A nurse is working with a client who is displaying disproportionate fear of having cancer. The nurse notes the client is seeking out medical care more frequently, has high anxiety, and believes they have cancer, despite no medical evidence to support this. Which of the following disorders is the client likely experiencing?

Somatic symptom disorder

Factitious disorder

Functional neurological symptom disorder

Illness anxiety disorder

Answer and Explanation

The Correct Answer is D

A. Somatic symptom disorder. This disorder involves excessive concern over physical symptoms that are actually present, even if they are mild. In contrast, illness anxiety disorder is characterized by intense fear of having a serious illness despite the absence of significant physical symptoms.
B. Factitious disorder. Factitious disorder involves deliberately fabricating or inducing symptoms to assume the sick role. In illness anxiety disorder, the client genuinely believes they are ill but does not intentionally create symptoms.
C. Functional neurological symptom disorder. This condition, previously called conversion disorder, involves neurological symptoms (e.g., paralysis, blindness) that cannot be explained by medical findings. Unlike illness anxiety disorder, these symptoms are involuntary and not focused on a fear of disease.
D. Illness anxiety disorder. This disorder, formerly known as hypochondriasis, involves excessive worry about having a severe illness despite little or no medical evidence. The client’s persistent health-related anxiety and frequent medical visits align with this diagnosis.

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Correct Answer is D

Explanation

A. Extrapyramidal symptoms. Extrapyramidal symptoms (EPS) include acute dystonia, akathisia, and parkinsonism, which are movement-related side effects caused by dopamine blockade. While EPS can involve muscle rigidity and tremors, tardive dyskinesia specifically refers to chronic, involuntary, repetitive movements such as facial twitching and tongue protrusion.
B. Impaired ability to regulate body temperature. Some antipsychotics can interfere with thermoregulation, leading to heat intolerance or hypothermia. However, this is not related to jerking or twitching movements seen in tardive dyskinesia.
C. Neuroleptic malignant syndrome. Neuroleptic malignant syndrome (NMS) is a life-threatening reaction to antipsychotics characterized by fever, muscle rigidity, autonomic instability, and altered mental status. Unlike tardive dyskinesia, NMS does not cause chronic, involuntary facial movements but rather widespread muscle stiffness and severe autonomic dysfunction.
D. Tardive dyskinesia. Tardive dyskinesia (TD) is a late-onset, irreversible movement disorder caused by long-term use of first-generation antipsychotics. It is characterized by involuntary, repetitive movements, especially in the face, tongue, and extremities (e.g., lip smacking, tongue rolling, grimacing, jerking movements). These symptoms distinguish TD from acute extrapyramidal symptoms.

A. Withdrawn B. Multiple hospitalizations C. Unexplained abdominal pain D. Excessive thinking about health E. Recent trauma

Correct Answer is ["A","B","C","D"]

Explanation

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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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has schizophrenia and has been taking a first generation medication for several years. The client is exhibiting jerking movements and twitching of the face and tongue. Which of the following is the client experiencing?

Correct Answer is D

Explanation

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.)

Correct Answer is ["A","B","C","D"]

Explanation

A nurse is caring for a client who has schizophrenia. In which of the following phases of the nurse-client relationship should the nurse suggest a guided therapy session?

A nurse is caring for a client who reports that they have been eliminating specific foods from their diet in order to "eat clean." The nurse should identify that this is an indication of which of the following conditions?

A nurse is preparing an in-service for a group of staff members about dissociative identity disorder. Which of the following should the nurse identify as a risk factor for this disorder?

A nurse is caring for a client who has psychosis and is prescribed chlorpromazine. The client reports feelings of restlessness. The nurse should identify that the client should be monitored for which of the following adverse effects?

A nurse is caring for a client who is crying and states they are depressed and feel like they are "going crazy." Which of the following client statements indicates the client is experiencing emotional abuse? (Select All that Apply.)

A nurse is planning discharge for a client who has schizophrenia and reports "I don't have a place to live." Which of the following referrals should the nurse request from the provider?

A nurse is admitting a client who has anorexia nervosa. Which of the following statements should the nurse expect from this client?

A nurse is assisting with an in-service to a group of staff members about schizophrenia. Which of the following age groups should the nurse include as the age when schizophrenia is typically diagnosed?