Chapter 17- Psych

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Emily asks you what kind of therapy will help her. Your best response, based on current knowledge, is:

"Cognitive behavioral therapy have been show to consistently provide the best outcome for these types of disorders"

What statement by a client would indicate that goals for treatment for a somatization disorder are being achieved?

"I don't think about my symptoms all the time as I used to do"

Which statement made by a client would support the diagnosis of hypochondirasis?

"I know I have cancer, but the doctors just cannot find it"

Emily is a veteran returning from Iraq. Ever since Emily participated in a village raid where explosives were used, she has been unable to walk. All diagnostic testing has been negative for any physical abnormalities, and she was diagnosed with conversion disorder. She asks you what that means. Your best response would be:

"Your emotional distress is being expressed as a physical symptom"

The most likely client to demonstrate behaviors suggesting a somatic disorder is a

23-year-old female (aged 16-25 are more likely)

Which statement about somatoform disorders is true?

Clients lack awareness of the relations among symptoms, anxiety, and conflicts

which term of data should be routinely gathered during assessment of a client with a somatoform disorder

Dependence on medication

What would be an appropriate expected outcome of Emily's treatment plan?

Emily will be able to state two new effective coping skills within 2 weeks

Which disorder is characterized by the client's misinterpretation of physical sensations or feelings?

Illness anxiety disorder

Which behavior by a client would not support a diagnosis of somatoform diosrder

Performing activities of daily living unassisted

Shane, aged 23 years, is admitted to your medical-surgical unit with complaints of abdominal pain, dizziness, and headaches. Results of a physical workup have been negative so far. Today Shane tells you, "Now I'm having back pain." Which of the following in Shane's medical record may alert you to the possibility of malingering?

Shane has a court date this week for drunk driving. Shane has a history of physical abuse by his stepfather

Which disorder places the client at highest risk for developing a coexisitng substance abuse disorder?

Somatoform pain disorder

A class of medications commonly prescribed for somatic disorders is

anxiolytics

Studies have shown a correlation between mental disorders and medical conditions such as

cancer

In somatization disorders, it is important for the nurse to employ holistic strategies. This can be defined as:

considering all dimensions of the patient, including biological, psychological, and sociocultural

An example of a somatoform disorder is

conversion disorder

Therapeutic intervention for a client with a somatoform disorder would include

conveying an interest in the client rather than in the symptoms

The primary difference between a factitious disorder and other somatic disorders is that factitious disorder

have a symptomatology that is actually controlled by the client

When caring for a client demonstrating the inability to provide effective self-care, the nurse

identifies the client's highest level of self-care and states reasonable expectations to the client

A physician describes a client as "malingering". The nurse knows this means that the client

is falsely claiming to have symptoms

A women suddenly finds she cannot see. She seems unconcerned about her symptom and tells her husband, "Don't worry, dear. Things will all work out." Her attitude is an example of

la belle indifference

Providing care to a client diagnosed with a somatization disorder can be frustrating owing to the client's lack of an organic illness. In order to best manage this barrier to care the staff will

regularly discuss their feelings about the client during the unit's interprofessional care meetings

When discussing somatic disorders from a cultural perspective, it is true that

somatic symptoms vary widely from culture to culture


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