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Therapy Quizzes & Trivia

Questions and Answers
  • 1. 

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  • 2. 

    Neurological: Which of the following methods is INCORRECT when working with a TBI patient with a Rancho Level IV?

    • A.

      Work in a quiet environment with minimal distracters

    • B.

      Maintain a predictable daily structure and routine

    • C.

      Be calm and confident in your approach with the patient

    • D.

      Maintain the activity despite agitation from patient

    Correct Answer
    D. Maintain the activity despite agitation from patient
    Explanation
    D is the correct answer. During this stage of recovery, we want to decrease the patient’s agitation by attempting to normalize the environment (A,B) and. providing consistency and predictability that counters their confusion (C). If a patient becomes agitated or restless during an activity, change the activity or move to another environment. Source: Occupational Therapy for Physical Dysfunction.

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  • 3. 

    Pediatrics: Prone is often the position of choice for which of following:

    • A.

      Infant with contractures

    • B.

      Agitated, arching infant

    • C.

      Infant with newly repaired abdominal defect

    • D.

      To promote midline orientation

    Correct Answer
    A. Infant with contractures
    Explanation
    A is the correct answer. Prone positioning allows gravity and body weight to be used for a gentle sustained stretch. Supine would be best for an infant with newly repaired abdominal defect, and side-lying would be best for agitated infant and to promote midline orientation. Source: Occupational Therapy for Children

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  • 4. 

    Neurological: What does a score of 9 mean on the Glasgow Coma Scale?

    • A.

      Minor brain injury

    • B.

      Moderate brain injury

    • C.

      Severe brain injury

    • D.

      Fully conscious

    Correct Answer
    B. Moderate brain injury
    Explanation
    B is the correct answer. Scores of 9-12 are moderate, scores 13 and higher are minor, and scores of 8 or lower is severe. The Glasgow Coma scale is out of 15 total points.
    Source: Occupational Therapy for Physical Dysfunction

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  • 5. 

    Management & Evidence: When arriving to an elderly patient’s home who lives with her daughter and son-in-law for a treatment session, the OTL/R notices that the patient’s glasses are broken and the patient has new bruises on her forearms around her wrists.  The OTL/R asks the patient once the son-in-law leaves the room what happened and the patient reports that the son-in-law has been physically abusing her for the past two weeks.  What is the most appropriate action the OTL/R should take?

    • A.

      Contact supervisor to report suspicious elderly abuse and suggest that Adult Protective Services get involved

    • B.

      Continue with treatment session and see if abuse continued until next session

    • C.

      Call the local police station to report suspicious elderly abuse

    • D.

      Explain to the son-in-law the allegations and get his side of the story before doing anything

    Correct Answer
    A. Contact supervisor to report suspicious elderly abuse and suggest that Adult Protective Services get involved
    Explanation
    Answer: a. Contact supervisor to report suspicious elderly abuse and suggest that Adult Protective Services get involved

    Rationale: Role of Occupational therapist is required to suspected or observed cases of elder abuse. Since the patient stated the son-in-law was abusing her and their was proof from the broken glasses and the bruises on her forearms and wrists, the OTL/R is required by law to report this case to Adult Protective Services so they can investigate.
    Source: National Occupational Therapy Certification Exam Review and Study Guide 5th Edition by Rita P. Fleming-Castaldy (page 122)

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  • 6. 

    General Rehab: When completing a home evaluation, what would be the most important suggestion to the patient to prevent falls:

    • A.

      Teach energy conservation techniques

    • B.

      Order appropriate adaptive devices and train safe us

    • C.

      Remove throw rugs from floors

    • D.

      Arrange furniture for easy maneuverability

    Correct Answer
    C. Remove throw rugs from floors
    Explanation
    Answer: c. Remove throw rugs from floors

    Rationale: All are interventions to prevent falls. However, the most important factor when assessing ones home would be to remove throw rugs. This is an immediate intervention that could be implemented at that moment.
    Source: National Occupational Therapy Certification Exam Review and Study Guide 5th Edition by Rita P. Fleming-Castaldy (page 319)

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  • 7. 

    Neurological: You are assessing a traumatic brain injury patient and note that the patient is very agitated, moving around in his bed almost non-stop (requiring restraints at times).  The patient is also very confused and follows very few one-step commands.  According to the Rancho Los Amigos Levels of Cognitive Function Scale, your patient is at:

    • A.

      Level II

    • B.

      Level III

    • C.

      Level IV

    • D.

      Level V

    Correct Answer
    C. Level IV
    Explanation
    Rationale: C is the correct answer because according to the Rancho Scale Level IV is confused, agitated. Agitation is the key in this answer. Level II and III are less responsive and only responding to certain stimuli. By Level V the agitation has subsided, but the confusion remains.

