Lippincott NCLEX Personality Disorders

Which of the following behaviors indicates to the nurse that the client diagnosed with avoidant personality disorder is improving? 1. Interacting with two other clients 2. Listening to music with headphones 3. Sitting at a table and painting 3. Talking on the phone

1. Interacting with two other clients

When developing the plan of care for a client diagnosed with a personality disorder, the nurse plans to assist the client primarily with which of the following? 1. Specific dysfunctional behaviors 2. Psychopharmacologic compliance 3. Examination of developmental conflicts 4. Manipulation of the environment

1. Specific dysfunctional behaviors

The client diagnosed with borderline personality disorder tells the nurse "You're the best nurse here. I can talk to you and you listen. You're the only one here that can help me" Which of the following responses by the nurse is most therapeutic? 1. Thank you; you're a good person 2. All of the nurses here provide good care 3. Other clients have told me that too 4. Mary and Sam are good nurses too

2. All of the nurses here provide good care

A client is complaining to other clients about not being allowed by staff to keep food in her room. The nurse should 1. Ignore the clients behavior 2. Set limits on the clients behavior 3. Reprimand the client 4. Allow the snack to be kept in her room

2. Set limits on the clients behavior

Which of the following approaches is the most appropriate to use with a client diagnosed with a narcissistic personality disorder when discrepancies exist between what the clients says and what actually exists? 1. Limit setting 2. Supportive confrontation 3. Consistency 4. Rationalization

2. Supportive confrontation

The nurse asses a client to be at risk for self-mutilation and implements a safety contract with the client. Which of the following client behaviors indicates that the contract is working? 1. The client withdraws to his room when feeling overwhelmed 2. The client notifies staff when anxiety is increasing 3. The client suppresses his feelings when angry 4. The client displaces his feelings onto the PCP

2. The client notifies staff when anxiety is increasing

A client diagnosed with paranoid personality disorder is hospitalized for physically threatening his wife because he suspects her of having an affair with a coworker. Which of the following approaches should the nurse employ with this client? 1. Authoritarian 2. Parental 3. Matter-of-fact 3. Controlling

3. Matter-of-fact

When planning care for a client diagnosed with schizotypal personality disorder, which of the following helps the client become involved with others? 1. Participating solely in group activities 2. Being involved with primarily one-to-one activities 2. Leading a sing-along in the afternoon 4. Attending an activity with the nurse

4. Attending an activity with the nurse

A 19 year old client is admitted to the psych unit with an Axis I diagnosis of alcohol abuse and an Axis II diagnosis of personality disorder not otherwise specified. The clients mother states "He's always in trouble, just like when he was a boy. Now hes just a bigger prankster and out of control". In view of the clients history which of the following is most important initially? 1. Letting the client know the staff has the authority to subdue him if he gets unruly 2. Keeping the client isolated from other clients until he is better known by the staff 3. Emphasizing to the client that he will have to pay for any damage he causes 4. Closely observing the clients behavior to establish a baseline pattern of functioning

4. Closely observing the clients behavior to establish a baseline pattern of functioning

One evening the client takes the nurse aside and whispers "Don't tell anybody but I'm going to call in a bomb threat to this hospital tonight. Which of the following actions is the priority? 1. Warning the client that his telephone privileges will be taken away if he abuses them 2. Offering to disregard the clients plan if he does not go through with it 3. Notifying the proper authorities after saying nothing until the client has actually completed the call 4. Explaining to the client that this information will have to be shared immediately with the staff and the PCP

4. Explaining to the client that this information will have to be shared immediately with the staff and the PCP

The client with histrionic personality disorder is melodramatic and responds to others and situations in an exaggerated manner. The nurse should recommend which of the following activities for this client? 1. Party planning 2. Music group 3. Cooking class 4. Role-playing

4. Role-playing

A 28 year old client with an Axis I diagnosis of major depression and an Axis II diagnosis of dependent personality disorder has been living at home with very supportive parents. The client is thinking about independent living on the recommendation of the treatment team. The client states to the nurse " I don't know if I can make it in an apartment without my parents." The nurse should respond by saying to the client: 1. You are a 28-year old adult now, not a child who needs to be cared for 2. Your parents won't be around forever. After all, they are getting older 3. Your parents need a break and you need a break from them 4. Your parents have been supportive and will continue to be even if you live apart

4. Your parents have been supportive and will continue to be even if you live apart

The client diagnosed with borderline personality disorder is admitted to the unit after having attempted to cut her wrists with a pair of scissors. The client has several scars on both arms from self-mutilation and suicide gestures. A staff member states to the nurse "it's just attention that she wants, she is not going to kill herself". The nurse should respond to the staff member by saying: 1. She's here now and we have to do our best 2. She needs to be here until she can control her behavior 3. I'm ashamed of you; you know better than to say that 4. Any attempt at self-harm is serious and safety is a priority

