A nurse notices other clients on the unit avoiding a client diagnosed with antisocial personality disorder. When discussing appropriate behavior in group therapy, which of the following comments is expected about this client by his peers?
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Solution
Lack of honesty.
Clients with antisocial personality disorder tend to engage in acts of dishonesty, shown by lying.
A client with antisocial personality is trying to convince a nurse that he deserves special privileges and that an exception to the rules should be made for him. Which of the following responses is the most appropriate?
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Solution
“What you’re asking me to do is unacceptable.”
These clients often try to manipulate the nurse to get special privileges or make exceptions to the rules on their behalf. By informing the client directly when actions are inappropriate, the nurse helps the client learn to control unacceptable behaviors by setting limits.
Option A: By sitting down to talk about the request, the nurse is telling the client there’s room for negotiating when there is none.
Which of the following interventions is important for a client with paranoid personality disorder taking olanzapine (Zyprexa)?
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Solution
Explain that the drug is less effective if the client smokes.
Olanzapine (Zyprexa) is less effective for clients who smoke cigarettes. Olanzapine doesn’t cause euphoria (damn), and extrapyramidal side effects aren’t a problem. However, the client should be aware of adverse effects such as tardive dyskinesia.
Which of the following types of behavior is expected from a client diagnosed with a paranoid personality disorder?
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Solution
Hypersensitive.
People with paranoid personality disorders are hypersensitive to perceived threats.
Option A: Schizotypal personalities appear eccentric and engage in activities others find perplexing.
Option B: Clients with narcissistic personality disorder are interpersonally exploitative to enhance themselves or indulge in their own desires.
Option D: A client with a histrionic personality disorder can be extremely seductive when in search of stimulation and approval.
Which of the following characteristics is expected for a client with paranoid personality disorder who receives bad news?
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Solution
The client responds from a rational, objective point of view.
Clients with paranoid personality disorder are affectively restricted, appear unemotional, and appear rational and objective.
Which of the following statements is typical for a client diagnosed with a personality disorder?
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Solution
“I see nothing humorous in this situation.”
Clients with paranoid personality disorder tend to be extremely serious and lack a sense of humor.
A nurse notices that a client is mistrustful and shows hostile behavior. Which of the following types of personality disorder is associated with these characteristics?
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Solution
Paranoid.
Paranoid individuals have a need to constantly scan the environment for signs of betrayal, deception, and ridicule, appearing mistrustful and hostile. They expect to be tricked or deceived by others.
An adult client with a borderline personality disorder become nauseated and vomits immediately after drinking after drinking 2 ounces of shampoo as a suicide gesture. The most appropriate initial response by the nurse would be to:
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Solution
Sit quietly with the client until nausea and vomiting subside.
This intervention demonstrates the nurse’s caring presence which is vital for this client.
Option A: Although the treatment team does need to know about the event, notification is not the immediate concern.
Option B: This is premature and it reinforces the client’s predisposition to manipulative behavior.
Option D: This medication is inappropriate in this situation; vomiting would be expected after the ingestion of shampoo.
A client with a diagnosis of narcissistic personality disorder has been given a day pass from the psychiatric hospital. The client is due to return at 6pm. At 5pm the client telephones the nurse in charge of the unit and says “6 o’clock is too early. I feel like coming back at 7:30.” The nurse would be most therapeutic by telling the client to:
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Solution
Return on time or restrictions will be imposed.
This sets limits, points out reality, and places responsibility for behavior on the client.
A nurse is orienting a new client to the unit when another client rushes down the hallway and asks the nurse to sit down and talk. The client requesting the nurse’s attention is extremely manipulative and uses socially acting-out behaviors when demands are unmet. The nurse should:
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Solution
Tell the interrupting client to sit down and be patient, stating, “I’ll be back as soon as possible.”
This sets realistic limits on behavior without rejecting the client