    Source: Occupational Therapy for Physical Dysfunction, Sixth Edition, Radomski and Latham, p. 1048

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  • 8. 

    Neurological: You are assessing a traumatic brain injury patient and note that the patient has a right eyelid droop.  This indicates that the patient has received injury to which cranial nerve?

    • A.

      Cranial nerve II

    • B.

      Cranial nerve III

    • C.

      Cranial nerve VI

    • D.

      Cranial nerve VII

    Correct Answer
    B. Cranial nerve III
    Explanation
    Rationale: B is the correct answer because Cranial nerve III (oculomotor) controls eyelid movement. A and D are distracters because you could be fooled that the optic (II) or facial (VII) nerves affect eyelid droop.

    Source: Neuroscience: Fundamentals for Rehabilitation, Lundy-Ekman

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  • 9. 

    Neurological: You read in a TBI patient’s chart that they are at Level III of the Rancho Los Amigos Levels of Cognitive Function Scale.  Which of the following is NOT an appropriate intervention for a patient at this level of cognition?

    • A.

      Simple ADL to promote automatic responses

    • B.

      Sensory stimulation such as tactile, visual, auditory, temperature, and proprioception

    • C.

      ROM to prevent contracture/tone and spasticity management

    • D.

      Multi-step command following

    Correct Answer
    D. Multi-step command following
    Explanation
    Rationale: A patient at Rancho Level III has a localized response to stimuli and their response is directly related to the type of stimuli they are receiving. At this point you want to stimulate them as much as possible to get consistent and automatic responses (choice A and B). You also want to keep them positioned and provide ROM since they do not have a lot of active movement (choice C). Choice D is beyond their ability at this point, because they are not even able to follow one-step commands at this level. They are simply responding to stimuli.

    Source: Occupational Therapy for Physical Dysfunction, Sixth Edition, Radomski and Latham, p. 1048

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  • 10. 

    General Rehab: A client with deficits in stereognosis would have MOST DIFFICULTY with?

    • A.

      Identifying coins in his/her pocket

    • B.

      Finding the route back to his/her room

    • C.

      Identifying a familiar face

    • D.

      Determining the distance from the front of the sink to the facet

    Correct Answer
    A. Identifying coins in his/her pocket
    Explanation
    Rational: The correct answer is A because stereognosis is the perceptual skill that enables an individual to identify common objects and geometric shapes through tactile perception without the aide of vision. Stereognosis is essential to occupational performance because the ability to see with the hands is critical to many daily activities.
    Source:Text book- Pedretti’s Occupational Therapy: Practice Skills for Physical Dysfunction and the OT Advantage website

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  • 11. 

    Orthopedic: An OTR is developing an exercise program for a client with Reflex sympathetic dystrophy/Complex regional pain syndrome in her right hand.  The client is demonstrating pain, swelling, and stiffness.  Which initial exercise plan would be BEST?

    • A.

      Manually manipulate the wrist and hand to increase ROM

    • B.

      Gentle active exercise and frequent massage

    • C.

      Protective sensory reeducation

    • D.

      Relaxation training

    Correct Answer
    B. Gentle active exercise and frequent massage
    Explanation
    Rational: The correct answer is B because active range of motion is crucial. Intervention that increases pain such as passive range of motion should be avoided. Massage reduces the swelling and reintroduces touching of the hand.
    Source: Text book- Pedretti’s Occupational Therapy: Practice Skills for Physical Dysfunction and the OT Advantage website

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  • 12. 

    Orthopedic: An OTR is evaluating and patient and notices that the patient’s PIP joint is hyperextended and the DIP joint is flexed. What best describes this condition?

    • A.

      Swan neck deformity

    • B.

      Subluxation deformity

    • C.

      Boutonniere deformity

    • D.

      Mallet deformity

    Correct Answer
    A. Swan neck deformity
    Explanation
    / Rational: The correct answer is A. Swan neck deformity is when the PIP joint is hyperextended and the DIP joint is in flexion. Boutonniere deformity is when the PIP joint is in flexion and the DIP joint is hyperextended. Mallet deformity is when the DIP joint is flexed/drooping.
    Source: Text book from Dr. Flinn’s class- Fundamentals of Hand Therapy by Cynthia Cooper

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  • 13. 

    Neurological: A person experiencing contralateral hemiplegia, homonymous hemianopsia, and aphasia would most likely have a CVA affecting the

    • A.

      Anterior cerebral artery

    • B.

      Middle cerebral artery

    • C.

      Posterior cerebral artery

    • D.

