Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Compare and contrast the biopsychosocial characteristics of various dissociative, somatoform, and factitious disorders.

Question 6

Type: MCSA

The nurse would teach the adolescent with a conversion disorder what the person gets from having the disorder. This explanation would include a discussion of:

1. Preoccupation with the belief that the person has a serious disease without physical evidence.

2. Primary and secondary gains.

3. An overreaction by caregivers to the clients somatic complaints.

4. A pain cure.

Correct Answer: 2

Rationale 1: Primary and secondary gains are the two mechanisms thought to explain what a person gets from a conversion disorder. An overreaction by caregivers to the clients somatic complaints addresses somatization disorder. A pain cure would be discussed with a paindisordered person. Hypochondriasis is a persons preoccupation with the belief that the person has a serious disease without physical evidence.

Rationale 2: Primary and secondary gains are the two mechanisms thought to explain what a person gets from a conversion disorder. An overreaction by caregivers to the clients somatic complaints addresses somatization disorder. A pain cure would be discussed with a paindisordered person. Hypochondriasis is a persons preoccupation with the belief that the person has a serious disease without physical evidence.

Rationale 3: Primary and secondary gains are the two mechanisms thought to explain what a person gets from a conversion disorder. An overreaction by caregivers to the clients somatic complaints addresses somatization disorder. A pain cure would be discussed with a paindisordered person. Hypochondriasis is a persons preoccupation with the belief that the personhas a serious disease without physical evidence.

Rationale 4: Primary and secondary gains are the two mechanisms thought to explain what a person gets from a conversion disorder. An overreaction by caregivers to the clients somatic complaints addresses somatization disorder. A pain cure would be discussed with a paindisordered person. Hypochondriasis is a persons preoccupation with the belief that the person has a serious disease without physical evidence.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Compare and contrast the biopsychosocial characteristics of various dissociative, somatoform, and factitious disorders.

Question 7

Type: MCSA

A 24-year-old client with body dysmorphic disorder (BDD) tells the nurse that he plans to have a surgical procedure that will affect his appearance. The nurse understands that this plan is an effort to:

1. Suppress intrusive thoughts.

2. Deal with multiple physical complaints.

3. Treat associated depression.

4. Cure the imagined defect.

Correct Answer: 4

Rationale 1: Clients with BDD may use cosmetic surgery to cure the imagined defect. Cosmetic surgery does not treat associated depression, deal with multiple physical complaints, or suppress intrusive thoughts.

Rationale 2: Clients with BDD may use cosmetic surgery to cure the imagined defect. Cosmetic surgery does not treat associated depression, deal with multiple physical complaints, or suppress intrusive thoughts.

Rationale 3: Clients with BDD may use cosmetic surgery to cure the imagined defect. Cosmetic surgery does not treat associated depression, deal with multiple physical complaints, or suppress intrusive thoughts.

Rationale 4: Clients with BDD may use cosmetic surgery to cure the imagined defect. Cosmetic surgery does not treat associated depression, deal with multiple physical complaints, or suppress intrusive thoughts.

Global Rationale:

Cognitive Level: Creating

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Compare and contrast the biopsychosocial characteristics of various dissociative, somatoform, and factitious disorders.

Question 8

Type: MCSA

The client states that she has been ill and in pain since childhood. Her many symptoms are not caused intentionally, nor are they feigned. She has seen many doctors. Consistent with this clients disorder, the nurse believes the pain the client experiences is:

1. Fake.

2. Exaggerated.

3. Real.

4. For attention.

Correct Answer: 3

Rationale 1: This client has somatization disorder and is genuinely experiencing pain. It is not fake or for attention as with factitious disorders, or exaggerated.

Rationale 2: This client has somatization disorder and is genuinely experiencing pain. It is not fake or for attention as with factitious disorders, or exaggerated.

Rationale 3: This client has somatization disorder and is genuinely experiencing pain. It is not fake or for attention as with factitious disorders, or exaggerated.

Rationale 4: This client has somatization disorder and is genuinely experiencing pain. It is not fake or for attention as with factitious disorders, or exaggerated.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Compare and contrast the biopsychosocial characteristics of various dissociative, somatoform, and factitious disorders.

Question 9

Type: MCSA

The nurse is working with a client who is being admitted to the psychiatricmental health unit. The client was missing for two weeks and returned home not knowing any time had passed. Which of the following dissociative disorders has this client experienced?

