Vocational assessment and occupational analysis

A client's functional capacity evaluation shows he can lift 20 pounds occasionally and 10 pounds frequently. His exertional level under DOT and SSA definitions is:

1. medium
   Medium work requires lifting up to 50 pounds occasionally and 25 pounds frequently, more than this client can do.
2. light
   Light work in DOT and SSA definitions means lifting up to 20 pounds occasionally and 10 pounds frequently, matching this FCE exactly.
3. sedentary
   Sedentary work involves lifting no more than 10 pounds occasionally; this client exceeds that ceiling.
4. heavy
   Heavy work involves lifting up to 100 pounds occasionally and 50 pounds frequently, far beyond these results.

Under the Assistive Technology Act, training a client to use screen-magnification software at his new job is classified as:

1. a job restructuring
   Job restructuring changes which tasks a job includes; training on software changes how he performs his tasks, not which tasks he has.
2. the assistive technology device itself
   The device is the software; teaching him to use it is a separate category, and this option merges the two.
3. a universal design feature
   Universal design builds usability for everyone into a product or space from the start; individual training for one user is not that.
4. an assistive technology service
   Under the Assistive Technology Act, an AT service is any help with selecting, acquiring, or using a device, and training the user is a listed example.

A client who is totally blind wants to read her printed mail independently at home. The MOST suitable technology is:

1. a screen reader on her computer
   A screen reader speaks text already on a computer; printed letters must first be scanned and converted, which this option leaves out.
2. a refreshable Braille display
   A refreshable Braille display shows digital text in Braille but cannot capture printed paper, so it fails without a scanning step.
3. a closed-circuit television magnifier
   A CCTV magnifier enlarges print for people with low vision; it does not help someone with no usable sight.
4. an OCR scanning app with speech output
   Optical character recognition turns printed text into digital text, and speech output reads it aloud, so a totally blind person can read paper mail alone.

A client with a traumatic brain injury reports memory and attention problems that are interfering with job training. To document these deficits and plan accommodations, the counselor should refer for:

1. a functional capacity evaluation
   An FCE focuses on physical work tolerances such as lifting and standing; it will not document memory and attention deficits.
2. a personality inventory
   A personality inventory describes traits, not the cognitive deficits that are interfering with training.
3. a neuropsychological evaluation
   A neuropsychological evaluation measures memory, attention, and executive functions and links the results to practical accommodations, which is what a TBI with training problems needs.
4. a vocational interest inventory
   Interests do not explain memory and attention problems, and they say nothing about which accommodations would help.

A client performs a standardized, timed task that simulates an electronics assembly job, and her performance is compared with industrial norms. This assessment is a:

1. situational assessment.
   A situational assessment observes general work behaviors over days in a real or simulated setting and is not scored against industrial norms.
2. work sample.
   A work sample is a standardized task that copies real job activities and is scored against norms, such as industrial production rates.
3. job tryout.
   A job tryout places the client in an actual job with a real employer, not in a standardized timed task in an evaluation unit.
4. functional capacity evaluation.
   An FCE measures physical tolerances such as lifting and endurance, not performance on a simulated assembly job.

After a transferable skills analysis identifies three suitable occupations, the counselor contacts local employers to confirm openings, wages, and hiring requirements. This activity is a:

1. labor market survey.
   Contacting employers to confirm openings, wages, and hiring requirements for target occupations is a labor market survey; it tests whether the TSA results are realistic locally.
2. job development contact.
   Job development seeks or creates a job for a particular client; this counselor is gathering data about occupations, not placing anyone.
3. transferable skills analysis.
   The TSA already produced the three occupations; checking local demand for them is the next, separate step.
4. job analysis.
   A job analysis studies the tasks and demands of one job on site; it does not survey several employers about openings and pay.

An employee with multiple sclerosis reports fatigue in the afternoon, and her employer is willing to make changes. The counselor's BEST next step is a:

1. job site and accommodation analysis.
   With a willing employer and a known symptom pattern, an on-site look at tasks, schedule, and environment finds accommodations such as rest breaks or moving demanding tasks to the morning.
2. vocational evaluation for new work.
   A full evaluation for new work assumes she cannot keep this job; that skips accommodation, which is the expected step while she is still employed.
3. fitness-for-duty medical exam.
   A fitness-for-duty exam asks whether she can do the job safely at all; nothing suggests a safety risk, and it does not design accommodations.
4. functional capacity evaluation.
   An FCE measures physical tolerances in a clinic; afternoon fatigue is a timing problem best solved by changing how and when the work is done.

A worker with C5 tetraplegia has no functional hand use but can talk normally, and he must write long reports. The BEST primary computer input method is:

1. a split ergonomic keyboard.
   A split keyboard helps people with wrist strain who can type; it does nothing for someone with no functional hand use.
2. a trackball with an on-screen keyboard.
   A trackball still needs hand control, and typing letter by letter on an on-screen keyboard is far too slow for long reports.
3. speech recognition software.
   With clear speech and no hand use, dictation software lets him produce long text quickly, so it is the best primary input method.
4. a keyguard on a standard keyboard.
   A keyguard helps people with tremor or poor motor control hit single keys, but it still requires usable hands.

