Chapter 22- personality disorders
The client diagnosed with antisocial personality disorder spits, curses, and refuses to
answer questions during the assessment interview. Which response would the nurse
make?
1. "You are very disrespectful. You need to learn to control yourself."
2. "I understand that you are angry, but this behavior will not be tolerated."
3. "What behaviors could you modify to improve this situation?"
4. "Which ant personality disorder medications have helped you in the past?" - 2
The appropriate nursing response is to reflect the client's feeling while setting firm limits
on behavior. Clients diagnosed with antisocial personality disorder have a low tolerance
for frustration, see themselves as victims, and use projection as a primary ego defense
mechanism.
At 11:30 p.m. the client diagnosed with antisocial personality disorder demands to
phone a lawyer to file for a divorce. Unit rules state that no phone calls are permitted
after 10 p.m. Which nursing response is most appropriate?
1. "Go ahead and use the phone. I know this pending divorce is stressful."
2. "You know better than to break the rules. I'm surprised at you."
3. "It is after the 10 p.m. phone curfew. You will be able to call tomorrow."
4. "A divorce shouldn't be considered until you have had a good night's sleep." - 3
The most appropriate response by the staff is to restate the unit rules in a calm,
assertive manner. The nurse can encourage the client to verbalize frustration while
maintaining an accepting attitude. The nurse may also help the client to identify the true
source of frustration.
The client diagnosed with paranoid personality disorder becomes aggressive on the
unit. Which nursing intervention is most appropriate?
1. Provide objective evidence that reasons for violence are unwarranted.
2. Initially restrain the client to maintain safety.
3. Use clear, calm statements with a confident physical stance.
4. Empathize with the client's paranoid perceptions. - The most appropriate nursing
intervention is to use clear, calm statements with a confident physical stance. A calm
attitude provides the client with a feeling of safety and security.
The client diagnosed with borderline personality disorder brings up a conflict with the
staff in a community meeting and develops a following of clients who unreasonably
demand modification of unit rules. How can the nursing staff best handle this situation?
1. Allow the clients to apply the autocratic process when developing unit rules.
2. Maintain consistency of care and open communication to avoid staff manipulation. 3.
Allow the client spokesman to verbalize concerns during a unit staff meeting.
4. Maintain unit order by the application of punitive leadership. - The nursing staff can
best handle this situation by maintaining consistency of care by open communication to
, avoid staff manipulation. Clients with borderline personality disorder can exhibit
negative patterns of interaction, such as clinging and distancing, splitting, manipulation,
and self-destructive behaviors.
Which approach should the nurse use to maintain a therapeutic relationship with a client
diagnosed with borderline personality disorder (BPD)?
1. Being firm, consistent, and empathic while addressing specific client behaviors
2. Promoting client self-expression by implementing laissez-faire leadership
3. Using authoritative leadership to help clients learn to conform to society norms
4. Overlooking inappropriate behaviors to avoid providing secondary gains - 1
The best nursing approach when working with a client diagnosed with borderline
personality disorder is to be firm, consistent, and empathetic while addressing specific
client behaviors. Individuals with borderline personality disorder always seem to be in a
state of crisis and can often have negative patterns of interaction, such as manipulation
and splitting.
Which physically healthy adult client should a nurse identify as exhibiting the
characteristics of a dependent personality disorder?
1. Meets social needs by contact with 15 cats
2. Has a history of depending on intense relationships to meet basic needs
3. Lives with parents and relies totally on public transportation
4. Is serious, inflexible, and lacks spontaneity - 3
An adult client who lives with parents and totally relies upon public transportation
exhibits signs of dependent personality disorder. Dependent personality disorder is
characterized by a pervasive and excessive need to be taken care of that leads to
submissive behaviors.
The client expresses low self-worth, has much difficulty making decisions, avoids
positions of responsibility, and has a behavioral pattern of "suffering" in silence. Which
information best explains the childhood nurturance of this client's personality disorder?
1. Was provided from many sources, and independent behaviors were encouraged
2. Was provided exclusively from one source, and independent behaviors were
discouraged
3. Was provided exclusively from one source, and independent behaviors were
encouraged
4. Was provided from many sources, and independent behaviors were discouraged - 2
The behaviors presented in the question represent symptoms of dependent personality
disorder. Nurturance provided from one source and discouragement of independent
behaviors can contribute to the development of this personality disorder. Dependent
behaviors may be rewarded by a parent who is overprotective and discourages
autonomy.
Family members of a client ask the nurse to explain the difference between schizoid
and avoidant personality disorders. Which nursing response is appropriate?
1. Clients diagnosed with avoidant personality disorder desire intimacy but fear it, and
clients diagnosed with schizoid personality disorder prefer to be alone.
