Question 1

Which nursing diagnosis should be prioritized when providing nursing care to a client diagnosed with avoidant personality disorder?

Accepted Answer

Rationale: The priority nursing diagnosis for a client diagnosed with avoidant personality disorder should be social isolation R/T inability to relate to others.These clients avoid close or romantic relationships,interpersonal attachments,and intimate sexual relationships.

Question 2

Looking at a slightly bleeding paper cut,the client screams,"Somebody help me quick! I'm bleeding.Call 911!" A nurse should identify this behavior as characteristic of which personality disorder?

Accepted Answer

Rationale: The nurse should identify this behavior as characteristic of histrionic personality disorder.Individuals with this disorder tend to be self-dramatizing,attention seeking,over gregarious,and seductive.

Question 3

During an assessment interview,a client diagnosed with antisocial personality disorder spits,curses,and refuses to answer questions.Which is the appropriate nursing response to this behavior?

Accepted Answer

Rationale: 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.

Question 4

When planning care for a client diagnosed with borderline personality disorder,which self-harm behavior should a nurse expect the client to exhibit?

Accepted Answer

Rationale: The nurse should expect that a client diagnosed with borderline personality disorder may use suicidal gestures to elicit a rescue response from others.Repetitive,self-mutilating behaviors are common in borderline personality disorders that result from feelings of abandonment following separation from significant others.

Question 5

Which nursing diagnosis should a nurse identify as appropriate when working with a client diagnosed with schizoid personality disorder?

Accepted Answer

Rationale: An appropriate nursing diagnosis when working with a client diagnosed with schizoid personality disorder is social isolation R/T inability to relate to others.Clients diagnosed with schizoid personality disorder appear cold,aloof,and indifferent to others.They prefer to work in isolation and are not sociable.

Question 6

Which reaction to a compliment from another client should a nurse identify as a typical response from a client diagnosed with avoidant personality disorder?

Accepted Answer

Rationale: The nurse should identify that a client diagnosed with avoidant personality disorder would be grateful for the compliment but would fear later rejection and humiliation.Individuals diagnosed with avoidant personality disorder are extremely sensitive to rejection and are often awkward and uncomfortable in social situations.

Question 7

At 11:00 p.m.a 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 10:00 p.m.Which nursing response is most appropriate?

Accepted Answer

Rationale: 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.

Question 8

A nurse tells a client that the nursing staff will start alternating weekend shifts.Which response should a nurse identify as characteristic of clients diagnosed with obsessive-compulsive personality disorder?

Accepted Answer

Rationale: The nurse should identify that a client with obsessive-compulsive personality disorder would have a difficult time accepting changes.This disorder is characterized by inflexibility and lack of spontaneity.Individuals with this disorder are very serious,formal,over-disciplined,perfectionistic,and preoccupied with rules.

Question 9

A 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?

Accepted Answer

Rationale: 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.

Question 10

Which nursing approach should be used to maintain a therapeutic relationship with a client diagnosed with borderline personality disorder?

Accepted Answer

Rationale: 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.

Question 11

When planning care for clients diagnosed with personality disorders,what should be the goal of treatment?

Accepted Answer

Rationale: The goal of treatment for clients diagnosed with personality disorders should be to reduce inflexibility of personality traits that interfere with functioning and relationships.Personality disorders are often difficult and,in some cases,seem impossible to treat.There are no psychotropic medications approved specifically for the treatment of personality disorders.

Question 12

Which client is a nurse most likely to admit to an inpatient facility for self-destructive behaviors?

Accepted Answer

Rationale: The nurse should expect that a client diagnosed with borderline personality disorder would be most likely to be admitted to an inpatient facility for self-destructive behaviors.Clients diagnosed with this disorder often exhibit repetitive,self-mutilating behaviors.Most gestures are designed to elicit a rescue response.

Question 13

A client diagnosed with paranoid personality disorder becomes violent on a unit.Which nursing intervention is most appropriate?

Accepted Answer

Rationale: The most appropriate nursing intervention is to use clear,calm statements and to assume a confident physical stance.A calm attitude provides the client with a feeling of safety and security.It may also be beneficial to have sufficient staff on hand to present a show of strength.

Question 14

Which adult client should a nurse identify as exhibiting the characteristics of a dependent personality disorder?

Accepted Answer

Rationale: A physically healthy adult client who lives with parents and depends on 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 and clinging behaviors.

Question 15

Which factors differentiate a client diagnosed with social phobia from a client diagnosed with schizoid personality disorder?

Accepted Answer

Rationale: A client diagnosed with schizoid personality disorder exhibits a profound deficit in the ability to form personal relationships.Clients diagnosed with schizoid personality disorder prefer being alone to being with others and avoid social situations,social contacts,and activities.

Question 16

During an interview,which client statement should indicate to a nurse a potential diagnosis of schizotypal personality disorder?

Accepted Answer

Rationale: The nurse should assess that a client who states that he or she is getting a message from beyond indicates a potential diagnosis of schizotypal personality disorder.Individuals with schizotypal personality disorder are aloof and isolated and behave in a bland and apathetic manner.The person experiences magical thinking,ideas of reference,illusions,and depersonalization as part of daily life.

Question 17

Which client symptoms should lead a nurse to suspect a diagnosis of obsessive-compulsive personality disorder?

Accepted Answer

Rationale: The nurse should suspect a diagnosis of obsessive-compulsive personality disorder when a client experiences inflexibility and lack of spontaneity.Individuals with this disorder are very serious,formal,and have difficulty expressing emotions.They are perfectionistic and preoccupied with rules.

Question 18

A nurse is admitting a client with a new diagnosis of a personality disorder.Which of the following would make the nurse question this diagnosis? (Select all that apply.)

Accepted Answer

Rationale: The DSM-5 states that impairments in personality functioning and the individual's personality trait expression are not better understood as normative for the individual's developmental stage or sociocultural environment.The impairments in personality functioning and the individual's personality trait expression are not solely due to the direct physiological effects of a substance (e.g.,a drug of abuse,medication)or a general medical condition (e.g.,severe head trauma).The nurse would question the diagnosis of a personality disorder in a client with sickle cell anemia,substance use disorder,or an intellectual developmental disorder.

Question 19

A highly emotional client presents at an outpatient clinic appointment and states,"My dead husband returned to me during a séance." Which personality disorder should a nurse associate with this behavior?

Accepted Answer

Rationale: The nurse should associate schizotypal personality disorder with this behavior.The behaviors of people diagnosed with schizotypal personality disorder are odd and eccentric but do not decompensate to the level of schizophrenia.

Question 20

A nursing instructor is teaching students about clients diagnosed with histrionic personality disorder and the quality of their relationships.Which student statement indicates that learning has occurred?

Accepted Answer

Rationale: The instructor should evaluate that learning has occurred when the student describes clients diagnosed with histrionic personality disorder as having relationships that are shallow and fleeting.These types of relationships tend to serve their dependency needs.

Quiz 23: Personality Disorders