A nurse admitting and orienting an older adult to the hospital unit discusses fall prevention and demonstrates the use of the call bell to the patient. The patient's daughter asks: "Why don't you just put up all the side rails to prevent my mother from getting out of bed by herself and falling. That should work, right?" What is the nurse's best response?

"Side rails do not decrease falls, but they do decrease fall related injuries."

"There is no evidence that side rail use decreases falls, and in fact, there is a greater risk of injury."

"Side rails are only effective when used with patients who have dementia"

Side rails have only proven to be effective in decreasing falls in patients who have already fallen."

Answer and Explanation

The Correct Answer is B

A. "Side rails do not decrease falls, but they do decrease fall-related injuries."

Explanation: While side rails may reduce the severity of injuries if a fall occurs, they are not proven to decrease the overall rate of falls. Additionally, side rails themselves can pose risks, including entrapment.

B. There is no evidence that side rail use decreases falls, and in fact, there is a greater risk of injury."

Explanation: The use of side rails as a fall prevention measure has been associated with risks and has not been shown to effectively decrease the overall rate of falls. There is evidence that side rails can contribute to injuries, including entrapment, when patients attempt to climb over or through them. The focus in fall prevention has shifted towards individualized assessments, environmental modifications, and other strategies that address the specific needs and risks of each patient.

C. "Side rails are only effective when used with patients who have dementia."

Explanation: The effectiveness of side rails is not limited to patients with dementia. However, the use of side rails as a general fall prevention strategy has been questioned, and their use should be carefully considered based on individual assessments and risks.

D. "Side rails have only proven to be effective in decreasing falls in patients who have already fallen."

Explanation: The use of side rails is not universally proven to be effective in decreasing falls, even in patients who have previously fallen. The decision to use side rails should be based on a thorough assessment of the individual's needs and risks, considering alternatives to promote safety.

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Correct Answer is D

Explanation

A. HIPAA (Health Insurance Portability and Accountability Act)

Explanation: HIPAA, enacted in 1996, focuses on protecting the privacy and security of individuals' health information. While it is essential in healthcare, it is not directly connected to the nursing home reform mandated by the 1987 law.

B. OASIS (Outcome and Assessment Information Set)

Explanation: OASIS is a set of standardized assessments used in home health care, primarily for Medicare-certified home health agencies. It is not directly connected to the nursing home reform mandated by the 1987 law.

C. Fulmer SPICES

Explanation: Fulmer SPICES is a tool used for assessing common geriatric syndromes, but it is not specifically associated with the nursing home reform mandated by the 1987 law.

D. Resident Assessment Instrument (RAI).

Explanation: The Resident Assessment Instrument (RAI) is associated with nursing home reform mandated by the Omnibus Budget Reconciliation Act (OBRA) of 1987. OBRA '87 established regulations and standards for nursing homes, including requirements for comprehensive assessments, care planning, and quality of care. The RAI, specifically the Minimum Data Set (MDS), is a standardized assessment tool used to evaluate the health status and needs of nursing home residents, ensuring a consistent and comprehensive approach to resident assessment and care planning.

A. "Side rails do not decrease falls, but they do decrease fall related injuries." B. "There is no evidence that side rail use decreases falls, and in fact, there is a greater risk of injury." C. "Side rails are only effective when used with patients who have dementia" D. Side rails have only proven to be effective in decreasing falls in patients who have already fallen."

Correct Answer is B

Explanation

A. "Side rails do not decrease falls, but they do decrease fall-related injuries."

B. There is no evidence that side rail use decreases falls, and in fact, there is a greater risk of injury."

C. "Side rails are only effective when used with patients who have dementia."

D. "Side rails have only proven to be effective in decreasing falls in patients who have already fallen."

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Naxlex Comprehensive Predictor Exams

Which one of the following is connected with the nursing home reform mandated by a 1987 law?

Correct Answer is D

Explanation

Correct Answer is B

Explanation

Which attempt by the family to prevent an older frail adult from falling causes the home health nurse concern?

The health care provider has not ordered the use of a restraint for an alert patient at high risk for falling. The nurse should implement which side rail use?

When assessing your client who has a history of falls, you should pay particular attention to which of the following? (Select all that apply.)

In reviewing an older adult's insurance history, you find that he is on Medicaid. What do you know that Medicaid is used for?

Which of the following is a true statement about nutrition for older adults?

The nurse wants to suggest exercise program options for an older client who is recovering losing her balance and falling. Which nursing intervention is suitable for this older adult?

A resident's family member is concerned that the resident is not eating adequately and is at risk for malnutrition. The family member says to a nurse, "I heard that there are drugs that can make my mother eat better. Do you think she should be on one?" What is the best response by the nurse?

An older adult client who was a veteran of World War II has just died. His widowed wife did not work and does not have sufficient funds to afford supplemental Medicare insurance. You would recommend which one of the following?