NOTCE Exam ACTUAL EXAM REAL EXAM QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES|ALREADY GRADED A+

NOTCE Exam ACTUAL EXAM REAL EXAM QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES|ALREADY GRADED A+ Pre-prosthetic LE phase purpose - ANSWER- learn how to manage the stump and regain lost strength and endurance Interventions in LE pre-prosthetic phase - ANSWER- figure eight method wrapping to reduce edema promote skin health: inspection with long-handled mirror after and prior to wrapping, wash limb daily with mild soap and pat dry, take circumference measurments to determine when stump is ready for prosthesis prevent contractures: prone lying, amputee board increase U/E strength and endurance decrease pain and desensitize residual limb increase mobility: transfer, wheelchair and bed mobility training assess the home for accessibility LE Postprosthetic phase purpose - ANSWER- learning to function with prosthesis Interventions in LE postprothetic phase - ANSWER- increase mobility: walking on uneven surfaces improve posture: practice balance activities and weight bearing assist in developing new body image: educate on grieving process, training program to integrate prosthesis into body scheme Preprosthetic UE interventions - ANSWER- wound care: massage for adhesions, circulation and desensitization decrease pain and desensitize: tapping, vibration, pressure, various textures edema: bandage or shrinker sock, recording limb length and circumference promote skin healing: same as LE- track sensory impaired limb with vision maintain PROM and AROM: exercises that mimc mvmts required for prosthesis improved independent living skills: adaptive equipment, one-handed techniques Prosthetic phase UE interventions - ANSWER- improve independent living status education regarding prosthetic components: sock hygeine, care, wearing schedule, controls, functional training ALS (progressive bulbar palsy, progressive spinal muscle atrophy, primary lateral sclerosis) - ANSWER- destruction of motor neurons within the spinal cord, motor cortex and brainstem focal weakness beginning in the arm, leg or bulbar (muscles of mouth or throat) Symptoms: dropping objects, slurred speach, fatigue, marked muscle atrophy, weight loss, spasticity, muscle crampling and fasticulation (twitching of muscle at rest) fatal with mean duration of 2-4 years does not affect eye function, cognition, bowel and bladder or sensation stages important? interventions: energy conservation, adaptive equipment, stretching, orthotic, dyphagia, wheelchair, home adaptations, slings, augmented speech devices, heat and massage to control spasms, electronic control for ADLS *careful with muscle strengthening Evidence based practice process - ANSWER- 1. identify question 2. literature search 3. Focus or broaden question 4. identify and retrieve relevant reports 5. Appraise evidence 6. Decide whether or not to change practice 7. Plan and make change 8. Evaluate effect of change on clients CMC joint important function - ANSWER- Thumb opposition during prehension Brachial plexus injury - ANSWER- Posterolateral hip replacement restrictions - ANSWER- no hip flexion > 90, no internal rotation or adduction Anterolateral hip replacement precautions - ANSWER- no external rotation, adduction or extension Knee Replacement Precautions - ANSWER- avoid rotation of the knee for 12 weeks, may use knee imobilizer typically no restrictions on bending the knee must maintain knee mobility Spinal injury levels - ANSWER- C1-3: limited movement of head and neck: splints, head control/breath control, computer access C3-4: usually has head and neck control, may shrug shoulders: head or breath control, environmental controls C5: above + can shrug shoulder and has shoulder control. Can flex elbows and supinate: can do UE self care activities, manual or power wheelchair C6: movement of head, neck, shoulders, arms and wrists. Can shrug shoulders, flex elbow, supinate and pronate and extend wrists: potential self-care independence, can propel manual wheelchair with modified rims, universal cuff C7-8: above + Elbow extensions, forearm pronation, wrist extension and flexion, thumb extension and abduction, passive finger flexion: independent in self care, ADLs with some assistance, transfers independent with or without a board, propel wheelchair with modified rims (C8-T1: has added strength and coordination of fingers with limited or even normal hand function) (T2-T6: normal UE function. Increased use of rib and chest muscles and may have some trunk control) T1-T9: UE in tack, limited trunk stability, independent in self care and other ADL and IADLs T10-L1: full trunk stability L2-S5: good trunk stability, partial to full control of LE (AFL, wheelchair or crutches) Intervention in SCI - ANSWER- Acute: AROM and AAROM within tolerance; encourage participation in ADLS; initiate caregiver education and home modifications for discharge; evaluate positioning and need for hand splinting. Splints should be dorsal to allow for sensory feedback Active: work on upright posture and sitting tolerance in wheelchair and pressure relieving techniques; active and passive ROM to prevent constractures; strengthen the shoulder girdle, triceps, pectoralis and lats for transfers and weightshifting equipment: universal cuff, wrist cock-up splint, plate guard, cup holder, straw, nonskid mat, soap holder, wash mitt, transfer board etc.