An older adult man diagnosed with diabetes mellitus complains to the nurse that his feet feel like they are burning. Which of the following interventions should the nurse recommend to this older adult to reduce his discomfort?
Wear well-fitting shoes
Soak the feet in warm water
Apply antifungal powder on the feet
Wear knee-high nylon stockings
The Correct Answer is A
Choice A reason: Wearing well-fitting shoes is a good intervention for the older adult man to reduce his discomfort, as it can prevent pressure, friction, or injury to his feet, which can worsen the burning sensation. The nurse would advise the older adult man to choose shoes that are comfortable, supportive, and breathable, and to avoid shoes that are too tight, too loose, or have high heels or pointed toes.
Choice B reason: Soaking the feet in warm water is not a recommended intervention for the older adult man to reduce his discomfort, as it can dry out his skin, increase the risk of infection, or cause thermal injury if the water is too hot. The nurse would advise the older adult man to wash his feet daily with mild soap and lukewarm water, and to dry them thoroughly, especially between the toes.
Choice C reason: Applying antifungal powder on the feet is not a necessary intervention for the older adult man to reduce his discomfort, unless he has a fungal infection, such as athlete's foot, which can cause itching, burning, or cracking of the skin. The nurse would advise the older adult man to check his feet regularly for any signs of infection, such as redness, swelling, or pus, and to seek medical attention if he has any.
Choice D reason: Wearing knee-high nylon stockings is not a helpful intervention for the older adult man to reduce his discomfort, as it can impair his blood circulation, trap moisture, or irritate his skin. The nurse would advise the older adult man to wear socks that are made of cotton or wool, and to change them daily or whenever they are wet or dirty.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: FACE pain rating scale is not the most useful assessment tool for a cognitively impaired patient who cannot accurately report pain, as it relies on the patient's ability to match their pain intensity to a series of facial expressions. The patient may not be able to understand or use the scale appropriately.
Choice B reason: OLDCART-based assessment tool is not the most useful assessment tool for a cognitively impaired patient who cannot accurately report pain, as it relies on the patient's ability to provide detailed information about the onset, location, duration, characteristics, aggravating factors, relieving factors, and treatment of their pain. The patient may not be able to recall or communicate this information effectively.
Choice C reason: PAINAD scale is the most useful assessment tool for a cognitively impaired patient who cannot accurately report pain, as it relies on the nurse's observation of the patient's behavior and physiological responses to pain. The scale consists of five items: breathing, vocalization, facial expression, body language, and consolability. Each item is scored from 0 to 2, and the total score ranges from 0 to 10. A higher score indicates more pain.
Choice D reason: 0 to 10 numeric pain scale is not the most useful assessment tool for a cognitively impaired patient who cannot accurately report pain, as it relies on the patient's ability to rate their pain intensity on a scale from 0 (no pain) to 10 (worst possible pain). The patient may not be able to comprehend or use the scale correctly.
Choice E reason: None of the above is not the correct answer, as there is one choice that is the most useful assessment tool for a cognitively impaired patient who cannot accurately report pain.
Correct Answer is D
Explanation
Choice A reason: Older adult’s self-report is not the most helpful tool, as it may not be reliable or consistent in older adults, especially if they have cognitive impairment, communication difficulties, or cultural barriers. Older adults may also underreport or overreport their pain due to fear, stoicism, or expectations.
Choice B reason: FPS-R (Faces Pain Scale-Revised) is not the most helpful tool, as it may not be suitable or valid for older adults, especially if they have visual impairment, facial paralysis, or dementia. FPS-R is a pictorial scale that uses six facial expressions to represent different levels of pain intensity, from 0 (no pain) to 10 (very much pain).
Choice C reason: Pain medication frequency is not the most helpful tool, as it may not reflect the actual pain level or the effectiveness of the pharmacotherapy. Pain medication frequency may vary depending on the type, dose, route, and duration of the medication, as well as the individual response and tolerance of the older adult.
Choice D reason: Older adult's pain diary is the most helpful tool, as it can provide a comprehensive and longitudinal record of the pain experience, including the location, intensity, quality, frequency, duration, triggers, relievers, and impact of the pain. A pain diary can also help track the use and response of the comfort measures, activity, and pharmacotherapy, and identify the patterns and trends of the pain.
Choice E reason: None of the above is not the correct answer, as there is one choice that is the most helpful tool for the nurse to use.
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