A 32-year-old male client with a history of arrests and substance use is admitted to the psychiatric unit for court-mandated evaluation. During the assessment, he is superficially charming, manipulates staff to get privileges, violates unit rules without remorse, and blames others for his behavior. Which of the following nursing interventions is most appropriate for managing this client?

Provide consistent structured rules and set firm limits on behavior.

Use sympathy and reassurance to reduce the client’s resistance to authority.

Allow the client flexibility in decision-making to encourage independence and self-direction.

Develop a close, personal rapport with the client to build trust and encourage emotional expression.

Answer and Explanation

The Correct Answer is A

Choice A reason: Consistent rules and firm boundaries are essential when working with individuals who display antisocial traits. Structure minimizes opportunities for manipulation and helps maintain safety and fairness on the unit.

Choice B reason: Offering sympathy and reassurance may reinforce manipulative behavior and undermine professional boundaries. It does not address the core issue of rule violation and lack of accountability.

Choice C reason: Allowing too much flexibility may increase opportunities for the client to exploit staff and disregard rules. This approach is counterproductive when dealing with manipulative behaviors.

Choice D reason: Developing a close, personal rapport risks blurring professional boundaries. Clients with these traits may exploit such relationships to gain privileges, which can disrupt treatment and unit structure.

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Free Nursing Study Resources

Correct Answer is ["A","B","C"]

Explanation

Choice A reason: Avoiding judgmental remarks supports therapeutic rapport and prevents worsening anxiety or defensiveness.

Choice B reason: Teaching coping strategies like thought stopping helps the client begin to manage obsessive behaviors more effectively.

Choice C reason: Identifying triggers for obsessive behaviors allows the nurse and client to develop strategies for prevention and management.

Choice D reason: Removing magazines to prevent counting avoids addressing the underlying compulsion and may increase anxiety. This approach is not appropriate in the initial care plan.

A. Haloperidol B. Lorazepam C. Naltrexone D. Disulfiram

Correct Answer is B

Explanation

Choice A reason: Haloperidol may be used for severe agitation or hallucinations but is not the first-line treatment for delirium tremens because it does not address the underlying withdrawal process.

Choice B reason: Lorazepam, a benzodiazepine, is the drug of choice for managing alcohol withdrawal and delirium tremens. It reduces agitation, prevents seizures, and manages autonomic instability.

Choice C reason: Naltrexone is used to reduce alcohol cravings and prevent relapse but is not appropriate for acute withdrawal or delirium tremens.

Choice D reason: Disulfiram is an aversive therapy medication used to discourage alcohol consumption by causing unpleasant effects if alcohol is ingested. It is contraindicated during withdrawal due to safety risks.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse plans care for a client newly admitted with obsessive-compulsive disorder who is repeatedly counting magazines in the commons room. Which of the following should the nurse include in the initial plan of care? (Select all that apply.)

Correct Answer is ["A","B","C"]

Explanation

A 52-year-old male with a long history of alcohol use disorder is admitted to the hospital and begins showing signs of Delirium Tremens, including agitation, tremors, tachycardia, and hallucinations. Which medication should the nurse anticipate administering to manage these symptoms?

Correct Answer is B

Explanation

A nurse observes a hospitalized client grabbing snacks from other patients' trays, despite being told not to. When confronted, the client says, "I was hungry, so I took it." Based on Freud's psychoanalytic theory, which part of the personality is most likely influencing the client's behavior?

According to psychoanalytic theory, which of the following best describes the role of the superego in personality development and mental health?

A nurse is caring for a client recently diagnosed with panic disorder. The provider has prescribed pharmacologic treatment. Which of the following medications are commonly used in the treatment of panic disorder? (Select all that apply.)

Which principle should guide the nurse in determining the extent of silence to use during patient interview sessions?

The nurse is developing a plan of care for a 16-year-old client with bulimia nervosa. Which interventions would be included in the plan of care? (Select all that apply.)

A psychiatric nurse is caring for several clients with personality disorders. The nurse understands that the DSM-5 groups these disorders into clusters based on characteristic behaviors. Which of the following client presentations is most consistent with a Cluster A personality disorder?

A nursing student new to psychiatric mental health nursing asks a peer what resources he can use to figure out which symptoms are present in a specific psychiatric disorder. The best answer would be:

A mental health nurse is working with a client experiencing severe depression. The nurse wants to provide supportive care while avoiding becoming emotionally overwhelmed. Which statement best reflects the difference between sympathy and empathy in this context?