Occupational Therapy for Physical Dysfunction
Exam Answer Key
Course Introduction
This course examines the fundamental principles and therapeutic techniques used in occupational therapy for individuals with physical dysfunction. Students will explore the assessment and intervention strategies aimed at improving functional independence, mobility, and quality of life in various populations affected by physical impairments such as neurological, musculoskeletal, and orthopedic conditions. Emphasis is placed on client-centered practice, adaptive approaches, and evidence-based interventions to enable participation in meaningful daily activities. Through lectures, case studies, and hands-on experiences, learners will develop essential skills for evaluating needs, setting goals, designing treatment plans, and collaborating within interdisciplinary healthcare teams.
Recommended Textbook
Pedrettis Occupational Therapy Practice Skills for Physical Dysfunct
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51 Chapters
444 Verified Questions
444 Flashcards
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Chapter 1: The Occupational Therapy Practice Framework
and the Practice of Occupational Therapy for People With
Physical Disabilities
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Sample Questions
Q1) The Framework refers to activities that are oriented toward interacting with the environment and are generally optional (may be delegated to another)as which of the following?
A) Activities of daily living (ADLs)
B) Instrumental activities of daily living (IADLs)
C) Performance skills
D) Areas of occupation
E) Context
Answer: B
Q2) The subcategories of care of pets,home management,and shopping are included in which area of occupation?
A) Education
B) Social participation
C) Leisure
D) IADLs
E) ADLs
Answer: D
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Chapter 2: The Occupational Therapy Practice Framework
and the Practice of Occupational Therapy for People With
Physical Disabilities
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5 Verified Questions
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Sample Questions
Q1) The OT practitioner observed a client playing a game of cards.During the game the client looped one elbow around the upright of her wheelchair,leaned toward the table,and grasped a card before going across the room to answer a phone call.The actions observed are primarily an example of which of the following?
A) Process skills
B) Performance patterns
C) Communication/interaction skills
D) Motor skills
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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Chapter 3: History and Practice Trends in Physical
Dysfunction Intervention
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Sample Questions
Q1) In the interactional or sociopolitical model,disability is defined not only by the physical qualities of the individual but also by the corresponding response of which of the following?
A) Therapist
B) Social environment
C) Piece of adaptive equipment
D) Physician
E) Object used for therapy
Answer: B
Q2) Under AOTA's Occupational Therapy Practice Framework,the focus on occupation-based treatment that is both holistic and humanistic reflects which treatment model or approach?
A) Arts and Crafts movement
B) Moral treatment
C) Social model
D) Medical model
E) Rehabilitation model
Answer: B
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Chapter 4: Application of the Occupational Therapy
Practice Framework to Physical Dysfunction
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Q1) There are several forms of clinical reasoning.Which statement best fits the concept of pragmatic reasoning?
A) This form of reasoning provides a connection between the client's identified problems and the interventions provided, sometimes referred to as critical pathways.
B) This form of reasoning is primarily concerned with the interactions between the client and the therapist, with a focus on understanding the client's point of view.
C) This form of reasoning is focused on the client's explanation or description of the disability experience and how that affects therapeutic interventions.
D) This form of reasoning considers the external demands of the intervention setting, financial resources, and the client's potential discharge placement.
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6
Chapter 5: Evidence-Based Practice for Occupational Therapy
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Q1) Which of the following statements is false?
A) It is an ethical obligation of occupational therapy (OT) professionals to collaborate with clients regarding their service need, provision, risk, and outcome.
B) Systematic OT practice (SOTP) steps are similar to the OT process.
C) Evidence is information used to support a claim.
D) Thinking processes involve the selection of the theoretical framework to be used to assess problems and plan strategy.
E) Inductive reasoning begins with a theory and reduces the theory to its parts, which are then verified through examination with experimental-type research.
Q2) 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
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7
Chapter 6: Health Promotion and Wellness for People With Physical Disabilities
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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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8
Chapter 7: Documentation of Occupational Therapy Services
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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 of the following statements is not correct?
A) Computerized documentation is becoming more common.
B) Computerized documentation can be used to record all aspects of the OT process from the evaluation report to the discharge report.
C) All documentation must be computerized.
