The nurse is assessing a client with fibromyalgia who reports disturbed sleep and fatigue. What additional symptom does the nurse anticipate?

Correct Answer: B

Rationale: The nurse anticipates widespread pain in a client with fibromyalgia reporting disturbed sleep and fatigue, as it's a hallmark symptom of the condition. Fibromyalgia involves chronic, diffuse musculoskeletal pain across multiple body regions, often exacerbated by poor sleep and fatigue, which disrupt pain modulation in the central nervous system. Increased appetite (Choice A) isn't typicalfatigue might reduce appetite due to low energy, not increase it. Headache (Choice C) can occur but isn't a core feature; fibromyalgia's pain is broader, not localized to the head. Bradycardia (Choice D), a slow heart rate, has no direct link to fibromyalgia, which doesn't typically affect cardiac rhythm. Widespread pain (Choice B) aligns with diagnostic criteria, making it the expected finding. Nurses assess this to tailor interventions like pain management, sleep aids, or stress reduction, addressing the triad of pain, sleep issues, and fatigue that defines fibromyalgia's impact on quality of life.

Correct Answer: A

Rationale: The basis for the nurse's follow-up teaching is that heat increases blood flow, dilating vessels to deliver oxygen and nutrients to arthritic joints, relaxing muscles and easing stiffness-related pain. This physiological effect underpins heat therapy's benefit in arthritis. Choice B, heat numbs nerve endings, is inaccurateheat soothes, but numbing is more cold's domain; it doesn't block nerve signals. Choice C, heat reduces inflammation, is misleadingheat may feel good but can worsen acute inflammation; arthritis pain relief here ties to chronic stiffness, not swelling reduction. Choice D, heat distracts from pain, oversimplifiesdistraction occurs, but increased circulation is the primary mechanism. Choice A is correct, guiding nurses to explain heat's vascular benefits, reinforcing safe use (e.g., warm packs) and pairing it with other therapies, enhancing the client's self-management of chronic arthritis pain.

Correct Answer: A

Rationale: The basis of the nurse's response is less distraction, as nighttime's quiet and inactivity allow greater focus on pain signals from a fractured arm, amplifying perception. During the day, activity or interaction diverts attention, dulling pain awarenessa psychological modulation effect. Choice B, more activity, is falsenight typically involves rest, not exertion, which might increase pain if true. Choice C, improved circulation, doesn't fit; circulation may stabilize at rest, but this doesn't inherently worsen painswelling might, but it's not specified. Choice D, increased appetite, is unrelatedhunger doesn't intensify fracture pain. Choice A is correct, guiding nurses to explain this common pattern, suggesting strategies like mild distraction (e.g., music) or timed analgesics to blunt nighttime pain spikes, enhancing comfort for acute injuries like fractures.

Correct Answer: B

Rationale: The best response is Take the medication at bedtime,' as it leverages drowsinessa common opioid side effectto aid sleep, a frequent issue in chronic pain, while maintaining pain control. Timing adjusts impact without altering the regimen. Choice A, stop taking it, risks uncontrolled pain, dismissing a manageable side effect over the drug's benefit. Choice C, you'll get used to it, assumes tolerance develops, which may notdrowsiness can persist, disrupting daytime function. Choice D, reporting to the physician, may follow, but nurses first offer practical solutions; this isn't urgent. Choice B is correct, empowering the client with a strategy nurses often suggest, aligning dose with lifestyle, reducing daytime sedation, and enhancing comfort, with follow-up if issues persist.

Correct Answer: A

Rationale: The basis of the nurse's response is slowed digestion, as opioid analgesics bind to gut mu receptors, decreasing peristalsis and delaying bowel motility, causing constipationa frequent, mechanism-based side effect. This explains its predictability. Choice B, reduced appetite, may occur with nausea but doesn't directly cause constipationmotility, not intake, is key. Choice C, increased fluid loss, is unrelated; opioids don't dehydrate bowelsstool hardens from slow transit. Choice D, allergic reaction, is wrongconstipation is a pharmacological effect, not hypersensitivity. Choice A is correct, enabling nurses to clarify this GI impact, recommending prophylactics (e.g., laxatives) and hydration to counteract slowed digestion, ensuring clients maintain comfort and bowel function while on chronic pain meds.