What is an appropriate initial outcome for a patient with a ...

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What is an appropriate initial outcome for a patient with a personality disorder who frequently manipulates others? The patient will:
 
  a. Identify when feeling angry.
  b. Use manipulation only to get legitimate needs met.
  c. Acknowledge manipulative behavior when it is called to his or her attention.
  d. Accept fulfillment of his or her requests within an hour rather than immediately.

Question 2

A patient's roommate has observed the patient behaving in uncharacteristic ways, but the patient cannot remember the episodes. A dissociative identity disorder is suspected. Which questions are most relevant to the assessment of this patient?
 
  Select all that apply.
 
  a. Are you sexually promiscuous?
  b. Do you think you need an antidepressant medication?
  c. Have you ever found yourself someplace and did not know how you got there?
  d. Are your memories of childhood clear and complete, or do you have blank spots?
  e. Have you ever found new things in your belongings that you can't remember buying?

[dlook33]

Answer to Question 1

ANS: C
Acknowledging manipulative behavior is an early outcome that paves the way for taking greater responsibility for controlling manipulative behavior at a later time. Identifying anger relates to anger and aggression control. Using manipulation to get legitimate needs is an inappropriate outcome. The patient will ideally use assertive behavior to promote the fulfillment of legitimate needs. Accepting fulfillment of requests within an hour rather than immediately relates to impulsivity and immediacy control.

Answer to Question 2

ANS: C, D, E
Asking, Are you sexually promiscuous? would probably produce defensiveness on the part of the patient. If a subpersonality acts out sexually, the main personality is probably not aware of the behavior. Do you think you need an antidepressant medication? is a premature question and not in the nurse's scope of practice. All of the other questions are pertinent.

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Excellent

[dawsa925]

Gracias!