Chapter 12: Somatoform Disorders and Dissociative Disorders

Chapter 12: Somatoform Disorders and Dissociative Disorders

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A medical-surgical nurse works with a patient diagnosed with a somatic system disorder. Care planning is facilitated by understanding that the patient will probably:

a.	Readily seek psychiatric counseling.
b.	Be resistant to accepting psychiatric help.
c.	Attend psychotherapy sessions without encouragement.
d.	Be eager to discover the true reasons for physical symptoms.

 

 

ANS:  B

Patients with somatic system disorders go from physician to physician trying to establish a physical cause for their symptoms. When a psychologic basis is suggested and a referral for counseling is offered, these patients reject both.

 

DIF:    Cognitive Level: Application           REF:   Page: 191       TOP:   Nursing Process: Planning

MSC:  NCLEX: Psychosocial Integrity

 

2. A patient has blindness related to a functional neurological (conversion) disorder but is unconcerned about this problem. Which understanding should guide the nurse’s planning for this patient? The patient is:

a.	suppressing accurate feelings regarding the problem.
b.	relieving anxiety through the physical symptom.
c.	meeting needs through hospitalization.
d.	refusing to disclose genuine fears.

 

 

ANS:  B

Psychoanalytic theory suggests conversion reduces anxiety through the production of a physical symptom that is symbolically linked to an underlying conflict. Conversion, not suppression, is the operative defense mechanism in this disorder. The other distracters oversimplify the dynamics, suggesting that only dependency needs are of concern, or suggest conscious motivation (conversion operates unconsciously).

 

DIF:    Cognitive Level: Application           REF:   Pages: 193-196

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

 

3. A patient has blindness related to a functional neurological (conversion) disorder. To help the patient eat, the nurse should:

a.	establish a “buddy” system with other patients who can feed the patient at each meal.
b.	expect the patient to feed him- or herself after explaining the arrangement of the food on the tray.
c.	direct the patient to locate items on the tray independently and feed self unassisted.
d.	address the needs of other patients in the dining room, and then feed this patient.

 

 

ANS:  B

The patient is expected to maintain some level of independence by feeding him- or herself, whereas the nurse is supportive in a matter-of-fact way. The distracters support dependency or offer little support.

 

DIF:    Cognitive Level: Application           REF:   Page: 196|Pages: 198-199

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

 

4. A patient with blindness related to a functional neurological (conversion) disorder says, “All the doctors and nurses in this hospital stop by often to check on me. Too bad people outside the hospital don’t find me interesting.” Which nursing diagnosis is most relevant?

a.	Social isolation
b.	Chronic low self-esteem
c.	Interrupted family processes
d.	Ineffective health maintenance

 

 

ANS:  B

The patient mentions that the symptoms make people more interested, which indicates that the patient believes he or she is uninteresting and unpopular without the symptoms, thus supporting the nursing diagnosis of Chronic low self-esteem. Defining characteristics for the other nursing diagnoses are not present in this scenario.

 

DIF:    Cognitive Level: Analysis                REF:   Page: 197

TOP:   Nursing Process: Diagnosis| Nursing Process: Analysis

MSC:  NCLEX: Psychosocial Integrity