A Native American patient describes a difficult childhood and dropping out of high school. The patient abused alcohol as a teenager to escape feelings of isolation but stopped 10 years ago. The patient now says, "I feel stupid. I've never had a good job. I don't help my people." Which nursing diagnosis applies?

Correct Answer: B

Rationale: The correct answer is B: Chronic low self-esteem. This diagnosis is appropriate because the patient's statement reflects a long-standing negative self-view, which aligns with chronic low self-esteem. The patient's feelings of inadequacy and self-doubt are indicative of this diagnosis. Choice A (Risk for other-directed violence) is incorrect because there is no evidence or indication of potential for violence in the patient's statement. Choice C (Deficient knowledge) is incorrect as the patient's concerns are related to self-perception rather than a lack of knowledge. Choice D (Social isolation) is incorrect because although the patient mentions feeling isolated in the past, the primary issue in the statement is low self-esteem rather than social isolation.

Correct Answer: B

Rationale: The correct answer is B: "I understand that you are angry, but this behavior will not be tolerated." Rationale: 1. Acknowledges the client's emotions: Acknowledging the client's anger shows empathy and validates their feelings. 2. Sets clear boundaries: It establishes that the behavior is not acceptable while still recognizing the underlying emotions. 3. Maintains therapeutic relationship: It addresses the behavior without resorting to judgment or confrontation. 4. Promotes safety: By stating that the behavior will not be tolerated, it ensures a safe environment for both the client and the nurse. Summary of other choices: A: Blaming and shaming the client may escalate the situation and damage the therapeutic relationship. C: Asking the client to modify behaviors may not be effective when dealing with personality disorders characterized by defiance and lack of empathy. D: Asking about medications for antisocial personality disorder is not appropriate during an initial assessment interview and may not address the immediate behavior.

Correct Answer: D

Rationale: The correct answer is D because it demonstrates a belief in supernatural or unusual experiences, which is a characteristic of schizotypal personality disorder. This statement suggests ideas of reference and magical thinking, common in individuals with this disorder. Explanation for why other choices are incorrect: A: This choice suggests paranoia, which can be seen in various mental health conditions but is not specific to schizotypal personality disorder. B: Excitement about nail polish is not a symptom of schizotypal personality disorder. C: Being knowledgeable about a specific topic, like bees, does not directly indicate schizotypal personality disorder.

Correct Answer: C

Rationale: The correct answer is C because individuals with avoidant personality disorder often have low self-esteem and fear rejection. Therefore, they may feel grateful for a compliment but still worry about potential future rejection and humiliation. A: Interpreting the compliment as a secret code used to increase personal power is more indicative of paranoid personality disorder. B: Feeling the compliment was well deserved shows a positive self-view, which is less common in avoidant personality disorder. D: Wondering what deep meaning and purpose are attached to the compliment suggests a more analytical or introspective response, rather than fear of rejection.

Correct Answer: C

Rationale: The correct answer is C because individuals with schizotypal personality disorder often exhibit incorrect interpretations of external events due to their distorted thinking patterns. This includes ideas of reference, magical thinking, and paranoid ideation. Choice A is incorrect as schizotypal individuals tend to have few close relationships. Choice B is incorrect as brief but intense relationships are more characteristic of borderline personality disorder. Choice D is incorrect as individuals with schizotypal personality disorder may have difficulty expressing emotions but not necessarily a lack of tender feelings.