      Basilar artery

    Correct Answer
    A. Anterior cerebral artery
    Explanation
    Answer: A, some of the middle cerebral artery symptoms include contralateral hemiplegia, hemianesthesia, homonymous hemianopsia, aphasia and apraxia.

    Fleming-Castaldy, R.P. (2009). National Occupational Therapy Certification Exam: Review and Study Guide. Evanston, IL: Therapy Ed.

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  • 14. 

    General Rehab: When evaluating a patient with low ulnar nerve palsy, which is NOT a symptom that would be present?

    • A.

      Limited extension at IP joints

    • B.

      Fromont's sign

    • C.

      Inability to assume intrinsic minus position

    • D.

      Inability to oppose thumb and 5th digit

    Correct Answer
    C. Inability to assume intrinsic minus position
    Explanation
    Answer: C, in a patient with low ulnar nerve palsy would have limited extension, Fromont’s sign, and inability to oppose the thumb and 5th digit. They would be able to assume the intrinsic minus position, but not the intrinsic plus position.

    Cooper, C. (2007). Fundamentals of Hand Therapy. St. Louis, Missouri: Mosby Elsevier.

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  • 15. 

    General Rehab: Handling techniques used in the NDT approach are utilized to obtain all of the following except

    • A.

      Normalization of movement patterns

    • B.

      Increasing range of motion

    • C.

      Facilitation and inhibition of muscle groups

    • D.

      Increasing associated reactions

    Correct Answer
    D. Increasing associated reactions
    Explanation
    Answer: D, NDT techniques are used to provide external stability during movement, normalize movement patterns, facilitate or inhibit specific muscle groups, inhibit abnormal patterns of control, provide sensory input, increase range of motion, dissociate body segments, and normalize tone. NDT tries to decrease associated reactions by assessing the situations that evoke them and reducing the demand of the task.

    Fleming-Castaldy, R.P. (2009). National Occupational Therapy Certification Exam: Review and Study Guide. Evanston, IL: Therapy Ed.

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  • 16. 

    Neurological: Which of the following are you least likely to observe following a CVA occurring in the middle cerebral artery?

    • A.

      Sensory deficits

    • B.

      Language deficits

    • C.

      Ataxia

    • D.

      Contralateral hemiplegia

    Correct Answer
    C. Ataxia
    Explanation
    Rational: Symptoms of a CVA occurring at the middle cerebral artery include contralateral hemiplegia, contralateral hemianopsia, sensory deficits, and language deficits.
    Source: Willard & Spackman’s Occupational Therapy, v. 10

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  • 17. 

    Orthopedic: Which of the following would NOT be therapeutic priorities following an above-knee amputation?

    • A.

      Standing balance

    • B.

      Upper extremity strengthening

    • C.

      Adaptive grooming techniques

    • D.

      Functional mobility

    Correct Answer
    C. Adaptive grooming techniques
    Explanation
    Rational: A lower extremity amputation alters one’s center of balance, therefore standing balance and endurance should be a priority. Upper extremity strengthening is important due to increase dependence on the arms following a lower limb amputation. Functional mobility will certainly change and should be a priority in occupational therapy as well as in physical therapy. One would not expect to see a change in grooming techniques as grooming is performed using the upper extremities, which are not impaired in this case.
    Source: Willard & Spackman’s Occupational Therapy, v. 10

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  • 18. 

    General Rehab: In what age-range are symptoms of multiple sclerosis most likely to emerge?

    • A.

      11-19

    • B.

      20-40

    • C.

      50-75

    • D.

      75 and up

    Correct Answer
    B. 20-40
    Explanation
    Rational: Individuals may begin to notice symptoms such as an incoordination or paresthesias of limbs, trunk, or face, as well as an overall fatigue.
    Source: Willard & Spackman’s Occupational Therapy, v. 10

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  • 19. 

    General Rehab: Which of the following is an appropriate assessment to administer to a teenager (13-18 years old)?

    • A.

      Beery VMI (Visual Motor Integration)

    • B.

      PDMS-II (Peabody)

    • C.

      SIPT (Sensory Integration & Praxis Test)

    • D.

      Battelle Developmental Inventory, 2nd edition

    Correct Answer
    A. Beery VMI (Visual Motor Integration)
    Explanation
    Rationale: VMI = ages 2 years 0 months – 18 years 11 months
    Peabody = 1 month – 71 months (5 years 11 months)
    SIPT = 4 years – 8 years 11 months
    Battelle = birth – 8 years
    *Source: test manuals

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  • 20. 

    Pediatrics: When initially working with a child with gravitational insecurity, what is not an appropriate intervention?

    • A.

      Tilt board or trampoline in sitting

    • B.

      Swinging low to the ground

    • C.

      Moving backwards in space

    • D.

