OTR Rehabilitation Quiz: Exam

Using a weighted or swivel spoon is a good intervention for a patient with tremors, ataxia, or choreiform movements. These patients often have difficulty controlling their movements and may have hand tremors, unsteady movements (ataxia), or involuntary jerky movements (choreiform movements). A weighted spoon can provide stability and help them eat independently, while a swivel spoon allows for easier movement and reduces spillage. Both types of spoons can assist patients with these movement disorders in maintaining their independence and improving their ability to eat.

The Brunnstrom approach was developed for individuals with CVA, which stands for cerebrovascular accident or stroke. This approach is a rehabilitation technique that focuses on the stages of recovery after a stroke, aiming to facilitate the return of voluntary movement and improve functional abilities. It involves the use of various therapeutic techniques and exercises to stimulate the affected muscles and promote motor recovery.

Flaccidity would be in stage I of the Brunnstrom stages of CVA recovery. In this stage, there is no voluntary movement or muscle activation. The affected limb is limp and cannot be moved voluntarily. This stage is characterized by the absence of any muscle tone or reflexes. It is the earliest stage of recovery after a stroke, and the goal of treatment during this stage is to initiate any movement or muscle activation in the affected limb.

Subluxation refers to partial dislocation of a joint, in this case, the glenohumeral joint. It is characterized by the instability of the joint, leading to malalignment. This can occur due to various factors such as trauma, ligamentous laxity, or muscle weakness. Subluxation is different from complete dislocation as the joint surfaces remain partially in contact with each other. It can cause pain, limited range of motion, and functional impairment. Therefore, subluxation is the correct answer as it aligns with the given definition of malalignment caused by glenohumeral joint instability.

Using a reacher to aid in lower extremity dressing is an example of a compensatory strategy. Compensatory strategies involve using tools or techniques to compensate for a deficit or limitation in a person's abilities. In this case, the reacher is being used to compensate for any difficulties or limitations the individual may have in reaching and dressing their lower extremities independently.

When treating a patient with CVA (cerebrovascular accident), it is important to be vigilant for the development of decubitus ulcers, also known as pressure ulcers or bedsores. These ulcers commonly occur in areas where there is prolonged pressure or friction against the skin. The heels and sacrum are particularly susceptible to developing decubitus ulcers due to their bony prominences and the potential for constant pressure when a patient is bedridden or immobile. Therefore, healthcare professionals should pay special attention to these areas to prevent and detect the formation of decubitus ulcers.

In Toglia's model, all of the factors mentioned (task demands, environment, and person and their emotional state) are considered critical in influencing cognitive assessment and treatment. This means that when assessing and treating cognitive abilities, it is important to take into account the demands of the task, the environment in which it is performed, and the emotional state of the person. These factors can significantly impact cognitive performance and should be considered in order to provide effective assessment and treatment.

The least difficult transfer would be from the bed to the wheelchair because it involves a shorter distance and does not require any additional equipment or adjustments.

The above picture demonstrates the UE D1 Pattern.

Global aphasia refers to a type of aphasia where there is a complete loss of language skills. It is characterized by difficulty in understanding and producing both spoken and written language. Individuals with global aphasia may struggle to form coherent sentences, find the right words, and comprehend what others are saying. This type of aphasia usually occurs after a severe brain injury, such as a stroke, that affects multiple language areas in the brain.

Sitting in a wheelchair would likely be the least challenging position for the patient. This is because sitting in a wheelchair provides stability and support, which can help the patient maintain balance and prevent falls. In contrast, sitting on a therapy ball or on the edge of a bed requires more core strength and balance control. Standing would be the most challenging position as it requires the most strength and balance to maintain.

Visual acuity refers to the ability to see small visual details. It is a measure of how well the eyes can distinguish fine details and is typically assessed using an eye chart. This ability is important for tasks that require sharp and clear vision, such as reading small print or recognizing distant objects. Visual perception, visual scanning, and visual attention are related concepts but do not specifically refer to the ability to see small visual detail.

Both A and B are methods used to diagnose edema. A volumeter is a device used to measure the volume of a body part, such as a limb, and can be used to assess the presence and severity of edema. Circumferential measurements involve measuring the circumference of a body part, typically at regular intervals along its length, and can also be used to detect and monitor the presence of edema. Therefore, both of these methods are commonly used in clinical practice to diagnose and assess edema.

