1.
EATING
Mr. J has no trouble feeding himself, or swallowing food or liquid. He needs a low sodium/renal diet. He has no problems coughing. He has no fluid or nutritional deficits. He requires dentures to eat.
What is the FIM score?
A. 
B. 
C. 
D. 
1 - Dependent/Total Assist
2.
GROOMING
Mr. J is able to wash his face and hands, brush his teeth and comb his hair. He requires encouragement to do this by staff and family members.
What is the FIM score?
A. 
B. 
C. 
D. 
3.
BATHING
Mr. J is only able to wash, rinse and dry both arms and chest. A staff member has to complete the remainder of the bath for him. (Think of this scenario as a math problem. There are 10 body parts in the definition of bathing. How many body parts is the patient able to wash/rinse/dry. Then calculate a percentage to reach the level of assistance needed.)
What is the FIM score?
A. 
1 - Dependent/Total Assis
B. 
C. 
D. 
4.
UPPER BODY DRESSING
After he is given his undershirt, shirt and sweater, Mr. J is able to dress his upper body independently.
What is the FIM score?
A. 
B. 
C. 
D. 
5.
LOWER BODY DRESSING
Mr. J requires a helper for dressing his lower body. He requires a helper to thread both legs into his underwear and his pants and he needs your assistance pulling them up over his hips on his own. A helper puts his socks and shoes on, and fastens his Velcro straps on his shoes.
What is the FIM score?
A. 
B. 
C. 
D. 
6.
TOILETING - A staff member needs to pull Mr. J's pants down and underwear down, prior to sitting on the toilet. Mr. J. uses toilet paper independently and is able to pull up his underwear and pants. (Toileting = 3 tasks. Think of this as a math problem. How many of the 3 tasks can the patient do without your assistance and then calculate a percentage.)
What is the FIM score?
A. 
B. 
C. 
D. 
7.
True or False
If you don't have to remind the patient to void but you have to stand by while the patient is using the toilet to void, and the patient does not take any medication for sphincter control, the FIM score for BLADDER MANAGEMENT would be a 7-Independent.
8.
BLADDER MANAGEMENT
Mr. J requires hemodialysis and does not void.
A. 
B. 
C. 
D. 
9.
BOWEL MANAGEMENT
Mr. J has had 3 small episodes of loose stool in the first 3 days of admission; requiring staff to help him re-dress and change the pad and linens on his bed.
What is the FIM score?
A. 
B. 
C. 
D. 
10.
TRANSFERS: Bed/Chair/Wheelchair
Mr. J can do a stand pivot transfer from bed to a wheelchair, and back. He does not require any lifting assistance, only contact guard assist.
What is the FIM score?
A. 
B. 
C. 
D. 
11.
TRANSFERS: Toilet
Mr. J is able to stand pivot transfer from a wheelchair to the toilet, using grab bars and raised toilet seat. To transfer back to wheelchair, Mr. J requires more than 50% lifting assistance from the helper.
What is the FIM score?
A. 
B. 
C. 
D. 
12.
COMPREHENSION
Mr. J is legally blind, and requires verbal instruction instead of written. He easily understands others.
What is the FIM score?
A. 
B. 
C. 
D. 
13.
EXPRESSION
Mr. J is independent in expressing both complex and basic concepts to staff and his family.
What is the FIM score?
A. 
B. 
C. 
D. 
14.
SOCIAL INTERACTION
Mr. J has a flat affect. His children feel that he is depressed; he was started on medication for depression about 3 weeks ago. Staff members need to encourage Mr. J to interact with others but no more than 10% of the time.
What is the FIM score?
A. 
B. 
C. 
D. 
15.
PROBLEM SOLVING
Mr. J requests that his dialysis schedule be changed back to his previous schedule when he was at home, because this allowed his daughter to provide transportation for him on her days off from work. MR. J is planning for family members to stay with him for a few weeks when he gets home, to make sure he is doing okay. He is able to solve basic problems as well.
What is the FIM score?
A. 
B. 
C. 
D. 
16.
MEMORY
Mr. J has no difficulty recognizing his family and the many friends from his church that visit almost daily. He easily follows his routine and questions medication changes that have occurred.
What is the FIM score?
A. 
B. 
C. 
D. 
17.
When the rehab term "max assist of 2" is used to describe level of assistance requiring 2 helpers, regardless of tasks, the FIM score is always a 1 or Total Assist, not a 2 or Max Assist.
18.
Both Bowel and Bladder Management consist of 2 "function modifiers" - 1. level of assistance (using a device or medication) and 2. # of accidents during your shift.
The lowest score between these 2 function modifiers is the final FIM score.
19.
The definition of Toileting is pants down, self hygiene, pants up. How do you score a patient for Toileting if the amount of assistance needed differs between voiding and bowel movements?
A. 
It doesn't matter. Choose either score.
B. 
Record the lowest of the two scores
C. 
Rrecord the highest of the two scores
D. 
20.
In addition to scoring Bladder/Bowel Management, TOILETING is also scored if the patient uses a bedpan.
True or False?
21.
If you judge that the patient needs a reminder to go to the bathroom to use the toilet before you leave the room, or needs periodic reminding but patient is not formally on a timed voiding program, the FIM score would be 5 or Supervision.
True or False