- Which of the following is a true statement about the theories of aging?
| a. | Research data support the disengagement theory, activity theory, and continuity theory. |
| b. | Everyone should be able to achieve the three tasks of Peck’s model of integrity. |
| c. | The exercise of rights is not a task of aging in Kelly’s model. |
| d. | A person may choose to avoid pursuing inner discovery in older age. |
ANS: D
Some persons do not value inner psychological exploration and remain action oriented even in an older age, and others are still subject to the same demands of daily living as they were in middle age. None of these theories is clearly supported by data. Peck’s tasks of ego differentiation, body transcendence, and ego transcendence demand a great deal of courage and energy that not everyone possesses. Tasks of aging in Kelly’s model are accepting reality, fulfilling responsibility, and exercising rights.
PTS: 1 DIF: Understand REF: 4-12
TOP: Nursing Process: Assessment MSC: Psychosocial Integrity
- Which of the following is a true statement about neuropsychiatric function in older adults?
| a. | Overall cognitive abilities are progressively degraded by neuron loss in the cerebral cortex with aging. |
| b. | Improving cognitive functions in an older person calls for sporadic mental activity around ideas the person finds significant and interesting. |
| c. | Nerve cells regenerate in the hippocampus. |
| d. | Mood does not influence an older person ability to remember verbal instructions. |
ANS: C
Nerve cells regenerate in the hippocampus; this is a true statement. Although neurons can regenerate in the hippocampus, regeneration is impeded by stress. Overall cognitive abilities are progressively degraded by neuron loss in the cerebral cortex with aging; this statement is not true. Neuron loss does not harm overall cognitive ability, although it makes neural processes run more slowly. Improving cognitive functions in an older person calls for sporadic mental activity around ideas the person finds significant and interesting; this is not a true statement. Neural functions can be retrained, but “exercising” the brain on a regular basis is necessary. Older adults learn best when new information is relevant to what is already familiar. Mood does not influence whether an older person remembers verbal instructions; this is a not a true statement. Recalling events, including communication, is impaired by a crisis situation or anxiety.
PTS: 1 DIF: Remember REF: 16
TOP: Nursing Process: Assessment MSC: Psychosocial Integrity
- Which of the following statements is true about social and emotional health of older adults?
| a. | Contemporary society has strong norms for the behavior of adults older than 80 years. |
| b. | The transition to old age entails a declining level of contribution to others as one becomes increasingly dependent on them. |
| c. | Computers and the Internet have little to contribute to older adults in their need for social support. |
| d. | Nurses are often significant sources of social and emotional support for older adults. |
ANS: D
Nurses are often important confidants and providers of social support in the lives of older adults. The diversity of cultures and individuals in a society such as the United States means that norms are almost nonexistent for those older than 80 years. Older adults have a great deal to contribute in wisdom and by example. E-mail and online chat rooms are a means of contact and social support for many older adults.
PTS: 1 DIF: Understand REF: 12-20| 29 Box 6-1| 33 Box 6-5| 34 Box 6-6
TOP: Nursing Process: Assessment MSC: Psychosocial Integrity
- Which role is most likely to have a significant effect on the type of aging process experienced by the older adult?
| a. | Grandparent | c. | Friend |
| b. | Spouse | d. | Parent |
ANS: B
The loss of a spouse is likely to be devastating for an older adult for economic and biopsychosocial reasons. When an older adult loses a spouse, the loss can include economic security, especially for a woman, and societal roles. Alterations in these roles are not usually as challenging as the loss of a spouse. Grandparenting can offer the potential for enhanced social experiences for an older adult; however, adults can age well without them when more basic needs are met. Alterations in these roles are not always as acutely demanding as the loss of a spouse. Alterations in these roles usually call for little or a gradual adjustment.
