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NUR 2092 Health Assessment Final Exam
Questions and Answers
Activity of Daily Living - Correct answer-Tasks that are necessary for self-care, such as eating/feeding, bathing, grooming, toileting, walking, and transferring. Advanced Activities of Daily Living - Correct answer-Activities that an older adult performs as a family member or as a member of society or community, including occupational and recreational activities. Caregiver Assessment - Correct answer-Assessment of the health and well-being of an individual's caregiver. Caregiver Burden - Correct answer-The perceived strain by the person who cares for an older, chronically ill, or disabled person. Domains of Cognition - Correct answer-Domains included in mental status assessments, such as attention, memory, orientation, language, visuospatial skills, and higher cognitive functions. Environment - Correct answer-Assessment of an indovodual's home environment and community systems, including hazards at home. Functional Ability - Correct answer-The ability of a person to perform activities necessary to live in modern society; may include driving, using the telephone, or performing personal tasks such as baking or toileting. Functional Assessment - Correct answer-A systematic assessment that includes assessment of an individual's activities of daily living, instrumental activities of daily living, and mobility. Functional Status - Correct answer-A person's actual performance of activities and tasks associated with current life roles. Geriatric Assessment - Correct answer-Multidimensional assessment; physical examination and assessments of mental status, functional status, social and economical status, pain, and physical environment safety. Home Care - Correct answer-Supportive services provided in the home: skilled nursing care, primary care, therapy (physical, occupational, speech), social work, nutrition, case management, ADL assistance, durable medical equipment.
Instrumental Activities of Daily Living - Correct answer-Functional abilities necessary for independent community living, such as, shopping, meal preparation, housekeeping, laundry, managing finances, taking medications, and using transportation.
CORRECT ANSWER
b. Ability to cook meals c. Ability to balance the checkbook and pay bills d. Hazards found in the home
You will use which technique when assessing an older individual who has cognitive impairment? - Correct answer-a. Ask open-ended questions b. Complete the entire assessment in one session c. Ask the family members for information instead of the older individual d. Ask simple questions that have yes or no answers. CORRECT ANSWER An older person needs to be assessed before going home as to whether he or she is able to go outside alone safely. Which test is best for this assessment? - Correct answer-a. Up and go test CORRECT ANSWER b. Performance of activities of daily living c. Older americans resources and services multidimensional functional assessment questionnaire d. Lawton IADL Instrument An older adult has had surgery for a fractured hip and has a history of dementia. You should keep in mind that older adults with cognitive impairment: - Correct answer-a. Experience less pain b. can provide a self-report of pain *CORRECT ANSWER8 c. Cannot be relied on to self-report pain d. Will not express pain sensations. An appropriate use of the caregiver strain index would be which situation? - Correct answer-a. A daughter who is taking her older father home to live with her b. An older patient who lives alone c. A wife who has cared for her husband for the past 4 years at home CORRECT ANSWER d. A son whose parents live in an assisted living facility Which is an example of a formal social support network for the aging adult? - Correct answer-a. A neighbor who drops by with newspapers and magazines on a regular basis b. An area church that offers a weekly activity an luncheon for seniors in the neighborhood c. A home health care agency that provides weekly blood pressure screenings at the church luncheon CORRECT ANSWER d. A senior citizen chess club whose members hold classes at the local boys club When completing a spiritual assessment you should? - Correct answer-a. Use yes and no questions as the foundation for future dialogue b. Use open-ended questions to help the patient understand potential coping mechanisms CORRECT ANSWER c. Try to complete this assessment as soon as possible after meeting the
b. Ask the patient's wife or husband how he or she does when performing tasks c. Review the medical record for information on the patient's abilities d. Ask the pastient's physician for information on the patient's ability The Lawton IADL instrument is described by which of the following? - Correct answer-a. The nurse uses direct observation to implement this tool b. It is designed as a self-report measure of performance rather than ability CORRECT ANSWER c. It is not useful in the acute hospital setting d. It is best used for those residing in an institutional setting An older adult's advanced activities of daily living would include: - Correct answer-a. Recreational activities CORRECT ANSWER b. Meal Preparation c. Balancing the checkbook d. Self- grooming activities When using the various instruments to assess an older person's activities of daily living, remember that a disadvantage of these instruments includes: - Correct answer-a. The reliability of the tools b. Self or proxy report of functional activities CORRECT ANSWER c. Lack of confidentiality during the assessment d. Insufficient detail about the deficiencies identified Acculturation - Correct answer-Process of social and psychological exchanges with encounters between persons of different cultures, resulting in changes in either group. Cultural and Linguistic Competence - Correct answer-A set of congruent behaviors, attitudes and policies that come together in a system among professionals that enables work in cross-cultural situations. Culture - Correct answer-The nonphysical attributes of a person-the thoughts, communications, actions, beliefs, values, and institutions of racial, ethnic, religious, or social groups. Cultural Care - Correct answer-Professional health care that is culturally sensitive, appropriate, and competent. Ethnicity - Correct answer-A social group within the social system that claims to possess variable traits such as common geographic origin, migratory status, and
religion. Ethnocentrism - Correct answer-Tendency to view your own life as the most desirable, acceptable, or best and to act superior to another culture's way of life.
