Neuro Management Test 1-Pedi, TBI, Test PDF

Summary

This is a sample neurology test that assesses the cognitive function in pediatric patients with traumatic brain injuries.

Full Transcript

Neuro Management Test 1- Pedi, TBI, cognition, behavior, perception, ECI 1. If your patient is characterized as having cognitive and perceptual, could expect to observe any of the following except: a. difficulty switching from one task to the next. b. diminished capacity to i...

Neuro Management Test 1- Pedi, TBI, cognition, behavior, perception, ECI 1. If your patient is characterized as having cognitive and perceptual, could expect to observe any of the following except: a. difficulty switching from one task to the next. b. diminished capacity to identify objects necessary to complete a task. c. inability to localize to light-touch testing. d. inability to do tasks independently or safely. 2. A PTA is working on rolling with a patient who is known to have apraxia. In order to differentiate whether the apraxia is ideational or ideomotor, the PTA could: a. demonstrate rolling for patient first. b. give the patient an opportunity to do the activity automatically. c. manually cue the patient to initiate and complete the roll. d. provide verbal cues and commands for the task. 3. A patient does not appear able to follow verbal instructions even when provided with additional visual cues and demonstration. This patient most likely has problems with: a. hemianopsia. b. receptive aphasia. c. hearing loss. d. hemi-neglect. 4. Terms used to describe cognitive function include all except: a. judgment. b. attention. c. lethargy. d. emotion. 5. CTE is characterized by changes in the brain tissue consistent with: a. Chiari formations b. arteriovenous malformations c. midline shift d. generalized atrophy 6. The deficits of late stage CTE are most commonly mistaken for what other condition? a. Alzheimer's b. Multiple Sclerosis c. PTSD d. Supra-nuclear palsy 7. A concussion can be classified as any of the listed types of brain injury except? a. penetrating b. acceleration/deceleration c. blunt force trauma d. blast wave 8. A PTA is educating a parent on post-concussion management of their adolescent. The best recommendation for return to sport is: a. requesting long-term learning accommodations due to diagnosis of mild TBI b. requesting 3 days off from practice to rest c. taking a week off school due to irritability d. returning to sport based on symptom resolution 9. Severity of concussion is based on: (this question has been regraded.) a. GCS scores b. symptom clusters c. change in behavior d. mechanism of injury 10. A 12 year old female who became anoxic in a near drowning performs dynamic activities in quadruped. Following a developmental sequence, the next posture in which she should work would be: a. side-sitting b. standing c. half kneeling d. tall kneeling 11. A 5 year-old child with cerebral palsy has a persistent STNR. In order for the child to maintain stability in the quadruped position, the physical therapist assistant should: a. turn the child's head to the nondominant side. b. keep the child's head and neck extended. c. tap on the paraspinal muscles. d. apply approximation to both shoulders. 12. A child in a pediatric physical therapy setting is standing and throwing a beanbag at a target. Based only on this description, which one is least likely being addressed? a. motor planning. b. right-left discrimination. c. eye-hand coordination. d. equilibrium. 13. A child with spasticity is diagnosed with cerebral palsy. The areas of the brain most likely impaired are: a. reticular formation and cerebellum. b. cerebral cortex and pyramidal tracts. c. vestibulospinal and vestibulocerebellar loop. d. cortical-basal ganglia-thalamic loop. 14. A child with cerebral palsy has been fitted with an appropriate stander. The stander will most likely provide all but: a. postural support. b. improved body alignment. c. interaction with the environment. d. dynamic balance. 15. A client with a TBI begins to demonstrate signs and symptoms of a seizure. Appropriate intervention would include: a. place a soft object between the client’s teeth b. hold or restrain the client c. protect but do not restrain the patient d. attempt to check airway breathing 16. An APGAR assesses all but: a. muscle tone b. skin color c. pulse d. spontaneous eye opening e. reflex irritability 17. An area of the brain that when impaired is associated with athetosis in cerebral palsy is: a. extrapyramidal tracts. b. pyramidal tracts. c. cerebellum. d. basal ganglia. 