Physical Dysfunction Assessment and Intervention
Exam Preparation Guide
Course Introduction
This course provides an in-depth exploration of the principles and practices involved in assessing and intervening with individuals experiencing physical dysfunction. Students will develop skills in evaluating motor, sensory, and functional limitations using standardized assessment tools, while learning to design and implement evidence-based intervention strategies aimed at improving independence and quality of life. Emphasis is placed on client-centered, occupation-based approaches to rehabilitation across the lifespan and integrating the latest research findings into clinical practice. The course also addresses interdisciplinary collaboration and ethical considerations in physical rehabilitation settings.
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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Q1) Sequencing and timing are considered in which Framework section?
A) Performance skills
B) Performance patterns
C) Context
D) Activity demands
E) Client factors
Answer: D
Q2) 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
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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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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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Q1) 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
Q2) Which describes the founders of the field of occupational therapy (OT)?
A) They were all nurses.
B) They were all women.
C) They had a variety of professional backgrounds.
D) They all thought scientific management should be the foundation of OT.
E) They all worked as OT restoration aides in World War I.
Answer: C
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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 procedural 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) 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) What are the two kinds of objectives?
A) Reflexive and systematic
B) Process and outcome
C) Goals and causes
D) Downstream and upstream
E) Scientific and intuitive
Q3) Which of the following is a problem statement?
A) A type of intervention
B) A specific claim of what is not desired or what should be changed
C) A type of outcome assessment
D) Understanding what is needed to resolve all or part of the problem
E) Setting goals and objectives
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Chapter 6: Health Promotion and Wellness for People With Physical Disabilities
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Sample Questions
Q1) All of the following are examples of secondary preventive measures except:
A) Joint protection instruction
B) Energy conservation instruction
C) Ergonomic assessment and modification
D) Work simplification instruction
Q2) Which of the following statements accurately reflects international trends in health promotion concerning occupational justice?
A) The idea of occupational justice first emerged in Canada and Australia.
B) The World Federation of Occupational Therapists has been active in promoting occupational therapy (OT) involvement in occupational justice.
C) The discussion of occupational justice is slowly emerging in the United States.
D) All of the above.
Q3) Which assumptions guide health promotion OT service?
A) Client-centered care, empowerment, enablement
B) Client-centered care and client compliance with procedures
C) Client compliance with procedures and therapist expertise
D) All of the above
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Page 8
Chapter 7: Documentation of Occupational Therapy Services
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Q1) An occupational profile does not include information about the client's
A) Patterns of daily living
B) Occupational history and experiences
C) Values and interests
D) Needs
E) Past medical history
Q2) 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
Q3) Safety measures to prevent unauthorized persons from accessing client records include which of the following?
A) Requiring personal identification and user verification codes for access to records
B) Sharing login pass codes among staff
C) Working on notes from home
D) Leaving computer up and accessible in front of clients
Page 9
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Chapter 8: Documentation of Occupational Therapy Services
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Q1) Pick the best answer to explain what is wrong with using the following statement as the objective part of a note: "The client has decreased grip strength of the right hand,which limits his ability to open a jar."
A) It should be in the subjective portion of the note.
B) It does not state what interventions are planned.
C) It is not an objective measurement.
D) It is an interpretation of an objective measurement, rather than an objective measurement.
Q2) 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.
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Page 10
Chapter 9: Infection Control and Safety Issues in the Clinic
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Q1) The occupational therapist should observe several precautions when providing intervention to a client who is catheterized.Which of the following precautions are appropriate?
A) Avoid crimping or stretching the catheter drainage tube, and place the urine catheter bag below the level of the bladder.
B) Avoid crimping and stretching the catheter drainage tube, and place the urine collection bag in the client's lap.
C) Avoid crimping and stretching the catheter drainage tube, and place the urine catheter bag above the level of the bladder.
D) Avoid crimping and stretching the catheter drainage tube, and place the urine catheter bag in a location convenient for the client.
