Question 1

Fran, your 74-year-old cancer patient, is scheduled to be discharged from the nursing home in two days. She is concerned about carrying heavy pots and pans around her kitchen. How do you teach Fran to manage heavy items in her kitchen?
A)Tell Fran to get help since she shouldn't be cooking alone anyway.
B)Show Fran how to slide heavy pots and pans between the stove top and sink using the countertop.
C)Show Fran how to use a wheeled cart to move heavy pots and pans across her kitchen.
D)Both B and C.

Accepted Answer

Either sliding heavy pots and pans along the countertop or using a wheeled cart are acceptable methods of showing Fran how to conserve her energy and handle heavy items while cooking.

Question 2

Arthur is an 82-year-old man with a diagnosis of left cerebrovascular accident with right hemiplegia. How do you teach him to put on a button-down shirt by himself?
A)Slide the right sleeve over the right arm using the left hand; pull the shirt around the back of the neck, slide the left arm in, and button using either one hand or a button hook.
B)Slide the right arm into the right sleeve using the shoulder muscles to push the arm in, pull the shirt around the back of the neck, slide the left arm in, and button using either one hand or a button hook.
C)Slide the left arm in the left sleeve, pull the shirt around the back of the neck, slide the right sleeve over the right arm using the left hand, and button using either one hand or a button hook.
D)Button the shirt first using one hand, slide the shirt over the head, and slide the arms in the sleeves.

Accepted Answer

You show Arthur how to put on a button-down shirt by sliding the right sleeve over the right arm using the left hand, then pull the shirt around the back of the neck, slide the left arm in, and button the shirt using either one hand or a button hook. A person with hemiplegia always dresses the affected side first. If the affected side has no movement, the person must use the functional arm and hand to position the affected limb and slide the clothing over it.

Question 3

Jenny, your 36-year-old patient with fibromyalgia, complains to you that she cannot get anything done during the day because she gets so tired. What do you recommend to Jenny to help her get more done during the day?
A)Hire a house cleaning service, so she does not have to do housework.
B)Make a To Do list every day; and alternate heavy and light activities to include rest breaks while working.
C)Only plan on doing one or two things every day because that is all a person with fibromyalgia can handle.
D)Ask her husband and children to pitch in more around the house.

Accepted Answer

You recommend to Jenny that she make a To Do list every day, alternating the heavy and light activities on the list and including rest breaks. Alternating heavy and light activities is an energy conservation principle that helps people take rest breaks while continuing with tasks.

Question 4

Ruby is a 56-year-old outpatient with rheumatoid arthritis. She has been experiencing increased pain and swelling in her hands every time she does her laundry. Her washer and dryer are in the basement of her home, and she uses large, plastic laundry baskets to carry her clothes. What do you recommend to Ruby?
A)Install a laundry chute, so Ruby does not have to carry clothes down the stairs.
B)Remodel a closet on the first floor of the home, so Ruby does not have to carry clothes to the basement.
C)Purchase smaller laundry baskets or bags with large handles, so Ruby can carry smaller loads of laundry using her forearms instead of her hands.
D)Hire a laundry service to do Ruby's laundry.

Accepted Answer

You recommend to Ruby that she purchase smaller laundry baskets or bags

Question 5

Max is your 67-year-old hip replacement patient. His doctor has ordered full hip precautions with toe touch weight bearing on the affected leg. How do you teach Max to put on his pants?
A)Place his feet in his pants and use his unaffected leg to push them up to where he can reach them with his hands. Then stand on both feet, and pull them up.
B)Use a reacher to hold his pants to put his feet in, and then stand on one foot to pull them up. Sit and use the reacher again to hold his pants to put his feet in, then stand on one foot to pull them up.
C)Use a reacher to hold his pants and put his feet in. Then use the reacher to hold the pants and put his feet in. Use the reacher to pull up the pants until he can reach them with his hand. Stand with weight on the unaffected leg and the toe of the affected leg just touching the floor for balance. Pull up the pants.
D)Lie on the bed on his side and bend to put both feet in the pants, and then lay on his back to pull them up.

Accepted Answer

Max's precautions mean he cannot bend past 90 degrees on the affected hip, and he can only touch a toe on the floor for balance on the affected side. To put on his pants, he will need to use a reacher to hold his pants and put his feet in. Then he will need to pull the pants up using the reacher until he can grasp them with his hand. He will then need to stand up once, bearing weight on his unaffected leg and touching his toe down with his affected leg for balance.

Question 6

How do you have a client complete active assistive range of motion exercises to both shoulders?
A)Have him lift his arms in the air under his own power and reach as high as he can.
B)Help the client lift his arms in the air as high as he can. Then ask the client to hold his arms in place while you let go.
C)Have the client place his arms on a towel. Then slide the towel on a table in the desired direction.
D)Both B and C.

Accepted Answer

To perform active assistive range of motion exercises, have the client place his arms

Question 7

Lucy is a 93-year-old nursing home patient who wants to be independent in her kitchen at home. How do you structure strengthening exercises, so Lucy can lift her arms to reach into her cupboards?
A)Have Lucy complete dowel exercises with a one-pound weight.
B)Have Lucy wear ½-pound wrist weights while she lifts plastic dishes to shelves at heights that are graded upward.
C)Have Lucy stand on a step stool and lift weights to waist height only.
D)Have Lucy do pulley exercises with 10 pounds of resistance.

Accepted Answer

To simulate the motion Lucy will use to reach into her cupboards, you would have her lift plastic dishes to shelves at heights that are graded upward. You would also add resistance to this activity by having Lucy wear ½-pound wrist weights. You do not want to increase the weight by too much, but you do want to build Lucy's endurance through repetition of the activity.

Question 8

How can you promote activity tolerance while completing self-care tasks with Frieda, your 86-year-old patient with osteoporosis?
A)Have Frieda stand at the sink to complete grooming tasks.
B)Have Frieda bend to put on her socks and shoes.
C)Have Frieda complete all her tasks without assistance.
D)Have Frieda use adaptive equipment to put on and take off her clothing.

Accepted Answer

To promote activity tolerance while completing self-care tasks, you could have Frieda stand at the sink to complete grooming tasks.

Question 9

Your outpatient, Amanda, asks you why she needs to complete internal and external active range of motion exercises to her dominant arm following a shoulder injury. What do you tell her?
A)So she can regain full motion in her shoulder joint.
B)So she can throw a softball again.
C)It is a part of the shoulder rehabilitation protocol.
D)So she can reach the back of her head to comb her hair.

Accepted Answer

You tell Amanda that she needs to complete internal and external active range of motion exercises so she can reach the back of her head to comb her hair. When a patient questions the need for a therapeutic exercise, it is always best to relate the exercise to a functional activity that the patient views as important.

Question 10

Mack is gung ho regarding upper-body strengthening. He often wants to perform the same exercises every day with more resistance than the amount you and your OT department have recommended. How do you help Mack to complete upper-body strengthening without hurting himself?
A)You restrict Mack's access to the therapy gym.
B)You tell Mack that he must stick to the exercise protocol, or his doctor will discontinue therapy.
C)You tell Mack that it is a good idea to exercise different muscles from day to day and slowly increase repetitions to avoid injury.
D)You tell Mack to exercise as much as he wants to because he will get better faster that way.

Accepted Answer

To help Mack complete upper-body strengthening without hurting himself, you tell him that it is a good idea to exercise different muscles from day to day and slowly increase repetitions to avoid injury. If a patient knows the reasons behind exercise precautions, he is more likely to follow those precautions.

Question 11

How would you set up a reaching activity for a patient with Parkinson's disease?
A)Make sure the objects grasped are lightweight to compensate for weakness.
B)Make sure the objects grasped are large to compensate for poor coordination.
C)Make sure the objects grasped are heavy to compensate for upper-extremity tremors.
D)Make sure the objects grasped are small to work on fine motor skills.

Accepted Answer

You would set up a reaching activity for a patient with Parkinson's disease by making sure the objects grasped are heavy to compensate for upper-extremity tremors. Adding weight to an activity helps control tremors. Another strategy would be to have the patient wear wrist weights.

Question 12

Angela is a 39-year-old outpatient recovering from a median nerve laceration. She is beginning to regain sensation in her hand. What activity could you have Angela do to help facilitate her awareness of this sensation?
A)Dig for small objects in rice.
B)Place small pegs in a pegboard.
C)Wash dishes in warm water.
D)Perform massage techniques to the laceration area.

