CRRN Exam 677 Questions with Verified Answers,100% CORRECT

CRRN Exam 677 Questions with Verified Answers Holistic Care - CORRECT ANSWER Incorporates the client's developmental needs, social networks, and lifestyle preferences. Gestalt Theory - CORRECT ANSWER States that the "Whole is greater than the sum of its parts." Pieces and parts fit together to produce thoughts, actions, and structures, such as family units. Advocates that the patient and entire family are assisted back to wellness. Developed by Max Wertheimer in the 1920's. Gardner - CORRECT ANSWER Suggests that individuals have multiple intelligences and growth can occur beyond traditional expectations such as intelligence quotient (IQ) measurements. Efficacy Theory - CORRECT ANSWER Relevant to life-span adjustments because independence correlates with opinions about self-care and situational control. Developmental Theories - CORRECT ANSWER Systematic statements to explain human phenomenon. Traditionally organized by: psychoanalytic, learning, cognitive, behavioral, and interactive. Intrapsychic (Psychoanalytic) Theorists - CORRECT ANSWER 1-Sigmund Freud () 2-Alfred Adler () 3-Carl Jung () Interpersonal Theorists - CORRECT ANSWER 1-Harry Stack Sullivan () 2-Frieda Fromm-Reichmann () and Clara Mabel Thompson () Social Learning Theorists - CORRECT ANSWER 1-Erik Erikson () 2-Joan Erikson () 3-Albert Bandura (1925-present) Behavioral Theorists - CORRECT ANSWER 1-Ivan Pavlov () 2-K. Warner Schaie (1928-present) Cognitive Theorists - CORRECT ANSWER 1-John Dewey () 2-Jean Piaget () Moral Theorists - CORRECT ANSWER 1-Lawrence Kohlberg () 2-Carol Gilligan (1936-present) Personality Theorists - CORRECT ANSWER 1-Abraham Maslow () 2-Carl Rogers () 3-Howard Gardner (1943-present) Family Development and Function Theorists - CORRECT ANSWER 1-Ruth Evelyn Millis Duvall () 2-Joan Stevenson-Hinde (1977) 3-Joan Bowlby () Nursing theories and Conceptualizations - CORRECT ANSWER 1-Metaparadigms 2-Philosophies 3-Conceptual Frameworks Freud's Theory - CORRECT ANSWER Intrapsychic Theory. Has four phases that occur within set time frames during childhood. Freud' Theory States: - CORRECT ANSWER Conflict between individuals' natural instincts and society's restrictions on them experienced in childhood influence individual's adult personality; children are thought to progress through four stages of psychosexual development: Oral, anal, phallic, and latent and genital. Believes fixation can result if phases are not achieved successfully. Freud's first phase of childhood development: - CORRECT ANSWER Oral phase (1st year of life). Involves exploring the world orally, and the mouth, lips, and tongue are the center of existence for the infant. Begins development of the infants personality, which depends on the mother's (mothering person or caretaker's) sense of personal security in self and satisfaction in the mother role. The infant experiences the mothers emotions, leading to vulnerability (e.g., if the mother has pervasive anxiety, the infant begins life with a deficit in adaptive abilities). weaning from breast-feeding can be challenging. Freud's 2nd phase of childhood development: - CORRECT ANSWER Anal phase (18 months-3 years of age): this phase centers on buildup and release of tension in the orifices; involves experiencing pleasure in expelling urine and feces. It is a challenge to parents' coping ability to allow their child to move away from them and seek freedom or a greater sense of self. This phase involves ambivalence related to complying with parental and societal values of illumination. (i) complying through proper elimination on the part of the infant (ii) Complying through retention or inappropriate discharge of feces or urine by the infant, which brings retribution and further anxiety (iii) Toilet training by the parents and the infants corresponding response which can govern adult personality. Freud's 3rd phase of childhood development: - CORRECT ANSWER Phallic phase (3-6 years of age): Becomes aware of gender roles and how males and females differ (i) has romantic attraction to the parent of the opposite sex (I.e. Oedipus complex, boys; Electra complex, girls). (ii) experiences rivalry with the same sex parent or resolves guilt and fear by identifying with the same sex parent. Develops a conscience (i) Represses sexual urges, (ii) Imitates sex-related behaviors and beliefs of the parent of the same sex, (iii) learns standards of society from parents. Freud's 4th phase of childhood development: - CORRECT ANSWER Latent and genital phase: 6-12 years of age (latent) and puberty (genital). Learned to hide sexuality or sublimate urges with hobbies and sports; also, during this time, children learn social roles while experiencing sexual gratification related to feelings towards others. Involves responses from the preceding stages; can cause serious adjustment problems if the stages are not accomplished and instead are carried into adulthood (e.g. the person is unable to turn away from the self to a more productive activity) and can produce sexual problems. Brings out defensive measures used during earlier phases (e.g. denial and regression). Other concepts developed by Freud include: - CORRECT ANSWER Theories of personality and coping. Lydia Hall's Theory shows three interrelated parts. What are they? - CORRECT ANSWER Care, core, and cure How is Martha Rogers Adaptation Model used in rehabilitation therapy? - CORRECT ANSWER By transmitting nursing knowledge, therapeutic touch and hands on education teaching the client to adapt and live as they wish. What three stages of prevention are in Newman's model? - CORRECT ANSWER Primary prevention, secondary prevention, and tertiary prevention; helps clients maximize their defenses. What theory believes that an individual's behavior control his or her outcomes? - CORRECT ANSWER The Locus of Control theory. People who believe they are in control of their health are more likely to change their behavior than those who believe outside forces are in control. Which nursing theorist wrote the "self care theory"? - CORRECT ANSWER Dorothea Orem's Theory is known as the self-care theory. The three related parts of this theory include the theory of self-care, theory of self-care deficit, and theory of nursing system. Which theory is one of the age specific nursing theories that are helpful when practicing rehabilitation across the lifespan? - CORRECT ANSWER Anne Casey: Model for children and families. What is the theoretical structure of rehabilitation nursing? - CORRECT ANSWER Rehabilitation nurses help individuals affected by chronic illness or physical disability to achieve their greatest potential, adapt to their disabilities, and work toward leading productive independent lives. Rehabilitation nurses take a holistic approach to meeting clients' medical, vocational, educational, environmental, and spiritual needs. Name the five core self management concepts around which outcomes and interventions are developed to promote self-efficacy in the Health Promotion Model. - CORRECT ANSWER Problem solving, Decision making, Resource use, Collaboration and action. What are the benefits of client education? - CORRECT ANSWER Better outcomes for a client and family, improved client and family satisfaction, continuity of care, cost containment, and improved staff satisfaction. What are the defining characteristics of an Ineffective Community Therapeutic Regiment Management? - CORRECT ANSWER Deficits of advocates for the aggregates, deficits in community activities for prevention, and insufficient healthcare resources. Which agency enforces federal laws related to employment discrimination against a person with a disability? - CORRECT ANSWER The U.S. Equal Employment Opportunity Commission. The Civil Rights Act of 1964 prohibits employment discrimination based on race, color, religion, sex or national origin. The Americans with Disabilities Act (ADA) prohibit employment discrimination against qualified people