Answer to Question 1ANS: A
The rapid pace walk is specifically suggested (AMA, 2010) as a good predictor of driving safety. The client is timed walking as swiftly as possible along a 10-foot path marked on the floor both away from and toward the examiner. A cane can be used, but this should be noted on the chart. A completion time of greater than 9 seconds indicates a possible need for intervention.
Answer to Question 2ANS: D
The get-up-and-go test is a simple screening measure that takes only minutes and can be conducted by trained staff. Instruct the patient to stand up from a seated position without using his or her arms or the chair arms for support, walk a few feet away, turn around and return to the chair, and sit down again without using any support. If the examiner observes any instability or difficulty with this test, further evaluation of gait and balance is required. Using the example of falls again, a home safety evaluation that includes questions about lighting, clutter on floors, footwear, bathroom configuration, stairways, sidewalks, and the availability of help in the case of a fall can focus attention on areas where safety can be improved to prevent falls. A useful tool that can be completed by patients or their families is available online in the Falls Toolkit (
www.gericareonline. net/tools/eng/falls) from the Practicing Physicians Education in Geriatrics (2006). In the case of patients who have fallen frequently, a home visit by a nurse or physical therapist is very helpful to determine what risk factors are modifiable.
Critical thinking involves analysis in which the nurse examines patient data available from a variet
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