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Neurological Rehabilitation focuses on the assessment, management, and recovery of individuals with neurological disorders affecting the central and peripheral nervous systems. This course covers key principles and evidence-based practices in the rehabilitation of conditions such as stroke, traumatic brain injury, spinal cord injury, multiple sclerosis, and Parkinsons disease. Students will explore a multidisciplinary approach involving physical, occupational, and speech therapies, as well as the use of advanced technologies and therapeutic interventions to optimize functional independence and improve quality of life. Emphasis is placed on understanding neural plasticity, designing individualized treatment plans, and collaborating within healthcare teams to address the complex needs of neurological patients.
Recommended Textbook
Pedrettis Occupational Therapy Practice Skills for Physical Dysfunct
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Q1) Work is a component of which Framework section?
A) Areas of occupation
B) Performance patterns
C) Activity demands
D) Contexts
E) Client factors
Answer: A
Q2) A 10-year-old client is making her bed.She needs two sheets and a pillowcase to do this task.She prefers flannel sheets.This would be considered under which section of activity demands?
A) Objects and their properties
B) Space demands
C) Sequence and timing
D) Required body structures
E) Required actions
Answer: A
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Q1) Both Client A and Client B suffered mild strokes.Client A has been an accountant at the same company for the past 25 years and hopes to retire there.Client B is a homemaker who diligently clips coupons,shops sales,and keeps track of spending every day,finding it a fun challenge.Which statement is correct?
A) Financial management is an activity for Client A and an occupation for Client B.
B) Financial management is an activity for both Clients A and B.
C) Financial management is an occupation for Client A and an activity for Client B.
D) Financial management is an occupation for both Clients A and B.
Answer: D
Q2) An OT practitioner is working with a client with carpal tunnel syndrome.Which of the following is not a preparatory method that the OT can use with the client?
A) Cock-up splinting to hold the wrist in neutral to 10 degrees of extension
B) Tendon-gliding exercises for the long finger flexors
C) Ergonomic modification of the client's workspace
D) Ultrasound phonophoresis and iontophoresis to reduce inflammation
Answer: C
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Q1) Which model views the individual as a passive participant in the intervention process?
A) Moral treatment
B) Disability rights movement
C) Interactional or sociopolitical model
D) Medical model
E) Social model
Answer: D
Q2) The Rehabilitation Act of 1973,the Individuals with Disabilities Education Act (IDEA)of 1973,and the Americans with Disabilities Act (ADA)of 1990 are all legislation acts that resulted from activists of which model or movement?
A) Arts and Crafts movement
B) Moral treatment
C) Scientific management
D) Medical model
E) Disability rights movement
Answer: E
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Q1) Which statement best reflects the difference between the occupational profile and the analysis of occupational performance?
A) The occupational profile is always first and is written on the referral form.
B) The analysis of occupational performance is a standardized manner of determining the intervention plan and is used with all clients.
C) The analysis of occupational performance guides the occupational profile.
D) The occupational profile guides the analysis of occupational performance.
Q2) Occupational therapy services provided within the client's home require careful consideration of the environment.What issues would typically be addressed within this setting?
A) Changing the furniture arrangement to eliminate potential falls
B) Safety in meal preparation
C) Simplification of household cleaning tasks
D) All of the above
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Q1) In systematic OT practice the ___________ and ___________ emerge from the need statement.
A) Goals, objectives
B) Problems, interventions
C) Thinking, action processes
D) Inductive, deductive reasoning
E) Causes, consequences
Q2) Systematically monitoring the client,the collaboration,professional practice,setting-based resources,and therapeutic use of self and other internal and external influences that affect practice process and outcome is all part of
A) Process assessment
B) Objective assessment
C) Reflexive intervention
D) Goals
E) Compensatory strategies
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Q1) The PRECEDE-PROCEED model is based on all but which of the following assumptions?
A) In the PRECEDE framework, factors influencing health are identified.
B) Objectives for a population are developed during the PRECEDE portion of the model.
C) People's health patterns are stable, consistent, and unable to be altered.
D) The PROCEED portion of the model includes policy development.
Q2) The transtheoretical model of health promotion consists of multiple stages.Which of the following statements does not accurately describe phases from this model?
A) The precontemplation stage involves a definite plan to change behavior but no plan or time frame.
B) The contemplation stage involves some ambivalence regarding the cost and benefits of modifying behavior.
C) The preparation stage involves an indication that the person is ready to change behaviors in the near future.
D) The duration of the action stage is a minimum of 6 months.
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Q1) Which statement below is incorrect?
A) Goals are written to reflect what the therapist will do.
B) Client-centered goals are written with input from the client.
C) Goals reflect what the client will do.
D) Goals should be measurable and objective and should include a time frame.
Q2) Which statement below is not true?
