A nurse is caring for a school-age client in an outpatient clinic. The nurse should identify which of the client findings are manifestations of a factitious disorder? (Select all that apply.)

Choice A reason: A withdrawn affect in a school-age child can be a manifestation associated with factitious disorder imposed on another. Children subjected to repeated medical evaluations, hospitalizations, and invasive procedures may display emotional withdrawal, fear, and reduced engagement. This behavioral change reflects psychological distress related to ongoing illness fabrication rather than a normal developmental response. Choice B reason: Multiple hospitalizations over a short period, particularly in the absence of a clear medical diagnosis, are a hallmark manifestation of factitious disorder imposed on another. Frequent admissions often result from a caregiver persistently seeking medical attention and interventions, despite inconclusive findings. This pattern strongly supports the presence of fabricated or induced illness. Choice C reason: Unexplained abdominal pain is a common manifestation in factitious disorder imposed on another. Symptoms are reported repeatedly without objective clinical findings to support an organic cause. The persistence of pain complaints despite extensive evaluations suggests symptom fabrication or induction rather than a true underlying medical condition. Choice D reason: Excessive thinking or preoccupation about health is characteristic of illness anxiety disorder, not factitious disorder. In factitious disorder imposed on another, the caregiver—not the child—drives the medical narrative and seeks attention through the child’s illness. Therefore, this finding does not align with the disorder in question. Choice E reason: Recent trauma is not a defining or typical manifestation of factitious disorder. While trauma may contribute to a variety of psychological or physical symptoms, it does not explain the pattern of repeated hospitalizations, unexplained symptoms, and caregiver behavior seen in this case.