1.
EATING - Mr. D is able to swallow thin liquids and any consistency of food without problems. He requires dentures in order to eat and feeds himself independently.
Correct Answer
B. 6 or Modified Independent
Explanation
The given answer of "6 or Modified Independent" suggests that Mr. D is able to eat and feed himself independently, but requires dentures in order to do so. This means that although he can eat without assistance, he relies on dentures for proper chewing and swallowing. Therefore, his level of independence is modified by the need for dentures.
2.
GROOMING - Mr. D sits in a wheelchair at the sink and his girlfriend brings him his supplies. He is able to wash, rinse and dry his face and hands. He brushes his teeth and shaves independently. He is able to comb his hair without help.
Correct Answer
B. 5 or Supervision/Set up
Explanation
Based on the given information, Mr. D is able to perform most grooming activities independently. However, he may require supervision or assistance in setting up the supplies or ensuring that he is following the correct steps. Therefore, the appropriate rating for his grooming ability would be 5 or Supervision/Set up.
3.
BATHING - Bathing on a shower bench with arm rests and a back rest, Mr. D is able to wash, rinse and dry his arms, chest, abdomen and upper legs. He is able to lean over to bathe his lower legs and feet without assistance. However, a helper bathes his buttocks and perineal area.
Correct Answer
A. 4 or Min Assist
Explanation
Mr. D is able to independently wash, rinse, and dry his upper body and upper legs while sitting on the shower bench with arm rests and a back rest. However, he requires assistance from a helper to wash his buttocks and perineal area. This indicates that Mr. D requires minimal assistance (Min Assist) during bathing.
4.
DRESSING UPPER BODY - After a helper sets out his shirt, Mr. D is able to put his t-shirt and sweatshirt on. He is independent in undressing and throws his own laundry in a basket that his girlfriend will pick up in a few days.
Correct Answer
C. 5 or Supervision/Set up
Explanation
The given answer of "5 or Supervision/Set up" suggests that Mr. D requires some level of assistance or supervision when dressing his upper body. Although he is able to put on his t-shirt and sweatshirt independently, he still needs someone to set out his shirt for him. This indicates that he may have difficulty with certain aspects of dressing, such as selecting the appropriate clothing or organizing the process. Therefore, supervision or assistance is needed to ensure that he is able to dress himself effectively and safely.
5.
DRESSING LOWER BODY - While seated in bed, Mr. D has difficulty threading his legs into his sweatpants, and he requires assistance with this task. Otherwise, he can pull up his pants independently. He is able to put his socks and shoes on, with extra time, and take them off independently. He removes his sweatpants independently and does not wear underwear.
Correct Answer
B. 4 or Min Assist
Explanation
The correct answer is 4 or Min Assist because Mr. D requires assistance with threading his legs into his sweatpants, but he is able to pull up his pants independently. He can also put on and take off his socks and shoes independently, although it takes him extra time. He is able to remove his sweatpants independently and does not wear underwear. Therefore, he only needs minimal assistance for one specific task.
6.
TOILETING - With contact guard assistance, Mr. D is able to pull down his sweatpants without assistance and sit on the toilet. He needs steadying assistance to lean forward so he can clean himself with toilet paper. He needs help pulling up his sweatpants. (Remember, it's a math problem)
Correct Answer
C. 3 or Mod Assist
7.
BLADDER - On admission, the nurse removed Mr. D's indwelling catheter, and started an intermittent catheter schedule every 4 hours. Mr. D is not voiding at all in between catheterizations. What is the level of assistance?
Correct Answer
C. 1 or Total Assist
Explanation
The level of assistance is "Total Assist" because Mr. D is unable to void at all in between catheterizations, indicating that he requires complete assistance in emptying his bladder.
8.
BLADDER - The following day, Mr. D is using a urinal but he has an bladder accident on evenings requiring a helper to change the linens and clothing. What is the level of assistance?
Correct Answer
C. 1 or Total Assist
Explanation
Based on the information provided, Mr. D requires total assistance in changing the linens and clothing after having a bladder accident. This indicates that he is unable to perform the task independently and requires someone else to provide complete assistance.
9.
BOWEL - The nurses are working to manage the patients bowels with a suppository every other morning. On one occasion, after the suppository was inserted by the nurse, Mr.D had a bowel movement on the toilet. The patient performed 25-49% of the task of inserting the suppository.
Correct Answer
C. Max Assist or 2
Explanation
The patient performed 25-49% of the task of inserting the suppository, indicating that they required maximum assistance (Max Assist or 2) from the nurse. This means that the nurse had to provide extensive physical or verbal assistance to the patient in order to complete the task successfully. The patient was unable to perform the task independently or with minimal supervision or set up.
10.
BED/CHAIR/WHEELCHAIR TRANSFER - After raising his bed height, Mr. D. can transfer from bed to the wheelchair, once a helper has locked the wheelchair brakes. He has more difficulty transferring from the wheelchair back to the bed. Mr. D. performs a little less than half the effort involved in the transfer.
