Deck 29: Somatic Symptom and Dissociative Disorders

Question 1

Neurological tests have ruled out pathology in a client's sudden lower-extremity paralysis.Which nursing care should be included for this client?

A)Deal with physical symptoms in a detached manner.
B)Challenge the validity of physical symptoms.
C)Meet dependency needs until the physical limitations subside.
D)Encourage a discussion of feelings about the lower-extremity problem.

Answer 1

Deal with physical symptoms in a detached manner.

Question 2

The nurse documents assessment findings of a patient who is unable to recall all specifics related to compound childhood traumas.Which disorder is the patient experiencing?

A)Localized amnesia
B)Selective amnesia
C)Generalized amnesia
D)Retrograde amnesia

Answer 2

Localized amnesia

Question 3

James is diagnosed with Somatic Symptom Disorder.Which question will help the nurse develop nursing diagnoses for James's plan of care? Select all that apply.

A)"Have you had thoughts of self-harm?"
B)"How many physicians have you seen in the past 6 months?"
C)"Do you take medication for anxiety as prescribed?"
D)"When did you last feel detached from your environment?"
E)"How long have you had these memory problems?"

Answer 3

"Have you had thoughts of self-harm?"
"How many physicians have you seen in the past 6 months?"
"Do you take medication for anxiety as prescribed?"

Question 4

The nurse is caring for a patient diagnosed with Conversion Disorder.Which statement made by the nurse is most therapeutic for this patient?

A)"I think you could get over this condition if you tried hard enough.A positive outlook can change everything."
B)"I'm so sorry that your back hurts so much.Yes,I'm happy to get you a wheelchair so you don't have to walk to meals."
C)"I think that your symptoms are just in your head.Therapy can help you get rid of them."
D)"I am pleased to hear you say that you recognize that your anxiety may be the cause of your swallowing difficulties.'

Question 5

Which of the following statements accurately describes dissociative fugue?

A)Dissociative fugue is not precipitated by stressful events.
B)Dissociative fugue is characterized by sudden,unexpected travel or bewildered wandering with inability to recall some or all of one's past.
C)Dissociative amnesia and dissociative fugue are completely different types of disorders.
D)Dissociative fugue is characterized by a sense of observing oneself from outside the body.

Question 6

The family of a client diagnosed with conversion disorder asks the nurse,"Will his paralysis ever go away?" Which of these responses by the nurse is evidence based?

A)"Most symptoms of conversion disorder resolve within a few weeks."
B)"Typically,people who have conversion disorder symptoms that include paralysis will be paralyzed for the rest of their lives."
C)"The only people who recover are those who develop conversion disorder symptoms without a precipitating stressful event."
D)"Technically,he could walk now since he is intentionally feigning paralysis."

Question 7

The nurse is working with a client diagnosed with Somatic Symptom Disorder.What predominant symptoms should the nurse expect to assess?

A)Disproportionate and persistent thoughts about the seriousness of one's symptoms
B)Amnestic episodes in which the client is pain free
C)Excessive time spent discussing psychosocial stressors
D)Lack of physical symptoms

Question 8

A client is diagnosed with Illness Anxiety Disorder.Which of the following symptoms is the client most likely to exhibit? Select all that apply.

A)Obsessive-compulsive traits
B)Pseudocyesis
C)Disabling fear of having a serious illness
D)Multiple pronounced physical symptoms
E)Depression

Question 9

Which of the following somatic symptom and dissociative disorders are identified with known effective pharmacological treatments for that disorder? Select all that apply.

A)Antidepressants have been used effectively in treating pain associated with somatic symptom disorder.
B)Lithium has been effective in treating illness anxiety disorder.
C)Muscle relaxants have been effective in resolving conversion disorder symptoms.
D)The antidepressant clomipramine (Anafranil)has shown promise in treating depersonalization-derealization disorder.

Question 10

The nurse is educating a patient diagnosed with Munchausen Syndrome.Which statement made by the nurse is most correct?

A)"A characteristic of your disorder is that you fabricate signs and symptoms of illness."
B)"Having your condition means that you hear voices that guide your actions."
C)"Your condition causes you to experience a change in body function that cannot be explained."
D)"Your symptom of memory loss is very common in your condition."

Question 11

Which should the nurse recognize as an example of localized amnesia?

A)A client cannot relate any lifetime memories,including personal identity.
B)A client can relate family memories but has no recollection of a particular brother.
C)A client cannot remember events surrounding a fatal car accident.
D)A client whose home was destroyed by a tornado only remembers waking up in the hospital.

Question 12

Carly has been diagnosed with Somatic Symptom Disorder.As the nurse is talking with Carly and her family,which of the following statements suggest primary or secondary gains that the physical symptoms are providing for the client?

