Question 1

An experienced nurse is teaching a student nurse about personality disorders in the older adult population.Which of the following statements by the student nurse would indicate a need for further education?

Accepted Answer

The statement "Antisocial personality disorder tends to worsen as a person moves from middle age into older adulthood" is incorrect. Antisocial personality disorder is a pervasive pattern of disregard for and violation of the rights of others that begins in childhood or early adolescence, and symptoms tend to stabilize or improve with age. Therefore, this statement indicates a need for further education. The other statements are correct and do not require further education.

Question 2

In an adult client,the presence of lanugo and dry,brittle nails is suggestive of which of the following conditions?

Accepted Answer

The presence of lanugo (fine, downy hair) indicates that the client is likely experiencing malnutrition, which is common in anorexia nervosa. Dry, brittle nails can also be a symptom of malnutrition. Bulimia nervosa may not present with these specific physical symptoms, and binge-eating disorder and pica do not typically involve the restrictive eating seen in anorexia nervosa.

Question 3

A nurse working on the behavioral health unit is developing a plan of care for a client.The client does not interact with others,refuses to attend group sessions,and has a history of throwing things at other clients.Which of the following is the priority nursing diagnosis for this client?

Accepted Answer

The priority nursing diagnosis for this client is Risk for Other-Directed Violence, as the client has a history of throwing things at other clients, which puts them and other clients at risk for harm. Ineffective Coping, Social Isolation, and Impaired Social Interaction are also appropriate nursing diagnoses for this client, but addressing the risk for violence is the priority at this time.

Question 4

An experienced nurse practitioner is teaching a student nurse about feeding and eating disorders in the pediatric population.Which of the following statements from the student nurse indicates that more education is necessary?

Accepted Answer

A)ARFID is the most significant eating disorder diagnosis among children. The ARFID diagnosis eliminates picky eaters by identifying only those children with clinically significant restrictive eating problems that result in persistent failure to meet the child's nutritional and/or energy needs. In recent years, higher rates of eating disorders have been observed in younger children, boys, and minority groups than in years past. Still, eating disorders remain underdiagnosed in the pediatric population. Thus, the nurse's statement that eating disorders are overdiagnosed in children indicates the need for further education.
B)ARFID is the most significant eating disorder diagnosis among children. The ARFID diagnosis eliminates picky eaters by identifying only those children with clinically significant restrictive eating problems that result in persistent failure to meet the child's nutritional and/or energy needs. In recent years, higher rates of eating disorders have been observed in younger children, boys, and minority groups than in years past. Still, eating disorders remain underdiagnosed in the pediatric population. Thus, the nurse's statement that eating disorders are overdiagnosed in children indicates the need for further education.
C)ARFID is the most significant eating disorder diagnosis among children. The ARFID diagnosis eliminates picky eaters by identifying only those children with clinically significant restrictive eating problems that result in persistent failure to meet the child's nutritional and/or energy needs. In recent years, higher rates of eating disorders have been observed in younger children, boys, and minority groups than in years past. Still, eating disorders remain underdiagnosed in the pediatric population. Thus, the nurse's statement that eating disorders are overdiagnosed in children indicates the need for further education.
D)ARFID is the most significant eating disorder diagnosis among children. The ARFID diagnosis eliminates picky eaters by identifying only those children with clinically significant restrictive eating problems that result in persistent failure to meet the child's nutritional and/or energy needs. In recent years, higher rates of eating disorders have been observed in younger children, boys, and minority groups than in years past. Still, eating disorders remain underdiagnosed in the pediatric population. Thus, the nurse's statement that eating disorders are overdiagnosed in children indicates the need for further education.

Question 5

A client tells the nurse,"My mother spent many years in a mental institution,and my father would abuse me when my mother was not around." Based on this information,the client is at greatest risk for developing which of the following conditions?

Accepted Answer

A)Risk factors for the development of personality disorders include a family history of mental illness, a history of abuse, instability in family life, and a personal history of other mental illnesses. The client's statement mentions several of these risk factors. Based on the information presented, this client is not necessarily at high risk for an eating disorder, poor relationships with individuals of the opposite sex, or substance abuse.
B)Risk factors for the development of personality disorders include a family history of mental illness, a history of abuse, instability in family life, and a personal history of other mental illnesses. The client's statement mentions several of these risk factors. Based on the information presented, this client is not necessarily at high risk for an eating disorder, poor relationships with individuals of the opposite sex, or substance abuse.
C)Risk factors for the development of personality disorders include a family history of mental illness, a history of abuse, instability in family life, and a personal history of other mental illnesses. The client's statement mentions several of these risk factors. Based on the information presented, this client is not necessarily at high risk for an eating disorder, poor relationships with individuals of the opposite sex, or substance abuse.
D)Risk factors for the development of personality disorders include a family history of mental illness, a history of abuse, instability in family life, and a personal history of other mental illnesses. The client's statement mentions several of these risk factors. Based on the information presented, this client is not necessarily at high risk for an eating disorder, poor relationships with individuals of the opposite sex, or substance abuse.

