Sladyk Section 2 Domain-Style Study

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1. Can OT services be started for a Medicare patient at home?
a. Only if PT, nursing, or speech is also servicing the patient A. At the time of the printing of this book, physical therapy, nursing,
b. Yes, even if OT is alone or speech also had to service the home care patient before the OT
c. Only if two physicians order OT could initiate service. AOTA is working to change this policy.
d. Yes, if DRGs are still available
2. During an OT task group, the OT asks a patient to check out
his self-perception with others in the group. This thinking process B. Reality testing is the process of evaluating and judging one's
is called: external environment in an objective manner. Autistic thinking
a. Autistic thinking refers to a preoccupation with one's inner world. Magical thing is
b. Reality testing when thoughts, words, or actions are believed to assume power.
c. Magical thinking Illogical thinking is contradicting and erroneous
d. Illogical thinking
3. Dysdiadochokinesia is a neurological disorder defined as:
a. A motor problem seen as overshooting or past pointing C. Dysdiadochokinesia is impaired alternating movement. Over-
b. A motor problem in which muscles are weak and tire easily shooting is a dysmetria, weak muscles is asthenia, and slow,
c. The impaired ability for rapid, repeated alternating movements twisting movements is athetosis
d. Slow, twisting movements
4. The client you are treating is a 60-year-old female with a
right CVA. She shows left: hemiplegia, severe left homonymous
D. All are good choices, but arranging the client's environment
hemianopsia, and left neglect. The best approach to facilitate
to encourage looking to the left is best. This should be done
acknowledgement of the left spatial and visual field is:
as long as the patient is cognitively aware of the neglect. If the
a. Remind client to look to the left
patient is not cognitively aware of the left, visitors or other stimulus
b. Ask family to remind client to look to the left
approaching from the left may scare her. Remind family staff to
c. Ask nursing to remind client to look to the left
announce their presence as they enter.
d. Arrange client's environment so it encourages the client to look
to the left
5. A hemiplegic patient with shoulder subluxation is best treated C. Subluxation itself is not painful but poor handling is. Transfers
by: and PROM will potentially cause soft tissue damage. Pay special
a. Wearing a sling for 24 hours a day attention in handling and in scapula mobilization. Slings are not
b. Only wearing a sling during gait training always helpful and should not be used 24 hours per day. A lap
c. Proper positioning while in bed and in wheelchair board may be helpful when the patient is in a wheelchair but does
d. A lap board while in a wheelchair not address the global issue.
6. What type of prehension is used to pick up small objects such D. Fingertip prehension, requires fine motor coordination. It allows
as pins, nails or buttons? one to sew, snap, or button. Palmar prehension involves three
a. Palmar prehension, palmar tripod, or three-jaw chuck fingers for writing or eating. Lateral prehension is used when
b. Lateral prehension turning a key. It generally involves the thumb. Hook prehension
c. Hook grasp is thumbless and is used when carrying a handle, case, or heavy
d. Fingertip prehension object.
7. When measuring for a wheelchair, what consideration should
be made for the seat?
a. None, seat is standard, no measurement are needed
b. If doorways in patient's home are narrow, wheelchair seat must
D. Two inches wider than the user is correct. One size does not fit
be narrow
all and too much padding or room can cause sores.
c. Seat should be 4 inches wider than patient's widest point across
hips or thighs so he/she can move around easier
d. Seat should be 2 inches wider than patient's widest point across
hips or thighs: if braces are worn, width should be increased
8. What fine motor activity is best for a 6-year-old child with
attention deficit disorder?
a. Dot-to-dot coloring A. Although all activities are fine motor, age and diagrams must
b. Musical instrument such as the piano be considered.
c. Handling a deck of cards
d. Mazes
9. When performing PROM on your client, you notice spasticity
during elbow flexion. Following the spasticity, you notice a sudden A. Continued passive stretching of spastic muscle may produce
relaxation and letting go of tone and full range is achieved. This is a sudden letting go relaxation. Claspknife phenomenon may be
called: seen in neurological disorders of upper motor neuron lesions.
a. Claspknife phenomenon Clonus is a spasmodic alteration of muscle contraction and re-
b. Clonus

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c. Rigidity laxation. Rigidity is relatively constant hypertonicity. Dystonia is a
d. Dystonia tone disorder resulting in slow movement or decrease tone.
