— 照護管理 · EASY · MCQ —
針對有跌倒史的病人，哪項護理措施為優先？
Which of the following is a priority nursing action for a client with a history of falls?
- AAssigning the client a private room將病人安置於單人房
- BEncouraging the client to walk barefoot鼓勵病人赤腳行走
- CKeeping the bed in the lowest position將床置於最低位置
- DUsing a fall-risk assessment tool✓ 正解使用跌倒風險評估工具
— Explanation · 中文詳解 —
護理程序第一步是評估（Assessment）。使用評估工具（如 Morse Fall Scale）能量化風險並據以規劃個別化照護（D）。B 是預防措施之一，但在執行前需先評估風險等級。B、A 與預防跌倒無直接相關。
The first step of the nursing process is assessment. Using an assessment tool (such as the Morse Fall Scale) quantifies risk and guides individualized care planning (D). Option C is a preventive measure, but the level of risk must first be assessed before implementing it. Options B and A are not directly related to fall prevention.
✦ 台美臨床差異
美國醫院將跌倒率列為核心績效指標（Core Measure）；台灣醫院評鑑亦重視此指標，但強調護理介入的持續性。