exam 2

Question 1

cluster A eccentric group psychotics: paranoid personality disorder

Answer 1

S: Spouse fidelity suspected
U: Unforgiving (bears grudges)
S: Suspicious of others
P: Perceives attacks (and reacts
quickly)
E: “Enemy or friend” (suspects
associates, friends)
C: Confiding in others feared
T: Threats p

Question 2

cluster A eccentric group psychotics: schizoid personality disorder: DISTANT

Answer 2

D: Detached (or flattened) affect
I: Indifferent to criticism and praise
S: Sexual experiences of little
interest
T: Tasks (activities) done solitarily
A: Absence of close friends
N: Neither desires nor enjoys close
relations
T: Takes pleasure in few activities

Question 3

cluster A eccentric group psychotics schizotypal personality disorder: MEPECULIAR

Answer 3

M: Magical thinking or odd beliefs
E: Experiences unusual perceptions
P: Paranoid ideation
E: Eccentric behavior or appearance
C: Constricted (or inappropriate)
affect
U: Unusual (odd) thinking and
speech
L: Lacks close friends
I: Ideas of reference
A: Anxiety in social situations
R: Rule out psychotic disorders and
pervasive developmental disorder

Question 4

cluster B dramatic, erratic group extraverts antisocial personality disorder: corrupt

Answer 4

C: Conformity to law lacking
O: Obligations ignored
R: Reckless disregard for safety of self or
others
R: Remorse lacking
U: Underhanded (deceitful, lies, cons
others)
P: Planning insufficient (impulsive)
T: Temper (irritable and aggressive)

Question 5

cluster B dramatic erratic group extraverts borderline personality disorder AMSUICIDE

Answer 5

A: Abandonment
M: Mood instability (marked reactivity of
mood)
S: Suicidal (or self-mutilating) behavior
U: Unstable and intense relationships
I: Impulsivity (in two potentially selfdamaging areas)
C: Control of anger
I: Identity disturbance
D: Dissociative (or paranoid) symptoms
that are transient and stress-related
E: Emptiness (chronic feelings of)

Question 6

cluster B: Dramatic, erratic group extraverts histrionic personality disorder: PRAISEME

Answer 6

P: Provocative (or sexually seductive)
behaviorR: Relationships (considered
more intimate than they are)
A: Attention (uncomfortable when not the
center of attention)
I: Influenced easily
S: Style of speech (impressionistic, lacks
detail)
E: Emotions (rapidly shifting and shallow)
M: Made up (physical appearance used to
draw attention to self)
E: Emotions exaggerated (theatrical)

Question 7

cluster B dramatic erratic group extraverts narcissistic personality disorder: special 5

Answer 7

S: Special (believes he or she is special and
unique)
P: Preoccupied with fantasies (of unlimited
success, power, brilliance, beauty, or ideal
love)
E: Entitlement
C: Conceited (grandiose sense of selfimportance)
I: Interpersonal exploitation
A: Arrogant (haughty)
L: Lacks empathy

Question 8

cluster C: Anxious, fearful group neurotics avoidant personality disorder CRINGES

Answer 8

C: Certainty (of being liked required before
willing to get involved with others)
R: Rejection (or criticism) preoccupies one’s
thoughts in social situations
I: Intimate relationships (restraint in intimate
relationships due to fear of being shamed)
N: New interpersonal relationships (is inhibited
in)
G: Gets around occupational activity (involving
significant interpersonal contact)
E: Embarrassment (potential) prevents new
activity or taking personal risks
S: Self viewed as unappealing, inept, or inferior

Question 9

cluster C: anxious, fearful group neurotics dependent personality disorder: RELIANCE

Answer 9

R: Reassurance required for decisions
E: Expressing disagreement difficult (due to fear
of loss of support or approval)
L: Life responsibilites (needs to have these
assumed by others)
I: Initiating projects difficult (due to lack of selfconfidence)
A: Alone (feels helpless and discomfort when
alone)
N: Nurturance (goes to excessive lengths to
obtain nurturance and support)
C: Companionship (another relationship) sought
urgently when close relationship ends
E: Exaggerated fears of being left to care for self

Question 10

cluster C: anxious, fearful group neurotics obsessive-compulsive personality disorder LAW FIRMS?

