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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
The correct answer isB.
Loss of muscle mass and strength.Sarcopenia is a condition that affects older adults and causes a progressive decline in skeletal muscle mass, strength, and function.This can lead to an increased risk of falls, fractures, disability, and mortality.
Choice A is wrong because the loss of bone mass and strength is calledosteoporosis, not sarcopenia.Osteoporosis is a condition that affects the density and quality of bones, making them more prone to fracture.
Choice C is wrong because loss of joint flexibility and range of motion is calledarthritis, not sarcopenia.
Arthritis is a term that refers to inflammation of the joints, which can cause pain, stiffness, swelling, and reduced mobility.
Choice D is wrong because loss of skin elasticity and moisture is calledskin aging, not sarcopenia.
Skin aging is a process that involves changes in the structure and function of the skin, such as wrinkles, sagging, dryness, and decreased wound healing.
Normal ranges for muscle mass and strength vary depending on age, sex, body size, and physical activity level.However, some general indicators of sarcopenia include:.
• A muscle mass index (muscle mass divided by height squared) below 7.26 kg/m2 for men and 5.45 kg/m2 for women.
• A handgrip strength below 30 kg for men and 20 kg for women.
• A gait speed below 0.8 m/s for both sexes.
Correct Answer is C
Explanation
The correct answer is C.
Ego integrity vs despair.
According to Erikson’s psychosocial theory, older adults face the challenge of looking back on their lives and evaluating their accomplishments and failures.
If they feel satisfied with their life course, they achieve a sense of ego integrity, which is a feeling of wholeness and coherence.
If they feel regretful or dissatisfied, they experience despair, which is a sense of hopelessness and bitterness.
Choice A is wrong because trust vs mistrust is the first stage of Erikson’s theory, which occurs in infancy.
It involves developing a basic sense of trust in oneself and others based on the quality of caregiving.
Choice B is wrong because generativity vs stagnation is the seventh stage of Erikson’s theory, which occurs in middle adulthood.
It involves contributing to society and the next generation through work, parenting, or other activities.
Choice D is wrong because identity vs role confusion is the fifth stage of Erikson’s theory, which occurs in adolescence.
It involves developing a stable and coherent sense of self and one’s role in society.
Normal ranges for Erikson’s stages are:.
• Trust vs mistrust: birth to 18 months.
• Autonomy vs shame and doubt: 18 months to 3 years.
• Initiative vs guilt: 3 to 6 years.
• Industry vs inferiority: 6 to 12 years.
• Identity vs role confusion: 12 to 18 years.
• Intimacy vs isolation: 18 to 40 years.
• Generativity vs stagnation: 40 to 65 years.
• Ego integrity vs despair: 65 years and older.
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