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
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11
Chapter 10: Infection Control and Safety Issues in the Clinic
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Sample Questions
Q1) 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
Q2) An OT practitioner is working with a client with a history of chronic obstructive pulmonary disease who has been admitted to the hospital with pneumonia.The client begins to experience some shortness of breath while seated at a table completing a meal preparation activity.Which of the following is the correct dyspnea control position to use for the client?
A) Client bends deeply at the waist, resting the chest on the thighs.
B) Client sits upright with arms relaxed at the sides of the body.
C) Client bends forward slightly at the waist, leaning the forearms on the table.
D) Client leans back against the chair backrest with arms resting in the lap.
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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) Stabilizing an extremity to reduce incoordination and 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) 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
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Chapter 12: Activities of Daily Living
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Sample Questions
Q1) 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.
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) 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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Page 14
Chapter 13: Mobility
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Sample Questions
Q1) 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
Q2) Correct measurement of a client for determining appropriate wheelchair seat width involves measuring which of the following?
A) Across the hips or thighs (whichever is widest) and adding 1 to 2 inches
B) Across the hips or thighs (whichever is widest) and subtracting 1 to 2 inches
C) From the back of the knee to the rear of the buttocks and adding 1 to 2 inches
D) From the back of the knee to the rear of the buttocks and subtracting 1 to 2 inches
Q3) A client at risk for foot drop deformity may benefit from the use of which orthotic?
A) Supramalleolar orthosis (SMO)
B) Knee-ankle-foot orthosis (KAFO)
C) Ankle-foot orthosis (AFO)
D) Hip-knee-ankle-foot orthosis (HKAFO)
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Chapter 14: Mobility
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Sample Questions
Q1) 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
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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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) "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
Q3) 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
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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) 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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Chapter 17: Americans With Disabilities Act and Related
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Sample Questions
Q1) 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.
Q2) On the basis of the home evaluation,the OT practitioner has recommended a ramp for the front entrance of her client's apartment.The client's family is willing to build the ramp; however,the landlord is prohibiting it.What should the OT practitioner do?
A) Inform the family of their rights under the Fair Housing Act and provide resources for self-advocacy. Follow up and advocate when necessary.
B) Encourage the client's family to move.
C) Recommend a wheelchair that can climb steps.
D) Threaten the landlord with a lawsuit.
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Chapter 18: Leisure Occupations
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Q1) Samuel is a 47-year-old African American man who owns his own landscaping business.He recently fell off a ladder and hit his head on concrete,causing brain damage.He is able to move all extremities,use a front wheel walker,and speak coherently,although he has problems finding the right word.After completing the Canadian Occupational Performance Measure,the OT practitioner discovered that his most important goal is returning to work.Which leisure occupation do you think would be most appropriate to include in his intervention plan?
A) Gardening in raised beds, giving him the ability to self-direct the activity
B) Playing cards to strengthen his hands and cognitive abilities
C) Cooking, using energy-conservation techniques
D) Grooming a canine companion to improve sequencing abilities and hand movements
Q2) 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
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Page 20
Chapter 19: Americans With Disabilities Act and Related
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Q1) 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
Q2) What year did Congress pass the Americans with Disabilities Act (ADA)?
A) 1973
B) 1990
C) 2002
D) 1969
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 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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23
Chapter 22: Joint Range of Motion
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Q1) Measuring joint ROM is contraindicated if _________________.
A) The client has a hematoma
B) The client has an unhealed fracture
C) The client has joint inflammation
D) The client has taken medication for pain
E) The client has osteoporosis
Q2) When analyzing results from ROM assessment,the therapist's first concern should be ROM that is ___________________.
A) Permanently lost
B) Painful
C) Lacking more than 10 degrees from normal
D) Lacking less than 10 degrees from normal
E) Below functional limits
Q3) When ROM of cervical lateral flexion is being measured,the goniometer axis is placed over what area?
A) External occipital protuberance
B) Spinous process of the second thoracic vertebra
C) Mastoid process
D) Spinous process of the seventh cervical vertebra
E) Sternum
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Chapter 23: Joint Range of Motion
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Q1) An OT practitioner has measured a client's passive thumb metacarpophalangeal (MP)flexion.The recorded ROM is -30 to 0 to 35.What does this tell the therapist?
