Misc

Question 1

With a nondisplaced fracture of the humeral neck, ______ ____ _ ____ and __________ ________ lead to the most desirable outcome.

Answer 1

support from a sling and supervised exercise nondisplaced fracture- the bone cracks either part or all of the way through, but does move and maintains its proper alignment

Question 2

A COTA® is working with a client who has chronic congestive heart failure. The client is displaying limited tolerance for light to moderate homemaking activities. Which compensatory strategies should the COTA demonstrate to the client to improve activity tolerance?

Answer 2

Incorporation of sitting into homemaking activities Use of lower extremities instead of upper extremities during activities when possible Avoidance of extreme temperatures and high humidity in the house

Question 3

Wheelchair Seat Width

Answer 3

measure the widest part of hips or thighs, then add 1-2”

Question 4

Wheelchair Seat Depth

Answer 4

measure from the base of the back to the popliteal space of the knee, subtract 1-2” so that the edge of the seat does not reach the knee and cause restriction of movement or circulation

Question 5

Wheelchair Seat Height

Answer 5

measure from the popliteal space to the bottom of client’s heal. Foot rest should have 2” clearance from the flr Seat cushions raise the overall seat height

Question 6

Wheelchair Seat-Back Height

Answer 6

measure from seat surface (including cushion) to top of client’s shoulder higher back need if poor trunk control

Question 7

Wheelchair Armrest Height

Answer 7

measure from seating surface to bottom of client’s flexed elbow, armrest should be about 1” higher

Question 8

W/c width Wheelchair Accessibility Requirements

Answer 8

24-26” rim to rim

Question 9

Doorway clearance Wheelchair Accessibility Requirements

Answer 9

32” (minimum), 36” (ideal) –> You can remove a doorstop or replace existing hinges with offset hinges for extra width

Question 10

Hallway clearance Wheelchair Accessibility Requirements

Answer 10

36” wide

Question 11

W/c length Wheelchair Accessibility Requirements

Answer 11

42-43”

Question 12

360° w/c turning space Wheelchair Accessibility Requirements

Answer 12

60”x60”

Question 13

Min/Max Height for Forward and Side Reaching Wheelchair Accessibility Requirements

Answer 13

15” min (to prevent tipping) and 48” max. 46” when obstructed by items such as countertop or shelf

Question 14

Countertop height Wheelchair Accessibility Requirements

Answer 14

31”

Question 15

Parking spaces Wheelchair Accessibility Requirements

Answer 15

adjacent 4 foot aisle

Question 16

Pathways and walkway width Wheelchair Accessibility Requirements

Answer 16

48”

Question 17

Ramp width Wheelchair Accessibility Requirements

Answer 17

36”

Question 18

Slope to rise ratio of ramp Wheelchair Accessibility Requirements

Answer 18

1:12 (for every 1” of rise, 12” of ramp required)

Question 19

Railings height Wheelchair Accessibility Requirements

Answer 19

29-36” high (average = 32”)

Question 20

Ramp curb height Wheelchair Accessibility Requirements

Answer 20

4”

Question 21

4’x4’ ramp landing required when Wheelchair Accessibility Requirements

Answer 21

ramp is excessively long or person has limited UE strength/cardiopulmonary capacity (req to allow for rest break); sharp turns (90° requires 4’x4’, 180° requires 4’x8’)

Question 22

If the ramp leads to a door Wheelchair Accessibility Requirements

Answer 22

5’x5’ platform required before the door that extends at least 12” (18” preferred) along the side of the door so person doesn’t need to back up

Question 23

Work readiness programs

Answer 23

aim to identify a person’s skills and interests to develop his or her readiness for work and to achieve the person’s goals related to work.

Question 24

Prader-Willi syndrome

Answer 24

Individuals with Prader-Willi syndrome often present with food-seeking behaviors, which might make waiting to eat until lunchtime difficult.

Question 25

During PROM exercises for a client with stroke, the client’s shoulder is resistant to flexion beyond 90°, although the client reports being pain free. What does this finding suggest to the COTA?

Answer 25

The scapula is not gliding to produce full flexion. The muscles supporting the scapula have likely shortened from disuse and are limiting the full range of shoulder motion. Both the humerus and the scapula must move to support full shoulder motion.

