Mental Health Ch 24 personality disorder

The nurse tells a patient diagnosed with borderline personality disorder, "A new case manager has been assigned to work with you." Which initial reaction is most likely for this patient? 1 Guilt 2 Anger 3 Silence 4 Withdrawal

Anger

The client diagnosed with a personality disorder who is most likely to be admitted to a psychiatric unit is one who has A. paranoid personality disorder and is suspicious of his neighbors. B. narcissistic personality disorder and is highly self-important. C. borderline personality disorder and is impulsive. D. dependent personality disorder and clings to her husband.

C. borderline personality disorder and is impulsive.

Clients with personality disorders have various self-defeating behaviors and interpersonal problems despite having near-normal ego functioning and intact reality testing. A nursing diagnosis that addresses this sort of interpersonal dysfunction is A. spiritual distress. B. defensive coping. C. impaired social interaction. D. disturbed sensory perception.

C. impaired social interaction.

Which behavior would be inconsistent with defining characteristics for the nursing diagnosis of ineffective coping? A. Difficulty in relationships B. High levels of anxiety C. Manipulation D. Interdependence

D. Interdependence

A nurse caring for a client who has been diagnosed with a personality disorder should expect that the client will exhibit which of the following characteristics? A. Frequent episodes of psychosis B. Constant involvement with the needs of significant others C. Inflexible and maladaptive responses to stress D. Abnormal ego functioning

Inflexible and maladaptive responses to stress

A patient was admitted to the psychiatric in-patient unit due to manipulative and aggressive behavior. What appropriate strategy does the nurse follow while interacting with the patient?

The nurse asks questions to explore the patient's situation.

A 16-year-old has stolen money from his invalid grandmother, uses drugs and alcohol, and frequently beats up acquaintances who disagree with him. Arrested for an assault in which he beat a classmate and caused brain damage, he stated in court "The guy deserved everything he got." The behaviors described are most consistent with the clinical picture of A. antisocial personality disorder. B. borderline personality disorder. C. schizotypal personality disorder. D. narcissistic personality disorder.

antisocial personality disorder.

A person diagnosed with obsessive-compulsive personality disorder is consistently late for appointments and says, "I have to check the safety features and fluid levels on my car six times before I leave home." Which nursing diagnosis has the highest priority?

anxiety

Characteristics the nurse will assess in the client with antisocial personality disorder are A. deceitfulness, impulsiveness, and lack of empathy. B. perfectionism, preoccupation with detail, and verbosity. C. avoidance of interpersonal contact and preoccupation with being criticized. D. need for others to assume responsibility for decision-making and seeks nurture.

deceitfulness, impulsiveness, and lack of empathy.

Characteristic behaviors the nurse will assess in the narcissistic client are A. dramatic expression of emotion, being easily led. B. perfectionism and preoccupation with detail. C. grandiose, exploitive, and rage-filled behavior. D. angry, highly suspicious, aloof, withdrawn behavior

grandiose, exploitive, and rage-filled behavior.

Research has indicated that antisocial personality may be characterized by: A. social isolation. B. lack of remorse. C. learning difficulties. D. difficulty with reality testing.

lack of remorse.

A nurse caring for a patient who has been diagnosed with a personality disorder should expect that the patient will exhibit which behavior?

maladaptive responses to stress

The primary goal of milieu therapy for clients with personality disorders is A. manage the affect behavior has on the entire group. B. one-on-one therapy. C. to help the client remain uninvolved with other patients. D. a laissez faire attitude.

manage the affect behavior has on the entire group.

What appropriate symptoms should the nurse asses to identify borderline personality disorder when interviewing patients? Select all that apply.

sarcasstic mood shifts "feeling empty inside"

Splitting is a process in which the client A. unconsciously represses undesirable aspects of self. B. places responsibility for his or her behavior outside the self. C. sees things as divided into "all good" or "all bad." D. evidences lack of personal boundaries.

sees things as divided into "all good" or "all bad."

The priority nursing intervention for a client with borderline personality disorder is to A. protect other clients from manipulation. B. respect the client's need for social isolation. C. assess for suicidal and self-mutilating behaviors. D. provide clear, consistent limits and boundaries.

. assess for suicidal and self-mutilating behaviors.

