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Fall prevention in older adults

doi: 10.1097/01.NPR.0000466251.43731.c8
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INSTRUCTIONS Fall prevention in older adults

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PROVIDER ACCREDITATION

Lippincott Williams & Wilkins, publisher of The Nurse Practitioner journal, will award 2.0 contact hours for this continuing nursing education activity.

Lippincott Williams & Wilkins is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 2.0 contact hours. Lippincott Williams & Wilkins is also an approved provider of continuing nursing education by the District of Columbia and Florida #50-1223.

Your certificate is valid in all states.

Fall prevention in older adults

General Purpose: The purpose of this learning activity is to provide information about the occurrence and prevention of falls in older adults. Learning objectives: After completing this continuing education activity, you should be able to: 1. explore the prevalence of falls among older adults. 2. identify risk factors that predispose the older adult to falls. 3. discuss tests used to assess the older adult's risk of falling.

  1. Falls are defined as the
    1. unintentional loss of balance resulting in injury.
    2. unintentional loss of balance resulting in contact with the ground.
    3. injury resulting from contact with the ground.
  2. Each year, the percentage of people over 65 who fall is approximately
    1. 33%.
    2. 43%.
    3. 53%.
  3. By the age of 80, the percentage of persons suffering falls is
    1. 50%.
    2. 60%.
    3. 70%.
  4. The CDC estimated that the medical cost of falls among older adults in 2012 was
    1. 30 billion dollars.
    2. 50 billion dollars.
    3. 70 billion dollars.
  5. The older adult most likely to have a fatal fall is a
    1. Black male.
    2. White female.
    3. White male.
  6. Which is least likely to cause a fall?
    1. position changes
    2. stepping
    3. pushing a grocery cart
  7. Which is a neurologic condition that can increase the risk of falling?
    1. balance disorder
    2. orthostatic hypotension
    3. arthritis
  8. Vertebrobasilar insufficiency, which lowers blood flow to the brain, occurs when a person
    1. turns quickly to reach for something behind him.
    2. stands up quickly from a sitting position.
    3. reaches up or extends the neck.
  9. Micturition syncope, a potential cause of falls, occurs when a person
    1. walks to the bathroom at night after rising from a deep sleep.
    2. urinates rapidly.
    3. sits down quickly on the toilet after rising from a deep sleep.
  10. When a fall occurs, which of the following requires further exploration to fully understand the event?
    1. symptoms associated with the fall
    2. any history of previous falls
    3. the severity of the injury suffered
  11. Which medication is most likely implicated in causing orthostatic hypotension and result in a fall?
    1. proton pump inhibitors
    2. angiotensin-converting enzyme inhibitors
    3. nonsteroidal anti-inflammatory drugs
  12. Benzodiazepines and psychotropics can increase the risk of falls in older adults because they can cause
    1. confusion.
    2. orthostatic hypotension.
    3. sleepiness.
  13. Which statement is accurate about the “timed up and go test”?
    1. Use of a regular walking aid is not permitted.
    2. It evaluates gait, balance, and position change.
    3. Successfully completing it within 30 seconds documents functional independence.
  14. A score of 17 on the Tinetti POMA, a mobility assessment tool, means the older adult is at
    1. low risk for falls.
    2. medium risk for falls.
    3. high risk for falls.
  15. The percentage of falls caused by arthritis in people over the age of 45 is
    1. 15% to 20%.
    2. 25% to 30%.
    3. 35% to 40%.
  16. Because of the correlation of dementia with falls, refer patients to a neurologist for an MMSE score of
    1. 30.
    2. 26.
    3. 20.
  17. Which screening tool is designed for rapid evaluation of fall risk in the hospitalized or long-term care older adult?
    1. Morse Fall Scale
    2. MoCA
    3. CDC Fall Assessment Algorithm
  18. As a prophylaxis for falls, the older adult may be prescribed alendronate for treatment of
    1. incontinence.
    2. osteoporosis.
    3. dizziness.
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