Nokea
The nurse performs a thorough physical examination for a client being admitted for somatic symptoms. Which of the following is the best rationale for the physical exam?
- A. Ease the client's mind that the nurse is looking for physical causes.
- B. Physical disorders underlie somatic disorders.
- C. Physical exams are reimbursed by third-party payers.
- D. Underlying pathology should be ruled out.
Correct Answer: D
Rationale: A thorough physical exam ensures no underlying organic pathology is missed, as somatic symptoms can coexist with physical conditions.
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The nurse is working with the client to develop emotion-focused coping strategies. Which should the nurse include as an emotion-focused coping strategy?
- A. Problem solving
- B. Assertiveness techniques
- C. Role-playing
- D. Deep breathing techniques
Correct Answer: D
Rationale: Deep breathing is an emotion-focused coping strategy that helps manage stress and emotional distress.
Which of the following are possible with psychosomatic illness? Select all that apply.
- A. Real symptoms can begin.
- B. Real symptoms can continue.
- C. Real symptoms can worsen.
- D. Unrelated symptoms can occur.
- E. Clients can control these symptoms.
Correct Answer: A,B,C,D
Rationale: Psychosomatic illnesses involve real symptoms that can start, persist, or worsen due to emotional factors, but clients cannot consciously control them.
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.
The client states, 'I can't go to group today. I have a very upset stomach this morning.' Which would be the nurse's most appropriate response?
- A. You have to go to group. The doctor has ordered it.
- B. Okay, you can miss this time.
- C. I know you don't feel well, but it's important for you to participate in therapy.
- D. You aren't really feeling nauseous. It is part of your illness.
Correct Answer: C
Rationale: Validating the client's feelings while encouraging participation supports therapy without dismissing symptoms.
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.