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A client has made multiple visits to the clinic. The nurse suspects that the client may be experiencing complex somatic symptom disorder based on which of the following?
- A. Expressions of concern about psychological problems
- B. Indications that parents were always in good health
- C. Reports of the same symptoms repeatedly
- D. Evidence of a need for social support from her friends
Correct Answer: C
Rationale: Repeated reports of the same somatic symptoms (C) are characteristic of CSSD, reflecting persistent preoccupation with physical complaints. Psychological concerns (A) are less specific, parental health (B) is irrelevant, and social support needs (D) are not diagnostic.
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A client with body dysmorphic disorder is admitted to the inpatient unit. Based on the nurse?s understanding about this disorder, the nurse would assess this client closely for which of the following?
- A. Suicidal ideation
- B. Escalating violence
- C. Anorexia
- D. Psychosis
Correct Answer: A
Rationale: Body dysmorphic disorder (BDD) is associated with high rates of suicidal ideation (A) due to distress over perceived flaws. Violence (B) is not typical, anorexia (C) is a separate disorder, and psychosis (D) is rare in BDD.
A nursing instructor is preparing a class about functional neurologic symptoms. Which of the following would the instructor most likely include as an assessment finding? Select all that apply.
- A. Difficulty swallowing
- B. Spasticity
- C. Urinary frequency
- D. Aphonia
- E. Blindness
Correct Answer: A,D,E
Rationale: Functional neurologic symptoms (FNS) include difficulty swallowing (A), aphonia (D), and blindness (E), reflecting neurologic-like symptoms without organic cause. Spasticity (B) and urinary frequency (C) are less typical.
The nurse is assisting in planning a series of group therapy sessions with several female clients diagnosed with complex somatic symptom disorder. The nurse plans to focus the sessions on which of the following as a priority?
- A. Causes of medical illnesses
- B. Positive self-talk
- C. Side effects of medications
- D. Assertiveness skills
Correct Answer: B
Rationale: Positive self-talk (B) is a priority in group therapy for CSSD to reframe negative symptom-focused thoughts, promoting coping. Medical causes (A) may reinforce preoccupation, medication side effects (C) are secondary, and assertiveness (D) is less relevant.
The husband 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?
- A. There is definitely an underlying genetic link for this disorder.
- B. Your wife is experiencing chronic stress that causes hypoarousal.
- C. The symptoms reflect an emotion that your wife cannot verbalize.
- D. The symptoms reflect an internal preoccupation with events.
Correct Answer: C
Rationale: CSSD symptoms often reflect unexpressed emotions (C), as psychological distress manifests physically. Genetic links (A) are not definitive, chronic stress (B) is too vague, and preoccupation with events (D) is less accurate than emotional expression.
The nurse is caring for a client in the neighborhood clinic. The client tells the nurse that ever since he was an adolescent, he has avoided social situations because he has one ear that is obviously bigger than the other ear. The nurse observes that one of the client?s ears does not appear to be larger than the other ear. The nurse suspects that the client may be experiencing which of the following?
- A. Complex somatic symptom disorder
- B. Functional neurologic symptoms
- C. Factitious disorder
- D. Body dysmorphic disorder
Correct Answer: D
Rationale: Body dysmorphic disorder (D) involves preoccupation with a perceived physical flaw, like an ear size discrepancy, not observed by others. CSSD (A) involves broader somatic complaints, functional neurologic symptoms (B) involve motor/sensory deficits, and factitious disorder (C) involves intentional symptom fabrication.