Functional Neuro Practice Exam

Before you can begin eating, you need to look at positioning, alertness, and perceptual ability to make sure they are ready for feeding and eating.

An abstraction of spoons meant to be cleaning products would be too difficult of a concept to grasp. If you are demonstrating bathing techniques, use the actual items you need.

C: Vision problems occur in 80% of patients. Often these are optic neuritis (optic nerve becomes inflamed), blurred vision, scotoma (blind spot), diplopia (double vision), and decreased acuity.
D: MS causes a decrease in serotonin. People often see signs of depression before they realize they have MS. Because it is often diagnosed after the birth of a child, many people think it is postpartum depression.

Rancho 5 patients are confused. Having the TV on during therapy is even difficult for people who have not had a brain injury.

Not holding breath is an EC/WS technique.

Put on gloves first!

You shouldn't get people with c-spine precautions to the edge of the bed because they could further injure themselves.

1-3: Coma like.
4-6: Confused.
7: can start do to daily routines and lack insight into extent of deficits. You want to challenge their problem solving skills in order to improve them and make them aware (see what solution they come up with for not having all of the ingredients). This task is appropriate at higher rancho levels as well (7 is the lowest that you want to try this activity with).

The cerebellum controls balance and coordination

People with GBS are likely to still have decreased sensation when they are discharged. Due to decreased sensation and weakness, they might have body awareness issues that could lead to falls, burns, etc.

In stage two, people have mild to moderate difficulty ambulating, so they do not need to be aware of skin integrity and wheelchair mobility until they transition to stage 3. People with ALS have decreased hand strength and coordination (hands are affected first), so this interferes with ADLs and equipment may help.

A) Paraesthesia is an abnormal sensation, typically tingling or pricking (like your foot fell asleep)
B) Dysesthesia: abnormal feeling associated with stim or loss of feeling to certain stim
C and D) Referred pain is not a specific symptom of MS. MS demyelinates nerves in the CNS, which can cause chronic pain but not specifically pain in the gallbladder (which would refer to the shoulder).

You should never stick your hands in a patient's mouth.
Some patients need to double swallow to get all of the food down. Giving them water right away is easier for them, so you first want to see if they can get all of the food down without water. He also has a chance of aspirating on the water.

B) Throwing and catching a ball is (most likely) not functional or occupation based. OTs also never document having someone "practice" anything (practice can be done on their own time).
C) A bend spoon wouldn't really help incoordination
D) Not our place to recommend surgery and isn't common in this case anyway

biVABA is the Brain Injury Visual Assessment Battery for Adults. This and the Rivermead are assessments, not interventions. The Self Awareness Training is better than the visual exercises because of his insistence on playing basketball despite his current weaknesses.

Decorticate: arms in flexion, legs in extension
Decerebrate: legs and arms in extension
Degenerate: Made up posturing

You need to assess what is going on in the environment before you can assess muscle tone.
You need to make note of the time you entered for documentation purposes.
You should look at their chart before entering their room.

A) You shouldn't give someone water to squish around because if they are only allowed puddling-like liquids, they probably don't have the oral control or impulse control not to swallow it (You should even watch while doing ADLs that they don't sneak water from washcloths, etc).
B) You shouldn't give thin liquids because they cannot tolerate it yet. If they are working toward that, they need to go from pudding like to honey like to nectar like.
C) Glycerin can help with dry mouth.
D) Pudding-like water won't quench their thirst.

Clonus is an involuntary sustained shaking at rest. While getting her to walk may help, the PT will probably be working on walking, and you will probably be more focused on functional occupations. If you teach her how to stretch out the muscles by not walking, this may be beneficial in completing bedside ADLs. A foot drop splint will keep her muscle from stretching and would not initially help. If she continues to rub her heel, a splint may be beneficial.

In Rancho 3, the patient responds generally to only certain stimuli. Completing simple commands is difficult and sitting at EOB without assistance is probably not realistic. Being able to verbalize names would also be difficult. Yes/no questions are more appropriate.

The Modified Ashworth scale measures increase in muscle tone on a 0-4 scale, with 0 being no increase in muscle tone, and 4 being rigid flexion or extension.

In stage 3, patients are using wheelchairs to transport themselves and will not regain use of their feet. Therefore, foot drop splints are not commonly used during this stage. Skin integrity, independence, and family/patient education is much more prevalent in stage 3. You want to try to help people do as much as they can for themselves.

People do not have to go through the stages of coma. Most people skip stages.
The longer someone is in a coma, the lower their prognosis.

OTs should not remove the collar because patients could further injure themselves. If it turns out to be unneeded, someone else will take it off. When the collar is removed, someone must manually control the cervical spine.

If you assess active range of motion, and she is not within functional limits, this could be because of other factors such as low or high muscle tone. To pinpoint assessing range of motion, you should perform passive range of motion. From there, you could potentially use MMT.

B) More appropriate for Rancho 8 or higher
C) More appropriate for around Rancho 3
D) Not properly written goal, more appropriate for 9 or 10

A)She is in the recovery stage of GBS and will most likely have OP or home health.
B)She should not purchase a wheelchair if she still needs one at discharge because she will not need it for very long.
C) Wrist supports, shower chairs, and dressing sticks are common adaptive equipment recommended at discharge.
D) If she is able to understand how to use a feeding tube and physically able to manipulate it, then she should be able to feed herself.