Therapy Ed test A Review

Question 1

Stress managment and pulmonary status

Answer 1

Stress management techniques are beneficial for the majoriyt of patients with COPD as stress can negatively impact one’s cardiovascular status. Patients with high levels of stress cna experience breathlessness and panic which causes shortness of breath

Question 2

Valsava Maneuver

Answer 2

Technique where a patient “bears down” or hold his/her breath while engaging in strenuous activity in order to gain more power. It is contraindicated in patents with cardio vascular conditions such as COPD and CABG.

Question 3

COPD and strengthening activities

Answer 3

Strengthening activities should include approaches such as free weights. and elastic bands, which all healp to build strength. The therapist should encourage the patient to pace him/herself during these activities to rest when feeling short of breath.

Question 4

Guidelines for DME medical necessity by insurance carriers

Answer 4

• include a diagnosis that requires the use of a hospital bed (such as CHF or pulmonary disease where the bed must be elevated higher than 30 degress, pressure sores, or the need for traction equipment) and the requirements for positioning cannot be accomplished in a standard bed.
• Anxiety is not a reimbursable condition for a hospital bed.

Question 5

How should the therapist/ caregivers speak to and individual with dementia

Answer 5

speak slowly and validate statements made by the client - speaking slowly allows for time to process and the validation of statemsn has proved to enhance the performance and carry-over skills in persons with cognitive impairments. This would allow for successful engagement in activities.

Question 6

Decreasing restlessness with clients with Dementia, (wandering due to hunger)

Answer 6

• Resless behavior can increase in the early evening hours due to hunger and the increased environmental stimulation. Providing a snack can help ameliorate hunger, decreasing the effect of stressor. Having them engage in favorable activity can provide appropriate snesory stimulation and positive feelings.

Question 7

Patient with Depression, taking MAOI’s complains of recurrent headaches and difficulty focuisng during the day

What should the OT do?…

Answer 7

notify the psychiatrist of these complaints

The symptoms should be considered serious side effects and may lead to stroke or other cardio vascular reactions. The physician must be contacted. The individual needs to collaborate with the psychiatrist to determin if an MAOI is the best medication

Question 8

PNF patterns facilitate…..

Answer 8

• trunk rotation. best when paired with a functional activity.

Question 9

You know of a patient who presents with unilateral neglect but insists on continuing to drive.

THE OT SHOULD…..

Answer 9

• Inform the physician - the physician is responsible for taking action on the individual’s ability to drive.

Question 10

OTAs and evaluations

Answer 10

• OTAs, depending on their experience level, are able to complete IADL evaluations, under the supervision of an OT.
• the OT is the only one able to interpret and design protocols.

Question 11

What to do when a 19 year old in a vocational rehabilitation program shows up, clearly intoxicated

Answer 11

• arrange for transportation to bring the client home - it is not approprate use of time to discuss alcohol use, nor is the client able to participate
• he is over 18 years of age so his parents do not need to be contacted.

Question 12

Child with spastic quadriplegic CP demonstrates a consistent gag reflex.

Technique used to inhibit this reflex

Answer 12

• Press a spoon down firmly on the center of the tongue - also apply pressure from distal to proximal.
• Lateral and circular movements can facilitate the gag reflex.

Question 13

degree of outrigger for most effective application of force

Answer 13

90 degrees to the joint - it is the most effective application of force. the application of a perpendicular force prevents unwanted traction on the joint and shearing stress.

Question 14

The best type of spoon for a child with a reflexive bite is….

Answer 14

• a narrow shallow coated spoon - it will help the food slide off. a deeper bowl would be more difficult for the food to slide off.

Question 15

ADA exemption

Answer 15

Religious organizations are exempt from ADA accessibility

Question 16

Some notes about Medicare part A

Answer 16

Too recieve medicare homecare reimbursement, an individual must be homebound which means he can only leave home according to specific criteria.

Question 17

focus of hospice care

Answer 17

The major focus of hospice care is to maintain teh individual’s control over his life while enabling engagement in meaning ful actvitiesthat are related to person’s valued roles. due to terminal stage, it is unlikely that person will make gains in ADLs, selfcare. They’re assistance level will stay the same or continue to decline..

Question 18

Osteogeneisis imperfecta

Answer 18

• results in brittle bones that fracture easily. Fracture prevention through activity restrictions is the primary focus.
• Social isolation can occur with this diagnosis
• find age approprate activities such as computer clubs for child.

