In the initial stages of distal symmetric polyneuropathy (DSP) in an HIV-infected patient, the nurse would expect to find on physical assessment:
A) a diminished brachioradialis reflex.
B) a diminished ankle reflex.
C) a hyperreflexive patellar reflex
D) a positive Babinski sign
B) a diminished ankle reflex.
Explanation: A) Distal symmetric polyneuropathy (DSP) is one of the most common forms of HIV-associated peripheral neuropathy. It is a sensory axonal neuropathy that involves the toes and soles of the feet; the fingers and hands may become involved over time. Because the client is in the initial stages of neuropathy, the upper extremities are not affected.
B) The most common manifestations of DSP involve absent or diminished ankle jerks and diminished vibration and pinprick sensations in the distal lower extremities.
C) Reflexes in the lower extremities would be diminished, not hyperreflexive.
D) The Babinski sign is not affected in polyneuropathy.
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