Midterm Review Flashcards
Which of the following is NOT a typical age-related change in the somatosensory system?
A) Decreased sensitivity to tactile stimuli
B) Increased sensitivity to taste
C) Alterations in kinesthetic sensitivity
D) Changes in the peripheral nervous system affecting sensation
B) Increased sensitivity to taste
EXPLAINATION:
Somatosensory changes
■ Decline in sensitivity to tactile stimuli
■ Temperature sensitivity
■ Alterations in kinesthetic sensitivity
■ Alterations in peripheral nervous system
■ Functional implications
● Safety - increased risk of injury
● Diminished fine motor skills
Mrs. Johnson, a 68-year-old woman, visits the clinic with complaints about her vision. She reports difficulty reading small print, especially in low light conditions, and has noticed that bright lights often cause discomfort. She also finds it challenging to adjust her eyes when moving from a bright environment to a dim one. Upon examination, it is noted that Mrs. Johnson’s eyes show signs of presbyopia.
Question:
Which of the following age-related visual changes is Mrs. Johnson likely experiencing based on her symptoms?
A) Reduced visual acuity and increased glare sensitivity
B) Increased ability to accommodate/focus and decreased glare sensitivity
C) Enhanced adjustment to changes in illumination and improved color sensitivity
D) Increased flexibility of the lens and improved near vision
A) Reduced visual acuity and increased glare sensitivity
Visual changes
■ Reduced visual activity
■ Decreased ability to accomodate/focus
■ Decreased ability to adjust to changes in illumination
■ Decreased resistance to glare
■ Changes in color sensitivity
■ Presbyopia - farsightedness, lens becomes harder and inflexible; increased rigidity
Mr. Smith, a 75-year-old man, reports having trouble hearing conversations, especially in noisy environments. He mentions that he often has to ask people to repeat themselves and finds it particularly hard to hear higher-pitched voices. He also notices that some sounds seem muffled and that distinguishing different tones is more challenging than it used to be. His audiologist has diagnosed him with presbycusis.
Question:
Based on Mr. Smith’s symptoms, which of the following characteristics is most likely associated with his condition?
A) Improved speech reception and understanding in noisy environments
B) Difficulty hearing low frequencies and enhanced pitch discrimination
C) Reduced ability to hear high frequencies and diminished pitch/tone threshold
D) Primarily conductive hearing loss with better reception in quiet settings
C) Reduced ability to hear high frequencies and diminished pitch/tone threshold
Reason:
Hearing
■ Presbycusis - age-related hearing loss
■ Difficulty hearing high frequencies
■ Diminished ability for pitch/tone threshold
■ Most age-related hearing loss is sensorineural
■ Interferes with ability to interact with environment (social and physical)
● Diminished speech reception, discrimination, and understanding
Which of the following symptoms is NOT commonly associated with age-related changes in the vestibular system, such as those seen in presbyastasis?
A) Loss of receptor organs and structures in the inner ear
B) Increased postural sway and a wide-based gait
C) Enhanced equilibrium reactions and improved balance control
D) Unsteadiness in standing and walking
C) Enhanced equilibrium reactions and improved balance control
Reason:
Vestibular System
■ Loss of receptor organs and structures - saccules, utricles, semicircular canals
■ Increased postural sway, wide based gait
■ Unsteadiness in standing/walking
■ Alterations in righting and equilibrium reactions
■ Presbyastasis - age related disequilibrium
Quiz Question:
Scenario:
Mr. Thompson, an 80-year-old man, reports that food tastes less flavorful and he has difficulty tasting sweet foods. He also experiences a persistent mild metallic taste in his mouth, which may be due to his medications. His doctor notes a reduction in the number of taste buds and decreased saliva production.
Question:
Which of the following factors is least likely contributing to Mr. Thompson’s altered taste perception?
