personality disorder

A client with borderline personality disorder starts flirting with the nurse, saying the client dreams about the nurse at night and wants to kiss the nurse. What would be the best response by the nurse? "That is very sweet of you to say." "I feel uncomfortable with what you said. My role is to support you in recovery." "I feel flattered that you think that much of me, but nurses don't date clients." "Let's talk about something else now."

"I feel uncomfortable with what you said. My role is to support you in recovery."

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? "Why are you sitting on the nurse's lap?" "You need to go to your room because you are engaging in sexually provocative behavior again!" "I need for you to get off his lap, this behavior is not appropriate." "Why don't we go play a game of ping-pong?"

"I need for you to get off his lap, this behavior is not appropriate."

A nurse is assessing a client and suspects that the client may have obsessive-compulsive personality disorder based on which statement? "I need to have everything perfect. My life is organized down to the second." "I don't have any friends and I don't like to do anything socially." "I can't trust anybody that I meet, no matter where it is or who they are." "I am better than everyone and they should emulate me."

"I need to have everything perfect. My life is organized down to the second."

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 was always timid and fearful." "My parent never had any family or friends over to the house." "My parent was constantly threatening to commit suicide." "My parent never really seemed to see me as a person with my own thoughts and problems."

"My parent never really seemed to see me as a person with my own thoughts and problems."

Which statement is typical of the first stage of grieving described by Engel? "No, not me." "Why me?" "My husband was the best man in the world." "The funeral service helped me survive."

"No, not me."

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? "Well, that's a good question. I need to check with the team." "No, only one cigarette is allowed per break time." "This is a good example of trying to push your limits." "It depends on whether or not we can make that exception that day."

"No, only one cigarette is allowed per break time."

A client with borderline personality disorder has had 21 admissions to the mental health unit, each of which was precipitated by a suicide attempt resulting in superficial cuts. During this admission, the client has developed a relationship with a highly supportive nurse and has progressed to having a pass to spend an afternoon in a nearby shopping mall. Later the day that the client uses the pass, the nurse is shocked when the emergency department calls to say that the client has just been brought in with multiple self-inflicted lacerations. The nurse asks a supervisor, "Everything was going well. How could this happen?" What response by the supervisor reflects an understanding of borderline personality disorder? "I know what you mean. You put a lot of energy into working with this client. It must be disappointing for something like this to happen." "I could have told you this would happen. Clients like these always get you in the end. I hope this will teach you not to get so involved." "The client's behavior seems personal, but it's really not. Clients with borderline personality disorder act out to relieve anxiety. I suspect having the pass provoked a great deal of anxiety." "I wonder if all this could have been avoided if I'd clued you in on the client. This is a usual pattern. The client burned me once, too, when I first worked here."

"The client's behavior seems personal, but it's really not. Clients with borderline personality disorder act out to relieve anxiety. I suspect having the pass provoked a great deal of anxiety."

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." "I and other members of the health care team would like you to attend group therapy each day." "You'll find your condition will improve much faster if you attend group therapy each day." "Please try to attend group therapy each day."

"You'll be expected to attend group therapy each day."

Which client is most at risk for experiencing anticipatory grief? 61-year-old spouse of a client experiencing symptomology of moderate-stage Alzheimer disease 18-year-old person who failed to earn a sports scholarship to college. 45-year-old person whose company is scheduled for major layoffs 24-year-old woman whose fiancé has suddenly broken off their wedding engagement

61-year-old spouse of a client experiencing symptomology of moderate-stage Alzheimer disease

Which is considered the etiology of personality disorders? Genetic predetermination Related to childhood abuse, neglect, and trauma Related to substance abuse A combination of psychosocial and biologic variables

A combination of psychosocial and biologic variables

In which ways can anticipatory grief be helpful for the client and family? Clear examination of treatment options Admission to hospice care An earlier and less painful death Acceptance of impending death

Acceptance of impending death

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 Young adulthood Middle-age individuals Late adulthood

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? Depression Identity diffusion Affective instability Dichotomous thinking

Affective instability

After receiving word from the oncologist that the client's tumor is malignant, the client says to the nurse, "If you people had the faintest clue what you were doing, I wouldn't be like this." The nurse should recognize that the client may be experiencing which stage of grief? Denial Anger Bargaining Depression

Anger

A client is diagnosed with terminal kidney failure. The client's spouse demonstrates loss and grief behaviors. Which term accurately describes the spouse's experience? Maturational loss Anticipatory grief Dysfunctional grieving Bereavement

Anticipatory grief

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? Attempt to discuss placing the client into an assisted living environment Ask the parents how they have coped with the client's behaviors over the years Ask the parents to keep a written schedule of activities for each day for the client Encourage the parents to discuss the possibility of the client going into a day-care program when the client goes home

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 Psychopath Sociopath Lacking empathy

Attention seeking

Which term describes the process by which a person experiences grief? Bereavement Homeostasis Mourning Attentive presence

Bereavement

A group of nursing students is reviewing information about grief and bereavement. The students demonstrate understanding of the information when they state: Grief and bereavement are used interchangeably as responses to loss. Bereavement is the process of mourning and grief is the emotional reaction. Grief involves confronting the stressor, but bereavement helps to avoid the stressor. Bereavement is influenced by culture, but grief is not.

