Human Occ. I - Quizzes/Exams (Final Exam Study Prep)

Healthy literacy is

• Needed to make appropriate health decisions and follow instructions for treatment

• The ability to obtain, process, and understand basic health information and services

• Facilitated by an individual’s ability to read

Adult populations (65+) that have basic or below basic health literacy skills are likely to have which insurance type/provider

• Medicare

One of the strongest predictors of poor health outcomes is

Literacy

List three (3) behaviors that may indicate the patient has limited health literacy skills.

1. Incomplete/inaccurate registration forms/paperwork

2. Frequently misses appointments

3. Does not follow through with testings or referrals for consultations

Give three (3) examples of things health care practitioners can do to improve an individual's understanding of their healthcare.

• Slow down, take your time & be available for questions

• Use plain/non-medical language

• Provide visuals/images

• Limit amount of information given at one time

List three main factors OTPs must consider when choosing an ambulation aide, other than physical need.

1. Cognitive ability/awareness - whether or not if the client can safely utilize the ambulation aide and if they have safety awareness

2. Space/environmental demands - depending on the ambulation aide, must consider environment if there are stairs, if it has multiple stories, terrain, what hazards are within that environment (carpet, bath mat)

3. Cost, if insurance covers it

Identify 2 functional uses of a gait trainer (vs. a walker)

1. provides WB support for UE

2. Pelvic support

One advantage & disadvantage of a rollator or 4WW over a standard 2WW

Advantage: works well on most surfaces/versatility

Disadvantage: limits forward access, difficulties with accessing things in front of the person

Which of the following is NOT true regarding functional ambulation?

All ambulation is inherently functional.  For example, it is good exercise.

Which statement accurately reflects gait training?

Gait training may involve the use of orthotics or ambulation aides.

When approaching a door, cabinet, drawer, refrigerator, or oven while using a walker, it is best to

Approach from the side, with the hip next to the item

When ambulating with a patient, you should position yourself

Slightly behind and to one side of the pt

When in doubt regarding how to best approach a functional task with an ambulation aide, it is BEST to

Try it out yourself ahead of time, using the ambulation aide and set up, and simulating the client's level of need

When a client begins to fall and cannot regain their balance during treatment, it is BEST to

Guide them back to sit on your knee, then lower to a chair or the floor if needed.

Properly donning and doffing orthotic devices, maintaining appropriate schedules of orthotic use, and maintaining orthotic devices is an ADL/IADL. T or F?

True

The type of ambulation aide may change over time due to improvements or due to progression/exacerbation of the health impairment. T or F?

True

The type of ambulation aide may change due to the nature of the activity. T or F?

True

The use of a mobility device or ambulation aide simplifies the task for the client. T or F?

False

It is not important for the OTA to follow through on recommendations made by the PT regarding gait.  The focus of OT is totally different. T or F?

False

List 3 steps of transfers

1. Consider the environment and client to ensure safety of the transfer.

2. Ensure the gait belt is on and considering positioning prior to transferring.

3. Ensure proper body mechanics and positioning are being used when lifting or stabilizing client (lift with knees, wide stance, elbows at sides)

List five (5) things the OTP must consider before or during the transfer process which may modify the way the transfer is performed.

1. Precautions

2. Enough time to safely transfer

3. Ensure clear pathway

4. Cognitive abilities

5. Secure gait belt

List five (5) tips for using proper body mechanics during transfers.

1. Lift with legs

2. Bend at knees

3. Back straight

4. Wide base of support - feet shoulder width apart

5. Keep elbows at sides

Explain how to properly position a patient so you get leverage and gravity to reduce the burden of care and enable the patient to get from sit -> stand more easily. (4 steps)

1. Have the client seated at the edge of the bed, feet flat on the floor, knees at 90 degrees

2. Stand in front of the client with proper body mechanics, position knees to support the client's knee/legs if needed

3. Have the client lean forward, have them utilize their hands to help push off the bed/surface

4. Ensure to lift with the legs, and use momentum and count down when ready to stand up 

Types of transfers

• Stand-pivot transfer

• Stand step transfer

• Squat-pivot transfer

• Slide board transfer

Choose appropriate transfer.

