A nurse is assessing a patient that presents with a chief complaint of decreased sensation in the feet and non-healing ulcers on the soles of his foot. The picture below shows the patient's foot. What is likely causing the patient's symptoms?

Diabetic Neuropathy

Chronic Arterial insufficiency

Lymphedema

Chronic Venous Insufficiency

Answer and Explanation

The Correct Answer is A

A) Diabetic Neuropathy: Diabetic neuropathy is a common complication of diabetes that affects the nerves, particularly in the extremities. Symptoms include decreased sensation, numbness, and the development of non-healing ulcers on the feet due to loss of protective sensation and poor wound healing. This condition aligns with the patient's symptoms of decreased sensation and non-healing foot ulcers.
B) Chronic Arterial Insufficiency: Chronic arterial insufficiency typically presents with symptoms such as intermittent claudication (pain or cramping in the legs during activity), cold or pale extremities, and ulcers on the toes or feet that often have a more well-defined border. The non-healing ulcers and decreased sensation described are more characteristic of diabetic neuropathy than arterial insufficiency.
C) Lymphedema: Lymphedema is characterized by swelling due to lymph fluid accumulation, often affecting the lower extremities. While it can cause skin changes and ulcers, it is less commonly associated with decreased sensation and is more likely to present with swelling and skin changes rather than the specific combination of symptoms described.
D) Chronic Venous Insufficiency: Chronic venous insufficiency involves issues with blood return from the legs to the heart, leading to symptoms such as swelling, varicose veins, and ulcers typically around the ankles. It is usually associated with aching, heaviness, and swelling rather than the decreased sensation and non-healing ulcers seen in diabetic neuropathy.

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Correct Answer is D

Explanation

A) Mitral stenosis: Mitral stenosis is best assessed in the left lateral decubitus position, not by asking the client to lean forward. This position brings the mitral valve closer to the chest wall, allowing for better auscultation of the mitral valve area.
B) Atrial repolarization: Atrial repolarization, which is not typically auscultated as a distinct sound, occurs during the repolarization phase of the atria and is not specifically assessed by positioning the client in any particular way.
C) The first heart sound: The first heart sound (S1) is best heard over the mitral and tricuspid areas of the heart and does not specifically require the client to lean forward. It is associated with the closure of the atrioventricular valves and can be assessed in various positions.
D) Aortic murmurs: Aortic murmurs, including those associated with aortic stenosis or regurgitation, are often best heard with the client sitting and leaning forward. This position brings the aortic valve closer to the chest wall and can enhance the auscultation of murmurs or abnormal heart sounds associated with the aortic area.

A. Obtunded B. Stupor C. Coma D. Lethargy

Correct Answer is C

Explanation

A. Obtunded: Obtunded describes a state where a person has reduced alertness and is difficult to arouse but can respond to stimuli, such as verbal commands or physical touch. The client’s eyes remain closed and they are unresponsive to all stimuli, which is more severe than obtunded.
B. Stupor: Stupor is a condition where a person is in a near-unconscious state and responds only to vigorous or painful stimuli. Although the client is unresponsive to all stimuli, stupor usually involves some minimal response to pain or other strong stimuli, which doesn’t match the complete unresponsiveness described.
C. Coma: A coma is a profound state of unconsciousness where a person is unresponsive to all stimuli, including verbal, visual, and painful stimuli, and their eyes remain closed. This description matches the client’s condition of being unresponsive and with closed eyes.
D. Lethargy: Lethargy is characterized by excessive drowsiness or a reduced level of consciousness where the individual can be aroused with minimal effort. This state does not accurately describe a client who is unresponsive to all stimuli and whose eyes remain closed.

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A nurse is assessing a patient that presents with a chief complaint of decreased sensation in the feet and non-healing ulcers on the soles of his foot. The picture below shows the patient's foot. What is likely causing the patient's symptoms?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Explanation

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