National Physical Therapy Examination (NPTE) Practice Exam

In which type of patient condition would dyspnea and skin pallor most likely occur?

1. Dehydration

2. End-stage renal disease

3. Myocardial infarction

4. Chronic obstructive pulmonary disease

The correct answer is: End-stage renal disease

The occurrence of dyspnea and skin pallor is particularly associated with end-stage renal disease due to several physiological changes and complications that arise from advanced kidney dysfunction. In end-stage renal disease, the kidneys are no longer able to effectively filter waste products from the blood, leading to the accumulation of toxins. This accumulation can cause a variety of systemic effects, one of which is anemia, as the kidneys also produce erythropoietin, a hormone essential for red blood cell production. Anemia can lead to paleness of the skin (pallor) and contribute to increased fatigue and dyspnea due to reduced oxygen-carrying capacity of the blood. As fluid balance is disrupted in end-stage renal disease, patients may also experience pulmonary edema, which can further exacerbate feelings of breathlessness (dyspnea). In this context, the combination of diminished oxygen transport due to anemia and potential fluid overload contributing to respiratory distress makes dyspnea and skin pallor particularly relevant in patients with this condition. While dehydration can lead to pallor, the absence of interrelated symptoms like dyspnea typically makes it less significant in this context. Myocardial infarction, although it can certainly cause dyspnea, tends to manifest with specific cardiovascular