A client continually reports physical symptoms in the absence of objective clinical findings. The nurse should suspect which of the following disorders?

Dysthymia

Body dysmorphic disorder

Somatoform disorder

Major depressive disorder

Answer and Explanation

The Correct Answer is C

C Somatoform disorders are characterized by physical symptoms that suggest a medical condition but cannot be fully explained by a general medical condition, another mental disorder, or substance use. Individuals with somatoform disorders often experience distress or impairment due to these symptoms despite medical reassurance that no physical cause can be found.

A. Dysthymia is a type of persistent depressive disorder characterized by a depressed mood that lasts for at least two years. It typically involves emotional and behavioral symptoms rather than physical symptoms without clinical findings.

B. Body dysmorphic disorder involves a preoccupation with perceived defects or flaws in physical appearance that are not observable or appear slight to others. While it involves body image concerns, it does not manifest as physical symptoms in the absence of objective findings.

D. Major depressive disorder primarily involves mood disturbances such as sadness, loss of interest or pleasure, and changes in appetite or sleep. While physical symptoms like fatigue and changes in weight can occur, they are not typically reported persistently without objective clinical findings as seen in somatoform disorders.

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Correct Answer is D

Explanation

D. Denial is a defense mechanism where individuals refuse to acknowledge or accept a painful or distressing reality. In this case, despite objective medical evidence (biopsy results and MRI findings), the client persists in believing that the diagnosis of terminal cancer is incorrect. This refusal to accept the reality of the situation is characteristic of denial.

A. Anger typically involves feelings of frustration, resentment, or hostility towards others or the situation. While anger can be a reaction to receiving a terminal diagnosis, it is not reflective of refusing to accept the diagnosis itself.

B. Anxiety involves feelings of worry, fear, or unease about future events or uncertainties. While anxiety can accompany a terminal diagnosis, it does not manifest as outright refusal or disbelief in the diagnosis itself.

C. Withdrawal refers to a retreat or disengagement from social interactions or activities. It can be a coping mechanism in response to stress or difficult emotions. However, withdrawal does not specifically relate to refusing to accept a diagnosis like terminal cancer.

A. Make a contract with the client for weight gain. B. Initiate one-to-one nursing observation. C. Administer the Hamilton depression scale. D. Review the client's toxicology laboratory report.

Correct Answer is B

Explanation

B. This is the most appropriate initial action. One-to-one observation ensures constant monitoring of the client's safety and prevents further harm, such as another suicide attempt or self-harm. Given the client's history of depression and recent suicide attempt, ensuring their safety is paramount.

A. This option is not the first priority because while addressing anorexia nervosa is important, safety concerns related to the suicide attempt and potential substance abuse take precedence. Making a weight gain contract requires the client's cooperation and readiness, which may not be feasible immediately upon admission.

C. While assessing the severity of depression is crucial, it is secondary to ensuring immediate safety in this context. The client's safety must be established first through continuous observation and intervention.

D. While important to understand the substances involved in the suicide attempt, this action is secondary to ensuring ongoing safety through direct observation. Toxicology results can guide subsequent treatment decisions but are not as urgent as immediate safety measures.

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A client continually reports physical symptoms in the absence of objective clinical findings. The nurse should suspect which of the following disorders?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A hospitalized client is told that he has terminal cancer. The client adamantly believes that the physician is wrong despite biopsy results and MRI findings. This is an example of which of the following?

Correct Answer is D

Explanation

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Correct Answer is B

Explanation

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