Nclex Personality Qs.
Which of the following nursing outcomes would be appropriate for a client with a narcissistic personality disorder? 1. Identifies factors that interfere with social interaction 2. Demonstrates a reduction in clinging and splitting behaviors 3. Demonstrates ability to reframe negative self-thoughts into more realistic appraisals 4. Seeks help when experiencing self-destructive impulses
1. A client with narcissistic personality disorder portrays a demeanor of grandiosity and a lack of empathy for others with relationships that are characterized by disruption (frequently provoke arguments) or control (consistently in power struggles). To be able to identify factors that interfere with social interaction would be most appropriate for a client with narcissistic personality disorder. Reduction in clinging, splitting, and seeking help when self-destructive behaviors are experienced and would be appropriate for a client with borderline personality disorder. Reframing negative self-thoughts would be appropriate for a client with a dependent personality disorder.
The nurse is developing long-term goals for a client with paranoid personality disorder who is trying to improve peer relationships. What is the most appropriate goal? 1. The client will verbalize a realistic view of self. 2. The client will take steps to address disorganized thinking. 3. The client will become appropriately interdependent on others. 4. The client will become involved in activities that foster social relationships.
4. An appropriate long-term goal is for the client to increase interactions and social skills and make the commitment to become involved with others on a long-term basis. To verbalize a realistic view of self is a short-term goal. The client with a paranoid personality disorder doesn't tend to have disorganized thinking. A client with paranoid personality disorder won't allow himself to be interdependent on others.
2. A nurse is distinguishing characteristics of schizotypal personality disorder from schizoid personality disorder. What is the most appropriate statement by the nurse? 1. Schizotypals are characterized by emotional detachment. 2. Schizotypals are characterized by disinterest in close relationships. 3. Schizotypals are indifferent to praise or criticism. 4. Schizotypals have magical thinking or perceptual distortions.
4. Emotional detachment, disinterest in close relationships, and indifference to praise or criticism are features of schizoid personality disorder.
Which of the following tasks could be delegated to a psychiatric technician on the unit? Select all that apply. 1. Assist a client with personal daily living activities. 2. Conduct educational sessions. 3. Administer medications to clients. 4. Develop recreational activities. 5. Teach clients about their medications. 6. Write medical orders from the physician. 7. Contribute to the planning and implementing of individual treatment plans. 8. Assist in the admission process by interviewing patients and record keeping. 9. Take vitals on clients.
1, 2, 4, 5, 7, 8, and 9. All of these tasks could be delegated to a psychiatric technician or unlicensed personnel except administering medications and writing medical orders from the physician. The certified medication aide could dispense medications, but writing medical orders from the physician requires a nurse's license to perform. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14892-14895). Lippincott Williams & Wilkins. Kindle Edition.
What contributes to the difficulty in creating a therapeutic alliance with clients with personality disorders? Select all that apply. 1. Client's suspiciousness 2. Aloofness from clients 3. Secretive style and hostility of clients 4. Transference from the nurse 5. Setting limits
1, 2, and 3. Client behaviors of suspicion, aloofness, secretive style, and hostility contribute to the difficulty in obtaining a therapeutic alliance with clients with a personality disorder. It is countertransference that the nurse experiences that could possibly affect the therapeutic alliance with personality-disordered clients. Setting limits is a crucial component of the therapeutic alliance with clients with personality disorders. These limits will need to be repeated to instill responsibility to clients for their behaviors.
When assessing a client diagnosed with impulse control disorder, the nurse observes violent, aggressive, and assaultive behavior. Which assessment data is the nurse also likely to find? Select all that apply. 1. The client functions well in other areas of his life. 2. The degree of aggressiveness is out of proportion to the stressor. 3. The violent behavior is most often justified by the stressor. 4. The client has a history of parental alcoholism and chaotic, abusive family life. 5. The client has no remorse about the inability to control his behavior.
1, 2, and 4. A client with an impulse control disorder who displays violent, aggressive, and assaultive behavior generally functions well in other areas of his life. The degree of aggressiveness is typically out of proportion with the stressor. Such a client commonly has a history of parental alcoholism and a chaotic family life, and often verbalizes sincere remorse and guilt for the aggressive behavior.
A nurse is assessing a client to determine if the client has an avoidant personality disorder. What are the most appropriate questions for the nurse to ask the client? Select all that apply. 1. Have you found yourself being worried that people won't like you? 2. Do you tend to drive yourself pretty hard, frequently feeling like you need to do just a little more? 3. Do you tend toward being a perfectionist? 4. Do you think that you would find it pretty easy to lie? 5. Have you often felt hurt by others, so that you are pretty wary of opening yourself to other people? 6. Do you tend to be very careful about selecting friends, perhaps only having one or two close friends in your whole life? 7. Is it hard for you to argue with your spouse because you are worried that he or she will really get mad at you and start to dislike you?
1, 5, and 6. Questions 2 and 3 describe obsessive-compulsive personality disorder, question 4 describes antisocial personality disorder, and question 7 describes dependent personality disorder.
The nurse is assessing a client who was just admitted to the psychiatric unit. What are the most appropriate questions by the nurse to determine if the client has an obsessive-compulsive personality disorder? Select all that apply. 1. " Do you tend to drive yourself pretty hard, frequently feeling like you need to do just a little more?" 2. " Is it hard for you to argue with your spouse, because you are worried that he or she will get really mad at you and start to dislike you?" 3. " Does anxiety make you want to self-mutilate?" 4. " Do you keep things to yourself just to make sure the wrong people don't get the right information?" 5. " Do you keep lists or sometimes feel a need to keep checking things such as whether the door is locked?" 6. " Do you tend to be a perfectionist?" 7. " Have you found yourself being worried that people won't like you?" Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14628-14637). Lippincott Williams & Wilkins. Kindle Edition.
1, 5, and 6. These questions describe the obsessive-compulsive personality disorder. Question 2 describes a dependent personality disorder. Self-mutilation describes borderline personality disorders. Keeping things to oneself so the wrong people don't get the right information describes the paranoid personality disorder. Being worried about people not liking you describes an avoidant personality disorder. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14639-14641). Lippincott Williams & Wilkins. Kindle Edition.
Which of the following outcomes would be appropriate for the nurse to expect from a client with an avoidant personality disorder? 1. Demonstrates an ability to use constructive criticism 2. Participates in impulse control training 3. Demonstrates a reduction in clinging, splitting, and manipulation behaviors 4. Demonstrates a decrease in attention-seeking behaviors
1. Avoidant personality disorder clients experience fear of rejection and/ or criticism and are very reluctant to participate in social situations because of this fear. Selections 2, 3, and 4 describe a cluster B personality disorder: borderline, antisocial, histrionic, or narcissistic.
