Which is the best intervention of the nurse for a diabetic patient who has rough skin on the feet and thick, overgrown toenails?

Gently trim the patient’s toenails after soaking the feet in warm soapy water.

Use a pumice stone to smooth roughened areas of skin on the patient’s feet.

Liberally apply lotion to the patient's feet especially between the toes.

Obtain a consultation for a podiatrist to assess the feet and provide nail care.

Answer and Explanation

The Correct Answer is D

Choice A reason: This is an incorrect choice because gently trimming the patient’s toenails after soaking the feet in warm soapy water is not the best intervention of the nurse for a diabetic patient who has rough skin on the feet and thick, overgrown toenails. Trimming the toenails can be risky for the diabetic patient, as it can cause bleeding, infection, or injury to the nail bed or surrounding skin. The nurse should avoid cutting the toenails of the diabetic patient, unless instructed by a podiatrist.

Choice B reason: This is an incorrect choice because using a pumice stone to smooth roughened areas of skin on the patient’s feet is not the best intervention of the nurse for a diabetic patient who has rough skin on the feet and thick, overgrown toenails. A pumice stone is a porous rock that can be used to exfoliate the skin and remove dead cells. However, it can also damage the skin and cause abrasions, irritation, or infection. The nurse should be careful when using a pumice stone on the diabetic patient, and avoid rubbing too hard or too often.

Choice C reason: This is an incorrect choice because liberally applying lotion to the patient's feet especially between the toes is not the best intervention of the nurse for a diabetic patient who has rough skin on the feet and thick, overgrown toenails. Applying lotion to the feet can help to moisturize and soften the skin, but it can also create a moist environment that can promote fungal growth and infection. The nurse should apply lotion sparingly to the feet of the diabetic patient, and avoid applying it between the toes.

Choice D reason: This is the correct choice because obtaining a consultation for a podiatrist to assess the feet and provide nail care is the best intervention of the nurse for a diabetic patient who has rough skin on the feet and thick, overgrown toenails. A podiatrist is a specialist who can diagnose and treat foot problems, such as nail disorders, skin conditions, or infections. The podiatrist can safely and effectively trim the toenails of the diabetic patient, and provide education and advice on foot care and prevention of complications. The nurse should refer the diabetic patient to a podiatrist at least once a year, or more often if needed.

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Correct Answer is C

Explanation

Choice A reason: This is an incorrect choice because the hospice RN works closely with the patient’s daughter to ensure that the patient’s dying requests are met is not a patient assignment that demonstrates the concept of team nursing. Team nursing is a model of care in which a team of healthcare providers, including RNs, licensed practical nurses (LPNs), nursing assistants, and other support staff, work together to provide care for a group of patients¹. Working closely with the patient’s daughter is an example of family-centered care, not team nursing.

Choice B reason: This is an incorrect choice because the RN cares for the same five patients every day during their stay following joint replacement surgery is not a patient assignment that demonstrates the concept of team nursing. Team nursing is a model of care in which a team of healthcare providers, including RNs, licensed practical nurses (LPNs), nursing assistants, and other support staff, work together to provide care for a group of patients¹. Caring for the same five patients every day is an example of primary nursing, not team nursing.

Choice C reason: This is the correct choice because the RN, the LPN, and the nursing assistant work together to provide all the care needed by eight patients for the shift is a patient assignment that demonstrates the concept of team nursing. Team nursing is a model of care in which a team of healthcare providers, including RNs, licensed practical nurses (LPNs), nursing assistants, and other support staff, work together to provide care for a group of patients¹. Each member of the team performs specific duties appropriate to their role to provide total patient care. Teams may include licensed practical nurses (LPNs) and unlicensed assistive personnel (UAP) that are supervised by a registered nurse (RN). Less experienced, or non-critical care RNs, may be assigned to a team in a critical care unit led by an experienced critical care RN. Each team member plays a vital role.

Choice D reason: This is an incorrect choice because the RN coordinates care of the patient with the physician assistant to ensure that the clinical pathway is followed is not a patient assignment that demonstrates the concept of team nursing. Team nursing is a model of care in which a team of healthcare providers, including RNs, licensed practical nurses (LPNs), nursing assistants, and other support staff, work together to provide care for a group of patients¹. Coordinating care of the patient with the physician assistant is an example of interprofessional collaboration, not team nursing.

A. The patient takes 30 mg morphine sulfate daily. B. The patient has severe joint pain due to aggressive arthritis. C. The patient has a gastrointestinal bleed. D. The patient has a history of diabetes and early renal failure. E. The patient has allergies to shellfish, strawberries, and iodine.

Correct Answer is ["C","D","E"]

Explanation

Choice A reason: This is incorrect. The patient takes 30 mg morphine sulfate daily does not lead the nurse to clarify the order for ibuprofen 600 mg PO every 8 hours. Morphine sulfate is an opioid analgesic that can be used in combination with ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID), for moderate to severe pain. The nurse should monitor the patient for signs of respiratory depression, sedation, or constipation, but there is no need to clarify the order.

Choice B reason: This is incorrect. The patient has severe joint pain due to aggressive arthritis does not lead the nurse to clarify the order for ibuprofen 600 mg PO every 8 hours. Ibuprofen is indicated for the relief of signs and symptoms of rheumatoid arthritis and osteoarthritis. The nurse should assess the patient's pain level, response to treatment, and adverse effects, but there is no need to clarify the order.

Choice C reason: This is correct. The patient has a gastrointestinal bleed leads the nurse to clarify the order for ibuprofen 600 mg PO every 8 hours. Ibuprofen can cause gastrointestinal irritation, ulceration, bleeding, and perforation. The nurse should question the order and consider alternative analgesics for the patient, especially if they have a history of peptic ulcer disease, gastritis, or bleeding disorders.

Choice D reason: This is correct. The patient has a history of diabetes and early renal failure leads the nurse to clarify the order for ibuprofen 600 mg PO every 8 hours. Ibuprofen can impair renal function, increase blood pressure, and interfere with the effects of antihypertensive and antidiabetic drugs. The nurse should question the order and monitor the patient's renal function, blood pressure, and blood glucose levels closely.

Choice E reason: This is correct. The patient has allergies to shellfish, strawberries, and iodine leads the nurse to clarify the order for ibuprofen 600 mg PO every 8 hours. Ibuprofen can cause hypersensitivity reactions, such as rash, angioedema, bronchospasm, or anaphylaxis. The nurse should question the order and ask the patient about any previous reactions to NSAIDs or aspirin. The patient may need to avoid ibuprofen and use a different analgesic..

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Which is the best intervention of the nurse for a diabetic patient who has rough skin on the feet and thick, overgrown toenails?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which patient assignment demonstrates the concept of team nursing?

Correct Answer is C

Explanation

Which assessment findings lead the nurse to clarify the order for ibuprofen 600 mg PO every 8 hours? (Select all that apply.)

Correct Answer is ["C","D","E"]

Explanation

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