Occupational Therapist Test Adult Rehabilitation 3 — Questions and Answers
Question 1: A client with Parkinson's disease freezes of gait in doorways. Which cueing strategy has the strongest evidence for this specific problem?
- Auditory rhythmic cues (metronome)
- Visual transverse line cues on the floor (Correct answer)
- Verbal commands to 'think big'
- Backward walking training
Correct answer: Visual transverse line cues on the floor
Transverse visual cues (lines on the floor) provide external spatial targets that bypass the defective internal rhythm generation causing freezing in narrow spaces.
Question 2: An OT evaluates a client 3 days post-hip arthroplasty (posterior approach). Which transfer technique is contraindicated?
- Stand-pivot transfer toward the surgical side (Correct answer)
- Supine to sit by rolling to the non-surgical side
- Sit to stand with a raised toilet seat
- Bed to wheelchair with foot positioned forward
Correct answer: Stand-pivot transfer toward the surgical side
Pivoting toward the surgical side causes hip internal rotation and adduction, violating posterior hip precautions and risking dislocation.
Question 3: A client with ALS at the early stage reports hand weakness affecting grip. Which is the MOST appropriate OT intervention at this stage?
- Provide static resting hand splints
- Prescribe strengthening exercises for intrinsic muscles
- Introduce lightweight adaptive equipment and energy conservation (Correct answer)
- Initiate AAC device training immediately
Correct answer: Introduce lightweight adaptive equipment and energy conservation
Early ALS management focuses on adaptive equipment and energy conservation to maintain function while avoiding overexertion of weakening muscles.
Question 4: Which pain assessment tool is MOST appropriate for a client with moderate cognitive impairment who cannot reliably self-report pain?
- Visual Analog Scale (VAS)
- Numeric Rating Scale (NRS)
- Pain Assessment in Advanced Dementia (PAINAD) (Correct answer)
- McGill Pain Questionnaire
Correct answer: Pain Assessment in Advanced Dementia (PAINAD)
PAINAD assesses behavioral indicators of pain (breathing, vocalization, facial expression, body language, consolability) for those unable to self-report.
Question 5: A right-handed client with right hemiplegia needs to write. The OT's FIRST intervention should be:
- Immediately train dominant-hand substitution with the left hand
- Assess residual right hand function before recommending alternatives (Correct answer)
- Order an AAC device for communication
- Begin constraint-induced movement therapy
Correct answer: Assess residual right hand function before recommending alternatives
Before recommending compensation or device training, the OT must assess residual motor function to determine the best rehabilitation approach.
Question 6: A client with burns to 40% TBSA covering bilateral hands is in the rehabilitation phase. Which splinting position prevents the most common burn contracture deformity?
- Intrinsic minus position (MCP extension, IP flexion)
- Antideformity position (MCP flexion, IP extension, thumb abduction) (Correct answer)
- Functional position (wrist extension, MCP/IP slight flexion)
- Wrist neutral with fingers extended and adducted
Correct answer: Antideformity position (MCP flexion, IP extension, thumb abduction)
The antideformity (intrinsic plus) position counteracts the natural pull of burn scar contracture, which tends to pull MCPs into extension and IPs into flexion.
Question 7: During a cognitive assessment, a client with TBI correctly copies a clock face but cannot recall three words after 5 minutes. This pattern suggests primary impairment in:
- Visuospatial processing
- Prospective memory
- Delayed recall/encoding (Correct answer)
- Executive function
Correct answer: Delayed recall/encoding
Intact visuospatial performance with failed delayed recall indicates the primary deficit is in memory encoding and retrieval, not visuospatial function.
Occupational Therapist Test Adult Rehabilitation 3
A client with Parkinson's disease freezes of gait in doorways.
Which cueing strategy has the strongest evidence for this specific problem?