How to do a diabetic foot exam
Other platforms explain it with text and video. In Making Synapses you practice it on the patient.
Foot ulcers in diabetes start with lost feeling and poor blood flow. A yearly foot exam finds both early.
What you need
- 10 g monofilament
- 128 Hz tuning fork
Step by step
Prepare
Introduce yourself, get consent, remove shoes and socks from both feet. [1]
Ask
Numbness, burning, pain, past ulcers or amputations, and how they check their feet. [1]
Look
Skin, between the toes, calluses, cracks, ulcers, nails, shape changes (hammer toes, collapsed arch) and the shoes. [2]
Pulses
Dorsalis pedis and posterior tibial on both feet. [2]
Monofilament
Eyes closed. Press the filament straight until it bends, for 1 to 2 seconds, at several sites on the sole, not on calluses. Ask "yes" when felt. [1]
Vibration
128 Hz tuning fork on the top of the big toe joint; ask when the buzzing stops. [1]
Teach
Look at the feet every day, never walk barefoot, check shoes before putting them on, and report any sore right away. [1]
Common errors
- Testing over calluses.
- Letting the patient see the filament.
- Not looking between the toes.
Practice it in Making Synapses
In Making Synapses you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.
Making Synapses cases that train this skill
- Diabetic peripheral neuropathy
- Fall risk at home, older adult
- Parkinson disease, home safety
- Hypoglycemia at school
- Anaphylaxis in a child
- Tuberculosis, contact with symptoms
61 Making Synapses cases train this skill: open the case library
Sources
- NCCPA PANCE Content Blueprint
- Open RN, Nursing Skills 2e (Chippewa Valley Technical College) (CC BY 4.0)
Steps adapted from Open RN, Nursing Skills 2e (Chippewa Valley Technical College), licensed under CC BY 4.0. Facts and steps also follow NCCPA PANCE Content Blueprint. Making Synapses is not affiliated with these organizations. Updated: 2026-10-11.