D) Computerized documentation guarantees legibility and helps ensure that no areas are left uncompleted.
Q3) Which of the choices below is not true of skilled services?
A) They require analysis and modification of functional tasks.
B) They include provision of instructions to the client, family, or caregivers.
C) Evaluation is a skilled service.
D) No revising or readjusting of the program is necessary.
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Page 9
Chapter 8: Documentation of Occupational Therapy Services
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Q1) 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.
Q2) What is the best reason to explain why leaving client charts out in plain view,where others can read the information,is wrong?
A) This is a violation of privacy standards mandated by the Health Insurance Portability and Accountability Act (HIPAA).
B) Food or beverages could be spilled on the charts.
C) They might be accidentally thrown away.
D) The client might see it.
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Chapter 9: Infection Control and Safety Issues in the Clinic
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Q1) During cardiopulmonary resuscitation (CPR),chest compressions are performed to facilitate circulation of blood.Correct procedures for chest compressions include providing firm downward pressure directly over the inferior portion of the sternum and
A) Depressing the chest approximately 1 inch with each compression
B) Depressing the chest approximately 1 to 1.5 inches with each compression
C) Depressing the chest approximately 1.5 to 2 inches with each compression
D) Depressing the chest approximately 2 to 2.5 inches with each compression
Q2) 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
Q3) A nosocomial infection is ___________.
A) Bacterial
B) Viral
C) Transmitted via bodily fluids
D) Acquired in the hospital
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Chapter 10: Infection Control and Safety Issues in the Clinic
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3 Verified Questions
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Sample Questions
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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12
Chapter 11: Activities of Daily Living
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Q1) 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
Q2) Which of the following is an example of an instrumental ADL (IADL)?
A) Care of others
B) Functional mobility
C) Toilet hygiene
D) Bowel and bladder management
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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13
Chapter 12: Activities of Daily Living
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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) Stabilizing an extremity to reduce incoordination to enable a client to perform activities of daily living (ADLs)is a common practice for clients with which of the following conditions?
A) Rheumatoid arthritis
B) Central nervous system (CNS) disorders
C) Temporary orthopedic disorders such as fractures
D) Quadriplegia
Q3) The most commonly used methods to teach clients who have perceptual problems,poor memory,and difficulty following directions include all but which of the following?
A) Brief demonstration and oral instruction
B) Concrete step-by-step approach and instruction
C) Backward chaining
D) Activity performance along with the therapist
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Chapter 13: Mobility
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Sample Questions
Q1) Which of the following is not a component of proper body mechanics used by the therapist when transferring clients?
A) Maintain a wide base of support.
B) Stand close to the client.
C) Use your back rather than your legs.
D) Maintain a neutral spine position.
Q2) What type of wheelchair should be recommended to maximize independence in mobility in the individual who has good cognitive and perceptual skills but very poor endurance and significant physical impairment of the upper and lower extremities?
A) Hemiplegia-style manual wheelchair
B) Lightweight manual wheelchair
C) Power wheelchair
D) Reclining wheelchair
Q3) 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
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Page 15
Chapter 14: Mobility
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Sample Questions
Q1) You are an occupational therapist,and your client is a 69-year-old man with left hemiplegia from a cerebrovascular accident.Your client has normal movement on his right side.He has a little movement in his left leg but none in his left arm.He has fair sitting balance but needs significant assistance to maintain a standing position.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) Two-person dependent transfer
Q2) 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
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Page 16
Chapter 15: Work Evaluation and Work Programs
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Q1) Which one of these risk factors is not usually included on an ergonomics checklist used by the ergonomics team?
A) Repetitions of task
B) Lunch break and break times
C) Use of vibration
D) Employee pay scale and benefits
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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Chapter 16: Work Evaluation and Work Programs
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Q1) As the OT consultant on a corporation's ergonomics team,you notice increased incidence of work-related musculoskeletal disorders in workers in the payroll department.What do you present to your team to increase awareness of the problem and generate possible solutions?
