Chapter 21 Mental

In which disorder is the individual motivated solely by the desire to become a health care client? Factitious disorder Somatic symptom disorder Conversion disorder Illness related disorder

Factitious disorder

A student nurse asks the mental health nurse about when somatic symptom disorder (SSD) usually begins. The nurse responds by saying that the first symptoms often appear during which time? Adolescence Early 20s Mid 30s After age 40 years

Adolescence

The la belle indifference occurs in which somatoform disorder? Conversion disorder Hypochondriasis Body dysmorphic disorder Somatization disorder

Conversion disorder

The nurse is caring for a client with conversion disorder. The client reports having paralysis of the right side of the body. Which action by the nurse would constitute a secondary gain? Feeding the client during mealtime Talking about family and friends with the client Teaching the client techniques of meditation and relaxation Discussing coping strategies that the client used in the past

Feeding the client during mealtime

Clients with a somatization disorder typically do what? Discuss feelings and express needs verbally Minimize their medical history Have a history of going to many different providers without satisfaction Avoid playing the sick role and resist attention from health care providers

Have a history of going to many different providers without satisfaction

A client is prescribed sertraline for treatment of a somatoform disorder. The nurse would instruct the client to be alert to which side effect? Headache Increased appetite Constipation Vomiting

Headache

A nurse is caring for a client with somatic symptom illness. The health care provider has prescribed sertraline, 80 mg, to the client. What should the nurse monitor the client for after administering the drug? Select all that apply. Rashes Headache Dry mouth Diarrhea Insomnia

Headache Diarrhea Insomnia

A client is admitted to a mental health unit with a diagnosis of factitious disorder. When reviewing the client's history, which would a nurse most likely find? Intentional self-injurious behavior Pain to achieve a self-serving goal Malingering to avoid work Parents who were restrictive

Intentional self-injurious behavior

A client's family member asks the nurse, "What is a conversion disorder?" Which is the best response by the nurse? It involves unexplained, usually sudden, deficits in sensory or motor function. It is characterized by multiple physical symptoms. It is a preoccupation with the fear that one has a serious disease. It is a preoccupation with an imagined or exaggerated defect in physical appearance.

It involves unexplained, usually sudden, deficits in sensory or motor function.

When assessing the mood of a client with somatic symptom disorder, which mood would the nurse expect to find? Consistently elevated Labile Within normal limits Consistently depressed

Labile

A nurse is conducting an inservice presentation for a group of newly hired mental health nurses. Which would the nurse most likely include when describing conversion disorder (functional neurologic symptom disorder)? Symptoms expressed reflect a neurologic illness. Laboratory and diagnostic test results are usually negative. The symptoms follow a typical neurologic pattern. The client's complaints are not real.

Laboratory and diagnostic test results are usually negative.

Based on the nurse's knowledge of common problems associated with somatic symptom disorder, the nurse would ensure that which areas are assessed? Select all that apply. Polypharmacy Sleep patterns Activity level Fluid intake Urinary function

Polypharmacy Sleep patterns Activity level

A client complains of severe low back pain that began shortly after the death of the client's mother 2 years ago. No physical cause has been found to account for the pain. The client has been largely responsible for the care of four younger siblings because the client's father spends much of the week out of town on work-related business. Based on the client's symptoms, which nursing diagnosis is most appropriate for the client at this time? Somatic complaints due to anxiety related to life stressors Depression exhibited by repressed rage Altered comfort exhibited by poor school grades Ineffective parenting due to poor coping

Somatic complaints due to anxiety related to life stressors

An adolescent experiencing severe abdominal pain after the client's parents' argument is an example of what? Somatization Depression Schizophrenia Bipolar disorder

Somatization

A client with conversion disorder talks at length about a loss of vision. The nurse talks to the client about good hygiene practices and encourages the client to talk about any topic of interest. What is the nurse's intention for this intervention? Choose the best answer. The client should adopt good hygienic practices. The client should feel comfortable with the nurse. The client should pay less attention to the physical problem. The client should express the physical problem to the nurse.

