Learning Activity 2 Flashcards
Which nursing diagnosis should be investigated for clients with somatoform disorders? A) Deficient fluid volume B) Self-care deficit C) Disturbed personal identity D) Delayed growth and development
B) Self-care deficit
Clients with somatoform disorders may be unable to meet certain self-care needs because of pain, paralysis, weakness, and fatigue.
Use of dissociation most closely resembles
A) sitting in a lecture and “tuning out.”
B) developing a headache to avoid an unpleasant task.
C) feeling angry with a co-worker who shirks work.
D) finding a socially acceptable reason to meet a need.
A) sitting in a lecture and “tuning out.”
Dissociation involves having one’s thoughts or feelings out of conscious awareness and is similar to, but more drastic than, inattention to a lecture.
A physician describes a client as “malingering.” The nurse knows this means the client
A) is falsely claiming to have the symptoms.
B) experiences symptoms that cannot be explained medically.
C) experiences symptoms that have a physiological basis.
D) is seeking medication to ease pain of psychological origin.
A) is falsely claiming to have the symptoms.
Malingering is a conscious effort to deceive others by pretending to have certain incapacitating physical symptoms. The goal of malingering can often be financial gain.
What symptom characterizes body dysmorphic disorder?
A) Severe pain with psychological origins
B) Fear of having a life-threatening illness
C) Multiple physical symptoms spanning many years
D) Preoccupation with an imagined defect in appearance
D) Preoccupation with an imagined defect in appearance
The primary symptom of body dysmorphic disorder is preoccupation and loathing of a defect in one’s physical appearance.
Which neurotransmitter has been implicated as a possible causative factor in both pain disorder and body dysmorphic disorder? A) Dopamine B) Serotonin C) Norepinephrine D) Acetylcholine
B) Serotonin
Serotonin is implicated primarily because clients with pain disorder and body dysmorphic disorder have responded to selective serotonin reuptake inhibitors.
Dissociative identity disorder is characterized by
A) the inability to recall important information.
B) sudden unexpected travel away from home and inability to remember the past.
C) the existence of two or more subpersonalities, each with its own patterns of thinking.
D) recurring feelings of detachment from one’s body or mental processes.
C) the existence of two or more subpersonalities, each with its own patterns of thinking.
In dissociative identity disorder, aspects of the self may emerge as distinct personalities, with the individual losing sense of who he or she is. Dissociative identity disorder was previously referred to as multiple personality disorder.
An example of a somatoform disorder is A) depersonalization. B) dissociative fugue. C) conversion disorder. D) dissociative identity disorder.
C) conversion disorder.
A somatoform disorder has physical symptoms. Conversion disorder is the only option in which the client would display somatic symptoms. The other options are examples of dissociative disorders.
Therapeutic intervention for a client with a somatoform disorder would include
A) steering conversation away from client feelings.
B) conveying interest in the client rather than in symptoms.
C) encouraging the client in liberal use of benzodiazepines.
D) encouraging the client to refer to the nurse for meeting client needs.
B) conveying interest in the client rather than in symptoms.
Clients with somatoform disorders often have poor self-esteem. They expect to receive attention for their symptoms rather than for themselves. Shifting emphasis from the symptom to the person raises self-esteem and does not reinforce reliance on the symptom as a way of getting emotional needs met.
What information should the nurse give to the family of a client who has had a dissociative episode?
A) Dissociation is a method for coping with severe stress.
B) Dissociation suggests the possibility of early dementia.
C) Alert family that brief periods of psychotic behavior may occur.
D) How to intervene to prevent self-mutilation and suicide attempts.
A) Dissociation is a method for coping with severe stress.
This explanation helps families see the disorder as less “weird” and helps them understand that treatment will be aimed at identifying and developing alternative coping strategies.
For a client with pain disorder, the etiology statement most consistent with current theory would be “related to
A) difficulty expressing emotions.”
B) altered perceptions of pain stimuli.”
C) lack of coping skills.”
D) unmet dependency needs.”
B) altered perceptions of pain stimuli.”
Current research suggests that clients with pain disorder have altered perceptions of pain stimuli, perhaps caused by serotonin and endorphin deficiency.
Which statement about somatoform and dissociative disorders is true?
A) An organic basis exists for each group of disorders.
B) Nurses perceive clients with these disorders as easy to care for.
C) No relation exists between these disorders and early childhood loss or trauma.
D) Clients lack awareness of the relations among symptoms, anxiety, and conflicts.
D) Clients lack awareness of the relations among symptoms, anxiety, and conflicts.
Option 4 is the only true statement.
Which item of data should be routinely gathered during assessment of a client with a somatoform disorder? A) Potential for violence B) Level of confusion C) Dependence on medication D) Personal identity disturbance
C) Dependence on medication
Many clients with somatoform disorder have received prescription medication for anxiety or pain relief and may have developed dependence. Assess not only for what the client has taken, but also for amounts and length of time over which the drugs have been prescribed.
Which item of data routinely gathered during assessment of a client with dissociative disorder would be of least relevance to planning?
A) Voluntary control of symptoms
B) Ability to remember
C) Level of anxiety
D) Evidence of confusion and disorientation
A) Voluntary control of symptoms
Clients with dissociative disorders do not have voluntary control of symptoms. Voluntary control of symptoms has greater relevance when the nurse is assessing clients with somatoform disorders.
Which behavior by a client would not support a diagnosis of somatoform disorder?
A) Attention seeking from significant others
B) Acquiring financial gain from a disability plan
C) Avoidance of certain unpleasant activities
D) Performing activities of daily living unassisted
D) Performing activities of daily living unassisted
Somatic symptoms are reinforced by situations in which there is some sort of “payoff” for the client: attention, financial gain, avoidance of unpleasant situations, or getting dependent needs met. Performing activities of daily living unassisted would have no payoff of the sort mentioned.
During which client assessment interview should the nurse be particularly alert for the possibility of coexisting substance abuse disorder?
A) Mrs. R, who has hypochondriasis
B) Mrs. S, who has body dysmorphic disorder
C) Mr. U, who has somatoform pain disorder
D) Mr. V, who has been diagnosed as malingering
C) Mr. U, who has somatoform pain disorder
Clients with pain disorder may use alcohol or other central nervous system depressants or anxiolytic drugs to self-medicate.
