Home Safety And Fall Prevention - NCLEX Rn

Which medication class is a common contributor to falls and should trigger a safety review?

Sedatives/hypnotics (including benzodiazepines). These medications impair alertness, coordination, and reaction time, necessitating a review to mitigate associated fall risks.
What is the priority nursing goal of a home fall-prevention plan for an at-risk client?

Reduce fall risk while maintaining independence and safety. This goal prioritizes minimizing hazards without compromising the client's autonomy and overall well-being in their home environment.
Which walker instruction best reduces fall risk during ambulation?

Lift or roll the walker, then step into it; do not pull on it to stand. Proper technique maintains stability during movement and prevents tipping or loss of balance when using the device for support.
Which exercise focus has the strongest evidence for reducing falls in community-dwelling older adults?

Balance and strength training (for example, tai chi). Such exercises improve stability, muscle strength, and proprioception, with strong evidence supporting their efficacy in fall reduction.
Which home emergency plan element best supports rapid help after a fall for someone living alone?

Wear a personal emergency response device and keep a phone accessible. These measures enable quick summoning of assistance post-fall, critical for isolated individuals to prevent complications from delays.
Which change best reduces kitchen-related falls during meal preparation?

Store frequently used items at waist level to avoid reaching. Waist-level storage eliminates the need for unsafe reaching or climbing, reducing balance disruptions during kitchen activities.
Which home practice best prevents falls related to clutter and narrow pathways?

Keep walkways clear and cords secured against walls. Clearing clutter and securing cords eliminates tripping hazards, promoting safe navigation through commonly used home pathways.
What is the safest immediate action if a client reports dizziness when standing up?

Sit or lie down immediately and rise slowly thereafter. This action prevents falls from orthostatic hypotension by allowing blood pressure to stabilize before attempting to stand or walk.
Identify the correct sequence for walking with a cane: cane, weak leg, strong leg.

Move cane, then weak leg, then strong leg. This sequence ensures stable progression by advancing support first, followed by coordinated leg movements to maintain balance.
Which action is safest if an older adult must reach items stored above shoulder height?

Use a stable step stool with a handrail; avoid chairs. A stable stool with a handrail provides secure support for reaching, unlike unstable chairs that increase the risk of falls from height.
Which vision-related intervention best reduces fall risk in the home?

Update prescriptions and ensure adequate lighting with minimal glare. Corrected vision and optimized lighting enhance environmental perception, decreasing the likelihood of misjudging distances or obstacles.
Which finding after a fall requires urgent evaluation due to possible intracranial bleeding?

New confusion, severe headache, vomiting, or anticoagulant use. These symptoms signal possible head trauma or bleeding, especially with anticoagulants, necessitating immediate medical intervention.
What is the safest water-heater setting to reduce scald injury risk in the home?

Set to $120^{\circ}\text{F}$ (about $49^{\circ}\text{C}$ ). This temperature prevents severe scald burns while allowing sufficient heat for household needs, balancing safety and functionality.
Which assistive device instruction best prevents falls when using a cane?

Hold the cane on the stronger side. Holding the cane on the stronger side maximizes support and balance for the weaker side during ambulation, minimizing fall risk.
Which cardiovascular medication effect most increases fall risk when changing positions?

Orthostatic hypotension. This effect causes dizziness or fainting upon position changes, heightening fall risk and requiring monitoring with such medications.
Which statement indicates correct client understanding of fall prevention related to pets?

I will keep pets out of walkways and use a bell on the collar. This approach minimizes tripping over pets by ensuring clear paths and auditory alerts to their presence in the home environment.
Which stairway safety feature is most important for an older adult with balance issues?

Secure handrails on both sides of the stairs. Bilateral handrails provide necessary support and stability for individuals with balance impairments during stair ascent and descent.
Which home modification best reduces falls related to poor nighttime visibility?

Install night-lights along the bedroom-to-bathroom path. Night-lights improve visibility in low-light conditions, addressing a common cause of falls during nighttime ambulation to the bathroom.
Which flooring condition is the highest fall hazard and should be corrected first?

Loose throw rugs or unsecured carpet edges. These conditions create tripping hazards that significantly increase fall risk, especially for older adults with impaired balance or vision.
Which bathroom installation most directly reduces fall risk during toileting and bathing?

Grab bars near the toilet and in the shower/tub. Grab bars offer essential support during transfers and movements in high-risk areas where slips are common due to wet surfaces.
Which footwear choice is best to prevent falls in an older adult at home?

Low-heeled, well-fitting shoes with non-skid soles. Such footwear provides stability, traction, and support, reducing the likelihood of slips or loss of balance on home surfaces.
Which change best reduces fall risk when an older adult must use stairs at night?

Ensure bright lighting and use contrasting edge strips on steps. Enhanced lighting and contrast improve step visibility, compensating for age-related vision changes and reducing misstep risks at night.
Which bathroom item should be recommended to reduce slipping in a tub or shower?

Non-slip bath mat or non-skid adhesive strips. These provide traction on wet surfaces, directly mitigating the risk of slips during bathing activities in the tub or shower.
Identify the safest immediate nursing advice after a client reports a fall with possible injury.

Do not move; call emergency services and assess for head/hip injury. Immobilization prevents further injury, while prompt assessment and emergency response address potential serious complications like fractures.

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