Occupational Therapy Methods and Techniques
Solved Exam Questions
Course Introduction
This course offers a comprehensive exploration of occupational therapy methods and techniques used to support individuals in achieving independence and improving their quality of life. Students will learn about evidence-based evaluation tools, intervention strategies, and therapeutic approaches applied across various practice settings, including physical rehabilitation, mental health, pediatrics, and geriatrics. Through a combination of theoretical knowledge and hands-on practice, the course covers activity analysis, adaptive equipment training, environmental modification, sensory integration, and client-centered care. Emphasis is placed on ethical decision-making, interdisciplinary collaboration, and culturally competent interventions tailored to diverse populations.
Recommended Textbook
Pedrettis Occupational Therapy Practice Skills for Physical Dysfunct
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Chapter 1: The Occupational Therapy Practice Framework
People With
Physical Disabilities
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Q1) Which of the following client factors would be considered a body structure issue?
A) The client's right thumb was cut off in an industrial accident.
B) The client has limited sensation in his left hand.
C) The client is incontinent.
D) The client has no hearing in his left ear.
E) The client's exercise tolerance is very poor.
Answer: A
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
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) The OT practitioner observed a client playing a game of cards.During the game the client looped one elbow around the upright of her wheelchair,leaned toward the table,and grasped a card before going across the room to answer a phone call.The actions observed are primarily an example of which of the following?
A) Process skills
B) Performance patterns
C) Communication/interaction skills
D) Motor skills
Answer: D
Q2) An OT practitioner is working with a client with carpal tunnel syndrome.Which of the following is not a preparatory method that the OT can use with the client?
A) Cock-up splinting to hold the wrist in neutral to 10 degrees of extension
B) Tendon-gliding exercises for the long finger flexors
C) Ergonomic modification of the client's workspace
D) Ultrasound phonophoresis and iontophoresis to reduce inflammation
Answer: C
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Chapter 3: History and Practice Trends in Physical
Dysfunction Intervention
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Q1) Under AOTA's Occupational Therapy Practice Framework,the advocacy of the reduction of functional impairments caused by physical and psychological limitations reflects which treatment model or approach?
A) Arts and Crafts movement
B) Moral treatment
C) Social model
D) Medical model
E) Rehabilitation model
Answer: D
Q2) 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
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Chapter 4: Application of the Occupational Therapy
Practice Framework to Physical Dysfunction
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Q1) Which statement best relationship between the occupational therapist and the occupational therapist assistant in the delivery of occupational therapy services?
A) The occupational therapist completes all the assessment instruments and develops the intervention plan independently before assigning the occupational therapist assistant specific tasks to complete with the client.
B) The occupational therapist assistant sets up the clinic equipment and cleans the clinic but is not allowed to provide direct client services.
C) The occupational therapist assigns the occupational therapist assistant specific assessments to complete with the client, and the occupational therapist assistant collaborates with the occupational therapist to develop the intervention plan.
D) The occupational therapist assistant completes assigned assessment instruments and develops the intervention plan independently.
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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) 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) 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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Q1) Which of the following statements accurately reflects international trends in health promotion concerning occupational justice?
A) The idea of occupational justice first emerged in Canada and Australia.
B) The World Federation of Occupational Therapists has been active in promoting occupational therapy (OT) involvement in occupational justice.
C) The discussion of occupational justice is slowly emerging in the United States.
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.
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Chapter 7: Documentation of Occupational Therapy Services
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Q1) 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
Q2) Individually identifiable health information _____________.
A) Refers to only recent medical information about the client
B) Is also known as protected health information (PHI)
C) Can be disposed of with the regular trash
D) Can be shared casually among the client's family members
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) 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
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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Chapter 9: Infection Control and Safety Issues in the Clinic
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Q1) The occupational therapist should observe several precautions when providing intervention to a client who is catheterized.Which of the following precautions are appropriate?
A) Avoid crimping or stretching the catheter drainage tube, and place the urine catheter bag below the level of the bladder.
B) Avoid crimping and stretching the catheter drainage tube, and place the urine collection bag in the client's lap.
C) Avoid crimping and stretching the catheter drainage tube, and place the urine catheter bag above the level of the bladder.
D) Avoid crimping and stretching the catheter drainage tube, and place the urine catheter bag in a location convenient for the client.
