Description
Ebersole and Hess Gerontological Nursing and Healthy Aging 1st Canadian Edition Touhy Test Bank
ISBN-13: 978-1926648231
ISBN-10: 1926648234
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Touhy: Ebersole and Hess’ Gerontological Nursing & Healthy Aging, 1st Canadian Edition
Test Bank
Chapter 13: Assessment Tools in Gerontological Nursing
MULTIPLE CHOICE
- Which of the following should the nurse include in the psychosocial assessment of an older patient?
| a. | Comorbid diseases |
| b. | Joint pain |
| c. | Genetics |
| d. | Family relationships |
ANS: D
| Feedback | |
| A | Incorrect. Comorbid diseases are part of a medical history. |
| B | Incorrect. Pain is an important influence on both the patient’s current well-being and the patient’s response to future stress. |
| C | Incorrect. Genetic factors provide important clues about an older adult’s medical risks. |
| D | Correct. Information about family relationships is important for the integration of the older person’s life: it provides important clues about sources of stress, support, food, companionship, and other issues. The Family APGAR assessment tool should be used. |
DIF: Comprehension REF: 218–219 OBJ: 4
TOP: CRNE: HW (Health & Wellness)
- Which type of assessment tool gives the most reliable results for an older adult?
| a. | Medical history |
| b. | Self-report |
| c. | Observational |
| d. | Report-by-proxy |
ANS: C
| Feedback | |
| A | Incorrect. The medical history provides information about the physical status of an older adult in the past, but can provide little information about past psychosocial, environmental, and other issues pertinent to the health and wellness of older adults. |
| B | Incorrect. A self-report tends to overestimate the person’s abilities and health. |
| C | Correct. An observational tool gives objective results based on the nurse’s observation and the older adult’s complaints as told to the nurse. The nurse uses information obtained from subsequent reassessment and compares the new data to the baseline data to identify trends and constants. |
| D | Incorrect. Report-by-proxy, used primarily when the person is cognitively impaired, tends to underestimate the person’s actual abilities. |
DIF: Comprehension REF: 210 OBJ: 1
TOP: CRNE: CH (Changes in Health)
- The FANCAPES model represents Fluids, Aeration, Nutrition, Communication, Activity, Pain, Elimination, and Socialization. When would this tool be used to assess an older adult?
| a. | To determine functional performance |
| b. | To determine mental status |
| c. | To determine physical assistance |
| d. | To determine caregiver burden |
ANS: A
| Feedback | |
| A | Correct. FANCAPES emphasizes the determination of basic needs and the individual’s functional ability to meet these needs independently. |
| B | Incorrect. Mental status assessment is determined with the Mini-Mental State Exam (MMSE). |
| C | Incorrect. Physical assistance is determined with the use of the Barthel Index. |
| D | Incorrect. Caregiver burden is determined by the Caregiver Strain Index. |
DIF: Knowledge | Application REF: 211 OBJ: 2
TOP: CRNE: CH (Changes in Health)
- Which tool is used to assess an older adult’s functional capability?
| a. | ADL |
| b. | MMSE |
| c. | OBRA |
| d. | FIM |
ANS: D
| Feedback | |
| A | Incorrect. Tools such as the Katz Index are used to measure the patient’s ability to perform activities of daily living (ADLs) and instrumental activities of daily living (IADLs). |
| B | Incorrect. The Mini-Mental State Exam (MMSE) is a tool for assessment of cognitive function. |
| C | Incorrect. The Omnibus Budget Reconciliation Act (OBRA) is the 1987 law that mandated nursing home reform in the United States. |
| D | Correct. The Functional Independence Measure (FIM) is the most comprehensive functional assessment tool for rehabilitation settings. |
DIF: Knowledge REF: 213 OBJ: 3
TOP: CRNE: CH (Changes in Health)
- Which question or command is a part of the Geriatric Depression Scale (GDS)?
