Question 1

You are working in a rehabilitation hospital and are responsible for helping patients obtain appropriate durable medical equipment. In considering wheelchair casters, which of the following choices would be most appropriate if you were concerned primarily about chair stability?

Accepted Answer

Larger casters, like 8-inch ones, provide greater stability as they can better handle uneven surfaces and obstacles, reducing the risk of tipping.

Question 2

Why is a wheelchair considered a mobility orthosis?

Accepted Answer

The external support provided by the wheelchair makes it an orthosis. However, in addition to providing support, the wheelchair is designed to facilitate mobility.

Question 3

Your patient is a 43-year-old woman with multiple sclerosis who needs a wheelchair for occasional use, especially for locomotion over long distances. Her husband will push her during such trips. He will also put the chair in the car trunk for transportation. Which of the following is likely to be the most appropriate type of legrest for this patient?

Accepted Answer

Removable swing-away legrests would be the most appropriate type for this patient as they allow for easy transfer to and from the wheelchair, as well as efficient storage in the car trunk. Elevating legrests may not be necessary for occasional use and can add weight and complexity to the chair. Fixed legrests would not allow for easy transfer or storage. Rigid footplate only would not provide adequate support for the patient's legs.

Question 4

Which of the following measures for wheelchair fitting is best taken with the patient in supine?

Accepted Answer

Seat depth is the best measure taken with the patient in supine position because the patient's legs are fully extended and at their natural resting length in this position, allowing for a more accurate measurement of the necessary seat depth to prevent pressure points and ensure proper positioning.

Question 5

When assisting a patient with wheelchair fitting, which of the following is the first goal in achieving postural stability?

Accepted Answer

Positioning the pelvis correctly is the first goal in achieving postural stability for a patient in a wheelchair. This ensures a stable base for the rest of the body and helps prevent pressure ulcers and other complications. Once the pelvis is positioned correctly, the feet, trunk, and head can be adjusted as needed for optimal comfort and support.

Question 6

Use of a sling seat in a wheelchair tends to result in all of the following except

Accepted Answer

Use of a sling seat in a wheelchair tends to result in a forward head posture, bilateral hip adduction, and internal rotation, as well as increased stress on the structure of the trunk. However, it does not typically result in decreased thoracic kyphosis; instead, it may actually increase thoracic kyphosis.

Question 7

What is meant by "90-90-90"? ____________________.

Accepted Answer

The answer of What is meant by "90-90-90"? ____________________....

Question 8

Which of the following is true regarding properly positioned wheelchair armrests?

Accepted Answer

Properly positioned armrests can help decrease the weight on the buttocks, as they provide a weight-bearing surface for the upper extremities. Option A is incorrect because armrests do add additional weight to the chair. Option B is incorrect because armrests are typically positioned to allow for some degree of shoulder abduction, usually between 20-30 degrees. Option C is incorrect because armrests are designed to be load-bearing to a certain extent.

Question 9

Your patient is getting ready to leave rehabilitation and needs a wheelchair for use at his office. He plans to spend several hours in the chair each day, although by the end of the day his upper extremities are fatigued from wheelchair propulsion. He weighs 220 lb. and is 6 ft, 2 in. tall. Which of the following armrest options would be best for this patient?

Accepted Answer

Removable desk armrests would be the best option for this patient as they provide support while also allowing for easy maneuverability when sitting at a desk. Full-length or tubular armrests may impede his ability to get close to a desk or cause discomfort when maneuvering. Removable armrests also allow the patient to adjust their position and relieve upper extremity fatigue.

Question 10

Your patient is a 63-year-old man who is undergoing chemotherapy and radiotherapy for treatment of colon cancer and is very weak as a result. His mobility level has been decreasing over the past few years, and he has very tight hamstring and hip flexor muscles. You are helping him select a wheelchair that he can use at home, where he lives alone. Which of the following legrests would be most appropriate for this patient?

Accepted Answer

The answer of Your patient is a 63-year-old man who...

Question 11

Which of the following wheelchair frames is most appropriate when the primary concern is shock absorption when traveling over rough or uneven surfaces?

Accepted Answer

Folding-frame wheelchairs are designed to absorb shock better than rigid frames, making them more suitable for rough or uneven surfaces.

Question 12

List at least four factors that must be considered in wheelchair selection.

Accepted Answer

The answer of List at least four factors that must...

Question 13

You are instructing a patient about wheelchair propulsion in a nursing home setting. Assuming that the patient has adequate strength and range of motion, what instructions should you give the patient for the most efficient forward propulsion using both hands?

Accepted Answer

C  For efficient wheelchair propulsion, the patient should start with both hands behind them at the 10 o'clock position and push forward with long strokes, releasing at about the 4 o'clock position. This maximizes the use of strength and reduces fatigue.

Question 14

List three potential physical and physiological risks associated with independent wheelchair propulsion. ____________________

Accepted Answer

The answer of List three potential physical and physiological risks...

Question 15

Which of the following is the best way for a wheelchair user to negotiate very steep slopes?

Accepted Answer

Going up a very steep slope using a zigzagging path is the safest and most stable way for a wheelchair user to negotiate the slope. This technique reduces the risk of the wheelchair tipping over and allows the user to maintain control and balance throughout the ascent. Having someone pull the chair up the slope backward or tipping the chair into a wheelie position and going up the slope backward or forwards are all risky and potentially dangerous methods that could result in the user falling or the wheelchair tipping over.

Question 16

Wheelchair selection is the domain of the durable medical equipment vendors and as such does not fall within the scope of skilled patient care.

Accepted Answer

While durable medical equipment vendors may assist with wheelchair selection, it is still important for healthcare professionals to be knowledgeable about appropriate wheelchair selection for their patients and provide guidance and recommendations to the vendors. Additionally, skilled patient care may involve assessing a patient's mobility needs and recommending a wheelchair, which falls within their scope of practice.

Question 17

Which of the following represents the best safety instruction for a patient who is learning to manage a sideways fall in a wheelchair?

Accepted Answer

Lateral flexion of the head away from the ground and tucking the arms close to the chest can protect the head and prevent arm injuries during a sideways fall in a wheelchair. Extending the arm in the direction of the fall can lead to injury, and flexing the elbows may not provide adequate protection. Tucking the chin towards the chest alone does not provide sufficient protection for the head.

Question 18

For the optimal push angle, wheelchair seat alignment should allow how much elbow flexion when the hand is at the apex of the wheel?

Accepted Answer

The answer of For the optimal push angle, wheelchair seat...

Question 19

The most common method of transporting a patient in a wheelchair up and down steps is to ascend the steps backward.

Accepted Answer

Ascending the steps backward while the patient is in a wheelchair is the most common method because it provides a better view of the steps and allows the caregiver to control the wheelchair more easily. It also reduces the risk of the front wheels of the wheelchair catching on the steps.

Question 20

Which of the following best describes an articulating legrest?

Accepted Answer

An articulating legrest is designed so that the footplate extends a few inches forward as it is elevated, allowing for a more comfortable and natural position for the user's leg and foot. It may or may not be lighter than a standard elevating legrest and the degree of elevation depends on the specific model. The length of the legrest may or may not change as it is elevated, but the movement of the footplate is the defining characteristic of an articulating legrest.

Quiz 13: Seated Mobility: Sitting but Not Sitting Still--Fitting and Propelling a Wheelchair