Personality Disorders
Emotional regulation skills are taught to those diagnosed with borderline personality disorder to manage what?
Impulsive behaviors
Which cluster of disorders corresponds to symptoms of being dramatic and emotional?
Cluster B
A client asks the nurse to go to lunch with the client one day next week after the client is discharged. Which statement is the most therapeutic response?
"My role here is to help you recover. Let's talk about what else you can be doing after discharge."
A mental health nurse is working with a client with antisocial personality disorder. The nurse has just reviewed the unit rule of one cigarette per break. While telling the client about the unit rules, the client asks, "Well, if I have not done anything bad all day, can I have two cigarettes instead of one?" Which would be the most therapeutic nursing response?
"No, only one cigarette is allowed per break time."
A client with borderline personality disorder has had 21 admissions to the mental health unit, each of which was precipitated by a suicide attempt resulting in superficial cuts. During this admission, the client has developed a relationship with a highly supportive nurse and has progressed to having a pass to spend an afternoon in a nearby shopping mall. Later the day that the client uses the pass, the nurse is shocked when the emergency department calls to say that the client has just been brought in with multiple self-inflicted lacerations. The nurse asks a supervisor, "Everything was going well. How could this happen?" What response by the supervisor reflects an understanding of borderline personality disorder?
"The client's behavior seems personal, but it's really not. Clients with borderline personality disorder act out to relieve anxiety. I suspect having the pass provoked a great deal of anxiety."
The nurse is caring for a client with antisocial personality disorder. Which statement is most appropriate for the nurse to make when explaining unit rules and expectations to the client?
"You'll be expected to attend group therapy each day."
Which is considered the etiology of personality disorders?
A combination of psychosocial and biologic variables
A nurse is providing care to a client with borderline personality disorder. When providing for the client's biopsychosocial needs, the nurse would address which in the biologic domain?
Assisting with sleep measures
A group of nursing students is reviewing information about antisocial personality disorder. The students demonstrate understanding of this disorder when they state what?
An individual must be at least 18 years of age to be diagnosed with the disorder.
Which diagnosis is associated with a pervasive disregard for and violation of the rights of others?
Antisocial personality
The nurse is interviewing a client with a history of violence. The client boasts that the client "put a kid in a wheelchair" once when the client was younger and has maimed others. The client states, "Who cares? Life's tough." Violence and insensitivity are associated with which personality disorder?
Antisocial personality disorder
A nurse is caring for a client diagnosed with borderline personality disorder. The nurse has instructed the client about using the communication triad. The nurse determines that the client has understood this technique when stating what?
Anxious or fearful behaviors
Avoidant, dependent, and obsessive-compulsive personality disorders are characterized by what?
Anxious or fearful behaviors
A client has a diagnosis of borderline personality disorder and lives at home with the client's parents. The client has been in the psychiatric unit for 2 weeks and is scheduled to be discharged tomorrow. Which would be most therapeutic when the client's parents come in to discuss discharge plans?
Ask the parents to keep a written schedule of activities for each day for the client
Which personality disorder is most often treated within the inpatient psychiatric setting?
Borderline
Which personality disorder would be placed in Cluster B?
Borderline
A 30-year-old client who has not paid rent in 4 months is being evicted from an apartment. The client is brought to the hospital after the client uses a kitchen knife to cut the client's wrist in response to the stress of the eviction. The client's behavior is consistent with what?
Borderline personality disorder
A client is admitted to the mental health unit after the client's spouse brings the client to the emergency department. Upon arrival, the spouse explained that the client had been crying all weekend and stating that the client wanted to die. Upon further assessment, the spouse reports that the client always has difficulty controlling anger and frequently worries that the spouse will leave the client. Recently, the client has been getting drunk every night, which the client never used to do. What diagnosis should the nurse suspect applies to this client?
Borderline personality disorder
Impulsivity and difficulty controlling anger are characteristic of which mental health diagnosis?
Borderline personality disorder
The nurse is counseling a 35-year-old client with a personality disorder. The client states that the client's problems are not the client's fault and that the client is a victim of circumstances and "fate." When experiencing stress, the client has impulsively called friends and family and stating, "It's my last day on earth." This client presentation is best described by which disorder?
Borderline personality disorder
The nurse is in the process of planning the care of a psychiatric-mental health client and has specified the following outcome: The client will be free from self-inflicted harm. What is this client's most likely diagnosis?
Borderline personality disorder
Into which personality disorder category are individuals placed whose behavior appears odd or eccentric?
Cluster A
Which cluster of personality disorders is represented by individuals who appear anxious or fearful?
