To plan effective interventions, the nurse should understand that the underlying reason a patient with paranoid personality disorder is so critical of others probably lies in the patient's:
a. need to control all aspects of the world around him.
b. use of intellectualization to protect against anxiety.
c. inflexible view of the environment and the people in it.
d. projection of blame for his own shortcomings onto others.
D
Projection allows the patient to disown negative feelings about himself and see these feelings as being directed at him from an outside source (the nurse) instead. The patient then can justifiably retaliate by being hostile to the nurse. To realize that the patient is accusing the nurse of his or her own faults makes the criticism easier to manage without retaliation. The other options are not related to the dynamics of critical behaviors on the part of the patient.
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