Final Exam

Question 1

1. The steering wheel angle should be directed:

Answer 1

Towards the chest

Question 2

2. The steering wheel distance from driver should be:

Answer 2

10 inches

Question 3

3. Hand positions on the steering wheel should be:

Answer 3

9 and 3

Question 4

4. If a person does not have good foot contact with the foot pedals, then:

Answer 4

Her leg muscles can fatigue resulting in delayed braking

Question 5

5. Mirrors should be positioned to:

Answer 5

Eliminate all blind spots

Question 6

Your client is experiencing loud wheezing and extreme difficulty breathing in and out. She is having tachycardia and is perspiring. What type of lung disease does she likely have?
A.	Asthma
B.	Bronchiectasis
C.	Emphysema
D.	Chronic bronchitis

Answer 6

Asthma

Question 7

2. Which of the following items should not be used on or near a patient with COPD?
A.	Talcum or other powders
B.	Oxygen
C.	Frozen foods
D.	Bath towels

Answer 7

A. Talcum or other powders

Question 8

3. What techniques can the COTA use with an elder who is predisposed to fatigue?
A.	Energy conservation techniques
B.	Resting techniques
C.	Work simplification techniques
D.	A and C

Answer 8

D. EC and WS

Question 9

4. How does pursed-lip breathing help patients with COPD?
   A. It improves breathing by keeping the airways open longer.
   B. It slows breathing.
   C. It calms anxious patients.
   D. A and B

Answer 9

A and B

Slows breathing and improves breathing by keeping airways open longer.

Question 10

What is the ultimate goal of OT with elders who have COPD?
A. To maximize their level of independence as they adjust to living with a chronic condition
B. To minimize the amount of time the elder spends unsupervised
C. To discourage the use of medications and encourage the use of breathing techniques
D. None of the above

Answer 10

A. To maximize their level of independence as they adjust to living with a chronic condition

Question 11

. What is the definition of scanning?
A. The ability to mentally manipulate visual information and integrate it with other sensory information to solve problems
B. The ability to retain a mental picture of a visual stimulus
C. The ability to identify the salient features of an objective
D. The ability to recognize patterns

Answer 11

A. The ability to mentally manipulate visual information and integrate it with other sensory information to solve problems

Question 12

A COTA is working with a client who had a CVA (stroke). The COTA notices that the client is not working with objects placed on the right side of the body. Which of the following actions would the COTA take first?
A. Review the chart for information on diagnoses that would lead to this vision deficit.
B. Call the OTR immediately and report the abnormality.
C. Call the low vision specialist.
Call the facility’s ophthalmologist or optometrist

Answer 12

Review the chart for information on diagnoses that would lead to this vision deficit.

Question 13

Which of the following environmental changes can improve an elder’s vision at home?
A. Good room lighting
B. Good direct lighting for detail work (reading and sewing)
C. Using solid backgrounds for bedspreads, place mats, and so on
D. All of the above

Answer 13

D. All of the above

Question 14

Select the best response for OTRs and COTAs implementing treatment strategies with visually impaired elders?
A. The COTA should attend seminars and be mentored by the OTR before performing treatment strategies.
B. The COTA and OTR should attend seminars and be supervised by a trained ophthalmologist during treatment strategies.
C. The COTA and OTR do not require service competency in this area.
D. The COTA should be mentored by an ophthalmologist.

Answer 14

B. The COTA and OTR should attend seminars and be supervised by a trained ophthalmologist during treatment strategies.

Question 15

Which of the following defines hemi-neglect?
A. The neglect of the left or right side of the visual space
B. The neglect of the top half of the body or the bottom half
C. Absence of neglect of left or right side of the visual space
D. Absence of neglect of the top or bottom half of the body

Answer 15

A. The neglect of the left or right side of the visual space

Question 16

Predict the maximum heart rate for a healthy elder who is 72 years old.
A.	43 bpm
B.	89 bpm
C.	148 bpm
D.	204 bpm

Answer 16

C. 148

220-72(age)=148

Question 17

Which of the following changes in an elder would cause you to stop an activity?
A. Cough
B. A heart rate between the normal and maximum ranges
C. Angina
D. Blood pressure of 140/84 mm Hg

