Why does peripheral neuropathy occur in people with uncontrolled diabetes?
Decreased blood sugar increases the sensitivity of nerves.
Excess circulating insulin damages the body's vasculature.
Autoantibodies destroy nerve fibers in the lower extremities.
Elevated blood sugar over time is toxic to nerve endings.
The Correct Answer is D
A. Decreased blood sugar increases the sensitivity of nerves: Hypoglycemia can cause temporary neurological symptoms such as tingling or weakness, but it does not cause the chronic nerve damage seen in diabetic peripheral neuropathy. Low blood sugar affects nerve function transiently rather than causing structural nerve injury.
B. Excess circulating insulin damages the body's vasculature: Hyperinsulinemia is not the primary mechanism of neuropathy in diabetes. While vascular complications contribute to long-term diabetes sequelae, insulin itself does not directly damage nerves.
C. Autoantibodies destroy nerve fibers in the lower extremities: Autoimmune-mediated nerve destruction is characteristic of conditions like Guillain-Barré syndrome, not diabetic neuropathy. Diabetes-induced neuropathy is primarily metabolic and vascular rather than autoimmune.
D. Elevated blood sugar over time is toxic to nerve endings: Chronic hyperglycemia leads to accumulation of advanced glycation end-products, oxidative stress, and microvascular damage, which impairs nutrient and oxygen delivery to nerves. This results in progressive degeneration of peripheral nerves, particularly in the lower extremities, causing numbness, tingling, and pain characteristic of diabetic neuropathy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. A type of stroke that occurs when a blood clot blocks blood flow to the brain:This describes an ischemic stroke, not brain herniation. Brain herniation is related to increased intracranial pressure causing displacement of brain tissue, rather than a vascular obstruction.
B. The bones of the skull fuse together, putting pressure on the brain:Premature fusion of skull bones is called craniosynostosis. While it can affect brain growth and intracranial pressure over time, it is not synonymous with brain herniation, which involves acute tissue displacement.
C. A condition in which the brain swells and becomes enlarged:Brain swelling, or cerebral edema, can precede herniation, but edema alone does not define herniation. Herniation specifically refers to the displacement of brain tissue due to elevated intracranial pressure.
D. Pressure inside the skull pushes the brain stem through the foramen magnum:Brain herniation occurs when increased intracranial pressure forces parts of the brain, such as the brain stem or cerebellar tonsils, downward through openings like the foramen magnum. This is a life-threatening event because it compresses vital centers controlling respiration and cardiac function.
Correct Answer is D
Explanation
A. Monitor blood glucose levels several times a day:Frequent glucose monitoring is important for managing diabetes but does not directly prevent increased intracranial pressure (ICP) or related complications in older adults. It addresses metabolic control rather than neurologic safety.
B. Take all medications at the same time every day:Consistent medication timing promotes adherence and therapeutic effectiveness, but it does not specifically reduce the risk of falls or activities that could lead to increased ICP.
C. Discontinue blood thinning medications:Stopping anticoagulants without medical guidance can be dangerous and increase the risk of thrombosis. Discontinuation should never be done independently and does not inherently prevent increased ICP.
D. Use an assistive device if experiencing problems with balance:Using canes, walkers, or other mobility aids helps prevent falls and head trauma, which are common triggers for increased intracranial pressure in older adults. Preventing falls directly reduces the risk of intracranial injury and secondary complications.
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