Which patient statement supports the diagnosis of histrionic personality disorder? Select all that apply. "My husband left because he said I flirt way too much." 2 "I think I'd feel better if I could just cry and let him know how I feel." 3 "I try really hard but I can never seem to please my husband 4 "I'm here because I got so depressed after my last divorce." 5 "I like being the center of attention."

1 "My husband left because he said I flirt way too much." 4 "I'm here because I got so depressed after my last divorce." 5 "I like being the center of attention."

Which behavior would be consistent with defining characteristics for the nursing diagnosis of ineffective coping? Select all that apply. ! Correct 1 Aggressiveness 2 Interdependence ! Correct 3 Manipulation ! Correct 4 High levels of anxiety ! Correct 5 Difficulty in relationships

1 Aggressiveness 3 Manipulation 4 High levels of anxiety 5 Difficulty in relationships

Screening for which personality disorder should be focused on the male population? Select all that apply. 1 Antisocial 2 Schizotypal 3 Paranoid 4 Dependent 5 Borderline

1 Antisocial 2 Schizotypal 3 Paranoid

A patient arrested for an assault in which the patient savagely beat a classmate states, "The guy deserved everything he got." The behaviors described are most consistent with the clinical picture of which disorder? 1 Antisocial personality disorder 2 Borderline personality disorder 3 Schizotypal personality disorder 4 Narcissistic personality disorder

1 Antisocial personality disorder

What appropriate symptoms should the nurse asses to identify borderline personality disorder when interviewing patients? Select all that apply. 1 Frequency of mood shifts 2 Extent of happiness 3 Feelings of emptiness 4 Inclination towards group activities 5 Tendency towards sarcasm

1 Frequency of mood shifts 3 Feelings of emptiness 5 Tendency towards sarcasm

Which assessment question focuses on the characteristic behaviors of a patient diagnosed with borderline personality disorder? Select all that apply. ! Correct 1 Have you ever attempted suicide? ! Correct 2 How would you describe your romantic relationships? 3 Do you experience visual or auditory hallucinations? ! Correct 4 Have you ever been told you are sarcastic? ! Correct 5 Over a few hours can your mood shift dramatically?

1 Have you ever attempted suicide? 2 How would you describe your romantic relationships? 4 Have you ever been told you are sarcastic? 5 Over a few hours can your mood shift dramatically?

A primary health care provider is prescribing medications for a patient with borderline personality disorder who shows risk of self-injuring. Which medication would a nurse expect to be prescribed? 1 Naltrexone (ReVia) 2 Diazepam (Valium) 3 Omega -3 supplements 4 Citalopram (Celexa)

1 Naltrexone (ReVia)

Which patient assessment data support the diagnosis of schizoid personality disorder? Select all that apply. ! Correct 1 Shares that, "I don't really care whether people are afraid of me." ! Correct 2 Is employed as a nightshift janitor at an office complex 3 Reports, "I like people but I have only two good friends" ! Correct 4 Raised in foster care after age 7 because of death of parents ! Correct 5 Has never been married

1 Shares that, "I don't really care whether people are afraid of me." 2 Is employed as a nightshift janitor at an office complex 4 Raised in foster care after age 7 because of death of parents 5 Has never been married

Which statement concerning impulse control training is true? Select all that apply. 1 The cost and benefit of actions are explored 2 Patients are encouraged to stop and think before acting 3 Focus is on social and interpersonal interactions 4 Interactions are weighed more heavily than outcomes 5 Problem solving strategies are taught and practiced

1 The cost and benefit of actions are explored 2 Patients are encouraged to stop and think before acting 3 Focus is on social and interpersonal interactions 5 Problem solving strategies are taught and practiced

A patient was admitted to the psychiatric in-patient unit due to manipulative and aggressive behavior. What appropriate strategy does the nurse follow while interacting with the patient? 1 The nurse asks questions to explore the patient's situation. 2 The nurse maintains a judgmental attitude towards the patient. 3 The nurse avoids explaining the present situation of the patient. 4 The nurse uses closed-ended statements while interacting with the patient.

