ELITE COMPREHENSIVE
VARCAROLIS — CHT 24 PERSONALITY DISORDERS
Advanced Comprehensive Psychiatric–Mental Health
Nursing Review
HESI • Mental Health Nursing Final Exam Preparation
SPRING SEMESTER EXAMINATION MAY 2026
1. A health care provider recently convicted of Medicare fraud says to a nurse, "Sure I
overbilled. Everyone takes advantage of the government. There are too many rules to
follow and I should get the money." These statements show:
a. shame.
b. suspiciousness
c. superficial remorse.
d. lack of guilt feelings.
• ANS: D
• Rationalization is being used to explain behavior and deny
wrongdoing. The individual who does not believe he or she has done
anything wrong will not manifest anxiety, remorse, or guilt about the
act. The patient's remarks cannot be assessed as shameful. Lack of
trust and concern that others are determined to do harm is not
shown.
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,2. Which intervention is appropriate for an individual diagnosed with an antisocial
personality disorder who frequently manipulates others?
a. Refer requests and questions related to care to the case manager.
b. Encourage the patient to discuss feelings of fear and inferiority.
c. Provide negative reinforcement for acting-out behavior.
d. Ignore, rather than confront, inappropriate behavior.
• ANS: A
• Manipulative people frequently make requests of many different staff,
hoping one will give in. Having one decision maker provides
consistency and avoids the potential for playing one staff member
against another. Positive reinforcement of appropriate behaviors is
more effective than negative reinforcement. The behavior should not
be ignored; judicious use of confrontation is necessary. Patients with
antisocial personality disorders rarely have feelings of fear and
inferiority.
3. As a nurse prepares to administer 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?
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, a. Reinforce this assertive action by the patient. Leave the medication on the table as
requested.
b. Respond to the patient, "I'm worried that you might not take it. I'll come back later."
c. Say to the patient, "I must watch you take the medication. Please take it now."
d. Ask the patient, "Why don't you want to take your medication now?"
• ANS: C
• The individual with a borderline personality disorder characteristically
demonstrates manipulative, splitting, and self-destructive behaviors.
Consistent limit setting is vital for the patient's safety, but also to
prevent splitting other staff. "Why" questions are not therapeutic. See
relationship to audience response question.
4. What is an appropriate initial outcome for a patient diagnosed with a personality
disorder who frequently manipulates others? The patient will:
a. identify when feeling angry.
b. use manipulation only to get legitimate needs met.
c. acknowledge manipulative behavior when it is called to his or her attention.
d. accept fulfillment of his or her requests within an hour rather than immediately.
• ANS: C
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VARCAROLIS — CHT 24 PERSONALITY DISORDERS
Advanced Comprehensive Psychiatric–Mental Health
Nursing Review
HESI • Mental Health Nursing Final Exam Preparation
SPRING SEMESTER EXAMINATION MAY 2026
1. A health care provider recently convicted of Medicare fraud says to a nurse, "Sure I
overbilled. Everyone takes advantage of the government. There are too many rules to
follow and I should get the money." These statements show:
a. shame.
b. suspiciousness
c. superficial remorse.
d. lack of guilt feelings.
• ANS: D
• Rationalization is being used to explain behavior and deny
wrongdoing. The individual who does not believe he or she has done
anything wrong will not manifest anxiety, remorse, or guilt about the
act. The patient's remarks cannot be assessed as shameful. Lack of
trust and concern that others are determined to do harm is not
shown.
1|Page
,2. Which intervention is appropriate for an individual diagnosed with an antisocial
personality disorder who frequently manipulates others?
a. Refer requests and questions related to care to the case manager.
b. Encourage the patient to discuss feelings of fear and inferiority.
c. Provide negative reinforcement for acting-out behavior.
d. Ignore, rather than confront, inappropriate behavior.
• ANS: A
• Manipulative people frequently make requests of many different staff,
hoping one will give in. Having one decision maker provides
consistency and avoids the potential for playing one staff member
against another. Positive reinforcement of appropriate behaviors is
more effective than negative reinforcement. The behavior should not
be ignored; judicious use of confrontation is necessary. Patients with
antisocial personality disorders rarely have feelings of fear and
inferiority.
3. As a nurse prepares to administer 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?
2|Page
, a. Reinforce this assertive action by the patient. Leave the medication on the table as
requested.
b. Respond to the patient, "I'm worried that you might not take it. I'll come back later."
c. Say to the patient, "I must watch you take the medication. Please take it now."
d. Ask the patient, "Why don't you want to take your medication now?"
• ANS: C
• The individual with a borderline personality disorder characteristically
demonstrates manipulative, splitting, and self-destructive behaviors.
Consistent limit setting is vital for the patient's safety, but also to
prevent splitting other staff. "Why" questions are not therapeutic. See
relationship to audience response question.
4. What is an appropriate initial outcome for a patient diagnosed with a personality
disorder who frequently manipulates others? The patient will:
a. identify when feeling angry.
b. use manipulation only to get legitimate needs met.
c. acknowledge manipulative behavior when it is called to his or her attention.
d. accept fulfillment of his or her requests within an hour rather than immediately.
• ANS: C
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