Author Question: A patient with antisocial personality disorder yells, Shut up about that, or I'll punch you in the ... (Read 28 times)

karateprodigy

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A patient with antisocial personality disorder yells, Shut up about that, or I'll punch you in the nose and shakes his fist at another patient in a group meeting after the patient speaks negatively of illicit drug use.
 
  The nurse quickly determines that the patient is at risk to act violently against others as evidenced by his aggressive behavior, verbal threats, and a history of impulsivity. Which is the best approach for the nurse to use?
  a. Secluding the patient to protect the other patients and staff
  b. Putting the patient in restraints to protect the entire milieu
  c. Exploring alternate ways to handle frustrating topics in the group
  d. Telling the patient to leave the group until he can behave appropriately

Question 2

Which intervention will best ensure a nonjudgmental evaluation of a patient's noncom-pliance with the treatment plan for management of his antisocial behaviors?
 
  a. Re-evaluating the patient's understanding of the goals of the prescribed treatment plan
  b. Asking questions that focus on his perception of why he can follow his treatment plan
  c. Expressing concern about the patient's long-term prognosis if his noncompliance continues
  d. Re-assessing the patient for changes that may require the revision of his current treatment plan



Jmfn03

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Answer to Question 1

ANS: C
Discussing angry feelings in a group setting that is focused on exploring alternative prob-lem-solving options will both distract the patient from angry feelings and help to focus ener-gy on constructive activities. Seclusion and restraints are not necessary until verbal interven-tions prove unsuccessful. Making the patient leave the group is not an approach that will lead to meaningful learning.

Answer to Question 2

ANS: B
The nurse asking questions to determine possible reasons for the outcome criteria not being met would exhibit a nonjudgmental approach to this patient's assessment interview. While appropriate, the remaining options are not nonjudgmental in nature.



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