10. A confused bead injured patient may ask a lot of questions, C. The OT could make a memory book for the patient that includes
often repeating the same question over and over. What is the best answers to common questions like, "Where am I?" Include family
activity for this patient? pictures and reality orientation information. Keep the book simple
a. Nothing, the patient is too agitated to reduce agitation and light in case the patient should throw it.
b. Socializing with other patients Having the patient play cards or socialize with others may be too
c. Looking at his or her memory book much stimulation. Doing nothing is likely to get the patient more
d. Playing cards agitated.
11. The difference between high technology and low technology
is:
a. Cost
C. The difference between high and low technology is electronics.
b. Design
c. Electronics
d. Patient diagnosis
C. Withdrawal is a group of symptoms that appears within hours
12. Which of the following terms describes symptoms caused by to 1 week of abstinence from a substance. Examples include
abstinence from a substance that the patient has taken over a delirium, tremors, seizures, psychosis, perceptual disturbances,
period of time? irritability, and gastrointestinal and sympathetic hyperactivity. Ad-
a. Addiction diction refers to a behavior and physical dependence, not a symp-
b. Intoxication tom. Intoxication is a state of progressive deterioration ranging
c. Withdrawal from exhilaration to stupefaction caused by ingesting substances.
d. Abuse Abuse refers to a mal-adaptive pattern leading to clinically signif-
icant impairment or distress
13. While assessing the mental status of a patient, the OT could
observe which of the following without asking a direct question?
a. If the patient can subtract 7 from 100 to measure visuospatial B. The patient's affect shows his or her emotional responsiveness.
ability This may affect the data collected during the rest of the intake.
b. If the patient's affect can be described as normal, flat, blunted, Asking the patient to subtract 7 from 100 is measuring attention
constricted and knowledge. Hallucination is disturbances in perception. Mood
c. If the patient has visual hallucinations, showing a disturbance is a pervasive, sustained emotion reported by the patient.
in thought process
d. The patient's mood
14. Residents of a nursing home are often lifetime members of
the nursing home community. An OT working in a nursing home
must therefore address a resident's needs as if it is his or her
home. What activity best facilitates fine motor coordination and
community development?
C. All the activities encourage either community involvement or
a. Sponsor a float in a community parade, residents can watch
fine motor skills, but only the quilt fundraiser provides both.
b. Develop a facility choir and perform for everyone while holding
choir music
c. Make a quilt & raffle it off to purchase something for the facility
that members vote on
d. Build birdhouses and install them outside the windows
15. When working in an activity group with a patient who has B. The OT should use universal precautions with all patients
AIDS, the OT should: whether they have AIDS or not. The person with AIDS is at greater
a. Always wear latex gloves risk of catching a disease from the therapist. Staff should wash
b. Wash hands before and after treatment their hands before and after all treatments. The OT needs to wear
c. Avoid touching the patient a mask only if he or she has a cold. Latex gloves are only needed
d. Always wear a face mask if there is a risk of contact with bodily fluids.
16. Which early childhood disease is progressive, fatal, and due
B. Only muscular dystrophy is an early childhood, progressive,
to fatty fibrous infiltration of muscles?
and fatal disease due to fatty infiltration of the muscles. Post-po-
a. Postpolio syndrome
lio syndrome is weakened musculature following poliomyelitis.
b. Muscular dystrophy
Parkinson's is a slow, progressive disease with onset after age
c. Pakinso's disease
40. Multiple sclerosis is due to a demyelination of the nerves.
d. Multiple sclerosis
17. Premature infants usually have mothers who have low so-
cioeconomic status, lack of prenatal care, and poor nutrition. A
premature infant is any infant born before:

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a. 37 weeks
b. 39 weeks
A. A premature infant is any infant born before 37 weeks
c. 41 weeks
d. 43 weeks
18. Vestibular stimulation can be used to increase muscle tone in
both adults and children. Always watch the patient for emotional
reactions. Spinning should not be done with what type of person? C. Spinning is contraindicated for people prone to seizures. The
a. Persons over the age of 50 patient may not be able to tolerate the vestibular input, thereby
b. Persons with poor ROM triggering a seizure.
