Introduction To Medical Surgical Nursing, 6th Edition by Linton
Introduction To Medical Surgical Nursing, 6th Edition by Linton
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Chapter 20: Falls
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
MULTIPLE CHOICE
| a. | Remove all scatter rugs from the home. |
| b. | Rearrange the bedroom furniture. |
| c. | Arrange for someone to stay with the patient 24 hours a day. |
| d. | Purchase oversized shoes so that they are easy to get on. |
ANS: A
Scatter rugs can slip and cause a patient to fall.
DIF: Cognitive Level: Application REF: p. 320 OBJ: 5
TOP: Fall Prevention KEY: Nursing Process Step: Planning
MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control
| a. | Ask the patient to stand up. |
| b. | Document the fall according to agency policy. |
| c. | Remove or correct the cause of the fall. |
| d. | Assess the circumstances of the fall and any injuries sustained. |
ANS: D
The first implementation should be to assess what happened, determine whether any injuries have occurred, and then document and correct the cause.
DIF: Cognitive Level: Application REF: p. 321-322 OBJ: 6
TOP: Implementations for a Fall KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort
| a. | Cannot go home unless someone is with him all the time |
| b. | Must go to a long-term care facility |
| c. | Can wear devices around the neck that can signal for help |
| d. | Needs to be aware of the dangers of living alone |
ANS: C
A person who is at risk for falling would be wise to have a call system to obtain help from others. Devices worn around the neck that can send signals to a control center are effective and provide a feeling of well-being for the individual who has the potential for falling.
DIF: Cognitive Level: Comprehension REF: p. 322 OBJ: 5
TOP: Implementations for a Fall KEY: Nursing Process Step: Planning
MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control
| a. | 13% |
| b. | 27% |
| c. | 40% |
| d. | 72% |
ANS: D
Older adults constitute only 12% to 13% of the total U.S. population, but they account for 72% of the total deaths resulting from falls.
DIF: Cognitive Level: Knowledge REF: p. 315 OBJ: 2
TOP: Incidence of Falls KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control
| a. | Leave all the lights on in the room at night. |
| b. | Leave the side rails down at all times to enable the patient to get to the bathroom quickly. |
| c. | Keep the call bell and other frequently used items in easy reach. |
| d. | Keep the bed in the high position to discourage the patient from getting out of bed without assistance. |
ANS: C
Keeping the call bell and other frequently used items within easy reach will prevent the patient from having to reach, which increases the risk for falling.
DIF: Cognitive Level: Application REF: p. 318 | p. 321
OBJ: 5 TOP: Fall Prevention
KEY: Nursing Process Step: Planning
MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control
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