Q2) 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) 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
Q2) An occupational therapy (OT)practitioner is working with a client who has been admitted to the hospital because of complications resulting from chronic obstructive pulmonary disease and insulin-dependent diabetes mellitus.While working on grooming and hygiene while standing at the sink,the client suddenly begins to get agitated,her skin becomes pale and appears moist,her breathing becomes shallow,and she begins to lose consciousness.Given the client's medical history,she is most likely experiencing which of the following?
A) Respiratory distress
B) Ketoacidosis
C) Insulin reaction
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Chapter 11: Activities of Daily Living
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Q1) 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
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 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
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Chapter 12: Activities of Daily Living
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Q1) 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
Q2) The occupational therapist is working with a client who has weakness and pain in the hands caused by 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
Q3) 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
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Chapter 13: Mobility
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Sample Questions
Q1) 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
Q2) Which of the following devices are considered primary controls on a vehicle?
A) Turn signal
B) Windshield wiper controls
C) Braking and steering controls
D) Mirrors and environmental controls
Q3) 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
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Chapter 14: Mobility
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Q1) You are an occupational therapist,and your client is a 69-year-old man with left hemiplegia from a cerebrovascular accident.Your client has normal movement on his right side.He has a little movement in his left leg but none in his left arm.He has fair sitting balance but needs significant assistance to maintain a standing position.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) Two-person dependent transfer
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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Page 16
Chapter 15: Work Evaluation and Work Programs
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Q1) 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
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 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
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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) A factory worker on an assembly line has been referred to occupational therapy (OT)for treatment of his right biceps tendonitis,which is prohibiting him from performing at a productive level because of his high pain levels.What risk factor must be closely assessed in a job analysis?
A) Cold temperatures
B) Vibration
C) Repetitions of tasks within a time period
D) Contact stress
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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 is working with a 67-year-old Latina client with rheumatoid arthritis.The client has minimal English-speaking abilities.Which assessment(s)do you think would be appropriate?
A) Occupational Profile
B) Canadian Occupational Performance Measure
C) Modified Interest Checklist
D) Role Checklist
E) All of the above
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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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) As an Area of Occupation,leisure is defined in the Occupational Therapy Practice Framework (2002)as ________________.
A) A nonobligatory activity that is internally motivated and engaged in during an individual's free time
B) An obligatory daily activity that provides the individual with social contacts
C) An activity determined by the occupational therapist to be beneficial to the client
D) Fun activities recommended by the client's family or caregiver
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Chapter 21: Occupation-Based Functional Motion Assessment
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Q1) While observing the client at work in her kitchen retrieving items to make a sandwich,cutting bread,reaching for dishes,loading the dishwasher,and opening and closing drawers,the therapist noticed that the client often grimaced when applying pressure to knives,lifting dishes,and opening the refrigerator.The therapist also observed that the client sometimes appeared confused,left out ingredients,and put dirty dishes in the cabinet instead of the clean ones she had set aside.When the client noticed some of her mistakes,she said,"Oh well,I live alone; who cares if the dish is a little dirty?" The occupation-based functional motion assessment allowed the practitioner to assess which of the following?
A) ROM, muscle strength, pain, endurance
B) Cognitive deficits, pain, perceptual deficits, endurance
C) Muscle strength, task importance, endurance
D) Task importance, cognitive deficits, pain, perceptual deficits
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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Chapter 22: Joint Range of Motion
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Q1) When ROM of wrist extension is being measured,where is the movable bar of the goniometer placed?
A) Parallel to the metacarpal of the index finger
B) Parallel to the radius
C) Parallel to the metacarpal of the small finger
D) Parallel to the anatomical snuffbox
E) Parallel to the ulna
Q2) 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
Q3) Which is true about normal joint ROM?
A) It may not be affected by age.
B) It may not be affected by gender.
C) It may not be affected by occupation.
D) It may not be the same from individual to individual.
E) It may not be determined.
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Chapter 23: Joint Range of Motion
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Q1) An occupational therapy (OT)practitioner is evaluating a 14-year-old client who sustained metacarpal fractures of her left ring and small fingers during a gymnastics competition.The fractures were treated with cast immobilization that ended last week.The OT practitioner should establish what normal range of motion (ROM)is for this client by doing which of the following?
A) Looking up published normative data
B) Measuring the client's right hand
C) Comparing the client with other clients who had similar injuries
D) Asking the physician what the expected ROM is
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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Chapter 24: Evaluation of Muscle Strength
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Q1) During the MMT,when should resistance be applied?
A) Before motion begins
B) Midway through motion
C) Throughout entire motion
D) At end of motion
E) With maximum force
Q2) A part that moves through incomplete motion with gravity minimized would be graded ____________________.