A)The family agrees that Carly began having physical symptoms after she lost her job.
B)Carly states that even though medical tests have not found anything wrong,she is convinced her headaches are indicative of a brain tumor.
C)Carly's mother reports that someone from the family stays with Carly each night because the physical symptoms are incapacitating.
D)Carly states she noticed feeling hotter than usual the last time she had a headache.

Question 13

Janie is a healthy female adolescent with no history of substance abuse who presents to the mental health clinic.Janie tells the nurse that she has experienced several episodes where she feels like she is watching a movie of herself where she is floating above and watching herself as an outside observer.Janie asks the nurse what is wrong with her.Which statement made by the nurse is most appropriate?

A)"You have derealization disorder and must be treated for this immediately."
B)"These may be symptoms of depersonalization disorder,but I'm going to suggest you meet with the psychiatrist for a diagnosis."
C)"You must be schizophrenic.I'm going to ask the psychiatrist to run some tests on you."
D)"I wouldn't worry about these symptoms.These are typical for female teenagers who are experiencing hormonal changes."

Question 14

Which is considered an appropriate outcome when planning care for an inpatient client diagnosed with Somatic Symptom Disorder?

A)The client will admit to fabricating physical symptoms to gain benefits by day 3.
B)The client will list three potential adaptive coping strategies to deal with stress by day 2.
C)The client will comply with medical treatments for physical symptoms by day 3.
D)The client will openly discuss physical symptoms with staff by day 4.

Question 15

A client diagnosed with DID switches personalities when confronted with destructive behavior.The nurse recognizes that this dissociation serves which function?

A)It is a means to attain secondary gain.
B)It is a means to explore feelings of excessive and inappropriate guilt.
C)It serves to isolate painful events so that the primary self is protected.
D)It serves to establish personality boundaries and limit inappropriate impulses.

Question 16

A client diagnosed with Somatic Symptom Disorder is most likely to exhibit which personality disorder characteristics?

A)Uses "splitting" and manipulation in relationships
B)Is socially irresponsible,exploitative,and guiltless and disregards rights of others
C)Expresses heightened emotionality,seductiveness,and strong dependency needs
D)Uncomfortable in social situations;perceived as timid,withdrawn,cold,and strange

Question 17

An inpatient client is newly diagnosed with Dissociative Identity Disorder (DID)stemming from severe childhood sexual abuse.Which is the priority nursing intervention?

A)Encourage exploration of sexual abuse.
B)Encourage guided imagery.
C)Establish trust and rapport.
D)Administer antianxiety medications.

Question 18

A client is diagnosed with DID.What is the primary goal of therapy for this client?

A)To recover memories and improve thinking patterns
B)To prevent social isolation
C)To decrease anxiety and need for secondary gain
D)To collaborate among subpersonalities to improve functioning

Question 19

A client is exhibiting symptoms of generalized amnesia.Which of the following questions should the nurse ask to confirm this diagnosis? Select all that apply.

A)"Can you tell me your name and where you live?"
B)"Have you ever traveled suddenly or unexpectedly away from home?"
C)"Have you recently experienced any traumatic event?"
D)"Have you ever felt detached from your environment?"
E)"Have you had any history of memory problems?"

Question 20

A nursing instructor is teaching about the etiology of dissociative disorders from a psychoanalytical perspective.What student statement about clients diagnosed with this disorder indicates that learning has occurred?

A)"Dissociative behaviors occur when individuals repress distressing mental information from their conscious awareness."
B)"When their physical symptoms relieve them from stressful situations,their amnesia is reinforced.
C)"People with dissociative disorders typically have strong egos."
D)"There is clear and convincing evidence of a familial predisposition to this disorder."

Question 21

Suzy is diagnosed with a dissociative disorder.Which actions should the nurse take when teaching Suzy about her disorder? Select all that apply.

A)The nurse should determine if Suzy is anxious.
B)The nurse should explore Suzy's fears.
C)The nurse should ask the physician to explain test results to Suzy.
D)The nurse should ask the family to engage in role-play.

Question 22

Dissociative disorders are defined by a disturbance of or alteration in the usually integrated functions of consciousness,memory,and __________.

Question 23

______ _______ is defined as an inability to remember or recall bits of information or behavioral skills.

Question 24

Mary is a 56-year-old female who is brought to the emergency department by the police because she was found wandering confusedly in a busy shopping center several miles from her home.The nurse assesses Mary and finds that she has been the victim of domestic violence for 32 years and has recently been beaten by her husband.Mary's recollection of current events is hazy and she is not able to give the nurse a detailed account of the abuse.Which of Mary's symptoms cause the nurse to suspect that Mary is suffering from dissociative fugue? Select all that apply.

A)Mary's travel to a shopping center several miles from her home
B)Mary's confused wandering
C)Mary's ability to stay with an abuser all these years
D)Mary's inability to offer details about the domestic abuse
E)Mary's inability to focus on the questioning

Question 25

The inability to maintain an integrated and complete perception of self is _____________.