Answer Options:
a. The patient will identify when feeling angry.
b. The patient will use manipulation only to get legitimate needs met.
c. The patient will acknowledge manipulative behavior when it is called to their attention.
d. The patient will accept fulfillment of their requests within an hour rather than immediately.
Answer: C. The patient will acknowledge manipulative behavior when it is called to their attention.
Question: A patient who fears serious heart disease was referred to the mental health center by a cardiologist after diagnostic evaluation showed no physical illness. The patient says, “My heart misses beats. I’m frequently absent from work. I don’t go out much because I need to rest.” Which health problem is most likely?
Answer Options:
a. Depersonalization disorder
b. Antisocial personality disorder
c. Illness anxiety disorder
d. Persistent depressive disorder
Answer: C. Illness anxiety disorder
Question: A patient diagnosed with borderline personality disorder has been hospitalized several times after self-inflicted lacerations. The patient remains impulsive. Dialectical behavior therapy starts on an outpatient basis. Which nursing diagnosis is the focus of this therapy?
Answer Options:
a. Risk for self-mutilation
b. Impaired skin integrity
c. Risk for injury
d. Powerlessness
Answer: A. Risk for self-mutilation
Question: Which characteristic of individuals diagnosed with personality disorders makes it most necessary for staff to schedule frequent meetings?
Answer Options:
a. Ability to achieve true intimacy.
b. Flexibility and adaptability to stress.
c. Ability to evoke interpersonal conflict.
d. Inability to develop trusting relationships.
Answer: C. Ability to evoke interpersonal conflict.
Question: A patient tells the nurse, “My sexual functioning is normal when my partner wears lace. Without it, I’m not interested in sex.” This comment evidences which sexual disorder?
Answer Options:
a. Exhibitionism
b. Voyeurism
c. Pedophilia
d. Fetishism
Answer: d. Fetishism
Question: Which statement made by a patient diagnosed with borderline personality disorder indicates the treatment plan is effective?
Answer Options:
a. “I think you’re the best nurse.”
b. “I’m never going to get high on drugs again.”
c. “I hate my doctor for not giving me what I ask for.”
d. “I felt empty and wanted to cut myself, so I called you.”
Answer: D. “I felt empty and wanted to cut myself, so I called you.”
Question: Which intervention is appropriate for a patient diagnosed with an antisocial personality disorder who frequently manipulates others?
Answer Options:
a. Refer the patient’s requests to identified staff.
b. Explore the patient’s feelings of fear and inferiority.
c. Provide immediate reinforcement for positive behavior.
d. Ignore, rather than confront, inappropriate behavior.
Answer: A. Refer the patient’s requests to identified staff.
Question: A nurse plans the care for an individual diagnosed with antisocial personality disorder. Which characteristic behaviors will the nurse expect? (Select all that apply.)
Answer Options:
a. Reclusive behavior
b. Callous attitude
c. Perfectionism
d. Aggression
e. Clinginess
f. Anxiety
Answer: B. Callous attitude
D. Aggression
Question: For which patients diagnosed with personality disorders would a family history of similar problems be most likely? (Select all that apply.)
Answer Options:
a. Obsessive-compulsive
b. Antisocial
c. Dependent
d. Schizotypal
e. Narcissistic
Answer: A. Obsessive-compulsive
B. Antisocial
D. Schizotypal
Question: A patient diagnosed with a personality disorder has used manipulation to get their needs met. The staff decides to apply limit setting interventions. What is the correct rationale for this action?
Answer Options:
a. It provides an outlet for feelings of anger and frustration.
b. It respects the patient’s wishes so assertiveness will develop.
c. External controls are necessary while internal controls are developed.
d. Anxiety is reduced when staff members assume responsibility for the patient’s behavior.
Answer: C. External controls are necessary while internal controls are developed.
Question: A nurse set limits for a patient diagnosed with a borderline personality disorder. The patient tells the nurse, “You used to care about me. I thought you were wonderful. Now I can see I was mistaken. You’re terrible.” This outburst can be documented using what term?
Answer Options:
a. Denial
b. Splitting
c. Reaction formation
d. Separation-individuation strategies
Answer: B. Splitting
Question: As a nurse prepares to administer an oral medication to a patient diagnosed with a borderline personality disorder, the patient says, “Just leave it on the table. I’ll take it when I finish combing my hair.” What is the nurse’s best response?
Answer Options:
a. “Alright. I’ll be back to make sure you’ve taken it.”
b. “I’m worried that you might not take it. I will come back later.”
c. “I must watch you take the medication. Please take it now.”
d. “Why don’t you want to take your medication now?”
Answer: C. “I must watch you take the medication. Please take it now.”
