1.
The term used to explain physical complaints and symptoms that are expressed because of psychologic stress is what?
A) Hysteria
B) Somatization
C) Psychophysiologic
D) Somatoform
2.
A 36-year-old male comes to the clinic complaining of severe headaches. After assessing the client and reviewing test results, the physician finds no physical cause for the headaches. The physician believes that the client has a psychophysiologic syndrome. What is the client getting from the attention of the health care workers?
A) Displacement of anxiety
B) Primary gain
C) Secondary gain
D) Repression of trauma
3.
A client is seen in the outpatient clinic for the first time. When reviewing the history, the nurse notes that the client has a long history of being seen by many different doctors. The client has also had multiple exploratory surgeries with nothing found to cause the clients problem. What would the nurse suspect of this patient?
A) A slow growing cancer
B) Hypochondriasis
C) A central nervous system disorder
D) A somatoform disorder
4.
What symptoms would a client with a somatoform disorder complain of? (Mark all that apply.)
A) At least two gastrointestinal symptoms
B) Severe headaches and visual problems
C) Pain in at least four different locations
D) A sexual or reproductive problem
E) Flatus and diarrhea
5.
A client with somatoform disorder is commonly found to be what?
A) Depressed
B) Delusional
C) Demyelinated
D) Deceptive
6.
A client with somatoform disorder has become enraged with his coworker. What would be a common threat for the client to make in order to manipulate his coworker into meeting his needs?
A) Quitting his job
B) Going on a hunger strike
C) To kill himself
D) To kill someone else
7.
You are researching somatoform disorder for your mental health nursing class. What ethnic populations would you find this disorder is most prevalent in?
A) Greek and Hispanic
B) Spanish and Puerto Rican
C) Hispanic and Arabic
D) Greek and Puerto Rican
8.
A client with somatoform disorder has been admitted to the inpatient unit of the local hospital. The nurse would know to assess for what other personality disorder that is often seen in these clients?
A) Borderline
B) Paranoid
C) Histrionic
D) Hypochondria
9.
A mental health nurse working with somatoform clients knows that primary care physicians are an important part of these clients treatment. Why does a trusting relationship need to be fostered between the client and the primary care physician?
A) To provide medical input into the care plan
B) To prevent the pattern of repeat medical treatment by a series of physicians
C) To prevent adverse interactions in pharmacotherapy
D) To provide support to the clients and their support system
10.
As a mental health nurse practitioner, you are treating a client with a somatoform disorder and a comorbidity of depression. You know that this patient will most likely benefit from what?
A) Reassurance that there is no serious medical reason for the symptoms
B) Psychotherapy
C) An antidepressant
D) An antianxiety agent
11.
What alternative therapies have been found helpful for some patients with somatoform disorders? (Mark all that apply.)
A) Pharmacotherapy
B) Massage therapy
C) Herbal medicine
D) Meditation
E) Group therapy
12.
When taking a health history on a new client with a somatoform disorder, what is it that is most important to elicit?
A) Any familial diseases
B) Any genetic diseases
C) Any surgical procedures
D) Any pattern of repeated complaints
13.
When writing a care plan for a client with a somatoform disorder, what nursing diagnosis would most likely be included?
A) Self-esteem disturbance, related to repressed unmet dependency needs and unsatisfactory interpersonal relationships
B) Sexual dysfunction, related to an inability to feel pleasure
C) Self-care deficit, related to loss of function
D) Chronic pain, related to severe physical ailment
14.
You are updating a care plan for a client with a somatoform disorder. What outcome would you expect to have met before the client is discharged from the hospital?
A) Demonstrates the use of manipulative behavior to secure attention
B) Expresses positive feelings about self
C) Verbalizes minor body defects and related feelings
D) Performs self-care needs with assistance
15.
A mental health nurse practitioner has a client with a somatoform disorder. This client is being seen on an outpatient basis. What is a realistic outcome the nurse practitioner would expect of this client near the end of the nursepatient relationship?
A) Expresses feelings of pain and distress
B) Verbalizes alteration in physical functioning
C) Discusses present health problem with health care provider and family
D) Acknowledges physical pain
16.
You are caring for a client with a conversion disorder. What would be an appropriate nursing diagnosis for this client?
A) Sleep pattern disturbance, related to sleep apnea
B) Self-esteem disturbance, related to repressed unmet dependency needs and unsatisfactory interpersonal relationships
C) Body image disturbance, related to severe anxiety or low self-esteem
D) Self-care deficit, related to perceived loss of function or paralysis of body part
17.
What would be your first nursing intervention when caring for a client with a somatoform disorder?
A) Establishing a trusting relationship
B) Providing a comfortable environment
C) Identifying positive feelings that the client may have
D) Helping the client face his or her responsibilities
18.
You are caring for a client who is exhibiting psychophysiologic behaviors. What would be an important nursing intervention for you to use?
A) Encourage confrontation concerning the psychologic defense nature of the symptoms.
B) Respond to the client with understanding and patience.
C) Identify fulfilled dependency needs of the client.
D) Maximize time and attention given to physical symptoms.
19.