The client should pay less attention to the physical problem.

In somatic symptom disorders, all except which are true? The client believes he/she has a serious illness. The client embraces the "sick role." The client usually believes he/she has some sort of anxiety disorder. The client believes that his/her condition is catastrophic and disabling.

The client usually believes he/she has some sort of anxiety disorder.

After teaching a group of nursing students about somatic symptom disorder, the instructor determines that additional education is needed when the students identify which as true? The client believes he/she has a serious illness. The client embraces the "sick role." The client usually thinks anxiety is behind the symptoms. The client believes that his/her condition is catastrophic and disabling.

The client usually thinks anxiety is behind the symptoms.

A nurse is caring for a client with conversion disorder. What immediate outcomes (within a week) indicate successful therapy for the client? Select all that apply. The client will communicate knowledge of the illness. The client will express feelings related to inadequacy and fear. The client will communicate the steps to solving the problems. The client will discuss problems and solve conflicts with family or friends. The client will identify the conflict underlying the physical symptoms experienced.

The client will communicate the steps to solving the problems. The client will identify the conflict underlying the physical symptoms experienced.

When describing the course of illness associated with somatic symptom disorder, which would the nurse include? The client readily discusses feelings and expresses needs verbally. The client will often minimize the medical history. The client will report going to many different providers without satisfaction. The client avoids playing the sick role and resists medical attention.

The client will report going to many different providers without satisfaction.

The nurse is seeing a an adolescent client who has attended the clinic frequently with vague reports of abdominal pain. Despite normal blood values, stool tests, and diagnotic imaging of the abdomen, the client continues to report symptoms. Which psychological factor may be contributing to the client's problem? The client's parents are considering getting divorced. The client recently received a low mark on an exam. The client is fearful of needles. The client is the head of the school debate team.

The client's parents are considering getting divorced.

A parent brings a teenaged child, who is complaining of having a severe headache, to the clinic. The teenager is groaning with pain. During assessment, the client asks the nurse for a note to excuse the absence from school. After further assessment, the nurse suspects that the client is malingering. What leads the nurse to come to this conclusion? Choose the best answer. The client's symptoms may have been a result of stress caused by studying all night for an exam. The client's symptoms disappeared after getting the medical note. The client was not found to have any underlying cause of headache on assessment. The client reported having signs related to raised intracranial pressure, such as nausea.

The client's symptoms disappeared after getting the medical note.

After teaching a group of nursing students about somatic symptom disorder (SSD), the instructor determines that additional education is necessary when the group identifies which statement as true? The condition is characterized by multiple physical symptoms. The condition is an acute short-term condition. The age of onset is usually before age 30 years. The disorder includes a combination of pain and gastrointestinal, sexual, and pseudoneurologic symptoms.

The condition is an acute short-term condition.

The nurse is teaching basic physical exercises and meditation techniques to a client recently diagnosed with conversion disorder. What outcome does the nurse expect from teaching the client these exercises? Choose the best answer. The exercises may help the client manage stress underlying the disorder The exercises may distract the client from the physical disability The exercises may help the client understand the conflict underlying the disorder The exercises may help the client express feelings of fear, anger, guilt, or inadequacy

The exercises may help the client manage stress underlying the disorder

A nursing instructor is describing complex somatic symptom disorder to a group of nursing students. The instructor determines that the teaching was successful when the students state what? The disorder typically is diagnosed in men. The first symptom usually appears during adolescence. The disorder commonly occurs with substance abuse. Highly educated individuals often develop this disorder.

The first symptom usually appears during adolescence.