1. Amnesia

2. Depersonalization disorder

3. Fugue

4. Dissociative identity disorder (DID)

Correct Answer: 3

Rationale 1: A person with dissociative fugue wanders, usually far from home and for days, perhaps even weeks or months, at a time. During this period, clients completely forget their past life and associations; but unlike people with amnesia, they are unaware of having forgotten anything. When they return to their former consciousness, they do not remember the period of fugue.

Rationale 2: A person with dissociative fugue wanders, usually far from home and for days, perhaps even weeks or months, at a time. During this period, clients completely forget theirpast life and associations; but unlike people with amnesia, they are unaware of having forgotten anything. When they return to their former consciousness, they do not remember the period of fugue.

Rationale 3: A person with dissociative fugue wanders, usually far from home and for days, perhaps even weeks or months, at a time. During this period, clients completely forget their past life and associations; but unlike people with amnesia, they are unaware of having forgotten anything. When they return to their former consciousness, they do not remember the period of fugue.

Rationale 4: A person with dissociative fugue wanders, usually far from home and for days, perhaps even weeks or months, at a time. During this period, clients completely forget theirpast life and associations; but unlike people with amnesia, they are unaware of having forgotten anything. When they return to their former consciousness, they do not remember the period of fugue.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Compare and contrast the biopsychosocial characteristics of various dissociative, somatoform, and factitious disorders.

Question 10

Type: MCSA

The nurse is caring for a client with a history of admissions to several hospitals over the last several years. Each hospitalization was for a different disorder in which there was no physical evidence. The medical record indicates the client is a pathological liar. Which of the following disorders does the client suffer from?

1. A somatoform disorder

2. Factitious disorder by proxy

3. Adult factitious disorder

4. Dissociative identity disorder

Correct Answer: 3

Rationale 1: When the disorder is severe, chronic, and unremittinginvolving repeated hospitalizations, traveling between health care providers and health care facilities, and pathological lying of an intriguing and fantastic nature (termed pseudologica fantastica)it is often referred to as Munchausen syndrome or adult factitious disorder (AFD). Factitious disorder by proxy sometimes called Munchausen by proxy syndrome(MBPS) occurs when parents or caregivers deliberately induce signs of an illness in another person, usually their own child. There is no evidence the client is suffering from dissociative identity disorder or a somatoform disorder.

Rationale 2: When the disorder is severe, chronic, and unremittinginvolving repeated hospitalizations, traveling between health care providers and health care facilities, and pathological lying of an intriguing and fantastic nature (termed pseudologica fantastica)it is often referred to as Munchausen syndrome or adult factitious disorder (AFD). Factitious disorder by proxy sometimes called Munchausen by proxy syndrome(MBPS) occurs when parents or caregivers deliberately induce signs of an illness in another person, usually their own child. There is no evidence the client is suffering from dissociative identity disorder or a somatoform disorder.

Rationale 3: When the disorder is severe, chronic, and unremittinginvolving repeated hospitalizations, traveling between health care providers and health care facilities, and pathological lying of an intriguing and fantastic nature (termed pseudologica fantastica)it is often referred to as Munchausen syndrome or adult factitious disorder (AFD). Factitious disorder by proxy sometimes called Munchausen by proxy syndrome(MBPS) occurs when parents or caregivers deliberately induce signs of an illness in another person, usually their own child. There is no evidence the client is suffering from dissociative identity disorder or a somatoform disorder.

Rationale 4: When the disorder is severe, chronic, and unremittinginvolving repeated hospitalizations, traveling between health care providers and health care facilities, and pathological lying of an intriguing and fantastic nature (termed pseudologica fantastica)it is often referred to as Munchausen syndrome or adult factitious disorder (AFD). Factitious disorder by proxy sometimes called Munchausen by proxy syndrome(MBPS) occurs when parents or caregivers deliberately induce signs of an illness in another person, usually their own child. There is no evidence the client is suffering from dissociative identity disorder or a somatoform disorder.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Compare and contrast the biopsychosocial characteristics of various dissociative, somatoform, and factitious disorders.

Question 11

Type: MCSA

The nurse is caring for a client with somatization disorder. When providing a report to the staff on the next shift, it is important for the nurse to relate the:

1. Amount of time the client talked about physical complaints.

2. Trigger for the clients worries.

3. Use of abdominal breathing at the first sign of anxiety.

4. The clients source of the original anxiety.

Correct Answer: 1

Rationale 1: Somatization disorder deals with physical problems that are found to have no organic basis. The amount of time the client talked about physical complaints is crucial to evaluate whether the client meets the goal of decreasing that time. The use of abdominal breathing at the first sign of anxiety, the clients source of the original anxiety, and the trigger for the clients worries are not priorities with somatization disorders.