A) Poor plus
B) Poor
C) Poor minus
D) Fair plus
E) Fair minus
Q3) 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
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Page 26
Chapter 25: Evaluation of Muscle Strength
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Q1) 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.
Q2) 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
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Chapter 26: Evaluation of Sensation and Intervention for Sensory Dysfunction
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Q1) 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
Q2) 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.
Q3) Why is fingertip sensation enhanced compared with proximal parts of our bodies?
A) Because our fingers are more exposed to the environment
B) Because we need more sensation in our fingertips to prevent injury
C) Because fingertips have a higher density of receptors and smaller receptive fields
D) Because fingertips are glabrous
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Page 28
Chapter 27: Evaluation of Sensation and Intervention for Sensory Dysfunction
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Q1) Localization of moving touch tends to return before localization of ___________.
A) Light pressure
B) Constant touch
C) Pinprick
D) Deep pressure
Q2) Difficulty of graded discrimination is increased by ____________.
A) Occluding vision
B) Standing up during treatment
C) Making the objects larger
D) Lowering the ambient lighting
Q3) When tapping elicits paresthesia,______________.
A) It is called allodynia
B) It is referred to as a Tinel's sign
C) It feels like a cooling sensation
D) It should be ignored
Q4) Semmes-Weinstein Monofilaments are used to test __________.
A) Sharp-dull
B) Proprioception
C) Pressure threshold
D) Sweating responses
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Chapter 28: Eating and Swallowing
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Q1) Videofluoroscopy is an example of what type of swallowing assessment?
A) Oral motor assessment
B) Bedside sensory assessment
C) Instrumental assessment
D) Clinical assessment
Q2) During which phase of the swallow is there closure of the glottic and supraglottic structures to cover the airway and provide protection from aspiration?
A) Pre-oral
B) Oral
C) Pharyngeal
D) Esophageal
Q3) An individual who has moderate to severe oral stage dysphagia and who has a reduced ability to protect the airway would benefit from beginning oral feedings with which food consistency?
A) Puréed (Level 1)
B) Mechanically soft (Level 2)
C) Dysphagia advanced (Level 3)
D) Only thin liquids
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Chapter 29: Evaluation and Treatment of Visual Deficits
Following Brain Injury
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Q1) 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
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) Which of the following capabilities does a client with a left hemianopsia possess that a client with neglect does not?
A) The ability to utilize attention to compensate for the visual field deficit
B) The ability to perceptually complete the left visual field
C) The ability to make eye movements toward the left half of the field
D) The ability to scan toward the left
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Chapter 30: Evaluation and Pain Management
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Q1) Catalina's story was used as the case study in the evaluation and pain management chapter.Approximately 5 months before being evaluated by the occupational therapist,she sustained a lumbar strain after catching a heavy weight while working.She reports nearly constant severe pain.She has not returned to work and describes her lifestyle as sedentary.When the occupational therapy evaluation occurred,her pain could be described as _____________.
A) Acute, because it served a biological purpose that signaled the need for immobilization and bed rest.
B) An arthritic spine condition caused by degenerative joint disease characterized by progressive joint swelling and aching.
C) A central pain syndrome caused by damage to the central nervous system
D) Chronic pain because it was not amenable to routine methods of pain control and was negatively affecting her occupational performance
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Chapter 31: Evaluation and Pain Management
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Q1) During an intervention session for Catalina's low back pain,the occupational therapist does which of the following?
A) Increases the activity levels quickly to promote muscle strengthening
B) Tells Catalina to initiate rest at the time of the pain onset during activities
C) Gradually increases activity levels, with Catalina working to "tolerance" as opposed to "pain," before a scheduled rest break
D) Applies modalities (e.g., heat or cold) after activity
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 is working with a client experiencing upper extremity weakness from a spinal cord injury.The client wants to be able to use her arm to drive a power wheelchair.The therapist has set up a MAS,but the client is having difficulty horizontally abducting her shoulder enough to reach the joystick control.Which adjustment can the therapist make to facilitate this motion?
A) Roll the semireclining mount outwardly.
B) Pitch the semireclining mount toward the rear of the wheelchair.
C) Lower the semireclining mount on the wheelchair upright.
D) Move the rocker arm more proximally on the forearm support.
Q2) An OT practitioner is working with a client who must wear a thumb spica splint for 3 more weeks after cast removal for a scaphoid fracture.The physician has allowed the patient to use the hand with the splint in place for light activities.When making the splint,the therapist must be sure to position the thumb in what position to allow light activities?
