Question 1

Roy is a 45-year-old client with Down syndrome. You have been working with him on independent community mobility, but he can never remember where to get off the bus near his apartment. What adaptation do you provide to Roy to help him get off at the correct bus stop?
A)Give the bus driver a picture of Roy and his address. Ask the driver to tell Roy when to get off the bus.
B)Do not let Roy ride the bus unsupervised since he cannot remember his bus stop.
C)Give Roy a picture of the bus stop, and tell him to watch for the same stop.
D)Give Roy an identification card with his address and bus stop number on it. Have him show it to the driver when he gets on the bus, and train him to ask the driver to tell him when the bus gets to his stop.

Accepted Answer

To help Roy get off at the correct bus stop, you could provide him with an identification card that states his name, address, and bus stop number. You would then work with Roy to teach him how to show the card to the bus driver and ask the bus driver to tell him when the bus gets to his stop. This way Roy will be able to ride the bus by himself and will be able to receive a reminder from the driver, regardless of who the driver is on a given day.

Question 2

Your outpatient Irma has Alzheimer's disease. Her husband would like to allow her to walk outside in the yard, but Irma forgets where she is and wanders down the street. The yard has a fence, but Irma still remembers how to operate the latch on the gate. What do you recommend to Irma's husband?
A)Lock the gate with a padlock, so Irma cannot get out.
B)Install a different latch on the gate that requires two steps to open.
C)Wire the gate shut, so it cannot be used.
D)Have the neighbor alert Irma's husband when Irma is out of the yard.

Accepted Answer

You recommend to Irma's husband that he install a different latch on the gate that requires two steps to open it. Because Irma has Alzheimer's disease, she is unlikely to be able to learn how to use a new latch that requires problem-solving skills.

Question 3

Steven has paranoid schizophrenia. He will, at times, become violent and unknowingly hurt himself by hitting his limbs against furniture and walls. What adaptation do you recommend to Steven's family?
A)Provide Steven with a room with soft furniture and no breakable items, so Steven can go there and be safe when he has violent episodes.
B)Strap Steven down when he has violent episodes, so he cannot hurt himself.
C)Admit Steven to the hospital since he should not be in the community when he is violent.
D)Leave Steven alone during a violent episode, so the episode does not become worse.

Accepted Answer

You recommend to Steven's family that they provide him with a room that has soft furniture and no breakable items. You tell them that the room is not to be used as a punishment, but as a safe place where Steven can go when he becomes violent.

Question 4

What common environmental modification is useful for adults with cognitive disabilities?
A)Auditory beep on crosswalk signal
B)Curb cuts
C)Public signs (with pictures instead of words)
D)Braille instructions

Accepted Answer

Public signs that use pictures instead of words are common environmental modifications that are useful for adults with cognitive disabilities. Adults with cognitive disabilities may have limited reading capabilities, so they have an easier time understanding signs that use pictures.

Question 5

Richard has severe panic attacks while he is out in his community. He only goes to a limited number of places when he is out of the house. What accommodation could you arrange for Richard to help manage his panic attacks?
A)Have Richard dial 911, so the police can pick him up and bring him home.
B)Arrange for someone to drive Richard everywhere he needs to go.
C)Arrange for two or three "safe places" where Richard can go to calm down if he has a panic attack.
D)Tell Richard to stay home.

Accepted Answer

To help manage Richard's panic attacks, you could arrange for two or three "safe places" with local businesses who know him. Richard would be able to go to these places to calm down when he has panic attacks.

Question 6

Don is a 35-year-old outpatient with a medical history of brain injury. He is able to drive, but often gets lost. He cannot remember the routes he needs to drive to get where he needs to go. What adaptation do you recommend for Don?
A)Map
B)Global Positioning System (GPS) unit with preprogrammed routes
C)Cell phone
D)Both B and C.

Accepted Answer

You recommend that Don get a GPS unit for his car. The routes he needs to drive can be preprogrammed, so Don can push a single button and get the driving directions he needs for a particular destination. You also recommend that Don carry a cell phone, so he can call for help if he gets lost.

Question 7

Roberta must take her Risperdal twice per day. She has difficulty remembering to take the second pill. How can you help Roberta remember to take her medication?
A)Set the alarm on Roberta's cell phone to repeat at the same time every day, with a message that reads "Take Risperdal."
B)Tell Roberta to set her alarm clock to go off at the same time every day to remind her to take her medication.
C)Tell Roberta to get a talking pill organizer that will talk to her when it is time to take her medication.
D)Ask Roberta's mother to remind her to take her medication.

