MH Exam #3 (17, 21, 27) questions
with correct answers
Chapter 17: Somatic Symptom Disorders - correct answer ✔✔ Keeping' our shit together thru
Q4!
1. Which assessment data would help the health care team distinguish symptoms of conversion
(functional neurological) disorder from symptoms of illness anxiety disorder (hypochondriasis)?
a. Voluntary control of symptoms
b. Patient's style of presentation
c. Results of diagnostic testing
d .The role of secondary gains - correct answer ✔✔ ANS: B
Patients with illness anxiety disorder (hypochondriasis) tend to be more anxious about their
concerns and display more obsessive attention to detail, whereas the patients with conversion
(functional neurological) disorder often exhibit less concern with the symptom they are
presenting than would be expected. Neither disorder involves voluntary control of the
symptoms. Results of diagnostic testing for both would be negative (i.e., no physiological basis
would be found for the symptoms). Secondary gains can occur in both disorders but are not
necessary to either. See relationship to audience response question.
2. Which prescription medication would the nurse expect to be prescribed for a patient
diagnosed with a somatic symptom disorder?
Narcotic analgesics for use as needed for acute pain
Antidepressant medications to treat co-morbid depression
Long-term use of benzodiazepines to support coping with anxiety
Conventional antipsychotic medications to correct cognitive distortions - correct answer ✔✔
ANS: B
,Various types of antidepressants may be helpful in somatic disorders not only directly by
reducing depressive symptoms and hence somatic responses, but also indirectly by affecting
nerve circuits that affect not only mood but also fatigue, pain perception, GI distress, and other
somatic symptoms. Patients may benefit from short-term use of antianxiety medication
(benzodiazepines) but require careful monitoring because of risks of dependence. Conventional
antipsychotic medications would not be used, although selected atypical antipsychotics may be
useful. Narcotic analgesics are not indicated.
A medical-surgical nurse works with a patient diagnosed with a somatic symptom 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. - correct answer ✔✔ ANS: B
Patients with somatic symptom disorders go from one health care provider to another trying to
establish a physical cause for their symptoms. When a psychological basis is suggested and a
referral for counseling offered, these patients reject both.
A patient has blindness related to conversion (functional neurological) disorder but is
unconcerned about this problem. Which understanding should guide the nurse's planning for
this patient?
A. The patient is suppressing accurate feelings regarding the problem.
B. The patient's anxiety is relieved through the physical symptom.
C. The patient's optic nerve transmission has been impaired.
D. The patient will not disclose genuine fears. - correct answer ✔✔ ANS: B
Psychoanalytical theory suggests conversion reduces anxiety through production of a physical
symptom symbolically linked to an underlying conflict. Conversion, not suppression, is the
operative defense mechanism in this disorder. While some MRI studies suggest that patients
with conversion disorder have an abnormal pattern of cerebral activation, there is no actual
alternation of nerve transmission. The other distracters oversimplify the dynamics, suggesting
that only dependency needs are of concern, or suggest conscious motivation (conversion
operates unconsciously).
,A patient has blindness related to conversion (functional neurological) 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 self after explaining arrangement of the food on the tray.
C. direct the patient to locate items on the tray independently and feed self.
D. address needs of other patients in the dining room, then feed this patient. - correct answer
✔✔ ANS: B
The patient is expected to maintain some level of independence by feeding self, while the nurse
is supportive in a matter-of-fact way. The distracters support dependency or offer little support.
A patient with blindness related to conversion (functional neurological) disorder says, "All the
doctors and nurses in the hospital stop by often to check on me. Too bad people outside the
hospital don't find me as interesting." Which nursing diagnosis is most relevant?
A. Social isolation
B. Chronic low self-esteem
C. Interrupted family processes
D. Ineffective health maintenance - correct answer ✔✔ ANS: B
The patient mentions that the symptoms make people more interested. This indicates that the
patient feels 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.
To assist patients diagnosed with somatic symptom disorders, nursing interventions of high
priority
A. explain the pathophysiology of symptoms.
B. help these patients suppress feelings of anger.
C. shift focus from somatic symptoms to feelings.
D. investigate each physical symptom as it is reported. - correct answer ✔✔ ANS: C
, Shifting the focus from somatic symptoms to feelings or to neutral topics conveys interest in the
patient as a person rather than as a condition. The need to gain attention with the use of
symptoms is reduced over the long term. A desired outcome would be that the patient would
express feelings, including anger if it is present. Once physical symptoms are investigated, they
do not need to be reinvestigated each time the patient reports them.
A patient with fears of serious heart disease was referred to the mental health center by a
cardiologist. Extensive diagnostic evaluation showed no physical illness. The patient says, "My
chest is tight, and my heart misses beats. I'm often absent from work. I don't go out much
because I need to rest." Which health problem is most likely? a. Dysthymic disorder
Somatic symptom disorder
Antisocial personality disorder
Illness anxiety disorder (hypochondriasis) - correct answer ✔✔ ANS: D
Illness anxiety disorder (hypochondriasis) involves preoccupation with fears of having a serious
disease even when evidence to the contrary is available. The preoccupation causes impairment
in social or occupational functioning. Somatic symptom disorder involves fewer symptoms.
Dysthymic disorder is a disorder of lowered mood. Antisocial disorder applies to a personality
disorder in which the individual has little regard for the rights of others. See relationship to
audience response question.
A nurse assessing a patient diagnosed with a somatic symptom disorder is most likely to note
that the patient
A. sees a relationship between symptoms and interpersonal conflicts.
B. has little difficulty communicating emotional needs to others.
C. rarely derives personal benefit from the symptoms.
D. has altered comfort and activity needs. - correct answer ✔✔ ANS: D
The patient frequently has altered comfort and activity needs associated with the symptoms
displayed (fatigue, insomnia, weakness, tension, pain, etc.). In addition, hygiene, safety, and
security needs may also be compromised. The patient is rarely able to see a relation between
symptoms and events in his or her life, which is readily discernible to health professionals.
Patients with somatic symptom disorders often derive secondary gain from their symptoms
with correct answers
Chapter 17: Somatic Symptom Disorders - correct answer ✔✔ Keeping' our shit together thru
Q4!
1. Which assessment data would help the health care team distinguish symptoms of conversion
(functional neurological) disorder from symptoms of illness anxiety disorder (hypochondriasis)?
a. Voluntary control of symptoms
b. Patient's style of presentation
c. Results of diagnostic testing
d .The role of secondary gains - correct answer ✔✔ ANS: B
Patients with illness anxiety disorder (hypochondriasis) tend to be more anxious about their
concerns and display more obsessive attention to detail, whereas the patients with conversion
(functional neurological) disorder often exhibit less concern with the symptom they are
presenting than would be expected. Neither disorder involves voluntary control of the
symptoms. Results of diagnostic testing for both would be negative (i.e., no physiological basis
would be found for the symptoms). Secondary gains can occur in both disorders but are not
necessary to either. See relationship to audience response question.
2. Which prescription medication would the nurse expect to be prescribed for a patient
diagnosed with a somatic symptom disorder?
Narcotic analgesics for use as needed for acute pain
Antidepressant medications to treat co-morbid depression
Long-term use of benzodiazepines to support coping with anxiety
Conventional antipsychotic medications to correct cognitive distortions - correct answer ✔✔
ANS: B
,Various types of antidepressants may be helpful in somatic disorders not only directly by
reducing depressive symptoms and hence somatic responses, but also indirectly by affecting
nerve circuits that affect not only mood but also fatigue, pain perception, GI distress, and other
somatic symptoms. Patients may benefit from short-term use of antianxiety medication
(benzodiazepines) but require careful monitoring because of risks of dependence. Conventional
antipsychotic medications would not be used, although selected atypical antipsychotics may be
useful. Narcotic analgesics are not indicated.
A medical-surgical nurse works with a patient diagnosed with a somatic symptom 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. - correct answer ✔✔ ANS: B
Patients with somatic symptom disorders go from one health care provider to another trying to
establish a physical cause for their symptoms. When a psychological basis is suggested and a
referral for counseling offered, these patients reject both.
A patient has blindness related to conversion (functional neurological) disorder but is
unconcerned about this problem. Which understanding should guide the nurse's planning for
this patient?
A. The patient is suppressing accurate feelings regarding the problem.
B. The patient's anxiety is relieved through the physical symptom.
C. The patient's optic nerve transmission has been impaired.
D. The patient will not disclose genuine fears. - correct answer ✔✔ ANS: B
Psychoanalytical theory suggests conversion reduces anxiety through production of a physical
symptom symbolically linked to an underlying conflict. Conversion, not suppression, is the
operative defense mechanism in this disorder. While some MRI studies suggest that patients
with conversion disorder have an abnormal pattern of cerebral activation, there is no actual
alternation of nerve transmission. The other distracters oversimplify the dynamics, suggesting
that only dependency needs are of concern, or suggest conscious motivation (conversion
operates unconsciously).
,A patient has blindness related to conversion (functional neurological) 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 self after explaining arrangement of the food on the tray.
C. direct the patient to locate items on the tray independently and feed self.
D. address needs of other patients in the dining room, then feed this patient. - correct answer
✔✔ ANS: B
The patient is expected to maintain some level of independence by feeding self, while the nurse
is supportive in a matter-of-fact way. The distracters support dependency or offer little support.
A patient with blindness related to conversion (functional neurological) disorder says, "All the
doctors and nurses in the hospital stop by often to check on me. Too bad people outside the
hospital don't find me as interesting." Which nursing diagnosis is most relevant?
A. Social isolation
B. Chronic low self-esteem
C. Interrupted family processes
D. Ineffective health maintenance - correct answer ✔✔ ANS: B
The patient mentions that the symptoms make people more interested. This indicates that the
patient feels 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.
To assist patients diagnosed with somatic symptom disorders, nursing interventions of high
priority
A. explain the pathophysiology of symptoms.
B. help these patients suppress feelings of anger.
C. shift focus from somatic symptoms to feelings.
D. investigate each physical symptom as it is reported. - correct answer ✔✔ ANS: C
, Shifting the focus from somatic symptoms to feelings or to neutral topics conveys interest in the
patient as a person rather than as a condition. The need to gain attention with the use of
symptoms is reduced over the long term. A desired outcome would be that the patient would
express feelings, including anger if it is present. Once physical symptoms are investigated, they
do not need to be reinvestigated each time the patient reports them.
A patient with fears of serious heart disease was referred to the mental health center by a
cardiologist. Extensive diagnostic evaluation showed no physical illness. The patient says, "My
chest is tight, and my heart misses beats. I'm often absent from work. I don't go out much
because I need to rest." Which health problem is most likely? a. Dysthymic disorder
Somatic symptom disorder
Antisocial personality disorder
Illness anxiety disorder (hypochondriasis) - correct answer ✔✔ ANS: D
Illness anxiety disorder (hypochondriasis) involves preoccupation with fears of having a serious
disease even when evidence to the contrary is available. The preoccupation causes impairment
in social or occupational functioning. Somatic symptom disorder involves fewer symptoms.
Dysthymic disorder is a disorder of lowered mood. Antisocial disorder applies to a personality
disorder in which the individual has little regard for the rights of others. See relationship to
audience response question.
A nurse assessing a patient diagnosed with a somatic symptom disorder is most likely to note
that the patient
A. sees a relationship between symptoms and interpersonal conflicts.
B. has little difficulty communicating emotional needs to others.
C. rarely derives personal benefit from the symptoms.
D. has altered comfort and activity needs. - correct answer ✔✔ ANS: D
The patient frequently has altered comfort and activity needs associated with the symptoms
displayed (fatigue, insomnia, weakness, tension, pain, etc.). In addition, hygiene, safety, and
security needs may also be compromised. The patient is rarely able to see a relation between
symptoms and events in his or her life, which is readily discernible to health professionals.
Patients with somatic symptom disorders often derive secondary gain from their symptoms