A) Decreased number of papillae and taste buds
B) Increased sensitivity to sweet substances
C) Atrophy of neurons in taste centers
D) Decreased saliva flow
Correct Answer:
B) Increased sensitivity to sweet substances
Taste
■ Overall decrease in taste perception
■ Decreased sensitivity to sweet substances
■ Related to decrease number of papillae and taste buds
■ Atrophy of neurons in taste centers
■ Mild dysgeusia -chronic taste in mouth due to dental problems; may also be due to
medications, diseases
■ Decreased saliva flow
As individuals age, multiple changes can occur in their cognitive functions due to various structural changes in the brain. Identify the structural changes and their functional consequences commonly associated with aging.
Options:
Structural Changes:
A. Increase atrophy
B. Increase dystrophy
C. Increase edema
D. All of the above
Functional Consequences:
A. Decrease in accuracy
B. Decrease in speed
C. Decrease in range
D. Decrease in endurance
E. Decrease in coordination
F. Decrease in stability
G. Decrease in strength
H. All of the above
Both answers are All of the above
Age-Related System Changes and Their Impact on Function and Occupations:
Match the factors with their potential impact on the function and occupations of older adults.
Options:
A. Genetics
B. Environmental factors and exposure
C. Injuries
D. Personality and attitude
E. Lifestyle
F. Advances in medicine
- Improved management of age-related conditions and enhanced quality of life
- Influence on adaptability and coping with aging
- Impact on physical health and well-being based on habits like diet and exercise
- Predisposition to certain diseases
- Potential decrease in mobility and independence
- Risk of chronic illnesses due to long-term exposure to pollutants
Answer Key:
A4: Genetics - Predisposition to certain diseases
B6: Environmental factors and exposure - Risk of chronic illnesses due to long-term exposure to pollutants
C5: Injuries - Potential decrease in mobility and independence
D2: Personality and attitude - Influence on adaptability and coping with aging
E3: Lifestyle - Impact on physical health and well-being based on habits like diet and exercise
F1: Advances in medicine - Improved management of age-related conditions and enhanced quality of life
Which of the following is NOT a common geriatric syndrome that impact their occupational performance and participation?
○ Incontinence
○ Falls
○ Dementia
○ Malnutrition
○ Functional decline
All of the above is a geriatric syndrome
Which statement best describes the difference between screening and evaluation?
A. Screening is a detailed and comprehensive assessment of an individual’s condition, while evaluation is a quick check to determine if there is a need for further examination.
B. Screening is a preliminary process that takes little time to identify individuals who may need further evaluation or intervention, while evaluation is a thorough and detailed examination of an individual’s condition and needs.
C. Screening and evaluation are terms used interchangeably in healthcare, both referring to a detailed assessment of an individual’s health status.
D. Screening is used to diagnose conditions, while evaluation is used to confirm a diagnosis and develop a treatment plan.
B. Screening is a preliminary process that takes little time to identify individuals who may need further evaluation or intervention, while evaluation is a thorough and detailed examination of an individual’s condition and needs.
Which of the following best describes the purpose of a descriptive evaluation in the context of healthcare or therapeutic services?
A. A descriptive evaluation focuses on providing a general overview of an individual’s health without distinguishing specific characteristics.
B. The primary aim of a descriptive evaluation is to gather information that describes the unique characteristics of an individual, differentiates between persons on specific characteristics being measured, and identifies issues that merit intervention, including determining specific problems in areas of impairment, activity limitation, and participation restriction.
C. Descriptive evaluation is primarily used to diagnose medical conditions and establish a treatment plan.
D. A descriptive evaluation solely assesses the environmental factors affecting an individual’s health, without considering personal characteristics.
B. The primary aim of a descriptive evaluation is to gather information that describes the unique characteristics of an individual, differentiates between persons on specific characteristics being measured, and identifies issues that merit intervention, including determining specific problems in areas of impairment, activity limitation, and participation restriction.
Which statement best describes a predictive assessment?
Options:
A. Focuses on identifying current traits without any intention of forecasting future outcomes.
B. Are used primarily to gather detailed descriptions of current characteristics, without making any predictions about future traits or criteria.
