The gas pedal on a person's car became stuck on a busy interstate highway, causing the car to accelerate rapidly. For 20 minutes, the car was very difficult to control. In the months after this experience, afterward, which assessment finding would the nurse expect?

Correct Answer: B

Rationale: The scenario depicts a frightening, traumatic, and stressful situation. Severe dissociation or "mind flight" may occur for those who have suffered significant trauma. The episodic failure of dissociation causes intrusive symptoms such as flashbacks. The problems identified in the distracters may or may not occur.

Correct Answer: B

Rationale: The patient mentions that the symptoms make people more interested. This indicates that the patient feels uninteresting and unpopular without the symptoms, thus supporting the nursing diagnosis of chronic low self-esteem. Defining characteristics for the other nursing diagnoses are not present in the scenario.

Correct Answer: D

Rationale: The correct answer is D) Factitious disorders are under voluntary control, whereas somatic symptom disorders involve the expression of psychological stress through somatization. This is because factitious disorders are characterized by intentional production or feigning of physical or psychological symptoms in order to assume the sick role, whereas somatic symptom disorders involve genuine physical symptoms that are linked to psychological distress. In factitious disorders, the individual consciously fabricates symptoms for various reasons such as gaining attention or sympathy, whereas in somatic symptom disorders, the physical symptoms are not intentionally produced but are a manifestation of underlying psychological distress. Option A is incorrect because both somatic symptom disorders and factitious disorders involve unconscious elements, but the key difference lies in the intentionality of symptom production. Option B is incorrect as it does not capture the essential distinction between intentional symptom fabrication in factitious disorders versus genuine symptom expression in somatic symptom disorders. Option C is incorrect as neither disorder is exclusively determined by childhood sexual abuse or solely culturally bound; they can have diverse etiologies and manifestations beyond these factors. In an educational context, understanding the differences between somatic symptom disorders and factitious disorders is crucial for nurses to accurately assess and provide care for patients presenting with complex health behaviors. By recognizing the underlying motivations and mechanisms behind these disorders, nurses can offer appropriate interventions and support tailored to the individual's needs.

Correct Answer: D

Rationale: CDs are manifested by a persistent pattern of behavior in which the rights of others and age-appropriate societal norms are violated. Intermittent explosive disorder is a pattern of behavioral outbursts characterized by an inability to control aggressive impulses in adults 18 years and older. Criteria for ADHD and PTSD are not met in the scenario.

Correct Answer: B

Rationale: Persons diagnosed with ODD are negativistic, disobedient, and defiant toward authority figures without seriously violating the basic rights of others, whereas persons with CD frequently behave in ways that do violate the rights of others and age-appropriate societal norms. Reliving traumatic events occurs with PTSD. Stereotypical language behaviors are seen in persons with autism spectrum disorders.