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1. Question
A client is admitted to a mental health unit for treatment of psychotic behavior. The client is at the locked exit door and is shouting, “Let me out. There’s nothing wrong with me. I don’t belong here.” A nurse analyzes this behavior as:
Correct
Answer & Rationale:
Option 1 is Correct
Rationale: Denial is refusal to admit to a painful reality, which is treated as if it does not exist. In projection, a person unconsciously rejects emotionally unacceptable features and attributes them to other persons, objects, or situations. In regression, the client returns to an earlier, more comforting, although less mature, way of behaving. Rationalization is justifying illogical or unreasonable ideas, actions, or feelings by developing acceptable explanations that satisfy the teller and the listener.
Incorrect
Answer & Rationale:
Option 1 is Correct
Rationale: Denial is refusal to admit to a painful reality, which is treated as if it does not exist. In projection, a person unconsciously rejects emotionally unacceptable features and attributes them to other persons, objects, or situations. In regression, the client returns to an earlier, more comforting, although less mature, way of behaving. Rationalization is justifying illogical or unreasonable ideas, actions, or feelings by developing acceptable explanations that satisfy the teller and the listener.
What is Paranoid Disorders?
Description
Paranoid disorder is a concrete, pervasive delusional system characterized by persecutory and grandiose beliefs.
The client exhibits suspiciousness and mistrust of others.
The client often is viewed by others as hostile, stubborn, and defensive.
Behaviors
Suspicious and mistrustful
Emotionally distant
Distortion of reality
Poor insight and poor judgments
Hypervigilance
Low self-esteem
Highly sensitive, difficulty in admitting own error, and taking pride in being correct
Hypercritical and intolerant of others
Hostile, aggressive, and quarrelsome
Evasive
Concrete thinking
Delusions
Delusions serve a purpose in establishing identity and self-esteem.
The client may have grandiose and persecutory delusions.
Process of delusion includes denial, projection, and rationalization.
As trust in others increases, the need for delusions decreases.
Types of paranoid disorders
Paranoid personality disorder (see later)
Suspicious
Nonpsychotic
No hallucinations or delusions
No symptoms of schizophrenia
Paranoia-induced state
Abrupt onset in response to stress; subsides when stress decreases
No hallucinations, but experiences paranoid delusions
May be sensitive and suspicious before the development of delusions