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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason:
When a client expresses thoughts of wanting to end their life, it is crucial for the nurse to immediately assess the risk of suicide. Asking the client if they have a plan to commit suicide is a direct approach to gauge the immediacy and seriousness of the risk. This information is vital for determining the next steps in care, which may include close supervision, safety precautions, and urgent psychiatric evaluation.
Choice B reason:
While ensuring the client is comfortable is important, allowing the client to rest without further assessment or intervention may not be safe if the client is at immediate risk of self-harm. The priority is to assess and secure the client's safety.
Choice C reason:
It is inappropriate and potentially dangerous to dismiss the client's statement as manipulation. All expressions of suicidal ideation should be taken seriously, and the nurse should provide a supportive response that addresses the client's emotional state and safety concerns.
Choice D reason:
Notifying the client's family can be part of a broader safety plan, but it should not replace immediate assessment and intervention by the healthcare team. Family members may provide support, but they are not a substitute for professional care and suicide risk assessment.
Correct Answer is B
Explanation
Choice A: Isolate the client for a period of time.
Isolation can lead to increased anxiety and may not be beneficial for a client with OCD. It does not address the underlying issue of the compulsive behaviors and may even exacerbate them.
Choice B: Plan the client's schedule to allow time for rituals.
This is generally the most effective approach. By allowing time for rituals, the nurse acknowledges the client's need for these behaviors and reduces anxiety. Over time, the goal would be to gradually reduce the time spent on these rituals as the client develops more effective coping strategies.
Choice C: Set strict limits on the behaviors so that the client can conform to the unit rules and schedules.
While it's important to have a structured environment, setting strict limits on compulsive behaviors can increase anxiety and resistance. It's more beneficial to work with the client to gradually decrease these behaviors rather than attempting to stop them abruptly.
Choice D: Confront the client about the senseless nature of the repetitive behaviors.
Confrontation is not typically helpful for clients with OCD. These clients are usually well aware that their behaviors are irrational, but they feel compelled to perform them anyway. Confrontation can lead to increased anxiety and defensiveness.
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