Nokea
The nurse is preparing to interview a client diagnosed with complex somatic symptom disorder. The nurse anticipates that the client will most likely exhibit which of the following?
- A. No facial expression during the interview
- B. Intermittent nodding and glancing at the clock on the wall
- C. Altered mental status
- D. Rapidly changing moods during the interview
Correct Answer: B
Rationale: Clients with CSSD often exhibit distracted behaviors like nodding and glancing at the clock (B), reflecting preoccupation with symptoms. No facial expression (A) suggests schizoid traits, altered mental status (C) indicates delirium, and rapid mood changes (D) suggest bipolar disorder.
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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 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.
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.
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.
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.