Author: Anonymous

Your 21 yo female client is s/p craniotomy secondary to bacterial meningitis.  After a vision screen, you determine that she demonstrates amblyopia in her L eye.  The patient reported that she had a “lazy” eye as a kid, she wore a patch on her R eye to strengthen her L eye, and it worked.  It seems that the reemergence of amblyopia is a symptom of the new onset of ABI and she would like to use an opaque patch on her R eye, now.  As a licensed and registered OT, you do not need to refer to a vision specialist to initiate patching for amblyopia.

Executive function impairments will typically be seen with ______________ damage:

For a newly acquired brain injury, when assessing the client with her glasses on the Snellen chart for visual acuity, a measurement of _________ indicates a referral for further evaluation with a vision specialist.

Answer the questions 33- 35 using the following case study: Genevieve is a 13-year-old female who sustained a TBI, Rancho Level 6. Her injuries include DAI (diffuse axonal injury) involving left anterior frontal lobes, left basal ganglia, right thalamus, left anterior temporal lobe, a left SDH, and scattered post-traumatic subarachnoid hemorrhages.   During a meal preparation task to make macaroni and cheese, Genevieve will sit at the table and wait until prompted to begin. She is having difficulty with:

Executive function impairments will typically be seen with ______________ damage:

Upon vision screening of a new patient on the TBI unit, you noticed that your patient’s R pupil is smaller than the L pupil. He complains of diplopia consistently during the assessment. After discussing your findings with the physician and obtaining orders, what would be the most likely choice of a team intervention to address his diplopia? 

Using the treatment activity in the above question (searching for specific canned goods in the pantry shelves, focus to help her establish environmental “anchors” on the left and then scanning from left to right) an appropriate upgrade would be:     _________ End of the Case______________________________

A client with a stroke to the L inferior parietal lobe demonstrates eating soap.  Due to the neurologic nature of the infarct, you would expect him to eat soap with:

Answer the questions 31-32 using the following case study:   Maria is a retired pharmacist who sustained a right MCA CVA. As a result of the CVA, she presents with a left visual field cut and neglect.  Her areas of strength are in initiation and planning.   Your treatment activity of choice for Maria consisted of searching for specific canned goods in the pantry shelves.  Your focus was to help her utilize an environmental anchor, such as the left boarder of the cabinet, and then scanning from left to right.  An appropriate downgrade would be (select the best answer):

The best intervention to improve decision making skill is: