What is the most appropriate response from a nurse to a client with antisocial personality disorder requesting an extra smoke break?

In the context of interacting with a client who has antisocial personality disorder, maintaining clear boundaries and rules is essential. The most appropriate response is to state that smoke breaks are only allowed at designated times. This response aligns with the need for structure and consistency in managing clients with this personality disorder, who may struggle with impulse control and disregard for rules.

Maintaining designated times for smoke breaks not only reinforces the established structure of the environment but also helps the client understand that their requests will be managed within the framework of the facility’s policies. This approach reduces the potential for manipulation or attempts to alter the rules, which can be common behaviors in individuals with antisocial tendencies.

Addressing the request solely on the basis of health risks or offering to discuss anxiety may divert from the immediate need to establish boundaries. While these approaches are caring and might be beneficial in other contexts, they do not directly address the client's immediate request in a way that reinforces the need for adherence to rules and structure. Consequently, the chosen response supports both the therapeutic milieu and the individual’s understanding of the need for compliance with the establishment’s policies.