Written Assessment Student Copy

1
Instruction to Students

Welcome to the written assessment. To successfully complete the assessment

requirements, you need to follow the following instructions.
Step 1
Read the study guide and the related resources.

Step 2
Read this assessment to gain an understanding of what you need to do to complete the unit.
Talk to your trainer or supervisor and ask for help if you need to.

Step 3
Complete all questions in this assessment. Please write clearly in pen (not pencil). You
may attach printed answers if you prefer. Do not remove any pages from this assessment.

Step 4
Complete the cover sheet and attach to this assessment. We recommend you make and
keep a copy of the entire Assessment.

Step 5
Submit for assessment.

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Part A

Question 1 (2 MARKS)

The following website may assist with this question

http://www.myagedcare.gov.au/health-conditions/chronic-diseases

List ten common chronic diseases for older people.

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Question 2 (2 MARKS)

Assessment is a key component of nursing practice, required for planning and provision of
preventative measures and the delivery of holistic client care. List the assessment tools,
including functional assessments that are used in the nursing home.

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Question 3 (2 MARKS)

The following website may assist with this question

http://nursinglink.monster.com/training/articles/331-functional-assessment---the-key-to-
geriatric-care-in-the-21st-century

What are the common conditions caused by functional deterioration?

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Question 4 (3 MARKS)

The following website may assist with this question

http://nursinglink.monster.com/training/articles/331-functional-assessment---the-key-to-
geriatric-care-in-the-21st-century

Discuss the complications related to functional deterioration.

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Question 5

The following websites may assist with this question

http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=6442455398
https://www.dhsv.org.au/professionals/aged-care-workers
https://www.sahealth.sa.gov.au/wps/wcm/connect/09fa99004358886a979df72835153af6/BO
HRC_Staff_Portfolio_Full_Version%5B1%5D.pdf?MOD=AJPERES&CACHEID=09fa990043
58886a979df72835153af6

High levels of oral diseases and conditions are prevalent in sub-groups of older adults,
including those who are financially disadvantaged, people who attend dentists irregularly,
those who are dependent, people with nutritional and swallowing problems, smokers and
those with a history of oral disease.

Part A (2 MARKS)

Refer to the policies and procedures of the nursing home and discuss the care of dental
prosthetics, screening for oral health conditions and soft tissue care.

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Part B (1.5 MARKS)

How would you document and report oral assessments as per the nursing homes policies
and procedures?

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Question 6 (2 MARKS)

The following website may assist with this question

http://www.caresearch.com.au/caresearch/tabid/1468/Default.aspx

Care of a deceased patient is a sensitive and important nursing skill that is often not
discussed in open. Most of us, at some time will be involved with the immediate care of a
person once they have died. Access the nursing homes policies and procedures and discuss
how the deceased person is cared for by nursing staff.

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Question 7

The following website may assist with this question

https://www.acn.edu.au/sites/default/files/advocacy/submissions/PS_Person-
centered_Care_C2.pdf

Ted, 78 years of age, has ischaemic heart disease. He had a percutanous stent inserted into
his left anterior descending coronary artery in June 2004. Three years ago he suffered a
myocardial infarct which resulted in congestive cardiac failure and a left ventricular ejection
fraction of 42%. He has a past history of smoking and a long history of type 2 diabetes with
hypercholesterolaemia and moderate hypertension. He was recently found to have
albuminuria. He has atrial fibrillation for which he is taking warfarin but he has erratic INRs
because, as a keen fisherman, he does not keep regular hours or meals. Ted has multiple
diagnosis so it is important to identify and priorities Teds needs and identify preventative
measures.

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Part A (2 MARKS)
Discuss how you would care for Ted to ensure that Teds care is client-centred.

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Part B (2 MARKS)

How would you document and report Ted’s assessment as per the nursing homes policies
and procedures?

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Part C (2 MARKS)

Ted was admitted to the hospital after falling at home and has a fractured NOF. Ted’s family
have arrived to visit him and ask you about his surgery. What information will you give to
Ted and his family about his upcoming surgery and his ongoing care needs?

