Occupational Therapy Final Exam
Questions
Course Introduction
Occupational Therapy is a healthcare discipline focused on enabling individuals of all ages to engage in meaningful activities and daily tasks that support health, well-being, and quality of life. This course explores the foundational theories, assessment techniques, and intervention strategies used by occupational therapists to assist people with physical, mental, or developmental conditions. Students will learn how to evaluate clients needs, develop personalized treatment plans, and use therapeutic activities to enhance clients independence and participation in home, work, school, and community environments. The course emphasizes a holistic, client-centered approach and introduces students to ethical, cultural, and professional issues relevant to contemporary occupational therapy practice.
Recommended Textbook
Therapeutic Exercise Foundations and Techniques 7th Edition by Carolyn Kisner
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26 Chapters
512 Verified Questions
512 Flashcards
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Chapter 1: Therapeutic Exercise: Foundational Concepts
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Q1) Which of the following is a true statement about the components of the patient management model described in the Guide to Physical Therapist Practice?
A)Patient education is the one intervention that should be included for every patient throughout the entire episode of care.
B)Goals and outcomes are synonymous terms.
C)A primary focus of the diagnostic process performed by physical therapists is the identification of pathology.
D)It is appropriate to discontinue a patient from an exercise program only when the patient has attained the goals stated in the initial plan of care.
Answer: A
Q2) Which of the following components of the ICF model is defined by the individual's life-style, education, and social and environmental backgrounds?
A)Risk factors for health conditions
B)Impairments in body function
C)Participation restrictions
D)Contextual factors
Answer: D
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3
Chapter 2: Prevention, Health, and Wellness
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Q1) Which of the following best describes the target audience for a program of physical activity designed for primary prevention of childhood obesity?
A)A group of morbidly obese children who have been diagnosed with type 2 diabetes
B)A group of mildly obese children who are identified as being "at risk" for type 2 diabetes
C)A group of mildly obese children
D)A group of sedentary children whose weight is within normal limits
Answer: D
Q2) You have designed and are directing an exercise class for individuals who have been diagnosed with high blood pressure.This type of program falls within the definition of which type of prevention?
A)Multifactorial prevention
B)Primary prevention
C)Secondary prevention
D)Tertiary prevention
Answer: C
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Chapter 3: Range of Motion
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Q1) The most effective and safe way to perform passive pronation and supination of the forearm is to:
A)Grasp the patient's hand around the metacarpals and perform ROM while maintaining the elbow in extension.
B)Grasp the patient's forearm just proximal of the wrist and perform ROM while maintaining the elbow in extension.
C)Grasp the patient's forearm just proximal of the wrist and perform ROM while maintaining the elbow in flexion.
D)Grasp the patient's hand around the metacarpals and perform ROM while maintaining the elbow in flexion.
Answer: C
Q2) During ROM of the cervical spine:
A)Avoid grasping the jaw.
B)Avoid extension past neutral (i.e., hyperextension).
C)Perform ROM while the patient is in an upright position (seated or standing).
D)Never combine flexion with rotation.
Answer: A
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Chapter 4: Stretching for Improved Mobility
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Q1) The glycosaminoglycans and water in the ground substance of connective tissue are important for connective tissue health because:
A)They bind the collagen fibers together, giving them their crystalline qualities.
B)They stimulate the elastic qualities in elastin.
C)They reduce friction and transport nutrients and metabolites.
D)They provide bulk to add strength to ligaments and tendons.
Q2) Which of the following is categorized as an extrinsic factor contributing to limited ROM?
A)Bony block
B)Inflammation of soft tissue
C)Paralysis
D)Cast immobilization after a fracture
Q3) To most effectively use the phenomenon of creep in a stretching routine:
A)The tissues should be warmed and the force (load) maintained as long as tolerated.
B)The force should be repeated in a cyclic manner.
C)A high-intensity, rapidly applied force should be used.
D)The force should be great enough to cause necking.
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Chapter 5: Peripheral Joint Mobilizationmanipulation
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Q1) In what way does mobilization with movement (MWM) differ from passive mobilization techniques? MWM:
A)Is appropriate for hypomobile or hypermobile joints.
