Question 1

Tim is an 83-year-old nursing home patient with a diagnosis of hip fracture. His hip must stay in alignment to heal, but he is sitting in a standard sling seat wheelchair. How can you adapt Tim's chair to align his hip while it heals?

Accepted Answer

You can adapt Tim's chair by providing him with a solid seat insert and a cushion with an abductor pommel. The solid seat insert will reduce the sling effect of Tim's wheelchair seat, and the cushion with the abductor pommel will keep Tim's knees separated and his hips in alignment.

Question 2

Mary's multiple sclerosis has progressed to the point that she can no longer maneuver her manual wheelchair in public. She still has good postural control. What type of device do you recommend Mary obtain for use in public?

Accepted Answer

You recommend that Mary obtain an electric scooter chair. This device will allow her to drive herself from place to place in public without having to push the wheels of a wheelchair. Since she still has good postural control, she does not need a custom electric wheelchair.

Question 3

Wanda is a 28-year-old sheltered workshop client with quadriplegic cerebral palsy. She uses an electric wheelchair with a seat belt and lap tray. She continuously slouches forward and to her right side when operating her joystick. What adaptations does your OT department recommend for Wanda's wheelchair?

Accepted Answer

Your OT department recommends an H-style shoulder harness and lateral supports. The shoulder harness buckles across the chest, keeping the upper torso upright in the wheelchair. The lateral supports prevent slouching to the side. Both of these devices would help Wanda stay upright and to the center when she is driving her wheelchair.

Question 4

Henrietta is unsteady while walking. She has tried using a cane, but it does not give her enough support. She has significant upper-body weakness. What does the physical therapist recommend for Henrietta?

Accepted Answer

The physical therapist recommends a wheeled walker for Henrietta. Since Henrietta can still walk, a wheelchair is not recommended. However, Henrietta's upper-body weakness makes using a standard walker difficult for her. A wheeled walker allows her to push the walker rather than lift it, making mobility easier.

Question 5

William is a new nursing home patient who had a hip replacement three days ago. The doctor has ordered that William's hips be positioned in abduction while he is in bed. What device can you use to position William's lower extremities while he is in bed?

Accepted Answer

You can use an abductor pillow to position William's lower extremities while he is in bed. An abductor pillow is specially designed to accommodate both legs and strap them into place, keeping the hips positioned in abduction.

Question 6

During a home evaluation, you observe that Frances has two narrow steps with no railings to enter her home. She is currently using a wheeled walker for mobility, but her physical therapist anticipates that she will not need this much longer. What modification do you recommend to Frances for her home?

Accepted Answer

You recommend railings on each side of the entry steps with a grab bar next to the door for stability when stepping over the threshold. Since Frances will not need a wheeled walker much longer, she should be able to enter her house through the front door. But she will need railings and a grab bar to stabilize herself.

Question 7

As you continue the home evaluation, you notice that Frances' home is full of beautiful antique furniture, accent tables, and handmade throw rugs. What do you tell Frances regarding her home?

Accepted Answer

Frances has beautiful belongings that she is probably very proud of, so you don't want to insult her. You do, however, want to point out that small pieces of furniture and throw rugs can be safety hazards. Frances might trip over them. Ask if someone could help her move them until she can move around without a wheeled walker.

Question 8

Bud is at home recovering from a stroke. He can no longer sit in the bathtub to take a bath. Bud uses a wheelchair to get around his house most of the time. What adaptation do you recommend to Bud for bathing?

Accepted Answer

You would recommend a bath bench that extends over the edge of the tub. Bud uses a wheelchair to get around his home, and his ability to lift his legs into the tub is limited. A bath bench with a back rest that extends over the edge of the tub would allow Bud to sit on the edge of the bench, grab the back rest to scoot himself back, and provide him back support as he lifts his legs into the tub.

Question 9

Your friend Angie has muscular dystrophy. She can still walk around her home using a wheeled walker, but she can no longer manage her grocery shopping. She gets too tired walking behind the shopping cart. What do you recommend to Angie?

