A nurse is developing a plan of care for a client who has paranoid personality disorder. Which of the following actions should the nurse include in the plan?

Provide written information about the client's treatment plan.

Encourage countertransference when developing the nurse-client relationship.

Monitor the client for splitting behaviors.

Isolate the client from social or group interactions.

Answer and Explanation

The Correct Answer is A

A.   Providing written information about the treatment plan promotes transparency and helps to establish trust with the client, which is important in the care of individuals with paranoid personality disorder.
B.   Encouraging countertransference can blur professional boundaries and may exacerbate distrust or suspicion in clients with paranoid personality disorder.

C.   Monitoring for splitting behaviors is important in personality disorders but does not directly address the client's needs or promote therapeutic engagement.
D.   Isolating the client from social or group interactions can exacerbate feelings of paranoia and may not be therapeutic or appropriate.

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Correct Answer is A

Explanation

A. Encouraging physical activity during the day has been shown to improve mood and reduce symptoms of depression by increasing endorphin levels and promoting a sense of well-being.

B. Identifying and scheduling alternative group activities for the client may be helpful in reducing social isolation and improving mood but should not replace physical activity.
C. Discouraging the client from expressing feelings of anger is not appropriate, as it may suppress emotions and hinder therapeutic communication. Instead, the nurse should encourage the client to express and explore their emotions in a healthy manner.

D. Keeping a bright light on in the client's room at night may disrupt sleep patterns and exacerbate symptoms of depression, as individuals with depression often have disturbances in their sleep-wake cycle.

A. The client walks their dog daily. B. The client's best friend moved away. C. The client exercises in the morning. D. The client has stopped drinking coffee.

Correct Answer is B

Explanation

A. Walking the dog daily can contribute positively to the client's recovery by promoting physical activity and potentially reducing stress.
B. The loss of social support due to the best friend moving away can increase stress and negatively impact the client's recovery.
C. Exercising in the morning can also contribute positively to recovery by promoting physical health and potentially reducing stress.
D. Stopping drinking coffee may have various effects on the client's health but is not directly related to recovery from coronary artery bypass surgery unless it exacerbates other issues such as anxiety or withdrawal symptoms.

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Nursing Test Bank

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