c. Persons prone to seizures
d. Persons who are 6 feet or over in height
19. Spina bifida is a disorder characterized by failure of the ver-
tebral column to close. Children may have a shunt placed in their
head. All of the following are warning signs of a malfunctioning
D. .Irritability, vomiting, headaches, and "setting sun" eyes are
shunt except:
all symptoms of a malfunctioning shunt. "Setting sun" eyes are
a. Irritability and fussiness
partially visible irises.
b. Vomiting
c. Headache
d. Wide open eyes, iris is totally visible
20. An upper motor neuron lesion may occur in all of the following
except:
B. The anterior motor roots within the spinal cord are considered
a. Brainstem
lower motor neuron. The CNS includes the brainstem, cranial
b. Spinal cord motor roots
nerves, and the cerebral cortex.
c. Cranial nerves
d. Cerebral cortex
21. Occupational therapy services can be paid for under which
part(s) of Medicare?
a. Part A C. Occupational therapy can be paid for under both Parts A and
b. Part B B of Medicare
c. Both A and B
d. Only under supplemental insurance
22. Supervision is considered a professional responsibility and
therefore a component of practice. Who is required to have su-
pervision? C. Entry-level OTAs are required to have supervision by OTs or
a. All OTAs and entry-level OTs advance practicing OTAs. All OT personnel should have supervi-
b. Entry-level OTA and OTs sion as needed to match their level of competence.
c. Entry-level OTAs
d. Entry-level OTs
23. Examination of the efficiency of institutional use and the
appropriateness of admission, services, length of stay, and dis-
charge is called:
C. Utilization review is an internal management review on how
a. Continuous quality assurance
resources are utilized.
b. Retrospective analysis
c. Utilization review
d. Fee monitoring
B. Symmetrical postures predominate at 16 weeks. The startle
24. Which of the following is not present birth?
reflex is present at birth when flexion of the extremities occurs
a. More reflex
when scared. Babinski can be induced by stroking the sole of the
b. Symmetrical postures
foot and the big toe rises. This is normal until age 1, nut after the
c. Babinski reflex
toe should plantar flex. Impassive facial expressions are typical
d. Impassive facial expression
social behavior of an infant under 4 weeks of age.
25. During an intake interview, a patient's ideas constantly shift
from one subject to another in an unrelated way. There is no D. Loose associations are a disturbance of thought. In severe
apparent connection to his thought. This is called: cases, the patient may become incoherent. Blocking refers to
a. Blocking abrupt interruptions. Preservation refers to persistent responses
b. Preservation often found in cognitive disorders. Flight of ideas refers to rapid
c. Flight of ideas thinking with shifting in ideas that are slightly connected.
d. Loose association

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26. All of the following are contraindications for aquatic therapy
except:
a. Open wound B. A person with decreased cardiovascular endurance may benefit
b. Decreased cardiovascular endurance from aquatic therapy
c. Incontinence
d. Serve cardiovascular endurance
27. When making a forearm through splint, the splint should be
what length of the forearm? D. Two thirds length allows full elbow motion and distributes weight
a. One fourth over the length. This splint is a first-class lever with the pivot point
b. One third or fulcrum at the wrist. The long trough distributes the weight of
c. One half the hand and acts as a counter balance.
d. Two thirds
28. The best activity to assess motor synthesis is:
a. Playing hopscotch
b. Guessing an object's name without looking at it A. Hopscotch involves motor synthesis.
c. Constructing a three-dimensional box put of paper
d. Copying a two-dimensional block design
29. All of the following activities are suited to increase spatial
relationship awareness except:
a. Making a tall tower of blocks
D. Drawing from memory is a visual motor synthesis activity
b. Doing arithmetic problems
c. Drawing hands on a clock
d. Drawing a designated object from memory
30. Your client has a dual diagnosis of hemiplegia and CHF.
You anticipate fluctuating edema in the involved hemiplegic hand.
What type of straps you use on the client's splint?