Answer 17

C. Angina

Question 18

. Your client today is a hemodialysis patient who has a shunt in the left forearm. You are preparing to take his vital signs (heart rate, pulse, and blood pressure). From where should you take his blood pressure?
A.	Left upper arm
B.	Left forearm
C.	Right upper arm
D.	Right forearm

Answer 18

C. Right upper arm

Question 19

For a client in cardiac rehabilitation with low endurance and low activity tolerance, the metabolic equivalent (MET) table can be used to estimate the energy expended when performing an activity. What do you use in addition to the MET table to determine cardiovascular stress for this client?
A. Heart rate and blood pressure responses
B. Patient complaints
C. Patient history
D. Age

Answer 19

A. Heart rate and blood pressure responses

Question 20

For elders in denial about their cardiac disease, which education should they receive from the COTA?
A. Eat the right diet and exercise daily.
B. Follow the work–rest–work principle to reduce fatigue.
C. Continue pushing yourself and overwork to improve their heart muscle.
D. Maintain a steady pace throughout the day and rest when they feel like it.

Answer 20

B. Follow the work–rest–work principle to reduce fatigue.

Question 21

1. Which of the following is the correct order of events for normal urination in women?
   A. The bladder fills with urine, stretch receptors activate, the pelvic floor and sphincter sense pressure, the urge to void is felt, the urethra relaxes, and the bladder empties.
   B. The stretch receptors activate, the pelvic floor and sphincter sense pressure, the bladder fills with urine, the urge to void is felt, the urethra relaxes, and the bladder empties.
   C. An urge to void is felt, the bladder fills with urine, the stretch receptor activate, the urethra relaxes, and the bladder empties.
   D. The pelvic floor and sphincter sense pressure, the stretch receptors activate, the bladder fills with urine, the urge to void is felt, and the bladder empties.

Answer 21

A. The bladder fills with urine, stretch receptors activate, the pelvic floor and sphincter sense pressure, the urge to void is felt, the urethra relaxes, and the bladder empties

Question 22

2.	Ms. Bell has symptoms of urinary incontinence, including uncontrollable loss of urine when she coughs, laughs, and sneezes. Which type of incontinence does she have?
A.	Stress incontinence
B.	Overflow incontinence
C.	Mixed incontinence
D.	Functional incontinence

Answer 22

A. Stress incontinence

Question 23

3.	Your client is having symptoms of urinary incontinence, including the inability to hold her urine until she gets to the bathroom. What type of incontinence does she have?
A.	Stress incontinence
B.	Overflow incontinence
C.	Urge incontinence
D.	Functional incontinence

Answer 23

C. Urge incontinence

Question 24

4. Your client is an 80-year-old newly admitted resident to a long-term care facility. The client recently became incontinent in the hospital while recovering from a total hip replacement. The health care team has determined that “prompted voiding” should be implemented. Which of the following reflects the correct actions taken in prompted voiding?
   A. The resident is taken to the bathroom or placed on a bedpan every 2 hours around the clock until the routine becomes habit.
   B. The resident is asked if she needs to void every 1 to 2 hours by the caregivers, who are responsible for documenting if the resident is wet or dry and if she needs to void.
   C. Caregivers instruct the resident to resist the urge to urinate except on a timed schedule determined by the staff.
   D. Caregivers instruct the resident to relax the abdominal muscles while contracting the pelvic floor muscles.

Answer 24

B. The resident is asked if she needs to void every 1 to 2 hours by the caregivers, who are responsible for documenting if the resident is wet or dry and if she needs to void.

Question 25

5. Your 80-year-old nursing home resident is on “timed voiding.” What does this mean? A. The resident is asked if she needs to void every 1 to 2 hours by the caregivers, who are responsible for documenting if the resident is wet or dry and if she needs to void. B. Caregivers instruct the resident to resist the urge to urinate except on a timed schedule determined by the staff. C. Caregivers instruct the resident to relax the abdominal muscles while contracting the pelvic floor muscles. D. The resident is taken to the bathroom or placed on a bedpan every 2 hours around the clock for the first 2 weeks to determine an appropriate voiding schedule

Answer 25

D. The resident is taken to the bathroom or placed on a bedpan every 2 hours around the clock for the first 2 weeks to determine an appropriate voiding schedule

