Deck 30: Functional Assessment of the Older Adult

Question 1

Which definition correctly describes one's functional ability?
1)Functional ability is the measure of the expected changes of aging that one is experiencing.
2)Functional ability refers to the individual's motivation to live independently.
3)Functional ability refers to the level of cognition present in an older person.
4)Functional ability refers to one's ability to perform activities necessary to live in modern society.

Answer 1

4
Functional ability refers to one's ability to perform activities necessary to live in modern society and can include driving,using the telephone,or performing personal tasks such as bathing and toileting.

Question 2

During a morning assessment,the nurse notices that an older patient is less attentive and is unable to recall yesterday's events.The nurse administers the Mini Mental State Examination,which will screen for:
1)dementia.
2)depression.
3)delirium.
4)psychosis.

Answer 2

3
For nurses in various settings,cognitive assessments provide continuing comparisons to the individual's baseline to detect any acute changes,such as with delirium.Altered cognition in older adults is commonly attributed to three disorders: dementia,delirium,or depression.Delirium presents as an acute change in cognition,affecting the domain of attention.

Question 3

Which statement about the Lawton IADL instrument is true?
1)The nurse uses direct observation to implement this tool.
2)It is designed as a self-report measure of performance rather than ability.
3)It is not useful in the acute hospital setting.
4)It is best used for those residing in an institutional setting.

Answer 3

2
The Lawton IADL instrument is designed as a self-report measure of performance rather than ability.Direct testing is often not feasible,such as demonstrating the ability to prepare food while a hospital inpatient.Attention to the final score is less important than identifying a person's strengths and areas where assistance is needed.The instrument is useful in acute hospital settings for discharge planning and continuously in outpatient settings.It would not be useful for those residing in institutional settings because many of these tasks are already being managed for the resident.

Question 4

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 go outside alone safely.The nurse will perform which test to assess this?
1)The Up and Go Test
2)The Performance Activities of Daily Living
3)The Physical Performance Test
4)Tinetti Gait and Balance Evaluation

Question 5

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:
1)depression.
2)weight gain.
3)hypertension.
4)social phobias.

Question 6

The nurse is assessing the abilities of an older adult.Which of the following activities are considered instrumental activities of daily living? Select all that apply.
1)Feeding oneself
2)Preparing a meal
3)Balancing a checkbook
4)Walking
5)Toileting
6)Grocery shopping

Question 7

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

Question 8

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?
1)Pain is inevitable with aging.
2)Older adults with cognitive impairment feel less pain.
3)Alleviating pain should be a priority over other aspects of the assessment.
4)The assessment should take priority so that care decisions can be made.

Question 9

The nurse needs to assess a patient's ability to perform activities of daily living and will choose which tool for this assessment?
1)Direct Assessment of Functional Abilities (DAFA)
2)Lawton and Brody IADL
3)Barthel Index
4)Older Americans Resources and Services Multidimensional Functional Assessment Questionnaire-IADL (OARS-IADL)

Question 10

The nurse is preparing to perform a functional assessment of an older patient and knows that a good approach would be to:
1)observe the patient's ability to perform the tasks.
2)ask the patient's wife how he does when performing tasks.
3)review the medical record for information on the patient's abilities.
4)ask the patient's physician for information on the patient's abilities.

Question 11

When beginning to assess a person's spirituality,which question by the nurse would be most appropriate?
1)"Do you believe in God?"
2)"Do you consider yourself to be a spiritual person?"
3)"What religious faith do you follow?"
4)"Do you believe in the power of prayer?"

Question 12

During an assessment of a newly admitted 92-year-old woman,the nurse notes that her son does not want to leave the room.In addition,the woman has signs of old bruises and healed cuts that happened "last week," according to the son.Which action by the nurse is appropriate?
1)Ask the son for details about the nature of the patient's injuries.
2)Recognize that older people are often unsteady on their feet and that falls do occur.
3)Notify the authorities of a potential abusive situation.
4)Recognize that these findings do not necessarily indicate that abuse has occurred but are signs that further assessment is needed.

Question 13

The nurse is assessing an older adult's advanced activities of daily living,which would include:
1)recreational activities.
2)meal preparation.
3)balancing the checkbook.
4)self-grooming activities.

Question 14

When using the various instruments to assess an older person's activities of daily living,the nurse needs to remember that a disadvantage of these instruments includes:
1)the reliability of the tools.
2)self or proxy report of functional activities.
3)lack of confidentiality during the assessment.
4)insufficient detail about the deficiencies identified.