OCCTH 585 Midterm 2 Exam Questions with
Complete Answers
why is it important for you to assess Fanny's functional ability to complete tasks after a
right hemisphere stroke - ✔✔safety - with hemi-neglect (visually), impulsivity with
mobility and lack of insight into deficits
the doctors tell you they will be doing thrombolytic management with Fanny which you
know means they will - ✔✔be helping to breakdown the blood clot and disrupt the
occlusion with intra-arterial administration of tPA (tissue plasminogen activator)
the doctors tell you about tPA which stands for _____, and ask when the onset of
Fanny's stroke was because for best results tPA should be administered within _____
but explains current practice is ____ - ✔✔tissue plasminogen activator; within 1 hour
for best results; current practice is 4.5 hours up to 6 hours
Doctors determine that tPA is not a viable option to treat Fanny potentially because... -
✔✔there is a hemorrhagic component to her stroke or the size of the stroke is
greater than 1/3 of the hemisphere
other acute medical management options that doctors present for Fanny include... -
✔✔taking out the clots, or administering anti-coagulation medication (ie. aspirin,
etc.)
The blockage resulting in Fanny's right CVA was most likely to occur at which point in
the brain... - ✔✔at the branches in the brain's arteries, as there is a higher risk fo
formation of plaque at the branch off areas of the vessel
,The doctors are saying that Fanny had an ischemic stroke, which is the most common
type of stroke which means... - ✔✔there is a blockage or loss of blood supply (could
also be ischemic necrosis, infarction, hypo-perfusion)
Knowing the type of stroke Fanny has had is good for you as an OT because an ischemic
stroke - ✔✔has quite predictable functional deficits
As you wait for the doctors to examine Fanny you recall that an ischemic stroke involves
atherosclerosis which means.. - ✔✔there is a plaque build up inside the arteries that
could be cholesterol, which narrows the arteries
Fanny's ischemic stroke, with the involvement of antherosclerosis is likely due to -
✔✔a bit of plaque build up breaking off and travelling to the brain, blocking the
blood supply
Fanny's infarct occurs are a result of - ✔✔a thrombosis or embolism
thrombosis refers to - ✔✔the formation of a thrombus, which is worsened by
antherosclerosis (narrowing of arteries)
embolism refers to - ✔✔the process by which the blood vessel is getting stuck
While on the stroke unit you see Brian, who experienced a left CVA stroke to the MCA.
This means he will see impacts with - ✔✔Broca's aphasia (loss of speech or
expression) or Wenicke's aphasia (comprehension, understanding of speech)
While seeing Brain, with a left hemisphere CVA, what areas of functional implication will
you consider as an OT (as part of an interdisciplinary team on the unit) - ✔✔apraxia
,(of speech, of gait or of dressing); difficulty walking, dressing, communicating or
transferring; general ADLs
You are the OT for Marissa on the stroke unit who has experienced a right MCA stroke.
As the OT you are expecting to potentially see what functional deficits -
✔✔contralateral hemisensory loss; hemiplegia; visual field deficits; visuospatial
deficits, apraxia; perseveration; poor judgement; emotional problem, apathy
Working with Marissa as an OT in the acute phase post-stroke, you will focus on -
✔✔early mobilization; working with the scapula in managing joint subluxation;
working on proper transfer techniques, bed and sitting positioning, examining skin
pressure and breakdown in order to lower risk of secondary complications; preventing
contractures/deformities; ensuring biomechanical alignment; return to self-care; patient
and caregiver education; falls prevention
You see in a clients chart that they have a lacunar stroke, and you know with your
intervention this means you will see - ✔✔no cognitive deficits, only motor and
sensory
Your client Amy has had a lacunar stroke, in the lenticulostriate arteries, you are
expecting to see - ✔✔pure motor effects, with clumsy hand syndrome and ataxic
hemiparesis
Your client Larry has had a lacunar stroke in the lateral thalamus, you know this will
effect his - ✔✔sensory - somatosensory loss to all primary modalities in the
contralateral face, arm and body
With Larry, and his lucunar infarct, you may work in which areas (as an OT) with him -
✔✔eating and feeding; fine motor including handwriting, dressing or typing; safety
(with sensory issues including water temperature)
, Your patient Bob has had a CVA in the ACA (anterior cerebral artery). You know this
blood supply is to the medial, anterior and posterior parietal lobes of the brain, with
functional implications to - ✔✔primarily motor and sensory, also cognition; affects
legs, bowel, and bladder, shoulder, and some behavioural disturbances
You will expect to see these functional deficits with Bob's CVA in the ACA -
✔✔behavioural disturbance; apraxia (with motor planning); contralateral
hemisensory loss; hemiparesis (especially in the foot)
You see that the doctors have added a note that Bob's stroke has been classified further
as a LEFT CVA in the ACA, which will have functional deficits on - ✔✔inertia of speech
or mutism affecting communication
anastomoses in the brain means - ✔✔there are connections at distal ends of cerebral
arteries - so with a blockage somewhere there may be ways to get around
ACA and MCA watershed stroke will clinically look like - ✔✔problems with shoulder
and UE + perhaps leg
You are seeing Polly who has experienced a PCA (posterior cerebral artery) CVA. This is
indicated when you see Polly through her displaying - ✔✔perceptual deficits (alexia -
reading problems; anomia - word retrieval difficulties; visual agnosia; prospagnosia);
memory impairment; homonymous hemianopsia
Wallenberg's syndrome - ✔✔a classical brainstem stroke in the vertebral or
cerebellar artery
You are seeing a patient for the first time who has Wallenberg's syndrome on their
chart. You know this means stroke and that it will be.. - ✔✔less functionally
Complete Answers
why is it important for you to assess Fanny's functional ability to complete tasks after a
right hemisphere stroke - ✔✔safety - with hemi-neglect (visually), impulsivity with
mobility and lack of insight into deficits
the doctors tell you they will be doing thrombolytic management with Fanny which you
know means they will - ✔✔be helping to breakdown the blood clot and disrupt the
occlusion with intra-arterial administration of tPA (tissue plasminogen activator)
the doctors tell you about tPA which stands for _____, and ask when the onset of
Fanny's stroke was because for best results tPA should be administered within _____
but explains current practice is ____ - ✔✔tissue plasminogen activator; within 1 hour
for best results; current practice is 4.5 hours up to 6 hours
Doctors determine that tPA is not a viable option to treat Fanny potentially because... -
✔✔there is a hemorrhagic component to her stroke or the size of the stroke is
greater than 1/3 of the hemisphere
other acute medical management options that doctors present for Fanny include... -
✔✔taking out the clots, or administering anti-coagulation medication (ie. aspirin,
etc.)
The blockage resulting in Fanny's right CVA was most likely to occur at which point in
the brain... - ✔✔at the branches in the brain's arteries, as there is a higher risk fo
formation of plaque at the branch off areas of the vessel
,The doctors are saying that Fanny had an ischemic stroke, which is the most common
type of stroke which means... - ✔✔there is a blockage or loss of blood supply (could
also be ischemic necrosis, infarction, hypo-perfusion)
Knowing the type of stroke Fanny has had is good for you as an OT because an ischemic
stroke - ✔✔has quite predictable functional deficits
As you wait for the doctors to examine Fanny you recall that an ischemic stroke involves
atherosclerosis which means.. - ✔✔there is a plaque build up inside the arteries that
could be cholesterol, which narrows the arteries
Fanny's ischemic stroke, with the involvement of antherosclerosis is likely due to -
✔✔a bit of plaque build up breaking off and travelling to the brain, blocking the
blood supply
Fanny's infarct occurs are a result of - ✔✔a thrombosis or embolism
thrombosis refers to - ✔✔the formation of a thrombus, which is worsened by
antherosclerosis (narrowing of arteries)
embolism refers to - ✔✔the process by which the blood vessel is getting stuck
While on the stroke unit you see Brian, who experienced a left CVA stroke to the MCA.
This means he will see impacts with - ✔✔Broca's aphasia (loss of speech or
expression) or Wenicke's aphasia (comprehension, understanding of speech)
While seeing Brain, with a left hemisphere CVA, what areas of functional implication will
you consider as an OT (as part of an interdisciplinary team on the unit) - ✔✔apraxia
,(of speech, of gait or of dressing); difficulty walking, dressing, communicating or
transferring; general ADLs
You are the OT for Marissa on the stroke unit who has experienced a right MCA stroke.
As the OT you are expecting to potentially see what functional deficits -
✔✔contralateral hemisensory loss; hemiplegia; visual field deficits; visuospatial
deficits, apraxia; perseveration; poor judgement; emotional problem, apathy
Working with Marissa as an OT in the acute phase post-stroke, you will focus on -
✔✔early mobilization; working with the scapula in managing joint subluxation;
working on proper transfer techniques, bed and sitting positioning, examining skin
pressure and breakdown in order to lower risk of secondary complications; preventing
contractures/deformities; ensuring biomechanical alignment; return to self-care; patient
and caregiver education; falls prevention
You see in a clients chart that they have a lacunar stroke, and you know with your
intervention this means you will see - ✔✔no cognitive deficits, only motor and
sensory
Your client Amy has had a lacunar stroke, in the lenticulostriate arteries, you are
expecting to see - ✔✔pure motor effects, with clumsy hand syndrome and ataxic
hemiparesis
Your client Larry has had a lacunar stroke in the lateral thalamus, you know this will
effect his - ✔✔sensory - somatosensory loss to all primary modalities in the
contralateral face, arm and body
With Larry, and his lucunar infarct, you may work in which areas (as an OT) with him -
✔✔eating and feeding; fine motor including handwriting, dressing or typing; safety
(with sensory issues including water temperature)
, Your patient Bob has had a CVA in the ACA (anterior cerebral artery). You know this
blood supply is to the medial, anterior and posterior parietal lobes of the brain, with
functional implications to - ✔✔primarily motor and sensory, also cognition; affects
legs, bowel, and bladder, shoulder, and some behavioural disturbances
You will expect to see these functional deficits with Bob's CVA in the ACA -
✔✔behavioural disturbance; apraxia (with motor planning); contralateral
hemisensory loss; hemiparesis (especially in the foot)
You see that the doctors have added a note that Bob's stroke has been classified further
as a LEFT CVA in the ACA, which will have functional deficits on - ✔✔inertia of speech
or mutism affecting communication
anastomoses in the brain means - ✔✔there are connections at distal ends of cerebral
arteries - so with a blockage somewhere there may be ways to get around
ACA and MCA watershed stroke will clinically look like - ✔✔problems with shoulder
and UE + perhaps leg
You are seeing Polly who has experienced a PCA (posterior cerebral artery) CVA. This is
indicated when you see Polly through her displaying - ✔✔perceptual deficits (alexia -
reading problems; anomia - word retrieval difficulties; visual agnosia; prospagnosia);
memory impairment; homonymous hemianopsia
Wallenberg's syndrome - ✔✔a classical brainstem stroke in the vertebral or
cerebellar artery
You are seeing a patient for the first time who has Wallenberg's syndrome on their
chart. You know this means stroke and that it will be.. - ✔✔less functionally
