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A client yells at the nurse, 'You are all quacks! Can't you see I am sick?' Which knowledge would help the nurse to work most effectively with this client?
- A. Client progress is expected to be very slow.
- B. Physical illness is the root of the client's problems.
- C. The client will never be free of somatic symptoms.
- D. The nurse has done everything possible to treat the client.
Correct Answer: A
Rationale: Recognizing that progress is slow helps the nurse remain patient and nonjudgmental, fostering a therapeutic relationship.
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The nurse is working with the client to develop emotion-focused coping strategies. Which should the nurse include as an emotion-focused coping strategy?
- A. Problem solving
- B. Assertiveness techniques
- C. Role-playing
- D. Deep breathing techniques
Correct Answer: D
Rationale: Deep breathing is an emotion-focused coping strategy that helps manage stress and emotional distress.
The nurse performs a thorough physical examination for a client being admitted for somatic symptoms. Which of the following is the best rationale for the physical exam?
- A. Ease the client's mind that the nurse is looking for physical causes.
- B. Physical disorders underlie somatic disorders.
- C. Physical exams are reimbursed by third-party payers.
- D. Underlying pathology should be ruled out.
Correct Answer: D
Rationale: A thorough physical exam ensures no underlying organic pathology is missed, as somatic symptoms can coexist with physical conditions.
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.
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.
Which is the primary gain for a client with conversion disorder?
- A. Emotional detachment
- B. Emotional support from family
- C. Identification of anxious feelings
- D. Relief from emotional conflict
Correct Answer: D
Rationale: Conversion disorder provides relief from emotional conflict by expressing it through physical symptoms, not through detachment or external support.