What expected physiological changes of the older adult put them at risk of falls? (Select all that apply).
Reduced muscle strength.
Sensory losses like vision and hearing.
Slowing of reflexes.
Dementia.
Inability to adapt.
Correct Answer : A,B,C
Reduced muscle strength, sensory losses like vision and hearing, and slowing of reflexes are all expected physiological changes of the older adult that can put them at risk of falls.
Reduced muscle strength can make it more difficult for older adults to maintain balance and stability.
Sensory losses like vision and hearing can affect an older adult’s ability to perceive their environment and navigate safely.
Slowing of reflexes can make it more difficult for older adults to react quickly to changes in their environment and prevent falls.
Choice D is not an answer because dementia is not a physiological change but rather a cognitive condition that can increase the risk of falls.
Choice E is not an answer because the inability to adapt is not a specific physiological change but rather a general characteristic that can increase the risk of falls.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
It is important for the nurse to understand the client’s cultural perspective and work with them to find a method that will help them adhere to their medication schedule.
This approach shows respect for the client’s cultural beliefs and values while also emphasizing the importance of taking their medications on time.
CHOICE A. Telling the client that they will die if they do not take their medications at a certain time is not an appropriate response as it may cause unnecessary fear and anxiety.
CHOICE B. Telling the client that it is their prerogative to follow the schedule or not does not emphasize the importance of adhering to the medication schedule.
CHOICE D. Simply providing the client with a schedule and a watch without discussing their cultural beliefs and values may not be effective in helping them adhere to their medication schedule.
Correct Answer is B
Explanation
Remaining attentive but silent is an appropriate response by the nurse.
This allows the client to express their feelings and concerns without interruption or judgment.
It also shows the client that the nurse is actively listening and interested in what they have to say.
Choice A is not an appropriate response because placing a client on a 72-hour hold should only be done if the client is a danger to themselves or others.
Choice C is not an appropriate response because leaving the room immediately would be unprofessional and could make the client feel abandoned.
Choice D is not an appropriate response because telling the client that everything will be fine may not be true and could give false hope.
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