A nurse is caring for a client at the endocrinologist's office.

Exhibits

The client sees the diabetic nurse educator. Click to highlight the findings that indicate an understanding of the diabetic foot care education the client received. To deselect a finding, click on the finding again.

"I understand that I need to inspect my feet daily. I will dry my feet thoroughly when I get out of the shower. It is important to apply lotion to my feet and especially my toes to keep my skin in good health. That will prevent any sores on my feet. I will be very careful when I cut my toenails and will be sure to cut them straight across and then file the edges with an emery board. I will wear closed toed shoes. I am glad I can still go barefoot in the house because I never wear shoes at home. If I have any foot sores or corns come up, I will see my doctor or go to a podiatrist instead of treating it myself."

I understand that I need to inspect my feet daily.

I will dry my feet thoroughly when I get out of the shower.

I will be very careful when I cut my toenails and will be sure to cut them straight across and then file the edges with an emery board.

I will wear closed toed shoes.

If I have any foot sores or corns come up, I will see my doctor or go to a podiatrist instead of treating it myself.

Answer and Explanation

The Correct Answer is ["A","B","C","D","E"]

Rationale:

A.   "I understand that I need to inspect my feet daily."Daily foot inspection is essential for individuals with diabetes to identify any cuts, blisters, or signs of infection early. Reduced sensation due to peripheral neuropathy can lead to unnoticed injuries that progress to serious complications if untreated.
B.   "I will dry my feet thoroughly when I get out of the shower." Keeping the feet dry, especially between the toes, helps prevent fungal infections and skin breakdown. Moist environments encourage fungal growth, which can worsen foot health in diabetic clients.
C.   "It is important to apply lotion to my feet and especially my toes to keep my skin in good health." While moisturizing helps prevent dry, cracked skin, lotion should not be applied between the toes. Moisture trapped between the toes increases the risk of fungal infections and skin maceration in diabetic clients.
D.   "I will be very careful when I cut my toenails and will be sure to cut them straight across and then file the edges with an emery board." Cutting toenails straight across and filing the edges helps prevent ingrown toenails and reduces the risk of accidental skin injury. Diabetic clients are advised to be cautious during nail care due to impaired healing and infection risk.
E.   "I will wear closed toed shoes." Wearing closed-toed shoes protects the feet from injury and trauma. Open-toed shoes or sandals may expose the feet to injury, and diabetic clients may not feel injuries due to neuropathy.
F.   "I am glad I can still go barefoot in the house because I never wear shoes at home."Going barefoot, even indoors, increases the risk of stepping on sharp objects and sustaining unnoticed injuries. Clients with diabetes should always wear well-fitting shoes or protective footwear, even at home.
G.   "If I have any foot sores or corns come up, I will see my doctor or go to a podiatrist instead of treating it myself." Diabetic clients should avoid self-treating foot problems like sores or corns. Prompt evaluation by a healthcare provider prevents complications like infections or ulcers, which can escalate quickly in this population.

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Correct Answer is C

Explanation

Rationale:

A. WBC count: Monitoring the white blood cell count is useful for detecting infection, but heroin toxicity primarily affects the respiratory system. An elevated or normal WBC does not provide immediate information about the client's ventilation or gas exchange status.

B. Intake and output: Tracking fluid balance is important for overall patient monitoring, especially in critically ill clients. However, it does not provide direct insight into the effectiveness of mechanical ventilation or the client's oxygenation status.

C. ABGs: Arterial blood gases are the priority assessment because they directly measure the client's oxygenation, ventilation (CO₂ removal), and acid-base status. Since heroin toxicity can cause respiratory depression, ABGs are essential to evaluate the effectiveness of mechanical ventilation.

D. Blood glucose level: Although monitoring glucose is important in critically ill clients, heroin use is not typically associated with hypo- or hyperglycemia. Blood glucose assessment is not as urgent as evaluating respiratory function in this scenario.

A. "I'm concerned because I'm so tired all the time." B. "I feel like I'm isolated from all my friends now." C. "I've had a fever the last couple of days." D. "I have a lot of questions about this disease."

Correct Answer is C

Explanation

Rationale:
A. "I'm concerned because I'm so tired all the time.": Fatigue is a common manifestation of SLE caused by chronic inflammation, anemia, or medication effects. While it impacts daily function, it is not an immediate threat compared to signs of infection, which can become life-threatening quickly in immunosuppressed clients.

B. "I feel like I'm isolated from all my friends now.": Emotional concerns like isolation are important in managing chronic illness, but they are not urgent physical issues. Addressing psychosocial health is necessary, but it does not take precedence over symptoms that may indicate infection or disease flare.

C. "I've had a fever the last couple of days.": Fever is a priority concern in clients with SLE as it may signal an active infection or disease flare. Immunosuppressive therapy increases the risk of severe infections, which can rapidly worsen if not treated promptly, making this the most urgent issue.

D. "I have a lot of questions about this disease.": Education is vital for long-term disease management and patient empowerment. However, it is not an immediate priority when signs of acute illness, such as fever, are present and require prompt clinical attention.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is intubated and receiving mechanical ventilation for heroin toxicity. Which of the following assessments is the nurse's priority?

Correct Answer is C

Explanation

A nurse in a community clinic is caring for a client who has systemic lupus erythematosus (SLE). Which of the following statements by the client should the nurse determine is the priority?

Correct Answer is C

Explanation

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