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Which are appropriate long-term treatment outcomes for clients who have somatic symptom illness? Select all that apply.
- A. The client will assume responsibility for self-care activities.
- B. The client will identify the relationship between stress and physical symptoms.
- C. The client will learn to vary his or her schedule.
- D. The client will verbally express emotional feelings.
- E. The client will demonstrate alternative ways to deal with stress, anxiety, and other feelings.
Correct Answer: B,D,E
Rationale: Long-term outcomes include recognizing stress-symptom links, expressing emotions, and developing alternative coping strategies.
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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.
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.
A client is seeking relief for undiagnosed pain. There is no history of significant physical illness. The history reveals that the client was laid off 4 months ago from her job. Which statement made by the client would most strongly suggest a somatoform disorder?
- A. I have been having a hard time lately. It's hard not working like I'm used to.
- B. I seem to have more pain now that I got laid off.
- C. I probably just overexerted myself working around the house. It's hard to slow down.
- D. I'm sure they will figure out what is wrong with me.
Correct Answer: B
Rationale: Linking increased pain to a stressful event like job loss suggests a somatoform disorder, where emotional distress manifests physically.
Which of the following terms are applicable when a person inflicts illness or injury on someone else to gain the attention of emergency medical personnel or to be a 'hero' for saving the victim?
- A. Malingering
- B. Factitious disorder
- C. Munchausen's syndrome by proxy
- D. Induced illness
Correct Answer: C
Rationale: Munchausen's syndrome by proxy involves inflicting harm on another to gain attention or hero status.
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.