Sbr: Johnson - Anderson

The client's symptoms of pain, progressive weakness, atrophy, and numbness and tingling in specific fingers suggest a compression or injury to the median nerve. The median nerve innervates the muscles of the thumb and is responsible for sensation in the thumb, index, long, and half of the ring fingers. The absence of paroxysmal UE limitations indicates that the problem is not related to the ulnar nerve, radial nerve, or brachial plexus. Therefore, the most likely suspect is the median nerve.

A C6 injury affects the sixth cervical vertebra, resulting in limited hand and wrist movement. Using a wrist driven flexor hinge splint would be most beneficial for someone with a C6 injury because it helps to stabilize and support the wrist joint, allowing for improved grip and control during prehension activities. This type of splint assists with flexion and extension movements of the wrist, which are particularly important for individuals with C6 injuries who have limited hand function.

The correct answer is Post-traumatic stress disorder (PTSD). PTSD is an anxiety disorder that can develop after experiencing or witnessing a traumatic event, such as a fire and the loss of a loved one. The client's symptoms, such as anxiety, distressing memories, nightmares, and avoidance of reminders related to the traumatic event, align with the diagnostic criteria for PTSD. Cyclothymic disorder is a mood disorder characterized by periods of hypomanic symptoms and depressive symptoms, while dysthymia is a chronic form of depression. Schizophrenia is a severe mental disorder characterized by hallucinations, delusions, and disorganized thinking.

The individual's alternating display of laughing and crying during the treatment session suggests emotional lability. Emotional lability refers to rapid and unpredictable shifts in mood, often accompanied by intense emotional reactions. This behavior is not indicative of mania, paranoia, or denial, as these terms do not encompass the specific pattern of emotional fluctuation observed in the individual.

An OT would most likely choose an interview as an assessment method to learn about a family's values and priorities. This is because an interview allows for direct communication and interaction with the family, providing an opportunity to ask specific questions and gather detailed information about their values and priorities. Skilled observation, inventory, and standardized tests may provide useful information about the family, but they may not directly capture the subjective perspectives and personal insights that can be gained through an interview.

The individual's performance demonstrates left unilateral neglect. Left unilateral neglect is a condition in which a person is unable to attend to or be aware of stimuli on one side of their body or environment, typically the left side. In this case, the individual's lopsided drawing of the clock with a flat side on the left suggests that they are neglecting the left side of the clock and focusing only on the right side. This is a common symptom seen in individuals who have had a stroke affecting the right side of the brain.

Individuals with borderline personality disorder often struggle with maintaining stable and healthy relationships with others. They may have difficulty with interpersonal relationships due to their intense and unstable emotions, impulsivity, and fear of abandonment. These challenges can lead to a pattern of unstable and tumultuous relationships, difficulty in maintaining long-term relationships, and conflicts with others.

In an oral motor evaluation, the OT practitioner is assessing the client's tongue movements and functions. Protrusion refers to the act of sticking out the tongue, while lateralization refers to moving the tongue from side to side. Therefore, the OT practitioner is attempting to facilitate both the protrusion and lateralization functions during the evaluation.

The most relevant short-term goal would be for the child to correctly identify, by feel only, five out of five common objects. This is because the deficit in tactile discrimination, specifically stereognosis, indicates a difficulty in recognizing objects by touch. By setting this goal, the child will be encouraged to improve their fine motor skills and tactile discrimination abilities by accurately identifying common objects through touch alone.

Obstacle courses would be the best activity to consolidate the child's skills in spatial organization and motor planning. Obstacle courses require the child to navigate through various physical challenges, such as climbing over objects, crawling under obstacles, and balancing on beams. These activities enhance the child's ability to plan and execute movements in a coordinated manner, while also improving their spatial awareness and problem-solving skills. Relay races and freeze tag may involve running and tagging, but they do not specifically target spatial organization and motor planning. The balance beam primarily focuses on balance skills rather than spatial organization and motor planning.

Left unilateral neglect refers to a condition where an individual is unable to pay attention to or be aware of stimuli on the left side of their body or environment. In this case, the individual with a stroke is copying a clock but only focuses on the right side, resulting in a lopsided circle with a flat side on the left. This demonstrates a lack of attention or neglect towards the left side, which is characteristic of left unilateral neglect.

The best recommendation the OT could make for wheelchair use at school would be to change to a power wheelchair to reduce effort. This would help alleviate the child's fatigue upon arrival at school, as they would no longer have to manually propel themselves between classes. The power wheelchair would provide the child with the necessary assistance and reduce the physical exertion required, allowing them to conserve energy for other activities throughout the day.

