GOLD RANK REVIEW CENTER JUNE 2022 POST LECTURE EXAMINATION: OT NEUROMANAGEMENTS - TBI NAME: SCHOO! 1 3 14 | Adare Email:goldrankreviewcenter@ ‘An OT practitioner is working on sequencing skills with a young patient who is s/p TBI. The Most effective activity to promote development of these skills is: ‘A, leather stamping using tools in a random design B. stringing beads for a necklace, following a pattern C._ putting together a 20 piece puzzle D. playing Concentration ‘An individual recovering from TBI is assessed to be at level VI of the Rancho Level of Cognitive Functioning Scale. Which should the OT use to implement treatment? ‘A. Sensory stimulation activities such as moving to music B. Repetitive brushing the hair C. Community re-entry activities such as taking a bus D. Simple meal preparation making a sandwich self-care tasks such as such as Heightened state of activity, bizarre and non- purposeful behavior: AW BV cw D. vil Gold Rank Review Center 5* floor Dona Amparo ygmail.com pate For questions 4-8: ‘An adult who incurred a traumatic brain injury three months ago is referred to a home care agency to receive OT services. The client's referral states that cognition is at level VII of the Ranchos Los Amigos scale and that grasp and shoulder mobility are limited. During the iterview, the client reports being frustrated by the inability to independently engage in the previously enjoyed and personally meaningful activity of cooking. The client reports frequently losing place when reading recipes and an inability to find things in the kitchen. 4, Upon evaluation, the client exhibits difficulty with letter cancellation task. Which visual deficit should the occupational therapist document as present? A. Imagery B. Scanning C. Cognition D. Memory During meal preparation tasks the client ignores items on the left side of the counter. The therapist to use 2 compensatory functional approach to improve the client's performance. Which is the most appropriate method for the therapist to use during intervention to develop meal preparation skills? ‘A. Encourage bilateral activities B. Place all items on the right side of the counter Practice scanning activities D. Place a brightly colored placemat on the left side of the counter decidesThe client responds well to the compensatory approach when performing countertop meal preparation tasks. The therapist decides to use ‘a dynamic interactional approach as the theoretical foundation for cognitive perceptual Intervention for other meal preparation activities. During a session to train the client in scanning strategies, the client accurately finds ‘two items in a refrigerator. Which is the therapist's most appropriate initial response to the lient’s task success? ‘A. Praise the client for successful task completion. B. Ask the client to now find three items in the refrigerator. C. Ask the client how he/she knows that ‘the items are correct. D. Ask the client to now find two items in ‘the pantry. During an intervention session focused on the development of grasp and shoulder mobility, ‘the occupational therapist asks the client to move numerous identical one pound cans of vegetables from the counter top to the cabinet shelf above the counter. According to contemporary motor learning approaches, which type of practice has the therapist designed this activity to provide to the client? ‘A. Random practice B. Blocked practice C. Planned practice D. Contextual practice The client is _attendit 8 a vocational rehabilitation program three days a week but is frequently late due to difficulties with getting ready in the morning. The client asks the home care therapists for suggestions to address this problem. Which is the most appropriate action for the occupational therapist to take in response to the client's request? 10. GOLD RANK REVIEW CENTER JUNE 2022 A. Advocate that the vocational program provide the client with a flexible start time B. Develop a visual chart with the client depicting the necessary sequence of his morning activities, C. Advise the client to call the vocational programs to tell staff when running late D. Advise the client to wake up one hour earlier on vocational rehabilitation program days The general aim of intervention for those at Rancho levels | through ll is to increase the individual's level of response and overall awareness of self and environment. The ‘occupational therapist must ensure that the environment is quiet with minimal during evaluation of those at RLA 1-3. A. First statement is true. Second statement is false. istractions B. First statement is false, Second statement is true. . Both statements are true. D. Both statements are false. ‘A patient who sustained head trauma is receiving an OT program of repetitive pegboard, paper and pencil tasks, and computer activities to remediate attention and memory deficits. The type of client MOST likely to benefit from this type of cognitive remediation is one who has: ‘A. Cognitive deficits which must be treated within a short treatment time frame B, Awareness, minimal deficits, and learning potential C. Difficulty transferring learned skills to new situations D. Ahistory of cognitive deficits resulting from a head trauma years ago3 | Adar GOLD RANK REVIEW CENTER JUNE 2022 11. Components of Glasgow Coma Scale, except: A. Eye Opening B. Best Motor Response