NSG 4067: ASSESSMENT OF HEALTH AND FUNCTIONING
1. A nurse is responsible for assessing an older adult in an acute care setting. Which of the
following statements most accurately captures the complexity involved in assessing the older
adult?
A) Older adults manifest fewer symptoms of illness than do younger clients.
B) Signs and symptoms of illness are often obscure and less predictable among older adults.
C) Care must be taken to avoid assessing normal, age-related changes.
D) Older adults experience fewer acute health problems but more chronic illnesses than do
younger clients.
Ans: B
Feedback:
The manifestations of illness in older adults can be less clear and less predictable than among
younger clients. Older adults often show different, but not necessarily fewer, symptoms than do
younger clients. Age-related changes must be recognized and acknowledged, not excluded from
the assessment process. Older adults do not experience fewer acute health problems than do
younger adults but rather different manifestations of health problems.
2. An 82-year-old client is getting advice from a family member on how to drive safely. What
piece of advice should the older adult follow?
A) "Avoid modifying your vehicle with devices that were not supplied by the manufacturer."
B) "Realize that normal, age-related changes should not affect your ability to drive safely."
C) "You can consider timing your medications to avoid their interfering with safe driving."
D) "You should transition from driving to using public transportation as soon as possible."
Ans: C
Feedback:
Older adults can be taught how to safely time their medications to avoid effects such as
drowsiness that can affect driving safely. Modification of vehicles with assistive devices can be a
useful tool in promoting safe driving. Age-related changes such as decreased visual acuity are
significant factors in driving safely. With compensation and education, many older adults can
safely drive and do not necessarily need to give up their licenses early.
3. A nurse conducts a functional assessment of a client who has moved to the assisted living
facility. Which of the following statements best describes this functional assessment?
A) Information on the client's medical diagnoses and health problems.
B) Client's ability to perform self-care tasks with a focus on rehabilitation.
C) Assessment of the client's activities of daily living (ADLs).
, D) Prioritization of the client's ability to perform roles in relationships and in society.
Ans: B
Feedback:
Functional assessment is a way of determining an individual's ability to fulfill responsibilities
and perform self-care. While it is distinct from a medical diagnosis approach, it does not
discount or ignore information on an older adult's diagnoses and health problems. It includes data
on ADLs and is not a counterpoint to ADL assessment. The focus is on the fulfillment of
responsibilities and self-care more than on performing social and relationship roles.
4. As part of a functional assessment, a nurse is assessing an older adult's ADLs and instrumental
activities of daily living (IADLs). What piece of assessment data would most likely be
considered an IADL rather than an ADL?
A) The older adult is able to ambulate to and from the bathroom at home.
B) The older adult can feed herself independently.
C) The older adult can dress in the morning without assistance.
D) The older adult is able to clean and maintain her own apartment.
Ans: D
Feedback:
IADLs refer to tasks higher in complexity than basic ADLs. IADLs include housekeeping and
shopping. Toileting, feeding, and dressing are all considered basic ADLs.
5. A nurse in a Medicare- and Medicaid-funded nursing home performs assessments and
develops care plans. Which of these statements is true of the functional assessments the nurse is
likely to perform?
A) The nurse will address core ADLs but not more complex IADLs.
B) The nurse will identify changes in the older adult's function over time.
C) The nurse will utilize various functional assessment models.
D) The main goal of functional assessments will be to ensure older adult safety.
Ans: B
Feedback:
Functional assessments consider an older adult's functional status and changes in this status over
time. They include both core ADLs and more complex IADLs. The nurse is likely to use the
Minimum Data Set for Resident Assessment and Care Screening, as mandated for Medicare- and
Medicaid-funded facilities. While safety is a consideration in functional assessment, the main
goal is determining the older adult's need for assistance and for planning care.
1. A nurse is responsible for assessing an older adult in an acute care setting. Which of the
following statements most accurately captures the complexity involved in assessing the older
adult?
A) Older adults manifest fewer symptoms of illness than do younger clients.
B) Signs and symptoms of illness are often obscure and less predictable among older adults.
C) Care must be taken to avoid assessing normal, age-related changes.
D) Older adults experience fewer acute health problems but more chronic illnesses than do
younger clients.
Ans: B
Feedback:
The manifestations of illness in older adults can be less clear and less predictable than among
younger clients. Older adults often show different, but not necessarily fewer, symptoms than do
younger clients. Age-related changes must be recognized and acknowledged, not excluded from
the assessment process. Older adults do not experience fewer acute health problems than do
younger adults but rather different manifestations of health problems.
2. An 82-year-old client is getting advice from a family member on how to drive safely. What
piece of advice should the older adult follow?
A) "Avoid modifying your vehicle with devices that were not supplied by the manufacturer."
B) "Realize that normal, age-related changes should not affect your ability to drive safely."
C) "You can consider timing your medications to avoid their interfering with safe driving."
D) "You should transition from driving to using public transportation as soon as possible."
Ans: C
Feedback:
Older adults can be taught how to safely time their medications to avoid effects such as
drowsiness that can affect driving safely. Modification of vehicles with assistive devices can be a
useful tool in promoting safe driving. Age-related changes such as decreased visual acuity are
significant factors in driving safely. With compensation and education, many older adults can
safely drive and do not necessarily need to give up their licenses early.
3. A nurse conducts a functional assessment of a client who has moved to the assisted living
facility. Which of the following statements best describes this functional assessment?
A) Information on the client's medical diagnoses and health problems.
B) Client's ability to perform self-care tasks with a focus on rehabilitation.
C) Assessment of the client's activities of daily living (ADLs).
, D) Prioritization of the client's ability to perform roles in relationships and in society.
Ans: B
Feedback:
Functional assessment is a way of determining an individual's ability to fulfill responsibilities
and perform self-care. While it is distinct from a medical diagnosis approach, it does not
discount or ignore information on an older adult's diagnoses and health problems. It includes data
on ADLs and is not a counterpoint to ADL assessment. The focus is on the fulfillment of
responsibilities and self-care more than on performing social and relationship roles.
4. As part of a functional assessment, a nurse is assessing an older adult's ADLs and instrumental
activities of daily living (IADLs). What piece of assessment data would most likely be
considered an IADL rather than an ADL?
A) The older adult is able to ambulate to and from the bathroom at home.
B) The older adult can feed herself independently.
C) The older adult can dress in the morning without assistance.
D) The older adult is able to clean and maintain her own apartment.
Ans: D
Feedback:
IADLs refer to tasks higher in complexity than basic ADLs. IADLs include housekeeping and
shopping. Toileting, feeding, and dressing are all considered basic ADLs.
5. A nurse in a Medicare- and Medicaid-funded nursing home performs assessments and
develops care plans. Which of these statements is true of the functional assessments the nurse is
likely to perform?
A) The nurse will address core ADLs but not more complex IADLs.
B) The nurse will identify changes in the older adult's function over time.
C) The nurse will utilize various functional assessment models.
D) The main goal of functional assessments will be to ensure older adult safety.
Ans: B
Feedback:
Functional assessments consider an older adult's functional status and changes in this status over
time. They include both core ADLs and more complex IADLs. The nurse is likely to use the
Minimum Data Set for Resident Assessment and Care Screening, as mandated for Medicare- and
Medicaid-funded facilities. While safety is a consideration in functional assessment, the main
goal is determining the older adult's need for assistance and for planning care.
