PrepU Mental Health Assignment 17

A client has a somatization disorder. Which statement by the client would indicate a need for additional client teaching?

"Drinking strong coffee really helps me combat my fatigue."

Which of the following statements by the client indicates an understanding of somatization disorder?

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

A client with recurrent headaches has been told by the physician that the cause is likely the result of somatization. The client reports this conversation to the nurse and says, "That just can't be true! My head hurts so bad sometimes that it makes me sick to my stomach." The nurse's best response is

"The pain in your head is very real."

The psychiatric nurse recognizes that the client exhibiting the most risk for developing a pain disorder is ...

A 53-year-old female mechanic who reports severe shoulder and neck pain with a history depression

A client diagnosed with hypochondriasis reports to the nurse that others doubt the seriousness of the client's illness. The client is angry, frustrated, and anxious. Which nursing intervention takes priority?

Acknowledge the client's frustrations without fostering continued focus on physical illness.

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

Which of the following statements accurately describes dissociation?

An alteration in self-awareness to escape an upsetting event or feeling

When the nurse attempts to find supportive evidence that a client is experiencing a dissociative fugue, the client's history is reviewed for

An event that he or she wishes to avoid being held responsible for

Which of the following is a disorder characterized by a preoccupation with an imagined or exaggerated defect in physical appearance, such as thinking one's nose if too large?

Body dysmorphic disorder

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

La belle indifference is a seeming lack of concern or distress. The la belle indifference occurs in which of the following somatoform disorders?

Conversion disorder

Some variables have more influence on symptomatology than others. Regarding dissociative experiences, which of the following factors should be considered especially carefully?

Culture

In planning care for clients with a somatic symptom disorder, an appropriate long-term outcome for treatment would be that the client will ...

Develop alternative coping mechanisms

When describing the term alexithymia as a personality trait associated with somatic symptom disorder, which of the following would the nurse include in the explanation?

Difficulty identifying and expressing emotion

A 27-year-old woman is receiving treatment at an outpatient mental health clinic. She has been severely depressed since her husband and infant daughter were killed in a car accident. She cannot remember any events immediately before or after the accident and reports that she occasionally has trouble recalling her own name and other personal information. This pattern most likely represents which of the following disorders?

Dissociative amnesia

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

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?

Health care providers

Treatment of body dysmorphic disorder (BDD) includes selective serotonin reuptake inhibitors (SSRIs). For this disorder, this drug classification is given in which dosage as compared with the same drug being used for anxiety disorder?

Higher

Which mental health disorder is characterized by a fear of developing a serious illness based on a misinterpretation of body sensation?

Hypochondriasis

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?

Illness anxiety disorder

The major difference between somatoform disorders and factitious disorders is what?

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

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.

A graduate nurse is scheduled to take the NCLEX-RN examination in 3 days. On awakening today, the graduate cannot see anything at all but tells fellow classmates, "Oh, don't worry; it will all work out." This statement is an example of

La belle indifference.

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

The nurse is caring for a client who was in a motorcycle accident 2 months ago. The client says he still has terrible neck pain, but he will be better once he gets "a big insurance settlement." The nurse suspects that the client is

Malingering

Which of the following is motivated by avoiding work, evading criminal prosecution, and obtaining drugs?

Malingering

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?

Pain

Which of the following is a direct external benefit that being sick provides, such as relief from anxiety?

Primary gain

A client diagnosed with factitious disorder tells the nurse about how he overcame a tremendous disability. Based on the client's history, the nurse knows that the story is not all true. The client is exhibiting which of the following?

Pseudologia fantastica

The nurse documents that the client is displaying symptomology of a dissociative disorder because when asked to provide a history of his life, he

Replies, "I don't remember much about my life."

An alteration in self-awareness to escape an upsetting event or feeling

SSRIs

A client with a dissociative disorder is admitted to a psychiatric facility. His insurer approves a 3-day hospitalization. Which of the following potential foci of care would the nurse deem important?

Safety and structured activity

Which drug classification has been shown to be effective in treating somatization disorders?

Selective serotonin reuptake inhibitors

Medications have been tried for somatic symptom disorder. Which drugs have been shown to be effective in some cases?

Selective serotonin reuptake inhibitors (SSRIs)

Somatic symptom illness disorders are characterized by what?

Severe physical symptoms that cannot be explained 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

Which of the following is an inaccurate statement regarding body dysmorphic disorder (BDD)?

Surgical correction of the problem corrects the preoccupation.

A nurse is performing a follow-up assessment of a client who had been treated for posttraumatic stress disorder (PTSD) a year ago. The client tells the nurse that the client is not able to maintain relationships and that the relationships last for a very short time. What is the most likely reason for this problem?

The client has issues with developing trust.

Which of the following is a central feature of somatoform disorders?

The client reports physical symptoms without a demonstrable organic basis to fully account for them.

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 disappeared after getting the medical note.

Which of the following statements about somatic symptom disorder is most accurate?

The disorder manifests differently in different populations.

What is the major clinical finding in somatic symptom disorder?

The report of symptoms with no demonstrable pathology on testing or examination

Which of the following statements about the etiology of somatic symptom illnesses is accurate?

They are believed to be caused by an interaction of neurobiologic, psychological, and familial factors.

A client experiencing the sudden onset of blindness is diagnosed with a conversion disorder. Which nursing intervention would be most appropriate?

provide nursing care in a supportive but matter-of-fact manner

A client reports severe pain during intercourse since being sexually assaulted three years ago. Which is the first step in confirming the diagnosis of a pain disorder?

ruling out a physical cause of pain