Ot 2nd Quarter 2014
Mr. X, a 72 yo male, fell down a flight of stairs and was admitted to the acute care hospital with confused sensorium and incomplete motor and sensory tetraplegia due to fracture dislocation at C6-7. There was no loss of conciousness. He had a cervical traction applied. The CT scan showed a right parietal subdural hematoma. Burrhole evacuation of the subdural hematoma was performed under local anesthesia. Two days later the cervical spine was reduced and fused posteriorly. He was then transferred to an IRF, Inpatient Rehab Facility.
Questions and Answers
- 1.
EATING: Mr. X eats a regular diet, however, he requires some (less than 50%) physical assistance with eating.The helper applies a universal cuff and scoops each spoonful of food onto Mr. X's spoon. Mr X then brings the food from the plate into his mouth and is able to chew and swallow without difficulty. What is the FIM score?
- A.
3 or Mod Assist
- B.
1 or Total Assist
- C.
5 or Supervision/Set up
- D.
6 or Mod I
Correct Answer
A. 3 or Mod AssistExplanation
The FIM score for Mr. X would be 3 or Mod Assist. This is because he requires some physical assistance with eating, specifically in the form of the helper applying a universal cuff and scooping each spoonful of food onto his spoon. However, Mr. X is able to bring the food from the plate into his mouth and chew and swallow without difficulty. Therefore, he does not require total assistance or supervision/set up, but rather only requires moderate assistance.Rate this question:
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- 2.
GROOMING: Mr. X washes his left hand after having a wash mitt applied to his right hand. Mr. X also washes his face, combs his hair and brushes his teeth. The helper washes his right hand and assists with shaving. Patient is able to complete 3 out of the 5 or 60% of the tasks for Grooming. What is the FIM score?
- A.
6 or Mod I
- B.
5 or Supervision
- C.
4 or Min Assist
- D.
3 or Mod Assist
Correct Answer
D. 3 or Mod AssistExplanation
The FIM score for Grooming is 3 or Mod Assist because the patient is able to complete 3 out of the 5 tasks for Grooming. This means that the patient requires moderate assistance to complete the tasks. The patient is able to wash his face, comb his hair, and brush his teeth independently, but requires assistance with washing his right hand and shaving.Rate this question:
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- 3.
BATHING - Mr. X washes, rinses and dries 2 body parts without assistance: chest and left arm. The helper washes, rinses and dries the remaining 8 body parts. In other words, the patient is able to complete 2 out of 10 tasks or less than 25% without assistance. What is the FIM score?
- A.
5 or Supervision/Set up
- B.
4 or Min Assist
- C.
2 or Max Assist
- D.
1 or Total Assist
Correct Answer
D. 1 or Total AssistExplanation
The FIM score is 1 or Total Assist because Mr. X requires assistance for all 10 body parts during bathing. He is only able to complete 2 out of the 10 tasks without assistance, which means he needs total assistance for the remaining 8 tasks.Rate this question:
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- 4.
UPPER BODY DRESSING: Mr X typically wears a pullover sweatshirt. The helper places the shirt over Mr. X's head and threads each arm. Mr. X then leans forward so the helper can pull the sweatshirt down over his trunk. Mr. X does less than 25% of the tasks to complete upper body dressing What is the FIM score?
- A.
1 or Total Assist
- B.
3 or Mod Assist
- C.
5 or Supervision/Set up
- D.
7 or Independent
Correct Answer
A. 1 or Total AssistExplanation
The FIM score is 1 or Total Assist because Mr. X does less than 25% of the tasks to complete upper body dressing. This means that he requires assistance from the helper to complete the activity.Rate this question:
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- 5.
LOWER BODY DRESSING: Mr. X usually wears sweat pants with an elastic waist, antiembolic stockings, socks and sneakers. The helper applies the antiembolic stockings and then threads both pant legs to Mr. X's knees. Mr. X then shifts side to side so the helper can pull up the pants over his hips.The helper then puts on Mr. X's socks and sneakers. The patient performs less than 25% of the lower body dressing tasks. What is the FIM score?
- A.
2 or Max Assist
- B.
5 or Supervision
- C.
6 or Mod I
- D.
1 or Total Assist
Correct Answer
D. 1 or Total AssistExplanation
The given scenario describes that Mr. X requires assistance for almost all of the lower body dressing tasks. The helper applies the antiembolic stockings and threads the pant legs, and Mr. X only shifts side to side to assist in pulling up the pants. Additionally, the helper also puts on Mr. X's socks and sneakers. As Mr. X performs less than 25% of the dressing tasks, the appropriate FIM score would be 1 or Total Assist, indicating that he requires complete assistance for lower body dressing.Rate this question:
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- 6.
TOILETING: Mr. X shifts from side to side as the helper adjusts his clothing before and after his intermittent catheterizations and bowel movements. Mr. X wipes himself. The patient can complete 1 out of the 3 (33%) of the tasks for Toileting What is the FIM score?
- A.
1 or Total Assist
- B.
5 or Supervision/Set up
- C.
2 or Max Assist
- D.
Activity did not occur
Correct Answer
C. 2 or Max AssistExplanation
The FIM score for this scenario would be 2 or Max Assist. This means that the patient requires maximum assistance to complete the tasks related to toileting. The patient is unable to complete 2 out of the 3 tasks independently and relies on the helper for assistance in adjusting clothing and wiping.Rate this question:
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- 7.
BED/CHAIR/WHEELCHAIR TRANSFER: Mr. X requires assistance from 2 staff members, a max assist of 2, to get into and out of bed. During one of those transfers, one of the 2 helpers does not physically assist the patient but is there for safety reasons. What is the FIM score?
- A.
6 or Mod I
- B.
