A nurse is reviewing the results of a functional status assessment for an older adult client using the Katz Index of Independence in Activities of Daily Living (ADLs). The nurse notes that the client scored 4 out of 6 on this tool.

What does this score indicate?

The client is independent in all ADLs.

The client needs assistance with two ADLs.

The client is dependent on others for all ADLs.

The client has difficulty with four ADLs.

Answer and Explanation

The Correct Answer is B

The correct answer is B.

The client needs assistance with two ADLs. This is because the Katz Index of Independence in Activities of Daily Living (ADLs) is a tool that measures the client’s ability to perform six basic ADLs independently: bathing, dressing, toileting, transferring, continence, and feeding. The score ranges from 0 to 6, with 6 indicating complete independence, 4 indicating moderate impairment, and 2 or less indicating severe dependence. The score is based on the number of ADLs that the client can perform without supervision, direction, personal assistance, or total care.

Therefore, a score of 4 out of 6 means that the client needs assistance with two ADLs.

Choice A is wrong because it implies that the client is independent in all ADLs, which would require a score of 6 out of 6.

Choice C is wrong because it implies that the client is dependent on others for all ADLs, which would require a score of 0 out of 6.

Choice D is wrong because it implies that the client has difficulty with four ADLs, which would require a score of 2 out of 6.

The normal range for the Katz Index of Independence in Activities of Daily Living (ADLs) depends on the setting and population of the client. For example, one study found that the average score for residents in skilled nursing facilities was 3.1 out of 6. Another study found that the hierarchy of difficulty of the six ADLs from least to greatest was: eating, maintaining continence, transferring, toileting, dressing, and bathing.

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Correct Answer is ["A","B","C","D"]

Explanation

These interventions are appropriate for reducing social isolation in older adult clients who live in a long-term care facility because they provide opportunities for social interaction, support, comfort and familiarity.

Choice A is correct because group activities such as games, music, art or exercise can foster a sense of belonging, enjoyment and engagement among older adults.Group activities can also improve physical and mental health, cognitive function and well-being.

Choice B is correct because encouraging family members or volunteers to visit or call the clients regularly can enhance the quality and quantity of social relationships, which can reduce loneliness and isolation.Family members or volunteers can also provide emotional support, companionship and practical assistance to the clients.

Choice C is correct because creating a homelike environment that promotes comfort, safety and privacy can increase the clients’ satisfaction, autonomy and dignity.A homelike environment can also facilitate social interactions among the clients and the staff by providing common areas, personal belongings and familiar objects.

Choice D is correct because assigning consistent staff members who are familiar with the clients’ needs and preferences can improve the continuity and quality of care, as well as the trust and rapport between the clients and the staff.Consistent staff members can also recognize and respond to the clients’ social needs and preferences, and provide personalized interventions.

Choice E is incorrect because providing feedback or recognition for the clients’ achievements or contributions may not be effective in reducing social isolation, unless it is combined with other interventions that promote social interaction and support.Feedback or recognition alone may not address the underlying causes of social isolation, such as lack of meaningful relationships, low self-esteem or poor health.

Normal ranges for social isolation and loneliness are difficult to define, as they depend on various factors such as individual characteristics, cultural norms and measurement tools.However, some indicators of social isolation include having few or no social contacts, participating in few or no social activities, feeling disconnected from others or society, and having low levels of perceived social support.Some indicators of loneliness include feeling unhappy about one’s social situation, feeling left out or unwanted, lacking companionship or intimacy, and having low levels of perceived belongingness or connectedness.

A. Promote physical activity and exercise to maintain muscle strength, joint mobility, balance and coordination. B. Encourage adequate nutrition and hydration to prevent malnutrition, dehydration and electrolyte imbalance. C. Manage chronic diseases and medications to prevent complications, adverse effects and polypharmacy. D. Provide assistive devices and adaptive equipment to enhance mobility, safety and independence E. Modify the environment to reduce hazards, improve accessibility and facilitate self-care.

Correct Answer is ["A","B","C","E"]

Explanation

The correct answer isA, B, C and E.These interventions are consistent with the best practices for optimizing functional status in the elderly.

Some explanations for the choices are:.

• Choice A is correct because physical activity and exercise can help maintain muscle strength, joint mobility, balance and coordination, which are essential for functional independence and quality of life.

• Choice B is correct because adequate nutrition and hydration can prevent malnutrition, dehydration and electrolyte imbalance, which can impair physical and cognitive function and increase the risk of complications.

• Choice C is correct because managing chronic diseases and medications can prevent complications, adverse effects and polypharmacy, which can affect functional status and increase the need for health care services.

• Choice D is wrong because providing assistive devices and adaptive equipment is not an intervention to improve functional status, but rather to enhance mobility, safety and independence for patients who already have functional limitations.

The question asks for interventions to improve functional status, not to compensate for it.

• Choice E is correct because modifying the environment can reduce hazards, improve accessibility and facilitate self-care, which can promote functional independence and prevent injuries or falls.

The normal ranges for blood glucose and blood pressure for older adults with diabetes and hypertension are:.

• Blood glucose: 80-130 mg/dL before meals and less than 180 mg/dL after meals.

• Blood pressure: less than 140/90 mmHg or individualized based on comorbidities and risk factors.

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A nurse is reviewing the results of a functional status assessment for an older adult client using the Katz Index of Independence in Activities of Daily Living (ADLs). The nurse notes that the client scored 4 out of 6 on this tool. What does this score indicate?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is implementing interventions to prevent or reduce social isolation in older adult clients who live in a long-term care facility. Which of the following interventions are appropriate for this setting? (Select all that apply.).

Correct Answer is ["A","B","C","D"]

Explanation

A nurse is implementing interventions to improve the functional status of an older adult client who has diabetes and hypertension. Which of the following interventions should the nurse include? (Select all that apply.).

Correct Answer is ["A","B","C","E"]

Explanation

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A nurse is reviewing the results of a functional status assessment for an older adult client using the Katz Index of Independence in Activities of Daily Living (ADLs). The nurse notes that the client scored 4 out of 6 on this tool.

What does this score indicate?