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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 in the neighborhood clinic. The client tells the nurse that ever since he was an adolescent, he has avoided social situations because he has one ear that is obviously bigger than the other ear. The nurse observes that one of the client?s ears does not appear to be larger than the other ear. The nurse suspects that the client may be experiencing which of the following?
- A. Complex somatic symptom disorder
- B. Functional neurologic symptoms
- C. Factitious disorder
- D. Body dysmorphic disorder
Correct Answer: D
Rationale: Body dysmorphic disorder (D) involves preoccupation with a perceived physical flaw, like an ear size discrepancy, not observed by others. CSSD (A) involves broader somatic complaints, functional neurologic symptoms (B) involve motor/sensory deficits, and factitious disorder (C) involves intentional symptom fabrication.
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.
A nursing instructor is describing complex somatic symptom disorder to a group of nursing students. The instructor determines that the teaching was successful when the students state which of the following?
- A. The disorder typically is diagnosed in men.
- B. The first symptom usually appears during adolescence.
- C. The disorder commonly occurs with substance abuse.
- D. Highly educated individuals often develop this disorder.
Correct Answer: B
Rationale: CSSD symptoms often first appear in adolescence (B), aligning with its chronic nature. It is more common in women (A), not strongly linked to substance abuse (C), and not specific to highly educated individuals (D).
A nurse is providing care for a client who has complex somatic symptom disorder and is exhibiting anxiety about having a severe illness. Which of the following would be appropriate for the nurse to do? Select all that apply.
- A. Listening closely to the client?s report of symptoms
- B. Discouraging the client from talking about fears
- C. Acknowledging that what the client is saying may be real
- D. Encouraging the client to write down symptoms in a journal
- E. Reviewing symptom pattern with the client
Correct Answer: A,C,D,E
Rationale: Appropriate interventions for CSSD with anxiety include listening closely (A), acknowledging the reality of symptoms (C), journaling symptoms (D), and reviewing patterns (E) to validate and manage distress. Discouraging fear discussion (B) is non-therapeutic.