Question 1

An OTA is working with a male client after surgery on a deformity in his ring and small fingers who also has a history of smoking. Which condition is this client most likely diagnosed with?&#10;A) A ganglion cyst&#10;B) de Quervain's tendinopathy&#10;C) Trigger finger&#10;D) Dupuytren's contracture

Accepted Answer

The client's history of smoking and surgery on the ring and small fingers suggest a diagnosis of Dupuytren's contracture, a condition characterized by the thickening and tightening of the fascia in the hand. Ganglion cysts typically present as lumps on the back of the hand or wrist, de Quervain's tendinopathy affects the tendons on the thumb side of the wrist, and trigger finger involves the locking or catching of a finger when bent.

Question 2

A client is complaining of discomfort in her hand related to osteoarthritis. Which carpometacarpal (CMC) joint is most likely contributing to this pain?&#10;A) CMC joint 1&#10;B) CMC joint 2&#10;C) CMC joint 3&#10;D) CMC joint 4

Accepted Answer

CMC joint 1, also known as the thumb CMC joint, is the most commonly affected joint in osteoarthritis of the hand. This joint is responsible for much of the mobility and function of the hand and is therefore susceptible to wear and tear over time, leading to osteoarthritis and pain.

Question 3

A client is complaining of pain and numbness on the back of the hand. Which hand nerve is most likely contributing to this issue?&#10;A) Medial&#10;B) Radial&#10;C) Ulnar&#10;D) Median

Accepted Answer

The radial nerve is responsible for innervating the back of the hand, which includes sensory functions. Pain and numbness in this area are indicative of issues with the radial nerve.

Question 4

A client who is an office worker would like to return to his position after surgery for bilateral carpal tunnel release. What would be the first step in providing education on ergonomic techniques for this client?

A) Discuss components of the job that may lead to elbow extension.
B) Maintain upright posture in the workstation design.
C) Obtain a job description, and explore the demands of the job to suggest modifications.
D) Raise the computer monitor to eye level.

Accepted Answer

The first step in providing education on ergonomic techniques for a client returning to their job after bilateral carpal tunnel release surgery is to obtain a job description and explore the demands of the job to suggest modifications. This allows the occupational therapist to understand the specific physical demands of the job and make modifications that will help the client perform their job without exacerbating their condition. Options A, B, and D may be appropriate ergonomic modifications but cannot be determined without first understanding the demands of the job.

Question 5

An OTA is working on sensory reeducation with a client who has experienced loss of sensation in her hand due to a nerve compression injury. Which intervention will most likely assist the client with this process?

A) Utilization of mirror visual feedback
B) Touching a variety of textures in a rice bin
C) Incorporating extreme temperatures into therapy
D) AROM

Accepted Answer

Mirror visual feedback can help the client remap the sensory homunculus in the brain, which can improve sensation in the affected hand.

Question 6

An OT practitioner is working with a client after surgery for a flexor tendon repair. What would the OTA do first as a part of the intervention program for this client?&#10;A) AROM&#10;B) Early protected motion&#10;C) Strengthening&#10;D) Scar massage

Accepted Answer

Early protected motion is the first priority in the intervention program for a client after surgery for a flexor tendon repair to prevent adhesion formation and to promote tendon healing. AROM, strengthening, and scar massage can be incorporated later in the healing process as appropriate.

Question 7

An OTA is working with a client who has sustained a distal radial fracture. As a part of the treatment program, the OTA is emphasizing pain-free motion. Which condition is the OTA helping the client to prevent?

A) Scaphoid fracture
B) Flexor tendon injury
C) Complex regional pain syndrome
D) Fibromyalgia

Accepted Answer

Emphasizing pain-free motion can help prevent the development of Complex Regional Pain Syndrome (CRPS), a condition characterized by chronic pain, swelling, and stiffness in the affected limb after an injury. Scaphoid fracture and flexor tendon injury are not necessarily prevented by emphasizing pain-free motion, and fibromyalgia is a chronic pain condition that is not directly related to a specific injury.

Question 8

An OT practitioner is evaluating the ROM in a client with complaints about difficulty moving his upper extremity. Upon assessment, the OT practitioner documents that PROM is greater than AROM. What would most likely be causing this?

A) Weakness
B) Pain
C) Deformities
D) Neuropathy

Accepted Answer

When PROM (Passive Range of Motion) is greater than AROM (Active Range of Motion), it often indicates muscle weakness, as the client may not have the strength to move the joint through its full range actively.

Question 9

A client is presenting with a thick, raised scar after a surgical repair of carpal tunnel syndrome. What should the OTA instruct the client to do as a part of his treatment?&#10;A) Perform scar massage several times a day.&#10;B) Perform AROM exercises several times per day.&#10;C) Fabricate an orthotic to protect the scar during healing.&#10;D) Measure for a compression garment.

Accepted Answer

Scar massage can help to decrease the thickness and raised appearance of scars. AROM exercises and orthotics may also be used as a part of scar management, but scar massage is the most appropriate choice in this scenario. Compression garments are typically used to manage swelling, which may not be a primary concern for this client.

Question 10

An OTA is assessing sensory function in a client's hand. The OTA is assessing to see if the client can discriminate pressure and recording the smallest-diameter touch that the client can report sensing while her vision is occluded. Which assessment is the OTA performing on this client?

A) Semmes Weinstein monofilament test
B) Two-point test
C) Moberg pickup Test
D) Sharp-dull discrimination test

Accepted Answer

The OTA is performing the Semmes Weinstein monofilament test, which is used to determine the client's ability to discriminate pressure. The test involves the use of a series of nylon monofilaments of varying diameters that are applied to the client's skin until they bend. The smallest diameter monofilament that the client can detect is recorded as the threshold value for that area of the body. This test is especially useful for assessing diabetic neuropathy. The two-point test is used to assess the client's ability to discriminate between two points of pressure, while the Moberg pickup test is used to assess the client's ability to identify and pick up small objects. The sharp-dull discrimination test is used to assess the client's ability to differentiate between sharp and dull stimuli.

Deck 22: Comprehensive Hand Management