A client with antisocial personality disorder yells, Shut up ...

[SGallaher96]

A client with antisocial personality disorder yells, Shut up about that, or I'll punch you in the nose and shakes his fist at another client in a group meeting after the client speaks negatively of illicit drug use.
 
  The nurse quickly determines that the client 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 ap-proach for the nurse to use?
  1. Seclude the client to protect the other clients and staff.
  2. Put the client in restraints to protect the milieu.
  3. Explore alternate ways to handle frustrating topics in the group.
  4. Tell the client to leave the group until he can behave appropriately.

Question 2

Which information should the nurse include when teaching a client with a personality disorder?
 
  1. Journal writing will help you recognize feeling states.
  2. Try problem solving independently to help with difficult relationships.
  3. Identify people and circumstances that create conflict; then avoid them.
  4. Try to alleviate behaviors that cause problems relating with others.

[vish98]

Answer to Question 1

ANS: 3
This would be an opportune time for the group to explore ways of handling frustration that may occur in the group setting. This approach may also help defuse the client's anger in a constructive way. Options 1 and 2 are not necessary until verbal interventions prove unsuccessful. Option 4 is not an approach that will lead to meaningful learning.

Answer to Question 2

ANS: 1
Journal writing will help the client identify his or her own behavior and its effect on others. After this step, the client can work on changing behaviors. 2. This increases client isolation. 3. Working through problems is preferable to avoiding them. 4. Alleviating problem behaviors is important, but the client must first identify the problems.