PTS: 1 DIF: Understand REF: 12-13
TOP: Nursing Process: Assessment MSC: Psychosocial Integrity
- The children in an African-American family attended college because their mother worked two jobs as they were growing up. She never finished high school, the children are grown, and she lives alone in retirement. Which noted weakness of sociological theories on aging explains why the social exchange theory is not applicable to this older adult?
| a. | Gender | c. | Ethnicity |
| b. | Culture | d. | Opportunity |
ANS: D
Social exchange theory ignores the effect that opportunity can have on aging because, according to this theory, the mother should be living with one of the children. They had the opportunities that she never had. Gender is not as relevant to this theory of the value of youth as being a period where social credits are earned for old age. Culture is not as relevant to this theory as the value of youth. Ethnicity is not as relevant to this theory as the value of youth.
PTS: 1 DIF: Analyze REF: 7
TOP: Nursing Process: Assessment MSC: Psychosocial Integrity
- In which context are members of a cohort described when using the age-stratification theory to explain the effect of similar events, conditions, and circumstances?
| a. | Historical | c. | Sociological |
| b. | Biological | d. | Chronological |
ANS: A
In the age-stratification model, historical context is used to understand members of a cohort in terms of similar events, conditions, and circumstances and the effect these have on the group as a whole. A good example of such a cohort is older adults who lived through World War II. Biological context is not important in considering the age-stratification theory. The age-stratification theory is a sociological theory of aging that uses historical context to describe cohorts. Chronological context of a cohort will span a range, but historical context is what describes the cohort.
PTS: 1 DIF: Knowledge REF: 6
TOP: Nursing Process: Assessment MSC: Psychosocial Integrity
- An older patient who was just diagnosed with a terminal disease states, “All my life I attended church, but I am still worried about what will happen after death.” The nurse’s best response is which of the following?
| a. | “The unknown may be frightening. Do you want to talk about this?” |
| b. | “Religious people know that God is a good God.” |
| c. | “People that have had near death experiences say it is peaceful.” |
| d. | “You must feel good about attending church most of your life.” |
ANS: A
“Often the unknown is very frightening,” uses the reflective technique to identify the patient’s feelings regarding the fear of the unknown. “Religious people know that God is a good God,” denies the patient’s feelings. “People that have had near death experiences say it is peaceful,” focuses on the experience of others. “You must feel good about attending church most of your life,” ignores the patient’s concern about death.
PTS: 1 DIF: Apply REF: 12-16| 32 Box 6-4| 33 Box 6-5| 34 Box 6-6
TOP: Nursing Process: Implementation MSC: Psychosocial Integrity
- An older man with severe knee pain tells the nurse how he lost his job and his home after starting a new business when he was 48 years old. Now he lives alone and relies on Social Security. Using Jung’s theory, what in this individual’s life is the most pivotal in his personality development?
| a. | Living alone | c. | Severe knee pain |
| b. | Meager income | d. | Job and home loss |
ANS: D
Jung’s theorizes that the personality forms, in part, after a crisis, as an individual moves from extroversion to introversion in aging. Living alone is a situation that is the result of many factors coalescing in an individual’s life. A meager income can be a result of the individual’s life work and other individual choices and events. His personality can affect how an individual deals with pain, and the pain can affect an individual’s personality. However, whether the pain is old or new is not known; thus a determination cannot be made.
PTS: 1 DIF: Analyze REF: 9-10
TOP: Nursing Process: Assessment MSC: Health Promotion and Maintenance
- The nurse plans care for older adults who are in good health but isolated from their families. If the nurse’s goal is to move the adults toward gerotranscendence, which intervention should the nurse use in the plan of care?
| a. | Give a daily tea party for the group. |
| b. | Call each family to encourage visiting. |
| c. | Assist them to resume midlife patterns. |
| d. | Help each person with individual activities. |
ANS: D
In Tornstam’s theory, aging offers the potential for gerotranscendence, a culmination of an individual’s life, wisdom, and spiritual growth that allows the older adult to live contentedly with and without social activities. An older adult spends more time on meditation and solitude, and less time on materialism and self-consciousness about body image. Individual activities or self-selected activities are satisfactory. Solitude is satisfactory. Midlife patterns are no longer relevant to contentment.