A client with paranoid personality disorder works toward the goal of increasing social interaction. Which behavior indicates that the client is meeting this goal? 1. The client develops and follows a schedule of group activities. 2. The client verbalizes aggressive feelings to the nurse. 3. The client visits the consumer center to use the Internet. 4. The client explores somatic complaints with the staff.
1. By developing and following a schedule of group activities, the client increases opportunities to use social skills and increase interactions with others. Verbalizing aggressive feelings doesn't give the client opportunities to increase social interaction. Using a computer at the consumer center is a solitary activity. Talking to the staff about somatic complaints doesn't provide opportunities for social interaction. CN: Psychosocial
What is the most appropriate goal for a client with antisocial personality disorder with a high risk for violence directed at others? 1. The client will discuss the desire to hurt others rather than act. 2. The client will be given something to destroy to displace the anger. 3. The client will develop a list of resources to use when anger escalates. 4. The client will understand the difference between anger and physical symptoms.
1. By discussing the desire to be violent toward others, the nurse can help the client get in touch with the pain associated with the angry feelings. It isn't helpful to have the client destroy something. The client needs to talk about strong feelings in a nonviolent manner, not refer to a list of crisis references. Helping the client understand the relationship between feelings and physical symptoms can be done after discussing the desire to hurt others. CN: Psychosocial integrity; CNS:
Which nursing intervention has priority in the plan of care for a client with antisocial personality disorder who shows defensive behaviors? 1. Help the client accept responsibility for his own decisions and behaviors. 2. Work with the client to feel better about himself by taking care of basic needs. 3. Teach the client to identify the defense mechanisms used to cope with distress. 4. Confront the client about the disregard of social rules and the feelings of others.
1. Clients with antisocial personality disorder tend to blame other people for their behaviors and need to be taught how to take responsibility for their actions. Clients with antisocial personality disorder don't tend to have problems with self-care habits or meeting their basic needs. Clients with antisocial personality disorder will deny they're defensive or distressed. Most often, these clients feel justified with retaliatory behavior. To confront the client would only cause him to become even more defensive.
A nurse notices other clients on the unit avoiding a client diagnosed with antisocial personality disorder. When discussing appropriate behavior in group therapy, which comment is expected about this client by his peers? 1. Lack of honesty 2. Belief in superstitions 3. Show of temper tantrums 4. Constant need for attention
1. Clients with antisocial personality disorder tend to engage in acts of dishonesty, shown by lying. Clients with schizotypal personality disorder tend to be superstitious. Clients with histrionic personality disorders tend to overreact to frustrations and disappointments, have temper tantrums, and seek attention.
Which of the following nursing diagnoses would be appropriate for a client with a histrionic personality disorder? 1. Impaired social interaction related to seductive and self-dramatizing behaviors 2. Risk for other-directed violence related to pacing and threatening stances 3. Chronic low self-esteem related to overt aggressiveness 4. Defensive coping related to absence of guilt and superior attitude toward others
1. Clients with histrionic personality disorders consistently draw attention to themselves. Risk for other-directed violence, chronic low self-esteem, and defensive coping would be appropriate for a client with an antisocial personality disorder. CN: Safe, effective care environment; CNS:
58. Which of the following responses would a nurse expect from a client with a narcissistic personality disorder? 1. " You owe me 5 more minutes on my smoke break since you let us out late from group." 2. " You are the only nurse that understands me; I don't like the other nurses at all. They are mean." 3. " I don't know what I should wear today or what groups I should go to." 4. " I can't go to group today because one of the clients hurt my feelings yesterday in group."
1. Clients with narcissistic personality disorder have a sense of entitlement. Splitting staff is a typical response from a client who has a borderline personality disorder. Indecisiveness is a characteristic of a client with a dependent personality disorder. Holding grudges is a characteristic of a client with a paranoid personality disorder.
Which of the following behavior patterns would a nurse expect to observe in a client with a schizoid personality disorder? 1. Emotional coldness and flattened affect 2. Submissive and clinging 3. Impulsive and unstable emotionally 4. Cheerful and carefree Lisko, Susan (2013-10-01).
1. Clients with schizoid personality disorder are emotionally cold and have a flattened affect. Submissive and clinging behaviors describe the dependent personality disorder. Impulsivity and unstable emotions describe borderline personality disorder, and cheerful and carefree describe the narcissistic personality disorder. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14723-14725). Lippincott Williams & Wilkins. Kindle Edition.
A nurse is assessing a client with a narcissistic personality disorder. The nurse anticipates the client's behavior to be characterized as which of the following? 1. Grandiose and entitled 2. Submissive and clinging 3. Impulsive and unstable emotionally 4. Provocative and seductive
1. Grandiosity and a sense of entitlement describe the behavior pattern of a client with a narcissistic personality disorder. Submissive and clinging describe the dependent personality disorder. Impulsivity and unstable emotions describe borderline personality disorder, and provocative and seductive behaviors describe the histrionic personality disorder. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14798-14800). Lippincott Williams & Wilkins. Kindle Edition.
A nurse notices that a client with dependent personality disorder is depressed. Which factor is assessed as contributing to depression? 1. Unmet needs 2. Sense of smothering 3. Messy, unkempt appearance 4. Difficulty delaying gratification
1. Having many unmet needs is a precursor to depression. Clients with dependent personality disorder don't experience a sense of smothering, a problem seen in clients with panic disorder. Poor hygiene is often a manifestation, not a cause, of depression. Clients with problems delaying gratification tend to have anxiety problems, not problems with depression. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14958-14961). Lippincott Williams & Wilkins. Kindle Edition.
A client with avoidant personality disorder says occupational therapy (OT) is boring and he doesn't want to go. Which action by the nurse is most appropriate? 1. State firmly that you'll escort him to OT. 2. Arrange with OT for the client to do a project on the unit. 3. Ask the client to talk about why OT is boring. 4. Arrange for the client not to attend OT until he feels better.
1. If given the chance, a client with avoidant personality disorder typically elects to remain immobilized. The nurse should insist that the client participate in OT. Arranging for the client to do a project on the unit validates and reinforces the client's desire to avoid going to OT. Addressing an invalid issue such as the client's perceived boredom avoids the real issue: the client's need for therapy. There's no indication that the client is incapable of participating in OT.
