A psychiatric nurse is caring for several clients with personality disorders. The nurse understands that the DSM-5 groups these disorders into clusters based on characteristic behaviors. Which of the following client presentations is most consistent with a Cluster A personality disorder?

A 28-year-old client who exhibits odd beliefs, magical thinking, social anxiety, and eccentric behavior.

A 34-year-old client who is dramatic, attention-seeking, and frequently exaggerates emotions in social situations.

A 45-year-old client who avoids close relationships due to fear of criticism and feelings of inadequacy, yet desires connection.

A 39-year-old client who is arrogant, lacks empathy, and shows a strong sense of entitlement in interactions with staff.

Answer and Explanation

The Correct Answer is A

Choice A reason: Odd beliefs, magical thinking, social anxiety, and eccentric behaviors are characteristic of schizotypal personality disorder, which belongs to Cluster A (odd and eccentric disorders).

Choice B reason: Dramatic, exaggerated emotional expression and attention-seeking behavior reflect histrionic personality disorder, which is classified under Cluster B (dramatic, emotional, or erratic disorders).

Choice C reason: Avoidance of relationships due to fear of rejection and inadequacy, despite desiring connection, is typical of avoidant personality disorder, which falls under Cluster C (anxious or fearful disorders).

Choice D reason: Arrogance, lack of empathy, and entitlement describe narcissistic personality disorder, which is in Cluster B.

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Correct Answer is ["A","B","D"]

Explanation

Choice A reason: Planning alternate escape routes is a core part of safety planning, ensuring the victim can exit safely even if blocked.

Choice B reason: Having an emergency bag ready allows quick departure and reduces risk of having to return to the abuser’s home.

Choice C reason: Giving the abuser information about location compromises safety and places the victim at greater risk.

Choice D reason: Establishing a signal with trusted individuals ensures the victim can get help quickly if violence escalates.

Choice E reason: Encouraging firearm purchase is not an appropriate nursing intervention due to safety risks and escalation potential. Safer protective strategies should be emphasized.

A. Encourage the client to explore childhood experiences that may have caused these fears. B. Reassure the client that everyone feels insecure sometimes and they are overthinking the situation. C. Advise the client to start attending large events to desensitize themselves to rejection. D. Assist the client in identifying and challenging negative self-beliefs through gradual social exposure.

Correct Answer is D

Explanation

Choice A reason: While exploring childhood experiences may provide insight into the origins of fear, this approach does not directly help the client build the confidence and skills needed to engage socially in the present. It may keep the focus on the past rather than promoting immediate coping strategies.

Choice B reason: Offering reassurance without addressing the underlying cognitive distortions minimizes the client’s distress and may come across as dismissive. This response fails to provide practical tools for overcoming fear of rejection.

Choice C reason: Encouraging participation in large social gatherings too quickly can overwhelm a client with avoidant traits. Such exposure without proper preparation and gradual buildup is more likely to increase anxiety and avoidance rather than reduce it.

Choice D reason: Supporting the client in recognizing and challenging self-defeating beliefs, while practicing gradual social exposure, is evidence-based and therapeutic. This method uses cognitive-behavioral strategies that are effective in reducing avoidance, building self-esteem, and encouraging healthier relationships.

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A psychiatric nurse is caring for several clients with personality disorders. The nurse understands that the DSM-5 groups these disorders into clusters based on characteristic behaviors. Which of the following client presentations is most consistent with a Cluster A personality disorder?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing education about strategies for a safety plan for a female client who is a victim of intimate partner violence. Which strategies should be included in the safety plan? (Select all that apply.)

Correct Answer is ["A","B","D"]

Explanation

A 28-year-old client with a diagnosis of Avoidant Personality Disorder tells the nurse, "I want to make friends. I'm too afraid they'll laugh at me or think I'm weak." Which nursing intervention is most appropriate to help this client begin developing healthier interpersonal relationships?

Correct Answer is D

Explanation

The nurse assigned to care for the client with a diagnosis of histrionic personality disorder expects to observe which characteristics and behaviors?

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