The nurse is caring for a client who has peripheral neuropathy who has developed a foot ulcer. The client's caregiver asks, "How could this have happened?" What is the nurse's best response(s)? (Select all that apply)
"Peripheral neuropathy occurs due to uncontrolled hypoglycemia, you may need to decrease your insulin."
"Decreased sensations of pain and temperature can increase your risk of undetected foot infections."
"As neuropathy progresses, feet become numb and you may not have noticed this in it's early stages."
"Foot ulcers do not occur with peripheral neuropathy, only with peripheral vascular disease".
"Peripheral neuropathy occurs due to elevated blood glucose levels over a period of years.
Correct Answer : B,C,E
A. Peripheral neuropathy is associated with chronic hyperglycemia, not hypoglycemia. Decreasing insulin would worsen blood glucose control and neuropathy risk.
B. Loss of protective sensation (pain, temperature, pressure) predisposes the client to unnoticed injuries and subsequent infections.
C. As neuropathy progresses, numbness and impaired sensation increase the risk of foot ulcers going unnoticed until they worsen.
D. Peripheral neuropathy is a leading cause of diabetic foot ulcers; it is not limited to vascular disease alone.
E. Chronic hyperglycemia over years damages nerves, leading to neuropathy and increased ulcer risk.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Macular degeneration is progressive and irreversible, so promoting hope for recovery may be unrealistic and could lead to frustration or false expectations.
B. While encouraging the use of other senses may help with adaptation, this does not directly address the client’s psychosocial needs.
C. Assessing and supporting the client’s coping skills is essential in helping them adjust to permanent vision loss, maintain independence, and prevent depression or anxiety. Psychosocial interventions are critical in chronic, irreversible conditions.
D. Blindness will change the client’s lifestyle, so emphasizing that nothing will change is misleading and could hinder realistic adjustment.
Correct Answer is D
Explanation
A. Acetaminophen is not effective in treating heat stroke, as this condition is not caused by an infection or hypothalamic reset but by failure of thermoregulation.
B. Warm blankets would worsen hyperthermia and are contraindicated in heat stroke.
C. Warm IV fluids would further increase body temperature, worsening the client’s condition.
D. The client is showing signs of heat stroke (very high temperature, confusion, tachycardia, tachypnea, and environmental exposure). The priority intervention is rapid cooling, which includes using cooled IV fluids, cooling blankets, ice packs to the groin/axillae, and removing excess clothing. This helps to lower the dangerously high core temperature and prevent organ failure.
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