Psych Chapter 21

A client frequently reports abdominal pain, headaches, and fatigue. Diagnostic testing has not identified an underlying medical condition. The client is convinced the symptoms are real and is distressed by them. Which concept best describes this process?

Somatization

A nursing student is reviewing the three central features of somatic symptom illnesses. Which statement demonstrates correct understanding?

Psychological factors may initiate or worsen symptoms, which are not under the client's conscious control.

A client tells the nurse, "My stomach pain gets worse whenever I argue with my husband, but I know the pain is real." Which response is most appropriate?

"Emotional stress can affect physical symptoms. Let's discuss what happens when the pain gets worse."

A client with somatic symptom disorder has visited several health care providers and undergone numerous diagnostic procedures. The client continues to report physical complaints despite reassuring test results. Which nursing intervention is most appropriate?

Encourage the client to establish a consistent relationship with one health care provider.

A client reports persistent pain that interferes with employment, family responsibilities, and social activities. The health care team identifies psychological factors that contribute to the pain. Which disorder from the lecture notes is most applicable?

Somatic symptom disorder with pain as the predominant symptom

A client reports an inability to walk after experiencing a highly stressful event. Neurologic testing does not demonstrate a medical explanation for the motor deficit. Which disorder should the nurse recognize?

Functional neurologic symptom disorder

A client frequently checks the body for signs of disease and believes a mild headache may indicate a brain tumor. Medical evaluations have not identified a serious illness. Which disorder is most consistent with this presentation?

Illness anxiety disorder

A nurse is teaching a client about the difference between somatic symptom disorder and illness anxiety disorder. Which statement is most accurate?

Somatic symptom disorder involves physical symptoms, while illness anxiety disorder centers on fear or conviction of having a serious illness.

A client intentionally exaggerates back pain to obtain financial compensation after a workplace injury. Which condition does this behavior represent?

Malingering

A client intentionally creates symptoms to receive attention and assume the patient role. The client does not appear to have an external financial or legal incentive. Which disorder is most consistent with this behavior?

Factitious disorder

A caregiver repeatedly causes illness in a dependent child and brings the child to the hospital to receive attention from medical professionals. Which condition should the nurse suspect?

Factitious disorder imposed on another

A nurse is comparing somatic symptom disorder, malingering, and factitious disorder. Which statement is correct?

Malingering involves external incentives, while factitious disorder involves assuming the sick role.

A client reports chronic fatigue, dizziness, and abdominal discomfort. Repeated evaluations have not identified a medical diagnosis explaining the symptoms. Which term may be used to describe these complaints?

Medically unexplained symptoms

A client experiences frequent headaches during periods of family conflict. The client has difficulty discussing emotions and tends to keep feelings inside. Which psychosocial theory best explains this pattern?

Internalization of stress

A client tells the nurse, "I know I'm upset, but I honestly cannot explain what emotion I'm feeling." Which concept does this statement demonstrate?

Alexithymia

A client experiences abdominal discomfort whenever there is conflict at home. After resolving the conflict, the physical discomfort decreases. Which concept best explains this relationship?

Interpersonal conflict

A client with somatic symptoms reports that physical discomfort temporarily reduces feelings of anxiety related to a stressful situation. Which type of gain is occurring?

Primary gain

A client with somatic symptom disorder receives increased attention and assistance from family members whenever physical symptoms occur. Which concept does this represent?

Secondary gain

A client reports that minor muscle tightness feels extremely painful and disturbing. The client constantly focuses on the sensation. Which biologic theory best explains this experience?

Amplified sensory awareness

A client experiences worsening gastrointestinal symptoms during periods of acute stress. Which biologic concept is most closely associated with this finding?

Visceral hypersensitivity

A nurse is reviewing biologic theories of somatic symptom illnesses. Which statement best describes difficulty regulating and interpreting stimuli?

Clients have difficulty distinguishing relevant from irrelevant stimuli and may respond equally to both.

A client from Korea reports insomnia, fatigue, panic symptoms, and physical distress related to suppressed anger. Which cultural concept should the nurse recognize?

Hwa-Byung

A client from Southeast Asia expresses an intense fear that the penis is shrinking into the body. Which cultural concept is being described?

Koro

A male client from India is extremely concerned about losing semen and believes the loss is causing physical weakness. Which cultural concept should the nurse recognize?

Dhat

A nurse is caring for a client from a Portuguese Cape Verdean background who reports pain, numbness, and tremors. Which cultural concept may be relevant?

Sangue dormido

A client from China reports persistent physical and mental fatigue, dizziness, and headaches. Which cultural concept is associated with these symptoms?

Shenjing shuairuo

A nurse is assessing a client who recently immigrated to the United States and reports unusual physical sensations. Which action demonstrates culturally competent care?

Ask the client what the symptoms mean within their cultural and personal background.

A client with somatic symptom disorder becomes upset when the nurse suggests that stress may be contributing to physical symptoms. Which response is best?

"I understand that the symptoms are distressing. We can work together on ways to manage them."

A client with somatic symptom disorder spends most of each appointment discussing physical complaints. Which nursing intervention is most appropriate?

Set appropriate limits on symptom-focused discussion and redirect attention toward emotions, coping, and daily functioning.

A client with somatic symptom disorder says, "I feel overwhelmed, but I don't know how to explain what is bothering me." Which nursing intervention is most appropriate?

Encourage the client to identify and express emotions.

A nurse is teaching a client several coping strategies. Which activity is an example of emotion-focused coping?

Practicing progressive muscle relaxation

A client reports frequent physical symptoms related to unresolved problems at work. The nurse helps the client identify the problem, consider solutions, and evaluate possible consequences. Which coping approach is being used?

Problem-focused coping

A client with somatic symptom disorder is reluctant to participate in physical activity, stating, "I don't feel well enough to do anything." Which nursing intervention is most appropriate?

Encourage gradual participation in appropriate activities and reinforce progress.

A family member tells the nurse, "Whenever my mother complains of pain, we cancel everything and do all her responsibilities for her." Which teaching should the nurse provide?

Provide attention and positive reinforcement when the client participates

A client with chronic pain associated with somatic symptom disorder is referred to a chronic pain clinic. Which intervention should the nurse expect to be included in the treatment plan?

Visual imagery, relaxation techniques, and physical therapy