D449 Psychology and Mental Health - Set 4 - Part 3

Correct Answer: Somatic symptom disorder pattern

Option c is correct because somatization involves the experience of genuine physical symptoms such as pain and discomfort without any identifiable medical cause despite thorough diagnostic evaluation, and the recurrent multi-system complaints described here are characteristic of this disorder. Option a is incorrect because malingering involves the deliberate fabrication of symptoms for external gain such as disability benefits or avoiding obligations, whereas patients with somatic symptom disorder genuinely experience their physical complaints and are not consciously creating symptoms. Option b is incorrect because hypochondriasis centers on excessive worry and fear about having a serious undiagnosed disease, which differs from somatization where the focus is on the distressing physical symptoms themselves rather than anxiety about what underlying illness they might represent. Option d is incorrect because chronic pain syndrome requires either an identified pain generator or establishe

Correct Answer: La belle indifference presentation

Option d is correct because la belle indifference describes the characteristic lack of emotional concern or distress that patients with conversion disorder display regarding their dramatic neurological symptoms, which paradoxically contrasts with the severity of the functional loss. Option a is incorrect because dissociative amnesia involves inability to recall important personal information usually following trauma, and while both conditions are trauma-related, amnesia does not explain the specific pattern of neurological symptom loss with emotional indifference seen here. Option b is incorrect because acute psychotic detachment involves loss of reality contact with hallucinations or delusions, which differs from conversion disorder where the patient maintains reality contact but demonstrates unexplained neurological deficits with notable emotional unconcern. Option c is incorrect because anosognosia is a neurological condition resulting from documented brain injury where patients can

Correct Answer: Neurological deficits without organic cause

Option a is correct because conversion disorder is specifically defined by the presence of neurological symptoms such as paralysis, blindness, or seizure-like episodes that cannot be explained by any known pathophysiological mechanism after thorough medical evaluation rules out organic causes. Option b is incorrect because symptoms worsening with treatment could indicate many conditions including medication side effects or disease progression, and is not a distinguishing feature of conversion disorder which typically responds to appropriate psychotherapeutic interventions over time. Option c is incorrect because positive findings on brain imaging would suggest an organic neurological condition rather than conversion disorder, as the hallmark of conversion disorder is the absence of structural or functional abnormalities on all diagnostic studies and examinations. Option d is incorrect because conversion disorder typically presents with sudden onset of neurological symptoms following a

Correct Answer: Respiratory depression risk

Option b is correct because benzodiazepines including clonazepam carry a significant risk of respiratory depression especially in the early stages of therapy, requiring careful monitoring of respiratory rate and oxygen saturation as the most critical safety concern. Option a is incorrect because mild appetite increase is not a primary concern with benzodiazepine therapy and does not represent a life-threatening side effect, whereas respiratory depression can be fatal if unrecognized and requires the nurse's highest level of vigilance during initial treatment. Option c is incorrect because slight headache is a minor and self-limiting side effect that does not pose the immediate danger to patient survival that respiratory depression represents, making it a lower monitoring priority compared to the risk of dangerously suppressed breathing patterns. Option d is incorrect because minor dry mouth is an uncomfortable but benign side effect that can be managed with oral care and hydration

Correct Answer: Gradual tapering prevents withdrawal seizures

Option c is correct because abrupt discontinuation of benzodiazepines after prolonged use can trigger life-threatening withdrawal symptoms including seizures, and gradual dose tapering under medical supervision is essential to safely wean the patient from the medication. Option a is incorrect because stopping clonazepam immediately after months of regular use is extremely dangerous, as sudden benzodiazepine withdrawal can cause severe symptoms including seizures, rebound anxiety, insomnia, and potentially fatal autonomic instability requiring emergency care. Option b is incorrect because switching to a stimulant medication to counteract sedation does not address the benzodiazepine dependence that develops with prolonged use, and combining or substituting medications without proper tapering creates additional pharmacological risks and complications. Option d is incorrect because taking one final large dose before stopping would increase central nervous system depression acutely and does