B)Uses only joint distraction techniques to mobilize joints.
C)Integrates active movements by the patient during the mobilization procedure to reduce/eliminate the barrier of pain during the technique.
D)Is performed only in the midrange of available motion to ensure patient comfort.
Q2) Your patient had a cast removed last week following a distal tibiofibular fracture.He now has limited motion of the ankle and foot.Which of the following joint-mobilization techniques would you use to increase ankle dorsiflexion?
A)Dorsal glide of calcaneus on talus
B)Plantar glide of navicular on talus
C)Anterior glide of talus on tibia
D)Posterior glide of talus on tibia
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Chapter 6: Resistance Exercise for Impaired Muscle
Performance
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Q1) A patient is holding a piece of elastic tubing with both hands in front of the body.Both elbows are flexed to 90°, and both upper arms are held gently against the sides of the patient's chest.Instruct the patient to internally and externally rotate both shoulders simultaneously in this position.This activity strengthens the:
A)Internal rotators concentrically and eccentrically.
B)External rotators concentrically and the internal rotators eccentrically.
C)Internal rotators concentrically and the external rotators eccentrically.
D)External rotators concentrically and eccentrically.
Q2) Within 1 week of beginning resistance exercise of the shoulder external rotators as a component of a rehabilitation program after a shoulder injury, your patient, Mr.K, is able to increase the level of resistance by using a heavier grade of elastic tubing.This improvement in muscle performance is due primarily to which of the following adaptive changes?
A)Increased recruitment of motor units
B)Increased oxygen to the muscle
C)Hypertrophy of muscle fibers
D)Fiber-type transformation from slow twitch to fast twitch
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Page 8
Chapter 7: Principles of Aerobic Exercise
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Q1) Which of the following is correct about the intensity of exercise and achieving a conditioning response?
A)For a young, healthy individual, training at an intensity of 70% maximum heart rate is considered the maximum-level stimulus for a safe training program.
B)If an adult is young, healthy, and accustomed to exercise, training at 100% of the maximum heart rate is recommended to achieve a conditioning response.
C)For a sedentary, deconditioned individual, an initial training intensity at 70% of the maximum heart rate is the level of training typically required to achieve a conditioning response.
D)For a sedentary, deconditioned individual, low-intensity exercise at the 40% to 60% level is usually sufficient to induce an initial conditioning response.
Q2) If jogging for 20 minutes requires 50 units of work output and 200 units of work input, what is the exercise efficiency?
A)2%
B)2.5%
C)20%
D)25%
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Chapter 8: Exercise for Impaired Balance
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Q1) The most important neural structures for the integration and processing of sensory information for balance control are:
A)Basal ganglia, primary motor area, and cerebellum.
B)Basal ganglia, thalamus, and supplementary motor area.
C)Supplementary motor area, cerebellum, and basal ganglia.
D)Supplementary motor area, cerebellum, and thalamus.
Q2) The typical pattern of muscle activation associated with an ankle strategy to correct forward body sway is:
A)Gastrocnemius and hamstrings are activated simultaneously, followed by the paraspinals.
B)Gastrocnemius is activated first, then the hamstrings, followed by the paraspinals.
C)Paraspinals are activated first, then hamstrings, followed by the gastrocnemius.
D)Hamstrings, gastrocnemius, and paraspinals are activated simultaneously.
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Chapter 9: Aquatic Exercise
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Q1) Meyer and Leblanc provided an algorithm for clinical decision making for aquatic therapy intervention for patients with stable congestive heart failure and/or left ventricular dysfunction.All of the following are true in this algorithm except:
A)Patients with decompensated congestive heart failure should participate in aquatic exercise for cardiac rehabilitation.
B)Patients with left ventricular dysfunction should not rely on how they feel in the water as an indicator of tolerance for aquatic exercise.
C)Patients with congestive heart failure who tolerate sleeping supine may be able to tolerate a half-sitting position if immersion is not above the xiphoid process.