nursing care d. understands the cultural context of the patient's situation CORRECT ANSWER
You are the triage nurse in the emergency department and perform the initial intake assessment on a patient who does not speak English. Based on your understanding of linguistic competence, which action would present as a barrier to effective communication? - Correct answer-a. maintaining a professional respectful demeanor b. allowing for additional time to complete the process c. providing the patient with a paper and pencil so he or she can write down the questions that you are going to ask CORRECT ANSWER d. seeing if there are any family members present who may assist with the interview process Which culture would describe illness as hot and cold imbalance? - Correct answer-a. Asian-American heritage b. African-American heritage c. Hispanic-American heritage CORRECT ANSWER d. American Indian heritage Of what does the patient believe the amulet is protective? - Correct answer-a. the evil eye CORRECT ANSWER b. being kidnapped c. exposure to bacterial infections d. an unexpected fall Which statement best illustrates the difference between religion and spirituality? - Correct answer-a. religion reflects an individual's reaction to life events whereas spirituality is based on whether the individual attends religious services b. religion is characterized by identification of a higher being shaping one's destiny while spirituality reflects the individual's perception of one's life having worth or meaning CORRECT ANSWER c. Religion is the expression of spiritual awakening whereas spirituality is based on belief in divine right d. religion is the active interpretation of one's spirituality The first step to cultural competency by a nurse is to: - Correct answer-understand your own heritage and its basis in cultural values Which statement is true in regard to pain? - Correct answer-The cultural background of the patient is important in a nurses's assessment of that patient's pain. Which factor is identified as a priority influence on a patient's health status? - Correct answer-Poverty
Which statement best describes ethnocentrism? - Correct answer-The tendency to view your own way of life as the most desirable. Which category is appropriate in a cultural assessment? - Correct answer- Health- related beliefs Which health belief practice is associated with patients who are of American Indian heritage? - Correct answer-Eating compatible foods in one's diet. Which statement best reflects the Magicoreligious causation of illness? - Correct answer-Belief in the struggle between good and evil is reflected in the regulation of health and illness. Auscultatory gap - Correct answer-A brief period when Korotkoff sounds disappear during auscultation of blood pressure; common with hypertension. Bradycardia - Correct answer-Heart rate fewer than 50 or 60 beats per minute in the adult (depending on agency). Sphygmomanometer - Correct answer-Instrument for measuring arterial blood pressure. Stroke Volume - Correct answer-Amount of blood pumped out of the heart with each heartbeat. Trachycardia - Correct answer-Heart rate greater than 95 beats per minute in the adult. The 4 areas to consider during the general survey include: - Correct answer- Physical appearance, body structure, mobility, and behavior. You are assessing a patient's gait. What do you expect to find? - Correct answer- Gait is as wide as the shoulder width. An 18-month old child is brought into the clinic for a health screening visit. To assess the height of the child: - Correct answer-Use a horizontal measuring board. Which changes in head circumference measurements in relation to chest measurements will occur from infancy through early childhood? - Correct answer- The newborn's head will be 2 cm larger than the chest circumference, but between 6 months and 2 years, they will be about the same. Which changes regarding height and weight occur during the 80's and 90's? -
Correct answer-Both decrease. During an initial home visit, the patient's temperature is noted to be 97.4 degrees F. How would you interpret this? - Correct answer-It cannot be evaluated without knowledge of the person's age.
