A nurse is caring for a client who has avoidant personality disorder. Which of the following types of therapy should the nurse anticipate that the client's problems arise from issues of role definition and grief and will frame solutions in interpersonal terms. This therapy is useful for those with avoidant personality disorder who seek the approval of others and fear rejection.

Correct Answer: D

Rationale: The correct answer is D: Interpersonal therapy. This therapy focuses on addressing issues related to interpersonal relationships and communication. For clients with avoidant personality disorder who fear rejection and seek approval, interpersonal therapy helps them navigate their difficulties in forming and maintaining relationships. It also addresses issues of role definition and grief, which are common challenges for individuals with this disorder. Antipsychotic medications (A) are typically used to treat psychotic disorders, not personality disorders like avoidant personality disorder. Dialectical behavior therapy (B) is more commonly used for borderline personality disorder, not avoidant personality disorder. Antidepressant medications (C) may be prescribed for individuals with avoidant personality disorder who also have comorbid depression, but they do not specifically target the interpersonal issues and fear of rejection that are core features of this disorder.

Correct Answer: D

Rationale: The correct answer is D because giving an as-needed dose of an antipsychotic drug without proper assessment or authorization can be considered a tort, specifically the tort of battery. This is because the nurse is administering medication without consent, which violates the patient's right to autonomy and bodily integrity. It can also result in harm or adverse effects to the patient. Choice A is not a tort as it relates to a delay in completing a plan of care, which may be a violation of hospital policies but not a legal tort. Choice B involves appropriate care and assessment based on the patient's history and symptoms, so it is not a tort. Choice C is related to changes in patient status based on improvement in symptoms, which is not a tort as long as it is done following proper protocols and procedures.

Correct Answer: B

Rationale: The correct answer is B: Risk for suicide. In this scenario, the patient's belief of having cancer as punishment indicates a distorted thought pattern and extreme guilt, which can increase the risk of suicidal ideation. Addressing the risk for suicide is the priority to ensure the patient's safety. Option A, powerlessness, may be relevant but is not the immediate concern. Option C, stress overload, is not as critical as the risk for suicide. Option D, spiritual distress, is not the priority compared to ensuring the patient's safety from self-harm.

Correct Answer: A

Rationale: The correct answer is A because catatonia is characterized by a state of unresponsiveness or immobility. In this case, the patient remaining in a fixed position and responding minimally to verbal cues aligns with catatonic symptoms. Option B is incorrect as mood shifts are not typically associated with catatonia. Option C is incorrect as hyperactivity is not a common feature of catatonia. Option D is incorrect as a flat affect and minimal verbal communication are more indicative of other conditions like depression or autism, not catatonia.

Correct Answer: B

Rationale: The correct answer is B: Ensure that the patient is in a safe environment and is not alone. This is the first intervention that should be implemented because safety is the top priority when a patient expresses suicidal ideation. Ensuring the patient is in a safe environment and not alone helps prevent immediate harm. Providing a quiet space (A) may not address the safety concern. Discussing feelings (C) and engaging in physical activity (D) can be important interventions, but safety must be addressed first.