A) HIPAA stands for the Health Insurance Portability and Accountability Act.
B) HIPAA clearly outlines the expectations of health care professionals in issues of confidentiality.
C) HIPAA provides federal protection of PHI.
D) There are no federal laws to protect the consumer against breaches of confidentiality.
Q3) Data recorded in the objective section of the note could include which of the following?
A) Orders in the referral
B) Specific degrees of measurement of range of motion (ROM)
C) List of activities performed by the client
D) Interpretation of the client's measurements
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Q1) Which statement is most true regarding documentation of skilled services?
A) Documentation of skilled services does not necessarily reflect the therapeutic rationale underlying the task performed.
B) Terminology reflecting skilled services includes words such as observe, help, and maintain.
C) Skilled services can be performed safely and/or effectively only by a qualified therapist or under the supervision of a qualified therapist.
D) Progress reports do not have to describe the type of skilled interventions that were provided.
Q2) Which of the following is an example of a long-term goal (also called discharge goal)?
A) The client will be able to dress self with a simple pullover shirt with no fasteners.
B) The client will be able to button and unbutton an article of clothing.
C) The client will be able to tie a pair of shoes.
D) The client will be able to dress independently.
E) The client will be able to put on and remove slacks.
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Q1) When working with a client who has a hyperalimentation device for nutritional support,the occupational therapist should ensure that catheter connections are secure before and after intervention.What potentially life-threatening condition can result from a disrupted connection?
A) Blood clot
B) Gastrointestinal reflux
C) Air embolus
Q2) When working with a client who has an intracranial pressure (ICP)monitor,certain positions and activities that cause increase in ICP should be limited.Which of the following are examples of activities and/or positions to be avoided?
A) Isometric exercises and neck flexion
B) Isotonic exercises and neck extension
C) Isometric exercises and neck extension
D) Isotonic exercises and neck flexion
Q3) A nosocomial infection is ___________.
A) Bacterial
B) Viral
C) Transmitted via bodily fluids
D) Acquired in the hospital
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Q1) An occupational therapy (OT)practitioner is working with a client who has been admitted to the hospital because of complications resulting from chronic obstructive pulmonary disease and insulin-dependent diabetes mellitus.While working on grooming and hygiene while standing at the sink,the client suddenly begins to get agitated,her skin becomes pale and appears moist,her breathing becomes shallow,and she begins to lose consciousness.Given the client's medical history,she is most likely experiencing which of the following?
A) Respiratory distress
B) Ketoacidosis
C) Insulin reaction
Q2) In addition to teaching the client to use dyspnea control postures,the occupational therapist also teaches the client to use pursed-lip breathing to reduce shortness of breath while performing activities of daily living.Which of the following best describes pursed-lip breathing?
A) Inhaling slowly through pursed lips, then exhaling through the nose
B) Inhaling through pursed lips, then exhaling slowly through the nose
C) Inhaling slowly through the nose, then exhaling through pursed lips
D) Inhaling through the nose, then exhaling slowly through pursed lips
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Q1) IADL skills needed for client safety and independence alone at home include all but which of the following?
A) The ability to retrieve a simple meal
B) The ability to ambulate independently
C) The ability to employ safety precautions
D) The ability to take medications.
Q2) Which of the following is the main technique used for a client with limited joint range of movement (ROM)to perform ADLs?
A) Compensatory strategy involving changing the method in which an activity is performed
B) Changing the environment where the activity is performed
C) Using an assistive device for the activity
D) Treatment including remediation
Q3) An occupational therapist is working with a patient with low vision in her home.Which environmental modification would be contraindicated?
A) Improve lighting by opening blinds and curtains.
B) Simplify figure-ground perception.
C) Use magnifiers with lights.
D) Maximize contrast for the task.
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Q1) The use of a wrist-driven flexor hinge splint may benefit a client with muscle function from which spinal cord level(s)?
A) C6
B) C5
C) C4
D) A and B
Q2) The occupational therapist is working with a client who has weakness and pain in the hands caused by moderate to severe arthritis.To increase functional independence,the client may use which of the following?
A) Plate guards or scoop dishes
B) A commercially available sock aid
C) An extended handle reacher
D) Lever-type doorknob extensions
Q3) IADL skills needed for client safety and independence alone at home include all but which of the following?
A) The ability to retrieve a simple meal
B) The ability to ambulate independently
C) The ability to employ safety precautions
D) The ability to take medications
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Q1) After a clinical assessment of the client,a predriving assessment is completed.Essential predriving skills that are evaluated include which of the following?
A) Cognitive and perceptual skills assessment
B) On-the-road evaluation of the client's skills using adapted equipment
C) The ability to handle keys, manage doors, mobility devices, and adjust seat belt
D) Muscle strength, range of motion, and grip measurements
Q2) It is recommended that wheelchair footplates clear the floor by a minimum distance of ________________.