Cluster C
When assessing a client with borderline personality disorder (BPD), which would a nurse expect to assess? Select all that apply.
Control necessary for a relationship Fear of rejection Self-injurious behavior
Which occurs when thinking, feeling, or behaviors occur outside a person's awareness?
Dissociation
A nurse is preparing a teaching plan for a client with antisocial disorder. Which would the nurse most likely employ to promote successful education?
Engaging the client in a discussion to direct the topic to the client.
Which personality disorder is diagnosed more often in women?
Histrionic
When documenting observations of the behaviors exhibited by a client diagnosed with borderline personality disorder, the nurse can correctly use which terms?
Impulsive, self-destructive, unstable
Gambling, binge eating, and engaging in unsafe sex are examples of what?
Impulsivity
When providing care to a client who consistently attempts to manipulate the staff, the nurse can best maintain the therapeutic milieu by doing what?
Instructing the staff to enforce all unit rules consistently
A nurse is providing care to a client with antisocial personality disorder. As part of the plan of care, the client is to participate in a problem-solving group. The nurse understands that this intervention is effective based on which rationale?
It helps to reinforce self-responsibility.
A nurse caring for a client with borderline personality disorder (BPD) consistently informs the client of the length of the relationship and routinely prepares the client for termination and the end of hospitalization. Which is the nurse trying to prevent?
Maladaptive expression of emotions
Which personality disorder is categorized as a Cluster B disorder?
Narcissistic personality disorder
A client admitted on the inpatient mental health unit has been suspicious of other clients on the unit. This client is often angry at others' comments, and carries a grudge against a roommate for accidentally using the client's bath towel. Which personality disorder is most likely the client's diagnosis?
Paranoid
A client is diagnosed with a personality disorder manifested by odd, eccentric behavior. Which personality disorder would be associated with this manifestation?
Paranoid
A client is admitted with a diagnosis of schizotypal personality disorder. Which characteristic would this client exhibit during social situations?
Paranoid thoughts
Clients with borderline personality disorder (BPD) are usually admitted to the inpatient setting because they exhibit what?
Self-harm
The most serious consequence of behaviors seen in borderline personality disorder includes what?
Self-injury
A client on an inpatient psychiatric unit has features of borderline personality disorder. The client is frequently angry, has an unstable sense of self, and is highly impulsive. The client can be verbally abusive to staff, who feel manipulated by the client's behaviors. Which intervention does the nurse determine as priority?
Setting limits
A nurse is assessing a client diagnosed with avoidant personality disorder. Which would the nurse expect to find? Select all that apply.
Shyness Feelings of inadequacy
A client with borderline personality disorder (BPD) tells the nurse, "You are good but the nurse on the afternoon shift is bad. The doctor is bad, too, but the therapist is good." The nurse interprets this statement as reflecting what?
Splitting
When clients diagnosed with borderline personality disorder (BPD) see nurses as either all good or all bad, the client is using which primitive defense?
Splitting
Which occurs when a client tends to adore and idealize other people even after a brief acquaintance but then quickly leaves them if these others do not meet the client's expectations in some way?
Splitting
The nurse is counseling a 28-year-old client with avoidant personality disorder. Despite being employed, the client verbalizes having low quality of life due to anxiety and isolation. Which therapeutic goals does the nurse establish as priority?
The client will experience increased self-esteem.
The nurse-therapist is conducting a group therapy session in which one of the participants is an adult who has been diagnosed with narcissistic personality disorder. The nurse recognizes the significance of childhood experiences in the etiology of personality disorders, which for this client may have included what pattern?
The client's parent catered to the client's every need and the client used temper tantrums to successfully get the client's way.
A nurse working with a client with borderline personality disorder could establish which as outcome criteria?
Tolerate stress without self-mutilation.
A nurse is preparing a presentation for a group of staff nurses on personality disorders. When describing antisocial personality disorders (ASPD), the nurse would explain that for a person to be diagnosed with the disorder, the person must be at least which age?
18 years
What does the nurse recognize as the most likely explanation for the self-mutilating behaviors that occur with borderline personality disorder?
An expression of intense anger or helplessness in order to block emotional pain
A nurse is conducting a review class on borderline personality disorder. When describing the characteristics associated with this disorder, which would the nurse most likely include? Select all that apply.
Difficulty regulating moods Problems with interpersonal relationships Impulsive behavior
The nurse in charge of an inpatient psychiatric unit is irritated with a client who has borderline personality disorder. Which step should the nurse take?
Discuss the feelings with a colleague to promote coping.
