Which behavior would the nurse observe in a client who has a histrionic personality disorder Quizlet
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Kim has a diagnosis of borderline personality disorder. She often exhibits alternating clinging and distancing behaviors. The most appropriate nursing intervention with this type of behavior would be to: D. Rotate staff members who work with Kim so that she will learn to relate to more than one person. Kim, a client diagnosed with borderline personality disorder, manipulates the staff in an effort to fulfill her own desires. All of the following may be examples of manipulative behaviors in the borderline client except:
A. refusal to stay in room alone, stating, "It's so lonely." "Splitting by the client with borderline personality disorder denotes: B. A primitive defense mechanism in which the client sees objects as all good or all bad. According to Margaret Mahler, predisposition to borderline personality disorder occurs when developmental tasks Jago unfilled in which of the following phases: D. Rapprochement phase, during which the mother withdraws emotional support in response to the child's increasing independence. Jack is a new client on the psychiatric unit with a diagnosis of antisocial personality disorder. Which of the following characteristics would you
expect to assess in Jack? A. Lack of guilt for wrongdoing Milieu therapy is a good choice for clients with antisocial personality disorder because it: B. Emulates a social community in which the client may learn to live harmoniously with others. In evaluating the progress of Jack, a client diagnosed
with antisocial personality disorder, which of the following behaviors would be considered the most significant indication of positive change? C. On his own initiative, Jack sent a note of apology to a man he had injured in a recent fight. Which of the following behavioral patterns is characteristic of individuals with narcissistic personality disorder? A. Overly self-centered and exploitative of others Carol is a new nursing graduate being oriented on a medical/surgical unit by the head nurse, Mrs. Carey. When Carol describes a new technique she has learned for positioning immobile clients, Mrs. Carey states, "What are you trying to do. . .tell me how to do my job? We have always done it this way on this unit, and we will continue to do it this way until I say differently?" This is an example of which type of personality
characteristic? D. Obsessive-compulsive Which of the following behavioral patterns is characteristic of individuals with schizotypal personality disorder? B. a lifelong pattern of social withdrawal Shows no remorse for exploitation and manipulation of others. Antisocial personality disorder Accepts a job he does not want to do, then does a poor job and delays past the deadline Passive-aggressive personality disorder Believes she is entitled to special privileges others do not deserve Narcissistic personality disorder They are suspicious of all others with whom they come in contact Paranoid personality disorder Swallows a bottle of pills after therapist leaves on vacation Borderline personality disorder Believes he has a "sixth sense" and can know what others are thinking. Schizotypal personality disorder Allows others to make all her important decisions for her Dependent personality disorder Refuses to enter into a relationship due to fear of rejection Avoidant personality disorder Demonstrates highly emotional and overly dramatic behaviors Histrionic personality disorder Has a life-long pattern of social withdrawal Schizoid personality disorder Believes everyone must follow the rules and that the rules can be "bent" for no one. . .ever Obsessive-compulsive personality disorder The totality of emotional and behavioral characteristics that are particular to a specific person and that remain somewhat stable and predictable over time. Personality Characteristics with which an individual is born or develops early in life. the influence the way in which he or she perceives and relates to the environment and are quite stable over time. Personality traits Traits become rigid and inflexible and contribute to maladaptive patterns of behavior or impairment in functioning Personality disorders What is a healthy personality? A pattern of perceiving, relating, thinking. An individual with a history of antisocial personality disorder was arrested for driving under the influence of alcohol and causing a serious car accident. Which comment on
this behavior would be expected? A. It's not my fault Individuals diagnosed with antisocial personality disorder lack remorse about their actions and view themselves as victims. This individual would most likely refuse to acknowledge responsibility for the accident.
