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1. You are triaging residents for an intensive fall-prevention program. Based on the course data on repeat falls, which resident represents the highest statistical priority for targeted interventions?
A. A 76-year-old who had a single fall 10 years ago and has been fully active since
B. A 70-year-old with no history of falls who walks independently without assistive devices
C. An 88-year-old who fell once last month and now reports fear of walking to the dining room
D. An 82-year-old who occasionally stumbles but has never actually fallen
2. CMS requires a "systems approach" to fall prevention in long-term care. Which action best reflects this regulatory expectation rather than a narrow, event-focused response?
A. Relying on quarterly quality meetings to discuss falls without linking findings to changes in individual care plans
B. Completing an incident report only when a fall results in a major injury requiring hospitalization
C. Conducting thorough documentation and investigation of every fall, then using findings to adjust environmental hazards and individualized supervision levels
D. Posting general fall-prevention posters on units while leaving room-level hazard checks to individual nurses’ discretion
3. During gait assessment, you notice an older adult walking with a wider base, shorter steps, and slowed gait. Based on the physiology of aging described in the course, how should you interpret these findings?
A. They prove that the vestibular system is intact and that fall risk is driven almost entirely by environmental hazards
B. They are harmless quirks of personal walking style that indicate the resident is at a lower risk of falls
C. They primarily reflect early cognitive decline rather than changes in sensory or balance systems
D. They are compensatory strategies for age-related decline in proprioception and reaction time that still leave the resident at increased fall risk
4. A resident taking seven daily medications, including a benzodiazepine at bedtime, has begun experiencing night-time falls. According to the course content, which interpretation should most strongly guide your next steps?
A. The resident’s falls are most likely unrelated to medication and instead reflect unavoidable consequences of normal aging
B. Benzodiazepines alone do not meaningfully affect night-time stability, so attention should focus exclusively on environmental hazards in the bedroom
C. Polypharmacy is defined purely by the number of prescriptions, so as long as each drug is indicated, fall risk is unaffected
D. The combination of polypharmacy (more than four medications) and benzodiazepine use significantly elevates fall and hip fracture risk, warranting an urgent interdisciplinary medication review
5. You are reviewing a resident’s profile: lower body weakness, vitamin D deficiency, vision problems, use of sedating medications, and home clutter. How does the course recommend conceptualizing this set of risks?
A. As primarily psychological issues in which fear of falling is the only factor that meaningfully predicts future falls
B. As largely independent variables where addressing any single factor will reliably eliminate fall risk
C. As additive "building blocks" that cumulatively make falls more likely as each new risk factor is layered on
D. As an atypical pattern, since older adults usually fall because of a single dominant risk factor
6. Your facility is preparing a resident to discharge home after rehabilitation. Which strategy best aligns with the course’s description of an effective home safety assessment process?
A. Relying on the resident’s verbal description of their home without an in-person visit and assuming it is hazard-free if they have lived there for many years
B. Handing the family a generic fall-prevention brochure and asking them to self-assess the home environment
C. Arranging a planned outing in which a trained staff member visits the home with the resident, assesses hazards firsthand, and then provides written modification recommendations
D. Postponing any home assessment until after the resident experiences a fall at home so you can see the "real" risk factors
7. In the shared room of Mr. Jones (walker, fall history) and Mr. Davis (wheelchair, many possessions), which initial action most closely reflects the course’s guidance on environmental safety and resident autonomy?
A. Explaining that clutter is a personal choice and that staff cannot interfere unless a fall has already occurred
B. Removing all of Mr. Davis’s personal items while he is at an activity to eliminate hazards as quickly as possible
C. Prioritizing Mr. Jones’s needs by moving his bed closer to the bathroom and leaving Mr. Davis’s side of the room unchanged
D. Collaboratively decluttering pathways with Mr. Davis by finding storage for items so both his personal belongings and clear, safe walkways are preserved
8. You are evaluating technology options for fall prevention. Based on the course, which implementation choice would most directly improve real-time response to unwitnessed falls?
