Difficulty: Medium
Average Score: 78%
Simulated
A nurse is caring for a client who is at risk for falls. Which of the following actions should the nurse take? (Select all that apply.)
Correct answer
C;D;E
Rationale
Correct Answer: C; D; E
Rationale:
C: Teaching the client to use the call light enables them to seek help promptly if needed, reducing the risk of falls.
D: Keeping the client's bed in the lowest position minimizes the potential fall height, enhancing safety.
E: Placing a fall-risk identification band on the client's wrist alerts healthcare providers to the need for extra precautions.
Summary:
A: Assessing the client every 4 hr is important but not directly related to fall prevention.
B: Keeping the client's room dark at night may increase the risk of falls rather than decreasing it.
F, G: No options provided, so not applicable.
Rationale:
C: Teaching the client to use the call light enables them to seek help promptly if needed, reducing the risk of falls.
D: Keeping the client's bed in the lowest position minimizes the potential fall height, enhancing safety.
E: Placing a fall-risk identification band on the client's wrist alerts healthcare providers to the need for extra precautions.
Summary:
A: Assessing the client every 4 hr is important but not directly related to fall prevention.
B: Keeping the client's room dark at night may increase the risk of falls rather than decreasing it.
F, G: No options provided, so not applicable.