A client with intermittent claudication is experiencing leg pain during exercise. Which of the following pathophysiological mechanisms is most likely contributing to this symptom?
Increased cardiac output leading to muscle fatigue.
Atherosclerosis leading to reduced blood flow to the muscles.
Decreased oxygen demand in the leg muscles.
Increased venous pressure causing fluid accumulation in the legs.
The Correct Answer is B
Rationale:
A. Increased cardiac output leading to muscle fatigue is incorrect. Intermittent claudication is not caused by cardiac output. While the heart supplies blood to the muscles, the issue in claudication is localized arterial insufficiency, not systemic cardiac function.
B. Atherosclerosis leading to reduced blood flow to the muscles is correct. Intermittent claudication occurs when arterial blood flow to the leg muscles is insufficient during exercise. Atherosclerotic plaques narrow or occlude peripheral arteries, reducing oxygen delivery to the muscles during increased activity. This oxygen deficit results in pain, cramping, and fatigue, which typically resolves with rest when oxygen demand decreases. Claudication is a hallmark symptom of peripheral artery disease (PAD).
C. Decreased oxygen demand in the leg muscles is incorrect. The symptom arises because oxygen demand exceeds supply, not because demand decreases. The muscles are actively working during exercise, which increases oxygen requirements, revealing the underlying ischemia caused by arterial obstruction.
D. Increased venous pressure causing fluid accumulation in the legs is incorrect. Venous insufficiency can cause edema and heaviness, but it does not produce the characteristic exercise-induced pain of intermittent claudication. Claudication is primarily an arterial problem rather than a venous one.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. In end-stage renal disease (ESRD), the kidneys lose the ability to produce sufficient erythropoietin (EPO), a hormone that stimulates the bone marrow to produce red blood cells. Without adequate EPO, erythropoiesis is impaired, leading to a reduced number of circulating red blood cells and anemia. This anemia is typically normocytic and normochromic, meaning the red blood cells are of normal size and color but decreased in number.
B. ESRD does not reduce red blood cell destruction. In fact, uremic toxins in ESRD may actually shorten the lifespan of red blood cells, contributing further to anemia rather than preventing it.
C. Increased erythropoietin production is incorrect. In ESRD, erythropoietin production is diminished, not increased. The lack of EPO is the primary reason for decreased red blood cell production in these patients.
D. Elevated hemoglobin levels is incorrect. Hemoglobin levels are typically decreased in ESRD due to the reduced erythropoiesis and shortened red blood cell lifespan. Elevated hemoglobin is not a feature of anemia associated with kidney disease.
Correct Answer is C
Explanation
Rationale:
A. High urine pH is not a primary factor contributing to recurrent UTIs in older men. While urine pH can influence bacterial growth, it is not the most significant predisposing factor in this population.
B. Use of cotton underwear is more relevant for women, as cotton can help reduce moisture and bacterial growth. In older men, underwear type has minimal impact on UTI risk, especially compared with underlying urinary tract abnormalities.
C. Urine retention caused by prostatic hypertrophy is correct. In older men, benign prostatic hyperplasia (BPH) is common and can partially obstruct urine flow. This obstruction leads to urinary stasis, which provides a favorable environment for bacterial proliferation and increases the risk of recurrent urinary tract infections. Chronic retention can also lead to incomplete bladder emptying, further exacerbating infection risk.
D. Increased fluid intake is protective, not causative. Adequate hydration helps flush bacteria from the urinary tract and reduces the likelihood of infection.
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