G7 - Quiz & Trivia

1. A 78-year-old man is being evaluated in the geriatric clinic. His daughter reports that he has been very forgetful lately, and she is concerned that he might be "senile." The advanced practice nurse administers the clock drawing test and the patient draws a distorted circular shape and places the numbers all on one side of the shape. Based on his performance, the nurse concludes that the patient:

A. probably has Alzheimer’s disease

B. needs further evaluation

C. probably has delirium

D. needs a functional status assessment

ANS: B
Errors on the clock drawing test, such as grossly distorted contour, are rarely produced by cognitively intact persons. A low score on the clock drawing test requires further evaluation. Alzheimer’s disease is not a diagnosis using a mental status assessment tool. It is definitively diagnosed with a brain biopsy. The clock drawing test does not assess for delirium. A low score on the clock drawing test does not necessarily warrant a functional status assessment

Explanation

ANS: B
Errors on the clock drawing test, such as grossly distorted contour, are rarely produced by cognitively intact persons. A low score on the clock drawing test requires further evaluation. Alzheimer’s disease is not a diagnosis using a mental status assessment tool. It is definitively diagnosed with a brain biopsy. The clock drawing test does not assess for delirium. A low score on the clock drawing test does not necessarily warrant a functional status assessment

2.

The FANCAPES assessment tool focuses on the older adult's:

A. ability to meet personal needs to identify the amount of assistance needed

B. ability to perform instrumental activities of daily living (IADLs)

C. cognitive abilities

D. level of dementia present

ANS: A
The FANCAPES assessment tool focuses on physical functioning and evaluates the individual’s ability to meet his or her needs and how much assistance is needed to meet the needs. FANCAPES evaluates physical functioning. IADLs involve more than just physical functioning. FANCAPES does not assess cognitive function, nor does it assess dementia.

Explanation

ANS: A
The FANCAPES assessment tool focuses on physical functioning and evaluates the individual’s ability to meet his or her needs and how much assistance is needed to meet the needs. FANCAPES evaluates physical functioning. IADLs involve more than just physical functioning. FANCAPES does not assess cognitive function, nor does it assess dementia.

3. When comparing the Older American's Resources and Services (OARS) with the Katz index of ADLs, what is true?

A. the Katz index and the OARS both measure only ADL performance

B. the OARS is a comprehensive assessment tool that measures ability in five areas; the Katz index measures only ADL performance

D. the OARS is not valid for use in older adults who are cognitively impaired, whereas the Katz index is

ANS: B
The OARS evaluates ability, disability, and capacity at which the person is able to function. Five dimensions are assessed: social resources, economic resources, physical health, mental health, and ADLs. The Katz index only evaluates ADL ability. Both instruments are used in a variety of care settings and are valid for use with cognitively impaired older adults.

Explanation

ANS: B
The OARS evaluates ability, disability, and capacity at which the person is able to function. Five dimensions are assessed: social resources, economic resources, physical health, mental health, and ADLs. The Katz index only evaluates ADL ability. Both instruments are used in a variety of care settings and are valid for use with cognitively impaired older adults.

4. A limitation of the Katz index of activities of daily living (ADLs) is that:

A. completion of the tool requires the joint efforts of the interdisciplinary team

B. all ADLs are weighted equally, and the cutoff score is arbitrarily determined

C. it puts a heavier weight on the cognitive abilities necessary to perform ADLs

D. it is completed as a self-report by the patient

ANS: B
The Katz index assigns an equal weight to all of the ADLs. The determination of a cutoff score is completely arbitrary. It is commonly accepted that a score of 4 indicates moderate impairment and a score of 2 or less indicates severe impairment. Any health care professional can complete the Katz index, although input from the interdisciplinary team is valuable. The Katz index does not address the cognitive abilities necessary to perform ADLs. It is not a self-report instrument; it is completed by the health care professional.

Explanation

ANS: B
The Katz index assigns an equal weight to all of the ADLs. The determination of a cutoff score is completely arbitrary. It is commonly accepted that a score of 4 indicates moderate impairment and a score of 2 or less indicates severe impairment. Any health care professional can complete the Katz index, although input from the interdisciplinary team is valuable. The Katz index does not address the cognitive abilities necessary to perform ADLs. It is not a self-report instrument; it is completed by the health care professional.

