The Symptom-Based Handbook for Ehlers-Danlos Syndromes and
Hypermobility Spectrum Disorders
1st Edition
Latest edition
Editors: Clair A. Francomano, Alan J. Hakim, Lansdale G.S. Henderson, Fraser C.
Henderson Sr.
,Chapter 1. Introduction
1. A nurse is reviewing the purpose of the handbook on Ehlers-Danlos syndromes (EDS)
and hypermobility spectrum disorders (HSD). Which statement best reflects the book’s
novel approach?
a. It focuses primarily on genetic testing and inheritance patterns
b. It organizes content by symptom presentation from head to feet
c. It emphasizes musculoskeletal manifestations exclusively
d. It eliminates the need for interdisciplinary collaboration
Answer: b. It organizes content by symptom presentation from head to feet
Rationale: The handbook is unique in being structured around symptoms patients report, rather
than organ systems or molecular pathways. This symptom-based approach allows clinicians to
evaluate complaints holistically and efficiently.
2. Which patient-centered goal aligns with the aim of the handbook?
a. Eliminating the need for patient self-advocacy
b. Informing and empowering patients to understand their symptoms and management
c. Encouraging patients to avoid medical evaluation unless symptoms worsen
d. Limiting communication between patients and multidisciplinary teams
Answer: b. Informing and empowering patients to understand their symptoms and
management
Rationale: A core aim is to educate and empower patients to participate actively in their care.
Knowledge supports better communication with providers and informed decision-making.
3. A nurse explains to a patient with HSD why an interdisciplinary team is essential. Which
reason is most appropriate?
a. EDS/HSD affects only joints and muscles
b. The conditions involve multiple systems requiring various specialties
c. A single specialist can address all patient needs
d. Multidisciplinary care is mainly for research purposes
Answer: b. The conditions involve multiple systems requiring various specialties
Rationale: EDS and HSD can affect cardiovascular, gastrointestinal, neurological,
musculoskeletal, and dermatological systems. Interdisciplinary collaboration ensures
comprehensive management.
4. In a case study from the handbook, the nurse notes that simplified algorithms are
provided. What is the primary purpose of these algorithms?
a. To replace clinical judgment entirely
b. To guide clinicians in diagnosing and managing symptoms efficiently
c. To minimize the need for differential diagnoses
d. To restrict patient care to protocol only
Answer: b. To guide clinicians in diagnosing and managing symptoms efficiently
Rationale: Algorithms streamline the decision-making process while still requiring clinician
judgment. They provide structured steps for evaluating and managing symptoms.
,5. A nurse educates students about the importance of differential diagnoses in EDS/HSD
care. Which explanation is accurate?
a. Differential diagnoses are unnecessary when genetic confirmation exists
b. They help rule out alternative explanations for symptoms
c. They delay treatment unnecessarily
d. They are only relevant in surgical care
Answer: b. They help rule out alternative explanations for symptoms
Rationale: Because many EDS/HSD symptoms overlap with other disorders, clinicians must
consider alternative diagnoses to avoid mismanagement.
6. A patient with suspected HSD asks how clinicians typically start the evaluation process.
What should the nurse explain?
a. Symptoms are considered individually, starting with genetic analysis
b. Symptoms are reviewed holistically, guided by algorithms and case-based learning
c. The evaluation is restricted to orthopedic assessments
d. Imaging studies are always the first step
Answer: b. Symptoms are reviewed holistically, guided by algorithms and case-based
learning
Rationale: The handbook’s design emphasizes holistic symptom-based evaluation with the
support of case studies and diagnostic tools.
7. Which statement best reflects the integrative understanding of EDS/HSD emphasized in
the handbook?
a. Care is limited to physical therapy
b. All manifestations can be explained by a single specialty
c. The conditions bridge multiple specialties requiring coordination
d. Integrative care delays interventions
Answer: c. The conditions bridge multiple specialties requiring coordination
Rationale: Because EDS/HSD symptoms span multiple specialties, integration across disciplines
provides more complete and patient-centered care.
8. During a teaching session, a nurse states: “This handbook is particularly useful because
it…” Which phrase best completes the statement?
a. Provides only genetic information
b. Focuses exclusively on musculoskeletal pathology
c. Presents complex disorders in a concise, symptom-based format
d. Eliminates the need for clinical experience
Answer: c. Presents complex disorders in a concise, symptom-based format
Rationale: The book condenses complex interdisciplinary knowledge into manageable,
symptom-driven discussions.
9. A nurse caring for a patient with EDS recognizes that patient empowerment is crucial.
Which action best promotes this empowerment?
a. Providing resources that explain symptoms and potential management strategies
b. Limiting discussions to provider decisions only
c. Avoiding patient involvement in differential diagnoses
, d. Discouraging questions to reduce anxiety
Answer: a. Providing resources that explain symptoms and potential management
strategies
Rationale: Empowerment comes from access to information and active involvement in care
decisions, which the handbook encourages.
10. Which example best demonstrates the practical application of the handbook’s case
study approach?
a. A patient learns about inheritance patterns in connective tissue disorders
b. A clinician uses a patient scenario to apply an algorithm for symptom management
c. A nurse memorizes all possible EDS subtypes without context
d. A physician disregards symptom overlap with other conditions
Answer: b. A clinician uses a patient scenario to apply an algorithm for symptom
management
Rationale: Case studies allow clinicians to contextualize symptoms and apply algorithms
effectively in practice.
11. A nurse notes that EDS/HSD patients often present with diverse complaints. What
clinical strategy aligns with the handbook’s recommendations?
a. Focusing narrowly on joint hypermobility only
b. Using symptom-based algorithms to organize evaluation
c. Initiating treatment before considering differential diagnoses
d. Avoiding interdisciplinary referrals
Answer: b. Using symptom-based algorithms to organize evaluation
Rationale: Symptom-based algorithms provide structured and systematic approaches to
evaluation and management.
12. When teaching a group of nursing students about EDS/HSD, which statement best
explains why these conditions are challenging to manage?
a. They involve multiple overlapping symptoms across systems
b. They can only be confirmed by imaging
c. They always progress at the same rate in all patients
d. They are restricted to dermatological manifestations
Answer: a. They involve multiple overlapping symptoms across systems
Rationale: Symptom variability and system overlap complicate diagnosis and care, requiring
comprehensive strategies.
13. Which nursing action best reflects the interdisciplinary collaboration emphasized in the
handbook?
a. Coordinating with cardiology, gastroenterology, and neurology teams for holistic care
b. Managing all patient concerns within a single specialty clinic
c. Relying solely on orthopedic interventions
d. Referring only after conservative measures fail
Answer: a. Coordinating with cardiology, gastroenterology, and neurology teams for
holistic care