Which of the following behavior patterns would a nurse expect to observe in a client with an obsessive-compulsive personality disorder? 1. Inflexible and lack of spontaneity 2. Submissive and clinging 3. Impulsive and unstable emotionally 4. Cheerful and carefree Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14644-14647). Lippincott Williams & Wilkins. Kindle Edition.
1. Inflexibility and lack of spontaneity describe the obsessive-compulsive personality disorder. Submissive and clinging describe the dependent personality disorder. Impulsivity and unstable emotions describe borderline personality disorder, and cheerful and carefree describe the narcissistic personality disorder. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14648-14650). Lippincott Williams & Wilkins. Kindle Edition.
Which of the following behaviors can a nurse expect to see in a client with a personality disorder? Select all that apply. 1. Compliance with the rules of the unit 2. Tendency to provoke interpersonal conflict 3. Inflexibility 4. Maladaptive responses to stress 5. Trouble in social and professional relationships 6. Personal boundaries are blurred
2, 3, 4, 5, and 6. These behaviors are evident regardless of the type of personality disorder. You will not see compliance with the unit rules with any personality disorder. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14286-14287). Lippincott Williams & Wilkins. Kindle Edition.
The nurse is assessing a client for narcissistic personality disorder. What are the best questions for the nurse to ask the client? Select all that apply. 1. " Do you frequently feel let down by people?" 2. " Do you find that most people aren't quite up to your standards?" 3. " Do you feel that other people take advantage of you?" 4. " Do you find that people often have a tendency to be disloyal or dishonest?" 5. " If people give you a hard time, do you tend to put them in their place quickly?" 6. " Are you a very special person?" 7. " Would you say it is fairly easy for you to get jealous?"
2, 5, and 6. Clients with narcissistic personality disorders feel others are not up to their standards, they put people in their place quickly, and they feel that they are very special people. Clients with borderline personality disorders feel let down by people. Clients with paranoid personality disorders feel that others take advantage of them, feel that people tend to be disloyal or dishonest, and get jealous easily. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14788-14791). Lippincott Williams & Wilkins. Kindle Edition.
Which of the following describes relationships of a client with a histrionic personality disorder? 1. Cold and distant 2. Shallow and smothering 3. Close and clingy 4. Distrustful and jealous Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14619-14623). Lippincott Williams & Wilkins. Kindle Edition.
2. A client with histrionic personality disorder has shallow and smothering relationships. Cold and distant relationships describe a client with schizoid personality disorder. Close and clingy relationships characterize dependent personality disorders. Distrustful and jealous characterize paranoid personality disorder relationships. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14623-14626). Lippincott Williams & Wilkins. Kindle Edition.
74. A nurse works with the family of a client diagnosed with schizoid personality disorder, helping them to assist him in making decisions. Which outcome indicates the nurse's interventions have been successful? 1. The family prevents the client from experiencing disappointments. 2. The family encourages the client to talk about specific issues and concerns. 3. The family removes alcohol and unnecessary prescription drugs from the house. 4. The family doesn't let the client obtain secondary gains from illness. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 15019-15025). Lippincott Williams & Wilkins. Kindle Edition.
2. A client with schizoid personality disorder typically is vague and has difficulty with self-expression; encouraging the client to talk about specific issues and concerns shows that the nurse's interventions were successful. It's neither realistic nor helpful for the family to protect the client from disappointments. Clients with schizoid personality disorder aren't at high risk for substance abuse and don't seek secondary gains from illness. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 15025-15029). Lippincott Williams & Wilkins. Kindle Edition.
A client with antisocial personality disorder says, "I always want to blow things off." Which response by the nurse is most appropriate? 1. " Try to focus on what needs to be done and just do it." 2. " Let's work on considering some options and strategies." 3. " Procrastinating is a part of your illness that we'll work on." 4. " The best thing to do is decide on some useful goals to accomplish."
2. By considering options or strategies, the client gains skills to overcome ineffective behaviors. The client tends to be irresponsible and needs guidance on what specifically to focus on to change behavior. Clients with an antisocial personality disorder don't tend to struggle with procrastination; instead, they show reckless and irresponsible behaviors. It's premature to decide on goals when the client needs to address the mental mind-set and work to change the irresponsible behavior.
Which of the following behavioral patterns is characteristic of individuals with histrionic personality disorders? 1. Berating themselves and their abilities 2. Overreacting to minor stimuli 3. Suspicious and mistrustful of others 4. Social withdrawal and distant relationships
2. Clients with a histrionic personality disorder are emotional and overreact to stimuli. Berating themselves describes an avoidant personality disorder. Suspiciousness describes a paranoid personality disorder. Socially withdrawn and distant relationships describe schizotypal personality disorder.
51. The nurse is identifying nursing outcomes for a client with a schizoid personality disorder. What is the most appropriate outcome? 1. Demonstrates an ability to use constructive criticism 2. Participates in two of the four scheduled groups on the unit 3. Demonstrates a reduction in clinging, splitting, and manipulation behaviors 4. Demonstrates a decrease in attention-seeking behaviors Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14758-14763). Lippincott Williams & Wilkins. Kindle Edition.
2. Clients with a schizoid personality disorder prefer solitary activities and do not enjoy close relationships. However, for this client to attend two out of four unit groups would be a step toward gaining some comfort in being around people. Avoidant personality disorder clients experience fear of rejection and/ or criticism and are very reluctant to participate in social situations because of this fear. Selections 3 and 4 describe a cluster B personality disorders: borderline, antisocial, histrionic, or narcissistic. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14764-14767). Lippincott Williams & Wilkins. Kindle Edition.
59. A client with dependent personality disorder is having trouble performing activities of daily living. Which nursing intervention should help facilitate the client's daily activities? 1. Have the client eat three meals a day. 2. Work with the client to establish a budget. 3. Make a chart to document hygiene practices. 4. Discuss how the client can obtain a driver's license. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14849-14854). Lippincott Williams & Wilkins. Kindle Edition.
2. Clients with dependent personality disorder tend to withdraw from adult responsibilities. Managing money through the use of a budget is a first step toward assuming adult responsibilities. These clients don't tend to have problems with nutritional intake. Hygiene issues usually aren't a problem for clients with dependent personality disorder. Clients with a dependent personality disorder don't have any special reasons for not obtaining a driver's license. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14855-14858). Lippincott Williams & Wilkins. Kindle Edition.
