Exam 2 HF Mock

During a wheelchair transfer, a client with a right hip replacement leans too far forward despite precautions. What should the OT do first?

Instruct the client to keep the surgical leg extended to avoid hip flexion beyond 90°.

A patient moving from supine to sitting reports dizziness and blurred vision. What condition is suspected?

Orthostatic hypotension.

Mr. Lopez with a T6 SCI becomes flushed and diaphoretic during dressing. What's the emergency response?

Sit him upright to reduce blood pressure—autonomic dysreflexia.

A client recovering from a stroke demonstrates right leg weakness and abulia. Which artery is occluded?

Left anterior cerebral artery (ACA).

A patient presents with right facial droop, expressive aphasia, and right arm weakness. The lesion site is?

Left middle cerebral artery (MCA).

A lesion in the right PCA produces what deficit?

Left homonymous hemianopsia with possible visual agnosia.

A client leans to the left while seated and cannot self-correct. Which cushion assists postural alignment?

Wedge or positioning cushion.

A 28-year-old man with T12 SCI lacks sensation below the waist. Which wheelchair cushion prevents pressure injuries?

ROHO air-cell cushion.

A patient with stage II ischial ulcers and diabetes needs what wheelchair surface?

Gel or gel-foam combination cushion.

After standing quickly from bed, Ms. Tran faints. What should the therapist do?

Lay her down and elevate her legs to restore blood flow.

A client on beta-blockers reports fatigue and slow HR (< 60 bpm). What term describes this?

Bradycardia.

A patient with a BP of 190/120 mmHg during activity shows confusion and headache. What's the OT action?

Stop activity and notify medical team—hypertensive crisis.

During therapy, blood glucose reads 55 mg/dl and the client appears shaky. What should be done?

Provide carbohydrates and defer activity — hypoglycemia.

A patient with hemoglobin 7 g/dl feels weak and short of breath. What's your next step?

Hold therapy until after transfusion or medical clearance.

A 70-year-old post-CABG patient begins cardiac rehab. Which MET level activity is safe first week?

1-2 METs (light self-care seated).

A patient performs light meal prep standing at a counter (≈ 3-4 METs). What phase of cardiac rehab is this?

Early Phase 2 outpatient training.

A patient walks 3 mph without symptoms. Approximate MET level?

3-4 METs.

A client performs yoga and light stretching daily after MI. What cardiovascular benefit occurs?

Improved activity tolerance without excess oxygen demand.

Ms. Reed with left-sided neglect bumps into objects on the left. Which artery is damaged?

Right middle cerebral artery.

A lesion in the dorsal column-medial lemniscus pathway causes loss of what?

Fine touch and conscious proprioception below the lesion.

After spinal cord injury, a patient has intact pain but absent vibration sense. What tract is impaired?

DCML (dorsal column-medial lemniscus).

Damage to the cerebellum produces which motor deficit?

Ataxia and impaired coordination.

A lesion in the left frontal lobe results in broken, effortful speech. Identify the disorder.

Broca's aphasia.

A patient speaks fluently but words make no sense and comprehension is poor. Location?

Left temporal lobe (Wernicke's area).

Mr. Smith's right optic-tract lesion causes vision loss where?

Left visual field (left homonymous hemianopia).

Pituitary tumor compressing optic chiasm leads to what?

Bipolar hemianopsia (loss of peripheral vision).

Lesion of CN VII causes what facial change?

Paralysis of facial expression and loss of anterior tongue taste.

Injury to CN VIII leads to what symptoms?

Hearing loss, tinnitus, and vertigo.

Lesion of CN IX impairs which reflex?

Gag and swallowing reflex.

A stroke damages the left occipital lobe. What major deficit results?

Right visual field loss.

Client reports severe vertigo and nausea during car rides. Which system is overstimulated?

Vestibular system (CN VIII and semicircular canals).

Romberg test shows postural sway with eyes closed but stability with eyes open. Interpretation?

Proprioceptive deficit.

The patient exhibits rhythmic involuntary eye movement during gaze stabilization test. Identify finding.

Nystagmus from vestibular or brainstem dysfunction.

During feeding, a client misjudges spoon position near the mouth. Which sensory system is impaired?

Proprioceptive feedback and motor planning integration.

A client with anosmia after head trauma likely damaged what?

Olfactory nerve (CN I) or olfactory bulb.

A patient with high-pitched hearing loss and balance issues likely injured which nerve?

CN VIII vestibulocochlear.

Ms. Davis with decreased vision and temporal lobe damage struggles recognizing voices. What is this called?

Auditory agnosia.

A patient post-stroke can't recognize familiar faces but vision is intact. What's the term?

Visual agnosia.

A therapist notes a client's posture with forward head and rounded shoulders at a computer desk. Long-term risk?

Cervical strain and TMJ pain from forward head posture.

Ms. Nguyen slumps forward in her wheelchair after 10 minutes. What environmental change improves alignment?

Add a wedge cushion angled posteriorly to prevent slouching.

A patient loses balance when turning the head quickly. Which sensory system coordinates gaze stabilization?

Vestibulo-ocular reflex (VOR).

A right-hand-dominant carpenter post-stroke shows left-sided weakness and poor coordination. Which hemisphere is damaged?

Right hemisphere motor damage.

Client demonstrates impulsivity, poor judgment, and emotional lability after TBI. Damaged area?

Frontal lobe.

A 45-year-old with left leg weakness, intact face/arm control—suspect lesion where?

Right ACA distribution.

A 58-year-old presents with right facial droop and aphasia. Lesion?

Left MCA cortical region affecting Broca's area.

A 50-year-old with blurred vision, confusion, and low BP on standing likely has what?

Orthostatic hypotension from autonomic instability.

The patient complains of tingling and vibration loss in feet but pain intact. What tract is damaged?

Dorsal column-medial lemniscus.

A client shows confusion, fatigue, and chest pain during exercise; BP 160/100 mmHg. What's your action?

Stop activity and monitor—hypertension response.

Client reports heart palpitations and clamminess during therapy; glucose 60 mg/dl. Appropriate response?

Give carbohydrate snack and pause session.

Mr. Reed's SpO₂ drops to 88% during ambulation. What's the OT's next step?

Stop activity and re-oxygenate to ≥ 90%.

Patient on blood thinners presents with new bruising and platelets < 150,000/µl. Implication?

High bleeding risk — modify therapy to avoid injury.

After head injury, patient loses smell and taste but hearing intact. Which cranial nerves are affected?

CN I and CN VII (olfactory and facial).