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Coordinated Care Plan to Prevent Older Adult Falls

Coordinating Fall Prevention Activities In Primary Care

1. What is the first step to reducing falls among older adults at the primary care clinic or health system level?

A. Identify a champion and create a fall prevention team.

B. Assess current fall prevention activities.

C. Assess readiness for practice change around fall prevention.

D. Obtain leadership support.

2. A fall prevention initiative will not succeed if the practice or institution is not ready to commit to reducing falls.

A. True

B. False

3. A fall prevention team is a small group of people within a practice who do all of the following, except:

A. Perform gait, strength, and balance tests to identify patients at risk of falling.

B. Identify barriers to implementing a fall prevention initiative.

C. Apply rapid-cycle changes to improve fall prevention activities.

D. Determine which strategies are feasible within the practice setting.

4. Which component of a clinical fall prevention program is to identify patients at increased risk of falling?

A. Screening

B. Assessment

C. Intervention

D. The purpose of screening, assessment, and intervention are to identify patients at increased risk of falling

5. All of the following are common ways to assess fall risk factors, except for:

A. Check visual acuity

B. Assess calcium intake

C. Assess feet and footwear

D. Measure orthostatic blood pressure

6. All of the following are interventions to address modifiable risk factors of older adults, except:

A. Talk with older patients about their fall risk, and actively engage them to develop their own personal fall prevention plan.

B. Optimize medications to eliminate or reduce those that may increase fall risk.

C. Provide referrals to an occupational therapist to improve home safety.

D. Address postural hypertension.

7. One of the biggest challenge to implementing a fall prevention program is:

A. Staff buy-in

B. Its complexity

C. Patient willingness

D. Caretaker awareness

8. Many people who fall become fearful and limit their activities, leading to decreased functional ability and increased frailty, which increases fall risk, therefore, fall prevention activities can enhance a patient’s self-confidence, and reduce their fear of falling.

A. True

B. False

9. All fall prevention tasks must be performed by a physician.

A. True

B. False

10. It is suggested that fall risk screening be conducted by which clinical team member?

A. Front office staff

B. Nurse

C. Medical assistant

D. Care coordinator

11. For effective fall prevention among patients, all staff members should be trained individually for the fall prevention initiative.

A. True

B. False

12. A new fall prevention program will be most successful if the implementation team:

A. Sets goals for short term wins.

B. Pays attention to the development of care plans for those who screen at risk of falls.

C. Develops a system for patient follow-up.

D. A new fall prevention program will be most successful if the implementation team sets goals for short term wins, pays attention to the development of care plans for those who screen at risk of falls, and develops a system for patient follow-up.

13. The number of fall screens performed should be reported weekly or monthly to keep team members engaged.

A. True

B. False

14. All of the following are evaluation and management codes for diagnosis and management of specific fall risk factors, except:

A. Cardiac disease

B. Incontinence

C. Cognition and neurologic diseases

D. Osteoporosis

Components of a Clinical Fall Prevention Program

15. Which core element of fall prevention is used to identify modifiable risk factors?

A. Screening

B. Assessing

C. Intervening

D. Follow-up

16. If a patient is _____ or older, they should be screened at least once a year for fall risk.

A. 45

B. 55

C. 65

D. 75

17. Which of the following is the gold standard screening tool?

A. Fall history

B. Gait, strength, and balance tests

C. The CDC’s “Stay Independent” questionnaire

D. There is no gold standard screening tool

18. All of the following people are more likely to fall, except:

A. Those who walk very slowly.

B. Those who use a cane or walker.

C. Those who have fallen before.

D. Those who are worried about falling.

19. A patient may be at increased risk of falling if a “yes” response is given to any of the following questions, except:

A. Have you fallen in the past year?

B. Do you wear bifocals?

C. Do you feel unsteady when standing or walking?

D. Are you worried about falling?

20. Which of the following is a common complaint and clinical finding in older adults that increases risk for falling and fear of falls, while decreasing mobility and independence?

A. Pain in lower extremities

B. Vision problems

C. Gait disturbance

D. Poorly fitting footwear

21. Which of the following is the preferred functional test for identifying problems with gait and balance?

A. Timed Up and Go Test

B. 30-Second Chair Stand Test

C. 4-Stage Balance Test

D. Fall History

22. Taking 2 or more of any medications can increase fall risk.

A. True

B. False

23. Low levels of _____ are associated with an increased risk of falls.

A. Calcium

B. Vitamin D

C. Vitamin B12

D. Folate

24. Patients with _____ fall at eight times the rate of patients without the condition.

A. Depression

B. Cardiac issues

C. Dementia

D. Incontinence

25. Which of the following medications requires tapering to safely discontinue use?

A. Benzodiazepines

B. Antidepressants

C. Opioids

D. Benzodiazepines, antidepressants, and opioids all require tapering to safely discontinue use

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