1.A client is going to have tender points examined to determine the diagnosis of fibromyalgia.
The nurse should instruct the client the number of tender points that must be positive for the
diagnosis would be:
1. 11.
2. 13.
3. 15.
4. 17.
ANS: 1
The presence of at least 11 of 18 tender points is considered diagnostic for fibromyalgia. The
other higher numbers would just be useful to confirm the diagnosis.
2.A client is surprised to learn that she has been diagnosed with osteoporosis since she does not
smoke, is not underweight, and exercises. The nurse should assess if the client has any secondary
conditions which could cause the disorder, including:
1. diabetes mellitus.
2. heart failure.
3. fibromyalgia.
4. lactose intolerance.
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, ANS: 4
Mild malabsorption syndrome as seen with lactose intolerance is a contributing factor to
secondary osteoporosis. Secondary osteoporosis is not associated with diabetes mellitus, heart
failure, or fibromyalgia.
3. During assessment of the patient with fibromyalgia syndrome (FMS), the nurse would expect
the patient to report (select all that apply)?
a. sleep disturbances.
b. multiple tender points.
c. cardiac palpitations and dizziness.
d. multijoint pain with inflammation and swelling.
e. widespread bilateral, burning musculoskeletal pain.
ANS: A, B, C, E
These symptoms are commonly described by patients with FMS. Cardiac involvement and joint
inflammation are not typical of FMS.
4. What is the distinguishing feature of primary fibromyalgia syndrome?
a. Joint pain and stiffness throughout the body
b. Degeneration and atrophy of skeletal muscles in back and lower limbs
c. Localized areas of constant pain
d. Specific trigger points for pain and tenderness
ANS: D
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