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A patient in an abusive relationship is hospitalized with abdominal and head trauma caused by their partner. The partner sends flowers to the patient and pizzas for all the staff. Via video chat, the partner tearfully begs the patient to forgive them and not press charges. The partner states, “I just want you, me, and the kids to be together. You know you do too.” What conclusions can the nurse make about this scenario? (Select All That Apply)

The patient’s partner’s act of sending flowers is an example of undoing.

The patient and partner are in the honeymoon phase of intimate partner violence.

The patient has a submissive personality and depression.

Since the injuries have caused hospitalization, the patient will end the relationship.

The partner may be trying to manipulate the staff by buying pizza.

Answer and Explanation

Correct Answer : A,B,E

The correct answer is a, b, and e.

Choice A Reason:

The patient’s partner’s act of sending flowers is an example of undoing. Undoing is a defense mechanism where a person tries to cancel out or remove an unhealthy, destructive, or otherwise threatening thought or action by engaging in contrary behavior. In this case, the partner is attempting to make amends for the abuse by sending flowers, which is a common tactic used by abusers to mitigate their guilt and manipulate the victim into forgiving them.

Choice B Reason:

The patient and partner are in the honeymoon phase of intimate partner violence. The cycle of abuse in intimate partner violence typically includes a honeymoon phase, where the abuser may apologize, show remorse, and promise to change. This phase often involves gestures of affection and kindness, such as sending flowers or gifts, to win back the victim’s trust and prevent them from leaving.

Choice C Reason:

The patient has a submissive personality and depression. While it is possible that the patient may have a submissive personality and depression, this conclusion cannot be definitively made based on the given scenario alone. Submissive personality traits and depression are complex and require thorough psychological evaluation to diagnose accurately.

Choice D Reason:

Since the injuries have caused hospitalization, the patient will end the relationship. This conclusion is not necessarily accurate. Victims of intimate partner violence often face significant psychological, emotional, and practical barriers to leaving an abusive relationship, even after severe incidents that result in hospitalization. The decision to leave an abusive relationship is influenced by various factors, including fear, financial dependence, emotional attachment, and lack of support.

Choice E Reason:

The partner may be trying to manipulate the staff by buying pizza. Manipulative behavior is common in abusive relationships. By buying pizza for the staff, the partner may be attempting to create a favorable impression and gain sympathy, which can influence the staff’s perception of the situation and potentially affect their support for the patient.

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Correct Answer is A

Explanation

Choice A Reason: Grandiose sense of self-importance

This is the hallmark characteristic of narcissistic personality disorder (NPD). Individuals with NPD often have an exaggerated sense of their own importance and abilities. They may believe they are superior to others and expect special treatment. This grandiosity is a core feature of the disorder and is often accompanied by fantasies of unlimited success, power, brilliance, beauty, or ideal love.

Choice B Reason: Pattern of intense and chaotic relationships

While individuals with NPD may have problematic relationships, this characteristic is more commonly associated with borderline personality disorder. People with NPD may exploit relationships for personal gain, but their relationships are not typically described as chaotic in the same way as those with borderline personality disorder.

Choice C Reason: Submissive and clinging behaviors

Submissive and clinging behaviors are characteristic of dependent personality disorder, not narcissistic personality disorder. Individuals with NPD are more likely to exhibit domineering and controlling behaviors rather than submissive ones.

Choice D Reason: Odd beliefs and magical thinking

Odd beliefs and magical thinking are more characteristic of schizotypal personality disorder. While individuals with NPD may have grandiose fantasies, these do not typically include the bizarre or eccentric beliefs seen in schizotypal personality disorder.

A. Prevents extrapyramidal side effects. B. Reduces agitation until the lithium takes effect. C. Cures manic symptoms. D. Ensures high-quality sleep.

Correct Answer is B

Explanation

Choice A Reason: Prevents Extrapyramidal Side Effects

Extrapyramidal side effects (EPS) are drug-induced movement disorders that include symptoms such as tremors, rigidity, bradykinesia, and tardive dyskinesia. These side effects are commonly associated with first-generation antipsychotics. While second-generation antipsychotics like olanzapine have a lower risk of causing EPS, their primary use in this context is not to prevent these side effects. Therefore, this choice is not the most appropriate response to the family’s question.

Choice B Reason: Reduces Agitation Until the Lithium Takes Effect

Olanzapine is a second-generation antipsychotic that is effective in managing acute agitation and psychotic symptoms in patients with bipolar disorder. Lithium, while effective for long-term mood stabilization, takes several days to weeks to reach therapeutic levels and exert its full effect. During this period, olanzapine can help reduce the client’s agitation and stabilize their mood. This makes it the most appropriate response to the family’s question.

Choice C Reason: Cures Manic Symptoms

While olanzapine can help manage manic symptoms, it does not “cure” them. Bipolar disorder is a chronic condition that requires ongoing management with medications and therapy. The term “cure” is misleading as it implies a permanent resolution of symptoms, which is not the case with bipolar disorder. Therefore, this choice is not accurate.

Choice D Reason: Ensures High-Quality Sleep

Olanzapine can have sedative effects and may help improve sleep in some patients. However, its primary use in this scenario is to manage acute agitation and psychotic symptoms rather than to ensure high-quality sleep. While improved sleep may be a beneficial side effect, it is not the main reason for its prescription in this context.

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Naxlex Comprehensive Predictor Exams

When assessing a client diagnosed with narcissistic personality disorder, the nurse expects to identify which characteristic behavior?

Correct Answer is A

Explanation

Correct Answer is B

Explanation

Psychiatric care technicians (PCTs) are unlicensed assistive personnel that are an integral part of the acute care mental healthcare team. Which of the following choices would be an example(s) of overdelegation by the nurse to a PCT? The nurse directs the PCT to (Select All that Apply):

The nurse is caring for a client with alcohol use disorder. Which of the following nursing interventions is appropriate for a client to prevent Korsakoff’s syndrome?

A client prescribed lithium carbonate 300 mg twice daily a month ago comes to the Emergency Department with mental confusion, frequent urination in large amounts, and coarse tremors. Which lithium level would the nurse expect?

A fifteen-year-old was referred to the adolescent mental health clinic after being arrested for prostitution. The client’s parents reported that they have run away several times and are abusive towards them. The nurse should anticipate that the diagnosis will be:

Several children come to the Emergency Department for treatment. The situation that would cause the nurse to have the highest suspicion of child abuse would be:

A nurse is providing teaching to a client about ways to improve their health. Which of the following modifiable risk factors should the nurse include? (Select All that Apply)

A nurse is providing care for a client who is malnourished and appears exhausted. What data would cause the nurse to suspect the client is a victim of human trafficking? The client:

During intake assessment, the nurse is most likely to hear a client with major depressive disorder say which of the following statements about depression? (Select All that Apply.)