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Physical Assessment Final Exam – Questions & Verified Answers
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Physical Assessment Final Exam – Questions & Verified Answers
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Physical Assessment Final Exam – Questions &Verified Answers
(CDFE) Why is it important to examine the feet of diabetic patients? (you are
looking for signs of what?) ✔️Ans - -Neuropathy which is one of the
complications of diabetes where they cant feel their feet
(CDFE) What are the symptoms of neuropathy? ✔️Ans - -Numbness,
tingling, burning
-Foot has also poor blood circulation
-dry skin -> cracks -> infection
(CDFE) Can callus on the foot lead to infections? ✔️Ans - Yes
(CDFE) What are some risk factors for ulcers and amputations? ✔️Ans - -
Poor glycemic control (patients don't monitor their sugar levels)
-Neuropathy with LOPS (loss of protective sensation)
-Smoking
-foot deformities current or history of having it
-peripheral arterial disease (PAD)
-amputation
-visual impairment (they can't tell if they have the above complications)
-Chronic kidney disease
(CDFE) Who are the patients that should be screened for a comprehensive
diabetic foot exam? ✔️Ans - -New patients
-Patients with prior evidence of neuropathy
,-patients with evidence of of sensory loss or prior
ulceration or amputation
(CDFE) When or how often should you screen patients for a comprehensive
diabetic foot exam (CDFE)? ✔️Ans - -type 2 annually
-type 1 five years after diagnosis then annually
-if the patient has a sensory loss or prior ulceration or amputation, then every
visit
(CDFE) What are the steps of comprehensive diabetic foot exam? ✔️Ans -
1) Wash hands
2) Patient interview
3) General inspection
4) Neurological exam
5) Vascular assessment
(CDFE) During the patient interview, what are you looking for to indicate you
are doing CDFE? ✔️Ans - -At their past history
-neuropathic symptoms that they might tell you about (like numbness,
tingling, or burning)
-vascular symptoms that they might tell you about like non-healing ulcers,
rest pains or claudication (pain from too little blood circulating in the foot)
-other diabetic complications
(CDFE) What types of questions would you ask during patient interview?
(Give examples) ✔️Ans - -How long have you been diagnosed with
diabetes?
-How often do you check your glucose or sugar levels?
,-what results have you been getting from checking your glucose? (if they have
uncontrolled numbers, you can continue to the next step but ask the rest of
the questions)
-Do you smoke?
-If they have any injury, ask them if the area healed or any ulceration
(CDFE) General inspection, what are you looking for? ✔️Ans - -Shoes and
socks (are they too small)
-Ulceration
-Calluses
-erythema (redness)
-nail dystrophy
-Paronychia (t.pedis)
-deformaties
-muscle wasting
(CDFE) Which of the four techniques (inspection, palpation, auscultation,
percussion) do you use during general inspection? ✔️Ans - -Inspection
and palpation only
(CDFE) How should patients cut their nails? ✔️Ans - -Across not rounding
them
(CDFE) What does hammer toe look like? ✔️Ans - It is a dip pointing
downward
(CDFE) what does claw toe look like? ✔️Ans - -The toe points upwards in
the middle then downward at the end. It curls like a claw
, (CDFE) What does charcot arthropathy look like? ✔️Ans - -It is swelling
that happens midfoot caused by the joint collapse
(CDFE) what does foot drop look like and what causes it? ✔️Ans - -The
foot dips because of loss of muscles
(CDFE) What tests do you do during neurological exam and which tests MUST
be done? ✔️Ans - -Monofilament test (must be done)
-Vibration test using a 128-hz tuning fork (must be done)
-pinprick sensation
-ankle reflexes (must be done)
-vibration perception threshold (VPT)
(CDFE) What indicates a loss of protective sensation (LOPS) after the
neurological exam? ✔️Ans - -A failure of one or more test indicate LOPS
(CDFE) Neurological 10g filament test , what does it test for and what are the
steps? ✔️Ans - -Tests for LOPS not neuropathy
1) Clean the filament (the hair) with an alcohol swab
2) Demonstrate what will happen to the patient's foot on another body part
3) Ask the patient to close their eyes
4) Avoid areas of callus
5) On EACH foot, you will pick 5 sites 3 of which are required. The 1st, 3rd, 5th
metatarsal heads are required and for the other 2 sites you can pick between
the 1st, 3rd, 5th toe
6) After you apply the filament against each site, tell them if they feel it (ask
them 1= don't feel it or 2= feel it)
7) record the results
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