Ch.23 Flashcards Preview

Mental health exam 4 > Ch.23 > Flashcards

Flashcards in Ch.23 Deck (24)
Loading flashcards...
1

1. 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?
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. “What anti-personality disorder medications have helped you in the past?”

2. “I understand that you are angry, but this behavior will not be tolerated.”

2

2. 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?
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 10:00 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. “It is after the 10:00 p.m. phone curfew. You will be able to call tomorrow.”

3

3. A client diagnosed with paranoid personality disorder becomes violent on a 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 and a confident physical stance.
4. Empathize with the client’s paranoid perceptions.

3. Use clear, calm statements and a confident physical stance.

4

4. 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?
1. Allow the clients to apply the democratic process when developing unit rules.
2. Maintain consistency of care by 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 autocratic leadership.

2. Maintain consistency of care by open communication to avoid staff manipulation.

5

5. Which nursing approach should be used to maintain a therapeutic relationship with a
client diagnosed with borderline personality disorder?
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. Being firm, consistent, and empathic, while addressing specific client behaviors

6

6. Which adult client should a nurse identify as exhibiting the characteristics of a
dependent personality disorder?
1. A physically healthy client who is dependent on meeting social needs by contact with
15 cat
2. A physically healthy client who has a history of depending on intense relationships to
meet basic needs
3. A physically healthy client who lives with parents and depends on public
transportation
4. A physically healthy client who is serious, inflexible, perfectionistic, lacks spontaneity,
and depends on rules to provide security

3. A physically healthy client who lives with parents and depends on public
transportation

7

7. A client expresses low self-worth, has much difficulty making decisions, avoids
positions of responsibility, and has a behavioral pattern of “suffering” in silence. Which
statement best explains the etiology of this client’s personality disorder?
1. Childhood nurturance was provided from many sources, and independent behaviors
were encouraged.
2. Childhood nurturance was provided exclusively from one source, and independent
behaviors were discouraged.
3. Childhood nurturance was provided exclusively from one source, and independent
behaviors were encouraged.
4. Childhood nurturance was provided from many sources, and independent behaviors
were discouraged.

2. Childhood nurturance was provided exclusively from one source, and independent

8

8. Family members of a client ask the nurse to explain the difference between schizoid
and avoidant personality disorders. Which is the appropriate nursing response?
1. Clients diagnosed with avoidant personality disorder desire intimacy but fear it, and
clients diagnosed with schizoid personality disorder prefer to be alone.
2. Clients diagnosed with schizoid personality disorder exhibit delusions and
hallucinations, while clients diagnosed with avoidant personality disorder do not.
3. Clients diagnosed with avoidant personality disorder are eccentric, and clients
diagnosed with schizoid personality disorder are dull and vacant.
4. Clients diagnosed with schizoid personality disorder have a history of psychosis, while
clients diagnosed with avoidant personality disorder remain based in reality.

1. Clients diagnosed with avoidant personality disorder desire intimacy but fear it, and
clients diagnosed with schizoid personality disorder prefer to be alone.

9

9. Which nursing diagnosis should a nurse identify as appropriate when working with a
client diagnosed with schizoid personality disorder?
1. Altered thought processes R/T increased stress
2. Risk for suicide R/T loneliness
3. Risk for violence: directed toward others R/T paranoid thinking
4. Social isolation R/T inability to relate to others

4. Social isolation R/T inability to relate to others

10

10. 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?
1. Schizoid personality disorder
2. Obsessive-compulsive personality disorder
3. Histrionic personality disorder
4. Paranoid personality disorder

3. Histrionic personality disorder

11

11. When planning care for a client diagnosed with borderline personality disorder, which
self-harm behavior should a nurse expect the client to exhibit?
1. The use of highly lethal methods to commit suicide
2. The use of suicidal gestures to elicit a rescue response from others
3. The use of isolation and starvation as suicidal methods
4. The use of self-mutilation to decrease endorphins in the body

2. The use of suicidal gestures to elicit a rescue response from others

12

12. 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 obsessivecompulsive
personality disorder?
1. “You really don’t have to go by that schedule. I’d just stay home sick.”
2. “There has got to be a hidden agenda behind this schedule change.”
3. “Who do you think you are? I expect to interact with the same nurse every Saturday.”
4. “You can’t make these kinds of changes! Isn’t there a rule that governs this decision?”

4. “You can’t make these kinds of changes! Isn’t there a rule that governs this decision?”

13

13. Which reaction to a compliment from another client should a nurse identify as a
typical response from a client diagnosed with avoidant personality disorder?
1. Interpreting the compliment as a secret code used to increase personal power
2. Feeling the compliment was well deserved
3. Being grateful for the compliment but fearing later rejection and humiliation
4. Wondering what deep meaning and purpose is attached to the compliment

3. Being grateful for the compliment but fearing later rejection and humiliation

14

14. Which factors differentiate a client diagnosed with social phobia from a client
diagnosed with schizoid personality disorder?
1. Clients diagnosed with social phobia are treated with cognitive behavioral therapy,
whereas clients diagnosed with schizoid personality disorder need medications.
2. Clients diagnosed with schizoid personality disorder experience anxiety only in social
settings, whereas clients diagnosed with social phobia experience generalized anxiety.
3. Clients diagnosed with social phobia avoid attending birthday parties, whereas clients
diagnosed with schizoid personality disorder would isolate self on a continual basis.
4. Clients diagnosed with schizoid personality disorder avoid attending birthday parties,
whereas clients diagnosed with social phobia would isolate self on a continual basis.