A) The names of all the employees with injuries in the past year
B) A summary of the scope of injuries in that focused area and the effects on production, workers' compensation, and associated costs to the company
C) A suggestion for an aggressive company-wide education program involving all employees
D) A suggestion that all the injured workers complain to management
Q2) A factory worker on an assembly line has been referred to occupational therapy (OT)for treatment of his right biceps tendonitis,which is prohibiting him from performing at a productive level because of his high pain levels.What risk factor must be closely assessed in a job analysis?
A) Cold temperatures
B) Vibration
C) Repetitions of tasks within a time period
D) Contact stress
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Chapter 17: Americans With Disabilities Act and Related
Laws That Promote Participation in Work, leisure, and
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Q1) JD has a medical history of fibromyalgia,which she has disclosed to her employer.She is independent in all of her activities of daily living (ADLs)and instrumental ADLs (IADLs),including her work tasks; however,she has requested to take rest breaks at specific times during the day (these do not interfere with her ability to complete her work assignments).She is an exemplary employee,but her employer has consistently passed her over for promotions and does not offer her the more challenging assignments.Which definition of a person with a disability under the Americans with Disabilities Act (ADA)best describes JD?
A) Physical or mental impairment that substantially limits one or more major life activities
B) Someone who has a record of having an impairment that limits at least one life activity
C) Someone with a "perceived" disability
D) She would not be considered to have a disability.
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19
Chapter 18: Leisure Occupations
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Q1) Which of the following age and culture-based activities would an OT practitioner assign to a 55-year-old Asian American woman who is recovering from a stroke?
A) Needlepoint
B) Adapted bowling
C) Swimming
D) Tile games (such as Mah Jong)
E) None of the above
Q2) An occupational therapist is working with a 67-year-old Latina client with rheumatoid arthritis.The client has minimal English-speaking abilities.Which assessment(s)do you think would be appropriate?
A) Occupational Profile
B) Canadian Occupational Performance Measure
C) Modified Interest Checklist
D) Role Checklist
E) All of the above
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20
Chapter 19: Americans With Disabilities Act and Related
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Sample Questions
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) The Air Carrier Access Act of 1986 (ACAA)prohibits discrimination against people with disabilities by air carriers.However,airlines may exclude someone from flying if
A) The person's disability results in an appearance that would offend someone
B) There is a risk of affecting the safety of the flight
C) There are other people with disabilities on the flight already and the staff would be inconvenienced
D) They did not give prior notice of special needs to preboard
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Chapter 20: Leisure Occupations
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Q1) Jeri's story was used as the case study in the Leisure Occupations chapter.Jeri was described as a 29-year-old,newly married woman who was in a traffic accident that resulted in a traumatic head injury,a broken wrist,and a broken leg.Before the accident she enjoyed scrapbooking,going to the nearby lake to boat and fish,playing with and caring for her dogs,and shopping.Jeri continues rehabilitation as an outpatient for the residual problems resulting from her head injury as well as for continuing problems using her dominant hand because of the healed wrist fracture (cast removed 2 weeks ago).She needs minimal assistance for safety because of poor balance and decreased judgment.Which intervention would be the best occupational therapy choice to assist her in engaging in her favorite leisure occupations?
A) A large button switch to listen to music
B) Use of adapted scissors to cut shapes that were glued to sturdy paper
C) Instruction in the using a rocker knife with her nondominant hand to cut meat
D) Teaching her to ride a hand-cycle racing bike
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Chapter 21: Occupation-Based Functional Motion Assessment
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Q1) 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
Q2) Which of the following cannot be assessed using the occupation-based functional motion assessment?
A) Motor control
B) Sensation
C) Range of motion (ROM)
D) Muscle strength
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23
Chapter 22: Joint Range of Motion
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Q1) When ROM of forearm supination is being measured,where is the stationary bar of the goniometer placed?
A) Parallel to the radius
B) Against the volar aspect of the wrist
C) Parallel to the floor
D) Against the dorsal aspect of the wrist
E) Perpendicular to the floor
Q2) Which of the following is not a purpose of joint ROM measurements?
A) Determine the need for splints or assistive devices
B) Determine joint limitations that interfere with function
C) Determine how many pounds a client may lift
D) Determine efficacy of intervention modalities
E) Determine how far a client can reach overhead
Q3) When joint motion is limited by the length of a muscle that crosses two joints,it is called ________________.