18. A primitive reflex is said to be integrated when it: a. can be elicited repeatedly b. is obligatory c. is modified and no longer recognized d. persists beyond the age of 18 months 19. A PTA is positioning a 2 month old infant with severe extensor hypertonicity. Which is the least beneficial position to inhibit the tone? a. prone b. sidelying left c. supine d. sidelying right 20. A PTA is providing gait training for a 9 year-old with myelomeningocele lesion at L4-5. The PTA should expect the child's maximum potential for mobility to be: a. household ambulation with reciprocating gait orthosis. b. household ambulation with crutches and KAFO's. c. community mobility with a power wheelchair. d. community ambulation with crutches and AFO's. 21. A PTA wants to work on independent sitting with a child with spastic diplegia and decreased trunk mobility. Which of these is the best position in which to work with the child? a. long sitting b. side sitting c. ring sitting d. w-sitting 22. A young child with cerebral palsy presents with severe spastic quadriplegia, poor head and trunk control, and no functional use of upper extremities. The appropriate piece of equipment for standing activities is a: a. posterior rolling walker. b. dynamic stander. c. supine stander. d. parapodium. 23. Because of difficulty interacting with the environment, the child with hypotonicity is likely to: a. develop spasticity. b. develop weakness of the suck and swallow reflexes. c. become irritable and over stimulated. d. develop passivity and decreased motivation. 24. Bilirubin encephalopathy can result in: a. spastic cerebral palsy. b. necrotizing enterocolitis. c. meconium staining of the skin. d. athetoid cerebral palsy. 25. Children with vestibular hyperresponsiveness: a. have little response to aggressive vestibular input. b. present with a stable static posture but fear movement. c. are considered to be on the spectrum d. will also present with tactile defensive behavior 26. Failure to integrate which reflex would most likely interfere with a child's ability to creep? a. tonic labyrinthine supine b. ATNR c. STNR d. Moro 27. Failure to move against gravity during early childhood could result in all but which one? a. decreased vestibular responses b. decreased numbers of tactile receptors c. decreased responsiveness to tactile input d. decreased exploration of the environment 28. For a child with spina bifida at the T6-7 level, therapy interventions should focus on: a. gait training with AFO's and crutches. b. strengthening of the hip extensor muscles. c. standing balance activities with KAFO's. d. wheelchair mobility training. 29. For someone with Duchenne Muscular Dystrophy, physical therapy would address all but: a. patient goals b. progressive functional mobility c. adaptive equipment d. respiratory issues 30. Gower's sign suggests: a. proximal weakness b. contracture formation c. asymmetrical weakness d. pelvic obliquity 31. The child with athetosis needs assistance to: a. develop midline control b. move to end ranges. c. initiate movement. d. dissociate extremities. 32. In an infant with patent ductus arteriosus the blood: (this question has been regraded) a. is not oxygenated because it does not reach the lungs. b. circulates from the pulmonary artery to the pulmonary vein. c. causes the lungs to engorge resulting in a chronic respiratory problem. d. must be circulated outside the body to be oxygenated. 33. In children who develop BPD, the lung tissue does not function in the normal manner because: a. decreased surfactant does not allow adequate air circulation. b. high amounts of oxygen cause bleeding in the lungs. c. blood is oxygenated in a reverse pattern, being transported from the pulmonary vein to the lungs d. normal tissue has been replaced with fibrotic tissue that inhibits air circulation 34. In late stages of muscular dystrophy, which treatment would most likely be emphasized? (this question has been regraded) a. maintain maximum respiratory function b. cardiopulmonary exercise c. patient advocacy for self-directed therapy d. wheelchair mobility training 35. The cleaning staff accidently leaves a bottle of cleaning fluid on the patients sink. When OT assists the patient to the sink for morning ADLs. the patient attempts to drink the cleaning fluid. This is an example of: a. an adaptive response b. ideomotor apraxia c. ideational apraxia d. a compensation 36. Match the disorders in the alphabetic list to the numbered items. Answers are used only once. Rett syndrome, Cri-du-chat, arthrogryposis multiplex congenital, osteogenesis imperfecta, and spinal muscular atrophy a. Progressive deterioration of anterior horn cells b. Non-progressive muscle weakness and contractures c. Mostly girls with loss of already acquired skills d. Congenital heart disease is common e. 4 types with bone involvement 37. Of the following, which should alert the therapist to the possibility of problems in a newborn? a. Apgar score of 7 b. muscle tone that fluctuates around normal c. failure to turn the head from side to side in prone d. the presence of physiological flexion 38. An effective physical therapy interventions to assist a two year-old child improve balance skills in sitting would include: a. supporting the child at the pelvis on your lap and tilting her slightly to the side b. lessening vestibular input c. dressing the child in a weighted vest d. sitting the child in a feeder seat to watch television 39. Sensory integration techniques are least likely needed for the child diagnosed with? a. learning disabilities. b. muscular dystrophy. c. cerebral palsy. d. attention deficit problems. 