Neuromgt 3

Question 1

An occupational therapist working in a private clinic receives a referral for a client who incurred a nerve laceration while working as a cable installer and repair person. Upon evaluation, the therapist determines that the client exhibits maximum motor and sensory losses consistent with a radial nerve laceration below the supinator.

1. The occupational therapist documents the result of the evaluation. Which deformity should the therapist note that the client is exhibiting?

A. Claw Hand
B. Wrist Drop
C. Ape Hand
D. Saturday Night Palsy

Answer 1

B. Wrist Drop

A: Ulnar nerve
C: Flattening of thenar eminence (Median)
D: Radial dt compression

Question 2

An occupational therapist working in a private clinic receives a referral for a client who incurred a nerve laceration while working as a cable installer and repair person. Upon evaluation, the therapist determines that the client exhibits maximum motor and sensory losses consistent with a radial nerve laceration below the supinator.

2. Through active participation in individual occupational therapy sessions, the client regains functional motor skills. To facilitate return to work, the occupational therapist refers the client to a local work hardening program. This program does not have the exact equipment that the client uses in the job setting. Which action is best for the therapist at the work-hardening program to take in response to this situation?

A. Refer the client to another work hardening program that has the equipment
B. Order and install the equipment necessary to duplicate the work setting
C. Perform some necessary
aspects of rehabilitation in the client’s work settings.
D. Duplicate the job task components as closely as possible.

Answer 2

D. Duplicate the job task components as closely as possible.

Work hardening: May be real or simulated task

A: If hindi kaya na OT
C: Logistics may be difficult

Question 3

An occupational therapist working in a private clinic receives a referral for a client who incurred a nerve laceration while working as a cable installer and repair person. Upon evaluation, the therapist determines that the client exhibits maximum motor and sensory losses consistent with a radial nerve laceration below the supinator.

3. The occupational therapist constructs a splint to facilitate healing and promote function. Which is the most effective splint for the therapist to fabricate for this individual?

A. A dynamic extension splint
B. A figure of eight splint
C. A dynamic flexion splint
D. A splint to support the functional position

Answer 3

A. A dynamic extension splint

Wrist, MP, thumb extension

B: Median and ulnar nerve
D: Not affected

Question 4

An occupational therapist working in a private clinic receives a referral for a client who incurred a nerve laceration while working as a cable installer and repair person. Upon evaluation, the therapist determines that the client exhibits maximum motor and sensory losses consistent with a radial nerve laceration below the supinator.

4. The client successfully completes the work hardening program. However, the client has residual moderate impairment in temperature perception. During the discharge planning session, the therapist discusses how this impairment may impact areas of occupation and suggests activity modifications to facilitate the client’s occupational performance. What is the most appropriate recommendation for the therapist to make to the client?

A. Request reassignment to work activities that do not involve exposure to extreme temperatures
B. Mark all potentially hot objects at home and at work with bright stickers
C. Wear work gloves for activities involving extremes or variations in temperature
D. Wear a protective splint during the work day and at home during home maintenance tasks

Answer 4

C. Wear work gloves for activities involving extremes or variations in temperature

A: Not needed because px has the skill
D: Not adequate protection

Question 5

5. A carpenter complains of tingling of the left thumb, index and middle finger, weakened grasp and right pain secondary to carpal tunnel syndrome. The left thenar eminence appears smaller and more flattened compared to the right thenar eminence. The occupational therapist collaborates with the client to develop an intervention plan. Which recommendation is best to include in this plan?

A. Wrapping wrists with elastic bandages to provide support
B. Modifications of techniques used to hold a hammer
C. Application of hot packs upon waking to decrease pain
D. Performance of wrist flexion and extension exercises with progressively increasing repetitions

Answer 5

B. Modifications of techniques used to hold a hammer

A: Not supportive enough
C: PAMS are prep
D: Avoid wrist flexion

Question 6

6. An OT practitioner is treating a client who demonstrates pain, progressive weakness of the thumb, atrophy of the thenar muscles and numbness and tingling in the thumb, index, long, and half of the ring fingers. The client is not experiencing proximal upper extremity limitations so the practitioner will MOST likely suspect problems with which of the following?