A) Passive instability
B) Joint stiffness
C) Passive insufficiency
D) Joint weakness
E) Joint shortening
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Chapter 23: Joint Range of Motion
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Q1) An OT practitioner is evaluating a 58-year-old client who sustained a stroke that resulted in hemiplegia of his right arm 3 months ago.While beginning to assess ROM,the therapist observes that the client's right wrist and hand are swollen and tender.The client reports having fallen in his bedroom the previous day.With regard to the wrist and hand,the therapist should do which of the following?
A) Measure active ROM and passive ROM.
B) Measure passive ROM only.
C) Measure active ROM only.
D) Defer measurements until a later time.
Q2) An occupational therapy (OT)practitioner is evaluating a 14-year-old client who sustained metacarpal fractures of her left ring and small fingers during a gymnastics competition.The fractures were treated with cast immobilization that ended last week.The OT practitioner should establish what normal range of motion (ROM)is for this client by doing which of the following?
A) Looking up published normative data
B) Measuring the client's right hand
C) Comparing the client with other clients who had similar injuries
D) Asking the physician what the expected ROM is
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Chapter 24: Evaluation of Muscle Strength
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Q1) 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
Q2) What is the best way to eliminate substitutions during MMT?
A) To perform the test in several different positions
B) To refrain from stabilizing so the client can move more freely
C) To observe the motion
D) To palpate contractile tissues
E) To allow extraneous motion
Q3) Which of the following is not a contraindication for MMT?
A) Joint hypermobility
B) Joint dislocation
C) Unhealed fracture
D) Bone carcinoma
E) Recent musculoskeletal surgery
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26
Chapter 25: Evaluation of Muscle Strength
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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 occupational therapy (OT)practitioner is testing a client's wrist flexion strength.The client is able to flex the wrist to 50 degrees against gravity.What should the therapist do next in the assessment?
A) Apply resistance.
B) Reposition the client to test in the gravity-minimized plane.
C) Assist the client into full wrist flexion and then apply resistance.
D) Flex the wrist passively to assess available range of motion.
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Chapter 26: Evaluation of Sensation and Intervention for Sensory Dysfunction
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Q1) 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
Q2) 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
Q3) Why is stereognosis important for hand function?
A) Without stereognosis our hands would not be able to sweat.
B) Without it we could not discriminate cold from hot.
C) Without it we could not identify an item with our vision occluded.
D) Without it we could not discern sharp items from dull items.
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Chapter 27: Evaluation of Sensation and Intervention for Sensory Dysfunction
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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) Superficial fine touch receptors include which of the following?
A) Pacinian corpuscles
B) Ruffini's corpuscles
C) Meissner's corpuscles
D) Golgi tendon organs
Q3) Nociceptors _________________.
A) Are a subset of receptors that sense pain when stimulated
B) Interpret temperature changes
C) Are a subset of receptors that relieve pain when stimulated
D) Are involved in the sense of pleasure
Q4) Semmes-Weinstein Monofilaments are used to test __________.
A) Sharp-dull
B) Proprioception
C) Pressure threshold
D) Sweating responses
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Chapter 28: Eating and Swallowing
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Q1) An individual who has moderate to severe oral stage dysphagia and who has a reduced ability to protect the airway would benefit from beginning oral feedings with which food consistency?
A) Puréed (Level 1)
B) Mechanically soft (Level 2)
C) Dysphagia advanced (Level 3)
D) Only thin liquids
Q2) 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
Q3) 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
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Chapter 29: Evaluation and Treatment of Visual Deficits
Following Brain Injury
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Q1) Colonel Pickle sustained a right posterior cerebral artery lesion.After the stroke the Colonel experienced difficulty reading and would often lose his place in the text or find that the sentence he was reading did not make sense.He also experienced a change in depth perception wherein an object,usually the arm of a chair or a table edge on the left,would suddenly appear in front of him.The Colonel scheduled an evaluation with his ophthalmologist.Which of the following diagnoses did the ophthalmologist most likely make?
A) Glaucoma
B) Presbyopia
C) Left homonymous hemianopsia
D) Hemi inattention
Q2) Why might changes in visual processing cause a corollary change in cognitive performance?
