NUR 333 EXAM 2 STUDY QUESTIONS
AND CORRECT ANSWERS
Cluster A ✅odd/eccentric
Paranoid, schizoid, schizotypal
Cluster B ✅dramatic, emotional, erratic
Antisocial, borderline, histrionic, narcissistic
Cluster C ✅Anxious, fearful
Avoidant, dependent, obsessive compulsive
Paranoid personality disorder characteristics ✅Longstanding distrust and suspicion of
others
Belief that others want to exploit, harm, or deceive the person
May be apparent in childhood
Social anxiety in childhood
Jealous, controlling as adults
Unwillingness to forgive and projection of feelings
Reluctance to share information about themselves due to fear that the information will
be used against them
Paranoid personality nursing care ✅Counteract mistrust
Adhere to schedules
Avoid being overly friendly
Give clear straightforward responses
Use simple, direct language
Project a neutral but kind affect
Limit setting is essential when threatening behaviors are present
Paranoid treatment ✅Psychotherapy is first line
Individual therapy focuses on the development of a professional and trusting
relationship
Group therapy is threatening to people with paranoid disorder but can be helpful in
improving social skills
Also other group members can provide a reality check for the paranoid patient
Role playing and group feedback can help improve suspiciousness
Antianxiety agents (diazepam)
Reduce anxiety and agitation
Antipsychotics for more severe delusions
Haloperidol (Haldol)
More severe agitation and delusions
,Pimozide (Orap)
Reduces paranoid ideation
Schizoid personality disorder characteristics ✅Symptoms appear in childhood and
adolescence
Loners, poor academic performance
Increased prevalence of disordered family life
Avoid close relationships
Depersonalization, detachment
Lifelong pattern of social withdrawal
Somewhat emotionless- restricted range of emotional expression
Schizoid nursing care ✅Avoid being too nice or friendly
Do not try to increase socialization
Assess for symptoms the patient is reluctant to discuss
Protect against group's ridicule
Schizoid treatment ✅Psychotherapy
May describe a full fantasy life
May help realize others' social cues
Group therapy
May be the only form of socialization the patient has
Provides practice for social interactions and getting feedback from others
Antidepressants
Bupropion- may help increase pleasure in life
2nd generation antipsychotics
Olanzapine- used to improve emotional expressiveness
Schizotypal personality disorder characteristics ✅Severe social and interpersonal
deficits
Anxiety in social situations
Rambling conversation
Paranoia, suspiciousness, anxiety, distrust
Brief, intermittent episodes of hallucination or delusion
Can be made aware of their own odd beliefs
May be vulnerable to involvement with cults or unusual religious/ occult groups
Magical thinking, odd beliefs, strange speech patterns, inappropriate affect
Schizotypal nursing care ✅Respect patient's need for social isolation
Be aware of and intervene appropriately with patient's suspiciousness
Perform careful diagnostic assessment for symptoms that may need intervention
Ex: suicidal thoughts
Withhold judgment or ridicule
Schizotypal treatment ✅Supportive psychological care (investigate possible
involvement with cults)
, Low dose antipsychotics help with day to day functioning
Histrionic personality disorder characteristics ✅Excitable, dramatic; often high
functioning
Bold external behaviors, flamboyant
Limited ability to develop meaningful relationships
Attention seeking, self centered; low frustration tolerance
Excessive emotions; may be provocative; smothering
No insight into disorder or role in ruining relationships
Do not think they need psychiatric help
Histrionic personality nursing care ✅Know that seductive behavior is a response to
distress
Keep interactions professional; ignore flirtations
Model concrete language
Help patient clarify inner feelings
Teach and role model assertiveness
Assess for suicidal idealation
Patient may exaggerate symptoms and have difficulty functioning
Histrionic treatment ✅Psychotherapy is treatment of choice
May promote clarification of inner feelings and appropriate expression
Group can be helpful but can also be disruptive due to distracting symptoms
Narcissistic personality disorder characteristics ✅Feelings of entitlement, exaggerated
self importance
Lack of empathy; tendency to exploit others
Weak self esteem and hypersensitivity to criticism/ rejection
Constant need for admiration
Less functional impairment than other personality disorders
Fear of abandonment/ intense shame
Narcissistic nursing care ✅Remain neutral
Promote a stronger patient self identity
Avoid power struggles or becoming defensive
Role model empathy
Narcissistic treatment ✅Difficult to treat and patients not likely to seek help or confront
shortcomings
Cognitive behavioral therapy (CBT) to deconstruct faulty thinking
Group therapy
Patient can see their own qualities in other people, practice sharing with others, and
learning empathy
Lithium for mood swings
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