Positioning
An OT is educating a family member on proper positioning for a client with moderate dysphagia to prevent aspiration during meals. Which of the following is the MOST appropriate position?
A. Supine with head elevated at 30 degrees
B. Upright at 90 degrees with head slightly flexed
C. Side-lying with the stronger side down
D. Reclined at 45 degrees with a neck extension
Correct Answer: B. Upright at 90 degrees with head slightly flexed
All of the following are Factors that Influence Motor Recovery EXCEPT:
A. Type and extent of stroke
B. Age
C. Cognitive or perceptual deficits
D. Proper use of AE
All are factors that influence intervention
approach choice EXCEPT:
A. Initial amount of motor recovery
B. Timing/continuum of care/practice
setting
C. Cognitive/perceptual/language
deficits
D. Client's preferred time of day for therapy
D. Client's preferred time of day for therapy
The dynamic systems theory is based on which kind of model:
A. Hierarchical model
B. Heterarchical model
C. Intentional model
D. Developmental model
B. Heterarchical model
What is the outcome of motor learning and involves the ability to produce purposeful movements of the extremities and and postural adjustments in response to activity and environmental demands:
A. Motor control
B. Motor learning
C. Brain plasticity
D. Motor programming
A. Motor control
A patient s/p stroke who is in the acute care setting is at risk for developing a subluxation. Which of the following interventions should the OTR do FIRST?
A. Ask a colleague trained in kinesiotaping to tape the
patient’s shoulder for increased support
B. Provide the patient a lap tray for his w/c to ensure
proper positioning when OOB
C. Provide the patient with a sling to wear while walking with the PT
D. Instruct the patient, patient’s family and nursing staff on proper UE positioning while in bed
D. Instruct the patient, patient’s family and nursing staff on proper UE positioning while in bed
A 42 yo patient presents with only motor control
deficits and performs all BADLs and related
functional mobility with max A. The patient has an
identified caregiver who is able to provide 24-hour
assistance; however, the caregiver does not drive.
Which of the following would be the MOST
APPROPRIATE discharge recommendation?
A. IP rehab
B. SNF
C. Home health services
D. OP services
A. IP Rehab
According to the task-oriented approach, which of the following is NOT true:
A. Clients need to have opportunities to solve motor problems across multiple contexts using various strategies
B. Rote exercises are more effective than an occupation-based approach in remediating motor control impairments
C. Activity analysis must be used to analyze movement needed to perform a task successfully
D. Activities must be upgraded and downgraded for clients to feel successful about meeting goals
B.
In the dynamic systems theory, motor behavior is the dynamic interaction of what three things:
A. Motivation, strength and ability
B. Client factors, context and occupations
C. Movement, occupation and commitment
D. Client factors, social support and motivation
B. Client factors, context and occupations
Which of the following could limit a client’s ability to integrate the affected UE into activity:
A. Orthostatic hypotension
B. Decreased sensation
C. Contracture and deformity
D. Fear of falling
C. Contracture and deformity
Which is NOT a problem that impairment of trunk control may lead to:
A. Decreased independence with ADLs
B. Decreased cognitive performance
C. Dysfunction of limb control
D. Impaired ability to interact with the environment
B. Decreased cognitive performance
Stroke can specifically affect the trunk in all the following ways EXCEPT:
A. Inability to shift weight through the pelvis anteriorly, posteriorly and laterally
B. Inability to move the trunk as a unit (e.g. logrolling)
C. Assumption of static postures (e.g. posterior pelvic tilt, kyphosis, lateral flexion)
D. Inability to perceive midline leading to misaligned sitting postures
B. Inability to move the trunk as a unit (e.g. logrolling)
According to the task-oriented approach, clients can achieve motor recovery through occupational performance using:
A. Facilitation of normal movement patterns
B. Tapping, stretching and brushing techniques
C. Combined diagonal patterns
D. Real objects, environments and meaningful occupations
D. Real objects, environments and meaningful occupations
Based on the Dynamic Systems Theory, which of the
following activities requires the LEAST dynamic
interaction and therefore, the LEAST motor control
requirements?
