護理師評估病人的跌倒風險。下列哪項因素最容易導致老年住院病人跌倒？
A nurse is assessing a client for fall risk. Which factor should the nurse consider as the most significant contributor to an elderly client's fall in the hospital?
- AAdvanced age over 8080歲以上的高齡
- BHistory of a previous fall✓ 正解有先前跌倒的病史
- CPresence of an intravenous line有靜脈輸液線
- DDim lighting in the hallway走廊照明不足
跌倒風險評估的核心在於識別病人是否有過往的跌倒史（History of fall）。臨床實證顯示，過去的跌倒史是預測未來再次跌倒最強而有力的指標，因為這暗示了病人可能存在尚未解決的生理、認知或環境因素。雖然老年、環境照明不足或設備干擾均為風險因子，但過往跌倒史代表病人可能已有步態不穩、感覺統合異常或藥物副作用等潛在問題，這對護理師而言是必須優先評估並介入的臨床警訊。
The core of fall risk assessment lies in identifying whether the patient has a history of previous falls. Clinical evidence shows that a history of previous falls is the strongest predictor of future falls because it suggests that the patient may have unresolved physiological, cognitive, or environmental factors. Although advanced age, inadequate environmental lighting, or interfering equipment are all risk factors, a history of falls indicates that the patient may have underlying issues such as gait instability, sensory integration abnormalities, or medication side effects; for the nurse, this is a clinical warning that must be prioritized for assessment and intervention.