D)Patients with Q-wave myocardial infarcts should wait 6 weeks and exercise upright in a water level that does not exceed the xiphoid process.
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Chapter 10: Soft Tissue Injury, Repair, and Management
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Q1) Your patient reports having had a sudden onset of severe pain in the left posterior thigh yesterday while sprinting.Today he is unable to fully extend his left knee while walking because of pain.Which of the following interventions is most appropriate today?
A)Passive knee flexion/extension with the hip flexed to 90°
B)Passive knee flexion/extension with the hip positioned in 0° extension
C)Active knee flexion but no passive or active extension
D)Submaximal resisted knee flexion in the prone-lying position
Q2) What is the best method for determining the progression of exercise during the subacute stage of healing?
A)Increase range of motion 10° each treatment session
B)Increase strength training by 1 lb each treatment session
C)Increase endurance exercises by 3 repetitions each treatment session
D)Let patient response guide the progression of exercise
Q3) During the repair process following tissue injury, the newly developing collagen fibrils are:
A)Ready to withstand normal stresses by 3 weeks.
B)Slow to be deposited.
C)Laid down in alignment exactly replicating the fibers that were damaged.
D)Thin and unorganized.
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Page 12
Chapter 11: Joint, Connective Tissue, and Bone Disorders and Management
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Sample Questions
Q1) Your patient has osteoarthritis of the left hip and states he experiences hip and thigh pain after walking for more than 20 to 30 minutes.As a therapist, which of the following is the most appropriate intervention for you to recommend?
A)A period of complete rest or immobility
B)Application of heat and massage after periods of walking
C)Measures to decrease the mechanical stresses on the hip joint, such as use of a cane when walking over an extended period of time
D)Use of anti-inflammatory medication
Q2) A therapist's role in diagnosing arthritic conditions is to:
A)Identify the underlying pathological process and inform the physician.
B)Order laboratory tests or radiological imaging that may confirm or rule out the diagnosis.
C)Determine the type of arthritis that is causing the patient's symptoms.
D)Identify impairments, such as the pattern and extent of range of motion (ROM) and joint mobility limitations, contributing to a patient's activity limitations and participation restrictions.
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13
Chapter 12: Surgical Interventions and Postoperative Management
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Q1) Synovectomy, when used, typically is indicated for:
A)Long-standing osteoarthritis.
B)Tear of a joint capsule as the result of trauma.
C)Rheumatoid arthritis.
D)Postimmobilization arthritis.
Q2) You are part of a team presenting a preoperative education program for a group of patients scheduled to undergo total knee or hip replacement during the next month at a large medical center where you are employed.As a therapist, you most likely would be responsible for presenting information on each of the following topics except:
A)An explanation and demonstration of exercises a patient is expected to do the day of or after surgery.
B)An explanation of early postoperative precautions, such as weight-bearing restrictions or safe and unsafe positioning.
C)An explanation of the administration of postoperative pain medication, such as patient-controlled analgesics.
D)Use of assistive devices, such as a walker or crutches, for early ambulation.
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14
Chapter 13: Peripheral Nerve Disorders and Management
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Sample Questions
Q1) Your patient describes total numbness in the tips of the index and middle fingers that has been there for 2 months.Four months ago, he sustained a Colles' fracture.While immobilized in a cast, he had experienced periods of intermittent numbness and pain.You observe atrophy in the thenar eminence and ape hand deformity.This patient most likely sustained:
A)Mild compression of the median nerve and has excellent prognosis for full recovery.
B)Laceration of the median nerve with complete interruption; there is no chance of neurological recovery.
C)Chronic compression of the median nerve; there is a guarded prognosis; may require surgical intervention.
D)A stretch injury to the median nerve with adhesions preventing normal mobility; gentle nerve mobilization should alleviate the symptoms.
Q2) The pain associated with CRPS characteristically is:
A)Entirely psychogenic and responsive to antidepressants.
B)Intermittent and related to body and head position.
C)Out of proportion to the report of history of injury or precipitating event.
D)Always responsive to modalities, primarily cold and electrical stimulation.
