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 C
Explanation
Choice A reason: Applying pediculicide lotion is inappropriate for tick removal, as it targets lice, not ticks. This could irritate the skin or prompt the tick to regurgitate, increasing the risk of pathogen transmission, such as Borrelia burgdorferi causing Lyme disease. Proper removal uses mechanical extraction to minimize infection, ensuring safe and effective tick removal without chemical interference.
Choice B reason: Using a hot ember to remove a tick is hazardous and ineffective. Heat may cause the tick to release pathogens into the bite site, heightening infection risk, and can burn the skin. Safe removal involves tweezers grasping the tick near the skin for intact extraction, reducing complications like Lyme disease or Rocky Mountain spotted fever transmission.
Choice C reason: Grasping the tick close to the skin with fine-tipped tweezers is the standard method. This ensures complete removal, including mouthparts, minimizing infection risk from pathogens like Borrelia burgdorferi, which causes Lyme disease. The technique prevents tissue damage and pathogen spread, promoting safe extraction and reducing complications from tick-borne illnesses.
Choice D reason: Using a twisting motion risks breaking the tick’s mouthparts, leaving them embedded, which increases infection risk and complicates removal. A steady, upward pull without twisting is recommended to extract the tick fully, preventing transmission of diseases like Lyme disease or babesiosis, ensuring effective and safe tick removal.
Correct Answer is A
Explanation
Choice A reason: Alcohol, particularly beer and liquor, triggers gout attacks by increasing uric acid production and reducing renal excretion. Ethanol metabolism raises purine breakdown, elevating serum urate levels, while dehydration from alcohol exacerbates crystal formation in joints. Avoiding alcohol is a key dietary recommendation to prevent acute gout flares.
Choice B reason: Orange juice, rich in vitamin C, may lower uric acid levels by enhancing renal excretion. It is not a trigger for gout attacks and is generally safe. Fructose in some juices can increase uric acid, but orange juice’s effect is minimal, making this an incorrect choice.
Choice C reason: Milk and dairy products are low in purines and may reduce gout risk by promoting uric acid excretion. Calcium and casein in milk have uricosuric effects, making it a beneficial beverage. Milk does not trigger attacks, so this choice is incorrect for gout management.
Choice D reason: Coffee, containing caffeine and polyphenols, may lower uric acid levels and gout risk through antioxidant effects and increased urate excretion. It is not a trigger for attacks and is generally safe for gout patients, making this an incorrect choice for dietary restrictions.
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