Which intervention is appropriate for a patient with an ...

[abarnes]

Which intervention is appropriate for a patient with an antisocial personality disorder who frequently manipulates others?
 
  a. Refer the patient's requests and questions related to care to the case manager.
  b. Encourage the patient to discuss his or her feelings of fear and inferiority.
  c. Provide negative reinforcement for acting-out behavior.
  d. Ignore, rather than confront, inappropriate behavior.

Question 2

A physical therapist recently convicted of multiple counts of Medicare fraud says to a nurse, Sure I overbilled. Why not? Everyone takes advantage of the government. They have so many rules; no one can follow them. These statements show:
 
  a. shame.
  b. suspiciousness.
  c. superficial remorse.
  d. lack of guilt feelings.

[yotaSR5]

Answer to Question 1

ANS: A
Manipulative patients frequently make requests of many different staff members, hoping someone will give in. Having only one decision-maker provides consistency and avoids the potential for playing one staff member against another. Positive reinforcement of appropriate behaviors is more effective than negative reinforcement. The behavior should not be ignored; judicious use of confrontation is necessary. Patients with antisocial personality disorders rarely have feelings of fear and inferiority.

Answer to Question 2

ANS: D
Rationalization is being used to explain behavior and deny wrongdoing. The individual who does not believe he or she has done anything wrong will not exhibit anxiety, remorse, or guilt about the act. The patient's remarks cannot be assessed as shameful. Lack of trust or concern that others are determined to cause harm is not evident.

[abarnes]

Excellent

[peter]

TYSM