exam
Course Introduction
This course provides an in-depth exploration of occupational therapy principles and interventions for individuals experiencing physical dysfunction. Emphasizing evidence-based practice, students will examine the impact of various physical injuries and chronic conditions on daily activities and occupational performance. The curriculum covers assessment techniques, intervention planning, adaptive strategies, and the use of assistive technologies to enhance client independence and participation. Through case studies, hands-on activities, and clinical reasoning exercises, students will develop skills to promote rehabilitation, restore function, and support the overall well-being of clients with physical impairments in diverse clinical settings.
Recommended Textbook
Pedrettis Occupational Therapy Practice Skills for Physical Dysfunct
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51 Chapters
444 Verified Questions
444 Flashcards
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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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Q1) Sequencing and timing are considered in which Framework section?
A) Performance skills
B) Performance patterns
C) Context
D) Activity demands
E) Client factors
Answer: D
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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Page 3
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 therapy (OT)practitioner is working with a 15-year-old client with a spinal cord injury.After discussing a list of activities of daily living,the client indicated a goal of keeping her thick,curly hair looking attractive.What should the occupational therapist do first?
A) Identify a caregiver who will brush and style the client's hair every day.
B) Observe whether the client has difficulties manipulating the comb in her hand and through her hair.
C) Locate hair-care products that will make thick and curly hair more manageable.
D) Teach the client how to use the various assistive devices she will need to brush her hair.
Answer: B
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4
Chapter 3: History and Practice Trends in Physical
Dysfunction Intervention
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Q1) Under the American Occupational Therapy Association's (AOTA's)Occupational Therapy Practice Framework,the promotion of client-centered treatment within the context of the social,cultural,and political environment reflects which treatment model or approach?
A) Arts and Crafts movement
B) Moral treatment
C) Social model
D) Medical model
E) Rehabilitation model
Answer: C
Q2) In 1972 Edward Roberts,at the University of California in Berkeley,initiated which of the following?
A) The disability rights movement
B) The interactional or sociopolitical model
C) The independent living movement
D) The interactional or sociopolitical movement
E) The social model
Answer: C
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Chapter 4: Application of the Occupational Therapy
Practice Framework to Physical Dysfunction
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Q1) Occupational therapy practitioners are identified as occupational therapists or occupational therapist assistants and have specialized training and deliver skilled occupational therapy services.Occupational therapy aides are also used in some settings.Which statement best represents the services that can be provided by these individuals?
A) The aide can administer specific occupational therapy assessment instruments and develop an intervention plan.
B) The aide can perform delegated tasks such as setting up equipment or transporting clients but cannot provide skilled occupational therapy service.
C) The aide can provide skilled occupational therapy service under the direction of an occupational therapist or occupational therapist assistant.
D) The aide can complete the documentation for occupational therapy services, but the note must be signed by the occupational therapist assistant or occupational therapist.
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6
Chapter 5: Evidence-Based Practice for Occupational Therapy
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Q1) "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
Q2) The Canadian Occupational Performance Measure (COPM)__________.
A) Is not client based
B) Is a standardized cognitive assessment
C) Is used for process objective assessment
D) Can be used only as a pretest
E) Is a criterion-referenced outcome measure
Q3) Which type of statement reflects what clients and relevant others would like to happen?
A) Objective
B) Specificity
C) Goal
D) Operational
E) Outcome
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Chapter 6: Health Promotion and Wellness for People With Physical Disabilities
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Q1) You are evaluating a 45-year-old male client who smokes a pack of cigarettes every day.He states that he has no interest in quitting smoking.He has tried to quit in the past,but he is not currently concerned about the health consequences of smoking.He tells you that he has not even considered quitting smoking for several years.According to the transtheoretical model of health promotion,his statement is most consistent with which of the following stages?
A) Precontemplation
B) Contemplation
C) Preparation stage
D) Termination
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.
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8
Chapter 7: Documentation of Occupational Therapy Services
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Q1) Which of the choices below is not true of skilled services?
A) They require analysis and modification of functional tasks.
B) They include provision of instructions to the client, family, or caregivers.
C) Evaluation is a skilled service.
D) No revising or readjusting of the program is necessary.
Q2) Safety measures to prevent unauthorized persons from accessing client records include which of the following?
