Nokea
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.
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A client yells at the nurse, 'You are all quacks! Can't you see I am sick?' Which knowledge would help the nurse to work most effectively with this client?
- A. Client progress is expected to be very slow.
- B. Physical illness is the root of the client's problems.
- C. The client will never be free of somatic symptoms.
- D. The nurse has done everything possible to treat the client.
Correct Answer: A
Rationale: Recognizing that progress is slow helps the nurse remain patient and nonjudgmental, fostering a therapeutic relationship.
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 somatic symptom illness tells the nurse that she is sick so often that her husband and children take over most of the household duties, such as cooking, cleaning, doing laundry, and so forth. Which is this evidence of?
- A. Dysfunctional family unit
- B. Primary gain
- C. Role reversal
- D. Secondary gain
Correct Answer: D
Rationale: Secondary gain involves external benefits like relief from responsibilities or increased attention due to illness.
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.
A client is seen in the primary care clinic complaining of headaches. The client appears extremely distressed and insists that she must have a brain tumor. Which diagnosis is most probable for this client?
- A. Conversion disorder
- B. Pain disorder
- C. Brain cancer
- D. Hypochondriasis
Correct Answer: D
Rationale: Hypochondriasis involves preoccupation with fear of serious illness, like a brain tumor, despite no organic basis.