A client with paranoid personality disorder responds aggressively during a psychoeducational group therapy session to something another client said about him. The nurse interprets this behavior as indicating which of the following? 1. The client doesn't want to participate in the group. 2. The client took the statement as a personal criticism. 3. The client is impulsive and was acting out of frustration. 4. The client was attempting to handle emotional distress.
2. Clients with paranoid personality disorder tend to be hypersensitive and take what other people say as a personal attack on their character. The client is driven by the suspicion that others will inflict harm. Group participation would be minimal because the client is directing energy toward emotional self-protection. Clients with a paranoid personality tend to be rigid and guarded rather than expressive and acting out. The client with a paranoid personality disorder is acting to defend himself, not handle emotional distress.
A nurse is providing care for a client who has obsessive-compulsive disorder. It is important for the nurse to do which of the following? 1. Use a friendly, gentle, reassuring approach because it is the best way to treat clients with an obsessive-compulsive disorder. 2. Guard against engaging in power struggles with these clients. Their need for control is very high. 3. Be aware that clients with this personality disorder can instill guilt when they are not getting what they want. 4. Teach and role model assertiveness. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14683-14689). Lippincott Williams & Wilkins. Kindle Edition.
2. Guarding against engaging in power struggles describes how a nurse should approach a client with obsessive-compulsive personality disorder. A friendly, gentle, reassuring approach is the best way to treat clients with an avoidant personality disorder. Antisocial personality disorder clients instill guilt in staff when they don't get what they want. Teaching and role modeling assertiveness are strategies for dependent and histrionic personality disorders. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14689-14693). Lippincott Williams & Wilkins. Kindle Edition.
Which statement made by a client with paranoid personality disorder shows that teaching about social relationships is effective? 1. " As long as I live, I won't abide by social rules." 2. " Sometimes, I can see what causes relationship problems." 3. " I'll find out what problems others have so I won't repeat them." 4. " I don't have problems in social relationships; I never really did."
2. Progress is shown when the client addresses behaviors that negatively impact relationships. Clients with paranoid personality disorder tend to have impaired social relationships and are very uncomfortable in social settings. Clients with paranoid personality disorder struggle to understand and express their feelings about social rules. Knowing other people's problems isn't useful; the client must focus on his own issues. Not recognizing the problem indicates the client is in denial.
67. The nurse is expecting the psychiatrist to order an antidepressant for a client with borderline personality disorder. Which of the following would be best for this client? 1. Monoamine oxidase inhibitors (MAOIs) work best for those with a borderline personality disorder because the effects are felt very quickly. 2. Selective serotonin reuptake inhibitors (SSRIs) in addition to an atypical antipsychotic treat dysphoria, mood instability, and impulsivity in clients with borderline personality disorder. 3. Antipsychotics treat illusions, ideas of reference, paranoid thinking, anxiety, and hostility in clients. 4. Anxiolytics will reduce the anxiety seen in borderline personality disorder clients.
2. SSRIs and atypical antipsychotics do treat dysphoria, mood instability, and impulsivity in clients with borderline personality disorder. This is the best selection of medications for a client with borderline personality disorder. MAOI medications have food restrictions, and clients with borderline personality disorder would not comply with such restrictions. Antipsychotics are prescribed for psychotic behaviors: illusions, ideas of reference, and paranoid thinking. Anxiolytics may be prescribed for clients with borderline personality disorder, but these medications are limited in addressing only the anxiety these clients would have. Borderline personality disorder clients experience more symptoms than just anxiety.
A client with dependent personality disorder makes the following statement: "I'll never be able to take care of myself." Which response by the nurse is best? 1. " How can you say that? You can function." 2. " Let's talk about what's making you feel so fearful." 3. " I think we need to work on identifying your strengths." 4. " Can we talk about this tomorrow at the family meeting?"
2. The client with dependent personality disorder is afraid of abandonment and being unable to care for himself. Talking about his fears is a useful strategy. The first option is inappropriate because the nurse doesn't recognize the client's feelings. When the client makes a desperate statement, the nurse must respond to the client's feelings, rather than insert her opinion. Working on identifying a client's strengths will add to his feelings of not being strong enough to care for himself. Waiting to talk about his concern until the family meeting minimizes its importance.
Which of the following responses from the nurse would enhance a therapeutic relationship with a client with a personality disorder? 1. " What would you like to do today?" 2. " After you attend the morning community meeting, you may work on your homework." 3. " You remind me of a friend of mine." 4. " We will have you get comfortable on the unit first before we have you work on any homework." Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14289-14294). Lippincott Williams & Wilkins. Kindle Edition.
2. This response reflects a firm yet supportive approach. Responses 1 and 4 leave the nurse open for manipulation by the client. The client could suggest any activity that might not be therapeutic. The client could also never become comfortable on the unit. That is not the reason for their admission— to become comfortable. Response 3 is an example of countertransference. It is important for the nurse to discuss countertransference with other staff, not with the client with a personality disorder. CN: Safe, effective Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14295-14299). Lippincott Williams & Wilkins. Kindle Edition.
3. The nurse is assessing a new client who was just admitted to the psychiatric unit. Which of the following assessment questions by the nurse would determine if the client has a schizotypal personality disorder? Select all that apply. 1. " Do you feel that people often want to reject you or that they find you odd?" 2. " Does anxiety make you want to self-mutilate?" 3. " Do people of the opposite sex frequently find you attractive?" 4. " Do you feel that other people take advantage of you?" 5. " Have you ever felt like you had some special powers like ESP or some sort of magical influence over other?" 6. " Do you tend to stay by yourself, even though you would like to be with others?" 7. " Have you ever been arrested or pulled over by the police?"
3. 1, 5, and 6. Self-mutilation describes borderline personality disorders. Attractiveness to the opposite sex describes histrionic personality disorders. Feelings that others are taking advantage describe paranoid personality disorder. Being arrested or in trouble with the law describes antisocial personality disorder behaviors. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14254-14257). Lippincott Williams & Wilkins. Kindle Edition.
The nurse is reviewing the behaviors of a client with a histrionic personality disorder. The nurse determines that a change in behavior may be occurring when the client does what? 1. Draws attention and dresses provocatively 2. Is easily influenced by others or circumstances 3. Shows concern about hurting someone else's feelings 4. Describes intimate relationships with casual acquaintances Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14588-14593). Lippincott Williams & Wilkins. Kindle Edition.
3. A client with a histrionic personality disorder typically is insensitive to anyone else's experience. Exhibiting concern for another's feelings would indicate a change in the histrionic personality disorder client's behavior. Selections 1, 2, and 4 describe typical behaviors of a client with a histrionic personality disorder. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14594-14596). Lippincott Williams & Wilkins. Kindle Edition.