Question 26

``` 1. What is one of the first changes in communication a person with Alzheimer’s disease might display? A. Problems with nouns B. Problems with long-term memory C. Problems with pronunciation of words D. All of the above ```

Answer 26

A. Problems with nouns

Question 27

While the COTA is performing therapy on an elder with mild or moderate Alzheimer’s disease, the elder states, “I don’t want to do this. I want to see my sister now; she’s waiting for me.” You know that the elder’s sister is not at the facility and probably is not coming today. Select your best response: A. “That’s okay, we can stop. I know you want to see your sister.” B. “Let’s continue your exercises until your sister comes.” C. “It will be very nice to visit with your sister today. I imagine you are missing her a little. Let’s continue your therapy until she arrives, okay?” D. “Your sister is not coming today. Let’s just keep going and spend some time together.”

Answer 27

C. “It will be very nice to visit with your sister today. I imagine you are missing her a little. Let’s continue your therapy until she arrives, okay?”

Question 28

3. A COTA’s resident with late or severe Alzheimer’s disease is receiving some bedside activities to maintain range of motion and support socialization. Which of the following COTA behaviors should be kept in mind while performing activities with this client? A. Be aware that nonverbal messages may still be comprehended by the resident such as acting rushed, looking at the clock, sighing, or raising the voice. B. Be aware that the patient can no longer hear or verbalize words, but the COTA can still talk gently to the resident. C. Be alert to the fact that the resident may stop breathing at any time and the COTA’s body language should be calm and the voice soothing. D. Be alert to the fact that the COTA’s performance is being observed at all times and the COTA’s behavior should be kind and gentle with late-stage patients.

Answer 28

A. Be aware that nonverbal messages may still be comprehended by the resident such as acting rushed, looking at the clock, sighing, or raising the voice.

Question 29

Which of the following behaviors would you expect to see in a dementia patient with “sun-downing” syndrome? A. Normal behavior for the resident, which might include confusion and wandering B. Abnormal behavior for the resident, which might include yelling, screaming, wandering continuously, and hitting or pushing staff C. Wandering, asking questions constantly, having delusions or hallucinations, and getting lost in the facility D. Impaired ambulation and gait with possible falls, lack of appetite, and incontinence

Answer 29

B. Abnormal behavior for the resident, which might include yelling, screaming, wandering continuously, and hitting or pushing staff

Question 30

. Which of the following actions should the COTA keep in mind when working with patients who have dementia or Alzheimer’s disease? A. The patients still are able to reason and follow directions, no matter what stage of the disease they are experiencing. B. Logic will help incoherent or hallucinating elders return to reality. C. A respectful response always exists for every behavior, and the COTA must find and use that response in the situation. D. Disrespect from confused elders is frequently seen and is something that is just tolerated.

Answer 30

C. A respectful response always exists for every behavior, and the COTA must find and use that response in the situation.

Question 31

``` Which of the following is a modifiable risk factor for stroke? A. Obesity B. Family history of stroke C. Increasing age D. Gender ```

