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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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A nursing instructor is describing complex somatic symptom disorder to a group of nursing students. The instructor determines that the teaching was successful when the students state which of the following?
- A. The disorder typically is diagnosed in men.
- B. The first symptom usually appears during adolescence.
- C. The disorder commonly occurs with substance abuse.
- D. Highly educated individuals often develop this disorder.
Correct Answer: B
Rationale: CSSD symptoms often first appear in adolescence (B), aligning with its chronic nature. It is more common in women (A), not strongly linked to substance abuse (C), and not specific to highly educated individuals (D).
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 providing care for a client who has complex somatic symptom disorder and is exhibiting anxiety about having a severe illness. Which of the following would be appropriate for the nurse to do? Select all that apply.
- A. Listening closely to the client?s report of symptoms
- B. Discouraging the client from talking about fears
- C. Acknowledging that what the client is saying may be real
- D. Encouraging the client to write down symptoms in a journal
- E. Reviewing symptom pattern with the client
Correct Answer: A,C,D,E
Rationale: Appropriate interventions for CSSD with anxiety include listening closely (A), acknowledging the reality of symptoms (C), journaling symptoms (D), and reviewing patterns (E) to validate and manage distress. Discouraging fear discussion (B) is non-therapeutic.
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 nurse is working with a client diagnosed with complex somatic symptom disorder. Which of the following would the nurse identify as the most difficult aspect of providing care to this client?
- A. Managing the client?s pain.
- B. Relieving the client?s anxiety.
- C. Developing the therapeutic relationship.
- D. Monitoring the client?s treatment program.
Correct Answer: C
Rationale: Developing a therapeutic relationship (C) is the most challenging in CSSD due to mistrust and symptom preoccupation. Managing pain (A), relieving anxiety (B), and monitoring treatment (D) are secondary to establishing trust.