Mental final
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 nurse is discussing the plan of care with a client who has anorexia nervosa. The client's weight is 15% below ideal. The nurse and client are now discussing the client's activity level. The client would like to run 5 miles per day as the client normally does. Which response by the nurse is best? "That's fine as long as you adhere to your eating program and do not use laxatives or purging." "No, exercise is not allowed until your weight is closer to normal." "Aerobic exercise is not the best choice now. Anaerobic exercise will help you increase lean body mass." "Five miles per day is too much. How about 3 miles per day?"
"Aerobic exercise is not the best choice now. Anaerobic exercise will help you increase lean body mass."
A nurse is interviewing a client and suspects an eating disorder. Which client statement would the nurse interpret as demonstrating a risk for the development of an eating disorder? Select all that apply. "Everything about my school work needs to be perfect." "I want things to be the way I want them to be." "I'll stand up for what I want, regardless of what you say." "Things being out of order really bothers me." "I consider myself a really laid-back individual."
"Everything about my school work needs to be perfect." "I want things to be the way I want them to be." "Things being out of order really bothers me."
During a therapy session, a client with anorexia tells the nurse, "I measured my thighs today. They are a quarter-inch larger than they were yesterday. I feel like a pig; I'm so fat." Which potential response by the nurse is most therapeutic? "I don't think you are fat." "Has something occurred that caused you to measure your thighs?" "You are exactly the right weight for your height." "You have always been very focused on your thighs. Is that the part of your body you like least?"
"Has something occurred that caused you to measure your thighs?"
Following a series of visits to the primary care provider and the hospital, a 22-year-old retail clerk has been diagnosed with anorexia nervosa. Which of the client's statements demonstrate an accurate understanding of the diagnosis? "I guess it's probably safe to say that anorexia runs in my family." "I know that if I could lose this last 10 pounds I'd feel completely different about things." "What you don't understand is that it's way healthier to be skinny than fat, and it looks better." "What no one seems to understand is that I'm concerned about my health, not ignoring it."
"I guess it's probably safe to say that anorexia runs in my family."
Which statement made by the nurse managing the care of an anorexic teenager demonstrates an understanding of the client's typical, initial reaction to the nurse? "I'm sorry that you are angry but you cannot throw food at me." "I realize this must be very difficult for you but try to remember I'm not your enemy." "I'm not the root of your problem." "I'm not going to take your insults personally but you need to be more respectful."
"I realize this must be very difficult for you but try to remember I'm not your enemy."
The nurse is interviewing an 18-year-old client about eating behaviors. The client's parents have brought the client to treatment because the client's mother suspects that the client has been binge eating and vomiting. The nurse asks the client if the client ever feels that the client cannot control the client's eating. The client's mother states, "I know the client can't control it; the client ate an entire cake last night!" Which comment by the nurse is best? "I see. What are your thoughts on what your mother has said?" "Do you often have to answer for your child?" " Is what your mother said true?" "I see. Do you ever feel as though you cannot control your eating?"
"I see. Do you ever feel as though you cannot control your eating?"
A client with anorexia weighs less than 85% of the client's normal body weight. The client says, "I'm so fat, I can't even get through this doorway, much less fit into any of my clothes." Which is the nurse's most therapeutic response? "Let's talk about your ideas about your body and why you perceive yourself to be fat." "You must try and stop thinking that way. Let's think of some alternative ideas for describing your body." "I understand what you are saying. However, you are under your ideal body weight, and it is causing you to have the medical problems that we have talked about." "You only weigh 100 pounds. It is just not true that you are fat."
"I understand what you are saying. However, you are under your ideal body weight, and it is causing you to have the medical problems that we have talked about."
While caring for a client with anorexia nervosa, a nurse anticipates that the client would have difficulty making which comment? "I'm mad at you because you won't let me go on a pass unless I gain weight!" "I need to have everything in its place and perfect." "If I gain a pound, I'll just keep gaining weight." "I am very involved in preparing my food and counting calories."
"I'm mad at you because you won't let me go on a pass unless I gain weight!"
A nurse is performing an admission assessment for an adolescent client with an eating disorder who is being admitted to the psychiatric unit. Which statement would the nurse interpret as most likely supporting the client's diagnosis? "My father was always very thin." "I've never really liked myself." "I have a lot of confidence in myself." "I feel really close to my parents and my brother."