• Ofen used when surfaces cannot be moved closer. Armrests are not removed. Client needs to bear weight and be able to step with assistance.

Stand-step-pivot transfer

Choose appropriate transfer.

• Used when client can bear some weight, can push off of chair arms, client's ankles point toward goal and client stands with assist.

Stand-pivot transfer

Choose appropriate transfer.

• Armrest is removed, patient's weight is shifted forward, and ankles point toward target surface. Client requires limited wight bearing as they do not come to a full stand.

Squat-pivot transfer

Choose appropriate transfer.

• Armrest is removed, patient's ankles point toward target surface, patient's legs are both supported by therapist

One person dependent transfer

Choose appropriate transfer.

• Typically used for clients who are dependent or total assist

Two person dependent transfer

Choose appropriate transfer.

• Can be modified to perform with 2 person assit, 1 person assist, or mod I. Armrest is removed and additional equipment is required.

Slide board transfer

Identify assist level.

• Client is unable to assist in transferring process

TA (total assist)/Dep

Identify assist level.

• Pt. requires lifting and lowering A or they perform ~25% of transfer

Max A

Identify assist level.

• Pt performs ~50% of the transfer or helper must lift legs in/out of bed

Mod A

Identify assist level.

• Pt. requires A for one leg, A for balance, or A for sequncing of task during the transfer

Min A

Identify assist level.

• Helper must position chair and remove arm rests, give VC for safety or sequencing

SBA

Identify assist level.

• Transfer takes more time or there are safety considerations.

Mod I

T/F: It is generally the PT’s responsibility to train family members in safely performing transfers in the home

False

T/F: It is often important to cue the client to or assist the client in scooting forward on the initial surface prior to performing a transfer.

True

T/F: It is important to drape the arms of a client who requires depedent assistance over your shoulders while performing all transfers.

False

T/F: It is important to apply a subluxation support or sling prior to every transfer in which the client/patient has a subluxation of the glenohumeral joint.

True

T/F: It is best practice to use a gait belt for every client/patient transfer.

True

T/F: Using the loop in a gait belt to hold a subluxed arm steady is best practice.

False

T/F: Verbal and/or physical cues are often helpful in bringing a client into midline prior to performing a transfer, therefore improving self-awareness, balance and safety during the transfer.

True

T/F: The practitioner may need to assist the pt into a neutral pelvic position or slightly posterior pelvic tilt prior to transferring.

False

An OTA is observing an individual during cooking activity and notices that the individual has deficits related to ideomotor apraxia. Which of the following activities would indicate a deficit?

Inability to initiate movement when asked to walk to the oven and turn it on

• the impaired ability to perform a skilled gesture with a limb upon verbal command and/or by imitation

An OTA is working with an individual in a rehabilitation setting who has visual deficits and has difficulty in navigating when attempting to return to his room. The OTA should

be aware that visual deficits may appear as deficits in topographic orientation.

• the ability to orient oneself within the environment and to navigate through it to specific destinations

An OTA is working with an individual who enjoys listening to music. The individual is able to turn on a CD player and insert a CD but does not attempt to find a solution when there is no music. This individual has deficits in

problem solving

An OTA is working with an individual who lacks thermal sensation and will be living alone. The OTA should plan intervention with a focus on

burn prevention methods and precautions against injury in ADL.

An individual with stroke is not able to complete the task of looking up a number in the telephone book when the OTA asks her a question. This individual may have deficits in

divided attention

During a hygiene activity, the OTA observes an individual overreaching for the toothpaste and knocking over the mouthwash. The OTA should inform the OT supervisor that the individual may have deficits related to

dysmetria

• the inability to control the distance, speed and range of motion necessary to perform smoothly coordinated movements

The presence of tonus or muscle tension in the neck, trunk, and limbs is referred to as

postural tone

Describe 5 considerations to process prior to administering an assessment:

1. Pain

2. Purpose of assessment

3. Cost

4. Is it appropriate for the client’s demographics?

5. What is your skill level? Is training or certification required?

Provide the name of one formal or informal assessment per area of concern:

Spasticity

Sharp/Dull sensation

Inattention

Cognition

Spasticity - range of motion

Sharp/dull sensation - pinprick test

inattention - have the client follow simple instructions

cognition - write out numbers and have the client identify the number that is missing

T/F: Following the completion of an assessment, the OTA is encouraged to provide to supervising OT with interpreted results related to their clien'ts function.

