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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.
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A client diagnosed with complex somatic symptom disorder and depression is prescribed medication therapy to treat both the pain and the symptoms of depression. When teaching the client about the medication, which of the following would the nurse emphasize?
- A. Need for signing a no-suicide contract
- B. Avoidance of foods that contain aged cheese
- C. Use of sunscreen when exposed to bright sunlight
- D. Limiting of the amount of water ingested
Correct Answer: C
Rationale: SSRIs or SNRIs, commonly used for CSSD and depression, may cause photosensitivity, making sunscreen use (C) important. No-suicide contracts (A) are not medication-related, aged cheese avoidance (B) applies to MAOIs, and water limitation (D) is irrelevant.
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.
The husband of a client diagnosed with complex somatic symptom disorder asks the nurse, What causes this condition? Which response by the nurse would be most accurate?
- A. There is definitely an underlying genetic link for this disorder.
- B. Your wife is experiencing chronic stress that causes hypoarousal.
- C. The symptoms reflect an emotion that your wife cannot verbalize.
- D. The symptoms reflect an internal preoccupation with events.
Correct Answer: C
Rationale: CSSD symptoms often reflect unexpressed emotions (C), as psychological distress manifests physically. Genetic links (A) are not definitive, chronic stress (B) is too vague, and preoccupation with events (D) is less accurate than emotional expression.
A client is being assessed for complex somatic symptom disorder. Which client statement would the nurse interpret as most likely supporting this diagnosis?
- A. It?s like my foot is asleep all the time; I can?t feel anything that touches my foot.
- B. I?m losing weight no matter what or how much I eat.
- C. I am always in pain; there is nothing I can do to relieve it.
- D. It seems like I am always having diarrhea at the most inconvenient times.
Correct Answer: C
Rationale: Chronic, unrelieved pain (C) strongly supports a CSSD diagnosis due to its persistent and distressing nature. Numbness (A) suggests functional neurologic symptoms, weight loss (B) aligns with eating disorders, and diarrhea (D) is less specific to CSSD.
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.