Regularly scheduled therapy sessions are integral to the treatment plans for all clients requiring psychiatric-mental health care. The nurse understands that this is important for clients with somatic symptom disorder for which reason? To monitor for suicidal ideation To prevent the client from relapsing To monitor the client's physical health To ensure a therapeutic relationship with the client

To ensure a therapeutic relationship with the client

The nurse is planning care for a client with a somatic symptom illness. What should the nurse's goals be while formulating the plan to treat the client? Select all that apply. To help the client express emotions freely To help the client cope with interpersonal conflicts To prevent any danger to other clients and medical personnel To help the client identify the cause of the physical illness To administer narcotic analgesics to reduce the somatic illness

To help the client express emotions freely To help the client cope with interpersonal conflicts To help the client identify the cause of the physical illness

The nurse is providing care to a client with somatic symptoms disorder. The client has been prescribed escitalopram one week ago. The client reports experiencing nausea after starting the medication and describes it as "worse than what the average person would have." Which intervention should the nurse recommend for this client? To monitor the nausea using a daily journal for one week To stop taking the medication immediately To consume a balanced diet To see physician specialized in gastric disorders

To monitor the nausea using a daily journal for one week

A nurse is preparing a plan of care for a client diagnosed with body dysmorphic disorder. Which nursing diagnosis would the nurse likely identify as the priority? Disturbed body image Ineffective coping Low self-esteem Risk for other-directed violence

Disturbed body image

Which statement by the client indicates an understanding of somatic symptom disorder? "As soon as my symptoms go away, I'll be my old self again." "How I handle stress and emotions can affect my physical health." "I have to avoid stress all my life to avoid getting sick again." "Taking medication won't help my pain since it's caused by stress."

"How I handle stress and emotions can affect my physical health."

he client asks the nurse, "What does having psychosomatic symptoms mean?" What is the nurse's best reply? "It means you're not physically sick." "It means that stress and/or emotions are causing your symptoms." "It means that you'll be well when you get your life in order." "It means that your symptoms are a product of your imagination."

"It means that stress and/or emotions are causing your symptoms." f

All of the following disease processes are caused by stress except which one? Deep vein thrombosis Colitis Diabetes Hypertension

Deep vein thrombosis

A nurse is reviewing the medical history of a client diagnosed with somatic symptom disorder. Which would the nurse expect to find as a comorbid condition? Depression Bipolar disorder Thought disorder Sleep disorder

Depression

The nurse is caring for a client with somatic symptom disorder. When assessing this client, the nurse would be especially alert for symptoms of what? Depression Avoidant personality disorder Deliriuim Bipolar disorder

Depression

The nurse is seeing a Chinese client who reports chronic pain that radiates to the lower back. The client reports the pain has been unresolved with analgesia, physical therapy and therapeutic massage. The client's diagnostic imaging reports are all unremarkable. Which statement by the nurse would be the most supportive response to this client? "You must be so frustrated with this unexplained pain. Do you have other stresses in your life too? "The treatment that was recommended to you has worked for many clients. It is supported by research." "Is it common in your culture to talk about psychological distress like it is physical pain?" "It would be best for your to see a specialist until the underlying issue is properly diagnosed."

"You must be so frustrated with this unexplained pain. Do you have other stresses in your life too?

When assessing a client with somatic symptom disorder (SSD), the nurse would be alert for which comorbidity as most common? Select all that apply. Depression Anxiety Social phobia Panic disorder Personality disorder

Depression Anxiety

Which would be most important for a nurse to do when caring for a client with somatic symptom disorder? Administer prescribed pharmacotherapy Ensure adherence to counseling Develop a sound, positive nurse-client relationship Assist in developing a daily routine

Develop a sound, positive nurse-client relationship

hich would be most important for a nurse to do when caring for a client with somatic symptom disorder? Administer prescribed pharmacotherapy Ensure adherence to counseling Develop a sound, positive nurse-client relationship Assist in developing a daily routine

Develop a sound, positive nurse-client relationship

A nurse is assessing a client with conversion disorder. The client complains that the client's left side is paralyzed. Which statement made by the client would indicate "la belle indifférence"? "My paralysis doesn't bother me. I have accepted my disability." "Please do something to cure me. I am a burden to everybody." "I am sure I will get well soon. This problem won't persist for long." "I am not able to walk or do anything at all. I am totally dependent on my mom."

"My paralysis doesn't bother me. I have accepted my disability."

