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Principles of Orthopedic Mgt Flashcards

1
Q
  1. RSD is a debilitating, progressive dse. Your client is in the 1st stage of RSD with classic signs of hand edema, fear of ROM, and SH-hand pain. What is your 1st priority in treatment?

a. Reduction of edema
b. AROM with emphasis on self-AROM
c. Aggressive PROM to prevent stage 2 progression
d. Establish rapport with pt while talking about ADLs

A

a. Reduction of edema

1st –> Edema

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2
Q
  1. Doorknobs should be placed at the height from the floor to allow for accessibility for people in wheelchair?

a. 28”
b. 30”
c. 32”
d. 36”

A

d. 36”

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3
Q
  1. When an elderly person has lost all vision, all of the ff. are helpful, EXCEPT:

a. Textured surfaces to indicate the top and bottom of stairs
b. Safety pins in different arrangement to mark clothes
c. Textured doorknobs to mark exits
d. Labels or signs in Braille

A

d. Labels or signs in Braille

Tedious na if mag aral pa ng Braille

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4
Q

An OT provides a wellness and prevention education series to a community senior center. The topic of the wk is jt protection. Which jt protection principle should the OT include in the presentation?

a. Stand diagonally to the side of containers to be opened or closed to maximize torque
b. Work through the pain experience during ax by performing stretching exercises
c. Preserve joint ROM and ms strength by using the minimal effort required to perform an ax
d. Start an ax only if it can be immediately stopped when it requires capacities beyond existing capabilities

A

d. Start an ax only if it can be immediately stopped when it requires capacities beyond existing capabilities

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5
Q
  1. Which scar management technique is most appropriate to utilize during the rehabilitative phase of treatment with an individual who sustained a partial thickness burn 6 months ago?

a. Prevent scar devt through static splint
b. Control edema to prevent loss of ROM
c. Minimize scar hypertrophy through compression garments and proper skin care
d. Promote self-care skills in order to resume the role of a homemaker

A

c. Minimize scar hypertrophy through compression garments and proper skin care

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6
Q
  1. Which of the following are domains of the biomechanical FOR, EXCEPT:

a. Edema
b. Low level endurance
c. Strength
d. Postural Stability

A

d. Postural Stability

D is NDT Approach

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7
Q
  1. Which piece of adaptive equipment is the most appropriate for a pt with a TKR?

a. Long handled shoe horn
b. Reacher
c. Sock aid
d. NOTA

A

d. NOTA

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8
Q
  1. A 70-year-old male lives alone just prior to having a THR. In order to manage his self-care, the best equipment he will need is:

a. A tea cart with wheels for the kitchen
b. Dressing stick, sock aid, long-handled shoe horn, bath sponge, and reacher
c. Tub seat adjusted to his tub at home
d. Commode for bedside

A

b. Dressing stick, sock aid, long-handled shoe horn, bath sponge, and reacher

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9
Q

When measuring for a wheelchair, what consideration should be made for the seat?

a. None. Seat is standard.
b. If doorways in px’s home are narrow, wc seat must be narrow
c. Seat should be 4” wider than the px’s widest point across hips or thighs so he/she can move around easier.
d. Seat should be 2” wider than the px’s widest point across hips or thighs. If braces are worn, width should be increased

A

d. Seat should be 2” wider than the px’s widest point across hips or thighs. If braces are worn, width should be increased

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10
Q
  1. Basic body mechanics assist both the pt and the OT. All of the ff. are good body mechanics, EXCEPT:

a. When possible, push, pull, or slide object rather thank pick it up
b. Slight body twisting provide more lift when picking up a heavy object
c. Maintain your COG to the COG of the object you are holding
d. Widen your BOS to stabilize your vertical gravity line

A

b. Slight body twisting provide more lift when picking up a heavy object

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11
Q
  1. An individual with COPD has limited endurance. The LTG is to be able to prepare 1 meal a day for a week. What STG is most relevant?

a. Use energy conservation techniques
b. Work hardening ax
c. Graded ax for strengthening
d. Safety educ in the kitchen

A

a. Use energy conservation techniques

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12
Q
  1. An OT practitioner is instructing an individual with L-hemiplegia how to remove shirt:

a. (1) Remove shirt from unaffected arm; (2) Remove shirt from affected arm; (3) Gather shirt up at the back of the neck; and (4) Pull gathered back fabric off OH
b. (1) Remove shirt from affected arm; (2) Remove shirt from unaffected arm; (3) Gather shirt up at the back of the neck; and (4) Pull gathered back fabric off OH
c. (1) Gather shirt up at the back of the neck; (2) Pull gathered back fabric off OH; (3) Remove shirt from affected arm; and (4) Remove shirt from unaffected arm
d. (1) Gather shirt up at the back of the neck; (2) Pull gathered back fabric off OH; (3) Remove shirt from unaffected arm; (4) Remove shirt from affected arm

