Nokea
A nurse assesses a patient diagnosed with functional neurological (conversion) disorder. Which comment best supports this diagnosis?
- A. "Since my father died, I've been short of breath and had sharp pains that go down my left arm, but I think it's just indigestion."
- B. "I have daily problems with nausea, vomiting, and diarrhea. My skin is very dry and I think I'm getting seriously dehydrated."
- C. "Sexual intercourse is painful. I pretend as if I'm asleep so I can avoid it. I think it's starting to cause problems with my marriage."
- D. "I get choked very easily and have trouble swallowing when I eat. I think I might have cancer of the esophagus."
Correct Answer: A
Rationale: Patients with functional neurological (conversion) disorder often demonstrate a lack of concern regarding the seriousness of symptoms. In addition, a specific cause for the development of the symptoms is identifiable; in this instance, the death of a parent precipitates the stress. The incorrect options suggest other types of somatic symptom disorders.
You may also like to solve these questions
Instructions concerning what stress management technique should be included in the care plan of a patient diagnosed with a somatic symptom disorder?
- A. Mindful awareness
- B. Positive self-talk
- C. Take a time out
- D. Meditation
Correct Answer: D
Rationale: Meditation has been shown to be effective in managing stress associated with somatic symptom disorders. Mindful awareness and positive self-talk are associated with anxiety management while the concept of a time out helps manage anger.
A nurse assesses a patient suspected to have somatic system disorder. Which findings support the diagnosis?
- A. Female
- B. Reports frequent dizziness
- C. Complains of heavy menstrual bleeding
- D. First diagnosed with psoriasis at 12 years of age
- E. Reports of back pain, painful urination and frequent diarrhea
Correct Answer: A,B,C,E
Rationale: No chronic disease explains the symptoms for patients with somatic system disorder. Patients report multiple symptoms; gastrointestinal, sexual, and pseudoneurological symptoms are common. This disorder is more common in women than in men.
A patient with a diagnosis of somatic symptom disorder is being assessed. What assessment questions are appropriate and therapeutic in nature?
- A. "Would you consider yourself to be mentally ill?"
- B. "Do you have periods of depression or extreme sadness thinking?""
- C. "Have you ever been told that your symptoms are not real?"
- D. "Are you able to care for yourself and meet your own basic needs?"
- E. "How do the members of your immediate family react to your illness?"
Correct Answer: B,D,E
Rationale: The assessment should address possible comorbid conditions like depression, the ability for a patient to be able to self-feed their basic needs independently, and the dynamics of feeding himself to the existence. The remaining options are likely to cause increased stress and foster anger, either of which would not be therapeutic.
To plan effective care for patients diagnosed with somatic system disorders, the nurse should understand that patients have difficulty giving up the symptoms because of what characteristic?
- A. They are generally chronic in nature.
- B. They have a physiological basis.
- C. They can be voluntarily controlled.
- D. They provide relief from health anxiety.
Correct Answer: D
Rationale: At the unconscious level, the patient's primary gain from the symptoms is anxiety relief. Considering that the symptoms actually make the patient more psychologically comfortable and may also provide a secondary gain, patients frequently and fiercely cling to the symptoms. The symptoms tend to be chronic; however, this does not explain why they are difficult to give up. The symptoms are not under voluntary control or physiologically based.
A patient has been diagnosed with a somatic symptoms disorder after various testing has failed to confirm a physiological cause for the patient's reports of back pain. What intervention by the nurse demonstrates the appropriate response when the patient continues to monopolize the group discussion with about back pain?
- A. Acknowledge the presence of pain but then redirect to another topic.
- B. Offer to discuss the back pain with the patient after the group session is over.
- C. In a matter-of-fact manner tell the patient that their pain is somatic in nature.
- D. Offer to discuss additional pain medication with the patient's health care provider.
Correct Answer: A
Rationale: After physical complaints have been investigated and a somatic symptom diagnosis is made, avoid further reinforcement of the somatic complaints by directing focus away from physical symptoms. The presence of the pain should not be denied but reinforcing or rewarding such behavior should not be engaged in.