A provider prescribes quetiapine 50 mg PO divided equally every 12 hr for 3 days. Available is quetiapine 25 mg tablets.
How many tablets should the nurse administer per dose on day 3? (Round the answer to the nearest whole number. Use a leading zero if it applies.
Do not use a trailing zero.)

Rationale for Choice A:

While it is important to address the client's behavior, simply explaining that it was unacceptable is unlikely to be effective in this situation. Clients with antisocial personality disorder often have difficulty understanding and accepting responsibility for their actions. They may lack empathy for others and may not see their behavior as problematic. Confronting the client about their behavior too early in the therapeutic relationship could lead to defensiveness, hostility, or even aggression. It is important to first establish a rapport with the client and build a foundation of trust before addressing difficult topics.

Rationale for Choice B:

Setting behavioral limits is an important aspect of treatment for clients with antisocial personality disorder. However, it is not the first priority in this situation. Before setting limits, the nurse needs to establish a relationship with the client and assess their individual needs and level of functioning. Attempting to set limits without first establishing a rapport could lead to power struggles and further resistance from the client.

Rationale for Choice C:

Exploring the truth of the client's statements may be necessary at some point in the treatment process. However, it is not the first priority in this situation. The nurse's initial focus should be on establishing a relationship with the client and assessing their immediate needs. Focusing on the accuracy of the client's statements too early in the therapeutic process could derail the development of a trusting relationship.

Rationale for Choice D:

Establishing a client relationship is the first and most important step in the treatment of any client, but it is especially crucial for clients with antisocial personality disorder. These clients often have difficulty trusting others and forming close relationships. By establishing a rapport with the client, the nurse can begin to build trust and create a safe and supportive environment. This foundation is essential for any further therapeutic interventions to be successful.

While the client's statement might seem like other defense mechanisms, here's why Denial is the most fitting choice: Denial:

Involves refusing to acknowledge a painful or threatening reality.

The client attributes their cough, a potential symptom of lung cancer, to a common cold, dismissing the possibility of their condition worsening.

This allows them to avoid the emotional distress associated with facing their illness. Other options and their rationales:

Reaction formation (Choice A): This involves expressing the opposite of what one truly feels or desires. The client doesn't show any outward signs of expressing emotions opposite to their actual feelings about their health.

Suppression (Choice C): This involves consciously pushing unpleasant thoughts or feelings out of awareness. While the client might downplay the cough, they haven't completely pushed the thought of their illness away.

Regression (Choice D): This involves reverting to an earlier stage of development in response to stress. There's no indication of the client displaying behaviors characteristic of an earlier developmental stage.

Addressing other potential mechanisms:

Displacement: Redirecting emotions towards a less threatening target is not evident in the scenario.

Rationalization: Justifying behavior in a way that avoids facing the true reasons is not seen in the client's explanation. Projection: Attributing one's own feelings or desires to others is not present in the client's statement.

Remember:

Denial is a common coping mechanism for dealing with difficult realities like illness.

It's crucial for the nurse to assess the extent of the client's denial and offer support without judgment.

The goal is to help the client acknowledge their illness while providing emotional support and resources for managing their condition.