Healthcare Training Institute - Quality Education since 1979

Pre-Test

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1. _____  What was said to focus on Effie’s capabilities rather than her limitations?
a. “You’ve got really good movement in your right hand!”
b. “Oh.  Well, that’s not too bad. No need to worry.”
c.  “You’ve lost a lot of movement in your left hand!”

2. _____  What was the motivating reason that was given to Effie for doing Can Rolling?
a. “What this exercise does is it encourages your hand to lay flat.”
b.  “The charge nurse thought it was a good idea.”
c.  “If you do these exercises, I’ll get you a box of cookies.”

3. _____  What question was asked to relate the Geometric Puzzle to Effie's life experiences?
a. “Did you and your sister ever play games or puzzles when you were a kid?”
b. “I bet you used to be able to do puzzles a lot more complicated than this.”
c. “This kind of looks like a Picasso painting, doesn’t it?”

4. _____  When Marie had problems opening the butter dish, what was said to blame her difficulty on the item and not on her stiff fingers?
a. "Yeah, it's hard to hold onto.  It's not a good size, is it?"
b. “Whoops!  Don’t worry, we all fumble things sometimes.”
c. “Well, maybe your fingers are a little too stiff for this activity.  Let’s try something easier.”

5. _____  How was Freida’s ability to follow simple directions assessed?
a. “Let’s see if you can pat your head and rub your stomach at the same time.”
b. “Can you close and open your hand like that for me?”
c. “See this bowl of M&Ms?  Take all of the red ones out and put them in this bowl here.”

6. _____  What question was asked to help Frieda identify pictures in the Reality Orientation Book?
a. “Did you ever make pancakes?”
b. “Do you miss having your own kitchen?”
c. “What is this a picture of?”

7. _____  How was permission to conduct a Hand Assessment requested?
a. “Can I see your hand a minute here?”
b. It is not necessary to ask permission if assessing the resident’s hand in his or her Care Plan.
c. “I have to assess your hand movement now.”

8.  _____ What was said to explain "Bean Bag Rolling" to Fannie?
a. "This is a little Bean Bag…do you want to hold this in your hand?  This is an exercise.  Can I hold your hand over here?  See if you’ll let me do this.  Can you squeeze that?"
b. “See what I’m doing?  Now you try.”
c. “Squeezing this bean bag will move the muscles in your hand, which can increase blood flow.”

9.  _____ What were three "Approaches" suggested for Fannie? 
a. Repeating understandable words, maintaining eye contact, making simple requests.
b. Remain quiet to avoid disturbing Fannie, maintain as much personal distance as possible, implement the hand exercise without explanation.
c. Pretend to understand Fannie’s answers even if they are unclear, explain the process of contracture as an introduction to the Bean Bag exercise, remain in motion so Fannie has to keep turning her head to make eye contact.

10. _____  What was stated as the motivator for the Hand Exercise?
a. “I’m worried your hand will go into a contracture if you don’t move them.”
b. “This is a fun game!”
c. “You have really nice hand movement… Let’s see if we can give you something to help remind you to move your hands in order to keep them nice and limber.”

11. _____  What were the two reasons why Marie could not do Lacing Cards?
a. Her fingers were too stiff, and her eyesight was not good.
b. She was hungry and in a bad mood.
c. Her working memory and processing speed were insufficient.

12. _____  What was said to create a successful experience for Marie?
a. “What a good job!  It looks very good, I can tell that is clearly M-A-R-I-E.”
b. “That’s not too bad, but you forgot to dot the ‘I’”
c. “Wow, that’s fantastic!  Your handwriting looks better than mine!”

13. _____  What were two supportive responses given to Mabel?
a. “That would be hard.”  and “That’s good that you were able to say how you felt about it.”
b. “Sure” and “Uh-huh.”
c. “That reminds me of a story…” and “Gosh, I know just how you felt, this one time…”

14. _____ What statement formed a sincere closure with Mabel?
a. “You know, Mabel, it was nice talking with you.  You’re a nice lady.”
b. “Okay, our 10 minutes are up.  I have to go work with another resident.”
c. “Well, looks like you’re doing pretty well.  I’ll let your doctor know.”

15. _____ What three activities could you try with a resident like Mabel?
a. Can rolling, Smell Can, or Mobile.
b. Yarn Winding, Magazine Folding, or Grocery Bag Weaving.
c. 1,000-piece puzzle, Baking, Horseshoes.

16. _____  What are three examples of techniques used to get Elizabeth’s attention?
a. Asking permission, commenting on responses, using scent therapy.
b. Using a loud voice, using firm movements, avoiding personal contact.
c. Changing the temperature of the resident’s room, tapping the resident’s hand, telling a story.

17. _____  How was Scent Therapy reinforced with Elizabeth?
a. By commenting positively on changes in Elizabeth’s eye movement, vocalizations, eye contact, and breathing rate.
b. By following Scent Therapy with the Geometric Puzzle.
c. Scent Therapy did not need to be reinforced with Elizabeth.

