AOTA-Vision MC Flashcards
An OTR® is working with a pediatric client with delayed visual–perceptual skills. Specifically, the child has difficulty with shape, letter, and color identification and recognition. On the basis of this description, with which visual–perceptual skill is the child having difficulty?
Visual discrimination
Visual memory
Visual closure
Figureground recognition
Solution: The correct answer is A.
Visual discrimination is the brain’s ability to process and interpret the features of an object (or other stimuli) related to matching, recognition, and categorization by different attributes.
B, C, D: Visual memory, visual closure, and visual figure ground are other important visualperceptual skills, but they do not allow the individual to visually discriminate among key features of objects.
Which occupational therapy intervention strategy is MOST appropriate for use with an older adult with low vision?
Instruct the client to reduce clutter and improve organization of the home and work environments.
Instruct the client in the use of bold, colored patterns on tablecloths.
Teach the client to use a medication chart printed in typical-size print (12-point Times Roman).
Teach the client how to use the sense of smell to compensate for vision loss.
Solution: The correct answer is A.
Reducing visual and physical clutter makes it easier for the client with low vision to find objects and reduces fall risk.
B: The use of patterns makes it more difficult for the person with low vision to distinguish an object from the background. The use of contrast makes it easier for the person with low vision to distinguish objects from the background
C. This strategy only makes it easier for the person with low vision to manage medications if the chart is large print.
D: The sense of smell may help partially compensate for vision loss, but it is helpful to additionally use other senses (such tactile or auditory). This helps supplement the reduced vision and enables participation in tasks and activities.
An older adult client with age-related macular degeneration (AMD) presents for evaluation and demonstrates difficulty reading and signing consent forms. What visual function should the OTR® evaluate FIRST?
Visual acuity
Tolerance to glare
Peripheral vision
Visual scanning
Solution: The correct answer is A.
In AMD, the macular scotoma develops within the central visual field, creating a blind spot that reduces the person’s ability to see color and visual details. When the scotoma encroaches on the fovea, the area of the retina with the greatest number of cone cells and the best visual acuity, the person begins to experience significant challenges in reading. Both visual acuity and reading speed decline as the size of the central scotoma increases. Because the client is presenting with reading challenges, visual acuity should be evaluated first.
B: This client is not presenting with complaints about glare.
C: Peripheral vision loss is not characteristic of AMD.
D. Visual scanning is a technique for compensating for central vision loss and may be a useful intervention for this client.
An older adult client who has difficulty completing feeding tasks demonstrates compensatory movements including holding food close, tilting the head when eating, and closing one eye when moving the fork to the mouth. Which factor would the OTR® assess FIRST during evaluation?
Visual foundation skills
Visual perception skills
Environmental factors
Motor planning skills
Solution: The correct answer is A.
Visual foundation skills, including visual acuity, oculomotor control, visual pursuits, saccades, and visual fields, should be assessed before completing a visual perception evaluation to screen out visual problems. Underlying problems with visual foundation skills may interfere with the accuracy of visual perception testing.
B, D: The client’s compensatory techniques suggest disruptions in visual foundation skills, which should be screened before assessing visual perception and motor planning.
C: Environmental factors do not influence the compensatory movements this client demonstrates.
An older adult client complains that objects appear distorted—for example, straight lines look wavy. The client has difficulty reading and makes frequent mistakes when reading but is able to navigate busy and crowded environments using peripheral vision. Which visual deficit would the OTR® suspect?
Glaucoma
Macular degeneration
Cataract
Diabetic retinopathy
Solution: The correct answer is B.
Macular degeneration results in a gradual loss of ability to see objects clearly when looking straight ahead. Objects appear distorted in shape and straight lines look wavy or crooked, creating difficulty with reading.
A: Clients with glaucoma experience decreased peripheral vision and often report difficulty with functional mobility.
C: Clients with cataract most frequently report blurred or hazy vision and reduced intensity of colors.
