Question 1

Gina is a 14-month-old infant who seemed to be developing normally, but she lately has started to have seizures and is no longer walking.She wrings her hands constantly.Which developmental disorder do these behaviors describe?

A) Developmental coordination disorder (DCD)
B) Attention deficit hyperactivity disorder
C) Autism spectrum disorder
D) Rett syndrome

Rett syndrome

Accepted Answer

Rett syndrome is a progressive neurologic disorder that occurs only in girls.It is a genetic disorder with mutation of the X chromosome.The infant or toddler seems to be developing normally until 6-18 months of age, at which time regression in all skills is observed.Microencephaly, seizures, abnormal muscle tone, intellectual disability, loss of purposeful hand use, and stereotypical patterns of behavior (especially hand wringing) emerge.Adolescents with Rett syndrome are generally nonambulatory and do not have functional hand use.

Question 2

Bob, a 5-year-old boy, is unable to dress himself and cannot write his name or count to 10.Bob has a longish face with a high forehead and prominent jaw; he has lax joints and stands with flat feet.Which genetic disorder is suspected?

A) Cri du chat syndrome
B) Down syndrome
C) Fragile X syndrome
D) Prader-Willi syndrome

Fragile X syndrome

Accepted Answer

Fragile X syndrome affects boys more often than girls because it is an X-linked genetic disorder.Children present with limited cognitive development, abnormal skull, joints, and feet structures.They exhibit typical structural features, including elongated faces, prominent jaws and foreheads, hypermobile or lax joints, and flat feet.Children with fragile X syndrome may be intellectually delayed and often present with autistic-like behaviors.OT practitioners often work with children with fragile X on sensory processing difficulties, social participation, ADLs, and IADLs.

Question 3

Which disorder is not considered a pulmonary disorder?&#10;A) Asthma&#10;B) Cystic fibrosis&#10;C) Chronic obstructive pulmonary disease&#10;D) Cerebrovascular accident (CVA)

Accepted Answer

Pulmonary disorders are conditions that involve the lungs and one's ability to breathe.The most common pulmonary diseases affecting children are asthma and cystic fibrosis.Children with pulmonary diagnoses are referred for OT when they experience problems that interfere with activities of daily living (ADLs), instrumental ADLs (IADLs), sleep and rest, education, play, and social participation.CVA is a neurological condition.

Question 4

What are common signs of arthrogryposis?&#10;A) Absence of muscle tissue and stiffness of all or most of the extremity joints.&#10;B) Arthritis, spinal stiffness, and visual problems.&#10;C) Developmental delays resulting from intellectual disabilities.&#10;D) All of the above.

Accepted Answer

Arthrogryposis can range from mild to severe, depending on the number of joints involved and the amount of muscle tissue missing.In the classic form of arthrogryposis, all the joints of the extremities are stiff, but the spine is not affected.In addition to contractures, muscles are often thin, weak, or missing.Arm posture in children with arthrogryposis often includes internal rotation, elbow extension with limited flexion, and flexed wrists with ulnar deviation.Contractures in the lower extremities are noted with typical posture including hip abduction and external rotation, knee extension or knee flexion contractures, and foot deformities.Arm and leg muscles are small, with webbed skin covering some or all of the joints.Infants are born with significant contractures that improve with aggressive ROM exercises during infancy.In typical cases, all the joints of the arms and legs are fixed in one position, partly due to muscle imbalance or lack of muscle development during gestation.

Question 5

Karen, the Certified Occupational Therapy Assistant (COTA), is concerned that Tom fell off the balance beam while in OT.He complained of pain, and Karen noticed some swelling and tenderness on his ankle.What is the most likely diagnosis for this injury?

A) Contusion
B) Crush injury
C) Dislocation
D) Sprain

Accepted Answer

A sprain is a traumatic injury to the tendons, muscles, or ligaments around a joint and is characterized by pain, swelling, and discoloration.Sprains can occur when children or adolescents lose their balance and consequently use a protective response that makes the wrist and ankle the most vulnerable joints for injury.Sprains are most frequently seen in the ankles and wrists.Most do not require emergency medical attention or OT intervention.

Question 6

Mira is a 10-year-old with juvenile rheumatoid arthritis (JRA).She has trouble completing her work at school.Which client factors (associated with JRA) may be interfering with her educational work?&#10;A) Decreased ROM.&#10;B) Increased muscle tone.&#10;C) Inability to process sensory information.&#10;D) Poor strength and endurance.

Accepted Answer

Children with JRA experience exacerbations and remissions of symptoms.During exacerbations, or flare-ups, symptoms worsen, and the joints become hot and painful; joint damage can occur.During remissions, or pain-free periods, children with JRA may resume typical activities.Joint protection techniques and energy conservation techniques are encouraged at all times so that these strategies become a habit.However, these children may have functional limitations due to contractures and deformities.The OT practitioner helps educate these children on how to protect their joints, compensate for decreased ROM during exacerbations, and complete activities with less stress on the joints (joint protection or energy conservation techniques).Furthermore, the OT practitioner provides these children with stretching and movement activities to maintain the functioning of the joints and prevent contractures.The OT practitioner may prescribe adaptive equipment or technology to help these children engage in everyday activities.

