Registered Practical Nurse (RPN) Practice Test

When assessing an elderly patient after a fall, which factor should be considered regarding their cognitive state?

1. Social history

2. Physical therapy needs

3. Presence of delirium

4. Medication adherence

The correct answer is: Presence of delirium

When assessing an elderly patient after a fall, considering the presence of delirium is crucial due to its direct impact on cognitive function. Delirium is an acute, fluctuating change in mental status that can result in confusion, disorientation, and altered levels of consciousness. This condition can arise from various factors such as infections, metabolic imbalances, medication side effects, or environmental changes. In elderly individuals, who may already have underlying cognitive impairments or neurodegenerative disorders, the occurrence of delirium can exacerbate their risk for falls. Assessing for delirium allows healthcare providers to determine the urgency of the situation and whether the cognitive changes are temporary and reversible or part of a more chronic issue. The other options, while important aspects of overall health and care, do not directly address the immediate cognitive changes that can lead to falls. Social history and medication adherence are relevant for long-term care planning and understanding the patient's background, while physical therapy needs pertain to mobility and rehabilitation, but they do not assess the acute cognitive status that could explain the fall. Thus, identifying the presence of delirium assists in tailoring the immediate care approach and improving patient safety.