The nurse is performing a neurologic assessment on a 41-year-old woman with a history of diabetes. When testing her ability to feel the vibrations of a tuning fork, the nurse notices that the patient is unable to feel vibrations on the great toe or ankle
bilaterally, but she is able to feel vibrations on both patellae. Given this information, what would the nurse suspect?
a.
Hyperalgesia
b.
Hyperesthesia
c.
Peripheral neuropathy
d.
Lesion of sensory cortex
ANS: C
Loss of vibration sense occurs with peripheral neuropathy (e.g., diabetes and alcoholism). Peripheral neuropathy is worse at the feet and gradually improves as the examiner moves up the leg, as opposed to a specific nerve lesion, which has a clear zone of deficit for its dermatome. The other responses are incorrect.
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