A. Using wearable pendants or necklaces with accelerometers that can detect at least 85% of falls and automatically alert staff
B. Relying solely on quarterly telehealth visits to address medical issues that might contribute to falls
C. Installing smart floor sensors throughout the entire building despite cost and feasibility concerns in skilled nursing settings
D. Replacing in-person rounds with video calls to resident rooms as the main method of monitoring mobility
9. CMS Appendix PP requires structured medication oversight in skilled nursing facilities. Which process best reflects compliance with these regulations as described in the course?
A. A nurse informally reviewing medications during routine vitals checks without regular physician or pharmacist input or formal documentation
B. A physician reviewing each resident’s health and medication orders on the mandated schedule while a pharmacist performs comprehensive monthly regimen reviews, with both sets of findings integrated into the care plan and communicated to frontline staff
C. A pharmacist performing an annual chart review while physicians adjust medications only when a resident or family member complains
D. An interdisciplinary team discussing medications during care conferences but not formally updating the resident’s care plan or documenting rationale for changes
10. After a resident falls, you lead an interdisciplinary review and suspect medication-related dizziness as a contributor. According to the course, which action most appropriately integrates this finding into ongoing care?
A. Recording the fall in the incident log but postponing medication review until the next routine pharmacist visit several months later
B. Discontinuing all psychoactive medications immediately without consulting the prescriber to remove any potential contributors
C. Focusing solely on adding a bed alarm, since environmental alarms are highlighted as effective primary fall-prevention tools
D. Analyzing the full medication profile, recent changes, and administration timing, then collaborating with the physician and pharmacist to adjust the regimen and documenting all changes in the care plan
11. A resident with diabetes, peripheral neuropathy, and fluctuating blood sugars reports feeling "weak and wobbly" before meals. Based on the course content, which interpretation best guides fall-prevention planning?
A. Diabetes mainly increases fracture risk rather than the likelihood of falling, so fall-prevention planning should focus on calcium and vitamin D alone
B. Blood sugar fluctuations are unlikely to affect balance, so fall-prevention efforts should focus mainly on footwear and environmental modification
C. Neuropathy alone explains the instability; there is no need to address blood sugar trends if the resident is not reporting pain
D. Both hyperglycemia and hypoglycemia can cause dizziness, weakness, and confusion, which, combined with neuropathy-related sensory loss, significantly increases fall risk and warrants tight coordination with diabetes management
12. You are updating the care plan for a resident with Parkinson’s disease (PD) who has begun experiencing "freezing" episodes and orthostatic hypotension. According to the course, which strategy best aligns with PD-specific fall-prevention guidance?
A. Discouraging PT/OT because challenging exercise is considered unsafe for individuals with PD
B. Assuming falls are unavoidable in PD and focusing solely on educating staff to expect more injuries
C. Relying primarily on adding sedative medications to reduce movement and thus theoretically reduce falls
D. Placing the resident on a preventative PT/OT maintenance program focused on balance, gait training, and compensatory strategies for freezing and blood pressure drops
13. Your facility is revising protocols for sensory health. Which policy change would most directly reflect the course’s recommendations linking sensory care and fall prevention?
A. Prioritizing decorative lighting and background music to enhance ambiance, regardless of illumination levels or noise volume
B. Providing magnifying glasses on request but not routinely arranging for formal vision or hearing assessments
C. Ensuring residents over 65 have access to comprehensive eye exams every 1–2 years, verifying updated eyeglass prescriptions and fit, and establishing processes for audiology referrals and hearing aid maintenance
D. Assuming that if residents do not complain about vision or hearing, specialized exams are unnecessary
14. A resident begins using a cane after a hip fracture. During training, which instruction is most consistent with the course’s evidence-based guidance on safe assistive device use?
