Coping With Cognitive Impairments Ch.31 Exam Prep Fell

Chapter 31: Overcoming Challenges of Impaired Perception, Cognition, and Communication (Aphasia or Dysarthria)

Jane Mertz Garcia, PhD, CCC-SLP

Beth Cardell, PhD, OTR/L

Dennis W. Fell, PT, MD

Jill Champley, PhD, CCC-SLP

Multiple Choice

1. Health-care professionals have different scopes of practice. Diagnoses of communication and clinical interventions for communication impairments are part of the roles and responsibilities of;

A. Speech-language pathologist (SLP)

B. Occupational therapist (OT)

C. Physical therapist (PT)

D. Registered nurse (RN)

2. Successful communication involves accurate encoding and decoding of messages. Which of the following best represents the application of concepts when providing physical therapy services to a person with dysarthria?

A. The therapist is challenged to encode a message in a manner that is understandable due to the comprehension difficulties associated with dysarthria.

B. The patient’s difficulty with language makes it impossible to encode or decode messages.

C. The person with dysarthria has difficulty encoding messages in a manner that are easily decoded by the therapist.

D. The person with dysarthria has difficulty decoding messages but the encoding aspect is easy.

A. Impaired language

B. Impaired swallowing

C. Less intelligible speech

D. Difficulty comprehending and using language

4. The ability to recall where I put my shoes earlier today is an example of ________________ memory and the ability to recall how to tie them represents _______________ memory.

A. Recent; Prospective

B. Prospective; Procedural

C. Recent; Procedural

D. Procedural; Recent

5. Many adult patients benefit from external aids to support completion of therapy activities due to impaired memory and executive function after a traumatic brain injury (TBI). Which of the following choices is NOT applicable for this purpose?

A. Family photo albums from childhood

B. Cellular phones with programmed alarms and reminders

C. “To-do” lists (paper or electronic)

D. Planners and organizers

6. Mr. Johnson suffered a recent right hemisphere stroke. In addition to physical impairments, he has unilateral neglect. An observation you have made during clinical interactions that exemplifies his neglect is the following:

A. Mr. Johnson consistently reaches for exercise equipment when it is positioned on his left but not when the same equipment is placed on his right side.

B. Mr. Johnson seems unaware and even denies presence of his left-side paralysis during range of motion activities.

C. Mr. Johnson frequently navigates his wheelchair into room furniture/equipment without noticing.

D. Mr. Johnson is unable to speak clearly making it difficult to know how much pain he is experiencing during stretching exercises.

7. The following statement about aphasia is true:

A. Aphasia impacts both formulation and understanding of language to some degree.

B. Aphasia typically develops and worsens as a process of aging.

C. Aphasia is considered to be a type of thought and memory disorder.

D. Aphasia is typically limited to one specific aspect of communication (e.g., ability to speak clearly).

8. The SLP indicates that your patient with aphasia has impaired comprehension. One recommendation is to adjust your spoken directions when instructing the patient about sitting to standing transfers. This means that your patient is most likely to successfully respond (show comprehension) if you say your directions in the following manner:

A. “Lock your brakes before you stand up.”

B. “Lock your brakes”… “Stand up”

C. “Did you get your brakes locked?”… “Stand up while staying focused on me”

D. “Before you stand up be sure to lock your brakes.”

9. Medical chart notes from the SLP indicate that your patient presents with expressive and receptive aphasia. This means that your patient:

A. Will have some difficulty comprehending what you say and being able to answer your questions easily.

B. Is likely disoriented to person, time, and place.

C. Has a selective impairment in hearing but not in thought organization.

D. Is unable to read and write but should be able to talk in clear sentences.

10. A new patient just transferred from an acute hospital to your rehabilitation center. Medical records and reports mention that the patient has dysarthric speech. Statements in the record that are consistent with dysarthria as this patient’s communication disorder include:

A. “The patient is unable to motor program words like hospital and tornado.”

B. “The patient has difficulty with word retrieval and may say the wrong word.”

C. “The patient understands one-step but not two-part directions.”

D. “The patient’s impairment is characterized by slow, weak, and imprecise movements of the speech musculature.”

11. Your 70 year-old outpatient has dysarthria resulting from a stroke. The patient’s symptoms include slurred speech, a low volume, and breathy sounding voice. You find it very difficult to understand the patient when providing feedback about completion of home-related activities. Select a “tip” or strategy that might be especially helpful to try in this situation:

A. Quit asking the patient questions in order to eliminate an embarrassing situation for both you and the patient.

B. Pretend to understand. You do not want to increase the patient’s frustration by creating difficult communication situations.

C. Be honest: Repeat back that part of the message you understood and ask the person to repeat the portion that you did not understand.

D. Ask the care provider who brings the patient to therapy to interpret or talk for the patient.