Question 1

An OT practitioner is beginning the assessment process for a client who has a shoulder issue. After gaining the client's history, what would be the next step in this process?&#10;A) Observe the client's posture.&#10;B) Observe the client participating in functional tasks.&#10;C) Observe the client's ROM.&#10;D) Observe the client's pain during ADLs.

Accepted Answer

The next step after gaining the client's history is to observe the client's posture, as it provides initial insights into potential issues affecting the shoulder and can guide further assessment steps.

Question 2

An OTA is instructing a client who has had shoulder surgery in upper body dressing. Which of the following is the correct way to don a shirt in this case?&#10;A) Place the sleeve on the surgical arm first.&#10;B) Place the nonsurgical arm in the sleeve first.&#10;C) Pull the shirt over the head first.&#10;D) Use a reacher to assist with dressing.

Accepted Answer

Placing the sleeve on the surgical arm first minimizes movement and strain on the shoulder that has undergone surgery, helping to prevent pain and injury during the dressing process.

Question 3

A client is having difficulty completing chores in the home due to pain and inflammation in his shoulder caused by bursitis. This condition is also classified as which of the following?&#10;A) Impingement syndrome&#10;B) Rotator cuff tear&#10;C) Shoulder instability&#10;D) Inflammatory myopathy

Accepted Answer

Bursitis is inflammation of a fluid-filled sac in the shoulder called the bursa. This can lead to impingement syndrome, which is compression of the rotator cuff tendons and bursa between the bones in the shoulder. Symptoms include pain and difficulty with shoulder movements, especially when reaching overhead or behind the back. Rotator cuff tear, shoulder instability, and inflammatory myopathy are all different conditions that can cause similar symptoms but are not directly related to bursitis.

Question 4

A client has recently had shoulder surgery and is currently in an immobilizer. Why is it important for an OT practitioner to address sleep hygiene at this stage in the recovery process?&#10;A) It is important for clients to be well rested for therapy sessions.&#10;B) Sleep is an occupation that often gets disturbed after surgery.&#10;C) Sleeping with an immobilizer can cause other orthopedic issues.&#10;D) Poor sleep can lead to weight gain.

Accepted Answer

Sleep is an important occupation that can be disrupted after surgery, and addressing sleep hygiene can promote overall well-being and recovery. Additionally, an immobilizer can be uncomfortable to sleep in and may require modifications or accommodations to ensure proper sleep hygiene.

Question 5

A client is presenting with a suspected rotator cuff tear. Which assessment will give the best information about this client's condition?&#10;A) The empty can test&#10;B) Hawkins-Kennedy test&#10;C) Disabilities of the Arm Shoulder and Hand Questionnaire&#10;D) Supine impingement test

Accepted Answer

The answer of A client is presenting with a suspected...

Question 6

A client is in the hospital after a rotator cuff repair. What is the ultimate goal of OT services while the client is in the acute phase of recovery?&#10;A) To enforce independence in IADLs&#10;B) To gradually resume desired occupations&#10;C) To provide exercises and strengthen the joint&#10;D) To build tolerance to resistive exercises

Accepted Answer

The ultimate goal of OT services during the acute phase of recovery for a rotator cuff repair is to gradually resume desired occupations based on the client's specific goals and needs. While exercises and strengthening the joint may be a part of the treatment plan, the focus should be on increasing functional abilities and returning to meaningful activities. Independence in IADLs and building tolerance to resistive exercises may also be important goals, but they are not the ultimate goal of OT services during the acute phase of recovery.

Question 7

To assist a client with pain and to help increase function, what physical agent modality can an OTA recommend for a client to utilize during the acute phase of shoulder recovery?&#10;A) Superficial heat&#10;B) Cryotherapy&#10;C) Ultrasound&#10;D) Fluidotherapy

Accepted Answer

Cryotherapy is recommended during the acute phase of injury or recovery because it helps reduce inflammation and pain, which are common during this phase.

Question 8

A client is complaining of issues with flexion and abduction of her left arm. Which muscle is mostly responsible for this action?&#10;A) Pectoralis major&#10;B) Trapezius&#10;C) Deltoid&#10;D) Subscapularis

Accepted Answer

The deltoid muscle is responsible for flexion and abduction of the arm. The pectoralis major helps with flexion and adduction of the arm, the trapezius is responsible for elevation, depression, and retraction of the scapula, and the subscapularis muscle is responsible for internal rotation of the arm.

Question 9

A client who had experienced a shoulder fracture has undergone surgery to repair the fracture and is now immobilized in a sling. The physician has written an order to begin OT services. Which question should the OT practitioner ask the physician before starting therapy?

A) When can weight-bearing begin?
B) What structures were repaired?
C) How much PROM can be tolerated?
D) How much pain is expected?

Accepted Answer

Before beginning OT services, it is important for the OT practitioner to know what structures were repaired during the surgery as this will impact the treatment plan and precautions that need to be taken. Knowing the level of weight-bearing, range of motion limitations, and expected pain level can also be helpful, but these can be determined through clinical evaluation and communication with the client.

Question 10

A client has a rotator cuff injury due to her job as a factory worker. The client is having issues with a pinching pain at the biceps tendon insertion with abduction. Which muscle is most likely to not be working effectively?

A) Supraspinatus
B) Teres minor
C) Subscapularis
D) Teres major

Accepted Answer

The supraspinatus muscle is responsible for initiating abduction of the arm (the first 15 degrees), and is often the first rotator cuff muscle to be injured or compromised. A rotator cuff tear or strain can result in weakness of the muscle, leading to a pinching pain at the biceps tendon insertion with abduction.

Deck 23: Orthopedic Considerations: the Shoulder