A newly licensed nurse asks the charge nurse about functional neurological symptom disorder. Which of the following responses should the charge nurse make?
"Clients who have this disorder consciously control the manifestations."
"Clients who have this disorder exhibit more than one personality."
"Feeling outside of one's body is a primary manifestation of this disorder."
"The manifestations of this disorder are worse during times of increased stress."
The Correct Answer is D
A. "Clients who have this disorder consciously control the manifestations." Functional neurological symptom disorder (formerly conversion disorder) involves involuntary neurological symptoms, such as paralysis, blindness, or seizures, that lack a medical explanation. Clients do not consciously produce or control these symptoms.
B. "Clients who have this disorder exhibit more than one personality." Multiple personalities are characteristic of dissociative identity disorder (DID), not functional neurological symptom disorder. Clients with functional neurological symptom disorder experience physical symptoms, not identity fragmentation.
C. "Feeling outside of one's body is a primary manifestation of this disorder." Feeling detached from one's body, known as depersonalization, is a symptom of depersonalization/derealization disorder. Functional neurological symptom disorder primarily involves physical, rather than perceptual, disturbances.
D. "The manifestations of this disorder are worse during times of increased stress." Symptoms of functional neurological symptom disorder often intensify during emotional or psychological stress. Stress-related factors contribute to the onset or worsening of symptoms, making stress management a key part of treatment.
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Correct Answer is D
Explanation
A. Systematic desensitization. This therapeutic approach is primarily used for anxiety disorders and phobias, not specifically for functional neurological symptom disorder. It may not directly address the complexities of the symptoms associated with this disorder.
B. Daily benzodiazepines to prevent new symptoms. Benzodiazepines are generally not the first-line treatment for functional neurological symptom disorder. While they may provide short-term relief for anxiety, they do not address the underlying issues related to functional symptoms and can lead to dependency.
C. Daily physical therapy. While physical therapy can be a component of treatment for functional neurological symptom disorder, focusing solely on physical therapy may not address the psychological factors that contribute to the disorder.
D. A combination of medication and psychotherapy. This approach is recognized as the most effective treatment for functional neurological symptom disorder. Psychotherapy, particularly cognitive-behavioral therapy (CBT), can help address the psychological aspects of the disorder, while medication may be used to manage comorbid conditions such as anxiety or depression. This combination provides a comprehensive treatment strategy.
Correct Answer is B
Explanation
A. The SANE does not directly request police involvement; their role is to provide forensic evidence collection and medical care while supporting the client’s choices. Law enforcement involvement depends on the client’s consent and legal requirements.
B. A key role of the SANE is to provide factual, expert testimony in legal proceedings regarding the evidence collected during the examination. This helps ensure that the findings are accurately presented in court and supports the legal process without acting as an advocate or attorney.
C. While protecting the client from further harm is part of nursing care, the SANE specifically focuses on forensic evaluation and documentation rather than general protective actions. Safety is addressed, but the legal testimony role is the distinguishing responsibility.
D. The SANE cannot require the client to report the assault to the police; reporting is voluntary unless mandated by state law. Respecting client autonomy is essential in sexual assault care.
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