A nurse identifies that theA nurse is educating a newly licensed nurse about comorbidities associated with cluster B personality disorders. The nurse should identify which of the following disorders as a comorbidity of histrionic personality disorder?

Choice A reason : While propranolol can be used to reduce the frequency and severity of migraine headaches, it is not contraindicated in patients with a history of migraines⁴.

Choice B reason : Propranolol is often prescribed for hypertension and is not contraindicated in such cases. It works by blocking beta-adrenergic receptors, which reduces heart rate and blood pressure⁴.

Choice C reason : Propranolol is contraindicated in patients with bronchial asthma. As a non-selective beta-blocker, it can cause bronchoconstriction and exacerbate asthma symptoms. Therefore, the nurse should report this finding to the provider⁴⁶.

Choice D reason : Hypothyroidism is not a contraindication for propranolol. However, the medication may mask signs of hypothyroidism, such as a slow heart rate, so the provider should be aware of the client's thyroid condition⁴.

Choice A reason : Fibromyalgia can indeed be associated with migraine headaches. Many individuals with fibromyalgia report experiencing headaches, and migraines are a common comorbidity. The exact link between fibromyalgia and migraines is not fully understood, but it is believed that the same abnormalities in neurotransmitter levels that contribute to fibromyalgia pain may also predispose individuals to migraines¹².

Choice B reason : The statement "Fibromyalgia causes joint inflammation" is incorrect and indicates a need for further teaching. Fibromyalgia does not cause inflammation within the joints. It is characterized by widespread musculoskeletal pain, fatigue, and tenderness in specific areas, but it does not involve the type of joint inflammation seen in conditions like rheumatoid arthritis¹². This misconception may arise because the symptoms can be similar to those of arthritic conditions, but the underlying mechanisms are different.

Choice C reason : Fibromyalgia may indeed cause chest pain, which is often referred to as costochondritis when it involves the cartilage of the rib cage. This chest pain can mimic that of a heart attack or other heart conditions, but it is actually a common symptom of fibromyalgia and is related to the tender points in the chest area¹².

Choice D reason : It is true that fibromyalgia symptoms may worsen depending on the weather. Many patients report that their symptoms flare up in response to changes in weather, temperature, and humidity. However, the reasons for this sensitivity are not entirely clear, and research on the subject has produced mixed results¹².