The client is experiencing symptoms that are consistent with carpal tunnel syndrome, which is caused by compression of the median nerve. The pain, weakness, atrophy, and numbness and tingling in the thumb, index, long, and half of the ring fingers are all characteristic of median nerve compression. The fact that the client is not experiencing proximal upper extremity limitations suggests that the issue is localized to the median nerve rather than a more widespread nerve problem such as ulnar nerve compression or brachial plexus injury. Therefore, the practitioner will most likely suspect problems with the median nerve.

The most appropriate recommendation would be to expand the doorway width to have a minimum clear opening of 32 inches. This is because the ADA guidelines require a minimum clear opening of 32 inches for wheelchair accessibility. A clear opening of 28 inches is not sufficient for the client to pass through comfortably with their wheelchair. Expanding the doorway width to 32 inches would ensure that the client can navigate through the doorway without any difficulties.

Contrast baths involve alternating between warm and cold water, which can help decrease joint stiffness. Active and passive range of motion exercises can help improve joint mobility and reduce stiffness. Retrograde massage involves using gentle pressure to stimulate lymphatic flow and reduce swelling, which can also help alleviate joint stiffness. Therefore, implementing these techniques would be the most appropriate initial approach for alleviating joint stiffness in a client with acute right upper extremity and hand lymphedema after a mastectomy.

The OT practitioner would determine that the child's dressing skills are age appropriate because the child is able to perform tasks such as putting on a jacket, zipping the zipper, and tying a knot in the drawstring, which are skills typically expected of a 5-year-old. The fact that the child needs verbal cueing to tie a bow suggests that they may still be developing this particular skill, but overall their dressing skills align with what is expected for their age.

The answer "Meal prep techniques using wheelchair" is the best option for addressing the goals of independence in meal preparation for an individual with ALS who is no longer able to ambulate. Since the individual is unable to stand or walk, using a wheelchair for meal preparation allows them to maintain independence and continue to participate in kitchen and home management activities. This option provides a practical solution that accommodates the individual's physical limitations while still allowing them to engage in meal preparation.

In order to evaluate the somatosensory system, the OT would need to include testing procedures for touch. The somatosensory system is responsible for processing the sensations of touch, pressure, temperature, and pain. By testing touch, the OT can assess the individual's ability to perceive and discriminate different tactile stimuli. This can help identify any deficits or abnormalities in the somatosensory system and guide the development of appropriate interventions to improve sensory processing and integration.

The movement pattern described in the question, where a 3-year-old boy shifts his weight onto one leg and steps to the side with the other while holding onto furniture, is best described as "cruising." Cruising is a developmental milestone in which a child uses furniture or other support to move around in a standing position. It is a precursor to walking independently and helps the child develop balance and coordination skills.

The ability to pick up a penny from a flat surface using the tip of the fingers is a characteristic of the "Tip" prehension pattern. In this pattern, the fingers and thumb come together to form a precision grip, allowing for precise and delicate manipulation of small objects. This is different from the other prehension patterns mentioned, such as the lateral pattern where the object is grasped between the fingers and thumb, or the palmar pattern where the object is held against the palm.

Children with flaccid bladders, such as those with spina bifida, typically have difficulties with bladder control and cannot be toilet trained. This is due to the fact that the nerves controlling the bladder are affected, resulting in a lack of sensation and muscle control. Therefore, the OT practitioner should not consider lack of bladder control as a delay and should not initiate a toilet training program for these children.

A keyguard is a device that is placed over the keyboard and has holes or slots that correspond to each key. It prevents the mouthstick from accidentally striking other keys by providing a physical barrier between the mouthstick and the rest of the keys. This allows the individual to accurately target and press the desired key without any unintended keystrokes.

In this scenario, the OT practitioner is tasked with collecting data on the teenage patient's family background, education, and habits. The most likely place to find this information would be in the social worker's notes. Social workers are trained to gather comprehensive information about a patient's social and familial context, which would include details about their family background, education, and habits. The nurse and doctor's notes may focus more on the medical aspects of the patient's condition, while the admitting note may provide general information but may not delve into specific details about the patient's family background, education, and habits.

Observing the toddler in his home during feeding time would provide the best opportunity to assess his feeding skills. It allows for a natural and familiar environment where the toddler is likely to be more comfortable and behave in a typical manner. By observing him in this setting, it would be easier to identify any specific challenges or difficulties he may have with finger-feeding and gather more accurate information about his feeding skills. This method also eliminates potential distractions that may occur in a clinic or other unfamiliar setting.

After mastering the task of understanding picture symbols and their use, the next step for an individual learning to use an augmentative communication system would be sequencing of picture symbols. This involves arranging the picture symbols in a specific order to convey a message or express a thought. It is a more advanced skill compared to simply recognizing letters or words, and it allows the individual to communicate more complex ideas and thoughts using the augmentative communication system.

