A nurse is caring for a client who is on fall precautions. Which of the following actions should the nurse take?

Rationale: A. Silence the bed alarm when visitors are at the client's bedside: Silencing the bed alarm, even with visitors present, eliminates an essential safety mechanism. The presence of visitors does not guarantee client supervision, and falls can still occur if the client attempts to get up unexpectedly. B. Establish an elimination schedule for the client: Creating a toileting schedule helps reduce the likelihood of the client attempting to ambulate independently to the bathroom, which is a common time for falls. This proactive approach promotes safety and preserves dignity. C. Allow the client to walk unassisted near the nursing station: Even when close to staff, allowing a fall-risk client to walk unassisted increases the chance of injury. Supervision does not replace physical support or assistive devices for those at risk. D. Raise all four bed rails on the client's bed: Raising all four bed rails is considered a form of restraint and may increase injury risk if the client attempts to climb over them. Instead, using two rails and other fall precautions is safer and more appropriate.