Chapter 17 Flashcards
Which assessment data would help the health care team distinguish symptoms of conversion (functional neurological) disorder from symptoms of illness anxiety disorder (hypochondriasis)?
a. Voluntary control of symptoms
b. Client’s style of presentation
c. Results of diagnostic testing
d. The role of secondary gains
b. Client’s style of presentation
Which prescription medication would the nurse expect to be prescribed for a client diagnosed with a somatic symptom disorder?
a. Narcotic analgesics for use as needed for acute pain
b. Antidepressant medications to treat co-morbid depression
c. Long-term use of benzodiazepines to support coping with anxiety
d. Conventional antipsychotic medications to correct cognitive distortions
b. Antidepressant medications to treat co-morbid depression
A medical-surgical nurse works with a client diagnosed with a somatic symptom disorder. An understanding how what client characteristic will facilitate care planning?
a. readily seek psychiatric counseling.
b. be resistant to accepting psychiatric help.
c. attend psychotherapy sessions without encouragement.
d. be eager to discover the true reasons for physical symptoms.
b. be resistant to accepting psychiatric help.
A client experiences blindness related to conversion (functional neurological) disorder but is unconcerned about this problem. Which understanding should guide the nurse’s planning for this client?
a. The client is suppressing accurate feelings regarding the problem.
b. The client’s anxiety is relieved through the physical symptom.
c. The client’s optic nerve transmission has been impaired.
d. The client will not disclose genuine fears.
b. The client’s anxiety is relieved through the physical symptom.
A client is experiencing blindness related to conversion (functional neurological) disorder. To help the client eat, the nurse should implement which intervention?
a. establish a “buddy” system with other clients who can feed the client at each meal.
b. expect the client to feed self after explaining arrangement of the food on the tray.
c. direct the client to locate items on the tray independently and feed self.
d. address needs of other clients in the dining room, then feed this client.
b. expect the client to feed self after explaining arrangement of the food on the tray.
A client experiencing blindness related to conversion (functional neurological) disorder states, “All the doctors and nurses in the hospital stop by often to check on me. Too bad people outside the hospital don’t find me as interesting.” Which nursing diagnosis is most relevant?
a. Social isolation
b. Chronic low self-esteem
c. Interrupted family processes
d. Ineffective health maintenance
b. Chronic low self-esteem
A client with fears of serious heart disease was referred to the mental health center by a cardiologist after extensive diagnostic evaluation showed no physical illness. The client says, “My chest is tight, and my heart misses beats. I’m often absent from work. I don’t go out much because I need to rest.” Which health problem is most likely?
a. Dysthymic disorder
b. Somatic symptom disorder
c. Antisocial personality disorder
d. Illness anxiety disorder (hypochondriasis)
d. Illness anxiety disorder (hypochondriasis)
To assist clients diagnosed with somatic symptom disorders, which nursing interventions have the highest priority?
a. explain the pathophysiology of symptoms.
b. help these clients suppress feelings of anger.
c. shift focus from somatic symptoms to feelings.
d. investigate each physical symptom as it is reported.
c. shift focus from somatic symptoms to feelings.
A nurse assessing a client diagnosed with a somatic symptom disorder is most likely to note which client characteristic?
a. sees a relationship between symptoms and interpersonal conflicts.
b. has little difficulty communicating emotional needs to others.
c. rarely derives personal benefit from the symptoms.
d. has altered comfort and activity needs.
d. has altered comfort and activity needs.
To plan effective care for clients diagnosed with somatic symptom disorders, the nurse should understand that clients have difficulty giving up the symptoms because of what fact?
a. They are generally chronic.
b. They have a physiological basis.
c. They can be voluntarily controlled.
d. They provide relief from health anxiety.
d. They provide relief from health anxiety.
A client with a somatic symptom disorder has the nursing diagnosis Interrupted family processes related to client’s disabling symptoms as evidenced by spouse and children assuming roles and tasks that previously belonged to client. What is an appropriate outcome for this client?
a. Will assume roles and functions of other family members.
b. Will demonstrate performance of former roles and tasks.
c. Will focus energy on problems occurring in the family.
d. Will rely on family members to meet personal needs.
b. Will demonstrate performance of former roles and tasks.
Which comment by a client who recently experienced a myocardial infarction indicates use of maladaptive, ineffective coping strategies?
a. “My employer should have paid for a health club membership for me.”
b. “My family will see me through this. It won’t be easy, but I will never be alone.”
c. “My heart attack was no fun, but it showed me up the importance of a good diet and more exercise.”
d. “I accept that I have heart disease. Now I need to decide if I will be able to continue my work daily.”
a. “My employer should have paid for a health club membership for me.”
A nurse assesses a client diagnosed with conversion (functional neurological) disorder. Which comment is most characteristic of this client?
a. “Since my father died, I’ve been short of breath and had sharp pains that go down my left arm, but I think it’s just indigestion.”
b. “I have daily problems with nausea, vomiting, and diarrhea. My skin is very dry, and I think I’m getting seriously dehydrated.”
c. “Sexual intercourse is painful. I pretend as if I’m asleep so I can avoid it. I think
it’s starting to cause problems with my marriage.”
d. “I get choked very easily and have trouble swallowing when I eat. I think I might have cancer of the esophagus.”
a. “Since my father died, I’ve been short of breath and had sharp pains that go down my left arm, but I think it’s just indigestion.”
A client who experienced a myocardial infarction was transferred from critical care to a step-down unit. The client then used the call bell every 15 minutes for minor requests and complaints. Staff nurses reported feeling inadequate and unable to satisfy the client’s needs. When the nurse manager intervenes directly with this client, which comment is most therapeutic?
a. “I’m wondering if you are feeling anxious about your illness and being left alone.”
b. “The staff are concerned that you are not satisfied with the care you are receiving.”
c. “Let’s talk about why you use your call light so frequently. It is a problem.”
d. “You frustrate the staff by calling them so often. Why are you doing that?”
a. “I’m wondering if you are feeling anxious about your illness and being left alone.”
A client reports fears of having cervical cancer and says to the nurse, “I’ve had Pap smears by six different doctors. The results were normal, but I’m sure that’s because of errors in the laboratory.” Which disorder would the nurse suspect?
a. Conversion (functional neurological) disorder
b. Illness anxiety disorder (hypochondriasis)
c. Somatic symptom disorder
d. Factitious disorder
b. Illness anxiety disorder (hypochondriasis)