Bereavement is the process of mourning and grief is the emotional reaction

Which personality disorder would be placed in Cluster B? Borderline Avoidant Paranoid Schizoid

Borderline

Which personality disorder is most commonly found in clinical settings? Borderline personality Antisocial personality Histrionic personality Narcissistic personality

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? Paranoid personality disorder Borderline personality disorder Schizotypal personality disorder Antisocial personality disorder

Borderline personality disorder

Impulsivity and difficulty controlling anger are characteristic of which mental health diagnosis? Depression Schizophrenia Posttraumatic stress disorder Borderline personality disorder

Borderline personality disorder

A personality disorder is defined as a collection of traits that do what? Cause behavioral dysfunction and inner distress Are malleable and poorly defined Lead to aggression and violence Lead to withdrawn and antisocial behavior

Cause behavioral dysfunction and inner distress

Which observation by the nurse is supportive of a diagnosis of avoidant personality disorder? Client talks about three failed marriages. Client cries loudly whenever requests are denied. Client fears criticism from others, including staff. Client shows no remorse when accidentally breaking another client's bracelet.

Client fears criticism from others, including staff.

Which cluster of disorders corresponds to symptoms of being dramatic and emotional? Cluster A Cluster B Cluster C Cluster D

Cluster B

The nurse is caring for a client whose spouse passed away several years ago. Upon assessment, the nurse finds that the client has a history of signs and symptoms of depression since the spouse's death. Which term correctly describes the client's response to the loss? Anger Outcry Complicated grief Disenfranchised grief

Complicated grief

The nurse is caring for a client who has just been diagnosed with cancer. The client states that the client will "never be able to cope with this situation." What is the nurse aware that coping is? Coping is a physiologic measure used to deal with change, and the client will physically adapt. Coping is the physiologic and psychological processes that people use to adapt to change. Coping is the human need for faith and hope, which create change. Coping is a social measure used to deal with change and loss.

Coping is the physiologic and psychological processes that people use to adapt to change.

A client grieving her husband's sudden death tells the bereavement nurse, "I am not feeling very well. Yesterday, I was sitting in my kitchen and a saw my husband walk through the door and stop and smile at me. Then he just faded away. I think I must be going crazy." Which is the most appropriate action for the nurse to take? Assess for recent substance use Suggest a referral to the mental health clinic Arrange for a prescription for risperidone Counsel that visualizations are a normal part of grieving

Counsel that visualizations are a normal part of grieving

Which can correctly be identified as a behavioral response to grief? Crying uncontrollably Weight loss Lack of energy Palpitations

Crying uncontrollably

The client has been recently diagnosed with cancer. When the nurse tells the client about the diagnosis, the client says, "I have been eating healthy food and working out regularly." According to the Kubler-Ross's stages of grieving, which stage of grief is the client in? Anger Denial Bargaining Depression

Denial

The client is a 29-year-old who is having a great deal of difficulty with a new job. The client has been unable to make decisions individually and feels overwhelmed when the client needs to begin a new project. The client often relies on one of her coworkers to help with decisions and projects. Which would describe the client correctly? Narcissistic personality Dependent personality Schizotypal personality Histrionic personality

Dependent personality

Based on psychological theories, which is believed to be critical to understanding personality disorders? Difficult temperament Chaotic families Abuse Functional attachments

Difficult temperament

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

Direct

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? Demonstrate empathy by reaching out to touch the client. Discuss displacement of anger and set limits. Report the behavior to the health care provider so that consistency and consequences can be followed. Walk away from the client.

Discuss displacement of anger and set limits.

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? Confront the client firmly about how the client's behavior makes the nurse feel. Direct the client to another staff member when the client tries to interact. Discuss the feelings with a colleague to promote coping. Arrange for the client to be transferred to another unit.

Discuss the feelings with a colleague to promote coping.

