1. A health care provider recently convicted of Medicare fraud says to a nurse, "Sure I

overbilled. Everyone takes advantage of the government. There are too many rules to

follow and I should get the money." These statements show:

a. shame.

b. suspiciousness

c. superficial remorse.

d. lack of guilt feelings. - CORRECT ANSWER✔✔ANS: D

Rationalization is being used to explain behavior and deny wrongdoing. The individual

who does not believe he or she has done anything wrong will not manifest anxiety,

remorse, or guilt about the act. The patient's remarks cannot be assessed as shameful.

Lack of trust and concern that others are determined to do harm is not shown.

2. Which intervention is appropriate for an individual diagnosed with an antisocial

personality disorder who frequently manipulates others?

a. Refer requests and questions related to care to the case manager.

b. Encourage the patient to discuss feelings of fear and inferiority.

c. Provide negative reinforcement for acting-out behavior.

d. Ignore, rather than confront, inappropriate behavior. - CORRECT ANSWER✔✔ANS:

A

Manipulative people frequently make requests of many different staff, hoping one will

give in. Having one decision maker provides consistency and avoids the potential for

playing one staff member against another. Positive reinforcement of appropriate

behaviors is more effective than negative reinforcement. The behavior should not be

ignored; judicious use of confrontation is necessary. Patients with antisocial personality

disorders rarely have feelings of fear and inferiority