Module test - CHSS eLearning

Please provide some personal information before proceeding with this Module Test. This information is required for creating your certificate and will also assist us in evaluating the website.

Each of the Managed Clinical Networks (MCNs) in Scotland will be given the names of those who have been awarded Module Test Certificates within their areas. We do not collect or share information on the number of times a person attempts the Test, or where a certificate is not awarded.
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Do you work in a:*
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Name of service (eg ESD, GP surgery):

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Ward no. / name:*
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Is this ward a Stroke Unit?*
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This is the module test for ‘Management of tone and spasticity after stroke: a role for everyone’. It is strongly recommended that you work though the learning materials of the module prior to commencing this test. By going straight to the test you may miss out on valuable learning contained within the module. The answers to all the test questions are contained within the module. This information may have been provided in the 'Additional Information' boxes on some of the pages.

There are 12 questions and you must answer all of these correctly to obtain a certificate of completion.

You should allow approximately 10 minutes to complete this test.

Management of tone and spasticity: Module test – Part 1. Q. Which of the following statements are true? After a stroke the Sarcomeres in muscle fibres ...*
- Select All
- A. Double in number
- B. Reduce in length
- C. Reduce in number
- D. Become longer

Part 1. Answer.

Unfortunately, you have answered Question 1 incorrectly.
Part 1. Answer.

Well done, the correct answers are B and C.

Management of tone and spasticity: Module test – Part 2. Q. Which one is true? Hypotonic muscles are…*
- A. Stiff, hard and difficult to position due to resistance
- B. Floppy, heavy and cause joints to become unstable

Part 2. Answer.

Unfortunately, you have answered Question 2 incorrectly.
Part 2. Answer.

Well done, the correct answer is B.

Management of tone and spasticity: Module test – Part 3. Q. Which one is true? A contracture is caused by …*
- A. Spasticity
- B. Immobilisation of a joint with muscles and other soft tissues in a shortened position

Part 3. Answer.

Unfortunately, you have answered Question 3 incorrectly.
Part 3. Answer.

Well done, the correct answer is B.

Management of tone and spasticity: Module test – Part 4. Q. If a muscle or limb is Hypertonic, which of the following are primary treatment aims? (Select all that apply)*
- Select All
- A. To maintain muscle length
- B. To support the elbow joint at 90 degrees of flexion at all times
- C. To allow normal positioning of the limbs
- D. To prevent secondary soft tissue shortening
- E. To hyperextend at the knee joint

Part 4. Answer.

Unfortunately, you have answered Question 4 incorrectly.
Part 4. Answer.

Well done, the correct answers are A, C and D.

Management of tone and spasticity: Module test – Part 5. Q. Which of the following may exacerbate or influence spasticity for your patient? (Select all that apply)*
- Select All
- A. Infection
- B. Poor pain control
- C. Fear of falling
- D. Blocked catheter
- E. Overuse of the non-affected side during functional tasks

Part 5. Answer.

Unfortunately, you have answered Question 5 incorrectly.
Part 5. Answer.

Well done, all are correct.

Management of tone and spasticity: Module test – Part 6. Q. When positioning a stroke patient you should… (Select all that apply)*
- Select All
- A. Ensure the equipment you use is at the correct height for the patient
- B. Ensure regular changes of position are given as per care plan and that they are also recorded along with any patient comments or observed changes in tone
- C. Ensure the patient is sitting in a wheelchair as soon as they get out of bed
- D. Ensure the patient and their carers are aware of the importance of positioning as part of treatment
- E. Ensure the patient has regular pain relief if it is required and that this is reviewed
- F. Only position the patient if you are a healthcare professional

Part 6. Answer.

Unfortunately, you have answered Question 6 incorrectly.
Part 6. Answer.

Well done, the correct answers are A, B, D and E.

Management of tone and spasticity: Module test – Part 7. Q. True or false? Patients with a persistent focal spasticity should be prescribed Baclofen?*
- True
- False

Part 7. Answer.