While assessing a client thought to have a factitious disorder, a nurse asks the client to describe when the client felt nurtured as a child. Which response would the nurse interpret as supporting the client's diagnosis? "I never felt nurtured or loved when I was growing up." "The only time I felt loved and appreciated was when I made the honor roll at school." "The only time I ever felt loved was when I was sick enough to miss school." "I felt loved and accepted when my father apologized for spanking me so hard."

"The only time I ever felt loved was when I was sick enough to miss school."

The spouse of a client diagnosed with complex somatic symptom disorder asks the nurse, "What causes this condition?" Which response by the nurse would be most accurate? "There is definitely an underlying genetic link for this disorder." "Your spouse is experiencing chronic stress that causes hypoarousal." "The symptoms reflect an emotion that your spouse cannot verbalize." "The symptoms reflect an internal preoccupation with events."

"The symptoms reflect an emotion that your spouse cannot verbalize."

The nurse is seeing a Chinese client who reports chronic pain that radiates to the lower back. The client reports the pain has been unresolved with analgesia, physical therapy and therapeutic massage. The client's diagnostic imaging reports are all unremarkable. Which statement by the nurse would be the most supportive response to this client? "You must be so frustrated with this unexplained pain. Do you have other stresses in your life too? " The treatment that was recommended to you has worked for many clients. It is supported by research." "Is it common in your culture to talk about psychological distress like it is physical pain?" "It would be best for your to see a specialist until the underlying issue is properly diagnosed."

"You must be so frustrated with this unexplained pain. Do you have other stresses in your life too? "

With treatment, conversion disorder often remits in a few weeks but recurs in approximately which percentage of clients? 10% 25% 35% 50%

25%

Characteristics of a conversion disorder include what? Select all that apply. A lack of stress over the physical loss Production of both a primary and secondary gain for the client Physical symptoms that are worse in the presence of the stressor Familiarity with medical and psychological information Seen in urban communities

A lack of stress over the physical loss Production of both a primary and secondary gain for the client Physical symptoms that are worse in the presence of the stressor

Which scenario best exemplifies the psychosocial theory of the development of somatic symptom disorders? An individual consciously develops fictitious complaints in order to distract himself or herself from stressors. A person's family of origin models ineffective coping and conflict-based interactions. An individual's neuroendocrine system is overstimulated and the person becomes accustomed to this condition. A person unconsciously realizes that a particular physiological response produces a reward.

A person unconsciously realizes that a particular physiological response produces a reward.

A client with pain who has been diagnosed with somatic symptom disorder and depression is prescribed medication therapy to treat both the pain and the symptoms of depression. When educating the client about the medication, which would the nurse emphasize? Use of sunscreen when exposed to bright sunlight Limiting of the amount of water ingested Alcohol should be avoided Stopping the medication if there is no change after 1 week

Alcohol should be avoided

Based on the psychosocial theory associated with somatic symptom illnesses, the mental health nurse suspects that a client who frequently fails to meet deadlines at work claiming reoccurring "stomach problems" is what? Select all that apply. Displaying somatizing behavior Being rewarded for this behavior Not consciously causing the "stomach problems" Likely to give up the behavior when it is identified as a mental health issue Not experiencing any negative repercussions at work

Displaying somatizing behavior Being rewarded for this behavior Not consciously causing the "stomach problems"

Which is a significant obstacle in providing psychiatric care for clients who have somatic symptom illnesses? Clients with these disorders find it difficult to go to a clinic setting. Clients are often embarrassed about the number and extent of their physical complaints. Clients are often unrecognized because clients receive treatment in different primary care offices, and care is often fragmented. There are no known successful treatments for these disorders.

Clients are often unrecognized because clients receive treatment in different primary care offices, and care is often fragmented.