with disabilities in the private sector and in state and local governments. Rehabilitation nursing - CORRECT ANSWER Defined in 2000 by the Association of rehabilitation nurses as the diagnosis and treatment of human responses of individuals and groups to actual or potential health problems relative to altered functional ability and lifestyle. What were the greatest factors in the development of the field of the rehabilitation nursing in the mid to early 1900s? - CORRECT ANSWER Immigration, World Wars I and II, and the occurrence of poliomyelitis epidemics. When did the federal department of social and rehabilitative services get set up? - CORRECT ANSWER 1960s When did Medicare Begin covering rehabilitative services for disabled persons? - CORRECT ANSWER 1972 What to major international programs were founded in response to World War I? - CORRECT ANSWER The Red Cross institute for crippled and disabled in 1917 and the international Society of crippled children in 1922. What major international initiative was enacted in 1953? - CORRECT ANSWER The Council of World Organizations Interested in the Handicapped. What is the gold standard for defining standard units of measurement and classifications of disabilities? - CORRECT ANSWER The International Classification for Functioning Disability and Health (ICF). Impairment - CORRECT ANSWER Any loss of normal structure or function at the organ level. disability - CORRECT ANSWER An impairment that renders the individual unable to perform activities of daily life without intervention from other people or equipment. handicapped - CORRECT ANSWER A concept that is really a measure of the degree of socialization of the individual. characterized as any social or personal shortcoming resulting from impairment or disability. What are the two primary individual models of disability? - CORRECT ANSWER the Nagi Scheme and the WHO International Classification of Impairments, Disabilities, and Handicaps (ICIDH) Linear biomedical model - CORRECT ANSWER When a particular pathology or disease is viewed as leading to impairment, which can be anatomical, physiological, or psychological. Nagi Scheme - CORRECT ANSWER Characterizes the subsequent manifestations as functional limitations eventually leading to disability, which is restricted capability to perform expected roles and tasks. WHO ICIDH - CORRECT ANSWER International Classification of Impairments, Disabilities, and Handicaps. WHO ICIDH - CORRECT ANSWER Distinguishes between initial disability, impaired functional and activity levels, and possible later handicap indicating disadvantages arising from the disability. Independent Living (IL) model - CORRECT ANSWER A social model that in the United States, approaches disability as a product of societal mind-sets and not the actual functional impairment. ICF - CORRECT ANSWER International Classification of Functioning, Disability, and Health ICF Model of disability - CORRECT ANSWER A paradigm with aspects of both individual and social models and in which disability is defined as any impairment of either bodily function or structure or ability to engage in daily activities (part I) and or personal or environmental dynamics (part II). Codes for conditions within each part have been developed to describe each factor. The underlying principle is that the actual disease or health condition of the person and it's effects on the body. Katherine Kolcaba - CORRECT ANSWER Developed comfort theory in which she stated that comfort is a process that should be the end product of nursing care. Theorized that holistic nursing produces comfort, and that comfort has three forms which are relief (specific needs are met) ease (how one feels) or transcendence (The ability to overcome circumstances). Also theorize there were four situations in which comfort can occur: physical, psycho spiritual, environmental, and socio-cultural. comfort theory - CORRECT ANSWER Empowers the nurse to work within the physical, psychospiritual, environmental, and socio-cultural situations to assist the patient finding the most comfort. The theory also predicts that if patients are taught to be self advocates with health seeking behaviors that the quality of the institution they are using will be improved. What two nursing approaches to rehabilitation emphasize adaptability of the patient? - CORRECT ANSWER 1. Orem's Self-Care Deficit Theory. 2. Roy's Adaptation Model. Orem's Self-Care Deficit Theory - CORRECT ANSWER The nurse's task is to restore the patient to self-care through the following stages: total compensation, partial compensation, and nursing support and education. Roy's Adaptation Model - CORRECT ANSWER The nurse's main job is to help the patient adapt as needed in the functional areas of self-concept, dependence on others, societal roles, and actual physiological changes. King's Open Systems Framework and Theory of Goal Attainment. - CORRECT ANSWER Concept that places the individual in the center and theorizes that he or she interfaces with interpersonal, group, and societal systems while the nurse functions to ensure that mutually agreed upon goals are achieved within all of the roles. Newman's System Theory - CORRECT ANSWER Multifaceted Model centered on developing the whole person in relation to his or her environment. Rogers' Model of the Science of Unitary Human Beings - CORRECT ANSWER A holistic approach that emphasizes the homeodynamics between the patient and their environment. Omaha System - CORRECT ANSWER A standardized agenda sanctioned by the ANA for classifying problems, defining interventions schemes and their targets, and rating the outcomes for health issues. Problems are categorized as primarily environmental, psychosocial, or physiological in nature or they are considered health related behaviors. The system places interventional approaches into four groups: 1. teaching, guidance, and counseling; 2. use of various techniques or procedures; 3. case management; or 4. surveillance. There are over 60 codes for the targets of these interventions ranging from several types of medication use to finances. The outcomes of these interventions are also rated in terms of both the level of knowledge attained by the patient and the consistency in appropriateness of the patient's behavior. social cognitive theory - CORRECT ANSWER States that behavioral change occurs relative to both the outcome of the behavior and particularly to the individual'ss perception of his or her capacity to perform the activity. Behavioral Theories - CORRECT ANSWER 1. Cultural care Theory 2. Social cognitive Theory Cultural Care Theory - CORRECT ANSWER Proposed by Leininger his colleagues emphasizes provision of care within the context of the values and belief systems of the culture of the individual concerned. A. Bandura - CORRECT ANSWER developed the social cognitive theory. Roper's Model - CORRECT ANSWER Develop models for both living and nursing that are essentially based on the ability to perform activities of daily living. They also sorted out types of factors that can affect ADLs such as biological and environmental factors. The model states that all ADLs are interconnected and influence the individual's ability to perform the function. Gordon's model - CORRECT ANSWER Describes functional health patterns (FHPs) that are also interconnected and related to the whole person, and these FHPs can be employed to treat the patient and those the patient interacts with. Each ADL in the Roper system has one or more FHPs described by Gordon. Corbin and Strauss's model - CORRECT ANSWER Chronic Illness Trajectory model that centers on disability as a chronic illness. Charmaz's theory - CORRECT ANSWER The Self in Chronic Illness and Time Paradigm Anderson's Family Health System Theory (FHS) - CORRECT ANSWER Focuses on family systems. Emphasizes the importance of integrating family and patient health. CARF - CORRECT ANSWER Commission on Accreditation of Rehabilitation Facilities CBR - CORRECT ANSWER Community-based Rehabilitation such as mobile teams that travel to rural areas and home health care. What are the 6 standards of care set by the ARN? - CORRECT ANSWER 1. Assessment, the collection of patient health data. 2. Diagnosis, use of the health data to identify the problem. 