A) 2 inches
B) 1 inch
C) 0.25 to 0.5 of an inch
D) 4 inches
Q3) Why might a rigid frame chair be preferable for individuals with paraplegia who are manually propelling the wheelchair?
A) They are more lightweight than folding chairs.
B) They are more energy efficient during propulsion.
C) They are more easily folded and stored.
D) They are more sturdy and do not need to be replaced as often.
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Q1) You are an occupational therapist with advanced training in driving evaluation.You are working with a client with paraplegia.After completion of a thorough predriving assessment,you determine that your client can safely drive with appropriate vehicle modifications.Which of the following are appropriate modifications for the individual with paraplegia?
A) Left foot accelerator, spinner knob
B) Hand controls for accelerator and brake, hand-operated parking brake
C) Pedal extensions
D) High-technology electronic controls and power equipment
Q2) You are an occupational therapist working with an individual with T1 spinal cord injury.Your client has paralysis of both legs.Upper extremity function is fully intact,but your client has limited upper trunk stability.Which of the following is the most appropriate type of transfer to use to maintain safety and maximize your client's independence in functional mobility?
A) Bent pivot transfer
B) Sliding board transfer
C) Stand pivot transfer
D) Transfer with mechanical lift
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Q1) Which organization would an occupational therapist contact for more information about community work and rehabilitation programs?
A) National Governors Association Center for Best Practices
B) Department of Labor
C) State vocational rehabilitation program
D) All of the above
Q2) _______ addresses "human performance and well-being in relation to one's job,equipment,tools,and environment."
A) Anthropometry
B) Ergonomics
C) Industrial hygiene
D) OSHA
Q3) "Primary" prevention of workplace injuries ______________.
A) Emphasizes early identification and intervention of workers and risk factors
B) Helps protect healthy workers against targeted conditions
C) Occurs after a worker suffers nonreversible injury, illness or disease
D) Is not addressed by occupational therapists
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Q1) The state Department of Rehabilitation refers many clients to OT for help with the transition from school to work.What would be an appropriate goal for a student with paraplegia who wants to be a teacher?
A) Increase upper extremity strength to within normal limits
B) Independence with using a computer and a projector to put lessons on the board.
C) Independent with all dressing skills
D) Any goal made collaboratively with the student, rehabilitation counselor, and the OT practitioner
Q2) LD sustained a spinal cord injury (SCI)at the T-11 level resulting from a car accident.Before his injury he worked as a service manager at a car dealership.He would like to return to this job.What type of vocational evaluation would provide the most information to help him return to his previous job?
A) A specific vocational evaluation
B) A general vocational evaluation
C) Work hardening
D) Valpar 9 Total Body Range of Motion test
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Q1) An OT practitioner is working in a public school with a child who uses a wheelchair for all mobility.He tells the OT practitioner that he cannot get into a toilet stall in the bathroom because the stall is too small.What should the OT practitioner do?
A) Perform an accessibility audit of the bathroom and make recommendations to the school principal to provide wheelchair access under the ADA.
B) Tell the student to file a complaint with the Department of Justice in Washington,
C) Ask the principal if the student can use the teachers' bathroom, which is larger.
D) There is nothing that the OT practitioner can do in this situation.
E)C.
Q2) A neighborhood restaurant needs to comply with ADA requirements to accommodate customers with disabilities.What is the first priority under Title III regulations?
A) Provide parking for the disabled and access into the restaurant.
B) Make the restrooms accessible for all people.
C) Make restaurant tables accessible to wheelchair users.
D) Make the menus more accessible for persons with visual limitations.
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Q1) An occupational therapist from the Midwest (where the population is predominantly white)is moving to southern California (where the population is an ethnic mix with a large segment being Mexican).What should the occupational therapist do to improve her knowledge and application of culturally appropriate occupations for her new clientele?
A) Gather examples of successful activities that she did in the Midwest and box them up to take to her new job.
B) Review manual muscle testing so that when assigning an embroidery project, the occupational therapist will know that the proper hand muscles are working.
C) Research leisure interests and occupations by ethnicity using books, articles, and the Internet.
D) Learn Mexican recipes because most clients she will be treating will be Mexican and will enjoy cooking groups.
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Q1) What year did Congress pass the Americans with Disabilities Act (ADA)?
A) 1973
B) 1990
C) 2002
D) 1969
Q2) For the purposes of determining application of the ADA,"essential job functions" are best determined _________________.
A) On a case-by-case basis, looking at the facts of each situation
B) By the supervisor of the department
C) By the employees doing the job
D) By the written job description
Q3) At which stage of the hiring process can an employer give a functional capacity assessment?