40. The medical chart for a five-year-old boy indicates he was diagnosed with Duchenne Muscular Dystrophy less than one year ago. Assuming a typical progression, which of the following findings would be the first to occur? a. cranial nerve weakness b. impaired respiratory function c. distal muscle weakness d. proximal muscle weakness 41. The physical therapist tells you that the 2-year old patient has a persistent tonic labyrinthine reflex. This reflex would most likely interfere with what motor skill? a. turning the head from side to side in sitting b. lifting the legs while in supine c. flexing the neck while in prone d. playing in sidelying 42. The spinothalamic pathway is important to normal sensory integration because this pathway: a. carries superficial sensory information b. integrates all sensory information c. carries discriminative sensory information d. sends information to the cerebellum 43. The term applied to the syndrome resulting from the removal of part of the intestines is: a. intestinal dysplasia b. celiac disease c. short gut syndrome d. necrobiosis 44. To facilitate functional capabilities in children with considerable developmental delay and persistence of the tonic labyrinthine reflex, it is best to have them practice reaching for objects by positioning them in a. supine b. sidelying c. tailor sitting d. prone 45. A normal 3 month old infant will demonstrate all behaviors below except: a. recognition of their care provider b. self-soothing c. crossing midline d. different cries for different needs 46. Treatment of the hypotonic child might include all but one of the following: a. facilitate mobility b. prevent contractures c. build stability d. decrease tone 47. Treatment strategies for a child with ataxic cerebral palsy include all but: a. increasing excursion of movement. b. maintaining midline. c. using somatosensory input and visual cueing. d. developing automatic strategies for balance. 48. Very premature children are often put on mechanical ventilation after birth. Which condition can result from mechanical ventilation? a. RDS b. BPD c. ADD d. MAS 49. Vomiting, lethargy, and irritability in an infant with hydrocephalus may indicate all but which below? a. brain lesion b. infection c. shunt malfunction d. patent cerebral vessels 50. When reading the chart of a child with CP, you note that motor involvement is classified as diplegia. You would expect which of the following distributions of involvement? a. 1 side of the body involved b. profound whole body involvement c. lower half greater than upper half involvement d. ataxia observable with upper greater than lower extremity tasks 51. When treating a child with Down's syndrome you would most likely concentrate on which one below? a. building trunk and proximal stability. b. cardio training exercise c. controlling fluctuations in tone. d. refining reciprocal movements 52. A mature transition from tall kneel to half kneel requires: a. the therapist to be "hands on" b. a small degree of pelvic rotation to occur c. the patient to have normal cognition d. the patient to be engaged in plantigrade activities 53. Which infant carrying position could encourage head lifting and neck and back extension? a. cradle hold b. using a backpack-style child carrier c. across the hip hold d. football hold 54. Which is not a sign of stress in a premature infant? a. hiccups b. gaze aversion c. bradycardia d. sucking 55. Which is not typically developed by the 12th month? a. equilibrium in prone b. rotation in sitting c. concentric control of knee extensors d. rotation in standing 56. Which of the following is least likely to be a risk factor for developmental problems? a. history of sibling depression b. prematurity c. TORCH d. a mother with poor nutrition 57. Your neighbor, Jane, has a preschool aged child with Down Syndrome. Jane tells you she is going to start an activity with her daughter that was recommended by her physical therapist. Which below did the PTA likely recommend? a. art school b. dance class c. bowling d. yoga 58. Which below is the best guideline for positioning the child with decerebrate posturing for independent play? a. build in flexion b. align in upright position c. use hands on facilitation d. provide age appropriate play 59. When placing a 10 month old baby, who is developmentally delayed, in a supine position to play, a major consideration is? a. remove clothing b. the use pillows for comfort c. the use of a safety belt d. support to encourage UEs in midline 60. Which medical condition is not highly associated with Down Syndrome? a. obesity b. hyperthyroidism c. leukemia d. heart