NBCOT Burn Questions And Answers Verified 100% Correct

NBCOT Burn Questions And Answers Verified 100% Correct An OTR® is working with a client who received significant burns to the elbow. The client presents with a soft-tissue contracture at the elbow and is noncompliant with wear of an anterior elbow extension splint. What alternative would be BEST for effective treatment of the soft-tissue elbow contracture? A. Ace wrap the splint on instead of using straps B. Discharge the client from occupational therapy secondary to treatment noncompliance C. Refer back to the plastic surgeon for surgery D. Use serial casting to slowly stretch the tissue - ANSWER The right Answer is D A cast is more difficult to remove and may promote better circumferential pressure to reduce hypertrophic scarring in addition to reducing the elbow contracture. Deshaies, L. D. (2008). Upper extremity orthoses. In M. V. Radomski & M. C. Trombly Latham (Eds.), Occupational therapy for physical dysfunction (6th ed., pp. 421-464). Baltimore: Lippincott Williams & Wilkins; p. 441. Explanations of Incorrect Answers A: Ace wrapping a splint reduces edema, not contracture. B: Discharging the client will not reduce the contracture. C: Surgery is appropriate for a boney block contracture, but alternative treatment methods should be implemented for soft-tissue contractures before surgery. An outpatient OTR® is assessing a burn survivor, who reports having increasing difficulty in self-feeding because of difficulty in bending the right elbow. During PROM assessment, the client reports localized pain at the elbow when flexed more than 100°. The OTR® feels a hard end feel at the elbow flexion. What is the BEST initial intervention? A. Provide the client with low-load prolonged stretch using an elbow flexion splint. B. Instruct the client in daily aggressive PROM at the elbow. C. Instruct the client in a daily AROM program within the pain-free range. D. Recommend the client use a long-handled swivel spoon for self-feeding. - ANSWER The right Answer is C The client is developing heterotopic ossification at the right elbow. The best intervention is to preserve AROM. Reeves, S. U., & Deshaies, L. (2013). Burns and burn rehabilitation. In H. M. Pendleton & W. Schultz-Krohn (Eds.), Pedretti's occupational therapy: Practice skills for physical dysfunction (7th ed., pp. ). St. Louis, MO: Elsevier; p. 1139. Explanations of Incorrect Answers A, B: The client is developing heterotopic ossification at the right elbow. Use of a splint for sustained stretches and aggressive PROM are contraindicated for this condition. D: The client is developing heterotopic ossification at the right elbow. The client may need adaptive equipment for self-feeding, but maintaining AROM should be the highest priority in the initial intervention. A softball player sustained a deep partial-thickness burn to the anterior aspect of the right arm from the wrist, proximal to the ulnar styloid process, to the mid-upper arm. A split-thickness skin graft from thigh to mid-forearm was performed 3 days postinjury. The client would like to return to softball practice as soon as possible. What would be the BEST activity during the initial phase of rehabilitation? A. Elbow extension splint 2 hours on, 2 hours off B. Upper arm rehab bike for 30 minutes, twice daily C. Scar massage followed by interactive, virtual-reality computer sports games D. Wall pulley and wall ladder followed by skin care regimen - ANSWER The right Answer is C Taking into consideration the client's previous occupation as a softball player, virtualreality computer sports games can involve similar sports movements and be motivating. However, because newly healed skin might split open as a result of overstretching or shearing force during movement, it is important to perform scar massage with a lubricant before activity. Reeves, S. U., & Deshaies, L. (2013). Burns and burn rehabilitation. In H. M. Pendleton & W. Schultz-Krohn (Eds.), Pedretti's occupational therapy: Practice skills for physical dysfunction (7th ed., pp. ). St. Louis, MO: Elsevier; pp. . Explanations of Incorrect Answers A, B, D: These activities are preparatory activities that do not take into consideration the client's areas of occupation. A softball player sustained a deep partial-thickness burn to the anterior aspect of the right arm from the wrist, proximal to the ulnar styloid process, to the mid-upper arm. A split-thickness skin graft from thigh to mid-forearm was performed 3 days postinjury. When all the wounds are closed and the graft is stable, what is the BEST intervention to prevent hypertrophic scar development? A. Jobst pressure sleeve with inserts B. Elastic bandage wrapping from distal to proximal C. Scar massage 3-5 times per day D. Frequent PROM and AROM - ANSWER The right Answer is A When most of the wounds are closed, a Jobst pressure garment is the best choice to prevent hypertrophic scarring. Adding inserts increases the effectiveness of compression therapy. Reeves, S. U., & Deshaies, L. (2013). Burns and burn rehabilitation. In H. M. Pendleton & W. Schultz-Krohn (Eds.), Pedretti's occupational therapy: Practice skills for physical dysfunction (7th ed., pp. ). St. Louis, MO: Elsevier; p. 1137. Explanations of Incorrect Answers B: Elastic bandaging provides light compression and can initially be used when the wounds are not closed. C, D: Scar massage and ROM activities are an important part of burn rehabilitation but are not interventions for preventing hypertrophic scars. An OTR® is treating a client who sustained second- and third-degree burns on the dorsal forearm and hand. Which splint would be appropriate for this client? A. Resting hand splint B. Intrinsic plus splint C. Cone antispasticity splint D. Dorsal flexor tendon repair splint - ANSWER The right Answer is B Burns to the dorsum of the hand require the metacarpophalangeal joints to be splinted in 70°-90° of flexion to prevent clawing of the fingers and shortening of the tendons and ligaments. This type of splint is also referred to as an antideformity splint or a safe position splint. Coppard, B. M. (2007). Hand immobilization splints. In B. M. Coppard & H. Lohman (Eds.), Introduction to splinting: A clinical reasoning and problem-solving approach (3rd ed., pp. 188-212). St. Louis, MO: Mosby; p. 194. Explanations of Incorrect Answers A: A resting hand splint is for support or immobilization.