Question: The manager of a health club put a hidden camera in the women’s locker room and videotaped women as they showered and dressed. Which sexual dysfunction is evident?
Answer Options:
a. Frotteurism
b. Exhibitionism
c. Pedophilia
d. Voyeurism
Answer: d. Voyeurism
Question: Consider these comments made to three different nurses by a patient diagnosed with an antisocial personality disorder: “You’re a better nurse than the day shift nurse said you were”, “Another nurse said you don’t do your job right?”, “You think you’re perfect, but I’ve seen you make three mistakes.” Collectively, these interactions can be appropriately assessed using what term?
Answer Options:
a. Paranoia
b. Entitlement
c. Manipulation
d. Pathological lying
Answer: C. Manipulation
Question: A patient who has been diagnosed with schizoid personality disorder is newly admitted to the unit. What is the best initial nursing intervention?
Answer Options:
a. Set firm limits.
b. Engage in trust building.
c. Involve in milieu and group activities.
d. Encourage identification and expression of feelings.
Answer: B. Engage in trust building.
Question: An adult says, “When I was a child, I took medication because I couldn’t sit still. I stopped taking it when I was about 13. I still have trouble getting organized, which causes difficulty at my job.” Which disorder is most likely?
Answer Options:
a. Stress intolerance disorder
b. Generalized anxiety disorder (GAD)
c. Borderline personality disorder
d. Adult attention-deficit/hyperactivity disorder (ADHD)
Answer: d. Adult attention-deficit/hyperactivity disorder (ADHD)
Question: A patient diagnosed with borderline personality disorder has self-inflicted wrist lacerations. The health care provider prescribes daily dressing changes. The nurse performing this care should focus on what?
Answer Options:
a. Encouraging the patient to express anger.
b. Providing care in a kind but matter-of-fact manner.
c. Demonstrating sympathy and concern.
d. Offering to listen to the patient’s feelings about cutting.
Answer: B. Providing care in a kind but matter-of-fact manner.
Question: A Puerto Rican–American patient uses dramatic body language when describing emotional discomfort. Which analysis most likely explains the patient’s behavior?
Answer Options:
a. A histrionic personality disorder is likely.
b. The patient is accustomed to touch during conversations, as are members of many Hispanic subcultures.
c. The patient understands that touch makes the nurse uncomfortable and controls the relationship based on that factor.
d. The patient is afraid of being alone. When touching the nurse, the patient is reassured and comforted.
Answer: B. The patient is accustomed to touch during conversations, as are members of many Hispanic subcultures.
Question: A patient diagnosed with borderline personality disorder and a history of self-mutilation has now begun dialectical behavior therapy (DBT) on an outpatient basis. Today the patient telephones to say, “I’m feeling empty and want to cut myself.” The nurse should implement what intervention?
Answer Options:
a. Arrange for emergency inpatient hospitalization.
b. Send the patient to the crisis intervention unit for 8 to 12 hours.
c. Assist the patient to identify the trigger situation and choose a coping strategy.
d. Advise the patient to take an antianxiety medication to decrease the anxiety level.
Answer: C. Assist the patient to identify the trigger situation and choose a coping strategy.
Question: Which nursing action should occur first when preparing to work with a patient who has a problem of sexual functioning?
Answer Options:
a. Acquire knowledge of the patient’s sexual roles and preferences.
b. Develop an understanding of human sexual responses.
c. Assess the patient’s sexual functioning.
d. Clarify the nurse’s own personal values.
Answer: d. Clarify the nurse’s own personal values.
Question: A person’s partner filed charges of battery. The person has a long history of acting-out behaviors and several arrests. Which statement by the person suggests an antisocial personality disorder?
Answer Options:
a. “I have a quick temper, but I can usually keep it under control.”
b. “I’ve done some stupid things in my life, but I’ve learned a lesson.”
c. “I’m feeling terrible about the way my behavior has hurt my family.”
d. “I get tired of being nagged. They deserved the beating.”
Answer: D. “I get tired of being nagged. They deserved the beating.”
Question: What is the priority nursing diagnosis for a patient diagnosed with antisocial personality disorder who has made threats against staff, ripped art off the walls, and thrown objects?
Answer Options:
a. Disturbed sensory perception—auditory
b. Risk for other-directed violence
c. Ineffective denial
d. Ineffective coping
Answer: B. Risk for other-directed violence
Question: When preparing to interview a patient diagnosed with narcissistic personality disorder, a nurse can anticipate the assessment findings will include what characteristics?
Answer Options:
a. Preoccupation with minute details; perfectionist
b. Charming, dramatic, seductive; seeking admiration.
c. Difficulty being alone; indecisiveness, submissiveness.
d. Lack of empathy, exploitive, and arrogance.
Answer: D. Lack of empathy, exploitive, and arrogance.