A patient with predominant pain disorder says, My pain is from an ...

[danielfitts88]

A patient with predominant pain disorder says, My pain is from an undiagnosed injury. I can't take care of myself. I need pain medicine six or seven times a day. I feel like a baby because my family has to help me so much.
 
  It is important for the nurse to assess:
 
  a. Mood
  b. Cognitive style
  c. Secondary gains
  d. Identity and memory

Question 2

A patient says, I feel detached and weird all the time, like I'm looking at life through a cloudy window. Everything seems unreal. These feelings really interfere with my work and study. Which term should the nurse use to document this complaint?
 
  a. Depersonalization
  b. Hypochondriasis
  c. Dissociation
  d. Malingering

[wergv]

Answer to Question 1

ANS: C
Secondary gains should be assessed. The patient's dependency needs may be met through care from the family. When secondary gains are prominent, the patient is more resistant to giving up the symptom. The scenario does not allude to a problem of mood. Cognitive style and identity and memory assessment are of lesser concern because the patient's diagnosis has been established.

Answer to Question 2

ANS: A
Depersonalization involves a persistent or recurrent experience of feeling detached from and outside one's mental processes or body. Although reality testing is intact, the detached experience causes significant impairment in social or occupational functioning and distress to the individual. Malingering involves a conscious process of intentionally producing symptoms for an obvious benefit; dissociation is an unconscious defense mechanism to protect the individual against overwhelming anxiety. Hypochondriasis involves the interpretation of body sensations as symptomatic of a serious illness.