disease 61. Which person was responsible for the theory of sensory integrative dysfunction and the fundamental principles for treatment? a. Jean Ayres b. Margaret Rood c. Berta Bobath d. Virginia Apgar 62. When working with adults or children, which approach is consistent between the two populations? a. use an appropriate toy b. talk on an appropriate child level c. involve the parent d. use a hands on approach 63. Which reflex would be absent at birth in a premature infant born at 30 weeks gestation? a. Moro b. plantar grasp c. rooting d. ATNR 64. Which statement is false about Rett syndrome? a. hypotonia develops into hypertonia in the late stage b. skills are lost then regained slowly with therapy c. seen most often in girls, boys rarely llive d. progressive microcephaly 65. Your client is stable in prone on forearms with good dynamic head control. You know he is progressing if two weeks later he: a. rolls in both directions b. is able to reach with one arm c. transitions to quadruped d. can bear weight in prone through extended arms for 1/2 hour 66. Your patient with spina bifida has complained of back pain and seems to be losing strength in muscles previously testing normal. What problem would most likely be causing these symptoms? a. Chiari II malformation b. Post-polio c. Medication d. Tethered cord 67. A 15 year-old patient is in a coma following a severe traumatic brain injury two weeks ago. She is beginning to lose range of motion in her ankles at a rapid rate. The most appropriate physical therapy intervention at this time would include: a. Traction b. PNF c. PROM d. Serial casting 68. A 16 year-old male with a traumatic brain injury is inconsistently oriented to time and place. He is unable to remember recent events and shows little or no carry-over for new learning. The primary focus of rehabilitation at this stage of recovery is to: a. promote development of problem solving skills. b. increase functional independence with therapist vs patient driven goals c. develop an environment with structure for the cognitive processing of stimuli. d. increase arousal and attention through the use of sensory stimulation. 69. All medications below can differentiate dystonia from spasticity except: a. Diazepam b. Baclofen c. Botulinum toxin d. Sinemet 70. A patient in the ICU exhibits eye opening but shows no signs of any other activity. He would be classified as being in which state? a. stuporous b. amnesiac c. vegetative d. minimally consciousness 71. An early medical concern for a person presenting with a new closed head injury, is: a. seizures b. infection c. hypotension d. disorientation 72. A primary concern in treating someone with anosognosia is: a. adaptation of the environment. b. anorexia. c. skin breakdown. d. safety. 73. A PTA is reviewing the chart of a patient with traumatic brain injury. The patient is said to be at Rancho Level 4. The PTA would expect to encounter any of the following except: a. bizarre and nonpurposeful behavior. b. lack of short term recall. c. response to stimuli in a generalized manner. d. brief attention span. 74. A PTA is to go to ICU to treat a patient with a brain injury. The patient's chart indicates the patient has decorticate rigidity. The PTA would expect to see: a. the patient's UE's in flexion and the LE's in extension. b. the patient's UE's in extension and the LE's in extension. c. the patient's UE's in flexion and the LE's in flexion. d. the patient's UE's in extension and the LE's in flexion. 75. A PTA is treating a patient who has had a brain injury. The therapist is using a treatment technique that consists of tracing different letters and numbers on the patient's hand while the patient is blindfolded. This technique is targeting: a. graphesthesia b. stereognosis c. texture recognition d. barognosis 76. A PTA reads in a patient's chart that a brain injury has resulted in widely scattered shearing of subcortical axons within the myelin sheaths. The PTA knows that: a. the patient has had a coup-contra coup injury. b. the occipital lobe has been spared. c. this is diffuse axonal injury with extensive brain damage. d. increased intracranial pressure causes this kind of injury. 77. A PTA works with a patient rehabilitating from a traumatic brain injury on a mat program. The program emphasizes developmental positions to prepare the patient for ambulation. Which position would be the most demanding? a. hook lying b. quadruped c. tall kneeling d. modified plantigrade 78. As a result of a traumatic brain injury, a patient is demonstrating static standing balance deficits. Which is the best intervention to address this problem with this patient? a. rhythmic stabilization in standing b. reaching tasks outside the base of support c. use of a standing tilt board d. weight-shifting to pick up objects from the floor 79. A sensory stimulation program for the brain injured patient is used to elicit movement and to arouse the patient. An important aspect of such a program is: a. providing structured and consistent stimulation. b. stimulating all sensory systems in a sequential manner. c. developing spontaneous swallowing to allow feeding by mouth d. habituating the patient to background noise before beginning. 