CDS Treatment Protocols & Procedures 2 — Questions and Answers
Question 1: When applying a splint to a client with spasticity, which technique best prevents pressure ulcers?
- Pad all bony prominences before securing the splint (Correct answer)
- Apply the splint as tightly as possible to control tone
- Leave the splint on continuously for 48 hours without removal
- Use metal splints exclusively for clients with high tone
Correct answer: Pad all bony prominences before securing the splint
Padding bony prominences distributes pressure and reduces risk of skin breakdown under orthotic devices.
Question 2: Which outcome measure is most appropriate for tracking functional independence in activities of daily living for adults with physical disabilities?
- Berg Balance Scale
- Functional Independence Measure (FIM) (Correct answer)
- Mini-Mental State Examination
- Modified Ashworth Scale
Correct answer: Functional Independence Measure (FIM)
The FIM assesses 18 ADL and mobility items scored 1–7, making it the standard tool for tracking functional independence.
Question 3: A client with ALS is losing respiratory function. Per established protocol, when should noninvasive ventilation (NIV) typically be introduced?
- Only after the client is hospitalized for acute respiratory failure
- When FVC drops below 50% predicted or symptoms of hypoventilation appear (Correct answer)
- After the client has been on supplemental oxygen for six months
- When oxygen saturation falls below 80% at rest
Correct answer: When FVC drops below 50% predicted or symptoms of hypoventilation appear
NIV is recommended when FVC is below 50% predicted or orthopnea and morning headache indicate nocturnal hypoventilation.
Question 4: Range-of-motion exercises for a client with a complete cervical spinal cord injury are primarily indicated to:
- Restore voluntary muscle strength below the injury level
- Prevent contractures and maintain joint mobility (Correct answer)
- Eliminate autonomic dysreflexia episodes
- Increase bone density in the lower extremities
Correct answer: Prevent contractures and maintain joint mobility
Passive ROM maintains flexibility and prevents contractures in paralyzed limbs, though it does not restore voluntary movement.
Question 5: A disability specialist observes that a client's pressure-relief schedule is not being followed by caregivers. The BEST immediate action is to:
- Document the concern and wait for the next team meeting
- Educate caregivers on-site about the schedule and rationale for pressure relief (Correct answer)
- Discharge the client from services for non-compliance
- Apply a thicker cushion to compensate for missed weight shifts
Correct answer: Educate caregivers on-site about the schedule and rationale for pressure relief
Immediate caregiver education addresses the gap in care directly and prevents skin breakdown without delay.
Question 6: Which principle guides the use of constraint-induced movement therapy (CIMT) for clients with hemiplegia?
- Restraining the unaffected limb to force use of the impaired limb (Correct answer)
- Providing bilateral arm exercises with equal resistance on both sides
- Immobilizing the affected limb to allow the unaffected limb to compensate
- Using electrical stimulation only on the stronger extremity
Correct answer: Restraining the unaffected limb to force use of the impaired limb
CIMT constrains the less-affected limb so the individual must use the impaired limb, promoting cortical reorganization and functional recovery.
Question 7: When developing a bowel management program for a client with a T10 spinal cord injury, the specialist should prioritize:
- High-fiber diet, adequate hydration, and scheduled digital stimulation (Correct answer)
- Low-fiber diet to reduce stool bulk and minimize accidents
- Continuous suppository use every two hours
- Elimination of all oral intake to reduce bowel movement frequency
Correct answer: High-fiber diet, adequate hydration, and scheduled digital stimulation
A reflex bowel program at T10 uses dietary fiber, fluids, and scheduled digital stimulation to trigger reflex evacuation.
CDS Treatment Protocols & Procedures 2
When applying a splint to a client with spasticity, which technique best prevents pressure ulcers?