Deep tendon pressure can be considered an inhibition technique because it involves applying pressure to a specific muscle or tendon in order to reduce muscle tone or spasm. This technique can help to relax and release tension in the muscle, promoting a decrease in pain and muscle tightness. It is commonly used in therapeutic settings to address muscle imbalances, improve range of motion, and alleviate musculoskeletal discomfort.

In patients with hemiplegia, one side of the body is paralyzed or weakened. In this case, the affected leg refers to the leg that is affected by the paralysis. The OTR should instruct the patient to insert the affected leg into his pants first because it may require more assistance and support. By addressing the affected leg first, the OTR can ensure that the patient is properly dressed and comfortable before moving on to the unaffected leg.

This approach refers to Constraint-Induced Movement Therapy (CIMT) or Constraint-Induced Therapy (CIT). It involves restraining the unaffected extremity (such as the arm) to encourage the use and rehabilitation of the affected extremity. By limiting the use of the unaffected extremity, the therapy aims to prevent learned nonuse, which occurs when individuals rely heavily on their unaffected side and neglect using the affected side. CIMT/CIT helps promote the recovery of motor function and encourages the individual to regain movement and function in the affected extremity.

Unilateral Visual Neglect (UVN) is a condition commonly observed in stroke patients. It refers to a decreased ability to pay attention to and be aware of one side of space. This means that individuals with UVN may ignore or neglect objects, people, or events on one side of their visual field, typically the side opposite to the brain hemisphere that has been affected by the stroke. This condition can lead to difficulties in daily activities and may require rehabilitation and therapy to improve spatial awareness and attention.

The correct answer is "Flaccid, hypotonic, normal, spastic, rigid." The words are arranged in order of increasing intensity or severity. Flaccid refers to a lack of muscle tone, followed by hypotonic which means abnormally low muscle tone. Normal is the next level, indicating a healthy and balanced muscle tone. Spastic refers to increased muscle tone and rigidity signifies the highest level of muscle tone.

The NDT approach has shifted recently to involve more movement from the patient and less physical involvement from the therapist. This means that the patient is taking a more active role in their therapy, actively participating in movements and exercises. The therapist is no longer doing the movements for the patient, but instead providing guidance and support. This shift allows the patient to develop their own movement patterns and improve their motor control and function.

A remedial approach should be used before a compensatory approach with CVA patients. This means that it is important to focus on addressing and improving the underlying impairments and deficits in motor control and function before implementing compensatory strategies. Remedial approaches aim to restore and improve the patient's ability to perform functional tasks using their own abilities and strengths. Once these underlying impairments have been addressed, compensatory approaches can be used to help the patient adapt and compensate for any remaining deficits.

Completing a puzzle is the best intervention for addressing the fine motor skills of a 48-year-old woman with a CVA. Puzzles require precise hand-eye coordination, finger dexterity, and manipulation of small pieces, which can help improve her fine motor skills. Stacking cones and blocks can also improve fine motor skills, but completing a puzzle involves more complex and varied movements, making it a more effective intervention. Finger and wrist exercises may be helpful for improving strength and range of motion, but they may not specifically target the fine motor skills needed for activities of daily living.

Concrete thinking refers to a thinking style that focuses on literal interpretations and facts rather than abstract or symbolic meanings. In this case, the patient's response of "My wife's car" indicates a literal interpretation of the question, rather than understanding it as a reference to his accident. This suggests that the patient is engaging in concrete thinking, as they are not able to grasp the abstract meaning behind the question.

UE D2 refers to upper extremity diagonal 2, which involves combining flexion with abduction and internal rotation. This movement pattern is commonly used in rehabilitation and physical therapy to improve shoulder function and range of motion. By performing UE D2 exercises, individuals can strengthen the muscles around the shoulder joint and enhance their ability to perform activities that require reaching, lifting, and overhead movements.

