OTA Neurological Rehabilitation 2 — Questions and Answers
Question 1: A client with right hemisphere stroke is observed eating only the food on the right side of the plate and missing items on the left. This is BEST described as:
- Hemianopia
- Unilateral neglect (Correct answer)
- Anosognosia
- Ideomotor apraxia
Correct answer: Unilateral neglect
Unilateral neglect (hemispatial neglect) is the failure to attend to stimuli on the contralateral side of a brain lesion, commonly seen after right hemisphere stroke.
Question 2: When using the Bobath/neurodevelopmental treatment (NDT) approach with a stroke client, the OTA focuses primarily on:
- Strengthening the unaffected limbs to compensate
- Inhibiting abnormal tone and facilitating normal movement patterns (Correct answer)
- Training the client to use adaptive equipment exclusively
- Maximizing speed of task completion
Correct answer: Inhibiting abnormal tone and facilitating normal movement patterns
The NDT/Bobath approach focuses on inhibiting abnormal muscle tone and spastic movement patterns while facilitating normal, coordinated movement.
Question 3: A client with ALS is losing hand function and needs to continue working on a computer. Which adaptive technology should the OTA recommend FIRST?
- Power wheelchair with head control
- Voice recognition software (Correct answer)
- Electric page turner
- Environmental control unit
Correct answer: Voice recognition software
Voice recognition software is the most direct and least restrictive solution for maintaining computer access when hand function is declining in ALS.
Question 4: Which intervention is MOST appropriate for a client in the acute phase following spinal cord injury to prevent respiratory complications?
- Aggressive upper extremity strengthening
- Assisted cough techniques and deep breathing exercises (Correct answer)
- Splinting the upper extremities in functional position
- Progressive ambulation training
Correct answer: Assisted cough techniques and deep breathing exercises
Assisted cough techniques and deep breathing exercises are critical in acute SCI to maintain airway clearance and prevent pneumonia, especially with cervical injuries affecting respiratory muscles.
Question 5: The OTA notices a client with TBI has difficulty sequencing steps to make a sandwich despite having no motor deficits. This is MOST likely an example of:
- Ideomotor apraxia
- Ideational apraxia (Correct answer)
- Limb-kinetic apraxia
- Constructional apraxia
Correct answer: Ideational apraxia
Ideational apraxia is the inability to sequence and conceptualize multi-step tasks despite intact motor function, often seen after TBI.
Question 6: A client with Guillain-Barré syndrome is in the recovery phase. OT intervention should prioritize:
- High-resistance strengthening to rebuild muscle bulk
- Graded activity and energy conservation as strength returns (Correct answer)
- Splinting all extremities in full extension
- Avoiding all activity until full recovery
Correct answer: Graded activity and energy conservation as strength returns
During GBS recovery, graded activity that progresses with improving strength combined with energy conservation prevents overexertion and supports functional recovery.
Question 7: When working with a client with a C4 spinal cord injury, the OTA's goal for independence in ADLs should focus on:
- Independent feeding using adaptive utensils
- Using technology such as mouth sticks and voice-activated controls (Correct answer)
- Independent wheelchair propulsion with hand rims
- Independent transfers with a sliding board
Correct answer: Using technology such as mouth sticks and voice-activated controls
At C4 level, only head, neck, and upper trapezius function is preserved; mouth sticks and voice-activated technology are the primary means for achieving independence in ADLs.
OTA Neurological Rehabilitation 2
A client with right hemisphere stroke is observed eating only the food on the right side of the plate and missing items on the left.
This is BEST described as: