When preparing to interview a patient with narcissistic ...

[APUS57]

When preparing to interview a patient with narcissistic personality disorder, a nurse can anticipate the assessment findings will include:
 
  a. preoccupation with minute details; perfectionist.
  b. charm, drama, seductiveness; seeking admiration.
  c. difficulty being alone; indecisive, submissiveness.
  d. grandiosity, self-importance, and a sense of entitlement.

Question 2

For which behavior would limit setting be most essential? The patient:
 
  a. clings to the nurse and asks for advice about inconsequential matters.
  b. is flirtatious and provocative with staff members of the opposite sex.
  c. is hypervigilant and refuses to attend unit activities.
  d. urges a suspicious patient to hit anyone who stares.

[Sassygurl126]

Answer to Question 1

ANS: D
According to the Diagnostic and Statistical Manual of Mental Disorders (fourth edition, text revision) (DSM-IV-TR), the characteristics of grandiosity, self-importance, and a sense of entitlement are consistent with narcissistic personality disorder. Charm, drama, seductiveness, and admiration seeking are observed in patients with histrionic personality disorder. Preoccupation with minute details and perfectionism are observed in individuals with obsessive-compulsive personality disorder. Patients with dependent personality disorder often express difficulty being alone and are indecisive and submissive.

Answer to Question 2

ANS: D
This option is an example of a manipulative behavior. Because manipulation violates the rights of others, limit setting is absolutely necessary. Furthermore, limit setting is necessary in this case because the safety of at least two other patients is at risk. Limit setting may be occasionally used with dependent behavior (clinging to the nurse) and histrionic behavior (flirting with staff members), but other therapeutic techniques are also useful. Limit setting is not needed for a patient who is hypervigilant and refuses to attend unit activities; rather, the need to develop trust is central to patient compliance.