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 Choices: 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 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 Choices: 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: What is the most challenging nursing intervention for patients diagnosed with personality disorders who use manipulation to get their needs met?
Answer Choices: a. Supporting behavioral change b. Monitoring suicide attempts c. Maintaining consistent limits d. Using aversive therapy
Answer: c. Maintaining consistent limits
Question: The history shows that a newly admitted patient has impulsivity. The nurse would expect:
Answer Choices: a. Adherence to a strict moral code b. Manipulative, controlling strategies c. Postponing gratification to an appropriate time d. Little time elapsed between thought and action
Answer: d. Little time elapsed between thought and action
Question: A patient tells a nurse, “I sometimes get into trouble because I make quick decisions and act on them.” Which response by the nurse would be most therapeutic?
Answer Choices: a. “Let’s consider the benefits of stopping to think the consequences.” b. “It sounds as though you’ve developed some insight into your situation.” c. “I’ll bet you have some interesting stories to share about overreacting.” d. “It’s good that you’re showing readiness for behavioral change.”
Answer: a. “Let’s consider the benefits of stopping to think the consequences.”
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 Choices: a. Risk for self-mutilation b. Impaired skin integrity c. Risk for injury d. Powerlessness
Answer: a. Risk for self-mutilation
Question: Which statement made by a patient diagnosed with borderline personality disorder indicates the treatment plan is effective?
Answer Choices: a. “I’m never going to get high on drugs again.” b. “I hate my doctor for not giving me what I ask for.” c. “I felt empty and wanted to cut myself, so I called you.” 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: When preparing to interview a patient diagnosed with narcissistic personality disorder, a nurse can anticipate the assessment findings will include what characteristics?
Answer Choices: 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
Question: For which patient behavior would limit setting be most essential?
Answer Choices: a. Clings to the nurse and asks for advice about inconsequential matters b. Is flirtatious and provocative with staff members of the opposite sex c. Is hypervigilant and refuses to attend unit activities as prescribed d. Urges a suspicious patient to hit anyone who stares at them
Answer: d. Urges a suspicious patient to hit anyone who stares at them
Question: A nurse in the emergency department tells an adult, “Your mother had a serious stroke.” The adult tearfully says, “Who will take care of me now?” Which term best describes this behavior?
Answer Choices: a. Histrionic b. Dependent c. Narcissistic d. Borderline
Answer: b. Dependent
Question: Others describe a worker as very shy and lacking in self-confidence. This worker stays in an office cubicle all day and seldom comes out for breaks or lunch. Which term best describes this behavior?
Answer Choices: a. Avoidant b. Dependent c. Histrionic d. Paranoid
Answer: a. Avoidant
Question: What is the priority intervention for a nurse beginning a therapeutic relationship with a patient diagnosed with a schizotypal personality disorder?
Answer Choices: a. Respect the patient’s need for periods of social isolation b. Prevent the patient from violating the nurse’s rights c. Engage the patient in many community activities d. Teach the patient how to match clothing
Answer: a. Respect the patient’s need for periods of social isolation
Question: A patient diagnosed with borderline personality disorder self-inflicted wrist lacerations after gaining new privileges on the unit. The cause of the self-mutilation is probably related to what trigger?
Answer Choices: a. An inherited disorder that manifests itself as an incapacity to tolerate stress b. The use of projective identification and splitting to bring anxiety to manageable levels c. A constitutional inability to regulate affect, predisposing to psychic disorganization d. The fear of abandonment associated with progress toward autonomy and independence
Answer: d. The fear of abandonment associated with progress toward autonomy and independence
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 Choices: 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 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 Choices: a. Denial b. Splitting c. Reaction formation d. Separation-individuation strategies
Answer: b. Splitting
Question: Which characteristic of individuals diagnosed with personality disorders makes it most necessary for staff to schedule frequent meetings?
Answer Choices: 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 who has been diagnosed with schizoid personality disorder is newly admitted to the unit. What is the best initial nursing intervention?
Answer Choices: 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: 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 Choices: a. Reclusive behavior b. Callous attitude c. Perfectionism d. Aggression e. Clinging 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 Choices: a. Obsessive-compulsive b. Antisocial c. Dependent d. Schizotypal e. Narcissistic
Answer: a. Obsessive-compulsive b. Antisocial d. Schizotypal
Question: Over the past year, a woman has cooked gourmet meals for her family but eats only tiny servings. She wears layered, loose clothing and now has amenorrhea. Her current weight is 95 pounds, a loss of 35 pounds. Which medical diagnosis is most likely?
Answer Choices: a. Binge-eating disorder b. Anorexia nervosa c. Bulimia nervosa d. Pica
Answer: b. Anorexia nervosa