Accepted Answer

You can help Roberta remember to take her medication by setting the alarm on her cell phone to repeat at the same time every day, with a message that reads "Take Risperdal." Cell phone alarms can accommodate multiple settings, so you will not disturb Roberta's other alarm reminders by adding this one. This adaptation allows Roberta to use a device that she already owns to remind her to take her medication.

Question 8

Harry wants to return to work. He is responsible for multiple projects and has an extremely difficult time staying organized. He owns an iPad. What adaptation do you recommend to help Harry stay organized?
A)Personal data assistant (PDA)
B)iPad application that provides organizational functions (To Do lists, reminder notifications, calendar)
C)Day planner
D)Personal secretary

Accepted Answer

You recommend an iPad application that provides organizational functions, such as a To Do lists, reminder notifications, and a calendar. Harry already owns an iPad, so it would be easy and inexpensive for him to download applications that provide the organizational functions he requires to return to work.

Question 9

Emily is an 88-year-old outpatient with senile dementia. Her family reports that Emily likes to watch television, but she cannot operate the remote control. They have to help her find stations. What adaptation do you recommend for Emily?
A)A television with an old fashioned dial that you have to turn by hand.
B)Tape off all the remote buttons, except for the On/Off button.
C)A simple remote control with large, color-coded buttons for On/Off, Channel, and Volume.
D)A special television that will change channels when Emily waves her hand.

Accepted Answer

An adaptation that might help Emily is a simple remote control with large, color-coded buttons for On/Off, Channel, and Volume. Emily should be able to read the button labels and remember which button does what by using the color coding. Taping the buttons on the existing remote is inconvenient for the family and will give Emily a self-conscious feeling.

Question 10

Nathan has advanced Alzheimer's disease and often wanders out of his yard and into the fields adjacent to his farm. What adaptation do you recommend to Nathan's family to assist them in locating Nathan when he wanders away from home?
A)Cell phone
B)Video cameras (located in strategic spots)
C)Walkie-talkie
D)GPS locator

Accepted Answer

You recommend a GPS locator to Nathan's family. This device is worn on the person, usually as a watch or on a cord around the neck. It can be used to track the person from a Web site. It pinpoints the location of the person wearing the device. The device could assist Nathan's family in locating him when he wanders into the farm fields.

Question 11

Fawn is an inpatient rehabilitation patient with a new brain injury. She cannot remember how to brush her teeth. How can you help Fawn complete this task by herself?
A)Set up the toothbrush for her and hope that she remembers what the toothbrush is used for.
B)Provide Fawn with hand-over-hand assistance while brushing her teeth.
C)Break down the steps of tooth brushing, and provide Fawn with a picture list of each step. Tape the list to the mirror where Fawn brushes her teeth, and teach her to refer to the list while brushing.
D)Have Fawn use an electric toothbrush.

Accepted Answer

You can help Fawn complete this task by breaking down the steps of tooth brushing and providing Fawn with a picture list of each step. You can then tape this list to Fawn's mirror and work with her on remembering to refer to it while brushing her teeth.

Question 12

Remy is a 37-year-old man with a cognitive disability. He has been working with you on shopping skills and can now successfully shop for and purchase one item at a department store with no assistance. What would be your next step in teaching Remy shopping skills?
A)Teach Remy how to take the bus to the store by himself.
B)Teach Remy how to make a shopping list and shop for more than one item.
C)Teach Remy how to shop at different stores.
D)Teach Remy how to shop on the Internet.

Accepted Answer

Your next step in teaching Remy shopping skills would be to teach him how to make a shopping list and shop for more than one item. Since Remy can now shop for and purchase one item, the next step in grading the activity to a higher level of difficulty would be to teach Remy how to shop for more than one item at a time.

Question 13

Carl is a 48-year-old man with multiple psychological diagnoses. He has difficulty with executive functions and is unable to balance his bank account without making numerous errors. What do you recommend to Carl to help him manage his bank account?
A)Use a calculator to make calculations, rather than attempting to complete math problems mentally while balancing his bank account.
B)Check the bank balance online every day to make sure the account has enough money.
C)Request that the bank monitor his bank balance for him.
D)Open more than one bank account in case one becomes overdrawn.

