Question 1

The client is exhibiting symptoms of generalized amnesia. Which questions should the nurse ask to help confirm this diagnosis? (Select all that apply.)

Accepted Answer

Generalized amnesia can be associated with new medications, traumatic events, or a history of memory problems. These questions help identify potential causes or contributing factors.

Question 2

Which are examples of primary and secondary gains that a client diagnosed with SSD: predominately pain, may experience?

Accepted Answer

Primary gain refers to the direct internal benefits of symptoms, such as relief from anxiety or conflict, which in this case is avoiding a stressful family reunion. Secondary gain refers to external benefits, such as attention or support from others, exemplified by receiving get-well cards.

Question 3

The DSM-5 diagnosis of functional neurological symptom disorder can also be identified as ___________________ disorder.

Accepted Answer

conversion

Question 4

The nurse discovers the client purposefully inserted a contaminated catheter into the urethra, leading to a urinary tract infection. The nurse recognizes this behavior as characteristic of which mental disorder?

Accepted Answer

The behavior of purposely inserting a contaminated catheter into the urethra is characteristic of factitious disorder, also known as Munchausen syndrome. In this disorder, the individual intentionally causes or fabricates physical or psychological symptoms for the purpose of assuming the sick role and receiving attention or sympathy. The individual may go to extreme lengths to achieve this, as seen in this scenario. Illness anxiety disorder involves excessive preoccupation with having or acquiring a serious illness, while functional neurological symptom disorder involves physical symptoms that are not fully explained by medical conditions. Depersonalization-derealization disorder involves feelings of detachment from oneself or the surrounding world.

Question 5

Neurological tests have ruled out pathology in a client's sudden lower-extremity paralysis. Which action would the nurse take?

Accepted Answer

The answer of Neurological tests have ruled out pathology in...

Question 6

Which finding would alert the nurse that a client is exhibiting selective amnesia?

Accepted Answer

Selective amnesia is the inability to recall specific memories while other memories are intact. Option B demonstrates this by stating that the client can remember driving to Iowa but cannot remember the car accident, indicating selective amnesia. Option A relates to global amnesia, option C relates to intact cognition, and option D relates to difficulty with recent memory or potentially a dissociative disorder.

Question 7

The client is diagnosed with functional neurological symptom disorder. Which symptoms would the nurse most likely observe? (Select all that apply.)

Accepted Answer

Functional neurological symptom disorder, also known as conversion disorder, involves neurological symptoms that cannot be explained by medical evaluation. Anosmia (loss of smell), Akinesia (loss of voluntary movement), and Aphonia (loss of voice) are common symptoms. Abreaction and Amnesia are more related to psychological conditions rather than conversion disorder.

Question 8

Which statement by the nurse indicates a correct understanding of psychopharmacology for somatic disorders?

Accepted Answer

Selective serotonin reuptake inhibitors (SSRIs) are commonly used to treat somatoform disorders with comorbid depression, as they can improve both depressive and somatic symptoms. However, it is worth noting that somatoform disorders can be complex and require an individualized approach to treatment. The use of medications such as benzodiazepines or intravenous antidepressants for other somatoform disorders is less established and may not be appropriate in all cases.

Question 9

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

Accepted Answer

Establishing trust and rapport is the top priority for a newly diagnosed client with DID. Trust is paramount for the therapeutic relationship to be effective, and is particularly important in cases where the client has experienced severe trauma. Only when trust is established can exploration of past abuse and other therapeutic interventions begin.

Question 10

The nurse is assessing a client diagnosed with somatic symptom disorder (SSD). Which findings would the nurse expect to observe?

Accepted Answer

Somatic symptom disorder (SSD) is a psychological disorder that involves physical symptoms that are not fully explained by a medical condition. Clients with SSD are often anxious, seek out multiple health-care providers simultaneously, overmedicate, and complain of vague symptoms. They do not intentionally pretend to be ill or inflict self-injury, nor do they typically exhibit multiple personalities, depersonalization, derealization, or hallucinations. Aphonia, la belle indifference, and paralysis with no physical reason are more commonly associated with conversion disorder.