A) Pre-offer stage
B) Post-offer stage
C) During the medical exam
D) During the interview
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Q1) Adults with physical disabilities may give up leisure activities for which of the following reasons?
A) Because their clinical setting does not employ a recreational therapist
B) Because they all prefer watching television
C) Because they are not aware of ways to adapt valued activities so that they may participate in them again
D) Because they do not wish to learn new hobbies or crafts
Q2) As an Area of Occupation,leisure is defined in the Occupational Therapy Practice Framework (2002)as ________________.
A) A nonobligatory activity that is internally motivated and engaged in during an individual's free time
B) An obligatory daily activity that provides the individual with social contacts
C) An activity determined by the occupational therapist to be beneficial to the client
D) Fun activities recommended by the client's family or caregiver
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Q1) Which of the following is an advantage of the occupation-based functional motion assessment?
A) The client will perform these tasks in contexts that are meaningful.
B) The occupational therapy (OT) practitioner can guide the movement patterns of the client to enhance performance.
C) The OT practitioner will provide a structured environment in which the assessment will occur.
D) The OT practitioner can provide verbal cues to direct the client in completion of the task.
Q2) Which of the following is a reason that assumptions can be made regarding lower extremity strength during functional activities?
A) The dependency of the distal joints on the more proximal joints for positioning
B) The complexity of motor patterns requiring gross and fine motor skill
C) The stereotypical movement patterns that occur due to the joints and relative arrangement of the muscle
D) The variety of patterns of movement that can be assumed
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Q1) What is the average normal joint ROM (using the 180-degree method)for thumb metacarpophalangeal (MP)flexion?
A) 0-70 degrees
B) 0-90 degrees
C) 20-90 degrees
D) 20-50 degrees
E) 0-50 degrees
Q2) When the joint is moved solely by an outside force,it is called ______________.
A) Functional range of motion (ROM)
B) Active ROM
C) External ROM
D) Passive ROM
E) Active-assistive ROM
Q3) When ROM is being measured,which is not a purpose of the therapist being in the proper position?
A) Making the client more comfortable
B) Ensuring accurate placement of the goniometer
C) Protecting the therapist's back
D) Giving the patient more time to move
E) Supporting the limb at the level of its center of gravity
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Q1) An OT practitioner is reassessing a client's shoulder external rotation active ROM at discharge.During the initial evaluation,ROM measurements (0-15)were taken with the client seated and the humerus adducted because of the presence of shoulder pain.The client's pain has since resolved,and ROM has improved so that the client is now able to abduct the humerus to assume the alternative testing position.To document discharge ROM,what should the OT do?
A) State that the ROM has improved but measurements were not taken because pain has resolved.
B) Observe the motion and estimate the ROM.
C) Measure external rotation with the humerus abducted.
D) Measure external rotation with the humerus adducted.
Q2) An OT practitioner is measuring the starting position of passive proximal interphalangeal (PIP)joint flexion in a client who has increased flexor tone in his wrist and fingers after a traumatic brain injury.The therapist should place the client's wrist in which position?
A) Neutral or flexion
B) Slight extension
C) Full extension
D) Any position, because wrist position has no effect on finger motion
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Q1) If a muscle contraction can be seen or felt but no motion is observed,the grade is
A) 0
B) 1-
C) 1
D) 1+
E) 2-
Q2) Which of the following is not considered a screening test for muscle strength?
A) Reviewing the medical record for previous strength assessments
B) Observing the client perform a functional activity
C) Observing the client move around the clinic
D) Performing a manual muscle test (MMT)
E) Performing a gross check of muscle group
Q3) In what plane is the MMT for grades F- and higher performed?
A) Horizontal plane
B) Gravity-minimized plane
C) Vertical plane
D) Gravity-assisted plane
E) Gravity-eliminated plane
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Q1) An OT practitioner is screening a client's wrist extension strength.The client is able to actively extend the wrist partially against gravity.Because of a joint limitation,the client's forearm cannot be placed in neutral rotation.What is the appropriate muscle grade?
A) 0
B) 1
C) 2
D) 3
Q2) An OT is performing manual muscle testing on a client's shoulders.Initial screening found all muscles were below a grade of 3-.Which tests can be performed with the client seated?
A) Flexion, abduction, internal rotation, external rotation
B) Internal rotation, external rotation, horizontal adduction, horizontal abduction
C) Horizontal adduction, horizontal abduction, extension, abduction
D) External rotation, internal rotation, flexion, horizontal abduction
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Q1) Why is it important to support the client's hand fully when performing a sensory evaluation?
A) So the client remains relaxed
B) To prevent the hand from moving, which could provide sensory information that interferes with the testing
C) To be sure that the client pays attention
D) To be consistent in technique among all clients
Q2) Why is fingertip sensation enhanced compared with proximal parts of our bodies?