A) Because the visual system is the primary system we use to acquire information about our environment and guides our decision making process
B) Because the visual system provides us with good acuity
C) Because the visual system allows us to identify objects in our environment
D) Because the visual system gives us the "big picture"
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Chapter 30: Evaluation and Pain Management
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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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Page 32
Chapter 31: Evaluation and Pain Management
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Q1) During an intervention session for Catalina's low back pain,the occupational therapist does which of the following?
A) Increases the activity levels quickly to promote muscle strengthening
B) Tells Catalina to initiate rest at the time of the pain onset during activities
C) Gradually increases activity levels, with Catalina working to "tolerance" as opposed to "pain," before a scheduled rest break
D) Applies modalities (e.g., heat or cold) after activity
Q2) 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
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Chapter 32: Orthotics
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Q1) 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.
Q2) An OT is working with a client experiencing upper extremity weakness from a spinal cord injury.The client wants to be able to use her arm to drive a power wheelchair.The therapist has set up a MAS,but the client is having difficulty horizontally abducting her shoulder enough to reach the joystick control.Which adjustment can the therapist make to facilitate this motion?
A) Roll the semireclining mount outwardly.
B) Pitch the semireclining mount toward the rear of the wheelchair.
C) Lower the semireclining mount on the wheelchair upright.
D) Move the rocker arm more proximally on the forearm support.
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Chapter 33: Orthotics
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Q1) 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
Q2) Clients with which condition would likely not be appropriate candidates for an MAS?
A) Cervical spinal cord injury
B) Cerebral palsy
C) Poliomyelitis
D) Muscular dystrophy
E) Guillain-Barré syndrome
Q3) Splints applied after a surgical procedure may require all but which of the following?
A) Frequent adjustments because of edema changes
B) Frequent adjustments because of bandage changes
C) Splinting materials without memory
D) Adaptations for surgical wound sites
E) Preferences of the surgeon
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Chapter 34: Traditional Sensorimotor Approaches to Intervention
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Q1) Which statement about relaxation techniques is inaccurate?
A) Contract-relax is used when no active range of motion in the agonist pattern is present.
B) Hold-relax involves an isometric contraction of the antagonist, followed by relaxation and then active movement in the agonistic pattern.
C) Rhythmic rotation is ineffective in decreasing spasticity and increasing range of motion.
D) Slow-reversal-hold relax is preferred when the client has the ability to move the agonist actively.
Q2) Which of the following techniques,using the Rood approach,is not an inhibitory technique?
A) Neutral warmth
B) Slow stroking
C) Light joint compression
D) Fast rocking/vestibular stimulation
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Chapter 35: Degenerative Diseases of the Central Nervous System
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Q1) What are the three classic clinical symptoms of Parkinson's disease?
A) Resting tremor, spasticity, rigidity
B) Resting tremor, impaired voluntary movement, rigidity
C) Spasticity, impaired postural reflexes, decorticate posture
D) Spasticity, choreiform movements, impaired postural reflexes
Q2) 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
Q3) Which form of multiple sclerosis is the most common and features repeated episodes in which the client has a loss of function and then the function returns?
A) Secondary-progressive
B) Primary-progressive
C) Relapsing-remitting
D) Progressive-relapsing
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Page 37
Chapter 36: Cerebrovascular Accident Stroke
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Q1) 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
Q2) Sequencing and timing are considered in which Framework section?
A) Performance skills
B) Performance patterns
C) Context
D) Activity demands
E) Client factors
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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Chapter 37: Spinal Cord Injury
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Q1) The occupational therapist can help achieve the desired flexor tightness necessary for tenodesis grasp by doing which of the following?
A) Ranging finger flexion with the wrist extended and finger extension with the wrist flexed
B) Ranging finger flexion with wrist flexed and finger extension with wrist extended
C) Ranging finger flexion with wrist at neutral and extension with wrist extended
Q2) For the person with C6 quadriplegia,it is desirable to develop some tightness in the long finger flexors because _____________________.
A) The tightness of the finger flexors, combined with active wrist flexion, can produce some functional grasp through tenodesis action
B) The tightness of the finger flexors, combined with active wrist extension, can produce some functional grasp through tenodesis action
C) The tightness of the finger flexors combined with weak but active wrist flexion can produce a functional hook grasp
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Chapter 38: Spinal Cord Injury
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Q1) While you are treating Rick,he begins to grow pale and faint.According to the text,he is showing signs of _____ and you should _____.