Answer 10

L: Loses point of activity (due to preoccupation
with detail)
A: Ability to complete tasks (compromised by
perfectionism)
W: Worthless objects (unable to discard)
F: Friendships (and leisure activities) excluded
(due to a preoccupation with work)
I: Inflexible, scrupulous, overconscientious (on
ethics, values, or morality, not accounted for by
religion or culture)
R: Reluctant to delegate (unless others submit to
exact guidelines)
M: Miserly (toward self and others)
S: Stubbornness (and rigidity)

Question 11

nursing interventions for lack of trust in feeling of safety and security

Answer 11

• Keep interactions brief, especially orientation
• Structure environment
• Be consistent and reliable; notify patient of anticipated schedule changes
• Decrease physical contact
• Eye contact during greeting
• Maintain attentiveness with head slightly leaning toward patient and nonintrusive attitude
• Allow physical distance
• Accept patient’s behavior (with silence), maintain matter-of-fact attitude toward behavior

Question 12

nursing interventions for hallucinations

Answer 12

• Maintain accepting attitude
• Do not argue with patient about reality of hallucinations
• Comment on feeling, tone of hallucinations, “that must be frightening to you”
• Encourage diversional activities (playing cards), especially activities in which patient can gain a sense of mastery (artwork)
• Encourage discussions of reality-based interests

Question 13

nursing intervention for lack of attention to personal needs (nutrition, hygiene, etc)

Answer 13

• Assess adequacy of hydration, nutrition
• Structure routine for bathing, mealtime
• Offer encouragement of assistance if necessary (sit with patient or feed patient if appropriate)
• Decrease environmental stimuli at mealtime (suggest early dinner before dining room crowds)
• Positioning and skin care for catatonic patient

Question 14

nursing intervention for mistrust and feeling of rejection

Answer 14

• Keep appointments with patients
• Clear, consistent communication
• Allow patient physical distance and keep door open when interviewing
• Genuineness and honesty in interactions
• Recognize testing behavior and show persistence in interest in client

Question 15

nursing intervention for delusions?

Answer 15

• Allow patient to verbalize the delusion in a limited manner
• Do not argue with patient or try to convince that delusions are not real
• Point out feeling tone of delusion
• Provide activities to divert attention from delusions
• Solitary activities best at first and then may progress to noncompetitive games or activities
• Do not reinforce delusions by validating them
• Focus on potential real concerns of patient

Question 16

nursing intervention for increased agitation and anxiety

Answer 16

• Recognize signs of impending violence (increased motor activity, pacing, or sudden stop – “calm before the storm”)
• Identify yourself, speak calmly but firmly in normal tone of voice
• Help verbalize feelings
• Use nonthreatening body language (arms to side, palms outward, keep distance, avoid blocking exit, avoid body contact)
• Avoid disagreeing with or threatening patient
• Decrease stimuli, remove threatening objects or people

Question 17

nursing intervention for violence

Answer 17

• Intercede early
• Continue nonthreatening behavior
• If patient needs to be restrained to protect self or others, get help (at least 4 people)
• Move in organized, calm manner, stating that you want to help and that you will not permit patient to harm self or others
• Use restraints correctly (never tie to bedside rail, check circulation frequently)

Question 18

defense mechanism: acting out

Answer 18

You engage in extreme, disruptive, and/or unacceptable behaviors and actions. Example: a child throws a temper tantrum because they cannot deal with frustration at school or home.

Question 19

defense mechanism: compensation

Answer 19

Your self-worth and self-esteem are protected by overachieving in a new area after failing in another area. Example: a young college student hoping to become an engineer fails his math class, so he decides to leave college and instead get and excel in a sales career.

Question 20

defense mechanism denial

Answer 20

You completely reject the thought or feeling to avoid damage to the ego caused by the anxiety or guilt of accepting them. Example: A married woman might deny to herself that she holds affections for her husband’s friend, rather than accepting her true feelings.

