A 40-year-old male patient diagnosed with Schizoid Personality Disorder has been admitted to an inpatient psychiatric unit. He consistently avoids group therapy, speaks minimally with staff, and prefers solitary activities. Which nursing intervention is most appropriate to support this patient’s care plan?
Assign the patient as a leader in a small group activity to build confidence and self-esteem.
Confront the patient about his avoidance behaviors and insist on more social interaction with peers.
Provide structured one-on-one interactions that respect the patient’s need for limited emotional engagement.
Encourage daily participation in group therapy to improve social skills and reduce isolation.
The Correct Answer is C
Choice A reason: Assigning leadership in a group setting may overwhelm a patient with schizoid personality disorder, as they are uncomfortable with close social interactions. This approach could increase withdrawal.
Choice B reason: Confrontation about avoidance behaviors is not therapeutic. It may heighten resistance and increase distress rather than encourage trust or engagement.
Choice C reason: Structured one-on-one interactions allow the nurse to build rapport while respecting the patient’s preference for limited emotional involvement. This is the most appropriate approach for schizoid personality disorder.
Choice D reason: Forcing daily group therapy participation may cause stress and withdrawal, as these patients are more comfortable with solitary activities. Gentle encouragement, not insistence, is better suited.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: This presentation is consistent with neuroleptic malignant syndrome (NMS), a rare but life-threatening reaction to antipsychotics characterized by severe muscle rigidity, hyperthermia, altered mental status, and autonomic dysfunction. Immediate discontinuation of the drug and emergency treatment are required.
Choice B reason: Restlessness and inability to sit still are signs of akathisia, an extrapyramidal side effect of antipsychotics. While distressing and requiring management, it is not life-threatening compared to NMS.
Choice C reason: A flat affect and reduced speech are negative symptoms of schizophrenia and may persist despite treatment. These are concerning for quality of life but do not require urgent medical intervention.
Choice D reason: Mild weight gain is a known side effect of many antipsychotics. It should be monitored and managed with lifestyle modifications but does not represent an immediate threat.
Correct Answer is A
Explanation
Choice A reason: The Durham Rule states that a defendant is not criminally responsible if their unlawful act was the result of a mental illness or defect. This directly matches the legal standard, making it the correct choice.
Choice B reason: The “irresistible impulse” test applies when a person cannot control their actions despite knowing right from wrong. This is not the Durham Rule’s standard.
Choice C reason: This statement describes the M’Naghten Rule, which requires proof that the defendant did not understand the wrongfulness of their act. It does not represent the Durham Rule.
Choice D reason: Temporary intoxication or delirium does not meet the criteria under the Durham Rule. Voluntary intoxication in particular is not considered a valid legal defense.
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