Personality Disorders NCLEX TYPE
Exam Questions with Correct Answers
A 36-year-old client with paranoid schizophrenia believes the room is bugged by the
Central Intelligence Agency and a roommate is a foreign spy. The client has never
had a romantic relationship, has no contact with family, and hasn't been employed
for the past 14 years. Based on Erikson's theories, the nurse should recognize that
this client is in which stage of psychosocial development?
A. Autonomy versus shame and doubt
B. Generativity versus stagnation
C. Integrity versus despair
D. Trust versus mistrust - ANSWER-D
This client's paranoid ideation indicates difficulty in trusting others.
Before eating a meal, a client with obsessive-compulsive disorder must wash his
hands for 18 minutes, comb his hair 444 strokes, and switch the bathroom light on
and off 44 times. What is the most appropriate long-term treatment goal for this
client?
A. Omit one unacceptable behavior each day
B. Increase the client's acceptance of therapeutic drug use
C. Allow ample time for the client to complete all rituals before each meal
D. Systematically decrease the amount of time spent in - and the number of
repetitions of - rituals - ANSWER-D
When treating a client with obsessive-compulsive disorder, the long-term goal is to
systematically decrease the undesirable behavior.
The nurse counsels a client with obsessive-compulsive disorder. Which statement by
the client indicates the need for reassessment?
A. "I must work overtime every night this week or the job won't get done right."
B. "I'm working on developing a relationship with one coworker whom I like."
C. "I've decided I won't be able to go to the islands for my vacation."
D. "I may never have many people in my life except for my family." - ANSWER-A
The perception that the client needs to work overtime every night indicates a
perfectionist tendency and an excessive focus on work to the exclusion of social or
leisure activities.
A client with antisocial personality disorder smokes where it is prohibited and doesn't
follow other unit or facility rules. The client gets others to do the laundry and other
personal chores, tries to divide the staff, and works only with certain nurses. The
primary focus on this client's care plan should be:
A. consistently enforcing unit rules and facility policy
B. isolating the client to decrease contact with easily manipulated clients
C. engaging in power struggles with the client to decrease the incidence of
manipulative behavior
,D. using behavior modification to decrease the amount of negative behavior by using
negative reinforcement - ANSWER-A
Firmness and consistency about rules are the hallmarks of a care plan for a client
with a personality disorder.
During a private conversation, a client with borderline personality disorder asks the
nurse to "keep my secret" and then displays multiple, self-inflicted, superficial
lacerations on the forearms. What is the nurse's best response?
A. "This type of behavior requires you to be on suicide precautions."
B. "I'm going to tell your physician. Do you want to tell me why you did that?"
C. "Tell me what type of instrument you used. I'm concerned about infection."
D. "Whenever something important occurs, the team needs to know about it. I'll have
to tell the others, but let's talk about it first." - ANSWER-D
This response informs the client of the nurse's planned actions and allows time to
discuss the client's action.
Which nursing intervention is most appropriate for a client with obsessive-compulsive
disorder?
A. Encouraging the client to concentrate on and pay attention to unwanted thoughts
B. Giving antipsychotic medications as needed
C. Interrupting the client's ritual to empower the client in gaining control over the
ritual
D. Allowing the client to carry out his rituals - ANSWER-D
allowing the client to carry out rituals is important because such behavior is aimed at
preventing or reducing distress or preventing some dreaded event or situation from
occurring.
The nurse is assessing the client with paranoid personality disorder. Which behavior
should the nurse expect?
A. Able to trust only those who are fair and treat the client well
B. Sees the goodwill of another when that behavior does not exist
C. Acts the opposite of what the client may be thinking or feeling
D. Analyzes the behavior of others to find hidden and threatening meanings -
ANSWER-D
The client with paranoid personality disorder exhibits mistrust and suspicion of others
such that the behavior of others is analyzed to find hidden and threatening
meanings.
The nurse identifies that an individual with antisocial personality disorder exhibits
poor judgment, emotional distance, aggression, and impulsivity. Which step of the
nursing process is being completed by the nurse?
A. Assessment
B. Diagnosis
C. Outcome Identification
D. Planning
E. Implementation
F. Evaluation - ANSWER-A
The nurse is completing an assessment of the client by collecting information about
the client's behavior.
, The nurse is working with the client with paranoid personality disorder. The nurse
understands that the client likely experienced what in the past?
