Nokea
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.
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The client asks the nurse, 'What does having psychosomatic symptoms mean?' What should the nurse reply?
- A. It means you're not physically sick.
- B. It means that stress and/or emotions can cause or worsen physical symptoms.
- C. It means that you'll be well when you get your life in order.
- D. It means that your symptoms are a product of your imagination.
Correct Answer: B
Rationale: Psychosomatic symptoms are real physical manifestations caused or worsened by stress or emotions, not imagined or consciously controlled.
Which of the following accurately describes how somatic symptoms are distinguished from factitious disorders and malingering?
- A. Munchausen's syndrome cannot be controlled by persons who have it.
- B. Persons who experience somatic disorders intentionally produce symptoms for some external purpose or gain.
- C. In malingering or factitious disorders, people willfully control the symptoms, and in somatic symptom illnesses, clients do not voluntarily control their physical symptoms.
- D. People who experience somatic symptom illnesses can stop the physical symptoms as soon as they have gained what they wanted.
Correct Answer: C
Rationale: Somatic symptom illnesses involve involuntary symptoms, unlike malingering or factitious disorders where symptoms are willfully produced.
Which are the factors that are currently considered to be possible reasons for the increased incidence of somatization in women? Select all that apply.
- A. Boys in the United States are taught to be stoic and to take it like a man.
- B. Women seek medical care more frequently.
- C. Women more often receive treatment for psychological symptoms.
- D. Women are more likely to have experienced childhood sexual abuse.
- E. Unexplained female pains
Correct Answer: A,B,C,D
Rationale: Cultural expectations of stoicism in men, frequent medical care-seeking, treatment for psychological symptoms, and higher rates of childhood sexual abuse contribute to somatization in women.
The family members of a client with somatic symptom illness report to the nurse that every time they invite the client to join in an activity the client declines, saying things like, 'I wish I could, but I feel so terrible.' Which of the following approaches should the nurse suggest to encourage activity?
- A. What does your pain feel like right now?
- B. You are fine, the doctor said so. Let's go.
- C. I know this is difficult, but exercise is important. It will be a short walk.
- D. I'll let you rest. Let me know when you feel better.
Correct Answer: C
Rationale: Validating feelings while encouraging activity promotes participation without dismissing the client's experience.
Which of the following are possible with psychosomatic illness? Select all that apply.
- A. Real symptoms can begin.
- B. Real symptoms can continue.
- C. Real symptoms can worsen.
- D. Unrelated symptoms can occur.
- E. Clients can control these symptoms.
Correct Answer: A,B,C,D
Rationale: Psychosomatic illnesses involve real symptoms that can start, persist, or worsen due to emotional factors, but clients cannot consciously control them.