A client with diabetes mellitus presents with a foot ulcer that is not healing. Which of the following factors could be contributing to the delayed healing?
Poor blood glucose control.
Inadequate protein intake.
Peripheral neuropathy.
All of the above.
The Correct Answer is D
Choice A rationale
Poor blood glucose control is a significant factor in delayed wound healing in patients with diabetes. Hyperglycemia impairs various aspects of the immune response, reduces blood flow, and increases the risk of infection, all of which contribute to delayed healing.
Choice B rationale
Inadequate protein intake can also contribute to delayed wound healing. Protein is essential for the repair and regeneration of tissues, and a deficiency can impair the body’s ability to heal wounds effectively.
Choice C rationale
Peripheral neuropathy, a common complication of diabetes, can lead to decreased sensation in the feet, making it more likely for injuries to go unnoticed and untreated. This can result in chronic wounds and delayed healing.
Choice D rationale
All of the above factors—poor blood glucose control, inadequate protein intake, and peripheral neuropathy—can contribute to delayed healing of foot ulcers in patients with diabetes. Each of these factors plays a role in the complex process of wound healing and can hinder the body’s ability to repair itself.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Increased shortness of breath is a key symptom of worsening congestive heart failure (CHF). It indicates that the heart is not effectively pumping blood, leading to fluid buildup in the lungs and increased respiratory effort.
Choice B rationale
A temperature of 37°C (98.6°F) is within the normal range and does not indicate worsening CHF. Monitoring the patient’s temperature is important, but it is not a sign of CHF exacerbation.
Choice C rationale
A blood pressure of 120/80 mmHg is within the normal range and does not indicate worsening CHF. Blood pressure should be monitored, but this reading does not suggest an acute issue.
Choice D rationale
Occasional dizziness can be a symptom of many conditions, including CHF, but it is not as specific or critical as increased shortness of breath. It should be monitored, but it does not indicate an immediate worsening of CHF.
Correct Answer is A
Explanation
Choice A rationale
Administering antihypertensive medication as prescribed is the priority action for a client with a history of hypertension presenting with severe headache, blurred vision, and confusion.
These symptoms suggest a hypertensive crisis, which requires immediate blood pressure reduction to prevent further complications.
Choice B rationale
Preparing the client for a lumbar puncture is not the priority action in this scenario. While a lumbar puncture may be necessary to rule out other conditions, the immediate concern is to manage the hypertensive crisis.
Choice C rationale
Initiating seizure precautions is important if the client is at risk of seizures, but the priority action is to address the hypertensive crisis by administering antihypertensive medication.
Choice D rationale
Monitoring the client’s blood glucose levels is important for overall health management, but it is not the priority action in this scenario. The immediate concern is to manage the hypertensive crisis.
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