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A nurse is reinforcing teaching with the family of an older adult client about safety precautions. Which of the following recommendations should the nurse include to reduce the risk of a client fall? (Select all that apply.)

Ensure the client wears nonskid slippers when walking around the house.

Attach full-length side rails to the client's bed.

Install a raised toilet seat in the client's bathroom.

Encourage an annual review of the medications the client is taking.

Place throw rugs on uncarpeted floors in the client's home.

Answer and Explanation

Correct Answer : A,C,D

Ensure the client wears nonskid slippers when walking around the house.

Explanation: Nonskid slippers provide better traction and stability, reducing the risk of slipping.

B.Attach full-length side rails to the client's bed.

Explanation: Side rails can pose a risk of entrapment and may not prevent falls. The use of side rails is associated with safety concerns, and their use should be carefully evaluated.

C.Install a raised toilet seat in the client's bathroom.

Explanation: A raised toilet seat makes it easier for the client to sit down and stand up, reducing the risk of falls in the bathroom.

D.Encourage an annual review of the medications the client is taking.

Explanation: Medication reviews help identify drugs that may increase the risk of falls or interactions that could affect balance or cognitive function.

E.Place throw rugs on uncarpeted floors in the client's home.

Explanation: Throw rugs can be tripping hazards, especially for older adults with mobility issues. It's safer to have clear, unobstructed pathways in the home.

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Correct Answer is C

Explanation

A. Disinfect hands using an alcohol-based waterless antiseptic:

While alcohol-based hand sanitizers are effective against many germs, including bacteria, they may not be as effective against C. difficile. Soap and water are preferable for hand hygiene in C. difficile cases because alcohol does not effectively kill the spores.

B. Wear an N95 respirator when caring for the client:

The primary mode of transmission for C. difficile is through the fecal-oral route, and respiratory precautions are not necessary. Standard precautions, including wearing gloves and gowns, are generally sufficient.

C. Use diluted bleach to clean soiled equipment:

This is the correct answer. Bleach is an effective disinfectant against C. difficile spores. It is recommended for cleaning surfaces and equipment that may be contaminated.

D. Provide a room with negative-pressure airflow:

Negative-pressure airflow rooms are typically reserved for airborne infections, and they are not necessary for C. difficile. Standard precautions, along with thorough cleaning and disinfection, are the key measures.

A. A client who reports experiencing short-term memory loss B. A client who is wearing urine-scented clothing C. A client who has fingernails that are discolored and broken D. A client who provides a detailed description of a recent fall at home

Correct Answer is B

Explanation

A. A client who reports experiencing short-term memory loss:

Memory loss is a common issue in older adults and does not necessarily indicate elder abuse. While it is a concern that should be addressed, it may not be related to abuse unless there are specific circumstances suggesting mistreatment.

B. A client who is wearing urine-scented clothing.

Wearing urine-scented clothing can be indicative of neglect, which is a form of elder abuse. Neglect occurs when the basic needs of an older adult, such as hygiene and cleanliness, are not adequately met. The nurse should report this finding to the case manager so that appropriate interventions and assessments can be made to address the potential abuse or neglect.

C. A client who has fingernails that are discolored and broken:

Fingernail issues can have various causes, including medical conditions or self-neglect. Discolored and broken fingernails alone may not be conclusive evidence of elder abuse, and further assessment is needed to determine the cause.

D. A client who provides a detailed description of a recent fall at home:

While falls are a concern, providing a detailed description of a fall is not necessarily indicative of elder abuse. Falls can occur for various reasons, and additional assessment is needed to determine the circumstances surrounding the fall and whether abuse or neglect is involved.

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A nurse is reinforcing teaching with the family of an older adult client about safety precautions. Which of the following recommendations should the nurse include to reduce the risk of a client fall? (Select all that apply.)

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