POT RATIONALES MH MOD 6 Flashcards

1
Q

A patient with severe chronic depression is getting ready to return home after 3 weeks in the inpatient psychiatric unit. What should the OT set up for the patient to help prevent a relapse of severe depression before the patient leaves the unit?

A

A HEP

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2
Q

What term describes when a patient believes that flying pigs are in the room?

A

Hallucinations.

A patient is diagnosed with hallucinations when he reports seeing things that aren’t really there.

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3
Q

Diane is a 45-year-old female with a diagnosis of severe chronic anxiety. She was admitted to the inpatient psychiatric unit following a “nervous breakdown”. What activities should the OT introduce to help Diane manage her anxiety levels?

A

Progressive relaxation techniques, structured journaling, and graded yoga to match pt’s skills.

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4
Q

An OTR® is working with a group of caregivers in a community setting. The focus of the group is on teaching the caregivers strategies of how to cope with work stress. In this type of group, what type of leadership style should the OT use?

A

Advisory

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5
Q

Group setting of patients with GAD are in a group to manage anxiety. Using the CBT approach, what is the best way to ensure that what is learnt in the group setting, will be integrated into the members’ daily routine?

A

Provide patients with new skills they can easily incorporate into their daily routine

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6
Q

An OT leads a daily craft group for inpatients with acute exacerbation of schizophrenia. Since this is a parallel group where each patient works on his or her own project, how should the OT lead this group?

A

OT should provide complete leadership of the group, including structure to encourage the patients to communicate appropriately with each other

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7
Q

What are the advantages of community-based mental health treatment?

A

= More cost effective that inpatient facilities
=Minimizes stigma against associated with MH illness
=Provide a wide range of services and supports

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8
Q

An OT is working with a patient who has severe cognitive deficits. Using a functional skill training approach, the MOST appropriate method to teach the patient to comb his hair would be:

A

Repetition of task and gradually fading cues

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9
Q

A patient with moderate stage dementia has a caregiver for assistance with ADLs and IADLs. What is MOST important when training the caregiver?

A

Explain the importance of visual cues.

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10
Q

An 80-year-old woman with stage 3 Alzheimer’s disease. What symptoms would you expect to observe as Gertrude completes daily activities?

A

Difficulty finding words when speaking, misplacing valuable objects, and trouble with planning and organization

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11
Q

An elderly lady, who is suffering from Alzheimer’s disease, falls and seriously injures her hip while receiving training in transfer skills from an OT. The OT informs the doctor, and in addition he should:

a. Report the incident according to facility guidelines
b. Do not explain how the fall took place at the time of treatment
c. Request the patient to arrange for first aid first
d. Report the disaster to the nearest legal council

A

Report the incident according to facility guidelines

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12
Q

A woman who has been diagnosed with a somatoform disorder frequently complains of pain in her neck and shoulder region. What treatment should the OT introduce to address the woman’s pain?

A

Stress Management.

Since patients with somatoform disorders typically present with physical symptoms without any underlying physical or neurological explanation, the goal is to retrain the brain in improving the signals from the brain and nerves including stress management techniques.

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13
Q

Patient is at 4.2 at the ACL. Which cues would be MOST helpful to use to help Luanne become more thorough with her oral care?

A

Demonstrate repetitive action sequence with timing and adjustment of pressure, i.e. “Brush harder here several times”

At 4.2- person is able to do fx routine activities, but may need cueing esp VISUAL cues for thoroughness and recognizing details.

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14
Q

An OT leads several mental health groups at a local community church. Topics include ways to relieve anxiety, ways to increase social skills, and crafts that help bring self-awareness. What would be the PRIMARY role of the OT when leading an egocentric cooperative group in this setting?

a. Make suggestions to allow patients to choose and carry out the task and group plan
b. Providing transportation costs
c. Enforcing the guidelines
d. Encouraging the group to get close to each other and discuss hobbies

A

a. Make suggestions to allow patients to choose and carry out the task and group plan

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15
Q

A pt who has mild cognitive decline in rt to AD has been observed to be arriving later than usual. When asked why he is delayed in getting to the activity room, Charles states, “These halls are so tricky”. What action should the OTR® take INITIALLY to help Charles navigate the hallways?

A

Write down instructions for the patient to refer to when walking on his way to the class (gym)

Mild cognitive (Stage 3 of Reisberg’s AD)- At this stage, pt presents wild spatial navigation and may need step by step instruction from point A to B. to continue having patient participate in activity as IND as possible.

