Somatic symptom and dissociative disorders

A newly licensed nurse ask the charge nurse on a mental unit which age groups are impacted by dissociative identity disorder. Which of the following responses to the caregiver make?

"Dissociative identity disorder can be present throughout the lifespan" Rational: Dissociative identity disorder can occur at any age and can persist throughout a person's entire life.

A nurse is caring for a client who has illness anxiety disorder. The client says to the nurse, "I don't know what you can do for me. I have seen so many health providers and no one has been able to help." Which of the following responses should the nurse make?

"I can help you learn new coping skills to better manage your symptoms" Rational: The nurse should teach the client coping skills that will assist them to better manage their symptoms.

A nurse in an outpatient clinic is working with a client who has been diagnosed with dissociative amnesia. Which of the following client statements would be an indication that the client is likely to experience an exacerbation of manifestations related to dissociative amnesia?

"Last week I learned that I have an aggressive form of skin cancer" Rational: Manifestations of a dissociative disorder may be exacerbated by continued severe psychological trauma, such as experiencing intimate partner violence, abuse, or a severe medical illness.

A nurse on an inpatient unit is speaking with a client about the recent diagnosis of depersonalization/derealization disorder. The client asked the nurse, " what is the treatment for this disorder?" Which of the following responses to the nurse make.

"a combination of psychotherapy and medication is often used" Rational: The treatment for depersonalization/derealization disorder can include psychotherapy and medications. Cognitive-behavioral therapy combined with anxiolytics and/or an antidepressant can be successful in minimizing or eliminating manifestations.

A nurse is caring for a client who has somatic symptom disorder and reports frequent abdominal pain. Which of the following responses should the nurse make?

"what has worked in the past to relieve the pain" Rational: This response is therapeutic, as the nurse is acknowledging the client's pain as real while requesting further input from the client about how to address the pain.

A nurse is caring for a client in an outpatient clinic. Select the 3 interventions the nurse should plan to take.

-Encourage the client to think positive thoughts. -Assist the client in distinguishing between anxiety and physical manifestations. -Provide relief measures for manifestations the client is experiencing Rational: The nurse should encourage the client to think positive thoughts about their condition. This helps the client think of effective ways to cope with the concerns that are causing them stress. The nurse should assist the client to determine the difference between an anxiety response and a physical manifestation of their condition. Being able to make this distinction can improve the client's coping abilities. The nurse should provide relief measures for the manifestations the client is experiencing. These relief measures can include medication, relaxation techniques, or a change of focus.

A nurse is caring for a client in an outpatient clinic. The nurse suspects the client may be experiencing dissociative amnesia. Select the 3 interventions the nurse should plan to take.

-Inform the client that memory loss is a form of coping. -Provide relaxation techniques to the client when they are experiencing anxiety. -Encourage the client to hold an object and focus on it. Rational: The nurse should inform the client that dissociative amnesia is a way of coping with a traumatic event. The nurse should provide relaxation techniques when the client is experiencing dissociative amnesia due to a traumatic event. The nurse should encourage the client to hold an object and focus on it to distract them from their feelings of anxiety, stress, or thoughts of a traumatic event. This is known as a grounding technique.

A nurse is planning care for a client who has somatic symptom disorder. Which of the following actions should the nurse include? (Select all that apply)

-Teach the use of relaxation techniques -Provide symptomatic relief measures as prescribed -Provide education on basic cognitive behavioral and mindfulness interventions Rational: Teaching and encouraging the use of relaxation techniques will help reduce the client's anxiety. The nurse must assess interventions that have worked in the past to treat the client's concerns and lessen their symptoms. Cognitive behavioral therapy techniques and mindfulness are effective strategies for managing anxiety.

A nurse is preparing to provide a presentation about somatic symptom disorder and related disorders at a local high school. Which of the following would be correct about the prevalence of somatic symptom disorder in the general population?

4% to 6% Rational: It is estimated that the prevalence of somatic symptom disorder is 4% to 6% of the general population.

A nurse is discussing somatic symptom disorder with a newly licensed nurse. Which of the following should the nurse identify as a risk factor for this disorder.

A history of alcohol use disorder Rational: A history of alcohol use disorder is a risk factor for developing somatic symptom disorder.

A nurse is admitting a client who has somatic symptom disorder and reports recurrent episodes of back pain. Which of the following actions should the nurse take first?

Bulid a therapeutic relationship with the client Rational: The first action the nurse should take is to build a therapeutic rapport with the client. This occurs during the orientation phase of the nurse-client relationship.