| a. | “Do you have the coordination, balance, and strength to participate in day-to-day life?” |
| b. | “How often does your family provide support for you?” |
| c. | “Do you prefer to stay at home rather than go out and do things?” |
| d. | “Please repeat the three words I asked you to remember.” |
ANS: C
| Feedback | |
| A | Incorrect. This is part of the FANCAPES questionnaire under the Activity section. |
| B | Incorrect. This is part of the Family APGAR, which assesses a family’s capability for adaptation, partnership, growth, affection, and resolution. |
| C | Correct. A “yes” answer to this question, which is part of the Geriatric Depression Scale (GDS), contributes to an assessment of depression. |
| D | Incorrect. This is part of the Mini-Mental State Exam (MMSE). |
DIF: Comprehension REF: 218, Fig 13-1
OBJ: 3 TOP: CRNE: CH (Changes in Health)
- Which one of the following categories is not found in the Fulmer SPICES assessment tool?
| a. | Pain |
| b. | Confusion |
| c. | Falling |
| d. | Incontinence |
ANS: A
| Feedback | |
| A | Correct. Pain is not one of the SPICES categories; the P in SPICES stands for “problems with eating or feeding.” |
| B | Incorrect. Confusion is the C in SPICES. |
| C | Incorrect. Evidence of falling is the E in SPICES. |
| D | Incorrect. Incontinence is the I in SPICES. |
DIF: Knowledge REF: 221 OBJ: 3
TOP: CRNE: CH (Changes in Health)
- Which assessment tool is the most comprehensive exam of an older adult’s functional status?
| a. | Katz Index |
| b. | Fulmer SPICES |
| c. | The Functional APGAR Evaluation Tool |
| d. | The Older Americans Resources and Services (OARS) instrument |
ANS: D
| Feedback | |
| A | Incorrect. The Katz Index is a basic assessment tool that evaluates most measures of activities of daily living. |
| B | Incorrect. The Fulmer SPICES assessment tool is shorter than the OARS and less comprehensive. |
| C | Incorrect. The Functional APGAR Evaluation Tool does not exist. There is a Family APGAR tool, which addresses a family’s functional abilities. |
| D | Correct. The OARS tool evaluates an older adult’s ability, disability, and capacity in terms of social resources, economic resources, physical health, mental health, and ability to perform activities of daily living. |
DIF: Comprehension REF: 220 OBJ: 4
TOP: CRNE: CH (Changes in Health)
- Which of the following does the nurse do when preparing to perform a skilled and detailed assessment of an older adult that is not usually required when assessing a younger individual?
| a. | Provide for adequate privacy. |
| b. | Allow more time for assessing. |
| c. | Gather all needed supplies. |
| d. | Complete the evaluation in one sitting. |
ANS: B
| Feedback | |
| A | Incorrect. The nurse provides adequate privacy when assessing anyone. |
| B | Correct. To assess an older adult, the nurse allows for more time because there is more information to collect and the response time of an older adult can be longer than that of a younger individual. |
| C | Incorrect. The nurse gathers all supplies required during the assessment beforehand when assessing anyone. |
| D | Incorrect. The nurse prepares to complete the assessment in more than one sitting, if necessary, and with the help of a team, in many sittings. |
DIF: Comprehension REF: 209 OBJ: 5
TOP: CRNE: CH (Changes in Health)
- Why should a new nurse use a standardized assessment tool?
| a. | It allows for electronic data collection and analysis. |
| b. | It increases the likelihood of collecting the most accurate data. |
| c. | It is a substitute for possessing refined interviewing skills. |
| d. | It provides an automated means of choosing nursing diagnoses. |
ANS: B
| Feedback | |
| A | Incorrect. Standardized assessment tools are not necessarily electronic. |
| B | Correct. By learning how to use an assessment tool and following some basic rules, the new nurse can collect reasonably reliable assessment data without using advanced interviewing skills. |
| C | Incorrect. A standardized tool is only as good as the nurse administering the tool; as the nurse’s skill level for assessing an older adult increases, the data collected will increase in comprehensiveness and reliability. |
| D | Incorrect. After data collection, the new nurse must analyze the data to determine suitable nursing diagnoses; most assessment tools do not perform the analysis in place of the nurse’s judgement. |
DIF: Comprehension REF: 210 OBJ: 1
TOP: CRNE: CH (Changes in Health)
- The nurse assesses an older female adult in midmorning and, in a normal-toned voice, asks her, “Do you walk to the library to borrow books?” How should this nurse improve an assessment of an older adult?
