Prince of OT Final Flashcards
(133 cards)
1
Q
According to MOHO, the individual is:
Answer:
a. Separate from the environment
b. Influenced by context
c. Bound to experience difficulties in occupation
d. Limited by habitual behaviors
A
b. Influenced by context
2
Q
Empathy, therapeutic use of self, and effective communication skills are integral to the provision of
answers.
a. The disability experience
b. Client centered care
c. Loss and adjustment
d. Sudoku
A
b. Client centered care
3
Q
For the OT practitioner, the ability to resolve conflict, build rapport and respect, consider new ideas, and problem solve requires
Answers:
a. Cultural change
b. Context and environment
c. Effective communication
d. A linear approach
A
c. Effective communication
4
Q
List 3 factors that may be contributing to the behavior of the client who seems unmotivated
A
Anxiety about the therapy process; Fatigue; Communication barriers; Vision/Hearing impairments
Cognitive deficits; fear of failure; grief; worry over finances or the future
Frustration over slow progress; depression; problems with social support
5
Q
Instrumental ADLs are:
Answers
a. Shopping, laundry, and dressing
b. Bowel and bladder management, rest and child-rearing
c. Community mobility, religious observance, and home management
d. Participation with peer groups, education participation, and job performance
A
c. Community mobility, religious observance, and home management
6
Q
Most occupations require:
Answer
a Cognitive skills
b. Motor and praxis skills
c. Sensory-perceptual skills
d. All of the above
A
d. All of the above
7
Q
List and discuss 3 ways to implement therapeutic use of self with an individual with a physical disability according to text:
A
Effective communication strategies
Mindful engagement in client-centered care
recognizing important occupations and environments
Develop and manage therapeutic relationships with clients
Allow clients to practice locus of control
8
Q
The client’s engagement in meaningful occupations and increased participation in therapy goals may lead to a greater sense of
Answers
a. Continuum of care
b. Disability experience
c. Reflective practice
d. Self-efficacy
A
d. Self-efficacy
9
Q
The frame of reference that uses controlled sensory input to help normalize muscle tone is the
answers.
a. Biomechanical
b. Sensorimotor
c. Motor learning
d. Rehabilitation
A
b. Sensorimotor
10
Q
List 2 diagnoses with which it would be more appropriate to use a frame of reference other than biomechanical
A
Stroke
TBI
Addiction
11
Q
The frame of reference that is best used when the CNS is intact is the:
Answers.
a Biomechanical
b. Sensorimotor
c. Motor learning
d. Rehabilitation
A
a. Biomechanical
12
Q
A collaborative process using mindful, effective communication to build true and a positive interpersonal relationships between the practitioner and the client:
Answers
a. Interactive reasoning
b. Scientific/Procedural reasoning
c. Narrative reasoning
d. Ethical reasoning
A
a. Interactive reasoning
13
Q
The OT practitioner _____ and _____ change.
A) The individual
B) Actual vs contrived
C) Client change
D) Appropriate
E) Meaningful
F) Guides
G) History of change
H) Supports
I) Environment
J) Relationships
A
The OT practitioner (F) guides and (H) supports change.
14
Q
The focus of therapy is _____
A) The individual
B) Actual vs contrived
C) Client change
D) Appropriate
E) Meaningful
F) Guides
G) History of change
H) Supports
I) Environment
J) Relationships
A
The focus of therapy is (C) client change
15
Q
Therapeutic change is part of an individual’s _____
A) The individual
B) Actual vs contrived
C) Client change
D) Appropriate
E) Meaningful
F) Guides
G) History of change
H) Supports
I) Environment
J) Relationships
A
Therapeutic change is part of an individual’s (G) history of change
16
Q
Client change is accomplished by _____.
A) The individual
B) Actual vs contrived
C) Client change
D) Appropriate
E) Meaningful
F) Guides
G) History of change
H) Supports
I) Environment
J) Relationships
A
Client change is accomplished by (A) the individual.
17
Q
Therapeutic change includes changes in the individual and in the _____ and _____.
A) The individual
B) Actual vs contrived
C) Client change
D) Appropriate
E) Meaningful
F) Guides
G) History of change
H) Supports
I) Environment
J) Relationships
A
Therapeutic change includes changes in the individual and in the (I) environment and (J) relationships.
18
Q
Activities must be relevant, _____ and _____ in order to be therapeutic.
A) The individual
B) Actual vs contrived
C) Client change
D) Appropriate
E) Meaningful
F) Guides
G) History of change
H) Supports
I) Environment
J) Relationships
A
Activities must be relevant, (D) appropriate and (E) meaningful in order to be therapeutic.