A) Thumb extension
B) Thumb flexion
C) Palmar prehension
D) Hook grasp
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Page 34
Chapter 33: Orthotics
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Q1) What is the term for a static splint that is fabricated and repeatedly adjusted to allow for slow progressive gains in joint end range of motion?
A) Dynamic traction
B) Static traction
C) Serial static traction
D) Static progressive traction
E) Progressive serial traction
Q2) 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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Page 35
Chapter 34: Traditional Sensorimotor Approaches to Intervention
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Q1) Which of the following statements accurately describes techniques directed to the agonist?
A) Rhythmic initiation is ineffective for improving the ability to initiate movement.
B) Rhythmic initiation involves voluntary relaxation, passive movement, and repeated isotonic contractions of the agonistic pattern.
C) Repeated contractions techniques assume that the number of repetitions of an activity is not necessary for motor learning.
D) Resistance should never be used during rhythmic initiation to reinforce a movement pattern.
Q2) Which of the following techniques,using the Rood approach,is not an inhibitory technique?
A) Neutral warmth
B) Slow stroking
C) Light joint compression
D) Fast rocking/vestibular stimulation
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Chapter 35: Degenerative Diseases of the Central Nervous System
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Q1) You are reviewing the medical record of your next patient,who has Parkinson's disease.The neurologist has indicated that this man has bradykinesia.What does this mean?
A) He has no movement available.
B) His movements are slow.
C) He has oscillations in his movements.
D) His movements are very erratic and quick.
Q2) The progression of Parkinson's disease has been described in stages.Which description best fits Stage IV of the disease progression?
A) Client is able to complete all activities of daily living (ADLs) but has difficulties with balance reactions.
B) The client experiences marked impairment and is bedridden.
C) The client has mild asymmetrical involvement but no problem with ADLs.
D) Although still ambulatory, the client needs assistance with ADLs.
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
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Chapter 36: Cerebrovascular Accident Stroke
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Q1) Which is the most common form of stroke?
A) Ischemic
B) Embolic
C) Thrombotic
D) Hemorrhagic
Q2) Which of the following client factors would be considered a body structure issue?
A) The client's right thumb was cut off in an industrial accident.
B) The client has limited sensation in his left hand.
C) The client is incontinent.
D) The client has no hearing in his left ear.
E) The client's exercise tolerance is very poor.
Q3) The Framework refers to activities that are oriented toward taking care of one's own body as which of the following?
A) Activities of daily living (ADLs)
B) Instrumental ADLs (IADLs)
C) Performance skills
D) Areas of occupation
E) Context
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Chapter 37: Spinal Cord Injury
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Q1) 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
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) 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
Q2) While you are treating Rick,he begins to grow pale and faint.According to the text,he is showing signs of _____ and you should _____.
A) Autonomic dysreflexia; elevate his legs
B) Postural hypotension; tip the wheelchair back
C) Autonomic dysreflexia; rush him to the ward and notify the physician
D) Postural hypotension; put his head down between his knees
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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40
Chapter 39: Disorders of the Motor Unit
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Sample Questions
Q1) Which of the following is a disorder of the neuromuscular junction?
A) Postpolio syndrome
B) Muscular dystrophy
C) Guillain-Barré syndrome
D) Myasthenia gravis
Q2) 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
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Chapter 40: Disorders of the Motor Unit
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Q1) 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
Q2) An occupational therapist is treating an 18-year-old man who has Duchenne muscular dystrophy.He has expressed fear and anxiety over his declining bodily functions.How might the therapist respond?
A) Help him and his family find meaningful activities in which to participate as individuals or as a family.
B) Encourage the use of humor and to play and laugh together.
C) Refer him for psychological counseling.
D) Refer him to a spiritual advisor.
E) All of the above.
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Page 42
Chapter 41: Arthritis
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Sample Questions
Q1) 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
Q2) More than ______% of patients with rheumatoid arthritis will develop characteristic joint deformities.
A) 100%
B) 50%
C) 33%
D) 25%
E) 10%
Q3) 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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Chapter 42: Arthritis
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Q1) A clinician is evaluating a client with rheumatoid arthritis.In addition to the client-centered interview,occupational profile,and occupational performance evaluation,the therapist wishes to document the clinical status.The clinician notices severe hand deformities and joint enlargements that may make goniometric measurements difficult.How should the therapist go about documenting digit flexion?
A) The therapist will be unable to measure the joint flexion because of the deformities.
B) The therapist should measure the distance from the fingertips to the distal palmar crease with a ruler.