Question 7

What do boys with Duchenne muscular dystrophy (DMD) commonly develop?&#10;A) Arthritis&#10;B) Osteoporosis&#10;C) Scoliosis&#10;D) Seizures

Accepted Answer

Boys with Duchenne muscular dystrophy (DMD) commonly develop scoliosis, which is an abnormal curvature of the spine. This occurs because the muscles that support the spine weaken, causing it to become curved. Arthritis, osteoporosis, and seizures are not common symptoms of DMD.

Question 8

What must the OT practitioner never do when a child is having a seizure?&#10;A) Turn the child's head to the side in case she or he vomits.&#10;B) Put a finger in the child's mouth.&#10;C) Remove dangerous objects around her or him.&#10;D) Put something soft under her or his head.

Accepted Answer

If a child has a seizure, the OT practitioner may need to ensure that the child is in a comfortable setting with no dangerous objects nearby.The child can be placed on his or her side on the floor.The OT practitioner should never place an object in the child's mouth during a seizure.

Question 9

Which statement most closely reflects the OT intervention for a child who has a traumatic brain injury (TBI)?&#10;A) Intervention is aimed at maintaining skills.&#10;B) Intervention is short and focuses on motor impairments.&#10;C) Intervention targets motor, cognitive, and emotional changes.&#10;D) Intervention targets sensory processing skills.

Accepted Answer

Children and adolescents with TBIs are referred for OT because of their inability to function in the areas of occupation (ADLs, IADLs, education, work, play, and social participation; see Box 13-12).The trauma to the brain typically results in motor, cognitive, and emotional changes.Motor deficits may include abnormal muscle tone (changes in the resting state of a muscle typically resulting in increased muscle tone), hemiplegia (involvement of the arm and leg on one side of the body), and quadriplegia (involvement of both arms and legs).As the swelling of the brain begins to heal, some of the deficits may improve.Children and adolescents with TBI may need to relearn motor patterns.They may have musculoskeletal concerns secondary to tone problems and may require orthoses of the extremities to maintain and improve the ROM.OT practitioners work with children and adolescents who have sustained TBIs to help them relearn movements.OT practitioners address cognitive changes such as difficulty with attention and concentration, loss of memory, word-finding problems, and poor abstract thinking and reasoning.These children and adolescents may experience perceptual deficits that include lack of awareness of their surroundings and poor sequencing and timing skills.They may experience emotional changes such as lability (moods ranging from happy to tearful or angry), inappropriateness (e.g., cursing, touching, and disrobing), and personality changes.Children and adolescents with TBI may demonstrate a "flat" affect, showing little or no emotion.Often, aggressiveness, impulsivity, and irritability occur during recovery.

Question 10

Martin is a 10-year-old boy with DCD who has difficulty writing and tying his shoes.He is falling behind in school.He falls and bumps into things frequently and performs poorly in sports.Which statement is true concerning DCD?

A) Martin probably has associated cognitive problems.
B) Martin will need classroom modifications.
C) Martin will show high self-esteem.
D) Martin will outgrow it.

Accepted Answer

DCD encompasses a wide range of characteristics, but an essential feature is that the child's motor coordination is markedly below his or her chronologic age and intellectual ability and significantly interferes with ADLs.If intellectual disability is present, the motor difficulties must be in excess of those usually associated with the level of severity of intellectual disability.These children also often exhibit low self-esteem, show frustration, and begin to expect failure.Many professionals suggest that these children will outgrow their coordination deficits, but evidence indicates that children who have DCD continue to have difficulty in adolescence and adulthood.

Question 11

Kendra, a 7-year-old girl, shows some hand flapping behaviors and some difficulty with expressing herself.She speaks slowly and does not seek out her peers.Although Kendra is able to perform her self-help skills and receives good grades in school, the teacher notices that Kendra is "by herself" frequently.Which developmental disorder do these behaviors describe?

A) Developmental Coordination disorder
B) Attention deficit hyperactivity disorder
C) Autism spectrum disorder
D) Rett syndrome

Accepted Answer

The answer of Kendra, a 7-year-old girl, shows some hand...

Question 12

Why is it important for a COTA to understand the problems commonly associated with a specific diagnosis?&#10;A) To know what to expect when seeing the child for the first time.&#10;B) To prepare for the initial evaluation.&#10;C) To be a more valuable member of the treatment team.&#10;D) All of the above.

Accepted Answer

The answer of Why is it important for a COTA...

Question 13

Theodore is a 2-year-old boy who avoids playing with others.He does not ask his mother for help, screams to have his needs met, prefers to sit alone, and flaps his hands in front of his face.He loves to spin the wheels on toy cars and to swing.Which developmental disorder do these behaviors describe?

A) Asperger syndrome
B) Attention deficit hyperactivity disorder
C) Autism
D) Rett syndrome

Accepted Answer

The answer of Theodore is a 2-year-old boy who avoids...

Question 14

Carolyn is a 5-year-old with a cardiac disorder.She has trouble playing with her peers at day care.Which client factors (associated with cardiac disorders) may be interfering with her play?&#10;A) Decreased range of motion (ROM).&#10;B) Increased muscle tone.&#10;C) Inability to process sensory information.&#10;D) Poor strength and endurance.

Accepted Answer

The answer of Carolyn is a 5-year-old with a cardiac...

Question 15

Sean injured himself on the stove, resulting in a second-degree burn.Which statement describes the involvement?&#10;A) Bone involved&#10;B) Epidermis and portions of the dermis involved&#10;C) Muscle involved&#10;D) Tissue minimally damaged

Accepted Answer

The answer of Sean injured himself on the stove, resulting...

Deck 13: Pediatric Health Conditions