CRC Medical & Psychosocial Aspects of Disability 2 — Questions and Answers
Question 1: A client with a complete C6 spinal cord injury would most likely retain which functional ability?
- Wrist extension enabling a tenodesis grasp (Correct answer)
- Elbow extension through triceps strength
- Finger flexion for a full grip
- Independent trunk control for unsupported sitting
Correct answer: Wrist extension enabling a tenodesis grasp
C6 preserves the wrist extensors, which allow a tenodesis grasp, while triceps (C7) and finger flexors (C8) are not preserved.
Question 2: A client with a T4 spinal cord injury suddenly reports a pounding headache, flushing above the injury, and very high blood pressure. What should be done first?
- Apply cold compresses and schedule a physician visit
- Sit the client upright and look for a noxious stimulus such as a full bladder (Correct answer)
- Lay the client flat and elevate the legs
- Give fluids and wait for symptoms to pass
Correct answer: Sit the client upright and look for a noxious stimulus such as a full bladder
Autonomic dysreflexia is a medical emergency in injuries at T6 or above, managed by sitting the person upright and removing the trigger.
Question 3: Which disease course is most common at the initial diagnosis of multiple sclerosis?
- Secondary progressive
- Progressive-relapsing
- Relapsing-remitting (Correct answer)
- Primary progressive
Correct answer: Relapsing-remitting
About 85% of people with MS are first diagnosed with a relapsing-remitting course.
Question 4: An employee with MS reports that symptoms get worse in a hot warehouse. Which accommodation best addresses this?
- Moving all job tasks to the night shift
- Cutting the workweek to three days
- Giving the employee a motorized scooter
- Moving to a climate-controlled work area or providing cooling equipment (Correct answer)
Correct answer: Moving to a climate-controlled work area or providing cooling equipment
Heat sensitivity (Uhthoff's phenomenon) temporarily worsens MS symptoms, so temperature control is the most direct accommodation.
Question 5: The Rancho Los Amigos Levels of Cognitive Functioning scale is mainly used to:
- Track cognitive and behavioral recovery after a traumatic brain injury (Correct answer)
- Classify the type of seizure in epilepsy
- Grade the severity of a spinal cord injury
- Measure motor strength after a stroke
Correct answer: Track cognitive and behavioral recovery after a traumatic brain injury
The Rancho scale describes stages of cognitive and behavioral recovery after a TBI, from no response to purposeful, appropriate behavior.
Question 6: Which description best fits amyotrophic lateral sclerosis (ALS)?
- A non-progressive motor disorder caused by injury to the developing brain
- Progressive degeneration of upper and lower motor neurons, usually with sensation preserved (Correct answer)
- Loss of dopamine-producing neurons that causes a resting tremor
- An autoimmune attack on peripheral nerve myelin that usually resolves on its own
Correct answer: Progressive degeneration of upper and lower motor neurons, usually with sensation preserved
ALS destroys upper and lower motor neurons, while sensation and bowel and bladder control are usually spared.
Question 7: Which tremor is typical of Parkinson's disease?
- An intention tremor that gets worse when reaching for an object
- A tremor limited to the head and voice
- A resting tremor that lessens with voluntary movement (Correct answer)
- A tremor that happens only during sleep
Correct answer: A resting tremor that lessens with voluntary movement
Parkinson's disease classically causes a 'pill-rolling' resting tremor that decreases with purposeful movement.
