A nurse is reinforcing teaching for a client who has type 1 diabetes mellitus about foot care. Which of the following client statements should indicate to the nurse an understanding of the instructions?

“I put lotion between my toes.”

“I check my feet every day for sores and bruises.”

“I wear sandals in warm weather.”

“I soak my feet in warm, soapy water every night before I go to bed.”

Answer and Explanation

The Correct Answer is B

Choice A: “I put lotion between my toes.” This is incorrect because putting lotion between the toes can create a moist environment that promotes fungal growth and infection. The client should apply lotion to the tops and botoms of the feet, but avoid the areas between the toes.

Choice B: “I check my feet every day for sores and bruises.” This is correct because checking the feet every day for any signs of injury, infection, or ulceration is an important part of foot care for a client who has diabetes mellitus. The client should also report any problems to the provider and seek prompt treatment.

Choice C: “I wear sandals in warm weather.” This is incorrect because wearing sandals can expose the feet to injury, sunburn, or insect bites. The client should wear closed-toe shoes that fit well and protect the feet from trauma and environmental hazards.

Choice D: “I soak my feet in warm, soapy water every night before I go to bed.” This is incorrect because soaking the feet can cause maceration of the skin and increase the risk of infection. The client should wash the feet with mild soap and warm water, but not soak them. The client should also dry the feet thoroughly, especially between the toes.

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Correct Answer is D

Explanation

Choice A: Place the client on his back. This is incorrect because the client should be placed in a sitting position with the head of the bed elevated to 30 to 45 degrees. This allows the ﬂuid to accumulate in the lower abdomen and reduces the risk of puncturing the diaphragm.

Choice B: Have the client increase ﬂuid intake after the procedure. This is also incorrect because the client should restrict ﬂuid intake after the procedure to prevent ﬂuid overload and electrolyte imbalance. The nurse should monitor the client’s intake and output, weight, and vital signs.

Choice C: Assure the client that the procedure is painless. This is not true because the client may experience some discomfort or pressure during the insertion of the needle or catheter. The nurse should administer analgesics as prescribed and provide emotional support.

Choice D: Instruct the client to empty his bladder. This is correct because this reduces the risk of bladder injury during the procedure. The nurse should also measure and record the amount of urine voided.

A. Weight loss B. Diaphoresis C. Hyperpigmentation D. Hypotension

Correct Answer is C

Explanation

Choice A reason: Weight loss is not a symptom of Cushing’s syndrome. On the contrary, weight gain and obesity are common signs of this condition, especially in the trunk, face and upper back1.

Choice B reason: Diaphoresis, or excessive sweating, is not a symptom of Cushing’s syndrome. It can be caused by other conditions, such as hyperthyroidism, menopause or anxiety.

Choice C reason: Hyperpigmentation, or darkening of the skin, is a symptom of Cushing’s syndrome. It occurs due to increased production of melanin, the pigment that gives color to the skin. Hyperpigmentation can aﬀect any part of the body, but it is more noticeable in areas exposed to friction or pressure, such as the elbows, knees, knuckles and armpits.

Choice D reason: Hypotension, or low blood pressure, is not a symptom of Cushing’s syndrome. In fact, high blood pressure (hypertension) is one of the common symptoms of this condition, due to the eﬀects of cortisol on the cardiovascular system.

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A nurse is reinforcing teaching for a client who has type 1 diabetes mellitus about foot care. Which of the following client statements should indicate to the nurse an understanding of the instructions?

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