A client with antisocial personality disorder refuses to attend group therapy and states, "You can't make me do anything. I don't care about your rules." What is the nurse's best response?
"You don't have to go, but it would be helpful for your progress."
"Let's talk about what's bothering you today."
"Attendance is expected. The consequences for refusing are outlined in your treatment plan."
"If you don’t attend group, you will lose your privileges."
The Correct Answer is C
Choice A reason: Allowing the client to skip group undermines structure and reinforces manipulative behavior.
Choice B reason: Redirecting to feelings does not address the refusal to follow rules. Clients with antisocial personality disorder often lack insight and empathy, so this approach is ineffective.
Choice C reason: Setting clear expectations and outlining consequences is the best response. Clients with antisocial personality disorder require firm, consistent boundaries to manage manipulative and defiant behavior.
Choice D reason: Threatening loss of privileges may escalate defiance. While consequences are necessary, they should be presented in a structured, non-confrontational way, as in option C.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Asking "Why" questions can make the client feel defensive and judged. It does not promote therapeutic communication because it may sound confrontational rather than supportive.
Choice B reason: Telling the client they will not get better unless they take medication is a directive and authoritarian response. It lacks empathy and does not encourage the client to share their feelings or reasoning.
Choice C reason: This response is therapeutic because it invites the client to elaborate on their thoughts and feelings. It shows openness and respect, allowing the nurse to gather more information and understand the client’s perspective. This approach fosters trust and collaboration in care.
Choice D reason: Saying "I always do what the doctor tells me to do" shifts the focus away from the client and onto the nurse. It is non-therapeutic because it does not address the client’s concerns or encourage dialogue.
Correct Answer is D
Explanation
Choice A reason: Automatic obedience refers to a client automatically following instructions without resistance, not hearing voices.
Choice B reason: Gustatory hallucination involves false perceptions of taste, not auditory commands.
Choice C reason: Negativism is resistance to instructions or doing the opposite of what is asked, not hearing voices.
Choice D reason: Command hallucinations are auditory hallucinations where voices instruct the client to perform actions, often harmful. This is a dangerous symptom requiring immediate intervention.
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