When planning care for a client with somatic symptom disorder, the nurse would include the following interventions: Select all that apply.

Somatic symptom disorderis characterized by excessive focus on physical symptoms and associated emotional distress. Effective nursing care involves promoting functionality, emotional insight, and validationwithout reinforcing symptom preoccupation. Interventions should encourage routine, help clients connect symptoms to stressors, and validate their experience to build trust and therapeutic alliance.

Rationale for correct answers

2.Encouraging daily activities promotes function, reduces symptom focus, and supports behavioral activation, which improves mood and coping.

3.Helping the client link symptoms to stress fosters insightand supports cognitive restructuring, a core component of therapeutic progress.

6.Validation of distress builds rapportand therapeutic trust, essential for engagement and emotional regulation.

Rationale for incorrect answers

1.Confronting test results may provoke defensivenessand worsen anxiety, undermining therapeutic goals.

4.Providing extra attention during symptom discussion reinforces somatic focus, which perpetuates maladaptive coping.

5.Refusing to listen invalidates the client’s experience, damages rapport, and increases emotional distress.

Take Home Points

• Nursing care for somatic symptom disorder should promote function, insight, and emotional validation.
• Avoid reinforcing symptom preoccupation through excessive attention or confrontation.
• Encourage routine and structured activities to reduce distress and improve coping.
• Therapeutic communication must balance empathy with boundaries to support recovery.

Illness anxiety disorderis a psychiatric condition marked by excessive preoccupation, fear, and hypervigilanceabout having or acquiring a serious illness. Individuals often misinterpret normal bodily sensations—such as belching, sweating, or mild discomfort—as signs of severe disease. Despite minimal or absent somatic symptoms, their anxiety persists for at least six months and leads to significant distress or impairment. The disorder may present as care-seeking or care-avoidant behavior, and reassurance rarely alleviates their concern.

Rationale for correct answers

1.Clients with illness anxiety disorder often misinterpret normal sensationsas pathological, driven by persistent health-related anxietyand catastrophic thinking.

Rationale for incorrect answers

2.Fabrication of symptoms is typical of factitiousdisorder or malingering, not illness anxiety disorder, which involves genuine fear without intentional deception.

3.Clients with illness anxiety disorder show distress, not indifference; their anxiety is centered on the possibility of serious illness.

4.Not all listed statements are true; only the misinterpretation of normal sensations aligns with the diagnostic criteria for illness anxiety disorder.

Take Home Points

• Illness anxiety disorder involves misinterpretation of normal bodily sensations as signs of serious illness.
• It differs from factitious disorder and malingering, which involve intentional symptom fabrication.
• Clients often experience significant distress and impairment despite minimal physical symptoms.
• Reassurance is typically ineffective; cognitive behavioral strategies are preferred for management.