PTS: 1 DIF: Apply REF: 12 TOP: Nursing Process: Planning
MSC: Psychosocial Integrity
- The nurse observes older female adults learning advanced knitting techniques. The nurse concludes that this learning activity is suitable for these women because it accomplishes which of the following?
| a. | Helps maintain joint flexibility |
| b. | Improves the group’s cohesiveness |
| c. | Provides a needed social opportunity |
| d. | Adds to their existing knowledge base |
ANS: D
Learning advanced techniques is a suitable activity for older adults because it builds on knowledge they already have; further, this activity is suitable because it is concrete and practical for experienced knitters to develop advanced skills. Joint flexibility is a physical activity and not necessarily a learning activity. The members share enjoyment of knitting; other than being women and older, the group has no special bond on which to build. The need for socializing is not evident.
PTS: 1 DIF: Apply REF: 19-20 TOP: Nursing Process: Evaluation
MSC: Psychosocial Integrity
- The nurse at a nursing home wants to help decrease the risk of Alzheimer disease in the residents. Which should the nurse do to implement this goal?
| a. | Keep the curtains open in their rooms. |
| b. | Offer beads for them to string on yarn. |
| c. | Show movies that the residents choose. |
| d. | Assist residents with ambulation to meals. |
ANS: D
Engaging in physical activity and social interaction are associated with a lower risk for Alzheimer disease. Keeping the curtains open can make a resident’s room more pleasant but is likely to be counterproductive in lowering the risk; brightening the room can entice the resident to stay in the room and decrease social interaction. Stringing beads is a passive and sedentary activity and therefore unlikely to decrease the risk for Alzheimer disease; physical activity is associated with a lower risk for Alzheimer disease. Watching movies is a sedentary but not a mentally stimulating activity for an adult with a normal intelligence.
PTS: 1 DIF: Apply REF: 15-18 TOP: Nursing Process: Planning
MSC: Health Promotion and Maintenance
- Which physiological change in the brain is the reason the nurse allows more time for answering questions with older adults?
| a. | Increased secretion of cholinesterase |
| b. | Decreased secretion of neurotransmitters |
| c. | Loss of spinal cord and brainstem neurons |
| d. | Atrophy of dendrites in the cerebral cortex |
ANS: D
Dendrites are the receiving end of neurons (receiving electrochemical signals) and the branched ends extending from the cell body. The atrophy of dendrites contributes to slower thought processes with aging because the synapses are impaired; this changes the transmission of neurotransmitters that are vital in the transmission of an electrical impulse from neuron to neuron. The secretion of cholinesterase, the enzyme that inactivates acetylcholine in the synapse, does not increase with aging. Changes in the transmission of neurotransmitters are associated with the atrophy of dendrites. The spinal cord and the cerebral cortex lose neurons with age, the cerebral cortex more than the spinal cord.
PTS: 1 DIF: Understand REF: 16
TOP: Nursing Process: Assessment MSC: Safe, Effective Care Environment
- The nurse provides opportunities for nursing home residents to read aloud to others. Which cognitive skill is this nursing intervention most likely to improve?
| a. | Verbal fluency | c. | Object naming |
| b. | Logical analysis | d. | Visuospatial skills |
ANS: A
Allowing residents to read aloud helps improve and maintain verbal fluency because it provides an opportunity to practice these skills. Reading aloud does not usually require analysis. Reading is unlikely to improve object recall unless displaying objects is part of the reading. Visuospatial skills require the ability to perceive the relationship of objects in terms of the space each object occupies; reading is unlikely to improve this skill.