"I've never really liked myself."
An adolescent diagnosed with anorexia nervosa is insistent on being allowed to take a laxative. Which response by the nurse best demonstrates the management of this client request? "Using laxatives is bad for you because your electrolytes can become unbalanced." "Using a laxative to purge is not an acceptable way to manage your weight." "Why do you want to take a laxative?" "Laxatives are not a part of your treatment plan."
"Laxatives are not a part of your treatment plan."
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."
A nurse is providing care to a client with an eating disorder. Which client statement best demonstrates an understanding of the etiology of the disorder? "My strict dieting led to my problem with anorexia." "There are many factors involved with how I developed anorexia ." "Society told me I needed to be thin and I believed that." "There is a history of obsessive-compulsive disorder in my family."
"There are many factors involved with how I developed anorexia ."
A nurse who provides care at an inpatient eating disorder clinic is performing an admission assessment of a young client who has been diagnosed with anorexia nervosa. Which assessment question reflects therapeutic communication? "Why do you prefer not to eat food?" "What do you think about how much you weigh right now?" "What do you believe has caused your anorexia?" "Is there anything that I can get you to eat right now?"
"What do you think about how much you weigh right now?"
The client is 16 years old with an identical twin just diagnosed with anorexia nervosa. The client tells the nurse the client is concerned that the client may also develop the disorder. Which response by the nurse is the most appropriate? "Eating disorders have not been found to be genetic, so you do not have a risk." "While eating disorders have shown a genetic link, other factors also play a role in its development." "Identical twins have about a 5% chance of both twins developing an eating disorder." "It is not genetics but the environment that increases your risk. Since you live together, you have an equal chance."
"While eating disorders have shown a genetic link, other factors also play a role in its development."
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?
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? "
A nurse is initiating a group for adolescent girls diagnosed with anorexia nervosa. Many of the clients in the group are irritable and resent having to attend. One of them comments, "This is a stupid waste of time!" Which response by the nurse would be most appropriate? "If you feel that way, then you can just leave." "You sound irritated; tell me about what is bothering you." "You were assigned to this group by your therapist, so you must participate." "Sit down and be quiet; your peers would appreciate some peace and quiet."
"You sound irritated; tell me about what is bothering you."
Which percentage accurately reflects the prevalence of anorexia and bulimia in the United States? 1% to 4% 4% to 6% 6% to 9% 10% to 12%
1% to 4%
With treatment, conversion disorder often remits in a few weeks but recurs in approximately which percentage of clients? 10% 25% 35% 50%
25%
What percentage of clients who have fully recovered from bulimia nervosa later experience a relapse? 10% 23% 30% 50%
30%
Which individual most clearly exhibits the characteristics of body image disturbance? A 44-year-old who is committed to going to the gym every day both before work and after work A 71-year-old who talks frequently about multiple health problems A 20-year-old who weighs 98 pounds but who considers onself obese A 13-year-old who is in the fifth percentile of height and weight for age and sex
A 20-year-old who weighs 98 pounds but who considers onself obese
Which client being treated for anorexia displays assessment values that warrant hospitalization? A 25-year-old whose weight is 70% of ideal and who has a serum glucose of 58mg/dL A 32-year-old with a temperature of 98° F and a pulse rate of 54 bpm A 16-year-old with serum potassium of 3.8 mEq/L and a blood pressure of 98/66 mmHg A 10-year-old whose weight has remained unchanged in spite of a 3-inch growth spurt
A 25-year-old whose weight is 70% of ideal and who has a serum glucose of 58mg/dL
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 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
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
A client is being seen in the health clinic. During the nursing assessment, the client states that she has had amenorrhea for the last 6 months. The client weighs 80 pounds and is 5 feet 2 inches tall. The client states that she usually eats salads to not gain weight. These data supports which diagnosis? Anorexia nervosa Bulimia nervosa Depression Anxiety disorder
Anorexia nervosa
A client is 5 feet 6 inches tall, weighs 105 pounds, exercises 4 hours per day, and does not engage in any binging or purging behaviors. The client believes that he or she is becoming obese and states, "I'm shocked that you think I'm underweight. You don't understand me." The most likely diagnosis for this client is what? Anorexia nervosa, binge eating, and purging type Anorexia nervosa, restricting type Bulimia nervosa, nonpurging type. Eating disorder not otherwise specified
Anorexia nervosa, restricting type
Fluoxetine has been approved for the treatment of anorexia nervosa. Fluoxetine is from which drug classification? Antidepressant Antianxiety Antiparkinsonian Antimanic
Antidepressant
Treatment of eating disorders often combines psychotherapy and psychopharmacology. Which classes of medications can be used to treat eating disorders? Antipsychotics Stimulants Mood stabilizers Antidepressants
Antidepressants