19
Q
Occupations must be _____ for the activity to be therapeutic
A) The individual
B) Actual vs contrived
C) Client change
D) Appropriate
E) Meaningful
F) Guides
G) History of change
H) Supports
I) Environment
J) Relationships
A
Occupations must be (B) actual vs contrived for the activity to be therapeutic
20
Q
Ensures that choices made during the OT process are morally justified and are in the best interest of the client
Answers
a. Pragmatic reasoning
b. Scientific/ Procedural reasoning
c. Narrative reasoning
d. Ethical reasoning
A
d Ethical reasoning
21
Q
When we examine personal, social, physical, and cultural aspects of the client and consider these during treatment, we are using what component of the OTPF to make activities meaningful?
Answers
a. Context and environment
b. Time and space
c. Environment and time
d. Context and space
A
a. Context and environment
22
Q
Role change or transition:
Answers:
a. Occurs as the individual grows
b. May be scary or exciting
c. becomes internalized over time
d. All of the above
A
d All of the above
23
Q
Provides the opportunity for clients to tell their story
Answers
a. Interactive reasoning
b. Scientific/Procedural reasoning
c. Narrative reasoning
d. Ethical reasoning
A
c. Narrative reasoning
24
Q
Caregiver burden may be described as
Answers
a Client-centered care
b. A major concern for the families/significant others of clients with significant functional limitations
c. Mindfulness
d. Uncooperative behavior and the labeling of the client as difficult
A
b. A major concern for the families/significant others of clients with significant functional limitations
25
The concept that human beings have an intrinsic motivation to explore, interact with and master their environment is a
Answers.
a. The Model of Occupational Behavior
b. The Lived Body Concept
c. The Model of Human Occupation
d. Sensory-Motor Theory
c. The Model of Human Occupation
26
The dynamic process of an individual's adjustment to disability represents
Answers:
a. Continuum of care
b. Disability experience
c. Reflective practice
d. Self-efficacy
b. Disability experience
27
When we focus on ROM, strength, and task tolerance for activities, we generally use which frame of reference under what conditions?
Answers.
a. Motor learning; CNS intact
b. Motor learning; CNS impaired
c. Biomechanical; CNS intact
d. Biomechanical; CNS impaired
c. Biomechanical: CNS intact
28
The frame of reference that requires the patient to problem solve and practice to improve movement is the:
Answers:
a. Biomechanical
b. Sensorimotor
c. Motor learning
d. Rehabilitation
c. Motor learning
29
Occurs when the practitioner considers the diagnosis or condition of the client
Answers.
a. Interactive reasoning
b. Scientific/Procedural reasoning
c. Narrative reasoning
d. Ethical reasoning
b. Scientific/Procedural reasoning
30
List 3 diagnoses with which would be appropriate to use the biomechanical frame of reference
Orthopedic Conditions-RA, OA, fractures, amputations, hand trauma burns, Lower motor neuron disorders-peripheral nerve injuries, Guillain-Barre; SC. Primary mm diseases-MD
31
The frame of reference that focuses on residual abilities and compensatory strategies is the.
Answers:
a. Biomechanical
b. Sensorimotor
c. Motor learning
d. Rehabilitation
d. Rehabilitation
32
A surgical procedure that may be used to relieve pressure on the spinal cord or spinal nerve roots is called a ________. The surgeon may perform a
_______ during the surgery if the intervertebral disc is involved.
laminectomy, discectomy
33
What does RICE stand for?
rest, ice, compression, elevate
34
Decreased coordination, ROM, and strength are:
Answers:
a. Sensory signs
b. Motor signs
c. Vascular signs
d. Neurological signs
b. Motor signs
35
List 3 general OT interventions for UE fractures
Follow all medical precautions
Monitor and treat edema
Passive/Active ROM per MD orders
Encourage functional use
36
During morning ADL with an elder pt with compression fx, the pt's spouse is present and expresses willingness to assist with the morning routine. After assisting the pt with donning a brace in supine under direction, SPV, and assistance from the COTA, the spouse repeatedly cues the pt to "sit up straight" once bed > w/c transfer is complete, the COTA should
Answers:
a. Respect the spouse's opinion and not respond
b. Educate pt and spouse about changes in posture resulting from compression fx, pain, and aging
c. Provide VC to reinforce the spouse's directions for upright posture
d. Manually assist the pt in sitting upright in the w/c
b Educate pt and spouse about changes in posture resulting from compression fx, pain, and aging
37
In general. the etiology for frozen shoulder or adhesive capsulitis in an individual with an intact nervous system is:
selected Answer:
a. Insidious and idiopathic
b. Physical trauma
c. emotional trauma
d. Cardiovascular disease
a. Insidious and idiopathic
38
List and describe 3 conditions that cause impingement of the brachial plexus
Thoracic Outlet Syndrome: BP impingement as they enter/exit the spinal cord through the scalene mm of the neck
Costoclavicular Syndrome: BP becomes impinged between the posterior clavicle and rib 1
Pectoralis Minor Syndrome: BP impingement deep to the pectoralis minor
Signs and symptoms:
localized or radiating pain
sensory and motor signs, vascular signs of the UE on the associated side
39
The COTA is working with a 7 y/o child with a greenstick fracture of the left fibula; the pt's condition is
Answers
a. The lateral bone of the LLE is damaged on one side but not completely fractured
b. The medial bone of the LLE is damaged on one side but not completely fractured
c. The lateral bone of the LLE is fractured in a spiral pattern
d. The medial bone of the LLE is fractured in a spiral pattern
a. The lateral bone of the LLE is damaged on one side but not completely fractured
40
The COTA is working with a pt who has had a recent C5-C7 discectomy and fusion. The pt is requesting a shower during OT tx and is wearing a soft cervical collar secured with Velcro. What steps should the COTA take to ensure safety during the shower activity?
