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An appropriate outcome for a patient with a personality disorder and a nursing diagnosis of Ineffective coping as evidenced by use of manipulation would be that the patient will:
- A. refrain from manipulative behavior at all times
- B. use manipulation only to get legitimate needs met
- C. acknowledge manipulative behavior when it is pointed out
- D. identify when he is experiencing feelings of anger
Correct Answer: C
Rationale: Rationale: Choice C is correct as it focuses on the patient acknowledging manipulative behavior when pointed out. This is important for growth and self-awareness in handling emotions and behaviors effectively. Choices A and B are extreme and unrealistic expectations, as complete cessation or selective use of manipulation may not be achievable. Choice D is irrelevant to the nursing diagnosis and does not address the core issue of ineffective coping through manipulation.
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How the child's development is influenced by the school and the teacher?
- A. mental
- B. social
- C. emotional
- D. all of these
Correct Answer: D
Rationale: Schools and teachers shape children holistically. Mental development occurs through intellectual stimulation (A), social development via peer interactions (B), and emotional development through resilience and self-awareness (C). 'All of these' (D) reflects their comprehensive influence.
A client has been admitted with disorganized type schizophrenia. The nurse observes blunted affect and social isolation. The client occasionally curses or calls another client a 'jerk' without provocation. The nurse asks the client how he is feeling, and he responds, 'Everybody picks on me. They frobitz me.' The best response for the nurse to make would be:
- A. That's really too bad.'
- B. Who do you mean when you say 'everybody'?'
- C. What difference does frobitzing make?'
- D. Why do they frobitz?'
Correct Answer: B
Rationale: The correct answer is B: "Who do you mean when you say 'everybody'?" This response is the best because it acknowledges the client's feelings and seeks clarification. By asking for specifics, the nurse can gain a better understanding of the client's perceptions and experiences, which can help in providing appropriate care and support.
Choice A: "That's really too bad." This response lacks empathy and does not address the client's concerns directly.
Choice C: "What difference does frobitzing make?" This response is dismissive and does not focus on the client's feelings or experiences.
Choice D: "Why do they frobitz?" This response is confrontational and may make the client feel defensive, hindering effective communication and rapport-building.
A patient with an eating disorder states, 'I heard people laughing behind me in the check-out line at the department store. I bet they thought it was hysterically funny that I gained a pound in the last few days.' The nurse documents that the patient is exhibiting which cognitive distortion related to maladaptive eating regulation responses?
- A. Magnification
- B. Personalization
- C. Overgeneralization
- D. Dichotomous thinking
Correct Answer: B
Rationale: The correct answer is B: Personalization. Personalization is a cognitive distortion where an individual takes responsibility for events that are not entirely their fault. In this scenario, the patient is attributing the laughter of people in the check-out line to being about them and their weight gain, when in reality, the laughter may have had nothing to do with them. This distortion can contribute to feelings of guilt, shame, and self-blame.
A: Magnification involves exaggerating the importance or meaning of an event, which is not evident in the scenario.
C: Overgeneralization involves making broad negative conclusions based on a single event, which is not demonstrated here.
D: Dichotomous thinking is the tendency to view situations in black and white terms, with no middle ground, which is not present in the patient's statement.
A client with obsessive-compulsive personality disorder seeks treatment for depression after the recent breakup of a relationship. The client constantly procrastinated about proposing marriage and said his girlfriend complained that he did not show her affection and that he was too controlling. Now he describes inability to sleep, poor concentration, and loss of energy since the breakup. Which outcome is a priority for the client? The client will:
- A. Demonstrate assertive behavior
- B. Express hope for developing a new relationship in the future
- C. Identify feelings of sadness related to the failed relationship
- D. List three new ways to reduce stress
Correct Answer: C
Rationale: Rationale: The correct answer is C: Identify feelings of sadness related to the failed relationship. This is the priority outcome because the client is experiencing symptoms of depression following the breakup, such as insomnia, poor concentration, and loss of energy. By identifying and processing the feelings of sadness related to the failed relationship, the client can begin to work through the grief and start the healing process.
Summary:
A: Demonstrating assertive behavior may be beneficial for the client in the long term but is not the priority at this stage when dealing with depression.
B: Expressing hope for a new relationship may provide temporary relief but does not address the underlying issues of depression and unresolved feelings from the breakup.
D: Listing new ways to reduce stress is important for overall well-being but does not address the primary concern of processing feelings of sadness and grief related to the failed relationship.
A patient remanded by the court after his wife had him jailed for battery told the judge how sorry he was and suggested he needed psychiatric help. His history reveals acting-out behaviors as an adolescent and several adult arrests. The nurse interviews him about his relationship with his wife. Which statement by the patient is most consistent with a diagnosis of antisocial personality disorder?
- A. I've done some stupid things in my life, but I've learned a lesson.'
- B. I'm feeling terrible about the way my behavior has hurt my family.'
- C. I have a quick temper, but I can usually keep it under control.'
- D. I hit her because she nags at me. She deserves it when I beat her up.'
Correct Answer: D
Rationale: The correct answer is D because it demonstrates a lack of remorse, empathy, and justification for violent behavior, which are key characteristics of antisocial personality disorder. The statement indicates a pattern of blaming others for his actions and a sense of entitlement to use violence as a means of control.
Choice A is incorrect because it shows acknowledgment of past mistakes and a willingness to learn from them, which is not typical of individuals with antisocial personality disorder. Choice B is incorrect as it reflects genuine regret and concern for the impact of his actions, which is inconsistent with the disorder. Choice C is incorrect because it implies an ability to control his temper, whereas individuals with antisocial personality disorder often struggle with impulsivity and aggression.