A) Because our fingers are more exposed to the environment
B) Because we need more sensation in our fingertips to prevent injury
C) Because fingertips have a higher density of receptors and smaller receptive fields
D) Because fingertips are glabrous
Q3) Why is it important to test temperature sensation before applying heat or cold modalities in the clinic?
A) To avoid burning the client
B) To know whether to adjust the thermostat in the room
C) To know whether to put a blanket on the client
D) To find out whether the client prefers heat over cold or vice versa
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Q1) Sensory reeducation includes all but which of the following?
A) Contralateral upper extremity constraint
B) Stimulating localization
C) Tasks of recognition
D) Tasks of graded stimulus
Q2) Localization of moving touch tends to return before localization of ___________.
A) Light pressure
B) Constant touch
C) Pinprick
D) Deep pressure
Q3) Normal static two-point discrimination is ____________.
A) 11-15 mm
B) 60-10 mm
C) < 6 mm
D) < 8 mm
Q4) Superficial fine touch receptors include which of the following?
A) Pacinian corpuscles
B) Ruffini's corpuscles
C) Meissner's corpuscles
D) Golgi tendon organs
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Q1) A wet or gurgly vocal quality after an individual swallows is indicative of what?
A) Poor vocal fold control when talking
B) Poor respiratory support and a weak voice
C) Material collecting in the larynx
D) Nasal congestion
Q2) The hypoglossal nerve (XII)is active during what stages of the swallow?
A) Oral preparatory and pharyngeal stages
B) Oral preparatory and oral stages
C) Oral and pharyngeal stages
D) Pharyngeal and esophageal stages
Q3) During which phase of the swallow is there closure of the glottic and supraglottic structures to cover the airway and provide protection from aspiration?
A) Pre-oral
B) Oral
C) Pharyngeal
D) Esophageal
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Q1) All but which of the following could directly or indirectly result from a head injury?
A) Cataract
B) Diabetic retinopathy
C) Corneal scarring
D) Vitreous hemorrhage
Q2) Captain Hatrack woke up one morning feeling funny and not seeing too well.He went to the ophthalmologist,Dr.Eye,who told him that he experienced a small stroke and has developed a left hemianopsia.Dr.Eye told the Captain that he had to stop driving immediately.The Captain is very upset because he feels as if he is seeing everything in his field and that all he needs is a better pair of glasses; he thinks the doctor is a quack and he can drive just fine.Which one of the following provides the best explanation for why the Captain does not realize he has a field deficit?
A) The Captain has cataracts.
B) The Captain has a relative visual field loss on the left.
C) The Captain is exercising perceptual completion.
D) The Captain is experiencing confusion because of the stroke.
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Q1) What are the four distinct domains of the biopsychosocial model of pain?
A) Nonmalignancy, trauma, disease, and fear
B) Muscular weakness, noxious stimuli, nervous system syndrome, and chronic illness
C) Nociception, pain, suffering, and pain behavior
D) Arthritis, fibromyalgia, cancer, and headaches
Q2) Which of the following best defines pain?
A) An objective experience that is either acute or chronic
B) An unpleasant sensory and emotional experience, usually associated with actual or potential tissue damage
C) A physical disability with an emotional component
D) A negative sensation that always disrupts normal occupations
E) All of the above
Q3) What assessments are appropriate for an occupational therapist to use with clients,such as Catalina,who report pain?
A) Visual analog scale
B) Occupational profile
C) Numeric pain intensity scale
D) Activity diaries
E) All of the above
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Q1) An occupational therapy (OT)practitioner has received an order to evaluate a middle-aged man because of shoulder pain that is impeding his ability to go back to work. The OT practitioner observes guarded movement,bracing,posturing,rubbing,and facial grimacing.These are examples of which of the following?
A) Asymmetry of the spine
B) Pain behaviors
C) Myasthenia gravis symptoms
D) Hypochondriasis
E) All of the above
Q2) For which of the following pain interventions does the occupational therapist need post-professional education to ensure competency?
A) Adaptive equipment
B) Splinting
C) Relaxation training
D) Physical agent modalities (PAMs)
E) All of the above
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Q1) The shape of the forearm changes as it moves from supination to pronation.When a volar splint is being made,which of the following techniques will assist in accommodating this change in the fabrication process?
A) Have the patient lie down to fabricate the splint.
B) Pronate and supinate the forearm continuously during the splint fabrication process.
C) Pronate the forearm before the splint material has set.
D) Make the splint with the forearm in neutral.
Q2) An occupational therapy (OT)practitioner is working with a 30-year-old police officer who reports a painful wrist after trying to restrain a prisoner.The police officer has persistent pain and weakness with resistive tasks 2 months after the incident.The pain is on the ulnar side of the hand.The OT practitioner may opt to send the patient back to the physician for further evaluation for which of the following possible reasons?