The nurse is caring for a client diagnosed with bulimia. Which would be important for the nurse to do first? Ask the client directly about thoughts of suicide or self-harm Identify the cues related to binging Control the eating responses Provide small regular meals and snacks
Ask the client directly about thoughts of suicide or self-harm
A client has been purging to maintain weight loss. Which would be an important goal immediate for this client? Understanding that purging is an ineffective means of weight control Recognizing that purging promotes binge eating Being free of self-inflicted harm Using distraction to stop the urge to purge
Being free of self-inflicted harm
A client is an overweight 32-year-old who regularly binges on large amounts of food. After the client binges, the client feels guilty and ashamed about eating the food. Despite the bad feelings, the client binges almost daily. Which would the nurse most likely suspect? Anorexia nervosa Bulimia nervosa Binge eating disorder Eating disorder not otherwise specified
Binge eating disorder
A nurse is preparing a presentation for a local middle school health class about eating disorders as a means for prevention and early detection. Which would the nurse incorporate into the presentation as being common to both anorexia nervosa and bulimia nervosa? Select all that apply. Body dissatisfaction Feelings of control Obsessiveness Boundary problems Sexuality fears Cognitive distortions
Body dissatisfaction Obsessiveness Cognitive distortions
A client with anorexia nervosa self-describes as "a whale." However, the nurse's assessment reveals that the client is 5 feet 8 inches tall and weighs only 90 pounds. The nurse identifies this as reflecting what? Body image disturbance Drive for thinness Interoceptive awareness Perfectionism
Body image disturbance
A college student has been referred to the clinic for evaluation for anorexia nervosa. The nursing assessment to substantiate this disorder should include what? Onset of symptoms in early adolescence Body weight significantly below ideal for height and age Temper tantrums and sleep disturbance Oily skin and acne
Body weight significantly below ideal for height and age
A client is suspected of having anorexia nervosa and meets the diagnostic criteria for the disorder. When conducting the physical examination, which would be a probable finding from the assessment? Heat intolerance Complaints of heartburn Hypertension Bradycardia
Bradycardia
A group of nurses is reviewing information about the complications associated with eating disorders. The group demonstrates understanding of the information when they identify which as a possible cardiac complication? Select all that apply. Hypertension Bradycardia Enlarged heart Ventricular tachycardia Loss of cardiac muscle
Bradycardia Ventricular tachycardia Loss of cardiac muscle
While a nurse talks to the mother of a fc-year-old client, the mother expresses concern over the client's eating and exercise habits. The mother says that as soon as the client comes home from school, the client exercises for 2 to 3 hours every day. She says the client eats very little at dinner, but in the morning she notices that large amounts of food are missing from the kitchen. The client was complaining of tooth pain, and when the mother took the client to the dentist, the client had over 10 cavities. Which disorder is the client most likely suffering from? Anorexia nervosa Binge-eating disorder Bulimia nervosa Eating disorder not otherwise specified
Bulimia nervosa
The dentist of a client noticed that the client's teeth were losing enamel and that the client looked extremely thin. The dentist refers the client for follow up based on the understanding that eating disorder is most often associated with dental caries and enamel loss? Bulimia nervosa, purging type Anorexia nervosa, restricting type Anorexia nervosa, purging type Binge eating disorder
Bulimia nervosa, purging type
A 17-year-old client with a long-standing diagnosis of bulimia nervosa has been admitted to the emergency department after collapsing in a mall. The care team that admits the client to the hospital should prioritize which assessment? Complete blood count and differential Evidence of injury to skin by cutting Cardiac assessment and measurement of electrolyte levels Psychosocial assessment and determination of coping skills
Cardiac assessment and measurement of electrolyte levels
Which is a family risk factor for bulimia nervosa? Chaotic family Lack of emotional support Self-perception of being overweight Inability to deal with conflict
Chaotic family
A 30-year-old client is in therapy for bulimia, depression, and anxiety. The client relates that the client feels unable to cope with the demands of the client's job and that the client's partner recently ended their long-term relationship. The client states that the client frequently binges when stress levels are high. The client denies feeling suicidal but states, "I'm a mess. I'm just not smart enough to figure out how to run my life!" Which nursing diagnosis would best identify the client's problems? Social isolation related to recent loss of significant relationship Chronic low self-esteem related to unrealistic self-expectations Anxiety related to job stressors Risk for impulse control related to unidentified triggers
Chronic low self-esteem related to unrealistic self-expectations
A client's diagnosis of anorexia nervosa is supported when the psychiatric nurse documents assessment data that includes which finding? Select all that apply. Client reports "being depressed." Client claims that she "hasn't had a menstrual period in over 2 years." Client is overheard telling other clients "I weigh myself three times a day when I'm home." Client consistently denies that she "has a problem with the way she looks." Client has a history of "sleeping 9 hours a night and taking frequent naps."