Accepted Answer

You recommend to Carl that he use a calculator to make calculations, rather than attempting to complete math problems mentally while balancing his bank account. Since Carl has difficulty with executive functions, he will have difficulty completing math problems in his head. He will make fewer errors if he uses a calculator to compensate for his difficulty completing math problems.

Question 14

Ava is your outpatient with a diagnosis of bipolar disorder. She is going on her first job interview in two years, and she is very nervous. How can you help calm Ava's nerves before she goes on her job interview?
A)Tell Ava to take her anti-anxiety medication.
B)Drive Ava to her job interview to help calm her down.
C)Assure Ava that she is an intelligent woman, and she will do fine during her interview.
D)Conduct two or three practice interviews prior to the actual interview. This will allow Ava to become comfortable with the interview process.

Accepted Answer

You can help calm Ava's nerves before she goes on her job interview by conducting two or three practice interviews. This will allow Ava to become comfortable with the interview process. The practice sessions will allow Ava to work out any difficult or awkward answers prior to the actual interview. Also, practice interviews will give her confidence and reduce her anxiety.

Question 15

Amy is a 57-year-old inpatient with a diagnosis of schizophrenia. She dislikes the smell of food and avoids eating when possible. Amy's doctors are concerned about her nutritional status. What interventions could you try with Amy to desensitize her sense of smell, so she can eat?
A)Have Amy smell foods that she dislikes to desensitize her to their presence.
B)Have Amy smell essential oils from bottles to stimulate her appetite.
C)Place an essential oils diffuser in Amy's room, and load it with oils that are designed to stimulate her appetite.
D)Tell Amy she must eat or her doctor will make her use a feeding tube.

Accepted Answer

One intervention you could try with Amy is to place an essential oils diffuser in her room with oils that are designed to stimulate her appetite. Amy is likely to resist attempts to get her to smell or eat food or to smell essential oils directly. A diffuser would expose Amy to the smell of the essential oils subtly, without her direct knowledge. This will increase the chance that the intervention will be effective.

Question 16

You have spent a month teaching Gary, your outpatient with a diagnosis of brain injury, how to use tablet applications to remind him about his work schedule and various appointments. On a follow-up visit, you find out that Gary has missed two appointments because his children were playing with his tablet. What do you discuss with Gary's wife to insure that he has access to his tablet?
A)Tell Gary's wife to buy the children their own tablets.
B)Tell Gary's wife that no one is allowed to touch Gary's tablet except for Gary.
C)Emphasize to Gary's wife the importance of Gary consistently using the tablet as a memory aid.
D)Ask Gary's wife to remind him of his work schedule and appointments since the children are using his tablet.

Accepted Answer

You discuss with Gary's wife the importance of Gary consistently using the tablet as a memory aid. If Gary does not have consistent access to his tablet, he will forget how to use it and begin relying on his wife to remind him about his schedule. His wife must insure that Gary has access to his tablet, so that he can be as independent as possible.

Question 17

Rhetta is a nursing home patient with a diagnosis of Stage 3 Alzheimer's disease. You have taught her how to use a calendar to remind her of appointments, and she can now do this independently. Rhetta is scheduled to be discharged to her home in three days. She lives alone, but her children live in the same town. How do you insure that she continues to use a calendar as a reminder at home?
A)Tell Rhetta to hang the calendar up at home in a location where she will see it every day.
B)Ask Rhetta's children to hang the calendar up in her home in a location where she will see it every day.
C)Go to Rhetta's home yourself and hang the calendar up in a location where she will see it every day.
D)Ask Rhetta's children to manage her appointments for her.

Accepted Answer

To insure that Rhetta continues to use a calendar at home, ask her children to hang the calendar up in her home in a location where she will see it every day. Rhetta has learned how to use a calendar in the nursing home, but she may not have the ability to remember to hang the calendar up or generalize using it in a home setting. Her children can assist by hanging the calendar up and reminding Rhetta to use it.

Question 18

Ferdinand is a 28-year-old man with a developmental disability. He is now able to stock a soda machine with cans, if the cartons are opened for him first. Whom do you need to communicate this information to?
A)Ferdinand's mother
B)Ferdinand's line supervisor
C)Ferdinand's best friend
D)Ferdinand's job coach

Accepted Answer

You would communicate this information to Ferdinand's job coach. His job coach would be the person setting up Ferdinand's work station and insuring that Ferdinand is able to follow through with the job of stocking soda machines.

