Quiz: FIM Scoring & PT Clinical Documentation Skills

1. The moment an activity requires physical assistance by a caregive that is greater than 50% such as holding or physically lifting (generally more than one limb), then based on your clinical judgement, the level of assistance is either a 1- Total assist or a 2- Max assist.

True

False

When an activity requires physical assistance that is greater than 50%, such as holding or physically lifting, it is considered a 1- Total assist or a 2- Max assist. This means that the caregiver is providing the majority of the assistance for the activity. Therefore, the statement "The moment an activity requires physical assistance by a caregiver that is greater than 50% such as holding or physically lifting, then based on your clinical judgement, the level of assistance is either a 1- Total assist or a 2- Max assist" is true.

Explanation

When an activity requires physical assistance that is greater than 50%, such as holding or physically lifting, it is considered a 1- Total assist or a 2- Max assist. This means that the caregiver is providing the majority of the assistance for the activity. Therefore, the statement "The moment an activity requires physical assistance by a caregiver that is greater than 50% such as holding or physically lifting, then based on your clinical judgement, the level of assistance is either a 1- Total assist or a 2- Max assist" is true.

2. PROBLEM SOLVING: Mrs. P is able to tackle routine problems more than 50% of the time. Sometimes she needs verbal cues and prompts to come to an appropriate solution to the problem. What assistance is required to make appropriate decisions to solve problems?

7- None. Consistently carries out sequence of steps to solve complex problems.

3 - Moderate Assistance; Some direction needed. Patient solves routine problems 50-74% of the time.

1 - Total Assistance - All or almost all of the time. Patient solves routine problems less than 25% of the time.

5 - Only under stressful or unfamiliar conditions, but no more than 10% of the time.

6 - No assistance needed. Only mild difficulty but is able to self correct and/or requires extra time to solve complex problems.

Based on the given information, Mrs. P is able to solve routine problems more than 50% of the time, which indicates a moderate level of ability. However, she sometimes requires verbal cues and prompts to come to an appropriate solution, which suggests that she needs some direction and assistance. Therefore, the answer "3 - Moderate Assistance; Some direction needed. Patient solves routine problems 50-74% of the time" accurately describes the assistance required for Mrs. P to make appropriate decisions and solve problems.

Explanation

Based on the given information, Mrs. P is able to solve routine problems more than 50% of the time, which indicates a moderate level of ability. However, she sometimes requires verbal cues and prompts to come to an appropriate solution, which suggests that she needs some direction and assistance. Therefore, the answer "3 - Moderate Assistance; Some direction needed. Patient solves routine problems 50-74% of the time" accurately describes the assistance required for Mrs. P to make appropriate decisions and solve problems.

3. EXPRESSION: Mrs. P communicates by gesturing and using only single words. Staff members are usually able to understand the basic information that she is trying to express. When staff members need to prompt her to repeat herself more than 50% of the time, she becomes frustrated and waves them off, or laughs and cries inappropriately. What level of assistance is needed?

6 - No assistance required - Patient expresses complex or abstract ideas but requires a computer to assist with expressing ideas.

4- Minimal assistance - Patient expresses basic daily needs and ideas 75-90% of the time.

2 - Maximal Assistance required - Uses only single words or gestures to express basic needs; requiring prompting more than 50% of the time.

0 - activity did not occur

1 - Total Assistance - Expresses basic needs appropriately or consistently less than 25% of the time despite prompting

The given answer of 2 - Maximal Assistance required is appropriate because the expression states that Mrs. P communicates by gesturing and using only single words. It also mentions that staff members need to prompt her to repeat herself more than 50% of the time. This indicates that she requires a significant amount of assistance to express her basic needs, as she is unable to effectively communicate without frequent prompting.

Explanation

The given answer of 2 - Maximal Assistance required is appropriate because the expression states that Mrs. P communicates by gesturing and using only single words. It also mentions that staff members need to prompt her to repeat herself more than 50% of the time. This indicates that she requires a significant amount of assistance to express her basic needs, as she is unable to effectively communicate without frequent prompting.

4. COMPREHENSION: It is difficult to assess Mrs. P's comprehension for complex ideas, because she has such a great delay in response. Mrs. P follows one-step commands with repetition. She responds appropriately to directions about her basic daily needs with prompting approximately 50%-74% of the time. The information she understands consists of more than just simple statements. What level of assistance is needed?

7 - No assistance required. Patient comprehends complex or abstract directions and conversation, and understands either spoken or written language.