A) Requiring personal identification and user verification codes for access to records
B) Sharing login pass codes among staff
C) Working on notes from home
D) Leaving computer up and accessible in front of clients
Q3) Which of the following is not included as subjective part of a SOAP note?
A) Information reported by the doctor
B) Information reported by the client
C) Information reported by the caregiver
D) Information reported by the family
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9
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) Which statement is most true regarding documentation of skilled services?
A) Documentation of skilled services does not necessarily reflect the therapeutic rationale underlying the task performed.
B) Terminology reflecting skilled services includes words such as observe, help, and maintain.
C) Skilled services can be performed safely and/or effectively only by a qualified therapist or under the supervision of a qualified therapist.
D) Progress reports do not have to describe the type of skilled interventions that were provided.
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Page 10
Chapter 9: Infection Control and Safety Issues in the Clinic
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Q1) 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
Q2) Fowler's position is the terminology used when the hospital bed is positioned so that:
A) The lower portion of the bed is elevated 45 to 60 degrees to reduce lower body edema.
B) The upper portion of the bed is elevated 45 to 60 degrees to elevate the client's upper body.
C) The bed is maintained in a level position so that client remains in level supine.
Q3) A nosocomial infection is ___________.
A) Bacterial
B) Viral
C) Transmitted via bodily fluids
D) Acquired in the hospital
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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) 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.
Q3) The occupational therapist is working with a client who has pain and weakness in her hands as a result of moderate to severe arthritis.To increase functional independence,the client may use which of the following?
A) Plate guards or scoop dishes
B) A commercially available sock aid
C) An extended handle reacher
D) Lever-type doorknob extensions
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Page 13
Chapter 12: Activities of Daily Living
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Q1) Which of the following is an example of an instrumental ADL (IADL)?
A) Care of others
B) Functional mobility
C) Toilet hygiene
D) Bowel and bladder management
Q2) The most commonly used methods to teach clients who have perceptual problems,poor memory,and difficulty following directions include all but which of the following?
A) Brief demonstration and oral instruction
B) Concrete step-by-step approach and instruction
C) Backward chaining
D) Activity performance along with the therapist
Q3) 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.
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14
Chapter 13: Mobility
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Sample Questions
Q1) When is a car (e.g.,sedan)an appropriate vehicle option for the disabled client?
A) When the individual uses a powered wheelchair
B) When the individual uses a manual wheelchair
C) When the individual requires a mechanical lift
D) When the individual is independent in transfers and in loading mobility equipment.
Q2) After a clinical assessment of the client,a predriving assessment is completed.Essential predriving skills that are evaluated include which of the following?
A) Cognitive and perceptual skills assessment
B) On-the-road evaluation of the client's skills using adapted equipment
C) The ability to handle keys, manage doors, mobility devices, and adjust seat belt
D) Muscle strength, range of motion, and grip measurements
Q3) During a stand pivot transfer,the occupational therapist should __________.
A) Stand on the client's involved (weak) side
B) Stand on the client's uninvolved (strong) side
C) Stand behind the client
D) Alternate standing on either side during transfers so the client will be comfortable with having support from either side during the transfer
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Chapter 14: Mobility
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Q1) 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
Q2) 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
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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) Which of the following was the first milestone of occupational therapy (OT)involvement in work programs?
A) "Prevocational" programs were accepted as OT intervention
B) Eleanor Clarke Slagle created a work program at Hull House in Chicago
C) Florence Cromwell established norms on prevocational tests for the disabled
D) Occupational Safety and Health Administration (OSHA) unveiled a comprehensive approach to ergonomics to decrease musculoskeletal disorders
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Chapter 16: Work Evaluation and Work Programs
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Q1) As the OT consultant on a corporation's ergonomics team,you notice increased incidence of work-related musculoskeletal disorders in workers in the payroll department.What do you present to your team to increase awareness of the problem and generate possible solutions?
A) The names of all the employees with injuries in the past year
B) A summary of the scope of injuries in that focused area and the effects on production, workers' compensation, and associated costs to the company
C) A suggestion for an aggressive company-wide education program involving all employees
D) A suggestion that all the injured workers complain to management
Q2) LD sustained a spinal cord injury (SCI)at the T-11 level resulting from a car accident.Before his injury he worked as a service manager at a car dealership.He would like to return to this job.What type of vocational evaluation would provide the most information to help him return to his previous job?
