Which attempt by the family to prevent an older, frail adult from falling causes the home health nurse concern?
Installing wooden railings on the stairway to the bathroom
Keeping the side rails up on the client's bed at night
Keeping several low wattage night-lights on in the evening
Encouraging the client to use a cane when ambulating
The Correct Answer is B
A. Installing handrails is a helpful safety measure that supports balance and mobility, reducing fall risk.
B. Keeping bed side rails up can be dangerous, especially for older, frail adults. They may try to climb over them, increasing the risk of serious injury from falls. This intervention is often considered a form of restraint.
C. Low wattage night-lights improve visibility and reduce disorientation at night, helping to prevent falls.
D. Encouraging proper assistive device use (like a cane) enhances safety during ambulation and is an appropriate fall-prevention strategy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","D"]
Explanation
A. Relaxation techniquescan help reduce symptoms and improve sleep quality in individuals with Restless Legs Syndrome (RLS), also known as Willis-Ekbom Disease (WED).
B. Diphenhydramineand other antihistamines are not recommendedfor RLS, as they can actually worsen symptomsand cause anticholinergic side effects in older adults.
C. Regular mild to moderate physical activity, especially stretching the lower extremities, can help relieve RLS symptoms and improve circulation.
D. Avoiding caffeine, alcohol, and tobaccois essential because these substances can exacerbate RLS symptoms.
E. Hot bathsare not contraindicated; in fact, they may actually help relieve symptoms for some individuals. Therefore, avoiding them is not recommended.
Correct Answer is B
Explanation
A. Immediate reversal of all symptomsis unrealistic—while levodopa can improve symptoms, it does not completely reversethe disease or do so instantly.
B. A “challenge test”involves administering levodopato see if there is a dramatic improvement in overall Parkinsonian symptoms, such as tremor, rigidity, and bradykinesia. A positive response supports the diagnosis of Parkinson’s disease.
C. Improvement in tremor onlyis too narrow and not reflective of the full purpose of the challenge test.
D. Improvement in gait onlyalso limits the test’s scope—the response is evaluated based on multiple motor symptoms, not just gait.
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