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.
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