Question 6

A client who has been diagnosed with a personality disorder tells the nurse,"Sometimes I daydream that I go home and kill my family." Which of the following is the priority nursing diagnosis for this client?

Accepted Answer

The client's statement indicates a high risk for other-directed violence, which is a priority concern for the safety of the client and others. Ineffective Coping may also be relevant, but it is not as urgent as the risk for violence. Deficient Knowledge and Dysfunctional Family Processes are not directly related to the client's statement about harming their family.

Question 7

An adolescent client tells the nurse that she plans to fight recent charges of shoplifting because she was just taking what was rightfully hers.Which trait associated with personality disorders is this client exhibiting?

Accepted Answer

The client is exhibiting narcissism, which is a trait commonly seen in personality disorders. Narcissistic individuals often have an inflated sense of self-importance and entitlement, believing that they are above the rules and that they deserve special treatment. This can lead them to engage in behaviors such as lying, manipulation, and projection in order to get what they want or to avoid consequences for their actions.

Question 8

A college student tells the nurse about being "out of control" with eating.The client states,"I am trying to keep my weight down so my mom doesn't call me fat.Usually,I make myself throw up after eating." Based on this data,the nurse should plan on providing care for which of the following disorders?

Accepted Answer

The client's behavior of making herself throw up after eating and being motivated by a desire to keep her weight down and avoid criticism from her mother is consistent with the diagnosis of bulimia nervosa. Binge-eating disorder involves recurrent episodes of eating large amounts of food without purging behaviors. Anorexia nervosa is characterized by restriction of food intake and an intense fear of gaining weight. Purging disorder is characterized by recurrent purging behaviors without binge eating episodes.

Question 9

The nurse is planning care for a client who has been diagnosed with antisocial personality disorder.Which goals address the client's antisocial behavior? Select all that apply.

Accepted Answer

A)This client is demonstrating antisocial behavior. Goals that address antisocial behavior are for the client to interact socially with others and to share meals in the community dining area. The other goals would not specifically measure the effectiveness of interventions to address the client's antisocial behavior.
B)This client is demonstrating antisocial behavior. Goals that address antisocial behavior are for the client to interact socially with others and to share meals in the community dining area. The other goals would not specifically measure the effectiveness of interventions to address the client's antisocial behavior.
C)This client is demonstrating antisocial behavior. Goals that address antisocial behavior are for the client to interact socially with others and to share meals in the community dining area. The other goals would not specifically measure the effectiveness of interventions to address the client's antisocial behavior.
D)This client is demonstrating antisocial behavior. Goals that address antisocial behavior are for the client to interact socially with others and to share meals in the community dining area. The other goals would not specifically measure the effectiveness of interventions to address the client's antisocial behavior.
E)This client is demonstrating antisocial behavior. Goals that address antisocial behavior are for the client to interact socially with others and to share meals in the community dining area. The other goals would not specifically measure the effectiveness of interventions to address the client's antisocial behavior.

Question 10

A nurse is caring for a pregnant client who has a history of bulimia nervosa.Which of the following statements should the nurse include when counseling this client about the potential effects of pregnancy on eating disorder?

Accepted Answer

Women with a history of bulimia nervosa are at increased risk of developing binge eating behaviors during pregnancy. Hormonal changes and body image concerns may exacerbate the disorder, and the stress of pregnancy and childbirth can also be a trigger for disordered eating behaviors. Therefore, it is important for the nurse to counsel the client about the potential risks and to provide resources for support and treatment. Choices B, C, and D are not accurate and could be potentially harmful or misleading for the client.

Question 11

The nurse is providing care to a client who has been diagnosed with a personality disorder.Which finding indicates that the treatment plan has been beneficial for this client?

Accepted Answer

Sitting with others in the lounge area and engaging in conversation about current affairs shows a positive change in the client's behavior and socialization skills, indicating that the treatment plan may have been beneficial. Choices A and B indicate ongoing symptoms of a personality disorder, and choice C suggests the client may be engaging in manipulative behavior.

Question 12

A client is admitted with behavior consistent with borderline personality disorder.Which of the following interventions should the nurse anticipate for this client?

Accepted Answer

Dialectical behavior therapy, or DBT, is a specialized psychotherapy approach designed specifically for individuals with borderline personality disorder. It involves a combination of individual therapy, group therapy, skills training, and phone coaching. DBT has been shown to be effective in reducing self-harm and suicide attempts in individuals with borderline personality disorder. The other options (exercise therapy, vitamin injections, and occupational therapy) may be helpful for some aspects of the client's care, but are not specific interventions for borderline personality disorder.

Question 13

Which of the following personality disorders is characterized by an inability to trust others;a rigid worldview that often conspiratorial in nature;and the belief that other people's actions are based on ulterior motives?

