Therapeutic Approaches in Occupational Therapy
Final Exam
Course Introduction
This course offers an in-depth exploration of evidence-based therapeutic approaches applied within the field of occupational therapy. Students will examine a range of intervention strategies designed to support individuals of all ages in developing, recovering, or maintaining the skills necessary for daily living and working. The curriculum covers foundational theories, client-centered practice frameworks, and practical application of intervention techniques across physical, cognitive, psychosocial, and sensory domains. Through case studies and hands-on simulations, students will learn to develop personalized treatment plans, evaluate outcomes, and adapt interventions to promote optimal occupational performance and participation in meaningful activities.
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) 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
Answer: D
Q2) The effects of a client's culture on his performance of an activity fall within which Framework section?
A) Performance in areas of occupation
B) Performance patterns
C) Activity demands
D) Contexts
E) Client factors
Answer: D
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Chapter 2: The Occupational Therapy Practice Framework
and the Practice of Occupational Therapy for People With
Physical Disabilities
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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) In the interactional or sociopolitical model,disability is defined not only by the physical qualities of the individual but also by the corresponding response of which of the following?
A) Therapist
B) Social environment
C) Piece of adaptive equipment
D) Physician
E) Object used for therapy
Answer: B
Q2) Under AOTA's Occupational Therapy Practice Framework,the advocacy of the reduction of functional impairments caused by physical and psychological limitations reflects which treatment model or approach?
A) Arts and Crafts movement
B) Moral treatment
C) Social model
D) Medical model
E) Rehabilitation model
Answer: D
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Chapter 4: Application of the Occupational Therapy
Practice Framework to Physical Dysfunction
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Q1) Which statement best fits with the form of occupational therapy service that is known as health promotion?
A) This strategy is aimed at improving a client's ability to perform skills, thus allowing greater participation in occupations.
B) This approach is focused on modifying the environment to foster improved occupational performance.
C) This approach recognizes that many clients are faced with degenerative disorders, and occupational therapy services should actively address the need to maintain occupational engagement.
D) A disabling condition is not assumed, but instead occupational therapy services are provided to enhance and enrich occupational performance.
Q2) Occupational therapy services provided within the client's home require careful consideration of the environment.What issues would typically be addressed within this setting?
A) Changing the furniture arrangement to eliminate potential falls
B) Safety in meal preparation
C) Simplification of household cleaning tasks
D) All of the above
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Chapter 5: Evidence-Based Practice for Occupational Therapy
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Q1) 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
Q2) "Jane will arrive at work on time." This is an example of which type of objective?
A) Process
B) Intuitive
C) Outcome
D) Specific
E) Reflexive
Q3) 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
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Chapter 6: Health Promotion and Wellness for People With Physical Disabilities
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Q1) All but which of the following statements about health promotion as described in the OT Practice Framework are accurate?
A) The Framework describes health promotion as an appropriate intervention for OT.
B) The Framework describes disability prevention as an appropriate intervention for OT.
C) Disability prevention is included in the Framework.
D) Wellness, as described in the Framework, involves only the lack of disease symptoms.
Q2) Which of the following statements accurately describes the elements of symbols and disability?
A) Symbols can convey feelings, identity, beliefs, and knowledge.
B) Symbols can change over time in a society.
C) Symbols can change in significance depending on an individual's changes in development or life experiences.
D) All of the above.
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8
Chapter 7: Documentation of Occupational Therapy Services
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Q1) Individually identifiable health information _____________.
A) Refers to only recent medical information about the client
B) Is also known as protected health information (PHI)
C) Can be disposed of with the regular trash
D) Can be shared casually among the client's family members
Q2) Which statement below is incorrect?
A) Goals are written to reflect what the therapist will do.
B) Client-centered goals are written with input from the client.
C) Goals reflect what the client will do.
D) Goals should be measurable and objective and should include a time frame.
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
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9
Chapter 8: Documentation of Occupational Therapy Services
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Q1) What is the best reason to explain why leaving client charts out in plain view,where others can read the information,is wrong?
A) This is a violation of privacy standards mandated by the Health Insurance Portability and Accountability Act (HIPAA).
B) Food or beverages could be spilled on the charts.
C) They might be accidentally thrown away.
D) The client might see it.
Q2) 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.
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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) A nosocomial infection is ___________.
A) Bacterial
B) Viral
C) Transmitted via bodily fluids
D) Acquired in the hospital
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Chapter 10: Infection Control and Safety Issues in the Clinic
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Q1) 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.
