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70 Cards in this Set
- Front
- Back
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What personality disorder is characterized primarily by a profound defect in the ability to form personal relationships or to respond to others in any meaningful, emotional way?
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Schizoid Personality Disorder
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How is antisocial personality disorder characterized?
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It is a pattern of socially irresponsible, exploitative, and guiltless behavior that reflects a disregard for the rights of others (similar to conduct disorder in kids)
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What disorder is characterized by a pattern of intense and chaotic relationships, with affective instability and fluctuating attitudes towards other people?
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Borderline personality disorder.
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A person with ____ has an exaggerated sense of self-worth. They lack empathy, and are hypersensitive to the evaluation of others.
a) borderline personality disorder b) avoidant personality disorder c) narcissistic personality disorder d) histrionic personality disorder |
c) narcissistic personality disorder
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A patient with ____ is characterized by colorful, dramatic, and extroverted behavior in excitable, emotional people. They have difficulty maintaining long-lasting relationships.
a) borderline personality disorder b) avoidant personality disorder c) narcissistic personality disorder d) histrionic personality disorder |
d) histrionic personality disorder
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What characterizes a patient with avoidant personality disorder?
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They are so sensitive to rejection that they lead a very socially withdrawn life to prevent it.
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What is dependent personality disorder?
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A excessive need to be taken care of that leads to submissive and clinging behavior and fear of separation.
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Patients with OCD have an intense fear of:
a) abandonment b) rejection c) making mistakes d) change |
c) making mistakes: This leads to difficulty with decision making.
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The idea of splitting is an ego defense mechanisms that holds the idea that all people and life situations are:
a) either all good or all bad b) either benefit them or will harm them c) can be categorized as black or white d) are positive or negative |
a) are either all good or all bad
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Which of the following is most beneficial for the borderline personality disorder client who is at risk for self-mutilation?
a) drawing attention to maladaptive behavior to decrease its occurrence b) securing a verbal contract from the client that they will not hurt themselves c) appear watchful so they know you are looking out for them d) avoid 1:1 supervision that instills an environment of mistrust |
b) securing a verbal contract from the client that they will not hurt themselves
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True or False: Initially it is appropriate to offer sympathy to the borderline personality patient who has a cutting episode when admitted on your unit.
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False: If self-mutilation occurs, care for client's wounds in a matter-of-fact manner. Do not give positive reinforcement to this behaviors by offering sympathy or additional attention. Lack of attention to the maladaptive behavior may decrease repetition of its use.
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When teaching the person with antisocial personality disorder appropriate behavior, which of the following phrases is appropriate:
a) "You should..." b) "You shouldn't..." c) "You will be expected to.." d) "I wouldn't" |
d) "You will be expected" Do not attempt to coax or convince the client to do the right thing. Do not use the words "you should" or "you shouldn't". Instead use "You will be expected to" The ideal would be for the client to eventually internalize societal norms beginning with this step by step "either/or" approach (either you do this, or this will occur)
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What is the treatment of choice for individuals with histrionic personality disorder?
a) medication b) psychotherapy c) group therapy d) personal refection through journaling |
b) psychotherapy
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What type of treatment is especially appropriate for individuals with antisocial personality disorder?
a) medication b) psychotherapy c) group therapy d) personal refection through journaling |
c) group therapy
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What type of medications are most useful in decreasing impulsivity and self-destructive acts in clients with borderline personality disorder?
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SSRIs and MAOIs
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The patient with antisocial personality disorder is given lithium carbonate and propanolol (Inderal). These medication prevent:
a) violent episodes b) depression c) anticholinergic effects d) extrapyramidal effects |
a) violent episodes
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Kim has a diagnosis of borderline personality disorder. She often exhibits alternating clinging and distancing behaviors. The most appropriate nursing intervention with this type of behaviors would be to:
a) encourage Kim to establish trust in one staff person, with whom all therapeutic interaction should take place b) secure a verbal contract from Kim that she will discontinue these behaviors c) withdraw attention if these behaviors continue d) rotate staff members who work with Kim so that she will learn to relate to more than one person |
d) rotate staff members who work with Kim so that she will learn to relate to more than one person
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The most striking gender difference among the personality disorders appears in______ personality disorder, where men are five times more likely to be diagnosed with the disorder than are females.
