Wound, Ostomy and Continence Nurses Society (WOCN) Practice Exam

How does phase 1 of necrotizing fasciitis typically present?

1. Slight fever and mild pain

2. Severe chills and out of proportion pain

3. Body aches and delayed healing

4. Localized redness and warmth

The correct answer is: Severe chills and out of proportion pain

Phase 1 of necrotizing fasciitis is characterized by severe chills and out of proportion pain. This phase often begins abruptly and can present with systemic signs of infection, including high fever and chills. The term "out of proportion pain" refers to pain that is significantly more intense than what would be expected based on the initial physical examination findings. This is a critical sign that sets necrotizing fasciitis apart from other types of infections, as it may indicate rapid tissue destruction. In this context, the intense pain, combined with systemic chills, signals the body's response to a serious and progressing infection. Recognizing these symptoms early is vital for timely intervention, as necrotizing fasciitis requires aggressive treatment including surgical intervention and broad-spectrum antibiotics. Other presentations like localized redness and warmth typically suggest less severe infections, while body aches and delayed healing may not clearly correlate with the early, aggressive nature of necrotizing fasciitis.