Psych Ch 24 EAQ
Screening for which personality disorder should be focused on the male population? Select all that apply.
Antisocial Paranoid Schizotypal
A primary health care provider is planning therapy for a patient with narcissistic personality disorder. What treatment option does the nurse anticipate as most effective for the patient?
Individual cognitive-behavioral therapy
A patient arrested for an assault in which the patient savagely beat a classmate states, "The guy deserved everything he got." The behaviors described are most consistent with the clinical picture of which disorder?
Antisocial personality disorder
Which characteristic demonstrated by a patient diagnosed with a personality disorder will result most likely in an admission to a psychiatric unit?
Borderline personality disorder and reporting stress.
Which statement made by a patient illustrates a primary coping style of persons with borderline personality disorder (BPD)?
"Last night the nurse let me go outside and smoke. I can't believe you aren't letting me. I used to think you were the best nurse here."
The nurse tells a patient diagnosed with borderline personality disorder, "A new case manager has been assigned to work with you." Which initial reaction is most likely for this patient?
Anger
A patient is very sensitive to criticism, lacks empathy towards others, and remains neutral. Which treatment strategy does the primary health care provider instruct the nurse to include in the patient's treatment plan? Select all that apply.
"Administer lithium carbonate to the patient." "Teach socialization techniques in a group." "Give psychotherapy to the patient."
A patient diagnosed with a borderline personality disorder shows the nurse multiple new, shallow self-inflicted cuts. Select the nurse's therapeutic response.
"I will care for your wounds, and then you should write down what you were thinking and feeling when this happened. We will discuss it later."
Which statement by the nurse demonstrates communication specifically appropriate for a patient diagnosed with antisocial personality disorder? Select all that apply.
"No, I don't think the rules are the problem, but you need to follow the rules." "Referring to the staff in a sexual manner is not acceptable behavior." "I don't accept responsibility for you losing privileges for arguing with staff. "
The nurse is preparing to manage the care of a patient diagnosed with a borderline personality disorder. The nurse demonstrates an understanding of therapeutic interventions that focus on the characteristics of such disorders when making which statement to the patient?
"When you want my attention, please explain that to me rather than resorting to manipulative behavior."
The nurse is teaching the family of a patient with a personality disorder that psychological problems are often due to a disruption in the normal separation-individuation of the child from the mother. Identify the correct order of the different stages of this process as described by Margaret Mahler and her colleagues.
1. Normal autism 2. Symbiosis 3. Differentiation 4. Practicing 5. Rapprochement 6. Object constancy
Which is true of pharmacological therapies for treatment of personality disorders?
Although there are no Food and Drug Administration (FDA)-approved drugs specific to the treatment of personality disorders, patients benefit from specific off-label uses of antipsychotics, mood stabilizers, and antidepressants, depending on which personality disorder is evident.
A patient diagnosed with an antisocial personality disorder becomes frustrated and angry when unable to get connected to the internet. The patient then curses loudly, disrupting, frightening, and disturbing others. Which nursing actions are therapeutic? Select all that apply.
Ask the patient, "How were you feeling when you were having this difficulty?" Encourage the patient to recognize signs of mounting tension and seek assistance. Tell the patient, "Further outbursts will result in suspension of your computer privileges."
The priority nursing intervention for a patient diagnosed with borderline personality disorder is to
Assess for suicidal and self-mutilating behaviors
A patient at the mental health center says to the nurse, "Most of the staff does not care about me, but you are different. You understand my problems." When the nurse tells this patient about an upcoming career change, the patient becomes very angry. An hour later, the patient loudly announces, "I'm going to cut my wrists. I need to be hospitalized immediately." Given this scenario, which personality disorder is most likely?
Borderline
Which statement about persons diagnosed with personality disorders is accurate?
Characteristics of these disorders are most evident in social and interpersonal interactions.
Which is the best treatment method for the patient who speaks of several failed relationships and appears arrogant and lacks empathy for others?
Cognitive-behavioral therapy
What is the psychosocial assessment focus for a patient diagnosed with antisocial personality disorder? Select all that apply.
Current stressors Substance abuse Anxiety level Homicidal ideations
Which characteristics will the nurse assess in the patient diagnosed with antisocial personality disorder?
Deceitfulness, impulsiveness, and lack of empathy
What personality disorders are more common in women than in men?
Dependent
A patient with borderline personality disorder has suicidal intentions. The nurse plans to teach mindfulness and emotion regulation to improve interpersonal effectiveness skills in the patient. Which therapy does the nurse follow to effectively work with the patient?
Dialectical behavior therapy
The nurse is assessing a patient with narcissistic personality disorder. What behavior is the nurse most likely to find in this patient compared to other patients in the ward?
Exploitation of others
Which intervention by the nurse is associated specifically with care provided for a patient diagnosed with paranoid disorder? Select all that apply.
Giving the patient a copy of the daily routine the patients are expected to follow Explaining why the scheduled therapy session will be delayed 30 minutes Monitoring the patient for behaviors associated with psychosis
Which behaviors are demonstrated characteristically by a patient diagnosed with narcissism?
Grandiose, exploitive, and rage-filled behavior
Which patient assessment data support the diagnosis of schizoid personality disorder? Select all that apply.
Has never been married Raised in foster care after age 7 because of death of parents Is employed as a nightshift janitor at an office complex Shares that, "I don't really care whether people are afraid of me."
Patients demonstrating characteristics of personality disorders have various self-defeating behaviors and interpersonal problems despite having near-normal ego functioning and intact reality testing. A nursing diagnosis that addresses this sort of interpersonal dysfunction is
Impaired social interaction
A nurse caring for a patient who has been diagnosed with a personality disorder should expect that the patient will exhibit which behavior?