A client diagnosed with borderline personality disorder is admitted to a psychiatric unit. Which behavior pattern would the nurse expect to observe? D. generates conflict among the staff Clients diagnosed with borderline personality disorder, having little empathy toward others, are unable to accept both positive and negative feelings, and view others as all good or all bad. they tend to split staff, generating conflict In assessing a client diagnosed with borderline personality disorder, which characteristic would the nurse expect to observe? C. Little tolerance for being alone Clients diagnosed with borderline personality disorder have little tolerance for being alone. they prefer a frantic search for companionship no matter how unsatisfactory rather than experience feelings of loneliness, emptiness and boredom. Which statement is correct concerning personality disorders? C. personality disorders occur when personality traits become inflexible and maladaptive Feedback: When either significant functional impairment or subjective distress occurs as a result of inflexible and maladaptive personality traits, a diagnosis of personality disorder can be made. In caring for a client diagnosed with borderline personality disorder, which nursing intervention takes priority? B. observe client's behavior frequently. Feedback: Clients diagnosed with borderline personality disorder often resort to self-mutilating behaviors in an attempt to seek attention. Close observation is prioritized so that intervention can be implemented to ensure client safety. The nurse should avoid appearing watchful and suspicious while observing the client's activities and interactions. A client diagnosed with avoidant personality disorder states, "I've never been close to my
daughter. I'm sure she will never have time for me." Which nursing diagnosis applies to this client? C. social withdrawal Feedback: The statement presented in the question suggests feelings of rejection leading to social withdrawal. The individual diagnosed with avoidant personality disorder is extremely sensitive to rejection and, because of this, experiences a very socially withdrawn life. There may be a strong desire for companionship, but extreme shyness and fear of rejection create a need for usually strong guarantees of uncritical acceptance. A client diagnosed with borderline personality disorder is admitted to a psychiatric unit. Which behavior pattern would the nurse expect to observe? D. generating conflict among the staff (splitting) Feedback: clients diagnosed with borderline personality disorder, having little empathy toward others, are unable to accept both positive and negative feelings and view others as all good or all bad. They tend to split staff, generating conflict. A client diagnosed with a borderline personality disorder presents to the
mental health clinic and demands to see a counselor immediately. Which is the appropriate nursing action? C. explain the rules and set limits. Feedback: Explaining rules and setting limits establish clear boundaries. This provides the firm structure needed by a client diagnosed with borderline personality disorder. The nurse may state, "Clients are seen in the order of their scheduled appointments. It looks like it will be another 20 minutes before you are seen. Walter, a patient diagnosed with antisocial personality disorder, was witnessed taking illicit drugs on the psychiatric unit, in direct violation of unit policy and law. It is his first offense. Which of the following nurse behaviors are appropriate
in response to the client's behavior? (Select all that apply) D. Inform the patient that as a consequence, the police will be notified. Feedback: This consequence is appropriate and may be more significant to the client, as he is forced to recognize that there are also legal consequences for illegal behavior A client diagnosed with a personality disorder tells the nurse, "With my expertise, I could become this hospital's CEO tomorrow." This statement would be associated with which personality disorder? C. narcissistic personality disorder Feedback: Clients diagnosed with narcissistic personality disorder are often boastful and grandiose. These individuals have an exaggerated sense of self-worth. they believe that they have an inalienable right to receive special consideration and that their desire is sufficient justification for possessing whatever they seek. A nursing student is learning about
schizoid personality disorder. Which statement by the student indicates that learning has occurred? B. These individuals have a profound inability to form personal relationships Feedback: Having a profound inability to form personal relationships is characteristic of clients with diagnosed schizoid personality disorder. These individuals display a lifelong pattern of social withdrawal, and their discomfort with human interaction is apparent. A psychologist is administering a personality inventory. The individual being tested dresses flamboyantly, has a dramatic communication pattern, and easily becomes overly emotional. These
behaviors would be indicative of which DSM-5 personality cluster? B. cluster B Feedback: A client diagnosed with a personality disorder is cold, aloof, and avoids others on the unit. The nurse
recognizes that this behavior is symptomatic of which personality disorder? A. Schizoid personality Feedback: A hallmark of the schizoid personality is a market withdrawal from social contact. The client behaviors presented in the question are indicative of schizoid personality disorder. People
with schizoid and schizotypal personality disorders share which of the following features in common? (Select all that apply) A. lack of close friends or confidants Feedback: This is a diagnostic feature common to both schizoid and schizotypal personaltiy disorders Oliver has been referred by his boss to the employee assistance program because of difficulties that have arisen in his relationships with coworkers. During the nurse's intake assessment, which of the following statements by Oliver are consistent with a diagnosis of
paranoid personality disorder? (Select all that apply) B. I stay away from my coworkers because they'd love to see me fail.