C) The therapist should measure over the joint enlargements at each joint.
D) The therapist should account and subtract for the enlarged joint in determining the joint flexion.
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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) A client arrives for evaluation with the inability to extend her wrist,thumb,or MP joints of her right dominant hand.What nerve is involved?
A) Ulnar nerve
B) Radial nerve
C) Median nerve
D) Musculocutaneous nerve
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) Pilar's story was used as the case study in the low back pain chapter.She is a homemaker with a husband and four children.Her occupational performance has been impaired as a result of low back pain during home management activities.During the occupational therapy evaluation,it was noted that Pilar was bending at the waist repeatedly during homemaking activities (e.g.,reaching and pulling opening the vegetable drawer of the refrigerator,removing clothes from dryer,cleaning the bathtub).The occupational therapist ________________.
A) Reassures Pilar that bending at the waist is the normal movement for most people performing these activities and that she just needs to pace her activity level throughout the day
B) Teaches Pilar that bending at the waist increases pressure at the back of the disk and increases stretch at the anterior portion of the vertebral body and disk, thus straining the lower back
C) Instructs Pilar to squat, keeping a straight back while positioned close to the vegetable drawer of the refrigerator while she opens it and removes vegetables
D) Orders a wheelchair for Pilar to use during homemaking activities to rest her back
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Chapter 45: Hand and Upper Extremity Injuries
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Q1) 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
Q2) Which of the options below is an accessory motion?
A) Joint distraction
B) Extension
C) Flexion
D) Abduction
Q3) Which of the following is the most common injury to the wrist?
A) Colles' fracture
B) Scaphoid fracture
C) Lunate fracture
D) Pisiform fracture
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Chapter 46: Burns and Burn Rehabilitation
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Q1) A meshed split thickness skin graft is a type of _______________.
A) Allograft
B) Autograft
C) Xenograft
D) Heterograft
E) Homograft
Q2) A burn involving fascia,muscle,or tendon would be classified as ___________.
A) Superficial
B) Superficial partial thickness
C) Deep partial thickness
D) Full thickness
E) Subdermal
Q3) Which is true about a superficial partial thickness burn?
A) It corresponds to a traditionally classified second-degree burn.
B) It involves the superficial epidermis only.
C) Surgical intervention is required for healing.
D) It is not painful.
E) It is commonly caused by extended exposure to chemical agents.
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Chapter 47: Burns and Burn Rehabilitation
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Q1) An OT practitioner is treating a client who has been hospitalized with acute burns to the face,neck,chest,and bilateral upper extremities.The therapist wants to initiate immediate antideformity positioning.Which position would not be appropriate?
A) Using a pillow behind the client's head
B) Using armboards to place shoulders in 90 degrees of abduction
C) Using a towel roll beneath the thoracic spine
D) Using splints to place elbows in extension
Q2) 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.
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Chapter 48: Amputations and Prosthetics
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Q1) 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
Q2) 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
Q3) A client feeling a limb that is no longer there is experiencing ___________.
A) Neuroma
B) Phantom pain
C) Hyperesthesia
D) Phantom limb
E) Sympathetic sensation
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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 4 days ago.With regard to wheelchair and positioning,what should be the therapist's priority?
A) To provide a residual limb support
B) To place the large wheelchair wheels farther back to distribute weight
C) To remove both leg rests
D) To issue an extra-heavy wheelchair for stability
Q2) An OT practitioner is evaluating a client who has just received an upper extremity prosthesis.The therapist should instruct the client to begin wearing the prosthesis:
A) Once a day for 30 to 45 minutes, increasing by 60 minutes each day
B) Three times a day for 15 to 30 minutes, increasing by 30 minutes each day
C) Twice a day for 60 to 90 minutes, increasing by 15 minutes each day
D) Four times a day for 10 to 30 minutes, increasing by 45 minutes each day
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Chapter 50: Oncology
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Q1) 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
Q2) A malignant tumor of the lung is classified as a ______________.
A) Lymphoma
B) Sarcoma
C) Carcinoma
D) Leukemia
Q3) Which of the following is a word for the process of cancer cells being carried to new sites in the body via the blood stream to develop new tumors?
A) Sarcomas
B) Malignancies
C) Lymphomas
D) Metastases
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Page 52
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) OT services provided to persons infected with HIV for the purpose of promoting healthy lifestyles,preventing future opportunistic infections,and promoting balance or well-being are examples of which of the following?
A) Primary prevention
B) Secondary prevention
C) Tertiary prevention
D) Postoperative intervention
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