Chapter 32: Functional Assessment of
the Older Adult
Physical Examination and Health Assessment, 8th Edition by
Carolyn Jarvis
MULTIPLE CHOICE
1. The nurse is assessing an older adults functional ability. Which definition correctly
describes ones functiona ability? Functional ability:
a. Is the measure of the expected changes of aging that one is experiencing.
b. Refers to the individuals motivation to live independently.
c. Refers to the level of cognition present in an older person.
d. Refers to ones ability to perform activities necessary to live in modern society.
ANS: D
Functional ability refers to ones 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)
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 patients ability to perform the tasks.
b. Ask the patients wife how he does when performing tasks.
c. Review the medical record for information on the patientsabilities.
d. Ask the patients physician for information on the patients 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 persons actual abilities.
DIF: Cognitive Level: Applying (Application)
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
3. The nurse needs to assess a patients 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 QuestionnaireIADL (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)
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 persons 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)
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
5. The nurse is assessing an older adults 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)
the Older Adult
Physical Examination and Health Assessment, 8th Edition by
Carolyn Jarvis
MULTIPLE CHOICE
1. The nurse is assessing an older adults functional ability. Which definition correctly
describes ones functiona ability? Functional ability:
a. Is the measure of the expected changes of aging that one is experiencing.
b. Refers to the individuals motivation to live independently.
c. Refers to the level of cognition present in an older person.
d. Refers to ones ability to perform activities necessary to live in modern society.
ANS: D
Functional ability refers to ones 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)
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 patients ability to perform the tasks.
b. Ask the patients wife how he does when performing tasks.
c. Review the medical record for information on the patientsabilities.
d. Ask the patients physician for information on the patients 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 persons actual abilities.
DIF: Cognitive Level: Applying (Application)
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
3. The nurse needs to assess a patients 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 QuestionnaireIADL (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)
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 persons 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)
MSC: Client Needs: Safe and Effective Care Environment: Management of Care
5. The nurse is assessing an older adults 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)
