Mental Health - Prep U - Chapter 18

The nurse is assessing a client who is diagnosed with borderline personality disorder. Which client statement indicates the client is at risk for self-injurious behavior?

"I have felt so down lately. I don't enjoy doing anything anymore."

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."

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 been admitted to the inpatient unit because the client has been engaging in wrist cutting. The client's sibling is visiting, and the sibling asks the nurse to explain why the client sometimes does this. Which response by the nurse would be most appropriate?

"Sometimes the self-injurious behavior is undertaken to relieve stress."

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."

Which statement by a client with borderline personality disorder (BPD) is an example of catastrophizing?

"This is the most awful thing that has ever happened to me."

For a person to be diagnosed with antisocial personality disorder, the individual must be a minimum of what age?

18 years

Which is considered the etiology of personality disorders?

A combination of psychosocial and biologic variables

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

A nurse is describing histrionic personality disorder to a group of new nurses. Which term would the nurse most likely use?

Attention seeking

Impulsivity and difficulty controlling anger are characteristic of which mental health diagnosis?

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

Which cluster of disorders corresponds to symptoms of being dramatic and emotional?

Cluster B

The nurse is conducting an admission assessment of a 41-year-old client. Each time that the nurse asks the client a question, the client defers to the client's spouse to answer the question. Such behavior is consistent with which personality disorder?

Dependent personality disorder

When teaching a client with antisocial personality disorder (ASPD), which approach would be most appropriate for the nurse to use?

Direct

Which occurs when thinking, feeling, or behaviors occur outside a person's awareness?

Dissociation

Emotional regulation skills are taught to those diagnosed with borderline personality disorder to manage what?

Impulsive behaviors

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

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 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

A client diagnosed with a personality disorder exhibits a pervasive pattern of grandiosity, need for admiration, and a lack of empathy. Which personality disorder would the nurse identify as being characterized by this behavior?

Narcissistic

Which personality disorder is categorized as a Cluster B disorder?

Narcissistic personality disorder

Which statement accurately reflects the prognosis for a client with a personality disorder?

Prognosis varies based on the degree of functional impairment and the client's motivation to change.

Which would be the priority nursing diagnosis for a client diagnosed with borderline personality disorder (BPD)?

Risk for self-mutilation

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

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-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.

Clients with borderline personality disorder (BPD) are usually admitted to an inpatient setting because of what?

Threats of self-harm

A nurse working with a client with borderline personality disorder could establish which as outcome criteria?

Tolerate stress without self-mutilation.