False

T/F: Once the OTA has completed an assessment, it should be documented as an evaluation and signed by that practitioner

False

What are the concerns of people with disabilities with respect to participating in leisure and social activities?

• feeling uncomfortable

• limited confidence

• accessibility

List five (5) things the OTP must consider before or during the transfer process which may modify the way the transfer is performed.

1. Contrainidcations (fractures, surgery)

2. Environment - make sure there will not be anything in the way when transferring

3. Precautions/safety

4. Level of function - this can help decide what type of transfer will be performed

5. Positioning of chair/wheelchair when transferring

List three main factors OTPs must consider when choosing an ambulation aide, other than physical need.

1. Size/type

2. Insurance

3. Safety

List three (3) behaviors that may indicate the patient has limited health literacy skills.

1. The client will say they will read it at home

2. They may want you to read it or explain it them

3. They are not able to relay the information back to you

When meeting a client for the first time to discuss leisure and social activities, how would you solicit the client's perspective?

• initiate rapport with the client - introduce yourself, tell them a little bit about you (leisure activity you enjoy)

• ask the client what they like to do in their leisure

• ask the client if there is something that they would like to be able to do again or be able to participate in again

During a slide-board transfer, explain what the OTP and patient might be doing is the patient requires max A for the transfer. 

Consider safety, consider patients balance, use of belt, position, use of secondary person. 

What does it mean for a measure to be valid, reliable and psychometrically sound? Why is this important for the OT evaluation and intervention planning/delivery process?

For a measure to be valid, reliable and psychometrically sound, the results should be consistently accurate and trustworthy. This is important for the OT evaluation and intervention planning so that the OTP is able to provide educated treatment. 

List three (3) facts or aspects of Rehabilitation Technology.

1. Use to establish, restore, or modify function

2. Used in tx setting by a professional for a short time (PAMs)

3. Used for individuals with developmental delays

An OTA is teaching an individual to use speech recognition. The training should focus on

consistent and accurate methods used to correct errors.

Provide two (2) occasions when Assistive Technology would be used with a client.

• affected lower extremities

• individual had THA - teach how use sock aid w/o breaking precautions

• challenges with feeding due to impaired grip - universal cuff to improve independence

An OTA is working with an older client who has general weakness due to a coronary artery bypass graft. The client will be utilizing a rubber jar grip and a buttonhook to accommodate weak grasp and decreased fine motor skills. These pieces of assistive technology would most likely fit under which category?

low-tech

An OTA is teaching an individual to use an electronic aid to daily living (EADL). The OTA should INITIALLY assess the individual’s ability to

understand which control operates which device.

An OTA is working with an elderly client with low vision who has limited financial resources and mild dementia. What would be the best way for the client to access her email independently?

Increase the contrast and font size of the email

Supplements or replaces verbal and/or nonverbal communication

AAC - augmentative and alternative communication

Devices that control electrical devices in the client's environment

EADL - electronic aids of daily living

Equipment or devices that are more easily reproduced than they are compatible with external technology

subsumed

Can serve as AT for the person with a wide range of disabilities

computers

An OTA is helping an individual with a C5 spinal cord injury explore assistive technology for being able to live as independently as possible. Due to the severity of the condition, the OTA is aware that the client will need high-tech assistive technology. Which of the following would best fit this criterion?

Switch-activated environmental aids, including smart-home options

How is Universal Design used? Discuss in detail.

The concept of universal design is that devices are designed for a wide range of abilities, and reducing special adaptations. Making it for all users, disability or not. Universal design promotes inclusivity, making sure to avoid barriers so that all can participate regardless of ability or disability. 