Utilizing visual cues when appropriate is a good approach to working with communication deficits because it can help individuals who have difficulty understanding or expressing themselves verbally. Visual cues, such as pictures, gestures, or written words, can provide additional context and support to enhance communication. This approach can be particularly helpful for individuals with language disorders, cognitive impairments, or hearing impairments. By incorporating visual cues, it allows for a more inclusive and effective means of communication, promoting understanding and engagement.

An OTR working on EADLs with a client may encompass the use of assistive technology. This could involve assessing the client's needs and recommending devices or equipment that can help them perform daily activities more independently. Assistive tech can include anything from mobility aids like wheelchairs or walkers, to communication devices, adaptive switches, or computer software that assist with tasks like writing or reading. The goal is to enhance the client's functional abilities and improve their overall quality of life.

The FTHUE (Functional Test for the Hemiparetic Upper Extremity) is the best assessment for an OTR (Occupational Therapist Registered) to use when assessing a CVA (Cerebrovascular Accident) patient's use of the UE (Upper Extremity). This assessment specifically focuses on evaluating the functional abilities and limitations of the patient's affected arm and hand, providing valuable information for treatment planning and intervention.

A patient who can recite many facts but has lost the ability to remember their own life experiences would be said to have good explicit memory and poor episodic memory, respectively. Explicit memory refers to the conscious, intentional recollection of factual information, which the patient still retains. Episodic memory, on the other hand, involves the recall of personal experiences and events, which the patient has lost the ability to remember.

The KTA (Kitchen Task Assessment) is the best assessment for evaluating a patient with Alzheimer's basic cooking skills. This assessment specifically focuses on assessing a person's ability to perform basic cooking tasks, such as measuring ingredients, following a recipe, and using kitchen utensils safely. It provides a comprehensive evaluation of the individual's cognitive and functional abilities related to cooking, making it an appropriate choice for assessing cooking skills in patients with Alzheimer's.

Anosognosia refers to a lack of knowledge or denial of deficits or disease process and the implications of the deficit. This means that individuals with anosognosia are unaware or deny that they have any deficits or illness, even though they may clearly be experiencing them. This can be seen in conditions such as stroke or traumatic brain injury, where a person may be unable to recognize their own physical or cognitive impairments. This lack of awareness can make it difficult for them to seek or accept appropriate treatment and support.

The Rivermead Behavioral Memory Test (RBMT) is the best assessment for evaluating the everyday memory and functioning of a client. This test is specifically designed to assess memory impairments and functional difficulties in daily life activities. It includes various tasks that measure different aspects of memory, such as recall, recognition, and prospective memory. The RBMT has been widely used and has demonstrated good reliability and validity in assessing memory deficits in clinical populations. Therefore, it is the most suitable option for evaluating everyday memory and functioning in this scenario.

Based on the given information, the patient would receive a score of 5 on the FIM. The OTR gathered the necessary items for grooming ADLs and arranged them on the sink, but allowed the patient to complete the task independently without further assistance. This indicates that the patient has some level of independence in performing grooming tasks, but still requires some level of assistance or supervision. A score of 5 on the FIM indicates that the patient requires setup or cleanup assistance.

This question is asking for an explanation of the correct answer, which is "EFPT." EFPT stands for the Executive Function Performance Test, which is a tool used to assess an individual's ability to perform everyday tasks that require executive functioning skills. The EFPT assesses functioning in four specific areas: cooking, telephone use, medication management, and bill management. Therefore, EFPT is the correct answer because it aligns with the areas of functioning mentioned in the question.

The patient is experiencing anomic aphasia. This type of aphasia is characterized by difficulty in finding the correct words or names for things. The patient is able to speak articulately and grammatically correct, but they struggle with word-finding. This can be frustrating for the patient as they may have the thoughts and ideas in their mind, but struggle to express them due to difficulty in recalling the appropriate words.

This represents level III of the Brunnstrom stages. At this stage, the patient is able to perform some voluntary movements, but they are limited to synergistic patterns. Synergistic patterns refer to movements that occur in a fixed and stereotyped manner, such as flexion and extension of the limbs together. The patient is not able to perform isolated or selective movements yet.

The given explanation states that the reflex described is stimulated by rotating the upper trunk in relation to the pelvis. This results in increased flexor tone in the upper extremities (UE) and increased extension tone in the lower extremities (LE) on the side to which the trunk is turned. This reflex is known as the Tonic Lumbar reflex.

