一位社區健康護理師對居住在兩層樓透天厝的85歲獨居男性進行居家安全評估。該個案身體健康，但因輕度白內障有輕微視力障礙，以及預期內的年齡平衡感退化。護理師注意到屋內幾個環境特徵。下列哪項發現構成了最重大、且最容易修正的跌倒危害，護理師必須立刻指示個案將其移除？
A community health nurse conducts a home safety assessment for an 85-year-old male living independently in a two-story house. The client is healthy but has slight visual impairment from mild cataracts and expected age-related changes in balance. The nurse notes various environmental features in the house. Which finding presents the most significant, easily correctable fall hazard that the nurse must instruct the client to remove immediately?
- ASmall, unanchored throw rugs scattered across the polished hardwood living room floor.✓ 正解散落在拋光硬木地板上的小型、未固定的地毯
- BA raised, elevated toilet seat equipped firmly with grab bars in the main bathroom.主浴室中配備牢固扶手的高架馬桶座
- CA brightly lit, glaring table lamp positioned next to his favorite reading recliner.放置在最愛閱讀躺椅旁的明亮、眩光強烈的桌燈
- DStaircases entirely covered with closely woven, tightly secured wall-to-wall carpeting.完全覆蓋著緊密編織、牢固固定的滿鋪地毯的樓梯
本題單純但極度核心地測驗居家環境評估（Home Safety Assessment）。在所有預防老年人跌倒的干預措施中，移除「散佈在地板上的小地毯 (Throw rugs/Scatter rugs)」是第一優先。老年人由於步態改變（常伴隨拖步或無法抬高腳尖）以及視覺深淺判斷力退化，這種未固定的薄地毯極容易折起絆倒腳尖，或在踩踏時在地板上滑動，直接引發髖部骨折的悲劇（選項A正確）。選項C雖然反光（Glaring）可能會刺激有白內障的老人，但充足的照明基本上是好東西，且並非最直接的致死跌倒點。選項D的全面密實鋪設地毯（Wall-to-wall carpeting）實際上提供了優良的地板摩擦力並能緩衝跌倒的衝擊；選項B高架馬桶座（Raised toilet seat）及扶手，也是極為優良以避免老人起立時腿部無力跌倒的安全改裝。
This item is straightforward but profoundly tests home environment assessment (Home Safety Assessment). Among all interventions for preventing falls in older adults, removing 'small scatter/throw rugs' scattered on the floor is the highest priority. Because of gait changes (often shuffling or inability to lift the toes) and reduced depth perception in older adults, these unsecured thin rugs are extremely likely to fold up and trip the toes, or slide on the floor when stepped on, directly causing the tragedy of a hip fracture (option A is correct). Although the glare from the bright lamp in option C may irritate an older adult with cataracts, adequate lighting is fundamentally a good thing and is not the most direct fall hazard. The wall-to-wall carpeting in option D actually provides excellent floor friction and cushioning in the event of a fall; the raised toilet seat with grab bars in option B is also an excellent modification that prevents the older adult from falling due to leg weakness when standing up.
美國有龐大的人口擁有透天以及愛用地毯軟裝的文化，因此 "Throw rugs"（小塊地毯）在美國保險公司的理賠清單與 NCLEX 中永遠佔據致死排行榜首。台灣住家雖較少鋪地毯，但概念常轉換為「浴室地墊」或「門前無防滑擦腳墊」，兩地防跌邏輯相同。