A) Autonomic dysreflexia; elevate his legs
B) Postural hypotension; tip the wheelchair back
C) Autonomic dysreflexia; rush him to the ward and notify the physician
D) Postural hypotension; put his head down between his knees
Q2) When being trained to use the tenodesis wrist-hand orthosis or flexor hinge hand splint,Rick should be taught to perform palmar prehension by doing which of the following?
A) Flexing the wrist
B) Extending the wrist
C) Flexing the fingers
D) Extending the fingers
Q3) 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
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Page 40
Chapter 39: Disorders of the Motor Unit
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Q1) The motor unit is the elementary functional unit of the peripheral nervous system.What are its four elements?
A) The cell body of the motor neuron in the anterior horn of the spinal cord; the axon of the motor neuron, which travels via spinal nerves and peripheral nerves to muscle; the neuromuscular junction; and the muscle fibers innervated by the neuron
B) The spinal nerve, the peripheral nerve, the neuromuscular junction, and the muscle fibers
C) The cell body of the motor neuron in the posterior spinal cord, the dorsal root, the peripheral nerve, and the muscle fibers
D) The synaptic junction, the anterior spinal cord, the neuromuscular junction, and the muscle fibers
Q2) Which of the following is a disorder of the neuromuscular junction?
A) Postpolio syndrome
B) Muscular dystrophy
C) Guillain-Barré syndrome
D) Myasthenia gravis
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Chapter 40: Disorders of the Motor Unit
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Q1) 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
Q2) An occupational therapist is treating an 18-year-old man who has Duchenne muscular dystrophy.He has expressed fear and anxiety over his declining bodily functions.How might the therapist respond?
A) Help him and his family find meaningful activities in which to participate as individuals or as a family.
B) Encourage the use of humor and to play and laugh together.
C) Refer him for psychological counseling.
D) Refer him to a spiritual advisor.
E) All of the above.
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Chapter 41: Arthritis
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Q1) Avoiding MP ulnar deviation is an important joint protection principle in cases of rheumatoid arthritis.To open a jar,the patient should be instructed to do which of the following?
A) To open the jar using the palm of his or her hand
B) To use two hands and wall mount jar opener
C) To use shoulder rotation
D) A and B
E) All of the above
Q2) Rheumatoid arthritis is a systemic disease affecting the entire body,unlike osteoarthritis,which attacks individual joints.Osteoarthritis results in deterioration of the joint cartilage because of __________________.
A) Wear and tear on the joint
B) Genetic factors
C) Biomechanical, biochemical, and cellular events
D) Both A and B
E) All of the above
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Chapter 42: Arthritis
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Q1) A patient with osteoarthritis demonstrates a type III thumb deformity and reports pain with pinching activities.The therapist notices that there appears to be subluxation of the metacarpal during pinching,as noted by a bony enlargement at the base of the thumb.The splint should gently position the thumb opposite of the passively corrected deformity.With a type III deformity,the splint should gently place the thumb in which of the following?
A) CMC abduction, metacarpophalangeal (MP) joint slight flexion, and provide CMC stability to prevent subluxation
B) CMC joint adduction, MP extension, and provide CMC stability to prevent metacarpal subluxation
C) CMC abduction, interphalangeal (IP) flexion, and provide CMC stability to prevent metacarpal subluxation.
D) CMC flexion, IP extension, and provide CMC stability to prevent metacarpal subluxation
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44
Chapter 43: Hand and Upper Extremity Injuries
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Q1) 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
Q2) Explain why the tip of the thumb flexes when trying to grasp a piece of paper between the thumb and index finger in a client who has ulnar nerve paralysis.
A) Because the flexor pollicis longus substitutes for the absent adductor pollicis muscle
B) Because the extensor pollicis longus is absent in ulnar nerve injuries
C) Because the index flexor tendons are absent in ulnar nerve injuries
D) Because the thumb opponens pollicis is absent in ulnar nerve injuries
Q3) 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
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Chapter 44: Low Back Pain
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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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Chapter 45: Hand and Upper Extremity Injuries
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Q1) Which of the following is the most common injury to the wrist?
