An older adult client with type 2 diabetes mellitus (DM) is hospitalized with an infected ulcer on his right great toe. Which instruction should the nurse emphasize during discharge teaching?
Open toed shoes allow air to circulate and help prevent toenail fungus growth.
Check the insides and linings of all enclosed shoes before putting the shoes on.
Nylon socks provide warmth without trapping excess moisture around your feet.
Be sure that you only walk barefoot on soft surfaces, such as fully carpeted rooms.
The Correct Answer is B
A. Open toed shoes allow air to circulate and help prevent toenail fungus growth: While open shoes allow ventilation, they increase the risk of trauma and infection in clients with diabetes, making them unsafe for routine use.
B. Check the insides and linings of all enclosed shoes before putting the shoes on: Inspecting shoes for debris or rough spots prevents foot injuries, which is critical for clients with diabetes who are at high risk for ulcers and infections.
C. Nylon socks provide warmth without trapping excess moisture around your feet: Nylon socks can increase moisture retention and friction, potentially worsening skin breakdown. Cotton or moisture-wicking socks are preferred.
D. Be sure that you only walk barefoot on soft surfaces, such as fully carpeted rooms: Walking barefoot increases the risk of cuts or puncture wounds, which can lead to infection in diabetic clients, and is therefore unsafe advice.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Review the client's glycosylated hemoglobin A1C (HbA1C) level: HbA1C provides an objective measurement of average blood glucose over the past 2–3 months. Reviewing this value is the most important intervention to determine overall glycemic control and guide adjustments in therapy.
B. Compare current weight with weight 3 months ago: While weight trends are useful in diabetes management, they do not directly reflect glycemic control and are secondary to evaluating blood glucose trends.
C. Ask the client to recall her last 3 days of food intake: Short-term dietary recall can help identify patterns, but it provides limited information about long-term glucose control compared with HbA1C.
D. Collect a voided urine specimen for ketone analysis: Urine ketone testing is indicated for clients at risk for diabetic ketoacidosis, usually in type 1 DM or during acute illness. It is less relevant for chronic glycemic assessment in type 2 DM.
Correct Answer is C
Explanation
A. Pitting ankle edema: Mild peripheral edema is common in Cushing's syndrome due to fluid retention. While it should be monitored, it does not typically require immediate intervention.
B. Purple marks on skin of the abdomen: These striae are characteristic of Cushing's syndrome and reflect chronic cortisol excess. They are not an acute complication requiring urgent action.
C. Irregular apical heart rate: An irregular heart rate may indicate cardiac dysrhythmia, which can be life-threatening, especially postoperatively. Immediate assessment and intervention are necessary to prevent serious complications.
D. Quarter size blood spot on dressing: Minor bleeding at a surgical site may be expected postoperatively. It requires monitoring but does not warrant urgent intervention unless it increases or shows signs of active hemorrhage.
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