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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Chapter 11: 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) Which of the following is the main technique used for a client with limited joint range of movement (ROM)to perform ADLs?
A) Compensatory strategy involving changing the method in which an activity is performed
B) Changing the environment where the activity is performed
C) Using an assistive device for the activity
D) Treatment including remediation
Q3) 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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Page 13
Chapter 12: Activities of Daily Living
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Sample Questions
Q1) The occupational therapist is working with a client who has weakness and pain in the hands caused by moderate to severe arthritis.To increase functional independence,the client may use which of the following?
A) Plate guards or scoop dishes
B) A commercially available sock aid
C) An extended handle reacher
D) Lever-type doorknob extensions
Q2) An occupational therapist is working with a client who has an impaired right upper extremity resulting from a lower motor neuron dysfunction.What is a common problem that the therapist will have to address?
A) Speech disorders
B) Impaired ability to learn and perform
C) Difficulty with motor planning
D) Reduction of work speed and dexterity
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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Page 14
Chapter 13: Mobility
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Sample Questions
Q1) After a clinical assessment of the client,a predriving assessment is completed.Essential predriving skills that are evaluated include which of the following?
A) Cognitive and perceptual skills assessment
B) On-the-road evaluation of the client's skills using adapted equipment
C) The ability to handle keys, manage doors, mobility devices, and adjust seat belt
D) Muscle strength, range of motion, and grip measurements
Q2) Which of the following devices are considered primary controls on a vehicle?
A) Turn signal
B) Windshield wiper controls
C) Braking and steering controls
D) Mirrors and environmental controls
Q3) Why might a rigid frame chair be preferable for individuals with paraplegia who are manually propelling the wheelchair?
A) They are more lightweight than folding chairs.
B) They are more energy efficient during propulsion.
C) They are more easily folded and stored.
D) They are more sturdy and do not need to be replaced as often.
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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 working with an individual with T1 spinal cord injury.Your client has paralysis of both legs.Upper extremity function is fully intact,but your client has limited upper trunk stability.Which of the following is the most appropriate type of transfer to use to maintain safety and maximize your client's independence in functional mobility?
A) Bent pivot transfer
B) Sliding board transfer
C) Stand pivot transfer
D) Transfer with mechanical lift
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Page 16
Chapter 15: Work Evaluation and Work Programs
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Q1) Which one of these risk factors is not usually included on an ergonomics checklist used by the ergonomics team?
A) Repetitions of task
B) Lunch break and break times
C) Use of vibration
D) Employee pay scale and benefits
Q2) 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) _______ addresses "human performance and well-being in relation to one's job,equipment,tools,and environment."
A) Anthropometry
B) Ergonomics
C) Industrial hygiene
D) OSHA
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Chapter 16: Work Evaluation and Work Programs
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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) An occupational therapist from the Midwest (where the population is predominantly white)is moving to southern California (where the population is an ethnic mix with a large segment being Mexican).What should the occupational therapist do to improve her knowledge and application of culturally appropriate occupations for her new clientele?
A) Gather examples of successful activities that she did in the Midwest and box them up to take to her new job.
B) Review manual muscle testing so that when assigning an embroidery project, the occupational therapist will know that the proper hand muscles are working.
C) Research leisure interests and occupations by ethnicity using books, articles, and the Internet.
D) Learn Mexican recipes because most clients she will be treating will be Mexican and will enjoy cooking groups.
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Chapter 19: Americans With Disabilities Act and Related
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Sample Questions
Q1) What year did Congress pass the Americans with Disabilities Act (ADA)?
A) 1973
B) 1990
C) 2002
D) 1969
Q2) 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
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) Adults with physical disabilities may give up leisure activities for which of the following reasons?
A) Because their clinical setting does not employ a recreational therapist
B) Because they all prefer watching television
C) Because they are not aware of ways to adapt valued activities so that they may participate in them again
D) Because they do not wish to learn new hobbies or crafts
Q2) 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
Q3) Which of the following is not a benefit of leisure occupations for adults with physical disabilities?
A) Increased sense of self-worth
B) Increased ability to chew and swallow without aspirating
C) Improved or maintained perceptual abilities
D) Experience of intellectual stimulation
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Page 22
Chapter 21: Occupation-Based Functional Motion Assessment
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Q1) Which of the following cannot be assessed using the occupation-based functional motion assessment?