A

d. (1) Gather shirt up at the back of the neck; (2) Pull gathered back fabric off OH; (3) Remove shirt from unaffected arm; (4) Remove shirt from affected arm

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13
Q
  1. An individual with GBS exhibits good upper extremity strength. The activity that would be most appropriate for further strengthening and endurance building would be:

a. Peeling potatoes
b. Bedmaking
c. Polishing furniture
d. Washing windows

A

d. Washing windows

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14
Q
  1. A 30-year-old female waitress worked long hrs. One evening, she fell asleep resting on her R-FA. She awoke 5hrs later with signs of radial nerve injury, including wrist drop. Which splint is the best option for tx?

a. Resting hand splint
b. Dynamic extension splint
c. Radial gutter splint
d. Ulnar gutter splint

A

b. Dynamic extension splint

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15
Q
  1. An individual exhibits hypersensitivity to the fingers following a crush injury. What method would be appropriate for desensitization?

a. Textured materials, rubbing, tapping, and prolonged contact
b. Massage, facilitatory electrical stimulation, and progressive desensitization program
c. Pressure, percussion, vibration, icing, and edema massage
d. Visual compensation and fxnl use of ex

A

a. Textured materials, rubbing, tapping, and prolonged contact

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16
Q
  1. A 32-year-old female is being assessed by the OT in terms of hand function. While making a coffee, the individual is unable to remove the lid from the coffee container but is able to stand throughout the duration of the activity, scoop a tablespoon of coffee powder and mix it inside the cup with hot water, and put back the lid. The deficit is most likely in which of the ff.?

a. ROM
b. Endurance
c. Strength
d. Coordination

A

c. Strength

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17
Q
  1. An individual with hand weakness has difficultly holding a fork. Using a biomechanical FOR, which of the ff interventions would be most appropriate?

a. Elicit fxnl grasp using RIPs
b. Stimulate the hand flexors to promote a fxnl grasp
c. Repeatedly squeeze with the hand against increasing amt of resistance
d. Built-up utensil handles

A

c. Repeatedly squeeze with the hand against increasing amt of resistance

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18
Q
  1. An individual recently had a traumatic R UE below elbow amputation. Which should be addressed first in patient education?

a. Training to put on and take off the prosthesis
b. Training in residual limb wrapping
c. Ax to teach grasp and prehension fxn
d. Training to resume vocational ax

A

b. Training in residual limb wrapping

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19
Q
  1. A self-feeding session is being implemented by an OT with an individual with C5 SCI. Which feeding equipment is most appropriate to introduce?

a. Wrist driven flexor hinge splint
b. Mobile arm support
c. Electric self-feeder
d. Built up utensils

A

b. Mobile arm support

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20
Q
  1. A client with THR is demonstrating a stand-to-sit transfer:

a. Extend unoperated leg forward, reach back for the armrest, bend the operated leg, and slowly sit.
b. Extend operated leg forward, reach back for the armrest, bend the unoperated leg, and slowly sit.
c. Extend operated leg forward, hold the walker securely, and slowly sit
d. Extend unoperated leg forward, reach back for the armrest with 1 hand while holding the walker securely with the other, then slowly sit

A

b. Extend operated leg forward, reach back for the armrest, bend the unoperated leg, and slowly sit.

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21
Q
  1. Goal of hand splints recommended to a child with active juvenile RA is?

a. Inhibit hypertonus
b. Increase ROM
c. Prevent deformity
d. Correct deformity

A

c. Prevent deformity

22
Q
  1. An OT is observing an individual with C7 quadriplegia during a leather working activity to increase grip strength. Which component of the activity addresses this client factor?

a. Holding the hammer
b. Holding the stamping tools
c. Squeezing sponge the wet the leather
d. Lacing with needle

A

a. Holding the hammer

Need igrip para hindi mahulog

23
Q
  1. The ff are contraindications in giving an elderly a rocker knife, except:

a. Lim ROM in UE
b. Tremors
c. Cog impairment
d. Weak grip

A

a. Lim ROM in UE

24
Q
  1. An OT practitioner is fabricating a splint for an individual who has CTS. Which of the ff splint fabrication techniques should be adhered to in order to allow for adequate digit motion?

a. Trim lines of the splint should extend distal to the MCP crease
b. Trim lines of the splint should extend proximal to the MCP crease
c. Trim lines of the splint should extend proximal to the DIP joint
d. Trim lines of the splint should extend distal to the ulnar 5th MCP crease

A

b. Trim lines of the splint should extend proximal to the MCP crease

25
Q
  1. A client who has severe RA, but is currently in remission, wants to engage in a strengthening program. What type of exercises would be the most beneficial?