A client's children have downplayed their grief following the death of their mother's partner, claiming that their mother and her partner were only together for a few months and that "he was no good for her anyways." The client is at risk of experiencing which type of grief? Unresolved grief Atypical grief Disenfranchised grief Dysfunctional grief

Disenfranchised grief

Which is a term used to describe grief over a loss that is not or cannot be acknowledged openly, mourned publicly, or supported socially? Disenfranchised grief Anticipatory grieving Bereavement Mourning

Disenfranchised grief

A client diagnosed with schizoid personality disorder is described by family members as what? Emotionless and a loner Dramatic and emotional Nervous and fearful Tired and sad

Emotionless and a loner

Which would the nurse expect to assess in a client with narcissistic personality disorder? Genuine concern for others Mistrust of others Grandiose and superior self-concept Dependence on others for decision making

Grandiose and superior self-concept

Emotional regulation skills are taught to those diagnosed with borderline personality disorder to manage what? Problem solving Impulsive behaviors Physical disability Psychotic behaviors

Impulsive behaviors

Gambling, binge eating, and engaging in unsafe sex are examples of what? Identity diffusion Dissociation Affective instability Impulsivity

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 Encouraging questions and discussing the client's concerns Promoting social ostracism of the client's exhibiting manipulation Scheduling staff one-on-one time with the client

Instructing the staff to enforce all unit rules consistently

After reviewing information about different personality disorders, a group of nursing students demonstrates understanding when they identify which characteristic as associated with schizoid personality disorder? Introverted Overly friendly Highly social Exuberant

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? Poor social skills Depression Mania Maladaptive expression of emotions

Maladaptive expression of emotions

A client diagnosed with a personality disorder exhibits a pervasive pattern of grandiosity, need for admiration, and a lack of empathy. Which personality disorder would the nurse identify as being characterized by this behavior? Narcissistic Histrionic Dependent Obsessive-compulsive

Narcissistic

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 Avoidant personality disorder Narcissistic personality disorder Paranoid personality disorder

Obsessive-compulsive personality disorder

The nurse is speaking to the caregivers of a client who is experiencing complicated grief. The nurse is explaining some of the consequences of complicated grief. What are the health-related consequences associated with this type of grieving? Select all that apply. Panic disorder Neurofibromatosis Psychosomatic disorder Development of cancer Precipitation of a cardiac disease

Panic disorder Psychosomatic disorder Precipitation of a cardiac disease

Which personality disorder is characterized by mistrust and suspiciousness of others? Paranoid Dependent Histrionic Narcissistic

Paranoid

A client is admitted with a diagnosis of schizotypal personality disorder. Which characteristic would this client exhibit during social situations? Paranoid thoughts Perfectionism Trusting behaviors Dependency needs

Paranoid thoughts

How does personality disorder differ from personality traits? Personality disorder causes impairment in social and occupational functioning, whereas traits do not. Personality disorder is usually evident earlier in the person's development than are traits. Personality traits usually cause the person a great deal of difficulty but only sporadically. Personality disorder is usually more long term than are traits.

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

A woman has had a breast removed to treat cancer. What type of loss will she most likely experience? Physiologic loss Perceived loss Maturational loss Anticipatory loss

Physiologic loss

Which statement accurately reflects the prognosis for a client with a personality disorder? Clients make the most improvement with short-term insight-oriented therapy. The prognosis for personality disorders is poor, even with very long-term therapy. Clients with personality disorders have a fairly good prognosis even without therapy. Prognosis varies based on the degree of functional impairment and the client's motivation to change.

Prognosis varies based on the degree of functional impairment and the client's motivation to chang

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. Development of strict plans for the future Rationalization for harming an individual Overly empathetic to others Inflated view of self History of a sustained monogamous relationship

Rationalization for harming an individual Inflated view of self

The nurse is caring for a client who has been placed in palliative care. The nurse observes the client constantly looking at photographs from youth. According to the tasks of grieving by Rando, which task is being accomplished here? (idk if we learned this) React Recognize Relinquish Recollect

Recollect

Which would be the priority nursing diagnosis for a client diagnosed with borderline personality disorder (BPD)? Disturbed thought process Ineffective coping Personal identity disturbance Risk for self-mutilation

Risk for self-mutilation

Which would be the priority nursing diagnosis for a client diagnosed with borderline personality disorder (BPD)? Risk for self-mutilation Ineffective coping Disturbed thought process Chronic low self-esteem

Risk for self-mutilation

Clients with borderline personality disorder (BPD) are usually admitted to the inpatient setting because they exhibit what? Aggression Splitting Self-harm Impulsivity

Self-harm

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? Social skills training Setting limits Stress management techniques Increased recreational therapy

Setting limits

The nurse is informing the client about being diagnosed with cancer. Which is most likely going to be the client's initial reaction? Anger Shock Anxiety Depression

Shock

A client states to a nurse, "They found a lump in my neck, and now they tell me I have an incurable disease." The client is young and appears to find this information hard to believe. What pattern of response does the client's statement reflect? Restitution Shock and disbelief Physiologic grieving Recovery

Shock and disbelief

When developing the plan of care for a client with borderline personality disorder (BPD), which areas would the nurse identify as likely problematic? Select all that apply. Hydration Self-care Pain Sleep Nutrition Self-harm