After a period of prolonged bedrest, it is important for the individual to gradually regain their strength and endurance. Walking at 1mph would be the most appropriate activity to introduce at this stage. Walking helps in improving cardiovascular fitness, muscle strength, and balance. It also promotes weight-bearing and helps in preventing complications such as blood clots. Peeling potatoes while seated, wheelchair propulsion, and taking a shower may be introduced at a later stage when the individual has further progressed in their recovery.

Hallucinations are considered to be an acute or positive symptom of schizophrenia. Hallucinations refer to sensory perceptions that are not based on external stimuli, such as hearing voices or seeing things that are not there. These hallucinations can be auditory, visual, or even tactile in nature. The presence of hallucinations is an important symptom to document in the assessment of a client with schizophrenia as it helps in understanding the severity and nature of their psychotic experiences.

The given scenario describes a transfer where the client is able to participate in the transfer by placing both feet on the floor and moving their buttocks to the edge of the wheelchair. The therapist provides assistance by placing one hand on the client's right anterior pelvis and the other hand on the client's left shoulder. The transfer is performed towards the client's stronger side, and the client pushes to a standing position and pivots with the therapist's guidance. This indicates that the client is able to actively participate in the transfer but requires some assistance and guidance from the therapist, making it an example of an assisted stand pivot transfer.

The observation of a 5-year old child with Down syndrome exclusively using a "W" sitting position indicates that the child is demonstrating typical development for a child with Down syndrome. "W" sitting is a common sitting position for children with low muscle tone as it provides a wider base of support and helps to stabilize their bodies. While it may not be a typical sitting position for a 5-year old child without Down syndrome, it is considered normal for children with Down syndrome due to their specific physical characteristics and muscle tone.

The correct answer is the Oral preparatory phase. In the oral preparatory phase of the swallowing process, the food is prepared to be swallowed. This includes activities such as chewing and mixing the food with saliva to form a bolus. In this case, the client's swallowing limitation is partly caused by the inability to receive visual and olfactory stimulation before eating, which suggests that the issue is occurring before the food is actually being swallowed. Therefore, it is likely to be happening in the oral preparatory phase.

The child's behavior of grabbing toys from others, becoming easily frustrated, and being unable to sit still is indicative of ADHD (Attention Deficit Hyperactivity Disorder). ADHD is a neurodevelopmental disorder characterized by symptoms such as impulsivity, hyperactivity, and difficulty in sustaining attention. The mentioned behaviors align with the common symptoms of ADHD, making it the most likely explanation for the observed behavior.

The primary expectation for becoming a member in a self-help group for alcohol problem is that members share their experiences and struggles with alcohol use. This is a fundamental aspect of self-help groups, as it allows individuals to connect with others who have similar experiences and learn from each other's journeys. Sharing personal experiences and struggles helps create a supportive and empathetic environment where members can gain insights, receive encouragement, and develop coping strategies for their alcohol problems.

Vestibular stimulation and gross motor exercise would be the most suitable activities for a young adult diagnosed with schizophrenia, undifferentiated type, who needs help with receiving, processing, and responding to sensory information. Vestibular stimulation involves activities that stimulate the inner ear and help with balance and spatial orientation, which can be beneficial for individuals with sensory processing difficulties. Gross motor exercise, on the other hand, involves physical activities that engage large muscle groups, promoting body awareness and coordination. Both of these activities can help the individual improve their sensory integration skills and enhance their ability to process sensory information effectively.

The most important performance components to consider when analyzing activities for use with adults with psychosocial problems are the amount of self-control demands, time management demands, self-expression opportunities, and interest in the activity. These factors are crucial in promoting emotional regulation, cognitive functioning, and overall engagement in the activity, which can have a positive impact on individuals with psychosocial problems. Considering these components can help ensure that the chosen activities are suitable and beneficial for this specific population.

The individual with C6 spinal cord injury demonstrates fair plus wrist extension and poor minus finger flexion. Wrist splints should be implemented first to promote the development of tenodesis. Tenodesis is a functional grasp pattern that allows individuals with limited finger flexion to grasp objects by using wrist extension. By using wrist splints, the individual can practice and strengthen this grasp pattern, which will ultimately promote independence in activities of daily living. The other options, such as volar resting pan splints and wrist support with a universal cuff, may be beneficial later in the rehabilitation process, but the priority at this stage is to promote the development of tenodesis. Instruction in bed mobility techniques is not directly related to the individual's hand function and would not be the first intervention to implement.

The individual with aC6 spinal cord injury would have limited hand function and dexterity. Therefore, the most suitable adaptive equipment would be a buttonhook attached to a cuff that fits around the palm. This would provide stability and support to the hand, allowing the individual to grasp and manipulate the buttonhook more easily. The cuff would also distribute pressure evenly across the palm, reducing the strain on the individual's hand and fingers.