Client reports "being depressed." Client claims that she "hasn't had a menstrual period in over 2 years." Client is overheard telling other clients "I weigh myself three times a day when I'm home." Client consistently denies that she "has a problem with the way she looks."
A client's diagnosis of bulimia nervosa is supported when the psychiatric nurse documents assessment data that includes (Select all that apply.) Client reports of "being depressed" History of purging "3 times a week for 2 years." Often heard discussing "how hard it is to stay thin" with other clients Lanugo observed on forearms and face Serum potassium of 3.8 mEq/L
Client reports of "being depressed" History of purging "3 times a week for 2 years." Often heard discussing "how hard it is to stay thin" with other clients
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.
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 group of nursing students is reviewing the similarities and differences between bulimia nervosa and binge eating disorder (BED). The students demonstrate understanding when they identify which characteristics as specific to BED? Select all that apply. Clients typically are obese. Clients refrain from purging behaviors. Binge eating periods are shorter. Clients engage in overexercising. Feelings of guilt do not occur after binging.
Clients typically are obese. Clients refrain from purging behaviors.
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
Which intervention has been found to be most effective reducing the initial symptoms of bulimia? Cognitive behavior therapy and pharmacologic interventions Behavioral therapy and psychoeducation Daily monitoring of sound dietary principles and meditation sessions Clearly stated unit rules and a supportive milieu
Cognitive behavior therapy and pharmacologic interventions
A nurse is developing a plan of care for a client newly diagnosed with bulimia nervosa. Which would the nurse expect to implement in conjunction with pharmacologic therapy? Behavioral therapy Cognitive behavioral therapy Interpersonal therapy Family therapy
Cognitive behavioral therapy
For clients with bulimia, nursing interventions are often directed toward improving self-concept and regaining control. Which would be included in the primary interventions? Cognitive-behavioral therapy (CBT) including self-monitoring One-on-one time with psychiatric staff and antidepressant medication therapy Daily reinforcement of sound dietary principles and meditation sessions Clearly stated unit rules and a supportive milieu
Cognitive-behavioral therapy (CBT) including self-monitoring
Which behavior is not associated with purging? Consuming large amounts of food Self-induced vomiting Use of laxative Misuse of diuretics
Consuming large amounts of food
When working with the client with bulimia, the nurse should be aware that the nurse's own feelings and needs may affect care. Feelings that may be aroused in the nurse may include what? Depression Anxiety Control Dependency
Control
The la belle indifference occurs in which somatoform disorder? Conversion disorder Hypochondriasis Body dysmorphic disorder Somatization disorder
Conversion disorder
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 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.
