Physical Rehabilitation Study Guide
Questions
Course Introduction
Physical Rehabilitation is a comprehensive course that explores the principles, techniques, and evidence-based practices involved in restoring and enhancing physical function in individuals affected by injury, illness, or disability. The course covers a wide range of therapeutic interventions, assessment methods, and rehabilitation strategies tailored to various musculoskeletal, neurological, and cardiopulmonary conditions. Students will gain an understanding of functional anatomy, biomechanics, and the physiological processes underlying recovery, as well as the roles of multidisciplinary teams in patient-centered care. Practical components include the development and implementation of individualized rehabilitation plans aimed at improving mobility, strength, endurance, and overall quality of life for patients across different age groups and clinical 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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Sample Questions
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.
Answer: A
Q2) Work is a component of which Framework section?
A) Areas of occupation
B) Performance patterns
C) Activity demands
D) Contexts
E) Client factors
Answer: A
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3
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) Which statement best relationship between the occupational therapist and the occupational therapist assistant in the delivery of occupational therapy services?
A) The occupational therapist completes all the assessment instruments and develops the intervention plan independently before assigning the occupational therapist assistant specific tasks to complete with the client.
B) The occupational therapist assistant sets up the clinic equipment and cleans the clinic but is not allowed to provide direct client services.
C) The occupational therapist assigns the occupational therapist assistant specific assessments to complete with the client, and the occupational therapist assistant collaborates with the occupational therapist to develop the intervention plan.
D) The occupational therapist assistant completes assigned assessment instruments and develops the intervention plan independently.
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Chapter 5: Evidence-Based Practice for Occupational Therapy
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Q1) A need statement should specify who is the target of the problem,what changes are desired,what degrees of change is desired,and which of the following?
A) Data needed
B) Reflexive intervention one needs to provide
C) The Canadian Occupational Performance Measure
D) How one will recognize that change has occurred
E) The problem statement
Q2) 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.
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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) 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.
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
Page 8
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Chapter 7: Documentation of Occupational Therapy Services
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Q1) The Medicare 700 form ________________.
A) Does not require that all sections be completed
B) Is used for outpatient evaluations of Medicare clients
C) Has unlimited space for documentation
D) Can never be replaced with modified versions
Q2) How often is documentation required?
A) Daily
B) Weekly
C) Monthly
D) Whenever occupational therapy (OT) services are provided
Q3) 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.
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Page 9
Chapter 8: Documentation of Occupational Therapy Services
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Q1) What is the most compelling reason for the therapist to fill out all sections of the Medicare 700 form?
A) Because it makes the therapist appear thorough
B) Because failure to complete a section on the form could result in a technical denial
C) Because supervisors want all the sections completed so they will pass an audit
D) Because filling in all sections makes the need for therapy seem more justified
Q2) Which of the following is an example of a long-term goal (also called discharge goal)?
A) The client will be able to dress self with a simple pullover shirt with no fasteners.
B) The client will be able to button and unbutton an article of clothing.
C) The client will be able to tie a pair of shoes.
D) The client will be able to dress independently.
E) The client will be able to put on and remove slacks.
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10
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 an intracranial pressure (ICP)monitor,certain positions and activities that cause increase in ICP should be limited.Which of the following are examples of activities and/or positions to be avoided?
A) Isometric exercises and neck flexion
B) Isotonic exercises and neck extension
C) Isometric exercises and neck extension
D) Isotonic exercises and neck flexion
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11
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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Sample Questions
Q1) 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
Q2) 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
Q3) The use of a wrist-driven flexor hinge splint may benefit a client with muscle function from spinal cord levels __________.
A) C6
B) C5
C) C4
D) A and B
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Chapter 12: Activities of Daily Living
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Sample Questions
Q1) 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
Q2) Any item,piece of equipment,or product system,whether acquired commercially,off the shelf,modified,or customized,that is used to increase or improve functional capabilities of individuals with disabilities is the definition of which of the following terms?
A) Adaptive equipment
B) Assistive device
C) Assistive technology
D) All of the above
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 13: Mobility
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Sample Questions
Q1) Why might a rigid frame chair be preferable for individuals with paraplegia who are manually propelling the wheelchair?
A) They are more lightweight than folding chairs.
B) They are more energy efficient during propulsion.
C) They are more easily folded and stored.
D) They are more sturdy and do not need to be replaced as often.
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) When is a car (e.g.,sedan)an appropriate vehicle option for the disabled client?
A) When the individual uses a powered wheelchair
B) When the individual uses a manual wheelchair
C) When the individual requires a mechanical lift
D) When the individual is independent in transfers and in loading mobility equipment.