24 hour recalls, food frequency questionnaires, food diaries, and similar sources. Kwashiorkor - Correct answer-Primarily a protein deficiency characterized by edema, growth failure, and muscle wasting.
Malnutrition - Correct answer-May mean any nutrition disorder but usually refers to long term nutritional inadequacies or excesses. Marasmic Kwashiorkor - Correct answer-Combination of chronic energy deficit and chronic or acute protein deficiency. Marasmus - Correct answer-Results from energy and protein deficiency, manifesting with significant loss of body weight, skeletal muscle, and adipose tissue mass, but with serum protein concentrations relatively intact. Nutritional Monitoring - Correct answer-Assessment of dietary or nutritional status at intermittent times with the aim of detecting changes in the dietary or nutritional status of a population. Nutrition Screening - Correct answer-a process used to identify individuals at nutritional risk or with nutritional problems. Obesity - Correct answer-Excessive accumulation of body fat; usually defined as 20% above desirable weight or body mass index of 30.0-39. Protein Calorie Malnutrition (PCM) - Correct answer-Inadequate consumption of protein and energy, resulting in gradual body wasting and increased susceptibility to infection. Recommended Dietary Allowance (RDA) - Correct answer-Levels of intake of essential nutrients considered to be adequate to meet the nutritional needs of almost all healthy persons. Sarcopenic Obesity - Correct answer-Combined loss of muscle mass with weight gain occurring in old age. Skinfold Thickness - Correct answer-Double fold of skin and underlying subcutaneoustissue that is measured with skinfold calipers at various body sites. Waist-to-hip Ratio (WHR) - Correct answer-Waist or abdominal circumference divided by the hip or gluteal circumference; method for assessing fat distribution. The balance between nutrition intake and nutrient requirements is described as: - Correct answer-Nutritional Status You are providing health promotion teaching for a newly pregnant woman, and
You obtain which data when screening patients for nutritional status? - Correct answer- Weight and nutrition intake history. A 24-hour recall of dietary intake is used: - Correct answer-As a questionnaire or interview of everything eaten within the last 24 hours. Mary, a 15 year old, has come for a school physical. During the interview, you learn that menarche has not occurred. The BMI is 17.1. You suspect: - Correct answer-Nutritional deficiency Which older adult is at lowest risk for alteration in nutritional status? - Correct answer-65 year old widower who visits a senior center with a meal program 5 days per week. The examiner is completing an initial assessment for a patient admitted to a long-term care facility. The patient is unable to stand for a measurement of height. To obtain this important anthropometric information, the examiner would? - Correct answer-Measure arm span. Which assessment finding indicates a patient at nutrition risk? - Correct answer- BMI = 19kg/m(2) Marasmus is often characterized by: - Correct answer-Low weight for height Which BMI category in adults is indicative of obesity? - Correct answer-30.0- 39.9 kg/m(2) Why should you ask about the use of medications when assessing a patient's nutritional status? - Correct answer-Many drugs can interact with nutrients and impair their digestion, absorption, metabolism, or uptake. Alopecia - Correct answer-Baldness; Hair loss. Annular - Correct answer-Circular shape to skin lesion Bulla - Correct answer-Elevated cavity containing free fluid larger than 1cm in diameter. Confluent - Correct answer-Skin lesions that run together. Crust - Correct answer-Thick, dried-out exudate left on skin when vesicles or pustules burst or dry up.
Cyanosis - Correct answer-Dusky blue color to skin or mucous membranes as a result of increased amount of non oxygenated hemoglobin. Erosion - Correct answer-Scooped-out shallow depressions of skin.