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16
Q

An OT working in a sheltered workshop with adults with developmental disabilities is preparing a craft activity for a group of individuals functioning at Allen’s Cognitive Level 4.0. What is the BEST method for introducing an activity assembling a tiled trivet?

A

Provide a sample that will model the finished product. Patients performing at Allen Cognitive Level 4.0 can follow a demonstrated sequence when presented one at-a-time.

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17
Q

A patient with schizophrenia is working on a craft activity in the occupational therapy clinic. Suddenly the patient begins screaming that snakes are crawling up the walls. How should the OT respond to this behavior?

A

Remove the patient from the room and take her to a quiet area.

Often when patients experience active hallucinations, its better to remove external stimuli that could possibly trigger those hallucinations in order to ID what they’re seeing real or not.

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18
Q

What type of group provides an awareness of its goals and norms and willingness to abide by them? The people in the group can carry out long-term activities that allow them to experiment with different roles and levels of participation, while providing an opportunity to recognize and reward the achievement of others and to seek recognition for oneself.

A

Egocentric-cooperative

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19
Q

In a group discussion about social skills, a patient listens carefully as an older member, whom she admires, discusses strategies that have helped him to get along well with co-workers. After the group, the OT documents that the individual appeared to benefit from the curative factor of:

A

Identification

involves benefiting from behaviors of others by deciding to imitate their positive behaviors.

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20
Q

What is guidance?

A

Acceptance of specific advice

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21
Q

What is Catharsis?

A

Relieving emotions by expressing one’s feelings

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22
Q

What is interpersonal learning?

A

Feedback about one’s behavior via other group members.

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23
Q

A hypochondriasis patient, who is partaking in a partial-hospitalization program, has an impaired self-concept and cannot perform daily tasks because of a preoccupation with health-related issues. By using an informational approach, the OT should:

A

Assist the patient to learn methods for incorporating valued activities into daily routines

To reduce opportunities of preoccupation with health-related issues.

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24
Q

To determine how a patient with schizophrenia functions and problems-solves, what would be the best treatment intervention for his OT to use?

A

Simple Craft project

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25
Q

What is cooperative group?

A

a group that provides an environment for group members to openly share emotions, challenges and shared intentions.

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26
Q

A group of adults who have all lost a spouse, gather together to share something that helps them remember their loved ones. Some members share a song, or a picture, others just recount a memory of their spouse. What type of group is this referring to?

A

Cooperative group

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27
Q

An OT is leading a cooperative group for adults with depression secondary to recent onset of physical disability. What is the OT’s role in this type of group?

A

Advisory role

28
Q

What is the cognitive-behavioral approach?

A

The cognitive-behavioral approach involves the patient consciously replacing incorrect thoughts and fears with positive or correct thoughts, resulting in a change in emotional response

29
Q

An OT is working with 5 patients in a mental health cooking group. After 10 minutes, a patient with oppositional defiant disorder (ODD) suddenly screams at another patient for not following the directions. What is the BEST course of action for the OT to take?

A

De-escalating technique.

To diffuse conflict and offset patients sxs

30
Q

What is the name of the group in which patients are interested in participating in a task or game, yet recognize that they need the other group members in order to do it? As a result, the patients are willing to take turns, share materials, cooperate, and ask for help- as well as offer it.

A

Project level group.

31
Q

What approach utilizes a “teacher-student” format, as opposed to “learning by doing” approach? It often includes a homework component.

A

Psychoeducation

32
Q

A patient is able to copy demonstrated directions presented to him one step at a time and is interested in doing simple two dimensional projects. What ACL is he at?

A

Level 4

A person at this level does not plan for such details such as spacing. Finds it easier to imitate a sample than to follow a diagram or picture. Cannot recognize errors and may not be able to correct them when they are pointed out. Does not understand that objects can be hidden from view.

33
Q

After observing an individual with schizophrenia, the OT has noted that the patient answers each question by consistently redirecting the focus to a story about his good old college days. After the session, the OT will document in her notes that this patient is exhibiting a sign of:

A

Perseveration.

Meaning repetition of particular responses, word, phrase, gesture despite absence of stimulus.

34
Q

What is a brain disorder that affects how people think, feel, and perceive, and which the signs and symptoms
may be divided into the above 4 domains (positive, negative, cognitive, mood)

A

Schizophrenia

35
Q

What would be the first treatment the OT should work on with this patient who has bulimia?

