NORCET 1 - 2020
Medical & Surgical Nursing
Medium
Which of the following is least likely to be considered a major independent risk factor for falls in the elderly?
Appeared in: NORCET 1 - 2020
Explanation
- Hearing impairment is considered a contributing, but not typically a major, independent risk factor for falls compared to factors that directly affect mobility.
- While it can reduce environmental awareness and may be linked to vestibular dysfunction, its impact is less direct than muscle weakness or arthritis.
- Key clinical guidelines often categorize muscle weakness, gait problems, arthritis, and history of falls as the most significant predictors.
Why Other Options Were Wrong
- Option A: Muscle weakness (sarcopenia) is a well-established major risk factor. It directly impairs strength, balance, and the ability to prevent a fall after a trip.
- Option C: Advanced age is a very strong independent risk factor. It represents the cumulative effect of physiological decline in multiple systems essential for maintaining balance.
- Option D: Arthritis is a major risk factor. The associated joint pain, stiffness, and deformity lead to gait instability and reduced mobility, directly increasing fall risk.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification of major versus minor risk factors for falls in the geriatric population as background academic context rather than a clinical decision trigger.
- Nurses must conduct multifactorial fall risk assessments for all elderly patients, using tools like the Morse Fall Scale or Hendrich II Fall Risk Model.
- Identifying and differentiating major from minor risk factors allows for targeted interventions, such as physical therapy for muscle weakness versus environmental modifications for sensory deficits.
- A key nursing role is medication review (polypharmacy) and patient education on fall prevention strategies, including home safety and appropriate footwear.
How to Approach the Question
- First, identify the core of the question: it asks to find the 'least likely' major risk factor for falls from the given options.
- Analyze each option's relationship to balance and mobility.
- Muscle weakness, advanced age, and arthritis all have a direct, profound impact on a person's ability to stand and walk safely.
- Consider hearing impairment. While it is a risk factor (affecting environmental awareness), its impact is more indirect compared to the physical limitations imposed by the other options.
- Conclude that hearing impairment, while relevant, is the least significant major factor among the choices provided.
Concept Tested & Keywords
- Concept Tested: Identification of major versus minor risk factors for falls in the geriatric population.
- Stem keywords: falls, elderly, risk factor
- Lead-in keywords: least likely, major independent
- Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.
- Negative lead-in flag: The question asks for the 'least likely' option, requiring identification of the weakest risk factor among the choices.
Question ID
Q5hMJkiHsNwWNPWsWggAi0
Reference Book
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 13660-13662
E6 Medicine Harrison 22e Part 1 p. 221-223
Practise the full NORCET 1 - 2020
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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