Question 26

A COTA® completes a home assessment of a person with Parkinson’s disease who lives at home but has begun to have mobility challenges. Which intervention is BEST to facilitate lifestyle changes to improve safety?

Answer 26

Introduce use of a rhythmic beat to facilitate mobility The use of rhythm has been shown to support mobility in people with Parkinson’s disease. This approach can minimize the impact of the immobilization that may occur from this disease.

Question 27

Bennett's fracture

Answer 27

an intraarticular fracture of the thumb metacarpal bone.

Question 28

Boxer's fracture

Answer 28

the result of a clenched fist hitting an object with enough force to break the metacarpophalangeal neck, most commonly seen in the fourth and fifth digits.

Question 29

A client who has Parkinson's disease reports increased tremors, problems knocking items over while eating, and poor articulation, leading to recent social isolation. Which intervention strategy would be MOST effective for this client?

Answer 29

Educate about timing social activities when medication is most effective.

Question 30

Dementia with Lewy bodies

Answer 30

Distinguishing features of dementia with Lewy bodies are visual hallucinations and Parkinson-like motor symptoms.

Question 31

RUMBA

Answer 31

Relevant Understandable Measurable Behavioral Achievable in the time frame

Question 32

Conversion Disorder

Answer 32

a mental condition in which a person has blindness, paralysis, or other nervous system (neurologic) symptoms that cannot be explained by medical evaluation. Causes Symptoms may occur because of a psychological conflict. Symptoms usually begin suddenly after a stressful experience. People are at risk of conversion disorder if they also have: A medical illness A dissociative disorder A personality disorder

Question 33

Parkinson's Disease

Answer 33

Slow progressive disease of the nervous system Symptoms Bradykinesia; Muscle Rigidity; Resting Tremor; Cog-wheel Rigidity; Micrographia; Dementia; Memory Deficits; Voice softens-becomes monotone; Reduced facial expression; Shuffling Gait; Freezing

Question 34

Parkinson's Disease Stages

Answer 34

I- Unilateral symptoms, no or minimal functional implications, usually a resting tremor II- Bilateral symptom involvement, no balance difficulty, mild problems with trunk mobility and postural reflexes III- Postural instability, mild to moderate functional disability IV- Postural instability increasing, though able to walk; functional disability increases, interfering with ADL; decreased manipulation and dexterity V- Confined to wheelchair or bed

Question 35

Amyotrophic Lateral Sclerosis ALS

Answer 35

Degenerative motor neuron disease of unknown etiology; more prevalent in men; avg onset 57yrs; life expectancy 2-5yrs Symptoms Affects Voluntary Muscles Spasticity and Stiffness Weakness, low tone and atrophy Speech deficits, swallowing and respiratory involvement Eye Muscles; external sphincters controlling bowel and bladder management; five senses; heart, liver, and kidneys are spared.

Question 36

Peripheral Neuropathies

Answer 36

Result of trauma, pressure paralysis, forcible over-ext of a joint, hemorrhage into a nerve, exposure to cold or radiation, or ischemic paralysis. Symptoms include pain, weakness, and paresthesias in the distribution of the affected nerve

Question 37

Guillain-Barre Syndrome

Answer 37

Inflammatory disease that causes demyelination of axons in peripheral nerves Etiology unknown; may occur after an infectious disorder, surgery, or immunization Three Phases Onset and Acute: acute weakness occurs in at least two extremeties and advances (20-30% req mechanical ventilation) Plateau: sypmtoms most disabling with little/no change for days-weeks Recovery: starts head/neck moves distally; sig-complete return of func, may have residual fatigue

Question 38

OT TBI Acute Treatment Focus

Answer 38

Sensory stimulation ROM Positioning Splinting

Question 39

OT TBI Rehab Treatment Focus

Answer 39

Regaining func in ADLs, IADLs, executive func skills, and community reintegration

Question 40

Stages of ALS

Answer 40

I: Independent in walking and ADLs, some weakness II: Can walk; mod weakness III: Can walk; severe weakness IV: Req w/c for mobility; some assist w/ADLs; severe weakness in legs V: Req w/c for mob; dependent for ADLs; severe weakness in arms and legs VI: Confinded to bed; req assist for ADLs and most self-care