Deck 30: Somatoform and Disassociative Disorders

Question 1

What symptom differentiates dissociative fugue from dissociative amnesia?

A)Clients diagnosed with dissociative fugue experience symptoms that are precipitated by extreme stress, and clients diagnosed with dissociative amnesia do not.
B)Clients diagnosed with dissociative fugue are unaware of their memory loss, whereas clients diagnosed with dissociative amnesia are aware of their forgetfulness.
C)Clients diagnosed with dissociative amnesia assume a new identity, and clients diagnosed with dissociative fugue do not.
D)Clients diagnosed with dissociative amnesia usually recover completely, whereas clients diagnosed with dissociative fugue display residual effects.

Answer 1

Clients diagnosed with dissociative fugue are unaware of their memory loss, whereas clients diagnosed with dissociative amnesia are aware of their forgetfulness.

Question 2

A nurse is working with a client diagnosed with somatoform pain disorder. What predominant symptoms should a nurse expect to assess?

A)The client's predominant symptom focuses on discomfort in one or more anatomical sites.
B)The client's predominant symptom affects voluntary motor or sensory functioning.
C)The client's predominant symptom is the belief that the body is deformed or defective.
D)The client's predominant symptom is the preoccupation and fear of having a serious disease.

Answer 2

The client's predominant symptom focuses on discomfort in one or more anatomical sites.

Question 3

An inpatient client is newly diagnosed with dissociative identity disorder (DID) stemming for severe childhood sexual abuse. Which nursing intervention takes priority?

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

Answer 3

Establish trust and rapport

Question 4

A client is diagnosed with dissociative identity disorder (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 5

A client diagnosed with somatization disorder is most likely to exhibit which personality disorder characteristic?

A)Experiences intense and chaotic relationships with fluctuating attitudes toward others
B)Socially irresponsible, exploitative, guiltless, and disregards rights of others
C)Self-dramatizing, attention seeking, overly gregarious, and seductive
D)Uncomfortable in social situations, perceived as timid, withdrawn, cold, and strange

Question 6

Which are examples of primary and secondary gains that clients diagnosed with somatoform pain disorders may experience?

A)Primary: chooses to seek a new doctor; secondary: euphoric feeling from new medications
B)Primary: euphoric feeling from new medications; secondary: chooses to seek a new doctor
C)Primary: receives get-well messages; secondary: pain prevents attendance at family reunion
D)Primary: pain prevents attendance at family reunion; secondary: receives get-well messages

Question 7

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

A)"They express personal worthlessness through physical symptoms because physical problems are more acceptable than psychological problems."
B)"When the sick role relieves them from stressful situations, their physical symptoms are reinforced."
C)"They misinterpret and cognitively distort their physical symptoms."
D)"They tend to have a familial predisposition to this disorder."

Question 8

Which symptom exhibited by a client diagnosed with a conversion disorder would predict the poorest prognosis?

A)Seizures
B)Blindness
C)Aphonia
D)Paralysis

Question 9

A client is diagnosed with hypochondriasis. Which of the following symptoms is the client most likely to exhibit? (Select all that apply.)

A)Obsessive-compulsive traits
B)Pseudocyesis
C)Anxiety
D)Flat affect
E)Depression

Question 10

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.

Question 11

Which of the following combinations of somatoform disorder diagnoses and appropriate pharmacological treatment are correctly matched? (Select all that apply.)

A)Pain disorder treated with venlafaxine (Effexor)
B)Hypochondriasis treated with cefadroxil (Duricef)
C)Conversion disorder treated with cyclobenzaprine (Flexeril)
D)Body dysmorphic disorder treated with clomipramine (Anafranil)
E)Depersonalization treated with mometasone (Elocom)

Question 12

A client diagnosed with dissociative identity disorder (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 13

Which would be considered an appropriate outcome when planning care for an inpatient client diagnosed with somatization 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 14

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)"Have you taken any new medications recently?"
B)"Have you recently traveled 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 15

Which should the nurse recognize as an example of systematized 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.