      Therapeutic listening

    Correct Answer
    C. Moving backwards in space
    Explanation
    Rationale: All of these are appropriate interventions when beginning treatment, except for moving backwards in space – children with gravitational insecurity tend to be frightened of moving backwards and this should not be done until later in treatment after you have gained the trust of the child and he/she has made some gains.
    *Source: OT 745 (Case-Smith) notes titled “Sensory Integration”
    Additional information: Chapter 11 in Occupational Therapy for Children textbook (Case-Smith)

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  • 21. 

    Pediatrics: A child with tactile defensiveness can probably best tolerate:

    • A.

      Light touch

    • B.

      Actively self-applied stimuli

    • C.

      Stimuli applied when unable to see the source of touch

    • D.

      Hair brushing

    Correct Answer
    B. Actively self-applied stimuli
    Explanation
    Rationale: Children with tactile defensiveness do not seem to mind deep touch as it is calming. Light touch is most aversive. They should always see the source of touch and tend to tolerate actively self-applied stimuli better than when it is done passively by a therapist or someone else.
    *Source: Occupational Therapy for Children textbook (By Case-Smith) p. 378

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  • 22. 

    Orthopedic: Which of the following standardized tests would be the LEAST helpful when performing an evaluation of an individual who has undergone a recent carpal tunnel release?

    • A.

      Using a goniometer to measure AROM

    • B.

      Using the Semmes Winestein monofilaments to measure sensation

    • C.

      Having the patient perform Phalen’s test to check for positive symptoms

    • D.

      Using a dynamometer to measure grip strength

    • E.

      Having the patient dip his/her hand in a volumeter to analyze amount of edema

    Correct Answer
    C. Having the patient perform Phalen’s test to check for positive symptoms
    Explanation
    Rationale: The standardized test that would be the least helpful would be Phalen’s test. The reason why this would be the least helpful is because Phalen’s test is used when an individual is being diagnosed with carpal tunnel syndrome. However, the individual in the question has already had release surgery which means that Phalen’s test should not elicit symptoms. The other tests will all be helpful in establishing baseline measurements that can be used for writing goals and assessing progress.
    Reference:
    Fundamentals of Hand Therapy: Clinical Reasoning and Treatment Guidelines for Common Diagnoses of the Upper Extremity (2007)
    Edited by Cynthia Cooper

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  • 23. 

    Orthopedic: A patient presents to your outpatient facility several weeks after a recent 2nd digit compression fracture. Surgery was completed and several pins were placed in the finger to provide stability. The digit is noticeably swollen and lacks both passive and active range of motion. Upon evaluation you find that his grip and pinch strength are much lower than those in his none affected hand and that he is unable to make a full fist. What would be your first priority with this patient?

    • A.

      Providing resistive strengthening exercises to increase grip strength

    • B.

      Providing manual therapy to stretch the shortened muscle fibers and increase ROM

    • C.

      Providing ultrasound to the affected digit to decrease pain

    • D.

      Providing the patient with a compression garment and strategies to reduce edema at home

    Correct Answer
    D. Providing the patient with a compression garment and strategies to reduce edema at home
    Explanation
    Rationale: According to a “clinical pearl” in Cooper’s book, “Reducing edema is almost always the first priority; do this and the client will gain motion.” A digit that is extremely swollen will not tolerate stretch to be placed upon it the way that a non-swollen digit would. With edema in the way the finger will be stiff and unable to bend. Once the edema is gone the patient will gain the ability to bend and then focusing upon increasing ROM and strength will be appropriate. Also, it is important to use modalities that are appropriate for the client. Using ultrasound on an individual with pins could be detrimental as
    the deep heat could increase the temperature of the metal pins and burn internal tissues.
    Reference:
    Fundamentals of Hand Therapy: Clinical Reasoning and Treatment Guidelines for Common Diagnoses of the Upper Extremity (2007)
    Edited by Cynthia Cooper

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  • 24. 

    Orthopedic: Which diagnoses is most likely to be associated of the following characteristics? Pain with resisted thumb extension or abduction Positive Finkelstein’s test Can be caused by forceful, repetitive motions involving the thumb Pain with activities such as wringing out washrags, opening jars, and using scissors Swelling over the first dorsal compartment of the thumb

    • A.

      Lateral epicondylitis

    • B.

      De Quervain’s disease

    • C.

      Carpal Tunnel syndrome

    • D.

