Following the teaching of foot care to a diabetic patient, the nurse determines that additional instruction is needed when the patient makes which statement?

Correct Answer: D

Rationale: The correct answer is D: "I'll know if I have sores or lesions on my feet because they will be painful." The rationale for why this statement indicates a need for additional instruction is because individuals with diabetes often experience neuropathy, which can result in reduced sensation in their extremities, including the feet. This means that a diabetic patient may not feel pain from sores or lesions developing on their feet, leading to potential complications like infections and ulcers. Option A is correct because washing feet daily with soap and warm water is an essential part of foot care for diabetic patients to prevent infections. Option B is correct because wearing shoes at all times is crucial to protect diabetic feet from injuries that could lead to serious complications. Option C is correct because using a heating pad when feet are cold can cause burns due to reduced sensitivity in diabetic feet. Educationally, this question highlights the importance of proper foot care in diabetic patients to prevent complications such as infections, ulcers, and amputations. It emphasizes the need for diabetic individuals to inspect their feet regularly, regardless of pain, to identify issues early and seek medical attention promptly. This scenario underscores the significance of patient education in managing diabetes effectively and promoting self-care practices.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Calcium supplements with vitamin D can effectively maintain calcium balance. This is the most appropriate teaching for a patient with hypoparathyroidism post-surgical treatment for hyperparathyroidism because it addresses the specific issue of calcium imbalance that arises from the reduced parathyroid function. Option A) is incorrect because increasing dairy intake alone may not provide sufficient calcium and vitamin D to maintain the required balance, especially in cases of hypoparathyroidism. Option B) is incorrect as routine parenteral replacement of parathyroid hormone is not typically required for life and is not the standard of care. Option D) is incorrect as bran and whole-grain foods are not specifically indicated for managing the GI effects of replacement therapy in hypoparathyroidism. Educationally, it is essential for nurses to understand the specific dietary and therapeutic needs of patients with endocrine disorders. Providing accurate and tailored education to patients empowers them to manage their condition effectively and prevent complications. By explaining the rationale behind the correct answer, patients can make informed decisions about their health and well-being.

Correct Answer: C

Rationale: The correct answer is C) void one-half hour before the test, then at the time of the test. Rationale: For an accurate urine test for glucose and acetone, it is essential to instruct the patient to void one-half hour before the test and then at the time of the test. Voiding before the test helps to ensure that the urine sample is not contaminated with residual urine from the bladder, which could give false results. This practice helps obtain a more accurate representation of the body's current status in terms of glucose and acetone levels. Explanation of other options: A) Performing the urine test one-half hour after meals and at bedtime may not provide a clear indication of the baseline glucose and acetone levels in the urine because they can be influenced by recent food intake. B) Drinking three glasses of water before the test may dilute the urine sample, affecting the concentration of glucose and acetone, leading to inaccurate results. D) Increasing carbohydrate intake if the results are negative is not a correct practice as it does not address the immediate need for an accurate urine test and could potentially skew the results. Educational context: Understanding the correct timing and preparation for urine tests is crucial for healthcare professionals to accurately assess a patient's health status. Educating patients on the proper procedures for urine testing helps ensure reliable results and effective monitoring of conditions such as diabetes or ketosis. Proper instructions contribute to better patient outcomes and informed decision-making in healthcare.

Correct Answer: C

Rationale: In the case of Mrs. Jones, a 46-year-old diabetic who is overweight, managing her diet should assume the greatest priority. This is because diet plays a crucial role in controlling blood sugar levels in diabetics. By educating Mrs. Jones on the importance of a balanced diet, low in sugar and carbohydrates, she can better manage her diabetes and potentially lose weight, which can further improve her condition. Exercise, while important, may not be the immediate priority as dietary changes can have a more significant impact on blood sugar levels. Foot care and eye care are also important aspects of diabetes management, but they are secondary to diet in terms of immediate importance. In an educational context, this question highlights the significance of dietary management in diabetes care. It emphasizes the need for healthcare providers to prioritize teaching patients about nutrition and its impact on their condition. By focusing on diet first, patients like Mrs. Jones can take proactive steps towards better managing their diabetes and overall health.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Severe tachycardia. A thyroid storm is a severe, life-threatening exacerbation of hyperthyroidism characterized by a surge in thyroid hormones. Severe tachycardia, or a rapid heartbeat, is a hallmark symptom of a thyroid storm and indicates a significant increase in the body's metabolic rate. Immediate intervention is necessary to prevent complications like heart failure or arrhythmias. Option A) Hypothermia is incorrect as individuals in a thyroid storm typically have a high fever due to the increased metabolic activity associated with hyperthyroidism. Option B) Low blood pressure is incorrect because individuals in a thyroid storm often present with hypertension due to the increased cardiac output and peripheral resistance caused by excess thyroid hormones. Option D) Weight gain is incorrect because hyperthyroidism is associated with weight loss due to increased metabolism, and weight gain would not be a typical symptom in a thyroid storm. Educationally, understanding the signs and symptoms of a thyroid storm is crucial for healthcare providers to provide timely and appropriate care. Recognizing the urgency of addressing severe tachycardia in a thyroid storm can prevent life-threatening complications and improve patient outcomes. It underscores the importance of quick assessment and intervention in managing endocrine emergencies.