NCLEX: Fundamentals Of Psychiatric Nursing

1. A client tends to be insensitive to others, engages in abusive behaviors and does not have a sense of remorse. Which personality disorder is he likely to have?

Narcissistic

Paranoid

Histrionic

Antisocial

Antisocial
These are the characteristics of an individual with antisocial personality. A. Narcissistic personality disorder is characterized by grandiosity and a need for constant admiration from others. B. Individuals with paranoid personality demonstrate a pattern of distrust and suspiciousness and interprets others motives as threatening. C. Individuals with histrionic have excessive emotionality, and attention-seeking behaviors.

Explanation

Antisocial
These are the characteristics of an individual with antisocial personality. A. Narcissistic personality disorder is characterized by grandiosity and a need for constant admiration from others. B. Individuals with paranoid personality demonstrate a pattern of distrust and suspiciousness and interprets others motives as threatening. C. Individuals with histrionic have excessive emotionality, and attention-seeking behaviors.

2. The client joins a support group and frequently preaches against abuse, is demonstrating the use of:

Denial

Reaction formation

Rationalization

Projection

reaction formation
Reaction formation is the adoption of behavior or feelings that are exactly opposite of one’s true emotions. A. Denial is refusal to accept a painful reality. C. Rationalization is attempting to justify one’s behavior by presenting reasons that sounds logical. D. Projection is attributing of one’s behaviors and feelings to another person.

Explanation

reaction formation
Reaction formation is the adoption of behavior or feelings that are exactly opposite of one’s true emotions. A. Denial is refusal to accept a painful reality. C. Rationalization is attempting to justify one’s behavior by presenting reasons that sounds logical. D. Projection is attributing of one’s behaviors and feelings to another person.

3. A teenage girl is diagnosed to have borderline personality disorder. Which manifestations support the diagnosis?

Lack of self esteem, strong dependency needs and impulsive behavior

Social withdrawal, inadequacy, sensitivity to rejection and criticism

Suspicious, hypervigilance and coldness

Preoccupation with perfectionism, orderliness and need for control

Lack of self esteem, strong dependency needs and impulsive behavior
These are the characteristics of client with borderline personality. B. This describes the avoidant personality. C. These are the characteristics of a client with paranoid personality D. This describes the obsessive compulsive personality

Explanation

Lack of self esteem, strong dependency needs and impulsive behavior
These are the characteristics of client with borderline personality. B. This describes the avoidant personality. C. These are the characteristics of a client with paranoid personality D. This describes the obsessive compulsive personality

4. Situation: Clients with personality disorders have difficulties in their social and occupational functions. Clients with personality disorder will most likely:

Recover with therapeutic intervention

Respond to antianxiety medication

Manifest enduring patterns of inflexible behaviors

Seek treatment willingly from some personally distressing symptoms

manifest enduring patterns of inflexible behaviors
Personality disorders are characterized by inflexible traits and characteristics that are lifelong. A and D. This disorder is manifested by life-long patterns of behavior. The client with this disorder will not likely present himself for treatment unless something has gone wrong in his life so he may not recover from therapeutic intervention. B. Medications are generally not recommended for personality disorders.Situation: Clients with personality disorders have difficulties in their social and occupational functions.

Explanation

manifest enduring patterns of inflexible behaviors
Personality disorders are characterized by inflexible traits and characteristics that are lifelong. A and D. This disorder is manifested by life-long patterns of behavior. The client with this disorder will not likely present himself for treatment unless something has gone wrong in his life so he may not recover from therapeutic intervention. B. Medications are generally not recommended for personality disorders.Situation: Clients with personality disorders have difficulties in their social and occupational functions.

5. Clients who are suspicious primarily use projection for which purpose:

Deny reality

To deal with feelings and thoughts that are not acceptable

To show resentment towards others

Manipulate others

to deal with feelings and thoughts that are not acceptable
Projection is a defense mechanism where one attributes ones feelings and inadequacies to others to reduce anxiety. A. This is not true in all instances of projection C and D. This focuses on the self rather than others

Explanation

to deal with feelings and thoughts that are not acceptable
Projection is a defense mechanism where one attributes ones feelings and inadequacies to others to reduce anxiety. A. This is not true in all instances of projection C and D. This focuses on the self rather than others

