chapter 29 mh
The nurse provides education to the parent of a child diagnosed with intermittent explosive disorder. In addition to medication, what additional therapy does the nurse recommend?
anger management
A nurse suspects that a child has oppositional defiant disorder. When reviewing the child's history, which would support this suspicion? Select all that apply.
angry outbursts, blaming others, disobedience
A client with a dependent personality disorder is receiving treatment on a medical unit. The client asks the nurse for assistance to open the tube of toothpaste so they can brush their teeth. Which is the best response by the nurse?
"I'll stay here and you can show me what you've tried to do to get the top off"
Upon admission, a client with a personality disorder identifies areas of concern for which the client would like help. The nurse is aware that which will most likely be addressed by the health care team?
Psychological distress
An attractive and engaging client with antisocial personality disorder (ASPD) asks a nurse providing inpatient care to go out on a date. Which is the nurse's best response?
"No, my code of ethics prohibits me from dating clients."
A nurse providing care to a client with avoidant personality disorder establishes the underlying cause of problematic behavior. The client states, "I've pushed all my friends away and I hardly ever get out to have fun." Which is the nurse's best response
"You have a fear of being rejected by others."
A nurse has worked for a year with a client with Antisocial Personality Disorder (ASPD). The client offers to provide fitness consultation for the nurse at a gym the client attends. Which is an effective response?
"You seem interested in fitness and helping others
A client with a diagnosis of antisocial personality disorder would exhibit a history of conduct disorder before which age?
15 years old
The nurse provides education about antisocial personality disorder (ASPD) to a group of vocational support workers involved with former inmates entering the workforce. Which description outlines how ASPD is defined?
A pattern of disregard for and violation of the rights of others
Which individual is most susceptible to developing ASPD?
An 8-year-old with conduct disorder and attention ddeficit hyperactivity disorder (ADHD)
A client with antisocial personality disorder uses manipulation to try leaving the unit with another client's family members after visiting hours. Which of the following interventions is best to deal with the manipulative behavior
Assist the client to identify patterns of behavior and consequences as determined by the team plan.
A client with antisocial personality disorder (ASPD) is admitted to hospital. The nurse identifies which nursing diagnosis as the priority?
Risk for other directed violence
A family member of a client asks the nurse a question about personality disorders. The family member asks, "What personality disorder diagnosis makes a client most at risk for self-harm behaviors?" What is the nurse's best response?
Borderline personality disorder
A nurse working in a children's hospital is mindful of those at greatest risk of developing dependent personality disorder as adults. A child with which diagnosis is at highest risk of developing this disorder?
CYSTIC FIBROSIS
The nurse completes an intake assessment for a client. Which symptoms are associated with dependent personality disorder
Difficulty making everyday decisions Withdrawal from adult responsibilities Expresses fears of being unable to manage self-care
A nurse is preparing a teaching plan for a client with antisocial disorder. Which would the nurse most likely employ to promote successful education?
Engaging the client in a discussion to direct the topic to the client.
The nurse plans care for a client with antisocial personality disorder (ASPD) and concurrent chronic pain. Which assessment finding is anticipated?
Exaggeration of the physical symptoms
The nurse completes an assessment for a female client in an outpatient clinic. In addition to her medical issues, the client shares that she has a personality disorder. The client wears heavy makeup and demonstrates strong emotional intensity. Which personality disorder does the nurse identify based on the assessment findings?
Histrionic personality disorder
The nurse working with students in a modified school setting completes a screening with the intention to identify students at risk for antisocial personality disorder (ASPD). Which findings predict a risk of developing ASPD?
Harming a sibling Pattern of impulsive behavior Treatment for attention deficit hyperactivity disorde
a nurse is working in a prison setting with a client diagnosed with Antisocial Personality Disorder (ASPD). The client has identified impulse control issues particularly around urges for sexual intimacy. The client has assaulted people who have interfered with their gratification. What is the priority intervention for the nurse?
Helping to express anger in an adaptive and non-violent manner
The nurse is asked to assess an adult for Antisocial Personality Disorder (ASPD). Which details occurring prior to the age of 15 support the diagnosis? Select all that apply.
Killing a neighbor's cat Initiating frequent physical fights Stealing a purse from a woman in a store
The nurse in an outpatient clinic conducts an assessment for a client employed full time as a professional. The client has an unstable mood and feels sad most of the time. The client shares that they were recently charged for shoplifting cosmetics valued under $10. The client has admitted to shoplifting more than five times before this incident. In addition to a mood disorder, what other disorder does the nurse identify?
Kleptomania
Which is the main reason why the periodic team meetings are important when caring for a client with antisocial personality?
Team consistency is important to prevent manipulation by the client.
A nurse working in an inner city youth support program identifies that antisocial personality disorder (ASPD) can develop in those who have dysfunctional attachments. Which are risks for developing dysfunctional attachments?
Losing of a parent through death Experiencing physical or sexual abuse Experiencing parental abandonment or neglect
After reviewing the different types of personality disorders, a group of nurses demonstrates understanding when they identify which type as being associated with emotional volatility? Select all that apply.
Narcissistic Histrionic
A client presents to a mental health clinic. The nurse notes that the client is grandiose and brags that that they earn "a six-figure income" and tells the nurse that they are more well known that the president. Which diagnosis is grandiosity associated with
Narcissistic personality disorder
Which would a nurse assess in a client suspected of having paranoid personality disorder? Select all that apply.
Need to be in a position of power in a relationship Suspiciousness and guarded behavior Outwardly argumentative
After reviewing information about the various impulse control disorders, a nurse demonstrates understanding of the information by identifying which disorder as involving a persistent pattern of disobedience and argumentativeness?