A. A bank teller counting dollars/change during a lull in the day
B. A student bubbling in a scantron using a sharp pencil during a timed final exam
C. A mother filling goldfish crackers into a snack cup while the toddler is sleeping
D. A nurse pushing down on a syringe while giving a calm adult patient a flu shot
C. Least motor control requirements – filling goldfish in a cup (quiet, large rim of a cup)
Not nurse – shots given in large muscle group (less need for accuracy, patient is not making a scene/not upset or squirming around)
Not bank teller – has to switch between dollars/change but no customers, no time demand
Greatest – student, scantron bubble is small, high stakes exam, time requirement
Which of the following is the BEST intervention for a client who has a shoulder subluxation s/p stroke:
A. Implementing self-overhead ROM
B. Providing a custom-made orthotic
C. Wearing a sling for a prolonged period
D. Supporting the UE with pillows while in bed or in a wheelchair
D. Supporting the UE with pillows while in bed or in a wheelchair
Which of the following does NOT describe a component of desirable posture, which is a prerequisite for engaging upper and lower limbs in activity:
A. Feet flat on the floor shoulder distance apart and bearing weight
B. Head over shoulders and shoulders over hips
C. Neutral to slight posterior pelvic tilt
D. Equal weightbearing through both ischial tuberosities
C. Neutral to slight posterior pelvic tilt
Which of the following treatment activities could help improve a client’s ability to integrate their UE into tasks:
A. Teaching the client to use one-handed techniques and assistive devices
B. Positioning the client’s affected UE in a sling for additional support
C. Implementing CIMT techniques where the affected UE is constrained
D. Using objects of different size and shape to encourage hand control
D. Using objects of different size and shape to encourage hand control
An OTR is planning a treatment session for a client with moderate cognitive impairment following a stroke. The goal is to support independence in ADLs using a compensatory approach.
Which of the following is the MOST appropriate intervention?
A. Retraining the client to recall each ADL step using verbal cues
B. Using a checklist of grooming steps with visual pictures
C. Removing all mirrors and distractions from the room
D. Teaching relaxation techniques before each task
B. Using a checklist of grooming steps with visual pictures
While more contemporary models are typically used to address CNS dysfunction, which four traditional sensorimotor intervention approaches were presented in the text as an appreciation to their clinical practice contributions:
A. Rood, PNF, CIMT, NDT
B. NDT, PNF, dynamic systems theory, task-oriented approach
C. Brunnstrom, CIMT, dynamic systems theory, task-oriented approach
D. Rood, Brunnstrom, PNF, NDT
D.
An OTR is developing an intervention plan based on a task-oriented approach for a client who has hemiparesis secondary to CVA. Which of the following interventions is MOST CONSISTENT with this approach?
A.Tapping over the muscle belly to increase tone while sorting laundry into 2 baskets
B.Reaching laundry detergent from an overhead shelf using a diagonal pattern
C.Grabbing a handful of clothes out of the washing machine during a laundry task
D.Folding clothes while lying on a mat in propped prone (on belly while using hands)
Answer: C
Which of the following is NOT an example of an external cue to maintain the trunk at midline in sitting:
A. Provide a target such as bolster or wall
B. Provide visual cues such as a mirror
C. Client reminds self to stay straight and upright
D. Therapist provides a verbal cue such as “sit up nice and tall”
C. Client reminds self to stay straight and upright
An OT is working with a client 6 weeks post right CVA who demonstrates mild motor return in the left upper extremity, including active shoulder flexion and elbow extension against gravity. The client reports frustration about not being able to use the affected arm during dressing.
Which of the following interventions is MOST appropriate to promote motor recovery during this stage of rehabilitation?
A. Educate the client to complete dressing tasks using only the unaffected arm to increase independence
B. Encourage bilateral task training, such as pulling up pants using both hands while seated
C. Provide passive range of motion to the affected arm prior to dressing activities
D. Recommend assistive devices such as a button hook and reacher for one-handed dressing
B. Encourage bilateral task training, such as pulling up pants using both hands while seated
A client recovering from a left CVA demonstrates impaired right arm motor coordination during dressing. The OTR chooses a remedial approach to address this deficit.
Which of the following interventions BEST aligns with a remedial approach?
A. Educating the client to don clothing using only the unaffected limb
B. Providing adaptive dressing equipment such as a button hook
C. Engaging the client in bilateral fine motor tasks like threading beads
D. Instructing a caregiver to assist the client with dressing daily
C. Engaging the client in bilateral fine motor tasks like threading beads
According to the reflex and hierarchical models, how are movement strategies viewed:
A. Along a continuum of care
B. Randomly
C. Along a developmental continuum
D. As a dynamic interaction
C.
An OT is working with a client who sustained a right hemispheric CVA. During a meal preparation task, the client forgets items on the left side of the counter and bumps into the left side of the doorway when exiting the kitchen.
Which of the following impairments is MOST likely contributing to the client's performance?
A. Apraxia
B. Visual field cut
C. Left unilateral neglect
D. Diplopia
C. Left unilateral neglect