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Chapter 21 PrepU NRS 330

Terms in this set (43)

Which is a significant obstacle in providing psychiatric care for clients who have somatic symptom illnesses?
Clients are often unrecognized because clients receive treatment in different primary care offices, and care is often fragmented.
Medications have been tried for somatic symptom disorder. Which drugs have been shown to be effective in some cases?
Selective serotonin reuptake inhibitors (SSRIs)
Which drug classification has been shown to be effective in treating somatization disorders?
Selective serotonin reuptake inhibitors
A client's family member asks the nurse, "What is a conversion disorder?" Which is the best response by the nurse?
It involves unexplained, usually sudden, deficits in sensory or motor function.
The la belle indifference occurs in which somatoform disorder?
Conversion disorder
In the care of a client with somatic symptom disorder, the nurse should anticipate that drug treatment will prioritize which class in order to treat the disorder?
Selective serotonin reuptake inhibitors (SSRIs)
A client is admitted to the mental health unit because the client was found trying to inject diluted feces into the client's hospitalized child's intravenous line. The client has a history of similar attempts of harming the child. The nurse would most likely suspect what?
Munchausen's syndrome by proxy
Which best describes the concept of somatization?
Manifestation of physical symptoms from psychological distress
Which statement about the etiology of somatic symptom disorder is accurate?
The exact etiology is unknown.
A client has been diagnosed with somatic symptom disorder. The client's assessment reveals high levels of anxiety. Which would the nurse expect to be prescribed?
Selective serotonin reuptake inhibitors (SSRIs)
A client with complex somatic symptom disorder is complaining of significant pain in the joints. When providing care to this client, which would be most important for the nurse to keep in mind?
The client's experience of pain is real.
A nurse is preparing a plan of care for a client diagnosed with body dysmorphic disorder. Which nursing diagnosis would the nurse likely identify as the priority?
Disturbed body image
A client is admitted to a mental health unit because the client was found trying to inject diluted feces into the client's hospitalized child's intravenous line. The client has a history of similar attempts of harming the child. The nurse would most likely suspect what?
Factitious disorder imposed on another
When assessing a client with somatic symptom disorder, which would the nurse most likely note?
Reports of physical symptoms do not have a demonstrable organic basis to fully account for them.
The nurse is providing care to a client with somatic symptoms disorder. The client has been prescribed escitalopram one week ago. The client reports experiencing nausea after starting the medication and describes it as "worse than what the average person would have." Which intervention should the nurse recommend for this client?
To monitor the nausea using a daily journal for one week
What is the major clinical finding in somatic symptom disorder?
The report of symptoms with no demonstrable pathology on testing or examination
xAll of the following disease processes are caused by stress except which one?
DVT
Which characteristic differentiates conversion disorder from malingering disorder?
Conversion disorder is an unconscious process, while malingering disorder is a deliberate fabrication of symptoms.
The client asks the nurse, "What does having psychosomatic symptoms mean?" What is the nurse's best reply?
"It means that stress and/or emotions are causing your symptoms."
Which occurs when an individual intentionally produces illness symptoms to avoid work?
Malingering
A parent brings a teenaged child, who is complaining of having a severe headache, to the clinic. The teenager is groaning with pain. During assessment, the client asks the nurse for a note to excuse the absence from school. After further assessment, the nurse suspects that the client is malingering. What leads the nurse to come to this conclusion? Choose the best answer.
The client's symptoms disappeared after getting the medical note.
The nurse is caring for a client with somatic symptom disorder. When assessing this client, the nurse would be especially alert for symptoms of what?
Depression
Which would be most important for a nurse to do when caring for a client with somatic symptom disorder?
Develop a sound, positive nurse-client relationship
When describing somatic symptom disorder to a group of nurses, which would the nurse include as a significant obstacle in providing psychiatric care for clients with that disorder?
Clients are often unrecognized because clients seek out multiple care providers and care is often fragmented.
After teaching a group of nursing students about somatic symptom disorder (SSD), the instructor determines the need for additional education when the students identify which as a characteristic of the disorder?
Easily manageable with treatment
A client complains of severe low back pain that began shortly after the death of the client's mother 2 years ago. No physical cause has been found to account for the pain. The client has been largely responsible for the care of four younger siblings because the client's father spends much of the week out of town on work-related business. Based on the client's symptoms, which nursing diagnosis is most appropriate for the client at this time?
Somatic complaints due to anxiety related to life stressors
The nurse is teaching basic physical exercises and meditation techniques to a client recently diagnosed with conversion disorder. What outcome does the nurse expect from teaching the client these exercises? Choose the best answer.
The exercises may help the client manage stress underlying the disorder
A group of nursing students is reviewing information about somatic symptom and related mental health disorders. The students demonstrate understanding of the information when they identify which disorder as involving physical or psychological symptoms (or both) fabricated to assume the sick role?
Factitious disorder
Somatic symptom disorder is characterized by what?
Severe physical symptoms unexplainable by any organic or physical pathology
The nurse is providing care to a client with somatic symptom disorder (SSD). Which would the nurse expect to be included in the client's plan of care?
Cognitive behavior therapy
A nurse was placed in charge of the pediatric care unit. Over a period of time it was discovered that most of the children on the unit experienced sudden cardiac arrest. Although the nurse went to great lengths to revive the children, most of these children died. On further investigation, it was found that the nurse had been injecting high doses of digoxin drug in the children, which caused the cardiac arrest. The nurse was arrested and found guilty. What would have been the most likely cause of the nurse's behavior?
The nurse might have Munchausen's syndrome by proxy.
In which disorder is the individual motivated solely by the desire to become a health care client?
Factitious disorder
A nursing instructor is describing somatic symptom disorder to a group of nursing students. The instructor determines that the education was successful when the students state what?
The first symptom usually appears during adolescence.
A client who has been having difficulty functioning in daily life comes to the nurse and states, "I'm really afraid. I've had these funny feelings in my stomach. I'm scared that I might have cancer." The client has been seen by numerous health care professionals and no evidence of cancer has been demonstrated. The nurse suspects what?
Illness anxiety disorder
After teaching a group of nursing students about somatic symptom disorder, the instructor determines that additional education is needed when the students identify which as true?
The client usually thinks anxiety is behind the symptoms.
In somatic symptom disorders, all except which are true?
The client usually believes he/she has some sort of anxiety disorder.
Regularly scheduled therapy sessions are integral to the treatment plans for all clients requiring psychiatric-mental health care. The nurse understands that this is important for clients with somatic symptom disorder for which reason?
To ensure a therapeutic relationship with the client
Which mental health disorder is characterized by a fear of developing a serious illness based on a misinterpretation of body sensation?
Hypochondriasis
While assessing a client thought to have a factitious disorder, a nurse asks the client to describe when the client felt nurtured as a child. Which response would the nurse interpret as supporting the client's diagnosis?
"The only time I ever felt loved was when I was sick enough to miss school."
A nurse is caring for a client with conversion disorder. What immediate outcomes (within a week) indicate successful therapy for the client? Select all that apply.
The client will communicate the steps to solving the problems.
The client will identify the conflict underlying the physical symptoms experienced.
A nurse is reviewing the medical history of a client diagnosed with somatic symptom disorder. Which would the nurse expect to find as a comorbid condition?
Depression
The nurse is educating the spouse of a client with a somatic symptom disorder about how to best help the client. Which strategy should the nurse suggest?
Empathize about physical discomfort but encourage independence.
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