A mental health nurse is caring for a client with Antisocial Personality Disorder who attacked one of her friends and is admitted to the psychiatric unit.
Which of the following actions should the nurse take first?
Explain to the client that the behavior was unacceptable.
Set behavioral limits for the client.
Explore the truth of the client's statements.
Establish a client relationship.
The Correct Answer is D
Rationale for Choice A:
While it is important to address the client's behavior, simply explaining that it was unacceptable is unlikely to be effective in this situation. Clients with antisocial personality disorder often have difficulty understanding and accepting responsibility for their actions. They may lack empathy for others and may not see their behavior as problematic. Confronting the client about their behavior too early in the therapeutic relationship could lead to defensiveness, hostility, or even aggression. It is important to first establish a rapport with the client and build a foundation of trust before addressing difficult topics.
Rationale for Choice B:
Setting behavioral limits is an important aspect of treatment for clients with antisocial personality disorder. However, it is not the first priority in this situation. Before setting limits, the nurse needs to establish a relationship with the client and assess their individual needs and level of functioning. Attempting to set limits without first establishing a rapport could lead to power struggles and further resistance from the client.
Rationale for Choice C:
Exploring the truth of the client's statements may be necessary at some point in the treatment process. However, it is not the first priority in this situation. The nurse's initial focus should be on establishing a relationship with the client and assessing their immediate needs. Focusing on the accuracy of the client's statements too early in the therapeutic process could derail the development of a trusting relationship.
Rationale for Choice D:
Establishing a client relationship is the first and most important step in the treatment of any client, but it is especially crucial for clients with antisocial personality disorder. These clients often have difficulty trusting others and forming close relationships. By establishing a rapport with the client, the nurse can begin to build trust and create a safe and supportive environment. This foundation is essential for any further therapeutic interventions to be successful.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The correct answer is choice d. “St. John’s wort can reduce the effectiveness of oral contraceptives.”
Choice A rationale:
St. John’s wort is commonly used to treat mild to moderate depression. It has been shown to be effective in alleviating symptoms of depression, likely due to its impact on neurotransmitters like serotonin.
Choice B rationale:
There is no evidence to suggest that St. John’s wort can lower prostate-specific antigen (PSA) levels. PSA levels are typically monitored for prostate health, and St. John’s wort does not have an impact on these levels.
Choice C rationale:
St. John’s wort does not increase estrogen levels in the body. It primarily affects neurotransmitters and has no known effect on hormone levels.
Choice D rationale:
St. John’s wort can indeed reduce the effectiveness of oral contraceptives. It induces certain liver enzymes that can increase the metabolism of contraceptive hormones, thereby reducing their effectiveness and increasing the risk of unintended pregnancy.
Correct Answer is ["A","B","D"]
Explanation
Choice A rationale: Expression of guilt feelings is a positive outcome in the treatment of conduct disorder. Guilt is an emotional response to one’s actions that are perceived as wrong or inappropriate. It is a self-conscious emotion that often involves a
sense of tension and regret. In the context of conduct disorder, the expression of guilt feelings can be seen as a sign of developing empathy and understanding the consequences of one’s actions. This is a crucial step in the process of behavior change and rehabilitation. The client showing signs of remorse during one-on-one counseling is a positive sign indicating that the treatment is having an effect.
Choice B rationale: A statement regarding unit rules is another positive outcome in the treatment of conduct disorder. Understanding and acknowledging the rules of the unit indicates that the client is beginning to accept the boundaries and norms set by the authority. This is a significant step towards improving their behavior, as individuals with conduct disorder often have difficulties following rules and respecting authority. The verbal altercation with another client could be seen as a negative event, but it also could indicate that the client is engaging with others, which could be a step towards improvement, depending on the context of the altercation.
Choice C rationale: A renewed relationship with an uncle does not necessarily indicate a positive outcome from the treatment of conduct disorder. While family support can be beneficial in the treatment process, it does not directly indicate that the client’s conduct disorder is improving. More information would be needed to determine if this is a positive outcome related to the treatment.
Choice D rationale: A positive attitude toward school is a positive outcome in the treatment of conduct disorder. School is a structured environment where rules and expectations are clearly laid out, and a positive attitude towards school can indicate that the client is beginning to accept these structures. This can be a sign of improvement in their behavior and attitude.
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