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Chapter 29 somatic symptom dissociative disorder 1) A client diagnosed with somatic symptom disorder is most likely to exhibit which personality disorder characteristics? A

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Chapter 29 somatic symptom dissociative disorder

1) 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D. Uncomfortable in social situations; perceived as timid, withdrawn, cold, and strange

2. A nurse is working with a client diagnosed with somatic symptom disorder. What predominant symptoms should a nurse expect to assess?

A. Disproportionate and persistent thoughts about the seriousness of ones symptoms

B. Amnestic episodes in which the client is pain free

C. Excessive time spent discussing psychosocial stressors

D. Lack of physical symptoms

3. Which would be 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.

4. 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. Carlys 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.

5. 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.

6. An inpatient client is newly diagnosed with dissociative identity disorder (DID) stemming from 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

7. 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.

8. 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

9. 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 ones 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.

10. 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.

11. Neurological tests have ruled out pathology in a clients 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.

12. 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 that develop conversion disorder symptoms without a precipitating stressful event.

D. Technically, he could walk now since he is intentionally feigning paralysis.

13. 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

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. 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?

15. 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.