The nurse assesses the quality of which of the following patient characteristics when applying the Get-Up-and-Go test from the Hendrich II Fall Risk Model?

Balance

Stride

Flexibility

Speed

Answer and Explanation

The Correct Answer is A

A. Balance:

The Get-Up-and-Go test assesses the patient's ability to maintain balance during the process of standing up from a chair, walking a short distance, turning around, and sitting down. Impaired balance can be a significant risk factor for falls.

B. Stride:

Stride, or the length of a person's step, is not explicitly assessed in the Get-Up-and-Go test. However, the test may indirectly provide information about the patient's walking pattern and step characteristics.

C. Flexibility:

While flexibility is not a specific focus of the Get-Up-and-Go test, the test involves movements that require a degree of joint flexibility, such as bending the knees to stand up and sit down.

D. Speed:

Speed is an important aspect of the Get-Up-and-Go test. The time taken by the patient to complete the entire sequence of standing up, walking, turning, and sitting down is considered. Slower performance on the test may indicate an increased risk of falls.

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Correct Answer is ["A","C","D","F"]

Explanation

A. Has a history of alcohol abuse
Explanation: Alcohol can contribute to hypothermia as it causes vasodilation, leading to heat loss. It can impair the body's ability to regulate temperature.

B. Bathes three to four times a week
Explanation: While personal hygiene is important, the frequency of bathing alone may not be a direct risk factor for hypothermia. The overall environmental temperature and the individual's ability to regulate their body temperature are more critical considerations.

C. Has a history of diabetes mellitus
Explanation: Diabetes mellitus can increase the risk of hypothermia as it may affect circulation and peripheral nerve function. Impaired sensation and reduced blood flow can contribute to difficulty in maintaining body temperature.

D. Becomes diaphoretic on warm days
Explanation: Excessive sweating (diaphoresis) can contribute to the risk of hypothermia, as it leads to moisture loss from the skin, making it more challenging for the body to maintain a stable temperature.

E. Is prescribed antidepressant
Explanation: While certain medications, including some antidepressants, can affect thermoregulation, the prescription of an antidepressant alone does not necessarily indicate an increased risk of hypothermia. It is essential to consider the specific medication and its potential side effects.

F. Has a history of a cerebrovascular accident (CVA)
Explanation: Individuals with a history of a cerebrovascular accident may have impaired thermoregulation due to damage to the central nervous system. This can increase susceptibility to temperature extremes.

A. TRICARE for Life B. Medicaid C. Medicare Part D D. Supplemental Security Income

Correct Answer is B

Explanation

A. TRICARE for Life.
Explanation: TRICARE for Life is a health insurance program for military retirees and their dependents. While it may be relevant for veterans, it is not typically available to widowed spouses, especially if they did not serve in the military themselves.

B. Medicaid.
Explanation: Medicaid is a state and federally funded program that provides health coverage to individuals with limited income and resources. In many states, Medicaid can assist in covering the costs not covered by Medicare, including premiums, deductibles, and other out-of-pocket expenses. Eligibility criteria for Medicaid vary by state, but it often considers income, assets, and medical needs.

C. Medicare Part D.
Explanation: Medicare Part D is the prescription drug coverage program for Medicare beneficiaries. It is not a substitute for supplemental insurance to cover other healthcare costs, and it focuses specifically on prescription medications.

D. Supplemental Security Income (SSI).
Explanation: SSI is a needs-based program that provides financial assistance to elderly or disabled individuals with limited income and resources. While it can assist with income support, it is not a health insurance program and may not directly cover healthcare costs. Medicaid is often coupled with SSI to provide comprehensive coverage.

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The nurse assesses the quality of which of the following patient characteristics when applying the Get-Up-and-Go test from the Hendrich II Fall Risk Model?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse plans care to prevent a dangerous thermal environment for an older adult client who lives in a northern climate of the United States. Which client assessment data does the nurse recognize that can contribute to the risk of hypothermia? (Select all that apply.)

Correct Answer is ["A","C","D","F"]

Explanation

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Correct Answer is B

Explanation

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