A) Colles' fracture
B) Scaphoid fracture
C) Lunate fracture
D) Pisiform fracture
Q2) 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
Q3) Which of the following is not a sympathetic response?
A) Sweating
B) Gooseflesh
C) Trophic changes (skin texture, nail and hair growth)
D) Tendon adherence
Q4) The volumeter is used to measure which of the following?
A) Strength
B) Girth
C) Hand volume (edema)
D) Sensation
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Chapter 46: Burns and Burn Rehabilitation
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Q1) The rehabilitation phase of burn recovery continues until ____________.
A) The client is medically stable
B) Wounds are closed
C) The patient goes home from the hospital
D) Scars are mature
E) The last surgery is performed
Q2) A burn scar typically matures in _____________.
A) 3-6 weeks
B) 6-12 weeks
C) 3-4 months
D) 8-12 months
E) 12-18 months
Q3) Which is true about a superficial partial thickness burn?
A) It corresponds to a traditionally classified second-degree burn.
B) It involves the superficial epidermis only.
C) Surgical intervention is required for healing.
D) It is not painful.
E) It is commonly caused by extended exposure to chemical agents.
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Chapter 47: Burns and Burn Rehabilitation
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Q1) An OT practitioner is treating a client with burns to the chest and upper extremities sustained 6 weeks ago.The client is exhibiting new stiffness and deep pain in the elbow at the end of elbow flexion range.The therapist suspects development of heterotopic ossification and should take which of the following actions?
A) Discontinue all elbow ROM until pain resolves.
B) Initiate dynamic elbow flexion splinting.
C) Have client perform active elbow ROM exercises within pain-free range.
D) Perform more aggressive passive stretching into elbow flexion.
Q2) An OT practitioner is evaluating a client whose primary complaint is the inability to raise her arm to reach high cabinets and shelves.The therapist notes a very tight mature scar band crossing the client's posterior axilla that is limiting full shoulder motion.What should the therapist do?
A) Initiate stretching exercises for shoulder flexion.
B) Explore assistive devices or compensatory strategies to reach items.
C) Fit the client with a clavicular strap.
D) A and
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49
Chapter 48: Amputations and Prosthetics
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Q1) 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
Q2) Which of the following is a Syme's amputation?
A) Ankle disarticulation
B) Above-knee
C) Below-knee
D) Through-knee
E) Transmetatarsal
Q3) What is the leading cause of lower extremity amputation?
A) Peripheral vascular disease (PVD)
B) Motor vehicle accidents
C) Gunshot wounds
D) Osteogenic sarcoma
E) Chronic infection
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Chapter 49: Amputations and Prosthetics
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Q1) 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
Q2) An OT practitioner is working with a client who had a unilateral below-knee amputation 2 weeks ago and wants to be able to resume living alone as soon as possible.To meet this goal,the therapist should:
A) Alter the client's preexisting performance patterns.
B) Encourage the client to focus on his former sense of self.
C) Discourage the client's independent process skills.
D) Adapt the client's activity demands.
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Chapter 50: Oncology
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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) Which of the following is a word for the process of cancer cells being carried to new sites in the body via the blood stream to develop new tumors?
A) Sarcomas
B) Malignancies
C) Lymphomas
D) Metastases
Q3) In cancer staging,the letter N refers to which of the following?
A) Lymph node involvement
B) Development of primary tumor
C) Invasion of adjacent tissues
D) Presence of known metastasis
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Chapter 51: HIV Infection and Aids
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Q1) A 37-year-old man was diagnosed with AIDS five years ago and was prescribed a variety of medications.His physician has recently changed the medication regimen.This man has been referred for an occupational therapy (OT)assessment to establish baseline occupational performance and instruct in energy conservation techniques.You know that clients diagnosed with AIDS may have neurological compromises and other complications secondary to the medications.What potential problems may be seen with this client?
A) Peripheral neuropathy, osteoarthritis, and depression
B) Memory difficulties, anemia, and hepatotoxicity
C) Gastrointestinal problems, pancreatitis, and osteopenia
D) All of the above
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
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