Answers.
a Clarify MD orders for C-collar wear schedule
b. Ask the pt if they are allowed to remove the C-collar
c. Proceed with the shower with C-collar in place
d Ask the OTR if they are allowed to remove the C-collar
a Clarify MD orders for C-collar wear schedule
41
The COTA is working with a pt who has sustained multiple compression fractures due to osteoporosis. The pts condition is most likely to include which of the following.
Answer.
a. vertebral body fractures
b. Pain and postural changes
c. impaired bed mobility
d. all of the above
d All of the above
42
The COTA is working with a pt with a comminuted right radial fx; the pt's condition is;
Answers
a. Medial bone of the forearm is in several pieces
b. Lateral bone of the forearm is in several pieces
c. Medial bone of the forearm is protruding through the skin
d. Lateral bone of the forearm is protruing through the skin
b. Lateral bone of the forearm is in several pieces
43
The individual in question #11 (The COTA is working with a pt with a comminuted right radial fx; the pt's condition is) is most likely to have
Answers.
a Bruising/hematoma of the affected area
b. Edema distal to the fracture site
c. AROM and PROM Drecautions
d. All of the above
d. All of the above
44
The COTA is working with a young adult patient with Down Syndrome who complains of neck pain and headache. Observation reveals flattening of the cervical curve. The COTA should report their observations to the:
Answers:
a. Patient and family
b. Family and OTR
c. OTR and physician
d. Physician and patient
c. OTR and physician
45
The condition the COTA may suspect in question #13 (The COTA is working with a young adult patient with Down Syndrome who complains of neck pain and headache. Observation reveals flattening of the cervical curve.) is:
a. Os odontoldeum
b. Rheumatoid arthritis
c. Osteogenesis imperfecta
d. Atlantoaxial subluxation
d. Atlantoaxial subluxation
46
The COTA is working with an elderly pt who sustained a left Colles fracture; what part of the UE is affected?
Answers
a. Humerus
b. Elbow
c. Wrist
d. Metacarpal
c. Wrist
47
The COTA is working with an individual who has a compound humeral fracture; the fracture:
Answers:
a. Is in a spiral pattern
b. Protrudes through the skin
c. Is in multiple pieces
d. Is across the bone
b. Protrudes through the skin
48
The COTA is working with an individual with TOS and palpates both UE; the affected side is cool to the touch. The COTA is assessing
Answers.
a. sensory signs
b. Motor signs
c. Vascular signs
d. Neurological signs
c Vascular signs
49
The COTA is working with an individual with an UE repetitive motion injury sustained during the occupation of work. Which of the following is the most practical intervention the COTA can provide:
Answers
a. Assess and analyze the offending activity and provide suggestions for activity and/or pt position adaptations
b. Assess and analyze the pt's sleeping position to avoid re-injury and/or worsening of the original injury
c. Collaborate with pt and their employer to modify workload as it relates to activity schedule
d. Measure and document ARUM, coordination, pain, strength, and edema and use clinical activities to improve occupational performance
a. Assess and analyze the offending activity and provide suggestions for activity and/or pt position adaptations
50
The COTA is working with an individual with a radial fracture and an individual with a wrist sprain. Both are the same age, and general health of both individuals is similar. Which individual is likely to have the best outcome and why?
Answers
a. Wrist sprain; soft tissue healing is predictable
b. Radial fracture: bone healing is predictable
c. Both are likely to have equally successful. outcomes
d. The individual who attends most scheduled therapies
b. Radial fracture; bone healing is predictable
51
The etiology common to most brachial plexus impingement syndromes is:
Answers.
a. cervical spine dysplasia
b. Postural influences
c. Trauma
d. Repetitive motion injuries
b. Postural influences
52
This device bypasses the mouth to allow access to the stomach for the administration of food and/or medications, as well as emptying the stomach of gas or liquid.