3. Outcome identification, individualized identification of the expected result. 4. Planning, development of a plan of care. 5. Implementation, execution of the care plan. 6. Evaluation, charting of the patient's progress toward the desired result. What are the ARNs 8 standards of nursing professional performance? - CORRECT ANSWER 1. Quality of care, evaluation of the quality of the professional's practice. 2. Performance appraisal, internal evaluation relative to relevant standards and regulations. 3. Education, keeping up to date. 4. Collegiality, encouragement of peers. 5. Ethics, conducting business with patients in an ethical manner. 6. Collaboration, interaction with patient, family and colleagues for care provision. 7. Research, use of data from studies. 8. Utilization, use of principles of safety, efficacy, and cost effectiveness. Multidisciplinary teams - CORRECT ANSWER Composed of specialists from a variety of fields who all communicate with each other regarding their suggestions for patient care and goals. Specialists from different fields are involved in the care of a single patient. Interdisciplinary teams - CORRECT ANSWER Differ from Multidisciplinary teams in that the whole team works together to identify ways to manage the patient; the suggestions are then executed by the appropriate team members. Transdisciplinary teams - CORRECT ANSWER Chooses one team member to be the primary caregiver while the other professional service consultants; well this approach can be cost-effective, it also assigns duties to the primary therapist that may be performed better by others and obscures roles. Models of rehabilitation care - CORRECT ANSWER 1. Team-based models such as multidisciplinary teams, interdisciplinary teams, and transdisciplinary teams. 2. Provider-based models such as primary nursing model, case management, and advanced practice nurses. Provider-based rehabilitation models - CORRECT ANSWER The types of health care providers included are determined by the type of setting and the available payment schemes. There are 3 types of provider-based models: primary nursing, case management, and advance practice. Primary Nursing Model - CORRECT ANSWER A primary nurse is responsible for a patient, usually under the umbrella of a nursing team; this approach is useful for chronic conditions. case management model - CORRECT ANSWER A system in which there is a team of healthcare providers, but the patient is referred to a rehabilitation nurse who follows the patient throughout the course of his or her disability, regardless of setting. Advanced practice nurses - CORRECT ANSWER Such as nurse practitioners and clinical nurse specialists, can act as consultants to other nurses for provision of specialized care. RNRA - CORRECT ANSWER Rehabilitation Nursing Research Agenda. Developed in conjunction with the rehabilitation nursing foundation. Speaks to four areas of desired research. 1. Enhanced function 2. Documentation 3. Changing healthcare system and practice setting and 4. Rehabilitation nursing profession. What are the two main groups involved in research programs for rehabilitation nurses? - CORRECT ANSWER 1. National Institute of Nursing Research (NINR) 2. Rehabilitation Nursing Foundation (RNF). NINR - CORRECT ANSWER National Institute of Nursing Research. Focused on assimilating biological and behavioral research with the goals of wellness and disease prevention, disease management, and enhancement of care settings. RNF - CORRECT ANSWER Rehabilitation Nursing Foundation. Provides grants to researchers whose work has the potential to enrich the quality of care to patients with disabilities or chronic illnesses; it also disseminates research findings. ARN - CORRECT ANSWER Association of Rehabilitation Nurses. Issued a rehabilitation research nurse scope of practice statement in 2001 emphasizing identification of healthcare issues, conduct of studies, and distribution of results. American Association of Spinal Cord Injury Nurses - CORRECT ANSWER Specifies a few additional issues needed and research such as management of pressure sores and caregiver strain. Contains many of the same types of issues outlined in the RNRA statement with regards to spinal cord injury National Institute of Disability Rehabilitation Research (NIDRR) - CORRECT ANSWER Recognized the 6 areas of outcome research focused primarily on ways to re-integrate the disabled individual into the community and workplace including attitude adjustment, skill improvement, and methods of providing support. NIDRR - CORRECT ANSWER National Institute of Disability Rehabilitation Research National Institute of Neurological Disorders and Stroke - CORRECT ANSWER Interested in promoting the discipline of restorative neurology. National Center for Medical Rehabilitation Research (NCMRR) - CORRECT ANSWER Primarily sponsors research addressing functional improvement and precise measurement techniques. NCMRR - CORRECT ANSWER National Center for Medical Rehabilitation Research What is the process of research for theory development? - CORRECT ANSWER 1. A description of the phenomenon through which qualitative and/or quantitative methods such as interviewing or measurable surveys respectively are used. 2. Identification of interrelationships between variables through the use of statistical methods is completed. If a relationship is deemed statistically significant, then it is tested in populations using conditions as controlled as possible. 3. Generally an actual clinical trial, designed to see whether some type of intervention can produce a particular goal. EBP - CORRECT ANSWER evidence based practice evidence-based practice - CORRECT ANSWER The use of research results to enhance clinical practice. Rosswurn and Larrabee - CORRECT ANSWER Developed a model for evidence-based practice. They outlined 6 steps for the nurse to apply evidence-based practice. 1. Evaluation of the need for change. 2. Identification of methods of management and outcomes. 3. Synthesis of various research applications. 4. Design of pilot studies for a change. 5. Implementation and analysis of those studies. 6. Education of staff, including ways to monitor use of proposed changes. outcomes research - CORRECT ANSWER Examines the influence of care directions on the results, is with the most prevailant types of research currently performed. What are the three social science conceptual models of education? - CORRECT ANSWER 1. The health belief model (HBM) 2. The self-efficacy theory 3. The locus of control (LOC) theory HBM - CORRECT ANSWER Health Belief Model Health Belief Model (HBM) - CORRECT ANSWER Proposes that an individual's receptiveness to education is related to the following issues: the individual's own probability of having a particular problem, the belief that the issue is relatively serious, the belief that the benefits to acting are greater than impediments, and the belief that his or her own health will be enhanced. Self-Efficacy Theory - CORRECT ANSWER States that greater confidence on the part of the individual to achieve a specific behavior increases the probability of learning a new behavior locus of control theory - CORRECT ANSWER Proposes that the level of control an individual has over an outcome influences his or her receptivity to a behavioral change; if the individual believes that he or she can influence the outcome (internal LOC), the individual is more likely to implement a change than if the individual believes his or her fate is handled by external forces (external LOC). Kolb Model of learning - CORRECT ANSWER Suggests that people learn either by tangible experience, reflective observation, abstract conceptualization, or active participation. What are the 4 social