Question 1

Your work hardening patient, Shelly, is recovering from an L1-L2 laminectomy. She will be ready to return to her job at a local daycare center in about two weeks. What information will you need to gather to insure that Shelly is able to meet the physical requirements of her job?

Accepted Answer

You will need to obtain a copy of Shelly's job description. The job description should sufficiently outline the physical lifting requirements and other physical mobility requirements of Shelly's position at the daycare center.

Question 2

You have a new referral from the intensive care unit of your hospital. What information will you need to gather before your OT department can conduct an initial evaluation?

Accepted Answer

The OT department will need to know the date of admission, primary diagnosis, what procedures the physician has ordered, and any precautions that must be followed. Copies of consults or other reports may not be available yet, due to the short-term nature of the patient's admission to the hospital.

Question 3

Your OT department has asked you to handle the administration of the Sensory Processing Measure as a part of the re-evaluation process for William, a kindergarten student with autism. What are you required to do to administer this test?

Accepted Answer

You will be required to distribute the test questionnaires to William's teacher, parents, and other adults. The Sensory Processing Measure uses questionnaires completed by a child's caregivers, classroom teacher, and other adults who work with the child to obtain information about sensory processing skills.

Question 4

Sally has senile dementia and is a patient in your nursing home. You have received orders from Sally's doctor to complete an OT evaluation, and your OT department has asked you to complete an Allen Cognitive Levels screen. What will you have Sally do?

Accepted Answer

You will have Sally complete leather lacing. The Allen Cognitive Levels screen utilizes a simple leather lacing task to analyze a person's functional cognitive level.

Question 5

Your OT department is busy and needs you to complete a visual perception test with Howard, a 67-year-old stroke patient. You need to identify Howard's current abilities to develop a goal for handwriting. What test will you use?

Accepted Answer

The Beery-Buktenica Developmental Test of Visual-Motor Integration is the only selection that offers a motor component (design copying) and is for adults up to age 99.

Question 6

You must measure grip strength for Doris, your 58-year-old hand rehabilitation patient. What position will you have Doris place her arm in before you use a dynamometer to test her hand strength?

Accepted Answer

You will have Doris place her arm with her shoulder adducted and neutrally rotated, elbow flexed to 90 degrees, forearm in a neutral position, and her wrist between 0-30 degrees dorsiflexion and 0-15 degrees ulnar deviation. This is the position described in the 1985 study by Mathiawicz, et. al., which established the normative data on hand strength for adults.

Question 7

Your OT department has asked you to complete a 9-hole peg test with Doris, your 58-year-old hand patient. After you complete the test, you realize that you had placed the board in front of Doris backwards. What should you do?

Accepted Answer

You would re-administer the test and explain to Doris that you made an error. You would also inform your OT department about the error. The 9-hole peg test must be administered according to standardized protocols for the results to be accurately compared to normative data. Your OT department may want to know that the test was administered twice, as this may have affected the patient's performance.

Question 8

Your monthly OT summary for Medicare is due on Velma, your 89-year-old patient with a diagnosis of generalized weakness. You must measure her shoulder flexion. How will you position the goniometer to complete this measurement?

Accepted Answer

You would position the goniometer with the axis positioned over the lateral aspect of the head of the humerus approximately 1 inch below the acromion process, stationary arm of the goniometer parallel to the midaxillary line of the trunk, movable arm parallel to the longitudinal axis of the humerus pointing toward the lateral epicondyle. This is the correct position to measure shoulder flexion.

Question 9

Your OT department has asked you to complete a portion of the Peabody Developmental Motor Scales with a second-grade student. You have not been trained to administer this assessment. How do you respond?

Accepted Answer

You could remind the OT department that you are only qualified to complete ADL assessments or you could to be trained in order to administer future assessments. OT assistants (OTAs) are not trained to administer portions of assessments in school, but can receive training from an OT department to administer specific assessments. OTAs may not score these assessments, but may gather the data for the OT department.

Question 10

Marti, your kindergarten student with autism, has been making steady progress. During your next session, however, she displays more repetitive behaviors and resistance to structured tasks. What is the most likely cause of this change?

