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Stroke Rehabilitation

Key Points

1. The primary goal of rehabilitation is to prevent complications, ____________________, and maximize function.

A. Manage risk factors

B. Enhance social-adjustment

C. Minimize impairments

D. Promote stabilization


Stroke Rehabilitation Assessment

2. The initial brief stroke assessment should include assessment of complications as well as prior and current impairment.

A. True

B. False


Annotations

3. Following the “acute” phase of stroke care, the focus of care turns to encouraging resumption of self-care activities as well as provision of emotional support to the patient and family.

A. True

B. False


Screening for Aspiration Risk

4. Patients who are cooperative, able to talk, voluntary cough, swallow saliva and pass a simple swallowing screening test are generally at low risk for aspiration following a stroke.

A. True

B. False


Assessment of Stroke Severity/Use of Standardized Assessments

5. It is strongly recommend that the National Institutes of Health Stroke Scale (NIHSS) be used at the time of presentation/hospital admission or at least within the first _____ hours following presentation.

A. 8

B. 12

C. 18

D. 24


Annotation F: Swallowing Problems Aspiration Risk

6. All patients should receive evaluation of nutrition and hydration status as soon as possible after admission, and then food and fluid intake should be monitored weekly and body weight determined regularly.

A. True

B. False


Bowel and Bladder Dysfunction

7. Which of the following is NOT one of the factors that should be considered in a structured assessment of bladder function in acute stroke patient?

A. A complete urodynamic assessment

B. Assessment of urinary retention through the use of bladder scanner or an in-and-out catheterization

C. Measurement of urinary frequency, volume, and control

D. Presence of dysuria


Pain

8. When practical, a behavioral health provider should be utilized to address psychological aspects of pain and to improve adherence to the pain treatment plan.

A. True

B. False


Seizures

9. Brivaracetam and methazolamide are the first-line anticonvulsants for post-stroke seizure and epilepsy in elderly patients or in younger patients requiring anticoagulants.

A. True

B. False


Post Stroke Depression

10. Following a stroke, patients exhibiting extreme emotional lability such as pathological crying or tearfulness should be given a trial of an SSRI antidepressant as long as no contraindication exits.

A. True

B. False


Assessment of Communication Impairment

11. An example of a sensory/motor based communication problem is:

A. Aphasia

B. Dysarthria

C. Dementia

D. All of the above


Assessment of Emotional and Behavioral State

12. Sufficient evidence recommends the use of the Emotional Functioning Measure (EFM) to assess psychological adjustment following stroke.

A. True

B. False


Annotation N: Treatment Plan

13. Which of the following is NOT one of the items that should be documented as part of the treatment plan.

A. Etiology of stroke

B. Patient's strengths, impairments and current level of functioning

C. Psychological resources and needs, including caregiver capacity and availability

D. Goals and strategies for achieving these goals


Sexual Function

14. Sexual issues should be discussed during rehabilitation and addressed again after transition to the community when the post-stroke patient and partner are ready.

A. True

B. False


Annotation K: Discharge Patient from Rehabilitation

15. Prior to discharge, patient and family should be educated regarding pertinent risk for stroke and should receive all necessary equipment and training.

A. True

B. False


Non-Drug Therapies for Cognitive Impairment

16. Experts recommend that patients be given cognitive re-training if __________________ is present.

A. Attention or memory deficits

B. Visual neglect

C. Executive function and problem-solving difficulties

D. All of the above


Communication

17. For aphasia and other impairments of language, treatment can include models designed to improve comprehension and/or ______________ of language.

A. Articulation

B. Fluency

C. Expression

D. Resonance


Lower Extremities

18. Partial body weight support for treadmill training (up to 60% of individual's weight) in conjunction with other exercise training techniques is recommended for individuals with gait impairments post stroke.

A. True

B. False


Sensory Impairment-Vision Seeing

19. Scanning training and visual field stimulation should be used as compensatory intervention strategies for patients with eye motility impairments after stroke.

A. True

B. False


Family-Community Support

20. Experts recommend that patient and caregiver education be provided in both interactive and written formats, using a variety of methods.

A. True

B. False


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