      Cubital Tunnel syndrome

    Correct Answer
    B. De Quervain’s disease
    Explanation
    Rationale: Lateral epicondylitis is a form of tendinitis where there is point tenderness over the lateral epicondyle. There is no thumb involvement. Grip strength is reduced when the elbow is extended and there are complaints of nighttime aching and morning stiffness of the elbow. Carpal Tunnel syndrome is a compression of the median nerve. Symptoms include numbness and tingling in the median nerve distribution of the hand, nighttime numbness, reduced ROM, and reduced grip strength. Cubital Tunnel syndrome deals with ulnar nerve compression in the elbow. Numbness and tingling in the ulnar distribution of the hand is noticed.
    Reference:
    Fundamentals of Hand Therapy: Clinical Reasoning and Treatment Guidelines for Common Diagnoses of the Upper Extremity (2007)
    Edited by Cynthia Cooper

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  • 25. 

    General Rehab: Which of the following methods is the BEST way to evaluate for a hook grasp?

    • A.

      Direct the individual to hold a sewing needle while it is being threaded.

    • B.

      Observe the individual lift a tall glass filled with water

    • C.

      Have the individual hold a heavy handbag by the handles

    • D.

      Hand the individual a key to place in a lock.

    Correct Answer
    C. Have the individual hold a heavy handbag by the handles
    Explanation
    The needle would be held with a two point pinch while being threaded. A glass would be held with a cylindrical grasp and the key being place in a lock would be held with a lateral pinch.

    Reference: Johnson, Lorch, and DeAngelis: Occupational Therapy Exam Review Guide. ed 3. FA Davis Company, Philadelphia,2006.

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  • 26. 

    Management & Evidence: An OT manager is preparing the outpatient OT staff for a visit from an accrediting agency. The accrediting agency that surveys inpatient and comprehensive outpatient rehabilitation programs is BEST represented by which of the following

    • A.

      AOTA

    • B.

      JCAHO

    • C.

      CARF

    • D.

      NBCOT

    Correct Answer
    C. CARF
    Explanation
    CARF is a regulatory agency for the provision of rehabilitation services
    AOTA is a national society that promotes occupational therapy
    JCAHO reviews medical care provided by hospitals
    NBCOT an agency who develops and administers the OT exam

    Reference: Johnson, Lorch, and DeAngelis: Occupational Therapy Exam Review Guide. ed 3. FA Davis Company, Philadelphia,2006.

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  • 27. 

    Orthopedic: An OT practitioner is fabricating a static splint that will assist with the maintenance of a functional hand and finger position while keeping the soft tissures of the hand in midrange position. Which splint would the OT MOST likely select to address these needs?

    • A.

      Bivalve cast

    • B.

      Resting pan splint

    • C.

      Dynamic extension splint

    • D.

      Wrist cock-up splint

    Correct Answer
    B. Resting pan splint
    Explanation
    It is the most appropriate to fabricate to maintain a functional hand position.
    The bivalve cast is typically used when circumferential pressure of a body part is required to maintain a desired position.
    The dynamic extension splint is not considered to be a static splint and incorporates outriggers to maintain a functional hand position. A wrist cockup splint does not impact the position of the entire hand since it ends at the MCP crease.

    Reference:Pedretti, LW and Early, ME: Occupational Therapy:Practice Skills for Physical Dysfunction, ed 5. CV Mosby, St. Louis, 2001.

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  • 28. 

    General Rehab: To facilitate increasing independence in lower body dressing in a patient with a TL-spine precautions and wearing a TLSO, which intervention is contraindicated?

    • A.

      Provide the patient with a reacher.

    • B.

      Instruct the patient to raise the head of the bed 50 degrees so they can reach their feet prior to donning the TLSO.

    • C.

      Teach effective bed mobility techniques to assist in rolling.

    • D.

      Use leg straps to help pull legs into a circle sit.

    Correct Answer
    B. Instruct the patient to raise the head of the bed 50 degrees so they can reach their feet prior to donning the TLSO.
    Explanation
    Answer B, if a patient has TL-spine precautions, they need to wear their TLSO whenever they are out of bed or the head of bed is raised higher than 30 degrees.

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  • 29. 

    General Rehab: When advising a patient with a higher level SCI how to provide pressure relief seated in their wheelchair for the first time, which is NOT the safest recommendation?

    • A.

      Lean forward so their chest is resting on their thighs.

    • B.

      Tilt the back of the chair as far back as possible.

    • C.

      Lean to the right, then to the left.

    • D.

      Get back in bed and perform bed mobility to the left and right.

    Correct Answer
    A. Lean forward so their chest is resting on their thighs.
    Explanation
    Answer A, because soon after a SCI, patients have trouble regulating blood pressure, and leaning forward can lead to dizziness, nausea and loss of consciousness.

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  • 30. 

    Neurological: In patients with complete SCI’s, which is NOT an appropriate technique to prevent orthostatic hypotension?

    • A.

      TED hose.

    • B.

      Abdominal binder.

    • C.

      Monitor their blood pressure to make sure their systolic BP is above 100.

    • D.

      Wrapping legs with Ace wraps

    Correct Answer
    C. Monitor their blood pressure to make sure their systolic BP is above 100.
    Explanation
    Patients with SCI tend to have a lower blood pressure, so as long as the patient isn’t showing signs of being hypotensive, than having a low BP is considered normal.

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  • 31. 

    Orthopedic: Range of motion to the hand of a tetraplegia patient is performed in a specific way to facilitate tenodesis grasp. Which is correct?

    • A.

      Passive opening of the fingers when the wrist is flexed and closing of the fingers when the wrist is extended.

    • B.

      Passive closing of the fingers when the wrist is flexed and opening of the fingers when the wrist is extended.

    • C.

      Passive closing of the fingers when the wrist is flexed AND closing of the fingers then the wrist is extended

    Correct Answer
    A. Passive opening of the fingers when the wrist is flexed and closing of the fingers when the wrist is extended.
    Explanation
    Answer: A – To promote and facilitate tenodesis grasp passive opening of the fingers in extension and closing of the fingers when extended.

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  • 32. 

    Neurological: A person who recently suffered a TBI is aggressive, agitated due to a heightened response and is confused.  What Ranchos level is the patient at?

    • A.

      VI

    • B.

      IV

    • C.

      II

    Correct Answer
    B. IV
    Explanation
    Answer: B – A person who is classified as a Ranchos level four is confused (often times severely) and commonly aggressive and agitated due to their inability to regulate and interpret outside stimulation.

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  • 33. 

    General Rehab: Which is not a contraindication for superficial thermal agents?

    • A.

      Deep-vein thrombosis

    • B.

      Chronic inflammation

    • C.

      Impaired cognitive status

    Correct Answer
    B. Chronic inflammation
    Explanation
    Answer: B – Chronic inflammation is not a contraindication, however acute inflammation or acute edema IS a contraindication for superficial thermal agents.

    Source: Radomski, M.V. & Trombly Latham, C.A. (2008). Occupational therapy for physical dysfunction. Baltimore: Lippincott Williams and Wilkins.

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  • 34. 

    Mangement & Evidence: Working in a SNF setting, you notice a patient is fatigued and seems more weak then usual. After weighing the patient, you determine that they have lost 9 lbs in the past week. What course of action should you take?

    • A.

      Notify nursing and patients physician

    • B.

      Consult the dietitian

    • C.

      Discontinue the exercise and activities portion of intervention and focus on discussion/observation.

    • D.

      All of the above

    Correct Answer
    D. All of the above
    Explanation
    Rational: Failure to thrive (FTT) is common within the nursing home environment, and it is important that clients demonstrating symptoms of FTT conserve their energy. Nursing personnel and the physician should be notified to modify treatment/medications, and the dietitian should be notified to monitor calorie intake. Client should conserve what energy they have remaining, and physical activities should be discontinued until weight is regained.
    Source: www.fpnnoteook.com, presentation/in-service on FTT

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  • 35. 

    Neurological: An adult patient with a history of right hemisphere CVA would most likely demonstrate which of the following characteristics?

    • A.

      Slow and labored movements

    • B.

      Standing up from a wheelchair without locking the brakes

    • C.

      Information that seemed confabulated

    • D.

      All of the above

    Correct Answer
    B. Standing up from a wheelchair without locking the brakes
    Explanation
    Rational: Impulsive and poor safety awareness are common characteristics of a CVA in the right hemisphere. Disregarding the safety precaution
    Source: http://medicalcenter.osu.edu

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  • 36. 

    General Rehab: You are seeing a patient in isolation, with a diagnosis of MRSA. What precautions should you take before treating the patient?

    • A.

      Discharge the patient and refuse to treat them.

    • B.

      Donn gloves, mask, and gown and continue treatment within the patient’s room. Wash hands and disinfect treatment tool upon conclusion of intervention.

    • C.

      Treat the patient in their room without precautions.

    • D.

      Donn gloves only, and wash hands after treating the patient.

    Correct Answer
    B. Donn gloves, mask, and gown and continue treatment within the patient’s room. Wash hands and disinfect treatment tool upon conclusion of intervention.
    Explanation
    Rational: Standard precautions include wearing disposable gloves, a face shield and gown when treating a patient in an isolated environment to prevent spreading the disease to other personnel and residents.
    Source: http://www.edcp.org/guidelines/mrsa.cfm

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  • 37. 

    Orthopedic: Which provocative test would not be used when evaluating De Quervain’s tenosynovitis? 

    • A.

      Look for pain with resisted thumb extension or abduction

    • B.

      Thickening/swelling over first dorsal compartment

    • C.

      Cozen’s test

    • D.