The nurse is providing care to a client with somatic symptom disorder (SSD). Which would the nurse expect to be included in the client's plan of care? Cognitive behavior therapy Multiple provider evaluations Mood stabilizers to manage the symptoms Electroconvulsive therapy

Cognitive behavior therapy

The nurse is studying the medical record of a client who reports blindness. The record indicates there is no ocular abnormality. The client doesn't seem upset by the blindness. What is the client's most likely diagnosis? Hypochondriasis Conversion disorder Optic nerve dysfunction Somatic symptom disorder

Conversion disorder

Which disorder is characterized by unexplained, sudden deficits in sensory or motor function? Body dysmorphic disorder Hypochondriasis Somatization disorder Conversion disorder

Conversion disorder

Which characteristic differentiates conversion disorder from malingering disorder? Conversion disorder is normally permanent, while malingering disorder is transient in response to stress. Conversion disorder is an unconscious process, while malingering disorder is a deliberate fabrication of symptoms. Conversion disorder produces reward, while malingering disorder normally results in punishment or difficulty. Conversion disorder has no pathophysiological cause, while malingering disorder has a neurological or endocrine basis.

Conversion disorder is an unconscious process, while malingering disorder is a deliberate fabrication of symptoms.

After teaching a group of nursing students about somatic symptom disorder (SSD), the instructor determines the need for additional education when the students identify which as a characteristic of the disorder? Easily manageable with treatment Symptoms that move from one body system to another Symptoms tend to change Symptoms that can last from 6 to 9 months

Easily manageable with treatment

The nurse is educating the spouse of a client with a somatic symptom disorder about how to best help the client. Which strategy should the nurse suggest? Keep a log of the client's physical symptoms to track improvement. Empathize about physical discomfort but encourage independence. Encourage the client to acknowledge the spouse's frustration and helplessness. Ignore the client's complaints about physical discomfort and help the client focus on feelings instead.

Empathize about physical discomfort but encourage independence.

When assessing a client diagnosed with hypochondriasis, the most serious risk factor to be identified for this client is what? Extensive use of over-the-counter medications Ruminating thoughts Aggressive behavior Denial of emotional problems

Extensive use of over-the-counter medications

A group of nursing students is reviewing information about somatic symptom and related mental health disorders. The students demonstrate understanding of the information when they identify which disorder as involving physical or psychological symptoms (or both) fabricated to assume the sick role? Factitious disorder Conversion disorder Illness anxiety disorder Alexithymia

Factitious disorder

In which disorder is the individual motivated solely by the desire to become a client? Factitious disorder Body dysmorphic disorder (BDD) Conversion disorder Complex somatic symptom disorder (CSSD)

Factitious disorder

A client is admitted to a mental health unit because the client was found trying to inject diluted feces into the client's hospitalized child's intravenous line. The client has a history of similar attempts of harming the child. The nurse would most likely suspect what? Schizoid personality traits Factitious disorder imposed on another Functional neurologic symptoms Borderline personality disorder

Factitious disorder imposed on another

A nurse is describing the social network of clients diagnosed with somatic symptom disorder when conducting a class for a group of staff nurses. The nurse determines that the class was successful when the group identifes which network as the primary network for this population? Peers Coworkers Health care providers Siblings

Health care providers

Which mental health disorder is characterized by a fear of developing a serious illness based on a misinterpretation of body sensation? Hypochondriasis Alexithymia Conversion disorder Body dysmorphic disorder

Hypochondriasis

A nurse is working with a client diagnosed with somatic symptom disorder who is experiencing pain. Which would be an important focus of care? Select all that apply. Administering opioid analgesics as neeeded Identifying strategies to relieve pain Examining stressors in the client's life Addressing nonpharmacologic measures for symptom relief Suggesting the use of complementary and alternative treatments.

Identifying strategies to relieve pain Examining stressors in the client's life Addressing nonpharmacologic measures for symptom relief Suggesting the use of complementary and alternative treatments.

