A nurse is caring for a school-age client in an outpatient clinic.

Exhibits

The nurse should identify which of the client findings are manifestations of a factitious disorder? (Select all that apply.)

A. Encourage the client to think positive thoughts. While promoting positive thinking can be helpful, this approach may oversimplify the client's experience and does not address their anxiety or physical symptoms effectively.
B. Assist the client in distinguishing between anxiety and physical manifestations. This intervention is crucial as it helps the client understand the connection between their anxiety and physical symptoms. It can empower the client to better manage their feelings and reduce their fixation on health issues.
C. Provide relief measures for manifestations the client is experiencing. Addressing the client's physical symptoms, such as anxiety and stomach discomfort, is important for their overall well-being and can improve their quality of life.
D. Inform the client that nothing is medically wrong with them. This statement may dismiss the client's concerns and could lead to feelings of frustration or invalidation. It is important to listen to the client’s experiences without minimizing them.
E. Suggest to the client's provider that multiple tests need to be performed. Given the client's report of ongoing symptoms and concerns about their health, it is appropriate to recommend further evaluation to rule out any underlying medical issues. This ensures that the client feels heard and their concerns are taken seriously.
F. Perform a lengthy exam of the client's condition. Conducting a lengthy exam may not be necessary at this stage, especially in an outpatient setting. Instead, focusing on understanding the client's experience and addressing their concerns is more beneficial.

A. Identification phase. In this phase, the nurse and client begin to build a therapeutic relationship and establish trust. The focus is on identifying the client's needs and concerns rather than actively engaging in therapeutic interventions like guided therapy.
B. Exploitation phase. During the exploitation phase, the nurse encourages the client to utilize the resources and therapeutic interventions available to them. This is an appropriate time to suggest guided therapy sessions, as the client is actively engaged in exploring their issues and working toward improvement.
C. Resolution phase. The resolution phase involves evaluating the progress made and preparing for the termination of the nurse-client relationship. It is not the appropriate time to introduce new therapeutic modalities, as the focus shifts to consolidating gains and planning for future support.
D. Orientation phase. The orientation phase establishes the groundwork for the therapeutic relationship, including discussing goals and expectations. While important, it is not the phase where guided therapy sessions would typically be suggested, as the relationship is still in its initial stages.