Which assessment question could a nurse ask to help identify secondary gains associated with a somatic symptom disorder?
a. "What are you unable to do now but were previously able to do?"
b. "How many doctors have you seen in the last year?"
c. "Who do you talk to when you're upset?"
d. "Did you experience abuse as a child?"
ANS: A
Secondary gains should be assessed. Secondary gains reinforce maladaptive behavior. The patient's dependency needs may be evident through losses of abilities. When secondary gains are prominent, the patient is more resistant to giving up the symptom. There may be a history of abuse or doctor shopping, but the question does not assess the associated gains.
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