What is a complication of peripheral neuropathy?
Decreased blood pressure.
Increased blood sugar.
Decreased urine output.
Increased falls.
The Correct Answer is D
Choice A rationale
Decreased blood pressure is usually a sign of autonomic neuropathy rather than simple peripheral neuropathy. While peripheral neuropathy affects the distal nerves of the limbs, autonomic dysfunction affects the nerves controlling involuntary functions like vascular tone. A drop in blood pressure, specifically orthostatic hypotension, is a related but distinct neurological complication. Therefore, decreased blood pressure is not the primary expected complication when discussing sensory or motor deficits in the extremities of the patient.
Choice B rationale
Increased blood sugar is a common cause of peripheral neuropathy, particularly in diabetes mellitus, rather than a complication of the neuropathy itself. Chronic hyperglycemia leads to the glycation of proteins and oxidative stress that damages the myelin sheath and axons. High glucose levels remain an ongoing metabolic issue that the patient must manage to prevent further nerve damage. It is the metabolic driver of the condition, not a secondary physiological outcome resulting from nerve death.
Choice C rationale
Decreased urine output is generally associated with renal dysfunction or dehydration rather than peripheral neuropathy. While neurogenic bladder can occur if the autonomic nerves serving the urinary system are damaged, peripheral neuropathy typically focuses on the long nerves of the hands and feet. Urinary retention or decreased output would point toward kidney failure or a lower urinary tract obstruction. It is not a standard complication of the sensory and motor losses found in the limbs.
Choice D rationale
Increased falls are a major complication of peripheral neuropathy due to the loss of proprioception and sensory feedback from the feet. When a person cannot feel the ground or determine the position of their joints, their balance is severely compromised. Additionally, motor nerve damage can lead to muscle weakness and foot drop, further increasing the risk of tripping. This lack of sensory input makes navigating uneven surfaces difficult, leading to a high incidence of injury.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Repeated requests to extend work deadlines can be a warning sign of substance abuse as the individual may struggle with impaired cognitive function, decreased focus, and poor time management. Substance use often interferes with a person's ability to fulfill major role obligations at work or school. As the addiction progresses, the individual's priority shifts toward obtaining and using the substance, leading to a decline in productivity and an inability to meet previously manageable professional or academic responsibilities.
Choice B rationale
Participation in a fitness challenge program is generally considered a positive health behavior and is not associated with the warning signs of substance abuse. Engaging in regular physical activity and community wellness programs often indicates a focus on health, discipline, and social integration. While not a definitive indicator of the absence of substance issues, it is the opposite of the social withdrawal and physical decline typically observed in individuals struggling with active substance use disorders.
Choice C rationale
Collaboration with teammates on projects indicates good social functioning and the ability to maintain interpersonal relationships, which are often impaired in those with substance abuse problems. Individuals struggling with addiction frequently isolate themselves or experience conflict with others due to their behavioral changes and reliability issues. Active participation and effective communication within a team setting suggest a level of stability and social engagement that is inconsistent with the typical patterns of substance abuse.
Choice D rationale
Decreased absences at work and school would suggest improved reliability and attendance, which is the opposite of what is typically seen in substance abuse. One of the primary indicators of a substance use problem is an increase in unexplained absences, frequent tardiness, and a general lack of dependability. Improved attendance usually points toward increased stability and health, whereas substance abuse is strongly correlated with higher rates of absenteeism due to the physical and mental effects of the drugs.
Correct Answer is A
Explanation
Choice A rationale
When dehydration occurs, the total blood volume decreases, leading to a drop in blood pressure. The body compensates through the baroreceptor reflex, which detects the decrease in stretch within the carotid sinuses and aortic arch. This triggers the sympathetic nervous system to increase the heart rate, known as tachycardia. By increasing the heart rate, the body attempts to maintain adequate cardiac output and ensure that vital organs continue to receive sufficient oxygenated blood despite the lower circulating volume.
Choice B rationale
Dehydration leads to a decrease in skin elasticity, often referred to as poor skin turgor. When the body is dehydrated, fluid is pulled from the interstitial spaces and intracellular compartments to maintain vascular volume. This loss of fluid from the dermal layers causes the skin to lose its resiliency. Scientifically, skin that stays "tented" when pinched is a classic sign of dehydration, representing a failure of the compensation mechanism to keep peripheral tissues hydrated during a fluid deficit.
Choice C rationale
In response to dehydration and increased serum osmolality, the posterior pituitary gland actually increases the secretion of antidiuretic hormone, also known as vasopressin. This hormone acts on the collecting ducts of the kidneys to increase water reabsorption, thereby concentrating the urine and conserving as much fluid as possible. A decrease in antidiuretic hormone secretion would lead to more fluid loss through urine, which would exacerbate the dehydration rather than serving as a compensatory mechanism.
Choice D rationale
Dehydration typically causes an increase in hematocrit, not a decrease. Hematocrit is the ratio of the volume of red blood cells to the total volume of blood. When the plasma volume decreases due to water loss, the concentration of red blood cells becomes relatively higher, a condition called hemoconcentration. A decreased hematocrit would suggest anemia or fluid overload. Therefore, an elevated hematocrit level is a common laboratory finding that reflects the state of fluid volume deficit in the body.
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