NBCOT OTR Burn Questions and
Answers.
An OTR® is working with a client who has had a cerebrovascular accident (CVA). One
of the client's goals is independence in baking activities. Which modality intervention is
BEST used to decrease shoulder subluxation of the nonpainful hemiparetic arm during
this task?
A. Ultrasound
B. Fluidotherapy
C. Neuromuscular electrical stimulation (NMES)
D. Conventional transcutaneous nerve stimulation (TENS) -
\The right answer is C
NMES can be used during an activity to decrease shoulder subluxation post CVA.
Bracciano, A. (2008). Therapeutic ultrasound and phonophoresis. In A. Bracciano (Ed.),
Physical agent modalities: Theory and application for the occupational therapist (2nd
ed., pp. 125-156). Thorofare, NJ: Slack; p. 188.
Explanations of Incorrect Answers
A, B: Ultrasound and fluidotherapy cannot be used during an activity and do not
increase functional control of muscles.
D: TENS can be used during an activity but is typically used for pain and edema control.
A client sustained a burn injury to the hand 1 year ago and has returned to occupational
therapy for scar management. The client has been wearing a compression glove as
originally prescribed and asks the OTR® if the glove is still necessary. Which factor is
MOST IMPORTANT for the OTR® to consider prior to advising the client to discontinue
glove wear?
A. Documented changes in volumetric measurements since beginning therapy
B. Physical characteristics of the scar and the stage of wound healing
C. Client's overall psychological adjustment to the burn scars
D. Improvements in composite finger ROM and scar sensitivity -
\The right answer is B
The primary outcome when using a compression glove is to decrease scar tissue
formation and improve the appearance of a scar, and this is assessed through physical
characteristics of the scar. Once the appearance of the scar along with the stage of
wound healing are considered, the determination of continued compression glove use
can be made.
, Pessina, M. A., & Orroth, A. C. (2008). In M. V. Radomski & C. A. Trombly Latham
(Eds.), Occupational therapy for physical dysfunction (6th ed., pp. 1244-1263).
Baltimore: Lippincott Williams & Wilkins; p. 1254.
Explanations of Incorrect Answers
A: Volumetric measurements are used to assess edema in an extremity and would not
be a reasonable measure for scar management.
C: The client's psychological adjustment to the burn scars should be addressed by the
practitioner; however, this information is not essential in determining the discontinuing of
a scar management glove.
D: Although ROM and scar sensitivity may be secondary effects of glove use in scar
management, the primary outcome when using a compression glove is to decrease scar
tissue formation and improve the appearance of a scar.
A softball player sustained a deep partial-thickness burn to the anterior aspect of the
right arm from the wrist, proximal to the ulnar styloid process, to the mid-upper arm. A
split-thickness skin graft from thigh to mid-forearm was performed 3 days postinjury.
What is the OPTIMAL intervention to prevent formation of elbow contracture?
A. A dorsal elbow flexion splint to position the elbow at 90° flexion and the forearm in
supination.
B. A volar elbow flexion splint to position the elbow at 90° flexion and the forearm in
neutral.
C. A dorsal elbow extension splint to position the elbow at extension and the forearm in
neutral.
D. A dorsal elbow extension splint to position the elbow at extension and forearm in
supination. -
\The right answer is C
The antideformity position for the elbow is elbow extension and forearm in neutral
position. Also, because the client has a partial-thickness skin graft at the anterior aspect
of the forearm and to maintain maximum surface area of the grafted area, it is better to
position the forearm in a neutral position.
Reeves, S. U., & Deshaies, L. (2013). Burns and burn rehabilitation. In H. M. Pendleton
& W. Schultz-Krohn (Eds.), Pedretti's occupational therapy: Practice skills for physical
dysfunction (7th ed., pp. 1110-1148). St. Louis, MO: Elsevier; pp. 1125-1128.
Explanations of Incorrect Answers
A, B: Positioning the elbow in 90° flexion will encourage contracture that will prevent
elbow extension. Only a dorsal arm splint should be used because the burn area is in
the anterior aspect of the arm.