A. Hold the cane on the same side as the painful leg so weight is kept off the stronger side
B. Hold the cane on the side opposite the weak or painful leg, with the handle at wrist height to create about a 20–30 degree elbow bend
C. Adjust the cane so the resident’s elbow is completely straight when holding it, maximizing weight transfer
D. Use the cane in either hand depending on comfort; hand dominance is more important than leg weakness
15. You notice an older adult wearing backless slippers with worn, smooth soles and reporting new foot numbness. Based on the course, which combined intervention best targets their fall risk?
A. Allowing continued use of the slippers but adding a second pair of socks for warmth and cushioning
B. Replacing the footwear with well-fitting shoes that have secure fastenings, non-slip soles, and low heels, while assessing for neuropathy-related gait changes
C. Focusing solely on strength exercises, since footwear type has minimal impact on slips and trips
D. Recommending higher heels to improve posture and reduce the need for assistive devices
16. A new nutrition protocol is being developed. Which recommendation best reflects the course’s evidence on nutrition, hydration, and fall risk?
A. Promoting diets rich in fish, vegetables, fruits, nuts, and low-fat dairy while encouraging roughly one-third of body weight in ounces of fluid daily (about 13 cups for older men and 9 for older women), with active monitoring for malnutrition and dehydration signs
B. Prioritizing high-calorie sweets and red meat to prevent weight loss, while advising residents to drink fluids only when thirsty to avoid nocturia
C. Focusing exclusively on vitamin supplements and assuming overall diet composition has little effect on fall vulnerability
D. Discouraging soups and water-rich foods because they may reduce appetite for solid meals
17. Your team is redesigning the exercise program in an assisted living facility. Which model most closely applies the research summarized in the course?
A. Implementing a progressive, multi-component program that blends resistance training, balance-challenging tasks, and aerobic activity for at least two hours per week, with ongoing progression to meaningfully reduce fall rates
B. Offering only gentle seated stretching three times a month to avoid any risk of muscle fatigue or discomfort
C. Using high-tech equipment exclusively, as effective fall-prevention exercise depends mainly on expensive machinery rather than program design
D. Providing brief, unsupervised walking sessions and assuming residents will self-intensify activities as needed
18. While implementing a new falls class, a colleague argues that "any movement is good" and that challenging residents is unnecessary. How does the course’s review of Sadaqa et al. (2023) help you respond?
A. It concludes that mild stretching is as effective as intensive multi-component programs, so avoiding challenge is preferred for safety
B. It emphasizes that programs which truly challenge lower extremity strength and balance—using progressive resistance and destabilizing tasks—can reduce falls by up to 50%, whereas low-challenge routines may not significantly change fall trajectories
C. It shows that exercise has minimal effect on falls and is mainly useful for resident enjoyment rather than measurable risk reduction
D. It recommends limiting exercise to short, once-weekly sessions to avoid interfering with other facility activities
19. You find a resident on the floor after an unwitnessed fall. According to the emergency response guidance in the course, what is the most appropriate sequence of your initial actions?
A. Leave the resident in place and wait for the next scheduled physician round rather than activating emergency protocols
B. Quickly lift the resident back into bed to avoid embarrassment, then check for pain once they are lying down
C. Ensure the scene is safe, avoid moving the resident, perform a rapid assessment for serious injury, and call emergency medical services immediately if you identify altered consciousness, severe pain, deformity, or inability to move
D. Ask the resident to stand immediately to see if they can walk, using their response as the primary injury assessment
20. After confirming no serious injury, you prepare to help a resident up from the floor. Which technique aligns with the fall-recovery steps outlined in the course?
A. Have the resident grab your shoulders while you lift them directly to standing in one movement to minimize time on the floor
B. Guide the resident to roll onto their side, then to hands and knees, use a sturdy chair or furniture for support, allow rest, and assist them to rise slowly into a seated position with help from another staff member if needed
C. Use a rapid drag technique to pull the resident across the floor to the nearest bed before performing any assessment
D. Encourage the resident to get up without any furniture support so they can "rebuild confidence" immediately
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