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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Offering information is supportive, but this does not address the spouse’s emotional needs or encourage discussion about the client’s values.
Choice B reason: Calling a chaplain might be supportive later, but it avoids addressing the spouse’s statement directly and risks shifting responsibility away from the nurse.
Choice C reason: Reassurance without exploring the client’s and family’s values minimizes the spouse’s need for deeper reflection and personal decision-making.
Choice D reason: Encouraging the spouse to reflect on the client’s beliefs and values promotes autonomy and supports decision-making that honors the client’s wishes, making it the most therapeutic response.
Correct Answer is B
Explanation
Choice A reason: Forcibly removing the client escalates anxiety and can increase resistance. This action does not support therapeutic management of OCD.
Choice B reason: Providing a clear, respectful, and time-limited reminder supports structure and helps the client redirect behavior without confrontation. It balances therapeutic boundaries with empathy.
Choice C reason: Dismissing the client’s concern as unreasonable invalidates their experience, increasing defensiveness and mistrust. This does not support treatment goals.
Choice D reason: Avoiding the problem by redirecting the roommate fails to address the client’s compulsive behavior and disrupts the care environment.
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