Situation: A 30-year-old male employee frequently complains of low back pain that leads to frequent absences from work. Consultation and tests reveal negative results. The client has which somatoform disorder?

Correct Answer: D

Rationale: The correct answer is D: Somatoform Pain Disorder. This disorder is characterized by persistent, severe pain without any identifiable physical cause. In this case, the individual's low back pain has been investigated with negative results, indicating no physical basis for the pain. This aligns with the criteria for somatoform pain disorder. A: Somatization Disorder involves a history of multiple, recurrent physical complaints across various organ systems, not just focused on pain. B: Hypochondriasis is characterized by excessive fear of having a serious illness, whereas this individual's pain is the primary concern. C: Conversion Disorder involves neurological symptoms that cannot be explained by medical evaluation, such as paralysis or blindness, which is not the case here. In summary, the individual's unexplained, persistent pain fits the criteria for Somatoform Pain Disorder, making it the correct choice among the options provided.

Correct Answer: B

Rationale: The correct answer is B: Cocaine. The symptoms described align with acute cocaine intoxication, including hallucinations, agitation, and nasal irritation from snorting it. Heroin (A) typically causes drowsiness, LSD (C) hallucinations without agitation, and marijuana (D) does not typically lead to hallucinations or nasal irritation. Identifying the correct substance can guide appropriate medical interventions and ensure the client's safety.

Correct Answer: B

Rationale: The correct answer is B: Weight gain. In anorexia nervosa, weight gain is a key indicator of improvement as it signifies the client is increasing their nutritional intake and addressing their malnourishment. This is a tangible and measurable sign of progress in treatment. Choices A, C, and D may also be positive indicators, but weight gain directly addresses the core issue of the disorder by improving physical health and reversing the effects of malnutrition. Eating in the dining room (A) may not necessarily mean the client is consuming adequate calories. Attending ward activities (C) and having a more realistic self-concept (D) are important psychosocial aspects but do not directly address the physical health aspect of anorexia nervosa.

Correct Answer: C

Rationale: The correct answer is C: The conversion symptom has symbolic meaning to the client. In conversion disorder, physical symptoms arise unconsciously due to psychological stress. The symptom may represent an underlying emotional conflict or distress that the individual is unable to express verbally. Understanding the symbolic meaning of the symptom is crucial for effective treatment. Choice A is incorrect because conversion symptoms are not consciously created to control anxiety. Choice B is incorrect as the client may not necessarily experience high anxiety in response to the paralysis; anxiety may be present but is not the primary cause of the symptom. Choice D is incorrect as a confrontational approach can be counterproductive in conversion disorder, as it may increase resistance and worsen symptoms.

Correct Answer: C

Rationale: The correct answer is C because helping the client establish a plan using privileges and restrictions based on compliance with refeeding is crucial during initial hospitalization for anorexia nervosa. This approach provides structure and support to promote healthy eating behaviors and weight restoration. Option A is incorrect as simply emphasizing good nutrition may not be sufficient for a client with anorexia nervosa who likely has deep-seated psychological issues related to food and body image. Option B is incorrect as ignoring mealtime behavior can be detrimental to the client's recovery process. Option D is incorrect as focusing on long-term consequences may not be effective during the initial phase of treatment when the priority is refeeding and stabilizing the client's health.