A) A specific vocational evaluation
B) A general vocational evaluation
C) Work hardening
D) Valpar 9 Total Body Range of Motion test
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Chapter 17: Americans With Disabilities Act and Related
Laws That Promote Participation in Work, leisure, and
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Q1) JD has a medical history of fibromyalgia,which she has disclosed to her employer.She is independent in all of her activities of daily living (ADLs)and instrumental ADLs (IADLs),including her work tasks; however,she has requested to take rest breaks at specific times during the day (these do not interfere with her ability to complete her work assignments).She is an exemplary employee,but her employer has consistently passed her over for promotions and does not offer her the more challenging assignments.Which definition of a person with a disability under the Americans with Disabilities Act (ADA)best describes JD?
A) Physical or mental impairment that substantially limits one or more major life activities
B) Someone who has a record of having an impairment that limits at least one life activity
C) Someone with a "perceived" disability
D) She would not be considered to have a disability.
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19
Chapter 18: Leisure Occupations
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Q1) Samuel is a 47-year-old African American man who owns his own landscaping business.He recently fell off a ladder and hit his head on concrete,causing brain damage.He is able to move all extremities,use a front wheel walker,and speak coherently,although he has problems finding the right word.After completing the Canadian Occupational Performance Measure,the OT practitioner discovered that his most important goal is returning to work.Which leisure occupation do you think would be most appropriate to include in his intervention plan?
A) Gardening in raised beds, giving him the ability to self-direct the activity
B) Playing cards to strengthen his hands and cognitive abilities
C) Cooking, using energy-conservation techniques
D) Grooming a canine companion to improve sequencing abilities and hand movements
Q2) Which of the following age and culture-based activities would an OT practitioner assign to a 55-year-old Asian American woman who is recovering from a stroke?
A) Needlepoint
B) Adapted bowling
C) Swimming
D) Tile games (such as Mah Jong)
E) None of the above
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Page 20
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) For the purposes of determining application of the ADA,"essential job functions" are best determined _________________.
A) On a case-by-case basis, looking at the facts of each situation
B) By the supervisor of the department
C) By the employees doing the job
D) By the written job description
Q3) What year did Congress pass the Americans with Disabilities Act (ADA)?
A) 1973
B) 1990
C) 2002
D) 1969
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Chapter 20: Leisure Occupations
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Q1) Humor and laughter ______________.
A) Can be used with all clients because of their benefits to health
B) Are not helpful in establishing a therapeutic alliance with adult clients with physical disabilities
C) Are easy for everyone to use as a way to adapt to a physical disability
D) May be used to build relationships, help clients cope, promote health, and Comply with treatment
E) All of the above
Q2) Which of the following is not a benefit of leisure occupations for adults with physical disabilities?
A) Increased sense of self-worth
B) Increased ability to chew and swallow without aspirating
C) Improved or maintained perceptual abilities
D) Experience of intellectual stimulation
Q3) Which group did the Centers for Disease Control identify as engaging in the least amount of physical activity?
A) African Americans
B) Women in all cultures
C) Hispanics
D) Asians
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Chapter 21: Occupation-Based Functional Motion Assessment
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Q1) Which of the following is not an expected outcome of an occupation-based functional motion assessment?
A) The OT practitioner conducting interviews with the client to determine the problems encountered during performance of functional activities
B) The OT practitioner having the client perform other tasks associated with his or her habits while interacting in varied environmental contexts
C) The OT practitioner making the decision to conduct formal assessments of performance skills or body function
D) Meaningful intervention goals relative to improving occupational performance will be selected
Q2) An advantage of the occupation-based functional motion assessment is that the OT practitioner as the opportunity to do which of the following?
A) Measure muscle strength.
B) Observe complex motor patterns required to fully engage in occupations.
C) Gain information about movement of a specific limb.
D) Measure flexibility of joint components.
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Chapter 22: Joint Range of Motion
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Q1) Which of the following is not a purpose of joint ROM measurements?
A) Determine the need for splints or assistive devices
B) Determine joint limitations that interfere with function
C) Determine how many pounds a client may lift
D) Determine efficacy of intervention modalities
E) Determine how far a client can reach overhead
Q2) What is the average normal joint ROM (using the 180-degree method)for thumb metacarpophalangeal (MP)flexion?
A) 0-70 degrees
B) 0-90 degrees
C) 20-90 degrees
D) 20-50 degrees
E) 0-50 degrees
Q3) When ROM of forearm supination is being measured,where is the stationary bar of the goniometer placed?