A nurse is evaluating the effectiveness of an assertiveness group that a client with dependent personality disorder attended. Which client statement indicates the group had therapeutic value? 1. " I can't seem to do the things other people do." 2. " I wish I could be more organized like other people." 3. " I want to talk about something that's bothering me." 4. " I just don't want people in my family to fight anymore."
3. By asking to talk about a bothersome situation, the client has taken the first step toward assertive behavior. To smooth over or minimize troubling events isn't an assertive position. The first option reflects a lack of self-confidence; it's not an assertive statement. Statements that express the client's wishes aren't assertive statements. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14923-14925). Lippincott Williams & Wilkins. Kindle Edition.
When reviewing a client's chart, the nurse notes the progress note below. Which statement about the client's condition is most accurate? "Client, age 28, admitted to unit with diagnosis of antisocial personality disorder and suicide attempt after cutting his right wrist. Right wrist dressing appears dry and intact. Client states, "I don't want to be here and I'm not following your treatment plan or any of your rules. I'm going to tell everyone here not to follow your rules" 1. The client requires psychotropic drugs to treat his condition, which he refuses. 2. The client manipulates other clients but not his family. 3. The client may not be motivated to change his behavior or his lifestyle. 4. The client could quickly make behavior changes if motivated.
3. Clients with antisocial personality disorder feel nothing is wrong with their behavior and have no desire to change. These clients don't benefit from psychotropic drug therapy. They attempt to manipulate all people with whom they come in contact. A quick behavior change isn't realistic expectation for clients with this disorder.
Which of the following nursing diagnoses would be appropriate for a client with an avoidant personality disorder? 1. Risk for self-mutilation related to a desperate need for attention 2. Ineffective coping related to negative attitudes toward health behavior 3. Anxiety related to fear of criticism, disapproval, and rejection 4. Risk for injury related to uncontrolled anger and hostility toward others
3. Clients with avoidant personality disorder fear criticism, disapproval, and rejection. Self-mutilation describes borderline personality disorder. Negative attitudes toward health behaviors and uncontrolled anger and hostility describe antisocial personality disorder.
56. Which of the following nursing diagnoses would be appropriate for a client with a narcissistic personality disorder? 1. Risk for self-mutilation related to a desperate need for attention 2. Ineffective coping related to negative attitudes toward health behavior 3. Impaired social interaction related to use of control strategies and disruption of close relationships 4. Risk for injury related to uncontrolled anger and hostility toward others .
3. Clients with narcissistic personality disorder have relationships that are characterized by disruption (frequently provoke arguments) or control (consistently in power struggles). Risk for self-mutilation describes clients with borderline personality disorder. Negative attitudes toward health behavior and risk for injury related to uncontrolled anger and hostility toward others describe antisocial personality disorder.
75. A nurse discusses job possibilities with a client diagnosed with schizoid personality disorder. Which suggestion by the nurse should be helpful? 1. " You could work in a family restaurant part-time on the weekends and holidays." 2. " Maybe your friend could get you that customer service job where you work only in the evenings." 3. " Your idea of applying for the position of filing and organizing records is worth pursuing." 4. " Being an introvert limits the employment opportunities you can pursue."
3. Clients with schizoid personality disorder prefer solitary activities, such as filing, to working with others. Working as a cashier or customer service representative would involve interacting with many people. Not all jobs require extensive interpersonal contact.
Which of the following nursing diagnoses would be appropriate for a client with a schizoid personality disorder? 1. Impaired social interaction related to seductive and self-dramatizing behaviors 2. Risk for other-directed violence related to pacing and threatening stances 3. Ineffective coping related to difficulty in developing close relationships 4. Defensive coping related to absence of guilt and superior attitude toward others Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14748-14752). Lippincott Williams & Wilkins. Kindle Edition.
3. Clients with schizoid personality disorders consistently have difficulty in cultivating close relationships, even within their own family. Clients with histrionic personality disorders consistently draw attention to themselves. Risk for other-directed violence, chronic low self-esteem, and defensive coping would be appropriate for a client with an antisocial personality disorder. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14753-14756). Lippincott Williams & Wilkins. Kindle Edition.
11. A nurse is caring for a client with schizotypal personality disorder. The nurse would expect to observe which of the following? 1. Exhibitionism 2. Impulsiveness 3. Bodily illusions 4. Repetitive behaviors
3. Clients with schizotypal personality disorders tend to have bodily illusions. Clients with histrionic personality disorder tend to be exhibitionists, borderlines are impulsive, and obsessive-compulsive individuals engage in repetitive behaviors. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14338-14339). Lippincott Williams & Wilkins. Kindle Edition.
The nurse would expect to observe which of the following behaviors in a client who has a histrionic personality disorder? 1. Exploitation of others to meet their own needs and desires 2. Portray a demeanor of grandiosity 3. Portray excessive provocative behaviors 4. Expression of feelings of emptiness and boredom
3. Histrionic personality disorders exhibit provocative behaviors. Exploitation of others and grandiosity are descriptions of narcissistic personality disorder. Feelings of emptiness and boredom are descriptions of borderline personality disorder.
What behaviors would a nurse expect to see in a client who has a schizoid personality disorder? 1. Fearful and anxious 2. Erratic and emotional 3. Odd and eccentric 4. Emotional and dramatic
3. Odd and eccentric behaviors are seen in clients with a cluster A personality disorder: paranoid, schizotypal, and schizoid disorders. Fearful and anxious describe clients with a cluster C personality disorder: avoidant, dependent, and obsessive-compulsive disorders. Erratic, emotional, and dramatic describe clients with a cluster B personality disorder: borderline, antisocial, histrionic, and narcissistic disorders. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14700-14702). Lippincott Williams & Wilkins. Kindle Edition.
A client with antisocial personality disorder is trying to manipulate the health care team. What is the best strategy for the staff to implement? 1. Focus on how to teach the client more effective behaviors for meeting basic needs. 2. Help the client verbalize underlying feelings of hopelessness and learn coping skills. 3. Remain calm and don't emotionally respond to the client's manipulative actions. 4. Help the client eliminate the intense desire to have everything in life turn out perfectly.
3. The best strategy to use with a client trying to manipulate staff is to stay calm and refrain from responding emotionally. Negative reinforcement of inappropriate behavior increases the chance it will be repeated. Later, it may be possible to address how to meet the client's basic needs. Clients with antisocial personality disorder don't tend to experience feelings of hopelessness or to desire life events to turn out perfectly. In most cases, these clients negate responsibility for their behavior.
