A group activity on an inpatient psychiatric unit is scheduled to begin at 1000. A patient, who was recently discharged from U.S. Marine Corps, arrives at 0945. Which analysis best explains this behavior?

Correct Answer: C

Rationale: The correct answer is C: The military culture values timeliness. The patient does not want to be late. The patient's behavior aligns with the values instilled in the U.S. Marine Corps, where punctuality is highly emphasized. This explains why the patient arrived early for the group activity, as being late goes against the core values of the military culture. A: The patient arriving early does not necessarily indicate a desire to lead the group. B: Securing a chair close to the group leader is not the most likely explanation for the patient's early arrival. D: The patient's behavior is more likely motivated by adherence to military values rather than seeking appreciation for self-importance. In summary, choice C is the best analysis as it directly relates the patient's behavior to their military background and the importance of timeliness in that culture.

Correct Answer: C

Rationale: The correct action is to leave the picture where the patient placed it (Choice C) because it shows respect for the patient's cultural and religious beliefs, promoting patient-centered care. Moving the picture (Choice A) disrespects the patient's wishes. Sending it to the business office safe (Choice B) or home with the family (Choice D) interferes with the patient's autonomy and cultural practices.

Correct Answer: B

Rationale: The correct approach is B: Maintain consistency of care by open communication to avoid staff manipulation. In this scenario, the client with BPD is exhibiting manipulative behavior by rallying other clients to unreasonably demand rule modifications. By maintaining consistency in care and open communication, staff can address the conflict effectively without succumbing to manipulation. This approach also promotes a therapeutic environment and upholds boundaries. Choice A: Allowing clients to apply the democratic process may further enable manipulation and chaos rather than resolving the conflict effectively. Choice C: Allowing only the client spokesperson to verbalize concerns may not address the underlying issue of manipulation and could potentially reinforce the behavior. Choice D: Applying autocratic leadership may lead to a power struggle and exacerbate the conflict, rather than promoting a collaborative resolution.

Correct Answer: D

Rationale: The correct answer is D because it demonstrates impulsive behavior commonly associated with Borderline Personality Disorder (BPD). Cutting oneself in response to fear of abandonment is a hallmark of BPD. This behavior is impulsive, self-destructive, and a maladaptive coping mechanism. Choices A, B, and C do not involve self-harm or the extreme impulsivity typical of BPD. While they all depict fear of abandonment, only choice D involves a drastic and impulsive action in response to the perceived threat of the nurse leaving, aligning with the impulsive behavior seen in BPD.

Correct Answer: D

Rationale: The correct answer is D because it directly addresses the concept of secondary gains related to extreme dependency on the spouse. By asking about the specific benefits gained from the relationship, the nurse can uncover underlying motivations for the dependency. A: This choice focuses on a broad question about lifelong concerns, not specifically targeting the secondary gains of dependency. B: This choice asks about anxiety related to decision-making, which is not directly addressing the benefits gained from dependency. C: This choice is too general and does not directly address the issue of secondary gains in the context of dependency.