A) Parallel to the radius
B) Against the volar aspect of the wrist
C) Parallel to the floor
D) Against the dorsal aspect of the wrist
E) Perpendicular to the floor
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Chapter 23: Joint Range of Motion
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Q1) An OT practitioner is reassessing a client's shoulder external rotation active ROM at discharge.During the initial evaluation,ROM measurements (0-15)were taken with the client seated and the humerus adducted because of the presence of shoulder pain.The client's pain has since resolved,and ROM has improved so that the client is now able to abduct the humerus to assume the alternative testing position.To document discharge ROM,what should the OT do?
A) State that the ROM has improved but measurements were not taken because pain has resolved.
B) Observe the motion and estimate the ROM.
C) Measure external rotation with the humerus abducted.
D) Measure external rotation with the humerus adducted.
Q2) 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
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25
Chapter 24: Evaluation of Muscle Strength
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Q1) MMT would never be appropriate for a client with which of the following conditions?
A) Peripheral nerve injury
B) Spastic cerebral palsy
C) Muscular dystrophy
D) Spinal cord injury
E) Multiple sclerosis
Q2) If a muscle contraction can be seen or felt but no motion is observed,the grade is ____________________.
A) 0
B) 1-
C) 1
D) 1+
E) 2-
Q3) Which of the following is not a criterion used to measure strength in MMT?
A) Amount of motion through which the joint moves when the muscle contracts
B) Evidence of muscle contraction
C) Endurance of muscle
D) Amount of resistance against which the muscle can contract
E) A and C
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Chapter 25: Evaluation of Muscle Strength
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Q1) An OT is performing manual muscle testing on a client's shoulders.Initial screening found all muscles were below a grade of 3-.Which tests can be performed with the client seated?
A) Flexion, abduction, internal rotation, external rotation
B) Internal rotation, external rotation, horizontal adduction, horizontal abduction
C) Horizontal adduction, horizontal abduction, extension, abduction
D) External rotation, internal rotation, flexion, horizontal abduction
Q2) An OT practitioner is testing a client's shoulder strength.The client is able to actively abduct to 90 degrees against gravity.What should the therapist do next?
A) Apply resistance.
B) Reposition the client to test in the gravity-eliminated plane.
C) Assist the client into full abduction and then apply resistance.
D) Abduct the shoulder 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 support the client's hand fully when performing a sensory evaluation?
A) So the client remains relaxed
B) To prevent the hand from moving, which could provide sensory information that interferes with the testing
C) To be sure that the client pays attention
D) To be consistent in technique among all clients
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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Page 28
Chapter 27: Evaluation of Sensation and Intervention for Sensory Dysfunction
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Q1) Sensory reeducation includes all but which of the following?
A) Contralateral upper extremity constraint
B) Stimulating localization
C) Tasks of recognition
D) Tasks of graded stimulus
Q2) Which statement is not true?
A) Axons with larger diameters transmit information more quickly.
B) Afferents are peripheral axons.
C) Afferents are categorized by the diameter of the axon.
D) Afferents with larger diameters transmit information more slowly.
Q3) Semmes-Weinstein Monofilaments are used to test __________.
A) Sharp-dull
B) Proprioception
C) Pressure threshold
D) Sweating responses
Q4) 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
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Chapter 28: Eating and Swallowing
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Q1) What is the cause of aspiration that occurs after the swallow has taken place?
A) Poor tongue control of the bolus
B) Delayed initiation of the swallow, and the bolus enters the airway
C) Reduced laryngeal closure, allowing the bolus to enter the airway
D) Pooled material in the pyriform sinuses overflows into the trachea
Q2) Mattias is concerned about his frequent drooling and difficulties controlling the food bolus within his mouth.His daughter's wedding is in 4 weeks,and he does not want to embarrass himself or his family by drooling or choking on food or liquids.Which strategies would be most appropriate?
A) His wife uses a side handgrip on Mattias to improve his head control, and he should only eat crumbly foods.
B) Mattias should frequently pat his mouth during the meal and alternate between cold and hot foods.
C) Mattias should lean back in his chair while eating to avoid drooling.
D) Mattias should only eat pureed foods and thin liquids while at the wedding.
