A nurse is caring for a client who has a diagnosis of conversion disorder with paralysis of the lower extremities. Which is the most therapeutic nursing intervention?
Encouraging the client to try to walk.
Explaining to the client that there is nothing wrong.
Avoiding focusing on the client’s physical symptoms.
Helping the client follow through with the physical therapy plan.
The Correct Answer is D
Conversion disorder is a type of functional neurological symptom disorder characterized by motor or sensory deficits that are not explained by medical conditions. Symptoms arise unconsciously in response to psychological stress and often reflect symbolic resolution of internal conflict. Paralysis, blindness, or seizures may manifest without organic pathology. Management involves a multidisciplinary approach including psychotherapy and rehabilitation, with emphasis on restoring function while avoiding reinforcement of symptoms.
Rationale for correct answers
4. Physical therapy provides a structured, goal-directed approach that supports functional recovery without reinforcing the sick role. It promotes independence and helps shift focus from symptoms to capability. Behavioral reinforcement of normal movement patterns is central to recovery.
Rationale for incorrect answers
1. Premature encouragement to walk may provoke anxiety or resistance, especially if the client is not yet psychologically ready. It risks invalidating the client’s experience and may worsen symptoms.
2. Invalidation of symptoms by stating “nothing is wrong” undermines therapeutic rapport. Conversion symptoms are real to the client, and dismissing them can increase distress and resistance to care.
3. Avoidance of symptom discussion may hinder therapeutic engagement. While excessive focus is discouraged, acknowledging symptoms within a supportive framework is essential for trust and progress.
Take Home Points
- Conversion disorder presents with neurological symptoms without organic cause, often linked to psychological stress.
- Physical therapy is a key intervention, using behavioral reinforcement to restore function.
- Therapeutic communication must validate the client’s experience while guiding toward recovery.
- Differentiation from malingering and factitious disorder is essential, as conversion symptoms are unconscious and not intentionally produced.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Conversion disordersymptoms such as paralysis often resolve spontaneously but may recur under stress. The disorder is episodic, stress-sensitive, and typically involves motor or sensory deficits. Clients may regain function but are vulnerable to relapse during emotional distress.
Rationale for correct answers
3.Symptom recurrenceunder stress is characteristic. The brain converts emotional conflict into physical symptoms, which may reappear with future stressors.
Rationale for incorrect answers
1.Spread of paralysis is not typical. Symptoms usually remain localized and consistent with the initial presentation.
2.Continuous psychiatric care is not always required. Many clients recover with short-term therapy and support.
4.Emotional course may vary, but symptom recurrence is more predictable than general emotional instability.
Take Home Points
- Conversion disorder symptoms may resolve but recur with stress.
- Motor and sensory deficits are functional, not due to organic pathology.
- Long-term psychiatric care is not always necessary.
- Relapse prevention focuses on stress management and emotional insight.
Correct Answer is D
Explanation
Conversion disorderpresents with neurological symptoms such as paralysis, seizures, or sensory lossthat lack a medical basis. Before confirming the diagnosis, it is essential to rule out organic pathologyto avoid misdiagnosis and ensure appropriate care. This step protects patient safety and guides further psychiatric evaluation and treatment.
Rationale for correct answers
4.Ruling out organic causes ensures diagnostic accuracyand prevents mismanagement, making it the first priority in suspected conversion disorder.
Rationale for incorrect answers
1.Avoiding secondary gain is important but not the initial clinical priorityduring assessment.
2.Confrontation may provoke defensivenessand worsen symptoms; it is not therapeutic or diagnostic.
3.Teaching coping skills is valuable but follows confirmationof diagnosis and safety clearance.
Take Home Points
- Ruling out organic pathology is the first step in managing suspected conversion disorder.
- Accurate diagnosis prevents inappropriate treatment and supports safe psychiatric care.
- Confrontation is contraindicated; supportive and nonjudgmental approaches are preferred.
- Coping strategies are introduced after diagnostic clarity and patient engagement.
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