A. Mechanical Ventilator
B. Chest tube
C. Physiologic tele monitor
D. Pulse Oximeter
E. Colostomy
F. IV line
G. Swan-Ganz catheter
H. PICC line
I. Foley catheter
J. NG tube
J. NG tube
53
This device is a peripherally inserted central catheter that may be used long-term for drawing blood and administering medications
A. Mechanical Ventilator
B. Chest tube
C. Physiologic tele monitor
D. Pulse Oximeter
E. Colostomy
F. IV line
G. Swan-Ganz catheter
H. PICC line
I. Foley catheter
J. NG tube
H. PICC line
54
This device collects urine and is held in place in the bladder by a balloon inflated with saline.
A. Mechanical Ventilator
B. Chest tube
C. Physiologic tele monitor
D. Pulse Oximeter
E. Colostomy
F. IV line
G. Swan-Ganz catheter
H. PICC line
I. Foley catheter
J. NG tube
I. Foley catheter
55
This device is a more temporary port for accessing the circulatory system to deliver medications or other products, e.g., blood transfusion
A. Mechanical Ventilator
B. Chest tube
C. Physiologic tele monitor
D. Pulse Oximeter
E. Colostomy
F. IV line
G. Swan-Ganz catheter
H. PICC line
I. Foley catheter
J. NG tube
F. IV line
56
This procedure allows stool to bypass damaged or nonfunctional portions of the large intestine; stool is collected in an external device
A. Mechanical Ventilator
B. Chest tube
C. Physiologic tele monitor
D. Pulse Oximeter
E. Colostomy
F. IV line
G. Swan-Ganz catheter
H. PICC line
I. Foley catheter
J. NG tube
E. Colostomy
57
This machine helps a patient breathe when recovering from surgery or illness or when they cannot breathe on their own
A. Mechanical Ventilator
B. Chest tube
C. Physiologic tele monitor
D. Pulse Oximeter
E. Colostomy
F. IV line
G. Swan-Ganz catheter
H. PICC line
I. Foley catheter
J. NG tube
A. Mechanical Ventilator
58
This device may or may not be portable and measures arterial blood pressure, oxygen saturation, heart rate, and respiration
A. Mechanical Ventilator
B. Chest tube
C. Physiologic tele monitor
D. Pulse Oximeter
E. Colostomy
F. IV line
G. Swan-Ganz catheter
H. PICC line
I. Foley catheter
J. NG tube
C. Physiologic tele monitor
59
This pulmonary artery catheter is inserted into the right atrium of the heart and is instrumental in measuring blood flow and pressures in and around the heart
A. Mechanical Ventilator
B. Chest tube
C. Physiologic tele monitor
D. Pulse Oximeter
E. Colostomy
F. IV line
G. Swan-Ganz catheter
H. PICC line
I. Foley catheter
J. NG tube
G. Swan-Ganz catheter
60
This device may or may not be portable and measures hemoglobin saturations on red blood.
A. Mechanical Ventilator
B. Chest tube
C. Physiologic tele monitor
D. Pulse Oximeter
E. Colostomy
F. IV line
G. Swan-Ganz catheter
H. PICC line
I. Foley catheter
J. NG tube
D. Pulse Oximeter
61
This device may be used for a collapsed lung and/or to drain fluid from the lungs or pleural.
A. Mechanical Ventilator
B. Chest tube
C. Physiologic tele monitor
D. Pulse Oximeter
E. Colostomy
F. IV line
G. Swan-Ganz catheter
H. PICC line
I. Foley catheter
J. NG tube
B. Chest tube
62
What is the role of OT in acute care?
Answers.
a. Promote highest level of function
b. Assist with early mobilization
c. Provide discharge planning recommendations
d. Assist patients with improving their functional abilities
e. All of the above
e. All of the above
63
Which of the following would be a treatment idea you could implement in acute care?
Answers:
a. Assessing a patient's ability to complete a car transfer.
b. Educating the patient on the choice of color for their UE prosthetic
c. Educating on donning/doffing a patient's limb protector after a BRA and the precautions associated.
d. Assessing development milestones
c. Educating on donning/doffing a patient's limb protector after a BRA and the precautions associated.
