A nurse is assisting a sexual assault nurse examiner (SANE) with the care of a client who has experienced sexual assault. The nurse should identify which of the following as the role of the SANE?

A. Withdrawn: The child's withdrawn behavior, such as looking downcast and avoiding eye contact, may indicate emotional distress or a potential psychological issue, which can be associated with factitious disorder. Individuals with factitious disorder may exhibit emotional signs that reflect their internal struggles and manipulation of health-related situations.
B. Multiple hospitalizations: Frequent hospitalizations, especially without a clear medical diagnosis, can suggest factitious disorder. This pattern often reflects a behavior where an individual seeks medical attention and care, indicating a need to assume the sick role.
C. Unexplained abdominal pain: The presence of unexplained abdominal pain, particularly when combined with a history of seeking medical attention, aligns with factitious disorder. In this condition, individuals often feign or produce symptoms for psychological reasons, leading to repeated medical evaluations without a clear medical basis.
D. Excessive thinking about health: An intense preoccupation with health issues can be indicative of factitious disorder. This behavior demonstrates a focus on illness that may lead to manipulative behaviors in seeking attention or care.
E. Recent trauma: While trauma can contribute to various psychological conditions, it is not specifically indicative of factitious disorder. Many individuals may experience trauma without developing this disorder, making it less relevant in this context.

A. Inform the client that the pain is not real. Clients with somatic symptom disorder experience genuine distress, even if their symptoms lack a medical explanation. Dismissing their pain as "not real" can damage trust and discourage them from seeking appropriate care.
B. Provide reassurance to the client. Reassurance helps reduce anxiety and reinforces that the symptoms are not life-threatening. The nurse should validate the client’s feelings while gently redirecting their focus to coping strategies and stress management techniques.
C. Encourage the client to request invasive cardiac testing. Since the client has no cardiac risk factors and all test results are normal, unnecessary invasive procedures are not warranted. Encouraging further testing could reinforce the client’s health anxieties rather than helping manage their symptoms.
D. Refer the client for flooding therapy. Flooding therapy is an exposure-based treatment used for phobias and post-traumatic stress disorder (PTSD). It is not an appropriate intervention for somatic symptom disorder, which requires cognitive-behavioral therapy (CBT) and supportive reassurance.