A) The client is exaggerating the pain.
B) The client has a median nerve compression.
C) There is injury to the triangular fibrocartilage complex (TFCC).
D) None of the above.
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Q1) Which is considered a "special part" used for a mobile arm support (MAS)?
A) Distal arm
B) Proximal arm
C) Semireclining mount
D) Outside rocker arm assembly
E) Forearm support
Q2) The distal transverse arch of the hand lies obliquely to the ___________.
A) Proximal interphalangeal joints of digits 2 through 5
B) Metacarpal joint of the thumb
C) Distal interphalangeal joints of digits 2 through 5
D) Wrist carpal bones
E) Metacarpal heads of digits 2 through 5
Q3) Semiflexible splints can be made from which of the following materials?
A) Neoprene
B) Thin thermoplastics
C) Cotton duck and elastics
D) Both A and C
E) All of the above
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Q1) Which of the following statements accurately describes PNF reversal of antagonists techniques?
A) Slow reversals are characterized by alternating isotonic contractions of both the agonist and antagonists opposed by enough resistance to prevent motion.
B) Stabilizing reversals are isotonic contractions of the antagonists followed by an isotonic contraction of the agonist.
C) Rhythmic stabilization increases stability through contractions of only the antagonistic muscle groups.
D) All of the above.
Q2) Which of the following statements best describes the procedure of maximal resistance?
A) If resistance breaks the client's hold, apply additional resistance.
B) Strength is increased by movement against resistance that requires maximal effort by the client.
C) For clients with neurological impairment, very light resistance is usually ineffective and may not meet the client's needs.
D) If a client has spasticity, resistance cannot increase existing muscle imbalance.
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Q1) You are reviewing the medical record of your next patient,who has Parkinson's disease.The neurologist has indicated that this man has bradykinesia.What does this mean?
A) He has no movement available.
B) His movements are slow.
C) He has oscillations in his movements.
D) His movements are very erratic and quick.
Q2) What are common psychosocial issues seen with clients who are diagnosed with Huntington's disease?
A) Depression
B) Suicidal thoughts
C) Emotional lability
D) All of the above
Q3) Amyotrophic lateral sclerosis has three clinical subtypes.Which type is associated with a quicker progression and problems with dysphagia and dysarthria?
A) Progressive bulbar palsy
B) Progressive spinal muscular atrophy
C) Primary lateral sclerosis
D) Primary medial sclerosis

37
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Q1) Sequencing and timing are considered in which Framework section?
A) Performance skills
B) Performance patterns
C) Context
D) Activity demands
E) Client factors
Q2) To make her bed,the 10-year-old client will need to unfold the pillowcase and push the pillow all the way into the case so that the corners of the pillow and case match.This would be considered under which section of activity demands?
A) Social demands
B) Sequence and timing
C) Required actions
D) Required body function
E) Required body structures
Q3) Roles and routines are under which Framework section?
A) Performance skills
B) Performance patterns
C) Context
D) Activity demands
E) Client factors
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Q1) The person with C6 quadriplegia may be able to assist in transfers by locking the elbows in extension and performing shoulder _________________.
A) Depression, extension, and adduction
B) Depression, external rotation, and adduction
C) Adduction and elbow flexion
D) Horizontal abduction and humeral adduction
Q2) The patient has a C6 quadriplegia.We can anticipate that he or she has innervation of which of the following?
A) Deltoids, latissimus, biceps, radial wrist extensors
B) Latissimus, serratus, biceps, triceps
C) Deltoids, biceps, triceps, hand intrinsics
D) All of the above
Q3) The patient has a C5 quadriplegia.We can anticipate that he or she has innervation of which of the following?
A) Upper trapezius, deltoids, biceps, levator scapulae, wrist flexors
B) Latissimus, deltoids, biceps, supinators, pronators
C) Upper trapezius, diaphragm, levator scapulae, biceps, and supinators.
D) A and B
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Q1) Which of the following activities of daily living and instrumental activities of daily living will be most difficult for Rick to perform independently?
A) Feeding himself and brushing his hair
B) Upper extremity dressing
C) Driving
D) Lower extremity dressing
Q2) You are testing Rick's sensation/perception. Which of the following tests should be least relevant to his disability?
A) Touch and superficial pain
B) Position sense and stereognosis
C) Body scheme and visual spatial perception
D) Thermal and pressure sensitivity
Q3) Which of the following is another primary goal in the early stage of OT for Rick?
A) Achieve independence in lower extremity dressing
B) Improve physical endurance
C) Learn transfer skills
D) Explore vocational possibilities
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Q1) An occupational therapist has received an order to evaluate Jan,a 45-year-old photographer who has been diagnosed with myasthenia gravis.In what aspect of evaluation should the therapist have advanced training to perform?
