Fall Prevention Competency Exam —
Code: NUR-FALL-COMP | 100-Question
Advanced Practice Exam 2026 |
Questions & Answers with Detailed
Rationales | Complete Exam Prep &
Study Guide
1. An older adult hospitalized with orthostatic hypotension reports dizziness
when standing. Which intervention is most appropriate to reduce fall risk?
A. Encourage rapid position changes to improve circulation
B. Restrict oral fluids
C. Have the patient sit at the bedside before standing
D. Keep the patient on strict bed rest
Answer: C. Have the patient sit at the bedside before standing
Rationale: Sitting at the bedside allows the patient to stabilize before standing
and helps reduce falls associated with orthostatic hypotension.
, 2. A patient who recently received an opioid reports feeling lightheaded when
walking to the bathroom. What should the nurse do first?
A. Encourage the patient to walk independently
B. Assist the patient back to a safe position and reassess
C. Administer another dose of analgesic
D. Tell the patient to walk more slowly
Answer: B. Assist the patient back to a safe position and reassess
Rationale: Opioids can cause sedation, dizziness, and impaired balance.
Immediate safety takes priority before further ambulation.
3. Which hospitalized patient has the greatest immediate risk for falling?
A. A 30-year-old with a healed wrist fracture
B. A 45-year-old receiving oral antibiotics
C. An 82-year-old with delirium receiving sedating medications
D. A 55-year-old with controlled hypertension
Answer: C. An 82-year-old with delirium receiving sedating medications
Rationale: Advanced age, acute cognitive impairment, and sedating medications
are major interacting fall-risk factors.
4. A nurse is assessing a patient's gait. Which finding requires the greatest
concern?
A. Slightly decreased walking speed
B. Stable gait using prescribed footwear
C. Unsteady gait with frequent loss of balance
D. Use of a properly adjusted cane
Answer: C. Unsteady gait with frequent loss of balance
Rationale: Frequent loss of balance indicates significant mobility impairment
and substantially increases fall risk.
, 5. Which environmental intervention is most effective for preventing
nighttime falls?
A. Turning off all lights to promote sleep
B. Keeping frequently used items within reach and providing adequate lighting
C. Raising all four side rails
D. Placing the bedside table across the room
Answer: B. Keeping frequently used items within reach and providing adequate
lighting
Rationale: Adequate lighting and easy access to essential items reduce
unnecessary attempts to get out of bed and decrease environmental hazards.
6. A patient repeatedly attempts to climb out of bed despite instructions.
Which nursing action is most appropriate initially?
A. Apply restraints immediately
B. Determine why the patient is attempting to get out of bed
C. Raise all four side rails
D. Administer a sedative without further assessment
Answer: B. Determine why the patient is attempting to get out of bed
Rationale: Repeated attempts may result from toileting needs, pain, confusion,
or another unmet need. Identifying and addressing the cause is preferred over
restrictive measures.
7. Which medication class is particularly associated with increased fall risk in
older adults?
A. Sedative-hypnotics
B. Topical emollients
C. Fiber supplements
D. Multivitamins
Answer: A. Sedative-hypnotics
, Rationale: Sedative-hypnotics can cause sedation, impaired coordination,
delayed reaction time, and dizziness, increasing fall risk.
8. A patient using a walker consistently places the walker too far ahead before
stepping. What should the nurse teach?
A. Move the walker farther away to increase stride length
B. Keep the walker close and advance it a manageable distance before stepping
C. Lift the walker above waist level
D. Use the walker only when feeling dizzy
Answer: B. Keep the walker close and advance it a manageable distance before
stepping
Rationale: Excessive forward placement can shift the patient's center of gravity
outside the base of support and increase the risk of falling.
9. Which assessment finding should prompt a medication review for fall
prevention?
A. Patient takes one medication daily
B. Patient recently started several medications and reports dizziness
C. Patient takes vitamins with breakfast
D. Patient has no prescription medications
Answer: B. Patient recently started several medications and reports dizziness
Rationale: Polypharmacy and medication-related dizziness are important
modifiable contributors to falls.
10.A nurse discovers that a patient has fallen beside the bed. What is the
priority action?