| a. | Assess her earlier in the day. |
| b. | Get this data from the family. |
| c. | Use a soft voice for questions. |
| d. | Ask her how she obtains books. |
ANS: D
| Feedback | |
| A | Incorrect. Midmorning is a good time to interview older adults because they are likely to be more alert at this time and not as likely to be awaiting a meal. |
| B | Incorrect. Report-by-proxy data is not as reliable as data collected by the nurse’s observations because this type of report tends to underestimate the person’s abilities. |
| C | Incorrect. The nurse does not have to use a soft voice when asking questions about borrowing books because it is not a sensitive topic such as sexual practices or how someone obtains food. |
| D | Correct. While interviewing for an assessment, the nurse avoids directing the conversation or the older adult’s responses in any manner and thus uses open-ended questions as much as possible. |
DIF: Analysis REF: 210 OBJ: 4
TOP: CRNE: CH (Changes in Health)
- Which functional assessment tool asks about the mechanical and psychological factors affecting an older adult’s ability to maintain an adequate diet?
| a. | Katz Index |
| b. | FANCAPES |
| c. | Functional Independence Measure |
| d. | Older Americans Resources and Services |
ANS: B
| Feedback | |
| A | Incorrect. The Katz Index assigns a score to an older adult’s level of dependence in performing activities of daily living (ADLs). |
| B | Correct. FANCAPES is a prioritized and comprehensive functional assessment tool used to evaluate basic needs and the older adult’s ability to meet those needs; it asks pointed questions about fluids, aeration, nutrition, communication, activity, pain, elimination, and socialization. |
| C | Incorrect. The Functional Independence Measure is the most comprehensive assessment for the rehabilitation setting and includes the evaluation of ADLs, mobility, cognition, and social functioning. |
| D | Incorrect. The OARS tool examines an older adult’s ability, disability, and capacity to function in five categories. |
DIF: Comprehension REF: 211 OBJ: 4
TOP: CRNE: CH (Changes in Health)
- Which of the following is considered a functional activity needed for independent living (an instrumental activity of daily living, or IADL)?
| a. | Feeding |
| b. | Dressing |
| c. | Washing clothes |
| d. | Getting out of bed |
ANS: C
| Feedback | |
| A | Incorrect. Feeding is an activity of daily living, or ADL. |
| B | Incorrect. Dressing is an ADL. |
| C | Correct. Washing and hanging up clothes is an IADL, needed for independent living. |
| D | Incorrect. Getting out of bed is an ADL. |
DIF: Knowledge REF: 213 OBJ: 4
TOP: CRNE: HW (Health & Wellness)
- The nurse assesses an older male adult who has Alzheimer’s disease and his caregiver. Which information from the caregiver warrants further investigation by the nurse to assess the caregiver for strain?
| a. | The patient wants to stay home. |
| b. | The patient sleeps on two pillows. |
| c. | The patient sits in the chair all day. |
| d. | The patient does not like to be alone. |
ANS: D
| Feedback | |
| A | Incorrect. Wanting to stay home can be managed, as long as the older adult can be left alone safely or the caregiver has someone to stay with him. |
| B | Incorrect. Sleeping on two pillows can be a preference or a requirement for living with heart failure, but it should not create undue stress. |
| C | Incorrect. Sitting in a chair all day can be managed as long as he is willing to make trips to the bathroom, go to bed at night, and so on. |
| D | Correct. The nurse investigates the older adult’s preference for continuous company because providing companionship for another person can become a source of stress. After completing an assessment of caregiver strain, the nurse can offer suggestions and provide resources for relief for the caregiver. |
DIF: Application REF: 219 OBJ: 4
TOP: CRNE: HW (Health & Wellness)
