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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A client is admitted to the mental health unit with a diagnosis of factitious disorder. When reviewing the client?s history, which of the following would the nurse most likely find?
- A. Intentional self-injurious behavior
- B. Pain to achieve a self-serving goal
- C. Malingering to avoid work
- D. Parents who were restrictive
Correct Answer: B
Rationale: Factitious disorder involves fabricating symptoms, like pain, for psychological gain, such as attention (B). Self-injury (A) is more typical of borderline personality disorder, malingering (C) seeks external gain, and restrictive parents (D) are not specific.
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.
A client with complex somatic symptom disorder also has anxiety. Which of the following would the nurse expect to be prescribed?
- A. Monoamine oxidase inhibitor (MAOI)
- B. Selective serotonin reuptake inhibitor (SSRI)
- C. Tricyclic antidepressant (TCA)
- D. Atypical antipsychotic
Correct Answer: B
Rationale: SSRIs (B) are commonly prescribed for CSSD with anxiety due to their efficacy in managing both somatic and anxiety symptoms. MAOIs (A) and TCAs (C) are less preferred due to side effects, and atypical antipsychotics (D) are not first-line.
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 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.