a. Concentric
b. Eccentric
c. Isotonic
d. Isometric

A

d. Isometric

26
Q
  1. A 46-year-old male complains of diffuse left elbow pain. His left elbow becomes stiff when picking things up and pain in left hand increases. What FOR should you use to treat his lateral epicondylitis?

a. MOHO
b. Acquisitional
c. Biomechanical
d. Developmental

A

c. Biomechanical

27
Q
  1. All of the ff. are effective in reducing hand edema for post-op client, EXCEPT:

a. Cold, wet packs
b. Massage
c. Elevation
d. Isotoner brand gloves

A

a. Cold, wet packs

28
Q
  1. Treatment option that is least effective in controlling edema in a person with L-hemiplegia SH subluxation?

a. Slings or shoulder taping
b. Lapboard
c. Arm trough
d. Bilateral rolling platform walker

A

a. Slings or shoulder taping

29
Q
  1. All of the ff. supportive and compensatory strategies are effective in treating a person with low vision, EXCEPT

a. Eye patch
b. Modify lighting
c. Increase contrast
d. Teach the use of visual markers

A

a. Eye patch

30
Q
  1. Energy conservation techniques include all of the following, except:

a. Sit to work
b. Limit amt of work
c. Organize storage
d. Plan 1 day at a time

A

d. Plan 1 day at a time

31
Q
  1. Which is most effective in preventing contracture?

a. Positioning
b. Therapeutic exercise
c. Serial casting
d. Splinting

A

a. Positioning

32
Q
  1. What should be the position of the neck being splinted for a pediatric client with burns?

a. 10 deg hyperextension
b. 10 deg flexion
c. Flexion, as much as possible
d. 0 deg, neutral

A

d. 0 deg, neutral

33
Q
  1. A child with JRA wears bilateral night resting splint with wrist 0 degrees extension, MP and IPs flexion, 0 degrees UD, and thumbs in opposition. The child complains of pain in the wrists upon awakening. No redness is noted upon removing splints. ROM measurements show 5 degrees UD. Which action should the OT take in response to this complaint and this observation?

a. Modify splints @ the wrist
b. Pad the ulnar aspect on the inside of the splints
c. Discontinue the splints and monitor the status of pain for 2 weeks
d. Construct volar cock-up splints for use during the day

A

a. Modify splints @ the wrist

34
Q
  1. A 30-year-old patient sustained partial thickness burns with a total BSA of 50%, including BUE and upper trunk. What should the OT focus on during the acute phase of burn?

a. Scar mgt
b. Returning sensation
c. Prevent deformity
d. Loss of fluid

A

c. Prevent deformity

35
Q
  1. A patient with peripheral neuropathy has impaired sensation in B hands and feet. Main focus of treatment should be on:

a. Desensitization techniques
b. Sensory training or reeducation
c. Compensatory techniques related to safety
d. Assisting px in diminishing astereognosis

A

c. Compensatory techniques related to safety

Impaired na talaga so wala namagagawa
A if hypersensitivity
B if partial loss

36
Q
  1. What type of splint can control swan neck deformities and meet emotional issues?

a. Small serial casting splint in bright thermoplastics
b. Resting hand splint with velcro closure in the color choses by the cx
c. Silver ring splint
d. Dynamic extension alignment splint

A

c. Silver ring splint

37
Q
  1. An elderly underwent THR a week ago and is being discharged with a home program. Following HIP precautions when doing basic ADLs, the patient should avoid:

a. Leaning over a counter right in front to reach into cabinets
b. Bathing in the shower
c. Picking up pants from floor with a reacher
d. Sitting on a regular toilet

A

d. Sitting on a regular toilet

38
Q
  1. OTs use all of the following modalities during treatment, EXCEPT:

a. Adaptive clothing
b. ECT
c. PAMs
d. Communication devices and envt controls

A

c. PAMs

39
Q
  1. Harry is a 65-year-old male with DM and secondary to PVD that resulted in a RLE AKA. He does not have a history of cardiac complication. He lives with his wife of 40 years and worries about his ability to attend to social and community activity. He is a VFW member and officer in the organization, serving on the honor guard. An important biomechanical FOR focus in tx will be:

a. Body image changes and the resultant issue of self-esteem and self-efficacy concerns for this cx’s adjustment to his amputation
b. Strengthening of the UE and LE musculature primarily though the practice of fxnl tasks, such as dressing, bathing, and light exercise
c. Dynamic balance component that requires subtle shifts in the COG, esp, when coming to standing from the wc, helping the px to adjust to changes with and without a prosthetic limb
d. Educating the px as to stump care, which will include skin integrity inspection and donning and doffing his prosthetic limb

A

c. Dynamic balance component that requires subtle shifts in the COG, esp, when coming to standing from the wc, helping the px to adjust to changes with and without a prosthetic limb

