A nurse is reinforcing education to a newly licensed nurse about comorbidities associated with cluster B personality disorders. The nurse should identify which of the following disorders as a comorbidity?
Obsessive-compulsive disorder
Schizophrenia
General anxiety disorder
Anorexia nervosa
The Correct Answer is D
A. "Obsessive-compulsive disorder.": Obsessive-compulsive disorder (OCD) is more commonly associated with cluster C personality disorders, particularly obsessive-compulsive personality disorder, which involves rigid perfectionism and a preoccupation with orderliness.
B. "Schizophrenia.": Schizophrenia is not a common comorbidity of cluster B personality disorders. It is more closely linked to schizotypal personality disorder, a cluster A disorder, which involves eccentric behaviors and cognitive distortions.
C. "General anxiety disorder.": Generalized anxiety disorder (GAD) is more frequently seen in cluster C personality disorders, such as avoidant and dependent personality disorders, which are characterized by excessive fearfulness and anxiety-driven behaviors.
D. "Anorexia nervosa.": Anorexia nervosa is commonly comorbid with cluster B personality disorders, particularly borderline personality disorder, due to emotional dysregulation, impulsivity, and an intense fear of abandonment that can contribute to disordered eating behaviors.
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Correct Answer is D
Explanation
A. To keep the client's environment calm and with minimal daily stimuli: While a calm environment can help manage acute psychotic symptoms, it is a short-term intervention rather than a long-term goal. Long-term management focuses on adherence to treatment and relapse prevention.
B. To be reoriented to their current environment as needed: Reorientation is beneficial for clients experiencing disorientation due to acute psychosis, but it is a short-term intervention. A long-term goal should focus on maintaining stability and preventing future relapse.
C. To ensure the client participates in a walk with staff on a daily basis: Regular physical activity can improve mental health, but it does not directly address medication adherence or long-term relapse prevention. The goal should focus on strategies to maintain treatment compliance.
D. To develop and acknowledge understanding of a relapse plan prior to discharge: A relapse plan helps the client recognize early warning signs, understand medication importance, and seek support when needed, which is essential for long-term symptom management and prevention of future hospitalizations.
Correct Answer is C
Explanation
A. Inappropriate guilt is a common symptom of depression, but it does not involve false beliefs about being targeted. Clients with major depressive disorder may feel excessive guilt, but this differs from the fixed, false beliefs seen in delusions.
B. Mania is characterized by elevated mood, impulsivity, and hyperactivity rather than paranoid thoughts. While manic episodes may include grandiose delusions, the belief that a government agency is attempting to capture the client aligns more with persecutory delusions.
C. Delusions are fixed, false beliefs that persist despite evidence to the contrary. The client’s statement suggests a persecutory delusion, which is commonly seen in psychotic disorders, including severe depression with psychotic features.
D. Confusion involves disorganized thinking, memory impairment, or difficulty understanding surroundings, often seen in delirium or cognitive disorders. While delusions can contribute to disorganized thoughts, they are distinct from general confusion.
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