Finals Quiz 1

Question 1

are characterized by physical symptoms suggesting medical disease but without demonstrable organic pathology or a known pathophysiological mechanism to account for them

Answer 1

Somatoform disorders

Question 2

is a chronic syndrome of multiple! somatic symptoms that cannot be explained medically and are associated with psychosocial distress and long-term seeking of assistance from health care professionals

Answer 2

Somatization disorder

Question 3

The essential feature of pain disorder is severe and prolonged pain that causes clinically significant distress or impairment in social, occupational, or
other important areas of functioning

Answer 3

Pain disorder

Question 4

is an unrealistic preoccupation with the fear of having a serious illness

Answer 4

Hypochondriasis

Question 5

This disorder, formerly called dysmorphophobia, is characterized by the exaggerated belief that the body is deformed or defective in
some specific way

Answer 5

Body dysmorphic disorder

Question 6

Body dysmorphic disorder
This disorder, formerly called _____

Answer 6

dysmorphophobia

Question 7

The pathophysiology of somatoform disorders is ____

Answer 7

unknown

Question 8

Primary somatoform disorders may be associated with a _____

Answer 8

heightened awareness of normal bodily sensations.

Question 9

This heightened awareness may be paired with a ______ to interpret any physical symptom as indicative of medical illness

Answer 9

cognitive bias

Question 10

may be high in some patients with somatoform disorders

Answer 10

Autonomic arousal

Question 11

This autonomic arousal may be associated with physiologic effects of endogenous noradrenergic compounds such as ___________ or _________

Answer 11

tachycardia or gastric hypermotility.

Question 12

Heightened arousal also may induce muscle tension and pain associated with muscular hyperactivity, as is seen with ________

Answer 12

muscle tension headaches

Question 13

Causes of Somatoform Disorders Predisposing factors to somatoform disorders include:

Answer 13

Genetic
Biochemical
Psychodynamic
Family dynamics
Sociocultural/familial factors.
Past experience with physical illness
Cultural and environmental factors

Question 14

Studies have shown an increased incidence of somatization disorder, conversion disorder, and hypochondriasis in first-degree relatives, implying a possible inheritable disposition

Answer 14

Genetic

Question 15

Decreased levels of serotonin and endorphins may play a role in the etiology of pain disorder.

Answer 15

Biochemical

Question 16

Some psychodynamics view hypochondriasis as an

ego defense mechanism; the psychodynamic theory of conversion disorder proposes that emotions associated with a traumatic event that the individual cannot express because of moral or ethical unacceptability are “converted” into physical symptoms

Answer 16

Psychodynamic

Question 17

Some families have difficulty expressing emotions openly and resolving conflicts verbally; when this occurs, the child may become ill, and a shift in focus is made from the open conflict to the child’s illness, leaving unresolved the underlying issues that the family cannot confront openly.

Answer 17

Family dynamics

Question 18

Somatic complaints are often reinforced when the sick role relieves the individual from the need to deal with a stressful situation, whether it be within the society or within the family.

Answer 18

Sociocultural/familial factors

Question 19

Personal experience, or the experience of close family members with serious or life-threatening illness can predispose an individual to hypochondriasis

Answer 19

Past experience with physical illness

Question 20

Some cultures and religions carry implicit sanctions against verbalizing or directly expressing emotional states, thereby indirectly encouraging “more acceptable” somatic behaviors.

Answer 20

Cultural and environmental factors.

Question 21

Clinical Manifestations

Symptoms of somatoform disorder include:

Answer 21

Pain symptoms
Gastrointestinal symptoms
Sexual Symptoms
Pseudo neurologic symptoms

Question 22

Complaints of headache, pain in the abdomen, head, joints, back, chest, rectum; pain during urination, menstruation, or

sexual intercourse.

Answer 22

Pain symptoms

Question 23

There is nausea, bloating, vomiting

(other than during pregnancy), diarrhea, or intolerance of several

foods.

Answer 23

Gastrointestinal symptoms

Question 24

Sexual indifference, erectile or ejaculatory dysfunction, irregular menses, excessive menstrual bleeding, and vómiting through pregnancy

Answer 24

Sexual symptoms

Question 25

Conversion symptoms such as impaired coordination or balance, paralysis or localized weakness, difficulty swallowing or lump in throat, aphonia, urinary retention, hallucinations, loss of touch or pain sensation, double vision, blindness, deafness, and seizures.

Answer 25

Pseudo neurologic symptoms

Question 26

Medical Management

Answer 26

1.Cognitive-behavioral psychotherapy
2.Psychosocial therapies
3. Psychoeducation

Question 27

strategies may be specifically helpful in reducing distress and high medical use.

Answer 27

Cognitive-behavioral psychotherapy

Question 28

directed by physicians form the basis for successful treatment; a strong relationship between the patient and the primary care physician can assist in long-term management.

Answer 28

Psychosocial therapies

Question 29

can be helpful by letting the patient know that physical symptoms may be exacerbated by anxiety or other emotional problems; however, be careful because patients are likely to resist suggestions that their condition is due to emotional rather than physical problems

Answer 29

Psychoeducation

Question 30

The nurse must investigate physical health status thoroughly to ensure there is no underlying pathology requiring treatment.

Answer 30

Nursing Assessment

Question 31

Clients usually provide a lengthy and detailed account of previous physical problems, numerous diagnostic tests, and perhaps even a number of surgical procedures.
General appearance and motor behavior. Often, clients walk slowly or with an unusual gait because of the pain or disability
caused by the symptoms; they may exhibit a facial expression of discomfort or physical distress.

Answer 31

History

Question 32

Mood is often labile, shifting from seeming depressed and sad when describing physical problems to looking bright and excited when talking about how they had to go to the hospital in the middle of the night by ambulance.

Answer 32

Mood and affect.

Question 33

Clients who somatize do not experience disordered thought processes; the content of their thinking is primarily about often exaggerated physical concerns, for example, when they have a simple cold they may be convinced it is pneumonia.

Answer 33

Thought process and content.

Question 34

Nursing Diagnosis

Answer 34

Chronic pain related to severe levels of anxiety, repressed.
Ineffective coping related to inadequate coping skills.
Disturbed body image related to low self-esteem, severe level of anxiety.
Disturbed sensory perception related to regression to, or fixation in, an earlier level of development.
Self-care deficit related to paralysis of body parts, pain, discomfort.
Deficient knowledge related to lack of interest in learning, severe anxiety

Question 35

The nurse must help the client establish a daily routine that includes improved health behaviors.

Answer 35

Providing health teaching

Question 36

Clients may keep a detailed journal of their physical symptoms; the nurse might ask them to describe the situation at the time such as whether they were alone or with others, whether any disagreements were occurring, and so forth.

Answer 36

Assisting the client to express emotions

Question 37

Emotion-focused strategies include progressive relaxation, deep breathing, guided imagery, and distractions such as music or other activities; problem-focused coping strategies include problem-solving methods, applying the process to identified problems, and role-playing interactions with others.

Answer 37

Teaching coping strategies