During a home visit, the client with fibromyalgia is concerned about being constantly tired. Which response should the nurse make to this client?

You are fatigued because you stay up too late

Maybe you should get a new mattress or pillow

Have you been worried about anything in particular lately?

Your fatigue is most likely the result of sleep disturbances, particularly insomnia

Answer and Explanation

The Correct Answer is D

Choice A reason: Assuming fatigue is due to staying up late is not evidence-based for fibromyalgia. Fatigue in fibromyalgia is linked to chronic pain and sleep disturbances, not simply lifestyle choices. This response dismisses the condition’s complexity and does not address the physiological basis of fibromyalgia-related fatigue.

Choice B reason: Suggesting a new mattress or pillow ignores the underlying pathophysiology of fibromyalgia. Fatigue in this condition stems from non-restorative sleep and chronic pain, not solely sleep environment. This response is unhelpful, as it does not address the medical reasons for the client’s fatigue.

Choice C reason: While anxiety can exacerbate fibromyalgia symptoms, asking about worries does not directly address the primary cause of fatigue. Sleep disturbances and chronic pain are more directly linked to fibromyalgia-related fatigue. This response is less precise, as it focuses on a secondary factor rather than the core issue.

Choice D reason: Fatigue in fibromyalgia is strongly linked to sleep disturbances, particularly non-restorative sleep or insomnia, due to chronic pain and central nervous system dysregulation. This disrupts deep sleep stages, leading to persistent tiredness. This response accurately reflects the pathophysiology, making it the most appropriate choice.

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Correct Answer is A

Explanation

Choice A reason: Metabolic acidosis is characterized by a pH below 7.35 due to increased hydrogen ions or decreased bicarbonate. This results from conditions like diarrhea or lactic acid buildup, reducing the blood’s buffering capacity. The kidneys attempt compensation, but low pH is the hallmark, making this the correct choice.

Choice B reason: PaO2 below 70 mm Hg indicates hypoxemia, affecting oxygen levels, not acid-base balance. Metabolic acidosis is driven by bicarbonate loss or acid accumulation, not oxygenation. This parameter is irrelevant to confirming metabolic acidosis, making this choice incorrect.

Choice C reason: PaCO2 above 45 mm Hg suggests respiratory acidosis, not metabolic acidosis, as it indicates CO2 retention. In metabolic acidosis, PaCO2 may decrease due to compensatory hyperventilation to expel CO2, making this choice incorrect for the expected ABG results.

Choice D reason: HCO3 above 26 mEq/L indicates metabolic alkalosis, not acidosis. In metabolic acidosis, HCO3 is typically below 22 mEq/L due to loss (e.g., diarrhea) or acid overload, reducing buffering capacity. This choice is incorrect as it contradicts the condition’s definition.

A. States that connecting with family is comforting B. Loss of appetite C. Loss of interest in pleasurable activities D. Has intense moments of sadness

Correct Answer is C

Explanation

Choice A reason: Finding comfort in family connections is typical of grief, not clinical depression. Grief involves sadness but often retains social engagement, whereas depression involves persistent isolation and anhedonia due to serotonin and dopamine dysregulation, making this choice incorrect.

Choice B reason: Loss of appetite occurs in both grief and clinical depression, as stress or serotonin imbalances affect appetite regulation. However, it is not specific to depression, as transient appetite loss is common in grief, making it less definitive than anhedonia.

Choice C reason: Loss of interest in pleasurable activities, or anhedonia, is a hallmark of clinical depression, reflecting disrupted dopamine reward pathways in the brain. Unlike grief’s temporary sadness, this persistent symptom impairs daily functioning, making it a key indicator of clinical depression.

Choice D reason: Intense moments of sadness are characteristic of grief, a normal response to loss, and do not necessarily indicate clinical depression. Depression involves persistent, pervasive symptoms, not episodic sadness, which is driven by situational triggers rather than chronic neurochemical imbalances.

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During a home visit, the client with fibromyalgia is concerned about being constantly tired. Which response should the nurse make to this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing the arterial blood gas (ABG) results of a client who the provider suspects has metabolic acidosis. Which of the following results should the nurse expect to see?

Correct Answer is A

Explanation

A nurse is assessing a client who is experiencing grief. The nurse should identify which of the following findings as an indication that the client has developed clinical depression?

Correct Answer is C

Explanation

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