The client diagnosed with antisocial personality disorder spits, curses, and refuses to
answer questions during the assessment interview. Which response would the nurse
make?
1. "You are very disrespectful. You need to learn to control yourself."
2. "I understand that you are angry, but this behavior will not be tolerated."
3. "What behaviors could you modify to improve this situation?"
4. "Which ant personality disorder medications have helped you in the past?" - 2
The appropriate nursing response is to reflect the client's feeling while setting firm limits
on behavior. Clients diagnosed with antisocial personality disorder have a low tolerance
for frustration, see themselves as victims, and use projection as a primary ego defense
mechanism.
At 11:30 p.m. the client diagnosed with antisocial personality disorder demands to
phone a lawyer to file for a divorce. Unit rules state that no phone calls are permitted
after 10 p.m. Which nursing response is most appropriate?
1. "Go ahead and use the phone. I know this pending divorce is stressful."
2. "You know better than to break the rules. I'm surprised at you."
3. "It is after the 10 p.m. phone curfew. You will be able to call tomorrow."
4. "A divorce shouldn't be considered until you have had a good night's sleep." - 3
The most appropriate response by the staff is to restate the unit rules in a calm,
assertive manner. The nurse can encourage the client to verbalize frustration while
maintaining an accepting attitude. The nurse may also help the client to identify the true
source of frustration.
The client diagnosed with paranoid personality disorder becomes aggressive on the
unit. Which nursing intervention is most appropriate?
1. Provide objective evidence that reasons for violence are unwarranted.
2. Initially restrain the client to maintain safety.
3. Use clear, calm statements with a confident physical stance.
4. Empathize with the client's paranoid perceptions. - The most appropriate nursing
intervention is to use clear, calm statements with a confident physical stance. A calm
attitude provides the client with a feeling of safety and security.
The client diagnosed with borderline personality disorder brings up a conflict with the
staff in a community meeting and develops a following of clients who unreasonably
demand modification of unit rules. How can the nursing staff best handle this situation?
1. Allow the clients to apply the autocratic process when developing unit rules.
2. Maintain consistency of care and open communication to avoid staff manipulation. 3.
Allow the client spokesman to verbalize concerns during a unit staff meeting.
4. Maintain unit order by the application of punitive leadership. - The nursing staff can
best handle this situation by maintaining consistency of care by open communication to
, avoid staff manipulation. Clients with borderline personality disorder can exhibit
negative patterns of interaction, such as clinging and distancing, splitting, manipulation,
and self-destructive behaviors.
Which approach should the nurse use to maintain a therapeutic relationship with a client
diagnosed with borderline personality disorder (BPD)?
1. Being firm, consistent, and empathic while addressing specific client behaviors
2. Promoting client self-expression by implementing laissez-faire leadership
3. Using authoritative leadership to help clients learn to conform to society norms
4. Overlooking inappropriate behaviors to avoid providing secondary gains - 1
The best nursing approach when working with a client diagnosed with borderline
personality disorder is to be firm, consistent, and empathetic while addressing specific
client behaviors. Individuals with borderline personality disorder always seem to be in a
state of crisis and can often have negative patterns of interaction, such as manipulation
and splitting.
Which physically healthy adult client should a nurse identify as exhibiting the
characteristics of a dependent personality disorder?
1. Meets social needs by contact with 15 cats
2. Has a history of depending on intense relationships to meet basic needs
3. Lives with parents and relies totally on public transportation
4. Is serious, inflexible, and lacks spontaneity - 3
An adult client who lives with parents and totally relies upon public transportation
exhibits signs of dependent personality disorder. Dependent personality disorder is
characterized by a pervasive and excessive need to be taken care of that leads to
submissive behaviors.
The client expresses low self-worth, has much difficulty making decisions, avoids
positions of responsibility, and has a behavioral pattern of "suffering" in silence. Which
information best explains the childhood nurturance of this client's personality disorder?
1. Was provided from many sources, and independent behaviors were encouraged
2. Was provided exclusively from one source, and independent behaviors were
discouraged
3. Was provided exclusively from one source, and independent behaviors were
encouraged
4. Was provided from many sources, and independent behaviors were discouraged - 2
The behaviors presented in the question represent symptoms of dependent personality
disorder. Nurturance provided from one source and discouragement of independent
behaviors can contribute to the development of this personality disorder. Dependent
behaviors may be rewarded by a parent who is overprotective and discourages
autonomy.
Family members of a client ask the nurse to explain the difference between schizoid
and avoidant personality disorders. Which nursing response is appropriate?
1. Clients diagnosed with avoidant personality disorder desire intimacy but fear it, and
clients diagnosed with schizoid personality disorder prefer to be alone.