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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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Sample Questions
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) 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
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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Sample Questions
Q1) 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
Q2) The ABC candy company requires workers to perform packaging of 1-pound boxes at a standing workstation.What is the best height for this type of workstation?
A) 34-37 inches: slightly below elbow
B) 37-43 inches: above elbow height
C) 28-35 inches: heavy work
D) This task should be done while sitting.
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18
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) 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) 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
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Page 20
Chapter 19: Americans With Disabilities Act and Related
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Sample Questions
Q1) At which stage of the hiring process can an employer give a functional capacity assessment?
A) Pre-offer stage
B) Post-offer stage
C) During the medical exam
D) During the interview
Q2) What year did Congress pass the Americans with Disabilities Act (ADA)?
A) 1973
B) 1990
C) 2002
D) 1969
Q3) 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
21
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Chapter 20: Leisure Occupations
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Q1) Which group did the Centers for Disease Control identify as engaging in the least amount of physical activity?
A) African Americans
B) Women in all cultures
C) Hispanics
D) Asians
Q2) As an Area of Occupation,leisure is defined in the Occupational Therapy Practice Framework (2002)as ________________.
A) A nonobligatory activity that is internally motivated and engaged in during an individual's free time
B) An obligatory daily activity that provides the individual with social contacts
C) An activity determined by the occupational therapist to be beneficial to the client
D) Fun activities recommended by the client's family or caregiver
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22
Chapter 21: Occupation-Based Functional Motion Assessment
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Q1) A client who is able to perform most basic activities of daily living and instrumental activities of daily living independently but who experiences low endurance and fatigue somewhat easily during upper extremity tasks will most likely have which of the following?
A) Poor muscle strength
B) Good muscle strength
C) Fair plus muscle strength
D) Normal muscle strength
Q2) A 75-year-old woman with rheumatoid arthritis reports having some difficulty managing in her kitchen during meal preparation and cleanup.The client lives alone,is fiercely protective of her independence,and works 3 days a week at the local library's reading program for children.The OT practitioner arranges a home visit and decides the best sequencing of assessments to determine the problems would be which of the following?
A) Occupation-based functional motion; manual muscle testing; functional ROM
B) Functional motion; ROM; manual muscle testing; occupation-based functional motion
C) Functional motion; occupation-based functional motion; manual muscle testing
D) ROM; occupation-based functional motion; functional motion
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Chapter 22: Joint Range of Motion
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Q1) When ROM of wrist extension is being measured,where is the movable bar of the goniometer placed?
A) Parallel to the metacarpal of the index finger
B) Parallel to the radius
C) Parallel to the metacarpal of the small finger
D) Parallel to the anatomical snuffbox
E) Parallel to the ulna
Q2) Which is true about normal joint ROM?
A) It may not be affected by age.
B) It may not be affected by gender.
C) It may not be affected by occupation.
D) It may not be the same from individual to individual.
E) It may not be determined.
Q3) 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
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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 OT practitioner is measuring the starting position of passive proximal interphalangeal (PIP)joint flexion in a client who has increased flexor tone in his wrist and fingers after a traumatic brain injury.The therapist should place the client's wrist in which position?
A) Neutral or flexion
B) Slight extension
C) Full extension
D) Any position, because wrist position has no effect on finger motion
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Chapter 24: Evaluation of Muscle Strength
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Q1) Which of the following is true about MMT?
A) It can measure muscle endurance.
B) It cannot help determine if a nerve injury is partial or complete.
C) It can measure muscle coordination.
D) It cannot be used to identify muscle imbalance.
E) It can help determine the level of spinal cord injury.
Q2) 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
Q3) If a muscle contraction can be seen or felt but no motion is observed,the grade is
A) 0
B) 1-
C) 1
D) 1+
E) 2-
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Page 26
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 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
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Chapter 26: Evaluation of Sensation and Intervention for Sensory Dysfunction
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Q1) Which of these is not an example of protective sensory reeducation?
A) Using a screwdriver for 30 minutes without any gloves
B) Softening the amount of force used when gripping objects
C) Moisturizing the skin regularly to keep it supple
D) Checking for blisters or cuts
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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28
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) Semmes-Weinstein Monofilaments are used to test __________.
A) Sharp-dull
B) Proprioception
C) Pressure threshold
D) Sweating responses
Q3) Which of these is not a sensory threshold test?
A) Moving two-point discrimination
B) Touch-pressure
C) Temperature awareness
D) Pinprick
Q4) Difficulty of graded discrimination is increased by ____________.