A) Motor control
B) Sensation
C) Range of motion (ROM)
D) Muscle strength
Q2) Which of the following is not an expected outcome of an occupation-based functional motion assessment?
A) The OT practitioner conducting interviews with the client to determine the problems encountered during performance of functional activities
B) The OT practitioner having the client perform other tasks associated with his or her habits while interacting in varied environmental contexts
C) The OT practitioner making the decision to conduct formal assessments of performance skills or body function
D) Meaningful intervention goals relative to improving occupational performance will be selected
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23
Chapter 22: Joint Range of Motion
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Sample Questions
Q1) What term is used for feeling the bony landmarks and soft tissues around the joint to be measured?
A) End-feel
B) Palpation
C) Preparatory touch
D) Passive feel
E) Visual observation
Q2) What is the average normal joint ROM (using the 180-degree method)for thumb metacarpophalangeal (MP)flexion?
A) 0-70 degrees
B) 0-90 degrees
C) 20-90 degrees
D) 20-50 degrees
E) 0-50 degrees
Q3) 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
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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 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.
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25
Chapter 24: Evaluation of Muscle Strength
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Q1) If a muscle contraction can be seen or felt but no motion is observed,the grade is
A) 0
B) 1-
C) 1
D) 1+
E) 2-
Q2) Which of the following is not a contraindication for MMT?
A) Joint hypermobility
B) Joint dislocation
C) Unhealed fracture
D) Bone carcinoma
E) Recent musculoskeletal surgery
Q3) The amount of resistance applied to a muscle should not depend on which of the following?
A) The cross-sectional size of the muscle
B) The age of the client
C) The relative power of the muscle
D) The gender of the client
E) The strength of the therapist
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Chapter 25: Evaluation of Muscle Strength
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Q1) An OT practitioner is testing a client's shoulder strength.The client is able to actively abduct to 90 degrees against gravity.What should the therapist do next?
A) Apply resistance.
B) Reposition the client to test in the gravity-eliminated plane.
C) Assist the client into full abduction and then apply resistance.
D) Abduct the shoulder passively to assess available range of motion.
Q2) An OT is performing manual muscle testing on a client's shoulders.Initial screening found all muscles were below a grade of 3-.Which tests can be performed with the client seated?
A) Flexion, abduction, internal rotation, external rotation
B) Internal rotation, external rotation, horizontal adduction, horizontal abduction
C) Horizontal adduction, horizontal abduction, extension, abduction
D) External rotation, internal rotation, flexion, horizontal abduction
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Chapter 26: Evaluation of Sensation and Intervention for Sensory Dysfunction
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Q1) 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.
Q2) Why is it important to support the client's hand fully when performing a sensory evaluation?
A) So the client remains relaxed
B) To prevent the hand from moving, which could provide sensory information that interferes with the testing
C) To be sure that the client pays attention
D) To be consistent in technique among all clients
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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Page 28
Chapter 27: Evaluation of Sensation and Intervention for Sensory Dysfunction
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Q1) Clients are candidates for discriminative sensory training if they have protective sensation intact,with recognition of at least _______________.
A) 8 mm on the moving two-point discrimination test
B) 8 mm on the static two-point discrimination test
C) 4.56 on the Semmes-Weinstein monofilaments test
D) 4.31 on the Semmes-Weinstein monofilaments test
Q2) When tapping elicits paresthesia,______________.
A) It is called allodynia
B) It is referred to as a Tinel's sign
C) It feels like a cooling sensation
D) It should be ignored
Q3) What does sensory reeducation require?
A) Specialized and standardized equipment
B) 30-minutes sessions
C) 10- to 15-minute sessions
D) Clients to be experiencing hypersensitivity
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Chapter 28: Eating and Swallowing
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Q1) A wet or gurgly vocal quality after an individual swallows is indicative of what?
A) Poor vocal fold control when talking
B) Poor respiratory support and a weak voice
C) Material collecting in the larynx
D) Nasal congestion
Q2) Videofluoroscopy is an example of what type of swallowing assessment?
A) Oral motor assessment
B) Bedside sensory assessment
C) Instrumental assessment
D) Clinical assessment
Q3) 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
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Chapter 29: Evaluation and Treatment of Visual Deficits
Following Brain Injury
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Q1) 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
Q2) Why might changes in visual processing cause a corollary change in cognitive performance?
A) Because the visual system is the primary system we use to acquire information about our environment and guides our decision making process
B) Because the visual system provides us with good acuity
C) Because the visual system allows us to identify objects in our environment
D) Because the visual system gives us the "big picture"
Q3) Which of the following conditions could create cloudy vision in one eye after a traumatic brain injury?
A) Vitreous hemorrhage
B) Cataract
C) Optic nerve injury
D) Retinal detachment
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Chapter 30: Evaluation and Pain Management
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Q1) In working with Catalina,the occupational therapist should ensure that she takes her pain medications at least 30 minutes before the therapy session to promote maximal participation.Interventions include which of the following?
A) Instruction to bend from the waist when picking up heavy objects
B) Teaching her tasks and positions that move her body out of balance to challenge the low back muscles
C) Energy conservation and pacing during activities of daily living and instrumental activities of daily living
D) Use of a front-wheeled walker
Q2) Which of the following best defines pain?
A) An objective experience that is either acute or chronic
B) An unpleasant sensory and emotional experience, usually associated with actual or potential tissue damage
C) A physical disability with an emotional component
D) A negative sensation that always disrupts normal occupations
E) All of the above
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Chapter 31: Evaluation and Pain Management
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Q1) 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
Q2) During an intervention session for Catalina's low back pain,the occupational therapist does which of the following?
A) Increases the activity levels quickly to promote muscle strengthening
B) Tells Catalina to initiate rest at the time of the pain onset during activities
C) Gradually increases activity levels, with Catalina working to "tolerance" as opposed to "pain," before a scheduled rest break
D) Applies modalities (e.g., heat or cold) after activity
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33
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) An OT practitioner is working with a client who must wear a thumb spica splint for 3 more weeks after cast removal for a scaphoid fracture.The physician has allowed the patient to use the hand with the splint in place for light activities.When making the splint,the therapist must be sure to position the thumb in what position to allow light activities?
A) Thumb extension
B) Thumb flexion
C) Palmar prehension
D) Hook grasp
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Chapter 33: Orthotics
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Q1) A wrist splint that needs to allow full motion of digits should be trimmed
A) Distal to the metacarpophalangeal creases
B) Proximal to the metacarpophalangeal creases
C) Proximal to the proximal interphalangeal creases
D) Distal to the proximal interphalangeal creases
E) Distal to the wrist creases
Q2) Clients with which condition would likely not be appropriate candidates for an MAS?
A) Cervical spinal cord injury
B) Cerebral palsy
C) Poliomyelitis
D) Muscular dystrophy
E) Guillain-Barré syndrome
Q3) Which is not true about a suspension arm support?
A) Can be used as a precursor to a MAS
B) Lacks fine adjustments possible with a MAS
C) Uses a spring
D) Uses wrist and elbow suspension slings
E) Can be attached to an over-bed frame
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Page 35
Chapter 34: Traditional Sensorimotor Approaches to Intervention
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Q1) Which of the following is not a contraindication for use of PNF techniques or procedures?
A) Traction for persons with fractures
B) Traction for persons who have had recent surgery
C) Multiple repetitions of rhythmic stabilization with maximal exertion for persons with cardiac involvement
D) Hold-relax techniques for persons with RSD/CRPS
Q2) Which of the following statements accurately describes techniques directed to the agonist?
A) Rhythmic initiation is ineffective for improving the ability to initiate movement.
B) Rhythmic initiation involves voluntary relaxation, passive movement, and repeated isotonic contractions of the agonistic pattern.
C) Repeated contractions techniques assume that the number of repetitions of an activity is not necessary for motor learning.
D) Resistance should never be used during rhythmic initiation to reinforce a movement pattern.
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36
Chapter 35: Degenerative Diseases of the Central Nervous System
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Q1) 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
Q2) Which statement best represents the function of occupational therapy with clients in the partially independent phase (Phase II)of amyotrophic lateral sclerosis?
A) Progressive resistive exercises on a daily basis along with stretching
B) Gentle resistive exercise on a daily basis along with training for suctioning
C) Assess and instruct in use of assistive technology and potential power mobility
D) Instruct family members in skin care and train in suctioning
Q3) The problems associated with multiple sclerosis are due to which of the following?
A) Denervated peripheral muscle fibers
B) Demyelinated peripheral nerves
C) Destruction of the anterior horn cells
D) Demyelinated central nerves
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Page 37
Chapter 36: Cerebrovascular Accident Stroke
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Q1) The Framework refers to activities that are oriented toward taking care of one's own body as which of the following?
