Somatic Disorders
Which of the following are common features of somatic symptom disorder? (Select all that apply.)
A. Symptoms cause significant distress
B. Symptoms are intentionally produced
C. Excessive thoughts about the symptoms
D. High levels of anxiety about health
E. Lack of any physical complaints
Correct Answers: A, C, D
Rationale: Clients experience real symptoms that are distressing and have excessive health-related anxiety, but they are not intentionally faked.
Which of the following are appropriate de-escalation techniques during a psychiatric crisis? (Select all that apply.)
A. Maintain a calm voice
B. Allow the client personal space
C. Touch the client to redirect behavior
D. Offer choices when possible
E. Use physical restraints immediately
Correct Answers: A, B, D
Rationale: De-escalation includes offering space, using a calm voice, and providing options. Touching or restraining may escalate the situation.
Which findings differentiate delirium from dementia? (Select all that apply.)
A. Sudden onset
B. Impaired short- and long-term memory
C. Reversible if cause is treated
D. Stable course with gradual decline
E. Fluctuating level of consciousness
Correct Answers: A, C, E
Rationale: Delirium is sudden, fluctuates, and is often reversible. Dementia has a stable but progressive decline.
Which symptoms are characteristic of oppositional defiant disorder (ODD)? (Select all that apply.)
A. Argues with authority figures
B. Violates others’ rights
C. Loses temper frequently
D. Blames others for mistakes
E. Physically aggressive toward peers
Correct Answers: A, C, D
Rationale: ODD includes defiance and irritability but not aggression or violation of rights (seen in conduct disorder).
Which findings are signs of lithium toxicity? (Select all that apply.)
A. Coarse hand tremors
B. Severe hypotension
C. Slurred speech
D. Blurred vision
E. Polyuria
Correct Answers: A, C, D, E
Rationale: Early signs include tremor, GI distress, and CNS changes. Severe hypotension is less common.
The nurse should expect which of the following findings in a client with conversion disorder? (Select all that apply.)
A. Sudden loss of motor function
B. Indifference to the symptoms
C. Multiple somatic complaints
D. Neurological symptoms without a physical cause
E. Symptoms that are under voluntary control
Correct Answers: A, B, D
Rationale: Conversion disorder involves neurological symptoms without organic cause and a lack of concern (la belle indifférence).
The nurse suspects intimate partner violence. Which behaviors support this suspicion? (Select all that apply.)
A. Partner answers questions for the client
B. Client avoids eye contact
C. Partner is overly attentive
D. Client arrives with repeated injuries
E. Client is eager to disclose details
Correct Answers: A, B, C, D
Rationale: Over-control, avoidance, and repeated injuries are red flags for IPV. Clients are often reluctant to disclose.
Which interventions are appropriate for a hospitalized client with delirium? (Select all that apply.)
A. Provide a clock and calendar
B. Encourage frequent naps during the day
C. Keep lighting low and consistent
D. Involve family for reorientation
E. Use physical restraints for safety
Correct Answers: A, C, D
Rationale: Reorientation and consistent environment help. Restraints should be avoided unless absolutely necessary.
What are appropriate nursing interventions for a hospitalized child with autism spectrum disorder? (Select all that apply.)
A. Maintain structured routine
B. Avoid excessive stimulation
C. Use detailed verbal instructions
D. Use limited eye contact
E. Allow time for processing
Correct Answers: A, B, D, E
Rationale: Autism care includes structured, low-stimulation environments and simplified communication.
Which adverse effects are associated with SSRIs like fluoxetine? (Select all that apply.)
A. Sexual dysfunction
B. Hypertensive crisis
C. Weight changes
D. Serotonin syndrome
E. Sleep disturbances
Correct Answers: A, C, D, E
Rationale: SSRIs can cause weight gain/loss, serotonin syndrome, insomnia, and sexual issues—not hypertensive crisis.
Which nursing actions are appropriate for a client with illness anxiety disorder? (Select all that apply.)
A. Limit discussion of physical complaints
B. Avoid scheduling regular appointments
C. Encourage journal writing about emotions
D. Focus on coping strategies
E. Reinforce that their symptoms are imagined
Correct Answers: A, C, D
Rationale: Focusing on coping and minimizing reinforcement of somatic concerns is key. Regular appointments are helpful to reduce anxiety.
Which interventions are priorities during the crisis intervention phase? (Select all that apply.)
A. Promote immediate safety
B. Identify the triggering event
C. Establish therapeutic rapport
D. Teach long-term coping skills
E. Validate the client’s feelings
Correct Answers: A, B, C, E
Rationale: During crisis, the focus is on safety, understanding the cause, and establishing support—not teaching long-term coping yet.
Which medications are commonly used in the treatment of Alzheimer’s disease? (Select all that apply.)