a) schizotrypal b) antisocial c) obsessive-compulsive d) narcissistic |
b) antisocial
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Which of the following is false about antisocial personality disorder?
a) They are more likely to have low levels of education b) The tendency to engage in antisocial behaviors tends to begin in childhood and is one of the most stable personality characteristics c) they have difficulty in inhibiting impulsive behaviors d) they have high levels of arousability, which leads them to avoid stimulation through impulse dangerous acts and to experience punishment as less severe |
d) they have high levels of arousability, which leads them to avoid stimulation through impulse dangerous acts and to experience punishment as less severe: This is typical of borderline personality disorder
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The personality disorder characterized by instability and "splitting" is:
a) paranoid b) dependent c) borderline d) histrionic |
c) borderline
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The personality disorder that is diagnosed more often in woman than in men and is characterized by rapidly shifting emotions, unstable relationships, and highly dramatic and seductive behaviors performed to gain the attention and approval of others, is known as:
a) narcissistic b) dependent c) histrionic d) antisocial |
c) histrionic
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People with antisocial personality disorder exhibit all of the following except:
a) deficits in the parietal lobes of the brain b) poor impulse control c) deficits in executive functions d) difficulty inhibiting impulsive behaviors |
a) deficits in the parietal lobes of the brain
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People with ____ are heavy users of mental health services, in contrast to people with other personality disorders.
a) borderline b) antisocial c) avoidant d) narcissistic |
a) borderline
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Kim has a diagnosis of borderline personality disorder. She often exhibits alternating clinging and distancing behaviors. The most appropriate nursing intervention with type of behavior would be to:
a) Encourage Kim to establish trust in one staff person, with whom all the therapeutic interaction should take place b) Secure a verbal contract from Kim that she will discontinue these behaviors c) Withdraw attention if these behaviors continue d) Rotate staff members who work with Kim so that she will learn to relate to more than one person |
d) Rotate staff members who work with Kim so that she will learn to relate to more than one person
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Kim manipulates the staff in an effort to fulfill her own desires. All of the following may be examples of manipulative behaviors in the borderline client except:
a) refusal to stay in her room alone, stating, "It's so lonely" b) asking the nurse for cigarettes after 30 minutes, knowing the assigned nurse has explained she must wait 1 hour c) stating "I really like having you for my nurse. You're the best one around here" d) Cutting arms with razor blade after discussing discharge plans with the doctor |
a) refusal to stay in her room alone, stating, "It's so lonely"
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"Splitting" by the client with borderline personality disorder denotes:
a) evidence of precocious development b) a primitive defense mechanism in which the client see objects as all good or all bad c) a brief psychotic episode in which the client loses contact with reality d) two distinct personalities within the borderline client |
b) a primitive defense mechanism in which the client see objects as all good or all bad
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According to Margaret Mahler, predisposition to borderline personality disorder occurs when developmental tasks go unfulfilled in which of the following phases?
a) autistic phase, during which the child's needs for security and comfort go unfulfilled b) symbiotic phase, during which the child fails to bond with the mother c) differentiation phase, during which the child fails to recognize a separateness between self and mother d) rapprochement phase, during which the mother withdraws emotional support in response to the child's increasing independence |
d) rapprochement phase, during which the mother withdraws emotional support in response to the child's increasing independence
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Jack was arrested for breaking into a jewelry store and stealing thousands of dollars worth of diamonds. At his arraignment, the judge ordered a psychological evaluation. He has just been admitted by court to the locked unit. Based on a long history of maladaptive behavior, he has been given the diagnosis of antisocial personality disorder. Which of the following characteristics would you expect to assess in Jack?
a) lack of guilt for wrongdoing b) insight into his own behavior c) ability to learn from past experiences d) compliance with authority |
a) lack of guilt for wrongdoing
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Milieu therapy is a good choice for clients with antisocial personality disorder because it:
a) provides a system of punishment and rewards for behavior modification b) emulates a social community in which the client may learn to live harmoniously with others c) provides mostly one-to-one interaction between the client and therapist d) provides a very structured setting in which the client have very little input into the planning of their care |
b) emulates a social community in which the client may learn to live harmoniously with others
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In evaluating Jack's progress(he has antisocial personality disorder), which of the following behaviors would be considered the most significant indication of positive change?
