During a foot assessment, the nurse observes an area of skin that is discolored, darkened, and slightly raised. The client reports that the area has been present for several weeks. What action should the nurse take?
Apply an antibiotic ointment to the area.
Document the findings as a normal skin variation.
Instruct the client to keep the area dry and clean.
Refer the client for further evaluation by a healthcare provider.
The Correct Answer is D
An area of discolored, darkened, and slightly raised skin that has been present for several weeks may indicate a potential skin condition or complication that requires further evaluation and treatment by a healthcare provider.
Incorrect choices:
a. This choice is incorrect. Applying an antibiotic ointment without a proper diagnosis may not address the underlying issue.
b. This choice is incorrect. The described findings are not consistent with a normal skin variation and require further assessment.
c. This choice is incorrect. While keeping the area dry and clean is important, it may not be sufficient to address the underlying issue.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
New shoes should be gradually broken in to prevent friction and blisters. Wearing new shoes for long periods of time can lead to discomfort and foot injuries.
Incorrect choices:
a. This choice is correct. Choosing shoes with a wide toe box helps prevent pressure on the toes and reduces the risk of developing foot ulcers.
c. This choice is correct. Shaking out shoes before putting them on helps remove any debris that could cause discomfort or injury to the feet.
d. This choice is correct. Wearing moisture-wicking socks helps keep the feet dry and reduces the risk of moisture-related skin issues.
Correct Answer is B
Explanation
Loss of sensation to touch in the feet is consistent with peripheral neuropathy, a common complication of diabetes that affects nerve function.
Incorrect choices:
a. This choice is incorrect. Rapid capillary refill indicates good blood flow and is not directly related to neuropathy.
c. This choice is incorrect. The presence of abundant hair does not directly indicate neuropathy; rather, absence of hair may be more indicative of poor circulation.
d. This choice is incorrect. Normal skin temperature does not necessarily indicate the presence or absence of neuropathy.
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