Chapter 23 Personality Disorders

Chapter 23  Personality Disorders

Complete Chapter Questions And Answers
 

Sample Questions

___ 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 antipersonality disorder medications have helped you in the past?”

____ 2. At 11 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 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 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. 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.

____ 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.

Answer Section

MULTIPLE CHOICE

1. ANS: 2
Chapter: Chapter 23, Personality Disorders
Objective: Identify various types of personality disorders
Page: 613–614
Heading: Planning and Implementation > Risk for Other-Directed Violence > Interventions
Integrated Processes: Nursing Process
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Cognition
Difficulty: Moderate

Feedback
1
This statement may escalate the client’s behavior.
2
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.
3
The nurse should set limits on the client’s behavior.
4
This statement is not therapeutic to the client.

PTS: 1 CON: Cognition

2. ANS: 3
Chapter: Chapter 23, Personality Disorders
Objective: Identify various types of personality disorders
Page: 613–614
Heading: Planning and Implementation > Risk for Other-Directed Violence > Interventions
Integrated Processes: Nursing Process
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Cognition
Difficulty: Moderate

Feedback
1
The nurse should remain consistent with the unit rules.
2
This statement may escalate the client’s behavior.
3
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.
4
This statement is not therapeutic to the client.

PTS: 1 CON: Cognition

3. ANS: 3
Chapter: Chapter 23, Personality Disorders
Objective: Identify various types of personality disorders
Page: 593
Heading: Types of Personality Disorders > Paranoid Personality Disorder
Integrated Processes: Nursing Process
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Cognition
Difficulty: Moderate

Feedback
1
This approach may not be effective with this client at this time, because the paranoid client does not accept responsibility for actions.
2
This approach may escalate the client’s behavior, and increase feelings of fear and mistrust.
3
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.
4
The nurse should present reality at all times.

PTS: 1 CON: Cognition

4. ANS: 2
Chapter: Chapter 23, Personality Disorders
Objective: Describe appropriate nursing interventions for behaviors associated with borderline personality disorder and antisocial personality disorder.
Page: 605–608
Heading: Table 23-3 Care Plan for the Client With Borderline Personality Disorder
Integrated Processes: Nursing Process
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Cognition
Difficulty: Moderate

Feedback
1
The nursing staff should maintain consistency and maintain authority.
2
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.
3
This approach does not best handle the situation.
4
The nursing staff should maintain consistency and order.

PTS: 1 CON: Cognition