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Adult-Gerontology Primary Care (AGPCNP)

Adult-Gerontology Primary Care Nurse Practitioner Certification Examination

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The Anatomy of a Question


Question

A healthy 47-year-old woman presents to the clinic for evaluation of foot pain. She reports pain on the bottom of her feet that worsens with walking and weight-bearing activities. She reports no known injury or changes in activity. She works as a nurse on a medical floor. She reports this pain has been ongoing for approximately 3 to 4 weeks. Exam of the affected foot revealed point tenderness with palpation. Tenderness is also reproducible with dorsiflexion of the affected foot. Which of the following is the most likely diagnosis?


Answer choice options
  • A. Bursitis
  • B. Neuropathy
  • C. Plantar fasciitis
  • D. Stress fracture

The incorrect options (distractors) are not totally wrong. These options can be diagramed as follows:

Most Correct
Least Correct
  • C.
    Plantar fasciitis Pain will be aggravated by walking and weight-bearing activities and relieved with rest.
  • D.
    Stress fracture Similar presentation but associated with an increase in physical activity
  • A.
    Bursitis May cause foot pain but associated with erythema and swelling.
  • B.
    Neuropathy Chronic in nature and often due to diabetes and associated with sensory deficits.

The Anatomy of an Explanation

Risk factors include high body mass index, diabetes, and prolonged standing. Plantar fasciitis occurs due to microtears in the plantar fascia. It is caused by a tight Achilles tendon. The pain associated with plantar fasciitis is on the plantar portion of the foot. Pain will be aggravated by walking and weight-bearing activities and relieved with rest. Treatment options for plantar fasciitis include losing weight, taking NSAIDs (oral and topical), applying ice, wearing an orthotic foot appliance, and stretching and massaging the affected foot.

“I love love love this Qbank! It was super helpful for my Certification Exam!”

-Ofelia Cantu, MSN, AGNP-C

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Adult-Gerontology Primary Care (AGPCNP)

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