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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.
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Which are appropriate long-term treatment outcomes for clients who have somatic symptom illness? Select all that apply.
- A. The client will assume responsibility for self-care activities.
- B. The client will identify the relationship between stress and physical symptoms.
- C. The client will learn to vary his or her schedule.
- D. The client will verbally express emotional feelings.
- E. The client will demonstrate alternative ways to deal with stress, anxiety, and other feelings.
Correct Answer: B,D,E
Rationale: Long-term outcomes include recognizing stress-symptom links, expressing emotions, and developing alternative coping strategies.
A client with recurrent headaches has been told by the physician that the cause is likely psychosomatic. The client reports this conversation to the nurse and says, 'That just can't be true. My head hurts so bad sometimes that it makes me sick to my stomach.' Which is the nurse's best response?
- A. To give the client some privacy and time to calm down.
- B. To say nothing and sit quietly with the client.
- C. The pain in your head is very real.
- D. Well, that's not what your doctor thinks.
Correct Answer: C
Rationale: Validating the reality of the client's pain builds trust and supports further discussion about psychosomatic causes.
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.
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.
The husband of a woman with a somatic symptom illness asks the nurse why the doctors cannot find anything wrong with her. Which would be the appropriate explanation for the nurse to offer?
- A. She is not really experiencing the symptoms. She is making them up to get attention.
- B. There is no physical cause. Mental distress is causing the symptoms, even though she is not aware of it.
- C. She controls the symptoms when she isn't feeling much stress. It is hard to diagnose when the symptoms are intermittent.
- D. There is a physical cause. It just has not been detected yet.
Correct Answer: B
Rationale: Somatic symptom illnesses cause real symptoms due to mental distress, not consciously controlled or fabricated, despite negative diagnostic results.