science concepts for understanding behavioral change in the rain setting? - CORRECT ANSWER 1. Cognitive Dissonance Theory 2. Developmental theory 3. Adult learning theory 4. Transtheoretical Model of Change cognitive dissonance theory - CORRECT ANSWER The degree of discomfort to the likelihood for behavioral change. developmental theory - CORRECT ANSWER Propose that a person's developmental level should direct the type of effective educational plan to utilize. Adult Learning Theory - CORRECT ANSWER Assumes adults are self-directed learners; learning must be individualized for adults because they have different experiences. Receptiveness increases when they feel change will directly influence some part of their life and if they have strong internal motivators. Adults can take various approaches to learning, focusing on their life, the task at hand, or a specific problem. Transtheoretical Model of Change - CORRECT ANSWER Proposes that for a change to occur an individual needs to go through 5 stages: pre-contemplation, contemplation, preparation, action, and maintenance. What three categories or behavioral domains is Conduct generally divided into? - CORRECT ANSWER 1. Cognitive (Encompasses in the intellectual or knowledge based activity). 2. Psychomotor area (includes the development of motor or physical skills within the context of the individual's disability). 3. Affective (anything involving attitudes, values, or sentiments). What are the three schools of learning? - CORRECT ANSWER 1. By association (in which the learner makes a connection between a stimulus and an expected reaction) 2. Cognitive approach (means that they consider the process of gathering information to make associations and answer questions more important. This approach is more internal as it requires the learners input and it is shaded by the learners experiences). 3. Humanistic (emphasizes the individual's potential for growth by making him or her active participants in the process) Pharmacokinetics (PK) - CORRECT ANSWER Assessment of the body's response to medications. Concerned with the absorption rate of a drug relative to it's full affect when introduced IV. Pharmaceutics - CORRECT ANSWER The science of preparing and dispensing drugs, including evaluation of all properties involved with design, formulation, and production. Bioavailability - CORRECT ANSWER The rate at which and degree to which the drug is observed into the bloodstream. Bioequivalence - CORRECT ANSWER Defines the relationship between the bioavailability of two forms of a drug (I.e. generic vs brand-name). Distribution of a drug - CORRECT ANSWER It's a relative spread to target sites after it is absorbed into the circulation. Cockcroft-Gault formula - CORRECT ANSWER Used for calculating creatinine clearance: (140 - age) x weight (kg) Cc = —————————————————— x Ksex 72 + Serum Creatinine Kmale = k Female = 0.85 Pharmacodynamics (PD) - CORRECT ANSWER The study of the mechanisms of action of a drug in the end result of its use on the body What two categories do drugs fall into? - CORRECT ANSWER 1. Agonists 2. Antagonists Agonists - CORRECT ANSWER Induce functional cellular changes. Antagonists (drugs) - CORRECT ANSWER Bind to a receptor but do not cause functional changes Conformational changes - CORRECT ANSWER Happens with continued drug use resulting in loss receptors, rendering an individual relative unresponsive to the drug. acute confusion - CORRECT ANSWER Can be caused by temporary or controllable factors. chronic confusion - CORRECT ANSWER Generally a sign of more permanent problems. WeeFIM - CORRECT ANSWER Functional Independence Measure for Children from age 6 months to 16 years WeeFIM II - CORRECT ANSWER Functional independence measure for children up to age 3. PEDI - CORRECT ANSWER Pediatric Evaluation of Disability Inventory PEDI - CORRECT ANSWER Pediatric evaluation of disability inventory. Looks at functional skills related to self-care, mobility, and social functioning in children between 6 months and 7 years of age. It can also be used for older children with functional abilities below their chronological age. Modification Scale of PEDI - CORRECT ANSWER Provided to assess the child's environment. infancy - CORRECT ANSWER The period from birth to 1 year of age. Toddlerhood - CORRECT ANSWER The period from 1 to 4 years of age. Early childhood - CORRECT ANSWER Early childhood or preschool age is the period from 4 to 6 years of age. Middle childhood - CORRECT ANSWER Refers to a school age child between 6 and 12 years of age. Adolescence - CORRECT ANSWER Ages 12 to 18 Developmentally in infancy a baby should: - CORRECT ANSWER Learn to trust, go through stages from sitting to crawling to walking, and explore his or her various senses and environment. They experience separation anxiety and express their emotions through crying and motor activities such as kicking or sucking on their thumb or a pacifier. Developmentally a toddler should: - CORRECT ANSWER Learn various skills such as walking, climbing, drinking from a cup, communicating through language, and using the toilet. It is also when a child develops independence and separates from his or her parents and develops the ability to think. Developmentally in early childhood a child should: - CORRECT ANSWER It is generally the time where a child learns socialization skills and the concepts of right and wrong. A healthy preschool child can freely discover the wonders of his or her environment, has developed independent skills related to activities of daily life, has gender identity, and has mastered thought processes, such as questioning, fantasizing, and fear. The preschooler may interact through routine activities, play, and aggressive actions or words. Developmentally in middle childhood the child should be able to: - CORRECT ANSWER A large part of the child's environment shifts from the familiarity of home to the school and increased social interaction and independence. The child usually learns a number of academic skills, develops a logical pattern of thought, learns new motor skills such as bike riding, and forms same sex friendships. The child also begins to consider the point of view of others. Developmentally the adolescent child should be: - CORRECT ANSWER Generally characterized by rapid and marked changes and physiology (mainly related to puberty), reasoning abilities and abstract thinking, a new viewpoint of personal identity, and increased interest in the opposite sex. It is also the period where the girl or boy considers career and personal goals, gets into conflict with parents, and eventually transitions into adulthood. CAT - CORRECT ANSWER Competency assessment tools. Useful for assessing the mastery of knowledge of specific skills or performance areas. Cranial nerve (IX) - CORRECT ANSWER Glossopharyngeal Cranial nerve ( X) - CORRECT ANSWER Vagus Control sensory responses in the membrane of the larynx and the pharynx Cranial nerve (V) - CORRECT ANSWER Trigeminal - chewing Motor control of the mandibular muscles and sensory functions of both jaws. Cranial nerve (VII) - CORRECT ANSWER facial nerve Controls motor functions in salivary glands and those involving facial expression; also associated with frontal taste buds. Cranial nerve (XII) - CORRECT ANSWER hypoglossal nerve Regulates the motor functions of the tongue Cranial nerve (XI) - CORRECT ANSWER spinal accessory nerve Regulates motor functions of the sternocleidomastoid muscle. autonomic nervous system - CORRECT ANSWER Responsible for maintaining internal body temperature. Hypothalamus - CORRECT ANSWER a neural structure lying below the thalamus; directs eating, drinking, body temperature; helps govern the endocrine system via the pituitary gland, and is linked to emotion How does the hypothalamus trigger heat production or reduction? - CORRECT ANSWER Through feedback loops such as the TSH-RH pathway, The sympathetic nervous system, or messages to the cerebral cortex. TSH-RH pathway - CORRECT ANSWER