4. Any attempt at self-harm is serious and safety is a priority

A client diagnosed with paranoid personality disorder is being admitted to a 24-hour hold after a physical altercation with a police officer who was investigating the clients threatening phone calls to his neighbors. He states that his neighbors are spying on him for Homeland Security. "I want them to stop and leave me alone. Now they have you nurses and doctors involved in their conspiracy". Which of the following nursing approaches are most appropriate? Select all that apply 1. Approach the client in a professional, matter-of-fact manner 2. Avoid intrusiveness in interactions with the client 3. Gently present reality to counteract the clients current paranoid beliefs 4. Develop trust consistently with the client 5. Do not pressure the client to attend any groups

1. Approach the client in a professional, matter-of-fact manner 2. Avoid intrusiveness in interactions with the client 4. Develop trust consistently with the client 5. Do not pressure the client to attend any groups

The nurse is talking with a client who has been diagnosed with antisocial personality disorder about how to socialize during activities without being seductive. The nurse should focus the discussion on which of the following areas? 1. Explaining the negative reactions of others toward his behavior 2. Suggesting he apologize to others for his behavior 3. Asking him to explain the reasons for his behavior 4. Discussing his relationship with his mother

1. Explaining the negative reactions of others toward his behavior

When teaching a nursing assistant new to the unit about the principles for the care of a client diagnosed with a personality disorder, the nurse should explain that 1. The clients are accepted although their behavior may not be 2. Clients need limits on their behavior 3. The staff members are the primary ones left to care about these clients 4. The staff should use minimal humor when working with these clients

1. The clients are accepted although their behavior may not be

A client with an Axis II diagnosis of antisocial personality disorder has a potential for violence and aggressive behavior. Which of the following client outcomes to be accomplished in the short term is most appropriate for the nurse to include in the plan of care? 1. Use humor when expressing anger 2. Discuss feelings of anger with staff 3. As the nurse for mediation when upset 4. Use indirect behaviors to express anger

2. Discuss feelings of anger with staff

The client who has a history of using angry outbursts when frustrated begins to curse at the nurse during an appointment after being informed that she will have to wait to have her medication refilled. Which of the following response by the nurse is most appropriate? 1. You're being very childish 2. I'm sorry if you can't wait 3. I will not continue to talk with you if you curse 4. Come back tomorrow and your medication will be ready

3. I will not continue to talk with you if you curse

The client diagnosed with borderline personality disorder who is to be discharged soon threatens to do something to herself if discharged. The nurse should first 1. Request that the clients discharge be cancelled 2. Ignore the clients statement as it is a sign of manipulation 3. Ask a family member to stay with the client at home temporarily 4. Discuss the meaning of the client's statement with her

4. Discuss the meaning of the client's statement with her

The client tells the nurse at the outpatient clinic that she doesn't like to attend groups because shes not regular like these other people here. The nurse should respond to the client by saying 1. Because you're not a regular client, sit in the hall when the others are in group 2. Your family wants you to attend and they will be very disappointed if you don't 3. I'll have to mark you absent from the clinic today and speak to the doctor about it 4. You say you're not a regular here, but you're experiencing what others are experiencing

4. You say you're not regular here, but you're experiencing what others are experiencing

A new client on the psyc unit has been diagnosed with depression and OCPD. During visiting hours her husband share to the nurse that he does not understand what OCPD is and what can be done about it. What information by the nurse should she share with the client and her husband? Select all that apply 1. Perfectionism and overemphasis on tasks usually interfere with friendships and leisure time 2. It will help to interrupt her tasks and tell her you are going out for the evening 3. There are medications, such as clomipramine or fluoxetine that may help 4. Remind your wife that it is okay to be human and make mistakes 5. Reinforce with her that she is not allowed to expect the whole family to be perfect too 6. This disorder typically involves inflexibility and a need to be in control

1. Perfectionism and overemphasis on tasks usually interfere with friendships and leisure time 3. There are medications, such as clomipramine or fluoxetine that may help 4. Remind your wife that it is okay to be human and make mistakes 6. This disorder typically involves inflexibility and a need to be in control

A client diagnosed with borderline personality disorder has self-inflicted cuts on her arms. The nurse is assessing the client for the risk of suicide. What should the nurse ask the client first? 1. About medications she has taken recently 2. If she is taking antidepressants 3. If she has a suicide plan 4. Why she cut herself

3. If she has a suicide plan

The client approaches various staff with numerous request and needs to the point of disrupting the staffs work with other clients. The nurse meets with the staff to decide on a consistent, therapeutic approach for the client. Which of the following approaches will be most effective? 1. Telling the client to stay in his room until staff approach him 2. Limiting the client to the day room and dining area 3. Giving the client a list of permissible requests 4. Having the client address needs to the staff person assigned

4. Having the client address needs to the staff person assigned