Chapter 20: Somatic Symptom and Dissociative Disorders

Chapter 20: Somatic Symptom and Dissociative Disorders

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____     1.   A client diagnosed with somatic symptom disorder (SSD) is most likely to exhibit which personality disorder characteristics?

1.	Experiences intense and chaotic relationships with fluctuating attitudes toward others
2.	Socially irresponsible, exploitative, guiltless, and disregards rights of others
3.	Self-dramatizing, attention seeking, overly gregarious, and seductive
4.	Uncomfortable in social situations, perceived as timid, withdrawn, cold, and strange

 

 

____     2.   A nurse is working with a client diagnosed with SSD. What criteria would differentiate this diagnosis from illness anxiety disorder (IAD)?

1.	The client diagnosed with SSD experiences physical symptoms in various body systems, and the client diagnosed with IAD does not.
2.	The client diagnosed with SSD experiences a change in the quality of self-awareness, and the client diagnosed with IAD does not.
3.	The client diagnosed with SSD disorder has a perceived disturbance in body image or appearance, and the client diagnosed with IAD does not.
4.	The client diagnosed with SSD only experiences anxiety about the possibility of illness, and the client diagnosed with IAD does not.

 

 

____     3.   Which would be considered an appropriate outcome when planning care for an inpatient client diagnosed with SSD?

1.	The client will admit to fabricating physical symptoms to gain benefits by day three.
2.	The client will list three potential adaptive coping strategies to deal with stress by day two.
3.	The client will comply with medical treatments for physical symptoms by day three.
4.	The client will openly discuss physical symptoms with staff by day four.

 

 

____     4.   Which are examples of primary and secondary gains that clients diagnosed with SSD: predominately pain, may experience?

1.	Primary: chooses to seek a new doctor; Secondary: euphoric feeling from new medications
2.	Primary: euphoric feeling from new medications; Secondary: chooses to seek a new doctor
3.	Primary: receives get-well cards; Secondary: pain prevents attending stressful family reunion
4.	Primary: pain prevents attending stressful family reunion; Secondary: receives get-well cards

 

 

____     5.   A nursing instructor is teaching about the etiology of IAD from a psychodynamic perspective. What student statement about clients diagnosed with this disorder indicates that learning has occurred?

1.	“They tend to have a familial predisposition to this disorder.”
2.	“When the sick role relieves them from stressful situations, their physical symptoms are reinforced.”
3.	“They misinterpret and cognitively distort their physical symptoms.”
4.	“They express personal worthlessness through physical symptoms, because physical problems are more acceptable than psychological problems.”

 

MULTIPLE CHOICE

 

1. ANS:  3

Chapter: Chapter 20, Somatic Symptom and Dissociative Disorders

Objective: Describe various types of somatic symptom and dissociative disorders and identify symptomatology associated with each; use this information in client assessment.

Page: 506

Heading: Application of the Nursing Process > Somatic Symptom Disorder

Integrated Processes: Nursing Process

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Analysis [Analyzing]

Concept: Patient-Centered Care

Difficulty: Moderate

 

	Feedback
1	The client is not likely to experience intense and chaotic relationships.
2	The client is not likely to be socially irresponsible or exploitive.
3	The nurse should anticipate that a client diagnosed with SSD would be self-dramatizing, attention seeking, and overly gregarious. It has been suggested that, in somatic symptom disorder, there may be some overlapping of personality characteristics and features associated with histrionic personality disorder. These symptoms include heightened emotionality, impressionistic thought and speech, seductiveness, strong dependency needs, and a preoccupation with symptoms and oneself.
4	The client is not likely to be perceived as timid or withdrawn.

 

 

PTS:   1                    CON:  Patient-Centered Care

 

2. ANS:  1

Chapter: Chapter 20, Somatic Symptom and Dissociative Disorders

Objective: Describe various types of somatic symptom and dissociative disorders and identify symptomatology associated with each; use this information in client assessment.

Page: 505

Heading: Epidemiological Statistics

Integrated Processes: Assessment

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Analysis [Analyzing]

Concept: Patient-Centered Care

Difficulty: Moderate

 

	Feedback
1	Individuals experiencing somatic symptoms without corroborating pathology are considered to have SSD, and those with minimal or no somatic symptoms would be diagnosed with IAD, a diagnosis new to the DSM-5.
2	Clients with IAD experience a change in self-awareness
3	Clients with IAD experience a change in body image.
4	Clients with SSD experience corroborating pathology.

 

 

PTS:   1                    CON:  Patient-Centered Care

 

3. ANS:  2

Chapter: Chapter 20, Somatic Symptom and Dissociative Disorders

Objective: Describe various types of somatic symptom and dissociative disorders and identify symptomatology associated with each; use this information in client assessment.

Page: 515–518

Heading: Table 20-2 Care Plan for the Client with a Somatic Symptom Disorder

Integrated Processes: Nursing Process

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application [Applying]

Concept: Patient-Centered Care

Difficulty: Moderate

 

	Feedback
1	The client is experiencing real symptoms and is not likely to admit to fabricating symptoms.
2	The nurse should determine that an appropriate outcome for a client diagnosed with SSD would be for the client to list three potential adaptive coping strategies to deal with stress by day two.
3	The outcome may not be realistic for this client, and may require more time.
4	This outcome may not be realistic for the client.

 

 

PTS:   1                    CON:  Patient-Centered Care

 

4. ANS:  4

Chapter: Chapter 20, Somatic Symptom and Dissociative Disorders

Objective: Describe various types of somatic symptom and dissociative disorders and identify symptomatology associated with each; use this information in client assessment.

Page: 506

Heading: Application of the Nursing Process > Somatic Symptom Disorder

Integrated Processes: Nursing Process

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Analysis [Analyzing]

Concept: Patient-Centered Care

Difficulty: Moderate

 

	Feedback
1	Choosing a new doctor and euphoric feelings do not accurately describe primary and secondary gains for this client.
2	These feelings listed do not accurately describe primary and secondary gains for this client.
3	The primary and secondary gains listed do not accurately describe primary and secondary gains for this client.
4	The nurse should identify that primary gains are those that allow the client to avoid an unpleasant activity (stressful family reunion) and that secondary gains are those in which the client receives emotional support or attention (get-well cards).

 

 

PTS:   1                    CON:  Patient-Centered Care

 

5. ANS:  4

Chapter: Chapter 20, Somatic Symptom and Dissociative Disorders

Objective: Describe various types of somatic symptom and dissociative disorders and identify symptomatology associated with each; use this information in client assessment.

Page: 506–507

Heading: Application of the Nursing Process > Illness Anxiety Disorder

Integrated Processes: Nursing Process

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application [Applying]

Concept: Patient-Centered Care

Difficulty: Moderate

 

	Feedback
1	These clients do not tend to have familial disposition for the disorder.
2	Physical symptoms are not reinforced when the sick role relieves them from stressful situations.
3	They do not misinterpret or cognitively distort their physical symptoms.
4	The nurse should understand that from a psychoanalytical perspective, IAD occurs because physical problems are more acceptable than psychological problems.

 

 

PTS:   1                    CON:  Patient-Centered Care