7 or Independent
- C.
2 or Max Assist
- D.
1 or Total Assist
Correct Answer
D. 1 or Total AssistExplanation
During the bed/chair/wheelchair transfer, Mr. X requires assistance from 2 staff members. However, one of the helpers does not physically assist the patient but is there for safety reasons. This means that Mr. X needs total assistance during the transfer, as one staff member is not providing physical assistance. Therefore, the FIM score for this situation would be 1 or Total Assist.Rate this question:
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- 8.
TOILET TRANSFER: Mr. X requires help from 2 staff members to get on and off the toilet, one to physically assist and the second one to be there "just in case". What is the FIM score?
- A.
1 or Total Assist
- B.
5 or Supervision
- C.
4 or Min Assist
- D.
2 or Max Assist
Correct Answer
A. 1 or Total AssistExplanation
The FIM score for Mr. X in this situation would be 1 or Total Assist because he requires assistance from two staff members to get on and off the toilet. This means that he is unable to perform the task independently and relies on the help of others for complete assistance.Rate this question:
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- 9.
TUB/SHOWER TRANSFER: Mr. X does not perform bath or shower transfers during the first 3 days of admission because he refused. He bathes in bed each morning. What is the FIM score?
- A.
7 or Independent
- B.
1 or Total Assist
- C.
0 or Activity did not occur
- D.
5 or Supervision/Set up
Correct Answer
C. 0 or Activity did not occurExplanation
The FIM score is 0 or "Activity did not occur" because Mr. X did not perform bath or shower transfers during the first 3 days of admission. Instead, he bathes in bed each morning. Since the activity did not occur, it cannot be scored and the FIM score is 0.Rate this question:
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- 10.
COMPREHENSION: Mr. X consistently understands questions that the staff asks him about routine every day matters such as meals, and need for pain medication. He watches television programs, but cannot understand abstract information such as the plot of a movie, current events or humor. He requires prompting less than 10% of the time. What is the FIM score?
- A.
2 or Maximal Prompting
- B.
4 or Minimal Prompting
- C.
5 or Stand by Prompting
- D.
1 or Total Assist
Correct Answer
C. 5 or Stand by PromptingExplanation
The FIM score for Mr. X would be 5 or Stand by Prompting because he requires prompting less than 10% of the time. This means that he can perform daily routine tasks with minimal assistance and can understand questions about everyday matters such as meals and pain medication. However, he struggles with abstract information like the plot of a movie, current events, and humor.Rate this question:
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- 11.
EXPRESSION: Mr. X consistently expresses information about daily needs clearly, but cannot discuss abstract information such as financial and insurance matters. With prompting 10% of the time, he expresses such things as menu choices, and makes statements about activities in which he is involved during occupational and physical therapy. What is the FIM score?
- A.
0 or Activity did not occur
- B.
5 or Stand by Prompting
- C.
1 or Total Assist
- D.
3 or Moderate Prompting
Correct Answer
B. 5 or Stand by PromptingExplanation
Based on the given expression, Mr. X is able to express information about his daily needs clearly with some prompting. However, he struggles to discuss abstract information like financial and insurance matters. This suggests that he requires stand-by prompting, which means he needs someone nearby to provide occasional assistance or reminders in order to complete the activity. Therefore, the FIM score for Mr. X would be 5 or Stand by Prompting.Rate this question:
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- 12.
SOCIAL INTERACTION: Mr. X is very cooperative with the rehab staff and interacts well with patients. What is the FIM score?
- A.
5 or Supervision Set up
- B.
3 or Mod Assist
- C.
7 or Independent
- D.
6 or Mod I
Correct Answer
C. 7 or IndependentExplanation
Based on the given information, Mr. X is described as being cooperative with the rehab staff and interacting well with patients. This suggests that he is able to independently perform tasks and does not require any assistance or supervision. Therefore, his FIM score would be 7 or Independent.Rate this question:
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- 13.
PROBLEM SOLVING: Mr. X. consistently recognizes and solves routine problems, such as asking for help when unable to reach something or putting on his call light. However, he cannot make decisions about household finances, discharge plans or transportation arrangements. He requires supervision no more than 10% of the time. What is the FIM score?
- A.
5 or Supervision/Standby
- B.
4 or Minimal Direction
- C.
3 or Moderate Direction
- D.
2 or Maximal Direction
Correct Answer
A. 5 or Supervision/StandbyExplanation
The given information indicates that Mr. X is able to consistently recognize and solve routine problems, but he is unable to make decisions about household finances, discharge plans, or transportation arrangements. However, he only requires supervision for no more than 10% of the time. Based on this information, Mr. X would be classified as having a FIM score of 5 or Supervision/Standby, as he is able to perform tasks independently but may need someone nearby for supervision or standby assistance.Rate this question:
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- 14.
MEMORY: Mr. X. recognizes the rehab staff who treat him but cannot always recall their names. He can list his daily activities to the staff. He responds to requests appropriately, but needs repetition less than 10% of the time in a stressful or unfamiliar circumstance. What is the FIM score?
- A.
7 or Independent
- B.
5 or Supervision or requires prompting no more than 10% of the time.
- C.
2 or Maximal Prompting or requires prompting more than half of the time
- D.
4 or Minimal Prompting or requires prompting 10-25% of the time
Correct Answer
B. 5 or Supervision or requires prompting no more than 10% of the time.Explanation
Based on the given information, Mr. X recognizes the rehab staff and can list his daily activities to them. He responds appropriately to requests and needs repetition less than 10% of the time in stressful or unfamiliar situations. This indicates that Mr. X requires prompting no more than 10% of the time, which corresponds to a FIM score of 5 or Supervision.Rate this question:
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Mar 18, 2023Quiz Edited by
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