Question 1

An OTA is working the family of a 24-year-old with an ABI. The client is going to be discharged to his parents' home, and the parents are eager to help him transition. What is most important when educating the parents on their son's care?

A) Allow the client to be as independent as possible when providing support.
B) Provide maximum assistance to the client until he feels comfortable at home.
C) Wait until the client requests assistance to help him.
D) Allow the client to drive whenever he feels ready to do so.

Accepted Answer

Allowing the client to be as independent as possible when providing support is important because it promotes their autonomy and helps maintain or improve their physical and cognitive abilities. It is also important to ensure the client's safety and prevent further injury, but this can be done while still promoting independence. Providing maximum assistance or waiting for the client to request assistance may hinder their progress and result in learned helplessness. Allowing the client to drive whenever they feel ready is also not recommended without a proper evaluation of their driving abilities.

Question 2

A 30-year-old client with a TBI has been discharged to her parents' home for continued recovery after inpatient rehabilitation. The client does not have good insight into her condition and becomes confused in the evening when tired. The client is refusing to utilize her adaptive equipment because she believes she is independent. How should the OTA educate the parents in managing the client's behavior and increasing cooperation?

A) Use contingency strategies to promote cooperative behavior with the parents.
B) Create a structured environment with specific responsibilities for the client.
C) Focus treatment on behavior management strategies and social skills.
D) Create a list of tasks to perform in the evening to get ready for bed to assist performance.

Accepted Answer

Creating a structured environment with specific responsibilities can help the client understand her limitations and gradually increase her cooperation by providing a clear routine and expectations.

Question 3

An OTA is working with a client who is currently functioning at Rancho Level VIII-Purposeful, Appropriate Response. What intervention would the OTA most likely focus on with a client at this level?&#10;A) Physical fitness goal setting&#10;B) Using money in a community setting&#10;C) Utilizing a daily schedule&#10;D) Functional math skills and banking

Accepted Answer

Functional math skills and banking are necessary for a client at Rancho Level VIII-Purposeful, Appropriate Response to function independently in the community.

Question 4

An OTA is working with a client who is currently functioning at Rancho Level IV-Confused, Agitated Response. What should the OTA work on with the client as a part of her plan of care at this level?&#10;A) Using external cues for direction&#10;B) Sensory stimulation and family education&#10;C) Familiar occupations in a safe manner&#10;D) Showing her pictures of safe and unsafe situations for correct identification

Accepted Answer

At Rancho Level IV, the client is confused and agitated, so focusing on familiar occupations in a safe manner can help provide structure and reduce agitation.

Question 5

When a client is rated using the Supervision Rating Scale, what sort of supervision needs would be in the category of full-time direct supervision?&#10;A) Someone is in the home overnight, but there are periods when the client is alone.&#10;B) The client lives in a setting with locked exits.&#10;C) At least one supervision person is present at all times and checks in once an hour.&#10;D) The client is supervised overnight and frequently during the day.

Accepted Answer

Full-time direct supervision involves a setting where the client is under constant supervision, such as living in a place with locked exits to prevent them from leaving unsupervised.

Question 6

A 21-year-old adult sustained a TBI due to a car accident in which he was not wearing his seatbelt. One of his symptoms is increased intracranial pressure due to swelling of the brain. What type of injury did this individual most likely sustain?

A) Closed head injury
B) Open head injury
C) Diffuse axonal injury
D) Anoxia

Accepted Answer

The individual most likely sustained a closed head injury, in which the brain is injured by trauma without a break in the skull. Increased intracranial pressure due to swelling of the brain is a common symptom of a closed head injury.

Question 7

An OTA is working with a client who is experiencing an ABI. Which of the following would the client most likely have experienced that caused the ABI?&#10;A) Falling on a hard surface&#10;B) Gunshot wound&#10;C) Viral encephalitis&#10;D) Concussion

Accepted Answer

ABI stands for acquired brain injury, which refers to any injury to the brain that occurs after birth. While all of the options listed could potentially cause a brain injury, viral encephalitis specifically refers to inflammation of the brain caused by a viral infection and is therefore the most likely to cause an acquired brain injury.

Question 8

An OTA is working with a client who sustained a TBI as the result of a severe blow to the head on a construction site. The OTA is showing the client pictures of his family and is using a penlight to encourage eye tracking and other sensory responses. Which Rancho level is this client most likely functioning at?

A) Level II
B) Level I
C) Level III
D) Level V

Accepted Answer

The client is likely at Rancho Level II, which is characterized by generalized responses to stimuli, such as eye tracking and sensory responses, but not yet specific or purposeful responses.

Question 9

An OTA is working with a client utilizing hands-on activities to develop safety awareness. In addition, the OTA is working on initiating and terminating tasks and functional balance. Which Rancho level is this client most likely functioning at?

A) Level VI-Confused, Appropriate
B) Level VII-Automatic, Appropriate
C) Level VIII-Purposeful, Appropriate
D) Level IV-Confused, Agitated

Accepted Answer

At Rancho Level VI, clients are confused but appropriate, meaning they can follow simple directions and are beginning to show awareness of their environment, making it suitable for working on safety awareness, task initiation, and functional balance.

Question 10

The OTA is working with clients with TBI in an outpatient day program. Many of the clients have difficulty reading social cues and behaving appropriately in social situations. What are strategies the OTA could use to work on these areas?

A) Role-playing and practicing social situations
B) Allowing group members to criticize each other's performance in social settings
C) Creating a list for more organized grocery shopping for the weekly meal
D) Pulling aside clients who are acting strangely in the group

Accepted Answer

Role-playing and practicing social situations would allow clients to practice appropriate behaviors in a safe and controlled environment. Criticizing each other's performance may not be constructive or therapeutic. Creating lists for grocery shopping and pulling aside clients who are acting strangely are not directly related to improving social cues and appropriate behavior.

Deck 34: Traumatic and Acquired Brain Injury: Management and Treatment