Chapter 24-Psych

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

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

Belinda is a 24-year-old patient with borderline personality disorder (BPD). She is admitted to the inpatient psychiatric unit following a suicide attempt. You are caring for Belinda. Which of the following statements by Belinda illustrates a primary coping style of persons with BPD?

"Last night the nurse let me go outside and smoke. I can't believe you aren't letting me. I used to think you were the best nurse here."

Which is true of pharmacological therapies for treatment of personality disorders

Although there are no FDA-approved drugs specific to the treatment of personality disorders, patients benefit from specific off-label uses of antipsychotics, mood stabilizers, and antidepressants, depending on which personality disorder is evident.

Which behavior would be inconsistent with defining characteristics for the nursing diagnosis of ineffective coping?

Interdependence

Which of the following are true of antisocial personality disorder (APD)?

Persons with APD are concerned with personal pleasure and power It is characterized by deceitfulness, disregard for others, and manipulation. Frontal lobe dysfunction is a brain change identified in APD

Which statement is descriptive of clients with a personality disorder?

They are resistant to behavioral change

The priority nursing intervention for a client diagnosed with borderline personality disorder is to

assess for suicidal and self-mutilating behaviors

A nurse who is idealized by a client is at risk for

becoming over-involved and being protective and indulgent

The client diagnosed with a personality disorder who is most likely to be administer to a psychiatric unit is one who has

borderline personality disorder and is impulsive

Characteristics the nurse will assess in the client diagnosed with antisocial personality disorder are

deceitfulness, impulsiveness, and lack of empathy

Characteristic behaviors the nurse will assess in the narcissistic client are

grandiose, exploitive, and rage-filled behaviors

A nurse is caring for a client who has been diagnosed with a personality disorder should expect that the client will exhibit

inflexible and maladaptive responses to stress

Patients with borderline personality disorder (BPD) exhibit negative effect, which includes emotional _________, as described as rapidly moving from one emotional extreme to another

lability

Research has indicated that the antisocial personality may be characterized by

lack of remorse

When providing care for a client diagnosed with borderline personality disorder, the nurse will need to consider strategies for dealing with the client's

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

respect need for isolation

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:

schizotypal personality disorder (STPD)

Splitting is a process in which the client

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

Playing one staff member against another is an example of

splitting (splitting involves setting up individuals or groups to disagree. while the two parties are busy disagreeing, they are too busy to maintain consistent limits for the manipulative client. the client can enjoy the spectacle and do as he/she pleases)

The primary goal of milieu therapy for clients diagnosed with personality disorders is

to manage the effect the behavior has on the entire group

A client arrested for an assault in which he savagely beat a classmate states, "The guy deserved everything he got." The behaviors described are most consistent with the clinical picture of

Antisocial personality disorder (clients with antisocial personality act out feelings without consideration for the rights of others. they feel no remorse for their antisocial acts)