Foundations of Psychiatric Mental Health Nursing A Clinical Approach, 5th Edition by Elizabeth M. Varcarolis
Foundations of Psychiatric Mental Health Nursing A Clinical Approach, 5th Edition by Elizabeth M. Varcarolis
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Chapter 15: Somatoform and Dissociative Disorders
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
MULTIPLE CHOICE
1) The medical-surgical nurse working with a client who has a somatoform disorder will find planning is facilitated by the understanding that the client will probably
| A. | readily seek psychiatric counseling. |
| B. | be difficult to convince to seek psychiatric help. |
| C. | attend psychotherapy sessions without encouragement. |
| D. | be eager to discover the true reasons for his or her physical symptoms. |
ANS: B
Clients with somatoform disorders go from doctor to doctor trying to establish a physical cause for their symptoms. When a psychological basis is suggested and a referral for counseling is offered, these clients reject both. Thus, options A, C, and D are incorrect.
DIF: Cognitive Level: Application REF: Text Page: 258, Text Page: 262
TOP: Nursing Process: Planning MSC: NCLEX: Psychosocial Integrity
2) A client has been diagnosed as having blindness related to conversion disorder. She displays indifference regarding the conversion symptom. The nurse states “I can’t understand why the client doesn’t seem more anxious about her symptom.” The understanding that should guide planning is that the
| A. | client is suppressing her true feelings. |
| B. | client’s anxiety has been relieved through the physical symptom. |
| C. | client’s needs are met during hospitalization, so she has no need to be anxious. |
| D. | client does not wish to display her actual fear. |
ANS: B
Psychoanalytical theory suggests conversion reduces anxiety through production of a physical symptom that is symbolically linked to an underlying conflict. Option A: Conversion, not suppression, is the operative defense mechanism in this disorder. Option C: This explanation oversimplifies the dynamics, suggesting that only dependency needs are of concern. Option D: This option suggests conscious motivation, but conversion operates unconsciously.
DIF: Cognitive Level: Application REF: Text Page: 259
TOP: Nursing Process: Planning MSC: NCLEX: Psychosocial Integrity
3) A client has blindness related to conversion disorder. To help the client eat, the nurse should
| A. | establish a “buddy” system with other clients who can feed the client at each meal. |
| B. | expect the client to feed self after explaining the arrangement of the food on the tray. |
| C. | see to the needs of other clients in the dining room, then feed this client. |
| D. | direct the client to locate items on the tray independently and feed self unassisted. |
ANS: B
The client is expected to maintain some level of independence by feeding self, while the nurse is supportive in a matter-of-fact way. Options A and C support dependency. Option D offers little support.
DIF: Cognitive Level: Application REF: Text Page: 262
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
4) A client with blindness related to conversion disorder tells the nurse “I’m really popular here in the hospital. Lots of doctors and nurses stop by to check on my blindness and the other patients are really interested in it, too. Too bad people outside the hospital don’t find me so interesting.” On the basis of this statement, the nurse should continue to gather assessment data to support the nursing diagnosis of
| A. | social isolation. |
| B. | chronic low self-esteem. |
| C. | interrupted family processes. |
| D. | ineffective health maintenance. |
ANS: B
The client mentions that her symptoms make her more interesting to people, inferring that 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 the scenario.
DIF: Cognitive Level: Analysis REF: Text Page: 256, Text Page: 257
TOP: Nursing Process: Nursing Diagnosis
MSC: NCLEX: Psychosocial Integrity
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