A) That the joint has normal hyperextension and normal flexion
B) That the joint has limited hyperextension and limited flexion
C) That the joint has abnormal hyperextension and limited flexion
D) That the joint has abnormal hyperextension and normal flexion
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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25
Chapter 24: Evaluation of Muscle Strength
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Q1) MMT would never be appropriate for a client with which of the following conditions?
A) Peripheral nerve injury
B) Spastic cerebral palsy
C) Muscular dystrophy
D) Spinal cord injury
E) Multiple sclerosis
Q2) Which of the following statements is true about a muscle with a number grade of 3+?
A) Part moves through less than 50% of available ROM.
B) Part can move against gravity.
C) Part cannot take resistance.
D) Part can take maximal resistance.
E) Part can take moderate resistance.
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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Chapter 25: Evaluation of Muscle Strength
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Q1) An OT practitioner is testing thumb interphalangeal (IP)flexion strength.The therapist definitely observes flexion of the IP joint but cannot palpate a contraction of the flexor pollicis longus (FPL).What is the most likely reason?
A) The FPL may be too weak to palpate.
B) The client is giving less than maximal effort.
C) The flexor pollicis brevis may be substituting.
D) The extensor pollicis longus may be substituting.
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 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
Q2) 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.
Q3) 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
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Chapter 27: Evaluation of Sensation and Intervention for Sensory Dysfunction
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Q1) Superficial fine touch receptors include which of the following?
A) Pacinian corpuscles
B) Ruffini's corpuscles
C) Meissner's corpuscles
D) Golgi tendon organs
Q2) Signs of sympathetic nervous system responses include all but one of these signs.Which one is it?
A) Skin temperature
B) Skin color
C) Sudomotor function (abnormal sweating)
D) Goose bumps
Q3) Localization of moving touch tends to return before localization of ___________.
A) Light pressure
B) Constant touch
C) Pinprick
D) Deep pressure
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29
Chapter 28: Eating and Swallowing
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Q1) During a swallowing evaluation the tongue is noted to be retracted.What would typically be the reason for tongue retraction?
A) Abnormal tone or loss of range of motion as a result of soft-tissue shortening
B) The oral cavity is too large and makes the tongue appear retracted within the oral cavity
C) The tongue is abnormally small for the oral cavity
D) Protective response seen with a hyperactive gag
Q2) What is the cause of aspiration that occurs after the swallow has taken place?
A) Poor tongue control of the bolus
B) Delayed initiation of the swallow, and the bolus enters the airway
C) Reduced laryngeal closure, allowing the bolus to enter the airway
D) Pooled material in the pyriform sinuses overflows into the trachea
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) Why do persons with hemianopsia often experience difficulty reading?
A) Because they lose their place on the line
B) Because their acuity is diminished by the visual field deficit
C) Because the perceptual span they use in reading has been reduced on one side by the hemianopsia
D) Because they experience language deficits secondary to the brain injury
Q2) 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
Q3) Occlusion is used with the client with paralytic strabismus to __________.
A) Reestablish binocular use of the eyes
B) Prevent secondary contracture
C) Eliminate the double image
D) Improve focus
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Chapter 30: Evaluation and Pain Management
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Q1) 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
Q2) 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
Q3) 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
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Page 32
Chapter 31: Evaluation and Pain Management
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Q1) Catalina's low back pain has led to the inability to work and engage in leisure occupations.Which of the following apply to her condition?
A) Is typical of a central pain syndrome
B) Needs to be treated by a physical therapist, not an occupational therapist.
C) Fortunately hasn't produced any fear of movement in Catalina
D) 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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Chapter 32: Orthotics
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Q1) An OT practitioner is working with a client experiencing proximal upper extremity weakness as a result of polymyositis.The client wants to be able to feed himself while sitting up in his wheelchair.The therapist has set up a MAS ,but the client is having difficulty flexing his elbow enough to reach his hand to his mouth.Which adjustment can the therapist make to facilitate this motion?
A) Lower the semireclining mount on the wheelchair upright.
B) Move the rocker arm more distally on the forearm support.
C) Roll the semireclining mount outwardly.
D) Move the rocker arm more proximally on the forearm support.