18. _____  What did the instructor indicate were two important factors in communicating with Lillian?
a. Using her name, and picking up words Lillian uses which are understandable.
b. Speaking very loudly and using gestures for emphasis.
c. Explaining everything thoroughly and using many descriptive words.

19. _____  What are some sample Care Plan Goal starter phrases for Lillian?
a. “To squeeze a hand upon request” or “To roll Bean Bag with total physical assistance.”
b. “To identify a picture” or “To name relatives in a family photo.”
c. “To knit independently for one hour” or “To read five pages in a Reader’s Digest.”

20. _____  What three thing were done to communicate with Mary?
a. Staying out of Mary’s line of sight to encourage attention, repositioning the resident in a sitting position, using directive gestures.
b. Positioning in Mary’s line of vision, commenting on open eyes and noises, asking permission before doing anything.
c. Nothing was done to communicate with Mary, as Mary can no longer appreciate communication.

21. _____  What was stated to be the most important approach with a resident like Mary?
a. Being sensitive to the resident’s reaction
b. Using a very loud voice.
c. Not trying very hard, as Mary is unlikely to recognize the attempt to communicate with her.

22. _____  Although Cecil could not speak, how was he involved in the selection of pictures for his Flat Ceiling Mobile?
a. The Activity Director showed Cecil the pictures and asked him to show a preference by opening and closing his eyes.
b. The Activity Director made guesses about Cecil’s preference from personal items in his room, and from what she knew about his background.
c. Since Cecil could not speak, he could not be involved in the selection process.

23. _____  How can a resident’s inability to follow a pattern card in Bead Stringing be reframed into a positive approach?
a. “Why specifically can’t s/he do this?  How can I adapt Bead Stringing to bring it to his/her level?”
b. “S/he can’t do this.  At least I tried something.”
c. “S/he could do this last week!  Something must be wrong with me!”

24. _____  Why is it better to have an Activity Apron made from a solid color of fabric?
a. If the Activity Apron is made from a printed fabric, the item affixed to it tends to get lost in the pattern for the resident, and he or she tends not to notice the object as much.
b. Because solid colors will coordinate better with a resident’s clothing.
c. It is easier to spot stains on a solid color of fabric.

25. _____  What are three categories of Facial Expressions you might look for in a heavy care or semi comatose resident?
a. Drooling, Unfocused, and Agitated.
b. Frustration, Anger, and Happiness.
c. A Look of Recognition, a Change of Expression, and a Smile.

26. _____  What is the progression of difficulty of Vocalization from the lowest to highest level of ability?
a. Physical Noise, Meaningless Sound, Meaningful Sound, and Word.
b. Word, Meaningful Sound, Meaningless Sound, and Physical Noise.
c. Word, Simple Sentence, Complex Sentence, and Anecdote.

27.  _____  What are the four areas of assessment for a heavy care resident?
a. Eyes, breathing, gestures, and vocalizations.
b. Strength, dexterity, endurance, and reaction time.
c. Social skills, responsiveness, attention span, and IQ.

28.  _____  What is one important use of Scent Therapy?
a. To stimulate the resident’s appetite.
b. As an introductory activity to bring a resident to a more alert state.
c. To relax the resident so that s/he stays quiet.

29. _____  What are two possible adaptations of the Smell Can?
a. A Guess Game or topic of conversation for a Reminiscence Group.
b. A deterrent for disruptive behavior, or a reward for compliance.
c. To cover up a bad smell in the resident’s room, or to check for allergies.

30.  _____  React to a Sound can be used to encourage which Gesture?
a. Slapping.
b. Frowning.
c. Turn Head.

31. _____ If your facility’s fire regulations prohibit hanging anything from the ceiling, how might you adapt the Hanging Mobile?
a. Keep a Hanging Mobile on a One-to-One Activity Cart to bring to room-bound residents; hold the mobile at the resident’s eye level.
b. Abandon the Mobile as an Activity Idea.
c. Hang the Mobile from the ceiling anyway.

32. _____  What is a crucial key in implementing a Mobile with a resident?
a. Have the resident assist in selecting the pictures used.
b. Use the Mobile only with residents who can sustain eye contact with the pictures for 30 seconds or more.
c. Use the Mobile only with residents who can verbally identify the objects in the pictures.

33. _____  How does the philosophy of “Expect and Assume” apply to semi-comatose residents?
a. Expect the resident will understand your words, and Assume that something is getting through to the resident.
b. Expect no meaningful communication, Assume the exercise will be physically beneficial.
c. Expect the resident does not understand what you are saying, Assume you do not need to explain the activity to the resident.

34. _____  With what type of resident might you consider using an Activity Apron?
a. A disoriented  resident who likes to have something to hold in his or her hands to manipulate, but who is likely to drop an object frequently.
b. A highly alert resident who reports being bored in between scheduled Activities.
c. A semi-comatose, bedridden resident who cannot manipulate objects independently.

35. _____  What is one key advantage of the Velcro Baseball Mitt?
a. It is a repetitive exercise that keeps residents occupied so they do not bother you.
b. Many residents can relate to playing baseball as a child, and like the activity.
c. The activity looks impressive for the State Survey.