A) Dysphagia
B) Manual muscle testing
C) Home evaluation
D) Running groups
E) All of the above
Q2) In a recent study reported in this chapter,Wenneberg,Gunnarsson,and Ahlstrom (2004)found that subjects with muscular dystrophy _________________.
A) Showed improved functional movements during activities of daily living and instrumental activities of daily living after muscle overexertion exercises
B) Needed shoulder slings to drive a powered wheelchair
C) Had a decreased rate of decline with qigong used as an adjunct therapy program
D) Experience maximal weakness during the first year after diagnosis
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Q1) What interventions are appropriate for an occupational therapist to use with clients who have postpolio syndrome (PPS)?
A) Psychological counseling
B) Pain management
C) Exercise designed to work the muscles at maximum capacity with frequent, intermittent periods of rest
D) Diet recommendations and cooking groups
Q2) During a Backpack Awareness Day event,occupational therapy (OT)students educated middle school-aged children about carrying the correct amount of weight and wearing their backpacks correctly to prevent injury of which peripheral nerve?
A) Brachial plexus
B) Axillary nerve
C) Median
D) Long thoracic
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Q1) Patients with rheumatoid arthritis frequently have joint replacements or arthroplasties because of the extensive joint damage.All but which of the following joints are common sites for an arthroplasty?
A) The hips
B) The knees
C) The distal interphalangeal joints
D) The MP joints
Q2) The synovial tissue that lines the joint becomes inflamed in rheumatoid arthritis.This is referred to as synovitis and results in all but which of the following?
A) Increased joint lubrication
B) Destruction of cartilage and bone
C) Limiting joint motion
D) Weakening of the joint capsule
E) Distending of the tendons and ligaments
Q3) A common hand deformity in rheumatoid arthritis includes which of the following?
A) Metacarpophalangeal (MP) ulnar deviation and wrist ulnar deviation
B) MP radial deviation and wrist ulnar deviation
C) MP ulnar deviation and wrist radial deviation
D) MP radial deviation and wrist radial deviation
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Q1) An OT practitioner is working with a 55-year-old client with osteoarthritis.She has pain at the base of her thumb at the carpometacarpal (CMC)joint and nodes at several of the distal interphalangeal (DIP)joints.She reports attending a yoga class the previous evening that required weight bearing on her hands.Her pain increased after the class and still persists during her OT appointment.What should the OT practitioner tell the patient?
A) Continue the yoga class to increase strength.
B) Avoid any activity that causes pain for more than 1 to 2 hours after completion.
C) Review joint protection principles.
D) B and C.
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Q1) A client arrives for evaluation with the inability to extend her wrist,thumb,or MP joints of her right dominant hand.What nerve is involved?
A) Ulnar nerve
B) Radial nerve
C) Median nerve
D) Musculocutaneous nerve
Q2) What does digital clawing indicate?
A) Weakness or absence of the extensor muscles
B) Weakness or absence of the intrinsic muscles of the hand
C) Weakness or absence of the flexor muscles of the hand
D) Flexor tenosynovitis
Q3) Why is surgery required for neurotmesis?
A) Because it would take too long to wait for the nerve to regenerate
B) Because the nerve is contused
C) Because there is a complete laceration of both nerve and fibrous tissues
D) Because nerve fibers distal to the injury degenerate, despite the fact that the internal organization of the nerve is intact
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Q1) In working with Pilar,the occupational therapist will teach her the concepts of body mechanics,which include ___________________.
A) Avoiding twisting movements, holding objects close to the body, lifting with the legs
B) Teaching her tasks and positions that move her body out of balance to challenge and strengthen the low back muscles
C) Forceful dynamic stretching of the upper and lower back
D) Balancing on one leg while reaching overhead
E) All of the above
Q2) Which of the following best defines spinal stenosis?
A) The narrowing of the intervertebral foramen that decreases the space where the spinal nerve exits or enters the spine
B) A type of muscular weakness
C) A condition that never causes low back pain
D) A condition that is caused by the sciatic nerve
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Q1) Name the test in which the examiner places pressure over the median nerve in the carpal tunnel for up to 30 seconds to see if this creates tingling in the median nerve distribution.
A) Carpal compression test
B) Reverse Phalen's test
C) Test for Tinel's sign
D) Roos test
Q2) Sensibility testing is performed for all but one answer below.Pick the one that is not correct.
A) To assess the recovery of a nerve following laceration and repair
B) To assess mobility of a joint
C) To determine the presence of a nerve compression syndrome and the return of nerve function after surgical decompression
D) To determine the efficacy of conservative intervention to reduce compression
Q3) Positive Phalen's test is associated with which of the following?