Unfortunately, you have answered Question 7 incorrectly. Baclofen or other anti-spasmodic medication is used to treat generalised or diffuse spasticity. Focal spasticity should be treated following a combined assessment by an experienced multidisciplinary team. Treatment can include splinting, orthotics, physiotherapy & Botulinum toxin A injections.
Part 7. Answer.

Well done, the correct answer is False. Focal spasticity should be treated following a combined assessment by an experienced multidisciplinary team. Treatment can include splinting, orthotics, physiotherapy & Botulinum toxin A injections. Baclofen or other anti-spasmodic medication is used to treat generalised or diffuse spasticity.

Management of tone and spasticity: Module test – Part 8. Q. People with stroke should routinely be offered splinting for the affected arm and hand?*
- True
- False

Part 8. Answer.

Unfortunately, you have answered Question 8 incorrectly. Many stroke patients do not require any form of splinting at all.
Part 8. Answer.

Well done, the correct answer is A. Many stroke patients do not require any form of splinting at all.

Management of tone and spasticity: Module test – Part 9. Q. Which of the following statements are true? Before you refer to a specialist spasticity service you should… (Select all that apply)*
- Select All
- A. Discuss with your MDT the existing physical measures for treating your patient
- B. Tell the patient they will receive Botulinum Toxin A injections
- C. Tell the patient Botulinum Toxin A injections will give big improvements for them
- D. Manage any trigger factors which increase tone in your patient and ensure this is discussed and recorded in the care plan

Part 9. Answer.

Unfortunately, you have answered Question 9 incorrectly.
Part 9. Answer.

Well done, the correct answers are A and D.

Management of tone and spasticity: Module test – Part 10. Q. Which of the following statements are true? A custom made orthosis aims to… (Select all that apply)*
- Select All
- A. Improve function
- B. Restore movement to a contracted limb joint
- C. Reduce pain
- D. Prevent deformity
- E. Prevent excessive range of movement in a joint
- F. Be used for up to six weeks only

Part 10. Answer.

Unfortunately, you have answered Question 10 incorrectly.
Part 10. Answer.

Well done, the correct answers are A, C, D and E.

Management of tone and spasticity: Module test – Part 11. Q. If your patient has been seen at a specialist spasticity clinic, which one of the following is true?*
- A. Patient care is now the sole responsibility of the spasticity clinic
- B. It is likely that the patients spasticity has now stabilised and will not require further treatment
- C. There will be ongoing treatment or management issues to be addressed by the referring team after the patient has been seen at the spasticity clinic
- D. If the patient has medical issues, refer back to the spasticity clinic

Part 11. Answer.

Unfortunately, you have answered Question 11 incorrectly.
Part 11. Answer.

Well done, the correct answer is C.

Management of tone and spasticity: Module test – Part 12. Q. Which of the following statements are true? For good practice to manage spasticity after stroke… (Select all that apply)*
- Select All
- A. Sit in a reclined position in a tilt in space chair
- B. Pull up on a rail to stand from sitting
- C. When putting on a shirt, bend forward and extend the affected arm in midline using gravity to assist getting arm in to sleeve
- D. Position the patient on the toilet with hips, knees and ankles at 90 degrees
- E. Encourage patients to take most of their weight through their non-affected side
- F. Give the patient time to attempt each task

Part 12. Answer.

Unfortunately, you have answered Question 12 incorrectly.
Part 12. Answer.

Well done, the correct answers are C, D and F.

Stroke Training and Awareness Resources (STARs)

Part 1. Answer.

Part 1. Answer.

Part 2. Answer.

Part 2. Answer.

Part 3. Answer.

Part 3. Answer.

Part 4. Answer.

Part 4. Answer.

Part 5. Answer.

Part 5. Answer.

Part 6. Answer.

Part 6. Answer.

Part 7. Answer.

Part 7. Answer.

Part 8. Answer.

Part 8. Answer.

Part 9. Answer.

Part 9. Answer.

Part 10. Answer.

Part 10. Answer.

Part 11. Answer.

Part 11. Answer.

Part 12. Answer.

Part 12. Answer.