mental health prep u chapter 18

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?"

A nursing instructor is teaching about using behavioral interventions when caring for clients with borderline personality disorder. Which statement by a student indicates a need for further instruction?

"Grossly disrespectful behaviors are better ignored."

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 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?

"I should start by stating my feelings as an 'I' statement."

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 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."

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."

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

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

18 years

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

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

Which personality disorder is most often treated within the inpatient psychiatric setting?

Borderline

Which personality disorder is most commonly found in clinical settings?

Borderline personality

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

Into which personality disorder category are individuals placed whose behavior appears odd or eccentric?

Cluster A

A nurse is developing a plan of care for a client diagnosed with an antisocial personality disorder who has been admitted to the inpatient psychiatric unit. Which would the nurse likely include? Select all that apply.

Developing a therapeutic relationship Holding the client responsible for behavior

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

Direct

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.

Which personality disorder is diagnosed more often in women?

Histrionic

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 diagnosed 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.

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

Which personality disorder is characterized by a pervasive pattern of grandiosity, need for admiration, and a lack of empathy?

Narcissistic

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?

Obsessive-compulsive 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

How does personality disorder differ from personality traits?

Personality disorder causes impairment in social and occupational functioning, whereas traits do not.

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.

A client with borderline personality disorder has been admitted to the inpatient unit after being found in the client's parents' bedroom, burning the client's arm with an iron. This injury required a brief stay in the hospital's burn unit prior to transfer to your psychiatric unit. Which is the nursing care priority for this client during the first 24 hours of admission?

Protection from self-mutilation

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

Risk for self-mutilation

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 in the emergency department has self-inflicted wounds on both arms. Assessment reveals that the client was diagnosed with borderline personality disorder 6 months ago, for which the client has been receiving outpatient treatment. The client tells the nurse that the client recently found out the client's therapist is moving and will no longer be able to work with the client. What is the priority nursing diagnosis for this client?

Self-mutilation

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 caring for a client diagnosed with schizoid personality trait. When developing a plan of care for the client, which would a nurse most likely include?

Social skills training

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.

Which is a technique used to help the client with borderline personality disorder gain control over self-critical thoughts?

Thought stopping

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

Threats of self-harm

The use of pharmacotherapy in the treatment of personality disorders is optimized if this intervention is what?

Used in addition to psychotherapy

Treatment approaches for clients with personality disorders generally rely on which modality?

a combination of approaches

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 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

When reviewing the history of a client with antisocial personality disorder, which would the nurse expect to find? Select all that apply.

b) Episodes involving scams for personal gain d) Repeated incidents involving assaults e) Lack of remorse for actions

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

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

dissociation

A nurse is assessing a client diagnosed with avoidant personality disorder. Which characteristic 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