Deck 14: Somatic Symptom Disorders and Dissociative Disorders

Question 1

The nurse understands that the patient with somatic symptom disorder may have an increased sensitivity to pain. This explanation of the patient's symptoms is based in which domain?

A) Genetic domain
B) Biologic domain
C) Humanistic domain
D) Psychological domain

Answer 1

Biologic domain

Question 2

The nurse in a clinic is caring for a patient whom she suspects has a somatic symptom or related disorder. Which risk factors will the nurse include in the assessment? Select all that apply.

A) Female gender
B) High achieving
C) Lower socioeconomic status
D) Older age
E) Recently divorced

Answer 2

Lower socioeconomic status

Question 3

The nurse knows that which types of complementary and alternative therapy may be helpful for patients with dissociative identity disorder (DID)? Select all that apply.

A) Hypnosis
B) Art therapy
C) Music therapy
D) Dance therapy
E) Acupuncture

Answer 3

Hypnosis
Art therapy
Music therapy
Dance therapy

Question 4

The nurse is caring for a patient who is morbidly obese and who has been diagnosed with somatic symptom disorder. The patient history reveals that the patient's mother suffered from alcohol use disorder. Which domain does the nurse recognize as the most useful in explaining the patient's condition?

A) Cultural domain
B) Spiritual domain
C) Biological domain
D) Psychological domain

Question 5

The nurse is caring for a patient diagnosed with dissociative identity disorder (DID). Which statements by the patient best describes the manifestations of this disorder? Select all that apply.

A) "I feel like my body is here but my mind is not."
B) "I have chronic pain, not a psychological problem."
C) "I can't really find any words to describe my feelings."
D) "I sometimes feel like I am floating in the air looking down at myself."
E) "I cannot recall the events that happened during certain periods of time."

Question 6

The nurse is caring for a patient with somatic symptom disorder. What information is most important for the nurse to include in the report to the staff on the next shift?

A) The trigger for the patient's worries
B) The original source of the patient's anxiety
C) The amount of time the patient talked about physical complaints
D) The patient's use of abdominal breathing at the first sign of anxiety

Question 7

The nurse is caring for a 40-year-old patient suspected of having a somatic symptom or related disorder. Which symptoms within the psychological domain would suggest that the patient does not have a somatic symptom or related disorder? Select all that apply.

A) Hallucinations
B) Compulsions
C) Flashbacks
D) Irritability
E) Withdrawal

Question 8

Which nursing intervention helps promote stress reduction and healthy coping in a patient diagnosed with a dissociative disorder?

A) Perform safety checks at each health care interaction.
B) Discuss activities that patients can do that eliminate the need for safety provisions.
C) Review the patient's daily personal journal to assess appetite.
D) Teach nonpharmacologic strategies for reducing pain.

Question 9

The nurse is caring for a patient who has been diagnosed with a dissociative disorder after being missing for two weeks and returning home, not knowing any time had passed. The nurse recognizes the patient is experiencing which condition associated with dissociative disorders?

A) Fugue
B) Amnesia
C) Alexithymia
D) Derealization

Question 10

The nurse suspects that the patient who was brought to the emergency department (ED) because of what the family describes as "a sudden case of Alzheimer disease" may have general amnesia. Which characteristics make the nurse suspect general amnesia? Select all that apply.

A) The patient cannot remember any personal information.
B) The patient has been wandering away from home.
C) The patient describes a "detachment" from her mind.
D) The patient feelings of "disconnection" with her home.
E) The patient has developed an alternate personality.

Question 11

The nurse caring for a patient admitted with somatic symptom disorder questions the health care provider about which orders? Select all that apply.

A) Morphine 4 mg PO prn pain
B) Alprazolam 2 mg PO prn anxiety
C) Teach patient breathing techniques
D) Psychotherapy with family involvement
E) Walk 15-30 minutes per day in neighborhood

Question 12

The nurse is taking care of patient admitted with a diagnosis of dissociative identity disorder. The nurse knows that which symptoms differentiate dissociative disorders from somatic symptom disorder? Select all that apply.

A) Flashbacks
B) Self-mutilation
C) Dissociation
D) Struggling with faith
E) Lack of connectedness

Question 13

A patient suffering from dissociative identity disorder complains of intrusive thoughts. The anticipates an order for which medication?

A) Insulin
B) Epinephrine
C) Beta-blocker
D) Benzodiazepine

Question 14

A patient diagnosed with dissociative identity disorder is in the emergency department after attempting suicide. After a thorough assessment the nurse determines the attempted suicide was in response to which event?

A) Drug abuse and living homeless on streets
B) Childhood sexual abuse by biological father
C) Unidentified continuous abdominal and neck pain
D) Multiple somatic and psychological issues over the past 6 months

Question 15

The nurse is caring for a patient with dissociative identity disorder who has been admitted to the hospital for dehydration. Which question is the priority for including in the assessment?

A) "Do you remember what you were doing today?"
B) "Do you look in the mirror and not recognize yourself?"
C) "Do you ever think about harming yourself?"
D) "Do you find new things among your belongings that you don't recall obtaining?"

Question 16

The nurse taking care of a patient recently diagnosed with somatic symptom disorder knows that which biological symptoms are related to this disorder? Select all that apply.

A) Pain
B) Anxiety
C) Gastrointestinal distress
D) Paralysis
E) Blindness

Question 17

A patient has had what appeared to be an epileptic seizure; however, the patient's MRI and EEG results that do not show seizure activity. After a thorough assessment and appropriate tests by the patient's health care professional, the nurse begins to suspect which psychological disorder?

A) Factitious disorder
B) Conversion disorder
C) Illness anxiety disorder
D) Somatic symptom disorder

Question 18

A 29-year-old patient is admitted with nausea and diarrhea. She has not eaten anything since she learned her dog was hit by a car three days ago. She complains of "a migraine." The patient has a flat affect and her family says she "has not shed a tear." The patient is exhibiting which personality trait?

A) Negative Affectivity
B) Hypochondriasis
C) Dysthymia
D) Alexithymia

Question 19

When assessing patients with dissociative disorders, the nurse knows that which assessments are most important?

A) Pain, bowel sounds, behaviors
B) Anxiety, B12 level, heart sounds
C) LOC, patient safety, and level of anxiety
D) Facial expression, body image, pupillary reactivity

Question 20

The nurse knows that which modality is the best for patients with dissociative disorders?

A) Group therapy
B) Support groups
C) Individual psychotherapy
D) Dialectical behavior therapy

Question 21

What is the best action by the nurse to intervene effectively with patients who have been diagnosed with somatic symptom disorder?

A) Address patient's anxiety at a later time.
B) Help the patient express a decreased degree of comfort regarding physical symptoms.
C) Encourage the patient's expression of feelings symbolically through physical symptoms.
D) Recognize and understand the patient conceptualizes the symptoms to be physical in nature.

Question 22

The nurse taking care of a patient with a diagnosis of dissociative identity disorder is developing a plan of care. The nurse knows that which nursing diagnoses relate to the patient's diagnosis?

A) Nutrition, Impaired
B) Parenting, Impaired
C) Body Image, Disturbed
D) Pain, Related to violence

Question 23

When planning care for a client with somatic symptom disorder the nurse knows that which activity is the most important?

A) Determine patient needs in each of the five domains.
B) Determine patient willingness to try new interventions.
C) Review patient daily journal to obtain a realistic view of the patient's activities.
D) Encourage interactions with family and friends to keep the patient's mind off of somatic issues.

Question 24

What is the most appropriate initial nursing intervention, which promotes stress reduction and healthy coping in a patient who is diagnosed with a dissociative disorder?

A) Encourage the patient to increase contact with friends and family.
B) Disregard the patient's other personalities.
C) Help the patient create distance from family members who do not believe the patient is sick.
D) Determine patient's level of safety and encourage the patient to recognize triggers.