An older adult client, who is insulin-dependent, arrives at the diabetic clinic with concerns of thick, crusty, and long toenails that are piercing the adjacent toes. Which action should the nurse take?

Cut the nails straight across, then soak the feet for 10 minutes in an antibiotic solution.

Check the client’s feet for cuts or injury, then refer to a foot specialist for nail trimming.

Soak the feet in warm water for 5 minutes, then cut the nails straight across.

Advise the client to soften the nails with lotion prior to cutting them.

Answer and Explanation

The Correct Answer is B

Choice A reason: Cutting nails and soaking in antibiotic solution risks infection in insulin-dependent diabetes, where neuropathy impairs sensation and healing. Thick nails may be fungal, needing specialist care. Checking for injuries and referring to a podiatrist ensures safe management, preventing ulcers in high-risk diabetic feet.

Choice B reason: Checking for cuts assesses diabetic foot risk, as neuropathy and poor glycemic control impair healing. Thick nails piercing toes require podiatrist trimming to prevent trauma or infection. Referral ensures expert care, addressing pathophysiological risks of neuropathy and vascular impairment, preventing serious complications like ulcers.

Choice C reason: Soaking and cutting nails is risky in diabetes, as neuropathy increases injury risk, and warm water may introduce infection in unnoticed wounds. Fungal nails need specialist care. Referral to a podiatrist ensures safe trimming, preventing infection in compromised feet, making this action unsafe.

Choice D reason: Advising lotion to soften nails does not mitigate injury risk from trimming thick nails in diabetes. Neuropathy and poor healing increase infection risk from errors. Specialist referral ensures safe nail management, preventing trauma or ulceration, critical in diabetic foot care due to vascular deficits.

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Correct Answer is A

Explanation

Choice A reason: Questioning about related symptoms (e.g., urgency, frequency) clarifies nocturia and hesitancy, suggesting causes like benign prostatic hyperplasia. This comprehensive data guides targeted assessments, ensuring accurate diagnosis and treatment, per urological assessment and patient history standards in elderly male nursing care.

Choice B reason: Palpating for an inguinal bulge assesses hernia, unrelated to nocturia or hesitancy. Questioning related symptoms better identifies urinary issues, guiding diagnosis. Hernias are not primary causes, per urological assessment and differential diagnosis protocols in nursing care for urinary complaints.

Choice C reason: Inspecting the meatus for abnormalities or discharge may follow but is less comprehensive than symptom questioning, which broadens the urinary history. Symptoms like hesitancy suggest internal issues, per urological assessment and benign prostatic hyperplasia diagnostic standards in nursing practice for elderly men.

Choice D reason: Observing scrotal swelling assesses testicular issues, not directly linked to nocturia or hesitancy. Questioning symptoms like weak stream or dribbling prioritizes urinary tract evaluation, per urological and geriatric assessment protocols in nursing care for male urinary symptoms.

A. Eat a soft diet with increased intake of milk and milk products. B. Eat a high fiber diet and increase fluid intake. C. Have small frequent meals and sit up for at least two hours after meals. D. Eat a bland diet and avoid spicy foods.

Correct Answer is B

Explanation

Choice A reason: A soft diet with milk products may worsen diverticulosis, as dairy can cause bloating or intolerance. High fiber and fluids prevent constipation, reducing diverticular pressure. This is inappropriate, per dietary management and gastrointestinal health guidelines for diverticulosis in nursing education.

Choice B reason: A high fiber diet and increased fluid intake prevent constipation, reducing pressure in diverticula and preventing complications like diverticulitis. This promotes bowel regularity, critical for managing diverticulosis, per evidence-based dietary recommendations and gastrointestinal health protocols in patient education for nursing care.

Choice C reason: Small frequent meals and sitting up after meals aid digestion but do not address diverticulosis-specific needs. High fiber and fluids directly prevent constipation, reducing diverticular strain. This is less effective, per dietary management and patient teaching standards for diverticulosis in nursing.

Choice D reason: A bland diet avoiding spicy foods is unrelated to diverticulosis, which requires fiber to prevent constipation. Spicy foods do not directly affect diverticula. High fiber and fluids are critical, per gastrointestinal health and dietary management guidelines for diverticulosis in nursing education.

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An older adult client, who is insulin-dependent, arrives at the diabetic clinic with concerns of thick, crusty, and long toenails that are piercing the adjacent toes. Which action should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

An older male client reports nocturia with difficulty starting his urine stream. Which additional assessment should the nurse perform to obtain further data related to this information?

Correct Answer is A

Explanation

When conducting discharge teaching for a client diagnosed with diverticulosis, which diet instruction should the nurse include?

Correct Answer is B

Explanation

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