Occupational Therapist Test Adult Rehabilitation 5 — Questions and Answers
Question 1: A client with a traumatic below-elbow (transradial) amputation is being fit with a body-powered prosthesis. Which motion activates terminal device opening?
- Shoulder flexion with scapular abduction (Correct answer)
- Elbow extension
- Wrist pronation
- Shoulder abduction only
Correct answer: Shoulder flexion with scapular abduction
In a standard body-powered transradial prosthesis, humeral flexion combined with scapular abduction creates cable tension that opens the voluntary-opening terminal device.
Question 2: An OT uses the Allen Cognitive Level Screen (ACLS) and scores a client at level 4.0. Which work task is WITHIN this client's cognitive capacity?
- Managing a complex medication schedule independently
- Following a simple 2-step repetitive assembly task (Correct answer)
- Planning and executing a multi-step cooking project
- Independently managing finances and appointments
Correct answer: Following a simple 2-step repetitive assembly task
ACL level 4 (goal-directed actions) supports simple, repetitive tasks with concrete, visible steps but not complex planning or abstract reasoning.
Question 3: A client post-CABG at week 3 is cleared for Phase II cardiac rehabilitation. Which upper extremity activity should the OT AVOID at this stage?
- Light bilateral arm reaching below shoulder height
- Overhead bilateral shoulder lifting with resistance (Correct answer)
- Seated bilateral upper extremity ADLs
- Grooming with both hands at face level
Correct answer: Overhead bilateral shoulder lifting with resistance
Overhead bilateral upper extremity resistance activities place excessive stress on healing sternal tissue and elevate cardiac demand beyond safe post-CABG Phase II limits.
Question 4: Which standardized assessment is MOST appropriate for evaluating instrumental activities of daily living (IADL) performance in a community-dwelling adult with mild cognitive impairment?
- Mini-Mental State Examination (MMSE)
- Lawton IADL Scale (self-report)
- Performance Assessment of Self-Care Skills (PASS) (Correct answer)
- Kohlman Evaluation of Living Skills (KELS)
Correct answer: Performance Assessment of Self-Care Skills (PASS)
The PASS is an observational, performance-based IADL assessment that directly measures task execution, making it more objective than self-report scales for those with cognitive impairment.
Question 5: A client with rheumatoid arthritis of the hands asks which grip pattern to use when opening jars. The OT should recommend:
- Using a lateral (key) pinch with the index finger
- Using a built-up handle jar opener with palm pressure
- Applying force with the ulnar side of the hand (Correct answer)
- Squeezing the jar with fingertip pinch for better control
Correct answer: Applying force with the ulnar side of the hand
Using the ulnar side of the hand to open jars avoids ulnar deviation stress and protects MCP joints from deforming forces in RA joint protection.
Question 6: A client with a right CVA demonstrates motor apraxia when attempting to use a comb. The MOST appropriate OT strategy is:
- Strengthen shoulder musculature for better motor control
- Provide verbal step-by-step cueing during the task
- Use physical guidance and task repetition to relearn the motor plan (Correct answer)
- Switch to a larger-handle adaptive comb
Correct answer: Use physical guidance and task repetition to relearn the motor plan
Motor apraxia is a motor planning disorder; physical guidance combined with repetitive practice helps re-establish the stored motor program through procedural learning.
Question 7: During a vocational rehabilitation evaluation, a client with a spinal cord injury reports difficulty with sustained computer use due to wrist pain. The OT's FIRST action is:
- Prescribe a wrist cock-up splint for all computer use
- Conduct an ergonomic workstation assessment (Correct answer)
- Immediately refer to a hand surgeon
- Recommend voice recognition software
Correct answer: Conduct an ergonomic workstation assessment
An ergonomic workstation assessment identifies modifiable environmental and postural contributors to wrist pain before implementing adaptive equipment or referrals.
Occupational Therapist Test Adult Rehabilitation 5
A client with a traumatic below-elbow (transradial) amputation is being fit with a body-powered prosthesis.
Which motion activates terminal device opening?