A. Ulnar nerve
B. Median nerve
C. Radial nerve
D. Brachial plexus

Answer 6

B. Median nerve

A: Loss of sensation at the 4th-5th finger
C: Wrist
D: Any or all UE

Question 7

7. A therapist is evaluating an individual with a peripheral nerve injury for strength, range of motion and endurance. The most appropriate frame of reference on which to base the evaluation

A. Rehabilitative FOR
B. Neurodevelopmental FOR
C. Biomechanical FOR
D. Psychoanalytic FOR

Answer 7

C. Biomechanical FOR

Question 8

8. The OT practitioner is treating a person with mild carpal tunnel syndrome. The MOST important Instruction for the therapist to give the patient is to avoid:

A. Extension
B. Flexion
C. Ulnar deviation
D. Radial deviation

Answer 8

B. Flexion

+ Gripping and pinching

Question 9

9. An OT practitioner is fabricating a dynamic splint for a butcher who sustained a low-level radial nerve injury should.

A. Provided wrist extension, MCP flexion, and thumb flexion
B. Prevent wrist extension, MCP extension, and thumb extension
C. Prevent wrist extension, MCP flexion, and thumb flexion
D. Provide wrist extension, MCP extension, and thumb extension

Answer 9

D. Provide wrist extension, MCP extension, and thumb extension

Question 10

10. Guttering of the hand. What nerve is affected?

A. Radial Nerve
B. Median Nerve
C. Ulnar Nerve
D. NOTA

Answer 10

C. Ulnar Nerve

Code: gULtering

Question 11

11. A computer operator presents the ff symptoms during a work site assessment: tingling sensation at the level of the wrist and fingers, pain on prolonged supination of the forearm, and pain at the shoulder and neck all on the right side of the body. You suspect a possible compression injury of the brachial plexus proximally and median nerve distally. Your treatment priority would be:

A. Wrist cock-up splint and reminders to the client to take frequent breaks during the day
B. Wrist cock-up splint and readjustment of her chair and position of the computer keyboard
C. Teach the client gentle positioning exercises that will promote nerve gliding as compression of the brachial plexus is present
D. Advise the client to consider a job change as her condition is not likely to improve given the severity of her symptoms

Answer 11

C. Teach the client gentle positioning exercises that will promote nerve gliding as compression of the brachial plexus is present

Question 12

12. Low Median Nerve Injury

A. Loss of thumb abduction, opposition
B. Loss of FA pronation, wrist and finger flexion, thumb opposition and abduction
C. AOTA
D. NOTA

Answer 12

A. Loss of thumb abduction, opposition

B: High Median Nerve Injury

Question 13

13. An OT practitioner is fabricating a splint for a client who sustained a low-level ulnar nerve injury. The OTR explains that the PRIMARY purpose of an ulnar nerve splint is to:

A. block hyperextension of the PIP joints and allow PIP flexion.
B. block hyperextension of the MCP joints and allow MCP flexion.
C. block PIP flexion and allow for PIP hyperextension.
D. block MCP flexion and allow for MP hyperextension.

Answer 13

B. block hyperextension of the MCP joints and allow MCP flexion.

Question 14

14. A 5 year old boy presents with a waiter’s tip deformity. What roots are possibly involved?

A. C5-C6
B. C7-C8
C. CB-T1
D. T1-T2

Answer 14

A. C5-C6

Code: Tip kaya nasa taas

Question 15

15. What would you expect in a median and ulnar nerve injury?

A. Weakness of flexion of the distal phalanx of the thumb
B. Loss of thumb opposition
C. Claw hand deformity
D. Hypothenar wasting

Answer 15

C. Claw hand deformity

A, B, and D: Median Nerve only

Question 16

16. As part of an initial evaluation of an individual with carpal tunnel syndrome, the OTR evaluates light touch sensation using a cotton ball. After wearing a wrist splint for 2 weeks the patient returns for re- evaluation, which the COTA performs. At this time, the MOST appropriate method for re-evaluation of light touch is to use:

A. a cotton ball
B. an aesthesiometer
C. Semmes-Weinstein monofilaments
D. a pin or straightened paper clip

Answer 16

A. a cotton ball

Since re-evaluation we need na same yung gagamitin to see the difference

Question 17

17. Entrapment of the anterior interosseous nerve between the two heads of the pronator teres may be indicated by a positive:

A. Test for pronator teres syndrome
B. Pinch grip test
C. Wartenberg’s sign
D. Egawa’s sign

Answer 17

B. Pinch grip test

A: Flexion of elbow at 90 degree/ hand shaking position
C: Unable to adduct little finger when hand is abducted
D: Flexed fingers on the table then UD/ RD

Question 18

18. What nerve passes through the carpal tunnel:

A. Median
B. Ulnar
C. Radial
D. Musculocutaneous

Answer 18

A. Median

Question 19

19. Common peroneal nerve is damaged. Client has difficulty with:

A. Inversion
B. Eversion
C. Dorsiflexion
D. Plantarflexion

Answer 19

C. Dorsiflexion

Question 20

20. An occupational therapist receives a referral to construct a splint for an individual with Erb’s palsy. Which orthosis would be most effective for this condition?

A. A flail arm splint
B. An elbow lock splint
C. A figure of eight splint
D. A deltoid sling

Answer 20

B. An elbow lock splint

Question 21

21. Before treating a client referred to the hand center for a nerve injury, the OTR must understand the nerve pathways that innervate the hand. The nerves of the hand are MOST commonly referred to
    as:

A. Lateral, medial, and central
B. Femoral, obturator, and sciatic
C. Radial, median, and ulnar
D. Dorsal, lateral, and volar

Answer 21

C. Radial, median, and ulnar

Question 22

22. Froment’s sign is a test for:

A. Ulnar collateral ligament
B. Ulnar nerve entrapment
C. De quervain’s tenosynovitis
D. Suprascapular nerve

Answer 22

B. Ulnar nerve entrapment

Question 23

23. Erb Duchenne

A. C3-C4
B. C4-C5
C. C5-C6
D. None of the above

Answer 23

C. C5-C6

Question 24

24. The nerve most likely to be injured in wrist slashing:

A. Median nerve
B. Ulnar nerve
C. Musculocutaneous nerve
D. Radial nerve

Answer 24

A. Median nerve

Question 25

25. You are to assess edema on a patient. As an OT, what should you do first? A. Palpate to check if it's pitting or non-pitting B. Measure in circumference C. Measure using volumeter D. Elevate affected extremity prior to measurement

Answer 25

A. Palpate to check if it's pitting or non-pitting

Question 26

26. What are the cords of your median nerve? A. Lateral and posterior B. Lateral and medial C. Posterior only D. Posterior and medial

Answer 26

B. Lateral and medial

Question 27

27. A 30 y/o female waitress worked very long hours. One evening she fell asleep resting on her right forearm. She awoke 5 hours later with signs of radial nerve injury, including wrist drop. Which splint is the best option: A. Resting hand splint B. Dynamic extension splint C. Radial gutter splint D. Ulnar gutter splint

Answer 27

B. Dynamic extension splint Best type of splint for wrist drop

Question 28

28. Occupational therapists can assess peripheral nerve function in their clients with many quick screening tests available to clinicians. The simple test for radial nerve function would be: A. Thumb and little finger opposition B. Wrist extension C. Gross grasp assessment with dynamometer D. Pinch thumb and index finger

Answer 28

B. Wrist extension

Question 29

29. Muscle innervated by the radial nerve: A. Flexor Carpi Radialis B. Flexor Pollicis Longus C. Flexor Digitorum Superficialis D. Abductor Pollicis Longus

Answer 29

D. Abductor Pollicis Longus A, B, C: Median Nerve

Question 30

30. A computer programmer arrives at an OT clinic complaining of pain while on the job. Which of the following are MOST likely to be considered work- related injuries specifically linked to the age of technology? A. Systemic disease B. Edema and paresthesias C. Burns and electrocution D. Carpal tunnel and chronic cervical tension.