Correct Answer
C. Max Assist or 2
Explanation
Mr. D. requires maximum assistance or a score of 2 when transferring from the wheelchair back to the bed. This means that he is unable to perform more than 50% of the effort involved in the transfer. It indicates that he heavily relies on the assistance of others to complete the task safely and effectively.
11.
TOILET TRANSFER - Mr. D. is able to transfer from the wheelchair to the toilet with contact guard assist, but needs a little lifting when returning to the wheelchair.
Correct Answer
D. Mod Assist or 3
Explanation
The explanation for the correct answer, Mod Assist or 3, is that Mr. D. requires moderate assistance when transferring from the wheelchair to the toilet and back. This means that he can perform the task with some help, such as guidance or steadying, but still needs assistance with lifting when returning to the wheelchair. The other options, Max Assist or 2, Min Assist or 4, and Total Assist or 1, do not accurately describe the level of assistance required by Mr. D.
12.
LOCOMOTION - Mr. D can propel himself in a manual wheelchair for over 175 feet. He requires intermittent verbal cues when negotiating corners or estimating the space that his wheelchair could fit in, for example, when trying to get on the elevator.
Correct Answer
A. Supervision/Set up or 5
Explanation
Based on the given information, Mr. D is able to propel himself in a manual wheelchair for over 175 feet. However, he requires intermittent verbal cues when negotiating corners or estimating the space that his wheelchair could fit in. This suggests that Mr. D is able to perform the task of locomotion with supervision or set up, indicating that he may need assistance or guidance in certain situations. Therefore, the correct answer is Supervision/Set up or 5.
13.
STAIRS - Mr. D has not attempted stairs, but is independent in using an elevator to get to his therapy sessions, located 2 floors down from his hospital room.
Correct Answer
C. Activity did not occur or 0
Explanation
The given information states that Mr. D did not attempt stairs but used an elevator to get to his therapy sessions. This means that he did not engage in the activity of using stairs. Therefore, the correct answer is "Activity did not occur or 0".
14.
Comprehension - The staff often need to gesture to Mr. D, during his therapy sessions. His sister is present during therapy sessions to help him participate. Mr. D is able to understand basic commands over half the time, with consistent gesturing and prompting by the staff and his sister.
Correct Answer
C. Mod Assist or 3
Explanation
The correct answer, "Mod Assist or 3," suggests that Mr. D requires moderate assistance during his therapy sessions. This is supported by the information provided that the staff often need to gesture to him and his sister is present to help him participate. Additionally, it is mentioned that Mr. D is able to understand basic commands over half the time with consistent gesturing and prompting. Therefore, a moderate level of assistance is required to facilitate his participation and understanding during the therapy sessions.
15.
Expression - Staff members are able to understand what Mr. D is trying to express. He asks questions and talks about his daily care, but does not discuss more complex issues. He requires prompting less than 10% of the time to be understood.
Correct Answer
B. Standby Prompting or 5
Explanation
The staff members are able to understand what Mr. D is trying to express, but he requires prompting less than 10% of the time to be understood. This indicates that Mr. D can express himself fairly well but may occasionally need some assistance or prompting. Standby Prompting or 5 is the most appropriate answer because it suggests that Mr. D can communicate with minimal assistance, but may occasionally require some support or prompting from the staff members.
16.
Social Interaction - Mr. D participates in activities or therapy sessions only if his sister is there to assist. She assists less than 10% of the time. When he participates, he is appropriate.
Correct Answer
B. Supervision/set up or 5
Explanation
Mr. D requires supervision/set up or a level 5 of assistance during social interaction activities or therapy sessions. This means that he can participate in these activities independently, but may need occasional assistance or guidance from his sister. The fact that his sister assists less than 10% of the time suggests that Mr. D is able to engage appropriately in these activities most of the time without significant direction or support.
17.
Problem Solving - Mr. D's room is close to the nurse's station because he periodically tries to climb over the side rails to get out of bed. He does not require a 1:1. Mr. D shows appropriate problem solving 55% of the time.
Correct Answer
B. Moderate Direction or 3
Explanation
Mr. D's room is close to the nurse's station because he periodically tries to climb over the side rails to get out of bed. This indicates that he requires some level of assistance and supervision to ensure his safety. The fact that he shows appropriate problem solving 55% of the time suggests that he is able to solve problems independently most of the time, but occasionally requires moderate direction or guidance from the nursing staff. Therefore, the correct answer is Moderate Direction or 3.
18.
Memory - Mr. D requires constant cuing to maintain hip precautions. He needs to be reminded continually not to get out of bed on his own. A few minutes after reviewing hip precautions, Mr. D is seen bending over in the wheelchair trying to pick up a piece of paper that had fallen onto the floor. He does not effectively remember these precautions nor does he recognize staff he encouters each day.
Correct Answer
C. Total Assist or 1
Explanation
The given scenario describes a patient, Mr. D, who requires constant cuing to maintain hip precautions and needs to be reminded continually not to get out of bed on his own. Despite reviewing the precautions a few minutes ago, Mr. D is seen bending over in a wheelchair, indicating that he does not effectively remember these precautions. Additionally, he does not recognize the staff he encounters each day. These observations suggest that Mr. D requires total assistance (level 1) to ensure his safety and compliance with hip precautions.