Which description best characterizes antisocial personality disorder, and what nursing approach is appropriate?

• A. They are extremely anxious and seek approval.
• B. They exhibit a pattern of dramatic mood swings and attention seeking.
• C. They show persistent fear of social situations.
• D. They disregard rules, have a history of irresponsible behavior, and can be managed by setting clear limits and rules.

Answer: (D)

Antisocial personality disorder presents as a pattern of disregard for the rights of others, with a history of irresponsible, deceitful, and sometimes manipulative behavior and a lack of remorse. In nursing care, the best approach is to establish and uphold clear, firm limits and rules with consistent, predictable consequences. This helps protect safety for the patient and others because individuals with this pattern may test boundaries or try to manipulate staff. Communicate in a straightforward, nonemotional, and nonconfrontational manner, and avoid getting drawn into arguments or power struggles. Provide structure through predictable routines and clear expectations, and respond to behaviors with consistent consequences rather than sympathetic attempts that could be interpreted as approval. Always prioritize safety, assess for risk of harm to self or others, document incidents, and involve the broader care team to ensure a stable, controlled environment.