A nurse is caring for a client who repeatedly reports episodes of paralysis of the arms. The client has received a medical work up and there is no identifiable cause. The nurse understands that the client will likely be diagnosed with which of the following disorders?

Choice A reason: Functional neurological symptom disorder, formerly known as conversion disorder, involves deficits in voluntary motor or sensory functions that cannot be explained by neurological or medical conditions. Paralysis, as seen in this client, is a classic manifestation where psychological stress is converted into physical symptoms without a clear physiological etiology. Choice B reason: Illness anxiety disorder is characterized by a preoccupation with having or acquiring a serious, undiagnosed medical illness. Unlike the current scenario, patients with this disorder typically have minimal or no somatic symptoms; their primary distress is the high level of anxiety regarding the perceived threat of a future or hidden disease. Choice C reason: Somatic symptom disorder involves one or more distressing physical symptoms that result in significant disruption of daily life, accompanied by excessive thoughts, feelings, or behaviors. While similar, it focuses on the patient's reaction to the symptoms rather than the specific neurological "mismatch" found in functional neurological symptom disorder. Choice D reason: Factitious disorder occurs when an individual deliberately creates, exaggerates, or feigns physical or psychological symptoms to assume the "sick role." In this case, there is no evidence that the client is intentionally producing the paralysis for secondary gain or attention, which is a requirement for a factitious diagnosis.