Answer 30

D. Carpal tunnel and chronic cervical tension. A and C: Not associated with repetitive motions B: Not injury but symptom

Question 31

31. Nerve being stretched when shoulder is in IR, FA in pronation, and wrist and fingers are flexed: A. Median nerve B. Ulnar nerve C. Radial nerve D. Axillary nerve

Answer 31

C. Radial nerve

Question 32

32. The OT practitioner has completed patient education with an individual who has just received a splint for carpal tunnel syndrome. When documenting this session, the OT practitioner will indicate that the patient was instructed in precautions, wearing schedule, and care of a: A. Wrist cock-up splint B. Thermoplastic splint C. Resting hand splint D. Dynamic MP flexion splint

Answer 32

A. Wrist cock-up splint Position wrist in 10-20 degree flexion B: Not for CTS C: Arthritis D: Weakness

Question 33

33. Following nerve injury repair surgery, an individual is evaluated for sensory return. Which measurement tool is best for the occupational therapist to use to assess for the return of vibration? A. A tuning fork B. Nylon filament C. A disk-criminator D. The ninhydrin test

Answer 33

A. A tuning fork

Question 34

34. A patient suffers from ulnar nerve entrapment, which of the following functional tasks is most difficult to perform? A. Holding a pen B. Picking up a coin C. Grabbing a hammer D. Clicking a mouse

Answer 34

C. Grabbing a hammer Code: U Power Me Pre (Ulnar Power, Median Prehension)

Question 35

35. An individual is evaluated for a repetitive stress disorder. The individual complains of numbness and tingling of the thumb, index, middle and radial half of the ring finger and aching pain in the proximal forearm. The client states that these symptoms are not evident at night. The occupational therapist notes a positive Tinel's sign. Which site should the therapist document as the location of this sign for this client? A. The wrist B. The Guyon's canal C. The elbow D. The forearm

Answer 35

D. The forearm Pronator Teres Syndrome A: CTS + @ nocturnal pain B: Ulnar nerve C: Cubital Tunnel Syndrome

Question 36

36. A child with moderate Klumpke's paralysis on the right side wants to cut meat. The child holds the fork with the right hand and the knife in the left hand, and practices with therapy putty. To begin cutting, which is the best way to configure the therapy putty? A. Flattened and placed directly on the table B. Rolled and placed on a plate on the table C. Flattened on a plastic that rests on a non-skid mat D. Flattened and placed on a plate on the table

Answer 36

A. Flattened and placed directly on the table Practice and refine technique B: 4th C: 2nd D: 3rd

Question 37

37. In ulnar nerve paralysis, the following happens, EXCEPT: A. The hypothenar group does not function B. The 4 and 5 digits cannot be extended due to the absence of intrinsic muscles C. Abduction and adduction of all digits are not affected D. The extensor digitorum is capable of extending the IP joints if the MCP joints are stabilized in a flexed position

Answer 37

C. Abduction and adduction of all digits are not affected Innervates APoL and Digiti Minimi kaya affected dapat

Question 38

38. An OT practitioner is fabricating a splint for an Individual who has a carpal tunnel syndrome. Which of the following splint fabrication techniques should be adhered to in order to allow for adequate digit motion? A. Trim line of the splints should extend distal to the MCP crease B. Trim lines of the splint should extend proximal to the DIP joint C. Trim lines of the splint should extend proximal to the MCP crease D. Trim lines of the splint should extend distal to the ulnar 5 MCP crease

Answer 38

C. Trim lines of the splint should extend proximal to the MCP crease Allows adequate digit, MCP flexion and extension A, B, D: Restrictions

Question 39

39. An OT practitioner is evaluating a young cabinet maker who complains of sensory changes over the dorsal thumb and proximal phalanx of the index, long, and half of the ring finger. The practitioner will MOST likely suspect involvement of the: A. ulnar nerve B. median nerve C. radial nerve D. brachial plexus

Answer 39

C. radial nerve

Question 40

40. A person with peripheral neuropathy exhibits loss of pinprick, light touch, pressure and temperature sensation. The most appropriate form of intervention to address this type of sensory loss would be a program of: A. sensory re-education B. sensory desensitization C. sensory bombardment D. sensory compensation

