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Exam (elaborations)

Psychiatric Nursing Final Exam Review | Practice Questions, Answers & Study Guide 2026/2027

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Psychiatric Nursing Final Exam Review | Practice Questions, Answers & Study Guide 2026/2027

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Nursing Final
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Antisocial PD


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


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.
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.


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Avoidant PD


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


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.



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Borderline PD


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.


Nursing Guidelines for Borderline PD


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.




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Dependent PD


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


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 clinging (demands of extra time, nighttime calls, crisis before vacations); therefore,
supervision is well advised.
4. Teach and role-model assertiveness.




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