3 - Moderate: Patient understands directions and conversations about basic daily needs and ideas 50-74% of the time.

1 - Total Assistance: Patient understands only simple, commonly used spoken expressions or gestures about basic daily needs less than 25% of the time, despite prompting.

5 - Comprehends directions and conversation about basic daily needs requiring prompting no more than 10% of the time to be understood.

4 - Minimal: Understands directions and conversations about basic daily needs and ideas 75-90% of the time.

The given information states that Mrs. P follows one-step commands with repetition and responds appropriately to directions about her basic daily needs with prompting approximately 50%-74% of the time. This indicates that she understands directions and conversations about basic daily needs and ideas 50-74% of the time. Therefore, the level of assistance needed for Mrs. P is moderate.

Explanation

The given information states that Mrs. P follows one-step commands with repetition and responds appropriately to directions about her basic daily needs with prompting approximately 50%-74% of the time. This indicates that she understands directions and conversations about basic daily needs and ideas 50-74% of the time. Therefore, the level of assistance needed for Mrs. P is moderate.

5. LOCOMOTION: Walk - Mrs. P is able to walk 100 feet with her quad cane, before she requires a helper to remind her to stand up straight and pick up your left foot. Without stopping to rest she is able to continue another 60 feet. She does not have shortness of breath during rest or exertion. In preparation for her discharge, she has vowed to walk more than she would use the wheelchair. Her house is not wheelchair accessible. What is her mode of locomotion?

Wheelchair

Both

Walk

Mrs. P's mode of locomotion is walking. She is able to walk 100 feet with her quad cane before needing a reminder to stand up straight and lift her left foot. She can then continue another 60 feet without resting. She does not experience shortness of breath during rest or exertion. Since her house is not wheelchair accessible and she has vowed to walk more than use a wheelchair, it can be concluded that her mode of locomotion is walking.

Explanation

Mrs. P's mode of locomotion is walking. She is able to walk 100 feet with her quad cane before needing a reminder to stand up straight and lift her left foot. She can then continue another 60 feet without resting. She does not experience shortness of breath during rest or exertion. Since her house is not wheelchair accessible and she has vowed to walk more than use a wheelchair, it can be concluded that her mode of locomotion is walking.

6. SOCIAL INTERACTION: Mrs. P is emotionally labile and inappropriate the majority of the time. When her physicians come in to see her on the morning rounds, she starts crying uncontrollably and when her nurses greet her in the morning, she laughs hysterically. Mrs. P is successfully redirected by the staff more than 50% of the time. What level of assistance is needed?

7 - No assistance to re-direct needed. No activity limitations

5 - She requires redirection, only under stressful or unfamiliar conditions, but no more than 10% of the time, she is encouraged to participate.

1 - Requires total assistance all or most of the time. Patient is appropriate less than 25% of the time.

2 - Maximal direction needed. Patient is appropriate 25-49% or less than half of the time.

4 - Minimal/occasional direction. Patient is appropriate 75-90% of the time.

The given scenario describes Mrs. P as emotionally labile and inappropriate most of the time. It mentions that she starts crying when her physicians come in and laughs hysterically when her nurses greet her. However, the staff is able to successfully redirect her more than 50% of the time. This indicates that Mrs. P requires maximal direction, as she is only appropriate less than half of the time. Therefore, the correct answer is 2 - Maximal direction needed.

Explanation

The given scenario describes Mrs. P as emotionally labile and inappropriate most of the time. It mentions that she starts crying when her physicians come in and laughs hysterically when her nurses greet her. However, the staff is able to successfully redirect her more than 50% of the time. This indicates that Mrs. P requires maximal direction, as she is only appropriate less than half of the time. Therefore, the correct answer is 2 - Maximal direction needed.

7. MEMORY: Mrs. P recognizes her husband and children, but she needs occasional reminders, about once or twice a day , re: where she is, where her room is, or how to use a call light. What level of assistance does she need?

4 - Minimal Assistance needed; Occasional prompting. Patient recognizes and remembers 75-90% of the time.

1 - Total Assistance needed: All or almost all of the time. Patient recognizes and remembers less than 25% of the time.

7 - None needed. No activity limitations

2 - Max Assistance; A lot of prompting. Patient recognizes and remembers 25-49% of the time.

5 - Only under stressful or unfamiliar conditions, but no more thatn 10% of the time.

The patient, Mrs. P, recognizes her husband and children but occasionally needs reminders about her location, room, or how to use a call light. She requires minimal assistance and only needs occasional prompting. This suggests that she is able to remember and recognize things 75-90% of the time, indicating a relatively high level of cognitive functioning.

