A client with antisocial personality disorder refuses to attend group therapy and states, "You can't make me do anything. I don't care about your rules." What is the nurse's best response?
"You don't have to go, but it would be helpful for your progress."
"Let's talk about what's bothering you today."
"Attendance is expected. The consequences for refusing are outlined in your treatment plan."
"If you don’t attend group, you will lose your privileges."
The Correct Answer is C
Choice A reason: Allowing the client to skip group undermines structure and reinforces manipulative behavior.
Choice B reason: Redirecting to feelings does not address the refusal to follow rules. Clients with antisocial personality disorder often lack insight and empathy, so this approach is ineffective.
Choice C reason: Setting clear expectations and outlining consequences is the best response. Clients with antisocial personality disorder require firm, consistent boundaries to manage manipulative and defiant behavior.
Choice D reason: Threatening loss of privileges may escalate defiance. While consequences are necessary, they should be presented in a structured, non-confrontational way, as in option C.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Encouraging the client to argue with voices reinforces the hallucination and is not therapeutic.
Choice B reason: Telling the client the hallucination is not real helps orient them to reality while maintaining empathy. It acknowledges their experience without validating the hallucination.
Choice C reason: Acting as if the hallucination is real reinforces psychosis and is inappropriate.
Choice D reason: Asking direct questions about the hallucination can increase focus on the false perception, worsening symptoms.
Correct Answer is C
Explanation
Choice A reason: Dysphoria refers to a state of unease or generalized dissatisfaction, often linked to mood disorders such as depression. It is considered a negative symptom or affective disturbance rather than a positive symptom of schizophrenia. Positive symptoms are those that add abnormal experiences, such as hallucinations or disorganized speech, rather than subtracting normal functioning.
Choice B reason: Poor hygiene is a behavioral deficit often seen in schizophrenia, but it is classified as a negative symptom. Negative symptoms involve a reduction or absence of normal behaviors, such as lack of motivation, poor grooming, or social withdrawal.
Choice C reason: Disorganized speech is a hallmark positive symptom of schizophrenia. It reflects disturbances in thought processes, where the client’s communication becomes incoherent, illogical, or fragmented. This symptom demonstrates the addition of abnormal cognitive patterns, making it a positive symptom.
Choice D reason: Anhedonia is the inability to experience pleasure, which is a negative symptom. It reflects a deficit in emotional responsiveness and motivation rather than the presence of abnormal behaviors or perceptions.
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