Answers.
An OTR® is working with a client who has had a cerebrovascular accident (CVA). One
of the client's goals is independence in baking activities. Which modality intervention is
BEST used to decrease shoulder subluxation of the nonpainful hemiparetic arm during
this task?
A. Ultrasound
B. Fluidotherapy
C. Neuromuscular electrical stimulation (NMES)
D. Conventional transcutaneous nerve stimulation (TENS) -
\The right answer is C
NMES can be used during an activity to decrease shoulder subluxation post CVA.
Bracciano, A. (2008). Therapeutic ultrasound and phonophoresis. In A. Bracciano (Ed.),
Physical agent modalities: Theory and application for the occupational therapist (2nd
ed., pp. 125-156). Thorofare, NJ: Slack; p. 188.
Explanations of Incorrect Answers
A, B: Ultrasound and fluidotherapy cannot be used during an activity and do not
increase functional control of muscles.
D: TENS can be used during an activity but is typically used for pain and edema control.
A client sustained a burn injury to the hand 1 year ago and has returned to occupational
therapy for scar management. The client has been wearing a compression glove as
originally prescribed and asks the OTR® if the glove is still necessary. Which factor is
MOST IMPORTANT for the OTR® to consider prior to advising the client to discontinue
glove wear?
A. Documented changes in volumetric measurements since beginning therapy
B. Physical characteristics of the scar and the stage of wound healing
C. Client's overall psychological adjustment to the burn scars
D. Improvements in composite finger ROM and scar sensitivity -
\The right answer is B
The primary outcome when using a compression glove is to decrease scar tissue
formation and improve the appearance of a scar, and this is assessed through physical
characteristics of the scar. Once the appearance of the scar along with the stage of
wound healing are considered, the determination of continued compression glove use
can be made.
, Pessina, M. A., & Orroth, A. C. (2008). In M. V. Radomski & C. A. Trombly Latham
(Eds.), Occupational therapy for physical dysfunction (6th ed., pp. 1244-1263).
Baltimore: Lippincott Williams & Wilkins; p. 1254.
Explanations of Incorrect Answers
A: Volumetric measurements are used to assess edema in an extremity and would not
be a reasonable measure for scar management.
C: The client's psychological adjustment to the burn scars should be addressed by the
practitioner; however, this information is not essential in determining the discontinuing of
a scar management glove.
D: Although ROM and scar sensitivity may be secondary effects of glove use in scar
management, the primary outcome when using a compression glove is to decrease scar
tissue formation and improve the appearance of a scar.
A softball player sustained a deep partial-thickness burn to the anterior aspect of the
right arm from the wrist, proximal to the ulnar styloid process, to the mid-upper arm. A
split-thickness skin graft from thigh to mid-forearm was performed 3 days postinjury.
What is the OPTIMAL intervention to prevent formation of elbow contracture?
A. A dorsal elbow flexion splint to position the elbow at 90° flexion and the forearm in
supination.
B. A volar elbow flexion splint to position the elbow at 90° flexion and the forearm in
neutral.
C. A dorsal elbow extension splint to position the elbow at extension and the forearm in
neutral.
D. A dorsal elbow extension splint to position the elbow at extension and forearm in
supination. -
\The right answer is C
The antideformity position for the elbow is elbow extension and forearm in neutral
position. Also, because the client has a partial-thickness skin graft at the anterior aspect
of the forearm and to maintain maximum surface area of the grafted area, it is better to
position the forearm in a neutral position.
Reeves, S. U., & Deshaies, L. (2013). Burns and burn rehabilitation. In H. M. Pendleton
& W. Schultz-Krohn (Eds.), Pedretti's occupational therapy: Practice skills for physical
dysfunction (7th ed., pp. 1110-1148). St. Louis, MO: Elsevier; pp. 1125-1128.
Explanations of Incorrect Answers
A, B: Positioning the elbow in 90° flexion will encourage contracture that will prevent
elbow extension. Only a dorsal arm splint should be used because the burn area is in
the anterior aspect of the arm.