A) Activities of daily living (ADLs)
B) Instrumental ADLs (IADLs)
C) Performance skills
D) Areas of occupation
E) Context
Q2) Work is a component of which Framework section?
A) Areas of occupation
B) Performance patterns
C) Activity demands
D) Contexts
E) Client factors
Q3) Sequencing and timing are considered in which Framework section?
A) Performance skills
B) Performance patterns
C) Context
D) Activity demands
E) Client factors
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Page 38
Chapter 37: Spinal Cord Injury
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Q1) The occupational therapist can help achieve the desired flexor tightness necessary for tenodesis grasp by doing which of the following?
A) Ranging finger flexion with the wrist extended and finger extension with the wrist flexed
B) Ranging finger flexion with wrist flexed and finger extension with wrist extended
C) Ranging finger flexion with wrist at neutral and extension with wrist extended
Q2) The patient has a C5 quadriplegia.We can anticipate that he or she has innervation of which of the following?
A) Upper trapezius, deltoids, biceps, levator scapulae, wrist flexors
B) Latissimus, deltoids, biceps, supinators, pronators
C) Upper trapezius, diaphragm, levator scapulae, biceps, and supinators.
D) A and B
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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) While working with Rick,you notice that he begins to perspire profusely,complains of a severe headache,and looks flushed.He is showing signs of _____,and you should
A) Postural hypotension; tip the wheelchair back for a few minutes
B) Autonomic dysreflexia; elevate his legs
C) Malingering; continue intervention and ignore complaints
D) Autonomic dysreflexia; seek medical assistance
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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) An occupational therapist has received an order to evaluate Jan,a 45-year-old photographer who has been diagnosed with myasthenia gravis.In what aspect of evaluation should the therapist have advanced training to perform?
A) Dysphagia
B) Manual muscle testing
C) Home evaluation
D) Running groups
E) All of the above
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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) 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
Q2) Avoiding MP ulnar deviation is an important joint protection principle in cases of rheumatoid arthritis.To open a jar,the patient should be instructed to do which of the following?
A) To open the jar using the palm of his or her hand
B) To use two hands and wall mount jar opener
C) To use shoulder rotation
D) A and B
E) All of the above
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43
Chapter 42: Arthritis
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Q1) A clinician is evaluating a client with rheumatoid arthritis.In addition to the client-centered interview,occupational profile,and occupational performance evaluation,the therapist wishes to document the clinical status.The clinician notices severe hand deformities and joint enlargements that may make goniometric measurements difficult.How should the therapist go about documenting digit flexion?
A) The therapist will be unable to measure the joint flexion because of the deformities.
B) The therapist should measure the distance from the fingertips to the distal palmar crease with a ruler.
C) The therapist should measure over the joint enlargements at each joint.
D) The therapist should account and subtract for the enlarged joint in determining the joint flexion.
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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) Explain why the tip of the thumb flexes when trying to grasp a piece of paper between the thumb and index finger in a client who has ulnar nerve paralysis.
A) Because the flexor pollicis longus substitutes for the absent adductor pollicis muscle
B) Because the extensor pollicis longus is absent in ulnar nerve injuries
C) Because the index flexor tendons are absent in ulnar nerve injuries
D) Because the thumb opponens pollicis is absent in ulnar nerve injuries
Q3) What does digital clawing indicate?
A) Weakness or absence of the extensor muscles
B) Weakness or absence of the intrinsic muscles of the hand
C) Weakness or absence of the flexor muscles of the hand
D) Flexor tenosynovitis
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Chapter 44: Low Back Pain
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Q1) In working with Pilar,the occupational therapist will teach her the concepts of body mechanics,which include ___________________.
A) Avoiding twisting movements, holding objects close to the body, lifting with the legs
B) Teaching her tasks and positions that move her body out of balance to challenge and strengthen the low back muscles
C) Forceful dynamic stretching of the upper and lower back
D) Balancing on one leg while reaching overhead
E) All of the above
Q2) Which of the following best defines spinal stenosis?
A) The narrowing of the intervertebral foramen that decreases the space where the spinal nerve exits or enters the spine
B) A type of muscular weakness
C) A condition that never causes low back pain
D) A condition that is caused by the sciatic nerve
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Chapter 45: Hand and Upper Extremity Injuries
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Q1) Which digit is the most important to the hand?
A) Thumb
B) Index finger
C) Long finger
D) Ring finger
Q2) 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
Q3) Which nerve is called the "eyes" of the hands?