1 The nurse asks questions to explore the patient's situation.

The nurse is caring for a patient with borderline personality disorder who has impaired social interaction. What symptoms does the nurse find in the patient? Select all that apply. 1 The patient has unstable relationships. 2 The patient reports to have intense relationships. 3 The patient does not show emotional response. 4 The patient engages in social activities. 5 The patient feels rejected.

1 The patient has unstable relationships. 2 The patient reports to have intense relationships. 3 The patient does not show emotional response. 4 The patient engages in social activities. 5 The patient feels rejected.

A nurse assesses an individual diagnosed with schizoid personality disorder. Which characteristics are most likely? Select all that apply. 1 Uncle diagnosed with schizophrenia 2 Multiple somatic complaints 3 Complaints of depression 4 Hyperactivity 5 Male gender

1 Uncle diagnosed with schizophrenia 3 Complaints of depression 5 Male gender

Which statement by the nurse demonstrates communication specifically appropriate for a patient diagnosed with antisocial personality disorder? Select all that apply. 1 "Remember you promised to tell me if you begin to think about hurting yourself." 2 "I don't accept responsibility for you losing privileges for arguing with staff." 3 "You don't have to go to the unit party if it will make you anxious." 4 "Referring to the staff in a sexual manner is not acceptable behavior." 5 "No, I don't think the rules are the problem, but you need to follow the rules."

2 "I don't accept responsibility for you losing privileges for arguing with staff." 4 "Referring to the staff in a sexual manner is not acceptable behavior." 5 "No, I don't think the rules are the problem, but you need to follow the rules."

A patient at the mental health center says to the nurse, "Most of the staff does not care about me, but you are different. You understand my problems." When the nurse tells this patient about an upcoming career change, the patient becomes very angry. An hour later, the patient loudly announces, "I'm going to cut my wrists. I need to be hospitalized immediately." Given this scenario, which personality disorder is most likely? 1 Narcissistic 2 Borderline 3 Histrionic 4 Avoidant

2 Borderline

A patient with borderline personality disorder has suicidal intentions. The nurse plans to teach mindfulness and emotion regulation to improve interpersonal effectiveness skills in the patient. Which therapy does the nurse follow to effectively work with the patient? 1 Schema-focused therapy 2 Dialectical behavior therapy 3 Supportive psychotherapy 4 Family therapy

2 Dialectical behavior therapy

What type of dialectical behavior therapy (DBT) for borderline personality disorder aims at reducing the person's destructive behavior? 1 Inpatient treatment 2 Intensive outpatient treatment 3 Outpatient skills group 4 Aftercare therapy

2 Intensive outpatient treatment

A nurse is caring for a patient with paranoia and severe social and interpersonal deficits. What interventions should the nurse perform while caring for the patient? 1 Be overfriendly with the patient. 2 Leave the patient alone when needed. 3 Involve the patient in group tasks frequently. 4 Ignore suspicions voiced by the patient.

2 Leave the patient alone when needed.

What personality disorder is more common among men? 1 Avoidant personality disorder 2 Paranoid personality disorder 3 Histrionic personality disorder 4 Narcissistic personality disorder

2 Paranoid personality disorder

The nurse is assessing a patient for a possible personality disorder. What behavior does the nurse identify as feature of paranoid personality disorder? 1 Excessive emotionality 2 Reluctance to answer any questions 3 Defers questions to his or her mother 4 Dichotomous thinking

2 Reluctance to answer any questions

A patient experiences extreme anxiety in social situations and seems to have some intellectual and perceptual distortions but can be made aware of the misinterpretations of reality. What is the patient likely to be suffering from? 1 Schizoid personality disorder 2 Schizotypal personality disorder 3 Paranoid personality disorder 4 Obsessive-compulsive personality disorder

2 Schizotypal personality disorder

During an interview, the nurse asks a patient with borderline personality disorder about childhood experiences. What findings about the patient's childhood may relate to the patient's borderline personality disorder? 1 Starting to explore their environment at the age of 11-18 months 2 Seeking emotional support from their mother at the age of 18-24 months 3 Getting emotional support from their parents at the age of 2-5 years 4 Sleeping most of the time at the age of 0-1 month

2 Seeking emotional support from their mother at the age of 18-24 months

A patient gets excessively anxious in group activities such as playing an indoor game and is hypersensitive to negative evaluation. What interventions should the nurse perform while caring for this patient? Select all that apply. 1 The nurse avoids having a friendly approach with the patient. 2 The nurse accepts the patient's request to not be involved in group activities. 3 The nurse has a friendly approach towards the patient. 4 The nurse assigns the patient to another group activity. 5 The nurse insists the patient participate in group activates.