PTS: 1 DIF: Understand REF: 16 TOP: Nursing Process: Evaluation
MSC: Health Promotion and Maintenance
MULTIPLE RESPONSE
- Which statements are true about aging and the brain? (Select all that apply.)
| a. | Most areas of the brain do not lose brain cells. |
| b. | Memory decline is inevitable as people age. |
| c. | Basic intelligence remains unchanged with age. |
| d. | The brain does not continue to make new brain cells. |
ANS: A, C
Most areas of the brain do not lose brain cells. Although older adults may lose some nerve connections, it can be part of the reshaping of the brain that comes with experience. Basic intelligence remains unchanged with age, and older adults should be provided with opportunities for continued learning. Many people reach older age and have no memory problems. Participation in physical exercise, stimulating mental activity, socialization, health diet, and stress management help brain health.
PTS: 1 DIF: Understand REF: 12-Apr
TOP: Nursing Process: Assessment MSC: Psychosocial Integrity
- The nurse is admitting a patient to a long-term care facility. During the admission, the patient verbalizes a concern about getting dementia now that he is in a nursing home. In what activity(ies) should the nurse encourage the patient to participate to maintain brain health? (Select all that apply.)
| a. | Physical exercise | c. | Socialization |
| b. | Stimulating mental activity | d. | Increasing dietary intake |
ANS: A, B, C
Many people reach older age and have no memory problems. Participation in physical exercise, stimulating mental activity, socialization, health diet, and stress management help brain health. An increase in dietary intake has not been shown to influence brain health.
PTS: 1 DIF: Apply REF: 37 TOP: Nursing Process: Planning
MSC: Health Promotion and Maintenance
Chapter 7: Assessment and Documentation for Optimal Care
Test Bank
MULTIPLE CHOICE
- Which option is not a primary reason that documentation is important?
| a. | Documentation enables the team to provide care to meet a resident’s individual needs. |
| b. | Documentation helps defend the nurse in the event of a possible lawsuit. |
| c. | Documentation enables a patient to receive consistent care from one shift to the next. |
| d. | Documentation is the basis for reimbursement to the facility. |
ANS: B
Although providing a defense in the event of a possible lawsuit should not be the primary motive for the nurse to keep accurate and thorough documentation, doing so is the best defense in the event of legal action against anyone involved in a patient’s care. Enabling the team to provide care that meets individual needs is a primary reason; documentation is necessary to ensure that the team has accurate and complete information about the resident’s specific conditions. Enabling the patient to receive consistent care is a primary reason; documentation enables nurses on later shifts to be aware of conditions that have developed and the actions that have been taken on previous shifts. Providing the basis for reimbursement is a primary reason; the use of standard documentation in applying for reimbursement is a matter of law.
PTS: 1 DIF: Understand REF: 20-21
TOP: Communication and Documentation
MSC: Safe, Effective Care Environment
- What is a SOAP note?
| a. | Record of supplies used in patient hygiene |
| b. | Record of an event during a patient’s stay, formatted according to the Simple Object Access Protocol (SOAP), enabling it to be easily transmitted between computers |
| c. | Form of bar code |
| d. | Record of patient data listing the patient’s subjective complaint, objective data recorded by the nurse, the nurse’s assessment of the situation, and the nurse’s plan of action |
ANS: D
SOAP stands for subjective (patient complaint), objective (observed data), assessment, and plan. A SOAP note is a record of an event in which a patient makes a subjective complaint and the nurse observes objective data, makes an assessment on the basis of the complaint and the data, and makes a plan for interventions based on the assessment. A SOAP note is a record in human language describing a problem, its assessment, and planned interventions.