      Finkelstein’s test

    Correct Answer
    C. Cozen’s test
    Explanation
    Since De Quervain’s affects the first dorsal compartment ( Abductor pollicis longus and extensor pollicis brevis are there), swelling and pain in that area (think: snuffbox, radial styloid area) are indicators. Finkelstein’s is the test where they grab their thumb with their fingers, then move hand toward ulnar deviation- pain in the radial styloid/ radial wrist/thumb area is a positive test. Cozen’s test is a test of the elbow, which is not directly involved in De Quervain’s.

    Fundamentals of hand therapy (Cynthia Cooper)

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  • 38. 

    General Rehab: Which frequency of ultrasound would most likely be used over areas of the hand?

    • A.

      1MHz

    • B.

      2MHz

    • C.

      3MHz

    • D.

      4MHz

    Correct Answer
    C. 3MHz
    Explanation
    3 MHz is used to treat smaller or more superficial structures, because it penetrates to a depth of 1-2 cm. 2 MHz is the next deepest penetration. 1 MHz penetrates to a depth of 5 cm, and should only be used for deeper structures such as the shoulder, otherwise it could penetrate too deeply and cause pereosteal heating (damage the bone). There is no 4 MHz.

    AOTA continuing ed article: Physical agent modalities- Developing a framework for clinical application in occupational therapy practice. From the June 2009 issue of OT Practice.

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  • 39. 

    General Rehab: Passive stretching to increase ROM should not involve:

    • A.

      Hold the stretch for 15-30 seconds

    • B.

      Holding the stretch a few degrees beyond the point of discomfort

    • C.

      Quick, vigorous movements

    • D.

      Relief of discomfort immediately after release of stretch

    Correct Answer
    C. Quick, vigorous movements
    Explanation
    To increase (and not just maintain)ROM, the limb must be stretched to the point of maximal stretch, which is just a few degrees beyond the point of mild discomfort- this can be assessed by patients verbal or facial indications. The mild discomfort should not linger after release of stretch (if it does, you may have injured the tissue). The most effective stretch is a slow, controlled movement which allows for the tissues to adjust gradually. The stretch should be held for 15-30 seconds. Quick movements are counterproductive and should be avoided, as connective tissue will resist the movement as a protective mechanism.
    Reference:
    Occupational Therapy for Physical Dysfunction 6th Edition (Mary Vining Radomski & Catherine A Trombly Latham)

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  • 40. 

    General Rehab: Which option below is most important as the INITIAL OT intervention for an individual with a severe form of Guillain-Barré syndrome who has complete paralysis?

    • A.

      ADL training

    • B.

      Balance and core strengthening activities

    • C.

      Passive ROM, splinting, and positioning

    • D.

      Resistive activities for intrinsic hand strengthening

    Correct Answer
    C. Passive ROM, splinting, and positioning
    Explanation
    Rationale: Since the individual has a severe form of Guillain-Barré, the most important initial approach is to protect weak muscles and prevent contractures. Although ADL performance is important for this patient, protecting muscles and maintaining ROM is most important and light ADL training should follow. After strength improves, balance and strengthening interventions can then be used.

    Source(s):

    Blesedell Crepeau, E. Cohn, E., Boyt Schell, B. A. (2003). Willard and Spackman's Occupational Therapy. Philadelphia: Lippincott Williams & Wilkins.

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  • 41. 

    General Rehab: When transferring a patient an OT can best protect themselves from injury by doing which of the following?

    • A.

      Stepping back from the individual

    • B.

      Keeping the knees bent

    • C.

      Keeping the back in a flexed position

    • D.

      Maintaining a narrow base of support

    Correct Answer
    B. Keeping the knees bent
    Explanation
    Rationale: Keeping the knees bent keeps you in the correct anatomical position for a transfer. All other answers are incorrect, and could possibly result in injury to the individual performing the transfer. You should stand close to the individual, keep the back in a neutral position, and maintain a wide base of support.

    Source(s):

    Johnson, C. R., Lorch, A., & DeAngelis, T. (2006). Occupational Therapy Examination Review Guide. Philadelphia: F.A. Davis Company

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  • 42. 

    General Rehab: Which of the following hemoglobin levels indicate a safe reading to get a patient up out of bed, in an acute setting?

    • A.

      3.0 L

    • B.

      5.0 L

    • C.

      8.0 L

    • D.

      12.0 L

    Correct Answer
    D. 12.0 L
    Explanation
    all other responses are too low, and may result in hypotension, syncope, weakness, dixxyness or nausea.

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  • 43. 

    General Rehab: Which of the following evaluation methods can not be used to test manual dexterity/motor function?

    • A.

      Purdue Pegboard

    • B.