5. When using the Fulmer SPICES assessment tool the nurse expects to ask:

A. “Do you think that you sleep well?”

B. “Are you ever incontinent of urine?”

C. “When was the last time you fell?”

D. “Who helps you when you can’t do something by yourself?”

ANS: D
The Fulmer SPICES assess six syndromes that are common to older adults and require nursing intervention. The syndromes are sleep disorders, problems with eating or feeding, incontinence, confusion, evidence of falls, and skin breakdown. Social support is not assessed with this tool.

Explanation

ANS: D
The Fulmer SPICES assess six syndromes that are common to older adults and require nursing intervention. The syndromes are sleep disorders, problems with eating or feeding, incontinence, confusion, evidence of falls, and skin breakdown. Social support is not assessed with this tool.

6. An 88-year-old, being admitted to rule out lung cancer, is assessed using the short form of the Geriatric Depression Scale tool. When it is determines that the earned score is 9, the nurse initially:

A. asks if they have any thoughts of committing suicide

B. recognizes that this score is not indicative of depression

C. knows it is not unusual for clients this age to earn such a score

D. notifies the client’s healthcare provider immediately

ANS: A
The shortened version of this assessment tool does not specifically address the presence of suicidal ideations. With a score of 9, which generally indicates depression, this limitation of the tool must be addressed with a specific question. It is not to be considered usual for an older to score such a high score. The heath care provider needs to be made aware of the results of the assessment but the focused question regarding suicide should be asked first.

Explanation

ANS: A
The shortened version of this assessment tool does not specifically address the presence of suicidal ideations. With a score of 9, which generally indicates depression, this limitation of the tool must be addressed with a specific question. It is not to be considered usual for an older to score such a high score. The heath care provider needs to be made aware of the results of the assessment but the focused question regarding suicide should be asked first.

7. What is true about instruments to assess for depression in older adults?

A. Older adults tend to score inaccurately low (indicating less depression) than younger adults on the Zung Self-Rating Depression Scale.

B. The shortened Geriatric Depression Scale does not contain a question to evaluate suicide potential.

C. The Beck Depression Inventory is designed for gerontological patients.

D. The Geriatric Depression Scale is administered by a health care provider in an interview with the older adult.

ANS: B
The 15 and 5 item Geriatric Depression Scales do not include an assessment item focused on the suicidal intent or thoughts. Older adults tend to score inaccurately high (indicating more depression) than younger adults because of the number of physical complaints that are associated with aging and because of the number of frequently used medications rather than because of true depression. The Beck Depression Inventory was not designed specifically for use with gerontological patients. The Geriatric Depression Scale is administered as a self-report by the older adult.

Explanation

ANS: B
The 15 and 5 item Geriatric Depression Scales do not include an assessment item focused on the suicidal intent or thoughts. Older adults tend to score inaccurately high (indicating more depression) than younger adults because of the number of physical complaints that are associated with aging and because of the number of frequently used medications rather than because of true depression. The Beck Depression Inventory was not designed specifically for use with gerontological patients. The Geriatric Depression Scale is administered as a self-report by the older adult.

8. A nurse shows an understanding of the appropriate administration of a Mini-Cog assessment tool when: Select all that apply.

A. Informing the client that, “I’m going to say three (3) words; cat, coffee, and smile.”

B. Asking the client, “Do you have trouble remembering names and addresses?”

C. Asking the client, “Can you repeat the words we talked about a little while ago?”

D. Explaining to the client that, “I’d like you to draw a clock for me on this paper.”

E. Asking the client to, “Tell me what time this clock is showing.”

ANS: A, C, D
The Mini-Cog assessment tool requires that the client be introduced to three unrelated words and then immediately asked to repeat them; draw a clock; again repeat the original 3 words. Questions concerning memory loss or the ability to recognize time on a clock are not a part of this assessment process.

Explanation

ANS: A, C, D
The Mini-Cog assessment tool requires that the client be introduced to three unrelated words and then immediately asked to repeat them; draw a clock; again repeat the original 3 words. Questions concerning memory loss or the ability to recognize time on a clock are not a part of this assessment process.

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