Nokea
A client is admitted to the mental health unit because she was found trying to inject diluted feces into her hospitalized child?s intravenous line. The client has a history of similar attempts of harming the child. The nurse would most likely suspect which of the following?
- A. Schizoid personality traits
- B. Munchausen?s syndrome by proxy
- C. Functional neurologic symptoms
- D. Borderline personality disorder
Correct Answer: B
Rationale: Munchausen?s syndrome by proxy (B) involves fabricating or inducing illness in another, typically a child, for attention, matching the client?s behavior. Schizoid traits (A), functional symptoms (C), and borderline personality (D) do not involve harming others for attention.
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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.
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 which of the following?
- A. The disorder typically is diagnosed in men.
- B. The first symptom usually appears during adolescence.
- C. The disorder commonly occurs with substance abuse.
- D. Highly educated individuals often develop this disorder.
Correct Answer: B
Rationale: CSSD symptoms often first appear in adolescence (B), aligning with its chronic nature. It is more common in women (A), not strongly linked to substance abuse (C), and not specific to highly educated individuals (D).
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.
The nurse is preparing to interview a client diagnosed with complex somatic symptom disorder. The nurse anticipates that the client will most likely exhibit which of the following?
- A. No facial expression during the interview
- B. Intermittent nodding and glancing at the clock on the wall
- C. Altered mental status
- D. Rapidly changing moods during the interview
Correct Answer: B
Rationale: Clients with CSSD often exhibit distracted behaviors like nodding and glancing at the clock (B), reflecting preoccupation with symptoms. No facial expression (A) suggests schizoid traits, altered mental status (C) indicates delirium, and rapid mood changes (D) suggest bipolar disorder.
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.