80. The labyrinthine righting reflex is tested with the baby: a. held in arms upright b. prone c. supine d. on lap 81. During a therapy session, a patient with TBI has become argumentative and angry. The best approach for the PTA is to: a. orient the patient to time of day and task at hand b. pacify, empathize, allow the patient to vent during the treatment session c. present a reasonable counter argument d. acknowledge, then focus on the treatment 82. IVH in the infant may be caused by all but: a. too much handling b. asphyxia c. fragile blood vessels d. oxygenation 83. Family education for the patient in Rancho Level IV should include: a. instructions for helping the patient practice new skills. b. teaching family members to facilitate motor return. c. providing information about the patient's behavior. d. providing a prognosis 84. For a patient with brain injury, working in developmental sequence can be useful to: a. match cognitive level to functional level. b. promote maturity in the peripheral nervous system c. inhibit pain d. lay a foundation for higher level motor skills. 85. Learning new tasks, less confusion and the ability to accomplish activities with structure correlates with which Rancho Los Amigos level? a. VII b. VI c. V d. VIII 86. The most severe form of mucopolysaccharidoisis Type 1 is: a. Angelman Syndrome b. Tourette Syndrome c. Cri-du-Chat Syndrome d. Hurler Syndrome 87. Learning the skills of time management, money management, and taking public transport would be most appropriate for a patient post-TBI functioning at what Rancho Los Amigos level? a. Localized Response b. Automatic-Appropriate c. Confused-Inappropriate d. Confused-Agitated 88. Perceptual deficits refer to an individual's inability to: a. generalize skills b. understand and coordinate motor tasks c. problem solve d. interpret sensory information 89. Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS) has a link to: a. Autism b. Tourette Syndrome c. Fetal Alcohol Syndrome d. Prader-Willi Syndrome 90. Post traumatic Amnesia is defined as: a. active from the time of injury until the patient can recall the incident b. the length of time from injury until continuous memory returns c. the lack of focus required for return to work d. memory loss that begins in the subacute recovery period 91. Serial casting as a treatment can be used as a progression to improve: a. coordination b. vestibular function c. gait d. bone density 92. When working with a patient who is diagnosed with a hypersensitivity to vestibular input the approach should initially be: (this question has been regraded) a. challenging b. reactive c. collaborative d. proactive 93. The Glasgow Coma Scale is one way to: a. diagnose CVA. b. determine cognitive function in CVA. c. define severity of injury after TBI. d. measure physical functional status in TBI. 94. The plan of care for a patient with traumatic brain injury includes range of motion. The patient has hip flexor tightness and decreased knee extension bilaterally. In addition, abnormal reflex activity has been documented. In order to achieve maximal range of motion, the PTA should provide range of motion in what position? a. prone b. side-lying c. supine d. sitting 95. Options to control spasticity include all but which below? a. baclofen b. tysabri c. neurontin d. valium 96. Which is false about IDEA? a. Is a law that ensures public education for children with disabilities b. Provides early childhood intervention in the home c. Provides early intervention and special education d. Only direct, hands on services are covered. 97. School based therapy services include all but which: a. training on durable medical equipment b. consultation with parents and teachers c. addressing medical necessities d. time spent on the playground with the student 98. Which of the following statements is false with regard to intracranial pressure (ICP)? a. Elevated ICP is treated with positioning and sedating medications b. patients will likely present hypotensive c. Normal ICP is between 5 and 15 mm Hg. d. Ventricular drainage can be used to treat elevated ICP. 99. Section 504 of the rehabilitation act: a. ensures children under 3 are covered for therapy services b. covers durable medical equipment for school children c. provides therapy services for children 5-18 d. prohibits discrimination based on disability 100. Your patient is suspected of having heterotopic ossificans of the shoulders. Which treatment would be contraindicated? a. transfer training b. facilitation of B upper extremity functional exercise c. PROM d. weightbearing activities of the upper extremities

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