A nurse in a mental health facility is admitting a client who was brought in by the police department.

Exhibits

Complete the diagram by selecting from the choices below to specify what condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client's progress.

Choice A reason: Identifying when the client engages in splitting behaviors is more relevant to borderline personality disorder than schizoid personality disorder. Splitting is a defense mechanism where individuals fail to integrate positive and negative aspects of self and others into cohesive images. People with schizoid personality disorder typically exhibit detachment from social relationships and a restricted range of emotional expression, not splitting.

Choice B reason: Giving the client a choice of solitary activities aligns with the characteristics of schizoid personality disorder. Individuals with this disorder often prefer to engage in activities alone, as they feel more comfortable being by themselves than in social situations. Providing options for solitary activities can help meet the client's needs for privacy and personal space while also respecting their autonomy.

Choice C reason: Setting limits on the client's need for constant social contact is not applicable to schizoid personality disorder. In fact, individuals with this disorder typically do not desire social contact and may already isolate themselves. The intervention would be more appropriate for disorders where the individual seeks excessive social interaction.

Choice D reason: Assisting the client in identifying sources of anger may not be a priority in the care of someone with schizoid personality disorder unless there is a specific indication for it. These individuals often do not express emotions openly and may not experience or show anger in the same way as those without the disorder. The focus should be on interventions that respect the client's emotional expression, or lack thereof.

Choice A Reason: The belief that a partner will not be violent in the future can be a form of denial or wishful thinking, especially without any evidence of change or intervention. It is not uncommon for individuals in abusive relationships to hope for change, but without concrete actions, such as therapy or other interventions, this hope does not indicate an improvement in the client’s situation.

Choice B Reason: Agreeing to an appointment with a social worker is a positive step towards addressing the situation and seeking help. Social workers can provide support, resources, and guidance, which can be crucial for someone experiencing partner violence. This choice indicates a potential improvement in the client’s psychological status as it shows a willingness to engage with support services.

Choice C Reason: A decrease in reported pain levels can indicate physical improvement. Pain scales are subjective but provide a measure of the client’s comfort and can reflect healing or the effectiveness of pain management strategies.

Choice D Reason: Requesting help to develop a safety plan is a proactive step in ensuring personal safety and preparing for potential future incidents of violence. It shows the client’s awareness of the risks and a desire to protect themselves, which is a positive indicator of psychological improvement.

Choice E Reason: While claiming responsibility for the physical altercation may seem negative, it can also be seen as the client’s attempt to make sense of the situation. It is important to note that responsibility for violence lies with the perpetrator, not the victim. However, recognizing the dynamics of the relationship and the events leading up to the violence can be part of the healing process and taking control of one’s life.