Question 19

Aggie, your 48-year-old outpatient, has worked with you for several weeks on problem-solving skills. What activity could you recommend for Aggie to participate in to continue to develop her problem-solving skills once therapy is finished?
A)Show Aggie how to play brain games on a tablet.
B)Tell Aggie to do crossword puzzles.
C)Tell Aggie to watch trivia game shows on television.
D)Tell Aggie to do math problems.

Accepted Answer

You could show Aggie how to play brain games on a tablet. Several applications are available for download that provide games designed to develop cognitive skills, including problem solving. These games would provide an entertaining way for Aggie to continue to work on her problem-solving skills after therapy is finished.

Question 20

You have worked on relaxation techniques with your inpatient, Chelsea. She is ready to be discharged from the inpatient psychiatric unit. What do you give Chelsea to take home with her, so she can continue to practice relaxation skills?
A)Aromatherapy set
B)Relaxation CD and handout with several relaxation techniques
C)Ear plugs and eyeshades
D)All of the above.

Accepted Answer

You give Chelsea a relaxation CD and a handout with several relaxation techniques that she has learned during therapy. Chelsea is familiar with these relaxation techniques and can continue to follow through with them at home.

Quiz 2: Implementing Interventions

Roy is a 45-year-old client with Down syndrome. You have been working with him on independent community mobility, but he can never remember where to get off the bus near his apartment. What adaptation do you provide to Roy to help him get off at the correct bus stop?

Your outpatient Irma has Alzheimer's disease. Her husband would like to allow her to walk outside in the yard, but Irma forgets where she is and wanders down the street. The yard has a fence, but Irma still remembers how to operate the latch on the gate. What do you recommend to Irma's husband?

Steven has paranoid schizophrenia. He will, at times, become violent and unknowingly hurt himself by hitting his limbs against furniture and walls. What adaptation do you recommend to Steven's family?

What common environmental modification is useful for adults with cognitive disabilities?

Richard has severe panic attacks while he is out in his community. He only goes to a limited number of places when he is out of the house. What accommodation could you arrange for Richard to help manage his panic attacks?

Don is a 35-year-old outpatient with a medical history of brain injury. He is able to drive, but often gets lost. He cannot remember the routes he needs to drive to get where he needs to go. What adaptation do you recommend for Don?

Roberta must take her Risperdal twice per day. She has difficulty remembering to take the second pill. How can you help Roberta remember to take her medication?

Harry wants to return to work. He is responsible for multiple projects and has an extremely difficult time staying organized. He owns an iPad. What adaptation do you recommend to help Harry stay organized?

Emily is an 88-year-old outpatient with senile dementia. Her family reports that Emily likes to watch television, but she cannot operate the remote control. They have to help her find stations. What adaptation do you recommend for Emily?

Nathan has advanced Alzheimer's disease and often wanders out of his yard and into the fields adjacent to his farm. What adaptation do you recommend to Nathan's family to assist them in locating Nathan when he wanders away from home?

Fawn is an inpatient rehabilitation patient with a new brain injury. She cannot remember how to brush her teeth. How can you help Fawn complete this task by herself?

Remy is a 37-year-old man with a cognitive disability. He has been working with you on shopping skills and can now successfully shop for and purchase one item at a department store with no assistance. What would be your next step in teaching Remy shopping skills?

Carl is a 48-year-old man with multiple psychological diagnoses. He has difficulty with executive functions and is unable to balance his bank account without making numerous errors. What do you recommend to Carl to help him manage his bank account?

Ava is your outpatient with a diagnosis of bipolar disorder. She is going on her first job interview in two years, and she is very nervous. How can you help calm Ava's nerves before she goes on her job interview?

Amy is a 57-year-old inpatient with a diagnosis of schizophrenia. She dislikes the smell of food and avoids eating when possible. Amy's doctors are concerned about her nutritional status. What interventions could you try with Amy to desensitize her sense of smell, so she can eat?

Ferdinand is a 28-year-old man with a developmental disability. He is now able to stock a soda machine with cans, if the cartons are opened for him first. Whom do you need to communicate this information to?

Aggie, your 48-year-old outpatient, has worked with you for several weeks on problem-solving skills. What activity could you recommend for Aggie to participate in to continue to develop her problem-solving skills once therapy is finished?

You have worked on relaxation techniques with your inpatient, Chelsea. She is ready to be discharged from the inpatient psychiatric unit. What do you give Chelsea to take home with her, so she can continue to practice relaxation skills?