Inflexible and maladaptive responses to stress
A nurse is caring for a patient with antisocial personality disorder. What appropriate interventions should the nurse take to control aggressive behavior of the patient?
Instruct the patient to make a model from clay.
What type of dialectical behavior therapy (DBT) for borderline personality disorder aims at reducing the person's destructive behavior?
Intensive outpatient treatment
Research has indicated that the antisocial personality may present with which characteristic?
Lack of remorse
A nurse is caring for a patient with paranoia and severe social and interpersonal deficits. What interventions should the nurse perform while caring for the patient?
Leave the patient alone when needed
An adult diagnosed with antisocial personality disorder begins an outpatient program at the community mental health center. Which is an appropriate outcome for this patient?
Listen attentively as others share their feelings
What is the primary goal of milieu therapy for patients diagnosed with personality disorders?
Managing the effect of the behavior on the entire group.
When providing care for a patient diagnosed with borderline personality disorder, the nurse will need to consider strategies for dealing with the patient's
Mood shifts, impulsivity, and splitting
A primary health care provider is prescribing medications for a patient with borderline personality disorder who shows risk of self-injuring. Which medication would a nurse expect to be prescribed?
Naltrexone (ReVia)
The nurse is caring for a patient with antisocial behavior. The patient is aggressive, exploits the group members during any group activities, and lacks sympathy toward others. What appropriate action should the nurse take while caring for the patient?
Note signs of aggression in the patient
Which assessment question focuses on the characteristic behaviors of a patient diagnosed with borderline personality disorder? Select all that apply.
Over a few hours can your mood shift dramatically? Have you ever been told you are sarcastic? How would you describe your romantic relationships? Have you ever attempted suicide?
A nurse observes that a patient with osteoarthritis behaves rudely to the staff and refuses to take treatment. On inquiry, the nurse learns that the patient thinks that all staff members are planning to harm and deceive him or her. What is the patient likely to be suffering from?
Paranoid personality disorder
What personality disorder is more common among men?
Paranoid personality disorder
What statement about histrionic personality disorder is most appropriate?
People who are egocentric by birth are predisposed to the disorder.
What are the features of antisocial personality disorder?
Prevalence is higher among African-American men.
Which statement concerning impulse control training is true? Select all that apply.
Problem solving strategies are taught and practiced Focus is on social and interpersonal interactions Patients are encouraged to stop and think before acting The cost and benefit of actions are explored
The nurse explains to a patient with a borderline personality disorder that the patient's former psychiatrist resigned and a new psychiatrist has been hired. Which patient reaction is most likely?
Rage
The nurse is assessing a patient for a possible personality disorder. What behavior does the nurse identify as feature of paranoid personality disorder?
Reluctance to answer any questions
A newly admitted patient has an axis II diagnosis of schizoid personality disorder. The nursing intervention of highest priority will be to
Respect need for social isolation
A patient is withdrawn and suspicious and states he or she has always preferred to be alone. The patient describes him- or herself as having "special powers" and states, "I believe we can all read each other's thoughts at times." Based on this presentation, the nurse suspects which personality disorder?
Schizotypal (STPD)
A patient experiences extreme anxiety in social situations and seems to have some intellectual and perceptual distortions but can be made aware of the misinterpretations of reality. What is the patient likely to be suffering from?
Schizotypal personality disorder
During an interview, the nurse asks a patient with borderline personality disorder about childhood experiences. What findings about the patient's childhood may relate to the patient's borderline personality disorder?
Seeking emotional support from their mother at the age of 18-24 months
What term is used to identify the inability to view both positive and negative aspects of others as part of a whole?
Splitting
A community mental health nurse works with an adult patient diagnosed with borderline personality disorder. The patient says to the nurse, "I'm under so much stress, I feel like cutting my throat." What should the nurse do first?
Talk with the patient about the feelings of stress.
What appropriate symptoms should the nurse asses to identify borderline personality disorder when interviewing patients? Select all that apply.
Tendency towards sarcasm Feelings of emptiness Frequency of mood shifts
A patient was admitted to the psychiatric in-patient unit due to manipulative and aggressive behavior. What appropriate strategy does the nurse follow while interacting with the patient?
The nurse asks questions to explore the patient's situation.
A patient gets excessively anxious in group activities such as playing an indoor game and is hypersensitive to negative evaluation. What interventions should the nurse perform while caring for this patient? Select all that apply.
The nurse has a friendly approach towards the patient. The nurse accepts the patient's request to not be involved in group activities.
The nurse is caring for a patient who had attempted suicide. The nurse reports that the patient has histrionic personality disorder. Based on which symptom did the nurse diagnose the patient's behavioral disorder? Select all that apply.
The patient feels comfortable when given complete attention. The patient wants the best of everything.
The nurse is caring for a patient with borderline personality disorder who has impaired social interaction. What symptoms does the nurse find in the patient? Select all that apply.
The patient feels rejected. The patient reports to have intense relationships. The patient has unstable relationships.
The nurse is caring for a rheumatoid arthritis patient with borderline personality disorder. Which behavior does the nurse find in the patient when compared to other patients in the ward?
The patient shows extreme fluctuating emotions.
Which statement is descriptive of patients with a personality disorder?
They are resistant to behavioral change
A nurse manages care for an individual with a personality disorder. What is the most attainable outcome for this patient?
Within four weeks, the patient will describe personal characteristics of reactions to stress
A nurse manages care for an individual diagnosed with avoidant personality disorder. Select the appropriate outcome for this patient. The patient will:
demonstrate use of assertive communication within three months.