A 28-year-old client with a diagnosis of Avoidant Personality Disorder tells the nurse, "I want to make friends. I'm too afraid they'll laugh at me or think I'm weak." Which nursing intervention is most appropriate to help this client begin developing healthier interpersonal relationships?
Encourage the client to explore childhood experiences that may have caused these fears.
Reassure the client that everyone feels insecure sometimes and they are overthinking the situation.
Advise the client to start attending large events to desensitize themselves to rejection.
Assist the client in identifying and challenging negative self-beliefs through gradual social exposure.
The Correct Answer is D
Choice A reason: While exploring childhood experiences may provide insight into the origins of fear, this approach does not directly help the client build the confidence and skills needed to engage socially in the present. It may keep the focus on the past rather than promoting immediate coping strategies.
Choice B reason: Offering reassurance without addressing the underlying cognitive distortions minimizes the client’s distress and may come across as dismissive. This response fails to provide practical tools for overcoming fear of rejection.
Choice C reason: Encouraging participation in large social gatherings too quickly can overwhelm a client with avoidant traits. Such exposure without proper preparation and gradual buildup is more likely to increase anxiety and avoidance rather than reduce it.
Choice D reason: Supporting the client in recognizing and challenging self-defeating beliefs, while practicing gradual social exposure, is evidence-based and therapeutic. This method uses cognitive-behavioral strategies that are effective in reducing avoidance, building self-esteem, and encouraging healthier relationships.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: This response is factual but does not promote engagement or address the client’s passive stance. It emphasizes the nurse’s role without encouraging participation or collaboration from the older adult.
Choice B reason: This statement makes an assumption about the client’s feelings, labeling them as “angry,” which may not be accurate. It risks creating defensiveness and does not foster open communication or trust within the group.
Choice C reason: This response inappropriately offers group leadership to a member without assessing readiness or interest. It minimizes the therapeutic structure of the group and could confuse roles, making the group less effective.
Choice D reason: This option balances the acknowledgment of the nurse’s leadership role with an invitation for the client to share personal goals. It encourages involvement, respects autonomy, and helps build a therapeutic alliance by showing interest in what the older adult wants to accomplish.
Correct Answer is A
Explanation
Choice A reason: The Durham Rule states that a defendant is not criminally responsible if their unlawful act was the result of a mental illness or defect. This directly matches the legal standard, making it the correct choice.
Choice B reason: The “irresistible impulse” test applies when a person cannot control their actions despite knowing right from wrong. This is not the Durham Rule’s standard.
Choice C reason: This statement describes the M’Naghten Rule, which requires proof that the defendant did not understand the wrongfulness of their act. It does not represent the Durham Rule.
Choice D reason: Temporary intoxication or delirium does not meet the criteria under the Durham Rule. Voluntary intoxication in particular is not considered a valid legal defense.
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