A client with a dependent personality disorder is taking fluoxetine (Prozac) for depression. Which instruction is included in client teaching? 1. Drink only wine and beer when taking this drug. 2. Add as-needed doses if depression becomes worse. 3. Expect 3 to 4 weeks to go by before effects are seen. 4. Be aware that alterations in usual sleep patterns, especially nightmares, may occur.
3. The client must take the drug for 3 to 4 weeks before therapeutic effects are seen. The nurse must caution the client against the use of alcohol, including wine and beer, when taking fluoxetine. The client is to take the drug as prescribed. Additional doses must not be self-administered. Fluoxetine treats disruptions in sleep and doesn't cause nightmares. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14866-14868). Lippincott Williams & Wilkins. Kindle Edition.
4. Which of the following nursing diagnoses would be most appropriate for a client with a schizotypal personality disorder? 1. Ineffective coping related to repetitive behaviors such as hand washing 2. Risk for self-mutilation related to social anxiety 3. Risk for violence toward others related to lack of remorse for behaviors 4. Impaired thought processes related to ideas of reference and magical thinking
4. 4. People with a schizotypal personality disorder have ideas of reference and magical thinking. Repetitive behaviors describe obsessive-compulsive personality disorder, self-mutilation describes borderline personality disorders, and violence toward others with lack of remorse describes antisocial personality disorder. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14264-14266). Lippincott Williams & Wilkins. Kindle Edition.
A nurse admits a client who has an obsessive-compulsive personality disorder to the unit. The nurse expects this client to be preoccupied with which of the following? 1. Their own attractiveness 2. Their own needs and desires being met 3. Rules and regulations of the unit 4. Isolating from all the other clients on the unit Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14652-14656). Lippincott Williams & Wilkins. Kindle Edition.
3. The client with an obsessive-compulsive disorder is preoccupied with rules and regulations of the unit. The histrionic personality disorder client will be concerned about their own attractiveness. The narcissistic personality disorder client will be looking to see how their own needs and desires will be met. Clients with schizotypal personality disorder will socially isolate from others on the unit. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14657-14660). Lippincott Williams & Wilkins. Kindle Edition.
A client with antisocial personality disorder is trying to convince a nurse that he deserves special privileges and that an exception to the rules should be made for him. What is the best response by the nurse? 1. " I believe we need to sit down and talk about this." 2. " Don't you know better than to try to bend the rules?" 3. " What you're asking me to do for you is unacceptable." 4. " Why don't you bring this request to the community meeting?"
3. These clients often try to manipulate the nurse to get special privileges or make exceptions to the rules on their behalf. By informing the client directly when actions are inappropriate, the nurse helps the client learn to control unacceptable behaviors by setting limits. By sitting down to talk about the request, the nurse is telling the client there's room for negotiation when there is none. The second option humiliates the client. The client's behavior is unacceptable and shouldn't be brought to a community meeting.
A nurse caring for a client with an avoidant personality disorder has established an outcome of demonstration of newly acquired social skills in social situations. Which of the following interventions would address this outcome? 1. Discuss with counselor factors that interfere with social interaction. 2. Identify social skills that the client already performs well. 3. Go to hospital cafeteria, purchase desired item, and eat in cafeteria. 4. Complete a work sheet on social skills.
3. This describes actually performing the skill in a social situation. The other selections address social skills, but there is no performance associated with them.
A nurse tells a client with a personality disorder that he must clean his room before he can go to the dayroom. The client asks if he can play one game of pool first. What is the most appropriate response by the nurse? 1. " You can play one quick game. Then you have to clean your room." 2. " No, you may not." 3. " No, you may not play pool first. The rules were explained to you." 4. " Yes, you may play a quick game. But don't tell the other clients about this." Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14609-14614). Lippincott Williams & Wilkins. Kindle Edition.
3. This response is firm and reinforces the rules. Allowing the client to play one game before cleaning his room and telling him not to tell anyone else encourages manipulative behavior. Saying no to the client without an explanation doesn't outline or reinforce the rules. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14615-14617). Lippincott Williams & Wilkins. Kindle Edition.
The nurse is developing outcomes for a client with a histrionic personality disorder. What is the most appropriate outcome for this client? 1. Contracts for safety and is free of self-inflicted injury 2. Participates in impulse control training 3. Participates in anger management classes 4. Participates in group without being the center of attention
31. 4. A client with histrionic personality disorder thrives on being the center of attention. Contracting for safety and impulse control training would be appropriate for a client with borderline personality disorder. Anger management class would be appropriate for antisocial personality disorder.
34. A client with dependent personality disorder is working to increase self-esteem. Which statement by the client shows teaching was successful? 1. " I'm not going to look just at the negative things about myself." 2. " I'm most concerned about my level of competence and progress." 3. " I'm not as envious of the things other people have as I used to be." 4. " I find I can't stop myself from taking over things others should be doing."
34. 1. As the client makes progress on improving self-esteem, self-blame and negative self-evaluations will decrease. Clients with dependent personality disorder tend to feel fragile and inadequate and would be extremely unlikely to discuss their level of competence and progress. These clients focus on self and aren't envious or jealous. Individuals with dependent personality disorders don't take over situations because they see themselves as inept and inadequate.
A client with schizotypal personality disorder is sitting in a puddle of urine. He's playing in it, smiling, and softly singing a child's song. Which action would be best? 1. Admonish the client for not using the bathroom. 2. Firmly tell the client that his behavior is unacceptable. 3. Ask the client whether he's ready to get cleaned up now. 4. Help the client to the shower and change the bedclothes.
4. A client with a schizotypal personality disorder can experience high levels of anxiety and regress to childlike behaviors. This client may require help meeting self-care needs. The client may not respond to the other options or those options may generate more anxiety. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14993-14995). Lippincott Williams & Wilkins. Kindle Edition.
A client with borderline personality disorder is learning how to verbalize, rather than act on, the desire to hurt himself. What is the most appropriate nursing intervention? 1. Explain how pain triggers intense anger and causes the client to act out. 2. Determine how problems with the client's family cause him to act aggressively. 3. Teach the client that being volatile is a normal reaction to unfair events. 4. Have the client work on identifying speech and behavior that accompany anger.
4. Aggressive speech and inappropriate behaviors indicate that the client is angry or upset; these feelings may trigger acting out. Pain rarely triggers intense anger or makes a client act out. Blaming one's family of origin for inappropriate handling of anger isn't helpful. Being volatile isn't a normal reaction to unfair life events. The client needs to express anger in safe and appropriate ways.
