A nurse on an inpatient unit is caring for a client who has somatic symptom disorder. The client comes to the nurse's station and reports chest pain. The nurse knows this is a new symptom for the client. Which of the following actions should the nurse take?

Encourage the client to use relaxation techniques.

Reassure the client that pain is an expected part of their disorder.

Explain to the client that the pain is not real.

Assess the client's vital signs.

Answer and Explanation

The Correct Answer is D

A. Encourage the client to use relaxation techniques. While relaxation techniques can help manage symptoms in somatic symptom disorder, they should not be the first response to a new symptom like chest pain. The nurse must first rule out a medical cause before assuming the pain is psychological.
B. Reassure the client that pain is an expected part of their disorder. Assuming that the pain is purely psychosomatic without assessing for a potential medical emergency could lead to a delay in necessary treatment. Each new symptom should be evaluated independently.
C. Explain to the client that the pain is not real. The pain experienced by clients with somatic symptom disorder is real to them, even if a physical cause is not found. Dismissing their symptoms can damage trust and discourage them from reporting future concerns.
D. Assess the client's vital signs. Any new report of chest pain should be taken seriously, regardless of the client’s psychiatric history. Assessing vital signs ensures that a potential cardiac event or other medical issue is not overlooked before considering psychological factors.

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Correct Answer is ["A","C","D","E","F"]

Explanation

A. "My parents divorced when I was 13 years old." Divorce is recognized as an adverse childhood experience (ACE) because it can create emotional instability, financial stress, and changes in family dynamics, potentially affecting long-term mental health outcomes.
B. "We always had plenty of food in the house to eat." Having consistent access to food suggests a stable home environment, which is not classified as an ACE. Adverse experiences often include neglect, which involves a lack of basic needs such as food, shelter, or medical care.
C. "I was teased at school for wearing dirty clothes every day for weeks." Persistent neglect, such as not having clean clothing, can indicate parental neglect—one of the recognized ACEs. This can contribute to feelings of shame, social isolation, and long-term psychological distress.
D. "My parents would get in physical altercations." Witnessing domestic violence is a significant ACE that can lead to long-term emotional trauma, increased risk of anxiety, depression, and difficulty forming healthy relationships later in life.
E. "My parent went to prison when I was 12 years old." Parental incarceration is a recognized ACE, as it can cause emotional distress, economic hardship, and social stigma, increasing the child's risk for mental health disorders and substance use.
F. "My parent would swear often at my sibling and I." Verbal abuse, including frequent swearing or demeaning language, is a form of emotional abuse. Emotional abuse is a major ACE that can contribute to low self-esteem, difficulty regulating emotions, and increased vulnerability to mental health conditions.

A. Employment assistance B. Psychiatrist C. Social worker D. Spiritual advisor

Correct Answer is C

Explanation

A. Employment assistance. While employment support is valuable for clients with schizophrenia, housing stability should be prioritized first. A client without a place to live may struggle to maintain a job, making housing support the more immediate concern.
B. Psychiatrist. A psychiatrist plays a crucial role in managing schizophrenia through medication and therapy. However, the client’s immediate need is housing, which falls outside the psychiatrist’s primary role and is better addressed by a social worker.
C. Social worker. A social worker can assist with housing placement, financial aid, and community resources for individuals experiencing homelessness. They are the most appropriate referral to help the client secure stable living arrangements.
D. Spiritual advisor. While spiritual guidance may provide emotional support, it does not directly address the client’s urgent need for housing. The primary intervention should focus on securing a safe and stable place to live.

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A nurse on an inpatient unit is caring for a client who has somatic symptom disorder. The client comes to the nurse's station and reports chest pain. The nurse knows this is a new symptom for the client. Which of the following actions should the nurse take?

Nursing Test Bank

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Explanation

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Correct Answer is C

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