OCC 748 Final Case Study Questions

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Questions 21
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Difficulty Easy
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Barbara is a 55 year old female who was diagnosed with ALS about 3 years ago. Barbara is still able to walk and perform a sit to stand transfer, though she has a significant posterior lean. She is able to complete the following movements: Shoulder shrugging, shoulder flexion to 90 degrees, elbow flexion and extension and all cervical movements. Barbara has lost her ability to flex/extend her wrists, or move her digits in any fashion. In fact, her palmar arches are now flat. You have been called in for an OT Eval as Barbara has been having difficulties with self feeding. She has been eating by raising her plate and eating from it directly with her mouth. Which of the following would be your FIRST recommendation for Barbara?

Barbara has also been experiencing increasing amounts of pain during the day. It is eased through manual therapy, movement and moist heat. Which of the following would be the MOST appropriate intervention for Barbara’s pain?

You are back to visit Barbara after discharging her 6 months prior. On your new evaluation, you find that Barbara has now lost her ability to perform elbow flexion/extension and shoulder flexion/extension. She can still walk but her fall frequency has been increasing. She can still move her neck however, she fatigues quickly with extended use. She and her husband have already acquired the necessary splints to prevent hand contractures and equipped her bathroom with a bidet, hoyer lift, and supportive seating for bathing. They have also hired an aide to assist her. Barbara’s main complaint is that she overheats so easily in the apartment. What would be the most APPROPRIATE recommendation for her?

After the last discharge, it has been another 6 months before the next initial evaluation. This time, you find Barbara having difficulty breathing when sitting straight in her recliner chair. She has very little cervical AROM left and can no longer walk or stand unsupported. She has purchased a portable tilt in space wheelchair so that she can still go to the grocery store with her husband. Which would be the BEST initial intervention for this episode of care?

Marcos is a 64 year old man who voluntarily underwent a R total hip arthroplasty to address his pain as a result of significant osteoarthritis. The surgeon took a posterior approach during the surgery, and Marcos' recovery has been nonremarkable (aka going smoothly without any complications). You are seeing Marcos for his first visit in acute care. Which of the following actions would you advise AGAINST doing as a result of his procedure?

Marcos is moving to inpatient rehabilitation with an anticipated discharge of home with outpatient services. He lives alone in a condo and has no family nearby. He is able to answer all questions clearly with accuracy and demonstrates use of hip kit with 100% compliance. During the OT's initial evaluation, which of the following information would be important in the maintenance of Marcos' safety, independence, and recovery from surgery?

Which of the following pieces of equipment would Marcos need in order to properly complete meal preparation with use of a rolling walker?

Linda is a 45 year old female with diabetes. She has a history of poor healing wounds as a result of her diabetes. Which of the following conditions would she be at particularly high risk of experiencing?

Unfortunately, Linda experienced a wound on her leg that did not heal and turned gangrenous. She lost her left leg below the knee. Just after surgery, what would be the focus of OT intervention?

Linda has moved to the prosthetic phase in her recovery process. She was taught to inspect her residual limb every day to check for any red spots or start of sores. She noticed that she has a red mark on her limb from poor socket fit. Which of the following actions should she have been instructed to take?

Tyrone is a 50 year old man who recently underwent a CABGx3. He is recovering well in acute care and is on cardiac and sternal precautions. You are seeing him for his first OT visit after his surgery. Which of the following ADLs would be appropriate to complete at this time?

Tyrone stays in acute care for three days before his discharge. He is at MET level 2.0 at the moment. He lives in a single family home with 4 steps to enter. He is able to tolerate 3 hours of therapy a day. Where would you recommend he be discharged?

While in inpatient rehabilitation, Tyrone is cleared to MET level 4.0. This is significant because:

Taylor (they/theirs) is a 25 year old who sustained a TBI in a motor vehicle accident. The TBI was categorized as a coup-contre coup injury. They were unconscious at the scene and remained unconscious for 3 days. When they returned to consciousness, they had posttraumatic amnesia for a week. How would Taylor's injury be categorized?

As you are working with Taylor, their heart rate begins to rise. Their BP goes to 145/100 and they become very warm. They begin to breathe very quickly and start to go into decorticate posturing. What emergency situation is occurring?

Taylor has been improving and now is at Ranchos Level V. Which of the following interventions might be appropriate at this stage?

Nadia has sustained a R sided ischemic CVA in the MCA. Which symptom would you most likely anticipate seeing upon initial evaluation?

Nadia's left neglect can be observed when she completes grooming and self feeding as she leaves the left side of her body alone and does not eat off the left side of her plate. Which intervention might you implement to address this?

Jamal has sustained a C7 ASIA-A SCI from a skateboarding accident. His family is very concerned about his ability to be independent as he is a junior in college, studying to be an engineer. What prognosis should the family reasonably expect at this level of injury?

With a C7 level injury, the OT should be aware of which emergency situation?

Jamal enjoys being outside and does not intend to stop skateboarding, abeit in an adaptive fashion. Given his level of injury, what recommendation would you make to him?

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