6. The client on Haldol has pill rolling tremors and muscle rigidity. He is likely manifesting:

Tardive dyskinesia

Pseudoparkinsonism

Akinesia

Dystonia

Pseudoparkinsonism
Pseudoparkinsonism is a side effect of antipsychotic drugs characterized by mask-like facies, pill rolling tremors, muscle rigidity A. Tardive dyskinesia is manifested by lip smacking, wormlike movement of the tongue C. Akinesia is characterized by feeling of weakness and muscle fatigue D. Dystonia is manifested by torticollis and rolling back of the eyes

Explanation

Pseudoparkinsonism
Pseudoparkinsonism is a side effect of antipsychotic drugs characterized by mask-like facies, pill rolling tremors, muscle rigidity A. Tardive dyskinesia is manifested by lip smacking, wormlike movement of the tongue C. Akinesia is characterized by feeling of weakness and muscle fatigue D. Dystonia is manifested by torticollis and rolling back of the eyes

7. The client is very hostile toward one of the staff for no apparent reason. The client is manifesting:

Splitting

Transference

Countertransference

Resistance

Transference
Transference is a positive or negative feeling associated with a significant person in the client’s past that are unconsciously assigned to another A. Splitting is a defense mechanism commonly seen in a client with personality disorder in which the world is perceived as all good or all bad C. Counterttransference is a phenomenon where the nurse shifts feelings assigned to someone in her past to the patient D. Resistance is the client’s refusal to submit himself to the care of the nurse

Explanation

Transference
Transference is a positive or negative feeling associated with a significant person in the client’s past that are unconsciously assigned to another A. Splitting is a defense mechanism commonly seen in a client with personality disorder in which the world is perceived as all good or all bad C. Counterttransference is a phenomenon where the nurse shifts feelings assigned to someone in her past to the patient D. Resistance is the client’s refusal to submit himself to the care of the nurse

8. The client says " the NBI is out to get me." The nurse's best response is:

“The NBI is not out to catch you.”

“I don’t believe that.”

“I don’t know anything about that. You are afraid of being harmed.”

“ What made you think of that.”

“I don’t know anything about that. You are afraid of being harmed.”
This presents reality and acknowledges the clients feeling A and B. are not therapeutic responses because these disagree with the client’s false belief and makes the client feel challenged D. unnecessary exploration of the false

Explanation

“I don’t know anything about that. You are afraid of being harmed.”
This presents reality and acknowledges the clients feeling A and B. are not therapeutic responses because these disagree with the client’s false belief and makes the client feel challenged D. unnecessary exploration of the false

9. The plan of care for clients with borderline personality should include:

Limit setting and flexibility in schedule

Giving medications to prevent acting out

Restricting her from other clients

Ensuring she adheres to certain restrictions

Ensuring she adheres to certain restrictions
The client is manipulative. The client must be informed about the policies, expectations, rules and regulation upon admission. A. Limits should be firmly and consistently implemented. Flexibility and bargaining are not therapeutic in dealing with a manipulative client. B. There is no specific medication prescribed for this condition. C. This is not part of the care plan. Interaction with other clients are allowed but the client should be observed and given limits in her attempt to manipulate and dominate others.

Explanation

Ensuring she adheres to certain restrictions
The client is manipulative. The client must be informed about the policies, expectations, rules and regulation upon admission. A. Limits should be firmly and consistently implemented. Flexibility and bargaining are not therapeutic in dealing with a manipulative client. B. There is no specific medication prescribed for this condition. C. This is not part of the care plan. Interaction with other clients are allowed but the client should be observed and given limits in her attempt to manipulate and dominate others.

10. Situation: A 42 year old male client, is admitted in the ward because of bizarre behaviors. He is given a diagnosis of schizophrenia paranoid type.

Trust vs. mistrust

Industry vs. inferiority

Generativity vs. stagnation

Ego integrity vs. despair

Trust vs. Mistrust is the first stage, typically occurring in infancy.

Industry vs. Inferiority is associated with school-age children.

Ego Integrity vs. Despair is the stage associated with older adults, typically in late adulthood.

Generativity vs. Stagnation is the stage experienced in middle adulthood, usually between the ages of 40 and 65, where the individual focuses on contributing to society and helping guide the next generation.

Explanation

Trust vs. Mistrust is the first stage, typically occurring in infancy.

Industry vs. Inferiority is associated with school-age children.

Ego Integrity vs. Despair is the stage associated with older adults, typically in late adulthood.

Generativity vs. Stagnation is the stage experienced in middle adulthood, usually between the ages of 40 and 65, where the individual focuses on contributing to society and helping guide the next generation.