a) Jack got angry only once in group this week b) Jack was able to wait a whole hour for a cigarette without verbally abusing the staff c) On this own, Jack sent a note of apology to a man he had injured ina recent fight d) Jack states that he would no longer start any more fights |
c) On this own, Jack sent a note of apology to a man he had injured ina recent fight
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Donna and Katie work in the secretarial pool of a large organization. It is 30 min until quitting time when a supervisor hands Katie a job that will hake an hour and sys he wants if before she leaves. She says to Donna, "I can't stay over, be a doll Donna and do it for me?!?" Donna agrees, although silently she is furious at Katie because this is the third time this has happened. Donna says to herself, "This is crazy. I'm not finishing this job for her. Let's see how she like getting in trouble for a change." Donna leaves without finishing the job. This is an example of which type of personality characteristic?
a) antisocial b) paranoid c) passive-aggressive d) obsessive-compulsive |
c) passive-aggressive
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Carol is a new nursing graduate being oriented on a med/surg unit by the head nurse Mrs Carey. When Carol describes a new technique she has learned for positioning immobile clients, Mrs. Carey states, "What are you trying to do...tell me how to do my job? We have always done it this way on this unit, and we will continue to do it this way until I say differently!" This is an example of what type of personality characteristic?
a) antisocial b) paranoid c) passive-aggressive d) obsessive-compulsive |
d) obsessive-compulsive
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Which of the following behavioral patterns is characteristic of individuals with histrionic personality disorder?
a) belittling themselves and their abilities b) overreacting inappropriately to minor stimuli c) suspicious and mistrustful of others d) a lifelong pattern of social withdrawal |
b) overreacting inappropriately to minor stimuli
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After a traumatic event, a client is extremely upset and exhibits pressured and rambling speech. A therapeutic technique that the nurse can use when a client's communication rambles is:
a) touch b) silence c) focusing d) summarizing |
c) focusing
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The nurse can best handle the answering of personal questions asked by the client in any phase of the nurse-client relationship by:
a) reviewing the positive and negative aspects of the subject b) providing brief, truthful answers and redirecting the focus of the conversation c) offering an honest, brief expression of personal views on the subject raised d) reminding the client gently that the nurse's feelings are not the client's concern |
b) providing brief, truthful answers and redirecting the focus of the conversation
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At a therapy group session a group member, using a teasing manner, makes several negative remarks about the nurse's appearance and behavior. The nurse could best respond by saying to:
a) the group "What do you think this client is trying to tell me?" b) the group "Do you think this client's behavior is appropriate today?" c) the client "You seem very interested in my appearance and behavior. What's this all about?" d) the client "I cannot just sit here allowing you to talk about me this way. What have I done to make you angry?" |
c) The client, "You seem very interested my my appearance and behavior. What's this all about?": This response focuses the client on the behavioral and what the client is trying to achieve by such behavior; it also helps the client to see how the behavior affects others
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A client who has been living with her family after her boyfriend of 4 weeks told her to leave is admitted to the subacute unit complaining of feeling empty and lonely, being unable to sleep, and hardly eating for the past week. Her arms are scarred from frequent self-mutilation. The nurse interprets these findings as indicating which of the following personality disorders?
a) antisocial b) avoidant c) borderline d) compulsive |
c) borderline: remember they are impulsive, self mutilating and have intense relationships
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A 19 year old client is admitted with a diagnosis of personality disorder:not otherwise specified. The client's mother states, "He's always in trouble, just like when he was a boy. Now he's just a bigger prankster and out of control." In view of the client's history, which of the following is most important initially?
a) letting the client know the staff has the authority to subdue him if he gets unruly b) keeping the client isolated form other clients until he is better known by the staff c) emphasizing to the client that he will have to pay for any damages he causes d) closely observing the client's behavior to establish a baseline pattern of functioning |
d) closely observing the client's behavior to establish a baseline pattern of functioning: This client was just admitted and this would be the main focus at first. The other options are threatening at this time.