A. Little affection or approval during the childhood years
B. Lack of empathy and lack of nurturing during upbringing
C. Indifference and lack of affection during early upbringing
D. Recognition for accomplishments only in early childhood - ANSWER-A
Individuals with paranoid personality disorder may have been subjected to parental
antagonism and harassment. They served as scapegoats for displaced parental
aggression and eventually gave up all hope of affection and approval.
The nurse is caring for the client with paranoid personality disorder. Which approach
should the nurse use when working with the client?
A. Use a businesslike manner using clear, concrete, and specific words
B. First use social conversation to work on developing social relationships
C. Include jokes when conversing to work on reducing the client's serious behavior
D. Confront the client when stating suspicious ideas to aid the client in seeing reality
- ANSWER-A
Clients with paranoid personality disorder take everything seriously and are attuned
to the actions and motivations of others. A businesslike approach with clear,
concrete, and specific words keeps the intended message clear by decreasing
ambiguity.
The nurse reads in the medical record that the client with BPD has "splitting." What
is the nurse's interpretation of "splitting?"
A. The client is having an intense psychotic episode and has become catatonic
B. The client has an identity disturbance with an unstable self-image or sense of self
C. The client is using a defense mechanism in which all objects are seen as good or
bad
D. The client's behavior shows a pattern of unstable and intense interpersonal
relationships - ANSWER-C
Splitting is a primitive defense mechanism in which all objects, individuals, or
situations are seen as good or bad. Individuals with BPD have an inability to accept
and integrate positive and negative feelings.
The nurse is working with the client with histrionic personality disorder. Which
behaviors should the nurse expect? (Select all that apply)
A. Uses physical appearance to gain attention
B. Shows apathy in conversations until trust is established
C. Lacks close friends or companions other than first-degree relatives
D. Harbors recurrent suspicions about the fidelity of his or her marital partner
E. Discomfort in situations in which the client is not the center of attention -
ANSWER-A,E
-The client with histrionic personality disorder requires constant affirmation of
approval and acceptance from others and often uses physical appearance to gain
attention and approval.
-Diagnostic criteria for histrionic personality disorder include discomfort in situations
in which the client is not the center of attention. The client requires constant
affirmation of approval and acceptance from others.
Exam Questions with Correct Answers
A 36-year-old client with paranoid schizophrenia believes the room is bugged by the
Central Intelligence Agency and a roommate is a foreign spy. The client has never
had a romantic relationship, has no contact with family, and hasn't been employed
for the past 14 years. Based on Erikson's theories, the nurse should recognize that
this client is in which stage of psychosocial development?
A. Autonomy versus shame and doubt
B. Generativity versus stagnation
C. Integrity versus despair
D. Trust versus mistrust - ANSWER-D
This client's paranoid ideation indicates difficulty in trusting others.
Before eating a meal, a client with obsessive-compulsive disorder must wash his
hands for 18 minutes, comb his hair 444 strokes, and switch the bathroom light on
and off 44 times. What is the most appropriate long-term treatment goal for this
client?
A. Omit one unacceptable behavior each day
B. Increase the client's acceptance of therapeutic drug use
C. Allow ample time for the client to complete all rituals before each meal
D. Systematically decrease the amount of time spent in - and the number of
repetitions of - rituals - ANSWER-D
When treating a client with obsessive-compulsive disorder, the long-term goal is to
systematically decrease the undesirable behavior.
The nurse counsels a client with obsessive-compulsive disorder. Which statement by
the client indicates the need for reassessment?
A. "I must work overtime every night this week or the job won't get done right."
B. "I'm working on developing a relationship with one coworker whom I like."
C. "I've decided I won't be able to go to the islands for my vacation."
D. "I may never have many people in my life except for my family." - ANSWER-A
The perception that the client needs to work overtime every night indicates a
perfectionist tendency and an excessive focus on work to the exclusion of social or
leisure activities.
A client with antisocial personality disorder smokes where it is prohibited and doesn't
follow other unit or facility rules. The client gets others to do the laundry and other
personal chores, tries to divide the staff, and works only with certain nurses. The
primary focus on this client's care plan should be:
A. consistently enforcing unit rules and facility policy
B. isolating the client to decrease contact with easily manipulated clients
C. engaging in power struggles with the client to decrease the incidence of
manipulative behavior
,D. using behavior modification to decrease the amount of negative behavior by using
negative reinforcement - ANSWER-A
Firmness and consistency about rules are the hallmarks of a care plan for a client
with a personality disorder.
