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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.
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While assessing a client thought to have a factitious disorder, the nurse asks the client to describe when she felt nurtured as a child. Which response would the nurse interpret as supporting the client?s diagnosis?
- A. I never felt nurtured or loved when I was growing up.
- B. The only time I felt loved and appreciated was when I made the honor roll at school.
- C. The only time I ever felt loved was when I was sick enough to miss school.
- D. I felt loved and accepted when my father apologized for spanking me so hard.
Correct Answer: C
Rationale: Feeling nurtured only when sick (C) supports factitious disorder, as it suggests a pattern of seeking attention through illness. Lack of nurturing (A), academic achievement (B), or parental apologies (D) are less specific to this disorder.
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.
A nurse is preparing a plan of care for a client diagnosed with body dysmorphic disorder. Which nursing diagnosis would the nurse most likely identify as the priority?
- A. Disturbed Body Image
- B. Ineffective Coping
- C. Low Self-Esteem
- D. Risk for Other-Directed Violence
Correct Answer: A
Rationale: Disturbed Body Image (A) is the priority nursing diagnosis for BDD, as it directly addresses the core issue of preoccupation with perceived flaws. Coping (B), self-esteem (C), and violence (D) are secondary concerns.
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.
A client with body dysmorphic disorder is admitted to the inpatient unit. Based on the nurse?s understanding about this disorder, the nurse would assess this client closely for which of the following?
- A. Suicidal ideation
- B. Escalating violence
- C. Anorexia
- D. Psychosis
Correct Answer: A
Rationale: Body dysmorphic disorder (BDD) is associated with high rates of suicidal ideation (A) due to distress over perceived flaws. Violence (B) is not typical, anorexia (C) is a separate disorder, and psychosis (D) is rare in BDD.