Question 1

When a patient diagnosed with a personality disorder uses manipulation to get needs met, the staff applies limit-setting interventions. What is the correct rationale for this action?

Accepted Answer

Limit-setting interventions are used because individuals with personality disorders often lack internal controls, and external controls help manage their behavior effectively.

Question 2

What is an appropriate initial outcome for a patient diagnosed with a personality disorder who has impulse control interferences?

Accepted Answer

Identifying harmful impulsive behaviors is a realistic and foundational step for patients with impulse control issues, as it helps them recognize and understand the behaviors they need to change.

Question 3

What is the most challenging nursing intervention with patients diagnosed with personality disorders who use manipulation?

Accepted Answer

Maintaining consistent limits is challenging because patients with personality disorders often test boundaries and may manipulate situations, requiring staff to be firm and consistent in their approach.

Question 4

A nurse reports to the treatment team that a patient diagnosed with antisocial personality disorder has displayed the behaviours below. This patient is detached and superficial during counselling sessions. Which behaviour by the patient most clearly warrants limit setting?

Accepted Answer

Verbal abuse of another patient is a behavior that directly affects others and disrupts the therapeutic environment, warranting immediate intervention and limit setting.

Question 5

What is the priority intervention for a nurse beginning to work with a patient diagnosed with a schizotypal personality disorder?

Accepted Answer

Respect the patient's need for periods of social isolation is the priority intervention for a nurse working with a patient diagnosed with schizotypal personality disorder. People with this disorder oftentimes have difficulties with social interactions and relationships, and may prefer to be alone. It is important for the nurse to understand and respect this need for social isolation while still providing support and encouragement for the patient to engage in therapeutic activities. Preventing the patient from violating the nurse's rights may be a concern, but it is not the priority intervention at the beginning of the nurse-patient interaction. Teaching the patient how to select clothing and engaging the patient in community activities may be important interventions, but they should come after the nurse establishes trust and rapport with the patient.

Question 6

Which intervention is appropriate for an individual diagnosed with antisocial personality disorder who frequently manipulates others?

Accepted Answer

Ensuring limits are adhered to by all staff is crucial in managing individuals with antisocial personality disorder, as it helps establish consistent boundaries and reduces opportunities for manipulation.

Question 7

Others describe a worker as very shy and lacking in self-confidence. This worker stays in an office cubicle all day, never coming out for breaks or lunch. Which term best describes this behaviour?

Accepted Answer

The behavior described is characteristic of avoidant personality, where an individual is extremely shy, feels inadequate, and is sensitive to rejection, leading them to avoid social interactions.

Question 8

When preparing to interview a patient diagnosed with narcissistic personality disorder, a nurse can anticipate the assessment findings will include which of the following?

Accepted Answer

Patients with narcissistic personality disorder typically exhibit grandiosity, a sense of self-importance, and a sense of entitlement.

Question 9

What is the priority nursing diagnosis for a patient diagnosed with antisocial personality disorder who has made threats against staff, ripped art off the walls, and thrown objects?

Accepted Answer

The priority nursing diagnosis for a patient who has exhibited aggressive and violent behavior is Risk for other-directed violence. This diagnosis takes priority over other diagnoses because it addresses the immediate safety of the patient, staff, and other patients.

Question 10

Which statement made by a patient diagnosed with borderline personality disorder indicates the treatment plan is effective?

Accepted Answer

The statement indicates that the patient utilized a coping skill (calling for help) rather than acting on their impulsive behavior to harm themselves. This shows progress in managing their symptoms and utilizing treatment techniques.

Question 11

The history shows that a newly admitted patient is impulsive. The nurse would expect behaviour to be characterized by which of the following?

Accepted Answer

Impulsive behavior is characterized by acting on urges or desires without considering the consequences or thinking things through.

Question 12

A patient says, "I get in trouble sometimes because I make quick decisions and act on them." Select the nurse's most therapeutic response.

Accepted Answer

The answer of A patient says, "I get in trouble...

Question 13

As a nurse prepares to administer medication to a patient diagnosed with 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?

Accepted Answer

The nurse must ensure the patient takes the medication as prescribed, especially with patients who may have compliance issues.

Question 14

Consider this comment to three different nurses by a patient diagnosed with antisocial personality disorder. "Another nurse said you don't do your job right." Collectively, these interactions can be assessed as which of the following?

Accepted Answer

Individuals with antisocial personality disorder often use manipulative behavior to control or influence others, and the comment made by the patient is an example of attempting to manipulate the nurses by creating conflict or doubt among them.

Question 15

A patient diagnosed with borderline personality disorder has a history of self-mutilation and suicide attempts. The patient reveals feelings of depression and anger with life. Which type of medication would the nurse expect to be prescribed?

Accepted Answer

Mood-stabilizing medications are often used to help manage mood swings and impulsivity in patients with borderline personality disorder.

Question 16

A patient diagnosed with borderline personality disorder was hospitalized several times after self-mutilating episodes. The patient remains impulsive. Which nursing diagnosis is the initial focus of this therapy?

Accepted Answer

The initial focus of therapy for a patient with borderline personality disorder who has a history of self-mutilation is to assess and intervene for the risk for self-directed violence. This includes close monitoring of the patient's behavior, identifying triggers for self-harm, and implementing appropriate coping strategies to prevent further self-injury. Impaired skin integrity, risk for injury, and powerlessness may also be relevant nursing diagnoses to address during therapy, but they are not the initial focus in this case.

Question 17

Which personality dimension is reflective of the behaviours of absorption, dissociation, eccentricity, openness to experience, and perceptual cognitive distortion?

Accepted Answer

The personality dimension of unconventionality versus closedness to experience encompasses traits such as openness to experience, eccentricity, and perceptual cognitive distortion, which align with the behaviors described.

Question 18

For which behaviour would limit setting be most essential?

Accepted Answer

Limit setting is most essential for the patient who encourages violence, as this behavior can lead to harm and disrupt the safety and therapeutic environment.

Question 19

One month ago, a patient diagnosed with borderline personality disorder and a history of self-mutilation began dialectical behaviour therapy. Today, the patient phones to say, "I feel empty and want to hurt myself." What should the nurse do?

Accepted Answer

The nurse should assist the patient in choosing coping strategies, as dialectical behavior therapy focuses on teaching skills to manage emotions and reduce self-harm behaviors.

Question 20

A patient's spouse filed charges after repeatedly being battered. The patient sarcastically says, "I'm sorry for what I did. I need psychiatric help." Which statement by the patient supports antisocial personality disorder?

Accepted Answer

The statement reflects a lack of remorse and justification for harmful behavior, which are characteristic of antisocial personality disorder.

Quiz 19: Personality Disorders