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Worksheets

Rancho Los Amigos Levels

Total questions: 10

Worksheet time: 5mins

Name
Class
Date
1.

The individual is in a heightened state of activity with severely decreased ability to process information. "Confused Agitated"

a)

Level II

b)

Level VI

c)

Level IV

d)

Level V

2.

The individual appears to be in a deep sleep and is unresponsive to stimuli. "No response"

a)

Level I

b)

Level II

c)

Level III

d)

Level IV

3.

The individual is alert and oriented, able to recall and integrate present and past events. Decreased reasoning/judgement ability. "Purposeful and appropriate"

a)

Level III

b)

Level VII

c)

Level VIII

d)

Level IX

4.

Clt appears A&O but is robot-like in performance. "Automatic appropriate"

a)

Level V

b)

Level VI

c)

Level VII

d)

Level VIII

5.

Clt shows goal-directed behavior but is dependent on external input for direction. "Confused appropriate"

a)

Level III

b)

Level II

c)

Level IV

d)

Level VI

6.

Clt is "Purposeful appropriate. Standby assistance provided on request"

a)

Level IX

b)

Level X

c)

Level VIII

d)

Level VII

7.

Clt reacts inconsistently and nonpurposefully to stimuli. "Generalized response"

a)

Level I

b)

Level II

c)

Level III

d)

Level IV

8.

Clt is "Purposeful appropriate: modified independent"

a)

Level X

b)

Level IX

c)

Level VIII

d)

Level VII

9.

Clt reacts specifically but inconsistently to stimuli. "Localized response"

a)

Level I

b)

Level II

c)

Level III

d)

Level IV

10.

Clt appears alert and responds to simple commands fairly consistently. Responses may be non-purposeful or random with increased complexity. "Confused, appropriate, non-agitated"

a)

Level III

b)

Level IV

c)

Level V

d)

Level VI