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The family members of a client with somatic symptom illness report to the nurse that every time they invite the client to join in an activity the client declines, saying things like, 'I wish I could, but I feel so terrible.' Which of the following approaches should the nurse suggest to encourage activity?
- A. What does your pain feel like right now?
- B. You are fine, the doctor said so. Let's go.
- C. I know this is difficult, but exercise is important. It will be a short walk.
- D. I'll let you rest. Let me know when you feel better.
Correct Answer: C
Rationale: Validating feelings while encouraging activity promotes participation without dismissing the client's experience.
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The nurse is identifying outcomes for a client with a somatic symptom illness. Which is an appropriate outcome to include in the plan of care?
- A. The client will verbally express his or her emotions.
- B. The client will be free from stress.
- C. The client will demonstrate alternative ways to avoid stressful situations.
- D. The client will verbalize acceptance of physical symptoms.
Correct Answer: A
Rationale: Verbal expression of emotions is a realistic outcome, helping clients address underlying psychological factors.
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.
A client is seeking relief for undiagnosed pain. There is no history of significant physical illness. The history reveals that the client was laid off 4 months ago from her job. Which statement made by the client would most strongly suggest a somatoform disorder?
- A. I have been having a hard time lately. It's hard not working like I'm used to.
- B. I seem to have more pain now that I got laid off.
- C. I probably just overexerted myself working around the house. It's hard to slow down.
- D. I'm sure they will figure out what is wrong with me.
Correct Answer: B
Rationale: Linking increased pain to a stressful event like job loss suggests a somatoform disorder, where emotional distress manifests physically.
The nurse is planning care for a client with somatic symptom illness disorder. Which should the nurse plan to reassess on a daily basis?
- A. Sensory deficits experienced by the client
- B. Character of pain reported by the client
- C. Frequency of generalized somatic complaints
- D. Signs of possible neurologic disorders
Correct Answer: C
Rationale: Monitoring the frequency of somatic complaints tracks the status of the disorder without reinforcing unfounded health concerns.
The husband of a woman with a somatic symptom illness asks the nurse why the doctors cannot find anything wrong with her. Which would be the appropriate explanation for the nurse to offer?
- A. She is not really experiencing the symptoms. She is making them up to get attention.
- B. There is no physical cause. Mental distress is causing the symptoms, even though she is not aware of it.
- C. She controls the symptoms when she isn't feeling much stress. It is hard to diagnose when the symptoms are intermittent.
- D. There is a physical cause. It just has not been detected yet.
Correct Answer: B
Rationale: Somatic symptom illnesses cause real symptoms due to mental distress, not consciously controlled or fabricated, despite negative diagnostic results.