NSG 4067: MOBILITY AND SAFETY
1. A nurse is teaching health interventions to an older adult with osteoarthritis. Which of these
statements indicates that the individual needs additional teaching?
A) "I will avoid high-impact exercises."
B) "I will get adequate intake of calcium and vitamin D."
C) "I will try to limit my use of walkers and assistive devices."
D) "I will lose weight if it turns out that I need to."
Ans: C
Feedback:
Walkers and other assistive devices help relieve stress on weight-bearing joints and improve
balance. Individuals with osteoarthritis need to participate in supervised, low-impact exercises
and avoid high-impact activities. Vitamin D is essential for absorption of calcium. The individual
needs to lose weight if appropriate.
2. A nurse is teaching older adults at a senior center how to reduce the incidence of falls. Which
of the following statements indicates that the nurse's teaching has been effective?
A) "Benadryl is a safe medication to take for sleep."
B) "It is safe to have rugs in my kitchen and bathroom."
C) "It is safe to take a low dose of Ativan when I am anxious."
D) "I understand that over-the-counter medications can cause falls."
Ans: D
Feedback:
Numerous prescription and over-the-counter medications are implicated in falls.
Benzodiazepines have been studied, and it is suggested that their effect on psychomotor function
increases the incidence of falls. Benadryl (diphenhydramine) has been associated with significant
adverse effects on psychomotor skills.
3. A 99-year-old resident has fallen. Which of the following functional consequences of this fall
most strongly impacts the plan of care?
A) A 99-year-old is at much higher risk of a fracture from a fall than a younger person.
B) A 99-year-old is more likely to have limited range of motion, impacting performance of
some activities of daily living (ADLs).
C) A 99-year-old who has fallen is unlikely to develop fear of falls.
D) A 99-year-old will have diminished muscle strength related to muscle mass loss.
Ans: A
, Feedback:
The functional consequence of the fall is risk for future falls which may include a risk for
fractures. Osteoporotic fractures occur with little or no trauma to the older adult, and risk of
fractures increases in direct relation to age. While a 99-year-old may have slowed performance
of ADLs and decreased muscle mass, the high risk for falls is the most important factor (also
note these are not consequences of the fall). Fear of falling is a major concern that impacts many
residents of long-term care facilities.
4. Which of the following nursing interventions should be the priority for a nurse working in a
retirement community?
A) Using restraints to keep nursing home residents from getting out of chairs unattended
B) Establishing a fall-prevention program for residents at risk
C) Using cordless phones or emergency call systems for residents in assisted living
D) Using a monitoring device for people who live alone in their own home
Ans: B
Feedback:
Formal fall-prevention programs are implemented in home care and health care settings. These
programs can address multiple risk factors, focusing on those who are at risk for falls and the
consistent implementation of preventive measures.
5. Which of the following older adults is most at risk to develop osteoporosis?
A) A 65-year-old white woman with chronic obstructive pulmonary disease who takes
corticosteroids
B) A 65-year-old white man with rheumatoid arthritis
C) A 70-year-old African American man with a seizure disorder
D) A 68-year-old Hispanic woman who recently had a partial hysterectomy
Ans: A
Feedback:
White non-Hispanic women have a higher incidence of osteoporosis. Corticosteroids and
antiseizure medications are most frequently associated with secondary osteoporosis. White men
and African Americans of both genders have a lower incidence of osteoporosis.
6. A 79-year-old woman is scheduled to undergo hip replacement surgery after a fracture that
was caused by a fall. Which of the following age-related changes may have contributed to the
woman's susceptibility to bone fracture?
1. A nurse is teaching health interventions to an older adult with osteoarthritis. Which of these
statements indicates that the individual needs additional teaching?
A) "I will avoid high-impact exercises."
B) "I will get adequate intake of calcium and vitamin D."
C) "I will try to limit my use of walkers and assistive devices."
D) "I will lose weight if it turns out that I need to."
Ans: C
Feedback:
Walkers and other assistive devices help relieve stress on weight-bearing joints and improve
balance. Individuals with osteoarthritis need to participate in supervised, low-impact exercises
and avoid high-impact activities. Vitamin D is essential for absorption of calcium. The individual
needs to lose weight if appropriate.
2. A nurse is teaching older adults at a senior center how to reduce the incidence of falls. Which
of the following statements indicates that the nurse's teaching has been effective?
A) "Benadryl is a safe medication to take for sleep."
B) "It is safe to have rugs in my kitchen and bathroom."
C) "It is safe to take a low dose of Ativan when I am anxious."
D) "I understand that over-the-counter medications can cause falls."
Ans: D
Feedback:
Numerous prescription and over-the-counter medications are implicated in falls.
Benzodiazepines have been studied, and it is suggested that their effect on psychomotor function
increases the incidence of falls. Benadryl (diphenhydramine) has been associated with significant
adverse effects on psychomotor skills.
3. A 99-year-old resident has fallen. Which of the following functional consequences of this fall
most strongly impacts the plan of care?
A) A 99-year-old is at much higher risk of a fracture from a fall than a younger person.
B) A 99-year-old is more likely to have limited range of motion, impacting performance of
some activities of daily living (ADLs).
C) A 99-year-old who has fallen is unlikely to develop fear of falls.
D) A 99-year-old will have diminished muscle strength related to muscle mass loss.
Ans: A
, Feedback:
The functional consequence of the fall is risk for future falls which may include a risk for
fractures. Osteoporotic fractures occur with little or no trauma to the older adult, and risk of
fractures increases in direct relation to age. While a 99-year-old may have slowed performance
of ADLs and decreased muscle mass, the high risk for falls is the most important factor (also
note these are not consequences of the fall). Fear of falling is a major concern that impacts many
residents of long-term care facilities.
4. Which of the following nursing interventions should be the priority for a nurse working in a
retirement community?
A) Using restraints to keep nursing home residents from getting out of chairs unattended
B) Establishing a fall-prevention program for residents at risk
C) Using cordless phones or emergency call systems for residents in assisted living
D) Using a monitoring device for people who live alone in their own home
Ans: B
Feedback:
Formal fall-prevention programs are implemented in home care and health care settings. These
programs can address multiple risk factors, focusing on those who are at risk for falls and the
consistent implementation of preventive measures.
5. Which of the following older adults is most at risk to develop osteoporosis?
A) A 65-year-old white woman with chronic obstructive pulmonary disease who takes
corticosteroids
B) A 65-year-old white man with rheumatoid arthritis
C) A 70-year-old African American man with a seizure disorder
D) A 68-year-old Hispanic woman who recently had a partial hysterectomy
Ans: A
Feedback:
White non-Hispanic women have a higher incidence of osteoporosis. Corticosteroids and
antiseizure medications are most frequently associated with secondary osteoporosis. White men
and African Americans of both genders have a lower incidence of osteoporosis.
6. A 79-year-old woman is scheduled to undergo hip replacement surgery after a fracture that
was caused by a fall. Which of the following age-related changes may have contributed to the
woman's susceptibility to bone fracture?
