During assessment of the patient diagnosed with fibromyalgia, what would the nurse expect the patient to report in addition to widespread pain?
Nonrestorative sleep with resulting fatigue.
Widespread musculoskeletal pain that is accompanied by inflammation and fever.
Generalized muscle twitching and spasms.
Profound and progressive muscle weakness that limits ADLs.
The Correct Answer is A
Choice A reason: Nonrestorative sleep with fatigue is a core fibromyalgia symptom, alongside widespread pain. Disrupted sleep architecture, including reduced deep sleep, exacerbates pain sensitivity and fatigue, driven by central nervous system dysregulation. Recognizing this guides management with sleep hygiene, medications like amitriptyline, and exercise to improve sleep quality and reduce fatigue.
Choice B reason: Fibromyalgia does not involve inflammation or fever, unlike rheumatoid arthritis. It’s a noninflammatory pain syndrome with central sensitization. Expecting inflammation or fever misdiagnoses fibromyalgia, potentially leading to inappropriate treatments like corticosteroids, which are ineffective, delaying proper care with antidepressants or physical therapy for pain and fatigue.
Choice C reason: Generalized muscle twitching and spasms are not typical fibromyalgia symptoms. These suggest neurological conditions like myoclonus or electrolyte imbalances. Fibromyalgia involves diffuse pain and tenderness, not spasms. Assuming twitching misguides assessment, risking incorrect interventions and overlooking fibromyalgia’s core symptoms like sleep disturbance and fatigue.
Choice D reason: Profound muscle weakness limiting ADLs is characteristic of neuromuscular diseases like myasthenia gravis, not fibromyalgia. Fibromyalgia causes pain and fatigue, not progressive weakness. Expecting weakness misdirects diagnosis, potentially leading to unnecessary neurological testing, delaying fibromyalgia management with exercise, cognitive therapy, and medications to address pain and fatigue.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Localized erythema is a key manifestation of acute osteomyelitis, reflecting bacterial infection (often Staphylococcus aureus) in bone tissue following a puncture wound. Inflammation causes vasodilation and immune cell infiltration, producing redness, warmth, and swelling. Recognizing this prompts urgent antibiotic therapy and possible surgical debridement to prevent bone destruction and systemic infection.
Choice B reason: Hypothermia is not typical of acute osteomyelitis, which often presents with fever due to systemic inflammatory response to bone infection. Hypothermia may occur in sepsis or unrelated conditions but isn’t a hallmark. Expecting hypothermia misguides assessment, potentially delaying critical interventions like antibiotics for osteomyelitis’s infectious process.
Choice C reason: Bradycardia is not associated with acute osteomyelitis, which may cause tachycardia from fever and inflammation. Bradycardia suggests cardiac or autonomic issues, not bone infection. Assuming bradycardia misdirects focus from osteomyelitis’s infectious signs like erythema, risking delayed treatment and progression to chronic infection or abscess formation.
Choice D reason: Numbness of toes suggests nerve compression or vascular compromise, not acute osteomyelitis. Osteomyelitis causes localized pain, erythema, and swelling from bone infection, not sensory loss. Expecting numbness misdiagnoses the condition, potentially overlooking infection and delaying antibiotics or surgical intervention critical for preventing bone necrosis and systemic spread.
Correct Answer is D
Explanation
Choice A reason: Increasing caffeine intake is not recommended for fibromyalgia, as it can exacerbate sleep disturbances and anxiety, common in the condition. Fibromyalgia management focuses on improving sleep, reducing pain, and enhancing function through exercise and medications. This statement reflects misunderstanding, potentially worsening symptoms and hindering effective self-management strategies.
Choice B reason: Taking duloxetine in the morning is reasonable but not the best indicator of fibromyalgia teaching comprehension. Duloxetine, a serotonin-norepinephrine reuptake inhibitor, helps pain and mood but isn’t primarily for energy. This statement shows partial understanding, missing broader management strategies like exercise, which are central to fibromyalgia care.
Choice C reason: Chemotherapy is irrelevant for fibromyalgia, a non-inflammatory pain syndrome, not a malignancy. This statement indicates a significant misunderstanding of fibromyalgia’s nature and treatment, which involves exercise, medications like duloxetine, and cognitive therapies. Expecting a cure via chemotherapy misaligns expectations, delaying effective symptom management and patient education.
Choice D reason: Low-impact aerobics reduce fibromyalgia pain by improving muscle conditioning, circulation, and endorphin release, supported by evidence-based guidelines. This statement reflects understanding of nonpharmacological management, a cornerstone of fibromyalgia treatment, promoting physical function and pain relief, and aligning with comprehensive care to enhance quality of life.
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