3. Clients diagnosed with social phobia avoid attending birthday parties, whereas clients
diagnosed with schizoid personality disorder would isolate self on a continual basis.

15

15. Which client symptoms should lead a nurse to suspect a diagnosis of obsessivecompulsive
personality disorder?
1. The client experiences unwanted, intrusive, and persistent thoughts.
2. The client experiences unwanted, repetitive behavior patterns.
3. The client experiences inflexibility and lack of spontaneity when dealing with others.
4. The client experiences obsessive thoughts that are externally imposed.

3. The client experiences inflexibility and lack of spontaneity when dealing with others.

16

16. Which client is a nurse most likely to admit to an inpatient facility for self-destructive
behaviors?
1. A client diagnosed with antisocial personality disorder
2. A client diagnosed with borderline personality disorder
3. A client diagnosed with schizoid personality disorder
4. A client diagnosed with paranoid personality disorder

2. A client diagnosed with borderline personality disorder

17

17. When planning care for clients diagnosed with personality disorders, what should be
the goal of treatment?
1. To stabilize the client’s pathology by using the correct combination of psychotropic
medications
2. To change the characteristics of the dysfunctional personality
3. To reduce personality trait inflexibility that interferes with functioning and
relationships
4. To decrease the prevalence of neurotransmitters at receptor sites

3. To reduce personality trait inflexibility that interferes with functioning and
relationships

18

18. Which client situation would reflect the impulsive behavior that is commonly
associated with borderline personality disorder?
1. As the day-shift nurse leaves the unit, the client suddenly hugs the nurse’s arm and
whispers, “The night nurse is evil. You have to stay.”
2. As the day-shift nurse leaves the unit, the client suddenly hugs the nurse’s arm and
states, “I will be up all night if you don’t stay with me.”
3. As the day-shift nurse leaves the unit, the client suddenly hugs the nurse’s arm, yelling,
“Please don’t go! I can’t sleep without you being here.”
4. As the day-shift nurse leaves the unit, the client suddenly shows the nurse a bloody
arm and states, “I cut myself because you are leaving me.”

4. As the day-shift nurse leaves the unit, the client suddenly shows the nurse a bloody
arm and states, “I cut myself because you are leaving me.”

19

19. Which nursing diagnosis should be prioritized when providing nursing care to a client
diagnosed with paranoid personality disorder?
1. Risk for violence: directed toward others R/T paranoid thinking
2. Risk for suicide R/T altered thought
3. Altered sensory perception R/T increased levels of anxiety
4. Social isolation R/T inability to relate to others

1. Risk for violence: directed toward others R/T paranoid thinking

20

20. From a behavioral perspective, which nursing intervention is appropriate when caring
for a client diagnosed with borderline personality disorder?
1. Seclude the client when inappropriate behaviors are exhibited.
2. Contract with the client to reinforce positive behaviors with unit privileges.
3. Teach the purpose of anti-anxiety medications to improve medication compliance.
4. Encourage the client to journal feelings to improve awareness of abandonment issues.

2. Contract with the client to reinforce positive behaviors with unit privileges.

21

21. 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?
1. Obsessive-compulsive personality disorder
2. Schizotypal personality disorder
3. Narcissistic personality disorder
4. Borderline personality disorder

2. Schizotypal personality disorder

22

22. 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?
1. “Their dramatic style tends to make their interpersonal relationships quite interesting
and fulfilling.”
2. “Their interpersonal relationships tend to be shallow and fleeting, serving their
dependency needs.”
3. “They tend to develop few relationships because they are strongly independent but
generally maintain deep affection.”

4. “They pay particular attention to details, which can interfere with the development of
relationships.”

2. “Their interpersonal relationships tend to be shallow and fleeting, serving their
dependency needs.”

23

23. During an interview, which client statement should indicate to a nurse a potential
diagnosis of schizotypal personality disorder?
1. “I don’t have a problem. My family is inflexible, and relatives are out to get me.”
2. “I am so excited about working with you. Have you noticed my new nail polish, ‘Ruby
Red Roses’?”
3. “I spend all my time tending my bees. I know a whole lot of information about bees.”
4. “I am getting a message from the beyond that we have been involved with each other
in a previous life.”

4. “I am getting a message from the beyond that we have been involved with each other
in a previous life.”

24

24. Which nursing diagnosis should be prioritized when providing nursing care to a client
diagnosed with avoidant personality disorder?
1. Risk for violence: directed toward others R/T paranoid thinking
2. Risk for suicide R/T altered thought
3. Altered sensory perception R/T increased levels of anxiety
4. Social isolation R/T inability to relate to others

4. Social isolation R/T inability to relate to others