Question 21

defense mechanism displacement

Answer 21

You direct your feelings of anger and hostility to another target (person or object). Displacement allows the person to ventilate and act out their anger in a less harmful and more socially acceptable manner. Example: a man who is fired by their boss comes home and kicks the dog.

Question 22

defense mechanism dissociation

Answer 22

You lose track of time and/or person, and instead find another representation of yourself in order to continue in the moment. You can “disconnect” from the real world for a time and live in a world that is not cluttered with thoughts, feelings, or memories that are unbearable. In extreme cases, this can lead to a person believing they have multiple selves (dissociative identity disorder). Example: a friend enters a state of daydreaming, staring in to space and letting their mind wander until you nudge them, prompting them to acknowledge reality once more.

Question 23

defense mechanism: identification

Answer 23

In order to pacify a person whom we perceive to be a threat, we may emulate aspects of their behavior (adopting their mannerisms, repeating phrases or language patterns, and mirroring character traits). Example: A teenager moves to a new school and adopts the attitudes of classmates from whom they seek acceptance, in order to not be rejected by their new peers.

Question 24

defense mechanism intellectualization

Answer 24

A type of rationalization, only more intellectualized. You use conscious, intellectual, and rational thinking to explain some stressful event. This often involves standing back from the situation and attempting to take a cold, neutral view of it. Example: A person was laid off after twenty years of service may intellectualize it by acknowledging the management’s view that redundancies need to be made in order for the company to survive.

Question 25

defense mechanism isolation of affect

Answer 25

You isolate your affect and true feelings by thinking about your feelings, but not actually “feeling” the feeling because you cannot yet cope with it. Example: a victim thinks about their anger but does feel the anger because it causes too much stress at that time.

Question 26

defense mechanism minimization

Answer 26

You subconsciously lower, decrease, or minimize the magnitude of the problem or stressor that confronts you. Example: a diabetic client with severe peripheral neuropathy, a leg ulcer, and retinopathy may believe these losses are “no big deal”.

Question 27

defense mechanism projection

Answer 27

You believe someone other than yourself is to blame for your failures, weaknesses, and inappropriate thoughts. Example: A nursing student fails out of school and blames the nursing program and instructors for their failure rather than recognizing it was the result of their own lack of commitment and studying.

Question 28

defense mechanism rationalization

Answer 28

You come up with various explanations or acceptable motives to justify behavior that is not socially acceptable or based on sound logic. This protects you from the conscious realization that you lack the ability to meet standards and goals. Example: an adolescent who shop lifts may rationalize their behavior by subconsciously believing that this theft will not financially harm the mega store chain.

Question 29

defense mechanism reaction formation

Answer 29

You act and behave in a manner that is completely the polar opposite of your true feelings. Example: a man overly and openly adores his wife but actually intensely despises her.

Question 30

defense mechanism regression

Answer 30

When under extreme stress, a person regresses back to a safer and less threatening developmental stage. Example: a nine-year-old child who is hospitalized starts sucking her thumb.

Question 31

defense mechanism repression

Answer 31

Allows you to push threatening and socially unacceptable thoughts out of your consciousness and in to the deep subconscious. Example: a victim will not remember a violent rape as the result of repressive amnesia and will repress their thoughts of suicide and homicide deep into the subconscious until they are able to cope with it in a more conscious manner.

Question 32

defense mechanism sublimation

Answer 32

You redirect and replace unacceptable urges and feelings into a socially acceptable urge or feeling. Example: a father who has the urge to sexually abuse their child transforms and replaces this unacceptable urge by becoming a deacon of their church.

Question 33

defense mechanism suppression

Answer 33

You are vaguely aware of the thought or feeling, but subconsciously try and hide it. Suppression is somewhat similar to repression.

Question 34

defense mechanism undoing

Answer 34

You try to reverse or undo your feeling by DOING something that indicates the opposite feeling. It may be an “apology” for the unacceptable feeling. Example: a wife takes her husband out for a fancy dinner in his favorite restaurant after she has had an illicit affair with a coworker earlier in the day.