During a private conversation, a client with borderline personality disorder asks the
nurse to "keep my secret" and then displays multiple, self-inflicted, superficial
lacerations on the forearms. What is the nurse's best response?
A. "This type of behavior requires you to be on suicide precautions."
B. "I'm going to tell your physician. Do you want to tell me why you did that?"
C. "Tell me what type of instrument you used. I'm concerned about infection."
D. "Whenever something important occurs, the team needs to know about it. I'll have
to tell the others, but let's talk about it first." - ANSWER-D
This response informs the client of the nurse's planned actions and allows time to
discuss the client's action.
Which nursing intervention is most appropriate for a client with obsessive-compulsive
disorder?
A. Encouraging the client to concentrate on and pay attention to unwanted thoughts
B. Giving antipsychotic medications as needed
C. Interrupting the client's ritual to empower the client in gaining control over the
ritual
D. Allowing the client to carry out his rituals - ANSWER-D
allowing the client to carry out rituals is important because such behavior is aimed at
preventing or reducing distress or preventing some dreaded event or situation from
occurring.
The nurse is assessing the client with paranoid personality disorder. Which behavior
should the nurse expect?
A. Able to trust only those who are fair and treat the client well
B. Sees the goodwill of another when that behavior does not exist
C. Acts the opposite of what the client may be thinking or feeling
D. Analyzes the behavior of others to find hidden and threatening meanings -
ANSWER-D
The client with paranoid personality disorder exhibits mistrust and suspicion of others
such that the behavior of others is analyzed to find hidden and threatening
meanings.
The nurse identifies that an individual with antisocial personality disorder exhibits
poor judgment, emotional distance, aggression, and impulsivity. Which step of the
nursing process is being completed by the nurse?
A. Assessment
B. Diagnosis
C. Outcome Identification
D. Planning
E. Implementation
F. Evaluation - ANSWER-A
The nurse is completing an assessment of the client by collecting information about
the client's behavior.
, The nurse is working with the client with paranoid personality disorder. The nurse
understands that the client likely experienced what in the past?
A. Little affection or approval during the childhood years
B. Lack of empathy and lack of nurturing during upbringing
C. Indifference and lack of affection during early upbringing
D. Recognition for accomplishments only in early childhood - ANSWER-A
Individuals with paranoid personality disorder may have been subjected to parental
antagonism and harassment. They served as scapegoats for displaced parental
aggression and eventually gave up all hope of affection and approval.
The nurse is caring for the client with paranoid personality disorder. Which approach
should the nurse use when working with the client?
A. Use a businesslike manner using clear, concrete, and specific words
B. First use social conversation to work on developing social relationships
C. Include jokes when conversing to work on reducing the client's serious behavior
D. Confront the client when stating suspicious ideas to aid the client in seeing reality
- ANSWER-A
Clients with paranoid personality disorder take everything seriously and are attuned
to the actions and motivations of others. A businesslike approach with clear,
concrete, and specific words keeps the intended message clear by decreasing
ambiguity.
The nurse reads in the medical record that the client with BPD has "splitting." What
is the nurse's interpretation of "splitting?"
A. The client is having an intense psychotic episode and has become catatonic
B. The client has an identity disturbance with an unstable self-image or sense of self
C. The client is using a defense mechanism in which all objects are seen as good or
bad
D. The client's behavior shows a pattern of unstable and intense interpersonal
relationships - ANSWER-C
Splitting is a primitive defense mechanism in which all objects, individuals, or
situations are seen as good or bad. Individuals with BPD have an inability to accept
and integrate positive and negative feelings.
The nurse is working with the client with histrionic personality disorder. Which
behaviors should the nurse expect? (Select all that apply)
A. Uses physical appearance to gain attention
B. Shows apathy in conversations until trust is established
C. Lacks close friends or companions other than first-degree relatives
D. Harbors recurrent suspicions about the fidelity of his or her marital partner
E. Discomfort in situations in which the client is not the center of attention -
ANSWER-A,E
-The client with histrionic personality disorder requires constant affirmation of
approval and acceptance from others and often uses physical appearance to gain
attention and approval.
-Diagnostic criteria for histrionic personality disorder include discomfort in situations
in which the client is not the center of attention. The client requires constant
affirmation of approval and acceptance from others.