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Chapter 29: Evaluation and Treatment of Visual Deficits
Following Brain Injury
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Q1) Colonel Pickle sustained a right posterior cerebral artery lesion.After the stroke the Colonel experienced difficulty reading and would often lose his place in the text or find that the sentence he was reading did not make sense.He also experienced a change in depth perception wherein an object,usually the arm of a chair or a table edge on the left,would suddenly appear in front of him.The Colonel scheduled an evaluation with his ophthalmologist.Which of the following diagnoses did the ophthalmologist most likely make?
A) Glaucoma
B) Presbyopia
C) Left homonymous hemianopsia
D) Hemi inattention
Q2) 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
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Chapter 30: Evaluation and Pain Management
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Q1) In working with Catalina,the occupational therapist should ensure that she takes her pain medications at least 30 minutes before the therapy session to promote maximal participation.Interventions include which of the following?
A) Instruction to bend from the waist when picking up heavy objects
B) Teaching her tasks and positions that move her body out of balance to challenge the low back muscles
C) Energy conservation and pacing during activities of daily living and instrumental activities of daily living
D) Use of a front-wheeled walker
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
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Chapter 31: Evaluation and Pain Management
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Q1) An occupational therapist is treating a 56-year-old woman who has been diagnosed with fibromyalgia.She has expressed depression and anxiety over her diminished ability to lead a fulfilled life.She reports that her pain typically rates approximately 7 on the numerical pain intensity scale.What interventions should the OT practitioner employ?
A) Provide her with relaxation training to decrease muscle tension
B) Help her to resume leisure activities that she once enjoyed that would cause low stress on her body, such as swimming
C) Refer her for psychological counseling
D) Refer her to a spiritual advisor
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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33
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) An occupational therapy (OT)practitioner is working with a 30-year-old police officer who reports a painful wrist after trying to restrain a prisoner.The police officer has persistent pain and weakness with resistive tasks 2 months after the incident.The pain is on the ulnar side of the hand.The OT practitioner may opt to send the patient back to the physician for further evaluation for which of the following possible reasons?
A) The client is exaggerating the pain.
B) The client has a median nerve compression.
C) There is injury to the triangular fibrocartilage complex (TFCC).
D) None of the above.
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Chapter 33: Orthotics
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Q1) The preferred minimal shoulder flexion and abduction range of motion to use an MAS is _________________.
A) 20 degrees
B) 45 degrees
C) 90 degrees
D) 120 degrees
E) 150 degrees
Q2) The distal transverse arch of the hand lies obliquely to the ___________.
A) Proximal interphalangeal joints of digits 2 through 5
B) Metacarpal joint of the thumb
C) Distal interphalangeal joints of digits 2 through 5
D) Wrist carpal bones
E) Metacarpal heads of digits 2 through 5
Q3) The amount of force applied in dynamic splinting can be measured with a gauge and should generally be between _________.
A) 700 and 800 grams
B) 600 and 700 grams
C) 300 and 600 grams
D) 100 and 300 grams
E) 50 and 100 grams
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Chapter 34: Traditional Sensorimotor Approaches to Intervention
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Q1) You are working with a client who has had a recent RCVA with left hemiparesis.The client has difficulty maintaining trunk control while standing and has difficulty holding objects.Using Rood's approach to motor control,you decide to work with the client in a standing table while the client completes a jigsaw puzzle.This activity would involve which of Rood's components of motor control?
A) Reciprocal inhibition
B) Co-contraction
C) Heavy work
D) Skill
Q2) Which of the following statements best describes the procedure of maximal resistance?
A) If resistance breaks the client's hold, apply additional resistance.
B) Strength is increased by movement against resistance that requires maximal effort by the client.
C) For clients with neurological impairment, very light resistance is usually ineffective and may not meet the client's needs.
D) If a client has spasticity, resistance cannot increase existing muscle imbalance.
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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) 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
Q3) What are common psychosocial issues seen with clients who are diagnosed with Huntington's disease?
A) Depression
B) Suicidal thoughts
C) Emotional lability
D) All of the above
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Page 37
Chapter 36: Cerebrovascular Accident Stroke
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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
Q2) All the members of the 10-year-old client's family are expected to make their own beds after age 5.This would be considered under which section of activity demands?
A) Objects and their properties
B) Space demands
C) Sequence and timing
D) Social demands
E) Required actions
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Chapter 37: Spinal Cord Injury
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Q1) The occupational therapist can help achieve the desired flexor tightness necessary for tenodesis grasp by doing which of the following?