A) Occluding vision
B) Standing up during treatment
C) Making the objects larger
D) Lowering the ambient lighting
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Chapter 28: Eating and Swallowing
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Q1) Mattias is a 65-year-old man who experienced a right cerebrovascular accident resulting in left hemiplegia and dysphagia.During the occupational therapy assessment,Mattias had difficulties with chewing and swallowing of textured foods.He had frequent episodes of coughing and pocketing of food in the left cheek.He complains that he chokes on certain foods,including water.During the assessment Mattias's vocal quality was consistently clear,and no raspiness or gurgly quality was noted before,during,or after eating.These clinical signs indicate problems with which stages of the swallow?
A) Oral preparatory and esophageal stages
B) Oral preparatory and oral stages
C) Pharyngeal and esophageal stages
D) Esophageal and oral stages
Q2) The hypoglossal nerve (XII)is active during what stages of the swallow?
A) Oral preparatory and pharyngeal stages
B) Oral preparatory and oral stages
C) Oral and pharyngeal stages
D) Pharyngeal and esophageal stages
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Page 30
Chapter 29: Evaluation and Treatment of Visual Deficits
Following Brain Injury
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Q1) Captain Hatrack woke up one morning feeling funny and not seeing too well.He went to the ophthalmologist,Dr.Eye,who told him that he experienced a small stroke and has developed a left hemianopsia.Dr.Eye told the Captain that he had to stop driving immediately.The Captain is very upset because he feels as if he is seeing everything in his field and that all he needs is a better pair of glasses; he thinks the doctor is a quack and he can drive just fine.Which one of the following provides the best explanation for why the Captain does not realize he has a field deficit?
A) The Captain has cataracts.
B) The Captain has a relative visual field loss on the left.
C) The Captain is exercising perceptual completion.
D) The Captain is experiencing confusion because of the stroke.
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
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Page 31
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) An occupational therapist is treating a 56-year-old woman who has been diagnosed with fibromyalgia.She has expressed depression and anxiety over her diminished ability to lead a fulfilled life.She reports that her pain typically rates approximately 7 on the numerical pain intensity scale.What interventions should the OT practitioner employ?
A) Provide her with relaxation training to decrease muscle tension
B) Help her to resume leisure activities that she once enjoyed that would cause low stress on her body, such as swimming
C) Refer her for psychological counseling
D) Refer her to a spiritual advisor
E) All of the above
Q2) For which of the following pain interventions does the occupational therapist need post-professional education to ensure competency?
A) Adaptive equipment
B) Splinting
C) Relaxation training
D) Physical agent modalities (PAMs)
E) All of the above
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33
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 amount of force applied in dynamic splinting can be measured with a gauge and should generally be between _________.
A) 700 and 800 grams
B) 600 and 700 grams
C) 300 and 600 grams
D) 100 and 300 grams
E) 50 and 100 grams
Q2) When the occupational therapist is deciding which splint style and design to choose,the individual needs of the client must be considered.The therapist should consider all of the following except __________________.
A) Cognitive ability to don and apply the splint correctly
B) Ability of the caretaker to assist with applying the splint
C) Sensory dysfunction and fragile skin
D) Constant full time wear for optimal results
E) Compliance with the therapy program
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35
Chapter 34: Traditional Sensorimotor Approaches to Intervention
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Q1) 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
Q2) Your next client has sustained a right cerebral vascular accident (RCVA)with resultant left-sided hemiplegia and limited isolated control of the left upper extremity.Which SPECIFIC PNF diagonal pattern would you use to help your client regain the ability to comb her hair on the right side of her head using her left hand?
A) D1 flexion
B) D1 extension
C) D2 flexion
D) D2 extension
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Chapter 35: Degenerative Diseases of the Central Nervous System
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Q1) Your next client,a 71-year-old woman,has been diagnosed with Alzheimer's disease and has moderate memory loss for recent personal experiences and is having problems managing her finances.Using the four-stage classification method,identify the stage in which your client is at this time.
A) 1: Very mild to mild cognitive decline
B) 2: Mild to moderate decline
C) 3: Moderate to moderately severe decline
D) 4: Severe cognitive decline
Q2) 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
Q3) You are reviewing the medical record of your next patient,who has Parkinson's disease.The neurologist has indicated that this man has bradykinesia.What does this mean?
A) He has no movement available.
B) His movements are slow.
C) He has oscillations in his movements.
D) His movements are very erratic and quick.
Page 37
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Chapter 36: Cerebrovascular Accident Stroke
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Q1) All the members of the 10-year-old client's family are expected to make their own beds after age 5.This would be considered under which section of activity demands?
A) Objects and their properties
B) Space demands
C) Sequence and timing
D) Social demands
E) Required actions
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
Q3) Which is the most common form of stroke?
A) Ischemic
B) Embolic
C) Thrombotic
D) Hemorrhagic
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Page 38
Chapter 37: Spinal Cord Injury
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Q1) The person with C6 quadriplegia may be able to assist in transfers by locking the elbows in extension and performing shoulder _________________.