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Question 8

The following websites may assist with this question

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2995895/
http://lghttp.48653.nexcesscdn.net/80223CF/springer-
static/media/samplechapters/9780826162519/9780826162519_chapter.pdf

Aging is a process that begins at conception and continues for as long as we live. At any
given time throughout our lifespan, the body reflects:

 its genetic component and

 its environmental experience.

Over the years, many theories have emerged to explain what process or mechanisms move
you towards ageing. Theories help make sense of a particular phenomenon as they provide
a sense of order and give a perspective from which to view the facts. Theories provide a
platform for discussion and research. There are five main theories of ageing including

- Biological theories
- Psychosocial theory
- Disengagement theory
- Social exchange theory
- Wear and tear theory
- Activity theory

Part A (3 MARKS)
Discuss the five main theories of ageing and how each theory explains the process of
ageing.

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Part B (2 MARKS)

Discuss the external factors and common stereotypes in the community about ageing. How
can stereotypes impact older people?

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Part C (2 MARKS)

Discuss your own values, attitudes and beliefs towards ageing and the older person. How
will you monitor your own continuous professional development and work within your scope
of practice to provide contemporary nursing care?

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Question 9

The following website may assist with this question

http://www.britannica.com/science/human-aging

Discuss the physiology of the ageing process as it relates to disease processes on the
following body systems.

Sensory function (2 MARKS)

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Cardiac function (2 MARKS)

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Respiratory function (2 MARKS)

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Musculoskeletal function (2 MARKS)

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Genitourinary function (2 MARKS)

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Endocrine function (2 MARKS)

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Renal function (2 MARKS)

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Oncological disorders (2 MARKS)

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Skin integrity (2 MARKS)

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Question 10 (3 MARKS)

The underlying pathologies among the elderly are the same as among the whole population,
but at higher rates. However, there are specific features in the diagnosis and management
and the functional and social ability of elderly patients, for example:

- symptoms with no clearly identifiable aetiology

- altered patient presentations
- impact of aging on people with pre-existing conditions, particularly intellectual
impairment, mental illness or physical disabilities
- difficulties in cognition and communication
- multiple diagnosis
- multisystem disease that often involves chronic disease management
- problems of polypharmacy
- decreased reserves in elderly people (physiological, psychological, financial)
- the importance of functional assessment and support
- sensory deficits such as impaired vision, hearing and balance
- nutrition, physical activity, continence and pain
- the need to relate to carers, relatives and other health professionals
- the need to be aware of community resources
- the importance of continuity of care.

Discuss your understanding of quality aged care and how you can assist clients, families and
carers. Discuss how you will contribute to the development of nursing care plans for clients
in collaboration with the RN. Ensure that your answer considers the above points.

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Question 11 (2 MARKS)

Explore your local community and the nursing home for primary health services including
counselling and support services that are available for your clients. List the services
available and what they are able to offer older people.

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Question 12 (4 MARKS)

The following websites may assist with this question

http://www.webmd.com/healthy-aging/helping-older-adults-who-are-grieving
http://www.centreforconfidence.co.uk/flourishing-lives.php?p=cGlkPTE4NSZpZD03MDI=
http://www.health.vic.gov.au/dementia/
http://www.dementiacareaustralia.com/
https://fightdementia.org.au/
http://www.racgp.org.au/your-practice/business/tools/support/acp/
http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements.aspx
http://www.myagedcare.gov.au/financial-and-legal/protecting-consumer-rights
http://www.dhs.vic.gov.au/about-the-department/documents-and-resources/policies,-
guidelines-and-legislation/carers-recognition-act-2012
https://www.aacqa.gov.au/for-the-public/for-providers

Age, and the meaning of old age have changed dramatically of the past century. Average
life expectancies in Australia have increased, and as a result the number of people aged 65
years and over now makes up 12-3% of the Australian population. From your research
describe the issues and consequences of ageing. Discuss how you will ensure that you
provide person-centred care in a safe, physical, social and emotional environment for all
older people, particularly for people with dementia- including providing daily routines and
engaging environments. How will you assist the older person to identify their abilities and
limitations to attend to activities of daily living? How would you contribute to the development
of the nursing care plans in the nursing home? How would you provide support and comfort
for clients, families and carers including in time of grief and loss.

