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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).
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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 preparing to interview a client diagnosed with complex somatic symptom disorder. The nurse anticipates that the client will most likely exhibit which of the following?
- A. No facial expression during the interview
- B. Intermittent nodding and glancing at the clock on the wall
- C. Altered mental status
- D. Rapidly changing moods during the interview
Correct Answer: B
Rationale: Clients with CSSD often exhibit distracted behaviors like nodding and glancing at the clock (B), reflecting preoccupation with symptoms. No facial expression (A) suggests schizoid traits, altered mental status (C) indicates delirium, and rapid mood changes (D) suggest bipolar disorder.
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 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.
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.