Answer 31

A. Obesity

Question 32

``` Your 70-year-old male client has aphasia, perceptual deficits, and contralateral sensory deficits. Which cerebral artery was involved in the stroke? A. Middle cerebral artery B. Posterior cerebral artery C. Vertebral artery D. Cerebellar artery ```

Answer 32

A. Middle cerebral artery

Question 33

. Which of the following functions is evaluated by the COTA in the motor assessment following a stroke? A. Evaluation of pain, pressure, and temperature B. Ability to maintain the body in an upright position and hyper- or hypotonicity C. Cognitive skills D. Communication skills

Answer 33

B. Ability to maintain the body in an upright position and hyper- or hypotonicity

Question 34

When positioning a client with hemiplegia after therapy, the COTA places the client in a supine position. What else would the COTA do to complete positioning this client correctly? A. Ensure the trunk and upper extremities are aligned and support the hemiplegic upper extremity on pillows with the palm facing up. B. Place the client on the unaffected side with the trunk and upper extremities aligned. C. With the elder lying on his front, position the pillow for comfort and support the hemiplegic arm and leg with additional pillows. D. Nothing further is needed.

Answer 34

A. Ensure the trunk and upper extremities are aligned and support the hemiplegic upper extremity on pillows with the palm facing up.

Question 35

When performing activities and occupations with an elder with right hemiplegia of the upper extremity, special attention should be paid to: A. Prevention of flexion or abduction of the elder’s shoulder and scapula B. The elder’s verbal communication C. The elder’s hyper- or hypotonic unaffected arm D. The unaffected side of the body as much as the affected side of the body

Answer 35

A. Prevention of flexion or abduction of the elder’s shoulder and scapula

Question 36

Which of the following statements is true about the normal aging changes in the swallowing structures? A. The structures adapt and compensate with age. B. The structures lose their ability to adapt and compensate with age. C. The structure do not change with age. D. The structures change and leave the elder with the inability to swallow.

Answer 36

B. The structures lose their ability to adapt and compensate with age.

Question 37

In frail elders, which age-related swallowing change would you expect to see in the pharyngeal phase? A. Decreased strength in the lips and tongue and jaw muscles may result in drooling, decreased chewing, and problems moving the bolus in the mouth. B. The time of passage of the bolus increases, increasing the risk of aspiration. C. Food content may reflux from the stomach and reenter the esophagus and pharynx. D. Cognitive impairment, missing teeth, or poor-fitting dentures may result in slow eating.

Answer 37

B. The time of passage of the bolus increases, increasing the risk of aspiration.

Question 38

In healthy elders, which age-related swallowing change would you expect to see? A. Muscle tone decreases in the lips, tongue, and esophagus. B. Cognitive impairments distract elders from eating all of their food. C. Reflux of stomach contents occurs into the esophagus and pharynx. D. Decreased endurance in eating limits the amount of time spent eating.

Answer 38

A. Muscle tone decreases in the lips, tongue, and esophagus.

Question 39

You are considering making a few suggestions for improving the dining experience for elders in an assisted living facility. Which of the following would you recommend as an environmental change to improve social interaction during mealtimes? A. Take food items off the serving tray and place them directly on the table. B. Provide natural light without glare or soft, diffused overhead lighting. C. Turn off the TV during the meals and use age-appropriate soft music. D. Serve the meals soon after the elders arrive at the table.

Answer 39

C. Turn off the TV during the meals and use age-appropriate soft music

Question 40

Select the best seating option for a frail elder at mealtime. A. Sitting in bed B. Sitting in a geriatric chair C. Sitting in a wheelchair D. Sitting in a dining room chair with armrests

Answer 40

C. Sitting in a wheelchair

Question 41

At which point does safety related to hearing loss become a problem for elders? A. When elders have completely lost their hearing B. When elders are unable to hear alarms and other warning signals C. When elders cannot hear their children and grandchildren D. When elders cannot hear normal sounds around the house such as the TV

Answer 41

B. When elders are unable to hear alarms and other warning signals

Question 42

``` Hearing loss in the elderly results in which of the following? A. Embarrassment B. Loneliness C. Isolation D. All of the above ```

Answer 42

D. All of the above

Question 43

Your home-based client is having some mild hearing problems and asks you what she can do to improve her environment to hear better. What would you recommend she do? A. Nothing; you have assessed her hearing as normal. B. Have her hearing checked by an ear specialist. C. Add carpet to the floors and drapes on her windows to reduce background noise. D. Move to a house or apartment that is away from noisy environments.

Answer 43

C. Add carpet to the floors and drapes on her windows to reduce background noise.

Question 44

You see a hearing-impaired elder coming down the hallway. She appears lost as if she cannot find her room. How will you approach her? A. Walk up to the elder from behind, take her under the arm, and guide her to her room. B. Walk up to the side of the elder and touch her arm; then ask if you can take her to your room. C. Because the elder looks fine and appears stable walking on her own, she will find the room by herself. D. Approach the elder from the front, make eye contact, and then ask if you can help her find the room.

Answer 44

D. Approach the elder from the front, make eye contact, and then ask if you can help her find the room

Question 45

Which of the following recommendations would be made for an elder who has trouble with background noise at home? A. Have the elder focus on the speaker’s lips, looking directly at the speaker. The speaker should speak clearly and in a low tone. B. Add carpeting to floors and drapes on windows and replace wood and metal furniture with upholstered furniture. C. Go to restaurants at less crowded times and sit in areas away from music and the kitchen. D. Add flashing lights or lower pitched rings to smoke detectors, doorbells, and telephones.

Answer 45

B. Add carpeting to floors and drapes on windows and replace wood and metal furniture with upholstered furniture.