A nurse is providing care to a client who was admitted to the emergency department with superficial lacerations on their leg. The client states, "I was feeling bored, so I used a pair of gardening scissors to cut myself." The client denies current depression and suicidal thoughts. The client is demonstrating manifestations of which of the following disorders?

Somatic symptom disorder

Illness anxiety disorder

Factitious disorder

Functional neurological symptom disorder

Answer and Explanation

The Correct Answer is C

A. Somatic symptom disorder. This disorder involves experiencing physical symptoms that cause significant distress or impairment, typically related to an underlying medical condition. The client’s actions do not reflect a focus on physical symptoms for relief of anxiety or distress in the same way.
B. Illness anxiety disorder. This disorder is characterized by excessive worry about having a serious illness despite minimal or no symptoms. The client’s behavior of intentionally cutting themselves does not align with this disorder, as there is no indication of anxiety over illness.
C. Factitious disorder. This disorder involves intentionally producing or feigning symptoms for the purpose of assuming the sick role, without external incentives. The client’s admission of boredom as the reason for self-harm indicates an intent to create a situation for attention or care, aligning with factitious disorder.
D. Functional neurological symptom disorder. This condition involves neurological symptoms that cannot be explained by medical findings, often presenting as involuntary symptoms. The client’s self-inflicted injuries are not indicative of this disorder, as they intentionally engaged in self-harm.

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Correct Answer is C

Explanation

A. "I'm going to ignore your lack of self-care because it is an aspect of the disorder." Ignoring the client’s hygiene neglect does not support their well-being or promote self-care. While poor self-care is a symptom of schizophrenia, the nurse should encourage hygiene rather than dismiss it.
B. "Do you really think it is ok not to bathe? What is going on with you?" This confrontational statement may make the client feel judged or defensive, potentially worsening their resistance to self-care. Clients with schizophrenia may have impaired insight and motivation, making supportive guidance more effective.
C. "It is now time for you to bathe. Do you want to wear the red or green shirt?" Providing a structured directive while offering a simple choice promotes autonomy and encourages adherence to hygiene. Clients with schizophrenia benefit from clear instructions and limited choices, reducing decision-making stress and increasing cooperation.
D. "This is it! You are getting a bath! There are three of us here to bathe you!" Using forceful or coercive language can cause distress and escalate resistance. Encouraging hygiene should be done through therapeutic communication and gentle prompts rather than threats or intimidation.

A. Insist the client report the incident. B. Touch the client for reassurance. C. Ask the client a series of questions about who assaulted them. D. Allow the client to control the conversation.

Correct Answer is D

Explanation

A. Insist the client report the incident. While reporting the incident may be important, it is not appropriate to insist that the client do so, as this can create additional pressure and may lead to feelings of coercion. The client should be allowed to make their own choices regarding reporting.
B. Touch the client for reassurance. Touching the client without their consent can be intrusive and may not be welcome, especially after a trauma. It's essential to respect the client's personal space and boundaries.
C. Ask the client a series of questions about who assaulted them. While gathering information may be necessary, bombarding the client with questions immediately after a traumatic event can be overwhelming. It’s better to allow the client to share information at their own pace.
D. Allow the client to control the conversation. Empowering the client to control the discussion fosters a sense of safety and autonomy. It allows them to share their feelings and experiences when they feel ready, which is crucial for their emotional healing after an assault.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has been diagnosed with schizophrenia. The client has been wearing the same clothes for the past week and appears unkept and unbathed. Which of the following statements should the nurse make to the client?

Correct Answer is C

Explanation

A nurse is speaking with a client who experienced physical assault. Which of the following actions should the nurse take?

Correct Answer is D

Explanation

A nurse is caring for a client who has been newly diagnosed with schizophrenia. Which of the following findings is true regarding this disorder?

A nurse is weighing a client who was recently admitted into the eating disorder program. Which of the following actions should the nurse take?

A nurse is caring for a client who states, "When I get in the car to drive to work in the morning, my hands go numb. It is to the point where I can't grip the steering wheel." Which of the following conditions is the client likely experiencing?

A nurse is caring for a client who has anorexia nervosa. Which of the following findings should the nurse expect?

A nurse is caring for a client who has factitious disorder. The client states, "I am so tired of living like this. Maybe I should just end it all." Which of the following actions should the nurse take?

A nurse in the emergency department is caring for a client who reports having experienced sexual abuse. The nurse should identify that which of the following findings are consistent with the client's report? (Select All that Apply.)