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A nurse is evaluating the outcomes for a client diagnosed with complex somatic symptom disorder. Which of the following would the nurse most likely identify as interfering with achievement?
- A. Outcomes were stated in realistic terms
- B. Outcomes addressed overall issues
- C. Outcomes indicated small successes
- D. Outcomes were identified for specific behaviors
Correct Answer: B
Rationale: Broad, non-specific outcomes addressing overall issues (B) can interfere with achievement in CSSD due to lack of focus. Realistic (A), small (C), and specific (D) outcomes support progress by being measurable and attainable.
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A client is admitted to the mental health unit with a diagnosis of factitious disorder. When reviewing the client?s history, which of the following would the nurse most likely find?
- A. Intentional self-injurious behavior
- B. Pain to achieve a self-serving goal
- C. Malingering to avoid work
- D. Parents who were restrictive
Correct Answer: B
Rationale: Factitious disorder involves fabricating symptoms, like pain, for psychological gain, such as attention (B). Self-injury (A) is more typical of borderline personality disorder, malingering (C) seeks external gain, and restrictive parents (D) are not specific.
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.
The nurse is caring for a client with complex somatic symptom disorder. When assessing this client, the nurse would be especially alert for symptoms of which of the following?
- A. Depression
- B. Avoidant personality disorder
- C. Delirium
- D. Bipolar disorder
Correct Answer: A
Rationale: Complex somatic symptom disorder (CSSD) is frequently comorbid with depression (A) due to chronic distress from somatic symptoms. Avoidant personality disorder (B) is less common, delirium (C) involves acute cognitive changes unrelated to CSSD, and bipolar disorder (D) is not typically associated.
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.
The nurse is assisting in planning a series of group therapy sessions with several female clients diagnosed with complex somatic symptom disorder. The nurse plans to focus the sessions on which of the following as a priority?
- A. Causes of medical illnesses
- B. Positive self-talk
- C. Side effects of medications
- D. Assertiveness skills
Correct Answer: B
Rationale: Positive self-talk (B) is a priority in group therapy for CSSD to reframe negative symptom-focused thoughts, promoting coping. Medical causes (A) may reinforce preoccupation, medication side effects (C) are secondary, and assertiveness (D) is less relevant.