Chapter 5 (Safety)

Open Resources for Nursing (Open RN)

Answer Key to Chapter 5 Learning Activities

1. Risk factors include hip fracture, morphine pain medication, diminished eyesight and hearing, ambulates with walker with one assist, weakness on right side, and experience of recent fall.

2. Morse Fall Risk Assessment Scoring:

  • History of fall – 25
  • Walker – 15
  • Weak Gait -10
  • Total: 50 – High Risk

3. Additional interventions to address risk factors:

  • Provide adequate lighting and night-light
  • Encourage rest
  • Use assistive devices, glasses and hearing aids

4. Potential response: “Mr. Moore, your safety is most important, and we need to ensure you do not fall. If you have a bowel movement, we will clean it up. Moving forward, it may be helpful for us to have a commode chair closer to your bedside, so we do not need to travel so far if urgency arises.”

Answers to interactive elements are given within the interactive element.

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