Which of the following nursing diagnoses would be appropriate for a client with an obsessive-compulsive disorder? 1. Disturbed sensory perception related to body illusions experienced 2. Risk for self-directed violence related to evidence of recent self-mutilation 3. Risk for injury related to uncontrolled angry outbursts, hitting the wall 4. Ineffective coping related to indecisiveness and preoccupation with details Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14662-14667). Lippincott Williams & Wilkins. Kindle Edition.
4. Because clients with an obsessive-compulsive personality disorder are so preoccupied with details, they become indecisive. Body illusions are experienced by schizotypal personality disorder clients. Self-mutilation is a characteristic of borderline clients. Uncontrolled angry outbursts and hitting the wall would be seen in an antisocial personality disorder client. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14668-14670). Lippincott Williams & Wilkins. Kindle Edition.
Which of the following clients needs to be assigned as a 1: 1 with a psychiatric technician? 1. A client with histrionic personality disorder who frequently faints when a male individual is near 2. A client with antisocial personality disorder who steals food from other clients' meal trays 3. A client with an obsessive-compulsive personality disorder who insists all the rules of the unit be followed 4. A client with borderline personality disorder who has acted on stated suicidal thoughts and has cut herself
4. Because of the labile emotion and impulsivity characteristics of a client with borderline personality disorder, it is necessary to implement 1: 1 staffing for this borderline client to ensure safety of the client. The other client behaviors do need to be addressed but do not require 1: 1 staffing. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14912-14914). Lippincott Williams & Wilkins. Kindle Edition.
A client with dependent personality disorder is working on goals for self-care. Which short-term goal is most important to the client's everyday activities of daily living? 1. Do all self-care activities independently. 2. Write a daily schedule for each day of the week. 3. Do self-care activities in a minimal amount of time. 4. Determine activities that can be performed without help.
4. By determining activities that can be performed without assistance, the client can then begin to practice them independently. If the nurse only encourages a client to perform self-care activities independently, nothing may change. Writing a daily schedule doesn't help the client focus on what needs to be done to promote self-care. The amount of time needed to perform self-care activities isn't important. If time pressure is put on the client, there may be more reluctance to perform self-care activities. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14809-14813). Lippincott Williams & Wilkins. Kindle Edition.
A client with paranoid personality disorder is discussing current problems with a nurse. What is the most important intervention for the nurse to implement? 1. Have the client look at sources of frustration. 2. Have the client focus on ways to interact with others. 3. Have the client discuss the use of defense mechanisms. 4. Have the client clarify thoughts and beliefs about an event. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14300-14305). Lippincott Williams & Wilkins. Kindle Edition.
4. Clarifying thoughts and beliefs helps the client avoid misinterpretations. Clients with a paranoid personality disorder tend to mistrust people and don't see interacting with others as a way to handle problems. They tend to be aggressive and argumentative rather than frustrated. The client's priority must be to interpret his thoughts and beliefs realistically, rather than discuss defensive mechanisms. A paranoid client will focus on defending self rather than acknowledging the use of defense mechanisms. CN: Safe, effective care environment;
52. What might be an effective intervention for a client with a schizoid personality disorder? 1. Participates in impulse control training 2. Participates in anger management classes 3. Participates in group without being the center of attention 4. Participates in social skills training
4. Clients with schizoid personality disorder could benefit from social skills training because they are detached from others and loners. A client with histrionic personality disorder thrives on being the center of attention. Impulse control training would be appropriate for a client with borderline personality disorder. Anger management class would be appropriate for a client with antisocial personality disorder. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14775-14778). Lippincott Williams & Wilkins. Kindle Edition.
A client with a paranoid personality disorder makes an inappropriate and unreasonable report to a nurse. What is the most appropriate intervention by the nurse? 1. Use logic to address the client's concern. 2. Confront the client about the stated misperception. 3. Use nonverbal communication to address the issue. 4. Tell the client matter-of-factly that you don't share his interpretation. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14312-14317). Lippincott Williams & Wilkins. Kindle Edition.
4. Telling the client you don't share his interpretation helps the client differentiate between realistic and emotional thoughts and conclusions. When the nurse uses logic to respond to a client's inappropriate statement, the nurse risks creating a power struggle with the client. The use of nonverbal communication will probably be misinterpreted and arouse the client's suspicion. It's unwise to confront a client with a paranoid personality disorder as the client will immediately become defensive. CN: Psychosocial integrity; CNS: None; CL: Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14318-14322). Lippincott Williams & Wilkins. Kindle Edition.
A client with antisocial personality disorder talks about personal life changes that need to occur. Which client statement shows group therapy is having a positive therapeutic effect? 1. " I'm not doing as bad as I thought I was." 2. " I wish I could believe I can change, but it's probably too late." 3. " I see all the problems, but I'm not sure there are good solutions." 4. " I'm finally learning how to live my life without living on the edge." Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14598-14603). Lippincott Williams & Wilkins. Kindle Edition.
4. The client is becoming aware of risky behaviors and how problematic these behaviors are. The first option indicates denial, and the client is somewhat defensive about making a change. The second option indicates defeat, and the client seems to feel stuck. The third option indicates problem identification but also uncertainty and ambivalence about the client's ability to change. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14605-14607). Lippincott Williams & Wilkins. Kindle Edition.
What is the most appropriate short-term goal for a client with paranoid personality disorder and impaired social skills? 1. Obtain feedback from other people. 2. Discuss anxiety-provoking situations. 3. Address positive and negative feelings about self. 4. Identify personal feelings that hinder social Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14323-14327). Lippincott Williams & Wilkins. Kindle Edition.
4. The client must address the feelings that impede social interactions before developing ways to address impaired social skills. Feedback can only be obtained after action is taken to improve or change the situation. Discussion of anxiety-provoking situations is important but doesn't help the client with impaired social skills. Addressing the client's positive and negative feelings about self won't directly influence impaired social skills. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14328-14331). Lippincott Williams & Wilkins. Kindle Edition.
A client is admitted exhibiting the following: pervasive pattern of social inhibition, agoraphobia, fear of criticism, feelings of inferiority to others, and feelings of being totally unattractive to others. The nurse interprets this behavior as characteristic of which disorder? 1. Dependent personality disorder 2. Histrionic personality disorder 3. Narcissistic personality disorder 4. Avoidant personality disorder
4. The description is characteristic of avoidant personality disorder. Histrionic and narcissistic are cluster B and are quite emotionally labile in their demonstration of symptoms. Clients with dependent personality disorders generally cling to others in their personal relationships.
