You are caring for Aaron, a 38-year-old patient diagnosed with somatic symptom disorder. When interacting with you, Aaron continues to focus on his severe headaches. In planning care for Aaron, which of the following interventions would be appropriate?

Call for a family meeting with Aaron in attendance to confront Aaron regarding his diagnosis.

Educate Aaron on alternative therapies to deal with pain.

Improve reality testing by telling Aaron that you do not believe that the headaches are real.

Shift focus from Aaron’s somatic concerns to feelings and effective coping skills.

Answer and Explanation

The Correct Answer is D

Somatic symptom disorder involves persistent physical complaints that are distressing and often medically unexplained. These symptoms are accompanied by emotional dysregulation, maladaptive coping, and preoccupation with bodily sensations. Nursing care should redirect focus from symptoms to emotional processing and coping strategies. Therapeutic communication must validate the experience while guiding the patient toward insight and behavioral change.

Rationale for correct answers

4. Shifting focus to feelings and coping promotes emotional insight and reduces symptom fixation, supporting therapeutic goals and functional recovery.

Rationale for incorrect answers

1. Confrontation in a family meeting may provoke defensiveness, damage trust, and worsen emotional distress.

2. Educating on alternative therapies is helpful but does not address emotional processing, which is central to care planning.

3. Denying the reality of symptoms undermines validation, increasing resistance and emotional withdrawal.

Take Home Points

Redirecting focus from symptoms to emotional coping is essential in somatic symptom disorder.
Confrontation and invalidation hinder therapeutic rapport and worsen distress.
Education alone is insufficient without emotional engagement and behavioral strategies.
Nursing care must balance empathy with structured redirection to promote recovery.

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Free Nursing Study Resources

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

Explanation

Secondary gainrefers to the indirect benefits a person receives from being ill, which may unconsciously reinforce the persistence of symptoms. In somatic symptom disorder, these gains can include attention, avoidance, and relieffrom responsibilities or emotional distress. While the symptoms are not intentionally produced, the reinforcement from these gains can perpetuate the illness behavior and complicate recovery.

Rationale for correct answers

1.Acceptable absence from work provides avoidanceof stressors and responsibilities, reinforcing the sick role and reducing external pressure.

2.Freedom from chores offers relieffrom daily demands, which may unconsciously reinforce symptom persistence.

3.Increased attention from family satisfies emotional needs, reinforcing the behavior through interpersonal validation.

4.Provision of care by others enhances dependency, which may be comforting and reduce anxiety, reinforcing illness behavior.

6.Temporary relief of anxiety occurs when physical symptoms distract from emotional conflict, serving as an unconscious coping mechanism.

Rationale for incorrect answers

5.Resolution of family conflict is not a typical secondary gain; it implies problem-solving, not reinforcement of illness behavior.

Take Home Points

Secondary gain in somatic symptom disorder includes avoidance of stressors and increased interpersonal attention.
These gains are unconscious and can perpetuate symptom expression.
Nurses must recognize secondary gain to guide therapeutic interventions.
Addressing emotional needs and promoting adaptive coping reduces reliance on illness behavior.

A. Deep tendon reflexes intact. B. Muscle wasting. C. The client is unaware of the link between anxiety and physical symptoms. D. Physical symptoms are explained by a physiological cause. E. A lack of concern toward the alteration in function.

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

Explanation

Conversion disorderis a psychiatric condition where psychological stress manifests as neurological symptoms without an organic cause. It often presents with motor deficits, sensory changes, or seizure-like activity, and symptoms are not intentionally produced. Clients may show indifference to symptoms and lack insight into their psychological origin.

Rationale for correct answers

1.Deep tendon reflexes remain intactbecause conversion disorder does not involve actual damage to the neuromuscular system. Reflex arcs are preserved despite motor symptoms.

3.Clients are typically unawareof the psychological origin of their symptoms. The dissociation between emotional conflict and physical manifestation is unconscious.

5.A lack of concern, termed la belle indifférence, is common. Clients may appear oddly calm or indifferent about significant functional impairments.

Rationale for incorrect answers

2.Wasting does not occur because the paralysis is psychogenic, not due to disuse or neuromuscular pathology. Muscle bulk remains preserved.

4.Physiological causes are ruled out in conversion disorder. Symptoms are not explained by any identifiable medical or neurological condition.

Take Home Points

Conversion disorder presents with neurological symptoms that lack a medical explanation and are linked to psychological stress.
Clients often lack insight and may show indifference to their symptoms.
Neurological examination typically reveals intact reflexes and preserved muscle tone.
It must be differentiated from malingering, factitious disorder, and true neurological conditions.

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You are caring for Aaron, a 38-year-old patient diagnosed with somatic symptom disorder. When interacting with you, Aaron continues to focus on his severe headaches. In planning care for Aaron, which of the following interventions would be appropriate?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse understands that secondary gain for the client with a somatic symptom illness can include: Select all that apply.

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

Explanation

A client is suspected to be experiencing a conversion disorder. Which of the following would the nurse expect to assess? Select all that apply.

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

Explanation

A client fearful of an upcoming deployment to Iraq develops a paralytic conversion disorder. Which nursing diagnosis takes priority?

The information that is least relevant when assessing a patient with a suspected somatization disorder is:

Which intervention is a nurse’s priority when working with a client suspected of having a conversion disorder?

Which statement describes the etiology of somatization disorder from a learning theory perspective?

A client diagnosed with a conversion disorder has a nursing diagnosis of disturbed sensory perception related to anxiety as evidenced by paralysis. Which short-term outcome would be appropriate for this client?

An anxious client reports experiencing pain in the abdomen and feeling empty and hollow. A diagnostic workup reveals no physical causes of these clinical findings. What term best reflects what the client is experiencing?

You are caring for Aaron, a 38-year-old patient diagnosed with somatic symptom disorder. When interacting with you, Aaron continues to focus on his severe headaches. In planning care for Aaron, which of the following interventions would be appropriate?

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?