64
Why would someone be placed on Neutropenic precautions?
answers
a. They are immunocompromised
b. They have a diagnosis of pneumonia
c. They have a diagnosis of shingles.
d. They need to be in a negative-pressure patient room.
a. They are immunocompromised
65
A normal heart rate range is
60-100 bpm
66
A person is appropriate for a therapy treatment if their SPO2 is
Selected Answer:
Answers:
a. ≥95%
b. >90%
c. 12-20
d. 60-100
b. >90%
67
A normal blood pressure is_
120/80 mm Hg
68
If you complete a co-treatment in acute care, what is the most important thing to establish with your colleague before approaching the patient room?
Answers:
a. What topics you're going to discuss during the treatment
b. What area of Occupational therapy you're going to address to avoid duplication of services
c. Why the patient was not accepted to their first choice of rehabilitation center
d. What your supervisor said about your last review
b. What area of Occupational Therapy you're going to address to avoid duplication of services
69
Discuss 2 of the 4 acute phase goals of OT with the burn patient from the text/handout; state the goal and how OTPs contribute to meeting the goal
Splinting and positioning
Contractures
Psychosocial adjustment
Skin grafting
Scar formation and tx
Edema management
70
Although these body areas represent small percentages of total body surface area burned, what 3 areas are considered significant?
Face, hand, and feet
71
Discuss each of the body areas in the previous question; why are these areas significant medically and relative to OT intervention?
answers will differ
72
Discuss the difference between “background pain” and “breakthrough pain”
Background pain:
Constant; 24 hour pain
Managed with continual drip morphine, PCA morphine or long-acting oral meds
Breakthrough pain:
Occurs when blood level of pain meds drops below what is needed to manage burn pain
Managed with prn morphine bolus or oral meds
73
Discuss 2 OT considerations relative to pain and treatment implementation with a burn pt
Some interventions will cause increased pain. OT considerations are to coordinate tx with medication schedule, develop communication that supports interventions to pt tolerance and stop immediately when pt says “Stop.”
Teach coping strategies, provide pt and family education re: pain
74
Discuss the use of Ace or other wraps when splinting a burn pt vs more commonly seen strapping material
Using wraps to apply evenly distributed pressure will assist with edema prevention
75
A temporary covering that may be taken from another species
a. Allograft
b. Xenograft
c. Autograft
b. Xenograft
76
Tissue taken from the individual receiving the graft
a. Allograft
b. Xenograft
c. Autograft
c. Autograft
77
3. Tissue taken from a donor of the same species
a. Allograft
b. Xenograft
c. Autograft
a. Allograft
78
List 3 possible etiologies for amputation of all or part of a limb
Diabetes accounts for 82% of lower limb amputations due to diabetic related vascular disease.
Removal of cancerous tumors in the affected limb accounts for surgical amputations.
Trauma caused by motorcycles or various motor vehicle accidents are also a known cause for amputation.
79
State 3 reasons for early prosthetic fit and training with an individual who has experienced a traumatic amputation
One reason for early fitting is prevention of the deterioration of the postural reflexes.
The residual limb is more easily shaped and the skin shrinkage is at a more manageable and malleable state to where it almost contours to the concave portion of the artificial limb.
On a psychological level if the prosthetic is adapted early enough the user has a better chance at adapting to it and seeing it as an extension of themselves rather than a sad reminder of the loss itself. Essentially, early intervention helps in facilitating a mental adjustment to the loss.
80
Discuss 2 factors related to why many UE amputees favor mechanical prostheses over myoelectric prostheses
Myoelectric prostheses take longer to learn how to operate in general, meaning the training is more intense.
The maintenance of the Myoelectric prostheses also takes considerable time and attention to detail in order to preserve its integrity. This method can also be costly, while the mechanical one is simple to operate and cost effective.
81
State 2 reasons for implementation of ROM and therapeutic exercise in the treatment plan for the individual who has undergone a traumatic amputation
Prevents contractures of ligaments and muscles that inhibit good range of motion in a joint.
Administering good ROM exercises to the affected area will help the patient adapt to a prosthetic in the actual fitting and training due to joint stiffness that can occur.
82
Define desensitization of the residual limb. State 2 methods of grading sensory stimulation for this individual
Desensitization is the process of making your residual limb less sensitive.
You can grade the activity down by starting with a soft material and with gentle application apply this to the residual limb in a rubbing motion over the entire surface area.
To grade this up you would gradually up your tolerance to include a rougher fabric in the rubbing action of the residual limb's surface area.
By incorporating a rougher fabric to the same area you decrease the hypersensitivity and render the area tolerable to any tactile sensation.
83
Describe 2 of 3 of the typical contractures seen in an individual who has undergone a transfemoral/above knee amputation
A flexion contracture can occur with or without previous trauma that led to the amputation, with its major cause of the contracture being due to immobilization of the residual limb.
An abduction contracture is a common deformity that is associated with paralysis of the muscles around the hip.
