# A client with diabetes and reduced protective sensation is reviewing foot care. For each action, select the best classification.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=395669&lang=en  
> language: en  
> subject: Health Promotion/Disease Prevention  
> category: HPM

## Question

A client with diabetes and reduced protective sensation is reviewing foot care. For each action, select the best classification.

|  | Daily preventive self-care | Report or obtain professional assessment promptly | Increases injury risk |
| --- | --- | --- | --- |
| Inspect the tops and soles of both feet every day, using a mirror or help from another person when needed |  |  |  |
| Wash the feet in warm, not hot, water and dry carefully |  |  |  |
| Report a new blister, cut, redness, swelling, sore, or change in the skin or nails |  |  |  |
| Obtain the recommended professional foot examination even when the feet do not hurt |  |  |  |
| Walk barefoot indoors so the skin becomes tougher |  |  |  |
| Cut a corn or callus with a razor or use a chemical remover without professional guidance |  |  |  |

## Explanation

Diabetes and peripheral neuropathy can reduce awareness of pressure, heat, cuts, and blisters. Prevention includes daily inspection, warm rather than hot water, careful drying, well-fitting shoes and socks, and regular professional foot assessment. New cuts, blisters, redness, swelling, sores, or nail and skin changes should be reported promptly. Walking barefoot and attempting to cut corns or calluses can create wounds that are not felt and should be avoided.

## In-depth explanation

Correct Answer
Inspect and wash the feet safely every day, report new skin changes promptly, and avoid barefoot walking or self-removal of corns and calluses.

Why It Fits
Reduced protective sensation removes the warning pain that normally limits pressure, heat, and trauma. The plan therefore relies on visual inspection and prevention instead of waiting for discomfort.

Clinical Picture
A small blister or callus can progress before the client feels it. Early reporting allows the health care team to assess perfusion, infection, pressure, footwear, and the need for podiatric care.

Memory Link
Look every day, use warm not hot water, protect with shoes, and report changes early.

NCLEX Rule
Teaching must match the sensory deficit. Do not use pain as the only trigger for action in a client with neuropathy.

Why the Alternatives Fail
Bare feet increase exposure to cuts and burns. Razors and chemical corn removers can damage tissue, and soaking or very hot water can macerate or burn skin without a reliable warning sensation.

Source
1CDC Tips for Healthy Feet
2CDC Diabetes Care Schedule
32026 NCLEX-RN Test Plan

## Clinical scenario

The client has no current ulcer or infection and can perform daily self-care. The nurse teaches prevention, signs that require prompt reporting, and practices that can create an unnoticed injury.

## Key concepts

- **Protective sensation** — The ability to feel pressure, pain, and temperature strongly enough to avoid or respond to tissue injury.
- **Peripheral neuropathy** — Peripheral nerve damage that may cause numbness, tingling, pain, or loss of protective sensation in the feet.
- **Daily foot inspection** — A systematic visual check of the tops, soles, heels, between the toes, skin, and nails for a new injury or change.

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