Ot 3rd Quarter FIM Competency
Mrs. M is a 70 y. O, married white female who lives with her husband. She has PVD, Hypertension, DM and is obese. She had bilateral knee replacement on 8/14/13 due to degenerative joint disease and is transferred to SCC on 8/20/13 for acute rehab.
Questions and Answers
- 1.
Eating - Mrs. M requires dentures to chew a regular diet without problems; she can feed herself independently. What is the FIM score?
- A.
6 or Mod I
- B.
5 or Supervision
- C.
2 or Max Assist
- D.
7 or Independent
- E.
4 or Min Assist
Correct Answer
A. 6 or Mod IExplanation
Mrs. M requires dentures to chew a regular diet without problems, indicating that she has some level of difficulty with eating. However, she is able to feed herself independently, suggesting that she does not require any assistance or supervision while eating. According to the FIM scoring system, a score of 6 or "Mod I" (Modified Independence) is given when a person requires the use of assistive devices or special techniques but can perform the task independently. Therefore, the FIM score for Mrs. M in this case would be 6 or Mod I.Rate this question:
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- 2.
Grooming - Mrs. M keeps her grooming supplies in a basket at the sink. She needs to sit at the sink for safety concerns. Once she is seated at the sink, she is able to wash, rinse and dry her face and hands, clean her dentures and comb her hair without assistance. Mrs. M does not wear make-up. What is the FIM score?
- A.
6 or Mod I
- B.
4 or Min Assist
- C.
7 or Independent
- D.
5 or Supervision
- E.
1 or Total Assist
Correct Answer
C. 7 or IndependentExplanation
The FIM score is 7 or Independent because Mrs. M is able to perform all the grooming tasks without any assistance. She can wash, rinse, and dry her face and hands, clean her dentures, and comb her hair independently.Rate this question:
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- 3.
Bathing - Mrs. M is able to wash, rinse and dry her chest, abdomen and both arms. A helper has to wash rinse and dry both upper and lower legs/feet, perineal area and buttocks. What is the FIM score?
- A.
1 or Total Assist
- B.
5 or Supervision
- C.
3 or Mod Assist
- D.
2 or Max Assist
- E.
7 or Independent
Correct Answer
D. 2 or Max AssistExplanation
The FIM score for Mrs. M is 2 or Max Assist because she requires assistance from a helper to wash, rinse, and dry her upper and lower legs/feet, perineal area, and buttocks. However, she is able to independently wash, rinse, and dry her chest, abdomen, and both arms.Rate this question:
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- 4.
Dressing: Upper Body - Mrs. M is not able to gather her clothes from their customary place. After the helper places them on her nightstand, she is able to apply and remove her bra and shirt on her own. What is the FIM score?
- A.
4 or Min assist
- B.
5 or Set up
- C.
7 or Independent
- D.
1 or Total Assist
- E.
3 or Mod Assist
Correct Answer
B. 5 or Set upExplanation
The FIM score for this scenario would be 5 or Set up. Mrs. M is able to apply and remove her bra and shirt on her own, indicating that she has the ability to perform the task independently. However, she is unable to gather her clothes from their customary place, so she requires some assistance or set up from the helper to have the clothes placed on her nightstand. This level of assistance falls under the category of Set up in the FIM scoring system.Rate this question:
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- 5.
Lower Body: Dressing - Due to having had bilateral knee replacement, Mrs. M requires 2 helpers for undressing her lower body. She requires mod assist for removing her underwear and total assist to remove her pants, shoes and socks. What is the FIM score?
- A.
Activity did not occur because she was undressing, not dressing
- B.
6 or Mod I
- C.
2 or Max Assist
- D.
1 or Total Assist
- E.
4 or Min Assist
Correct Answer
D. 1 or Total AssistExplanation
The FIM score for this activity is 1 or Total Assist because Mrs. M requires complete assistance from two helpers to remove her pants, shoes, socks, and underwear. This indicates that she is unable to perform the activity independently and relies on others for assistance.Rate this question:
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- 6.
Toileting - During the first FIM Day, Mrs. M uses a bedpan when she needs to void. She needs a helper to pull down her pants and underwear. She requires help to clean herself and to pull up her pants and underwear. What is the FIM score?
- A.
1 or Total Assist
- B.