A. Immediately move the patient back into bed
B. Assess the patient for injury before moving them
C. Complete the incident report first
D. Ask the patient why they fell
Code: NUR-FALL-COMP | 100-Question
Advanced Practice Exam 2026 |
Questions & Answers with Detailed
Rationales | Complete Exam Prep &
Study Guide
1. An older adult hospitalized with orthostatic hypotension reports dizziness
when standing. Which intervention is most appropriate to reduce fall risk?
A. Encourage rapid position changes to improve circulation
B. Restrict oral fluids
C. Have the patient sit at the bedside before standing
D. Keep the patient on strict bed rest
Answer: C. Have the patient sit at the bedside before standing
Rationale: Sitting at the bedside allows the patient to stabilize before standing
and helps reduce falls associated with orthostatic hypotension.
, 2. A patient who recently received an opioid reports feeling lightheaded when
walking to the bathroom. What should the nurse do first?
A. Encourage the patient to walk independently
B. Assist the patient back to a safe position and reassess
C. Administer another dose of analgesic
D. Tell the patient to walk more slowly
Answer: B. Assist the patient back to a safe position and reassess
Rationale: Opioids can cause sedation, dizziness, and impaired balance.
Immediate safety takes priority before further ambulation.
3. Which hospitalized patient has the greatest immediate risk for falling?
A. A 30-year-old with a healed wrist fracture
B. A 45-year-old receiving oral antibiotics
C. An 82-year-old with delirium receiving sedating medications
D. A 55-year-old with controlled hypertension
Answer: C. An 82-year-old with delirium receiving sedating medications
Rationale: Advanced age, acute cognitive impairment, and sedating medications
are major interacting fall-risk factors.
4. A nurse is assessing a patient's gait. Which finding requires the greatest
concern?
A. Slightly decreased walking speed
B. Stable gait using prescribed footwear
C. Unsteady gait with frequent loss of balance
D. Use of a properly adjusted cane
Answer: C. Unsteady gait with frequent loss of balance
Rationale: Frequent loss of balance indicates significant mobility impairment
and substantially increases fall risk.
, 5. Which environmental intervention is most effective for preventing
nighttime falls?
A. Turning off all lights to promote sleep
B. Keeping frequently used items within reach and providing adequate lighting
C. Raising all four side rails
D. Placing the bedside table across the room
Answer: B. Keeping frequently used items within reach and providing adequate
lighting
Rationale: Adequate lighting and easy access to essential items reduce
unnecessary attempts to get out of bed and decrease environmental hazards.
6. A patient repeatedly attempts to climb out of bed despite instructions.
Which nursing action is most appropriate initially?
A. Apply restraints immediately
B. Determine why the patient is attempting to get out of bed
C. Raise all four side rails
D. Administer a sedative without further assessment
Answer: B. Determine why the patient is attempting to get out of bed
Rationale: Repeated attempts may result from toileting needs, pain, confusion,
or another unmet need. Identifying and addressing the cause is preferred over
restrictive measures.
7. Which medication class is particularly associated with increased fall risk in
older adults?
A. Sedative-hypnotics
B. Topical emollients
C. Fiber supplements
D. Multivitamins
Answer: A. Sedative-hypnotics
, Rationale: Sedative-hypnotics can cause sedation, impaired coordination,
delayed reaction time, and dizziness, increasing fall risk.
8. A patient using a walker consistently places the walker too far ahead before
stepping. What should the nurse teach?
A. Move the walker farther away to increase stride length
B. Keep the walker close and advance it a manageable distance before stepping
C. Lift the walker above waist level
D. Use the walker only when feeling dizzy
Answer: B. Keep the walker close and advance it a manageable distance before
stepping
Rationale: Excessive forward placement can shift the patient's center of gravity
outside the base of support and increase the risk of falling.
9. Which assessment finding should prompt a medication review for fall
prevention?
A. Patient takes one medication daily
B. Patient recently started several medications and reports dizziness
C. Patient takes vitamins with breakfast
D. Patient has no prescription medications
Answer: B. Patient recently started several medications and reports dizziness
Rationale: Polypharmacy and medication-related dizziness are important
modifiable contributors to falls.
10.A nurse discovers that a patient has fallen beside the bed. What is the
priority action?
A. Immediately move the patient back into bed
B. Assess the patient for injury before moving them
C. Complete the incident report first
D. Ask the patient why they fell
