Question 1

When comparing the Older American's Resources and Services (OARS)with the Katz index of ADLs,what is true?&#10;A) The Katz index and the OARS both measure only ADL performance.&#10;B) The OARS is a comprehensive assessment tool that measures ability in five areas; the Katz index measures only ADL performance.&#10;C) The OARS is used only for older adults in the long-term care setting; the Katz index is used in all settings.&#10;D) The OARS is not valid for use in older adults who are cognitively impaired,whereas the Katz index is.

Accepted Answer

The OARS evaluates ability,disability,and capacity at which the person is able to function.Five dimensions are assessed: social resources,economic resources,physical health,mental health,and ADLs.The Katz index only evaluates ADL ability.Both instruments are used in a variety of care settings and are valid for use with cognitively impaired older adults.

Question 2

A 78-year-old man is being evaluated in the geriatric clinic.His daughter reports that he has been very forgetful lately,and she is concerned that he might be "senile." The advanced practice nurse administers the clock drawing test and the patient draws a distorted circular shape and places the numbers all on one side of the shape.Based on his performance,the nurse concludes that the patient:

A) probably has Alzheimer's disease.
B) needs further evaluation.
C) probably has delirium.
D) needs a functional status assessment.

needs further evaluation.

Accepted Answer

Errors on the clock drawing test,such as grossly distorted contour,are rarely produced by cognitively intact persons.A low score on the clock drawing test requires further evaluation.Alzheimer's disease is not a diagnosis using a mental status assessment tool.It is definitively diagnosed with a brain biopsy.The clock drawing test does not assess for delirium.A low score on the clock drawing test does not necessarily warrant a functional status assessment.

Question 3

The FANCAPES assessment tool:&#10;A) appraises the older adult's ability to meet his or her needs and the amount of assistance needed.&#10;B) evaluates the older adult's ability to perform instrumental activities of daily living (IADLs).&#10;C) assesses the older adult's cognitive abilities.&#10;D) assesses the level of dementia present.

Accepted Answer

The FANCAPES assessment tool focuses on physical functioning and evaluates the individual's ability to meet his or her needs and how much assistance is needed to meet the needs.FANCAPES evaluates physical functioning.IADLs involve more than just physical functioning.FANCAPES does not assess cognitive function nor does it assess dementia.

Question 4

A limitation of the Katz index of activities of daily living (ADLs)is that:&#10;A) completion of the tool requires the joint efforts of the interdisciplinary team.&#10;B) all ADLs are weighted equally,and the cutoff score is arbitrarily determined.&#10;C) it puts a heavier weight on the cognitive abilities necessary to perform ADLs.&#10;D) it is completed as a self-report by the patient.

Accepted Answer

The Katz index assigns an equal weight to all of the ADLs.The determination of a cutoff score is completely arbitrary.It is commonly accepted that a score of 4 indicates moderate impairment and a score of 2 or less indicates severe impairment.Any health care professional can complete the Katz index,although input from the interdisciplinary team is valuable.The Katz index does not address the cognitive abilities necessary to perform ADLs.It is not a self-report instrument; it is completed by the health care professional.

Question 5

An 88-year-old woman with a new diagnosis of Alzheimer's disease is being cared for by her daughter,who is eager to honor her mother's wishes to be cared for at home and not be placed in a nursing home.The visiting nurse makes her initial home visit and administers the Family APGAR in order to assess the:

A) caregiver's perception of emotional and social support with a new diagnosis of Alzheimer's disease.
B) patient.
C) environmental changes needed to enhance function.
D) degree of physical assistance that the patient and caregiver need.

Accepted Answer

The Family APGAR evaluates family functioning on five levels: adaptation,partnership,growth,affection,and resolution.It is valuable in assessing the caregiver's perception of emotional and social support with a new diagnosis of Alzheimer's disease.It does not assess spiritual needs,environmental issues,or physical assistance needs.

Question 6

You are a nurse on a medical unit in a large academic medical center and you care primarily for older adults.Your unit manager introduced the Fulmer SPICES assessment tool to the unit.This tool assesses all except:

A) sleep.
B) incontinence.
C) falls.
D) social support.

Accepted Answer

The Fulmer SPICES assess six syndromes that are common to older adults and require nursing intervention.The syndromes are sleep disorders,problems with eating or feeding,incontinence,confusion,evidence of falls,and skin breakdown.Social support is not assessed with this tool.

Question 7

What is true about instruments to assess for depression in older adults?&#10;A) Older adults tend to score inaccurately low (indicating less depression)than younger adults on the Zung Self-Rating Depression Scale.&#10;B) The Geriatric Depression Scale cannot be used in older adults with dementia or cognitive impairment.&#10;C) The Beck Depression Inventory is designed for gerontological patients.&#10;D) The Geriatric Depression Scale is administered by a health care provider in an interview with the older adult.

Accepted Answer

The Geriatric Depression Scale cannot be used in individuals with dementia or cognitive impairment.Older adults tend to score inaccurately high (indicating more depression)than younger adults because of the number of physical complaints that are associated with aging and because of the number of frequently used medications rather than because of true depression.The Beck Depression Inventory was not designed specifically for used with gerontological patients.The Geriatric Depression Scale is administered as a self-report by the older adult.

Deck 6: Health Assessment in Gerontological Nursing