Ch. 18: Personality Disorders

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 a personality disorder is upset and calls the nurse a "stupid cow." Which is an effective initial response to this client's behavior?

Discuss displacement of anger and set limits

A client with borderline personality disorder (BPD) who evaluates experiences, people, and objects in terms of mutually exclusive categories (e.g., good or bad, success or failure) is demonstrating which type of thinking?

Catastrophizing

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

Which personality disorder is most commonly found in clinical settings?

Borderline personality

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

Borderline personality disorder

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."

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

Dissociation

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

Risk for self-mutilation

A nurse is interviewing a client and suspects that the client may have narcissistic personality disorder. Which statement by the client would help support the nurse's suspicions?

"I have a very important position in life; everyone I know wants to be like me."

A nurse is developing a nurse-client relationship with a client diagnosed with borderline personality disorder (BPD). Which statement by the nurse demonstrates that the nurse understands the client's fears of abandonment and intimacy?

"I will be seeing you during the daytime this week."

A client asks the nurse to go to lunch with the client one day next week after the client is discharged. Which statement is the most therapeutic response?

"My role here is to help you recover. Let's talk about what else you can be doing after discharge."

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 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

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."

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 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 describing the different clusters of personality disorders, the nurse includes which type as being characterized by dramatic or erratic behavior? Select all that apply.

Antisocial Borderline

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 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 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

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 with borderline personality disorder is prescribed pharmacotherapy. The nurse understands that this treatment aims to control which of the following? Select all that apply.

Emotional dysregulation Impulsive aggression Cognitive disturbances Anxiety

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.

Which personality disorder is diagnosed more often in women?

Histrionic

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

Impulsivity

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

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

Which personality disorder is categorized as a Cluster B disorder?

Narcissistic 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 mostlikely the client's diagnosis?

Paranoid

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

A nurse is reviewing the history of a client diagnosed with antisocial personality disorder. Which would the nurse expect to find? Select all that apply.

Rationalization for harming an individual Inflated view of self

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

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

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

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

Tolerate stress without self-mutilation.