PSYCHIATRIC NURSING FINAL EXAM REVIEW
UPDATED ACTUAL QUESTIONS AND CORRECT
ANSWERS
Question: 1.
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*
Question: 2.
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. 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.
Question: 3.
Avoidant PD
Answer:
characteristics are an extreme sensitivity to rejection and robust avoidance of interpersonal situations. These
individuals demon-
strate poor self-confidence and are prone to misinterpreting others' feedback because they are overly
sensitive to rejection.
,Question: 4.
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.
Question: 5.
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.
Question: 6.
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.
Question: 7.
Dependent PD
Answer:
establish relationships in which they are submissive, self-doubting, and avoid self responsibility. find it
difficult to sustain au-
tonomy and often seek out relationships in which they can be taken care of.
,Question: 8.
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 clinging (demands of extra
time, nighttime calls, crisis before vacations); therefore, supervision is well advised. 4. Teach and role-model
assertiveness.
Question: 9.
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.
Question: 10.
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.
Question: 11.
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. 4.
Teach and role-model assertiveness.
, Question: 12.
Narcissistic PD
Answer:
arrogance w/ grandiose view of self-importance. Has the need for constant admiration, along w/ a lack of
empathy for others, which strains relationships. results in exploitation of others. Underneath this personality
is a person w/ intense shame and fear of abandonment.
Question: 13.
Nursing Guidelines for Narcissistic PD
Answer:
1. Remain neutral; avoid engaging in power struggles or becoming defensive in response to the patient's
disparaging remarks. 2. Convey unassuming self-confidence.
Question: 14.
obsessive-compulsive PD
Answer:
characteristics of perfectionism w/ a focus on orderliness and control. These people become so preoccupied
w/ details and rules that they may not be able to accomplish a given task.
Question: 15.
Nursing Guidelines for Obsessive-Compulsive PD
Answer:
1. Guard against power struggles with patient. Need for control is very high. 2. Intellectualization,
rationalization, reaction formation, isolation, and undoing are the most common defense mechanisms.
UPDATED ACTUAL QUESTIONS AND CORRECT
ANSWERS
Question: 1.
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*
Question: 2.
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. 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.
Question: 3.
Avoidant PD
Answer:
characteristics are an extreme sensitivity to rejection and robust avoidance of interpersonal situations. These
individuals demon-
strate poor self-confidence and are prone to misinterpreting others' feedback because they are overly
sensitive to rejection.
,Question: 4.
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.
Question: 5.
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.
Question: 6.
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.
Question: 7.
Dependent PD
Answer:
establish relationships in which they are submissive, self-doubting, and avoid self responsibility. find it
difficult to sustain au-
tonomy and often seek out relationships in which they can be taken care of.
,Question: 8.
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 clinging (demands of extra
time, nighttime calls, crisis before vacations); therefore, supervision is well advised. 4. Teach and role-model
assertiveness.
Question: 9.
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.
Question: 10.
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.
Question: 11.
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. 4.
Teach and role-model assertiveness.
, Question: 12.
Narcissistic PD
Answer:
arrogance w/ grandiose view of self-importance. Has the need for constant admiration, along w/ a lack of
empathy for others, which strains relationships. results in exploitation of others. Underneath this personality
is a person w/ intense shame and fear of abandonment.
Question: 13.
Nursing Guidelines for Narcissistic PD
Answer:
1. Remain neutral; avoid engaging in power struggles or becoming defensive in response to the patient's
disparaging remarks. 2. Convey unassuming self-confidence.
Question: 14.
obsessive-compulsive PD
Answer:
characteristics of perfectionism w/ a focus on orderliness and control. These people become so preoccupied
w/ details and rules that they may not be able to accomplish a given task.
Question: 15.
Nursing Guidelines for Obsessive-Compulsive PD
Answer:
1. Guard against power struggles with patient. Need for control is very high. 2. Intellectualization,
rationalization, reaction formation, isolation, and undoing are the most common defense mechanisms.