Accepted Answer

To help facilitate awareness of returning sensation, you could have Angela dig for small objects in rice. The varied textures in the rice will help stimulate the small nerves at the surface of Angela's skin and will assist her awareness of sensation in her fingers.

Question 13

Regina is a 79-year-old patient with a diagnosis of multiple Transient Ischemic Attacks (TIAs). Your OT department has pinpointed visual closure as one of the deficits interfering with Regina's ability to write. What activity could you use with Regina to address visual closure?
A)Ask Regina to look at a picture and memorize it; and then locate it within an array.
B)Have Regina look for specific objects in a messy drawer.
C)Have Regina cross out all the letter Xs on a sheet full of letters.
D)Have Regina fill in the missing lines on partially written letters.

Accepted Answer

To address visual closure, you would have Regina fill in the missing lines on partially written letters. Visual closure is the brain's ability to complete an image based on a partial image.

Question 14

Charlie positions his right arm in slight flexion due to an old triceps tendon injury with resulting weakness. How could you facilitate contraction of the triceps muscle to improve extension and prevent contracture in Charlie's right arm?
A)Provide passive range of motion to Charlie's right elbow.
B)Provide quick stretch to Charlie's biceps, followed by reaching forward for a cone.
C)Provide quick stretch to Charlie's triceps, followed by weight bearing on the right arm.
D)Complete active range of motion exercises.

Accepted Answer

To facilitate contraction of the triceps muscle to improve extension, you could provide quick stretch to Charlie's triceps, and immediately follow the stretch with weight bearing on the right arm. The quick stretch causes the muscle fibers to fire and facilitates a quick contraction of the muscle. This response must be immediacy followed by activity addressing the motion the muscle creates, preferably with some resistance, if possible.

Question 15

Ana is a 51-year-old rehabilitation patient who has had a head injury resulting from a car accident. She has extreme difficulty controlling her arms to reach for objects and moving her body into different positions. Your OT department asks you to work on Ana's sense or proprioception. What activity could you use to address this area?
A)Balancing on a balance beam.
B)Joint compressions followed by Neurodevelopmental Treatment (NDT) mat techniques involving weight bearing.
C)Active exercises against resistance.
D)Yoga postures with eyes closed.

Accepted Answer

To address proprioception, or Ana's ability to sense her position in space, you could complete joint compressions to Ana's upper extremities followed by NDT mat techniques involving weight bearing. Both of these activities will facilitate Ana's sense of proprioception by providing input to Ana's upper-extremity joints, limbs, and trunk through compression and weight bearing in different physical positions - such as prone on elbows, side sitting, or all fours.

Question 16

Your patient Iva, who has a diagnosis of left cerebrovascular accident with right hemiplegia, has partial shoulder movement with grade 2+ strength. What modality could you use to facilitate shoulder flexion during a reaching activity?
A)Ultrasound
B)Transcutaneous Electrical Nerve Stimulation (TENS)
C)Neuromuscular Electrical Stimulation (NMES)
D)Diathermy

Accepted Answer

To facilitate shoulder flexion during a reaching activity, you could use NMES. Since Iva's shoulder strength is grade 2+, she has some active movement in the shoulder flexor muscles. By placing the pads for the NMES unit near the tendon insertions of the shoulder flexor muscles, you can stimulate contraction in these muscles and assist flexion during reaching.

Question 17

Rod is a 73-year-old patient with severe osteoarthritis in his shoulders. He has a pacemaker. What modality could you use to relieve shoulder pain prior to exercise?
A)Ultrasound
B)Transcutaneous Electrical Nerve Stimulation (TENS)
C)Diathermy
D)Hot pack

Accepted Answer

You may use a hot pack to help relieve Rod's shoulder pain prior to exercise. Modalities that use electricity to create waves or stimulate tissues are counter indicated for patients with pacemakers. The waves created can interfere with the pacemaker's function.