D: Clients with diabetic retinopathy see spots or floaters in the field of vision, have blurred vision, and have a dark or empty spot in the center of the visual field.
An OTR® is screening an older adult who has had a stroke. The physician’s referral notes that the client eats food on only half of the plate and completes grooming tasks swiftly, making many mistakes. Which scanning pattern would be MOST likely to prompt the OTR to recommend additional testing for unilateral neglect?
Organized, symmetrical scanning
Rescanning with an organized scanning pattern
Scanning with multiple short saccades
Disorganized, random scanning
Solution: The correct answer is D.
A disorganized, random scanning pattern is characteristic of unilateral neglect, or hemiinattention, which can be further assessed using a cancellation, drawing, or reading task.
A, B, C: An organized and symmetrical scanning pattern, rescanning with an organized scanning pattern, and an scanning pattern with multiple saccades are all characteristic of visual field deficit, not unilateral neglect.
A client with low vision was prescribed a handheld magnifier to promote reading. The client reports to the OTR® that the handheld magnifier does not make text clear enough to read. Which recommendation is BEST for the OTR to make?
The handheld magnifier should be held at a predetermined distance from what is being read.
The handheld magnifier should be held up to the eye to see objects in the distance.
With stronger magnification, the field of view is larger and the magnifier is held closer.
With weaker magnification, the field of view is smaller and the magnifier is held farther away.
Solution: The correct answer is A.
Handheld magnifiers, which are prescribed by an optometrist or ophthalmologist, must be held at a predetermined distance from what is being read.
B: Handheld magnifiers are used for reading and are not intended to view distant objects.
C, D: These statements, which are irrelevant to the client’s difficulty using a single magnifier, are also incorrect; in fact, the stronger the magnification, the smaller the field of view and the closer the magnifier is held to the eye.
An OTR® recommends task lighting for a client with age-related macular degeneration. Where should the task light be positioned to promote the client’s vision?
On top of a shiny surface that reflects light
On a patterned surface or cloth to decrease glare
Opposite the writing hand or nearest to the best seeing eye
On top of dull, low-contrast fabric to reduce reflected light
Solution: The correct answer is C.
Lighting should be positioned opposite the writing hand or nearest to the best seeing eye to promote the client’s vision.
A: Shiny surfaces should be avoided or covered to reduce reflection and improve visibility.
B, D: Patterns should be reduced and high contrast used so task lighting more effectively promotes the visibility of objects in the environment.
The director of rehabilitation asks a newly hired OTR® to provide occlusion to a client who is experiencing diplopia to enable the client to more fully participate in rehabilitation. Which action should the OTR take FIRST in response to this request?
Provide occlusion to the client and notify the director that the task has been completed
Refuse the director’s request, because occlusion is inappropriate for an OTR to provide
Explain to the director that occlusion can be provided only under the direction of a physician
Refer the request to another OTR with more experience in oculomotor function
Solution: The correct answer is C.
Diplopia causes perceptual distortion that creates confusion for the client and limits participation. Diplopia can be eliminated using occlusion, usually by covering part or all of one eye. OTRs can apply occlusion only under the direction of a physician.
A, B: Providing occlusion to the client, unless under the direction of a physician, is beyond occupational therapy’s scope of practice.
D: Occlusion can be applied by an OTR only under the direction of a physician; therefore, referring this request to another OTR would be inappropriate.
An older adult client with a history of falls and glaucoma is referred to occupational therapy for evaluation and intervention. Which strategy should the OTR® teach the client to compensate for impaired vision due to glaucoma?
Use a colorful, patterned tablecloth.
Place dinner plate to the left of midline.
Rotate head to choose clothing from a closet.
Pour coffee into a dark colored mug.
Solution: The correct answer is C.
Rotating the head would help the client use the remaining vision to compensate for peripheral vision loss.
A, D: These strategies result in less contrast and would make it more difficult for the person with glaucoma to distinguish objects from the background.
B: This strategy would not compensate for peripheral vision loss.
