9115.03 (2024) - Orion Associates

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9115.03 (2024)

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Question 1 of 13

1. Question
Does this person need support with hearing or vision?
- Yes
- No
Correct

Incorrect
Question 2 of 13

2. Question
Does this person have a history of seizures?
- Yes
- No
Correct

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Question 3 of 13

3. Question
What kind of supports are needed while the person is eating?
- None– the person is independent
- Needs supervision/verbal prompts
- Needs food cut up in bite sized pieces
- Needs food ground up in a food processor
- Needs food pureed
Correct

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Question 4 of 13

4. Question
What allergies does the person have. (Select all that apply. If none, select no allergies)
- no allergies
- sulfas
- environmental
- aspirin
- bee sting
- penicillin
- milk
- eggs
- fish
- wheat
- cat
Correct

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Question 5 of 13

5. Question
Does this person ambulate independently?
- Yes
- No– the person needs at least some support while walking or in the wheelchair
Correct

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Question 6 of 13

6. Question
Does this person need physical assistance with toileting?
- Yes
- No
Correct

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Question 7 of 13

7. Question
Does this person need physical assistance with bathing?
- Yes
- No
Correct

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Question 8 of 13

8. Question
Does this person need physical assistance with brushing their teeth?
- Yes
- No
Correct

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Question 9 of 13

9. Question
Does the person have any risks in regards to sexual abuse? (Select all that apply)
- This person is NOT at risk of sexual abuse.
- Inability to be assertive.
- Lack of understanding or sexuality.
- Likely to seek or cooperate in an abusive situation.
- Displays sexual behavior
Correct

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Question 10 of 13

10. Question
Does the person have risks in regards to physical abuse? (select all that apply)
- The person is NOT at risk for physical abuse.
- Inability to deal with verbally/physically aggressive persons.
- Inability to identify potentially dangerous situations.
- “Victim” history exists.
- Verbally/physically abusive to others.
- Lack of community orientation skills.
- Inappropriate interactions with others.
Correct

Incorrect
Question 11 of 13

11. Question
Is this person susceptible to self-abuse? (Select all that apply)
- The person is NOT at risk of self-abuse.
- Eats non-edible substances.
- Unsafe conduct in a vehicle.
- Dresses inappropriately
- Elopement
- Refuses to eat.
- Chooses not to take medications.
- Lack of self-preservation skills (ignores personal safety).
- Inability to care for self-help needs.
- Engages in self-injurious behaviors.
- Alcohol, tobacco, drug use.
Correct

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Question 12 of 13

12. Question
Is this person at risk of financial exploitation?
- Yes
- No
Correct

Incorrect
Question 13 of 13

13. Question
Does this person have a history of inaccurate reporting?
- Yes
- No
Correct

Incorrect

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Orion Associates

820 Lilac Drive N.

Golden Valley, MN 55422

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