Question 18

What modality could you use to heat the muscles in the shoulder girdle prior to deep tissue massage?
A)Ultrasound
B)Transcutaneous Electrical Nerve Stimulation (TENS)
C)Diathermy
D)Hot pack

Accepted Answer

To prepare the muscles for deep tissue massage, you could use diathermy. The diathermy process provides heat at a deeper level than a hot pack and to a larger area than ultrasound. Since you would like to massage the entire shoulder girdle, using diathermy to heat the area would be appropriate.

Question 19

Maria has acute swelling in her left hand following carpal tunnel surgery. Her hand is large and warm to the touch. Her wound is closed and stitches are out. What modality could you use to help control Maria's edema?
A)Ultrasound
B)Do not use any modality; report condition to Maria's physician
C)Neuromuscular Electrical Stimulation (NMES)
D)Paraffin bath

Accepted Answer

Because Maria's hand is large and warm to the touch, you might suspect a post-surgical infection. Physical agent modalities are counter indicated when an infection is present. You would not use a modality, instead report the condition to Maria's physician.

Question 20

You must perform scar mobilization to your outpatient Erick's forearm. What modality could you use to heat the area prior to completing scar mobilization?
A)Ultrasound
B)Diathermy
C)Transcutaneous Electrical Nerve Stimulation (TENS)
D)Paraffin bath

Accepted Answer

To heat the scarred area prior to scar mobilization, you could use ultrasound. This modality is designed to heat deeper tissues of a localized area. It also assists in breaking down scar tissue.

Quiz 2: Implementing Interventions

Fran, your 74-year-old cancer patient, is scheduled to be discharged from the nursing home in two days. She is concerned about carrying heavy pots and pans around her kitchen. How do you teach Fran to manage heavy items in her kitchen?

Arthur is an 82-year-old man with a diagnosis of left cerebrovascular accident with right hemiplegia. How do you teach him to put on a button-down shirt by himself?

Jenny, your 36-year-old patient with fibromyalgia, complains to you that she cannot get anything done during the day because she gets so tired. What do you recommend to Jenny to help her get more done during the day?

Max is your 67-year-old hip replacement patient. His doctor has ordered full hip precautions with toe touch weight bearing on the affected leg. How do you teach Max to put on his pants?

How do you have a client complete active assistive range of motion exercises to both shoulders?

Lucy is a 93-year-old nursing home patient who wants to be independent in her kitchen at home. How do you structure strengthening exercises, so Lucy can lift her arms to reach into her cupboards?

How can you promote activity tolerance while completing self-care tasks with Frieda, your 86-year-old patient with osteoporosis?

Your outpatient, Amanda, asks you why she needs to complete internal and external active range of motion exercises to her dominant arm following a shoulder injury. What do you tell her?

Mack is gung ho regarding upper-body strengthening. He often wants to perform the same exercises every day with more resistance than the amount you and your OT department have recommended. How do you help Mack to complete upper-body strengthening without hurting himself?

How would you set up a reaching activity for a patient with Parkinson's disease?

Angela is a 39-year-old outpatient recovering from a median nerve laceration. She is beginning to regain sensation in her hand. What activity could you have Angela do to help facilitate her awareness of this sensation?

Regina is a 79-year-old patient with a diagnosis of multiple Transient Ischemic Attacks (TIAs) . Your OT department has pinpointed visual closure as one of the deficits interfering with Regina's ability to write. What activity could you use with Regina to address visual closure?

Charlie positions his right arm in slight flexion due to an old triceps tendon injury with resulting weakness. How could you facilitate contraction of the triceps muscle to improve extension and prevent contracture in Charlie's right arm?

Your patient Iva, who has a diagnosis of left cerebrovascular accident with right hemiplegia, has partial shoulder movement with grade 2+ strength. What modality could you use to facilitate shoulder flexion during a reaching activity?

Rod is a 73-year-old patient with severe osteoarthritis in his shoulders. He has a pacemaker. What modality could you use to relieve shoulder pain prior to exercise?

What modality could you use to heat the muscles in the shoulder girdle prior to deep tissue massage?

Maria has acute swelling in her left hand following carpal tunnel surgery. Her hand is large and warm to the touch. Her wound is closed and stitches are out. What modality could you use to help control Maria's edema?

You must perform scar mobilization to your outpatient Erick's forearm. What modality could you use to heat the area prior to completing scar mobilization?