Which client is at the greatest risk for falling during a fall risk assessment?

The choice indicating that an elderly adult who is confused and has urinary frequency is at the greatest risk for falling is correct due to several critical factors.

Elderly adults are naturally at a higher risk for falls due to physical changes associated with aging, such as decreased balance, muscle strength, and coordination. Confusion further compounds this risk because it can lead to impaired judgment and poor spatial awareness. A confused individual may not recognize their surroundings or understand hazards, making them more vulnerable to accidents.

Additionally, urinary frequency suggests that the individual may need to get up frequently to use the restroom, potentially leading to hurried movements and a greater likelihood of losing balance or misstepping, particularly during the night when visibility is lower and the individual may be disoriented.

In comparison, the other scenarios present lower risks: a young adult with a sprained ankle might be cautious and take measures to avoid further injury; an older adult with no history of falls may demonstrate better balance and control; and a middle-aged client with stable medical conditions is less likely to be affected by the factors that typically lead to falls. Therefore, the combination of an elderly individual's increased susceptibility with the added complications of confusion and urinary frequency significantly heightens their fall risk.