PTS: 1 DIF: Remember REF: 22
TOP: Communication and Documentation
MSC: Safe, Effective Care Environment
- Which of the following is a true statement about documentation?
| a. | Nurses should keep records of patients’ wishes. |
| b. | Patients do not have access to their own medical records. |
| c. | The Outcomes and Assessment Information Set (OASIS) is a complete record of the health status of a patient. |
| d. | The nurse is responsible for completing all of the Minimum Data Set (MDS). |
ANS: A
Entering patients’ expressed wishes in the medical or clinical record helps ensure that the interdisciplinary team respects these wishes. According to regulations after the enactment of the Health Insurance Portability and Accountability Act (HIPAA), the patient has access to his or her own medical records and may designate others to have access. The OASIS is used to measure outcomes for quality improvement purposes; it does not contain all of the necessary information for care, such as vital signs. The MDS should be completed jointly by all members of the interdisciplinary team.
PTS: 1 DIF: Understand REF: 21
TOP: Communication and Documentation
MSC: Safe, Effective Care Environment
- Which one of the following is connected with the nursing home reform mandated by a 1987 law?
| a. | Resident Assessment Instrument (RAI) |
| b. | HIPAA |
| c. | OASIS |
| d. | Fulmer SPICES |
ANS: A
The RAI must be completed for all residents receiving Medicare or Medicaid. The HIPAA was passed in 1996 and mandates privacy practices. The OASIS is an assessment designed for use in the home health care setting. Fulmer SPICES is an overall assessment tool developed in 2007.
PTS: 1 DIF: Remember REF: 26| 19
TOP: Communication and Documentation
MSC: Safe, Effective Care Environment
- An older woman has diabetes mellitus and requires hemodialysis for renal failure. She is discharged to home to recover from a sternal wound infection and coronary artery bypass graft surgery (CABG). A home care nurse will provide wound care. Which of the following is the major justification for the complete and accurate documentation of this older adult’s care?
| a. | Requires complex health care |
| b. | Has needs in multiple settings |
| c. | Is at risk for iatrogenic problems |
| d. | Has significant health care expenses |
ANS: A
The major reason that documentation of this patient’s health care must be accurate and complete is that she has complex health care needs in multiple settings and experiences a high risk for iatrogenic problems and high reimbursement expenses. The duration of her care is likely to be lengthy; the sternal wound infection after CABG is serious because of the potential for sternal osteomyelitis. In addition, individuals with diabetes are at high risk for infection and are slow to heal.
The complexity of her care includes receiving care in multiple settings—at home, at dialysis, and in primary care for postdischarge follow-up care. For an older adult with diabetes, coronary artery disease, renal failure, and a serious infection, each facet of her health care depends on complete and accurate data on the other aspects of her care to help her achieve optimal health and wellness. This older adult is at risk for iatrogenic problems because of the complexity of her care. Each type of care, each illness or condition, and each setting exposes this older adult to a separate set of risks. In addition, individuals with diabetes can have peripheral neuropathies that increase the risk for falls and injuries. This older adult incurs health care expenses dealing with complex health care requirements including a recent hospital stay for surgery and complicated by an infection, ongoing needs for hemodialysis, and home care. Because much of the care is nurse driven, documentation is the basis for which reimbursement is provided.
PTS: 1 DIF: Analyze REF: 6-10
TOP: Communication and Documentation
MSC: Safe, Effective Care Environment
- The nurse scans an older man’s identification band in preparation for medication administration. Which step should the nurse implement next?
| a. | Ask the patient to state his name. |
| b. | Check for allergies to the medication. |
| c. | Document the medication as given. |
| d. | Administer the patient’s medication. |
ANS: A
The nurse verifies the patient’s identify to avoid computer errors before proceeding with administering the medication. Although computers were introduced to reduce documentation errors, verification of computer information is safe, effective nursing care. Checking for allergies is a reasonable nursing action; however, if a computer error misidentified the patient, then checking allergies of the wrong person can result in misidentification and serious adverse effects for this older adult. The nurse avoids documenting the medication as given until after the patient takes or receives the medication. The nurse avoids administering the medication until after verifying the patient identity a second time for safety. Further, regulatory agencies can require multiple forms of patient identification.
