Nokea
Which treatment modality should a nurse recommend to help a patient diagnosed with somatic symptom disorder cope more effectively?
- A. Flooding
- B. Relaxation
- C. Response prevention
- D. Systematic desensitization
Correct Answer: B
Rationale: Pain, a common complaint in patients diagnosed with somatic symptom disorder, increases when the patient has muscle tension. Relaxation can diminish the patient's perceptions of the intensity of pain. The distractors are modalities useful in treating selected anxiety disorders.
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A patient's blindness is related to a functional neurological (conversion) disorder. To help the patient eat, the nurse should implement what intervention?
- A. Establishing a "buddy" system with other patients who can feed the patient at each meal
- B. Expecting the patient to self-feed after explaining the arrangement of the food on the tray
- C. Directing the patient to locate items on the tray independently with feeding being unassisted
- D. Addressing the needs of other patients in the dining room, and then feeding this patient
Correct Answer: B
Rationale: The patient is expected to maintain some level of independence by feeding himself or herself, whereas the nurse is supportive in a matter-of-fact way. The distractors support dependency or offer little support.
A nurse assesses a patient suspected to have somatic system disorder. Which findings support the diagnosis?
- A. Female
- B. Reports frequent dizziness
- C. Complains of heavy menstrual bleeding
- D. First diagnosed with psoriasis at 12 years of age
- E. Reports of back pain, painful urination and frequent diarrhea
Correct Answer: A,B,C,E
Rationale: No chronic disease explains the symptoms for patients with somatic system disorder. Patients report multiple symptoms; gastrointestinal, sexual, and pseudoneurological symptoms are common. This disorder is more common in women than in men.
A patient whose blindness is related to a functional neurological (conversion) disorder appears to be unconcerned about this problem. Which understanding should guide the nurse's planning for this patient?
- A. Suppressing accurate feelings regarding the problem.
- B. Anxiety is relieved through the physical symptom.
- C. Emotional needs are met through hospitalization.
- D. The patient refuses to disclose genuine fears.
Correct Answer: B
Rationale: Psychoanalytic theory suggests conversion reduces anxiety through the production of a physical symptom that is symbolically linked to an underlying conflict. Conversion, not suppression, is the operative defense mechanism in this disorder. The other distractors oversimplify the dynamics, suggesting that only dependency needs are of concern, or suggest conscious motivation (conversion operates unconsciously).
What is the primary difference between somatic system disorders and dissociative disorders?
- A. They are under voluntary control
- B. They are related to resolved stress.
- C. They are generally strongly cultural bound.
- D. They are psychological stress expressed through somatic symptoms.
Correct Answer: D
Rationale: Somatic symptom disorders are expressions of unresolved emotional trauma characterized by the presence of one or more physical symptoms without a known organic source that causes substantial distress and psychosocial impairment with or without a known general medical disease. Somatic system disorders are neither under voluntary control nor are they cultural bound.
A patient with a diagnosis of somatic symptom disorder is being assessed. What assessment questions are appropriate and therapeutic in nature?
- A. "Would you consider yourself to be mentally ill?"
- B. "Do you have periods of depression or extreme sadness thinking?""
- C. "Have you ever been told that your symptoms are not real?"
- D. "Are you able to care for yourself and meet your own basic needs?"
- E. "How do the members of your immediate family react to your illness?"
Correct Answer: B,D,E
Rationale: The assessment should address possible comorbid conditions like depression, the ability for a patient to be able to self-feed their basic needs independently, and the dynamics of feeding himself to the existence. The remaining options are likely to cause increased stress and foster anger, either of which would not be therapeutic.