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Page 15
Chapter 14: The Spine: Structure, Function, and Posture
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Sample Questions
Q1) The spinal muscles that are activated first with rapid arm movements are the:
A)Erector spinae and rectus abdominis.
B)Internal and external obliques.
C)Multifidus and internal obliques.
D)Transversus abdominis and multifidus.
Q2) A sustained faulty posture that stresses the ligamentous or joint structures usually results in:
A)Diffuse pain that is relieved when the mechanical stress is stopped.
B)Diffuse pain that is relieved with pain medication, modalities, and massage
C)Sharp pain that cannot be relieved until the tissue heals.
D)Sharp pain that changes in intensity as the posture changes.
Q3) The difference between a lordotic posture and a slouched posture is:
A)Only the lordotic posture has lumbar lordosis.
B)Flexion in both the upper lumbar and lower thoracic spine occurs with the slouched posture.
C)Extension of the pelvis on the femurs occurs with the lordotic posture.
D)There is no difference; both affect the pelvis and lumbar spine the same way.
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16
Chapter 15: The Spine: Management Guidelines
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Q1) All of these are reasons to assess the thoracic spine during evaluation of patients who present with cervical spine dysfunction except:
A)The thoracic spine becomes unstable with pain and soft tissue dysfunction in the cervical spine.
B)The thoracic spine is prone to hypomobility.
C)There are common muscle attachments between the cervical and thoracic areas.
D)Joint manipulation performed along with high-velocity thrust of the thoracic spine often improves outcomes in patients with cervical complaints.
Q2) The vertebral arteries:
A)Are protected in positions of extreme cervical extension.
B)Cause tension headaches when they are occluded.
C)Are compromised with severe TMJ dysfunction.
D)Enter the transverse foramen of C6 bilaterally in their course to C1.
Q3) Scheuermann's disease:
A)Is a rheumatic disorder.
B)Results from weakened vertebral end-plates.
C)Begins with radicular signs that diminish over time.
D)Requires functionally increasing the lumbar lordosis to prevent development of kyphosis.
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Page 17
Chapter 16: The Spine: Exercise and Manipulation
Interventions
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Q1) Your patient describes frequent headaches, especially when working at her computer, which get progressively worse during the day.The following limitations in motion are noted: capital flexion, lower cervical extension, cervical side bending, and lateral rotation of the shoulders.Use of a pressure cuff to test control of capital flexion shows the ability to maintain an increase in pressure of 8 mm Hg for 3 seconds.She is not able to lie prone and perform axial extension by lifting her forehead off the table.All of the following would be appropriate methods for initiating your interventions except:
A)Gentle manual traction to the suboccipital region followed by passive capital flexion to increase flexibility.
B)Training of deep cervical flexors to maintain capital flexion for 10-second holds, using a pressure cuff for feedback.
C)Prone-lying axial extension with the head over the end of the table, holding for 10 seconds at a time.
D)Supine lying with a foam roller placed longitudinally under the spine and head, allowing the shoulders to roll outward into external rotation.
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Page 18
Chapter 17: The Shoulder and Shoulder Girdle
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Q1) Each of the following is correct about precautions that should be taken after repair of a full-thickness rotator cuff tear associated with chronic impingement except:
A)After a traditional open repair for a massive cuff tear, postpone active ROM exercises until about 2 weeks postoperatively to avoid avulsion of the deltoid that was detached and reattached during the procedure.
B)When the patient is lying in the supine position during the early postoperative days, place a folded towel under the humerus to position the arm slightly anterior to the frontal plane of the body to minimize anterior translation of the head of the humerus and the potential for impingement.
C)Before initiating active elevation of the arm in the sitting or standing position, restore strength in the rotator cuff muscles, especially the supraspinatus and infraspinatus muscles, to prevent superior translation of the head of the humerus during active elevation of the arm.
D)Delay weight-bearing/closed-chain exercises on the operated upper extremity for about 6 weeks.
