A nurse is developing a behavioral contract with a client who has antisocial personality disorder. Which of the following client goals should the nurse include in the contract?

Use bargaining skills for behavioral consequences.

Increase self-esteem.

Decrease the number of verbal outbursts.

Use projection during group therapy.

Answer and Explanation

The Correct Answer is C

A behavioral contract is a written agreement between the client and the nurse that specifies the desired and undesired behaviors and the rewards and penalties for each. A client who has antisocial personality disorder may exhibit impulsive, aggressive, and manipulative behaviors that disrupt the therapeutic milieu and interfere with treatment goals. Decreasing the number of verbal outbursts is a measurable and realistic goal that can improve the client's interpersonal skills and reduce conflict.

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Correct Answer is D

Explanation

During the orientation phase, the nurse should introduce herself and the group members, explain the purpose and goals of the group, and create a trusting and respectful atmosphere. Maintaining focus, encouraging problem-solving, and managing conflict are actions that belong to the working phase of group development.

A. Implement continuous one-to-one observation. B. Encourage the client to participate in group therapy. C. Ask the client to sign a no-suicide contract. D. Establish a rapport to foster trust.

Correct Answer is A

Explanation

The correct answer is:

A. Implement continuous one-to-one observation.

Choice A reason:

Implementing continuous one-to-one observation is the most immediate and direct method to ensure the safety of a client who has been admitted after a suicide attempt. This involves assigning a staff member to stay with the client at all times, providing constant supervision to prevent self-harm. It is a standard safety measure in mental health facilities for clients at high risk of suicide.

Choice B reason:

While encouraging the client to participate in group therapy is a valuable part of the treatment plan, it is not the first action a nurse should take. Group therapy is beneficial for social support and developing coping strategies, but it is not an immediate safety measure for a client at risk of suicide.

Choice C reason:

Asking the client to sign a no-suicide contract can be part of the therapeutic process, but it is not the first step in acute care. These contracts involve the client agreeing not to harm themselves and to seek help if suicidal thoughts occur. However, they are not considered a substitute for active supervision and intervention.

Choice D reason:

Establishing a rapport to foster trust is crucial for effective nursing care and is an ongoing process. It helps in creating a therapeutic relationship, which is essential for the client's long-term recovery. However, it is not the immediate priority in a crisis situation where the client's safety is at risk.

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A nurse is developing a behavioral contract with a client who has antisocial personality disorder. Which of the following client goals should the nurse include in the contract?

Nursing Test Bank

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