Rationale 2: Somatization disorder deals with physical problems that are found to have no organic basis. The amount of time the client talked about physical complaints is crucial to evaluate whether the client meets the goal of decreasing that time. The use of abdominal breathing at the first sign of anxiety, the clients source of the original anxiety, and the trigger for the clients worries are not priorities with somatization disorders.

Rationale 3: Somatization disorder deals with physical problems that are found to have no organic basis. The amount of time the client talked about physical complaints is crucial to evaluate whether the client meets the goal of decreasing that time. The use of abdominal breathing at the first sign of anxiety, the clients source of the original anxiety, and the trigger for the clients worries are not priorities with somatization disorders.

Rationale 4: Somatization disorder deals with physical problems that are found to have no organic basis. The amount of time the client talked about physical complaints is crucial to evaluate whether the client meets the goal of decreasing that time. The use of abdominal breathing at the first sign of anxiety, the clients source of the original anxiety, and the trigger for the clients worries are not priorities with somatization disorders.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: Differentiate among somatoform disorders, factitious disorders, and malingering.

Question 12

Type: MCSA

An 18-year-old client who joined the military shortly after graduating from high school is admitted to the mental health unit for depression and suicidal ideation. He tells the nurse the military is not what he expected and he wants to go home. The nurse observes a variance in affect between his interaction with peers and staff. The nurse suspects:

1. Conversion disorder.

2. Factitious disorder.

3. Malingering.

4. Body dysmorphic disorder.

Correct Answer: 3

Rationale 1: Malingering describes a person deliberately faking symptoms; it is usuallyadopted to obtain a secondary gain. Factitious disorder describes a person assuming a sick role by intentionally producing or feigning illness. People with body dysmorphic disorder are preoccupied by an imagined defect. A person with a conversion disorder will report impaired physical function related to the expression of a psychologic conflict.

Rationale 2: Malingering describes a person deliberately faking symptoms; it is usuallyadopted to obtain a secondary gain. Factitious disorder describes a person assuming a sick role by intentionally producing or feigning illness. People with body dysmorphic disorder are preoccupied by an imagined defect. A person with a conversion disorder will report impaired physical function related to the expression of a psychologic conflict.

Rationale 3: Malingering describes a person deliberately faking symptoms; it is usually adopted to obtain a secondary gain. Factitious disorder describes a person assuming a sick role by intentionally producing or feigning illness. People with body dysmorphic disorder are preoccupied by an imagined defect. A person with a conversion disorder will report impaired physical function related to the expression of a psychologic conflict.

Rationale 4: Malingering describes a person deliberately faking symptoms; it is usually adopted to obtain a secondary gain. Factitious disorder describes a person assuming a sick role by intentionally producing or feigning illness. People with body dysmorphic disorder are preoccupied by an imagined defect. A person with a conversion disorder will report impaired physical function related to the expression of a psychologic conflict.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Differentiate among somatoform disorders, factitious disorders, and malingering.

Question 13

Type: MCSA

A client is certain she has cancer and peritonitis despite her doctors reassurance she does not. She most likely is experiencing:

1. Malingering.

2. Conversion disorder.

3. Hypochondriasis.

4. Factitious disorder.

Correct Answer: 3

Rationale 1: This client is preoccupied with the belief she has a serious illness that is not medically present; this is hypochondriasis. Malingering describes a person deliberatelyfaking symptoms and usually results in a secondary gain. Factitious disorder describes a person who assumes a sick role by intentionally producing or feigning illness. A person with conversion disorder will report impaired physical function related to the expression of a psychological conflict.

Rationale 2: This client is preoccupied with the belief she has a serious illness that is not medically present; this is hypochondriasis. Malingering describes a person deliberatelyfaking symptoms and usually results in a secondary gain. Factitious disorder describes a person who assumes a sick role by intentionally producing or feigning illness. A person with conversion disorder will report impaired physical function related to the expression of a psychological conflict.

Rationale 3: This client is preoccupied with the belief she has a serious illness that is not medically present; this is hypochondriasis. Malingering describes a person deliberatelyfaking symptoms and usually results in a secondary gain. Factitious disorder describes a person who assumes a sick role by intentionally producing or feigning illness. A person with conversion disorder will report impaired physical function related to the expression of a psychological conflict.

Rationale 4: This client is preoccupied with the belief she has a serious illness that is not medically present; this is hypochondriasis. Malingering describes a person deliberatelyfaking symptoms and usually results in a secondary gain. Factitious disorder describes a person who assumes a sick role by intentionally producing or feigning illness. A person with conversion disorder will report impaired physical function related to the expression of a psychological conflict.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: