A patient with diabetes mellitus and poor circulation has thick and ingrown toenails. What should the nurse
instruct the patient to do?
1. Soak feet in
... [Show More] Epsom salts daily.
2. Use a clean sharp razor blade to trim nails.
3. Make an appointment with a podiatrist.
4. Cut toenails immediately prior to bathing.
Correct Answer: 3
Rationale 1: There is no indication for this patient to soak feet daily in Epsom salts.
Rationale 2: The use of a clean sharp razor could cause an injury.
Rationale 3: The toenails of the patient with diabetes require close care. If the nails are thick or ingrown, they
require the attention of a podiatrist.
Rationale 4: Cutting the nails before a bath would be difficult because the nails are thick and ingrown.
Global Rationale: The toenails of the patient with diabetes require close care. If the nails are thick or ingrown,
they require the attention of a podiatrist. Cutting the nails before a bath would be difficult because the nails are
thick and ingrown. There is no indication of a need for soaking feet daily in Epsom salts.
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Reduction of Risk Potential
QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care
AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage,
age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in
their care
NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health
assessments and interventions
Nursing/Integrated Concepts: Nursing Process: Implementation
LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank
Copyright 2015 by Pearson Education, Inc.
Learning Outcome: 5. Discuss best practices of self-care management of DM related to diet planning, sick day
management, and exercise.
MNL Learning Outcome: 10.5.4. Utilize the nursing process in care of client.
Page Number: 530
Question 2
Type: MCSA
A patient with diabetes asks what can be done to prevent the development of corns on the feet. How should the
nurse respond to this patient?
1. “Make sure that you select shoes that are appropriately fitted.”
2. “Use corn pads to gradually remove the growths.”
3. “Corns are best treated by shaving them off.”
4. “A mild abrasive soap can be used to scrub the area to remove them.”
Correct Answer: 1
Rationale 1: Corns can be prevented by wearing correctly fitting shoes.
Rationale 2: Corn pads are not an option for the diabetic patient.
Rationale 3: Shaving treatments to remove the corns and are not an option for the diabetic patient.
Rationale 4: Scrubs to remove the corns are not option for the diabetic patient.
Global Rationale: Corns can be prevented by wearing correctly fitting shoes. Corn pads, scrubs, and shaving
treatments to remove the corns and are not options for the diabetic patient.
Cognitive Level: Applying
Client Need: Safe and Effective Care Environment
Client Need Sub: Safety and Infection Control
QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care
AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage,
age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in
their care
NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health
assessments and interventions
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 5. Discuss best practices of self-care management of DM related to diet planning, sick day
management, and exercise.
MNL Learning Outcome: 10.5.4. Utilize the nursing process in care of client.
LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank
Copyright 2015 by Pearson Education, Inc.
Page Number: 530
Question 3
Type: MCSA
A patient at risk for the development of type 2 diabetes mellitus asks why weight loss will reduce risk of the
condition. Which response by the nurse is most accurate?
1. “The amount of foods taken in require more insulin to adequately metabolize them, resulting in diabetes.”
2. “Excess body weight impairs the body’s release of insulin.”
3. “Thin people are less likely to become diabetic.”
4. “The physical inactivity associated with obesity causes a reduced ability by the body to produce insulin.”
Correct Answer: 2
Rationale 1: This is not a true statement.
Rationale 2: Beta cells of the body release insulin. Their actions are hindered as the amount of adipose tissue in
the body increases.
Rationale 3: While obesity is a risk factor for the development of diabetes, this does not answer the patient’s
question.
Rationale 4: Inactivity is directly linked to obesity, but it does not present a direct tie to the production of insulin.
Global Rationale: Beta cells of the body release insulin. Their actions are hindered as the amount of adipose
tissue in the body increases. The amount of food ingested does not mean that diabetes will develop because more
insulin is needed to process the food eaten. While obesity is a risk factor for the development of diabetes, this
does not answer the patient’s question. Inactivity is directly linked to obesity, but it does not present a direct tie to
the production of insulin.
Cognitive Level: Applying
Client Need: Health Promotion and Maintenance
Client Need Sub:
QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care
AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage,
age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in
their care
NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health
assessments and interventions
Nursing/Integrated Concepts: Nursing Process: Implementation
LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank
Copyright 2015 by Pearson Education, Inc.