You are admitting a client to the clinic who exhibits psychophysiologic behaviors. What nursing intervention would be appropriate to use with this patient?
A) Confront the client when he or she exhibits psychophysiologic behaviors.
B) Recognize that the physical complaints are phantom to the client even though supportive medical evidence is lacking.
C) Remember that the client is not consciously trying to be sick or avoid responsibilities.
D) Observe behaviors unrelated to current illness.
20.
The mental health nurse is caring for a client with psychophysiologic behaviors. What would be an important intervention for the nurse with this client?
A) Encourage confrontation concerning the psychologic defense nature of the symptoms.
B) Encourage the client to use physical means to express feelings.
C) Maximize the time and attention given to physical symptoms.
D) Continue to monitor physical complaints to assist in ruling out any actual cause for the symptoms.
21.
When evaluating the nursing interventions used with a client exhibiting psychophysiologic behaviors, what is the nurses focus?
A) The clients ability to recognize the underlying psychologic stress and anxiety
B) The clients ability to decrease the manipulative behavior
C) The clients ability to perform self-care activities independently and willingly
D) The clients ability to verbalize the physical deficits
22.
A client diagnosed with conversion disorder may exhibit what?
A) Severe pain
B) Munchausen syndrome
C) La belle indifference
D) Physician-shopping
23.
What somatoform disorder is considered to be a chronic condition with an onset in the late teens, have intermittent reoccurrence over a lifetime, and occur with equal prevalence in both men and women?
A) Body dysmorphic disorder
B) Hypochondriasis
C) Pain disorder
D) Conversion disorder
24.
A father brings his 10-year-old daughter to see the pediatrician for complaints that lead to a differential diagnosis of somatoform disorder. The father tells the pediatrician that the childs mother was diagnosed with somatoform disorder 18 months ago. Why might this child adopt familial patterns of behavior?
A) To be more like her mother
B) So her daddy will love her as much as he loves her mother
C) To gain the attention of others in the family
D) To be loved more than her siblings
25.
An adolescent has been diagnosed with conversion disorder and is being seen in the local mental health clinic. The clients mother asks the nurse what the prognosis for this disorder is. What would be the nurses best response?
A) Unfortunately, this disorder tends to recur in times of severe stress.
B) Most clients recover in 2 to 4 weeks without reoccurrence.
C) Most clients recover in 8 to 12 weeks without reoccurrence.
D) Unfortunately, most patients never truly recover from this disorder.
26.
A client is being admitted to the psychiatric unit with a somatoform disorder. When assessing the client, what should the nurse be sure to assess?
A) Whether the persons lifestyle has improved
B) Previous coping skills
C) Any behavior that indicates independence
D) Is the client aware of events surrounding the disappearance of symptoms
27.
When assessing a client with a somatoform disorder, how would the mental health nurse assess the clients secondary gains?
A) By asking questions concerning the type and amount of medications the client is taking
B) By asking questions to elicit any pattern of repeated complaints by taking a history of current and past health status
C) By asking questions concerning any previous work or activity the client used to be able to do that he or she is unable to perform as a result of the symptoms
D) By asking questions concerning physical complaints
28.
An 18-year-old girl is diagnosed with body dysmorphic disorder. She has perceived her breasts as being too small. What symptoms would this client exhibit?
A) A sedentary lifestyle
B) Periods of checking and attempting to alter the defect
C) Seeing the flaw as slight
D) Feeling that they are one of a kind
29.
A 13-year-old boy is brought to the emergency department by his parents because he has lost the use of his right upper extremity. After medical testing, the physician tells the parents that there is no neurologic reason that can be found for the clients loss of functioning. The parents ask the nurse to explain what this means. What would be the nurses best response?
A) The actual conversion aspect of this disorder refers to the transfer of psychologic conflict or stressors into a perceived paralysis of body parts or sensory functioning.
B) This is not an unusual occurrence in an adolescent when there is trouble in the home.
C) Usually there are related stress or trauma factors that have occurred concurrently with the onset of the symptoms.
D) These types of disease processes are considered pseudoneurologic, or false neurologic.
30.
A 24-year-old female client presents at the clinic with specific complaints of a physical illness. This is the 5th time in 5 months this client has been seen. The nurse identifies what signs and symptoms that indicate hypochondriasis? (Mark all that apply.)
A) Concerns continue despite medical testing and reassurance that a disease does not exist
B) Multiple symptoms that begin before age 30 and extend over a period of years
C) Creates enough distress to cause difficulty in social or work-related functioning over a period of 6 months or more
D) Also referred to as Briquets syndrome
E) An excessive fear or preoccupation with having a serious illness that is based on a misinterpretation of somatic signs and symptoms
Answer Key
1.
B
2.
C
3.
D
4.
A, C, D
5.
A
6.
C
7.
D
8.
A
9.
B
10.
C
11.
B, C, D
12.
D
13.
A
14.
B
15.
C
16.
D
17.
A
18.
B
19.
C
20.
D
21.
A
22.
C
23.
A
24.
C
25.
B
26.
B
27.
C
28.
B
29.
D
30.
A, C, E
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