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The nurse is assisting in planning a series of group therapy sessions with several female clients diagnosed with complex somatic symptom disorder. The nurse plans to focus the sessions on which of the following as a priority?
- A. Causes of medical illnesses
- B. Positive self-talk
- C. Side effects of medications
- D. Assertiveness skills
Correct Answer: B
Rationale: Positive self-talk (B) is a priority in group therapy for CSSD to reframe negative symptom-focused thoughts, promoting coping. Medical causes (A) may reinforce preoccupation, medication side effects (C) are secondary, and assertiveness (D) is less relevant.
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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.
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.
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 nurse is preparing a plan of care for a client diagnosed with body dysmorphic disorder. Which nursing diagnosis would the nurse most likely identify as the priority?
- A. Disturbed Body Image
- B. Ineffective Coping
- C. Low Self-Esteem
- D. Risk for Other-Directed Violence
Correct Answer: A
Rationale: Disturbed Body Image (A) is the priority nursing diagnosis for BDD, as it directly addresses the core issue of preoccupation with perceived flaws. Coping (B), self-esteem (C), and violence (D) are secondary concerns.
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.