OCCTH 585 - Midterm 2 UPDATED Exam
Questions and CORRECT Answers
OT Role in Neuro Acute Care - CORRECT ANSWER - impairment > activity >
participation
You are seeing your client Fanny. She has trouble speaking but is trying to say that she is having
vision problems, weakness, headaches and is dizzy. You know its time to act FAST because
Fanny is likely experiencing... - CORRECT ANSWER - a stroke
Fanny continues describing her experience as you wait for the stroke ambulance to arrive from
the UofA hospital. Fanny would likely describe her symptoms as - CORRECT ANSWER -
progressive, spread across hours or days, starting with mild arm numbness or morning paralysis,
with onset during sleeping at night time
You know Fanny is at a higher risk for experiencing a stroke based on her having ALL these risk
factors for a stroke including... - CORRECT ANSWER - age, cardiac disease (AF, MI),
hypertension, blood lipids, diabetes mellitus, obesity, cigarette smoker, excessive alcohol
consumption
transient ischemic event vs. sustained ischemic event - CORRECT ANSWER - transient =
progressive symptoms of numbness or tingling to bring awareness to something not being right;
occurs before the actual infarction
complete/sustained = results in neurologic deficits that lasts for days/weeks/permanent
When you get Fanny to the hospital the doctors refer to her condition of a stroke as ___, as the
medical term - CORRECT ANSWER - cerebrovascular accident (CVA)
The first the doctors do for acute medical management of Fanny is - CORRECT
ANSWER - determine the nature of the stroke and size
,The doctors are referring to Fanny's condition as a right CVA, which you know will result in
_____ impacting her _____ - CORRECT ANSWER - left hemiplegia; left side
with Fanny's right CVA, what will be important for you as an OT to assess, based on what you
may be expecting to potentially see as a result of the region of this stroke (functional
implications in what areas) - CORRECT ANSWER - hemi-neglect to the left side (may
only dress or groom one side of the body, only eat food on one side of the plate, may be unaware
of people or cars approaching from the left side); lack of insight into own deficits; impulsivity
with mobility; communication difficulties
why is it important for you to assess Fanny's functional ability to complete tasks after a right
hemisphere stroke - CORRECT ANSWER - 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 - CORRECT ANSWER - 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 ____ - CORRECT ANSWER - 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... -
CORRECT ANSWER - 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... - CORRECT
ANSWER - 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... - CORRECT ANSWER - 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... - CORRECT ANSWER - 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 -
CORRECT ANSWER - has quite predictable functional deficits
As you wait for the doctors to examine Fanny you recall that an ischemic stroke involves
atherosclerosis which means.. - CORRECT ANSWER - 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 - CORRECT
ANSWER - 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 - CORRECT ANSWER - a thrombosis or embolism
thrombosis refers to - CORRECT ANSWER - the formation of a thrombus, which is
worsened by antherosclerosis (narrowing of arteries)
embolism refers to - CORRECT ANSWER - 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 - CORRECT ANSWER - 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) - CORRECT
ANSWER - 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 - CORRECT ANSWER -
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 - CORRECT
ANSWER - 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 - CORRECT ANSWER - no cognitive deficits, only motor and
sensory
Your client Amy has had a lacunar stroke, in the lenticulostriate arteries, you are expecting to see
- CORRECT ANSWER - 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 -
CORRECT ANSWER - 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 -
CORRECT ANSWER - 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 - CORRECT ANSWER - primarily motor and sensory, also cognition;
affects legs, bowel, and bladder, shoulder, and some behavioural disturbances
Questions and CORRECT Answers
OT Role in Neuro Acute Care - CORRECT ANSWER - impairment > activity >
participation
You are seeing your client Fanny. She has trouble speaking but is trying to say that she is having
vision problems, weakness, headaches and is dizzy. You know its time to act FAST because
Fanny is likely experiencing... - CORRECT ANSWER - a stroke
Fanny continues describing her experience as you wait for the stroke ambulance to arrive from
the UofA hospital. Fanny would likely describe her symptoms as - CORRECT ANSWER -
progressive, spread across hours or days, starting with mild arm numbness or morning paralysis,
with onset during sleeping at night time
You know Fanny is at a higher risk for experiencing a stroke based on her having ALL these risk
factors for a stroke including... - CORRECT ANSWER - age, cardiac disease (AF, MI),
hypertension, blood lipids, diabetes mellitus, obesity, cigarette smoker, excessive alcohol
consumption
transient ischemic event vs. sustained ischemic event - CORRECT ANSWER - transient =
progressive symptoms of numbness or tingling to bring awareness to something not being right;
occurs before the actual infarction
complete/sustained = results in neurologic deficits that lasts for days/weeks/permanent
When you get Fanny to the hospital the doctors refer to her condition of a stroke as ___, as the
medical term - CORRECT ANSWER - cerebrovascular accident (CVA)
The first the doctors do for acute medical management of Fanny is - CORRECT
ANSWER - determine the nature of the stroke and size
,The doctors are referring to Fanny's condition as a right CVA, which you know will result in
_____ impacting her _____ - CORRECT ANSWER - left hemiplegia; left side
with Fanny's right CVA, what will be important for you as an OT to assess, based on what you
may be expecting to potentially see as a result of the region of this stroke (functional
implications in what areas) - CORRECT ANSWER - hemi-neglect to the left side (may
only dress or groom one side of the body, only eat food on one side of the plate, may be unaware
of people or cars approaching from the left side); lack of insight into own deficits; impulsivity
with mobility; communication difficulties
why is it important for you to assess Fanny's functional ability to complete tasks after a right
hemisphere stroke - CORRECT ANSWER - 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 - CORRECT ANSWER - 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 ____ - CORRECT ANSWER - 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... -
CORRECT ANSWER - 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... - CORRECT
ANSWER - 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... - CORRECT ANSWER - 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... - CORRECT ANSWER - 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 -
CORRECT ANSWER - has quite predictable functional deficits
As you wait for the doctors to examine Fanny you recall that an ischemic stroke involves
atherosclerosis which means.. - CORRECT ANSWER - 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 - CORRECT
ANSWER - 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 - CORRECT ANSWER - a thrombosis or embolism
thrombosis refers to - CORRECT ANSWER - the formation of a thrombus, which is
worsened by antherosclerosis (narrowing of arteries)
embolism refers to - CORRECT ANSWER - 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 - CORRECT ANSWER - 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) - CORRECT
ANSWER - 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 - CORRECT ANSWER -
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 - CORRECT
ANSWER - 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 - CORRECT ANSWER - no cognitive deficits, only motor and
sensory
Your client Amy has had a lacunar stroke, in the lenticulostriate arteries, you are expecting to see
- CORRECT ANSWER - 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 -
CORRECT ANSWER - 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 -
CORRECT ANSWER - 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 - CORRECT ANSWER - primarily motor and sensory, also cognition;
affects legs, bowel, and bladder, shoulder, and some behavioural disturbances
