Author Question: A 54-year-old man was referred by his urologist for evaluation. The client has been complaining of ... (Read 45 times)

haleyc112 · **on:** Jul 19, 2018

A 54-year-old man was referred by his urologist for evaluation. The client has been complaining of testicular pain for several years.

Diagnostic testing and imaging showed nothing abnormal and the clinician was reluctant to perform any invasive procedures. The client has a long history of disorders with the primary feature of pain. The nurse should take which of the following actions?
A) Confront him with the fact that he is attention seeking.
B) Refer him to a pain management program.
C) Perform a comprehensive assessment.
D) Treat his pain with placebos.

Question 2

The nurse has concluded the assessment of a client recently diagnosed with undifferentiated somatoform disorder.

The client states her most significant source of stress is the fact that no one believes how sick I am despite her varied physical complaints. Based on these data, the most appropriate nursing diagnosis is which of the following?
A) Anxiety related to chronicity of symptoms as evidenced by dependency
B) Ineffective Coping related to unresolved psychological issues as evidenced by inability to express feelings verbally
C) Chronic Low Self-esteem related to physical symptoms that inhibit the client's daily functioning
D) Risk for Spiritual Distress related to feelings of isolation

ultraflyy23 · **Reply #1 on:** Jul 19, 2018

Answer to Question 1

Ans: C
Feedback:
A complete review of systems, including vital signs and laboratory work, is indicated. Nurses must elicit information about current and past medical history. In particular, a complete history of help-seeking behaviors through the medical care system is essential, including any diagnostic testing, workups, hospitalizations, and outpatient surgeries. Critical areas of assessment include sleep, appetite, weight gain or loss, and bowel function. Evaluating these can help to rule out psychiatric comorbidities, such as sleep, eating, mood, or anxiety disorders. Confrontation and pain treatment may be premature and the use of placebos is unethical.

Answer to Question 2

Ans: B
Feedback:
Nursing diagnoses for clients with somatoform disorders focus on identifying the causes of dysfunctional coping and issues related to the family and psychosocial interaction. Anxiety, low self-esteem, and distress are plausible but are not directly suggested by the scenario.