OTA 215 - Final Exam

An OTA working in a physical rehabilitation setting should be aware that the focus of occupational therapy should address:

Intrapersonal factors, social factors, and environmental factors

An OTA is working with a patient who is displaying anger about the cause of his disability toward his family and members of the health care team. The OTA should address his difficult behavior by using all of the techniques from the CALMER approach except:

Asking the psychiatrist to talk to the patient

Using the principles of the Model of Human Occupation (MOHO) in your interventions means understanding that all of the following comprise the subsystems except :

Role competence

An OTA is working with a person who had been training to compete in the Olympic games and experienced a C7 spinal cord injury. The individual's role as an Olympic level skier was very important to them. The most likely reason for them to refuse to participate in therapy is:

Grief

This frame of reference (FOR) targets populations with lower motor neuron or orthopedic disorders and focuses to remediate range of motion, strength, and endurance :

Biomechanical

An OTA is working with a person who has facial skin graft from burns and is concerned about returning to work as a tollbooth operator. They are experiencing:

Adjustment to a new body image

An OTA is working with a young male who previously lost his leg in a car accident. Despite his limitations, he is a member of his high school snow boarding team and plans to resume surfing. This individual would be described as having a:

Strong degree of internal locus of control

An OTA is working with a person who has lost his ability to verbally communicate and is refusing to use a communication device while attending college. He is frustrated that he requires the use of a communication device. This individual may be experiencing:

Adjustment to changed abilities within performance of occupations

An OTA is working with a person who for several weeks has depended on the OTA to solve problems and is dependent in ADL. The OTA should:

Maintain a balance between assistance and control to facilitate self-efficacy.

What is not true regarding the impact of a disability on an individual?

Disabilities only occur later in life

List 5 pieces of information gained from completing a chart review from the PowerPoint

dx, lab screening, precautions, current medical history, prior medical history

The bottom-up approach when gathering information means asking the client their goals

False

A standardized test follows a strict protocol and compares the score of a client with others.

True

Sequence the steps in the OT process

1. referral

2. evaluation

3. treatment planning (goals, deficits)

4. treatment implementation (interventions)

5. discharge/termination of txt

State 3 areas of observation when working with a patient and provide examples

• level of independence -

  • Observing if the client can perform an occupation at a level 6 (independently) or at a level 1 (dependent) or at another level, such as a client needing assistance in everything to complete an toileting would be a level 1.

• need of adaptive equipment -

  • Observing if the client is needs to use AE to be able to perform an occupation independently, such as a client needing a walker to be able to complete toileting.

• performance skills -

  • Observing the level of performance a client can complete an occupation independently, such as how a client performs the different steps to complete toileting.

State 3 sources for possible referrals to OT

• medical doctor (MD)

• nurse practitioner (NP)

• physician assistant (PA)

Provide 3 different ways the OTA contributes in the evaluation and treatment process

can contribute to treatment plan, goals, and re-evaluation

Discharge planning should include (list 3)

Match the appropriate Section GG levels for the following descriptions

• level 1

  • The patient is unable to help with any aspects of the ADL

• level 2

  • The patient needs physical assistance with the helper providing more than half the effort for the ADL

• level 3

  • The patient needs physical assistance with the helper providing less than half the effort for the ADL

• level 4

  • The patient needs only verbal/nonverbal cueing or contact guard assist for the ADL

• level 5

  • The patient adjusts his clothing before and after bowel and bladder management. He wipes himself after the helper passes him toilet tissue.

• level 6

  • The patient completes the ADL with or without assistive devices by themselves.

State 2 essential characteristics of a successful interviewer and provide examples

• solid knowledge base

• good listening skills

A deformity of the hand in which there is hyperextension of the PIP and flexion of the DIP is swan neck deformity

True

An arthritic condition that results from a painful build up of uric acid in the joint is

Gout

What does the abbreviation ORIF stand for and explain it.

open reduction internal fixation is a surgery with pins, plates, etc

Compare and contrast RA vs OA. Provide 3 examples.

What are two benefits of using a CPM machine?

What does CPM machine stand for?

continous passive motion

If you see a client that has had a total knee arthroplasty and observe that he cannot flex his knee much, what durable medical equipment would you recommend to him in the bathroom so that he can be modified independent. (hint: think about the activity and if it requires knee flexion). Provide the reason for your answer.

a raised toilet seat can be recommended for the bathroom as the raised toilet seat allows the client to not have to bend down in order to get seated onto the toilet.

List 3 adaptive equipment you would recommend to a client after a posterior approach total hip arthoplasty (THA) and the reasoning. (hint: reasoning can be the same for all three recommendations)

A sock aid, shoe horn, and a dressing stick can all be recommended to prevent the client from breaking the no 90 degree bending precaution and still be able to engage in dressing the lower extremities.

Gout most commonly affects

Men over 50

An arthritic condition that usually presents bilaterally and affects the smaller, distal joints of the body is

Rheumatoid arthritis

Define the following 4 types of weigh-bearing precautions: NWB, TDWB, PWB, WBAT.

Include full name and definition (ie: FWB: full weight bearing, can put as much weight on the extremity as they want)

• NWB: non-weightbearing - no weight on the affected leg

• TDWB: toe-touch weight bearing - can use the front of the foot to balance but do not put weight on it

• PWB: partial weightbearing - only 50% of weight on the affected leg

• WBAT: weightbearing as tolerate - only weightbear on the affected leg as much as the client can tolerate, such as 25% of weight

List 2 precautions for total knee arthroplasty (TKA)

no rotation of the knee and no kneeling of the affected leg

List 3 precautions for the posterior approach total hip arthroplasty (THA).

Provide an example of a functional activity that would not be allowed related to dressing and the reasoning.

no bending the hip past 90 degrees, no adduction, no internal rotation

State and explain 2 factors affecting psychological adjustment that can help after an amputation. (Hint: Annika mentioned them as well)

• psychosocial support can allow a client to have the support they need to overcome the depression or grieving process of the loss of a limb.

• recreational activities can allow a client to find support theough new activities that will allow them to overcome possible self-image anxiety after an amputation.

Most traumatic amputations affect the lower extremity.

False

What are 2 advantages of a mechanical prosthesis?

they are more durable and cheaper and also lighter than a myoelectric

82% of all lower extremity acquired amputations are due to diabetes mellitus and/or peripheral vascular disease.

true

What are 3 interventions for a post-op patient?

provide psychosocial support; stump care and hygiene, ROM exercises, desensitization, educate on wear and use schedule, dressing graded from bed to sitting to standing, bed mobility with bridging, transfers wtih slide board, stand pivot; bathing with DME and AE, balance activities

Surgical amputations are the last resort after more conservative measures have failed.

True

What is a 1 advantage and 1 disadvantage of a myoelectric prosthesis?

one advantage is that it has more grip strength and one disadvantage is that it takes more time to practice using a myoelectric prothesis to use functionally.

For individuals with diabetes mellitus (DM), skin checks of what body part are important to minimize risk of wounds and infection?

foot

List 3 advantages of fitting for an initial prosthesis early after post op.

reduces chances of developing a edema, allows for the tissue of the residual limb to become more familiar with prothestic, and allows for the client to demonstrate their motivation and compliance with the prothesis.

Amputations affect males more than females.

True