A nurse on a mental health unit is caring for a client who refuses to follow instructions and states that the unit rules do not apply to them. The nurse should identify that these findings are manifestations of which of the following personality disorders?

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Antisocial personality disorder. This disorder is characterized by a disregard for and violation of the rights of others. Individuals with antisocial personality disorder often exhibit a pattern of deceit, impulsivity, aggressiveness, and a lack of remorse for their actions. In the case described, the client's refusal to follow rules and belief that they are exempt from them align with the traits of antisocial personality disorder. Option B) Histrionic personality disorder is characterized by attention-seeking behavior, emotional instability, and a need for approval. This does not align with the client's behavior in the scenario. Option C) Narcissistic personality disorder is characterized by a grandiose sense of self-importance, a need for admiration, and a lack of empathy for others. While there may be some overlap in behaviors with antisocial personality disorder, the primary focus of narcissistic personality disorder is on self-aggrandizement rather than disregard for rules. Option D) Borderline personality disorder is characterized by unstable relationships, self-image, and emotions. While individuals with borderline personality disorder may engage in impulsive behaviors and have difficulties with interpersonal boundaries, the key feature of defiance and disregard for rules seen in the scenario is not typically associated with this disorder. In an educational context, understanding different personality disorders is crucial for nurses working in mental health settings. Recognizing the specific traits and behaviors associated with each disorder enables nurses to provide appropriate care and interventions tailored to the individual needs of clients. By correctly identifying the manifestations of personality disorders, nurses can better assess, communicate, and collaborate with other healthcare professionals to ensure effective treatment and support for clients.

Correct Answer: B

Rationale: In this scenario, the nurse is in the evaluation phase of the nursing process. Evaluation involves assessing the client's response to the interventions implemented. In this case, the nurse is analyzing the effectiveness of the client's treatment plan by reviewing the progress made during the three months, including follow-up appointments, group support attendance, and medication adherence. Option A, analysis/diagnosis, is incorrect because this phase focuses on gathering data, identifying issues, and formulating a nursing diagnosis. The nurse in this question is beyond the analysis phase and is assessing the outcomes of the interventions. Option C, planning, is incorrect as this phase involves developing a plan of care based on the identified nursing diagnosis. The nurse is no longer in the planning stage but rather evaluating the outcomes of the established plan. Option D, implementation, is incorrect because this phase pertains to the actual carrying out of the nursing care plan. The nurse in this scenario is not implementing new interventions but rather assessing the effectiveness of the existing ones. Understanding the different phases of the nursing process is crucial for nurses to provide holistic and effective care to their clients. Evaluation helps nurses determine the success of interventions and guides future decision-making in the client's care. This question reinforces the importance of continuous assessment and reflection in nursing practice to ensure positive client outcomes.

Correct Answer: C

Rationale: The correct answer is C) Adaptive vs. maladaptive. This concept is essential for the nurse to understand and deliver appropriate care to a client experiencing increased stressors. By assessing whether the client's responses to stress are adaptive (helpful in coping with stress) or maladaptive (detrimental to well-being), the nurse can tailor interventions to promote effective coping mechanisms and improve the client's overall well-being. Option A) Good vs. bad is overly simplistic and does not provide the nuanced understanding needed to address the complex nature of stress and coping mechanisms in healthcare settings. Option B) Justified vs. unjustified focuses more on moral or ethical considerations rather than the psychological aspects of stress and coping. Option D) Right vs. wrong is also too binary and does not capture the multidimensional nature of stress responses and coping strategies. In an educational context, understanding the difference between adaptive and maladaptive responses to stress is crucial for nurses to provide holistic and patient-centered care. By recognizing maladaptive coping mechanisms, nurses can intervene early to support clients in developing healthier strategies to manage stress and maintain their well-being. This knowledge enhances the nurse's ability to promote positive health outcomes and build therapeutic relationships with clients.

Correct Answer: B

Rationale: In this scenario, option B is the correct answer because it presents a client with multiple adverse childhood experiences and a family history of anxiety disorders. Adverse childhood experiences, such as trauma, neglect, or abuse, are known risk factors for developing anxiety-related disorders. Additionally, a genetic predisposition to anxiety disorders further increases the likelihood of developing such conditions. Option A is incorrect because having a family history of cancer and being recently unemployed are not directly linked to an increased risk of anxiety-related disorders. Option C is incorrect as not completing high school or GED may impact opportunities and socioeconomic status but does not necessarily correlate with a higher risk of anxiety-related disorders. Option D is incorrect because although a family history of anxiety disorders is a risk factor, having several positive childhood experiences may actually serve as protective factors against developing anxiety-related disorders. Educationally, understanding the interplay between genetic predispositions, adverse childhood experiences, and environmental factors is crucial for nurses to provide comprehensive care to clients with anxiety-related disorders. Recognizing these risk factors allows nurses to tailor interventions and support strategies to effectively address the client's needs.

Correct Answer: D

Rationale: In this scenario, option D, "I can't get my mind to stop racing at night. I'm only sleeping a couple of hours," is consistent with manifestations of depression. This statement reflects symptoms such as racing thoughts and insomnia, which are common in individuals experiencing depression. Option A is incorrect as it describes a physical health condition (high blood pressure) rather than emotional or mental health concerns associated with depression. Option B indicates increased alertness and improved focus, which are not typical symptoms of depression but could suggest other conditions like anxiety. Option C describes restlessness and a need for constant activity, which is more indicative of conditions like anxiety or hyperactivity rather than depression. Educationally, it's crucial for nurses to be able to differentiate between physical and mental health symptoms to provide appropriate care. Understanding the nuances of mental health conditions like depression helps nurses in accurately assessing and supporting patients, leading to better outcomes and quality of care.