Releases epinephrine to produce heat, raises the basal metabolic rate (BMR), and causes vasoconstriction and glycolysis. Sympathetic Nervous System (SNS) - CORRECT ANSWER Can either raise the temperature by increasing muscle tone and shivering or lower it through sweating causing vasodilation and decreasing muscle tone. Metabolic Syndrome (MetSyn) - CORRECT ANSWER A cluster of abnormalities in an individual, including hyperglycemia or is insulin resistance, hypertension, dyslipidemia and obesity. Diagnosis require the presence of at least three the following signs: abdominal obesity defined as a waistline > 40 or 35 inches for men or women; triglyceride level of >/= 150 mg/dL; HDL cholesterol levels less than either 40 or 50 mg/dL per for men or women; a blood pressure reading for both components of >/= 130/>/=85 mmHg; or a fasting glucose level of equal or greater than 110 mg/dL Calculate BMI - CORRECT ANSWER weight in kg/height in meters squared Underweight BMI - CORRECT ANSWER <18.5 Normal BMI - CORRECT ANSWER 18.5-24.9 Obese class I - CORRECT ANSWER BMI 30-34.9 Obese class II - CORRECT ANSWER BMI 35-39.9 Obese class III - CORRECT ANSWER BMI > 40 mild dehydration - CORRECT ANSWER Involves 5% loss of total body water. Symptoms include dizziness, lethargy, altered mentation, decreased skin turgor, dry mucous membranes, dysrhythmia, and orthostatic hypotension. type one diabetes mellitus - CORRECT ANSWER Due to destruction of or a flaw in the pancreatic beta cells (which produces insulin). Type two diabetes mellitus - CORRECT ANSWER Distinguished by insulin resistance and usually obesity. Signs of hypoglycemia: - CORRECT ANSWER Frequent urination, hunger or thirst, persistent infections, deficient wound healing, loss of weight, dry eyes, vision changes, or importance. Symptoms of hypoglycemia: - CORRECT ANSWER Confusion, hunger, weakness, rapid heartbeat, sweating, anxiety, trembling What are the 5 strata of the epidermis? - CORRECT ANSWER Starting from the outer most going inward are the stratum corneum, lucidum, granulosum, spinosum, and germinativum. Bates-Jensen Pressure Sore Status Tool - CORRECT ANSWER rates wound healing with possible 65 points. More points means more severe. It has 13 different items at the wound site which are rated on a scale from 1 to 5. AHA - CORRECT ANSWER American Hospital Association How often should patient's weight shift in a wheelchair? - CORRECT ANSWER They should shift weight every 15 minutes. Pressure relieving surface - CORRECT ANSWER Keeps the boundary pressure below 32 mmHg Pressure reducing surface - CORRECT ANSWER Keeps the boundary of pressure above 32 mmHg yet lower than a conventional mattress What are the stages of wound healing? - CORRECT ANSWER 1. Inflammatory stage - Lasts up to 6 days involves neutrophils, macrophages, mediators, and white blood cells. The stage is distinguished by the presence of swelling, redness, blood in the area, and pain and the patients who can feel it. 2. Proliferative stage - Takes several weeks. The wound bed is infilled with granulation tissue; collagen is generated for strength; angiogenesis occurs; and the wound contracts in size. 3. Maturation - characterized by new epithelium formation to close the wound bed, scar tissue, remodeling of the wound, and greater tensile strength. Supraglottic swallow technique - CORRECT ANSWER With or without food in the mouth the patient inhales and hold his or her breath and swallows. Then the patient either coughs or clears the throat before the next inhalation. Mendelson maneuver - CORRECT ANSWER Recommended for individuals who have insufficient laryngeal elevation or opening of the cricopharyngeal sphincter. Effortful swallows - CORRECT ANSWER For patients who cannot move the back of their tongue well. Helps to enhance tongue base. What opportunistic infections show up when CD4+ counts are less than about 350 cells/mm3? - CORRECT ANSWER Tuberculosis and oral candidiasis followed by the possibility of pneumocystic carini pneumoniae (PCP) and herpes simplex viral infections. Supraglottic swallow - CORRECT ANSWER Used for patients with a late Pharyngeal swallow or impaired closure of the vocal cords. Mendelson maneuver - CORRECT ANSWER The patient places his hand on his Larynx and swallows to get a sense of the Larynx position afterwards. The patient then usually puts food in his or her mouth and swallows while holding the Larynx in the predetermined highest position during the swallow. Zidovudine (AZT) - CORRECT ANSWER Greatly reduces the transmission of HIV from positive mothers to neonate. HIV symptoms and neonates include: - CORRECT ANSWER Failure to thrive, lymphadenopathy, hepatosplenomegaly, oral candidiasis, diaper rash, and chronic diarrhea, otitis media, or nasal discharge. Bedside swallow examination (BSE) - CORRECT ANSWER The medical professional places his four fingers (not the thumb) on the submandibular area, the hyoid bone, the thyroid notch, and the cricoid cartilage while the patient swallows to see whether the tongue and larynx move up and forward. Antispasmodics and anticholinergics: - CORRECT ANSWER Work by interfering with the neurotransmitter acetylcholine, which stops or decreases nerve impulse transmission of the parasympathetic nervous system. The result is relaxing of smooth muscle tissue like that found in the bladder or G.I. tract, decreasing spasms. Anticholinergic effects - CORRECT ANSWER Are cumulative and include urinary retention, dry mouth, dry eyes, and constipation. CNS effects include sedation, confusion, hallucinations (auditory and visual), and increased risk for falls. There's also an increased risk of orthostatic hypotension with this class of medication. What are the three main classes of antiretroviral medications utilized? - CORRECT ANSWER 1. Nucleoside reverse transcriptase inhibitors (NRTIs) 2. Non-nucleoside reverse transcriptase inhibitors (NNRTIs) 3. Protease inhibitors NRTIs - CORRECT ANSWER Nucleoside analogues such as Zidovudine (Retrovir, AZT) Works by incorporating with the viral DNA, rendering HIV an able to replicate. NNRTIs - CORRECT ANSWER Nevirapine (Viramune) Act earlier in the process with a similar result as NRTIs; they bind directly to the reverse transcriptase and thwart the conversion of RNA to DNA. Protease inhibitors - CORRECT ANSWER Ritonavir (Norvir) Acts by preventing HIV assemblage in and release from the CD4+ cell. Fusion inhibitors - CORRECT ANSWER Prevent HIV from fusing to the inside of the host cell. Thus, fusion inhibitors prevent a virus from replicating. ONS - CORRECT ANSWER Oncology rehabilitation programs 5 stages of CKD in terms of creatinine clearance: - CORRECT ANSWER >90 (stage 1) 60-89 (stage 2) 30-59 (stage 3) 15-29 (stage 4) Less than 10-15 ml/min (stage 5) CKD stage 1 - CORRECT ANSWER The disease is monitored CKD stage 2 - CORRECT ANSWER Blood pressure needs to be controlled in urine proteins or quantified. CKD stage 3 - CORRECT ANSWER The patient should be referred to a nephrologist CKD stage 4 - CORRECT ANSWER Need anemia management, blood pressure control, and are generally prepared for either dialysis or kidney transplant. CKD stage 5 - CORRECT ANSWER Classified as end stage renal disease particularly in terms of Medicare. Normal renal functions are shut down and dialysis is imperative to sustain life. Kidney transplants are performed in children with end stage renal disease if possible. Creatinine clearance or glomerulus filtration rate - CORRECT ANSWER Important because the rate at which creatinine is filtered out is indicative of kidney function. Higher rates mean the kidneys are functioning properly. Cockcroft and Gault formula - CORRECT ANSWER Used to calculate creatinine clearance. Creatinine clearance = (140 - age in years) x weight in kilograms/(72 x serum creatinine) ESTD Dietary guidelines: - CORRECT ANSWER Protein: 1 to 1.5/kg daily Sodium: 1 to 3gm daily Potassium: 69 to 99 milliequivalents daily Phosphorus: 600 to 800mg daily Fluid intake: 1 to 1.2 liters daily Cystometrogram (CMG) - CORRECT ANSWER Used to evaluate detrusor muscle function utilizing a urethral catheter to fill the bladder to capacity or until contraction. A CMG can be used to look at filling or voiding. Electromyogram (EMG) - CORRECT ANSWER Touches an electrode or wire to the urethral sphincter to evaluate innervation. Urethral pressure profilometry (UPP) - CORRECT ANSWER Looks at pressures within the urethra. cystourethrography - CORRECT ANSWER Uses an endoscope to identify lesions or constricted areas in the urinary tract. transient incontinence - CORRECT ANSWER temporary or occasional incontinence that is reversed when the cause is treated 5 types of scheduled voiding: - CORRECT ANSWER 1. Timed voiding: Teach the patient to avoid on a fixed schedule typically every two hours. 