C. Includes items related to a specific characteristic to forecast another trait. Items on a predictive measure are included if they describe the characteristic of interest and predict the trait or criterion of interest, either now or in the future.
D. The primary purpose is to diagnose conditions and establish immediate treatment plans.
C. Includes items related to a specific characteristic to forecast another trait. Items on a predictive measure are included if they describe the characteristic of interest and predict the trait or criterion of interest, either now or in the future.
True or False: Outcome evaluation is to ascertain how a particular intervention has affected the individual.
True
When assessing functional performance in older adults, which of the following areas are important to evaluate to gain a comprehensive understanding of their abilities and needs?
A. Exercise capacity and tolerance, functional mobility, cognition, and observed performance in multiple domains of physical function.
B. A person’s usual or actual performance of mobility, overall functioning and disability, performance difficulties in self-care, productivity, and leisure areas, and the roles that are important sources of activity for older adults.
C. Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), home safety, and observed performance in multiple domains of physical function.
D. All of the above
D. All of the above
Which of the following are needed consideration to guide an assessment of functional performance?
○ Performance-based vs. Patient-Reported Outcomes (PROs)
○ Standardized vs. functional assessment in patient’s home
○ Complex vs. Simple
○ Global vs. Multidimensional
○ Generic vs. Diagnosis-specific
○ Time to implement scale
○ Training and certification (if needed)
○ Cost
○ Computer-administration and scoring vs. paper-pencil
○ Fixed versus computer adaptive testing (from a pool of items)
All of the above
When assessing functional performance in older adults, which environmental factors related to sensory changes should be considered to ensure accurate and optimal assessment conditions?
Options:
A. Ensure that the lighting in the assessment environment is dim to reduce glare and create a calming atmosphere.
B. Provide written materials in small print and with minimal color contrast to minimize distractions.
C. Minimize background noise in the environment and ensure that written materials are in large print and in a contrasting color with the background, and ensure adequate lighting.
D. Conduct assessments in a busy and noisy environment to simulate real-life conditions.
Answer:
C. Minimize background noise in the environment and ensure that written materials are in large print and in a contrasting color with the background, and ensure adequate lighting.
In assessing functional performance in older adults considering sensory changes, which practices should be followed to ensure effective communication and proper use of aids?
Options:
A. The assessor should sit behind the client to avoid distractions and use minimal verbal communication. The client should not use any prescribed aids during the assessment.
B. The assessor should face the client, use clear verbal communication, and ensure the client is using prescribed aids such as glasses or hearing aids.
C. The assessor should speak loudly and ensure the client is seated away from them. The client’s use of prescribed aids is not necessary.
D. The assessor should use complex terminology and avoid making eye contact with the client. The use of prescribed aids should be monitored but not required.
B. The assessor should face the client, use clear verbal communication, and ensure the client is using prescribed aids such as glasses or hearing aids.
Which of the following statements best describes how fatigue can impact the functional performance and assessment of older adults?
Options:
A. Fatigue is a self-perceived concept that may lead to increased participation in physical activities, including walking and daily living tasks.
B. Fatigue is a self-perceived concept that can manifest as decreased participation in physical functioning activities such as walking or activities of daily living, potentially affecting the ability to participate in functional assessments.
C. Fatigue is a physical condition that improves functional performance and does not affect participation in functional assessments.
D. Fatigue is irrelevant to functional assessments as it does not influence mobility, activities of daily living, or upper extremity function.
B. Fatigue is a self-perceived concept that can manifest as decreased participation in physical functioning activities such as walking or activities of daily living, potentially affecting the ability to participate in functional assessments.
How does mild cognitive impairment affect an older adult’s ability to complete activities, and what should be considered when assessing cognitive and functional abilities?
A. Mild cognitive impairment generally does not affect an older adult’s ability to complete activities such as managing medications or banking, and limitations in functional abilities always indicate cognitive impairment.
