Nokea
A client is seeking relief for undiagnosed pain. There is no history of significant physical illness. The history reveals that the client was laid off 4 months ago from her job. Which statement made by the client would most strongly suggest a somatoform disorder?
- A. I have been having a hard time lately. It's hard not working like I'm used to.
- B. I seem to have more pain now that I got laid off.
- C. I probably just overexerted myself working around the house. It's hard to slow down.
- D. I'm sure they will figure out what is wrong with me.
Correct Answer: B
Rationale: Linking increased pain to a stressful event like job loss suggests a somatoform disorder, where emotional distress manifests physically.
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A client with a somatic symptom illness asks, 'Why do I have these symptoms?' Which would be the appropriate explanation for the nurse to offer?
- A. Physical symptoms can be attributed to an organic cause.
- B. Physical symptoms are deliberately expressed in order to benefit in some way.
- C. Physical symptoms are independent of the amount of stress.
- D. Physical symptoms are an involuntary way of dealing with psychic conflict.
Correct Answer: D
Rationale: Somatic symptom illnesses involve physical symptoms without an organic basis, involuntarily expressing psychological conflict.
Which of the following terms are applicable when a person inflicts illness or injury on someone else to gain the attention of emergency medical personnel or to be a 'hero' for saving the victim?
- A. Malingering
- B. Factitious disorder
- C. Munchausen's syndrome by proxy
- D. Induced illness
Correct Answer: C
Rationale: Munchausen's syndrome by proxy involves inflicting harm on another to gain attention or hero status.
A client is seen in the primary care clinic complaining of headaches. The client appears extremely distressed and insists that she must have a brain tumor. Which diagnosis is most probable for this client?
- A. Conversion disorder
- B. Pain disorder
- C. Brain cancer
- D. Hypochondriasis
Correct Answer: D
Rationale: Hypochondriasis involves preoccupation with fear of serious illness, like a brain tumor, despite no organic basis.
The nurse is planning care for a client with somatic symptom illness disorder. Which should the nurse plan to reassess on a daily basis?
- A. Sensory deficits experienced by the client
- B. Character of pain reported by the client
- C. Frequency of generalized somatic complaints
- D. Signs of possible neurologic disorders
Correct Answer: C
Rationale: Monitoring the frequency of somatic complaints tracks the status of the disorder without reinforcing unfounded health concerns.
The nurse is identifying outcomes for a client with a somatic symptom illness. Which is an appropriate outcome to include in the plan of care?
- A. The client will verbally express his or her emotions.
- B. The client will be free from stress.
- C. The client will demonstrate alternative ways to avoid stressful situations.
- D. The client will verbalize acceptance of physical symptoms.
Correct Answer: A
Rationale: Verbal expression of emotions is a realistic outcome, helping clients address underlying psychological factors.