Active kasi siya kaya ito pinaka angkop

40
Q
  1. Most effective method for scar reduction

a. Ace bandage
b. Friction massage
c. Compression
d. Splinting

A

c. Compression

Nasa quote sa handout
Compression + Silicone gel are most effective

41
Q
  1. An individual with severe pulmonary condition is being instructed by the OT in self-care modifications. What should the OT do when monitoring his endurance?

a. Take the px’s BP every now and then during the session
b. Have the px rest every few minutes
c. Stop the ax every few minutes and have the px rate their level of fatigue
d. Observe breathing pattern of the px while doing the task

A

d. Observe breathing pattern of the px while doing the task

42
Q
  1. An OT practitioner is instructing a pt with L-hemiplegia and unilateral neglect to put on a t-shirt. The best sequence to teach the pt would be:

a. (1) Place L hand into sleeve and pull sleeve past elbow; (2) Place R-hand into sleeve and pull up sleeve; (3) Pull shirt up OH; (4) Pull shirt down over trunk
b. (1) Position shirt on lap; (2) Place L-hand into sleeve and pull up sleeve; (3) Place R hand into sleeve and pull sleeve; (4) Pull shirt up OH
c. 1) Position shirt on lap; (2) Place R-hand into sleeve and pull up sleeve past; (3) Place L hand into sleeve and pull sleeve; (4) Pull shirt up OH
d. (1)Pull shirt up OH; (2) Place L hand into sleeve; (3) Place R-hand into sleeve; and (4) Pull down shirt over trunk

A

b. (1) Position shirt on lap; (2) Place L-hand into sleeve and pull up sleeve; (3) Place R hand into sleeve and pull sleeve; (4) Pull shirt up OH

43
Q
  1. The OT was evaluating a client being fitted for a splint with the goal increasing range of motion to improve FM coordination and prehension. What approach should the OT use to accomplish this?

a. Apply dynamic splint for controlled motion
b. Apply prolonged stretch tot he joint and soft tissue
c. Position the ex in a fxnl hand position
d. Position the ex in an antideformity position

A

c. Position the ex in a fxnl hand position

44
Q
  1. A patient with RA has been undergoing OT services for 3 weeks to work on strengthening and FMS to improve occupational performance in manipulation of buttons during dressing, cooking, and playing board games. Upon arriving on her scheduled session, the client is an exacerbated state with swollen and inflamed joints. The OT should:

a. Modify tx and focus on performing light ax such as playing board games
b. Continue current tx but shorten the duration of the session
c. Discontinue tx and reschedule when inflammation has subsided
d. Modify tx to focus on resting joints and engage in light ax as tolerated

A

a. Modify tx and focus on performing light ax such as playing board games

45
Q
  1. For a client in the early phase of rehabilitation for treatment of acute inflammatory demyelinating polyradiculoneuropathy (GBS), the least beneficial treatment would be:

a. Gentle stretching of those joints that exhibits decreased PROM
b. Active assisted exercise
c. Daily ADL ax to the px’s capacity
d. Aggressive stretching to increase ROM

A

d. Aggressive stretching to increase ROM

46
Q
  1. A client with a C-5 SCI is ready to address self-feeding. What piece of equipment would the client benefit most from?

a. MAS
b. Universal cuff
c. Electric wheelchair
d. Scoop dish

A

b. Universal cuff

47
Q
  1. An adult has been referred to OT. The individual demonstrates decreased ROM in the dominant hand secondary to nerve injury. Active thumb for the IP and MP is within normal limits. Active ROM of the IPs of all four fingers is 0-60 degrees. The individual wants to be able to hold a knife, spoon and fork. Which utensils are best for the therapist to recommend to this person?

a. Utensils with cylindrical foam handles 1 1/2” in diameter
b. Standard utensils with no adaptations
c. Utensils with custom-built handles made of low temperature thermoplastic splinting material
d. Utensils held in a universal cuff

A

a. Utensils with cylindrical foam handles 1 1/2” in diameter

48
Q
  1. An elementary school teacher has been recently diagnosed with MS. Which adaptation is best for the OT to recommend the teacher to use to accommodate for the effects of MS on classroom teaching?

a. Large print written material to compensate for visual impairments
b. Daily list of tasks to compensate for cognitive deficits
c. Motorized scooter to compensate for decreased endurance
d. High stool to compensate for LE weakness

A

d. High stool to compensate for LE weakness

49
Q
  1. Splinting of the wrist for the treatment of CTS should be static to prevent mvmt. At which position should be the wrist be?

a. 10-20 degrees flexion
b. 10-20 degrees extension
c. 5 degrees UD
d. 30 degrees flexion

A

a. 10-20 degrees flexion

50
Q
  1. A patient with proximal BUE weakness would benefit from what type of equipment while self-feeding?

a. Enlarged handles on utensils
b. Scoop dish
c. Rocker knife
d. Mobile arm support

A

d. Mobile arm support

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