B. Mild cognitive impairment can make it difficult for older adults to complete activities with higher cognitive demands, such as banking or managing medications. However, limitations in functional abilities do not necessarily imply that the older adult has cognitive impairment.
C. Mild cognitive impairment exclusively affects physical abilities, with no impact on activities requiring higher cognitive functions.
D. Limitations in functional abilities are always due to cognitive impairment, regardless of the nature of the tasks being performed.
B. Mild cognitive impairment can make it difficult for older adults to complete activities with higher cognitive demands, such as banking or managing medications. However, limitations in functional abilities do not necessarily imply that the older adult has cognitive impairment.
When conducting assessments for older adults, which factors related to education and caregiver support should be considered to ensure an accurate and effective evaluation?
A. Assessments should be conducted regardless of the individual’s level of education, and caregiver support is not a relevant factor in the evaluation.
B. Assessments must be tailored to the individual’s level of education, including reading comprehension, and both the need for caregiver support and the level of available support must be considered.
C. Assessments should only consider the level of caregiver support available, while the individual’s education level does not impact the evaluation.
D. Education and caregiver support are irrelevant in assessments, as the focus should be solely on the physical abilities of the individual.
B. Assessments must be tailored to the individual’s level of education, including reading comprehension, and both the need for caregiver support and the level of available support must be considered.
Which statement accurately defines what constitutes a fall, based on the definition provided by Tinetti et al. (1988)?
Options:
A. A fall is an unintentional event where a person comes to rest on the ground or another lower level, excluding instances caused by a violent blow, seizure, stroke, loss of consciousness (LOC), or syncope.
B. A fall includes any event where a person deliberately sits or lays down on the ground, regardless of the cause.
C. A fall is defined as a trip or stumble that results in a person reaching a lower level without catching themselves.
D. A fall is when a person intentionally lowers themselves to the ground due to a major intrinsic event, such as a stroke or syncope.
A. A fall is an unintentional event where a person comes to rest on the ground or another lower level, excluding instances caused by a violent blow, seizure, stroke, loss of consciousness (LOC), or syncope.
Which of the following complications and sequelae are commonly associated with falls in older adults?
Options:
A. Increased mortality, fractures (especially distal forearm and hip), head trauma, musculoskeletal injuries (including soft tissue injuries and skin tears), and risk of “long lies.”
B. Only increased mortality and head trauma are associated with falls, with no risk of fractures or musculoskeletal injuries.
C. Falls primarily result in only minor skin abrasions and do not lead to fractures or increased mortality.
D. The complications of falls in older adults are limited to psychological effects and do not include physical injuries or increased risk of mortality.
A. Increased mortality, fractures (especially distal forearm and hip), head trauma, musculoskeletal injuries (including soft tissue injuries and skin tears), and risk of “long lies.”
Which of the following describes intrinsic risk factors for falls in older adults?
Options:
A. Intrinsic risk factors are external environmental conditions, such as slippery floors or poor lighting.
B. Intrinsic risk factors focus only on the type of footwear worn and do not consider balance or medical conditions.
C. Intrinsic risk factors are limited to psychological factors, such as fear of falling, and do not include physical or medical conditions.
D. Intrinsic risk factors are internal to older adults and include medical conditions and significant balance risks
D. Intrinsic risk factors are internal to older adults and include medical conditions
Which statement accurately describes extrinsic risk factors for falls in older adults?
A. Extrinsic risk factors are internal medical conditions and balance issues that increase the risk of falls.
B. Extrinsic risk factors are external conditions, such as the environment, including elements like slippery floors, that contribute to the risk of falling.
C. Extrinsic risk factors are related to psychological factors, such as fear of falling, and do not involve environmental conditions.
D. Both intrinsic and extrinsic factors are unrelated to potential interventions and cannot be modified to reduce the risk of falls.
B. Extrinsic risk factors are external conditions, such as the environment, including elements like slippery floors, that contribute to the risk of falling.
Which of the following statements accurately describes the importance and relevance of the fear of falling in older adults?
