Chapter 17-Somatic Symptoms Disorder

Which statement by a client would indicate that goals for treatment for a somatization disorder are being achieved a) "I feel less anxiety than before" b) "My memory is better than it was a month ago" c) "I take my medications just as the physician prescribed" d) "I don't think about my symptoms all the time as I used to"

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

Which statement made by a client would support the diagnosis of illness anxiety disorder a) "I feel confused and disoriented" b) "I feel as though I'm outside my body watching what is happening" c) "I know I have cancer, but the doctors just cannot find it" d) "I woke up one morning and my left leg was paralyzed from the knee down"

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

Which client is most likely to initially demonstrate behaviors suggesting a somatic disorder a) 13 year old male b) 23 year old female c) 33 year old male d) 43 year old female

23 year old female

You are caring for Yolanda, a 67 year old patient who has been receiving hemodialysis for 3 months. Yolanda reports that she feels angry whenever it is time for her dialysis treatment. You attribute this to a) Organic changes in Yolanda's brain b) A flaw in Yolanda's personality c) A normal response to grief and loss d) Denial of the reality of a poor prognosis

A normal response to grief and loss

Which patient is at greatest risk for developing a stress induced myocardial infarction a) A patient who lost a child in an accidental shooting 24 hours ago b) A woman who has begun experiencing early signs of menopause c) A patient who has spent years trying to sustain a successful business d) A patient who has diagnosed with chronic depression 10 years ago

A patient who has diagnosed with chronic depression 10 years ago

A class of medications commonly prescribed for somatic disorders is a) Mood stabilizers b) Antidepressants c) Anxiolytics d) Antipsychotics

Anxiolytics

Conversational disorder is described as an absence of a neurological diagnosis that manifests in neurological symptoms. Channeling of emotions, conflicts and stressors into physical symptoms is thought to be the cause in conversion disorder. Which statement is true a) People with conversion disorder are extremely upset about often dramatic symptoms b) Abnormal patterns of cerebral activation have been found in individuals with conversion disorder c) An organic cause is usually found in most cases of conversion disorder d) Symptoms can be turned off and anon depending on the patients choice

Abnormal patterns of cerebral activation have been found in individuals with conversion disorder

You are caring for Aaron, a 38 year old patient diagnosed with somatic symptom disorder. When interacting with you, Aaron continues to focus on his severe headaches. In planning care for Aaron, which of the following interventions would be appropriate a) Call for a family meeting with Aaron in attendance to confront Aaron regarding his diagnosis b) Educate Aaron on alternative therapies to deal with pain c) Improve reality testing by telling Aaron that you do not believe that the headaches are real d) After a limited discussion of physical concerns, shift focus to feelings and effective coping skills

After a limited discussion of physical concerns, shift focus to feelings and effective coping skills

Emily asks you what kind of therapy will help her. Based on current knowledge, what form of therapy is most appropriate for a client diagnosed with a conversion disorder a) A combination of antianxiety and antidepressant therapy is the most effective therapy b) Aversion therapy is often used because in effect you are punishing yourself by not being able to walk c) Modeling will be used; as you see desired behaviors modeled by the therapist you will be able to also achieve the expected outcome d) CBT has been shown to consistently provide the best outcome for these types of disorders

CBT has been shown to consistently provide the best outcome for these types of disorders

The care plan of a patient diagnosed with a somatic disorder includes the nursing diagnosis "ineffective coping." which patient behavior demonstrates a successful outcome for that nursing diagnosis a) Showers and dresses in clean clothes daily b) Calls a friend to talk when feeling lonely c) Spends more time talking about pain in her abdomen d) Maintains focus and concentration

Calls a friend to talk when feeling lonely

What would be an appropriate expected outcome of the treatment plan for a client diagnosed with a conversion disorder that interferes with the ability to walk effective a) Client will walk unassisted within 1 week b) Client will return to a pre-illness level of functioning within 2 weeks c) Client will be able to state two new effective coping skills within 2 weeks d) Client will assume full self-care within 3 weeks

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

Which statement about somatoform disorders is true a) An organic basis exists for each group of disorders b) Nurses perceive clients with these disorders as easy to care for c) No relation exists between these disorders and early childhood loss or trauma d) Clients lack awareness of the relations among symptoms, anxiety and conflicts

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

Melanie, a 38 year old female admitted to the hospital to rule out a neurological disorder. The testing was negative, yet she is reluctant to be discharged. Today she has added lower back pain and a stabbing sensation in her abdomen. The nurse suspects a factitious disorder in which Melanie may a) Consciously be trying to maintain her role of a sick patient b) Not recognizer her unmet needs to be cared for c) Protect her child from illness d) Recognize physical symptoms as a coping mechanism

