NUR 234 CH 18 personality disorder
Which is considered the etiology of personality disorders?
A combination of psychosocial and biologic variable
Which personality disorder is diagnosed more often in women?
Historinic ***Borderline and histrionic personality disorders are diagnosed more often in women.***
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
Clients with borderline personality disorder (BPD) are usually admitted to the inpatient setting because they exhibit what?
self-harm
When conducting a social history with a client diagnosed with a borderline personality disorder (BPD), which question would be most important to ask the client related to impulsivity?
"Do you always practice safe sex?"
Which occurs when thinking, feeling, or behaviors occur outside a person's awareness?
dissociation
A client with a personality disorder is upset and calls the nurse a "stupid cow." Which is an effective initial response to this client's behavior?
Discuss displacement of anger and set limits.
Which personality disorder would be placed in Cluster B?
borderline
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
A client with borderline personality disorder (BPD) who evaluates experiences, people, and objects in terms of mutually exclusive categories (e.g., good or bad, success or failure) is demonstrating which type of thinking?
splitting
Clients with borderline personality disorder (BPD) are usually admitted to an inpatient setting because of what?
Threats of self-harm
A client is diagnosed with avoidant personality disorder. When assessing the client, which would be evident? Select all that apply.
Timidity Sensitivity to negative comments Fear of rejection
A 43-year-old female client is observed walking and dancing around the unit dressed in red high heels and a provocative style of dress. The client is seen sitting on the lap of a male client on the unit, and they are laughing. Which is the most therapeutic nursing intervention?
"I need for you to get off his lap, this behavior is not appropriate."
The adult children of a client with narcissistic personality disorder meet with the therapist as part of their parent's treatment. The nurse is aware that which statement by the daughter is consistent with behavior typically associated with this personality disorder?
"My parent never really seemed to see me as a person with my own thoughts and problems."
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 nursing instructor is teaching about the importance of bonding and how an easy temperament can serve as a protective factor against psychopathology. Which statement made by a student demonstrates a need for further instruction?
"Temperament is not changeable." Temperament has a major influence on the chances that a child may experience psychological problems. Temperament is not unchangeable--environmental influences can change or modify a child's emotional style. Temperamental differences can be observed early in life. The patterns of temperament seen in infancy often extend into childhood and later in life.
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."
Treatment approaches for clients with personality disorders generally rely on which modality?
A combination of approaches
After teaching a group of nurses about borderline personality disorder, the leader determines that the education was successful when the group identifies that symptoms typically begin in which age group?
Adolescence
A client comes to the clinic for a follow-up visit. Despite being warm and friendly with the nurse on a previous visit, today the client presents with anger and sarcastic undertones with the same nurse. The client is presenting which behavior commonly seen in borderline personality disorder?
Affective instability
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 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 d/o
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 d/o
Impulsivity and difficulty controlling anger are characteristic of which mental health diagnosis?
Borderline personality disorder
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
A client diagnosed with schizoid personality disorder is described by family members as what?
Emotionless and a loner
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.
The nurse in charge of an inpatient psychiatric unit is frustrated and angry with a client who has borderline personality disorder. Which steps should the nurse take?
Examine the nurse's own feelings to discover the source of the nurse's anger
Emotional regulation skills are taught to those diagnosed with borderline personality disorder to manage what?
Impulsive behaviors
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
The nurse is conducting an education group for women at risk for self-mutilation. What is the most important goal for this group?
Learning strategies to refrain from self-harm
A nurse is preparing an inservice program for a group of mental health nurses on the topic of borderline personality disorder. When discussing the need for hospitalization, which would the nurse include as the most likely reason for inpatient hospitalization?
Nonsuicidal self-injury
A client attends an outpatient mental health clinic accompanied by the client's spouse for an assessment. The client's spouse reports the client is easily irritated if the home is not maintained in a specific order and when the client is unable to complete a "to do" list on time. The client has a serious and formal demeanor. Which personality disorder best describes this client?
OCD
How does personality disorder differ from personality traits?
Personality disorder causes impairment in social and occupational functioning, whereas traits do not
When reviewing the history of a client with antisocial personality disorder, which would the nurse expect to find? Select all that apply.
Repeated incidents involving assaults Lack of remorse for actions Episodes involving scams for personal gain
A nurse is reviewing the medical record of a client diagnosed with antisocial personality disorder. The nurse notes that the client has had numerous episodes involving irritability, aggressiveness, and impulsivity and has exhibited callousness toward others. Based on this information, which nursing diagnosis would the nurse identify as a priority?
Risk for other-directed violence
Which would be the priority nursing diagnosis for a client diagnosed with borderline personality disorder (BPD)?
Risk for self-mutilation
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?
Selected: Assisting with sleep measures
The nurse is admitting a client with histrionic personality disorder to the inpatient unit. The nurse would anticipate that this client may exhibit which behavior?
Self-dramatization The client with histrionic personality disorder uses self-dramatization and emotional exaggeration to draw attention to self. The antisocial personality tends to be manipulative. Paranoid personality disorder causes the client to be suspicious and distrust others. In obsessive-compulsive personality disorder, the client's perfectionism interferes with task completion.
When developing the plan of care for a client with borderline personality disorder (BPD), which areas would the nurse identify as likely problematic? Select all that apply.
Self-harm Sleep Nutrition *** Usually, clients with BPD are managing hydration, self-care, and pain well. Problem areas include sleep, nutrition, and self-harm.***
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
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 is working with a client diagnosed with antisocial personality disorder. The nurse needs to keep in mind which about the therapeutic relationship?
The relationship initially is superficial because of a lack of client commitment
Which addresses the psychological domain of biopsychosocial interventions for a client with borderline personality disorder?
Withdrawing attention as much as possible
A client is admitted to the psychiatric unit with a diagnosis of borderline personality disorder. What finding does the nurse expect the assessment to reveal?
acute discomfort in relationships
Which cluster of personality disorders is represented by individuals who appear anxious or fearful?
cluster C Cluster C includes clients who appear anxious or fearful, such as avoidant, dependent, and obsessive-compulsive. Cluster A includes individuals whose behavior appears odd or eccentric. Cluster B includes individuals who appear dramatic, emotional, or erratic. There is currently no Cluster D in the DSM-5.
When teaching a client with antisocial personality disorder (ASPD), which approach would be most appropriate for the nurse to use?
direct
After reviewing information about different personality disorders, a group of nursing students demonstrates understanding when they identify which as associated with schizoid personality disorder?
introverted