All of the following disease processes are caused by stress except which one? Deep vein thrombosis Colitis Diabetes Hypertension
Deep vein thrombosis
Despite being admitted to the hospital yesterday for the treatment of complications of anorexia nervosa, a 19-year-old client continues to have only bites of food and small sips of fluids. Which of the following nursing diagnoses is paramount in this client's care? Deficient fluid volume related to inability to meet bodily fluid requirements Impaired social interaction related to aggressive behavior Anxiety related to inadequate coping mechanisms Imbalanced nutrition less than body requirements related to refusal to eat
Deficient fluid volume related to inability to meet bodily fluid
Despite being admitted to the hospital yesterday for the treatment of complications of anorexia nervosa, a 19-year-old client continues to refuse fluids and is only taking small bites of food during mealtime. Which nursing diagnosis is paramount in this client's care? Deficient fluid volume related to refusal to drink Impaired social interaction related to aggressive behavior Anxiety related to inadequate coping mechanisms Hyperactivity related to restlessness
Deficient fluid volume related to refusal to drink
A client was admitted to the eating disorder unit with bulimia. When the nurse assesses for a history of complications of this disorder, which are expected? Respiratory distress and dyspnea Bacterial gastrointestinal infections and overhydration Metabolic acidosis and constricted colon Dental erosion and chronic edema
Dental erosion and chronic edema
A nurse is caring for several hospitalized clients with anorexia nervosa. The nurse would be especially alert for which if noted in the clients' histories? Paranoia Primary insomnia Depression Aggression
Depression
A nurse is caring for several hospitalized clients with anorexia nervosa. The nurse would be especially alert for which if noted in the clients' histories? Paranoia Primary insomnia Depression Aggression
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
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
A psychiatric-mental health nurse working in the community is planning an educational program for fifth- and sixth-grade teachers. Which would the nurse include? Discussion of strategies the teachers can use to counteract the role media plays in encouraging eating disorders Emphasis on the need for teachers to focus their prevention efforts on female students Stressing the need to allow students to eat without undue attention or supervision in order to prevent inadvertently influencing eating patterns Clarification that peer pressure is not typically problematic in children who are in the fifth and sixth grades
Discussion of strategies the teachers can use to counteract the role media plays in encouraging eating disorders
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
The nurse is providing care to a client diagnosed with anorexia and notes that the client demonstrates behaviors that reflect an intense physical and emotional process that overrides all physiologic body cues. Which term would the nurse use to document this finding? Drive for thinness Body image distortion Interoceptive awareness Perfectionism
Drive for thinness
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
Which statement best describes the biologic theories of the etiology of eating disorders? Eating disorders involve dysregulation of multiple neurotransmitter systems and may be influenced by behavioral, cultural, and familial factors. Eating disorders involve dysregulation of the serotonergic system and have a strong genetic component. Eating disorders result from family dysfunction involving a controlling mother; neurotransmitter dysfunction is a result, not a cause, of the eating disorder. Eating disorders involve dysregulation of multiple neurotransmitter systems, whether as a cause or an effect of the eating disorder, and may be influenced by behavioral, cultural, and familial factors.
Eating disorders involve dysregulation of multiple neurotransmitter systems, whether as a cause or an effect of the eating disorder, and may be influenced by behavioral, cultural, and familial factors.
When a 27-year-old is admitted for treatment of anorexia nervosa, the nurse prepares the client for diagnostic testing that includes what? Select all that apply. Electrocardiogram (ECG) Serum glucose Serum amylase Serum cortisol Serum uric acid
Electrocardiogram (ECG) Serum glucose Serum amylase Serum cortisol
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.
A nurse is planning to explain the purpose of the behavioral therapy technique of self-monitoring to a client with bulimia nervosa. The nurse would emphasize keeping a diary to record what? Feelings of hunger Efforts at distraction Environmental cues Rigid rules about eating
Environmental cues
A client diagnosed with anorexia nervosa is being treated in an outpatient setting in the community. Which activity would be the priority? Improving nutritional status Acknowledging the severity of the illness Confirming beliefs about body size Establishing a therapeutic relationship
Establishing a therapeutic relationship
For a client diagnosed with anorexia nervosa, which goal takes priority? Establishing adequate daily nutritional intake Developing a contract with the nurse that sets a target weight Identifying self-perceptions about body size as unrealistic Verbalizing the possible physiologic consequences of self-starvation
Establishing adequate daily nutritional intake
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
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 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
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
Which medication has been found to be worthy of a trial in clients with bulimia nervosa who have obsessive-compulsive traits? Lithium Haloperidol Fluoxetine Bupropion
Fluoxetine
Exacerbation of anorexia nervosa results from the client's effort to do what? Gain control of one part of life Manipulate family members Diminish conflict Live up to family expectations
Gain control of one part of life
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
The nurse is performing the history and physical examination on a client who is being admitted for anorexia nervosa. The client, a 23-year-old, is 5 feet 2 inches, and weighs 88 pounds. The nurse assesses the client's history of weight gain and loss, typical daily food intake, electrolyte and other blood studies, and elimination patterns. The nurse observes typical physical findings such as dry skin, lanugo, and brittle hair and nails. Which factor is a priority for the nurse to assess next? Throat and esophagus Condition of mouth and gums Heart rate and rhythm Patterns of activity and rest
Heart rate and rhythm
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
Which area of the brain has been associated with the symptoms of eating disorders? Hypothalamus Cerebellum Pons Medulla
Hypothalamus
Which is a metabolic complication related to weight loss? Hypothyroidism Bradycardia Amenorrhea Leukopenia
Hypothyroidism
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.
