NBCOT Occupational Therapy Certification Practice Exam

What level of independence is most likely for a patient with complete T4 paraplegia regarding self-care and transfers?

1. Complete independence with self-care and modified independence with transfers

2. Independence with self-care and minimal assistance with transfers

3. Minimal assistance with self-care and moderate assistance with transfers

4. Dependence with both self-care and transfers

The correct answer is: Complete independence with self-care and modified independence with transfers

The most likely level of independence for a patient with complete T4 paraplegia involves complete independence with self-care and modified independence with transfers. This level of spinal cord injury typically results in the loss of movement and sensation in the legs and lower torso, while arm function remains intact. Individuals at this level can generally perform self-care tasks such as grooming, dressing, and eating independently because they have the necessary upper body strength and fine motor skills. They can utilize adaptive equipment as needed, ensuring they can complete these tasks without assistance. However, when it comes to transfers, which may involve moving from a wheelchair to a bed or a car, some modifications are often required. This may mean that while the individual can initiate and complete the transfer process with minimal help, they may still need some environmental adjustments or the use of assistive devices to facilitate these movements safely and effectively. For instance, they may require the assistance of a slide board but can perform the transfer independently given the right setup. This differentiation in abilities helps to reflect the realities of living with a spinal cord injury at the T4 level, where individuals can achieve a good degree of autonomy in daily activities while still facing challenges during transfers.