2 The nurse accepts the patient's request to not be involved in group activities. 3 The nurse has a friendly approach towards the patient.

A nurse manages care for an individual diagnosed with avoidant personality disorder. Select the appropriate outcome for this patient. The patient will: 1 refrain from aggressive behavior toward others within five days. 2 demonstrate use of assertive communication within three months. 3 establish an intimate relationship with another adult within two weeks. 4 make a permanent commitment never to self-mutilate within one week.

2 demonstrate use of assertive communication within three months.

The nurse is preparing to manage the care of a patient diagnosed with a borderline personality disorder. The nurse demonstrates an understanding of therapeutic interventions that focus on the characteristics of such disorders when making which statement to the patient? 1 "You must feel threatened when staff is involved with the problems of the other patients." 2 "When you feel the triggers of your agitation starting, come to me so I can help you de-escalate." 3 "When you want my attention, please explain that to me rather than resorting to manipulative behavior." 4 "We are here to keep you safe, so I will ask you several times a day whether you feel the need to harm yourself."

3 "When you want my attention, please explain that to me rather than resorting to manipulative behavior."

Which characteristic demonstrated by a patient diagnosed with a personality disorder will result most likely in an admission to a psychiatric unit? 1 Paranoid personality disorder and is suspicious of neighbors. 2 Narcissistic personality disorder and is highly self-important. 3 Borderline personality disorder and reporting stress. 4 Dependent personality disorder and clings to spouse.

3 Borderline personality disorder and reporting stress.

When assessing a patient for personality disorders, the nurse notices that a patient behaves in a melodramatic way and acts flirtatiously. What personality disorder is the nurse most likely to suspect in the patient? 1 Paranoid personality disorder 2 Schizoid personality disorder 3 Histrionic personality disorder 4 Narcissistic personality disorder

3 Histrionic personality disorder

A primary health care provider is planning therapy for a patient with narcissistic personality disorder. What treatment option does the nurse anticipate as most effective for the patient? 1 Omega-3 supplements 3 Individual cognitive-behavioral therapy 4 Low-dose antipsychotic medications

3 Individual cognitive-behavioral therapy

A patient was diagnosed with narcissistic personality disorder. Which aspect of the nursing assessment is most important? 1 Pain rating 2 Level of anxiety 3 Nutritional status 4 Attention span, hyperactivity

3 Nutritional status

What are the features of antisocial personality disorder? 1 Symptoms tend to peak around 30 years of age. 2 Level of 5-hydroxyindoleacetic acid in the urine is high. 3 Prevalence is higher among African-American men. 4 Patients commonly exhibit self-destructive behaviors.

3 Prevalence is higher among African-American men.

The nurse explains to a patient with a borderline personality disorder that the patient's former psychiatrist resigned and a new psychiatrist has been hired. Which patient reaction is most likely? 1 Silence 2 Withdrawal 3 Rage 4 Anxiety

3 Rage

A nurse manages care for an individual with a personality disorder. What is the most attainable outcome for this patient? 1 Within two weeks, the patient will establish a satisfying intimate relationship with another adult. 2 Within five days, the patient will identify factors that led to development of the personality disorder. 3 Within one week, the patient will make a permanent commitment never to self-mutilate. 4 Within four weeks, the patient will describe personal characteristics of reactions to stress.

4 Within four weeks, the patient will describe personal characteristics of reactions to stress.

A client diagnosed with obsessive-compulsive personality disorder takes the nurse aside and mentions, "I've observed you interacting with that new patient. You are not approaching him properly. You should be more forceful with him." The best response for the nurse would be A. "I will be continuing to follow the care plan for the patient." B. "I see you are trying to control that patient's therapy as well as your own." C. "Your eye for perfection extends even to my nursing interventions." D. "That patient's care is really of no concern to you or to other clients."

A. "I will be continuing to follow the care plan for the patient."

A client has been diagnosed with dependent personality disorder. Which behavior descriptions can the nurse expect to assess? A. Anxious, fearful B. Odd, eccentric C. Dramatic, emotional, erratic D. Disoriented, disorganized

A. Anxious, fearful

A client with histrionic personality disorder winks at an attractive nurse and states, "You and I should be able to turn those resident physicians into jelly if you'd wear your skirts about two inches shorter." The nurse's reply should be based on the understanding that the client's use of seductive behavior is A. a response to stress. B. based on a need to dominate. C. seated in primitive rage. D. callous disregard for others.

A. a response to stress.

A danger of working with a client who idealizes the nurse is A. becoming over-involved and being protective and indulgent. B. becoming indecisive about planned interventions. C. developing a prejudicial, blaming orientation. D. stringent enforcement of boundaries and limits

A. becoming over-involved and being protective and indulgent.

A nurse is assigned to work with a client with borderline personality disorder. The nurse will need to consider strategies for dealing with the client's A. mood shifts, impulsivity, and splitting. B. grief, anger, and social isolation. C. altered sensory perceptions and suspicion. D. perfectionism and preoccupation with detail.

A. mood shifts, impulsivity, and splitting.

A newly admitted client has an axis II diagnosis of schizoid personality disorder. The nursing intervention of highest priority will be to A. set firm limits on behavior. B. respect need for social isolation. C. encourage expression of feelings. D. involve in milieu and group activities.

B. respect need for social isolation.

A client with dependent personality disorder who had been living with her newly married son was admitted a week ago for treatment of depression, which began after her son suggested that she move out. Which remark by the client would the nurse evaluate as showing improvement in the client's condition? A. "My son's suggestion hurt me greatly." B. "My son is less at fault than my daughter-in-law." C. "I'm going to need help to afford to rent an apartment." D. "How will I ever live alone with no one to look after my affairs?"

C. "I'm going to need help to afford to rent an apartment."

Which statement about persons diagnosed with personality disorders is accurate? 1 Patients readily recognize their problems and seek professional assistance. 2 Extended hospitalization is the best intervention and commonly needed for stabilization. 3 Characteristics of these disorders are most evident in social and interpersonal interactions. 4 Research has produced multiple medications that effectively manage symptoms of personality disorders.

Characteristics of these disorders are most evident in social and interpersonal interactions.

Mary Alice is a 37-year-old patient referred to the mental health clinic with a suspected personality disorder. She is withdrawn and suspicious and states she has always preferred to be alone. She describes herself as having "special powers" and states that she is thinking of opening a business where she gives "readings" to people about their future. She states, "I believe we can all read each other's thoughts at times." Based on this presentation, you suspect: A. obsessive-compulsive personality disorder. B. narcissistic personality disorder. C. avoidant personality disorder. D. schizotypal personality disorder (STPD).

D. schizotypal personality disorder (STPD).

What is the psychosocial assessment focus for a patient diagnosed with antisocial personality disorder? Select all that apply. 1 Substance abuse 2 Current stressors 3 Chronic medical issues 4 Homicidal ideations 5 Anxiety level

Substance abuse Current stressors Homicidal ideations Anxiety level

The nurse is caring for a rheumatoid arthritis patient with borderline personality disorder. Which behavior does the nurse find in the patient when compared to other patients in the ward? 1 The patient is always calm and depressed. 2 The patient shows extreme fluctuating emotions. 3 The patient abuses peers and hospital staff. 4 The patient feels uncomfortable by the nurse's attention.

The patient shows extreme fluctuating emotions.

Which statement is descriptive of clients with personality disorders? A. They are resistant to behavioral change. B. They have an ability to tolerate frustration and pain. C. They usually seek help to change maladaptive behaviors. D. They have little difficulty forming satisfying and intimate relationships.

They are resistant to behavioral change.

A nurse observes that a patient with osteoarthritis behaves rudely to the staff and refuses to take treatment. On inquiry, the nurse learns that the patient thinks that all staff members are planning to harm and deceive him or her. What is the patient likely to be suffering from?

paranoid disorder

Playing one staff member against another is an example of A. devaluation. B. splitting. C. impulsiveness. D. social ineptitude.

splitting.