Accepted Answer

You recommend to Angie that she use the electric scooter already available at the grocery store. And suggest she use a reacher to reach for groceries on the higher shelves. Most larger grocery stores offer wheelchairs and electric scooters with shopping baskets attached as a convenience to their disabled customers. Angie would not need to purchase her own scooter, but could use the store's scooter instead.

Question 10

Brenda, your outpatient, owns an antique store. She has had multiple back surgeries and, as a result, can no longer climb the stairs to the second story of her shop. Brenda complains to you that the second story of her shop is where she keeps all of her inventory, and she must be able to access it. What recommendation do you give to Brenda to address this problem?

Accepted Answer

You recommend to Brenda that she install a chair lift along the stairs to the second story. A chair lift is much less expensive to install than an elevator and would allow her to access the second story of her current building - saving her the trouble and expense of moving.

Question 11

What does universal design mean?

Accepted Answer

Universal design means designing objects and spaces so they can be used by everyone, including elderly and disabled people.

Question 12

Wade, your work hardening patient, must return to his job at a warehouse after a L1-L2 laminectomy. Part of his job involves unloading small- to medium-sized boxes by hand from semi-trucks. What ergonomic principle are you going to teach Wade before he returns to work?

Accepted Answer

You will teach Wade to keep his back straight and bend his knees while lifting heavy

Question 13

Christy, your outpatient, sees you for conservative management of her carpal tunnel syndrome. She works in accounts receivable for a local car dealership. What recommendations will you give Christy regarding her work station?

Accepted Answer

You will recommend to Christy that she makes sure her keyboard is at a height that

Question 14

Regarding your outpatient, Christy, who has carpal tunnel syndrome and works in accounts receivable for a local car dealership: Besides her keyboard height, what other recommendations would you give her?

Accepted Answer

You would also recommend to Christy to use a wrist rest and ergonomic keyboard

Question 15

Your parents are building their retirement home. They tell you that they will live in this home until they die. What recommendations do you give them regarding the home?

Accepted Answer

You would recommend to your parents to build a one-story house with no steps to

Question 16

Millie, your 78-year-old outpatient with osteoporosis, loves to garden. She tells you she cannot get down on her hands and knees to pull weeds or tend to her flowers anymore. What do you recommend to Millie?

Accepted Answer

You recommend to Millie to use long-handled garden tools to pull weeds, which will allow her to stand or sit on a bench to garden. You also tell Millie that installing raised garden beds would allow her to stand or sit on a bench to weed, depending on the height of the bed. Both of these adaptations would protect Millie's back while gardening.

Question 17

Hannah is an 82-year-old nursing home patient who is recovering from hip replacement surgery. You are teaching her to use a sock aid to put on her socks, but she does not understand the process. How can you adapt this activity for Hannah?

Accepted Answer

If Hannah does not understand the process, she may not be able to remember the multiple-step sequence involved. You break the activity down into smaller steps, and have Hannah complete just one or two steps until she learns them. Then add additional steps until Hannah has learned the process of using the sock aid to put on her socks.

Question 18

Ford is a 33-year-old rehabilitation patient with a C5-C6 spinal cord injury. He would like to work on pulley exercises to strengthen his upper extremities, but he cannot hold on to the pulley handles. How can you adapt the pulleys, so Ford can exercise?

Accepted Answer

You have Ford wear holding mitts that will strap his fingers onto the pulley handles while he is exercising. Holding mitts are designed for people with limited hand function. They fit over a person's hands like gloves. They use a VELCRO strap to strap the fingers around a handle, allowing the person to hold on to the handle while participating in the activity.

Question 19

Luella, your nursing home patient, can easily reach for cones in diagonal patterns while seated in her wheelchair. How do you adjust this activity to make it more challenging for Luella?

Accepted Answer

You can make this activity more challenging for Luella by having her stand using a walker for support to reach for cones. Upper-body movement patterns become more challenging if they are completed in different positions.

Question 20

Karen loves to knit. But due to her CVA, she only has the use of one hand and cannot manage two knitting needles. How could you adapt this activity for Karen, so she can participate in knitting?

Accepted Answer

You would adapt the activity by clamping one needle in place, so Karen can knit with one hand. There are numerous clamps, devices, and instructional videos available to help people with one-handed knitting.

Quiz 2: Implementing Interventions