A nurse is assessing a client who has paranoid personality disorder. Which of the following findings should the nurse expect?
Takes advantage of others for her own benefit
Believes that others are deceiving her
Shows exaggerated expression of emotions
Demonstrates detachment from others
The Correct Answer is B
A. Takes advantage of others for her own benefit:
This behavior is not specific to paranoid personality disorder. Instead, it may be seen in individuals with antisocial personality disorder, who disregard the rights of others and exploit them for personal gain. People with paranoid personality disorder are more characterized by a pervasive distrust of others and a belief that others are out to harm or deceive them.
B. Believes that others are deceiving her:
This is a hallmark symptom of paranoid personality disorder. Individuals with this disorder often exhibit extreme distrust and suspicion, believing that others have hidden motives or are deliberately trying to deceive, harm, or manipulate them. This suspiciousness and belief in the untrustworthiness of others are key features of paranoid personality disorder.
C. Shows exaggerated expression of emotions:
Exaggerated expression of emotions is not a defining characteristic of paranoid personality disorder. People with this disorder tend to display a guarded and suspicious demeanor rather than exaggerated emotional expressions. Their interpersonal interactions are often marked by skepticism and wariness.
D. Demonstrates detachment from others:
Detachment from others is more characteristic of schizoid personality disorder, not paranoid personality disorder. Individuals with schizoid personality disorder tend to be emotionally detached and have limited interest in social interactions. In contrast, individuals with paranoid personality disorder are highly suspicious and tend to assume that others are hostile or malevolent, leading to interpersonal difficulties rooted in their intense distrust.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. The client states that he will harm himself unless the restraints are removed.
This statement indicates a clear risk, but merely stating a desire for restraint removal is not sufficient reason to remove restraints. It's essential to assess the patient comprehensively and make the decision based on their current state and safety concerns.
B. The client demonstrates that he is oriented to person, place, and time.
When a restrained patient shows orientation to person (knows who they are and who others are), place (knows where they are), and time (knows the current date and time), it suggests they are aware of their surroundings and can make rational decisions. This orientation indicates a level of awareness that might justify removing the restraints.
C. The client is able to follow commands.
While following commands is an important aspect, it alone might not be enough to guarantee the patient's overall awareness of their situation and safety. A comprehensive assessment, including orientation and ability to follow commands, is necessary.
D. The client refuses to take his medication unless he is released.
Medication refusal alone may not be a sufficient reason to remove restraints, especially if the patient is not demonstrating an understanding of their situation or if releasing the restraints could pose a risk to the patient or others.
Correct Answer is D
Explanation
A. Monitor the client's sodium levels:
This action is not directly related to the administration of olanzapine. Olanzapine does not typically affect sodium levels directly. Monitoring sodium levels is essential for some other medications or conditions, but it is not a specific consideration for olanzapine administration.
B. Evaluate the client's frequency of panic attacks:
Evaluating the frequency of panic attacks is not directly related to the administration of olanzapine. Olanzapine is an antipsychotic medication used to treat conditions like schizophrenia and bipolar disorder. It is not primarily indicated for the treatment of panic attacks. Monitoring panic attacks would be relevant if the client's primary concern was panic disorder, but it's not the priority in this scenario.
C. Inform the client that application site rash is common:
This information is not relevant to the administration of olanzapine in the form of an intramuscular injection. Application site rash is a concern for topical medications or transdermal patches, not for IM injections. Therefore, informing the client about application site rash is not necessary in this context.
D. Observe the client for 3 hours following the administration of medication:
This is the correct action. Olanzapine extended-release IM injection requires close observation for at least 3 hours after administration. This monitoring period is essential due to the potential risk of post-injection delirium/sedation syndrome, which can occur shortly after the injection. Monitoring allows for the early detection of any adverse reactions, ensuring the client's safety and well-being.
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