2. Habit training: Set voiding pattern is established based on historical data about the patients toileting habits. 3. Patterned urge response: A electronic monitoring device gauges periods of incontinence. 4. Prompted voiding: A programmed toileting program that incorporates rewards such as praise or assistance for remaining continent; it is primarily used in institutional our caregiver assisted homebound situations. 5. Urinary bladder training or re-training. Brain structures involved with voiding: - CORRECT ANSWER 1. Cerebral cortex region 2. Thalamus 3. Basal ganglia 4. Pons Parasympathetic nerve fibers - CORRECT ANSWER Control unconscious and involuntary bodily functions. The main parasympathetic fibers innervating the lower urinary tract comprise the pelvic nerve, which initiates bladder contraction. Other parasympathetic nerve fibers facilitate voiding by augmenting urine transport in the ureters, contracting the detrusor muscle, and opening the internal sphincter. Sympathetic fibers - CORRECT ANSWER Control other autonomic functions such as stress responses and changes in muscle tone. They aid bladder storage by slowing down urine transport in the ureters, easing the detrusor muscle, and constricting the internal sphincter, all in opposition to parasympathetic functions. Somatic nerve fibers - CORRECT ANSWER Are under voluntary control and are either EFFERENT, stimulating motor responses in the external sphincter and pelvic floor via the pudendal nerve, or they are AFFERENT, transmitting sensory responses from the bladder to the spinal cord. 5 Types of neurogenic bladder dysfunction: - CORRECT ANSWER 1. Uninhibited neurogenic bladder: characterized by numerous uninhibited contractions and complete voiding without residual volume. It is caused primarily by lesions in the brain or sub cortical areas. 2. Reflex neurogenic bladder: A patient may have little or no awareness of their voiding pattern, which occurs as a reflex instead of voluntarily. The etiology is upper spinal cord injury involving both motor and sensory tracts of regions down to T11. 3. Autonomous neurogenic bladder: The awareness of fullness, dribbling, and involuntary emptying due to bladder overflow as a result of lowered neural damage to the sacral reflex arc. 4. Motor paralytic bladder: patients have the feelings of fullness and emptiness but their motor functions and tone are diminished. Thus, they generally have difficult or incomplete urination. Common etioloies are a herniated disc, trauma to the pelvis, or poliomyelitis. 5. Sensory paralytic bladder: patients cannot sense voiding needs, but they can generally initiate voiding. They tend to have high volume but infrequent voiding patterns. This type of bladder can result from damage during childbirth in diabetics, peripheral vascular disease, and pelvic trauma. 3 types of neurogenic bladder that result from central nervous system damage include: - CORRECT ANSWER uninhibited neurogenic bladder, reflex neurogenic bladder, and autonomous neurogenic bladder. Motor and sensory paralytic bladders: - CORRECT ANSWER Result from their respective damage of the efferent or afferent portions of the micturition reflex arc, usually at the S2 to S4 level. spinal shock - CORRECT ANSWER A temporary loss of all reflex capabilities below the level of the spinal lesion after spinal cord injury. Autonomic dysreflexia - CORRECT ANSWER Occurs most often and patients with the spinal cord injury above the T6 level. Symptoms of autonomic dysreflexia - CORRECT ANSWER A rapid rise in blood pressure, sweating, skin flushing, intense headaches, nausea, fuzzy vision, nasal congestion, and cardiac abnormalities. Management of autonomic dysreflexia - CORRECT ANSWER Identify and correct the provoking stimuli - have patient sit up (lowers BP) loosen restrictive clothing and equipment check catheter for kinks or cath if bladder dysfunction check for fecal impaction examine skin for breakdown administer vasopressor enteric (intrinsic) nervous system - CORRECT ANSWER nervous system within gut that can control all gut function. Consist of two networks: 1. Outer motor or myenteric plexus (influences movement within the GI tract) 2. Inner sensory or submucosal plexus (regulates GI secretions and area blood flow) Reflex neurogenic bowel - CORRECT ANSWER Patients have upper motor neuron injuries and lack of cortical control of bowel functions. Autonomous neurogenic bowel - CORRECT ANSWER Occurs as the result of a lower spinal cord injury, therefore the patient does not have spinal reflex responses. They have decreased bowel tone and propulsive ability. Thus they are incontinent between expulsions due to their inability to control their external sphincter. Uninhibited Neurogenic Bowel - CORRECT ANSWER Experience by patients who have had a stroke or other cerebral vascular accident. The patient can usually return the continence with a good bowel training program. Three layers of the eye: - CORRECT ANSWER 1. Protective fibrous tunic - The outer layer comprised of the membranous cornea in the front covering of the iris and pupil and the Scalera or tough outer coating of the eyeball. 2. Vascular tunic - comprised of the Iris which is the colored muscular part surrounding the pupil, the ciliary body which is also muscular and controls the shape of the lens, and the choroid which contains blood vessels and pigmented cells and removes waste from the front of the retina. 3. Nervous tunic - The inside layer of the eye; contains the retina (a light-sensitive membrane in the rear of the eye that receives images from the lens and communicates them to the brain via the optic nerve). Retina - CORRECT ANSWER Composed of rods which are sensitive to dim light and account for peripheral vision and cones which are sensitive to colors and are responsible for daylight vision. Rods - CORRECT ANSWER Specialized visual receptors that play a key role in night vision and peripheral vision. Cones - CORRECT ANSWER Sensitive to colors and are responsible for daylight vision. Snellen reading test - CORRECT ANSWER The individual being tested stands 20 feet away from an eye chart and glasses may be worn if needed. Each eye is separately tested and rated as 20/x with X being the number feet away a person with normal vision can read what the examinee can see at 20 feet. How to check visual fields: - CORRECT ANSWER Brace the patient's head and have him or her follow the movement of a pen; restricted eye movement may indicate visual lesions. Normal people size: - CORRECT ANSWER 3 to 5 mm legally blind - CORRECT ANSWER When the patient has corrected vision of 20/200 in the stronger eye. macular degeneration - CORRECT ANSWER The progressive deterioration is the macula lutes resulting in central vision deficit. Refractive error - CORRECT ANSWER Blurriness due to a lack of precise retinal focus. This is completely treatable using correct of lenses. Intraocular diseases - CORRECT ANSWER Cataracts, glaucoma, and retinal detachment. Cataracts - CORRECT ANSWER An eye disease in which the lens becomes covered with an opaque film at that impedes the passage of light and causes blurriness, image distortion, and problems perceiving colors. Treatment is generally the removal of cataracts. Glaucoma - CORRECT ANSWER Imperceptible high pressure within the eyeball that can eventually damage the optic nerve and cause vision loss if untreated. It is treated with drops containing pilocarpine or timolol or surgically. closed angle glaucoma - CORRECT ANSWER A variant of glaucoma in which displacement of the iris occurs. Pressure shoots up rapidly and there is a cute pain. retinal detachment - CORRECT ANSWER The rods and cones deteriorate and a surgical vitrectomy is generally done Hemianopsia - CORRECT ANSWER Blindness affecting half of the visual field in one or both eyes after brain injuries or other impairments. 