The nurse provides care for a client who reports burning pain, which is worse at night, in both feet. The client states the pressure of the sheets on the feet is "unbearable". Which reason is the most common cause of this type of pain?

Liver failure

Diabetes mellitus

Mercury toxicity

Vitamin B12 deficiency

Answer and Explanation

The Correct Answer is B

Choice A reason: Liver failure is not the most common cause of this type of pain because it is a condition where the liver loses its ability to perform its vital functions, such as detoxifying the blood, producing bile, and metabolizing nutrients. Liver failure can cause symptoms such as jaundice, ascites, or bleeding, but it does not usually cause burning pain in the feet.

Choice B reason: Diabetes mellitus is the most common cause of this type of pain because it is a condition where the blood glucose level is too high, either due to insufficient insulin production or reduced insulin sensitivity. Diabetes mellitus can cause damage to the nerves, especially in the peripheral areas, such as the feet, which is called diabetic neuropathy. Diabetic neuropathy can cause symptoms such as burning pain, numbness, or tingling in the feet, which can worsen at night or with pressure.

Choice C reason: Mercury toxicity is not the most common cause of this type of pain because it is a condition where the body is exposed to high levels of mercury, which is a toxic metal that can be found in some fish, dental fillings, or thermometers. Mercury toxicity can cause damage to the nervous system, causing symptoms such as tremors, memory loss, or mood changes, but it does not usually cause burning pain in the feet.

Choice D reason: Vitamin B12 deficiency is not the most common cause of this type of pain because it is a condition where the body does not have enough vitamin B12, which is a nutrient that is essential for the production of red blood cells and the maintenance of the nervous system. Vitamin B12 deficiency can cause symptoms such as anemia, fatigue, or weakness, but it does not usually cause burning pain in the feet.

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Correct Answer is B

Explanation

Choice A reason: Numbness and tingling of the fingers and toes is not the expected finding because it is a sign of alkalosis, not acidosis. Alkalosis is a condition where the blood has a high pH, which means that it is too basic or alkaline. Alkalosis can cause numbness and tingling of the fingers and toes due to hypocalcemia, which is a low level of calcium in the blood, or hypokalemia, which is a low level of potassium in the blood. Both conditions can affect the nerve and muscle function, causing paresthesia, which is an abnormal sensation of the skin.

Choice B reason: A diffuse headache described as "throbbing" is the expected finding because it is a sign of acidosis, which is a condition where the blood has a low pH, which means that it is too acidic. Acidosis can cause a diffuse headache described as "throbbing" due to vasodilation, which is the widening of the blood vessels, especially in the brain. Vasodilation can increase the blood flow and the pressure in the head, causing pain and discomfort.

Choice C reason: Flushed skin that is warm to the touch is not the expected finding because it is a sign of fever, not salicylate toxicity. Fever is a condition where the body temperature is higher than normal, usually due to an infection or inflammation. Fever can cause flushed skin that is warm to the touch due to increased blood flow to the skin, which helps to dissipate the excess heat.

Choice D reason: Decreased muscle strength and deep tendon reflexes is not the expected finding because it is a sign of neuromuscular blockade, not salicylate toxicity. Neuromuscular blockade is a condition where the communication between the nerves and the muscles is impaired, causing paralysis or weakness. Neuromuscular blockade can be caused by various factors, such as medications, toxins, or diseases, that interfere with the transmission of acetylcholine, which is a neurotransmitter that stimulates the muscle contraction.

A. Formation of a clot in the middle cerebral artery B. Obstruction of left ventricular blood flow and cardiac dysrhythmias C. Fluid volume overload and decreased serum potassium levels D. Diffuse atherosclerosis in the left main coronary artery circulation

Correct Answer is B

Explanation

Choice A reason: Formation of a clot in the middle cerebral artery is not the most likely cause of death because it is a condition that affects the brain, not the heart. A clot in the middle cerebral artery can cause a stroke, which is a sudden interruption of blood flow to the brain, resulting in brain damage and neurological deficits. A stroke can be fatal, but it does not usually cause cardiopulmonary arrest, which is a sudden cessation of heart and lung function.

Choice B reason: Obstruction of left ventricular blood flow and cardiac dysrhythmias is the most likely cause of death because it is a condition that affects the heart, which is the organ responsible for pumping blood throughout the body. Obstruction of left ventricular blood flow can be caused by hypertrophic cardiomyopathy, which is a genetic disorder that causes the heart muscle to become abnormally thick and stiff, reducing the amount of blood that the heart can pump. Cardiac dysrhythmias are abnormal heart rhythms that can interfere with the electrical signals that control the heart's contractions. Both conditions can lead to sudden cardiac death, which is a sudden and unexpected loss of heart function, resulting in cardiopulmonary arrest.

Choice C reason: Fluid volume overload and decreased serum potassium levels are not the most likely cause of death because they are conditions that affect the fluid and electrolyte balance of the body, not the heart. Fluid volume overload is a condition where the body retains too much fluid, which can cause edema, hypertension, and heart failure. Decreased serum potassium levels are a condition where the blood has too little potassium, which is an electrolyte that helps regulate the nerve and muscle function, including the heart. Both conditions can affect the heart function, but they are not usually the direct cause of cardiopulmonary arrest.

Choice D reason: Diffuse atherosclerosis in the left main coronary artery circulation is not the most likely cause of death because it is a condition that affects the blood vessels, not the heart. Atherosclerosis is a disease that causes the buildup of plaque, which is a fatty substance, in the walls of the arteries, which are the blood vessels that carry oxygen-rich blood to the organs. Diffuse atherosclerosis in the left main coronary artery circulation means that the plaque affects the entire length of the artery that supplies blood to the left side of the heart, which is the side that pumps blood to the rest of the body. Atherosclerosis can cause coronary artery disease, which is a condition where the heart does not receive enough blood and oxygen, leading to chest pain, angina, or heart attack. A heart attack can cause cardiopulmonary arrest, but it is not as common as sudden cardiac death in young adults.

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The nurse provides care for a client who reports burning pain, which is worse at night, in both feet. The client states the pressure of the sheets on the feet is "unbearable". Which reason is the most common cause of this type of pain?

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