A nurse is developing a behavioral contract with a client who has antisocial personality disorder.
Which of the following client goals should the nurse include in the contract?

Use projection during group therapy.

Decrease the number of verbal outbursts.

Increase self-esteem.

Use bargaining skills for behavioral consequences.

Answer and Explanation

The Correct Answer is B

Choice A rationale:

Use projection during group therapy. Projection involves attributing one's own thoughts, feelings, or characteristics to another person. It is not an appropriate goal for a client with antisocial personality disorder in a therapeutic setting. Instead, the focus should be on helping the client take responsibility for their actions and develop pro-social behaviors.

Choice B rationale:

Decrease the number of verbal outbursts. This is a suitable goal for a client with antisocial personality disorder. Clients with this disorder may exhibit impulsive and aggressive behaviors, including verbal outbursts. Decreasing such outbursts is a positive therapeutic goal that can contribute to improved interpersonal relationships and overall functioning.

Choice C rationale:

Increase self-esteem. While improving self-esteem is important in many therapeutic settings, it may not be the primary goal for a client with antisocial personality disorder. The primary focus is often on addressing antisocial behaviors, impulsivity, and aggression, as these are the hallmark traits of this disorder.

Choice D rationale:

Use bargaining skills for behavioral consequences. Using bargaining skills may not be the most appropriate goal for a client with antisocial personality disorder. This disorder is characterized by a persistent pattern of violating the rights of others and a disregard for social norms. Instead of bargaining, the emphasis should be on developing empathy, impulse control, and more pro-social ways of interacting with others. .

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Correct Answer is A

Explanation

Choice A rationale:

The statement "I don't feel anything but numbness anymore" is indicative of anhedonia, which is a core symptom of clinical depression. Anhedonia is the inability to experience pleasure or interest in previously enjoyed activities. Reporting this statement to the provider is important as it suggests a significant emotional disturbance.

Choice B rationale:

While the statement "It'll be a long time before I'm happy again" does indicate a sense of hopelessness or prolonged sadness, it is not as specific to clinical depression as the presence of anhedonia. Clinical depression involves a range of symptoms, and the absence of pleasure or emotions (anhedonia) is a more concerning sign.

Choice C rationale:

Feeling angry at the world is a common emotional response to grief and loss and is not a direct indication of clinical depression. It is important to consider the context of grief when assessing client statements.

Choice D rationale:

Expressing reliance on family support is a healthy coping mechanism in response to grief and loss. It does not necessarily indicate clinical depression but rather a natural response to seeking support during a difficult time.

A. Role model healthy ways to express anger. B. Assist the client to explore techniques to reduce stress. C. Suggest the client make a list of things that make him angry. D. Ask the client if he intends to harm others.

Correct Answer is D

Explanation

Choice A rationale:

While role modeling healthy ways to express anger is important, it is not the priority when a client is being aggressive toward others. Safety is the primary concern.

Choice B rationale:

Assisting the client to explore techniques to reduce stress is a helpful intervention but is not the priority when the client is actively being aggressive toward others.

Choice C rationale:

Suggesting the client make a list of things that make him angry is a therapeutic intervention, but it is not the priority when the client's behavior poses an immediate threat to others.

Choice D rationale:

Asking the client if he intends to harm others is the priority because it assesses the immediate risk to the safety of others. This information is crucial for determining the appropriate interventions to ensure the safety of everyone in the facility. Depending on the client's response, the nurse can take further steps to manage the aggressive behavior. Safety is the top priority in such situations. .

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A nurse is developing a behavioral contract with a client who has antisocial personality disorder.Which of the following client goals should the nurse include in the contract?

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A nurse is developing a behavioral contract with a client who has antisocial personality disorder.
Which of the following client goals should the nurse include in the contract?