A) Ranging finger flexion with the wrist extended and finger extension with the wrist flexed
B) Ranging finger flexion with wrist flexed and finger extension with wrist extended
C) Ranging finger flexion with wrist at neutral and extension with wrist extended
Q2) For the person with C6 quadriplegia,it is desirable to develop some tightness in the long finger flexors because _____________________.
A) The tightness of the finger flexors, combined with active wrist flexion, can produce some functional grasp through tenodesis action
B) The tightness of the finger flexors, combined with active wrist extension, can produce some functional grasp through tenodesis action
C) The tightness of the finger flexors combined with weak but active wrist flexion can produce a functional hook grasp
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Chapter 38: Spinal Cord Injury
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Q1) 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
Q2) You are testing Rick's upper extremity function.Which of the following series of tests would you select to yield the most comprehensive information?
A) Manual muscle test, synergy patterns, functional muscle examination
B) Manual muscle test, active range of motion (ROM) test, functional motion test, visual perceptual tests
C) Manual muscle test, passive ROM test, functional motion test, sensory test
Q3) You are testing Rick's sensation/perception. Which of the following tests should be least relevant to his disability?
A) Touch and superficial pain
B) Position sense and stereognosis
C) Body scheme and visual spatial perception
D) Thermal and pressure sensitivity
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Chapter 39: Disorders of the Motor Unit
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Q1) An occupational therapist has received an order to evaluate Jan,a 45-year-old photographer who has been diagnosed with myasthenia gravis.In what aspect of evaluation should the therapist have advanced training to perform?
A) Dysphagia
B) Manual muscle testing
C) Home evaluation
D) Running groups
E) All of the above
Q2) In a recent study reported in this chapter,Wenneberg,Gunnarsson,and Ahlstrom (2004)found that subjects with muscular dystrophy _________________.
A) Showed improved functional movements during activities of daily living and instrumental activities of daily living after muscle overexertion exercises
B) Needed shoulder slings to drive a powered wheelchair
C) Had a decreased rate of decline with qigong used as an adjunct therapy program
D) Experience maximal weakness during the first year after diagnosis
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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) Juanita suffered a blunt force trauma to her axillary nerve that resulted in paralysis of the left deltoid muscle.The injury caused limitations in left shoulder movements and atrophy of the deltoid muscle.She is dealing with issues regarding her body image,and because of the asymmetry of her shoulders,she refuses to go out with her husband.She has come back into OT for a follow-up session.What intervention could the OT practitioner provide to address this body image problem?
A) Passive shoulder ROM to the left shoulder performed by the husband daily
B) Fabrication of a foam or thermoplastic pad to be worn under her clothing
C) Provide her with an arm sling to be worn at least 10 hours a day
D) Order a custom-fit Jobst garment to reduce edema
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Page 42
Chapter 41: Arthritis
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Q1) Only one of the following is true.Which one is it?
A) A positive rheumatoid factor laboratory test is needed to establish a diagnosis of rheumatoid arthritis.
B) The clinical evaluation is seldom utilized in establishing a diagnosis of rheumatoid arthritis.
C) Radiological findings can be utilized in establishing a diagnosis of rheumatoid arthritis.
D) At least three of the seven criteria are required to make a diagnosis of rheumatoid arthritis.
Q2) Avoiding MP ulnar deviation is an important joint protection principle in cases of rheumatoid arthritis.To open a jar,the patient should be instructed to do which of the following?
A) To open the jar using the palm of his or her hand
B) To use two hands and wall mount jar opener
C) To use shoulder rotation
D) A and B
E) All of the above
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43
Chapter 42: Arthritis
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Q1) A patient with osteoarthritis demonstrates a type III thumb deformity and reports pain with pinching activities.The therapist notices that there appears to be subluxation of the metacarpal during pinching,as noted by a bony enlargement at the base of the thumb.The splint should gently position the thumb opposite of the passively corrected deformity.With a type III deformity,the splint should gently place the thumb in which of the following?
A) CMC abduction, metacarpophalangeal (MP) joint slight flexion, and provide CMC stability to prevent subluxation
B) CMC joint adduction, MP extension, and provide CMC stability to prevent metacarpal subluxation
C) CMC abduction, interphalangeal (IP) flexion, and provide CMC stability to prevent metacarpal subluxation.
