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A nurse in a mental health facility is caring for a young adult client.

Exhibits
Which of the following findings in the client's medical record are consistent with antisocial personality disorder?

Click to highlight the findings that are consistent with antisocial personality disorder. To deselect a finding, click on the finding again.

Experience with legal system since teenage years

Adhering to financial responsibilities

Employment status

Relationship with family

Acceptance of responsibility

Substance use

Compassion toward others

Rechanneling anger with physical activity

Experience with legal system since teenage years

Adhering to financial responsibilities

Employment status

Relationship with family

Acceptance of responsibility

Substance use

Compassion toward others

Rechanneling anger with physical activity

Answer and Explanation

The Correct Answer is ["A","D","E","F"]

Findings Consistent with Antisocial Personality Disorder (ASPD)

1. Experience with the legal system since teenage years: Individuals with ASPD often exhibit a pattern of behavior that violates societal norms and legal codes, leading to frequent encounters with the legal system. The client has a history of criminal behavior, including shoplifting, auto theft, and resisting arrest, which aligns with the diagnostic criteria for ASPD.

2. Substance use: Substance abuse is common among individuals with ASPD. The client's history of driving under the influence of alcohol and possession and sale of marijuana demonstrates a disregard for the law and social norms, which is characteristic of ASPD.

3. Acceptance of responsibility: A key feature of ASPD is a lack of remorse or responsibility for one’s actions. The client’s statement, "That car wreck was not my fault! That judge just has it out for me," indicates a refusal to accept responsibility for their actions and a tendency to blame others, which is consistent with ASPD.

4. Relationship with family: Estrangement from family members is often seen in individuals with ASPD due to their manipulative, deceitful, or exploitative behavior, which can damage personal relationships. The client's estrangement from their family supports this pattern of unstable and problematic relationships.

Findings Not Consistent with ASPD

5. Adhering to financial responsibilities: The client does not adhere to financial responsibilities, as evidenced by their eviction for failure to pay rent. This behavior is consistent with ASPD, where individuals often exhibit irresponsibility, particularly in financial matters.

6. Employment status: Employment status alone is not a definitive indicator of ASPD. While the client is currently employed by a food delivery service, which suggests some level of functional ability, it does not provide enough context regarding their overall adherence to social norms or work behavior.

7. Compassion toward others: The client displays a lack of compassion toward others, which is a hallmark of ASPD. They refer to other clients in a derogatory manner ("losers") and show disdain for their feelings. This behavior reflects the lack of empathy and disregard for others typical in ASPD.

8. Rechanneling anger with physical activity: While engaging in physical activity to manage anger is generally a positive coping strategy, it does not specifically relate to the diagnostic criteria for ASPD. The client's use of physical activity to mitigate anger does not negate the presence of other antisocial traits.

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Correct Answer is C

Explanation

A. Phase I: This is the tension-building phase, where minor incidents of abuse occur, and the victim often tries to placate the abuser to avoid escalation.

B. Phase III: This is the honeymoon phase, where the abuser may apologize, show remorse, and promise that the abuse will not happen again. The victim may also experience a period of denial and hope for change.

C. Phase II: This is the acute battering incident, where the abuse reaches a peak and the victim is physically harmed. The client's statement and the injury indicate they are in this phase.

D. Phase IV: There is no recognized "Phase IV" in the cycle of abuse. The standard model includes tension-building, acute battering, and the honeymoon phases.

A. The pharmacological action of Ritalin causes a decrease in appetite. B. Side effects of Ritalin cause nausea; therefore, caloric intake is decreased. C. Increased ability to concentrate allows the client to focus on activities rather than food. D. Hyperactivity seen in ADHD causes increased caloric expenditure.

Correct Answer is A

Explanation

A. The pharmacological action of Ritalin causes a decrease in appetite. Methylphenidate (Ritalin) is a stimulant medication commonly prescribed for ADHD. One of its well-documented side effects is appetite suppression, which can lead to weight loss. This is the most accurate and direct explanation for the weight loss observed in the adolescent client.

B. Side effects of Ritalin cause nausea; therefore, caloric intake is decreased. While nausea can occur with methylphenidate, it is not the primary reason for weight loss. The main mechanism is appetite suppression rather than a direct reduction in caloric intake due to nausea. This response is less accurate than option A.

C. Increased ability to concentrate allows the client to focus on activities rather than food: While methylphenidate can improve concentration, this explanation does not directly address the physiological cause of weight loss. It is the decrease in appetite due to the drug's effects on neurotransmitters that leads to weight loss, not the increased focus on activities .

D. Hyperactivity seen in ADHD causes increased caloric expenditure: Hyperactivity itself can lead to higher caloric expenditure, but this is not directly related to the weight loss caused by methylphenidate. The primary reason for the weight loss in this case is the appetite suppression due to the medication, not increased activity .

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Correct Answer is C

Explanation

Correct Answer is A

Explanation

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