Options:
A. The fear of falling is solely experienced by individuals who have had previous falls and does not affect those who have never fallen.
B. Fear of falling is a temporary concern that usually resolves on its own without impacting an individual’s activity levels or quality of life.
C. The fear of falling is a lasting concern that can lead individuals to avoid activities they are still capable of performing. It can cause anxiety, restricted activity, poor quality of life, and may result in deconditioning and increased fall risk.
D. The fear of falling only affects physical health and does not have any impact on mental health or daily activities.
C. The fear of falling is a lasting concern that can lead individuals to avoid activities they are still capable of performing. It can cause anxiety, restricted activity, poor quality of life, and may result in deconditioning and increased fall risk.
Which of the following are fears associated with falling?
A. Not being able to get up on own - needing the assistance of another
B. Long lie times
C. Embarrassed about falling in public and looking frail
D. Fear of injury and/or nursing home placement
E. All of the above
E. All of the above
What are the key elements of fall prevention strategies for older adults? Select all that apply.
A) Education and prevention measures
B) Exercise and strength training
C) Balance and postural control exercises
D) Managing postural sway
E) Hip and ankle strategies
F) Stepping and stumbling strategies
G) Nutritional supplements
Correct Answers: A, B, C, D, E, F
How does fall prevention relate to the quality of life (QOL) in older adults? Choose the best answer.
A) Fall prevention primarily affects physical health but has little impact on mental well-being.
B) There is no significant relationship between fall prevention and quality of life in older adults.
C) Effective fall prevention can improve both physical and psycho-social aspects of life, thereby enhancing the overall quality of life in older adults.
D) Fall prevention only benefits those with existing medical comorbidities and does not impact healthy older adults.
Correct Answer: C
Explanation:
C) Effective fall prevention can improve both physical and psycho-social aspects of life, thereby enhancing the overall quality of life in older adults.
Falls are directly correlated with increased mortality, morbidity, and reduced functionality, particularly in older adults. This is due to the higher frequency of falls among this population and the presence of medical comorbidities that increase the risk of falls and subsequent injuries (Appeadu & Bordoni, 2023). The acute consequences of falls, such as fractures and a fear of falling, can lead to a decline in physical, psycho-social, and functional abilities, negatively impacting perceived health and quality of life (QOL). Therefore, fall prevention strategies are essential in maintaining and improving the overall well-being of older adults.
In the context of community-based occupational therapy (OT) practice with older adults, which factors should be considered to address the multidimensional needs of community-based elders? Select all that apply.
A) Underutilization of community services
B) Preference for receiving help from family, friends, and neighbors
C) Economic status, specifically high and low income versus middle income
D) Differences between rural and urban areas
E) Access to healthcare and related services
F) Disparities in service availability and quality
Correct Answers: A, B, C, D, E, F
Which of the following describe the varied programs and settings available in the community for older adults? Select all that apply.
A) Medical, educational, community, and social programs
B) Opportunities for work, learning, and volunteerism (“Something to do”)
C) Senior programs, adult day programs, and meal programs (“Somewhere to go”)
D) Supportive services (“Someone to care”)
E) Housing options for older adults (“Someplace to live”)
F) Childcare services for older adults
Correct Answers: A, B, C, D, E
Which of the following are barriers to receiving services for older adults in the community? Select all that apply.
A) System-level barriers
B) Agency-level barriers, such as staffing and funding structures
C) Individual-level barriers, including attitudes and behaviors
D) Group-level barriers
E) Access to recreational facilities
F) Advanced healthcare technologies
Correct Answers: A, B, C, D
Which of the following statements accurately describes frailty and its characteristics? Select all that apply.
A) Frailty is characterized by increased vulnerability due to impairments in multiple systems, leading to a diminished ability to respond to even mild stresses.
B) Sarcopenia is the sole component of frailty, and addressing muscle loss alone can fully address frailty.
C) Well-validated models of frailty exist that predict increased vulnerability to adverse health outcomes and mortality.