Learning Outcome: 2. Explain the pathophysiology, risk factors, manifestations, and complications of type 1 and
type 2 DM.
MNL Learning Outcome: 10.5.2. Differentiate the risk factors and manifestations for diabetes.
Page Number: 503
Question 4
Type: MCSA
A patient recently diagnosed with type 1 diabetes mellitus does not understand why the disease developed because
the patient is thin and eats all of the time. What is the most appropriate response by the nurse?
1. “Thin people can be diabetic, too.”
2. “Your condition makes it impossible for you to gain weight.”
3. “Diabetes makes it difficult for your body to obtain energy from the foods you eat.”
4. “Your lab tests indicate the presence of diabetes.”
Correct Answer: 3
Rationale 1: While the statement about diabetics being thin is correct, it does not answer the patient’s question.
Rationale 2: It is not impossible for diabetics to gain weight.
Rationale 3: The diabetic patient is unable to obtain the needed glucose for the body’s cells, due to the lack of
insulin. Patients diagnosed with type 1 diabetes mellitus experience polyphagia and are often thin.
Rationale 4: Although the laboratory tests might indicate the presence of diabetes, it does not meet the patient’s
needs for teaching.
Global Rationale: The diabetic patient is unable to obtain the needed glucose for the body’s cells, due to the lack
of insulin. Patients diagnosed with type 1 diabetes mellitus experience polyphagia and are often thin. While the
statement about diabetics being thin is correct, it does not answer the patient. It is not impossible for diabetics to
gain weight. Although the laboratory tests might indicate the presence of diabetes, it does not meet the patient’s
needs for teaching.
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Physiological Adaptation
QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care
AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage,
age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in
their care
LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank
Copyright 2015 by Pearson Education, Inc.
NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health
assessments and interventions
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 2. Explain the pathophysiology, risk factors, manifestations, and complications of type 1 and
type 2 DM.
MNL Learning Outcome: 10.5.2. Differentiate the risk factors and manifestations for diabetes.
Page Number: 505
Question 5
Type: MCSA
A 78-year-old patient without polyuria, polydipsia, or polyphagia has a serum glucose level of 130 mg/dL. What
should the nurse conclude about this patient?
1. The patient might have eaten a meal with high sugar content prior to the testing.
2. The laboratory results might be erroneous.
3. The patient has type 1 diabetes mellitus.
4. The patient will need to be assessed for other manifestations of diabetes.
Correct Answer: 4
Rationale 1: A slight elevation in serum glucose level warrants further investigation.
Rationale 2: There is no reason to question the laboratory results at this time.
Rationale 3: There is inadequate information to make a diagnosis of type 1 diabetes mellitus.
Rationale 4: Older adults with diabetes might not present with the classic symptoms of polyuria, polyphagia, or
polydipsia. Symptoms of diabetes in older patients can include hypotension, periodontal disease, infections, and
strokes. A slight elevation in serum glucose level warrants further investigation.
Global Rationale: Older adults with diabetes might not present with the classic symptoms of polyuria,
polyphagia, or polydipsia. Symptoms of diabetes in older patients can include hypotension, periodontal disease,
infections, and strokes. A slight elevation in serum glucose level warrants further investigation. In an adequately
functioning endocrine system, dietary intake is managed by the needed amounts of insulin produced by the
pancreas. There is no reason to question the laboratory results at this time. There is inadequate information to
make a diagnosis of type 1 diabetes mellitus.
Cognitive Level: Analyzing
Client Need: Health Promotion and Maintenance
Client Need Sub:
LeMone/Burke/Bauldoff/Gubrud, Medical-Surgical Nursing 6th Edition Test Bank
Copyright 2015 by Pearson Education, Inc.
QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care
AACN Essentials Competencies: IX. 8. Implement evidence-based nursing interventions as appropriate for
managing the acute and chronic care of patients and promoting health across the lifespan
NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health
assessments and interventions
Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 2. Explain the pathophysiology, risk factors, manifestations, and complications of type 1 and
type 2 DM.
MNL Learning Outcome: 10.5.2. Differentiate the risk factors and manifestations for diabetes.
Page Number: 506, 508 [Show Less]