Question 19

Leadership style needed for acute psychiatric inpatient groups

Answer 19

• Directive - involves the provision of structure, clear directions, immediate and consistent feedback which are needed in a group whose members are actuely ill with psychiatric disorders.

Question 20

Erb’s palsy

Answer 20

• injury to the brachial plexus characterized by weakness or paralysis of involved arm(injury to C5and C6). The arm hangs limp with the shoulder rotated inward due to atrophy and paralysis in the biceps, deltoid, brachilais and brachioradialis.
• The elbow lock splint stabilizes the elbow to enable the individual to position the hand closer to or away from his/her body for functional use.

Question 21

Can a therapist date a former patient

Answer 21

Yes. they can date a former patient but not a CURRENT patient. if there was no indication that they dated during treatment, then it is okay.

Question 22

How to address a situation where your client with an amputation does not want to use his prosthesis.

What should the OT do….

Answer 22

• Work on developing unilateral skills for completion of meaningful actvities - Most individuals are able to achieve functional independence in desired activities using their intact UE for skilled task functions with their residual limb serving as a stabilizer. a prosthesis can readily become unnecessary as a person develops unilateral skills.

Question 23

Working with an 8 month old child with mild developmental delay. Child had poor dynamic sitting balance.

What positioning and toy placement are the most beneficial for the therapist to use with the child

Answer 23

• Sit with the child between the therapist’s extended legs and laternate placing the covered toy to the child’s right and left side - this positioning can enable th etherapist to easily provide postural support for th child as needed. Placing th toy to right and lef will facilitate the child’s sideward protective extension response.
• being in a child seat would provide too much support and not enough challenge.

Question 24

Hypoglycemia

Answer 24

• abnormally low blood glucose.
• symptoms - acute weakness, dizziness nauseous, sweating profusely and unsteady when standing
• Intervention - have patient sit down and ingest an oral sugar.

Note - profuse sweating and nausea do not accompany orthostatic hypotension.

Question 25

Botox injections for treatment of flexor synergies for spastic cerebral palsy

Answer 25

• Botox injections lessens spasticity for 3-6 months to allow for the strengthening of the opposing non-spastic muscles. For example Botox injections for biceps are meant to relax the biceps to allow for strengthing of triceps.

Question 26

Sleeping position recommendation for an individual with rotator cuff injury

Answer 26

• sleep with the shoulder extended and adducted
• Generally, avoid above head activities.

Question 27

Electric convulsive treatment (ECT) for major depression

• How many hours after treatment can a patient resume activities.

Answer 27

• 6 hours after ECT, the individual is capable of engaging in a structured task.
• there is some temporary memeory loss after an ECT so it would not be appropriate to give the individual an activity that requires memory to complete.

Question 28

Carpenter recovering from injuries presents with decrease strenght in the triceps, bilaterally. MMT 3 in triceps

How should the table top wood project be positioned to work on tricep strength…?

Answer 28

• At a 45 degree incline angles so that the individual’s hands are above the elbows when the elbows are flexed. this position requires the triceps to perform movment against gravity, sanding activity will provide slight resistance.
• placing at chest height is gravity eliminated positions and are too easy for his level of ability.

Question 29

Klumpke’s paraysis

Answer 29

• Klumpke’s paralysis is a form of paralysis involving the muscles of the forearm and hand, resulting from a brachial plexus injury in which the eighth cervical (C8) and first thoracic (T1) nerves are injured either before or after they have joined to form the lower trunk. The subsequent paralysis affects, principally, the intrinsic muscles of the hand (notably the interossei, thenar and hypothenar muscles)[10] and the flexors of the wrist and fingers The classic presentation of Klumpke’s palsy is the “claw hand” where the forearm is supinated and the wrist and fingers are flexed.
• Symptoms include intrinsic minus hand deformity,[12] paralysis of intrinsic hand muscles, and C8/T1 Dermatome distribution numbness.
• contrasted to Erb’s palsy which effects C5 and C6

Question 30

Tethered cord (Spina bifida)

Answer 30

• child losing bladder control, minimal decrease in strength of bilateral lower and upper extremities. the spinal cord of a child with spina bifida is sometimes attached to the spinal colum and becaums taut as the child grows. requiring surgical release

Question 31

Executive funcitoning

Answer 31

• Executive funcitons are higher level cognitive abilities that are needed to perform unstructured multistep activities and rol tasks.
• the 4 main components of executive functioning are volition, planning, purposeful action and effectve performance
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