The term most likely used to document the observation of the client's right arm laying limply by their side after a right CVA with left hemiplegia is "flaccidity." Flaccidity refers to a lack of muscle tone or muscle weakness, which can result in the limb appearing limp and without resistance to movement. This is commonly seen in the acute stage following a stroke, where there is a loss of voluntary muscle control due to damage to the brain.

The OT practitioner is most likely to report about confusion as a side effect of the current antianxiety medications. This is because confusion is a common side effect of many medications, including antianxiety medications. It is important for the therapist to monitor and report any instances of confusion in order to ensure the individual's safety and well-being.

The biomechanical frame of reference is the most appropriate for evaluating an individual with a peripheral nerve injury for strength, range of motion, and endurance. This frame of reference focuses on the physical aspects of movement and function, such as muscle strength, joint range of motion, and endurance. It considers the mechanical principles of the body and aims to restore or improve the individual's physical abilities through specific exercises and interventions. This approach is particularly relevant for individuals with physical impairments, as it emphasizes the restoration of biomechanical function.

When assessing for Tinel's sign in a person suspected of having carpal tunnel syndrome, the OT tests by gently tapping the median nerve at the level of the carpal tunnel. The wrist should be positioned in a neutral position. This means that the wrist should not be deviated in either the ulnar or radial direction, and it should not be flexed or dorsiflexed. A neutral wrist position allows for a more accurate assessment of Tinel's sign and helps to identify any potential nerve compression or irritation in the carpal tunnel.

A client with a C6 injury would benefit the most from using a wrist-driven flexor hinge splint during a prehension activity. This is because a C6 injury typically results in limited hand function and weak wrist extension. The wrist-driven flexor hinge splint can provide support and assist with wrist extension, allowing the client to have a more functional grip and better control during prehension activities.

A pinch meter is a commonly used instrument in hand assessments to measure the strength of a three jaw chuck. It is specifically designed to measure the pinch force exerted by an individual's thumb and index finger. By using a pinch meter, an OT practitioner can accurately assess the strength and coordination of the muscles involved in a three jaw chuck grip. This information is crucial in determining a patient's functional abilities and designing an appropriate treatment plan.

The child's difficulty with problem solving when playing with LEGOS and their tendency to become frustrated and give up easily suggests a problem in the area of constructional play. Constructional play involves the ability to manipulate and build objects, which requires problem-solving skills and spatial reasoning. The child's struggles and frustration indicate a difficulty in this specific area of play.

The individual's difficulty with accepting feedback and acting out of turn may indicate challenges with social skills and impulse control. Participating in a food service group, where they would be responsible for handing out trays and utensils, can help address these limitations. This intervention would provide opportunities for the individual to practice appropriate social interactions, follow instructions, and develop self-control, which are important skills for success in a work environment. Additionally, the structured nature of a food service group can provide clear expectations and routines that can support the individual's learning and development.

The term "dual diagnosis" is used to indicate a diagnosis that involves two or more mental health conditions or disorders. In this case, the client is diagnosed with both depression and substance abuse, making it a dual diagnosis. The term "multiply handicapped" refers to individuals with multiple physical disabilities, so it does not apply to this situation. "Axis I and II duplicity" is not a recognized term in mental health diagnosis. "Primary and secondary diagnoses" does not specifically indicate that there are two mental health conditions present.

Concentration would be the best game to promote visual memory because it requires the player to remember the location of matching pairs of cards. This game helps improve visual memory by challenging the child to remember the positions of the cards and make connections between them. By playing Concentration, the child can practice and enhance their ability to retain and recall visual information, which can ultimately benefit their reading skills.

The best approach to promote awareness and insight in this situation is to have the client predict his performance before an activity and then have him self-evaluate his performance. This approach allows the client to actively participate in the evaluation process and reflect on his own abilities. It encourages self-awareness and insight by comparing his predictions to his actual performance, which can help him recognize any functional limitations resulting from his head injury. This approach respects the client's autonomy and allows him to take ownership of his therapy progress.

The child reaching out for a toothbrush and starting to brush her hair with it indicates initiative and beginning task-directed behavior. This behavior suggests that the child is attempting to engage in a purposeful activity and take the initiative to complete a task. It shows that the child is beginning to understand the concept of using objects for specific actions and is starting to demonstrate task-oriented behavior.

This answer is correct because stressors are defined as the conditions and events that trigger or elicit stress reactions in individuals. Stressors can be external events or situations that cause stress, such as work deadlines or relationship problems. By understanding and identifying these precipitating conditions and events, individuals can better manage and cope with their stress.

The statement "The patient arrived without her walker 3 out of 3 days this week" is an objective observation that can be measured and verified. It provides factual information about the patient's behavior. In a SOAP note, the Objective section is where the therapist records objective data such as observations, measurements, and test results. Therefore, this statement would be most appropriately placed in the Objective section of the SOAP note.