Oppositional defiant disorder
A nurse is assessing a client diagnosed with a narcissistic personality disorder. Which characteristics would the nurse expect to find?
Patronizing attitude Snobbish appearance Unrealistic grandiosity
The nurse is educating the parents of a client with a personality disorder. They are concerned that their 22-year-old has never shown an interest in a romantic relationship, has no real hobbies or friends, and is happy being the only guard in a factory on the night shift. Which potential comment by the nurse is accurate?
People with schizoid personality disorder, which the client has, tend to be lifelong loners.
The nurse is assigned to a client with schizoid personality disorder. Which does the nurse anticipate are client characteristics of the disorder?
Reclusive and distant Awkward interpersonal relations
A client in a psychiatric unit is diagnosed with antisocial personality disorder (ASPD). The client becomes aggressive and hits another client on the unit in a disagreement over the TV remote. Staff gains control of the situation. When planning for the next day, what is the priority intervention for the client?
Reinforce strategies to express anger in an adaptive manner
when reviewing the history of a client with antisocial personality disorder, which would the nurse expect to find? Select all that apply
Repeated incidents involving assaults Lack of remorse for actions Episodes involving scams for personal gain
During neighborhood scans, a nurse working in a community outreach program has identified an individual staying in a local shelter. The person has not engaged with the program. During the day, the client can be observed sweeping the pavement in a particular alley with a broom. There is no obvious purpose to the behavior. The individual is dressed in winter clothing even though it is summer. The client mutters expressions that are audible but cannot be understood. Based on the observations, which disorder does the nurse consider
Schizotypal personality disorder
Which population has the highest prevalence of disruptive behavior disorder?
School-age boys
The nurse caring for a client with avoidant personality disorder identifies increased self-esteem in social situations as the primary outcome for the plan of care. Which program does the nurse recommend?
Social skills training
Which client does the nurse identify as likely to have the diagnosis of obsessive compulsive personality disorder?
The client experiences a need for order and cannot adapt to change.
A client recovering from a medical condition expresses low self-esteem, has difficulty making decisions, minimizes their ability to carry through with interventions to promote recovery and seeks more support than would be expected from the nurse. The nurse determines the client has a personality disorder. What is the probable etiology of the disorder
The client was overprotected as a child and independence was discouraged
The nurse is talking to a client with schizoid personality disorder about finding a job. Which suggestion by the nurse would be most helpful?
There is a job posting at the hospital for a file clerk in medical records
A mental health nurse is consulted by staff on a surgical unit for a client who believes their actions are being monitored by their intravenous pump. The client is assessed and determined to fit the criteria for schizotypal personality disorder. There was no evidence of major depressive disorder or significant anxiety. What is the recommendation of the nurse
To have the surgical care team focus on surgical recovery
When discussing a school-aged child's behavioral contract with the school staff, how should the nurse most effectively explain a time-out?
a retreat away to regain self-control
The nurse is interviewing a client with a history of violence. The client boasts that the client "put a kid in a wheelchair" once when the client was younger and has maimed others. The client states, "Who cares? Life's tough." Violence and insensitivity are associated with which personality disorder?
antisocial D/O
Which client does a nurse discern to be more likely to be experiencing a personality disorder than a psychotic illness?
client who experiences persistent doubts that intensify every five years that they were switched at birth and their sibling is not their real brother
17s The nurse is aware that for some personality disorders, denial of symptoms is common. Which therapeutic approach does the nurse choose to address this denial
compasion
to be diagnosed with antisocial personality disorder (APD) as an adult, characteristics of which mental health disorder must be met?
conduct D/O
The nurse in a medical setting provides care for a client with histrionic personality disorder concurrent with their medical challenges. During the initial assessment with the client, the nurse identifies an altered expression of sexuality. To guide further assessment, what factor does the nurse anticipate from the client?
demonstrates seductive behavior
An adult female client presents to the mental health clinic and is assessed by the nurse. During the assessment, the nurse observes the client engage warmly with an appropriately variable affect and to be open to share their life story. The story included a pattern of failed intimate relationships, which the client attributes to a mild form of cerebral palsy. The client lives in the parental home. The client's father died when she was in high school and her mother passed away three months prior to the assessment. Interpersonally the client says she works hard to avoid conflict. References are made to being "unlovable" and that she is "engulfed in sadness" to the point of needing a disability income. This is due to the expressed fear of being "unable" to care for everyday needs independently. What disorder does the nurse suspect?
dependent personality D/O
The nurse is teaching parents of infants about the importance of autonomy and instilling coping skills in children. The nurse explains that these abilities can fail to develop in children whose parents offer high levels of affection as the parents overprotect their children. Which disorder is associated with overprotection in children?
dependent personality D/O
A nurse prepares an educational program for women during antenatal care. An outcome of the teaching is to lower the risk of antisocial personality disorder (ASPD) in the population who access the program. Which is a priority teaching need
ensure attachment after birth
The nurse formulates a nursing diagnosis of impaired social interaction related to disorganized thinking for a client with schizotypal personality disorder. What is the priority nursing intervention for this nursing diagnosis?
establish a one-on-one relationship with the client
The nurse provides care to clients who have a tendency toward antisocial and criminal behavior. Which term was used in the past to describe people with this disorder?
psychopath
A client with a diagnosis of dependent personality disorder is recovering from surgery. The nurse considers the importance of avoiding some interventions that could be therapeutic for another client without a personality disorder. Which intervention will the nurse avoid?
telling the client what to do
Which assessment details demonstrates to the nurse that a client has an obsessive-compulsive personality disorder rather than obsessive compulsive disorder (OCD)?
the client is able to delay hand washing