An OTA is working in an intensive care unit with an individual on a respirator. To assist the individual in communication, the OTA should

introduce a low-tech communication board.

An individual who uses an electronic AAC device is a member of an advisory committee at a community college. The advantage of using this device is

the user can construct, preview, and edit communication.

Discuss the Disability Divide in relation to assistive technology

It is when skills of an individual and the demands of the task do not match, then assistive technology can be used to bridge the gap

You are working with an 18 y/o who underwent massive transfusion protocol (MTP) following a car accident during which his femoral artery was injured. He has been cleared to participate with therapy and your session goal is to assist him up to bathroom. You assess his vitals while he is lying in bed, his BP is 105/70. Upon standing, he complains of dizziness and lightheadedness. You reasses his BP in standing and find it is 75/50. You assist him back to lying and after 2-3 minutes, his BP is around 85/60. The nurse has been alerted. What step should you take next?

Tilt the patient down in bed with the head below the heart

Allen Cognitive Level 5: What are the Characteristics & Intervention? 

ACL 5: Exploratory Actions: Global cognition is midly impaired. new learning can occur. Learns through trial and error. SBA.

List the 3 types of stitches utilized during the ACLS and what each type of stitch allows the OTP to judge

Running Stitch: Allows the OTP to judge the client's ability to complete BADLs. Whip Stitch: Allows the OTP to judge the client's problem-solving abilities. Cordovan Stitch: Allows the OTP to judge the client's ability to process information.

T/F: Your patient would like to don a t-shirt to attend his therapy session. He is connected to IV fluids. As an OTP, you are permitted to detach the IV to slide an arm in a shirt and then reattach the IV.

False

Adult populations that have basic or below basic health literacy skills are likely to have which insurance type/provider

Medicaid

Ability to identify an object through proprioception, cognition and sense of touch.

Stereognosis

Ability to identify the position of the body and its parts in relation to themselves and the environment

Body Scheme

The ability to plan and perform purposeful movement

Praxis

Inability to perform a motor act on command, despite the ability to perform the act automatically

Ideomotor Apraxia

What must you check each time you encounter a hospital bed when treating a client?

Ensure that the bed is locked

_______ is the careful balance between the challenge of the task and the skills of the person. If the challenge of a task is equal or slightly above the skills of a person can infuence optimal independence.

Just Right Challenge

T/F: It is generally the PT’s responsibility to train family members in safely performing transfers in the home

False

Factors that contribute to the development of bedsores (decubitus ulcers)

• immobility

• impaired blood flow

• lack of proper hygiene

• shear forces

• laying in bed for a prolonged amount of time

Tips for using proper body mechanics during transfers

1. wide base of support - feet shoulder width apart

2. lift with your legs

3. bend the knees

4. keep elbows at your side

5. straight back/neutral spine

Which of the following is NOT TRUE regarding functional ambulation:

All ambulation is inherently functional.  For example, it is good exercise.

Choose the appropriate transfer:

Motor: Limited ability to bear weight through legs

Cognition: Intact, follows commands and safety cueing

Skin: Intact

Slideboard transfer

Choose the appropriate transfer:

Motor: Limited ability to bear weight through legs

Cognition: Intact, follows commands and safety cueing

Skin: Sacral wounds

Squat-pivot transfer

Choose the appropriate transfer:

Motor: Able to stand with min A, can take a few steps but not yet able to walk

Cognition: Requires min verbal cues for sequencing

Skin: Intact

Stand-step transfer

Choose the appropriate transfer:

Motor: Mod A to stand

Cognition: Intact, follows commands and safety cueing

Skin: Diabetic foot wound on R foot that should not have weight beared upon it

Stand-pivot transfer

Choose the appropriate transfer:

Motor: Not yet able to provide assistance

Cognition: Follows simple commands. Not impulsive.

Skin: Intact

Hoyer lift

ACL level ______ descripes planned actions 

Level 6

Lost ability to make fine adjustments that allow for smooth coordination. Movements instead appear jerky or shaky.

Ataxia

Involuntary movement of the eyeballs

Nystagmus