Nokea
The nurse is caring for a client who was in a motorcycle accident 2 months ago. The client says he still has terrible neck pain, but he will be better once he gets a big insurance settlement. What condition might the nurse suspect?
- A. Hypochondriasis
- B. La belle indifference
- C. Conversion reaction
- D. Malingering
Correct Answer: D
Rationale: Malingering is suspected when symptoms are exaggerated for external gain, like an insurance settlement.
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The husband of a client with hypochondriasis has accompanied his wife to the follow-up doctor's visit. While waiting for the doctor, the husband expresses to the nurse his frustration with his wife's obsession about illness. He asks the nurse, 'What can I do?' The best response by the nurse would be.
- A. Try ignoring her complaints, and they should subside.
- B. Try finding an activity you enjoy doing together to help her feel better overall.
- C. Try to be the client and understand that she is worried that she is sick.
- D. Try to give her some sort of reward when she resists complaining about her illnesses.
Correct Answer: B
Rationale: Encouraging shared pleasurable activities provides emotional support and may reduce focus on illness.
A newly graduated nurse is scheduled to take the NCLEX RN examination in 3 days. On awakening today, the graduate cannot see anything. Which might this statement result from?
- A. La belle indifference
- B. Regression
- C. Malingering
- D. Undoing
Correct Answer: A
Rationale: La belle indifference is a lack of concern about functional loss, common in conversion disorder, as seen in this sudden blindness.
Psychosomatic illness refers to physical symptoms that are either created or worsened by psychic influences. Which conditions are thought to be attributed to the connection between mind and body? Select all that apply.
- A. Diabetes
- B. Arthritis
- C. Hypertension
- D. Headache
- E. Colitis
Correct Answer: A,C,D,E
Rationale: Psychosomatic illnesses involve physical symptoms influenced by emotional factors. Diabetes, hypertension, colitis, and headaches can be exacerbated by stress, unlike arthritis.
A client with recurrent headaches has been told by the physician that the cause is likely psychosomatic. The client reports this conversation to the nurse and says, 'That just can't be true. My head hurts so bad sometimes that it makes me sick to my stomach.' Which is the nurse's best response?
- A. To give the client some privacy and time to calm down.
- B. To say nothing and sit quietly with the client.
- C. The pain in your head is very real.
- D. Well, that's not what your doctor thinks.
Correct Answer: C
Rationale: Validating the reality of the client's pain builds trust and supports further discussion about psychosomatic causes.
Which of the following accurately describes how somatic symptoms are distinguished from factitious disorders and malingering?
- A. Munchausen's syndrome cannot be controlled by persons who have it.
- B. Persons who experience somatic disorders intentionally produce symptoms for some external purpose or gain.
- C. In malingering or factitious disorders, people willfully control the symptoms, and in somatic symptom illnesses, clients do not voluntarily control their physical symptoms.
- D. People who experience somatic symptom illnesses can stop the physical symptoms as soon as they have gained what they wanted.
Correct Answer: C
Rationale: Somatic symptom illnesses involve involuntary symptoms, unlike malingering or factitious disorders where symptoms are willfully produced.