3 or Mod Assist
- C.
5 or Supervision
- D.
7 or Independent
- E.
4 or Min Assist
Correct Answer
A. 1 or Total AssistExplanation
The FIM score for this scenario is 1 or Total Assist because Mrs. M requires assistance with all aspects of toileting. She needs help with pulling down and up her pants and underwear, as well as with cleaning herself.Rate this question:
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- 7.
Toileting - By her third day of admission, Mrs. M can use the commode. She is able to pull her own pants and underwear down, clean herself and pull her own pants and underwear up. However, she requires 1 helper to steady her during these 3 tasks. The helper does not assist with the tasks, but the helper is physically assisting for balance. What is the FIM score?
- A.
1 or Total Assist
- B.
3 or Mod Assist
- C.
4 or Min Assist
- D.
5 or Supervision
- E.
7 or Independent
Correct Answer
C. 4 or Min AssistExplanation
The FIM score for Mrs. M is 4 or Min Assist because she requires one helper to steady her during the tasks of using the commode, pulling her pants and underwear down, cleaning herself, and pulling her pants and underwear up. The helper does not assist with the tasks but provides physical assistance for balance. This indicates that Mrs. M is able to perform the tasks with minimal assistance.Rate this question:
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- 8.
Transfers: Toilet - Mrs. M uses a bedpan for toileting, with a helper emptying the bedpan after use.
- A.
1 or Total Assist
- B.
5 or Supervision
- C.
4 or Min Assist
- D.
Do not assess if patient is unable to use toilet or commode.
- E.
3 or Mod Assist
Correct Answer
D. Do not assess if patient is unable to use toilet or commode.Explanation
The correct answer is "Do not assess if patient is unable to use toilet or commode." This answer is appropriate because the scenario clearly states that Mrs. M uses a bedpan for toileting. Therefore, there is no need to assess her ability to use a toilet or commode.Rate this question:
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- 9.
Comprehension - Mrs. M easily follows concrete commands during therapy sessions but needs occasional repetition. She is concerned about the batteries in her hearing aid, and asked her husband to bring in extras.
- A.
6 or Mod I
- B.
5 or Supervision
- C.
2 or Max Assist
- D.
1 or Total Assist
- E.
7 or Independent
Correct Answer
B. 5 or SupervisionExplanation
Based on the given information, Mrs. M can easily follow concrete commands during therapy sessions but occasionally needs repetition. This suggests that she is able to perform tasks independently most of the time but may require some level of supervision to ensure that she understands and completes tasks correctly. Therefore, the answer "5 or Supervision" is the most appropriate choice as it indicates that Mrs. M can perform tasks independently but may need occasional supervision.Rate this question:
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- 10.
Expression - Mrs. M has no difficulty expressing herself . She is able to state her needs adequately to staff, and is currently calling her husband to make sure he brings the batteries in for her hearing aides.
- A.
3 or Mod Assist
- B.
1 or Total Assist
- C.
6 or Mod I
- D.
7 or Independent
- E.
4 or Min Assist
Correct Answer
D. 7 or IndependentExplanation
The correct answer is 7 or Independent. The explanation for this is that the passage states that Mrs. M has no difficulty expressing herself and is able to state her needs adequately to staff. Additionally, she is shown to be independently taking action by calling her husband to bring the batteries for her hearing aids. Therefore, she can be classified as independent in her ability to communicate and take care of her needs.Rate this question:
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- 11.
Social Interaction - Mrs. M is in pain periodically, is tearful at times alone in her room, but does not require redirection or medications. Around other patients, she enjoys interacting with them, encouraging them to participate and get stronger in their therapies.
- A.
1 or Total Assist
- B.
5 or Supervision
- C.
2 or Max Assist
- D.
0 or Activity did not occur
- E.
7 or Independent
Correct Answer
E. 7 or IndependentExplanation
Based on the given information, Mrs. M is able to interact with other patients, encourage them, and participate in therapies without requiring any redirection or medications. This indicates that she is able to independently engage in social interaction and does not need any assistance or supervision. Therefore, the correct answer is 7 or Independent.Rate this question:
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- 12.
Problem Solving - Mrs. M tends to overestimate her functional abilities and doesn't ask for help during lower body dressing for example; when her feet get caught in her pants, she needs a cue to initiate use of a reacher. She needs verbal cuing occasionally, less than 10% of the time, for problem solving during ADLs.
