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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.
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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.
The nurse has encouraged the client with a somatic symptom illness to keep a journal. Which treatment outcome might be met by journaling?
- A. The nurse will control external stressors that trigger the patient's physical symptoms.
- B. The nurse will assess the onset of physical symptoms.
- C. The client will express emotions privately.
- D. The client will identify the occurrence of physical symptoms when stressed.
Correct Answer: D
Rationale: Journaling helps clients recognize the link between stress and physical symptoms, fostering insight into the mind-body connection.
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.
Which are the factors that are currently considered to be possible reasons for the increased incidence of somatization in women? Select all that apply.
- A. Boys in the United States are taught to be stoic and to take it like a man.
- B. Women seek medical care more frequently.
- C. Women more often receive treatment for psychological symptoms.
- D. Women are more likely to have experienced childhood sexual abuse.
- E. Unexplained female pains
Correct Answer: A,B,C,D
Rationale: Cultural expectations of stoicism in men, frequent medical care-seeking, treatment for psychological symptoms, and higher rates of childhood sexual abuse contribute to somatization in women.
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.