Make reference to legal, ethical and nursing standards in your answer including
 Advance care directives
 Aged Care Act 1997 (Cwlth)
 Aged Care Funding Instrument (ACFI)
 Carers recognition legislation
 Aged care risk classification system
 Code of ethics for nurses in Australia and the Code of professional conduct
for nurses (Nursing and Midwifery Board of Australia)
 Residential Care Quality Assessment (ResCareQA)

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Question 13 (2 MARKS)

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The following websites may assist with this question
https://fightdementia.org.au/
http://www.dementiacareaustralia.com/
http://dementiaresearchfoundation.org.au/
http://www.aihw.gov.au/dementia/

Define the term Dementia.

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Question 14 (3 MARKS)

Outline the possible symptoms of dementia

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Question 15 (3 MARKS)
Outline current research relating to dementia. Include relevant statistics.

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Question 16 (3 MARKS)
Identify counselling resources within the health sector and the community to support
persons with dementia and their carers.

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Question 17 (3 MARKS)
Discuss a range of strategies used when working with people with dementia.

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Question 18 (3 MARKS)
Outline current communication strategies relevant to people with dementia.
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Question 19

Part A (2 MARKS)

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When designing activities for clients with dementia it is important that they are appropriate.
What would you consider to ensure that activities are engaging? How would you advocate
for your clients?
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Part B (2 MARKS)
People with dementia may sometimes behave in a challenging way, for example aggression
or shouting out. This can be very distressing. By understanding what may cause this type of
behaviour and learning how to deal with it, you make sure it happens less often and that you
feel able to manage when it does. Recognising triggers and providing person-centred care
can often alleviate behaviour. List possible reasons for challenging behaviour.

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Part C (2 MARKS)
List some appropriate activities which may help enrich the lives of people with dementia and
their carers.
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Question 20 (2 MARKS)

Discuss validation theory and the benefits for people who have dementia.
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Question 21 (3 MARKS)
Discuss the benefits of support services for people with dementia.
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Question 22 (3 MARKS)
What is considered the best physical, social and emotional environment for people with
dementia?
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Question 23 (4 MARKS)
What are the advantages of using the Abbey pain scale with dementia clients?
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Question 24 (2.5 MARKS)

The following website may assist with this question

https://fightdementia.org.au/support-and-services/families-and-friends/personal-
care/continence

Difficulties with using the toilet, accidents and incontinence can all be problems for people
with dementia, particularly as the condition progresses. What information would you give to
clients, families and carers in relation to coping with incontinence?

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Question 25 (2 MARKS)

The following websites may assist with this question

http://palliativecare.org.au/
http://www.myagedcare.gov.au/end-life-care
http://www.caresearch.com.au/caresearch/tabid/738/Default.aspx

Discuss the difference between palliative care and end-of-life care

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Question 26 (3 MARKS)

The following websites may assist with this question

http://www.health.gov.au/internet/publications/publishing.nsf/Content/mental-pubs-n-safety-
toc~mental-pubs-n-safety-3~mental-pubs-n-safety-3-use
https://ama.com.au/position-statement/restraint-care-people-residential-aged-care-facilities-
2015

A restraint is any device or action that interferes with the ability of a person to make
decisions or restricts their fee movement. Discuss the nursing homes policies and
procedures re the use of restraints (including physical, chemical and psychological
restraints). Discuss the legal ramifications of using restraints.

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Question 27 (3 MARKS)

Older people tend to take more drugs than younger people because they are more likely to
have more than one chronic medical disorder, such as high blood pressure, diabetes, or
arthritis. Most drugs used by older people for chronic disorders are taken for years. Other
drugs may be taken for only a short time to treat such problems as infections, some kinds of
pain, and constipation. Among people who are age 65 years or older, 90% take at least 1
drug per week, more than 40% take at least 5 different drugs per week, and 12% take 10 or
more drugs per week. Women typically take more drugs than men. Older people who are
frail, hospitalized, or in a nursing home take the most drugs. Nursing home residents are
prescribed an average of 7 to 8 different drugs to take on a regular basis. Older people also
take many nonprescription (over-the-counter, or OTC) drugs.
Discuss the possible age-related effects of drugs and medications and what adjustments
may need to be made.
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