C. Verbal Response D. NOTA 12. An OTR has been working in a medical setting with a 6 year old child who has had a traumatic brain injury. At what point should the OTR recommend discharge? ‘A. When the child refuses to attend OT B. When the child is ready to make the transition to first grade C. When the child has achieved a ‘maintenance level of functioning D. When the chil completely recovered is considered to be 13. A patient who has had a traumatic brain injury is beginning OT. The OTR practitioner needs to ‘assess whether this person can transfer learning from one activity to another in order to plan treatment appropriate way for an T to observe this learning ability would be to: A. describe situations that might be unsafe and ask the patient how he would respond B. give the patient a simple jigsaw puzzle tosolve C. have the patient get dressed in certain way, then change the task at the next session D. give the patient simple calculations performs Email:goldrankreviewcenter@ jgmail.com Gold Rank Review Center 5" floor Dona Amparo 14. A patient with neurological deficits has been unable to carry over skills learned previously in therapy and has exhibited no capacity to learn new information. The MOST appropriate intervention approach to improve ADL functioning for this patient would be: A. repetitive practice of simple ADL under therapist guidance B. recommendation of environmental adaptations and assistance for ADL . ADL training in the familiar home environment D. forward or backward chaining techniques 15. A woman with a head injury is impulsive during selffeeding and frequently attempts to place too much food in her mouth at one time. Which of the following methods would MOST effectively control her rate of intake during self- feeding? ‘A. Cuther food into smaller pieces B. Have her count to 10 between bites of food CC. Have her put the utensil down until she swallows D. Serve the various food items in separate containers on the meal tray 16. All of the ff techniques are effective in the behavioral management of persons with brain injury except: A, Praise efforts of the client to regain control B. Give an alternative such as “I'll have to report this behavior to the team” C. Greate a plan or agreement to accomplish tasks4) Adare GOLD RANK REVIEW CENTER JUNE 2022 D. Ignore negative, _attention-seeking behaviors and comments 17. An OT practitioner asks a client who recently sustained a head injury to repeat a random list ‘of numbers 1 minute after hearing the list. The OTR is MOST likely evaluating: A, Short-term recall B. Attention C. Hearing D. Abstraction 18. Heightened state of activity, bizarre and non- purposeful behavior: AW BV cw D. vil 19. Anew client exhibits no awareness of functional limitations resulting from his recent head injury, and he attempts to perform transfers without assistance. He also has expressed that he doesn’t see the need for therapy. The BEST approach to promote awareness and insight is to: ‘A. have the patient explain why he believes he is impaired B. provide the client with a checklist of the skills he must have to perform various activities and review these C._ have the client predict his performance before an activity, then have him self- evaluate the performance D. disregard the client’s perceptions and proceed with therapy 20. During a cooking evaluation, an individual with a history of traumatic brain injury (TBI) exhibits moderate upper extremity _incoordination. Which of the following recommendations would be MOST beneficial for this individual? Email:goldrankreviewcenter@ jgmail.com Gold Rank Review Center 5" floor Dona Amparo A. Use a built-up utensil handles Use heavy utensils, pots, and pans C. Use a high stool to work at counter height D. Place the most commonly used items fon shelves just above and below the counter 21. Client’s loss of consciousness is greater than 24 hours, post traumatic amnesia of greater than 7 days with a GCS score of less than 9. How severe is his TBI? A. Mild B. Moderate C. Severe D. NOTA 22. An OT practitioner is beginning training in meal preparation with a homemaker after a TBI. The activity that should be introduced FIRST is: ‘A. making 2 peanut butter and jelly sandwich B. preparing a hot cup of tea with sugar pouring a glass of orange juice D. cooking a grilled ham and cheese sandwich 23. A client with a TBI and a Glasgow Coma Scale score of 14, indicating @ non-coma status, appears to have third cranial nerve damage as noted in your observation of strabismus, diplopia, and ptosis. The area of the brain most likely damaged is: Parietal lobe Brainstem Frontal lobe No clear indicator present to determine area of damage papp5 | Adar GOLD RANK REVIEW CENTER JUNE 2022 24. According to Allen, besides a simple craft project, what other activity would be best for a client classified under level 4, goal directed to ‘work on cognitive functioning: ‘A, Playing the game “Simon Says” B. Making a sandwich C. Budgeting for 1 day D. Making a model airplane that snaps together 25. An OTR is implementing cognitive rehabilitation Interventions with a client and has given the client the task of finding telephone numbers of ‘a specific people in the phone book. The client has also been given a card with a series of questions written on it including, “Do | understand what | am supposed to do?” and “Do | have all the information | need?” and “Is. this the best way to do this?” This intervention is MOST accurately described as: ‘A. a self-management task with an environment cue B. a task to improve visual scanning a memory task with external aid D. a problem-solving task with a “self- task” cueing strategy 26. Severity of TBI: Mild, except: A. Loss of consciousness: <30 minutes B. Gcs9-12 C. Post traumatic amnesia <1 day D. Normal imaging; no abnormal findings 27.An OT is conducting a community transportation group with individuals attending ‘a traumatic brain injury day treatment program in an urban area. Which should the group do first? ‘A. Read a subway or bus map B. Take a subway or bus as a group C. Determine a destination D. Purchase a subway or bus fare cared Email:goldrankreviewcenter@ Gold Rank Review Center 5" floor Dona Amparo 28. An individual demonstrates a left visual filed cut ‘as a result of a TBI, and demonstrates difficulty crossing the midline during many self-care activities. Which of the following activities would MOST effectively promote this individual's ability to cross the midline? ‘A. Making a coil pot out of clay B. Making a macramé planter Stringing a bead necklace D. Weaving on a frame Loom 29. Which approach is least effective in managing negative behaviors in brain injury rehabilitation: ‘A. Work with the patient one-to-one in a quiet room B. Provide correct information when the patient does not know the information C. Expect the patient to participate in their rehabilitation by allowing them to select simple, meaningful activities D. Use simple words and sentences, allow processing time, and repeat if necessary 30. GCS: Decerebrate 1 monopp 31. A client who is s/p traumatic brain injury (TBI) ‘exhibits good strength with ataxia in both upper ‘extremities. The writing adaptation that would be MOST appropriate in compensating for the patient's deficit areas would be: A. Using a keyboard B. A universal cuff with penci-holder attachment Using a balanced forearm orthosis with built-up felt-tip pen D. Aweighted pen and weighted wristsGOLD RANK REVIEW CENTER JUNE 2022 32, 33. 34, “Adare id me atime Acclient with neurological deficits resulting from a head injury was performing the task of reaching for her brush on the shelf of her bathroom cabinet. During this task the OT practitioner observed that the client located the brush but became very distracted by the other items on the shelf, As a result of this ‘observation, the OT is most likely to provide activities that will improve: A. Learning B. selective attention C.figure-ground perception D._ problem solving A client with traumatic brain injury is in an ‘outpatient program with the long-term goal of returning to work as an auto mechanic installing mufflers. Motorically the client is exhibiting good overall strength and coordination. In groups, he is unable to work with others to inappropriate behaviors. His. ‘occupational therapy program should include: ‘A. Work program that includes muffler installations B. rework hardening with emphasis on social sills for work readiness impulse control it an inpatient hospital setting D. Patient is appropriate for any work program at this time control . Continued work oF ‘An OT practitioner is working with a homemaker who sustained a mild head injury. The client frequently forgets appointments and wakes up late for work. The practitioner suggests the use of external memory devices. Examples of external memory devices that might assist this individual would be: ‘A. Visual imagery and a diary B. Labeling and calendars Mnemonics and verbal cues D. Log and repetition Gold Rank Review Center 5* floor Dona Amparo ygmail.com 35. A person with a traumatic brain injury is assessed to score a 6 on the Glasgow Coma Scale. Which should the occupational therapist, Use to initiate intervention with this person? ‘A. Demonstrated directions B. Sensory stimulation C. Verbal cues D. Hand-over-hand assistance 36. An adult who incurred a severe traumatic brain injury is entering the second week of care at a long-term TBI patient's family visit regularly and frequently asks multiple questions of the treatment team. ‘A team and family conference is planned to ‘address family concerns. Which is the most important information for the team to share with the family? ‘A. Realistic and clear information about rehabilitation center. The the individual's current status and care plan B. Each team member's expert opinion about the expected prognosis and discharge recommendations C. Reimbursement each professional ser determining treatment choices. D. Community available to support the family and provide respite care, information about e to assist in resources that are 37. A child with a diagnosis of traumatic brain injury is evaluated by an OT. The child presents with extension of both UEs and flexion of both LEs following a stimulus of neck extension. When interpreting this observation, which statement is most accurate for the therapist to document? ‘A. The presence of + ATNR, which is abnormal and has reappeared after the TBI B. The presence of a + STNR, which is normal and not affected by the TBI7 | Adare GOLD RANK REVIEW CENTER JUNE 2022 C. The presence of a + ATNR, which is normal and not affected by the TBI D. The presence of a + STNR, which is abnormal and has reappeared