A

The OT can build trust, provide education on nutrition and food management, and help the patient develop healthy use of leisure time

36
Q

Marva is a 76-year-old woman who lives in a long-term care facility. Her score on the Allen Cognitive Levels screening test is a 4.0. What abilities would you expect to observe while watching Marva’s daily routine?

a. Becomes distracted by other people in the hallway, learns a new task through trial and error
b. Assists caregiver with dressing, tries to walk towards dining room but doesn’t seem to know where she has to go
c. Dresses self with minimal assistance, locates the dining room, therapy clinic, and own room within the facility with a few cues from staff, and becomes distracted by other people in the hallway
d. Becomes distracted by other people in the hallway, locates the dining room

A

C. Dresses self with minimal assistance, locates the dining room, therapy clinic, and own room within the facility with a few cues from staff, and becomes distracted by other people in the hallway

ACL 4.0- able to complete familiar, routine tasks with minimal assistance, but easily distracted by visual stimuli.

37
Q

Tracy was recently diagnosed with post-traumatic stress disorder following a history of domestic violence, is currently residing in a women/family shelter with her 4-year-old daughter. Tracy has stated that she wants to be an independent and productive “citizen in society and make my 4-year-old daughter feel safe”. What should the PRIMARY focus of Tracy’s initial group session be, in this scenario?

A

Assertiveness, advocacy training, and safety planning.

38
Q

A woman with stage 3 Alzheimer’s disease is asked to perform a cooking task by the OT. What level of assistance should the OT expect to provide as the woman completes the task?

A

Verbal cues to sequence steps of the task

39
Q

A pt with ALS. The OT determines that he is going through the grieving process after being informed of his diagnosis. What factor will influence this patient’s grieving process the most?

A

His social support from family and friends

How a patient works through the grieving process after the onset of a disabling condition is often influenced by how much support the patient receives from family and friends, more than how severe the condition is.

40
Q

When treating a patient who has been diagnosed with major depression, what guidelines should you follow?

A

Avoid too many choices, increase the opportunity for decision making, notify staff of suicidal ideation

41
Q

A group of 8 veterans who suffered from PTSD have been meeting every week for the past two years to discuss how they are coping after returning from war and ways to maintain their health and maintain their highest level of function. According to Mosey, what type of group is this?

A

Instrumental

42
Q

An OT is performing an Allen Cognitive Level (ACL) screening on a patient with cognitive dysfunction. The OT notices that the patient is able to imitate the running stitch and complete three whip stitches, but cannot complete any additional steps of the screening. At what ACL is this person showing abilities?

A

Level 4

43
Q

Carol, a 73-year-old resident of an assisted living facility was admitted to an inpatient rehabilitation unit after sustaining a right femoral fracture, 2 weeks ago. Carol has been diagnosed with Dementia and she is currently functioning at an ACL level of 3.8. She is ambulatory, using a FWW, and requires minimal assist with basic routine self-care. In order to alert the nursing staff that she needs to use the bathroom, Carol does not use the call button but instead, yells from her room that she needs to use the toilet. The case manager announces that Carol will be transferred to the next level of care in 2 days’ time. Which setting would be the most appropriate in terms of meeting Carol’s needs, based on her current level of functioning?

A

An adult group home or board and care.

The resident must not be exit-seeking and must be mobile with or without a mobility device.

44
Q

A patient has been referred to occupational therapy by a counselor. While working with the patient, who has borderline personality disorder, the patient whispers in the OT’s ear that he is suicidal. What is the BEST action to take next?

A

Refer to primary counselor/therapist.

45
Q

Staff has observed patient does not clean room and leave dishes. Using a cognitive-behavioral approach, which of the following types of intervention would be MOST effective for this patient with a history of substance abuse and lives in a group home.

A

Lead an instructional meeting with staff and residents about expectations in a group home

46
Q

A patient wants to learn to play guitar. What is the type of group that he should join?

A

Thematic groups. Designed for learning specific skills.

47
Q

A patient residing in a long-term care facility has progressed to the mid stage of Dementia. In which activity would this patient have the most difficulty participating?

a. Describing their daily routine of the past week
b. Difficulty dressing, needing maximum assistance
c. Answering open ended questions about their schooling and work history
d. Giving a detailed description of their childhood home and favorite family outing

A

Describing their daily routine of the past week

48
Q

In which type of developmental group does the leader become one of the group members by adopting a participatory leadership style?

