Mental Health CH 13 Review Summer 2025

A therapist recently convicted of multiple counts of Medicare fraud says, “Sure I overbilled. Why not? Everyone takes advantage of the government, so I did too.” These statements demonstrate which personal characteristic?

• Shame

• Anxiousness

• Superficial remorse

• Absence of guilt

Answer explanation

The therapist's statement reflects an absence of guilt, as they justify their actions by claiming that everyone exploits the system. This indicates a lack of remorse for their fraudulent behavior.

Which intervention is appropriate for a patient diagnosed with an antisocial personality disorder who frequently manipulates others?

• Refer the patient’s requests to identified staff.

• Explore the patient’s feelings of fear and inferiority.

• Provide negative reinforcement for acting-out behavior.

• Ignore, rather than confront, inappropriate behavior.

Answer explanation

Referring the patient's requests to identified staff helps set clear boundaries and reduces manipulation. This approach maintains structure and accountability, which is crucial for managing antisocial personality disorder.

As a nurse prepares to administer an oral medication to a patient diagnosed with a borderline personality disorder, the patient says, “Just leave it on the table. I’ll take it when I finish combing my hair.” What is the nurse’s best response?

• Alright. I’ll be back to make sure you’ve taken it.

• I’m worried that you might not take it. I will come back later.

• I must watch you take the medication. Please take it now.

• Why don’t you want to take your medication now?

Answer explanation

The best response is, "I must watch you take the medication. Please take it now." This ensures adherence to the medication regimen, which is crucial for patients with borderline personality disorder who may struggle with compliance.

What is an appropriate initial outcome for a patient diagnosed with a personality disorder who frequently manipulates others?

• The patient will identify when feeling angry.

• The patient will use manipulation only to get legitimate needs met.

• The patient will acknowledge manipulative behavior when it is called to their attention.

• The patient will accept fulfillment of their requests within an hour rather than immediately.

Answer explanation

The correct choice emphasizes using manipulation for legitimate needs, promoting healthier interactions. This outcome encourages the patient to recognize and modify their behavior positively.

Consider these comments made to three different nurses by a patient diagnosed with an antisocial personality disorder: “You’re a better nurse than the day shift nurse said you were”; “Another nurse said you don’t do your job right”; “You think you’re perfect, but I’ve seen you make three mistakes.” Collectively, these interactions can be appropriately assessed using what term?

• Paranoia

• Entitlement

• Manipulation

• Pathological lying

Answer explanation

The patient's comments reflect a strategy to manipulate the nurses by creating doubt and conflict among them. This behavior aligns with manipulation, as it seeks to control perceptions and responses.

A nurse reports to the interdisciplinary team that a patient diagnosed with an antisocial personality disorder lies to other patients, verbally abuses a patient diagnosed with dementia, and flatters the primary nurse. This patient is detached and superficial during counseling sessions. Which behavior most clearly warrants limit setting?

• Flattering the nurse

• Lying to other patients

• Verbal abuse of another patient

• Detached superficiality during counseling

Answer explanation

Verbal abuse of another patient is a clear violation of safety and respect in a healthcare setting, necessitating limit setting to protect vulnerable individuals, especially those with dementia.

A patient diagnosed with borderline personality disorder has a history of self-mutilation and suicide attempts. The patient reveals feelings of depression and anger with life. The treatment team suggests the use of a medication. Which type of medication should the nurse expect?

• Selective serotonin reuptake inhibitor (SSRI)

• Monoamine oxidase inhibitor (MAOI)

• Benzodiazepine

• Antipsychotic

Answer explanation

Selective serotonin reuptake inhibitors (SSRIs) are commonly used to treat depression and can help manage symptoms in patients with borderline personality disorder, making them the expected choice for this patient.

A person’s partner filed charges of battery. The person has a long history of acting-out behaviors and several arrests. Which statement by the person suggests an antisocial personality disorder?

• I have a quick temper, but I can usually keep it under control.

• I’ve done some stupid things in my life, but I’ve learned a lesson.

• I’m feeling terrible about the way my behavior has hurt my family.

• I get tired of being nagged. They deserved the beating.

Answer explanation

The statement "I get tired of being nagged. They deserved the beating." reflects a lack of empathy and justification for violence, which are indicative of antisocial personality disorder.

What is the priority nursing diagnosis for a patient diagnosed with antisocial personality disorder who has made threats against staff, ripped art off the walls, and thrown objects?

• Disturbed sensory perception–auditory

• Risk for other-directed violence

• Ineffective denial

• Ineffective coping

Answer explanation

The priority nursing diagnosis is 'Risk for other-directed violence' due to the patient's aggressive behaviors, including threats and property destruction, indicating a potential danger to staff and others.

A patient diagnosed with a personality disorder has used manipulation to get their needs met. The staff decides to apply limit setting interventions. What is the correct rationale for this action?

• It provides an outlet for feelings of anger and frustration.

• It respects the patient’s wishes so assertiveness will develop.

• External controls are necessary while internal controls are developed.

• Anxiety is reduced when staff members assume responsibility for the patient’s behavior.

Answer explanation

The correct rationale is that external controls help manage behavior while the patient develops internal controls. This structure is essential for patients with personality disorders who may struggle with self-regulation.