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.
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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.
The nurse is caring for a client in the neighborhood clinic. The client tells the nurse that ever since he was an adolescent, he has avoided social situations because he has one ear that is obviously bigger than the other ear. The nurse observes that one of the client?s ears does not appear to be larger than the other ear. The nurse suspects that the client may be experiencing which of the following?
- A. Complex somatic symptom disorder
- B. Functional neurologic symptoms
- C. Factitious disorder
- D. Body dysmorphic disorder
Correct Answer: D
Rationale: Body dysmorphic disorder (D) involves preoccupation with a perceived physical flaw, like an ear size discrepancy, not observed by others. CSSD (A) involves broader somatic complaints, functional neurologic symptoms (B) involve motor/sensory deficits, and factitious disorder (C) involves intentional symptom fabrication.
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.
A client is admitted to the mental health unit with a diagnosis of factitious disorder. When reviewing the client?s history, which of the following would the nurse most likely find?
- A. Intentional self-injurious behavior
- B. Pain to achieve a self-serving goal
- C. Malingering to avoid work
- D. Parents who were restrictive
Correct Answer: B
Rationale: Factitious disorder involves fabricating symptoms, like pain, for psychological gain, such as attention (B). Self-injury (A) is more typical of borderline personality disorder, malingering (C) seeks external gain, and restrictive parents (D) are not specific.
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.
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