MNT Foot Care for Elderly Patients 1 — Questions and Answers
Question 1: Which age-related change most increases the risk of nail pathology in elderly patients?
- Increased nail growth rate
- Reduced peripheral circulation, thinner epidermis, and slower nail regeneration (Correct answer)
- Increased skin moisture retention
- Enhanced immune response
Correct answer: Reduced peripheral circulation, thinner epidermis, and slower nail regeneration
Aging reduces peripheral blood flow, thins the protective skin barrier, and slows nail growth and healing, increasing susceptibility to infection, trauma, and chronic nail deformities.
Question 2: When assessing footwear in an elderly patient, the primary concern is:
- Fashion and style
- Fit, adequate toe box depth and width, non-slip sole, and ease of fastening (Correct answer)
- Color and material preference
- Brand name and cost
Correct answer: Fit, adequate toe box depth and width, non-slip sole, and ease of fastening
Poorly fitting footwear is the leading cause of nail and foot problems in elderly patients; proper fit prevents pressure injury, nail deformity, and falls.
Question 3: Which skin finding is most commonly observed on the feet of elderly patients during assessment?
- Smooth, moist skin with normal elasticity
- Xerosis (dry skin), fissuring, and loss of subcutaneous fat padding (Correct answer)
- Hyperpigmentation and increased sweat secretion
- Abundant skin turgor and nail growth
Correct answer: Xerosis (dry skin), fissuring, and loss of subcutaneous fat padding
Aging skin loses sebaceous and sweat gland function, subcutaneous fat, and elasticity, resulting in dry, fragile skin prone to fissuring, particularly on the heels.
Question 4: The term 'digital ischemia' in elderly foot care refers to:
- Fungal infection of the digits
- Insufficient blood supply to the toes causing tissue damage, pain, or non-healing wounds (Correct answer)
- Excessive moisture between the toes
- Bone deformity of the phalangeal joints
Correct answer: Insufficient blood supply to the toes causing tissue damage, pain, or non-healing wounds
Digital ischemia results from peripheral artery disease or small vessel disease, causing reduced oxygen delivery to toe tissue, increasing ulceration and gangrene risk.
Question 5: Orthopedic footwear for elderly patients with foot deformities (bunions, hammertoes) should provide:
- Maximum heel elevation
- A wide, deep toe box to accommodate deformities without pressure, with cushioned insoles (Correct answer)
- Minimal insole support to strengthen intrinsic muscles
- Rigid sole to limit all foot movement
Correct answer: A wide, deep toe box to accommodate deformities without pressure, with cushioned insoles
Accommodative orthopedic footwear protects bony prominences and toe deformities from pressure-induced ulceration while providing shock absorption.
Question 6: Heel fissures in elderly patients are best managed with:
- Vigorous pumice stone use on dry skin
- Mechanical debridement of hyperkeratosis followed by application of a high-concentration urea (20–40%) emollient (Correct answer)
- Application of nail varnish to seal the fissure
- Only warm water soaking without emollients
Correct answer: Mechanical debridement of hyperkeratosis followed by application of a high-concentration urea (20–40%) emollient
Deep heel fissures require removal of hyperkeratotic tissue followed by regular urea cream application to hydrate and soften the area, preventing recurrence and potential infection.
MNT Foot Care for Elderly Patients 1
Which age-related change most increases the risk of nail pathology in elderly patients?