ELITE COMPREHENSIVE
VARCAROLIS — CHPT 17 SOMATIC SYMPTOM DISORDERS
Comprehensive Psychiatric–Mental Health Nursing Review
ATI • HESI • Mental Health Nursing Final Exam Preparation
SPRING SEMESTER EXAMINATION MAY 2026
Which assessment data would help the health care team distinguish symptoms of
conversion (functional neurological) disorder from symptoms of illness anxiety disorder
(hypochondriasis)?
a.Voluntary control of symptoms
b. Patient's style of presentation
c. Results of diagnostic testing
d. The role of secondary gains
• ANS: B
• Patients with illness anxiety disorder (hypochondriasis) tend to be
more anxious about their concerns and display more obsessive
attention to detail, whereas the patient with conversion (functional
neurological) disorder often exhibits less concern with the symptom
they are presenting than would be expected. Neither disorder
involves voluntary control of the symptoms. Results of diagnostic
testing for both would be negative (i.e., no physiological basis would
be found for the symptoms). Secondary gains can occur in both
disorders but are not necessary to either. See relationship to
audience response question.
1|Page
,Which prescription medication would the nurse expect to be prescribed for a patient
diagnosed with a somatic symptom disorder?
a. Narcotic analgesics for use as needed for acute pain
b. Antidepressant medications to treat underlying depression
c. Long-term use of benzodiazepines to support coping with anxiety
d. Conventional antipsychotic medications to correct cognitive distortions
• ANS: B
• Various types of antidepressants may be helpful in somatic disorders
directly by reducing depressive symptoms and hence somatic
responses, but also indirectly by affecting nerve circuits that affect not
only mood, but fatigue, pain perception, GI distress, and other
somatic symptoms. Patients may benefit from short-term use of anti-
anxiety medication (benzodiazepines) but require careful monitoring
because of risks of dependence. Conventional antipsychotic
medications would not be used, although selected atypical
antipsychotics may be useful. Narcotic analgesics are not indicated.
A medical-surgical nurse works with a patient diagnosed with a somatic symptom
disorder. Care planning is facilitated by understanding that the patient will probably:
a.readily seek psychiatric counseling.
b.be resistant to accepting psychiatric help.
c. attend psychotherapy sessions without encouragement.
d.be eager to discover the true reasons for physical symptoms
• ANS: B
• Patients with somatic symptom disorders go from one health care
provider to another trying to establish a physical cause for their
2|Page
, symptoms. When a psychological basis is suggested and a referral
for counseling offered, these patients reject both.
A patient has blindness related to conversion (functional neurological) disorder but is
unconcerned about this problem. Which understanding should guide the nurse's
planning for this patient?
a.The patient is suppressing accurate feelings regarding the problem.
b.The patient's anxiety is relieved through the physical symptom.
c.The patient's optic nerve transmission has been impaired.
d.The patient will not disclose genuine fears.
• ANS: B
• Psychoanalytical theory suggests conversion reduces anxiety through
production of a physical symptom symbolically linked to an underlying
conflict. Conversion, not suppression, is the operative defense
mechanism in this disorder. While some MRI studies suggest that
patients with conversion disorder have an abnormal pattern of
cerebral activation, there is no actual alternation of nerve
transmission. The other distracters oversimplify the dynamics,
suggesting that only dependency needs are of concern, or suggest
conscious motivation (conversion operates unconsciously). See
relationship to audience response question.
A patient has blindness related to conversion (functional neurological) disorder. To help
the patient eat, the nurse should:
3|Page
VARCAROLIS — CHPT 17 SOMATIC SYMPTOM DISORDERS
Comprehensive Psychiatric–Mental Health Nursing Review
ATI • HESI • Mental Health Nursing Final Exam Preparation
SPRING SEMESTER EXAMINATION MAY 2026
Which assessment data would help the health care team distinguish symptoms of
conversion (functional neurological) disorder from symptoms of illness anxiety disorder
(hypochondriasis)?
a.Voluntary control of symptoms
b. Patient's style of presentation
c. Results of diagnostic testing
d. The role of secondary gains
• ANS: B
• Patients with illness anxiety disorder (hypochondriasis) tend to be
more anxious about their concerns and display more obsessive
attention to detail, whereas the patient with conversion (functional
neurological) disorder often exhibits less concern with the symptom
they are presenting than would be expected. Neither disorder
involves voluntary control of the symptoms. Results of diagnostic
testing for both would be negative (i.e., no physiological basis would
be found for the symptoms). Secondary gains can occur in both
disorders but are not necessary to either. See relationship to
audience response question.
1|Page
,Which prescription medication would the nurse expect to be prescribed for a patient
diagnosed with a somatic symptom disorder?
a. Narcotic analgesics for use as needed for acute pain
b. Antidepressant medications to treat underlying depression
c. Long-term use of benzodiazepines to support coping with anxiety
d. Conventional antipsychotic medications to correct cognitive distortions
• ANS: B
• Various types of antidepressants may be helpful in somatic disorders
directly by reducing depressive symptoms and hence somatic
responses, but also indirectly by affecting nerve circuits that affect not
only mood, but fatigue, pain perception, GI distress, and other
somatic symptoms. Patients may benefit from short-term use of anti-
anxiety medication (benzodiazepines) but require careful monitoring
because of risks of dependence. Conventional antipsychotic
medications would not be used, although selected atypical
antipsychotics may be useful. Narcotic analgesics are not indicated.
A medical-surgical nurse works with a patient diagnosed with a somatic symptom
disorder. Care planning is facilitated by understanding that the patient will probably:
a.readily seek psychiatric counseling.
b.be resistant to accepting psychiatric help.
c. attend psychotherapy sessions without encouragement.
d.be eager to discover the true reasons for physical symptoms
• ANS: B
• Patients with somatic symptom disorders go from one health care
provider to another trying to establish a physical cause for their
2|Page
, symptoms. When a psychological basis is suggested and a referral
for counseling offered, these patients reject both.
A patient has blindness related to conversion (functional neurological) disorder but is
unconcerned about this problem. Which understanding should guide the nurse's
planning for this patient?
a.The patient is suppressing accurate feelings regarding the problem.
b.The patient's anxiety is relieved through the physical symptom.
c.The patient's optic nerve transmission has been impaired.
d.The patient will not disclose genuine fears.
• ANS: B
• Psychoanalytical theory suggests conversion reduces anxiety through
production of a physical symptom symbolically linked to an underlying
conflict. Conversion, not suppression, is the operative defense
mechanism in this disorder. While some MRI studies suggest that
patients with conversion disorder have an abnormal pattern of
cerebral activation, there is no actual alternation of nerve
transmission. The other distracters oversimplify the dynamics,
suggesting that only dependency needs are of concern, or suggest
conscious motivation (conversion operates unconsciously). See
relationship to audience response question.
A patient has blindness related to conversion (functional neurological) disorder. To help
the patient eat, the nurse should:
3|Page