A) Radial nerve
B) Median nerve
C) Ulnar nerve
D) Posterior interosseous nerve
Q4) Which of the following is not a sympathetic response?
A) Sweating
B) Gooseflesh
C) Trophic changes (skin texture, nail and hair growth)
D) Tendon adherence
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Chapter 46: Burns and Burn Rehabilitation
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Q1) A burn involving fascia,muscle,or tendon would be classified as ___________.
A) Superficial
B) Superficial partial thickness
C) Deep partial thickness
D) Full thickness
E) Subdermal
Q2) Which is not true about splinting in the treatment of burns?
A) Splints do not need to be worn at all times to prevent contractures.
B) Splints can maintain correct positioning of joints.
C) Splints can protect compromised tissues to promote healing.
D) Splints can reverse scar contractures of mature scars.
E) Splints should not compromise function whenever possible.
Q3) The antideformity position for the wrist and hand is ________________.
A) Wrist flexion, thumb abduction and extension, metacarpophalangeal (MP) flexion, interphalangeal (IP) extension
B) Wrist flexion, thumb abduction and flexion, MP extension, IP extension
C) Wrist neutral, thumb adduction and extension, MP extension, IP flexion
D) Wrist extension, thumb adduction and extension, MP flexion, IP flexion
E) Wrist extension, thumb abduction and extension, MP flexion, IP extension
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Page 48
Chapter 47: Burns and Burn Rehabilitation
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Q1) An OT practitioner is treating a client with burns to the chest and upper extremities sustained 6 weeks ago.The client is exhibiting new stiffness and deep pain in the elbow at the end of elbow flexion range.The therapist suspects development of heterotopic ossification and should take which of the following actions?
A) Discontinue all elbow ROM until pain resolves.
B) Initiate dynamic elbow flexion splinting.
C) Have client perform active elbow ROM exercises within pain-free range.
D) Perform more aggressive passive stretching into elbow flexion.
Q2) An OT practitioner is evaluating 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.
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Chapter 48: Amputations and Prosthetics
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Q1) What is the leading cause of upper extremity amputation?
A) PVD
B) Osteogenic sarcoma
C) Trauma
D) Chronic infection
E) Peripheral vasospastic disease
Q2) When operating a body-powered voluntary opening upper extremity prosthesis,humeral flexion and scapular abduction will __________________.
A) Close the terminal device
B) Flex the elbow
C) Extend the elbow
D) Flex the wrist
E) A and B
Q3) Which is true about upper and lower extremity amputations?
A) The lower the level of amputation, the greater the functional loss.
B) The higher the level of amputation, the less complicated the prosthesis.
C) The higher the level of amputation, the less prosthetic training needed.
D) The lower the level of amputation, the more joints lost.
E) The higher the level of amputation, the less residual limb length.
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Page 50
Chapter 49: Amputations and Prosthetics
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Q1) An OT practitioner is working with a client who had a unilateral below-knee amputation 2 weeks ago and wants to be able to resume living alone as soon as possible.To meet this goal,the therapist should:
A) Alter the client's preexisting performance patterns.
B) Encourage the client to focus on his former sense of self.
C) Discourage the client's independent process skills.
D) Adapt the client's activity demands.
Q2) An OT practitioner is working with a client who had a unilateral below-knee amputation 4 days ago.With regard to wheelchair and positioning,what should be the therapist's priority?
A) To provide a residual limb support
B) To place the large wheelchair wheels farther back to distribute weight
C) To remove both leg rests
D) To issue an extra-heavy wheelchair for stability
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Chapter 50: Oncology
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Q1) For individuals with cancer,what is the most common impairment that leads to impaired ability to engage in meaningful activity?
A) Lymphedema
B) Peripheral neuropathy
C) Impaired cognition
D) Weakness
Q2) Hormone therapy is an example of this type of cancer therapy.
A) En bloc resection
B) Chemotherapy
C) Radiation therapy
D) Palliative therapy
Q3) Palliative therapy is used in the treatment of cancer to _____________.
A) Cure the disease
B) Reduce tumor size
C) Prevent metastases
D) Relieve pain and improve quality of life
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Chapter 51: HIV Infection and Aids
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Q1) The human immunodeficiency virus (HIV)can be transmitted through all but which of the following means?
A) Unprotected sex with an infected partner
B) Infected blood transfusion
C) Intact skin-to-skin contact with an infected person
D) During the birth process from infected mother to infant
Q2) 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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