Semi-Comatose & Low-Functioning 1-to-1 Activity Ideas with 91 Care Plan Goals
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Semi-Comatose & Low-Functioning 1-to-1 Activity Ideas with 91 Care Plan Goals

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LTC Administrator - Answer Booklet
(Note: There is nothing trick or hard about these questions.
They are merely intended to verify your review of the course's content.)

Answer questions below. Then click the "Check Your Score" button below. This Answer Booklet screen gives you FREE scoring and anonymous unlimited FREE trials. If you get a score of 80% or higher, and place a credit card order online, you can get an Instant Certificate for 10 CE's. (NAB guidelines require 5 quesions per credit hour. Therefore, the required 50 questions for this 10 hour course are below.)


Track 1 - Interview with Effie, Early Stage Alzheimer's
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, your movement is 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.  “This will make the State Surveyors happy.”

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?”

Track 2 - Interview with Marie S, Stiff Fingers
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. “You dropped it. Can you pick it up?”
c. “Gee your fingers are a too stiff for this activity.  Let’s try something easier.”

Track 3 - Interview with Freida, Three Piece Puzzle
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 open-ended question was asked to help Frieda identify pictures in the Reality Orientation Book?
a. “Is your daughter coming to visit?”
b. “Does your stomach hurt?”
c. “What is this a picture of?”

Track 4 - Interview with Fannie, Mid-stage Alzheimer's
7. According to the interview, 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 is in his or her Care Plan.
c. “I have to assess your hand movement now.”

8. According to the interview, 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. “Did you ever bake beans?”

9. What were three "Approaches" suggested for Fannie? 
a. Remain quiet to avoid disturbing Fannie, maintain as much personal distance as possible, implement the hand exercise without explanation.
b. 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.
c. Repeating understandable words, maintaining eye contact, making simple requests.

Track 5 - Interview with Marie J, Hand Exercise
10. According to the interview, what was stated as the motivator for the Hand Exercise?
a. “This will give you something to do.”
b. “Your hands really need help.”
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. She was hungry and in a bad mood.
b. Her fingers were too stiff, and her eyesight was not good.
c. Her working memory and processing speed were insufficient.

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

Track 6 - Interview with Mabel, Assessing Long-Term Memory
13. What were two supportive responses given to Mabel, in the interview?
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. Thank you. ”
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. According to the interview, 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.

Track 7 - Interview with Elizabeth, Semi-comatose, Scent Therapy
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.

Track 8 - Interview with Lillian: Bean Bag Rolling
18. What did the instructor indicate were two important factors in communicating with Lillian?
a. Speaking softly and using quick gestures for emphasis.
b. Using her name, and picking up words Lillian uses which are understandable.
c. Explaining everything in great detail 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 read five pages in a Reader’s Digest.”
c. “To knit independently for one hour”

Track 9 - Interview with Mary: Listening for Breathing Patterns & Using an Amplifier
20. What three things 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. Using an extremely loud voice.
b. Not trying very hard, as Mary is unlikely to recognize the attempt to communicate with her.
c. Being sensitive to the resident’s reaction

Track 10 - Photos with Commentary/Success Therapy Slides
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.
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 well.
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.

Section 11 - Activity Programs for your Semi-Comatose Residents
25. . _____  What are three categories of Eye Movement you might look for in a heavy care or semi comatose resident?
a. Eye Openness, Eye Movement and Eye Focus.
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. Strength, dexterity, endurance, and reaction time.
b. Eyes, breathing, gestures, and vocalizations.
c. Social skills, responsiveness, attention span, and IQ.

Section 12 - Sensory Stimulation
28. _____  According to the article what are results of Scent Therapy?
a. The resident may smile and/or have a more focused look on his/her face.
b. As an introductory activity to bring a resident to a more alert state.
c. Both A and B.

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. _____  According to the article "React to a Sound" can be used to encourage which Gesture?
a. Slapping.
b. Frowning.
c. Turn Head.

Section 13 - 3 Types of Mobiles
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 request to have one.
c. Use the Mobile only with residents who can verbally identify the objects in the pictures.

Section 14 - Bean Bag Rolling, Activity Apron, & Doll
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. _____  According to the article 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.

Section 15 - Velcro Baseball Mitt, Balloon Batting, Pillow Maze
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. State Surveys do not like to see activities related to resident's past interests.

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. Pull the bags out of the Pillow Maze in front of the resident, and make the visual stimulation the quality of the activity.
c.  Both a and b.

Section 16 - Clay & Success Therapy® Bags
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.

Section 17 - Stacking and the Need for an In-service Training Block
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. Very 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.

Section 18 - Bean Scooping & Clothes Pins
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 needs to understand the meaning of the activity first.

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 choked on the beans.

Section 19 - Bead Stringing
43. _____  What was suggested if the resident that pulls the needle too far, and the yarn slips out of the eye of the needle for Bead Stringing?
a. Give up and find a different activity.
b. Have the resident try poking the end of the yarn through by itself.
c. Try wrapping and crimping Scotch Tape around the end of the yarn to make a stiff end to the yarn.

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

Section 20 - Fish Game & Marshmallow Guess
45. _____  According to the article in the Fish Game, what is the advantage in using a paper clip and magnets over a Velcro ball in creating a successful experience for the resident?
a. Using a paper clip and magnets gives the resident a better chance at success, since the paper clip is drawn to the magnet.
b. The resident likes the shiny paper clip.
c. The paper clip and magnet are more fun for the resident.

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 21 - Bingo Adaptations
47. _____  What might you do to add an additional successful experience to Picture Bingo?
a. Create printed rules for the resident read.
b. Involve the resident in selecting pictures for his or her card, which can double as Reminiscence Therapy.
c. Not 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.

Section 22 - Envelope Stuffing
49. _____ Which of the following would be a good resident to Approach with the Envelope Stuffing activity?
a. Betty, who has an attention span of less than a minute and has hands going into contracture.
b. Ellen, who constantly wanders the halls of your facility.
c. Harold, who has an attention span of more than 5 minutes and is not interested in crafts, singing, or “fun.”

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.