A nurse is assessing a patient that presents with a chief complaint of decreased sensation in the feet and non-healing ulcers on the soles of his foot. The picture below shows the patient's foot. What is likely causing the patient's symptoms?
Diabetic Neuropathy
Chronic Arterial insufficiency
Lymphedema
Chronic Venous Insufficiency
The Correct Answer is A
A) Diabetic Neuropathy: Diabetic neuropathy is a common complication of diabetes that affects the nerves, particularly in the extremities. Symptoms include decreased sensation, numbness, and the development of non-healing ulcers on the feet due to loss of protective sensation and poor wound healing. This condition aligns with the patient's symptoms of decreased sensation and non-healing foot ulcers.
B) Chronic Arterial Insufficiency: Chronic arterial insufficiency typically presents with symptoms such as intermittent claudication (pain or cramping in the legs during activity), cold or pale extremities, and ulcers on the toes or feet that often have a more well-defined border. The non-healing ulcers and decreased sensation described are more characteristic of diabetic neuropathy than arterial insufficiency.
C) Lymphedema: Lymphedema is characterized by swelling due to lymph fluid accumulation, often affecting the lower extremities. While it can cause skin changes and ulcers, it is less commonly associated with decreased sensation and is more likely to present with swelling and skin changes rather than the specific combination of symptoms described.
D) Chronic Venous Insufficiency: Chronic venous insufficiency involves issues with blood return from the legs to the heart, leading to symptoms such as swelling, varicose veins, and ulcers typically around the ankles. It is usually associated with aching, heaviness, and swelling rather than the decreased sensation and non-healing ulcers seen in diabetic neuropathy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A) Lateralization of the sound/vibration to both ears equally: The Weber test is used to assess unilateral hearing loss and would not show equal lateralization in the presence of unilateral sensorineural hearing loss. Equal lateralization would suggest normal hearing or symmetrical hearing loss, which is not the case here.
B) Lateralization of the sound/vibration to the left ear: In sensorineural hearing loss, sound is perceived to lateralize to the unaffected ear. Therefore, with right ear sensorineural hearing loss, the sound will lateralize to the left ear, indicating that the left ear has better hearing capability.
C) Bone conduction (BC) is greater than air conduction (AC): This finding is characteristic of conductive hearing loss, not sensorineural hearing loss. In sensorineural hearing loss, air conduction is typically greater than or equal to bone conduction, but the Weber test focuses on lateralization rather than BC versus AC.
D) Lateralization of the sound/vibration to the right ear: If the sound were to lateralize to the affected ear in sensorineural hearing loss, it would suggest that the affected ear is hearing better, which contradicts the nature of sensorineural hearing loss. The sound will actually lateralize to the better-hearing, unaffected ear.
Correct Answer is D
Explanation
A. Pelvic examination: A pelvic examination is generally used to assess the reproductive organs in females rather than the prostate. It does not provide a direct assessment of the prostate gland in males.
B. Transillumination: Transillumination is a technique used to detect fluid-filled cysts or masses in areas such as the scrotum or breast. It is not used to assess the prostate gland.
C. Bladder percussion: Bladder percussion is used to assess bladder size and fullness, typically to diagnose conditions related to bladder dysfunction. It does not provide information about the prostate.
D. Digital rectal examination: A digital rectal examination (DRE) is the standard method used to assess the size, shape, and consistency of the prostate gland. It allows the clinician to feel the prostate through the rectal wall and is essential for evaluating prostate health.
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