after the TBI 38. An OT practitioner is working with a client who is has had a TBI and demonstrates deficits in sequencing and problem solving. The client has successfully prepared a cold meal in today’s treatment session. The next meal preparation activity the OTR should have client prepare is a: A. Fruit salad B. Cup of instant soup C. Casserole D. Spaghetti dinner with salad and garlic bread 39. An OT practitioner is working on morning activities of daily living with a young adult who recently sustained a traumatic brain injury. The client requires prompting to apply shaving cream to his face and to pick up his razor. After these cues, to client is then able to complete the activity. This is MOST likely to be documented as a deficit in which of the following performance components? A. Impulsivity B. Initiation c. Memory D. Attention 40. Patient needs full assistance in ADL throughout the day: A. Vegetative State B. Lower Severe Disability C. Upper Severe Disability D. Lower Moderate Disability Email:goldrankreviewcenter@ gmail.com Gold Rank Review Center 5" floor Dona Amparo 41. An OT practitioner is working with a group of patients who have orientation deficits resulting from head injuries. Using an adaptive or ‘compensatory approach, the MOST appropriate intervention would be to: ‘A. Provide verbal cues, external aids such as calendars and family pictures, and opportunities to practice using the external aids B. Reduce the number of distractions; ‘move the group to a quiet room G Present information in short units, spaced with time between each segment D. Connect new information to previously learned knowledge and skills 42. GCS: Decorticate 1 moopp> 43. A patient with neurological deficits has been unable to carry over skills learned previously in therapy and has exhibited no capacity to learn new information, The MOST appropriate intervention approach to improve ADL functioning for this patient would be: ‘A. repetitive practice of simple ADL under ‘therapist guidance B. recommendation of environmental adaptations and assistance for ADL . ADL training in the familiar home environment D. forward or backward chaining techniquesGOLD RANK REVIEW CENTER JUNE 2022 44, Client’s loss of consciousness is less than 24 hours, PTA less than 60 minutes with GCS score of 13, How severe is his TBI? A. Mild B. Moderate C. Severe D. NOTA 45. A preteen with a history of TBI is relearning to prepare simple foods but has been having with sequencing so the OT practitioner has provided the patient with a chart of steps to follow. The child has just learned to prepare his favourite sandwich without “losing his place” in the process but continues to need occasional verbal reminders to look at the chart and to ensure safety. At this point, the child's MOST recent level of independence would be documented as: ‘A. Independent B. Independent with setup ©. Supervision D. Minimal assist 46. Goal directed behavior but is dependent on external input AW BV c vil Dw 47.A therapist is planning a simple meal preparation activity that will result in success for a patient with cognitive deficits. The SIMPLEST activity would be preparing: A. Acanof soup B. Acasserole C. Brownies from a box mix "old Rank Review Conter goldrankreviewcenter@ gmail.com ™ floor Dona Amparo Building Tolentino er Espanc D. A meal with two side dishes and an entrée 48. Which of the following positioning device is used to decrease hip adduction and internal rotation? ‘A, Abductor Wedge B. Chest Strap C. Wedged Seat insert D. Lap Tray 49. An occupational therapist leads a work group at vocational rehabilitation program for persons with traumatic brain injuries, One member begins to make sexually suggestive comments to other group members. The therapist redirects the client to the work in progress but the member continues to make sexually suggestive statements. Which is the therapist's best initial response to this situation? ‘A. Explain to the client that such statements are not tolerated at work and call security to have the client removed from the group B. Explain to the client that such statements are not tolerated at work and the client must stop or leave the group C. End the group before the situation escalates and reschedule the group to meet without the disruptive client D. Set the client up at a different work station so the client is not in contact with other group members and cannot disrupt the group’s work.GOLD RANK REVIEW CENTER JUNE 2022 50. An individual with a cognitive disability has recently joined a sheltered workshop setting and has been referred to for assignment to the appropriate group. The individual demonstrates the ability to copy demonstrated directions presented one step at a time and visualize an ‘end product. However, the individual is unable to recognize errors and may not be able to correct them when they are pointed out. The MOST appropriate group for this individual is the one involved with: ‘A. sorting plastic utensil into separate containers B. assembling packets that include a knife, fork, spoon, and napkin based on sample . selecting matching shoelace from a mixed pile and lacing them onto a display card D. gluing labels to cans and placing them in the appropriate container according to color Q | Adaress: Gold Rank Review Center 5* floor Dona Amparo Email:goldrankreviewcenter@gmail.com