      Minnesota Rate of Manipulation Test

    • C.

      Bay Area Functional Performance Eval.

    • D.

      9-hole Peg Test

    Correct Answer
    C. Bay Area Functional Performance Eval.
    Explanation
    the Bay Area Functional Performance Eval. is used as phsychological/cognitive battery. All other responses assess manual dexterity/ fine motor coordination and function.

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  • 44. 

    Orthopedic: An OT is conducting a Manual Muscle Testing with a patient during an evaluation. The patient can hold the test position against slight pressure in an antigravity position. What is the patient’s manual muscle testing score?

    • A.

      Fair (3/5)

    • B.

      Fair – (3-/5)

    • C.

      Fair + (3+/5)

    • D.

      Good - (4-/5)

    Correct Answer
    C. Fair + (3+/5)
    Explanation
    Correct answer: Fair + or 3+/5 is when a patient can hold the test position against only slight pressure in an antigravity position.
    Wrong answer: Fair is when holds position in antigravity with no added pressure
    Fair – is when there is a gradual release from test position in antigravity position
    Good - is when patient can hold test position against slight to moderate pressure In antigravity position

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  • 45. 

    Orthopedic: What is NOT a sternal precaution for patients following heart surgery?

    • A.

      No pushing, pulling, lifting more than 4 lbs for 6 weeks following surgery

    • B.

      No pulling or pushing up with arms when transferring

    • C.

      No shoulder elevation above 90 degrees

    • D.

      No driving for 4 weeks post-operative

    Correct Answer
    A. No pushing, pulling, lifting more than 4 lbs for 6 weeks following surgery
    Explanation
    A is correct answer because the proper precaution is no pushing, pulling, or lifting more than 10 lbs for 6 weeks following surgery.

    All of the other answers are proper sterna precautions.

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  • 46. 

    Orthopedic: What is NOT a proactive contribution for a patient who is recovering from a total hip replacement?

    • A.

      Lie on your back while resting in bed with a pillow or foaming between thighs to prevent knees from touching

    • B.

      Sit on soft chairs to allow for greater comfort of the hip while sitting

    • C.

      Get up and move around every hour

    • D.

      Use a raised toilet seat

    Correct Answer
    B. Sit on soft chairs to allow for greater comfort of the hip while sitting
    Explanation
    Sitting on soft chairs is actually not recommended due to the fact that a person can sink lower than knee height, they are not firm and straight back , and are harder to transfer in and out of. All of the other answers are proactive suggestions to help a patient recover.

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  • 47. 

    General Rehab: Which of the following is a contraindication for electrical stimulation usage?

    • A.

      Knee replacement

    • B.

      Hip replacement

    • C.

      Pacemaker

    • D.

      COPD

    Correct Answer
    C. Pacemaker
    Explanation
    Pacemakers are a contraindication for any electrical stimulation or diathermy usage.
    Source- http://www.biomedofla.com/images/contraindications.htm

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  • 48. 

    Neurological: There are several complications that can occur after a stroke including all of the following EXCEPT:

    • A.

      Apraxia

    • B.

      Depression

    • C.

      Shoulder pain/subluxation

    • D.

      Anxiety

    Correct Answer
    D. Anxiety
    Explanation
    Anxiety is not a noted common occurrence after a stroke, however depression, shoulder sublaxation and apraxia are very common.
    Source- R&L physical function book

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  • 49. 

    Orthopedic: Which of the following is a hip precaution for the first 8 weeks after a hip replacement?

    • A.

      Do not cross legs or ankles

    • B.

      Do not bend knee

    • C.

      Do not lay on back

    • D.

      Do not lay on stomache

    Correct Answer
    A. Do not cross legs or ankles
    Explanation
    Legs ankles should not be crossed, do not bend at the waist, and you should not lie on your side.
    Source- http://www.hipsandknees.com/hip/hipprecautions.htm

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  • 50. 

    Neurological: A 90-year-old woman suffered a right CVA and will be receiving therapy in a SNF. Upon evaluation the OT determines that left shoulder is subluxed.  The most appropriate approach for treating the subluxed shoulder is:

    • A.

      Wear a shoulder sling 24 hrs a day to avoid movement in the left shoulder

    • B.

      Rest the left arm across the patient’s lap while in bed and seated in a wheelchair

    • C.

      Position the arm to avoid traction of the left shoulder muscles while in bed and seated in a wheelchair

    • D.

      Rest let arm in should extension and adduction

    Correct Answer
    C. Position the arm to avoid traction of the left shoulder muscles while in bed and seated in a wheelchair
    Explanation
    placing the arm in a position that minimizes constant pulling on the shoulder muscles (from the weight of the arm) is the most appropriate way to treat the subluxed shoulder.

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