A charge nurse is discussing illness anxiety disorder with a newly licensed nurse. Which of the following information should the charge nurse include?

Clients who have this disorder can experience suicidal thoughts Rational: Illness anxiety disorder is chronic and relapsing, and clients can experience significant depression, increasing their risk for suicidal ideation.

A nurse is caring for a client who states they feel like they see themselves from outside their body. The nurse should document that the client is experiencing which of the following manifestations?

Depersonalization Rational: Depersonalization is the feeling of being outside of one's body or detached from one's thoughts and feelings.

A nurse is caring for an adult client who was recently involved in a motor vehicle accident. The client states, " I feel strange, like I am outside of my body, watching myself talk." Which of the following is the client likely experiencing?

Depersonalization/derealization Rational: With depersonalization/derealization, the client would describe dissociative symptoms such as having an out-of-body experience.

A nurse is caring for a client who has been diagnosed with dissociative identity disorder. The client develops an altar personality when discussing the trauma. How should the nurse respond when this occurs?

Display empathic listening and keep the client comfortable and safe Rational: Empathetic listening and communication are always important for the client, but it is especially important for clients experiencing dissociative identity disorder.

A nurse is caring for a client who was sexually assaulted. The client is frustrated because they cannot recall any events or information related to the event. What condition is the client likely experiencing?

Dissociative amnesia Rational: Dissociative amnesia is the inability to recall events from the past, such as a specific traumatic event.

A nurse is caring for a client who reports an extensive history of physical and sexual abuse as a child. The client states, " sometimes I do things that I am not aware of. I see pictures of myself on social media, and I am wearing things that I would never wear, and I am in locations where I would never go. It makes me feel so frustrated." The client is exhibiting manifestations of which of the following disorders.

Dissociative identify disorder Rational: Dissociative identity disorder is characterized by two or more separate personalities that each have their own patterns of behavior and memories.

A nurse is discussing the risk factors for developing a dissociative disorder with a client. Which of the following would place the client at higher risk for developing dissociative disorder.

Experiencing physical abuse as a child Rational: A history of abuse or trauma is a risk factor for developing a dissociative disorder.

A nurse is caring for a client who has a new diagnosis of dissociative identity disorder. Which of the following medication should the nurse expect the provider to prescribe?

Fluoxetine Rational: The nurse should expect the provider to prescribe fluoxetine, a selective serotonin reuptake inhibitor, for a client who has dissociative identify disorder. Other medications used for this disorder include benzodiazepines and beta-blockers.

A nurse is providing care to a client who is experiencing a loss of motor strength with no identifiable physical cause. The nurse would suspect the client to be diagnosed with her the following disorders?

Functional neurological symptom disorder Rational: The client is describing manifestations with no identifiable physical cause as defined by functional neurological symptom disorder.

A nurse is caring for a client who seeks care frequently due to fear of having a serious illness. After learning that the laboratory results showed no abnormalities, the client begins to hyperventilate. The client is exhibiting manifestations of which of the following disorders.

Illness anxiety disorder Rational: Illness anxiety disorder is when a client experiences constant thoughts about having a significant illness related to misinterpreted bodily symptoms.

A nurse is providing education to a client and their partner about dissociative identity disorder. Which of the following information should the nurse include in the teaching?

Manifestations of dissociation may include depersonalization and a lack of access to memories. Rational: Dissociation is an unconscious defense mechanism whereby a client has an interruption in consciousness. This causes impairments in memory and perception, including depersonalization, which is the feeling of being outside of one's body.

A nurse is planning care for a client who has dissociative identity disorder. Which of the following actions should the nurse plan to take?

provide one-on-one therapeutic interaction and support Rational: Therapeutic interaction, which includes empathetic listening and support, is one of the most important nursing interventions.

A nurse is caring for a client who has dissociative identity disorder. In the morning, the client was pleasant and cooperative. However, when the nurse goes to administer lunchtime medications, the client is angry and refuses medication, stating " I want to die" which of the following action should the nurse take?

stay with the client and ensure they are safe Rational: The nurse's priority is to ensure the client is safe. The nurse should assess the client for suicidal ideation or thoughts of self-harm.

A nurse is caring for a client who has somatic symptom disorder. Which of the following assessments is the nurses priority?

thoughts of suicide or self-harm Rational: The priority assessment is to determine if the client is having suicidal ideation or thoughts of self-harm. Ensuring the client's safety is the priority.