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Page 19
Chapter 18: The Elbow and Forearm Complex
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Q1) You are modifying a home exercise program for a patient recovering from an episode of medial epicondylitis.Although pain has subsided, there is evidence of mild limitation of motion and pain when the involved muscle-tendon unit is placed on a stretch and overpressure is applied at the end of the available ROM.To fully lengthen the muscle-tendon unit typically involved in medial epicondylitis, have the patient perform a self-stretch by using the opposite hand to:
A)Flex and ulnarly deviate the wrist and flex the fingers while the elbow is extended and the forearm is pronated.
B)Flex and radially deviate the wrist and flex the fingers while the elbow is extended and the forearm is supinated.
C)Extend and ulnarly deviate the wrist and extend the fingers while the elbow is extended and the forearm is pronated.
D)Extend and radially deviate the wrist and extend the fingers while the elbow is extended and the forearm is supinated.
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Chapter 19: The Wrist and Hand
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Q1) Your patient has a 5-year history of RA.There are no obvious deformities, but during this current exacerbation of the disease, the wrist and MP joints are swollen, red, tender, and warm.There is generally decreased range of motion (ROM), pain during joint motion, and increased pain at the end of the available range of each joint.An appropriate short-term goal and intervention is:
A)Minimize deforming forces by maintaining ROM with gentle, passive stretching to the involved joints.
B)Maintain joint mobility and decrease pain by using grade I or II joint-oscillation techniques.
C)Increase muscle length by using contract-relax (hold-relax) techniques.
D)Control pain by imposing continuous rest and using orthoses on the wrists and hands.
Q2) Prerequisites for successful PIP arthroplasty include all of the following except:
A)Adequate bone stock.
B)No history of chronic synovitis.
C)Intact neurovascular system.
D)Functioning flexor/extensor mechanism.
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21
Chapter 20: The Hip
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Sample Questions
Q1) Your patient had a total hip replacement 3 days ago and will be discharged from the hospital tomorrow.Your home instructions should include, but are not limited to, each of the following except:
A)Avoid moving the hip past midline when moving in bed; do not cross your legs.
B)Perform ankle-pumping exercises on a regular basis throughout the day with the legs elevated.
C)Perform assisted, progressing to active, ROM exercises of the hip and knee within protected ranges.
D)Whenever possible, perform transfers toward the operated side.
Q2) The clinical prediction rule for the diagnosis of osteoarthritis of the hip developed by Sutlive and colleagues includes consideration of all of the following variables except:
A)Self-reported squatting aggravates symptoms.
B)Walking more than one block causes groin and anterior thigh pain.
C)Passive internal rotation is less than or equal to 25°.
D)Scour test with adduction causes lateral hip or groin pain.
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22
Chapter 21: The Knee
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Q1) Your patient has only 50° of passive and active knee flexion (but full passive extension) 2 weeks after removal of a cast for a fracture of the tibia.The bone is now radiologically healed.Each of the following techniques will be of value to increase the range of knee flexion except:
A)The hold-relax technique, with isometric contraction of the hamstrings with the knee at 45°, followed by relaxation, then passive movement into more flexion.
B)Low-load, long-duration self-stretching of the quadriceps.
C)Posterior glide of the tibia.
D)Caudal glide of the patella.
Q2) You are seeing a patient to initiate exercises 5 days after reconstruction of the ACL with a patellar tendon autograft.During the first phase of the postoperative exercise program, your primary concern is:
A)Preventing contractures at the knee.
B)Preventing atrophy and reflex inhibition of the quadriceps.
C)Imposing controlled loads on the knee while protecting the graft from excessive stresses.
D)Preventing joint swelling.
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Page 23
Chapter 22: The Ankle and Foot
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Q1) Your patient has RA and is complaining of pain in her ankles and feet when walking.You observe her gait and notice short steps and poor push-off.This is consistent with what deformity in RA?
A)Everted calcaneus and pronated forefoot
B)Inverted calcaneus and pronated forefoot
C)Everted calcaneus and supinated forefoot
D)Inverted calcaneus and supinated forefoot
Q2) A patient underwent a triple arthrodesis of the hindfoot 12 weeks ago and is now allowed to ambulate without the rigid boot.The patient has been referred to you for exercises to improve ROM and strength of the operated lower extremity and to re-establish a normal gait pattern.Which of the following interventions is inappropriate to include in your treatment plan to restore this patient's function?
