A nurse admitting and orienting an older adult to the hospital unit discusses fall prevention and demonstrates the use of the call bell to the patient. The patient's daughter asks: "Why don't you just put up all the side rails to prevent my mother from getting out of bed by herself and falling. That should work, right?" What is the nurse's best response?

"Side rails do not decrease falls, but they do decrease fall related injuries."

"There is no evidence that side rail use decreases falls, and in fact, there is a greater risk of injury."

"Side rails are only effective when used with patients who have dementia"

Side rails have only proven to be effective in decreasing falls in patients who have already fallen."

Answer and Explanation

The Correct Answer is B

A. "Side rails do not decrease falls, but they do decrease fall-related injuries."

Explanation: While side rails may reduce the severity of injuries if a fall occurs, they are not proven to decrease the overall rate of falls. Additionally, side rails themselves can pose risks, including entrapment.

B. There is no evidence that side rail use decreases falls, and in fact, there is a greater risk of injury."

Explanation: The use of side rails as a fall prevention measure has been associated with risks and has not been shown to effectively decrease the overall rate of falls. There is evidence that side rails can contribute to injuries, including entrapment, when patients attempt to climb over or through them. The focus in fall prevention has shifted towards individualized assessments, environmental modifications, and other strategies that address the specific needs and risks of each patient.

C. "Side rails are only effective when used with patients who have dementia."

Explanation: The effectiveness of side rails is not limited to patients with dementia. However, the use of side rails as a general fall prevention strategy has been questioned, and their use should be carefully considered based on individual assessments and risks.

D. "Side rails have only proven to be effective in decreasing falls in patients who have already fallen."

Explanation: The use of side rails is not universally proven to be effective in decreasing falls, even in patients who have previously fallen. The decision to use side rails should be based on a thorough assessment of the individual's needs and risks, considering alternatives to promote safety.

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Correct Answer is B

Explanation

A. TRICARE for Life.
Explanation: TRICARE for Life is a health insurance program for military retirees and their dependents. While it may be relevant for veterans, it is not typically available to widowed spouses, especially if they did not serve in the military themselves.

B. Medicaid.
Explanation: Medicaid is a state and federally funded program that provides health coverage to individuals with limited income and resources. In many states, Medicaid can assist in covering the costs not covered by Medicare, including premiums, deductibles, and other out-of-pocket expenses. Eligibility criteria for Medicaid vary by state, but it often considers income, assets, and medical needs.

C. Medicare Part D.
Explanation: Medicare Part D is the prescription drug coverage program for Medicare beneficiaries. It is not a substitute for supplemental insurance to cover other healthcare costs, and it focuses specifically on prescription medications.

D. Supplemental Security Income (SSI).
Explanation: SSI is a needs-based program that provides financial assistance to elderly or disabled individuals with limited income and resources. While it can assist with income support, it is not a health insurance program and may not directly cover healthcare costs. Medicaid is often coupled with SSI to provide comprehensive coverage.

A. "Use of drugs results in minimal improvement in appetite and weight gain and can have some serious side effects." B. There are no drugs that impact appetite or weight gain." C. These drugs are not permitted to be used in a long term care facility" D. Yes, there are some very effective drugs out there. Your mother should be on one of them

Correct Answer is A

Explanation

A. "Use of drugs results in minimal improvement in appetite and weight gain and can have some serious side effects."

Explanation: It is important for the nurse to provide accurate and balanced information about the use of drugs to stimulate appetite. While there are medications available that may be prescribed to improve appetite in certain situations, it is crucial to convey that the effectiveness of such drugs is limited, and they can also have potential serious side effects. Additionally, the decision to use appetite-stimulating drugs should be carefully considered, taking into account the individual's overall health, medical conditions, and potential risks associated with the medications.

B. "There are no drugs that impact appetite or weight gain."

Explanation: This statement is not accurate, as there are medications that may impact appetite and weight gain. However, the effectiveness and appropriateness of such medications should be assessed on a case-by-case basis.

C. "These drugs are not permitted to be used in a long term care facility."

Explanation: This statement is not accurate. The use of appetite-stimulating drugs may be permitted in long-term care facilities, but their use is typically based on individual assessment and consideration of potential risks and benefits.

D. "Yes, there are some very effective drugs out there. Your mother should be on one of them."

Explanation: This statement oversimplifies the decision-making process and may not provide adequate information about the potential risks and benefits of appetite-stimulating drugs. The decision to use such drugs should be made in consultation with the healthcare team, considering the individual's specific circumstances.

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Naxlex Comprehensive Predictor Exams

An older adult client who was a veteran of World War II has just died. His widowed wife did not work and does not have sufficient funds to afford supplemental Medicare insurance. You would recommend which one of the following?

Correct Answer is B

Explanation

A resident's family member is concerned that the resident is not eating adequately and is at risk for malnutrition. The family member says to a nurse, "I heard that there are drugs that can make my mother eat better. Do you think she should be on one?" What is the best response by the nurse?

Correct Answer is A

Explanation

A nurse counseling an 85-year-old person regarding modifying driving habits would include

To prevent malnutrition in older clients with dementia, which of the following would benefit your client? (Select all that apply.)

Hypothermia is a medical emergency defined as a core temperature less than 95°F. Which of the following tips to prevent hypothermia should you tell your elderly client? (Select all that apply.)

The nurse assesses the quality of which of the following patient characteristics when applying the Get-Up-and-Go test from the Hendrich II Fall Risk Model?

An older client is admitted to the hospital for treatment of pneumonia. The client has a court appointed conservator who manages her finances. The nurse understands what fact about the situation?

Which option is part of a program that addresses bowel incontinence in an older adult client?

The Bill of Rights for long-term residents was created to protect the rights of the residents in nursing homes. Which of the following examples protect these rights? (Select all that apply.)

Which attempt by the family to prevent an older frail adult from falling causes the home health nurse concern?