D. Wide, soft, foam like strap is the best choice because it allows
a. 1-inch wide webbing with a D ring
for slight fluctuations in edema.
b. 2-inch wide soft Velcro
c. 4-inch wide ace wrap
d. Wide, soft, foam-like strap
31. The ability to derive meaning from an event beyond the tan- B. Ability to abstract is to take an event such as picnic and value
gible aspects of the event itself is known as: the friendship of the people you are with as well as the food.
a. Immediate recall Immediate recall is remembering information within 1 minute.
b. Abstract thinking Concentration is the ability to maintain attention for longer periods
c. Concentration to complete a task. Attention is the ability of the CNS to focus on
d. Attention relevant stimuli while screening out the irrelevant.
32. In order to increase a patient's compliance with splint usage
after discharge, what is the most important factor?
a. Listen to the patient's complaints and adjust splint A. Compliance is enhanced if the therapist has listened to the
b. Allow the patient to practice donning and doffing the splint patient's issues concerning feel and fit.
c. Label the splint
d. Contrast the colors of the splint and the straps
33. The best activity for persons with schizophrenia according to
C. Lorna Jean King believed that persons with schizophrenia have
Lorna Jean King is:
ineffective proprioceptive feedback mechanisms with an underac-
a. A routine exercise program
tive vestibular regulating system. Activities should be non-cortical
b. Country line dancing
and pleasurable, since thinking about movements tends to slow
c. Spontaneous movement to music
down a person.
d. Tap dancing
34. What neurological pathway in the brainstem is responsible for
controlling consciousness and regulating the sleep-wake cycle? D. The reticular formation dispersed throughout the brainstem is
a. Basal ganglia responsible. The basal ganglia are not located in the brainstem.
b. Anterior corticospinal tract Although the anterior and lateral corticospinal tracts do pass
c. Lateral corticospinal tract through the brainstem, they are primarily involved in motor control.
d. Reticular formation
C. The prefrontal association circuit is involved in cognitive pro-
35. Which circuit within the basal ganglia has been implicated to
cessing, which includes attention switching. This circuit is believed
be involved in OCD?
to be affected in patients who are unable to control ritualistic
a. Motor circuit
and repetitive behaviors. The motor circuit aids in making move-
b. Oculomotor circuit
ments automatic and coordinated and is believed to be involved in

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Parkinson's disorder and Huntington's disease. The limbic circuit
c. Prefrontal association circuit
plays a role in emotions and motivation and is believed to be
d. Limbic circuit
involved in behaviors associated with Tourette's syndrome.
36. An 84-year-old female nursing home resident is 5 years post
CVA. Her left hand is in the fisted position and PROM is painful to
D. A soft splint such as a palm protector, places joints in sub-max-
her. Skin care is in concern. What is the best choice for interven-
imum extension. This allows for adequate skin hygiene. Answer
tion?
A is not true as options are available. Nursing can provide warm
a. None, nothing can be effectively done
socks. The resting hand splint is too rigid and likely painful for this
b. Daily soaks to relax the left hand and keep it clean
particular resident.
c. Resting hand splint
d. Soft splints
A. Emotional stress of serious magnitude that is traumatic for
37. Post-traumatic stress disorder is least likely to be triggered by:
almost everyone contributes to the development of PTSD. Recent
a. Job loss
research has placed greater emphasis on a person's subjective
b. Combat experience
response to trauma than on the severity of the stress itself. A
c. Sexual abuse
majority of people do not develop PTSD even when faced with
d. Natural catastrophes
overwhelming trauma.
38. Intrinsics of the hand include. All of the following except:
a. Flexor pollicis fungus A. The flexor pollicis longus originates on the body of the radius
b. Flexor digiti minimi and inserts on the base of the distal phalanx of digital. Therefore,
c. Flexor pollicis brevis the muscle belly is located within the forearm and not the hand.
d. Abductor pollicis brevis
39. At what age can a child maintain bend control when supported
in sitting? B. A child can maintain head control while supported at 2 months.
a. 1 month At 1 month the child can move his or her head slightly while in
b. 2 months prone. At 4 to 5 months the child can hold his or her chest off the
c. 4 months floor while in prone.
d. 5 months
40. A child of 2 to 3 years old who grabs a chunky crayon with his
fingers while his wrist is pronated is showing what type of grasp? C. A mature dynamic tripod grasp is typical of a 5 to 6 year old. A
a. Mature dynamic tripod less mature static tripod is used by a 3 to 4 year old and the hand
b. Less mature static tripod moves instead of the fingers during writing. A power grasp is used
c. Immature pronated grasp by a 1 year old and is fisted with the wrist flexed.
