Question 1

Gladys, the 92-year-old wife of your client, complains about stiffness in her shoulders. But she says she can do everything for herself. You would expect her range of motion measurements to include:

Accepted Answer

Expected range of motion would be about 160 to 170 degrees of flexion. Limitations in the end ranges of the larger joints are common in elderly people due to normal wear and mild osteoarthritis that occurs as people age.

Question 2

You walk into the kindergarten classroom of your 4-year-old child, and six children of the same age ask you to help them get ready for recess. You tell them to try doing everything themselves, except this task:

Accepted Answer

You tell them to try everything except tie their shoes. The fine motor coordination required to tie shoes does not develop in normal children until between the ages of 5 and 6.

Question 3

Your friend has a prestigious job in upper management at a high-profile company. Lately, she complains to you that she has been very forgetful. She is worried that she may have Alzheimer's disease. What questions do you ask before giving her advice?

Accepted Answer

You should ask her if she has been sleeping okay at night. Insomnia can cause decreased alertness and difficulty paying attention. This results in difficulty processing information and storing it in the short-term memory centers of the brain.

Question 4

A client has a 4-year-old son named Joey. She gushes to you about Joey's physical prowess. But she complains that he is not allowed to sign up for the local children's soccer league because he is too young. You know Joey and feel he is a perfectly typical 5-year-old boy. She asks you if she should file for an exception. What do you tell her?

Accepted Answer

You should tell her that Joey is really good at physical activities. However, you think he is a little young to play on the soccer team. She might want to wait a couple of years. Most children do not develop the coordination between gross motor movement skills, visual tracking, and visual attention to be able to play fast-paced team sports until the ages of 7 or 8.

Question 5

Your co-worker expresses to you that her 2- year-old son is not talking like the other 2 year olds at his daycare center. She asks you if you think she should take him to speech therapy. You know that your co-worker has four children and her 2 year old is the youngest. You also remember your co-worker complaining about her children having numerous ear infections. What recommendation would you give her?

Accepted Answer

You should tell her to have her son's hearing checked. Chronic ear infections can interfere with a baby or toddler's ability to listen to speech, resulting in a delay or impairment in expressive language. Toddlers do not typically develop speech delays due to older siblings speaking for them.

Question 6

Fred, your 75-year-old uncle, has declined an invitation to your college graduation, which is scheduled for 7 p.m. at your college. He lives in another city that is about 30 minutes away. You would really like him to attend. How do you respond?

Accepted Answer

You tell him you understand that it might be difficult for him to drive to another city at night. You offer to help him find a ride. Natural changes in vision, as well as eye disorders, are common in elderly people. Cataracts can impair a person's ability to drive at night.

Question 7

Your sister complains that your 14-year-old nephew eats all the food in the house. There is nothing left for anyone else. How do you comment?

Accepted Answer

That's normal for a boy his age. Teenage boys experience rapid growth spurts and require significantly increased numbers of calories during these times. An average teenage boy can consume as much as 3,500 calories per day.

Question 8

An 11-year-old boy displays difficulty sitting still in his classroom and repeatedly asks the teacher to repeat the instructions for assignments. He says his favorite class is physical education. In his records, you would expect to see a diagnosis of: ______.

Accepted Answer

You would expect to see a diagnosis of ADHD. Symptoms of this condition include difficulty attending to auditory input and excess need for movement.

Question 9

Arthur, a 75-year-old man, was just admitted to your rehabilitation unit. He is receiving treatment for Stage III colon cancer. What symptoms would you expect to observe?

Accepted Answer

You would expect to observe generalized weakness, poor appetite, and periodic confusion. Stage III colon cancer is treated by surgery and chemotherapy. All of these symptoms are side effects of chemotherapy.

Question 10

Roberto is a sheltered workshop employee who sorts and packages hardware parts. He has a diagnosis of cerebral palsy with spastic quadriplegia. What would you expect his body to look like as he places nuts and bolts into a template?

Accepted Answer

You would expect Roberto's body to display muscle tightness with flexion patterns in his arms and legs, along with more flexion in the non-dominant arm and hand. Spastic quadriplegia is characterized by high muscle tone in all limbs, with asymmetrical tonic neck reflex during unilateral reaching.

Question 11

Donna, a 35-year-old woman, is a new outpatient at your clinic. She complains of the following symptoms: Numbness and tingling in her hands and feet, severe fatigue, and blurred vision. You also notice that she drags her right foot when she walks. Upon review of her records, what diagnosis would you expect?

Accepted Answer

You would expect a diagnosis of multiple sclerosis. While these symptoms can occur with other conditions, the combination of numbness and tingling, severe fatigue, blurred vision, and foot drop are characteristic of multiple sclerosis.

Question 12

Mildred is a 67-year-old woman with chronic obstructive pulmonary disease (COPD). She tells you that she would like to be able to cook dinner again, but she just cannot do it. Her husband is tired of eating at McDonald's. What problems would you expect Mildred to report regarding cooking?

