skip to main content

Advance care planning in advanced heart failure — SCE Geriatric Medicine MCQ

Instant feedback + full explanation. One question, done properly.

HardPalliative careAdvance care planning in advanced heart failureSCE Geriatric Medicine

A 79-year-old with moderate frailty has fallen once in the past year without injury or loss of consciousness. She is unable to get up without help and remained on the floor for 90 minutes. Which next step is recommended?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: BUndertake a comprehensive falls assessment before agreeing a tailored management plan

Explanation lettering: C = shown as A · A = shown as C · E = shown as D · D = shown as E

B is correct: inability to get up independently after a fall is one of the NG249 triggers for comprehensive falls assessment and tailored management, as are frailty, injury, loss of consciousness and recurrent falls. A generic leaflet does not address medication, cardiovascular, gait, vision, continence, feet, environment or fear-of-falling contributors. Prediction scores are not recommended. Bone health is important but cannot substitute for assessment of why she fell or why she could not recover from the floor.

Reference: NICE NG249: Falls assessment and prevention: https://www.nice.org.uk/guidance/ng249/chapter/Recommendations/