Question 1

An OTA is teaching a client who has a total hip replacement safe mobility around his environment using a walker. The client stated that he would like to be able to carry items as well because there will be times that he will be by himself. What should the OTA recommend?

A) Use a walker basket so that both hands can stay on the walker.
B) Carry items with one hand and hold on to the walker with the other.
C) Carrying can be done for short distances without the walker.
D) Use a cane rather than a walker so that one hand is free.

Accepted Answer

Using a walker basket allows the client to carry items while keeping both hands on the walker, ensuring stability and safety while walking. This is the safest option for the client with a total hip replacement.

Question 2

A client has a fractured hip that will require surgery to repair. The physician has stated that the client will receive a replacement of the ball portion of the hip, but not the socket. Which procedure will this client be undergoing?

A) Hip compression screw
B) Hemiarthroplasty
C) Open reduction internal fixation
D) Anterolateral joint replacement

Hemiarthroplasty

Accepted Answer

Hemiarthroplasty is a surgical procedure that involves replacing only the ball portion of the hip joint with a prosthesis, while leaving the socket intact. This is a common procedure for clients with a fractured hip. Option A, hip compression screw, is a surgical procedure that involves placing a screw across the fracture to stabilize the hip. Option C, open reduction internal fixation, involves surgically aligning the fractured bones and fixing them in place with plates, screws, or pins. Option D, anterolateral joint replacement, is a type of total hip replacement that involves replacing both the ball and socket portions of the hip joint with prostheses.

Question 3

An OTA is working with a client who underwent an anterior total hip replacement 3 days ago. What should the OTA emphasize with the client for precautions following this procedure?&#10;A) No hip abduction beyond neutral&#10;B) No hip internal rotation&#10;C) No hip extension&#10;D) No hip flexion past 90 degrees

Accepted Answer

No hip extension

Question 4

An OTA is working with a population of older adults at a senior community center. What can the OTA educate them on to help reduce the risk of pelvic fractures?&#10;A) Fall prevention&#10;B) Safe driving techniques&#10;C) Safe weight-bearing techniques&#10;D) Cognitive strategies

Accepted Answer

Fall prevention is the best choice as pelvic fractures commonly result from falls. The OTA can educate older adults on strategies for preventing falls, such as proper footwear, removing tripping hazards, installing grab bars, and maintaining physical activity to maintain strength and balance. Safe weight-bearing techniques may also be beneficial, but fall prevention is more directly related to reducing the risk of pelvic fractures. Safe driving techniques and cognitive strategies may be important for older adults, but they are not directly related to reducing the risk of pelvic fractures.

Question 5

An elderly client has sustained a pelvic fracture and is getting ready to return home. The client enjoys knitting and would like to resume this hobby because she does not have to be mobile to enjoy it. What type of seating should the OTA recommend to this client to use while her fracture is healing?

A) A firm seat at the kitchen table
B) A padded, taller armchair in the living room
C) Legs outstretched on the bed
D) A soft couch

Accepted Answer

The client would benefit from a padded, taller armchair in the living room because it provides support to the pelvis and allows for easier standing and sitting without putting additional strain on the injured area. A firm seat at the kitchen table may be too hard and uncomfortable, while sitting with legs outstretched on the bed can also be uncomfortable and may not provide the necessary support. A soft couch may be too low and difficult to get in and out of.

Question 6

An OTA is working with a client who has recently undergone surgery to relieve back pain. The OTA is working with the client to prepare her for discharge and to eventually go back to work in the healthcare field. Which technique will the OTA be instructing the client on in relation to safe lifting and back precautions?

A) Keep back straight, with no twisting, and bend the knees when lifting.
B) When sitting, change positions after several hours.
C) Maintain an upright posture with an anterior pelvic tilt when standing.
D) Hold heavier items on one hip for support.

Accepted Answer

Keeping the back straight with no twisting and bending the knees when lifting is the proper technique for safe lifting and back precautions. Holding heavier items on one hip for support could cause uneven pressure on the spine and lead to further back injury. Changing positions after several hours while sitting and maintaining an upright posture with an anterior pelvic tilt when standing are also important for back health, but they are not specifically related to lifting and may not be as applicable in the healthcare field.

Question 7

An OTA is treating a client who has just received a total knee replacement. The physical therapist is working on stretching/ROM to assist with mobility of the joint. What can the OTA do to assist with this process?

A) Encourage knee flexion and extension during ADLs.
B) Discuss with the physical therapist when the level of flexion should be adjusted.
C) Provide adaptive equipment to use while in the room.
D) Have the client perform squatting motions when retrieving items from the floor.

Accepted Answer

The OTA can encourage the client to perform knee flexion and extension during ADLs to assist with stretching/ROM and mobility of the joint. This can include simple activities like bending and straightening the knee while sitting or standing, or incorporating those movements into functional tasks like reaching for an object on a low shelf. This can help the client build strength and range of motion in the knee joint while also practicing functional movements that they will need to complete their daily activities.

Question 8

A client is experiencing an increased amount of knee pain due to osteoarthritis. When would a surgeon most likely consider a knee-replacement surgery?&#10;A) When medication is no longer effective&#10;B) When insurance approves the procedure&#10;C) When the client requests the surgery&#10;D) When the pain is reduced

Accepted Answer

Knee replacement surgery is typically considered when other treatment options such as medication, physical therapy, and steroid injections have been exhausted and the patient's pain and mobility are significantly affected. Therefore, when medication is no longer effective, a surgeon would most likely consider knee replacement surgery.

Question 9

A client is currently being seen for back pain caused by ankylosing spondylitis. This condition is due to which of the following issues with the vertebrae?&#10;A) Displacement of the vertebrae&#10;B) Inflammation between the vertebrae&#10;C) Infection of the bone&#10;D) Heterotopic ossification

Accepted Answer

Ankylosing spondylitis is a type of arthritis that causes inflammation between the vertebrae, leading to chronic pain and stiffness in the back.

Question 10

A client develops a deep vein thrombosis after orthopedic surgery. What should the OTA do first once he notices these symptoms in the client?&#10;A) Continue therapy after alerting the nursing staff.&#10;B) Reduce the level of activity, and then return the client to his room.&#10;C) Call the physician to come to the therapy gym to clear the client.&#10;D) Notify the team members and return the client to bed.

Accepted Answer

When a client develops deep vein thrombosis, urgent medical attention is needed. Therefore, the OT assistant should immediately notify the team members (including the nursing staff and physician) and return the client to bed to prevent the thrombus from dislodging and causing a pulmonary embolism.

Deck 20: Orthopedic Considerations: Spine, Pelvis, Hip, and Knee