Consciously be trying to maintain her role of a sick patient

It is most important for the nurse to employ which holistic strategy when managing clients diagnosed with a somatization disorder a) Utilizing many different therapeutic strategies or modalities for enhanced coping b) Involving every member of the family as well as the patient in treatment c) Incorporating spirituality and religion into treatment d) Considering all dimensions of the patient, including biological, psychological and sociocultural

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

What therapeutic intervention should be prescribed for a client diagnosed with a somatoform disorder a) Steering conversation away from the client's feelings b) Conveying an interest in the client rather than the symptoms c) Encouraging the client to use benzodiazepine liberally d) Encouraging the client to rely on the nurse to meet the client's needs

Conveying an interest in the client rather than the symptoms

Which item of data should be routinely gathered during assessment of a client with a somatoform disorder a) Potential for violence b) Level of confusion c) Dependence on medication d) Personal identity disturbance

Dependence on medication

Diane, a 63 year old mother of three was brought to the community psychiatric clinic. Diane and her son had a bitter fight over finances. Ever since Diane has been complaining of a "severe pain in my neck". She has seen several doctors who cannot find a physical basis for the pain. The nurse knows that a) Showing concern for Diane's pain will increase her obsessional thinking b) Diane's symptoms are manipulative and under conscious control c) Diane believes there is a physical cause for the pain and will resist a psychological explanation d) Diane is trying to make her son feel bad about the argument

Diane believes there is a physical cause for the pain and will resist a psychological explanation

The primary difference between a factitious disorder and other somatic disorders is described in which statement a) Factitious disorders respond well to confrontation as a primary therapeutic technique b) Factitious disorders have a symptomatology that is actually controlled by the client c) Factitious disorders have their origins in depression and anxiety d) Factitious disorders are always self-directed

Factitious disorders have their origins in depression and anxiety

A physician describes a client as "malingering". The nurse knows this means that the client is demonstrating which behavior a) Falsely claiming to have symptoms b) Experiencing symptoms that cannot be explained medically c) Experiencing symptoms that have a physiological basis d) Seeking medication to ease pain of psychological origin

Falsely claiming to have symptoms

Living comfortable and materialistic lives in Western societies seems to have altered the original hierarchy proposed by Maslow that a) Once lower level needs are satisfied, no further growth feels necessary b) Self-actualization is easier to achieve with financial stability c) Esteem is more highly valued than safety d) Focusing on materialism reduces interest in love, belonging and family

Focusing on materialism reduces interest in love, belonging and family

A woman suddenly finds she cannot see but seems unconcerned about her symptoms and tells her husband, "Don't worry dear. Things will all work out." Her attitude is an example of what process a) Regression b) Depersonalization c) La belle indifference d) Dissociative amnesia

La belle indifference

Providing care to a client diagnosed with 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 should implement which personal intervention a) Regularly discuss their feelings about the client during the unit's interprofessional care meetings b) Attend in-services that focus on the various aspects of somatic disorders c) Rotate care of the client among the entire nursing department staff to minimize the frustration d) Provide a unified approach to the client's behavior so as to manage and lessen the barrier itself

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

When discussing somatic disorders from a cultural perspective, which statement is true a) Somatic disorders are rarely observed in males b) Somatic symptoms vary widely from culture to culture c) Underdeveloped countries rarely tolerate somatic disorders d) Secondary gain is seldom a factor in somatic disorders

Somatic symptoms vary widely from culture to culture

Lucas is a nurse on a medical floor caring for Kelly, a 48 year old patient with newly diagnosed type 2 diabetes. He realizes that depression is a complicating factor in the patient's adjustment to her new diagnosis. What problem has the most potential to arise a) Development of agoraphobia b) Treatment nonadherence c) Frequent hypoglycemic reactions d) Sleeping rather than checking her blood sugar

Treatment nonadherence

Studies have show a correlation between mental disorders and which medication condition a) Psoriasis b) Asthma c) Chronic renal failure d) Cardiovascular disease

cardiovascular disease

What precipitating emotional factor has been associated with an increased incidence of cancers SATA a) Anxiety b) Job-related stress c) Acute grief d) Feelings of hopelessness and despair from depression e) Prolonged, intense stress

d, e

Which mental health disorder is an example of a somatoform disorder a) Depersonalization b) Dissociative fugue c) Conversion disorder d) Dissociative identity disorder

conversion disorder

Which disorder is characterized by the client's misinterpretation of physical sensations or feelings a) Somatic disorder b) Factitious disorder c) Illness anxiety disorder d) Conversion disorder

illness anxiety disorder

Which nursing diagnosis should be investigated for clients with somatoform disorders a) Deficient fluid volume b) Self-care deficit c) Ineffective coping d) Delayed growth and development

ineffective coping