84
A pt had a femur fracture repaired with an ORIF; the pt had a(n)
Answers:
a. Open right inferior fixation
b. Over right internal fracture
c. Open reduction inferior fracture
d. Open reduction internal fixation
d. Open reduction internal fixation
85
The pt in Question #1 (A pt had a femur fracture repaired with an ORIF) is TTWB per MD orders; the pt is allowed to
answers:
a. Rest the toes or forefoot for balance only
b. Put no weight on the affected LE
c. Put a specified percentage of weight on the affected LE
d. Bear as much weight as is comfortable in both LE
a. Rest the toes or forefoot for balance only
86
What movements are the focus of restriction for a pt in a cast to immobilize a distal radius fracture?
Answers:
a. Shoulder flexion and extension
b. Forearm supination and pronation
c. Finger flexion and extension
d. All of the above
b. Forearm supination and pronation
87
A pt is WBAT per MD orders; the pt is allowed to
Answers:
a. Rest the toes or forefoot for balance only
b. Put no weight on the affected LE
c. Put a specified percentage of weight on the affected LE
d. Bear as much weight as is comfortable in both LE
. Bear as much weight as is comfortable in both LE
88
While working with a pt, the COTA notices the surgical site is not clean/dry/intact (CDI); the COTA should
answers:
a. Wash and inspect the wound
b. Apply pressure and elevate the affected area
c. Report to the medical team and document
d. Report to the therapy team and document
c. Report to the medical team and document
89
The condition noted in Q #5 (While working with a pt, the COTA notices the surgical site is not clean/dry/intact (CDI)) means the surgical wound (is)
Answers:
a, Draining blood or other fluids
b. Pulling apart
c. Requires a new covering
d. All of the above
d. All of the above
90
A pt is NWB per MD orders; the pt is allowed to
Answers:
a, Rest the toes or forefoot for balance only
b. Put no weight on the affected LE
c. Put a specified percentage of weight on the affected LE
d. Bear as much weight as is comfortable in both LE
b. Put no weight on the affected LE
91
A client who had a nondisplaced distal radius fracture to the right-dominant U works as a hairstylist. The client reports persistent wrist and finger stiffness that makes it 5 difficult to comb and style hair at work. Which intervention represents a biomechanical approach and should be included as part of the client's INITIAL intervention for maximizing long-term functional performance?
Answers:
a. Modifications to the client's workstation and work tools
b. Active-resistive ROM and strengthening exercises
c. Dynamic orthotic is worn during hours of sleep
d. Holding an eating utensil in the dominant hand
b. Active-resistive ROM and strengthening exercises
92
An individual with an acute hand injury is being seen in an outpatient setting. The individual has persistent edema. The OTA should initially instruct the individual to
Answers:
a. avoid using the hand during ADL
b. elevate the hand above the heart
c. purchase a sling and wear it during the day
d. place the hand on a pillow on a low stool
b. elevate the hand above the heart
93
An OTA is working with an individual who has an acute hand injury and is experiencing edema. The OTA should measure the volume
Answers:
a. after the individual has rested
b. at the same time every day
c. after participation in an activity
d. at different times of the day
d. at different times of the day
94
An individual with an acute hand injury is experiencing edema and has an open wound. When measuring volume, the OTA should
Answer:
a. use a tape measure
b. provide retrograde massage before measurement
c. use a volumeter
d. provide a contrast bath before measurement
a. use a tape measure
95
An OTA is using a dynamometer to measure grip strength. To ensure an accurate measurement, the OTA should
Answers
a. ask the occupational therapist to complete a measurement and compare findings
b. take three trials and determine the mean average
c. take the measurement while the individual is standing
d. set the handle in the third position
b. take three trials and determine the mean average
96
An individual with an acute hand injury is experiencing limited range of motion. To facilitate component motions, the OTA should
Answers:
a. apply joint distraction techniques (service competency has been established)
b. provide aggressive, passive range of motion
c. ask the occupational therapist to provide the appropriate technique
d. teach the individual active range of motion
a. apply joint distraction techniques (service competency has been established)
97
An OTA is instructing a family member on edema control. The OTA should recommend
Answers.
a. a whirlpool bath using lukewarm water
b. warm water soaks
c. alternating cold and hot water soaks (contrast bath)
d. cold water soaks
c. alternating cold and hot water soaks (contrast bath)
98
An individual with a fingertip amputation is experiencing hypersensitivity. The OT should provide an intervention with initial focus on
Answers.
a. picking up coins
b. desensitization using a terry cloth towel
c. manipulating checkers
d. buttoning a shirt
b. desensitization using a terry cloth towel
99
A client who has a swan-neck deformity would have the most difficulty
Answers.