Accepted Answer

It is a strong possibility that Marti is not feeling well. Children with autism often cannot communicate when they feel sick. Instead, the way they react may include resistance to expectations and a recurrence of repetitive behaviors.

Question 11

Your sheltered workshop client, Evan, has a cognitive developmental delay. He is able to feed himself lunch and go to the bathroom while at work. However, when he is out in the community, he needs help performing such tasks. Why does Evan have this problem?

Accepted Answer

Evan cannot generalize skills across environments due to his cognitive delay. People with cognitive developmental delays are often able to learn tasks within a specific sequence and setting. However, when they are in a new environment, they are unable to apply such skills and must relearn them.

Question 12

What factors would you consider when preparing a 78-year-old man to return after inpatient treatment for a hip fracture?

Accepted Answer

Marital status, availability and ability of family to help, and the location of the man's house. These factors all relate to the amount of help the man has available to him upon his return home.

Question 13

Sarah is a third-grade student with a history of nerve graft secondary to a right brachial plexus injury. You notice that she rushes through her hand exercises and is sometimes resistant to working on tip pinch activities. Which of these factors is responsible for Sarah's behavior during therapy?

Accepted Answer

Sarah also has a diagnosis of ADHD. This condition will affect Sarah's ability to attend to exercises and repetitive fine motor activities.

Question 14

Millie is your home health client. She is 87 and lives alone since the recent death of her husband. You are concerned that Millie is not progressing. She does not smile much and often speaks with a flat tone. She seems to have lost interest in keeping her house clean and is eating mostly junk food. What do you report to your OT department?

Accepted Answer

Millie appears depressed and should be assessed by the home health nurse. Presenting with a flat affect or tone of voice, neglecting daily chores, and eating a poor diet are all signs of depression. Considering that Millie's husband recently passed away, she is at a higher risk for developing depression and should be assessed for the condition.

Question 15

Your carpal tunnel patient comes to her therapy session on Monday morning reporting increased pain, stiffness, and numbness in her thumb and index finger. You are not surprised by her symptoms when you hear her tell you the following:

Accepted Answer

She drove 300 miles by herself to see her sister in a neighboring state. The static grasp of the hands on the steering wheel and the vibration of the car for a prolonged period of time could have exacerbated your patient's symptoms.

Question 16

George, your 92-year-old nursing home patient, is not willing to participate in therapy sessions. He feels therapy is not necessary because his wife will help him with everything at home. What do you tell him?

Accepted Answer

You encourage him to participate so that he can do more for himself and make things easier for his wife. Nursing home patients often assume that their families will help take care of them without considering the problems their caregivers might encounter. Encouraging them to do more for themselves to make life easier for loved ones makes them think about how much they are dependent on others and motivates them to try to do more for themselves.

Question 17

Emily is a new client in your inpatient psychiatric activity group. She tells you that the announcer on television is talking to her. She also paces the activity room, appears to talk to herself, and has difficulty remembering instructions for games or crafts. What diagnosis would you expect to see on her chart?

Accepted Answer

You would expect to see schizophrenia listed on her chart. The behaviors Emily exhibits are characteristic of schizophrenia.

Question 18

Which of the following are not typical symptoms of carpal tunnel syndrome?

Accepted Answer

Numbness in the ring and little fingers are not typical of carpal tunnel syndrome. These symptoms are typical of ulnar nerve compression. Carpal tunnel syndrome involves compression of the median nerve.

Question 19

Your elderly outpatient, Alice, cannot remember how to do her arm exercises. What can you do to help her remember?

Accepted Answer

You can associate the exercise movements with typical activities that Alice already knows how to do. Elderly people typically have some difficulty with short-term memory, but long-term memory remains intact. Associating the exercises with familiar activities will draw upon Alice's long-term memory and help her to recall the exercise movements.

Question 20

People with Down syndrome often thrust their tongues out as they concentrate on a task. Why do they do this?

Accepted Answer

People with Down syndrome usually have small mouths and large tongues, making it difficult to keep the tongue in the mouth. This is the primary reason people with Down syndrome often display tongue thrust when they are concentrating on a task.

Quiz 1: Acquiring Information