Rasmussen Mental Health Exam 3
UPDATED Exam Questions and
CORRECT Answers
Somatoform Disorders - CORRECT ANSWER- ✔✔An umbrella group of disorders
characterized by the presence of one or more physical symptoms accompanied by abnormal
thoughts, feelings, and behavioral reactions in response to these symptoms, with NO
PHYSICAL FINDINGS OR MEDICAL ILLNESSES TO EXPLAIN THEM. These
symptoms are NOT INTENTIONAL or under the conscious control of the patient.
They may DEMAND UNNECESSARY TESTS, and may be NON-COMPLIANT with
provider recommendations. Individuals with this disorder experience significant life
impairment as a result of their symptoms, preoccupation, and high anxiety.
Often undergo unnecessary surgeries, invasive diagnostic procedures, and drug trials, all of
which can be life-threatening.
Somatoform Disorders - Nursing interventions - CORRECT ANSWER- ✔✔1. Offer
explanations and support during diagnostic testing.
2. After physical complaints have been investigated, avoid further reinforcement of the
somatic complaints.
3. Spend time with the patient at times other than when he/she is expressing a physical
complaint (e.g., when talking about a pet or TV program and give the "reward" of extra
attention during those times).
4. Observe and record frequency and intensity of somatic symptoms.
5. DO NOT imply that symptoms are not real.
6. Shift focus from somatic complaints to feelings or to neutral topics.
,7. ******Assess secondary gains that physical illness provides for patient, such as attention,
lack of work responsibility, or guilt of a spouse causing them to stay rather than leave the
patient.
8. Use straightforward approach to patient exhibiting resistance or covert anger.
9. Have patient direct all requests to a designated nurse or clinician.
10. Show concern for patient, but avoid fostering dependency needs.
11. Reinforce patient's strengths and problem-solving abilities.
12. Teach assertive communication skills and techniques.
13. Teach patient stress reduction techniques, such as meditation, relaxation, and mild
physical exercise.
Important thing to remember regarding the assessment of a patient with somatoform disorder
- CORRECT ANSWER- ✔✔When patients complain of physical symptoms, TAKE THE
SYMPTOMS SERIOUSLY. Even if a medical explanation is not found understandable, the
symptoms are real and distressing to the patient.
Working with people who have somatic symptom disorders can be frustrating, and you and
other staff may find yourself avoiding interaction with them. However, when people feel they
are receiving care and attention, the intensity of symptoms tends to diminish. As the
symptoms are alleviated and **RAPPORT IS ESTABLISHED, it becomes easier to address
emotional issues.
Secondary Gains - CORRECT ANSWER- ✔✔Benefits that a person might be receiving from
the symptoms they are having.
Example: the patient is not able to perform the usual family, work, and social functions, and
receives extra attention from loved ones.
,If a patient derives personal benefit from the symptoms, relinquishing the symptoms is more
difficult.
Hypochondriasis (Illness Anxiety Disorder) - CORRECT ANSWER- ✔✔Preoccupied with
having or eventually developing a serious illness. Patients with this disorder may or may not
present with somatic symptoms, and if they do, the symptoms are usually mild.
What they do exhibit is a high level of anxiety and alarm about their health lasting at least 6
months, and may either excessively check for problems or avoid medical care. It is important
to consider other possible diagnoses such as anxiety disorders.
They are more alarmed by the potential implications of any disorder than with the disorder
itself, and are alarmed with any new bodily sensations. Patients can misinterpret normal
physical sensations such as sweating, abdominal cramping, or awareness of heartbeat as
indicative of disease.
Conversion Disorder - CORRECT ANSWER- ✔✔Disorder that presents with one or more
symptoms of impaired motor or sensory function. The deficit causes significant distress to the
patient and impaired social or occupational functioning.
Symptoms include weakness or paralysis, abnormal movement, swallowing or speech
difficulties, seizures or attacks, sensory loss or anesthesia, or symptoms involving the senses
(blindness or loss of smell).
Nursing Interventions for Conversion Disorder - CORRECT ANSWER- ✔✔Use a straight
forward approach
Be supportive, yet ASSERTIVE with them
Pt independence is IMPORTANT, they need to be able to take care of THEMSELVES. Don't
do everything for them!
Dissociative Disorders - CORRECT ANSWER- ✔✔A disturbance in the normally well-
integrated continuum of consciousness, memory, identity, and perception.
, Dissociation is an unconscious defense mechanism to protect the individual against
overwhelming anxiety RELATED TO PAST TRAUMA, and ranges from minor to severe in
presentation.
Patients with dissociative disorders have intact reality testing, meaning they are not
delusional or hallucinating. People with these disorders routinely experience significant
emotional pain and struggle with overall functioning and safety.
Dissociative Fugue - CORRECT ANSWER- ✔✔Often associated with dissociative amnesia,
which is amnesia related to a traumatic accident. Fugue is when the patient flees from their
normal life to another location and starts a new life.
Gradually over time, memories of the original life may be triggered. Patients can become
confused and embarrassed when the amnesia subsides and memory returns.
Interventions for Dissociative Disorders - CORRECT ANSWER- ✔✔1. Ensure patient safety
by providing safe, protected environment and frequent observation.
2. Provide non-demanding, simple routine.
3. Confirm identity of patient and orientation to time and place.
4. Encourage patient to do things for self and make decisions about routine tasks.
5. Assist with other decision making until memory improves.
6. Support patient during exploration of feelings surrounding the stressful event.
7. Do not overwhelm patient with data regarding past events.
8. Allow patient to progress at own pace as memory is recovered.
9. Provide support during disclosure of painful experiences.