A

Mature

49
Q

Sandra, a woman in her thirties who has a history of Bipolar Disorder has been referred for an OT evaluation at a behavioral health center. Sandra is currently unemployed, and she was recently evicted from her apartment. Her sister has allowed Sandra to stay with her until Sandra is “back on her feet”. Sandra arrives late to her appointment. She is wearing skimpy clothing, and her hair is tangled in knots. She explains her tardiness by stating, “I was up all night. I met a friend at a bar”. During her interview, Sandra expresses that her main goal is to work again. Using the Model of Human Occupation, what would the PRIMARY focus of intervention be, at this stage?

A

Supporting the patient to resume meaningful work roles and establish routines based on her skills and abilities

50
Q

What is the most important topic to include when teaching dementia care techniques to a family caregiver?

A

Focus on verbal cues to explain a situation to the patient

51
Q

The focus of the intervention is currently on meal preparation. The patient has successfully prepared cold cereal. What is the next type of meal the OT should select, to help this patient progress to the next level?

A

Prepare hot beverage, soup or prepared dish

52
Q

What should the OT do with a pt having delusions?

A

Redirect to reality-based thinking and actions and avoid discussions and other experiences that focus on and validate or reinforce delusional material

53
Q

What should the OT do with a pt having akathisia?

A

allow the person to move around and whenever possible, use gross motor activities over fine motor ones

54
Q

What should the OT do with a pt who has offensive behavior

A

Set limits, immediately address behavior, clearly present (nonjudgmentally) reasons why certain behavior is not acceptable, clearly communicate the consequences of continued offensive behavior

55
Q

What ACL would a patient be at when he is able to anticipate why he should not cross the road, what would happen if he walked when the light was red, and why it is important to walk in the cross walk?

A

Level 6

56
Q

What is Level 3 of ACL?

A

Manual Actions, MOD A, TACTILE CUES, RUNNING STITCH, REPETITION, ABLE TO DO FAMILIAR ADLS w/ reminders

  1. 0: Grasp objects
  2. 2: Distinguish objects
  3. 4: Sustain actions on objects- sequencing
  4. 6: Noting all effects on objects- Needed reminder to finish necessary steps
  5. 8: Using all objects
57
Q

What is Level 4 of ACL?

A

Goal-Directed Actions, MIN A, VERBAL CUES, WHIPSTITCH 2-step task, no new learning,

  1. 0: May fix a cold meal or snack
  2. 2: May walk to familiar locations or familiar bus route
  3. 4: May manage daily allowance
  4. 6: May able to live alone with daily check-ins
  5. 8: May schedule community activity or supported employment
58
Q

What is Level 5 of ACL?

A

Exploratory, SBA, TRIAL AND ERROR, SINGLE CORDOVAN, NEW LEARNING POSSIBLE

  1. 0:
  2. 2: May live alone with WEEKLY checks
  3. 4:
  4. 6: May be supervised to ID hazards. MAY DRIVE
  5. 8 May benefit from planning as well as discussion of complications (fatigue, energy conservation, joint protection)
59
Q

Reisberg Scale of AD: Stage 1

A

NO cognitive impairment present

60
Q

Reisberg Scale of AD: Stage 2

A

Mild memory decline. Forgetting words, keys. Person starts to notice memory problems

61
Q

Reisberg Scale of AD: Stage 3

A

Mild cognitive decline. Denies having problem. Family members or others may start to notice memory changes. increased forgetfulness.

62
Q

Reisberg Scale of AD: Stage 4

A

Beginning of Early Stage AD.

Difficulty with sequencing/planning
Still oriented to time and place
Denial
May live at home with compensatory strategies and assistance.

63
Q

Reisberg Scale of AD: Stage 5

A

MOD/MIDDLE AD

Cannot live alone.
Disorientated to time and space
Inability to drive
Requires cues and assistance
Forgets address and phone numbers
IND in Self-feeding and Toileting
64
Q

Reisberg Scale of AD: Stage 6

A

SEVERE/MIDDLE

Irritable 
Obsessive/delusional
Incontinent
Incomplete sentences
Wander around
65
Q

Reisberg Scale of AD: Stage 7

A

END/ LATE

Bed-ridden
Cannot sit, stand walk or talk
At risk for falls, infections and diseases