43. The nurse recently admitted a client with an obsessive-compulsive personality disorder. What is the most appropriate outcome for this client? 1. Participates in impulse control training 2. Demonstrates a reduction in clinging, splitting, manipulation, and other distancing behaviors 3. Demonstrates a decreased suspicion and increased security 4. Participates in recreational therapy on the unit Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14672-14677). Lippincott Williams & Wilkins. Kindle Edition.
4. The obsessive-compulsive personality overemphasizes work to the exclusion of participating in pleasurable leisure activities. For the client to be able to participate in recreational therapy on the unit is a good first step. Impulse control training, splitting and manipulation, and distancing behaviors describe the borderline personality disorder. Decrease in suspicion and increased security would be outcomes for a client with a paranoid personality disorder. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14678-14681). Lippincott Williams & Wilkins. Kindle Edition.
46. The nurse is assessing a new client who was just admitted to the psychiatric unit. Which of the following assessment questions by the nurse would determine if the client has a schizoid personality disorder? Select all that apply. 1. " Do you tend to be a perfectionist?" 2. " Have you found yourself being worried that people won't like you?" 3. " Do you enjoy making most decisions in your house, or would you prefer that others make the most important decisions?" 4. " During the course of your life, have you had only about one or two friends?" 5. " Over the years, have you been able to take care of yourself in a physical fight?" 6. " Do you prefer to be alone?"
46. 4 and 6. Clients with schizoid personality disorders will only have about one or two friends and prefer to be alone. Clients with obsessive-compulsive personality disorders are perfectionists. Clients with avoidant personality disorders are worried that people won't like them. Clients with dependent personality disorders would prefer that others make important decisions. Clients with antisocial personality disorders can take care of themselves in a physical fight.
48. What would be an important guideline for nurses working with clients with borderline personality disorder? 1. When behavioral problems emerge, calmly review the therapeutic goals and boundaries of treatment. 2. Try to prevent or reduce untoward effects of manipulation. 3. Remain neutral and avoid engaging in power struggles. 4. Respect a client's need for social isolation. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14727-14731). Lippincott Williams & Wilkins. Kindle Edition.
48. 1. Reminding the borderline client of the goals and boundaries of treatment helps the client to focus on therapy. Manipulation is an issue with antisocial personality clients. Power struggles are an issue for the narcissistic client, and respecting the client's need for social isolation describes a client with schizotypal personality disorder. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14732-14735). Lippincott Williams & Wilkins. Kindle Edition.
Which nursing intervention has priority for a client with borderline personality disorder? 1. Maintain consistent, realistic limits. 2. Give instructions for meeting basic self-care needs. 3. Engage in daytime activities to stimulate wakefulness. 4. Have the client attend group therapy on a daily basis. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14737-14741). Lippincott Williams & Wilkins. Kindle Edition.
49. 1. Clients with borderline personality disorder who are needy, dependent, and manipulative will benefit greatly from maintaining consistent, realistic limits. They don't tend to have difficulty meeting their self-care needs and don't tend to have sleeping difficulties. They enjoy attending group therapy because they typically attempt to use the opportunity to become the center of attention. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14742-14745). Lippincott Williams & Wilkins. Kindle Edition.
The nurse is caring for a client with an avoidant personality disorder. The nurse anticipates assessment of the client's behavior to include which characteristics? Select all that apply. 1. Vigilant and suspiciousness 2. Distant personal relationships 3. Stealing, lying, and vandalism 4. Unstable relationships 5. View themselves as inferior to others 6. Inflexible, rigid, and needs to be in control 7. Social phobias
5 and 7. Suspiciousness is characteristic of paranoid personality disorder. Distant personal relationships are characteristic of schizoid personality disorder. Stealing, lying, and vandalism are characteristic of antisocial disorder. Unstable relationships are characteristic of borderline personality disorder. Inflexible, rigid, and the need to be in control are characteristic of obsessive-compulsive disorder.
5. A nurse is caring for a client with schizotypal personality disorder. What is the most appropriate response by the nurse? 1. " You are to participate in all of the classes offered here on the unit." 2. " You may work on your assigned work sheets in your room." 3. " You are to conduct the community meeting this morning." 4. " You will help teach our medication class today to the entire group." Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14269-14273). Lippincott Williams & Wilkins. Kindle Edition.
5. 2. Clients with schizotypal personality disorders tend to isolate; this should be respected by the nurse. Answer choices 1, 3, and 4 are approaches that cause clients with schizoid personality disorders to be with the rest of the unit (attending, teaching, and conducting groups on the unit). The nurse may receive quite a bit of resistance from the client when there is a tone of control from the nurse. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14274-14277). Lippincott Williams & Wilkins. Kindle Edition.
61. The nurse has the following clients: A dependent personality disorder client who is seeking care from another client after experiencing a recent divorce A borderline personality disorder client who is cutting her wrists and arms since admission to the unit An avoidant personality disorder client who refuses to go to groups on the unit A paranoid personality disorder client who is suspicious of the male clients in the unit and refuses to attend the community morning meeting Which client is the nurse's first priority to see at the beginning of the shift? 1. Dependent personality disorder client 2. Borderline personality disorder client 3. Avoidant personality disorder client 4. Paranoid personality disorder client
61. 2. The nurse has to attend to the physical safety of the borderline personality disorder client first. The behaviors of the other three clients with personality disorders affect the milieu of the unit and can be addressed later. Lisko, Susan (2013-10-01). NCLEX-RN Questions and Answers Made Incredibly Easy (Nclexrn Questions & Answers Made Incredibly Easy) (Kindle Locations 14880-14881). Lippincott Williams & Wilkins. Kindle Edition.
77. A client with borderline personality disorder states that he doesn't know how to deal with his impulsive behavior. Which intervention should the nurse implement? 1. Teach the client that impulsive behavior is part of his illness. 2. Explore how depression influences impulsive situations. 3. Select an example of an impulsive situation and explore it. 4. Decrease interactions in which impulsive behavior occurs.
77. 3. By selecting an impulsive situation to explore with the client, the nurse can help him begin to understand the causes and consequences of his behavior and learn how to modify it. Although impulsive behavior is part of borderline personality disorder, the nurse's intervention needs to address ways to handle it. Anxiety, not depression, is strongly related to impulsive behavior. Decreasing social interactions is unrealistic; it's more useful to address the impulsive behavior.
