Chapter 11: Somatoform, Factitious, and Dissociative Disorders

Chapter 11: Somatoform, Factitious, and Dissociative Disorders

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. Which question would the nurse performing an admission interview for a patient with suspected dissociative amnesia disorder identify as a priority?

ANS: D

Due to a recent increase in reported cases of dissociative amnesia involving previously forgotten early childhood memories, assessing such memories would have priority with this patient. Obsessive-compulsive disorder is not generally viewed as a co-morbid disorder of dissociative amnesia. The remaining options would not provide much specific information for this patient’s condition.

DIF:   Cognitive Level: Application        REF:  Page 209

TOP:  Nursing Process: Assessment        MSC: NCLEX: Psychosocial Integrity

2. Which nursing assessment finding would support a diagnosis of somatoform disorder?

ANS: D

The diagnosis of somatization disorder requires that symptoms indicate there is involvement of multiple organ systems (e.g., gastrointestinal, reproductive, neurologic). Structural anomalies would indicate a medical problem exists. An early onset of symptoms (prior to age 30) is not recognized as a criterion for the diagnosis. A family history of depression is not a criterion for the diagnosis.

DIF:   Cognitive Level: Application        REF:  Page 209

TOP:  Nursing Process: Assessment        MSC: NCLEX: Psychosocial Integrity

3. To differentiate between somatoform and conversion disorders, the nurse will direct the assessment to determine the presence of the critical defining factor associated with conversion disorder. Which is true about a conversion reaction?

ANS: C

Symbolic psychological factors are identified as being related to the onset or exacerbation of a conversion symptom. An absence of a medical cause is present in both the case of conversion and somatization disorders. The conversion symptom is not limited to pain or sexual function nor is not under voluntary control.

DIF:   Cognitive Level: Application        REF:  Page 210

TOP:  Nursing Process: Assessment        MSC: NCLEX: Psychosocial Integrity

4. A diagnosis of dissociative identity disturbance has been identified for a patient who has stated that he is unable to distinguish between himself and his surroundings. What is an appropriate outcome for this patient?

ANS: B

Dissociative identity disturbance is exacerbated when the patient’s anxiety escalates. Identification of increasing anxiety permits the patient to exercise anxiety-management strategies and prevent dissociation. The patient should be expressing such feelings to others. The patient should refer to himself in the first person. Use of manipulative behavior is not desirable in this or any other patient.

DIF:   Cognitive Level: Application        REF:  Page 215        TOP:  Nursing Process: Planning

MSC: NCLEX: Psychosocial Integrity