A client presents with symptoms consistent with factitious disorder. Which of the following hypotheses should the nurse prioritize in the care of this client? (Select all that apply)
The client is seeking sympathy and pity from healthcare providers by feigning illness or injury.
The client is seeking attention and validation through inducing injury or illness.
The client's symptoms are the result of a misdiagnosis or medical error.
The client is seeking financial gain through feigning illness or injury.
The client is experiencing physical symptoms related to an underlying medical condition.
Correct Answer : A,B
Choice A reason:
This hypothesis aligns with the typical motivations seen in factitious disorder, where individuals intentionally produce or exaggerate symptoms of illness in themselves to receive attention, sympathy, and care from medical personnel¹. The nurse should prioritize understanding this behavior to manage the client's care effectively and to avoid unnecessary medical interventions.
Choice B reason:
Similar to choice A, individuals with factitious disorder may induce injury or illness to fulfill a psychological need for attention and validation. Recognizing this motivation is crucial for the nurse to provide appropriate psychological support and to prevent further self-harm.
Choice C reason:
While misdiagnosis or medical error can occur, this is not typically a hypothesis that should be prioritized in the care of a client with factitious disorder. The disorder involves intentional actions by the client, not errors by healthcare providers.
Choice D reason:
Seeking financial gain is more characteristic of malingering than factitious disorder. In factitious disorder, the primary motivation is psychological gratification from playing the patient role, rather than external incentives like financial gain.
Choice E reason:
Factitious disorder involves the intentional production of symptoms without an underlying medical condition. Therefore, this hypothesis would not be a priority in the care of a client with factitious disorder, as the symptoms are not related to a genuine medical condition but are self-induced.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason:
Supporting the client's attempt to rebuild damaged interpersonal relationships is an important long-term goal in the recovery process. However, it is not the immediate priority when a client is experiencing acute withdrawal symptoms, which can be life-threatening.
Choice B reason:
Educating the client about the effects of alcohol dependence and the need for rehabilitation is crucial for long-term recovery and preventing relapse. Nevertheless, during acute withdrawal, the priority is to manage the physical and psychological symptoms safely.
Choice C reason:
Teaching the client alternative strategies for managing anxiety is a valuable part of therapy and helps in long-term coping. However, during acute withdrawal, the client may not be able to learn or apply these strategies effectively due to the severity of their symptoms.
Choice D reason:
Preparing to administer Ativan as ordered is the priority action. Ativan (lorazepam) is a benzodiazepine commonly used to treat alcohol withdrawal symptoms. It helps to prevent seizures, reduce agitation, and manage other withdrawal symptoms. During the acute phase of alcohol withdrawal, maintaining physiological stability and ensuring the client's safety are the primary concerns.
Correct Answer is A
Explanation
Choice A reason:
Walking with the client at a gradually slower pace is a therapeutic technique that can help reduce anxiety. It allows the nurse to provide a calming presence and support while also helping to decrease the client's physical agitation in a controlled manner. This approach is non-confrontational and can be very effective in managing acute anxiety symptoms.
Choice B reason:
Having a staff member escort the client to her room might seem like a reasonable option, but it could be perceived as punitive or isolating, especially if the client is not posing a risk to themselves or others. It may also escalate the client's anxiety by making them feel confined or punished.
Choice C reason:
Instructing the client to sit down and stop pacing is not advisable as it may come across as dismissive of the client's distress. It could also increase the client's anxiety by making them feel that their coping mechanism (pacing) is not acceptable, which could lead to increased agitation or resistance.
Choice D reason:
Allowing the client to pace alone until physically tired is not the best option as it does not provide any direct support or intervention from the nurse. While pacing may be a self-soothing behavior, it does not address the underlying anxiety and could potentially lead to physical exhaustion without any emotional relief.
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