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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 has made multiple visits to the clinic. The nurse suspects that the client may be experiencing complex somatic symptom disorder based on which of the following?
- A. Expressions of concern about psychological problems
- B. Indications that parents were always in good health
- C. Reports of the same symptoms repeatedly
- D. Evidence of a need for social support from her friends
Correct Answer: C
Rationale: Repeated reports of the same somatic symptoms (C) are characteristic of CSSD, reflecting persistent preoccupation with physical complaints. Psychological concerns (A) are less specific, parental health (B) is irrelevant, and social support needs (D) are not diagnostic.
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.
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.
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.
A client with body dysmorphic disorder is admitted to the inpatient unit. Based on the nurse?s understanding about this disorder, the nurse would assess this client closely for which of the following?
- A. Suicidal ideation
- B. Escalating violence
- C. Anorexia
- D. Psychosis
Correct Answer: A
Rationale: Body dysmorphic disorder (BDD) is associated with high rates of suicidal ideation (A) due to distress over perceived flaws. Violence (B) is not typical, anorexia (C) is a separate disorder, and psychosis (D) is rare in BDD.