CMC Client Consultation & Needs Analysis 3 — Questions and Answers
Question 1: A CMC is meeting a client who recently acquired a spinal cord injury at the T6 level. Which mobility consideration is UNIQUE to this level of injury compared to a C6 injury?
- The client will have full hand and grip function available for manual wheelchair propulsion (Correct answer)
- The client will require a power wheelchair due to absent upper extremity function
- The client will need mechanical ventilator support during consultations
- The client cannot benefit from any home modification due to full paralysis
Correct answer: The client will have full hand and grip function available for manual wheelchair propulsion
A T6-level injury preserves full upper extremity and hand function, enabling manual wheelchair propulsion and a broader range of self-care options than cervical-level injuries.
Question 2: During a needs analysis, a client mentions she frequently skips her morning routine because the bathroom feels 'too hard to manage.' The CMC should interpret this as a signal of:
- Noncompliance that the client should overcome with willpower
- An occupational performance barrier requiring environmental or assistive device intervention (Correct answer)
- A psychiatric issue requiring referral before any home modification
- A minor complaint that does not affect the modification plan
Correct answer: An occupational performance barrier requiring environmental or assistive device intervention
Activity avoidance is a key clinical indicator of unmet occupational performance needs, signaling that the environment or available tools are not supporting safe participation.
Question 3: Which standardized tool is commonly used by CMCs during client consultations to assess fall risk in community-dwelling older adults?
- The Barthel Index
- The Timed Up and Go (TUG) test (Correct answer)
- The MMSE cognitive screening
- The Berg Balance Scale (BBS)
Correct answer: The Timed Up and Go (TUG) test
The Timed Up and Go test is a widely validated, quick assessment of functional mobility and fall risk that CMCs use to quantify transfer and gait safety in the home environment.
Question 4: A client reports that their wheelchair does not fit through the bathroom doorway. Before recommending door widening, the CMC should FIRST:
- Immediately schedule a contractor to widen the door
- Measure both the doorway clear width and the wheelchair's overall width to confirm the clearance deficit (Correct answer)
- Recommend a narrower wheelchair model without assessing the door
- Advise the client to use a bedside commode to avoid the doorway entirely
Correct answer: Measure both the doorway clear width and the wheelchair's overall width to confirm the clearance deficit
Accurate measurement of both the doorway and the wheelchair confirms the actual clearance deficit before recommending a structural modification or equipment change.
Question 5: Which aspect of a client's home environment is MOST likely to be overlooked if the CMC conducts the consultation only through a phone or video interview?
- The client's primary diagnosis
- Subtle flooring transitions, lighting conditions, and spatial constraints that create trip hazards (Correct answer)
- The client's insurance policy details
- The client's medication regimen
Correct answer: Subtle flooring transitions, lighting conditions, and spatial constraints that create trip hazards
Physical hazards such as uneven flooring transitions, poor lighting, and tight turning radii are reliably identified only through in-person environmental assessment.
Question 6: When a client's goals for independence conflict with a caregiver's goal for safety, the CMC's role is to:
- Side with the caregiver because safety always supersedes client wishes
- Facilitate a discussion that balances the client's autonomy with evidence-based risk management strategies (Correct answer)
- Terminate the consultation and defer to medical staff
- Document the conflict and recommend no modifications until resolved by a court
Correct answer: Facilitate a discussion that balances the client's autonomy with evidence-based risk management strategies
The CMC serves as a skilled mediator who integrates client-centered goals with safety evidence, seeking solutions that honor both independence and risk reduction.
Question 7: A needs analysis reveals that a client with Parkinson's disease freezes when transitioning from carpet to hard flooring. The MOST targeted environmental modification to address this specific phenomenon is:
- Installing handrails throughout the entire home
- Adding visual cue strips (tape lines) at flooring transitions to trigger gait initiation (Correct answer)
- Replacing all flooring with a uniform surface type
- Prescribing a walker without any environmental changes
Correct answer: Adding visual cue strips (tape lines) at flooring transitions to trigger gait initiation
Visual cues are an evidence-based strategy for Parkinson's freezing of gait; transverse lines at thresholds provide the visual rhythm the nervous system needs to reinitiate stepping.
CMC Client Consultation & Needs Analysis 3
A CMC is meeting a client who recently acquired a spinal cord injury at the T6 level.
Which mobility consideration is UNIQUE to this level of injury compared to a C6 injury?