NUR 511 CHAPTER 17 – NONSPECIFIC
COMPLAINTS (GOOLSBY & GRUBBS, 5TH
EDITION) LATEST VERIFIED STUDY GUIDE 2026
Types of Examination / Assessment
General Approach:
• Start with full history and physical, focusing on:
o Symptom onset, duration, pattern, aggravating/alleviating
factors.
o Functional impact, associated symptoms (constitutional signs).
o Medication review, social history, psychosocial context.
Vital Signs & Basic Screening:
• Temperature, HR, BP, RR, SpO₂.
• Weight changes, BMI.
• Mental status exam for fatigue, confusion, depression.
Focused Physical Exam:
• Depends on most likely systems based on history. Common focuses:
o Skin: rashes, pallor, bruising.
o HEENT: signs of infection, pallor, jaundice.
o Cardiovascular: murmurs, rhythm abnormalities.
o Abdomen: tenderness, organomegaly.
o Musculoskeletal: joint swelling, muscle weakness.
o Neuro: strength, reflexes, coordination.
Functional Assessment:
• Activities of daily living (ADLs).
• Fatigue scales, pain scales, or screening tools for depression/anxiety.
Common Nonspecific Complaints / Key Terms
Term Definition / Description
Subjective sense of tiredness, exhaustion, or lack of energy
Fatigue
not relieved by rest.
, Term Definition / Description
Weakness Loss of muscle strength, may be generalized or localized.
Sensation of unsteadiness, lightheadedness, or spinning;
Dizziness
differentiate vertigo vs presyncope.
Transient loss of consciousness due to cerebral
Syncope
hypoperfusion.
Malaise General feeling of discomfort or unease.
Weight Unintentional loss or gain may indicate systemic disease.
Change
Fever / Low-
Suggests infection, autoimmune disease, or malignancy.
grade Fever
Pain Often generalized, diffuse, or poorly localized; may indicate
(nonspecific) musculoskeletal, neuropathic, or systemic causes.
Common Causes / Differential Diagnoses
1. Fatigue
• Endocrine: Hypothyroidism, diabetes, adrenal insufficiency.
• Hematologic: Anemia (iron deficiency, B12/folate deficiency).
• Cardiopulmonary: Heart failure, chronic lung disease, sleep apnea.
• Psychiatric: Depression, anxiety, chronic stress.
• Infectious: EBV, HIV, hepatitis, chronic bacterial infections.
• Medications: Beta-blockers, antihistamines, sedatives.
2. Weakness
• Neurologic: Stroke, myasthenia gravis, neuropathy, multiple sclerosis.
• Metabolic: Electrolyte disturbances (hypokalemia,
hypophosphatemia).
• Musculoskeletal: Myopathies, polymyositis.
• Systemic Illness: Chronic infection, malignancy.
3. Dizziness / Vertigo
• Peripheral Vertigo: Benign paroxysmal positional vertigo (BPPV),
vestibular neuritis, Meniere’s disease.
COMPLAINTS (GOOLSBY & GRUBBS, 5TH
EDITION) LATEST VERIFIED STUDY GUIDE 2026
Types of Examination / Assessment
General Approach:
• Start with full history and physical, focusing on:
o Symptom onset, duration, pattern, aggravating/alleviating
factors.
o Functional impact, associated symptoms (constitutional signs).
o Medication review, social history, psychosocial context.
Vital Signs & Basic Screening:
• Temperature, HR, BP, RR, SpO₂.
• Weight changes, BMI.
• Mental status exam for fatigue, confusion, depression.
Focused Physical Exam:
• Depends on most likely systems based on history. Common focuses:
o Skin: rashes, pallor, bruising.
o HEENT: signs of infection, pallor, jaundice.
o Cardiovascular: murmurs, rhythm abnormalities.
o Abdomen: tenderness, organomegaly.
o Musculoskeletal: joint swelling, muscle weakness.
o Neuro: strength, reflexes, coordination.
Functional Assessment:
• Activities of daily living (ADLs).
• Fatigue scales, pain scales, or screening tools for depression/anxiety.
Common Nonspecific Complaints / Key Terms
Term Definition / Description
Subjective sense of tiredness, exhaustion, or lack of energy
Fatigue
not relieved by rest.
, Term Definition / Description
Weakness Loss of muscle strength, may be generalized or localized.
Sensation of unsteadiness, lightheadedness, or spinning;
Dizziness
differentiate vertigo vs presyncope.
Transient loss of consciousness due to cerebral
Syncope
hypoperfusion.
Malaise General feeling of discomfort or unease.
Weight Unintentional loss or gain may indicate systemic disease.
Change
Fever / Low-
Suggests infection, autoimmune disease, or malignancy.
grade Fever
Pain Often generalized, diffuse, or poorly localized; may indicate
(nonspecific) musculoskeletal, neuropathic, or systemic causes.
Common Causes / Differential Diagnoses
1. Fatigue
• Endocrine: Hypothyroidism, diabetes, adrenal insufficiency.
• Hematologic: Anemia (iron deficiency, B12/folate deficiency).
• Cardiopulmonary: Heart failure, chronic lung disease, sleep apnea.
• Psychiatric: Depression, anxiety, chronic stress.
• Infectious: EBV, HIV, hepatitis, chronic bacterial infections.
• Medications: Beta-blockers, antihistamines, sedatives.
2. Weakness
• Neurologic: Stroke, myasthenia gravis, neuropathy, multiple sclerosis.
• Metabolic: Electrolyte disturbances (hypokalemia,
hypophosphatemia).
• Musculoskeletal: Myopathies, polymyositis.
• Systemic Illness: Chronic infection, malignancy.
3. Dizziness / Vertigo
• Peripheral Vertigo: Benign paroxysmal positional vertigo (BPPV),
vestibular neuritis, Meniere’s disease.