d. Power grasp
41. All of the following are spinal cord level reflexes except:
a. Rooting, sucking
b. Flexor withdrawal, placing D. ATNR and STNR are brainstem level reflexes.
c. Stepping, galant
d. Asymmetric tonic neck reflex, symmetric tonic neck reflex
42. The most common classification of cerebral palsy is:
a. Spasticity A. Spasticity is most common and includes hyperactive deep
b. Athetosis tendon reflexes. Athetosis has varying muscle tone. Atonia is low
c. Flaccid/atonia tone, and mixed is usually spastic with athetosis.
d. Mixed
43. Developmental tasks of a person in alter adulthood include all
of the following except:
a. Acceptance of one's self and life D. Acceptance of one's sexual identity is a developmental task of
b. Acceptance of one's ethnic origin and identity later adolescence (18 to 22 years).
c. Acceptance of one's mortality
d. Acceptance of one's sexual identity
44. Tetraplegia is a tern that indicates:
a. The involvement of only the hands in plegia D. The American Spinal Cord Injury Association states that
b. The involvement of only the lower extremities tetraplegia is the preferred term to indicate impairment or loss of
c. The involvement of only one side motor and/or sensory function at the cervical level.
d. The involvement of four limbs
45. Post-polio syndrome can be associated with all of the following
except: C. PPS has a slow onset appearing decades after the acute onset
a. Weakness of polio or after decades of stable functioning.
b. Fatigue
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c. Rapid onset of symptoms
d. Chronic overuse resulting in limb pain
46. Pervasive development disorders include all of the following
except:
D. Percasive developmental disorders are distinct from schizo-
a. Autism
phrenia, although children with PPD may occasionally develop
b. Asperger's disorder
schizophrenia later in life
c. Rett syndrome
d. Childhood schizophrenia
47. A child in a full inclusion classroom requires staff and parent
education to succeed. The role of the OT includes all of the
following except:
a. Educate the teacher on body mechanics so the teacher does
not hurt her back when moving the child C. The occupational therapist does not advise about medical pro-
b. Educate the parents on techniques to maintain performance in cedures but may encourage the parent to ask the child's medical
the classroom staff for advice.
c. Advise the parents on medical procedures that can enhance
classroom performance
d. Educates the teacher's aside to optimum classroom positioning
and seating for the child
48. A 17-year-old young man with autism has been successful
in all his OT treatments except shaving. His female classroom
teacher reports some peers are leasing him about his "5 o'clock
D. As a consultant, you are advising the teacher and parent.
shadow." The teenager lives at home with his single mother and 2
Having the teenager wait until school to shave puts shaving out of
younger sisters. The mother is frustrated because she has to nag
the home and into an inappropriate site. Starting a shaving group
the teen to get him to shave in the morning. As the school-based
would only be appropriate if everyone else in the class needed
consulting OT, what is the best option for treatment:
instruction but this is not the case. Currently, the young man has
a. Have the teen wait to shave until he gets to school and then
no male role models are everyone around him of importance is
have his teacher supervise
female. A male teenager volunteer could be advised to role model
b. Allow the teen's beard to grow in and not shave at all
shaving and offer words of encouragement. An electric shaver
c. Start a shaving group with all the young men in the teen's
could provide added safety.
classroom
d. Arrange a male teen volunteer to role model shaving with the
young man
49. All of the following are foundations of the spatiotemporal
adaptation FOR except:
a. Adaptation occurs with interaction of the individual and envi- D. Handling, positioning, and inhibiting techniques are NDT terms.
ronment over time and space NDT techniques can be used along with spatiotemporal frame of
b. Spatiotemporal stress is both positive and negative reference but are not foundations as are A,B, and C.
c. Processing develops from reflex to motor planning
d. Handling and positioning are used with inhibiting techniques
50. Sensory integration development continues throughout life but
is generally complete by what age?
C. Even older adults can improve sensory integration and being
a. 1 to 3 years of age
active through life can facilitate this, however, basic sensory inte-
b. 4 to 5 years of age
gration development is generally developed by age 8 to 10.
c. 8 to 10 years of age
d. 14 to 18 years of age

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