What is the most effective intervention to reduce the risk of falls in older hospitalized clients?

Encouraging clients to use furniture for support while walking

Performing regular medication reviews to identify drugs that increase fall risk

Placing all clients on bed rest to prevent falls

Turning off all lights at night to ensure clients sleep well

Answer and Explanation

The Correct Answer is B

A. Encouraging clients to use furniture for support while walking: Relying on furniture for stability is unsafe because objects may be unstable or out of reach, increasing fall risk rather than reducing it. Mobility aids like canes or walkers are safer alternatives.

B. Performing regular medication reviews to identify drugs that increase fall risk: Many medications, including sedatives, antihypertensives, and anticholinergics, contribute to dizziness, orthostatic hypotension, or confusion. Regular medication review and adjustment is one of the most effective interventions to minimize fall risk in older hospitalized clients.

C. Placing all clients on bed rest to prevent falls: Prolonged bed rest causes muscle weakness, joint stiffness, and deconditioning, which increase fall risk once the client attempts to mobilize. It also raises the risk of pressure injuries and thromboembolic events.

D. Turning off all lights at night to ensure clients sleep well: Complete darkness can disorient older adults and make it harder to see when getting out of bed. Using night-lights or low-level lighting is safer to prevent falls during nighttime ambulation.

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Correct Answer is A

Explanation

A. A 78-year-old with bilateral cataracts and corrected hearing loss: Cataracts can impair vision and increase fall risk, but if hearing loss is corrected and no recent falls are noted, the immediate risk is lower compared to clients with multiple compounding factors.

B. An 86-year-old recovering from pneumonia who ambulates with standby assistance: Recent illness and weakness increase fall risk, but having standby assistance during ambulation reduces the likelihood of injury.

C. A 74-year-old with stage 1 Parkinson's disease and stable vital signs: Parkinson’s disease can impair gait and balance, but in stage 1, symptoms are generally mild and manageable. The risk of a severe fall-related injury is not as high as in a client with additional high-risk factors.

D. An 81-year-old who uses a walker, takes warfarin, and has a history of falls: The combination of impaired mobility, a documented fall history, and anticoagulant therapy makes fall-related injury highly probable and more severe.

A. Ibuprofen B. Diazepam C. Warfarin D. Digoxin E. Metformin

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

Explanation

A. Ibuprofen: NSAIDs such as ibuprofen are on the Beers List due to the risk of gastrointestinal bleeding, renal impairment, and hypertension in older adults. Safer alternatives are recommended when possible.

B. Diazepam: Long-acting benzodiazepines like diazepam are included because they increase the risk of sedation, confusion, and falls in older adults. Shorter-acting agents or nonpharmacologic approaches are preferred.

C. Warfarin: Warfarin is not broadly listed as inappropriate but requires careful monitoring of INR and diet. It is often necessary for anticoagulation and is not automatically contraindicated for older adults.

D. Digoxin: Digoxin is on the Beers List at doses greater than 0.125 mg/day due to the risk of toxicity, particularly with reduced renal clearance in older adults. Lower doses or alternatives are often considered safer.

E. Metformin: Metformin is not on the Beers List and is commonly used safely in older adults, except in cases of severe renal impairment where lactic acidosis risk is increased. It is generally a preferred first-line therapy for type 2 diabetes.

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What is the most effective intervention to reduce the risk of falls in older hospitalized clients?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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

Explanation

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