An FCE shows a client can lift 25 pounds occasionally. The job analysis for his target job lists occasional 50-pound lifts as an essential function. The counselor should NEXT:

1. ask the employer to remove the lifting task.
   The ADA does not require an employer to remove an essential function, so this option confuses essential and marginal duties.
2. explore accommodations such as lift assists.
   Before ruling out the job, the counselor checks whether lift assists or similar changes would let him perform the essential lifting within his limits.
3. rule out the job for this client permanently.
   Ruling out the job permanently skips the accommodation step and ignores that his capacity may change.
4. recommend the job without changes.
   Occasional lifting still means lifting 50 pounds, twice his tested limit, so placing him without changes risks injury.

A client reports she can sit for only 10 minutes, but during a 2-hour intake she sits without apparent discomfort. The counselor should:

1. confront the client about dishonesty.
   Confronting her assumes deception and damages the relationship; pain varies, and the observation needs checking, not accusation.
2. accept the self-report as definitive.
   Self-report is important but not definitive when observation conflicts with it; ignoring the gap leaves the plan built on uncertain limits.
3. document it and seek objective measures.
   A gap between reported and observed tolerance is recorded objectively and checked with measures such as an FCE; a single observation proves neither honesty nor dishonesty.
4. conclude that the client is malingering.
   Malingering requires evidence of deliberate faking for an external reward; one inconsistency does not establish it.

In occupational analysis, a job with a Specific Vocational Preparation (SVP) level of 2 is classified as:

1. sedentary work in exertional terms.
   SVP measures training time, not strength; exertional level is a separate DOT rating, so this option mixes up the two scales.
2. unskilled, learned within 30 days.
   SVP 1 and 2 are unskilled work; SVP 2 covers anything beyond a short demonstration up to and including one month.
3. skilled, requiring 1 to 2 years.
   Skilled work starts at SVP 5; 1 to 2 years of preparation corresponds to SVP 6.
4. semiskilled, learned in 3 to 6 months.
   Semiskilled work is SVP 3 to 4, and 3 to 6 months is SVP 4, so the level is too high.

At intake, a counselor gathers medical, psychological, educational, vocational, and social information to find out which services a client will need to reach an employment goal. This process is called:

1. a comprehensive needs assessment
   A comprehensive needs assessment gathers medical, psychological, educational, vocational, and social information to decide which services a person needs to reach an employment goal.
2. a functional capacity evaluation
   An FCE measures physical work tolerances such as lifting and sitting; it covers only one of the many areas a needs assessment pulls together.
3. a job analysis of the target position
   A job analysis studies one job's tasks and demands, not the person's overall service needs.
4. a transferable skills analysis
   A transferable skills analysis uses work history to find related jobs, which is only a part of planning services.

The Functional Independence Measure (FIM), long used in inpatient rehabilitation, rates a patient's:

1. level of consciousness at admission
   Level of consciousness is rated with tools such as the Glasgow Coma Scale, not the FIM.
2. range of motion at individual joints
   Joint range of motion is measured with a goniometer during a physical exam; the FIM rates whole activities, not single joints.
3. stage of cognitive recovery after TBI
   Stages of cognitive recovery after brain injury come from the Rancho Los Amigos scale; the FIM's cognitive items rate how much help a person needs, not a recovery stage.
4. amount of help needed in daily activities
   The FIM scores 18 motor and cognitive items, such as self-care, transfers, and communication, on a 7-level scale from total assistance to complete independence, showing how much help a person needs.

Which source replaced the Dictionary of Occupational Titles as the Department of Labor's primary occupational information database?

1. Occupational Outlook Handbook
   The OOH is a BLS career guide with outlook and pay summaries, not a replacement database for the DOT.
2. O*NET
   O*NET replaced the DOT as the Department of Labor's main occupational database and is updated continually.
3. Occupational Requirements Survey
   The ORS is a BLS survey of job requirements developed in part for SSA disability decisions; it did not replace the DOT as DOL's main database.
4. Standard Occupational Classification
   The SOC is a coding system for classifying occupations, not a database of job characteristics.

In an ergonomic assessment of a warehouse job, the revised NIOSH lifting equation is used to calculate the:

1. maximum weight one worker can lift a single time
   The equation does not measure any one person's one-time maximum; it sets a limit most healthy workers can lift repeatedly for that task.
2. worker's measured strength from a grip test
   Grip strength comes from a dynamometer, often during an FCE; the NIOSH equation rates the task, not the worker's hand strength.
3. recommended weight limit for that task
   The revised NIOSH equation multiplies a load constant by factors such as horizontal distance, height, twisting, frequency, and grip to give a recommended weight limit for that specific lift.
4. exertional level listed for the job in the DOT
   DOT strength levels describe whole occupations in broad bands; the NIOSH equation analyzes one lifting task in the actual workplace.