3 types of hemianopsia - CORRECT ANSWER Homonymous hemianopsia, bitemporal hemianopsia, attitudinal homonymous hemianopsia - CORRECT ANSWER Vision is lost in different visual fields of each eye. For example, the temporal part affecting peripheral vision is lost in one eye and the nasal field which is more centrally located is lost in the other. This is the most common type. Bitemporal hemianopsia - CORRECT ANSWER Peripheral vision in both eyes is affected. anopsia - CORRECT ANSWER Blindness in one eye or have vision loss in one area of a single eye. Glass prisms - CORRECT ANSWER Redirect images in the retina. Can be utilized as adjuncts to promote vision. Weber's test - CORRECT ANSWER When a tuning fork is placed at midline to test the symmetry of response of the ear. Rinne's test - CORRECT ANSWER Placing the tuning fork near the mastoid process and pinna to differentiate between bone and air conduction of the ear. audiometry - CORRECT ANSWER Uses specific tone frequencies to asses hearing. speech audiometry - CORRECT ANSWER Evaluates the percentage of specific two-syllable words understood. tympanometry - CORRECT ANSWER Quantifies the energy absorbed by the middle ear when sound is introduced into the canal. Conductive hearing loss - CORRECT ANSWER Lack of proper sound wave transmission. otitis media - CORRECT ANSWER Ear infection and associated inflammation is the greatest cause of conductive hearing loss with smoking being a risk factor sensorineural hearing loss - CORRECT ANSWER Less common but more critical. About 0.1% of the population is born with sensorineural hearing loss or deafness due to sensory hair cells or neural defects of the spiral ganglion cells. This type of hearing loss can also be acquired through certain infections, in conjunction with autoimmune diseases, through use of potentially ototoxic drugs (cisplatin and aminoglycosides), exposure to loud sounds, head trauma, spongy bone growth in the inner ear (otosclerosis), or the presence of a benign tumor (acoustic neuroma). 6 Kinds of sensory receptors: - CORRECT ANSWER Mechanoreceptors, proprioceptors, thermoreceptors, nocicepters, chemoteceptors, and photic receptors Mechanoreceptors - CORRECT ANSWER Situated within the skin and are involved with the sensations of touch, vibration, flutter, and pressure. Proprioceptors - CORRECT ANSWER In muscles or other soft tissues associated with sense of position. Thermoreceptors - CORRECT ANSWER In the skin that sense heat and cold. Nociceptors - CORRECT ANSWER React to pain or injury. Chemoreceptors - CORRECT ANSWER Responsive to chemical stimuli photic receptors - CORRECT ANSWER Respond to light. Right lobe (brain) - CORRECT ANSWER Spatial and textual information is processed. Left lobe (brain) - CORRECT ANSWER Where reading and writing is understood Somatognosia - CORRECT ANSWER Inability to identify body parts or their relationships to each other. Ignorance of one's own body parts and structure.. Anosognosia - CORRECT ANSWER denial of illness/paralysis Visual spatial neglect - CORRECT ANSWER Lack of response on affected side. Patient ignores one size of the body and stimuli coming from that side. finger agnosia - CORRECT ANSWER inability to distinguish between specific fingers Spatial relation disorders - CORRECT ANSWER Problems distinguishing distances, distinguishing an object from its background, or distinguishing similar forms. Includes agnosia and apraxia. Agnosia - CORRECT ANSWER The partial or total loss of recognition of familiar objects. Apraxia - CORRECT ANSWER The incapacity to perform complex movements. Inability to perform particular purposive actions, as a result of brain damage. Problems related to body image or arrangement: - CORRECT ANSWER Somatognosia, inability to discriminate between left and right, visual spatial neglect, anosognosia, and finger agnosia. How to manage perception deficits: - CORRECT ANSWER Sensorimotor approach, functional approach, transfer of training. Sensorimotor approach - CORRECT ANSWER Attempts to organize the thought pattern by controlling sensory stimulation and desired motor response. functional approach - CORRECT ANSWER Uses repetition of tasks to foster their relearning. Transfer of training - CORRECT ANSWER Making connections between similar applications in slightly different tasks. Ligaments - CORRECT ANSWER Relatively tough fibrous tissues that connect the joint area to other structures Tendons - CORRECT ANSWER Inelastic fibers bands that connects muscles to bones. Synarthrodial - CORRECT ANSWER immovable joints Diathrodial - CORRECT ANSWER freely movable joint amphiathrodial joints - CORRECT ANSWER Somewhat flexible joints between vertebrae. Isotonic movements - CORRECT ANSWER Occur when a muscle is maintained at a constant tension, but the muscle length is changed. Two types of isotonic movements: - CORRECT ANSWER Eccentric and concentric Isometric movements - CORRECT ANSWER Change the tension of the muscle while maintaining it at a constant length. Such a movement may involve pulling against a force without shortening the muscle. No actual body movement occurs during isometric exercises. eccentric - CORRECT ANSWER Those in which the muscle is lengthened. Isokinetic - CORRECT ANSWER When an individual is complete range of motion is utilized through intervention with specialized machinery. concentric - CORRECT ANSWER Those where the muscle is shortened. Tremors - CORRECT ANSWER Slight shaking or trembling movements that are usually rhythmic and unplanned. Chorea - CORRECT ANSWER Arrhythmic, erratic, and forceful unplanned movements. Athetoses - CORRECT ANSWER Slow and twisting involuntary movements that occur in distal limbs. Ballism - CORRECT ANSWER Very violent and erratic throwing around of the head or arms. It is usually a result of damage to the basal ganglion. Hypotone - CORRECT ANSWER A lack of muscle tone. Also known as flaccidity. Clonus or clonic spasm - CORRECT ANSWER The term for a rapid repetitive muscle contractions and relaxation usually linked to epileptic seizures. Arises from uninterrupted reflex arcing due to upper motor neuron lesions (UMN). Spasticity - CORRECT ANSWER increased muscle tone functional mobility - CORRECT ANSWER The ability to perform activities of daily life (ADLs) and instrumental activities of daily life (IADLs). Central Nervous System (CNS) - CORRECT ANSWER brain and spinal cord. Controls the auditory, olfactory, tactile, and visual senses, which in turn affect things such as one's ability to feel pain, grasp spatial relationships, and maintain balance. Peripheral Nervous System (PNS) - CORRECT ANSWER the sensory and motor neurons that connect the central nervous system (CNS) to the rest of the body. Controls descending motor systems that influence reflexes, muscle tone, coordination, and other motor processes. Cognition perception - CORRECT ANSWER The ability to acquire and assemblyassimilate knowledge, is also related to CNS function, and it can be related to impairments of hand-eye coordination, depth perception, inability to perform complex movements, or neglect. Genu valgum - CORRECT ANSWER medical term for knock-knee genu varum - CORRECT ANSWER medical term for bow legged Which labs are elevated with RA? - CORRECT ANSWER ESR and C-reactive protein Hemiplegic shoulder subluxation - CORRECT ANSWER