a. Placing coins in a vending machine
b. Washing dishes
c. Dusting a table
d. Applying body lotion
a. Placing coins in a vending machine
100
The occupational therapist asks an OTA to evaluate a client's range of motion, strength, and sensation. The OTA should
Answers:
a. Ask the occupational therapist to co-evaluate
b. Use a book to determine the proper way to evaluate
c. Complete the evaluation if service competency has been established
d. Refuse to do the evaluation because it is the role of the occupational therapist
c. Complete the evaluation if service competency has been established
101
An arthritic condition that results from a painful build-up of uric acid in the joint is:
Answer:
a. Rheumatoid arthritis
b. Osteoarthritis
c. Gout
d. Degenerative joint disease
c. Gout
102
The condition in Q #3 (Gout) most commonly affects:
Answers
a. Women over 50
b. Men over 50
c. Women under 50
d. Men under 50
b. Men over 50
103
Characteristics of osteoarthritis include which of the following:
Answers:
a. Bilateral presentation
b. Smaller joints affected
c. Inflammation
d. All of the above
c. Inflammation
104
The COTA is working with a pt with an arthritic condition of the (L) shoulder; there are multiple osteophytes noted on the x-ray report. The pt reports 5/10 pain that increases with increased shoulder flexion and ABDuction. Which of the following should the COTA adapt first to limit pain during daily activities?
Answers.
a. Chopping vegetables
b. Washing hair
c. Driving
d. Brushing teeth
b. Washing hair
105
In Q #6, (The COTA is working with a pt with an arthritic condition of the (L) shoulder; there are multiple osteophytes noted on the x-ray report. The pt reports 5/10 pain that increases with increased shoulder flexion and ABDuction.) osteophytes are the etiology of at least some pain in the (L) shoulder; how should the COTA explain this to the pt?
Answer.
a. New bone growth in the joint causes pain
b. Loss of cartilage in the joint causes pain
c. Pain is caused by shoulder flexion and ABDuction
d. Pain is caused by uric acid crystals in the joint
a. New bone growth in the joint causes pain
106
The pt in Q #6 (The COTA is working with a pt with an arthritic condition of the (L) shoulder; there are multiple osteophytes noted on the x-ray report. The pt reports 5/10 pain that increases with increased shoulder flexion and ABDuction.) likely has a dx of which of the following:
Answers:
a. DID
b RA
c. Gout
d. Inflammation
a DID
107
Likely etiology for the condition noted in Q #8 (a DID) is:
Answers:
a. Aging
b. Trauma
c. Wear and tear
d. All of the above
d. All of the above
108
Partial dislocation of the wrist
a. Ulnar drift
b. Rheumatoid nodules
c. Swan neck deformity
d. Subluxation
e. Boutonniere deformity
f. Hammer toes
g. Bunion
d. Subluxation
109
Enlargement of metatarsophalangeal joint of digit I
a. Ulnar drift
b. Rheumatoid nodules
c. Swan neck deformity
d. Subluxation
e. Boutonniere deformity
f. Hammer toes
g. Bunion
g. Bunion
110
Flexion of the PIP and hyperextension of the DIP
a. Ulnar drift
b. Rheumatoid nodules
c. Swan neck deformity
d. Subluxation
e. Boutonniere deformity
f. Hammer toes
g. Bunion
e. Boutonniere deformity
111
Hyperextension of the PIP and flexion of the DIP
a. Ulnar drift
b. Rheumatoid nodules
c. Swan neck deformity
d. Subluxation
e. Boutonniere deformity
f. Hammer toes
g. Bunion
c. Swan neck deformity
112
Hyperextension of metatarsophalangeal joints and flexion of PIP joints in the foot
a. Ulnar drift
b. Rheumatoid nodules
c. Swan neck deformity
d. Subluxation
e. Boutonniere deformity
f. Hammer toes
g. Bunion
f. Hammer toes
113
Migration of the digits toward the ulnar aspect of the hand
a. Ulnar drift
b. Rheumatoid nodules
c. Swan neck deformity
d. Subluxation
e. Boutonniere deformity
f. Hammer toes
g. Bunion
a. Ulnar drift
114
Subcutaneous masses more common in people with RA who smoke
a. Ulnar drift
b. Rheumatoid nodules
c. Swan neck deformity
d. Subluxation
e. Boutonniere deformity
f. Hammer toes
g. Bunion
b. Rheumatoid nodules
115
What is the first step the COTA should take with the pt in Q#10?
Answers.
a. Administer the Modified Interest Checklist
b. Issue adaptive equipment for eating, dressing, and bathing
c. Complete a home evaluation for safety and accessibility
d. Assess functional status during ADL.
d. Assess functional status during ADL
116
Which of the following activities should be avoided with the pt in Q #10 in the presence of ulnar drift?