A) Cubital tunnel syndrome
B) Radial tunnel syndrome
C) Carpal tunnel syndrome
D) Trigger finger
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Q1) Tensile strength of a burn scar never recovers more than what percentage of original unburned skin?
A) 80%
B) 85%
C) 90%
D) 95%
E) 100%
Q2) Which is not true about splinting in the treatment of burns?
A) Splints do not need to be worn at all times to prevent contractures.
B) Splints can maintain correct positioning of joints.
C) Splints can protect compromised tissues to promote healing.
D) Splints can reverse scar contractures of mature scars.
E) Splints should not compromise function whenever possible.
Q3) The antideformity position for the wrist and hand is ________________.
A) Wrist flexion, thumb abduction and extension, metacarpophalangeal (MP) flexion, interphalangeal (IP) extension
B) Wrist flexion, thumb abduction and flexion, MP extension, IP extension
C) Wrist neutral, thumb adduction and extension, MP extension, IP flexion
D) Wrist extension, thumb adduction and extension, MP flexion, IP flexion
E) Wrist extension, thumb abduction and extension, MP flexion, IP extension
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Q1) An occupational therapy (OT)practitioner is treating a client who had a split thickness skin graft (STSG)5 days ago after a release of an anterior elbow flexion contracture.At this time the therapist should begin which of the following?
A) Gentle passive range of motion (ROM) exercises
B) Gentle active ROM exercises
C) Gentle strengthening exercises
D) Gentle compression devices
Q2) An OT practitioner is treating a client who has been hospitalized with acute burns to the face,neck,chest,and bilateral upper extremities.The therapist wants to initiate immediate antideformity positioning.Which position would not be appropriate?
A) Using a pillow behind the client's head
B) Using armboards to place shoulders in 90 degrees of abduction
C) Using a towel roll beneath the thoracic spine
D) Using splints to place elbows in extension
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Q1) When operating a body-powered voluntary opening upper extremity prosthesis,humeral flexion and scapular abduction will __________________.
A) Close the terminal device
B) Flex the elbow
C) Extend the elbow
D) Flex the wrist
E) A and B
Q2) Which is not an advantage of a myoelectric prosthesis?
A) Minimal or no harnessing
B) Lighter weight
C) Increased grip force
D) Ability to use overhead
E) Minimal effort needed to control
Q3) A client feeling a limb that is no longer there is experiencing ___________.
A) Neuroma
B) Phantom pain
C) Hyperesthesia
D) Phantom limb
E) Sympathetic sensation
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Q1) An OT practitioner is working with a client who had a unilateral below-knee amputation 4 days ago.With regard to wheelchair and positioning,what should be the therapist's priority?
A) To provide a residual limb support
B) To place the large wheelchair wheels farther back to distribute weight
C) To remove both leg rests
D) To issue an extra-heavy wheelchair for stability
Q2) An OT practitioner is evaluating a client who has just received an upper extremity prosthesis.The therapist should instruct the client to begin wearing the prosthesis:
A) Once a day for 30 to 45 minutes, increasing by 60 minutes each day
B) Three times a day for 15 to 30 minutes, increasing by 30 minutes each day
C) Twice a day for 60 to 90 minutes, increasing by 15 minutes each day
D) Four times a day for 10 to 30 minutes, increasing by 45 minutes each day
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Q1) For individuals with cancer,what is the most common impairment that leads to impaired ability to engage in meaningful activity?
A) Lymphedema
B) Peripheral neuropathy
C) Impaired cognition
D) Weakness
Q2) A cancer with staging of III __________________.
A) Has a primary tumor greater than 5 cm, no invasion of adjacent tissues, no lymph involvement and no metastases
B) Has a primary tumor of 5 cm or less, no invasion of adjacent tissues, positive regional lymph involvement and no metastases
C) Has a primary tumor greater than 5 cm or less, no invasion of adjacent tissues, no lymph involvement, and distant metastases are present
D) Has a primary tumor with invasion to adjacent tissues, positive regional lymph involvement, and no metastases
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Q1) The human immunodeficiency virus (HIV)can be transmitted through all but which of the following means?
A) Unprotected sex with an infected partner
B) Infected blood transfusion
C) Intact skin-to-skin contact with an infected person
D) During the birth process from infected mother to infant
Q2) According to the Centers for Disease Control,which is the most common age group diagnosed with acquired immunodeficiency syndrome (AIDS)?
A) Under 15 years of age
B) Between 15 and 24 years old
C) Between 25 and 44 years old
D) Between 45 and 64 years old
Q3) What marks the difference between the diagnosis of HIV positive and the diagnosis of AIDS?
A) Presence of peripheral neuropathy
B) Presence of lymphadenopathy
C) Seroconversion with presence of the HIV
D) A CD4+ count below 200 and an AIDS-defining illness
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