Shoulder dislocation Complex Regional Pain Syndrome (CRPS) - CORRECT ANSWER Characterized by unremitting sharp and worsening pain, skin changes, and motor problems in extremities. Feldenkrais Method - CORRECT ANSWER A sensory motor approach to movement because it touts the reestablishment of lost or changed functional capacity through education and adaptation. Bobath program - CORRECT ANSWER A patient actively participates in goal-orientated tasks to improve movement through postural and other changes that e Vance his or her sensations and mobility. It's a sensorimmotor model of movement. Proprioceptive Neuromuscular Facilitation approach (PNF) - CORRECT ANSWER Emphasizes special movements of the extremities. Is also a sensorimotor model of movement. Classic movement theories - CORRECT ANSWER Regard motor development as a compilation of developmental milestones reached through maturation directed by the central nervous system. Life span viewpoints - CORRECT ANSWER Envision motor behaviors as changeable during life as a result of internal as well as external factors. Sensorimotor models of movement: - CORRECT ANSWER Use both the principles of classical movement theories and life span viewpoints. Dynamic systems models of movement: - CORRECT ANSWER View movement as a non-linear process in which many parts are interconnected in a multifaceted and dynamic manner. Thus, any of the rehabilitation measures that emphasize tasks to engage use of extremities have been affected in order to re-learn movements are dynamic systems. Dynamic pattern theory (DPT) - CORRECT ANSWER The patient is aided by the nurse in the reestablishment of some measure of function to perform the activities daily. This is accomplished through interventions that make it easier for the patient to perform these activities. Dyspraxias and apraxias - CORRECT ANSWER Referred to the inability to perform complex movements, especially as a result of brain damage. The damage is often due to a stroke. Five main types of apraxia: - CORRECT ANSWER Ideomotor, conduction, disassociation, ideational, and conceptual. Ideomotor apraxia: - CORRECT ANSWER The inability to process the sequential and spatial relationships of movement. There is a posterior form, resulting from damage to the left parietal cortex, in which the person has trouble responding to commands and discriminating his or her performance level. There is also an anterior form occurring further forward in the same area that is less severe. Conceptual apraxia - CORRECT ANSWER Arises from damage to the bilateral frontal and parietal areas and is characterized by an inability to recall how to use certain tools or mechanical objects. conduction apraxia - CORRECT ANSWER Can comprehend movements and gestures but have difficulty performing them. Disassociation apraxia - CORRECT ANSWER Can perform well with objects but have poor verbal response. ideational dyspraxia - CORRECT ANSWER Cannot carry out an idea or sequence of actions properly. (OARS) - CORRECT ANSWER Older American Resources and Services Scale Validated measures for ADLs include: - CORRECT ANSWER Barthel index, functional independence measure (FIM) for ADLs and older American resources and services scale (OARS) assess instrumental ADLs. Tools for neurological functions: - CORRECT ANSWER Glasgow coma scale, Mini-Mental State Examination (MMSE), Center fo Epidemiological Studies-Depression (CES-D). Barthel Index - CORRECT ANSWER (BI) Used for functional assessment for about 4 decades. It rates patients on 10 functions, each on a three-point scale. Patients are rated either as independent, requiring assistance, or completely dependent. A maximum score of 100 is possible, representing complete independence in terms of ADLs. The parameters evaluated are feeding, grooming, bathing, dressing, bladder and bowel control, capacity to perform wheelchair transfer, ability to walk on the level, and ability to climb stairs. Glasgow Coma Scale (GCS) - CORRECT ANSWER Measures level of consciousness (usually after head injuries or strokes). (MMSE) - CORRECT ANSWER Mini Mental State Examination. Evaluate seven areas (such as attention and recall) related to mental status. MOS - CORRECT ANSWER Medical outcomes study. It is a generic health status and quality-of-life rating tool that addresses physical functioning and a range of sources of limitation. MDS - CORRECT ANSWER Minimum Data Set for Long Term Care BI - CORRECT ANSWER Barthel index Functional assessment tools: - CORRECT ANSWER FIM Instrument, Barthel Index, Katz Index is ADLs, Kenny Self-Care Evaluation, PULSES profile, Level of Rehabilitation Scale (LORS), and the Patient Evaluation Conference System (PECS). plantar flexion - CORRECT ANSWER The downward motion of the foot at the ankle joint. Dorsiflexion - CORRECT ANSWER The upward motion of the foot at the ankle joint. hemiplegia - CORRECT ANSWER Partial or total inability to move one side of the body. Timed Up and Go Test (TUG) - CORRECT ANSWER A good, rapid screening tool to assess balance and gait. The patient is seated initially in a chair. He is then requested to get up without us using the chair arms for support, briefly standstill, then walk 10.75 feet, turn, and go back to sitting down in the chair. Nothing should be touched during the sequence, including the chair arms. If the patient is unsteady or must use support, further evaluation is indicated. ataxia - CORRECT ANSWER Lack of muscle control and coordination Berg Balance Scale - CORRECT ANSWER A 14-item objective measure designed to assess static balance and fall risk in adult populations 7 Motor stretch reflexes that are evaluated are: - CORRECT ANSWER Biceps, brachioradial, triceps reflexes, patellar or knee-jerk reflex, Achilles or ankle reflex, abdominal reflex, plantar or Babinski reflex. Biceps, brachioradial, and triceps reflexes: - CORRECT ANSWER Evaluate responses from the upper C5-C6 and C6-C8 (triceps) regions of the spinal cord Patellar or knee-jerk reflex - CORRECT ANSWER Measures lower L2-L4 functions Achilles or ankle reflex - CORRECT ANSWER Evaluate even lower S1 - S2 centers abdominal reflex - CORRECT ANSWER Looks at lower thoracic cord centers and can be used to diagnose multiple sclerosis. Planter or Babinski reflex - CORRECT ANSWER Toes should curl up when the sole of the foot is struck. It is a measurement of upper motor neuron injury in anyone older than one year of age. How to test for ataxia? - CORRECT ANSWER Have the patient perform two sequences, finger-to-nose-to-finger and heel-to-shin. deep tendon reflexes (DTR) - CORRECT ANSWER Measure functional responses that are controlled by different portions of the central nervous system. Isometric exercises - CORRECT ANSWER exercises in which one contracts muscles but does not move body parts. The patient tenses or contract certain muscles for 10 seconds before releasing them. Typical muscle groups include abdominal, gluteal, and quadriceps. LEAP program - CORRECT ANSWER Lower extremity amputation prevention program Five objectives of the leap program: - CORRECT ANSWER Reduction in osteoporotic fractures, reduction in the rate of amputation, reduction in pain associated with arthritis and other rheumatoid conditions, reduction and injury rates from repetitive motion or overexertion, and the prevention of workplace injuries. Ilizarov device - CORRECT ANSWER Separates the ends of bones, allowing them to align and heal. Double support walkers - CORRECT ANSWER Are moved forward first followed by the involved limb and then the uninvolved one. X-linked recessive types of muscular dystrophy include: - CORRECT ANSWER Duchenne muscular dystrophy Becker muscular dystrophy and Emery-Dreifuss muscular dystrophy. Duchenne muscular dystrophy - CORRECT ANSWER Generalized muscle weakness and atrophy usually noted at preschool ages which progresses and is usually fatal before adulthood. Becker muscular dystrophy - CORRECT ANSWER Similar to Duchenne's but milder and less fatal, having a later onset. Em