ASC Community Reintegration & Support 2 — Questions and Answers
Question 1: Which validated tool is most appropriate for assessing a stroke survivor's ability to perform instrumental activities of daily living (IADLs) in the community?
- Lawton-Brody IADL Scale (Correct answer)
- Berg Balance Scale
- NIH Stroke Scale
- Modified Rankin Scale
Correct answer: Lawton-Brody IADL Scale
The Lawton-Brody IADL Scale specifically measures complex daily tasks such as managing finances, using transportation, and cooking that are essential for community independence.
Question 2: A stroke survivor with aphasia wants to return to work. Which community resource should the stroke coordinator prioritize connecting them with?
- State vocational rehabilitation services (Correct answer)
- Adult day health center
- Skilled nursing facility
- Home health aide services
Correct answer: State vocational rehabilitation services
State vocational rehabilitation services provide job counseling, assistive technology, and job placement support for individuals with communication and other disabilities.
Question 3: When educating a caregiver about preventing post-stroke depression in the survivor, which strategy is most evidence-based?
- Encouraging social engagement and peer support group participation (Correct answer)
- Advising the survivor to avoid stressful activities entirely
- Recommending strict bed rest during the first 6 months
- Limiting visits from friends to reduce cognitive overload
Correct answer: Encouraging social engagement and peer support group participation
Social engagement and peer support have strong evidence for reducing post-stroke depression by combating isolation and providing emotional validation.
Question 4: Under the Americans with Disabilities Act (ADA), which type of employer accommodation would typically be required for a stroke survivor returning to work with mild hemiparesis?
- Modified workstation or ergonomic equipment (Correct answer)
- Permanent reduction in salary
- Transfer to a less demanding department without consultation
- Mandatory 6-month medical leave extension
Correct answer: Modified workstation or ergonomic equipment
The ADA requires employers to provide reasonable accommodations such as ergonomic modifications that allow qualified individuals with disabilities to perform essential job functions.
Question 5: A stroke survivor reports feeling isolated after returning home. Which intervention by the ASC is most appropriate as a first step?
- Refer to a community-based stroke support group (Correct answer)
- Recommend the patient be readmitted for inpatient rehabilitation
- Advise family members to move in with the survivor
- Prescribe increased home health aide hours
Correct answer: Refer to a community-based stroke support group
Community stroke support groups address social isolation while providing peer education and emotional support, making them an appropriate first-line community resource.
Question 6: Which factor is the strongest predictor of successful long-term community reintegration following stroke?
- Availability of caregiver and social support (Correct answer)
- Age at time of stroke
- Hospital length of stay
- Type of stroke (ischemic vs hemorrhagic)
Correct answer: Availability of caregiver and social support
Strong social support networks are consistently identified in research as the most powerful predictor of successful community reintegration after stroke.
Question 7: A stroke survivor with cognitive impairment wishes to resume driving. What is the stroke coordinator's most appropriate action?
- Refer for a formal driving evaluation with a certified driver rehabilitation specialist (Correct answer)
- Advise the patient that driving is permanently prohibited
- Recommend the patient take a standard DMV road test
- Allow driving if the patient passes a Mini-Mental State Examination
Correct answer: Refer for a formal driving evaluation with a certified driver rehabilitation specialist
A certified driver rehabilitation specialist uses specialized assessment tools to evaluate whether stroke survivors with cognitive or physical impairments can safely drive.
ASC Community Reintegration & Support 2
Which validated tool is most appropriate for assessing a stroke survivor's ability to perform instrumental activities of daily living (IADLs) in the community?