A client with somatic symptom disorder reports experiencing chest pain to the nurse. Which action should the nurse take?

Administer a PRN analgesic to the client.

Further assess the client's pain and vital signs.

Ask if the client to compare this pain to the pain in the past.

Remind the client that the symptoms are psychological in cause.

Answer and Explanation

The Correct Answer is B

A) Administering a PRN analgesic may provide temporary relief but does not address the need for a comprehensive assessment of the client's condition. It is essential to understand the nature and cause of the chest pain before treating it.

B) Further assessing the client's pain and vital signs is the most appropriate action. This allows the nurse to gather important clinical information that can help determine whether the chest pain is related to a medical condition or is part of the somatic symptom disorder. A thorough assessment is critical in ensuring the client's safety and addressing any potential underlying health issues.

C) Asking the client to compare this pain to past pain can provide context but is not a priority action. The immediate focus should be on assessing the current situation rather than reflecting on past experiences.

D) Reminding the client that the symptoms are psychological in cause can be invalidating and may hinder the therapeutic relationship. It is crucial to approach the client with empathy and understanding, rather than dismissing their experience.

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Correct Answer is C

Explanation

(A) Explain that these beliefs are related to her illness:While it is important to educate the client about their illness, directly challenging their delusions may increase distrust and anxiety. This approach might make the client feel misunderstood and less likely to trust the nurse.

(B) Explain that distrust is related to feeling anxious:This explanation might not be well-received by the client and could be perceived as dismissive of their concerns. It may not effectively address the client’s immediate need for trust and reassurance.

(C) Initiate short, frequent contacts with the client:This approach helps build trust through consistent and reliable interactions. It allows the nurse to establish a rapport without overwhelming the client, thereby promoting a sense of safety and trust. Regular, brief interactions can help the client feel more comfortable and secure.

(D) Offer to keep the belongings at the nurse’s desk:This action might be perceived as an attempt to take control of the client’s belongings, which could reinforce their delusions and decrease trust. It is important to respect the client’s need to keep their belongings close to them.

A. Move to a quiet area and provide peanut butter with crackers. B. Encourage the spouse to eat lunch with the client. C. Walk with the client to the cafeteria and stay while client eats. D. Request a full lunch tray from the dietary department.

Correct Answer is C

Explanation

A) Moving to a quiet area and providing peanut butter with crackers may help address the client’s nutritional needs, but it may not adequately address the client’s agitation and pacing. The immediate priority is to stabilize the client’s behavior before focusing on nutrition.

B) Encouraging the spouse to eat lunch with the client may create an opportunity for social interaction, but it might not be effective in calming the client’s agitation. If the client is already highly agitated, the spouse's presence alone may not help diffuse the situation.

C) Walking with the client to the cafeteria and staying while the client eats is the best intervention at this time. This approach allows the nurse to provide a calming presence and guidance while encouraging the client to eat. It also helps redirect the client's energy and agitation into a structured activity, promoting both physical movement and nutrition, which is crucial after several days without food.

D) Requesting a full lunch tray from the dietary department could provide a more substantial meal; however, it might not address the immediate need for calming the client. If the client remains agitated and loud, it may be challenging to ensure that they can eat peacefully, making this intervention less effective than accompanying the client directly to eat.

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A client with somatic symptom disorder reports experiencing chest pain to the nurse. Which action should the nurse take?

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