When caring for a client with a diagnosis of schizotypal personality disorder, the nurse should:
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Solution
Respect the client’s needs for social isolation.
These clients are withdrawn, aloof, and socially distant; allowing distance and providing support may encourage the eventual development of a therapeutic alliance. Group therapy would increase this client’s anxiety; cognitive or behavioral therapy would be more appropriate.
A young, handsome man with a diagnosis of antisocial personality disorder is being discharged from the hospital next week. He asks the nurse for her phone number so that he can call her for a date. The nurse’s best response would be:
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Solution
“I like you, but our relationship is professional.”
This accepts the client as a person of worth rather than being cold or implying rejection. However, the nurse maintains a professional rather than a social role.
A person with antisocial personality disorder has difficulty relating to others because of never having learned to:
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Solution
Empathize with others.
The lack of superego control allows the ego and the id to control the behavior. Self-motivation and self-satisfaction are of paramount concern.
The client with antisocial personality disorder:
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Solution
Is generally unable to postpone gratification.
Individuals with this disorder tend to be self-centered and impulsive. They lack judgment and self-control and do not profit from their mistakes.
A client with a diagnosis of borderline personality disorder has negative feelings toward the other clients on the unit and considers them all to be “bad.” The nurse understands this defense is known as:
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Solution
Splitting.
Splitting is the compartmentalization of opposite-affect states and failure to integrate the positive and negative aspects of self or others.
When working with the nurse during the orientation phase of the relationship, a client with a borderline personality disorder would probably have the most difficulty in:
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Solution
Setting mutual goals for the relationship.
Clients with borderline personality disorders frequently demonstrate a pattern of unstable interpersonal relationships, impulsiveness, affective instability, and frantic efforts to avoid abandonment; these behaviors usually create great difficulty in establishing mutual goals.
A hospitalized client, diagnosed with a borderline personality disorder, consistently breaks the unit’s rules. This behavior should be confronted because it will help the client:
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Solution
Become more self-aware.
Client’s must first become aware of their behavior before they can change it. Occurs after the client is aware of the behavior and has a desire to change the behavior.
A 20-year old college student has been brought to the psychiatric hospital by her parents. Her admitting diagnosis is borderline personality disorder. When talking with the parents, which information would the nurse expect to be included in the client’s history? Select all that apply.
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Solution
Answer: A, B, E.
A psychiatrist prescribes an anti-obsessional agent for a client who is using ritualistic behavior. A common anti-anxiety medication used for this type of client would be:
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Solution
Fluvoxamine (Luvox).
This drug blocks the uptake of serotonin.
The nursing diagnosis that would be most appropriate for a 22-year old client who uses ritualistic behavior would be:
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Solution
Ineffective coping.
Ineffective coping is the impairment of a person’s adaptive behaviors and problem-solving abilities in meeting life’s demands; ritualistic behavior fits under this category as a defining characteristic.