D) CMC flexion, IP extension, and provide CMC stability to prevent metacarpal subluxation
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44
Chapter 43: Hand and Upper Extremity Injuries
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Q1) A client arrives for evaluation with loss of sensation of the volar surface of the thumb,index,and middle fingers.What nerve is involved?
A) Radial nerve
B) Ulnar nerve
C) Posterior interosseous nerve
D) Median nerve
Q2) 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
Q3) 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
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Chapter 44: Low Back Pain
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Q1) Which of the following best defines spinal stenosis?
A) The narrowing of the intervertebral foramen that decreases the space where the spinal nerve exits or enters the spine
B) A type of muscular weakness
C) A condition that never causes low back pain
D) A condition that is caused by the sciatic nerve
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) Which nerve innervates the extensor-supinator group of muscles of the forearm?
A) Median nerve
B) Radial nerve
C) Ulnar nerve
D) Anterior interosseous nerve
Q2) Asking the client to oppose the thumb to the fingers and flex the fingers is a quick test for which nerve?
A) Radial
B) Ulnar
C) Posterior interosseous
D) Median
Q3) 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
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Chapter 46: Burns and Burn Rehabilitation
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Q1) The antideformity position for the wrist and hand is ________________.
A) Wrist flexion, thumb abduction and extension, metacarpophalangeal (MP) flexion, interphalangeal (IP) extension
B) Wrist flexion, thumb abduction and flexion, MP extension, IP extension
C) Wrist neutral, thumb adduction and extension, MP extension, IP flexion
D) Wrist extension, thumb adduction and extension, MP flexion, IP flexion
E) Wrist extension, thumb abduction and extension, MP flexion, IP extension
Q2) The rehabilitation phase of burn recovery continues until ____________.
A) The client is medically stable
B) Wounds are closed
C) The patient goes home from the hospital
D) Scars are mature
E) The last surgery is performed
Q3) Custom pressure garments ______________.
A) Should be measured for once scars have matured
B) Should not be worn more than 12 hours a day
C) Should be initiated as quickly as possible in the rehabilitation phase
D) Should not be combined with pressure inserts
E) Should be replaced every 2 to 3 weeks
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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 occupational therapy (OT)practitioner is treating a client who had a split thickness skin graft (STSG)5 days ago after a release of an anterior elbow flexion contracture.At this time the therapist should begin which of the following?
A) Gentle passive range of motion (ROM) exercises
B) Gentle active ROM exercises
C) Gentle strengthening exercises
D) Gentle compression devices
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Chapter 48: Amputations and Prosthetics
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Q1) Which component is not common to all upper extremity body-powered prostheses for wrist disarticulation and higher levels?
A) Terminal device
B) Wrist unit
C) Elbow unit
D) Socket
E) Harness
Q2) An upper extremity prosthesis with a myoelectric hand and body-powered elbow is a type of __________________.
A) Muscle-cable prosthesis
B) Dual-driven prosthesis
C) Composite prosthesis
D) Hybrid prosthesis
E) Electrical-body prosthesis
Q3) Which is not a function of a prosthetic sock?
A) Absorb perspiration
B) Protect against skin irritation
C) Compensate for residual limb volume changes
D) Provide comfort
E) Allow direct contact between socket and skin
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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) Peripheral neuropathy,which can include weakness and pain,is associated with this type of cancer therapy:
A) Surgery
B) Radiation therapy
C) Chemotherapy
D) Palliative therapy
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Chapter 51: HIV Infection and Aids
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Q1) For occupational therapists working with clients who have AIDS,the use of adaptive equipment ______________________.
A) Should always be used to reduce the effort expended during daily living tasks
B) Should never be used because it represents a disabling condition
C) Should be discussed with the family members before introducing the equipment to the client
D) May be rejected by the client as a symbol of diminished abilities
Q2) According to the Centers for Disease Control,which is the most common age group diagnosed with acquired immunodeficiency syndrome (AIDS)?
A) Under 15 years of age
B) Between 15 and 24 years old
C) Between 25 and 44 years old
D) Between 45 and 64 years old
Q3) What marks the difference between the diagnosis of HIV positive and the diagnosis of AIDS?
A) Presence of peripheral neuropathy
B) Presence of lymphadenopathy
C) Seroconversion with presence of the HIV
D) A CD4+ count below 200 and an AIDS-defining illness
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