Clinical practice quiz 2

Practice questions

Glenn is a 50 y/o engineer who has right hemiplegia due to a cerebrovascular accident (CVA). He is highly motivated to be independent with his basic self-care and eventually go back to work. How would the OT instruct him in donning a pullover shirt?

Put the right arm into the right sleeve of the shirt, then put your left arm into the sleeve next.

Susan is a 28 year-old teacher who was in a car accident, where she sustained a fracture in her thoracic vertebrae. She is wearing a Thoracic Sacral Lumbar Orthosis (TSLO). Which statement is the most accurate?

Occupational therapists do not fit and make TSLO’s for people. It is in the purview of orthotists to fabricate them, but OT can help train people in how to don and doff the device

Jim is a 40 year-old who had a traumatic brain injury being seen by the OT. The physical therapist (PT) recommended a custom articulating ankle-foot orthosis (AFO). Jim’s wife helps him don and doff the AFO, but he wants to be able to do it himself. What is the OT’s role?

Include the AFO as a dressing training task and once you assess Jim’s function, train him how to don and doff it.

Mr. Garcia had a right total hip arthroplasty after a hip fracture. The surgeon performed the surgery from a posterior approach. Which of the following precautions may be in place?

No hip flexion of the postsurgical hip beyond 90 degrees

Fred had a Rt THA (total hip arthroplasty), and the orthopedic surgeon did a posteriolateral approach surgery with typical precautions in place. Fred wants to work on dressing tasks. What are some pieces of adaptive equipment that Fred may need?

Long-handled dressing stick, sock aid, long reacher

Durable medical equipment (DME) is defined as all of the following EXCEPT

Is typically disposable and not reusable

Mr. Spring is a 69yo man with L hemiplegia from a CVA. He has a little movement in his L leg but non in his L arm. He has good sitting balance but requires minimal (25% from the OT) assistance to stand. He can follow verbal directions, but he can be impulsive and has decreased attention span. He has L-sided neglect and visual spatial problems.

Mr. Spring will most likely require adaptive equipment in order to be independent in upper and lower extremity dressing.

False

How can a button-down shirt be modified to make it easier for someone with limited fine motor coordination?

Replacing buttons with Velcro or magnetic closures behind the buttonholes

Rosa is being discharged after recovery from hip replacement surgery. She needs to continue to observe hip precautions, no more than 90 degrees hip flexion. Which is the more important equipment for the occupational therapist to review with the client prior to discharge?

A long-handled reacher

According to the dressing principles for paraplegia, which surface is often used to perform lower body dressing?

The bed

For a client with lower back pain OR a posterior lateral total hip replacement, which dressing technique is recommended for safety?

Sit down on a stable surface while dressing

Mrs. Smith had a total hip replacement one week ago with traditional posterior approach hip precautions. You issue Mrs. Smith a reacher, long-handled shoe horn and sock aide, and proceed to work on lower extremity dressing skills. Mrs. Smith begins to improve in her dressing skill. At this phase of her rehab (less than 1 week post-surgery), which of the following is NOT an appropriate way for you to grade the activity for lower body dressing as she improves?

Decrease the use of adaptive equipment

Which instruction demonstrates correct hemi-dressing technique when doffing a shirt?

Remove the unaffected arm first, then the affected arm

You are working with a client with L hemiplegia following a CVA. The patient has L hemionopia and poor trunk control. You are teaching the client to don a T-shirt. Ideally, you are positioned:

On the client’s L side so the client will learn to attend to that side and so you can help him with his balance

What is the purpose of sewing loops onto zippers as an adapative dressing technique?

To create a larger pull tab for someone with limited grasp

Which statement is true regarding adaptive devices issued by OTs?

A built-up handle can be indicated for individuals with painful hand grasp

Which individual would generally NOT be covered under the ADA’s protections?

A person with a temporary impairment, such as a broken leg in a cast

Under title 1 of the ADA, what is the primary obligation of a private employer regarding an employee with a disability?

Providing reasonable accommodations that do not cause undue hardship

Title 3 of the ADA covers public accommodations. Which of the following is considered a private entity that must comply with Title 3?

A private pre-school or college

What are examples of roles of occupational therapists in regards to the ADA?

All are possible roles for OTs

Which of the following are considered violations against Title 3 of the ADA?

All are considered violations

The following are good principles to follow to maintain good body mechanics when lifting, reaching or picking up objects from the floor.

Maintain wide base of support, maintain normal spine curvature keep the weight close to the body, and when possible, push rather than pull

The primary role of OT in transfer training is to:

To assess transfer status and set goals for our clients, to come up with the safest way for clients to transfer to increase independence, to train caregivers to help their loved ones be safe with transfers

Which client would be the BEST candidate for a transfer board/ sliding board transfer?

A client with good sitting balance and strong upper extremities

Which of the following is the BEST instruction to give a client during a transfer board/ sliding board transfer?

Use small push-ups and shift your weight side-to-side

Miguel is a 60yo who was in a car accident, and he had a fractured R femur. The orthopedic surgeon gave orders for non-weightbearing to Miguel’s R leg. Miguel has a history of orthostatic hypotension and is fearful of moving and has a lot of pain. The PT already saw Miguel and said that the client requires minimal assistance for transfers. What might be an appropriate transfer technique for the OT to use for the first time seeing Miguel?

Squat/ bent pivot transfer going towards the left (strong side)

Jane is a 24yo who identifies as female who was in a car accident and now has paraplegia. Jan has strong upper extremities, but she has no sensation or use of her muscles below the level of injury. What may be a more appropriate transfer for the OT to start with?

Lateral transfers using a transfer (slide) board

Mark is a 52yo who had surgery to his lumbar region. The orthopedic surgeon ordered standard spinal precautions. These precautions would likely include:

No bending, no twisting, log-rolling with bed mobility

Prior to initiating a stand pivot transfer, how should the wheelchair be positioned to ensure optimal safety?

Positioned at a 45deg angle to the transfer surface, with wheels locked and footrests removed

A client begins to stand prematurely during setup for a pivot transfer due to impulsivity. What is the BEST response?

Immediately stop the transfer and safely guide the client back to sitting

A client is 2-weeks post-coronary artery bypass graft (CABG) and is following sternal precautions. Which of the following demonstrates the MOST appropriate technique during a transfer or dressing task?

Using a “heart hug” pillow and rocking forward to stand without pushing through the arms