Difficulty: Medium
Average Score: 93%
Simulated
Passage / Scenario
The home health nurse is caring for a 67-year-old female client with progressive multiple sclerosis.Item 3 of 6
Current Medications
Nurses' Notes
ÔÇó cephalexin 500 mg p.o. every six hours for 10 days
ÔÇó diazepam 5 mg p.o. daily PRN muscle spasm
ÔÇó multivitamin 1 tablet daily
ÔÇó ergocalciferol 10,000 international units p.o. Daily
The nurse updates the nursing note with an environmental assessment for a 67-year-old female client with progressive multiple sclerosis. The nurse should first address the client's
Correct answer
D
Rationale
Environmental hazards (e.g., furniture used for ambulation) pose an immediate fall risk, which is critical to address first for safety.