A client who has been having difficulty functioning in daily life comes to the nurse and states, "I'm really afraid. I've had these funny feelings in my stomach. I'm scared that I might have cancer." The client has been seen by numerous health care professionals and no evidence of cancer has been demonstrated. The nurse suspects what? Factitious disorder Functional neurologic symptom disorder Conversion disorder Illness anxiety disorder

Illness anxiety disorder

During a client interview, the nurse determines that the client has a fear of developing a serious illness based on a misinterpretation of body sensation. The nurse identifies this as being characteristic of what? Illness anxiety disorder Alexithymia Conversion disorder Factitious disorder

Illness anxiety disorder

Which would the nurse expect to assess in a client diagnosed with functional neurologic symptom disorder? Headache Pain Gastrointestinal upset Imbalance

Imbalance

The major difference between somatoform disorders and factitious disorders is what? In somatoform disorders, clients consciously seek attention. In factitious disorders, clients are unaware that their symptoms are not real. In somatoform disorders, clients are not consciously aware that they are meeting needs through physical complaints. Factitious disorders respond much more readily to psychopharmacologic treatment than do somatoform disorders.

In somatoform disorders, clients are not consciously aware that they are meeting needs through physical complaints.

The nurse has concluded the assessment of a client recently diagnosed with somatic symptom disorder. The client states the client's most significant source of stress is that "No one believes how sick I am." The client's physical complaints include fatigue, loss of appetite, and frequent urination. Based on these data, the most appropriate nursing diagnosis is what? Hopelessness related to chronicity of symptoms as evidenced by dependency Ineffective coping related to unresolved psychological issues as evidenced by inability to express feelings verbally Chronic low self-esteem related to physical symptoms that inhibit the client's daily functioning Risk for spiritual distress related to feelings of isolation

Ineffective coping related to unresolved psychological issues as evidenced by inability to express feelings verbally

When developing the plan of care for a client with somatic symptom disorder, which would be the most important yet most difficult intervention for the nurse to implement? Maintaining a therapeutic relationship Discussing results of diagnostic tests Assisting with problem solving Educating the client about positive health care practices

Maintaining a therapeutic relationship

Assessment reveals that a client has been intentionally injuring the self so that the client can receive long-term disability and not have to work. The nurse interprets this behavior as suggesting which condition? Malingering Factitious disorder Factitious disorder imposed on another Functional neurologic symptom disorder

Malingering

Which occurs when an individual intentionally produces illness symptoms to avoid work? Malingering Alexithymia Conversion disorder Illness anxiety disorder

Malingering

Which best describes the concept of somatization? Manifestation of physical symptoms from psychological distress Psychological origin of illness that is not real Physical symptoms that are all in one's head Symptoms that cannot be substantiated by physicians

Manifestation of physical symptoms from psychological distress

A client is admitted to the mental health unit because the client was found trying to inject diluted feces into the client's hospitalized child's intravenous line. The client has a history of similar attempts of harming the child. The nurse would most likely suspect what? Schizoid personality traits Munchausen's syndrome by proxy Functional neurologic symptoms Borderline personality disorder

Munchausen's syndrome by proxy

Which statement best reflects the pharmacologic treatment of somatic symptom disorder? No medications have been specifically recommended for somatic symptom disorder. Selective serotonin reuptake inhibitors are especially helpful for clients experiencing pain. Monoamine oxidase inhibitors are effective in treating comorbid anxiety disorders. Pharmacologic therapy is the primary mode of treatment.

No medications have been specifically recommended for somatic symptom disorder.

The nurse obtains a psychosocial history from a client who may have psychological factors affecting the medical condition. Which should the nurse recognize as pertinent to this diagnosis? No physiologic cause has been found for the client's symptoms. The client's symptoms subside with appropriate medical treatment. The client is able to articulate the cause of psychological distress. The client's symptoms are related to conscious motives.

No physiologic cause has been found for the client's symptoms.

A nurse is assessing a client who is suspected of having somatic symptom disorder (SSD). Which would the nurse expect to report as the most common report? Nausea Dizziness Pain Cough

Pain

Which is an inaccurate statement regarding malingering? People who malinger usually do not stop the physical symptoms when given a reward. It is the intentional production of false or grossly exaggerated physical or psychological symptoms. It is motivated by external incentives. People who malinger have no real physical symptoms.

People who malinger usually do not stop the physical symptoms when given a reward.

