INI-CET EXAM -2026
Medical Surgical Nursing
Easy
. Which of the following is least likely to be considered a major independent risk factor for falls in the elderly?
Appeared in: INI-CET EXAM -2026
Explanation
- Hearing impairment is considered a contributing or secondary risk factor for falls, not a major independent one.
- While hearing loss can reduce awareness of environmental hazards, its impact on balance and stability is less direct than factors that compromise the musculoskeletal or central processing systems.
- Major risk factors are those that directly and significantly affect a person's strength, gait, balance, and stability.
- Literature on fall prevention prioritizes addressing muscle weakness, gait/balance problems, vision impairment, and medication side effects over hearing impairment.
Why Other Options Were Wrong
- Option A: This is incorrect because muscle weakness (sarcopenia) is one of the most significant and direct risk factors for falls. It impairs postural control, strength, and the ability to recover from a loss of balance.
- Option C: This is incorrect because advanced age (typically defined as over 65 or 75) is a primary non-modifiable risk factor. Aging is associated with a decline in multiple physiological systems essential for maintaining balance.
- Option D: This is incorrect because arthritis causes joint pain, stiffness, and deformity, which directly lead to gait instability and reduced mobility, making it a major risk factor for falls.
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 elderly population as background academic context rather than a clinical decision trigger.
- Nurses must perform comprehensive fall risk assessments on all elderly patients upon admission and regularly thereafter, using standardized tools like the Morse Fall Scale or Hendrich II Fall Risk Model.
- Fall prevention is a critical patient safety goal. Interventions are multifactorial and must be tailored to the individual's specific risk factors, including strength and balance exercises, medication review, environmental modifications, and patient education.
- What if? If the patient had a significant vestibular disorder (like vertigo) along with hearing impairment, the combination would constitute a major risk factor, as the vestibular system is crucial for balance.
How to Approach the Question
- First, recognize the negative framing of the question: 'least likely'. This means you are looking for the option that is the weakest risk factor compared to the others.
- Evaluate each option based on its direct impact on balance and stability.
- Analyze Option A (Muscle weakness): This directly affects strength and the ability to stay upright. It's a strong risk factor.
- Analyze Option C (Advanced age): This is a well-known, powerful predictor associated with declines in multiple systems related to balance.
- Analyze Option D (Arthritis): This directly causes pain and joint instability, affecting gait. It's a strong risk factor.
- Analyze Option B (Hearing impairment): This is a sensory deficit. While it can be a factor, its role is less direct in maintaining physical balance compared to muscle strength, joint function, and overall physiological resilience associated with age.
Concept Tested & Keywords
- Concept Tested: Identification of major versus minor risk factors for falls in the elderly population.
- Stem keywords: falls, elderly, risk factor, major, independent
- Lead-in keywords: least likely
- Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.
- Negative lead-in flag: The question asks for the option that is LEAST likely to be a major risk factor.
Question ID
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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 Nursing Fundamentals Taylor p. 290-292
Practise the full INI-CET EXAM -2026
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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