PTS: 1 DIF: Analyze REF: 21-22
TOP: Communication and Documentation
MSC: Safe, Effective Care Environment
- Which of the following does the nurse use to categorize the desired end result of nursing care delivered to a patient when using problem-oriented nurses’ notes?
| a. | North American Nursing Diagnosis Association (NANDA) nursing diagnosis |
| b. | Nursing Goals Classification |
| c. | Nursing Outcomes Classification (NOC) |
| d. | Nursing Interventions Classification (NIC) |
ANS: C
NOC helps the nurse categorize the desired end-result of nursing care with specific, measurable, patient-oriented, and time-sensitive endpoints for the patient to achieve. A nursing diagnosis from NANDA identifies the patient problem and the associated nursing interventions and outcomes for the problem. Nursing goals classification does not exist. NIC is a set of nursing interventions whose basis is found in evidence-based nursing and is associated with a specific nursing diagnosis.
PTS: 1 DIF: Understand REF: 22
TOP: Communication and Documentation
MSC: Safe, Effective Care Environment
- Which documentation tool does the nurse use to achieve optimal functional status for a nursing home resident?
| a. | Narrative patient progress notes |
| b. | Problem-oriented documentation |
| c. | Resource Utilization Group (RUG) |
| d. | Resident Assessment Instrument (RAI) |
ANS: D
Mandated by the federal government to improve the quality of care for nursing home residents, the nurse uses the RAI to help residents in nursing homes achieve optimal functional status. The RAI includes identification of issues with the MDS, a comprehensive assessment from Resident Assessment Protocols (RAPs), and the foundation for reimbursement using the RUG. Narrative progress notes are used in nursing homes to describe events that are unsuitable for other forms of documentation in the medical record. Problem-oriented documentation identifies resident problems, the plan of care to resolve the problem, and the outcome of the problem or response to treatment. The RUG is the reimbursement tool in the RAI.
PTS: 1 DIF: Understand REF: 24
TOP: Communication and Documentation
MSC: Safe, Effective Care Environment
- Using the RAI, the nurse identifies a trigger for a male nursing home resident who requires an indwelling urinary catheter from the MDS. Which should the nurse do next?
| a. | Develop an individualized care plan. |
| b. | Assign suitable nursing interventions. |
| c. | Use the RAPs. |
| d. | Institute agency-approved catheter care. |
ANS: C
The nurse uses the RAPs to assess triggers identified from the MDS. To help the resident achieve optimal functional status by determining his strengths, needs, and preferences, RAPs provide an organized framework used by the health care team for additional assessment of the trigger. The nurse develops the care plan after completing the RAPs. The nurse assigns suitable nursing interventions to the plan of care. The nurse uses agency-approved policies to provide care as assigned in the plan of care.
PTS: 1 DIF: Analyze REF: 24
TOP: Communication and Documentation
MSC: Safe, Effective Care Environment
- The federal government requires the use of a specific standardized documentation tool for home nursing care. Which information must a home nurse add to the approved documentation tool?
| a. | Activity | c. | Functional |
| b. | Vital signs | d. | Demographic |
ANS: B
The nurse must add the vital signs and information about the older adult’s health care beliefs to the OASIS. The nurse does not need to add information about the older adult’s activity level. The nurse does not need to add information about the older adult’s functional status. The nurse does not need to add demographic information about the older adult to the documentation tool.
PTS: 1 DIF: Understand REF: 26
TOP: Communication and Documentation
MSC: Safe, Effective Care Environment
- The nurse must inform an older adult who does not speak English about patient rights. In addition, the nurse must have the adult sign the document about information access. Which intervention should the nurse use to maintain the confidentiality of this older adult?
| a. | Present the patient with a Spanish version of the information access document. |
| b. | Have an English-speaking family member explain the document to the patient. |
| c. | Explain the document to the patient using an interpreter to ensure understanding. |
| d. | Instruct an interpreter to read the information access document to the resident privately. |
ANS: C
To ensure patient understanding, the nurse explains a patient’s rights about information access to the patient with the assistance of an interpreter. The nurse is responsible for patient understanding and thus cannot relinquish this task to another person. When understanding is reached concerning the rights associated with access to information, the patient can then make an informed decision about releasing health care information and thus maintain privacy. The nurse cannot ensure patient understanding without discussing the document with the patient using an interpreter. The nurse cannot delegate a nursing responsibility to a family member; the nurse does not have the right to release the health information to anyone. In private or public, the nurse cannot delegate this task to another person.