Sleep Nutrition Self-harm

Which is the most frequent and persistent bereavement-associated symptom? Sleep disturbances Headaches Impaired appetite Indigestion

Sleep disturbances

For clients with borderline personality disorder, there is a tendency to see the world as either good or bad. As a result, these clients use the primitive defense of what? Regression Denial Splitting Compensation

Splitting

A 74-year-old is being seen in the mental health clinic. The client has never fully regained the level of activity the client had prior to the death of the client's spouse. The client continues to have symptoms of depression and has not been able to work or volunteer. In addition, the client complains of "anxiety attacks" that occur nearly every night. What type of grief reaction is this client exhibiting? The client is experiencing a normal grief reaction and does not need any intervention at this time. The client is experiencing a prolonged reaction but within normal limits of the grieving process. The client is having a prolonged reaction to the spouse's death, but since the client is surrounded by family members who provide support, the client does not need any interventions at this time. The client is experiencing complicated grieving reaction. The client needs to have a comprehensive mental health assessment.

The client is experiencing complicated grieving reaction. The client needs to have a comprehensive mental health assessment.

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 be able to accept a job promotion. The client will experience increased self-esteem. The client will engage in less risk-taking behavior The client will form a romantic relationship.

The client will experience increased self-esteem.

The nurse is caring for a client who is extremely depressed after receiving a diagnosis of cancer. Which body language should the nurse adopt while speaking to the client in order to demonstrate an attentive presence? Select all that apply. The nurse should keep her arms folded. The nurse should stand facing the client. The nurse should lean slightly toward the client. The nurse should sit on one side of the client. The nurse should maintain moderate eye contact while the client speaks.

The nurse should stand facing the client. The nurse should lean slightly toward the client. The nurse should maintain moderate eye contact while the client speaks.

Which is a technique used to help the client with borderline personality disorder gain control over self-critical thoughts? Communication triad Thought stopping Delay gratification Affective instability

Thought stopping

A nurse working with a client with borderline personality disorder could establish which as outcome criteria? Display anger more frequently. Act out neediness. Filter concerns and insecurities through the nurse. Tolerate stress without self-mutilation.

Tolerate stress without self-mutilation.

The use of pharmacotherapy in the treatment of personality disorders is optimized if this intervention is what? Used in addition to psychotherapy The primary treatment modality Only minimally effective due to severe side effects Well accepted by the clients

Used in addition to psychotherapy

After losing the client's father in a car accident, a client has started practicing effective coping strategies. According to Horowitz's stages of loss and adaptation, which stage is this indicative of? Outcry Completion Working through Denial and intrusion

Working through

A nurse is counseling a client with depression on what to do in case the client has suicidal thoughts. Which option may provide the most immediate help for the client? a telephone hotline an office visit an emergency clinic an outpatient clinic

a telephone hotline

A client is admitted to the psychiatric unit with a diagnosis of borderline personality disorder. What finding does the nurse expect the assessment to reveal? acute discomfort in relationships disregard for the rights of others preoccupation with orderliness attention-seeking behaviors

acute discomfort in relationships

A female client who has recently been diagnosed with end-stage lymphoma tells the nurse, "I need to be able to go to my son's wedding. God, will you please just give me a little more time so I can see my first grandchild?" The nurse identifies that the client is experiencing which stage of Kubler-Ross' stages of grieving? denial depression bargaining acceptance

bargaining

A client who has been in recovery from alcohol abuse for over one year tells the nurse he is drinking 5 to 6 beers per night since the client's mother's death. Which is the nurse's most accurate explanation for the client's grief response? emotional behavioral spiritual physiologic

behavioral

Which type of grief occurs when a person is stuck in a state of chronic grieving? complicated grief traumatic grief uncomplicated grief bereavement

complicated grief

A client who is in the process of divorce tells the nurse the client will require some time off from work due to the inability to concentrate. According to Bowlby's phases of grieving, which phase best reflects this client's current experience? shock, numbness, and protest yearning disorganization and despair reorganization

disorganization and despair

A nurse in charge on a unit with a client who is receiving postoperative care for a below the knee amputation is deciding which nurse to assign to this client. Which nurse would be most beneficial for the client? the nurse who has worked with the client before and after the amputation a nurse who is just returning to work from a one-week vacation a nurse who often has been assigned to the client 3 previous night shifts a nurse with previous experience working with clients who have amputations

the nurse who has worked with the client before and after the amputation

Which client will the nurse identify as having the greatest risk for developing disenfranchised grief? a teenager who has lost his grandfather to cancer the wife of a man who was shot to death by police during a robbery a man who is grieving the loss of a business he founded 25 years ago a single adult whose 14 year old pet dog has died

the wife of a man who was shot to death by police during a robbery