A) Depression, extension, and adduction
B) Depression, external rotation, and adduction
C) Adduction and elbow flexion
D) Horizontal abduction and humeral adduction
Q2) The 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
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Chapter 38: Spinal Cord Injury
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Q1) 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
Q2) Rick was wearing a neck brace because of neck instability in the early phases of rehabilitation. During this time you were asked to do a manual muscle test of the upper extremities.What should you do?
A) Perform manual muscle test, following standard procedures for all movements.
B) Test forearms and hands only.
C) Test shoulders, forearms, and hands, forgoing resistance at end of motion while following the shoulder protocols.
D) Defer the test until the brace is removed.
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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) Which is the most commonly injured peripheral nerve injury,and which activity could be used by an occupational therapist as an intervention?
A) Long thoracic nerve; application of a variety of textures to the forearm
B) Brachial plexus; passive range of motion (ROM) with traction to the shoulder.
C) Axillary nerve; graded long, sweeping shoulder movements, such as wiping a table.
D) Musculocutaneous nerve; activities to strengthen forearm pronators
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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) Heat is a physical agent modality that is often used for patients with arthritis.Which of the following is not a benefit of applying heat to an arthritic patient?
A) Increased blood flow
B) Decreased inflammation
C) Pain relief
D) Increased tissue elasticity
E) Maintaining range of motion
Q3) A common hand deformity in rheumatoid arthritis includes which of the following?
A) Metacarpophalangeal (MP) ulnar deviation and wrist ulnar deviation
B) MP radial deviation and wrist ulnar deviation
C) MP ulnar deviation and wrist radial deviation
D) MP radial deviation and wrist radial deviation
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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) 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
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) 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) Low back pain may be a result of which of the following?
A) Poor conditioning
B) Improper use of the back
C) Obesity
D) Smoking
E) All of the above
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Chapter 45: Hand and Upper Extremity Injuries
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Q1) Name the test in which the examiner places pressure over the median nerve in the carpal tunnel for up to 30 seconds to see if this creates tingling in the median nerve distribution.
A) Carpal compression test
B) Reverse Phalen's test
C) Test for Tinel's sign
D) Roos test
Q2) Which digit is the most important to the hand?
A) Thumb
B) Index finger
C) Long finger
D) Ring finger
Q3) Which nerve is called the "eyes" of the hands?
A) Radial nerve
B) Median nerve
C) Ulnar nerve
D) Posterior interosseous nerve
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Chapter 46: Burns and Burn Rehabilitation
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Q1) Tensile strength of a burn scar never recovers more than what percentage of original unburned skin?
A) 80%
B) 85%
C) 90%
D) 95%
E) 100%
Q2) Which is not true about splinting in the treatment of burns?
A) Splints do not need to be worn at all times to prevent contractures.
B) Splints can maintain correct positioning of joints.
C) Splints can protect compromised tissues to promote healing.
D) Splints can reverse scar contractures of mature scars.
E) Splints should not compromise function whenever possible.
Q3) 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
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Chapter 47: Burns and Burn Rehabilitation
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Q1) An OT practitioner is treating a client who has been hospitalized with acute burns to the face,neck,chest,and bilateral upper extremities.The therapist wants to initiate immediate antideformity positioning.Which position would not be appropriate?
A) Using a pillow behind the client's head
B) Using armboards to place shoulders in 90 degrees of abduction
C) Using a towel roll beneath the thoracic spine
D) Using splints to place elbows in extension
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 practicing stacking small blocks would be in what phase of prosthetic training?
A) Preprosthetic
B) Control
C) Use
D) Functional
E) Repetitive
Q2) An upper extremity prosthesis with a myoelectric hand and body-powered elbow is a type of __________________.
A) Muscle-cable prosthesis
B) Dual-driven prosthesis
C) Composite prosthesis
D) Hybrid prosthesis
E) Electrical-body prosthesis
Q3) Not all above-knee or below-knee prostheses have a _____________.
A) Socket
B) Pylon
C) Suspension system
D) Terminal device
E) Articulating joint
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Chapter 49: Amputations and Prosthetics
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Q1) 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.
Q2) 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
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Chapter 50: Oncology
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Q1) 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
Q2) Hormone therapy is an example of this type of cancer therapy.
A) En bloc resection
B) Chemotherapy
C) Radiation therapy
D) Palliative therapy
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) What marks the difference between the diagnosis of HIV positive and the diagnosis of AIDS?
A) Presence of peripheral neuropathy
B) Presence of lymphadenopathy
C) Seroconversion with presence of the HIV
D) A CD4+ count below 200 and an AIDS-defining illness
Q2) 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
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