Q2) 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.
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Chapter 33: Orthotics
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Q1) Which is not true about a MAS?
A) Assists motion through linkage of ball-bearing joints
B) Compensates for proximal weakness in upper extremities
C) Allows for occupational performance
D) Can be used for therapeutic exercise
E) Adjustments require very little training to make
Q2) The preferred minimal shoulder flexion and abduction range of motion to use an MAS is _________________.
A) 20 degrees
B) 45 degrees
C) 90 degrees
D) 120 degrees
E) 150 degrees
Q3) To increase range of motion before application of a splint,the occupational therapist should __________________.
A) Apply ice to the joint
B) Apply heat to the joint
C) Have the client complete an aerobic activity
D) All of the above
E) Only A and B
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Chapter 34: Traditional Sensorimotor Approaches to Intervention
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Q1) You are working with a client who has had a recent RCVA with left hemiparesis.The client has difficulty maintaining trunk control while standing and has difficulty holding objects.Using Rood's approach to motor control,you decide to work with the client in a standing table while the client completes a jigsaw puzzle.This activity would involve which of Rood's components of motor control?
A) Reciprocal inhibition
B) Co-contraction
C) Heavy work
D) Skill
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) 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
Q2) 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
Q3) 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
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Page 37
Chapter 36: Cerebrovascular Accident Stroke
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Q1) Which of the following client factors would be considered a body structure issue?
A) The client's right thumb was cut off in an industrial accident.
B) The client has limited sensation in his left hand.
C) The client is incontinent.
D) The client has no hearing in his left ear.
E) The client's exercise tolerance is very poor.
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) Which is the most common form of stroke?
A) Ischemic
B) Embolic
C) Thrombotic
D) Hemorrhagic
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Chapter 37: Spinal Cord Injury
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Q1) 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
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) A primary intervention aim for Rick would be to increase the strength of which of the following?
A) Triceps, finger extensors, and finger flexors
B) Biceps, pectoralis major, and wrist extensors
C) All of the above plus hand intrinsics
D) All of the above plus wrist flexors
Q2) 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
Q3) You are testing Rick's upper extremity function.Which of the following series of tests would you select to yield the most comprehensive information?
A) Manual muscle test, synergy patterns, functional muscle examination
B) Manual muscle test, active range of motion (ROM) test, functional motion test, visual perceptual tests
C) Manual muscle test, passive ROM test, functional motion test, sensory test
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Chapter 39: Disorders of the Motor Unit
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Q1) 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
Q2) Edith's story was used as the Guillain-Barré case study in this chapter.Which of the following interventions was used with Edith?
A) A wrist support while reading the newspaper
B) A card holder and card shuffler to play cards independently
C) Prolonged exertion during shopping
D) Cardiac precautions
E) All of the above
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Chapter 40: Disorders of the Motor Unit
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Q1) 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.
Q2) 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
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Chapter 41: Arthritis
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Q1) A clinical symptom of rheumatoid arthritis in the acute stage includes which of the following?
A) Hot and red joints
B) Increased joint movement
C) Pain that decreases with movement
D) Joint deformities
E) Asymmetrical joint involvement
Q2) Only one of the following is true.Which one is it?
A) A positive rheumatoid factor laboratory test is needed to establish a diagnosis of rheumatoid arthritis.
B) The clinical evaluation is seldom utilized in establishing a diagnosis of rheumatoid arthritis.
C) Radiological findings can be utilized in establishing a diagnosis of rheumatoid arthritis.
D) At least three of the seven criteria are required to make a diagnosis of rheumatoid arthritis.
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43
Chapter 42: Arthritis
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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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44
Chapter 43: Hand and Upper Extremity Injuries
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Q1) A client arrives for evaluation with loss of sensation of the volar surface of the thumb,index,and middle fingers.What nerve is involved?
A) Radial nerve
B) Ulnar nerve
C) Posterior interosseous nerve
D) Median nerve
Q2) 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
Q3) 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
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Chapter 44: Low Back Pain
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Q1) 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
Q2) 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
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Chapter 45: Hand and Upper Extremity Injuries
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Q1) One tool used to test two-point discrimination is __________.
