Which behavior should a nurse expect a client diagnosed with paranoid personality disorder to exhibit?
Able to trust those who treat the client well
Sees the goodwill of others when none exists
Acts the opposite of what the client may be thinking or feeling
Analyzes the behavior of others to find hidden and threatening meanings
The Correct Answer is D
Paranoid personality disorder is a chronic psychiatric condition marked by pervasive distrust, suspicion, and hypervigilance toward others. Individuals with this disorder interpret others’ motives as malevolent, even without evidence. They often misread benign interactions as threatening, are reluctant to confide in others, and may bear grudges. Their interpersonal relationships are strained due to their guardedness and persistent belief that others are trying to exploit or harm them. These patterns are stable over time and begin by early adulthood, impairing social and occupational functioning.
Rationale for correct answer
D. Individuals with paranoid personality disorder exhibit persistent suspicion and hypervigilance, leading them to scrutinize others’ actions for perceived threats. They often misinterpret neutral or friendly behavior as hostile or manipulative. This cognitive distortion drives them to analyze others’ behavior obsessively, seeking hidden meanings that confirm their fears.
Rationale for incorrect answers
A. The word trust contradicts the core pathology of this disorder. These individuals rarely trust others, even those who treat them well. Their default assumption is that others have ulterior motives, making genuine trust nearly impossible.
B. Seeing goodwill where none exists is more characteristic of dependent or histrionic traits. Paranoid individuals do the opposite—they assume malevolence even when goodwill is present, due to their cognitive bias toward suspicion.
C. Acting the opposite of internal feelings is more aligned with passive-aggressive or certain neurotic defenses, not paranoid personality. Paranoid individuals are more likely to act in accordance with their suspicious thoughts, often becoming defensive or hostile.
Take Home Points
- Paranoid personality disorder is defined by pervasive distrust and suspicion without sufficient basis.
- Clients often misinterpret neutral or positive actions as hostile or threatening.
- It must be differentiated from delusional disorder (persecutory type), which involves fixed false beliefs.
- Therapeutic approaches require consistency, clear boundaries, and avoidance of overly familiar or intrusive behavior.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Schizotypal personality disorder is a pervasive pattern of social and interpersonal deficits marked by acute discomfort with close relationships, cognitive or perceptual distortions, and eccentric behavior. Individuals often display odd beliefs, magical thinking, and unusual perceptual experiences. They may appear socially anxious, have constricted affect, and exhibit paranoid ideation. These traits are stable over time and lead to significant functional impairment, particularly in interpersonal domains. Unlike schizophrenia, they do not typically experience full-blown psychosis, though they may have transient psychotic episodes under stress.
Rationale for correct answer
D. Individuals with schizotypal personality disorder are typically introverted and display emotional withdrawal due to their discomfort with close relationships and pervasive social anxiety. Their interpersonal deficits are rooted in cognitive distortions and eccentric behavior, leading to isolation and limited emotional expression. These clients often appear aloof, suspicious, and socially awkward, which aligns with the observed withdrawn demeanor.
Rationale for incorrect answers
A. The term rigid is more characteristic of obsessive-compulsive personality disorder, where individuals are preoccupied with orderliness, perfectionism, and control. Schizotypal individuals are not controlling but rather socially detached and eccentric.
B. Submissive and immature traits are more aligned with dependent personality disorder, where individuals exhibit clinginess and fear of separation. Schizotypal clients are socially distant and do not seek dependency on others.
C. Arrogant and attention-seeking behaviors are typical of narcissistic or histrionic personality disorders. Schizotypal individuals tend to avoid attention due to their discomfort in social settings and do not exhibit grandiosity or dramatic behavior.
Take Home Points
- Schizotypal personality disorder involves eccentric behavior, cognitive distortions, and social withdrawal without full psychosis.
- It must be differentiated from schizophrenia, which includes persistent hallucinations and delusions.
- Unlike avoidant personality disorder, schizotypal traits include magical thinking and perceptual distortions.
- Treatment includes supportive psychotherapy and sometimes low-dose antipsychotics for transient psychotic symptoms.
Correct Answer is B
Explanation
Cluster A personality disorders include paranoid, schizoid, and schizotypal types. These disorders are marked by odd, eccentric, or socially detached behaviors. Clients often exhibit distorted thinking, social withdrawal, and unusual beliefs. Paranoid individuals are suspicious and mistrustful; schizoid individuals are emotionally detached and prefer solitude; schizotypal individuals show magical thinking, perceptual distortions, and eccentric behavior. These disorders are ego-syntonic, meaning the individual does not see their behavior as problematic, and they often resist treatment due to mistrust or lack of insight.
Rationale for correct answer
B. The belief that one’s dinner has been poisoned reflects the suspiciousness and mistrust typical of paranoid personality disorder, a Cluster A condition. These clients often misinterpret benign actions as malevolent and may harbor persistent, unfounded suspicions about others’ intentions.
Rationale for incorrect answers
A. Grandiose self-appraisal such as claiming to be the best chef reflects narcissistic traits, which are part of Cluster B personality disorders. These individuals seek admiration and have an inflated sense of self-importance, not the social detachment or suspiciousness seen in Cluster A.
C. Repetitive handwashing is a hallmark of obsessive-compulsive disorder, which is an anxiety-related condition, not a personality disorder. Obsessive-compulsive personality disorder (Cluster C) involves rigidity and perfectionism, but not compulsions like this.
D. Inability to eat alone suggests dependent traits, where individuals feel anxious or helpless without others. This aligns with Cluster C disorders, which are marked by anxious and fearful behavior, not the eccentricity of Cluster A.
Take Home Points
- Cluster A personality disorders involve eccentric, socially detached, or suspicious behavior patterns.
- Paranoid personality disorder is characterized by pervasive mistrust and misinterpretation of others’ intentions.
- Schizotypal personality disorder includes magical thinking and perceptual distortions without full psychosis.
- These disorders must be differentiated from Cluster B (dramatic/emotional) and Cluster C (anxious/fearful) personality disorders.
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