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
A nurse is reviewing the plan of care for a client with anorexia nervosa and notes a behavioral plan for increasing weight. The nurse correlates this intervention with which nursing diagnosis? Disturbed body image Anxiety Imbalanced nutrition: less than body requirements Ineffective coping
Imbalanced nutrition: less than body requirements
A client with bulimia nervosa is scheduled for a visit to the clinic. When assessing this client, which would a nurse expect to find? Impulsivity Panic Hyperactivity Delusions
Impulsivity
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.
A nurse is developing the plan of care for a client with bulimia. Which intervention would the nurse most likely include? Increasing client's coping skills for anxiety Communicating aggressively with the client Encouraging client take time away from peers for a time Nurturing the client's need for dependency
Increasing client's coping skills for anxiety
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
A severely dehydrated teenager admitted to the hospital with hypotension and tachycardia undergoes evaluation for electrolyte disturbances. The client's history includes anorexia nervosa and a 15-pound weight loss in the last month. The client is 5 feet 5 inches tall and weighs 75 pounds. Which is the priority nursing intervention? Initiating total parenteral nutrition as ordered Initiating cognitive behavioral therapy as ordered Addressing the client's low self-esteem Monitoring vital signs and weight
Initiating total parenteral nutrition as ordered
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.
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
Which is a typical characteristic of parents of clients diagnosed with anorexia nervosa? Overprotective of their children A history of substance abuse Maintenance of emotional distance from their children Alternation between loving and rejecting their children
Overprotective of their children
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 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
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 with anorexia nervosa. Which would the nurse be least likely to find? Hypokalemia Overly oily skin Salivary gland hypertrophy Dental enamel erosion
Overly oily skin
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.
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
At the prompting of friends, a 16-year-old client has agreed to meet with the school nurse who suspects that the client may have an eating disorder. During the nurse's assessment, the nurse has asked the client to describe the client's family. Which family process and characteristic is thought to contribute to eating disorders? Poor communication and enmeshed family dynamics The absence of a parent and/or the presence of a stepparent Passive parenting and lack of encouragement An overemphasis of peer relationships over family relationships
Poor communication and enmeshed family dynamics
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
The nurse on an inpatient psychiatric unit is developing the plan of care for a 17-year-old client admitted with anorexia nervosa. The client's weight is 20% below normal. The client engages in many rituals related to eating, asks to be weighed several times per day, and complains that access to the bathroom is limited. The nurse develops a contract with the client. The purpose of the contract is to do what? Provide the client with a feeling of responsibility and control over the client's behavior Provide the therapist with a strategy for client compliance Allow the client a tool by which to negotiate behavior Provide the nurse with a tool for evaluating the plan of care
Provide the client with a feeling of responsibility and control over the client's behavior
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 client with bulimia reports feeling helpless and says, "What's the use?" As the nurse plans the client's care, the priority diagnosis is which? Ineffective individual coping Anxiety Nutrition that is less than body requirements Risk for self-directed violence
Risk for self-directed violence
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)
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
A client has been diagnosed with bulimia. Which cognitive behavioral technique would be useful for the client? Self-monitoring Guided imagery Distraction Music therapy
Self-monitoring
People diagnosed with bulimia nervosa have lower levels of which neurotransmitter? Serotonin Norepinephrine Dopamine Acetylcholine
Serotonin
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.
