Chapter 31: Functional Assessment of the Older Adult

A patient requests to be discharged to home instead of a rehabilitation hospital after a hip fracture. Which of the following is true about the difference between home care and hospital care? a) Home care is more expensive than hospitalization b) Patients have less risk for infection in the home setting c) Patients have been shown to recover more slowly at home than in the hospital d) Physical therapy is available only in the hospital setting

B

Altered cognition in older adults is commonly attributed to: a) An infection or injury b) Dementia, delirium, or depression c) The normal aging process d) Medication side effects

B

An older patient has been admitted to the intensive care unit (ICU) after falling at home. Within 8 hours, his condition has stabilized and he is transferred to a medical unit. The family is wondering whether he will be able to go back home. Which assessment instrument is most appropriate for the nurse to choose at this time? a. Lawton IADL instrument b. Hospital Admission Risk Profile (HARP) c. Mini-Cog d. NEECHAM Confusion Scale

B

The Get Up and Go Test would be used to: a) Determine a patient's ability to get dressed without assistance b) Asses functional activity of the patient along with safety determination c) Assess swallowing status of the patient d) Assess adults with dementia

B

The Katz Index of Independence in ADL would measure the functional ability to: a) Clean the house and take out the garbage b) Wash the face and hand and comb hair c) Pay the electric and telephone bill d) Do laundry and put clothes away

B

The nurse is preparing to use the Lawton IADL instrument as part of an assessment. Which statement about the Lawton IADL instrument is true? a. The nurse uses direct observation to implement this tool. b. The Lawton IADL instrument is designed as a self-report measure of performance rather than ability. c. This instrument is not useful in the acute hospital setting. d. This tool is best used for those residing in an institutional setting.

B

During a morning assessment, the nurse notices that an older patient is less attentive and is unable to recall yesterday's events. Which test is appropriate for assessing the patient's mental status? a. Geriatric Depression Scale, short form b. Rapid Disability Rating Scale-2 c. Mini-Cog d. Get Up and Go

C

It is dangerous for a cognitive change to be attributed to the normal aging process because: a) Cognitive change is not associated with aging b) Nurses are not trained properly to make these types of judgements c) This may delay the diagnosis of an underlying disease process d) The client could be saying confusing comments to avoid detection of addictions.

C

Signs or caregiver burnout include: a) Going to church every week b) Weight gain c) Headaches and epigastric pain d) Using an adult daycare facility

C

The nurse needs to assess a patient's ability to perform activities of daily living (ADLs) and should choose which tool for this assessment? a. Direct Assessment of Functional Abilities (DAFA) b. Lawton Instrumental Activities of Daily Living (IADL) scale c. Barthel Index d. Older Americans Resources and Services Multidimensional Functional Assessment Questionnaire-IADL (OMFAQ-IADL)

C

When completing a health assessment of an older adult with mobility problems, the sequence should: a) Begin with the physical examination followed by the health hx. b) Be from head to toe to prevent missing any important assessments c) Be arranged to minimize the number of position changes for the patient and the examiner d) Start with the most invasive assessments

C

The nurse is assessing an older adult's advanced activities of daily living (AADLs), which would include: a. Recreational activities. b. Meal preparation. c. Balancing the checkbook. d. Self-grooming activities.

A

A patient will be ready to be discharged from the hospital soon, and the patient's family members are concerned about whether the patient is able to walk safely outside alone. The nurse will perform which test to assess this? a. Get Up and Go Test b. Performance ADLs c. Physical Performance Test d. Tinetti Gait and Balance Evaluation

A

An 85-year-old man has been hospitalized after a fall at home, and his 86-year-old wife is at his bedside. She tells the nurse that she is his primary caregiver. The nurse should assess the caregiver for signs of possible caregiver burnout, such as: a. Depression. b. Weight gain. c. Hypertension. d. Social phobias.

A

An older adult with new-onset delirium usually has: a) A short attention-span b) Trouble naming common object c) Out bursts of violent behavior d) Vertigo

A

Prevention and treatment of ___________ may be one of the most effective interventions aimed at reducing functional decline in an older adult. a) Visual disturbances b) Muscle weakness c) Depression d) Bladder and bowel incontinence

A

The nurse is preparing to perform a functional assessment of an older patient and knows that a good approach would be to: a. Observe the patient's ability to perform the tasks. b. Ask the patient's wife how he does when performing tasks. c. Review the medical record for information on the patient's abilities. d. Ask the patient's physician for information on the patient's abilities.

A

The nurse is assessing the abilities of an older adult. Which activities are considered IADLs? Select all that apply. a. Feeding oneself b. Preparing a meal c. Balancing a checkbook d. Walking e. Toileting f. Grocery shopping

B,C,F

During a functional assessment of an older person's home environment, which statement or question by the nurse is most appropriate regarding common environmental hazards? a. "These low toilet seats are safe because they are nearer to the ground in case of falls." b. "Do you have a relative or friend who can help to install grab bars in your shower?" c. "These small rugs are ideal for preventing you from slipping on the hard floor." d. "It would be safer to keep the lighting low in this room to avoid glare in your eyes."

B

When beginning to assess a person's spirituality, which question by the nurse would be most appropriate? a. "Do you believe in God?" b. "How does your spirituality relate to your health care decisions?" c. "What religious faith do you follow?" d. "Do you believe in the power of prayer?"

B

When using the various instruments to assess an older person's ADLs, the nurse needs to remember that a disadvantage of these instruments includes: a. Reliability of the tools. b. Self or proxy reporting of functional activities. c. Lack of confidentiality during the assessment. d. Insufficient details concerning the deficiencies identified.

B

The nurse is preparing to assess an older adult and discovers that the older adult is in severe pain. Which statement about pain and the older adult is true? a. Pain is inevitable with aging. b. Older adults with cognitive impairments feel less pain. c. Alleviating pain should be a priority over other aspects of the assessment. d. The assessment should take priority so that care decisions can be made.

C

The nurse is assessing an older adult's functional ability. Which definition correctly describes one's functional ability? Functional ability: a. Is the measure of the expected changes of aging that one is experiencing. b. Refers to the individual's motivation to live independently. c. Refers to the level of cognition present in an older person. d. Refers to one's ability to perform activities necessary to live in modern society.

D

The nurse is assessing the forms of support an older patient has before she is discharged. Which of these examples is an informal source of support? a. Local senior center b. Patient's Medicare check c. Meals on Wheels meal delivery service d. Patient's neighbor, who visits with her daily

D

Which of the following would be an indication that an older adult should stop driving a vehicle? a) Taking insulin to control type 2 diabetes mellitus b) Difficulty walking and getting in and out of the vehicle c) A pacemaker placed 2 months ago for a complete heart block d) Difficulty checking over the shoulder when backing up or changing lanes

D

Which of the following would be included in an assessment of a patient's ability to perform instrumental activities of daily living? a) Balance, gait, and moto coordination b) Dressing, toileting, and using stairs c) Eating, bathing, and grooming d) Taking medication, shopping, and meal prep

D