C HAPTER 17: S OMATIC S YMPTOM D ISORDERS
Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: 8th Edition
MULTIPLE CHOICE
1. Which comment by a patient who recentl y experienced a m yocardial
infarction indicates use of maladaptive, ineffective coping strategies?
a. My employer should have paid for a health club membership for me.
b. My famil y will see me through this. It wont be easy, but I will never
be alone.
c. My heart attack was no fun, but it showed me up the importance of a
good diet and more exercise.
d. I accept that I have heart disease. Now I need to decide if I will be
able to continue m y work dail y.
ANS: A
Blaming someone else and rationalizing o nes failure to exercise are not
adaptive coping strategies. Seeing the glass as half full, using social
and religious supports, and confronting ones situation are seen as more
effective strategies. The distracters demonstrate effective coping
associated with a serious medical condition.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 317 TOP: Nursing Process: Assessment MSC:
Client Needs: Psychosocial Integrit y
,2. A nurse assesses a patient diagnosed with conversion (functional
neurological) disord er. Which comment is most likel y from this patient?
a. Since m y father died, I’ve been short of breath and had sharp pains
that go down m y left arm, but I think its just indigestion.
b. I have dail y problems with nausea, vomiting, and diarrhea. My skin
is very dry, and I think Im getting seriously dehydrated.
c. Sexual intercourse is painful. I pretend as if I ’m asleep so I can
avoid it. I think its starting to cause problems with m y marriage.
d. I get choked very easil y and have trouble swallowing when I eat. I
think I might have cancer of the esophagus.
ANS: A
Patients with conversion (functional neurological) disorder
demonstrate a lack of concern regarding the seriousness of symptoms.
This lack of concern is termed la belle indiffrence. There is also a
specific, i dentifiable cause for the development of the symptoms; in
this instance, the death of a parent would precipitate stress. The
distracters relate to sexual dysfunction and illness anxiet y disorder.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 316 TOP: Nursing Process: Assessment MSC:
Client Needs: Psychosocial Integrit y
3. A patient who experienced a m yocardial infarction was transferred from
critical care to a step -down unit. The patient then used the call bell every
15 minutes for minor requests and complaints. Staff nurses reported
feeling inadequate and unable to satisfy the patients needs. When the
nurse manager intervenes directl y with this patient, which comment is
most therapeutic?
, a. I’m wondering if you are feeling anxious about your illness and
being left alone.
b. The staff are concerned that you are not satisfied with the care you
are receiving.
c. Let’s talk about why you use your call light so frequentl y. It is a
problem.
d. You frustrate the staff by calling them so often. Why are you doing
that?
ANS: A
This patient is experiencing anxiet y associated with a serious medical
condition. Verbalization is an effective outlet for anxiet y. Im
wondering if you are anxious focuses on the emotions underl ying the
behavior rather than the behavior itself. This opening conveys the
nurses willingness to listen to the patients feelings and an
understanding of the commonl y seen concern about not having a nurse
always nearby as in the intensive care unit. The other options focus on
the behavior or its impact on nursing and do not help the patient with
her emotional needs.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 317 TOP: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
4. A patient reports fears of having cervical cancer a nd says to the nurse, Ive
had Pap smears by six different doctors. The results were normal, but Im
sure thats because of errors in the laboratory. Which disorder would the
nurse suspect?
a. Conversion (functional neurological) disorder
b. Illness anxiet y disorde r (hypochondriasis)
Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: 8th Edition
MULTIPLE CHOICE
1. Which comment by a patient who recentl y experienced a m yocardial
infarction indicates use of maladaptive, ineffective coping strategies?
a. My employer should have paid for a health club membership for me.
b. My famil y will see me through this. It wont be easy, but I will never
be alone.
c. My heart attack was no fun, but it showed me up the importance of a
good diet and more exercise.
d. I accept that I have heart disease. Now I need to decide if I will be
able to continue m y work dail y.
ANS: A
Blaming someone else and rationalizing o nes failure to exercise are not
adaptive coping strategies. Seeing the glass as half full, using social
and religious supports, and confronting ones situation are seen as more
effective strategies. The distracters demonstrate effective coping
associated with a serious medical condition.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 317 TOP: Nursing Process: Assessment MSC:
Client Needs: Psychosocial Integrit y
,2. A nurse assesses a patient diagnosed with conversion (functional
neurological) disord er. Which comment is most likel y from this patient?
a. Since m y father died, I’ve been short of breath and had sharp pains
that go down m y left arm, but I think its just indigestion.
b. I have dail y problems with nausea, vomiting, and diarrhea. My skin
is very dry, and I think Im getting seriously dehydrated.
c. Sexual intercourse is painful. I pretend as if I ’m asleep so I can
avoid it. I think its starting to cause problems with m y marriage.
d. I get choked very easil y and have trouble swallowing when I eat. I
think I might have cancer of the esophagus.
ANS: A
Patients with conversion (functional neurological) disorder
demonstrate a lack of concern regarding the seriousness of symptoms.
This lack of concern is termed la belle indiffrence. There is also a
specific, i dentifiable cause for the development of the symptoms; in
this instance, the death of a parent would precipitate stress. The
distracters relate to sexual dysfunction and illness anxiet y disorder.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 316 TOP: Nursing Process: Assessment MSC:
Client Needs: Psychosocial Integrit y
3. A patient who experienced a m yocardial infarction was transferred from
critical care to a step -down unit. The patient then used the call bell every
15 minutes for minor requests and complaints. Staff nurses reported
feeling inadequate and unable to satisfy the patients needs. When the
nurse manager intervenes directl y with this patient, which comment is
most therapeutic?
, a. I’m wondering if you are feeling anxious about your illness and
being left alone.
b. The staff are concerned that you are not satisfied with the care you
are receiving.
c. Let’s talk about why you use your call light so frequentl y. It is a
problem.
d. You frustrate the staff by calling them so often. Why are you doing
that?
ANS: A
This patient is experiencing anxiet y associated with a serious medical
condition. Verbalization is an effective outlet for anxiet y. Im
wondering if you are anxious focuses on the emotions underl ying the
behavior rather than the behavior itself. This opening conveys the
nurses willingness to listen to the patients feelings and an
understanding of the commonl y seen concern about not having a nurse
always nearby as in the intensive care unit. The other options focus on
the behavior or its impact on nursing and do not help the patient with
her emotional needs.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 317 TOP: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
4. A patient reports fears of having cervical cancer a nd says to the nurse, Ive
had Pap smears by six different doctors. The results were normal, but Im
sure thats because of errors in the laboratory. Which disorder would the
nurse suspect?
a. Conversion (functional neurological) disorder
b. Illness anxiet y disorde r (hypochondriasis)
