Chp 18

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."

Gambling, binge eating, and engaging in unsafe sex are examples of what?

Impulsivity

Which personality disorder is categorized as a Cluster B disorder?

Narcissistic personality disorder

When clients diagnosed with borderline personality disorder (BPD) see nurses as either all good or all bad, the client is using which primitive defense?

splitting

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

Impulsive behaviors

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

cluster B

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

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

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

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 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

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

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

thought stopping

Which is considered the etiology of personality disorders?

A combination of psychosocial and biologic variables

Which personality disorder is most commonly found in clinical settings?

Borderline personality

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

Cluster A

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.

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 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."

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 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 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."

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."

A nurse is preparing a presentation for a group of staff nurses on personality disorders. When describing antisocial personality disorders (ASPD), the nurse would explain that for a person to be diagnosed with the disorder, the person must be at least which age?

18 years

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

A combination of approaches

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

While shopping in a grocery store, a client with borderline personality disorder (BPD) greets the sibling of a neighbor with a great big hug. Then about 5 minutes later, the client walks past the sibling and ignores the sibling. The client is demonstrating what?

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

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

Avoidant, dependent, and obsessive-compulsive personality disorders are characterized by what?

Anxious or fearful behaviors

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

Which personality disorder would be placed in Cluster B?

Borderline

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 personality disorder is defined as a collection of traits that do what?

Cause behavioral dysfunction and inner distress

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

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

Dissociation

A client diagnosed with schizoid personality disorder is described by family members as what?

Eccentric and a loner

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.

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

The nurse working with women who have borderline personality disorder can do which to help clients build social skills and self-esteem? Select all that apply.

Offer cognitive restructuring classes. Offer assertiveness classes. Offer women's health issues classes.

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

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

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 group of nursing students is reviewing information about antisocial personality disorder. The students demonstrate understanding of this disorder when they state what?

The individual must be at least 18 years of age

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

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

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

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

narcissistic