Nokea
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.
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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.
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 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.
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 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.