An adolescent client has been diagnosed with anorexia nervosa. Which intervention should be included in the client's plan of care? Set up a strict eating plan for the client Restrict visits with the family until the client begins to eat Provide privacy during meals Encourage the client to exercise, which will reduce the client's anxiety
Set up a strict eating plan for the client
hospitalized with anorexia nervosa. Which would the nurse include in the education plan? Knowing the calorie content of numerous foods Learning strategies to control impulses Describing physiologic consequences of anorexia nervosa Setting realistic goals
Setting realistic goals
A college student has been referred to the college clinic for evaluation for anorexia nervosa. Which would help support the diagnosis? Onset of symptoms during preadolescence Significantly low body weight Temper tantrums Oily skin
Significantly low body weight
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
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 21-year-old client admits to recently using diuretics and laxatives to lose weight quickly. The client doesn't want to feel fat in a bathing suit on vacation. The client's sodium level is 150 mEq/L; potassium level is 3.2 mEq/L. The client is 5 feet tall, weighs 100 pounds, and has lost 15 pounds in 3 weeks. Which goal is a priority at this time? Stabilize electrolyte levels. Assist client to begin gaining weight at the rate of 2 to 3 pounds per week until reaching 112 pounds. Help build self-esteem. Develop a contract with the client to stop using laxatives and diuretics.
Stabilize electrolyte levels.
For clients who purge, what is the most important goal? Stop the behavior Understand that purging is an ineffective means of weight control Recognize that purging promotes binge eating Develop the technique of distraction
Stop the behavior
An obese client is admitted to the facility for abusing amphetamines in an attempt to lose weight. Which nursing intervention is appropriate for this client? Encouraging the client to suppress feelings regarding obesity Reinforcing the client's concerns over physical appearance Using an abrupt, forceful manner to communicate with the client Teaching the client alternative ways to lose weight
Teaching the client alternative ways to lose weight
A client with bulimia is being discharged from care. The nurse considers which indicator most important when evaluating the effectiveness of the care plan? The client has maintained a target weight for the last year. The client reports that the client has learned to accept the client's body. The client eats six small meals per day. The client has moved into the client's own apartment.
The client eats six small meals per day.
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 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.
After complaining of weakness and confusion while at school, a 16-year-old client was admitted to the hospital where admission assessments revealed hypokalemia. The client has normal body weight. In planning the client's nursing care and treatment, which outcome should be prioritized? The client will verbalize fears relating to the client's health needs. The client will acknowledge self-harm thoughts. The client will be free of self-induced vomiting. The client will identify alternatives to current coping patterns
The client will be free of self-induced vomiting.
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.
The nurse is carrying out the nursing process in the care of a client who has been diagnosed with body image disturbance. Which goal should be prioritized in the planning of this client's care? The client will experience diminished episodes of delusional thinking. The client will verbalize acceptance of appearance. The client will demonstrate measures to reduce body mass index. The client will demonstrate actions that promote health maintenance.
The client will verbalize acceptance of appearance.
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 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.
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 reviewing the medical records of several clients at the community mental health center being treated for eating disorders. Which behavior would the nurse identify as differentiating a client who is believed to have bulimia nervosa from one who has anorexia nervosa? The person is preoccupied with body image. The person judges worth based on a lack of fat. The person has feeling of powerlessness The person engages in episodic binge eating.
The person engages in episodic binge eating.
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
When working with a client with bulimia, the nurse should encourage the client to keep a self-monitoring journal for what reason? To raise self awareness and a sense of control To show the family evidence of the client's progress To document physical problems the client wants to share with the physician For the nurse to be able to document in the client record accurately
To raise self awareness and a sense of control
Which is most often the criterion for determining the effectiveness of treatment in the client diagnosed with anorexia nervosa? Weight gain Mood elevation Increased activity Positive self-esteem
Weight gain
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 school nurse is evaluating a 16-year-old student who came to the office complaining of dizziness. The student is very thin and was pacing in the office while waiting to see the nurse. The nurse asks the student to step on the scale. The student asks if the student can go to the bathroom first to empty the student's bladder, stating, "That can make a big difference." The student's comment raises the nurse's suspicion that the student has ... anorexia nervosa. binge-eating disorder. bulimia nervosa. eating disorder not otherwise specified.
anorexia nervosa.
What behavior is likely a result of an adolescent's attempt to manage the effects of over-productive parenting? engaging in severe dieting socially withdrawing compulsively washing his or her hands becoming sexually promiscuous
engaging in severe dieting
When reviewing the documented history of an adult client with anorexia nervosa, what is the nurse most likely to find? (Select all that apply.) food restriction began at age 15 depression at age 16 lasting one month reported believing that friends were "jealous" of her body reports strong relationship with parents had successful outpatient treatment one year after onset of disorder
food restriction began at age 15 depression at age 16 lasting one month reported believing that friends were "jealous" of her body
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.