Explanation

The patient, Mrs. P, recognizes her husband and children but occasionally needs reminders about her location, room, or how to use a call light. She requires minimal assistance and only needs occasional prompting. This suggests that she is able to remember and recognize things 75-90% of the time, indicating a relatively high level of cognitive functioning.

8. Re: the above. How many feet would you assess she walked, without rest.

50 ft

100 ft

Over 150 feet

Based on the question, it is stated that the person walked without rest. Since there are only two options given (50 ft and 100 ft) and the correct answer is "over 150 feet", it can be inferred that the person walked more than the other two options combined. Therefore, the correct answer is "over 150 feet".

Explanation

Based on the question, it is stated that the person walked without rest. Since there are only two options given (50 ft and 100 ft) and the correct answer is "over 150 feet", it can be inferred that the person walked more than the other two options combined. Therefore, the correct answer is "over 150 feet".

9. Re: the above. Scoring this item requires consideration of both the level of assitance AND the distance walked. What is her level of assistance based on walking 160 feet using a quad cane, requiring no physical assistance only verbal cues?

4 - Min Assist

5 - Supervision

2 - Max Assist

6 - Mod I

3 - Max Assist

Based on the given information, the individual is able to walk 160 feet using a quad cane and requires no physical assistance, only verbal cues. This indicates that they have a high level of independence and can perform the task with minimal support. Therefore, the appropriate level of assistance for this individual would be "Supervision" (Answer: 5).

Explanation

Based on the given information, the individual is able to walk 160 feet using a quad cane and requires no physical assistance, only verbal cues. This indicates that they have a high level of independence and can perform the task with minimal support. Therefore, the appropriate level of assistance for this individual would be "Supervision" (Answer: 5).

10. TRANSFERS; Bed/Chair/Wheelchair: Mrs. P does a stand pivot transfer from bed to the wheelchair. She needs a helper to arrange her wheelchair next to the bed, so that she transfers toward her strong side, only requiring contact guard assistance. When moving from wheelchair to the bed, she needs lifting assistance rather than just contact guard, but she still does the majority of the work in transferring. What is this patient's level of assistance?

Supervision - 5

Min Assist - 4

Max Assist - 2

Mod Assist - 3

Dependent - 1

The patient requires moderate assistance (Mod Assist - 3) during transfers. Although she is able to do the majority of the work herself, she still needs lifting assistance when moving from the wheelchair to the bed. This indicates that she requires some level of physical support and assistance during the transfer process.

Explanation

The patient requires moderate assistance (Mod Assist - 3) during transfers. Although she is able to do the majority of the work herself, she still needs lifting assistance when moving from the wheelchair to the bed. This indicates that she requires some level of physical support and assistance during the transfer process.

11. LOCOMOTION: Stairs -On admission, Mrs. P is only able to climb 4-5 stairs, using her quad cane. She is not able to climb the full set of stairs. She needs a helper to stand by. What is the level of assistance needed?

5 - Supervision

1- Total Assist

3 - Mod Assist

2 - Max Assist

The level of assistance needed is "2 - Max Assist" because Mrs. P is unable to climb the full set of stairs and requires a helper to stand by. This indicates that she needs maximum assistance to climb the stairs safely.

Explanation

The level of assistance needed is "2 - Max Assist" because Mrs. P is unable to climb the full set of stairs and requires a helper to stand by. This indicates that she needs maximum assistance to climb the stairs safely.

12. TRANSFERS; Toilet: Transferring onto a regular toilet seat, Mrs. P uses her quad cane and a helper provides verbal assistance to help her get situated on the toilet. Mrs. P needs just a slight amount of lifting assistance when rising from the toilet. What is her level of assistance?

Supervision - 5

Min Assist - 4

Mod Assist - 3

Max Assist - 2

Dependent - 1

Mrs. P requires moderate assistance when transferring onto a regular toilet seat. She uses her quad cane for support and receives verbal assistance from a helper. Although she only needs a slight amount of lifting assistance when rising from the toilet, her overall level of assistance is considered moderate.

Explanation

Mrs. P requires moderate assistance when transferring onto a regular toilet seat. She uses her quad cane for support and receives verbal assistance from a helper. Although she only needs a slight amount of lifting assistance when rising from the toilet, her overall level of assistance is considered moderate.

FIM Competency Quiz – Pt Functional Assessment Review