A nurse is caring for a client who frequently breaks their arms and other bones on purpose. The nurse understands that the client likely has which diagnosis?

Choice A rationale Illness anxiety disorder involves preoccupation with having or acquiring a serious illness, with somatic symptoms being absent or mild. The client's behavior of intentionally breaking bones is a deliberate act of self-harm or deception, which is inconsistent with the primary fear-driven preoccupation of illness anxiety disorder. Choice B rationale Factitious disorder is characterized by the falsification of physical or psychological signs or symptoms, or induction of injury or disease, associated with identified deception. The client's purposeful breaking of bones aligns with the diagnostic criteria, as they are intentionally causing harm to themselves for the purpose of assuming the sick role. Choice C rationale Functional neurological symptom disorder, also known as conversion disorder, involves neurological symptoms incompatible with recognized neurological or medical conditions. The symptoms are not intentionally produced or feigned. Intentionally breaking bones is a volitional act, distinguishing it from the non-volitional nature of conversion disorder symptoms. Choice D rationale Dissociative amnesia involves an inability to recall important personal information, usually of a traumatic or stressful nature, that is inconsistent with ordinary forgetting. It is a memory disturbance and does not involve the intentional self-infliction of physical injury as seen in the client's behavior.