PTS: 1 DIF: Apply REF: 26-27
TOP: Communication and Documentation
MSC: Safe, Effective Care Environment
MULTIPLE RESPONSE
- The same nursing documentation record is used in every unit of a hospital. Why does a hospital use a standardized form for nursing documentation? (Select all that apply.)
| a. | Helps provide continuity of care |
| b. | Standardizes patient care parameters |
| c. | Assists in maintaining confidentiality |
| d. | Reduces the number of medication errors |
| e. | Provides the foundation for staffing levels |
| f. | Allows for quality evaluations among units |
ANS: A, B, E, F
An institution uses the same nursing documentation record because it helps provide continuity of care across various settings by providing organized, pertinent, and thorough health care data on a specific individual. Other units in the hospital and other health care settings have an easier time locating relevant data. Specific health care data are found in one location on a standardized nursing documentation record throughout an institution and provide the basis for standardized patient evaluation across settings. Standardized documents help describe patient acuity levels and thus provide a justification for staffing. Because the same parameters are, or should be, recorded across all units, the standardized documentation record allows for hospital-wide quality evaluations. Nurses must restrict access to a standardized documentation record or any other type of patient record such as laboratory reports, narrative or progress notes, and other documents. A standardized nursing documentation record can reduce a specific type of documentation error but is unlikely to affect the rate of medication errors.
PTS: 1 DIF: Apply REF: 20
TOP: Communication and Documentation
MSC: Safe, Effective Care Environment
- The OASIS was implemented to provide the format for a comprehensive assessment in the home health care setting. How is this assessment tool used? (Select all that apply.)
| a. | To improve the quality of care |
| b. | To improve the communication about the individual |
| c. | To serve as a guide for reimbursement |
| d. | To evaluate the level of patient disability |
ANS: A, B, C
The OASIS was implemented to provide the format for a comprehensive assessment, which forms the basis for planning care and measuring patient outcomes–based quality improvement (OBQI) (CMS, 2011). As with all other documentation systems, OASIS is used to improve both the quality of care and the communication about the individual and serve as a guide for reimbursement. The OASIS assessment does not evaluate the level of patient disability; however, a portion of the assessment addresses the functional capabilities of the patient to perform activities of daily living.
PTS: 1 DIF: Apply REF: 26
TOP: Communication and Documentation
MSC: Safe, Effective Care Environment
- Which mental status assessment tool(s) would be appropriate for use in long-term care facilities? (Select all that apply.)
| a. | Fulmer SPICES |
| b. | Clock Drawing Test |
| c. | The Mini-Cog |
| d. | Mini-Mental State Examination (MMSE) |
ANS: B, C, D
The Clock Drawing Test, which has been used since 1992, is a screening tool that helps identify those with a cognitive impairment and is used as a measure of severity. The Mini-Cog was developed as a tool that could establish cognitive status more quickly than the MMSE and the limitations of educational adjustments. It is now the recommended evidenced-based tool and combines one aspect of the MMSE (short-term memory recall) with the test of executive function of the Clock Drawing Test. It has been found to be highly sensitive to diagnosing dementia. The MMSE tool has been used most often and is a 30-item instrument that has been used to screen for cognitive difficulties and is one of the tools often used in determining a diagnosis of dementia or delirium. Fulmer SPICES is an overall assessment tool developed in 2007.
PTS: 1 DIF: Apply REF: 13
TOP: Communication and Documentation MSC: Psychosocial Integrity
