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Stepping up care for diabetic foot ulcers

CE Test

Learn to assess and manage this dangerous complication correctly so you can help your patient avoid amputation.

GENERAL PURPOSE To provide nurses with an overview of diabetic foot ulcers. LEARNING OBJECTIVES After reading the preceding article and taking this test, you should be able to: 1. Discuss risk factors and pathophysiology related to the development of diabetic foot ulcers. 2. Identify assessment techniques and significant findings for diabetic foot ulcers. 3. Describe the management, patient teaching, and wound care for diabetic foot ulcers.

1. Which 50-year-old patient is athighestSrisk for developing diabetic foot ulcers?

a. a woman with optimal blood glucose control and no history of previous foot ulcers

b. a woman with poor blood glucose control who's never smoked

c. a man with optimal blood glucose control who's had diabetes for 7 years

d. a man with poor blood glucose control who smokes one pack of cigarettes per day

2. Peripheral vascular disease is most likely to cause which foot problems?

a. bone deformities

b. inactive sweat glands

c. ulcers and compromised healing

d. callus formation

3. The progressive and degenerative arthropathy that ultimately results in the collapse of the foot's arch is known as

a. Morton's neuroma.

b. Charcot's foot.

c. plantar fasciitis.

d. hallux valgus.

4. The most frequent cause of injury to the diabetic foot is

a. callus removal.

b. bunionectomy.

c. repetitive stress.

d. incorrect toenail trimming.

5. In a patient with decreased posterior tibial pulses and absent dorsalis pedis pulses, suspect

a. PAD.

b. peripheral neuropathy.

c. Charcot's foot.

d. venous stasis.

6. Which is a simple, inexpensive, and reliable test for neuropathy?

a. venography

b. magnetic resonance imaging

c. arteriography

d. Semmes-Weinstein monofilament test

7. An ankle/brachial index may be falsely elevated in a patient with diabetes because of

a. vessel calcification.

b. PAD.

c. venous stasis.

d. peripheral neuropathy.

8. Which TBI indicates that arterial flow is sufficient to heal a foot ulcer?

a. 0.3

b. 0.5

c. 0.8

d. 1.0

9. A patient with a Meggit-Wagner Ulcer Classification of 5 has

a. preulceration lesions.

b. gangrene.

c. osteomyelitis.

d. a superficial ulcer.

10. Themost appropriatedressing for a patient with a clean, uninfected diabetic foot ulcer with minimal drainage is

a. an absorbent dressing.

b. a silver impregnated dressing.

c. a skin substitute.

d. an occlusive dressing.

11. Absorbent dressings such as foams or alginates aremost appropriatefor which type of wound?

a. wounds with a large amount of exudate

b. wounds that are infected

c. wounds that are poorly vascularized

d. clean, uninfected wounds

12. A properly applied total contact cast promotes healing of foot ulcers by

a. applying pressure directly to the wound bed.

b. distributing pressure over the entire surface of the leg and foot.

c. limiting pressure to just the wound margins.

d. transferring pressure from the heel to the ball of the foot.



© 2005 Lippincott Williams & Wilkins, Inc.