Chapter 31: Functional Assessment of the Older Adult

Chapter 31: Functional Assessment of the Older Adult

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. 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.

 

 

ANS:  D

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.

 

DIF:    Cognitive Level: Understanding (Comprehension)             REF:   p. 832

MSC:  Client Needs: Health Promotion and Maintenance

 

2. 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.

 

 

ANS:  A

Two approaches are used to perform a functional assessment: (1) asking individuals about their ability to perform the tasks (self-reports), or (2) actually observing their ability to perform the tasks. For persons with memory problems, the use of surrogate reporters (proxy reports), such as family members or caregivers, may be necessary, keeping in mind that they may either overestimate or underestimate the person’s actual abilities.

 

DIF:    Cognitive Level: Applying (Application)                           REF:   p. 832

MSC:  Client Needs: Safe and Effective Care Environment: Management of Care

 

3. 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)

 

 

ANS:  C

The Barthel Index is used to assess ADLs. The other options are used to measure IADLs.

 

DIF:    Cognitive Level: Understanding (Comprehension)             REF:   p. 832

MSC:  Client Needs: Health Promotion and Maintenance

 

4. 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.

 

 

ANS:  B

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.

 

DIF:    Cognitive Level: Applying (Application)                           REF:   pp. 833-834

MSC:  Client Needs: Safe and Effective Care Environment: Management of Care

 

5. 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.

 

 

ANS:  A

AADLs are activities that an older adult performs such as occupational and recreational activities. Self-grooming activities are basic ADLs; meal preparation and balancing the checkbook are considered IADLs.

 

DIF:    Cognitive Level: Applying (Application)                           REF:   p. 835

MSC:  Client Needs: Health Promotion and Maintenance