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When told that he is scheduled to interview a patient with narcissistic personality disorder, the nurse can anticipate the assessment findings will include the following:
- A. charm, drama, seductiveness, and admiration seeking.
- B. preoccupation with minute details and perfectionism.
- C. difficulty being alone, indecisiveness, and submissiveness.
- D. grandiosity, self-importance, and a sense of entitlement.
Correct Answer: D
Rationale: The correct answer is D. In narcissistic personality disorder, individuals exhibit grandiosity, self-importance, and a sense of entitlement. This is a key feature of the disorder where individuals have an inflated sense of their own importance and require excessive admiration. This behavior is often accompanied by a lack of empathy and exploitation of others.
Choice A (charm, drama, seductiveness, and admiration seeking) is more characteristic of histrionic personality disorder.
Choice B (preoccupation with minute details and perfectionism) is more characteristic of obsessive-compulsive personality disorder.
Choice C (difficulty being alone, indecisiveness, and submissiveness) does not align with the typical presentation of narcissistic personality disorder.
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A student nurse visiting a senior center says, 'It's depressing to see these old people. They are weak and frail. I doubt any of them can engage in a discussion.' The student is expressing
- A. reality
- B. ageism
- C. empathy
- D. vulnerability
Correct Answer: B
Rationale: The correct answer is B: ageism. The student nurse's statement demonstrates prejudice and discrimination based on age. Ageism is the negative stereotypes, prejudice, and discrimination against individuals or groups based on their age. In this case, the student is making assumptions about the abilities and worth of older individuals solely based on their age. The statement does not reflect reality, as not all older people are weak or unable to engage in meaningful discussions. The other choices are incorrect as the statement is not reflective of reality (A), empathy (C), or vulnerability (D).
A client tried to gouge out his eye in response to auditory hallucinations commanding, 'If thine eye offend thee, pluck it out.' The nurse would analyze this behavior as indicating:
- A. Impaired impulse control
- B. Inability to manage anger
- C. Derealization
- D. Inappropriate affect
Correct Answer: A
Rationale: The correct answer is A: Impaired impulse control. This behavior shows a lack of control over impulsive actions, as the client acted immediately on the auditory hallucination without considering the consequences. Choice B is incorrect because anger management is not directly related here. Choice C, derealization, refers to feeling disconnected from reality, which is not evident in the scenario. Choice D, inappropriate affect, does not fit as the client's action is more about impulsivity than emotional expression. Ultimately, the client's behavior aligns most closely with impaired impulse control due to the immediate and extreme response to the auditory hallucination.
A patient with antisocial personality disorder tells Nurse A, 'You're a much better nurse than Nurse B said you were.' The patient tells Nurse B, 'Nurse A's upset with you for some reason.' To Nurse C the patient states, 'You'd like to think you're perfect, but I've seen three of your mistakes this morning.' These comments can best be assessed as:
- A. seductive.
- B. detached.
- C. guilt producing.
- D. manipulative.
Correct Answer: D
Rationale: The correct answer is D: manipulative. The patient's behavior demonstrates manipulation by attempting to create discord and control the relationships between the nurses. The patient uses different tactics to manipulate each nurse's emotions and perceptions for personal gain. Seductive (choice A) implies enticing or charming behavior, which is not evident in the scenario. Detached (choice B) suggests a lack of emotional connection, which is not the focus here. Guilt producing (choice C) involves inducing guilt, which the patient is not directly doing in this situation. Manipulative (choice D) best captures the patient's intent to influence others through deceptive and controlling tactics.
When planning inpatient psychotherapeutic activities for a patient who has antisocial personality disorder, the psychiatric-mental health nurse:
- A. focuses on group, rather than individual, therapy
- B. provides a permissive atmosphere, so the patient feels a sense of control
- C. provides an organized, structured environment
- D. recognizes that the disorder is characterized by social withdrawal
Correct Answer: C
Rationale: A structured environment sets clear boundaries, countering manipulative tendencies common in antisocial personality disorder.
During occupational therapy a young patient diagnosed with schizophrenia sits staring at a piece of paper. Which response is most therapeutic at this time?
- A. If you prefer to sit and stare for a time, it is acceptable for you to leave.'
- B. You seem immobilized by anxiety. Is there anything I can do to help?'
- C. Are you having trouble deciding where you want to glue that piece?'
- D. Rub the glue stick on the back of the paper.'
Correct Answer: D
Rationale: The correct answer is D because it provides a clear and simple directive that guides the patient on what to do next, promoting engagement in the therapeutic activity. By instructing the patient to rub the glue stick on the back of the paper, it helps redirect their focus and encourages participation in the task.
Choice A is incorrect as it allows the patient to disengage from the activity, which does not promote therapeutic progress. Choice B assumes the patient is anxious without evidence and may not address the core issue. Choice C is incorrect as it may not be relevant to the patient's current state and may further confuse or frustrate them.