- A.
7 or Independent
- B.
5 or Supervision
- C.
3 or Mod Assist
- D.
1 or Total Assist
- E.
4 or Min Assist
Correct Answer
B. 5 or SupervisionExplanation
Mrs. M tends to overestimate her functional abilities and doesn't ask for help during lower body dressing. However, she occasionally needs verbal cuing, less than 10% of the time, for problem solving during activities of daily living (ADLs). Therefore, she requires supervision, which means that someone needs to be present to monitor her and provide assistance if needed, but she is able to perform the task independently most of the time.Rate this question:
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- 13.
Memory - Mrs. M feels that her hospitalization has thrown her off kilter and she has come up with a daily planning system to remember the times and places of her therapy sessions, when visiting hours are, her room number, and the names of her rehab team.
- A.
3 or Mod Assist
- B.
4 or Min Assist
- C.
1 or Total Assist
- D.
7 or Independence
- E.
6 or Mod I
Correct Answer
E. 6 or Mod IExplanation
The given answer, 6 or Mod I, suggests that Mrs. M requires moderate assistance in her daily planning system to remember the times and places of her therapy sessions, visiting hours, room number, and the names of her rehab team. This means that she is able to perform the task independently, but with some difficulty or assistance.Rate this question:
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- 14.
If you, the helper, is providing between 50% - 75% of the effort to complete the task and the patient is performing 25-49% of the effort, the FIM score is:
- A.
2 or Max Assist
- B.
3 or Mod Assist
Correct Answer
A. 2 or Max AssistExplanation
If the helper is providing between 50% - 75% of the effort and the patient is performing 25-49% of the effort, the FIM score is 2 or Max Assist. This means that the patient requires maximum assistance from the helper in order to complete the task.Rate this question:
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- 15.
Patient wants to make chicken soup but the OT cannot get the exact ingredients that the patient wants. She's familiar with using boullion cubes but the kitchen only has broth concentrate. This is unfamiliar to her. She has never used broth concentrate and needed prompting to read the instructions in the packaging. After she solved the problem,she was able to finish the chicken soup without further direction, and it was delicious! What is the FIM score for Problem Solving?
- A.
5 or Supervison; needs direction less than 10% of the time.
- B.
4 or Minimal;occasional direction (pt solves routine problems 75-90% of the time)
Correct Answer
A. 5 or Supervison; needs direction less than 10% of the time.Explanation
The FIM score for Problem Solving is 5 or Supervision; needs direction less than 10% of the time. This is because the patient was initially unfamiliar with using broth concentrate but was able to solve the problem and finish making the chicken soup without further direction. This indicates that the patient only required minimal supervision and direction in solving the problem, as they were able to figure it out on their own with prompting to read the instructions.Rate this question:
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- 16.
When a patient transfers out unexpectedly: Kudos to all of you for documenting DC FIMs on the same day the patient leaves acutely, and documenting the FIM scores taken from the day before. Thank you!! The following is an usual clinical situation; If a patient is admitted on a Monday (FIM Day 1), transfers out acute on Wednesday (FIM Day 3), you do not have to complete a DC FIM because your admission FIMs are used to calculate the DC FIMs.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
The explanation for the correct answer, True, is that when a patient transfers out unexpectedly, there is no need to complete a DC FIM (Discharge Functional Independence Measure) because the admission FIMs (Functional Independence Measure) are used to calculate the DC FIMs. In this specific clinical situation, the patient was admitted on Monday (FIM Day 1) and transferred out on Wednesday (FIM Day 3), so the admission FIMs can be used for calculating the DC FIMs. Therefore, it is true that a DC FIM does not need to be completed in this case.Rate this question:
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- 17.
The definition of an accident is the wetting of linens and/or clothing only. If a patient is incontinent and wears a brief but does NOT soil their clothing or linens, this is NOT an accident. True or False
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
If a patient is incontinent and wears a brief but does not soil their clothing or linens, it is not considered an accident. The definition of an accident specifically refers to the wetting of linens and/or clothing. Therefore, the statement is true.Rate this question:
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Mar 21, 2023Quiz Edited by
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Aug 13, 2013Quiz Created by
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