A) A vibrator
B) Calipers
C) Monofilaments
D) The eraser end of a pencil
Q2) The volumeter is used to measure which of the following?
A) Strength
B) Girth
C) Hand volume (edema)
D) Sensation
Q3) Skier's thumb is _____________.
A) When the thumb locks in flexion
B) When the thumb interphalangeal joint is hyperextended
C) When the thumb web space is contracted
D) Instability of the thumb MP ulnar collateral ligament
Q4) Which of the options below is an accessory motion?
A) Joint distraction
B) Extension
C) Flexion
D) Abduction
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Chapter 46: Burns and Burn Rehabilitation
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Q1) Hair follicles,sebaceous glands,and sweat glands are located in which layer of skin?
A) Epidermis
B) Dermis
C) Stratum germinativum
D) Stratum spinosum
E) Stratum corneum
Q2) Revascularization,reepithelialization,and contraction of a burn wound occur in which phase of wound healing?
A) Emergent
B) Inflammatory
C) Proliferation
D) Maturation
E) Remodeling
Q3) 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
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Page 48
Chapter 47: Burns and Burn Rehabilitation
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Q1) An OT practitioner is evaluating the ROM of a client with an acute full thickness burn to the dorsum of the hand.The therapist is concerned about the integrity of the extensor tendons and should take which of the following actions?
A) Measure passive composite finger flexion.
B) Measure active composite finger flexion.
C) Measure metacarpophalangeal (MP) flexion with the interphalangeal joints in extension.
D) Refrain from performing all hand joint measurements until the burn has healed.
Q2) 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
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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) A traditional body-powered above-elbow prosthesis would require how many control cables?
A) None
B) One
C) Two
D) Three
E) Four
Q3) Which is not a function of a prosthetic sock?
A) Absorb perspiration
B) Protect against skin irritation
C) Compensate for residual limb volume changes
D) Provide comfort
E) Allow direct contact between socket and skin
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Page 50
Chapter 49: Amputations and Prosthetics
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Q1) An OT practitioner is doing functional unilateral myoelectric prosthetic training with a client who wants to be able to cut vegetables for meal preparation.What should the therapist teach the client?
A) To use packaged precut vegetables so that cutting is not necessary
B) To use a cutting board and a one-handed rocker knife
C) To use the terminal device to hold the knife and the sound hand to hold the vegetable
D) To use the sound hand to hold the knife and the terminal device to hold the vegetable
Q2) An occupational therapy (OT)practitioner is training a client in how to lock and unlock the elbow of an above-elbow body-powered prosthesis.The therapist should teach the client to do which of the following?
A) Hyperextend the shoulder and adduct the scapula.
B) Flex the shoulder and abduct the scapula.
C) Hyperextend the shoulder, abduct the shoulder, and depress the scapula.
D) Flex the shoulder, abduct the shoulder, and elevate the scapula.
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Chapter 50: Oncology
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Q1) Hormone therapy is an example of this type of cancer therapy.
A) En bloc resection
B) Chemotherapy
C) Radiation therapy
D) Palliative therapy
Q2) Peripheral neuropathy,which can include weakness and pain,is associated with this type of cancer therapy:
A) Surgery
B) Radiation therapy
C) Chemotherapy
D) Palliative therapy
Q3) 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
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Chapter 51: HIV Infection and Aids
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Q1) Which statement is true?
A) Once a person is taking highly active antiretroviral therapy (HAART), he or she is no longer able to transmit HIV.
B) Once a person is taking nucleoside reverse transcriptase inhibitors (NNRTIs), he or she is no longer able to transmit HIV.
C) There are no known medications to effectively block the enzyme required to replicate HIV.
D) Once a person has contracted the HIV virus, he or she can always transmit the virus during unprotected sex
Q2) For occupational therapists working with clients who have AIDS,the use of adaptive equipment ______________________.
A) Should always be used to reduce the effort expended during daily living tasks
B) Should never be used because it represents a disabling condition
C) Should be discussed with the family members before introducing the equipment to the client
D) May be rejected by the client as a symbol of diminished abilities
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