Which is the name given to a direct external benefit that being sick provides, such as relief from anxiety? Primary gain Secondary gain Malingering La belle indifference

Primary gain

A nurse is preparing to interview a client diagnosed with somatic symptom disorder. The nurse anticipates that the client will most likely exhibit what? No facial expression during the interview Intermittent nodding and glancing at the clock on the wall Altered mental status Rapidly changing moods during the interview

Rapidly changing moods during the interview

A client has been admitted to a hospital with the inability to move the client's right arm. The client has a diagnosis of conversion reaction. Which consequence of this condition would be an example of primary gain? Relief from anxiety Medical leave from the client's high-stress job Attention from the client's spouse and children Avoidance of jury duty

Relief from anxiety

A client is diagnosed with somatic symptom disorder. Which would the nurse expect to assess as the major clinical finding? The client's inability to focus on emotional content Report of symptoms with no demonstrable pathology on testing or examination Definitive medical finding with a history of "doctor shopping" Loss of voluntary motor or sensory functioning

Report of symptoms with no demonstrable pathology on testing or examination

When assessing a client with somatic symptom disorder, which would the nurse most likely note? The client's symptoms are under the conscious control of the client. Denial and repression are the chief defense mechanisms used. Reports of physical symptoms do not have a demonstrable organic basis to fully account for them. The client willfully controls the physical symptoms.

Reports of physical symptoms do not have a demonstrable organic basis to fully account for them.

The personal benefit derived from blocking psychological conflict from conscious awareness is called what? Primary gain Secondary gain La belle indifference Sick role reward

Secondary gain

A client has been diagnosed with somatic symptom disorder. The client's assessment reveals high levels of anxiety. Which would the nurse expect to be prescribed? Selective serotonin reuptake inhibitors (SSRIs) Antipsychotics Tricyclic antidepressants Mood stabilizers

Selective serotonin reuptake inhibitors (SSRIs)

Which medication classification has been shown to be effective in some cases of somatoform disorders? Serotonin reuptake inhibitors (SSRIs) Antimanics Antipsychotics Antibiotics

Serotonin reuptake inhibitors (SSRIs)

Following a long history of multiple visits to community clinics and emergency departments, a client has been diagnosed with hypochondriasis. During this current visit to the emergency department, the client has just been informed that diagnostic testing and assessment reveal no severe illness. Despite this, the client persists in verbalizing physical complaints. How should the nurse respond to this? Have a different member of the care team present the test and assessment results to the client. Facilitate a repeat of the previous diagnostic testing in order to appease the client. Set limits with the client about the complaints. Feign an assessment of the client in order to calm the client's anxiety

Set limits with the client about the complaints.

Somatic symptom disorder is characterized by what? Severe physical symptoms unexplainable by any organic or physical pathology Self-inflicted injuries Self-induced disease states or faked symptoms to garner attention Physical symptoms coupled with extreme focus on emotional state

Severe physical symptoms unexplainable by any organic or physical pathology

Over the past 5 years, a client has had two exploratory surgeries and numerous examinations for severe abdominal pain. All diagnostic and laboratory results have been negative for organic problems. The client has had vague descriptions of periods of anxiety and depression and has continued to seek medical assistance for the abdominal pain and various other physical problems. The nurse would assess this client as using which defense mechanism? Somatization Dissociation Displacement Repression

Somatization

Which term describes the conversion of unexpressed emotions into physical symptoms? Somatization La belle indifference Hysteria Psychosomatic

Somatization

The primary factor that differentiates somatization disorders from conversion disorders is what? Somatization disorders usually affect the cardiac system, whereas conversion disorders do not. Conversion disorders are always targeted at the respiratory system. Somatization disorders are conscious, whereas conversion disorders are unconscious. Somatization disorders affect multiple organ systems, whereas conversion disorders usually involve only one system.

Somatization disorders affect multiple organ systems, whereas conversion disorders usually involve only one system.

A nurse is assessing a client with hypochondriasis. Which signs could the nurse expect to find in the client? Select all that apply. The client is preoccupied with the self. The client will discuss many emotional problems. The client reports having visited many physicians or hospitals. The client does not believe in the use of over-the-counter medications. The client is reluctant to participate in psychiatric treatment programs.