D) All individuals over 70 years of age and those with significant weight loss (≥5%) due to chronic disease should be screened for frailty.
E) Disabled individuals are always considered frail.
Correct Answers: A, C, D
Match the factors that influence frailty with their corresponding categories.
Categories:
A. Psychological Factors
B. Sociodemographic Factors
C. Lifestyle Factors
Factors:
- Depression
- Anxiety
- Cognitive function
- Income
- Living environment
- Diet
- Smoking
8.Alcohol consumption
A. Psychological Factors:
Depression
Anxiety
Cognitive function
B. Sociodemographic Factors:
- Income
Living environment
C. Lifestyle Factors: - Diet
Smoking
Alcohol consumption
Delineate the differences between robust, pre-frail, and frail presentations using the following characteristics:
Characteristics:
- Weakness (grip strength)
- Slowness (gait speed)
- Low activity (decreased physical activity/sedentary behavior)
Match each characteristic to the appropriate frailty category:
A. Robust
B. Pre-Frail
C. Frail
EX: Poor endurance (exhaustion):
A. Robust (good endurance)
B. Pre-Frail (some level of exhaustion or poor endurance)
C. Frail (significant exhaustion and poor endurance
Weakness (grip strength):
B. Pre-Frail (may show mild weakness)
C. Frail (significant weakness)
Slowness (gait speed):
A. Robust (normal gait speed)
B. Pre-Frail (slower gait speed)
C. Frail (significantly slow gait speed)
Low activity (decreased physical activity/sedentary behavior):
A. Robust (high level of activity)
B. Pre-Frail (decreased physical activity)
C. Frail (very low activity/sedentary behavior)
Which strategies are effective for communicating with older adults who may have hearing difficulties? Select all that apply.
A) Ensure you have the client’s attention before speaking
B) Speak slowly, clearly, and avoid shouting
C) Write down any messages for additional clarification
D) Rely solely on verbal communication without using non-verbal cues
E) Check if the hearing aid is functional or properly adjusted
F) If the person does not understand, repeat the exact same words
G) If the person does not understand, use different words or paraphrase instead of repeating the same words
Correct Answers: A, B, C, E, G
Which concepts are associated with the wellness model for older adults? Select all that apply.
A) Awareness of choices toward a successful lifestyle
B) Focus exclusively on physical health
C) Addresses physical, spiritual, intellectual, emotional, social, and occupational components
D) Emphasizes maintaining current health care practices without adaptation
E) Considers changes in the health care system
Correct Answers: A, C, E
Which of the following activities are categorized as moderate-intensity exercise? Select all that apply.
A) Walking at a slow pace (<2 mph)
B) Mopping or vacuuming
C) Running
D) Tennis (doubles)
E) Bicycling >10 mph
F) Recreational swimming
G) Ballroom or line dancing
Correct Answers: B, D, F, G
Explanation:
B) Mopping or vacuuming: This activity generally falls under moderate-intensity exercise.
D) Tennis (doubles): This is considered moderate-intensity exercise.
F) Recreational swimming: This activity is categorized as moderate-intensity.
G) Ballroom or line dancing: These types of dancing are moderate-intensity activities.
Note:
A) Walking at a slow pace (<2 mph): This is classified as light-intensity.
C) Running: This is classified as vigorous-intensity.
E) Bicycling >10 mph: This is classified as vigorous-intensity.
Falls are more common among people living in ___ and _____
A) NORC
B) during hospitalization
C) Assisted living facilities
D) Long term care facilities
Both B and D
* Long term care facilities and during hospitalization
Which of the following are precautions we need to take when assessing older adults?
A) Vision quality
B) Safety
C) Caution regarding osteoporosis, potential for fracture
D) Concern about standing endurance/balance
E) Avoid valsalva maneuver because of possible cardiovascular problems
Safety, Caution regarding osteoporosis, potential for fracture, Concern about standing endurance/balance, Avoid valsalva maneuver because of possible cardiovascular problems