Answer 40

D. sensory compensation When protective sensations are decreased or absent, the focus of intervention ay magiging for protection A: Remedial B: Gradually decrease stimuli C: Stimulate

Question 41

41. A patient with ulnar palsy will not be able to perform a: A. Precision grip B. Power grip C. Prehension grip D. Spherical grip

Answer 41

B. Power grip Code: U Power Me Pre (Ulnar Power, Median Prehension)

Question 42

42. Part of brachial plexus that is damaged when there is weakness of biceps brachii A. Lateral cord B. Medial cord C. Upper trunk D. Posterior cord

Answer 42

B. Medial cord

Question 43

43. An OT practitioner is working with a client who sustained a traumatic injury to the right upper extremity during a motorcycle accident. The client states that he does not understand why he has paralysis to the deltoid, brachialis, biceps, and brachioradialis muscles. In addition to this, the client's arm hangs limply with minimal functional movement noted in the hand. The OTR suggests that this injury MOST accurately describes: A. A brachial plexus injury B. A long thoracic nerve injury c. An axillary injury D. Volkmann's contracture

Answer 43

A. A brachial plexus injury B: Serratus Anterior C: Deltoid, Teres Minor D: Fracture in the distal end of humerus

Question 44

44. An individual who works as a nurse reports difficulty squeezing the bulb of the sphygmomanometer when taking blood pressures and difficulty opening pill bottles. Which of the following instruments would be MOST appropriate for assessing the individual? A. Goniometer B. Aesthesiometer C. Volumeter D. Dynamometer (JAMAR)

Answer 44

D. Dynamometer (JAMAR)

Question 45

45. After a radial nerve injury, an individual initially had trace muscle strength in elbow extension. One week later, strength is noted to have increased to poor minus. The individual is ready for which activity? A. passively self-ranging the injured arm B. extending the elbow in mid-range 30 to 40 degrees with the forearm resting on the table C. Pushing a cup filled with pennies with the back of the hand, with arm resting on the table D. lifting a book placed on the back of the hand up off the table

Answer 45

B. extending the elbow in mid-range 30 to 40 degrees with the forearm resting on the table

Question 46

46. To assess an individual who is suspected of having carpal tunnel syndrome, the OTR tests for Tinel's sign by gently tapping the median nerve at the level of the carpal tunnel with the person's wrist positioned in: A. 10 degrees of ulnar deviation B. 10 degrees of radial deviation c. 20 degrees of flexion or 20 degrees of dorsiflexion D. Neutral

Answer 46

D. Neutral C: Phalen's Test/ Reverse Phalen's Test

Question 47

47. The simple test for radial nerve function would be: A. Thumb and little finger opposition B. Wrist extension C. Gross grasp D. Pinch thumb and index finger

Answer 47

B. Wrist extension

Question 48

48. An OT practitioner requests that an OT student treat a client with a condition involving the upper extremity. The OTR suggests the use of contrasts baths, retrograde massage, and pressure wraps. The OT student can consider these interventions a PRIMARY technique to address: A. Heterotopic ossification. B. Edema C. Would healing D. Scar management

Answer 48

B. Edema

Question 49

49. An individual is status post carpal tunnel release. When the occupational therapist conducts a sensory test for sharp/dull (pain), the person reports dull as sharp on the palmar surface of the thumb and index finger. All other responses were correct. Which is accurate for the therapist to document about the individual's sensation? A. Impaired for pain along C5 and C6 dermatomes B. Hypersensitive along the ulnar nerve distribution of the palmar surface of the hand C. Hypersensitive along the median nerve distribution of the thumb and index fingers D. Absent for pain along the median nerve distribution

Answer 49

C. Hypersensitive along the median nerve distribution of the thumb and index fingers

Question 50

50. An occupational therapist completes an ergonomic examination of a computer programmer and the programmer's workstation. Which is the best recommendation for the therapist to make to ensure the programmer uses ideal wrist and elbow positioning? A. Elevate the keyboard to increase wrist flexion B. Use a keyboard rest to maintain neutral position C. Lower the keyboard to increase wrist extension D. Add armrests to support elbows in 90 degrees of flexion

Answer 50

B. Use a keyboard rest to maintain neutral position