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A nurse is preparing a plan of care for a client diagnosed with body dysmorphic disorder. Which nursing diagnosis would the nurse most likely identify as the priority?
- A. Disturbed Body Image
- B. Ineffective Coping
- C. Low Self-Esteem
- D. Risk for Other-Directed Violence
Correct Answer: A
Rationale: Disturbed Body Image (A) is the priority nursing diagnosis for BDD, as it directly addresses the core issue of preoccupation with perceived flaws. Coping (B), self-esteem (C), and violence (D) are secondary concerns.
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A nursing instructor is preparing a class about functional neurologic symptoms. Which of the following would the instructor most likely include as an assessment finding? Select all that apply.
- A. Difficulty swallowing
- B. Spasticity
- C. Urinary frequency
- D. Aphonia
- E. Blindness
Correct Answer: A,D,E
Rationale: Functional neurologic symptoms (FNS) include difficulty swallowing (A), aphonia (D), and blindness (E), reflecting neurologic-like symptoms without organic cause. Spasticity (B) and urinary frequency (C) are less typical.
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.
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.
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 client with complex somatic symptom disorder is complaining of significant pain in the joints. When providing care to this client, which of the following would be most important for the nurse to keep in mind?
- A. Opioid analgesics are the primary mode of therapy.
- B. The client?s experience of pain is real.
- C. Complementary therapies are usually of little benefit.
- D. Outcomes need to reflect the biologic aspects of the pain.
Correct Answer: B
Rationale: The client?s pain experience in CSSD is real (B), requiring validation to build trust and support treatment. Opioids (A) are not primary due to dependency risks, complementary therapies (C) can be beneficial, and biologic outcomes (D) are secondary to psychological focus.