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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.
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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.
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.
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.
An actor has prepared extensively for his first stage production. On the morning of the opening of the play, the actor awakens with laryngitis. From which disorder is the actor most likely suffering?
- A. Acute upper respiratory infection
- B. Conversion disorder
- C. Hysteria
- D. Somatization disorder
Correct Answer: B
Rationale: Conversion disorder involves sudden sensory or motor deficits, like laryngitis, linked to psychological stress, not organic causes.
A middle-aged client goes to the physician falsely complaining of hip pain. The client's intention is to fake chronic hip pain to apply for disability benefits from the government. Which best reflects the client's potential diagnosis?
- A. Malingering
- B. Hypochondriasis
- C. Factitious disorder
- D. Munchausen's syndrome by proxy
Correct Answer: A
Rationale: Malingering involves intentionally faking symptoms for external gain, such as disability benefits.