36. _____  How might you adapt the Pillow Maze for a resident who cannot pull the bags out of the Maze?
a. You might adapt the Pillow Maze to be a passive activity in which the resident observes you pulling out each bag to find the ‘surprise’, making your conversation the quality of the activity.
b. The Pillow Maze is inappropriate for a resident who cannot pull the bags out of the Maze.
c. Pull the bags out of the Pillow Maze in front of the resident, and make the visual stimulation the quality of the activity.

37. _____  What is the progression of difficulty for the Clay activities from easiest to most challenging?
a. Clay Flattening, Clay Tearing, and Clay Rolling
b. Clay Tearing, Clay Rolling, and Clay Flattening
c. Clay Rolling, Clay Tearing, and Clay Flattening

38. _____ Why is Clay Rolling not implemented at a total physical assistance level?
a. Clay rolling is not implemented at a total physical assistance level because it is extremely difficult to totally physically assist a resident to glide his or her hand over the clay with the varying amounts of pressure required as the shape moves from a ball into a narrower and narrower rope.
b. Clay rolling is too easy to justify implementation at a total physical assistance level.
c. Clay rolling is too messy to be implemented with total physical assistance.

39. _____  What is a crucial key to remember when implementing Block Stacking with a resident?
a. A resident for whom Block Stacking is appropriate may be distracted by too much verbalization.
b. Make sure the blocks have engaging, colorful patterns for the resident to look at.
c. Only use small blocks.

40. _____  What is the first step in implementing Block Stacking with a resident?
a. Quickly stack the blocks from largest to smallest so the resident can see his or her goal.
b. Hand the resident a block and see what he or she does with it.
c. Introduce yourself, get eye contact, assess attention span, and assess the resident’s verbal and nonverbal reaction.

41. _____  What makes Bean Scooping a “nonsensical” activity?
a. Once the beans are scooped, they are dumped back into the empty can, and the resident starts all over again.
b. Nobody scoops beans into a container with a spoon in real life.
c. A resident for whom Bean Scooping is appropriate does not understand the activity.

42. _____  How did the author experience unusual success with Bean Scooping? 
a. A group of fairly alert residents came in to the Activity Room and asked to do Bean Scooping, because they thought it was fun, and liked the sound of the beans.
b. She forgot to remove the activity from the resident’s room, and a bean plant sprouted.
c. None of her residents tried to eat the beans.

43. _____  What was suggested if the resident was unable to keep the correct amount of tension on a yarn needle for Bead Stringing?
a. Try wrapping and crimping Scotch Tape around the end of the yarn to make a stiff end to the yarn.
b. Give up and find a different activity.
c. Have the resident try poking the end of the yarn through by itself.

44. _____  How might you adapt Bead Stringing to make it more difficult?
a. Create a Bead Stringing Pattern Card for the resident to follow.
b. Use smaller beads.
c. Use thinner yarn.

45. _____  In the Fish Game, what is the advantage in using a paper clip and magnets over a Velcro ball?
a. Using magnets and paper clips makes the activity easier to assemble.
b. The paper clip and magnet assembly looks more like a real fishing rod.
c. Using a paper clip and magnets gives the resident a better chance at success, since the paper clip is drawn to the magnet.

46. _____ According to the author, what is the key to success of the Marshmallow Guess game?
a. The larger the items are, the more encouraged the resident is to guess.
b. By letting the resident eat the marshmallows if they guess correctly, he or she is more likely to count accurately.
c. By using smaller items, the resident is encouraged to focus his or her attention.

Section 11
47. _____  What might you do to add an additional successful experience to Picture Bingo?
a. Involve the resident in selecting pictures for his or her card, which can double as Reminiscence Therapy.
b. Instituting an ‘everybody wins’ policy with prizes.
c. Giving food rewards to the winner of each game.

48. _____ What are adaptations you might consider when adapting Bingo for your low-functioning and Alzheimer’s residents?
a. Color Column Bingo, Single-Digit Bingo, and Picture Bingo.
b. Bingo cannot be adapted for low-functioning residents.
c. Switch all your scheduled Bingo games to a picture-Bingo format.

49. _____ Which of the following would be a good resident to approach with the Envelope Stuffing activity?
a. Harold, who has an attention span of more than 5 minutes and is not interested in crafts, singing, or “fun.”
b. Betty, who has an attention span of less than a minute and has hands going into contracture.
c. Ellen, who has a long attention span and is always playing table games with her friends in the facility.

50. _____  What are three ways in which Envelope Stuffing can be adapted for a low-functioning resident?
a. Provide the resident with a signature stamp, have the resident staple pages together so they hold together easier, and ask the resident to write addresses on the envelopes.
b. Provide the resident with obsolete materials, have the papers already tri-folded, and cut the papers so that they are smaller and slide into the envelope easier.
c. Have the resident fold multiple forms at once, ask each resident to fold 100-150 forms per day, and have the resident work on an active project to save time for the office staff.

Once you have completed your Pre-Test, please click here to access Course Content.