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A nurse is developing a plan of care for a client diagnosed with an antisocial personality disorder who has been admitted to the inpatient psychiatric unit. Which of the following would the nurse most likely include? Select all that apply.
- A. Developing a therapeutic relationship
- B. Bargaining about the unit rules
- C. Holding the client responsible for behavior
- D. Discouraging client from discussing thoughts
- E. Using a firm, lecture-like approach for teaching
Correct Answer: A,C
Rationale: For ASPD, developing a therapeutic relationship (A) builds trust, and holding the client responsible for behavior (C) promotes accountability. Bargaining about rules (B) undermines structure, discouraging thoughts (D) hinders therapy, and a lecture-like approach (E) may provoke resistance.
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A nurse is developing a teaching plan for a client with an impulse-control disorder. The nurse is planning to explain the emotional aspects associated with the behavior as part of the plan. Which of the following would the nurse describe as occurring first before the individual commits the act?
- A. Remorse
- B. Tension
- C. Regret
- D. Pleasure
Correct Answer: B
Rationale: In impulse-control disorders, tension (B) builds before the act, driving the impulsive behavior as a release. Remorse (A), regret (C), and pleasure (D) typically follow the act, not precede it.
A nurse is interviewing a client and suspects that the client may have narcissistic personality disorder. Which client statement would help support the nurse?s suspicions?
- A. I have a very important position in life; everyone I know wants to be like me.
- B. My wife is poisoning my food so she can get rid of me and marry her boss.
- C. I like to work alone because then I can let my thoughts wander.
- D. I?m always the life of the party, making new friends all the time.
Correct Answer: A
Rationale: The statement about having an important position and being envied (A) reflects grandiosity and a need for admiration, core features of narcissistic personality disorder. Paranoia (B) suggests paranoid personality, solitude preference (C) aligns with schizoid, and sociability (D) is more histrionic.
A nurse is assessing a client diagnosed with avoidant personality disorder. Which of the following would the nurse most likely expect to find? Select all that apply.
- A. Shyness
- B. Feelings of inadequacy
- C. Feelings of superiority
- D. Perfectionism
- E. Detail oriented
Correct Answer: A,B
Rationale: Avoidant personality disorder is characterized by shyness (A) and feelings of inadequacy (B) due to fear of rejection. Feelings of superiority (C) align with narcissistic personality, and perfectionism (D) and detail-oriented behavior (E) are more typical of obsessive-compulsive personality.
The nurse is reviewing the medical record of a client diagnosed with antisocial personality disorder. The nurse notes that the client has had numerous episodes involving irritability, aggressiveness, and impulsivity and has exhibited callousness toward others. Based on this information, which nursing diagnosis would the nurse most likely identify as a priority?
- A. Risk for Other-Directed Violence
- B. Risk for Self-Injury
- C. Risk for Suicide
- D. Risk for Self-Directed Violence
Correct Answer: A
Rationale: The client?s irritability, aggressiveness, impulsivity, and callousness suggest a high risk for other-directed violence (A), a priority due to potential harm to others. Self-injury (B), suicide (C), and self-directed violence (D) are less characteristic of ASPD.
A nurse is working with a client who is a compulsive gambler. Which of the following would the nurse emphasize as crucial for relapse prevention? Select all that apply
- A. Medication therapy
- B. Family involvement
- C. Identification of triggers
- D. Anger management
- E. Milieu management
Correct Answer: B,C
Rationale: Family involvement (B) supports accountability and a supportive environment, and identifying triggers (C) helps the client avoid situations that prompt gambling. Medication therapy (A) is not standard, anger management (D) is less relevant, and milieu management (E) is too vague for relapse prevention.