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The client with histrionic personality disorder is melodramatic and responds to others and situations in an exaggerated manner. The nurse should recommend which of the following activities for this client?
a) party planning b) music group c) cooking class d) role-playing |
d) role playing: This will help to teach the client appropriate responses to people and situations
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A diabetic client admitted to a medical floor for medication stabilization has a history of antisocial personality disorder. Which documented behavior would support this diagnosis?
a) labile mood and affect and old scars noted on wrists bilaterally b) appears younger than stated age with flamboyant hair and makeup c) began cursing when confronted with drug-seeking behaviors d) demands foods prepared by personal chef to be delivered to room |
c) began cursing when confronted with drug-seeking behaviors
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A client diagnosed with borderline personality disorder is admitted with recent self-inflected cuts to both arms. Which of the following would explain this behavior? CATA: Self mutilation:
a) is a manipulative gesture designed to elicit a rescue response b) is often attempted when a "safety" plan has been established c) proposes that feeling pain is better than feeling nothing d) results from feelings of abandonment following separation from significant others e) is attempted when voices tell the client to do self-harm f) is always done in an attempt to commit suicide |
Self mutilation:
a) is a manipulative gesture designed to elicit a rescue response b) is often attempted when a "safety" plan has been established c) proposes that feeling pain is better than feeling nothing d) results from feelings of abandonment following separation from significant others |
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Which of the following are diagnostic criteria for borderline personality disorder? CATA
a) arrogant, haughty behaviors or attitudes b) frantic efforts to avoid real or imagined abandonment c) recurrent suicidal and self-mutilating behaviors d) unrealistic preoccupation with fears of being left to take care of self e) chronic feelings of emptiness |
b) frantic efforts to avoid real or imagined abandonment
c) recurrent suicidal and self-mutilating behaviors e) chronic feelings of emptiness |
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A client diagnosed with OCD has a nursing diagnosis of anxiety R/T interference with hand washing AEB "I'll go crazy if you don't let me do what I need to do" Which short-term outcome is appropriate for this client?
a) the client will wash hands only at appropriate intervals: that is bathroom and meals b) the client will refrain from hand washing throughout the night c) the client will refrain from hand washing during a 3 hour period after admission o the unit d) the client will verbalize signs and symptoms of escalating anxiety within 72 hours of admission |
d) the client will verbalize signs and symptoms of escalating anxiety within 72 hours of admission
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A client diagnosed with antisocial personality disorder demands, at midnight, to speak to the ethics commit about the involuntary commitment process. Which nursing statement is appropriate?
a) "I realize you're upset; however, this is not the appropriate time to explore your concerns." b) "Let me give you a sleeping pill to help put your mind at ease" c)" It's midnight, and you are disturbing the other clients" d) "I will document your concerns in your chart for the morning shift to discuss with the ethics commit" |
a) "I realize you're upset; however, this is not the appropriate time to explore your concerns." This is acknowledging the patient's concern,but also setting limits on the unacceptable behavior.
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A client diagnosed with paranoid personality disorder needs information regarding medications. Which nursing intervention would assist this client in understanding prescribed medications?
a) ask the client to join the medication education group b) provide one-to-one teaching in the client's room c) during rounds, have th physician ask if the client has any questions d) let the client read the medication information handout |
b) provide 1:1 teaching in the clients room: This show him you are caring, and you are able to answer any questions: The medications information handout is good to supplement the 1:1,but not as the only means of teaching
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True or False: Personality disorders can be successfully controlled with medication.
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False: Hospitalization, group therapy...are also needed as there is no medication therapy that will fix their behavioral abnormalities.
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A client diagnosed with paranoid personality disorder is prescribed Risperdal. The client is noted to have restlessness and weakness in lower extremities and is drooling. Which nursing intervention would be most important?
a) hold the next dose of Risperdal, and document the findings b) monitor vitals, and encourage the client to rest c) give the ordered PRN dose of trihexyphenidyl (Artane) d) get a fasting blood sugar |
c) give the ordered PRN dose of trihexyphenidyl (Artane)
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Stimulant medications reduce the ___ symptoms of ADHD by increasing the client's ability to focus on tasks.
a) negative b) positive c) unacceptable d) abnormal |
a) negative
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All stimulant medications release what two neurotransmitters into the CNS and inhibit the reuptake of those two hormones?
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Norepinephrine and dopamine.
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Exhaustion, prolonged sleep, excessive eating, depression, and craving for more of that drug is termed ____.
