Occupational Therapist Test Geriatric Care 5 — Questions and Answers
Question 1: Which eating modification is MOST appropriate for an 82-year-old with moderate dysphagia and reduced tongue strength?
- Thin liquids with verbal reminders to swallow
- IDDSI Level 4 (pureed) diet with IDDSI Level 3 (liquidized) liquids (Correct answer)
- Regular diet with smaller bites
- NPO with tube feeding only
Correct answer: IDDSI Level 4 (pureed) diet with IDDSI Level 3 (liquidized) liquids
IDDSI Level 4 pureed foods and Level 3 liquidized fluids reduce the effort needed to manipulate the bolus and lower aspiration risk for someone with reduced tongue strength.
Question 2: A 68-year-old with diabetes and peripheral neuropathy is unable to feel foot injuries. Which self-care OT education is MOST critical?
- Daily foot inspection using a mirror or caregiver assistance (Correct answer)
- Alternating footwear styles each day
- Soaking feet in warm water nightly
- Wearing sandals to improve air circulation
Correct answer: Daily foot inspection using a mirror or caregiver assistance
Daily visual foot inspection (using a mirror or a caregiver) detects injuries early in patients who cannot rely on pain sensation, preventing serious complications such as infection or amputation.
Question 3: Which evidence-based OT program is designed specifically to reduce fall risk in community-dwelling older adults?
- CIMT (Constraint-Induced Movement Therapy)
- Otago Exercise Programme (Correct answer)
- PACE (Program of All-inclusive Care for the Elderly)
- MBSR (Mindfulness-Based Stress Reduction)
Correct answer: Otago Exercise Programme
The Otago Exercise Programme is an evidence-based, individually tailored exercise program proven to reduce falls and fall-related injuries in older adults living in the community.
Question 4: An OT is conducting a driving evaluation for a 75-year-old with early Alzheimer's disease. Who should receive the evaluation results?
- Only the patient, due to HIPAA confidentiality
- The patient, and the state DMV if safety concerns are identified per state law (Correct answer)
- Only the family caregiver
- The physician only
Correct answer: The patient, and the state DMV if safety concerns are identified per state law
The patient has the right to receive results, and OTs must follow state mandatory reporting laws, which may require reporting unsafe drivers with cognitive impairments to the DMV.
Question 5: A 79-year-old with heart failure reports severe fatigue during morning ADLs. Which energy conservation principle should be taught FIRST?
- Perform all ADLs in one session to preserve afternoon energy
- Pace activities by alternating exertion with rest periods (Correct answer)
- Complete the most tiring tasks in the evening when rested
- Increase activity speed to finish tasks before fatigue sets in
Correct answer: Pace activities by alternating exertion with rest periods
Pacing — alternating activity with planned rest periods — is the foundational energy conservation principle that prevents the energy expenditure peaks that worsen fatigue in heart failure.
Question 6: Which change in older adult skin directly increases pressure injury risk during prolonged wheelchair sitting?
- Increased melanin production
- Decreased subcutaneous fat and skin elasticity (Correct answer)
- Increased sebaceous gland activity
- Thickening of the epidermal layer
Correct answer: Decreased subcutaneous fat and skin elasticity
Decreased subcutaneous fat reduces cushioning over bony prominences, and decreased elasticity reduces the skin's ability to tolerate and recover from shear and pressure forces.
Question 7: A caregiver of a 90-year-old with advanced dementia asks the OT how to manage resistive behavior during bathing. What is the BEST recommendation?
- Restrain the patient gently to complete hygiene efficiently
- Switch to a bed bath with familiar music and a consistent routine (Correct answer)
- Bathe the patient only when fully cooperative
- Reduce bathing to once weekly to avoid distress
Correct answer: Switch to a bed bath with familiar music and a consistent routine
A bed bath eliminates the unfamiliar bathing environment, while familiar music and consistent routine reduce agitation and resistance by leveraging preserved procedural and emotional memory.
Occupational Therapist Test Geriatric Care 5
Which eating modification is MOST appropriate for an 82-year-old with moderate dysphagia and reduced tongue strength?