A patient who has type 2 diabetes for 26 years is beginning to experience peripheral neuropathy in the feet and lower leg. The nurse is providing education to the patient to prevent injury to the feet by wearing shoes or slippers when walking. Which statement by the nurse best explains the rationale for this instruction?
Wearing shoes blocks pain perception and helps you adapt to pain, which ends up protecting your feet.
The neurological gates open when wearing shoes, which protects your feet.
If you step on something without shoes, you might not feel it; this could possibly cause injury to your foot.
Shoes provide nonpharmacological pain relief to people with diabetes and peripheral neuropathy.
The Correct Answer is C
Choice A reason: This statement is incorrect. Peripheral neuropathy in diabetes impairs sensory nerve function, reducing pain perception. Shoes don’t block pain or aid adaptation but act as a physical barrier to prevent injury. Misrepresenting neuropathy’s sensory loss could lead to inadequate patient education, increasing risks of undetected injuries like cuts or infections.
Choice B reason: The concept of “neurological gates” opening with shoes is scientifically inaccurate. Gate control theory explains pain modulation via spinal cord pathways, not footwear. Shoes protect feet mechanically, not neurologically. This misstatement fails to address neuropathy’s sensory deficits, which heighten injury risk without protective footwear, misleading patient education.
Choice C reason: This is correct. Peripheral neuropathy diminishes sensation, so patients may not feel injuries like cuts or punctures. Shoes provide a protective barrier, preventing trauma to insensate feet. This reduces risks of infections or ulcers, critical in diabetic foot care due to impaired healing and increased susceptibility to complications.
Choice D reason: Shoes don’t inherently provide nonpharmacological pain relief for neuropathy. While they may reduce discomfort from pressure or injury, their primary role is injury prevention. Neuropathic pain requires specific treatments like gabapentin or physical therapy, not shoes, which primarily address mechanical protection rather than pain modulation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Stress incontinence involves urine leakage during physical activities (e.g., coughing, sneezing) due to weak pelvic floor muscles. It does not cause constant leakage or a distended bladder, as the bladder empties normally between episodes.
Choice B reason: Overflow incontinence occurs when the bladder is overdistended and cannot empty fully, leading to constant dribbling of small urine amounts. A palpable, distended bladder indicates urinary retention, often due to obstruction or weak detrusor muscle, matching the described symptoms.
Choice C reason: Reflex incontinence involves involuntary bladder emptying due to spinal cord issues, without sensation. It does not typically cause constant leakage or a distended bladder, as the bladder empties reflexively, not retaining large volumes.
Choice D reason: Urge incontinence results from sudden, uncontrollable bladder contractions, causing urgent urination with large volume leaks. It does not involve constant small leaks or a distended bladder, as the bladder empties during episodes.
Correct Answer is C
Explanation
Choice A reason: Incontinence is a common UTI symptom but not specific to older adults. It results from bladder irritation or detrusor muscle spasms, affecting all ages. Older adults may have baseline incontinence, making it less diagnostic for UTI compared to acute cognitive changes.
Choice B reason: Low back pain may occur in UTIs, particularly with kidney involvement (pyelonephritis), but it’s not specific to older adults. It reflects inflammation or infection spread, common across age groups, and is less distinctive than cognitive changes in elderly UTI presentations.
Choice C reason: Confusion is a hallmark UTI symptom in older adults due to their increased susceptibility to delirium triggered by infection. The inflammatory response and systemic effects disrupt cerebral function, causing acute cognitive changes, making it a specific and critical finding in this population.
Choice D reason: Urinary retention can occur in UTIs due to bladder inflammation but is not specific to older adults. It’s more common in men with prostate issues or patients with neurogenic bladder, making it less distinctive than confusion for elderly UTI presentations.
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