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Abstinence syndrome
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What effect results if Ritalin or Concerta is combined with Dilantin, Coumadin, or phenobarbital?
a) hypertensive crisis b) life threatening hypotension c) dizziness and decreases LOC d) causes increased serum levels of Dilantin, Coumadin, or phenobarbital |
d) causes increased serum levels of Dilantin, Coumadin, or phenobarbital
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What is a priority concern for children taking ADHD medications?
a) inappropriate selling of the drug to their friends b) appropriate growth c) fluid intake d) concurrent OTC medication use |
b) appropriate growth: monitor height and weight, and for appropriate growth at specified intervals
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A client who has taken methylphenidate (Ritalin) daily for 5 years decides to stop taking it altogether. Which of the following symptoms should the nurse expect to see a few days after the client discontinues the medication?
a) insomnia, irritability b) increased ability to concentrate c) depression and exhaustion d) generalized anxiety and possible panic attacks |
c) depression and exhaustion
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What are the three clusters of personality disorders?
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Cluster A: Odd or eccentric
Cluster B: Dramatic,emotional, or erratic Cluster C: Anxious or fearful |
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What personality disorder is characterized by disregard for others with exploitation, repeated unlawful actions, deceit, and failure to accept personal responsibility?
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Antisocial personality
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What personality disorder is characterized by instability of affect, identity, and relationships, fear of abandonment, splitting behaviors, manipulation, and impulsiveness, often tried to self-mutilate and may be suicidal?
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Borderline personality disorder.
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What cluster do Antisocial and Borderline personality disorder fall under?
a) Cluster A b) Cluster B c) Cluster C d) Cluster D |
b) Cluster B: Dramatic, emotional or erratic traits
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What cluster do paranoid, schizoid and schizotypal personality disorder fall under?
a) Cluster A b) Cluster B c) Cluster C d) Cluster D |
a) Cluster A: Odd or eccentric traits
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What cluster do avoidant, dependent and obsessive-compulsive personality disorder fall under?
a) Cluster A b) Cluster B c) Cluster C d) Cluster D |
c) Cluster C: Anxious or fearful traits
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A part-time staff nurse on a behavioral unit is stopped by a client whose treatment plan shows a nursing diagnosis of ineffective coping related to manipulation of others. When planning interventions for a manipulative client, the nurse should:
a) give negative reinforcement for acting-out behavior b) ignore any inappropriate behavior c) encourage the client to discuss her feelings of inadequacy d) refer requests and questions related to care to the client's primary nurse |
d) refer requests and questions related to care to the client's primary nurse
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A patient with which personality disorder is likely to engage in splitting?
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Borderline personality disorder
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A client with antisocial personality disorder is admitted to a chemical dependency unit.The nurse should be alert for which of the following characteristic behaviors: CATA
a) anxious b) indecisive c) exploitative d) submissive e) aggressive f) impulsive |
c) exploitative
e) aggressive f) impulsive |
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A father refuses to speak with or interact with his wife's illegitimate son, and so the mother has to provide all of his care. Is the father's actions considered neglectful, if the mother if providing all the care?
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Yes, the emotional care and/or stimulation necessary for a child to develop normally, such as speaking and interacting with a child is mandatory as it constitutes neglect if not provided
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A mother fails to enroll her child in grade school. What legal term is given to her shortcomings?
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Neglect
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When are victims at the greatest risk for violence?
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When trying to leave the relationship.
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Does pregnancy tend to increase or decrease the likelihood of violence toward the woman?
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It increases the likelihood of violence.
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What would the nurse assess for if she suspected shaken baby syndrome?
a) bruising on the abdomen, back or buttocks b) spiral fractures c) respiratory distress and retinal hemorrhage d) nausea |
c) respiratory distress and retinal hemorrhage; Also bulging fontanelles, and increased head circumference
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Nurses are legally mandated to report suspected or actual cases of:
a) abuse of any kind b) abuse of the elderly c) abuse of the elderly and children d) abuse of pregnancy women |
c) abuse of the elderly and children
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Nursing interventions to help prevent family violence include:
a) teaching strategies to manage grief b) referring them to DCF c) teaching normal growth and development d) providing psychological first aid |
c) teaching normal growth and development so potential issues can be anticipated and less likely to cause stress and result in violence
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An 8-year old child has not been attending school. The child has been staying home to care for a preschool sibling. The mother tells the nurse that she unexpectantly got pregnant with her oldest child. What factor in the child's life makes her vulnerable to abuse?
a) she is the oldest sibling b) she is female c) both parents are young d) her birth was unplanned |
d) her birth was unplanned: Unplanned pregnancy puts the child at additional risk for abuse
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