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.)

Withdrawn

Multiple hospitalizations

Unexplained abdominal pain

Excessive thinking about health

Recent trauma

Answer and Explanation

Correct Answer : A,B,C,D

A. Withdrawn: The child's withdrawn behavior, such as looking downcast and avoiding eye contact, may indicate emotional distress or a potential psychological issue, which can be associated with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.

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Correct Answer is D

Explanation

A. "Were you avoiding your friend so that you could hear the voices more clearly?" This response may imply blame or judgment and could be perceived as dismissive of the client’s experience. It does not provide a supportive or informative response to the client’s concern.
B. "That is very interesting. We are not sure why people start to isolate themselves." While it acknowledges the client's statement, this response does not provide any useful information or context about the relationship between isolation and the onset of schizophrenia symptoms.
C. "Do you think of yourself as more of an introvert? That makes a difference with how you socialize." This response shifts the focus to personality traits rather than addressing the symptoms of schizophrenia and their impact on social behavior. It may minimize the significance of the client’s experience with isolation.
D. "Before symptoms of schizophrenia begin, people often isolate themselves. This is an early warning." This response provides valuable information about the relationship between isolation and the onset of schizophrenia symptoms. It normalizes the client’s experience and helps them understand that social withdrawal can be a sign of emerging symptoms, fostering a better understanding of their condition.

A. Inform the client that the pain is not real. B. Provide reassurance to the client. C. Encourage the client to request invasive cardiac testing. D. Refer the client for flooding therapy.

Correct Answer is B

Explanation

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.

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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.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is discussing schizophrenia spectrum disorders with a client. The client states, "My friend says that before I started hearing voices, I stopped hanging out with them. Why is that?" Which of the following responses should the nurse make?

Correct Answer is D

Explanation

Correct Answer is B

Explanation

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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.)