The nurse is planning the type of approach that will be most effective in developing a therapeutic relationship with the client. With which types of personality disorders should the nurse use a matter-of-fact approach? (Select all that apply)
Paranoid
Avoidant
Schizotypal
Narcissistic
Antisocial
Correct Answer : A,C,E
Choice A reason:
Individuals with Paranoid Personality Disorder often exhibit distrust and suspicion of others. A matter-of-fact approach is beneficial as it avoids emotional engagement that could be perceived as threatening or deceitful. This approach helps in maintaining clear boundaries and reduces the potential for misunderstanding or paranoia.
Choice B reason:
For those with Avoidant Personality Disorder, a matter-of-fact approach might not be as effective because these individuals are often sensitive to negative evaluation and rejection. They may require a more supportive and encouraging approach to help them feel more comfortable in social interactions.
Choice C reason:
People with Schizotypal Personality Disorder display eccentric behaviors and have difficulty forming close relationships. A matter-of-fact approach can provide structure and clarity without overwhelming them with emotional intensity, which they may find difficult to process.
Choice D reason:
Individuals with Narcissistic Personality Disorder may not respond well to a matter-of-fact approach as they often have an inflated sense of self-importance and a need for admiration. They may perceive this approach as dismissive or not adequately acknowledging their perceived self-worth.
Choice E reason:
Those diagnosed with antisocial personality disorder tend to disregard the rights of others and may manipulate or treat others harshly. A matter-of-fact approach is useful as it sets clear expectations and limits, which is necessary to manage potentially manipulative or harmful behaviors.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C","D"]
Explanation
Choice A reason: Assertiveness training is not a direct intervention for situational phobias, although it may help improve overall confidence.
Choice B reason: Systematic desensitization is a common technique used to treat phobias, where the client is gradually exposed to the fear-inducing situation in a controlled manner.

Choice C reason: Flooding is an exposure technique where the client is exposed to a high level of fear-inducing stimuli all at once, which can be effective for some phobias.
Choice D reason: Decatastrophizing helps clients challenge and change catastrophic thoughts that often accompany phobias.
Choice E reason: Simply reminding a person to calm down is not a therapeutic technique and is unlikely to be effective for someone with a situational phobia.
Correct Answer is D
Explanation
Choice A reason: Gastric lavage is not indicated in this scenario as the client's lithium level is not extremely elevated. Gastric lavage is typically reserved for cases of acute lithium toxicity when levels are significantly higher than the therapeutic range.
Choice B reason: There is no need to hold the medication as the lithium level is within the normal therapeutic range, which is generally between 0.6 to 1.2 mEq/L. Early manifestations of toxicity typically occur at levels above 1.5 mEq/L.
Choice C reason: Checking the client's medication record is a standard procedure but does not take precedence over administering the medication. The lithium level indicates that the client has been compliant with the medication regimen.
Choice D reason: The nurse should administer the morning dose of lithium because the current level is within the therapeutic range, indicating that it is safe to continue the prescribed treatment.
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