A case management nurse is conducting a home assessment for an elderly client who sustained a recent fall. The case management nurse identifies which of the following environmental factors as posing the highest risk for future falls?

Slippery bathroom surfaces without grab bars

Clutter-free pathways and floors

Adequate lighting in hallways and staircases

Securely fastened area rugs on hardwood floors

Answer and Explanation

The Correct Answer is A

A. Slippery bathroom surfaces without grab bars are a significant risk factor for falls, as they can lead to slips and lack of support while moving.
B. Clutter-free pathways and floors reduce the risk of tripping hazards, which is beneficial for fall prevention.
C. Adequate lighting helps in reducing the risk of falls by making it easier to see potential hazards.
D. Securely fastened area rugs do not pose a risk; rather, they prevent tripping hazards associated with loose rugs.

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Correct Answer is C

Explanation

A. "Physician and nursing staff." While the physician and nursing staff play a role in providing medical care and guidance, they are not responsible for making decisions about end-of-life care when the client cannot communicate their wishes.
B. "Physician and family." The physician can provide medical recommendations and guidance, but the family members are responsible for making decisions about end-of-life care when there is no advance directive.
C. "Spouse and adult children." This is correct. In the absence of an advance directive, the responsibility for making end-of-life decisions typically falls to the spouse and/or adult children, as they are usually considered the next of kin or legal decision-makers.
D. "Notary and attorney." Notaries and attorneys are not responsible for making medical decisions about end-of-life care. Their role is more related to legal documentation and advice.

A. Apply clean gauze pads over the client's open eyes to prevent damage. B. Place the dentures in a bag that is clearly marked with the client's name. C. Remove the client's urinary catheter ensuring that the perineum is clean. D. Secure the client's upper extremities by tying them together over the abdomen.

Correct Answer is A

Explanation

A. "Apply clean gauze pads over the client's open eyes to prevent damage." This is appropriate. Closing the client's eyes and placing gauze pads over them helps to prevent drying and damage, maintaining a respectful appearance of the deceased.
B. "Place the dentures in a bag that is clearly marked with the client's name." This is incorrect. While it is important to handle personal items with respect, this option is less relevant to postmortem care compared to the other options.
C. "Remove the client's urinary catheter ensuring that the perineum is clean." This is incorrect. If the client is on home hospice care and has just died, it is generally not necessary to remove the urinary catheter unless specifically required by the hospice protocols.
D. "Secure the client's upper extremities by tying them together over the abdomen." This is incorrect and inappropriate. Tying extremities is not a standard practice and does not align with respectful postmortem care.

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A case management nurse is conducting a home assessment for an elderly client who sustained a recent fall. The case management nurse identifies which of the following environmental factors as posing the highest risk for future falls?

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