Correct Answer: Signs of elder abuse and neglect

Option d is correct because the combination of poor hygiene, weight loss, pressure ulcers, expired medications, broken assistive devices, and avoidance of eye contact in the caregiver's presence are recognized warning signs specifically associated with elder abuse and neglect. Option a is incorrect because while elderly patients may experience some functional decline, the constellation of findings including pressure ulcers, expired medications, a broken walker, and behavioral changes around the caregiver indicates neglectful care rather than expected age-related changes. Option b is incorrect because caregiver burnout without neglect would not explain the physical evidence of unmet care needs including pressure ulcers, expired medications, and broken equipment, as these findings indicate that the patient is actively being harmed through inadequate caregiving. Option c is incorrect because attributing these findings to the patient's noncompliance ignores the environmental evid

Correct Answer: Head-to-toe physical assessment first

Option a is correct because the standardized sexual assault examination protocol begins with a complete head-to-toe physical assessment observing for signs of injury before proceeding to genital examination, evidence collection, documentation, and finally treatment with discharge planning. Option b is incorrect because evidence collection occurs after both the head-to-toe physical assessment and detailed genital examination in the established protocol, as rushing to collect evidence before completing the physical assessment may miss injuries requiring immediate medical treatment. Option c is incorrect because the detailed genital examination is the second step in the sexual assault examination protocol following the head-to-toe assessment, as establishing the patient's overall physical condition and identifying all injuries takes precedence before focused examination. Option d is incorrect because discharge planning and follow-up care is the final step in the five-step sexual assa

Correct Answer: Separate the patient from the partner

Option b is correct because the nurse must first create a safe and private environment by separating the patient from the suspected abuser before conducting a thorough assessment, as patients cannot disclose abuse or answer honestly while the perpetrator is present. Option a is incorrect because confronting the suspected abuser in the patient's presence could escalate the situation, increase danger to the patient, and violate the trust needed for the patient to feel safe enough to disclose the abuse during a private and confidential assessment. Option c is incorrect because calling law enforcement before speaking privately with the patient removes the patient's autonomy and may not be legally required in all adult intimate partner violence situations unless mandatory reporting criteria are met for the specific circumstances and jurisdiction. Option d is incorrect because documenting findings and discharging without first separating the patient for private assessment fails to

Correct Answer: Report suspected abuse immediately

Option c is correct because nurses are mandatory reporters who are legally obligated to report suspected child abuse to appropriate authorities immediately upon suspicion, without needing definitive proof, as the investigation responsibility belongs to child protective services. Option a is incorrect because deferring to the parent's explanation without reporting contradicts mandatory reporting laws that require nurses to report suspicion of abuse regardless of the caregiver's stated rationale, as accepting explanations at face value may leave a vulnerable child in danger. Option b is incorrect because waiting for definitive proof before reporting is not required by mandatory reporting statutes, as nurses are obligated to report upon reasonable suspicion and delaying the report while seeking additional evidence places the child at continued risk of ongoing harm. Option d is incorrect because discussing concerns only with the suspected abuser could alert them to the nurse'

Correct Answer: Suspected abuse requires mandatory reporting

Option d is correct because nurses are legally mandated reporters who must break confidentiality to report suspected abuse of children, elderly persons, and vulnerable adults to appropriate authorities, while still protecting all other protected health information not relevant to the report. Option a is incorrect because confidentiality has specific legal exceptions including mandatory reporting of suspected abuse, threats of harm to identifiable third parties, and certain public health requirements, making the statement that confidentiality is never broken an inaccurate absolute claim. Option b is incorrect because while judicial orders can compel disclosure, nurses have independent mandatory reporting obligations for suspected abuse that do not require court authorization, making this response incomplete and potentially dangerous if the nurse delays reporting while awaiting judicial action. Option c is incorrect because family member requests do not override patient confidentiality p