Answers:
a. Wringing out a washcloth
b. Using a computer keyboard
c. Pushing from sit -> stand with BUE
d. Feeding with adapted utensils
a. Wringing out a washcloth
117
The doctor's orders for the pt in Q #10 state that resistive activity is contraindicated; this means resistive activity
Answers:
a. May be included with caution during OT tx only
b. May not be included in tx
c. May be included during ADL. using joint protection
d. Should be completed at least 2x/day
b. May not be included in tx
118
During which of the following phases of RA is resistive activity contraindicated?
Answers:
a. Exacerbation phase
b. Remission phase
c. Synovitis phase
d. Systemic phase
a. Exacerbation phase
119
Removal of all or part of a joint membrane
a. Arthroplasty
b. Synovectomy
c. Arthrodesis
b. Synovectomy
120
Replacement of all or part of a joint
a. Arthroplasty
b. Synovectomy
c. Arthrodesis
a. Arthroplasty
121
Surgical fusion of a joint or joints
a. Arthroplasty
b. Synovectomy
c. Arthrodesis
c. Arthrodesis
122
The COTA is treating a pt with gout; which of the following is in the COTA's scope of practice?
Answers.
a. Making dietary recommendations for disease management
b. Designing and implementing an aerobic HEP for weight loss
c. Collaborating to generate a schedule to support increased activity
d. Recommending alternative treatments for pain management
c. Collaborating to generate a schedule to support increased activity
123
Evidence supports the use of orthotics in clients with arthritis to:
Answers:
a Relieve pain
b. Increase grip strength
c. Prevent deformity
d. All of the above
d. All of the above
124
An OTA is working with an individual who enjoys gardening, especially planting tulip and daffodil bulbs, and experiences pain while planting. The OTA should
Answers:
a. Encourage the individual to pursue a new leisure activity
b. Suggest that the individual break the task into small steps
c. Encourage the individual to ask a friend to plant the bulbs
d. Suggest that the individual grow indoor plants that do not require planting
b. Suggest that the individual break the task into small steps
125
An OTA is providing education on resources and joint protection techniques to clients and their families. The OTA should
Answers:
a. Provide verbal and written instructions geared to the person's level of understanding
b. Ask the client and family to find local resources to assist them
c. Provide only written instructions so they can remember them at a later time
d. Provide a "key" so they can decipher medical terminology
a. Provide verbal and written instructions geared to the person's level of understanding
126
A woman with arthritis has been an active member of a knitting group that donates items to a local shelter and would like to continue this activity. The OTA should
Answers:
a. Teach the client ways to minimize the risk so she can continue to enjoy the activity
b. Recommend that the woman shop for the yarn so she can be part of the group
c. Use a leisure checklist and encourage the woman to develop new leisure skills
d. Recommend that the woman participate in the group for social reasons but give up knitting
a. Teach the client ways to minimize the risk so she can continue to enjoy the activity
127
Idiopathic etiology describes
Answers:
a. Smoking
b. Decreased vascular efficiency
c. Unilateral presentation
d. A disease of unknown cause
d. A disease of unknown cause
128
Systemic disease can best be described as
Answers:
a. Exacerbations and remissions
b. Progressive conditions
c. Affecting the entire body
d. The presence of deformity
c. Affecting the entire body
129
The OTA is working with a client with arthritis and wants to determine the client's ability to perform ADL. The OTA should
Answers.
a. Solicit responses from an interview
b. Ask the client to perform activities at different times of the day
c. Ask the family for input on how the client performs ADL
d. Ask the client to perform the ADL at the usual time
d. Ask the client to perform the ADL at the usual time
130
The OTA is teaching a client an exercise program to do at home. The OTA should recommend that the client
Answers:
a. Exercise first thing in the morning
b. Exercise before going to bed at night
c. Exercise when the person feels limber and has the least amount of pain
d. Exercise twice a day and stop when pain is intolerable
c. Exercise when the person feels limber and has the least amount of pain
131
List 2 reasons rest is an important component in treatment of the individual with rheumatoid arthritic disease
Reduces inflammation
Increases energy level
Diversion from stressful events
132
List 2 treatment objectives/goals specific to OT when working with an individual with arthritic disease with the exception of rest
PAMs per MD orders
Ther Ex and Therapeutic Activity
Remission phase: resistive exercises and activities with joint protection
Exacerbation phase; resistive exercises and activities are contraindicated
Gentle PROM without stretch 2x/day
Isometric exercise may preserve muscle strength
Positioning
Orthotic Intervention
ADL training and education:
Energy conservation
Joint protection
Assistive devices
133
List the 4 cardinal signs of joint inflammation
redness, pain, heat, swelling