Question 11

Which outcome would the nurse add to the plan of care for an inpatient client diagnosed with somatic symptom disorder (SSD)?

Accepted Answer

The goal for a client with somatic symptom disorder is to develop adaptive coping strategies to manage stress, rather than focusing on the fabrication of symptoms or maintaining reality, which are not typical issues in SSD.

Question 12

The client is diagnosed with illness anxiety disorder (IAD). Which symptoms would the client most likely exhibit? (Select all that apply.)

Accepted Answer

The answer of The client is diagnosed with illness anxiety...

Question 13

The nursing instructor is teaching about the DSM-5 diagnostic criteria for depersonalization-derealization disorder. Which student statement indicates a need for follow-up instruction?

Accepted Answer

The statement "During the course of this disorder, the client is out of touch with reality" is incorrect, as depersonalization-derealization disorder does not involve a complete loss of touch with reality. The disorder is characterized by feelings of unreality or detachment, but the individual is still aware of their surroundings and can distinguish between what is real and what is not.

Question 14

The nurse is working with a client diagnosed with somatic symptom disorder (SSD). Which distinguishing criterion is present in SSD but absent in illness anxiety disorder (IAD)?

Accepted Answer

Somatic symptom disorder (SSD) is characterized by significant physical symptoms that cause distress and impairment, while illness anxiety disorder (IAD) is characterized by anxiety about acquiring an illness, but with no or mild physical symptoms present. Therefore, experiencing significant physical symptoms is a distinguishing criterion present in SSD but absent in IAD.

Question 15

The nurse is caring for a client diagnosed with dissociative identity disorder (DID). What is the primary goal of therapy for this client?

Accepted Answer

The primary goal of therapy for a client with dissociative identity disorder (DID) is to collaborate among subpersonalities to improve functioning. This is achieved through the integration of the different identities or subpersonalities into one cohesive personality, allowing the client to have a more stable sense of identity and reduce symptoms such as memory gaps, mood changes, and amnesia. Therapy may include techniques such as cognitive-behavioral therapy, hypnosis, and psychoeducation. The other options provided, such as recovering memories, preventing social isolation, and decreasing anxiety and need for secondary gain, may be part of the overall treatment plan for the client with DID, but they do not represent the primary goal of therapy.

Question 16

Which criteria according to the DSM-5 would need to be present for a client to be diagnosed with dissociative fugue?

Accepted Answer

Dissociative fugue is characterized by sudden unexpected travel or bewildered wandering, often with the inability to recall important autobiographical information. Clinically significant distress in social and occupational functioning may be present, but it is not a specific criterion for this diagnosis. "Blackouts" related to alcohol toxicity refer to a substance-induced disorder and are not part of the criteria for dissociative fugue.

Question 17

The client diagnosed with dissociative identity disorder (DID) switches personalities when confronted by the nurse about inappropriate actions. The nurse recognizes that this dissociation serves which function?

Accepted Answer

Dissociation in DID serves to isolate painful events so that the person's awareness and anxiety are decreased. This allows the person to avoid the distress associated with traumatic events and protects them from overwhelming emotions. Switching personalities may be triggered by internal or external stressors, such as the nurse confronting the client about inappropriate actions. The purpose of the switch is to shift attention away from the distressing situation and protect the person from further psychological harm. Secondary gain, exploring guilt, and establishing personality boundaries are not primary functions of dissociation in DID.

Question 18

The nurse is teaching about the etiology of illness anxiety disorder (IAD) from a psychodynamic perspective. Which statement by a staff member about clients diagnosed with this disorder indicates that learning has occurred?

Accepted Answer

This statement reflects the psychodynamic view that individuals with IAD use physical symptoms as a means of expressing psychological distress, as physical problems are often viewed as more acceptable than psychological problems.

Quiz 20: Somatic Symptom and Dissociative Disorders