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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.
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A client with a somatic symptom illness asks, 'Why do I have these symptoms?' Which would be the appropriate explanation for the nurse to offer?
- A. Physical symptoms can be attributed to an organic cause.
- B. Physical symptoms are deliberately expressed in order to benefit in some way.
- C. Physical symptoms are independent of the amount of stress.
- D. Physical symptoms are an involuntary way of dealing with psychic conflict.
Correct Answer: D
Rationale: Somatic symptom illnesses involve physical symptoms without an organic basis, involuntarily expressing psychological conflict.
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.
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.
A middle-aged client goes to the physician falsely complaining of hip pain. The client's intention is to fake chronic hip pain to apply for disability benefits from the government. Which best reflects the client's potential diagnosis?
- A. Malingering
- B. Hypochondriasis
- C. Factitious disorder
- D. Munchausen's syndrome by proxy
Correct Answer: A
Rationale: Malingering involves intentionally faking symptoms for external gain, such as disability benefits.
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.