A nurse is planning the care of a client who has a long history of chronic pain, which has only recently been diagnosed as fibromyalgia. Which nursing diagnosis is most likely to apply to this client's care needs?

Ineffective role performance related to pain

Risk for infection related to tissue alterations

Risk for impaired skin integrity related to myalgia

Unilateral neglect related to neuropathic pain

Answer and Explanation

The Correct Answer is A

A. Ineffective role performance related to pain: Chronic pain, as seen in fibromyalgia, often affects a person's ability to perform daily activities and roles. Pain can impact physical, social, and occupational functioning, leading to feelings of inadequacy in role performance.

B. Risk for infection related to tissue alterations: Fibromyalgia is characterized by widespread musculoskeletal pain and tenderness, not tissue alterations like wounds or injuries, so the risk for infection is not directly related to fibromyalgia.

C. Risk for impaired skin integrity related to myalgia: Myalgia refers to muscle pain, and while fibromyalgia can cause muscle pain, it does not directly lead to impaired skin integrity. Skin issues are not a primary concern for fibromyalgia patients unless other factors are involved.

D. Unilateral neglect related to neuropathic pain: Unilateral neglect is typically associated with neurological conditions like stroke or brain injury, not fibromyalgia. Neuropathic pain can occur in fibromyalgia, but unilateral neglect does not accurately describe the condition's typical impact.

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Correct Answer is A

Explanation

A. Graft-versus-host disease (GVHD): GVHD is a complication that occurs after hematopoietic stem cell transplantation (HSCT), where the donor's immune cells (lymphocytes) recognize the recipient’s body as foreign and attack the recipient's tissues. This is a common concern in HSCT, particularly with allogeneic transplants.

B. Bone marrow depression: Bone marrow depression is a common side effect of both chemotherapy and radiation therapy, but it does not involve the donor’s immune cells attacking the recipient’s body. It refers to the reduced ability of the bone marrow to produce blood cells.

C. Acute respiratory distress syndrome (ARDS): ARDS is a severe lung condition that can result from various causes such as trauma, infection, or inflammation, but it is not specifically related to GVHD or HSCT.

D. Remission: Remission refers to the reduction or disappearance of disease symptoms, especially in cancer. It is not a complication of HSCT, and it does not involve the donor’s immune cells attacking the patient’s body.

A. Age 19 to 30 years B. Dark hair C. History of chronic skin irritation D. Female gender

Correct Answer is C

Explanation

A. Age 19 to 30 years: While malignant melanoma can occur at any age, it is more commonly diagnosed in individuals aged 30 to 40 years or older. Being in the 19-30 age group does not significantly increase the risk of developing melanoma.

B. Dark hair: Dark hair is not a major risk factor for malignant melanoma. In fact, individuals with lighter skin and hair are generally at a higher risk. Hair color alone does not place a person at high risk for melanoma.

C. History of chronic skin irritation: Chronic skin irritation or conditions that cause repeated trauma to the skin can increase the risk of melanoma. This includes a history of sunburns or other forms of skin damage, which can predispose the skin to malignant changes over time.

D. Female gender: While gender can play a role in the risk of melanoma, it is not as significant as other factors like fair skin, history of sun exposure, or family history of melanoma. Both males and females can be affected by melanoma.

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A nurse is planning the care of a client who has a long history of chronic pain, which has only recently been diagnosed as fibromyalgia. Which nursing diagnosis is most likely to apply to this client's care needs?

Nursing Test Bank

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