Accepted Answer

You would expect Mildred to complain that she becomes so short of breath that she cannot finish cooking a meal. COPD is characterized by shortness of breath and chronic coughing, usually producing mucus. Long-term COPD can also cause a decrease in overall strength and endurance.

Question 13

Your student, Michael, is a 16-year-old boy with Down syndrome. You have been seeing him for occupational therapy (OT) since he was 3 years old. His mother would like him to be independent with dressing in the morning. But she says she still has to help him zip his coat and get his shoes on. Sometimes she even has to help him snap his jeans after using the bathroom. What do you tell her?

Accepted Answer

Michael still has a hard time with fine motor skills, even after working on them. Those tasks may need to be adapted for him to be independent. People with Down syndrome have impairments in fine motor prehension patterns that impact their ability to manipulate small objects. Since this student is 16 years old and has not learned these tasks after years of therapy, it is likely that his fine motor skills are not adequate to perform these tasks without adaptations.

Question 14

Helen, your 86-year-old nursing home patient with a diagnosis of Stage IV Alzheimer's disease, is getting ready to go home. Her son asks you what he should do to help her at home. What do you tell him?

Accepted Answer

You would tell her son to label drawers and closets, place a list of telephone numbers next to the phone, purchase microwavable meals and/or order Meals on Wheels, and help her with banking, appointments, driving, and social functions. You would also recommend to the son that he check on his mother daily. The symptoms of Stage IV Alzheimer's disease include impaired short-term memory, mild deterioration of long-term memory, impaired executive functioning, difficulty sequencing and problem solving, and depression. A person with Stage IV Alzheimer's disease can still perform routine, basic tasks like bathing, dressing, simple meal preparation, and housekeeping. They may forget to complete these tasks or may just not feel like doing them, so daily monitoring is necessary to insure that health is maintained.

Question 15

Your occupational therapy (OT) department has asked you to set up a file for a newly admitted nursing home patient with a diagnosis of hip fracture with repair. What should you include in the file?

Accepted Answer

The patient's file should contain the blank evaluation form, hip protocol form, Medicare documentation forms, a copy of the physician's orders, and any information that might be pertinent when developing the treatment plan for the patient. Physician's orders, copies of medical records from the hospital, and specific post-surgical precautions will all affect what areas OT chooses to evaluate and address in the treatment plan.

Question 16

A toddler receiving birth-to-three services is being referred for continued therapy at your school, once he turns 3 years old. Your OT department has asked you to gather the background information for this student. What should you do?

Accepted Answer

Copies of the records from birth to 3 years old will give the OT department the information needed to plan and complete an evaluation. Additional information may be needed from the child's parents if the records are incomplete. It would not be appropriate for OT to schedule a time to visit the child at home. The OT department would wait to schedule this visit as a part of the initial evaluation.

Question 17

Gary is a 44-year-old male who sustained a degloving injury at work. OT is in the process of completing Gary's initial evaluation for outpatient services. You are asked to gather information about Gary's job requirements. What is the best way to do this?

Accepted Answer

You would call Human Resources at Gary's workplace and request a copy of the job description for his position. Each workplace has specific descriptions that list the physical and mental requirements of each job. Obtaining the actual job description from the company will insure that OT has the exact physical requirements that Gary must meet to return to work.

Question 18

Lola is a 72-year-old female who has just been admitted to your rehabilitation facility following a mild stroke. Her physician reports that her rehabilitation potential is excellent, and the plan is for Lola to return home in two weeks. OT has asked you to gather information about what Lola will be required to do before she can return home. How should you do this?

Accepted Answer

You would interview Lola to learn about her daily activities, hobbies, family, and community involvement. Since Lola has had a stroke, you would also want to verify the information Lola has given you by interviewing her family.

Question 19

Ashley, a first-grade student at your school, has just been diagnosed with Prader-Willi syndrome. Your OT department has asked you to research this condition because you have not had a student with this diagnosis. What is the best way to obtain information regarding your student's diagnosis?

Accepted Answer

You would contact the student's parents and request information they were given about the disease. If your student is newly diagnosed, her parents most likely received information about the disease from the physician. Asking the parents for a copy of the information will insure that you are working from the same understanding of the condition as your student's parents.

Question 20

Josh, a 21-year-old high school student with multiple developmental delays, is scheduled to graduate from your school district at the end of the school year. The work program he will be attending after graduation has requested a recommendation from your OT department. It will be used to determine the appropriate supported employment placement for Josh. What information will you need from the work program to be able to make the recommendation?

Accepted Answer

The OT department will need descriptions of a few job placements that the work program is considering for Josh. The OT department should be able to give the work program recommendations for Josh's placement based on these detailed job descriptions. The work program should narrow the selection of possible jobs down to two or three and then provide the OT department with those job descriptions.

Quiz 1: Acquiring Information