Neurodegenerative Conditions Correct

For a client in the early stages of Parkinson’s disease, which area should the OTR® focus on FIRST when completing an occupational profile?

Interest in social and leisure activities

Guide the caregiver in assisting the client with ADLs

A client diagnosed with amyotrophic lateral sclerosis (ALS) 2 years ago is admitted to the hospital because of worsening mobility at home. Before the hospitalization, the client was independent with ADLs but required assistance for IADLs, including cooking, shopping, and home management. Which approach is MOST likely to be the priority for this client in the acute care setting?

The client should use safety bars and a shower chair.

A client with early-stage Huntington’s disease is displaying excessive involuntary movements. The client prefers to bathe in the shower. What recommendation would be appropriate to improve the client’s ability to bathe as independently as possible?

Creation of a first-floor setup and increased accessibility to a wheelchair or durable medical equipment

An OTR® is performing a home evaluation for a client with Stage III amyotrophic lateral sclerosis (ALS). The client lives in a two-story home with the bedroom on the second floor. On what will the OTR’s recommendations MOST LIKELY focus?

A bed alarm system

An OTR® in home health care is seeing a client in the middle stage of Alzheimer’s disease who lives with an adult daughter. The client likes to wander around the house and has fallen twice in the middle of the night. The house is a single-level home with both front and back entrances. It has five steps at the back door leading to the garage, with railings on both sides, and has no step at the front entrance. The client’s daughter is determined to have the client remain at home with her as long as possible. To prevent the client from getting out of bed unnoticed at night, what would the OTR MOST likely recommend?

-Assess environmental barriers present in the home

-Ask family about interventions family members have already implemented to maintain the client’s safety at night

-Ask the family about the client’s daily routine when the client is not attending the adult day care program

A client with middle-stage dementia lives with family and recently fell down the stairs while wandering in the middle of the night. The client was uninjured, but family members are concerned about the client’s safety. Locks have been installed on all the doors to prevent the client from leaving the home in the middle of the night. The client has been attending adult day care, but the center is allowing the client to sleep all day.

Question

What information about the client’s current occupational performance should the OTR® gather during the evaluation process? Select the 3 best choices.

-Install door alarms that will sound when the door is opened

-Ask the day care center to provide the client with structured activity during the day, including exercise and time outside, instead of letting the client sleep

-Establish a nighttime sleep hygiene routine  

A client with middle-stage dementia lives with family and recently fell down the stairs while wandering in the middle of the night. The client was uninjured, but family members are concerned about the client’s safety. Locks have been installed on all the doors to prevent the client from leaving the home in the middle of the night. The client has been attending adult day care, but the center is allowing the client to sleep all day.

Question

Family members have placed a baby monitor in the client’s bedroom so that they can listen for movement during the night. What other strategies can the OTR® suggest to ensure the client’s safety at night? Select the 3 best choices.

Provide the client with a basket of socks at a set time each day, determined by the client's arousal level, to give structure to the client's day.

A client with middle-stage dementia has maintained the ability to complete repetitive tasks common in middle adulthood. For example, if given a basket of socks, the client will reflexively fold them until the task is complete. Given this information, what recommendation would be appropriate for the OTR® to give caregivers?

Frontotemporal dementia

A client with a recent diagnosis of dementia is receiving occupational therapy. The caregivers are distressed about the client’s increasingly inappropriate and tactless behavior, and the client has become increasingly impulsive and difficult to redirect. What type of dementia does this client MOST LIKELY have?

Do grocery shopping in the morning.

As part of an intervention plan, a client with multiple sclerosis has had training in strategies to limit energy expenditure on meaningful activities. The client reports increased fatigue when grocery shopping in the afternoon. Which of the following items is a recognized energy management strategy to address this fatigue?

-Observe as the client performs ADLs

-Interview caregivers about the client’s ADL performance

-Interview caregivers about the client’s ADL performance

A client with middle-stage dementia lives with family and recently fell down the stairs while wandering in the middle of the night. The client was uninjured, but family members are concerned about the client’s safety. Locks have been installed on all the doors to prevent the client from leaving the home in the middle of the night. The client has been attending adult day care, but the center is allowing the client to sleep all day.

Question

Which assessment options will provide the most useful information to guide intervention for this client? Select the 3 best choices.

Change to lighter bedding to decrease resistance during bed mobility.

A client with Parkinson's disease complains of difficulty with bed mobility resulting in difficulty changing position during the night. Which environmental modification BEST addresses this client's difficulties with bed mobility?

External cues and repetition for resuming task completion

A client with Parkinson’s disease has difficulty initiating performance of ADLs. Which intervention is BEST for this client?

-Schedule a home evaluation

-Interview the client and complete an occupational profile

-Observe the client performing basic ADLs

An OTR® is evaluating a 60-year-old client with multiple sclerosis who has been referred to the occupational therapy clinic because of recent falls at home. The client’s spouse indicates that the client’s most recent falls have occurred in the evening while showering and when transferring to bed. The client reports difficulty paying attention during tasks and increasing lack of endurance but states that it is a priority to complete self-care activities independently and without using adaptive equipment.

Question

What are the MOST appropriate initial actions for the OTR® to take regarding this referral?

-Move the client’s shower to the morning

-Suggest trialing use of a tub bench during showering

-Incorporate physical activity and a multicomponent intervention for falls reduction

An OTR® is evaluating a 60-year-old client with multiple sclerosis who has been referred to the occupational therapy clinic because of recent falls at home. The client’s spouse indicates that the client’s most recent falls have occurred in the evening while showering and when transferring to bed. The client reports difficulty paying attention during tasks and increasing lack of endurance but states that it is a priority to complete self-care activities independently and without using adaptive equipment.

Question

The OTR® finds that the client’s fatigue is having a significant impact on safety during transfers and on the client’s ability to complete desired occupations. Which interventions should the OTR include as part of the intervention plan to INITIALLY address the client’s fatigue?

Cue cards or signs in key places

A client presents with decreased memory resulting from dementia. What is the MOST EFFECTIVE strategy for an OTR® to implement to intervene with this cognitive impairment?

Recommend that the caregiver contact a local adult day care to inquire about its services.

Which recommendation should an OTR® make to the caregiver of a client with dementia who is suffering from caregiver stress?

An OTR® wishes to prioritize the focus of intervention for a client with Guillain-Barré syndrome in the acute inflammatory phase. Which factors should the OTR evaluate?

An OTR® wishes to prioritize the focus of intervention for a client with Guillain-Barré syndrome in the acute inflammatory phase. Which factors should the OTR evaluate?

Continue with gentle stretching, and determine pain by asking clear questions that require a one- or two-word response.

An OTR® is evaluating a client with Stage 4 Parkinson’s disease (PD), who presents with cogwheel rigidity. During ROM and manual muscle testing, the client is mostly quiet with an occasional moan. What would be the BEST action for the OTR to take?

Recommend modified workouts that consist of endurance and light strengthening with education on how to prevent overexertion.

A client with early-stage amyotrophic lateral sclerosis (ALS) wants to remain physically active and continue to go to the local gym. Which action would the OTR® take?