Feedback: This statement is a generalization of mistrust for all his coworkers and an assumption that they intend to harm him in some way. This statement is consistent with paranoid personality disorder. Which predisposing factor would be implicated in the etiology of a histrionic personality disorder? D. Parental approval was bestowed only when behaviors met parental expectations Feedback: Having parents who showed approval only when the child's behaviors met parental expectations is a predisposing factor for an individual diagnosed with histrionic personality disorder. The child may have learned that positive reinforcement was contingent on the ability to perform parentally-approved and admired behaviors. This would lead to a need for constant approval and acceptance by others, which is characteristic of histrionic personality disorder. Walt is admitted to the forensic psychiatry unit after assaulting a store clerk for waiting on another customer before him. He says the store clerk deserved to be hit "for being an idiot". He has previously been diagnosed with antisocial
personality disorder and his current nursing diagnosis is defensive coping. Which of the following are recommended approaches in intervention for this diagnosis? (Select all that apply) A. Explain the rules of the unit and consequences of violation of the rules Feedback: Since clients with this disorder do not self-impose limits on maladaptive behavior, clear communication of rules and consequences is essential When assessing a client diagnosed with narcissistic personality disorder, the nurse expects to identify which characteristic behavior? B. grandiose sense of self-importance Feedback: Clients diagnosed with narcissistic personality disorder have an exaggerated sense of self worth. they are often grandiose and believe they have an inalienable right to receive special considerations. An individual with a history of antisocial personality disorder was arrested for driving under the
influence of alcohol and causing a serious car accident. Which comment on this behavior would be expected? A. It's not my fault Feedback: Individuals diagnosed with antisocial personality disorders lack remorse about their actions and view themselves as victims. This individual would most likely refuse to acknowledge responsibility for the accident A husband brings home a diamond ring as an apology for slapping his wife that morning. Later, the wife apologizes profusely for dropping the ring into the running garbage disposal. Which personality trait is the wife exhibiting? C. passive-aggressive trait Feedback: When clients exhibit passive-aggressive traits, they believe others have wronged them and often go to great lengths to seek retribution, or to "get even". This is done in a subtle and passive manner, rather than by discussing their feelings with the offending individual. This question presents a wife exhibiting passive-aggressive traits. A client tells the nurse, "You're so much nicer than that mean nurse on nightshift." This
statement would be associated with which personality disorder? A. borderline Feedback: This statement would be typical of a client diagnosed with borderline personality disorder. These clients typically generate conflict in a maladaptive attempt to gain attention and acceptance. They use splitting, which is an ego defense manifested by an inability to integrate and accept both positive and negative feelings. Individuals, including themselves, are viewed as either all good or all bad. Which of the following features typify an individual diagnosed with obsessive-compulsive personality disorder? (Select all that apply) B. excessively devoted to work and productivity Feedback: Excess devotion to work to the exclusion of leisure activities and friends is a DSM-5 diagnostic criterion for this disorder A suicidal client diagnosed with borderline personality disorder exhibits both fear and anger during the intake interview. Which nursing intervention would be appropriate for this client? D. start supportive counseling to identify sources of anger. Feedback: A client diagnosed with borderline personality disorder often displaces negative feelings onto the staff, resulting in countertransference and splitting. Countertransference refers to the nurse's emotional and behavioral response to the client. Splitting is the client's inability to accept both positive and negative feelings about others, viewing them as all good or all bad. identifying the client's source of anger through supportive counseling may help decrease splitting, countertransference, and any resulting conflict. In assessing a client diagnosed with borderline personality disorder, which characteristics would the nurse expect to observe?
C. little tolerance for being alone Feedback: Clients diagnosed with borderline personality disorder have little tolerance for being along. They prefer a frantic search for companionship no matter how unsatisfactory, rather than experiencing feelings of loneliness, emptiness and boredom. The
nurse expects to establish a supportive therapeutic relationship with a client diagnosed with schizoid personality disorder. Which nursing intervention is most appropriate? B. allow the client's need for distance in a relationship Feedback: Schizoid personality disorder is characterized primarily by a profound defect in the ability to form personal relationships or to respond to others in any meaningful, emotional way. When dealing with a client diagnosed with this disorder, the nurse must recognize the need for distance in the relationship. Trying to become too close or friendly will cause the client to feel threatened and may lead to withdrawal. Providing distance will allow the client to initiate contact, depending on comfort level experienced. A client diagnosed with antisocial personality disorder is admitted to the inpatient unit after setting the policy chief's house on fire. The client is scheduled for further psychological testing this morning. Which nursing intervention takes priority? A. instruct the client about psychological testing Feedback: It is appropriate prior to any testing for the nurse to explain the procedure and what the client should expect. This information will put the client at ease and may lead to client cooperation and more accurate results. Because the psychological testing will be administered in the morning, this nursing intervention takes priority. Sandy has been hospitalized after expressing suicide ideation and is diagnosed with borderline personality disorder. The nurse notices during the admission assessment that Sandy has made several superficial cuts on her arms and legs. Which of the following are recommended nursing interventions in response to this self-mutilation? (Select all that apply) A. provide care for wounds, using a matter-of-fact approach without offering sympathy or additional attention Feedback: Minimizing attention to the undesired behavior may decrease the repetition of
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