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The client states, 'I can't go to group today. I have a very upset stomach this morning.' Which would be the nurse's most appropriate response?
- A. You have to go to group. The doctor has ordered it.
- B. Okay, you can miss this time.
- C. I know you don't feel well, but it's important for you to participate in therapy.
- D. You aren't really feeling nauseous. It is part of your illness.
Correct Answer: C
Rationale: Validating the client's feelings while encouraging participation supports therapy without dismissing symptoms.
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Which is the primary gain associated with developing physical symptoms in response to stress?
- A. Accept dependency
- B. Decrease anxiety
- C. Experience attention
- D. Suppress anger
Correct Answer: B
Rationale: The primary gain in psychosomatic illness is the reduction of anxiety or emotional conflict through physical symptom expression.
Which of the following terms are applicable when a person inflicts illness or injury on someone else to gain the attention of emergency medical personnel or to be a 'hero' for saving the victim?
- A. Malingering
- B. Factitious disorder
- C. Munchausen's syndrome by proxy
- D. Induced illness
Correct Answer: C
Rationale: Munchausen's syndrome by proxy involves inflicting harm on another to gain attention or hero status.
Which of the following are possible with psychosomatic illness? Select all that apply.
- A. Real symptoms can begin.
- B. Real symptoms can continue.
- C. Real symptoms can worsen.
- D. Unrelated symptoms can occur.
- E. Clients can control these symptoms.
Correct Answer: A,B,C,D
Rationale: Psychosomatic illnesses involve real symptoms that can start, persist, or worsen due to emotional factors, but clients cannot consciously control them.
Which are the factors that are currently considered to be possible reasons for the increased incidence of somatization in women? Select all that apply.
- A. Boys in the United States are taught to be stoic and to take it like a man.
- B. Women seek medical care more frequently.
- C. Women more often receive treatment for psychological symptoms.
- D. Women are more likely to have experienced childhood sexual abuse.
- E. Unexplained female pains
Correct Answer: A,B,C,D
Rationale: Cultural expectations of stoicism in men, frequent medical care-seeking, treatment for psychological symptoms, and higher rates of childhood sexual abuse contribute to somatization in women.
A client with a somatic symptom illness asks, 'Why do I have these symptoms?' Which would be the appropriate explanation for the nurse to offer?
- A. Physical symptoms can be attributed to an organic cause.
- B. Physical symptoms are deliberately expressed in order to benefit in some way.
- C. Physical symptoms are independent of the amount of stress.
- D. Physical symptoms are an involuntary way of dealing with psychic conflict.
Correct Answer: D
Rationale: Somatic symptom illnesses involve physical symptoms without an organic basis, involuntarily expressing psychological conflict.