The client is preoccupied with the self. The client reports having visited many physicians or hospitals. The client is reluctant to participate in psychiatric treatment programs.

The nurse suspects the client being seen for a physical examination meets the criteria for somatic symptom disorder. Which information from the client's history would support this diagnosis? Select all that apply. The client lived in foster care as a child The client experienced sexual assault as an adolescent The client has difficulty sustaining employment The client reports drinking 5 to 6 beers per day The client is fearful of medical procedures

The client lived in foster care as a child The client experienced sexual assault as an adolescent The client has difficulty sustaining employment The client reports drinking 5 to 6 beers per day

The nurse is assessing a client who has been unable to speak after witnessing a murder. The assessment and subsequent testing reveal no physical abnormality that may cause speech impairment. What is the most likely cause of this speech impairment in the client? The client may have vocal cord paralysis. The client may not want to speak. The client may be attempting to block the witnessed event to reduce anxiety. The client may have dysfunction of the speech center of the brain.

The client may be attempting to block the witnessed event to reduce anxiety.

The nurse is assessing a client who reports severe chest pain. The client appears worried and frightened. Further assessment and laboratory testing does not reveal any abnormalities. The nurse observes that in the absence of any medical personnel, the client watches TV, is relaxed, and speaks to a friend on the phone in a normal tone of voice. What should the nurse suspect in this case? The client may be a hypochondriac. The client may be malingering. The client may have silent angina. The client may have Munchausen's syndrome.

The client may be malingering.

A client reports a headache. On further assessment, the nurse finds that the client has been spending long hours on a difficult project at work. What should the nurse conclude from the assessment? The client may be a hypochondriac. The client may be lying about pain. The client may be stressed from work. The client may have conversion disorder.

The client may be stressed from work.

The nurse is studying the medical records of an Indian male client. The nurse finds that the client has dhat syndrome. What should the nurse infer from this? The client may have concerns regarding loss of semen. The client may have concerns about his penis shrinking. The client may have concerns about having insomnia, fatigue, and indigestion. The client may have concerns about having dizziness, headache, pain, and sleep disturbance.

The client may have concerns regarding loss of semen.

A client developed conversion blindness after witnessing the death of the client's twin in a car accident. When teaching the client's parent about the client's illness, the nurse explains what? The client's blindness is a reaction to the trauma of losing the twin and has no physiologic basis. The client's blindness results in increased anxiety and attention from family and friends. The clients blindness will gradually disappear if proper ophthalmologic care is provided. The client's blindness requires a conscious effort to maintain the feigned symptom.

The client's blindness is a reaction to the trauma of losing the twin and has no physiologic basis.

A client with somatic symptom disorder is complaining of significant pain in the joints. When providing care to this client, which would be most important for a nurse to keep in mind? Opioid analgesics are the primary mode of therapy. The client's experience of pain is real. Complementary therapies are usually of little benefit. Outcomes need to reflect the biologic aspects of the pain.

The client's experience of pain is real.

The nurse is caring for a client with conversion disorder. The nurse asks the client about the client's relationships with family and friends. What is the nurse trying to determine with this question? Choose the best answer. The nurse wants to find out if similar symptoms are evident in the family. The nurse wants to divert the client's attention from the illness. The nurse wants to minimize the chances of secondary gain. The nurse wants to learn if the client has any conflicts with family or friends.

The nurse wants to learn if the client has any conflicts with family or friends

A nurse is preparing a presentation for a staff meeting about somatic symptom disorder (SSD). When describing the epidemiology associated with SSD, the nurse would identify which groups as likely to develop this condition? Select all that apply. Non-White men White females Women of lower socioeconomic status African American women Men experiencing high emotional distress

Women of lower socioeconomic status African American women

The mental health nurse providing care for a client exhibiting symptoms of hypochondriasis is prepared to observe the client ... performing ritualistic, repetitive actions. treating a cognitively impaired client aggressively. producing grossly exaggerated physical symptoms to have needs met. seldom engaging in milieu activities.

performing ritualistic, repetitive actions.