A client with complex somatic symptom disorder is complaining of significant pain in the joints. When providing care to this client, which of the following would be most important for the nurse to keep in mind?

Correct Answer: B

Rationale: The correct answer is B: The client's experience of pain is real. In complex somatic symptom disorder, physical symptoms are real to the client even if there is no clear medical explanation. It is crucial for the nurse to validate the client's experience of pain to establish trust and promote therapeutic alliance. This approach can help address the underlying psychological factors contributing to the pain. Incorrect choices: A: Opioid analgesics are not always the primary mode of therapy for somatic symptom disorder as they may not address the underlying psychological factors contributing to the pain. C: Complementary therapies can be beneficial in managing pain and promoting overall well-being in clients with somatic symptom disorder. D: Outcomes need to consider not only the biologic aspects but also the psychosocial and environmental factors influencing the client's pain experience.

Correct Answer: B

Rationale: The correct answer is B because having a family member present during appointments ensures accurate information retention and understanding, especially for older patients with mild neurocognitive disorders who may have difficulty remembering or processing information independently. This support system can help clarify any confusion, address concerns, and monitor medication adherence. A: While reading the information provided by the pharmacist is helpful, it may not be sufficient for patients with cognitive impairments. C: While knowing they can call the doctor is important, relying solely on this may not provide immediate or real-time support when needed. D: Following instructions on the medication bottle is essential, but older patients with cognitive disorders may need additional assistance to ensure proper medication management.

Correct Answer: C

Rationale: In the working phase of the nurse-client relationship, the focus is on implementing interventions to address the client's issues. In this scenario, the nurse is actively helping the client practice assertive communication techniques and providing positive feedback for improvement. This phase involves collaboration and active problem-solving to achieve therapeutic goals. A: Pre-interaction phase is about gathering information before meeting the client. B: Orientation phase is about establishing rapport and setting goals. D: Termination phase is about summarizing progress and preparing for closure. Therefore, the correct answer is C because it aligns with the active intervention and problem-solving nature of the working phase.

Correct Answer: C

Rationale: The correct answer is C: Alprazolam. Alprazolam is a benzodiazepine that works quickly to alleviate anxiety symptoms due to its rapid onset of action. It enhances the effects of GABA, a neurotransmitter that reduces brain activity, providing immediate relief. Buspirone (A) may take weeks to reach full effect. Venlafaxine (B) is an SNRI that also takes time to show efficacy. Imipramine (D) is a tricyclic antidepressant with delayed onset of action and is not typically used as a first-line treatment for anxiety.

Correct Answer: B

Rationale: B is the correct answer because the patient's statement indicates a dangerous decision to switch from an SSRI (Prozac) to a MAOI without consulting a healthcare provider. MAOIs have significant interactions with certain foods and other medications that can lead to serious side effects such as hypertensive crisis. This decision shows a lack of understanding of the importance of proper medication management and the potential risks involved. Choices A, C, and D all demonstrate a reasonable understanding of antidepressant therapy and do not indicate immediate safety concerns.