A. Donepezil
B. Memantine
C. Haloperidol
D. Rivastigmine
E. Sertraline
Correct Answers: A, B, D
Rationale: These medications slow progression; SSRIs may be used for depression but not core treatment.
Which side effects should the nurse monitor in a child taking methylphenidate? (Select all that apply.)
A. Weight gain
B. Insomnia
C. Appetite suppression
D. Tachycardia
E. Sedation
Correct Answers: B, C, D
Rationale: Methylphenidate may cause stimulation-related side effects such as insomnia and elevated heart rate.
What symptoms are associated with neuroleptic malignant syndrome (NMS)? (Select all that apply.)
A. Muscle rigidity
B. High fever
C. Diaphoresis
D. Bradycardia
E. Altered mental status
Correct Answers: A, B, C, E
Rationale: NMS presents with high fever, muscle rigidity, mental status changes, and autonomic instability.
A nurse is caring for a client with factitious disorder. Which findings support this diagnosis? (Select all that apply.)
A. Client seeks multiple surgeries
B. Symptoms improve when under observation
C. Client refuses to allow contact with previous providers
D. History of frequent hospitalizations
E. Intentional production of symptoms for attention
Correct Answers: A, C, D, E
Rationale: These behaviors are consistent with factitious disorder; symptoms worsen when attention is received and often lack consistent medical evidence.
A nurse is caring for a victim of elder abuse. What actions are appropriate? (Select all that apply.)
A. Report to adult protective services
B. Document objective findings
C. Notify the suspected abuser
D. Perform a thorough physical assessment
E. Remove the client from the home immediately
Correct Answers: A, B, D
Rationale: Mandatory reporting, documentation, and assessment are required. Notification of the abuser or forced removal isn't the nurse’s role.
Which behaviors indicate progression from moderate to severe Alzheimer’s disease? (Select all that apply.)
A. Wandering
B. Inability to recognize family members
C. Need for help with dressing
D. Occasional memory lapses
E. Incontinence
Correct Answers: A, B, C, E
Rationale: Severe stages involve ADL dependence, disorientation, and physical decline.
Which of the following are therapeutic strategies for a child with ADHD? (Select all that apply.)
A. Reward-based behavior system
B. Clear, consistent expectations
C. Long lectures about behavior
D. Physical punishment
E. Scheduled breaks for movement
Correct Answers: A, B, E
Rationale: Positive reinforcement and structure improve outcomes for ADHD; punishment and lectures are ineffective.
Which teaching points should be included for a client taking MAOIs? (Select all that apply.)
A. Avoid aged cheeses and smoked meats
B. Rise slowly to avoid dizziness
C. Use NSAIDs for headaches
D. Report headache immediately
E. Avoid caffeine and tyramine
Correct Answers: A, B, D, E
Rationale: MAOIs require dietary restrictions and monitoring for hypertensive crisis; NSAIDs increase bleeding risk.
Which client statements reflect understanding of treatment goals for somatic symptom disorders? (Select all that apply.)
A. “I’m learning to manage stress better.”
B. “My doctor finally found what’s wrong with me.”
C. “Therapy is helping me focus less on my pain.”
D. “I’m using deep breathing when I feel anxious.”
E. “More tests will show the real issue.”
Correct Answers: A, C, D
Rationale: Effective treatment focuses on stress management and reframing symptoms, not pursuing endless diagnostics.
Signs of an adventitious crisis may include which of the following? (Select all that apply.)
A. Feelings of hopelessness
B. Difficulty sleeping
C. A sense of betrayal
D. Long-standing depression
E. Flashbacks or intrusive memories
Correct Answers: A, B, C, E
Rationale: Adventitious crises (e.g., violence or natural disaster) often result in acute stress reactions, not long-standing mood disorders.
Which safety interventions are necessary for clients with late-stage dementia? (Select all that apply.)
A. Install bed and chair alarms
B. Provide frequent reorientation
C. Lock external doors
D. Supervise all meals
E. Use mirrors to increase stimulation
Correct Answers: A, C, D
Rationale: Clients in late-stage dementia are at risk for elopement, choking, and falls.
What findings would support a diagnosis of conduct disorder? (Select all that apply.)
A. Lying for personal gain
B. Destroying others’ property
C. Refusal to comply with rules
D. Repetitive hand movements
E. Physical cruelty to animals
Correct Answers: A, B, E
Rationale: Conduct disorder involves severe violation of rights and rules, including aggression and destructiveness.
Which medications are considered atypical antipsychotics? (Select all that apply.)
A. Clozapine
B. Risperidone
C. Olanzapine
D. Haloperidol
E. Quetiapine
Correct Answers: A, B, C, E
Rationale: All except haloperidol are atypicals. Haloperidol is a typical antipsychotic.