Psychiatric Nursing Actual Exam Version 1,2,3 And
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Antisocial PD - ... ANSWER ...✓✓ this disorder reflects
constant disregard for others through exploitation and
repeated unlawful actions. No remorse for others,
neglect responsibilities, tell lies, and perform
destructive or illegal acts w/o developing any insight
into consequences. *Psychopaths/Sociopaths*
Nursing Guidelines for Antisocial PD - ... ANSWER ...✓✓
1. Try to prevent or reduce untoward effects of
manipulation (flattery, seductiveness, instilling of guilt):
• Set clear and realistic limits on specific behavior.
• Ensure that limits are adhered to by all staff.
• Carefully document signs of manipulation or
aggression.
• Document behaviors (give times, dates,
circumstances). Provide clear boundaries and
consequences.
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2. Be aware that antisocial patients can instill guilt
when they are not getting what they want. Guard
against being manipulated through feelings of guilt.
3. Substance abuse is best handled through a well-
organized treatment program before counseling and
other forms of therapy are started.
Avoidant PD - ... ANSWER ...✓✓ characteristics are an
extreme sensitivity to rejection and robust avoidance of
interpersonal situations. These individuals demonstrate
poor self-confidence and are prone to misinterpreting
others' feedback because they are overly sensitive to
rejection.
Nursing Guidelines for Avoidant PD - ... ANSWER ...✓✓
1. A friendly, accepting, reassuring approach is the best
way to treat patients.
2. Being pushed into social situations can cause
extreme and severe anxiety.
Borderline PD - ... ANSWER ...✓✓ most common and
dramatic, is characterized by severe impairments in
functioning; instability in emotion regulation,
interpersonal relationships, impulsivity, identity or self-
image distortions, and unstable mood.
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Nursing Guidelines for Borderline PD - ... ANSWER
...✓✓ 1. Set realistic goals, use clear action words.
2. Be aware of manipulative behaviors (flattery,
seductiveness, instilling of guilt).
3. Provide clear and consistent boundaries and limits.
4. Use clear and straightforward communication.
5. When behavioral problems emerge, calmly review
the therapeutic goals and boundaries of treatment.
6. Avoid rejecting or rescuing.
7. Assess for suicidal and self-mutilating behaviors,
especially during times of stress.
Dependent PD - ... ANSWER ...✓✓ establish
relationships in which they are submissive, self-
doubting, and avoid self responsibility. find it difficult to
sustain autonomy and often seek out relationships in
which they can be taken care of.
Nursing Guidelines for Dependent PD - ... ANSWER
...✓✓ 1. Identify and help address current stresses.
2. Try to satisfy patient's needs at the same time that
limits are set up in such a manner that patient does not
feel punished and withdraw.
3. Be aware that strong countertransference often
develops in clinicians because of patient's excessive
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clinging (demands of extra time, nighttime calls, crisis
before vacations); therefore, supervision is well
advised.
4. Teach and role-model assertiveness.
dialectical behavior therapy - ... ANSWER ...✓✓
evidence-based theory to successfully treat chronically
suicidal pts w/ borderline personality disorder.
combines cognitive behavioral techniques with
mindfulness, which emphasizes being aware of
thoughts and actively shaping them.
histrionic PD - ... ANSWER ...✓✓ marked by emotional
attention-seeking behavior in which the person needs
to be the center of attention.
-impulsive,melodramatic, flirtatious and provocative.
Nursing Guidelines for histrionic PD - ... ANSWER ...✓✓
1. Understand seductive behavior as a response to
distress.
2. Keep communication and interactions professional,
despite temptation to collude with the patient in a
flirtatious and misleading manner.
3. Encourage and model the use of concrete and
descriptive rather than vague and impressionistic
language.