The correct answer is lying on the right side during sex to be able to caress with the left hand. This modification is recommended for a patient who suffered a left cerebrum CVA because the left cerebrum is responsible for controlling the right side of the body. By lying on the right side, the patient can use their unaffected left hand to engage in caressing during sexual activity.

The correct answer is Brunnstrom. Brunnstrom approach is a movement theory that focuses on reflexive movement, sensory stimuli, and synergies. It is commonly used in neurorehabilitation to help individuals regain movement and function after a neurological injury or condition. The approach involves facilitating and guiding the patient's movement patterns through various stages of recovery, starting from reflexive movements and progressing towards more voluntary control.

Rood is the correct answer because the Rood motor control theory does not direct conscious attention towards movement. This theory focuses on utilizing sensory stimulation to facilitate or inhibit muscle activity, without requiring conscious effort or attention from the individual. Rood's approach emphasizes reflexes and the use of sensory input to elicit automatic movement responses, making it distinct from the other motor control theories listed.

The OTR is pressed for time and wants to test a variety of cognitive skills with her new TBI patient, including abstract reasoning, temporal awareness, and simple math skills. CAM (Cognitive Assessment of Minnesota) would be the best choice for this assessment as it is designed to assess various cognitive abilities, including abstract reasoning, temporal awareness, and simple math skills. This assessment would provide a comprehensive evaluation of the patient's cognitive abilities within a limited timeframe.

The LOTCA assessment would be the best choice for assessing cognition in a patient with a brain tumor. LOTCA stands for "Lowenstein Occupational Therapy Cognitive Assessment" and it is specifically designed to evaluate cognitive functions such as attention, memory, problem-solving, and visual perception. Since the patient has a brain tumor, it is important to use an assessment that can thoroughly evaluate their cognitive abilities and identify any deficits or impairments that may be present. The LOTCA assessment is widely recognized and used in the field of occupational therapy for this purpose.

NDT, or Neurodevelopmental Treatment, is a motor control theory that does not rely on reflexive movement to facilitate normal movement. Instead, it focuses on facilitating the development of normal movement patterns through the use of guided movement and handling techniques. NDT aims to improve posture, balance, and coordination by promoting active participation and motor learning. This approach is often used in rehabilitation settings to help individuals with neurological conditions regain functional movement abilities.

The given sequence of letters can be categorized into groups of three. The first group consists of the letters L, O, and T. The second group consists of the letters C, A, and M. The third group consists of the letters F, T, H, U, and E. The fourth group consists of the letters T, C, and A. Therefore, the correct answer is TCA, as it follows the pattern of the fourth group. This question assesses the client's ability to categorize and reason deductively based on the given pattern.

PASS stands for the Performance Assessment of Self-Care Skills. It is a comprehensive assessment tool that evaluates a client's ability to perform activities of daily living (ADLs) and instrumental activities of daily living (IADLs). It assesses the client's mobility and safety in performing these tasks, making it the best choice for the OTR working in home health to assess the client's mobility and ability to safely perform ADLs and IADLs.

Dentures are considered an adaptive device and thus the patient can only receive at max a 6.

SROM, or Self Range of Motion, is the best type of ROM for preventing contractures. This is because SROM involves the patient actively moving their own joints and muscles, which helps to maintain flexibility and prevent stiffness. AROM (Active Range of Motion) is also beneficial, but may not be suitable for all patients depending on their condition or limitations. PROM (Passive Range of Motion) involves a therapist or caregiver moving the patient's joints for them, and while it can be helpful, it may not be as effective in preventing contractures as SROM.

The BEST assessment for an OTR working with a CVA patient suspected of experiencing UVN would be the BIT (Behavioral Inattention Test). The BIT is specifically designed to assess for visual neglect and other visual perceptual deficits, which are common in CVA patients. This assessment would help the OTR determine the extent of the patient's UVN and develop appropriate interventions to address their visual deficits.

The patient completes 25% of her lower body dressing, indicating that she requires moderate assistance from the OTR. According to the FIM scoring system, a score of 1 is given when a patient requires moderate assistance. Therefore, the patient would receive a score of 1 on the FIM.