A)Passive stretching of the plantar flexors
B)Grade III medial and lateral sustained glides to increase inversion and eversion
C)Grade III sustained posterior glides of the talus on the tibia to increase dorsiflexion
D)Closed-chain training to improve lower extremity control
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24
Chapter 23: Advanced Functional Training
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Q1) Your patient is in the return-to-function phase of rehabilitation after recovering from a sprained ankle.She wants to be able to resume her hobby of extensive gardening and yard work.Which of the following combinations of progressions for balance describes less to more difficult activities?
A)Stationary to moving surface, wide-base to narrow-base stance, high-magnitude to low-magnitude perturbations
B)Bilateral to unilateral stance, firm surface to soft surface, slow- to high-speed repetitions
C)Narrow-base to wide-base stance, bilateral to unilateral activities, small- to large-range motions
D)Single leg to tandem stance, open environment to closed environment, unresisted to resisted movements
Q2) Each of the following describes the concept and/or mechanism of plyometrics except:
A)High-velocity eccentric to concentric muscle loading.
B)Stretch-strengthening drills.
C)Stretch-lengthening drills.
D)Reactive neuromuscular training.
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25
Chapter 24: Exercise in the Older Adult
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Q1) Your patient has type 2 diabetes mellitus and is on insulin.He arrives at 9 a.m.for a 1-hour resistance, aerobic, balance, and flexibility program under your supervision.You inquire whether he has checked his glucose level this morning and he indicates that it was 100 mg/dL.What decision do you make about his treatment today?
A)No exercises can be performed; reschedule him for tomorrow.
B)Call the emergency medical service because his condition is unstable.
C)Proceed with exercises while monitoring his tolerance and provide a carbohydrate snack and fluids to assure hydration.
D)Use this day to advance his program to the next level, challenging him with high-intensity, progressive activities
Q2) Abnormally diminished muscular function or mobility experienced by many older adults in the old-old stage of life is defined as:
A)Hypokinesis.
B)Secondary aging.
C)Senescence.
D)Sarcopenia.
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Chapter 25: Womens Health: Obstetrics and Pelvic Floor
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Q1) Which of the following statements adequately represents aerobic exercise guidelines for a woman during an uncomplicated pregnancy?
A)Continue exercise at levels prior to pregnancy with the understanding that a lower intensity of exercise results in the same level of exertion.
B)Limit exercise to three times a week at a target heart rate during exercise based on a conventional age-based calculation.
C)Women who have not been exercising prior to pregnancy should wait for 3 months after delivery to begin an exercise program.
D)If a woman has exercised prior to pregnancy, all types of exercise can be continued throughout pregnancy, including those with ballistic end-range movements and rapid changes of direction.
Q2) Each of the following is a normal change during pregnancy except:
A)Increased secretion of insulin.
B)Decreased ligamentous stability.
C)Decreased resting heart rate.
D)Increased thyroid activity.
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Chapter 26: Management of Lymphatic Disorders
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Q1) As part of the patient evaluation, you perform tests and measures to document your findings in a standard and objective way.You document a positive Stemmer sign when you find which of the following?
A)There is tenderness of the lymph nodes on palpation.
B)Skin on the dorsum of the fingers could not be pinched.
C)Skin is shiny and red.
D)Viscous fluid is weeping from the skin.
Q2) Which of the following factors associated with breast cancer surgery and adjuvant therapy is least likely to contribute to impaired shoulder mobility?
A)Incisional pain
B)Chemotherapy
C)Fibrosis of tissues in the axillary area as the result of radiation therapy
D)Increased thoracic kyphosis related to incisional pain or age
Q3) Which of the following is a true statement about lymphedema?
A)It is a disease of the lymphatic system.
B)It occurs when the transport capacity exceeds the lymphatic load.
C)It consists primarily of water and protein found in the extracellular spaces.
D)It is a natural immune response to trauma and initially is beneficial during the early phases of healing.
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