Accepted Answer

These are all symptoms of paranoid personality disorder, including an inability to trust others, a suspicious nature, and a belief that others have ulterior motives. Obsessive-compulsive personality disorder, on the other hand, is characterized by a need for control and perfectionism, while schizoid and schizotypal personality disorders involve detachment, social isolation, and odd or eccentric beliefs or behaviors.

Question 14

Why is the presence of dental caries and enamel erosion more suggestive of bulimia nervosa than of anorexia nervosa?

Accepted Answer

Clients with bulimia nervosa often purge by vomiting, which means their teeth are frequently exposed to the highly acidic contents of the stomach. This can lead to dental caries and enamel erosion. Clients with anorexia nervosa do not typically engage in purging behavior, so dental problems related to bulimia are more suggestive of bulimia nervosa.

Question 15

Which of the following manifestations would the nurse least likely observe in a client with a Cluster B personality disorder?

Accepted Answer

Cluster B personality disorders (borderline, narcissistic, histrionic, and antisocial) are characterized by dramatic, erratic, and emotional behaviors. Extreme fearfulness would be more commonly associated with Cluster C personality disorders (avoidant, dependent, and obsessive-compulsive).

Question 16

The parents of an adolescent client tell the nurse that their daughter is very shy,exhibits intense anxiety about new people and situations,and tends to internalize negative comments from her peers.They ask the nurse whether they should be concerned about this behavior.What is the nurse's best response?

Accepted Answer

The best response is D because it acknowledges that some of the behaviors described are developmentally appropriate for adolescents but also acknowledges that persistent or severe impairment may suggest a personality disorder. It avoids making diagnostic assumptions or alarming the parents unnecessarily while still encouraging them to seek further evaluation if necessary. Choices A and B are not appropriate because making diagnostic assumptions and discussing personality disorders may unintentionally cause anxiety for the parents and may not accurately reflect the client's situation. Choice C implies that the behaviors will naturally resolve without further evaluation or intervention, which may not be the case.

Question 17

A nurse working on the behavioral health unit is caring for a client with histrionic personality disorder.Which types of behaviors should the nurse anticipate when assessing this client? Select all that apply.

Accepted Answer

A)Clients with histrionic personality disorder tend to be flamboyant and dramatic, and they seek to be the center of attention. Competitiveness, arrogance, and manipulative behaviors are more commonly associated with narcissistic personality disorder.
B)Clients with histrionic personality disorder tend to be flamboyant and dramatic, and they seek to be the center of attention. Competitiveness, arrogance, and manipulative behaviors are more commonly associated with narcissistic personality disorder.
C)Clients with histrionic personality disorder tend to be flamboyant and dramatic, and they seek to be the center of attention. Competitiveness, arrogance, and manipulative behaviors are more commonly associated with narcissistic personality disorder.
D)Clients with histrionic personality disorder tend to be flamboyant and dramatic, and they seek to be the center of attention. Competitiveness, arrogance, and manipulative behaviors are more commonly associated with narcissistic personality disorder.
E)Clients with histrionic personality disorder tend to be flamboyant and dramatic, and they seek to be the center of attention. Competitiveness, arrogance, and manipulative behaviors are more commonly associated with narcissistic personality disorder.

Question 18

The nurse is providing care to a client who has been diagnosed with a personality disorder.Which treatment options should the nurse anticipate for this client? Select all that apply.

Accepted Answer

A)For a client who has been diagnosed with a personality disorder, the nurse would anticipate antipsychotic medication, antidepressant medication, and cognitive-behavioral therapy. Nutritional counseling and a weight management program would be more appropriate for a client with an eating disorder.
B)For a client who has been diagnosed with a personality disorder, the nurse would anticipate antipsychotic medication, antidepressant medication, and cognitive-behavioral therapy. Nutritional counseling and a weight management program would be more appropriate for a client with an eating disorder.
C)For a client who has been diagnosed with a personality disorder, the nurse would anticipate antipsychotic medication, antidepressant medication, and cognitive-behavioral therapy. Nutritional counseling and a weight management program would be more appropriate for a client with an eating disorder.
D)For a client who has been diagnosed with a personality disorder, the nurse would anticipate antipsychotic medication, antidepressant medication, and cognitive-behavioral therapy. Nutritional counseling and a weight management program would be more appropriate for a client with an eating disorder.
E)For a client who has been diagnosed with a personality disorder, the nurse would anticipate antipsychotic medication, antidepressant medication, and cognitive-behavioral therapy. Nutritional counseling and a weight management program would be more appropriate for a client with an eating disorder.

Question 19

A client who was admitted for treatment of a personality disorder is observed pulling another client's hair and pushing clients out of their chairs.What is the priority nursing intervention for this client?

Accepted Answer

The safety of other clients is the priority in this situation. The client needs to be removed from the room to prevent further acts of aggression, and the behavior needs to be addressed privately to maintain confidentiality and avoid shaming or embarrassing the client.

Quiz 29: Self