Personality, Mood Disorders, And Suicidal Behavior | NCLEX Quiz 209

1. Angela has a history of conflict-filled relationships. Despite an expressed desire for friends.she acts in ways that tend to alienate people. Which nursing intervention would be important for Angela?

Establish a therapeutic relationship in which the nurse uses role-modeling and role-playing for appropriate behaviors.

Help the client to select friends who are kind and extra caring.

Point out that the client acts in ways that alienate others.

Recognize that this client is unlikely to change and therefore intervention is inappropriate.

A therapeutic relationship shows acceptance.and using role modeling and role-playing can help the client to learn appropriate behaviors.Option B is an inappropriate and unrealistic solution to the client’s problem behaviors.Option C is also inappropriate because the client is not likely to accept direct criticism of her behavior; such individuals do not perceive a problem with their own behavior.Option D ignores the client’s potential for growth and improvement.

Explanation

A therapeutic relationship shows acceptance.and using role modeling and role-playing can help the client to learn appropriate behaviors.Option B is an inappropriate and unrealistic solution to the client’s problem behaviors.Option C is also inappropriate because the client is not likely to accept direct criticism of her behavior; such individuals do not perceive a problem with their own behavior.Option D ignores the client’s potential for growth and improvement.

2. Barbara is a client with borderline personality disorder. She is defensive and emotionally labile and often becomes suddenly and explosively angry. When interacting with her.you as a nurse would:

Point out how angry Barbara is becoming.and confront the behavior.

Take a calm.quiet.and nonconfrontational approach.and avoid arguing with Barbara.

Tell Barbara to calm down and to avoid becoming explosive or restraints will be used.

Use a gentle touch and a caring approach to calm Barbara.

The best way to respond to the client with angry behavior is a calm.nonconfrontational.nonargumentative approach. This will avoid further escalating the client’s behavior.Option A: Confronting the client’s behavior could exacerbate anger and trigger explosive behavior.Option C: Telling the client to calm down minimizes the client’s problems.and the mention of restraints may be perceived as threatening to the client.Option D: Touch may also be perceived as threatening; it is not recommended for a client who may become explosive.

Explanation

The best way to respond to the client with angry behavior is a calm.nonconfrontational.nonargumentative approach. This will avoid further escalating the client’s behavior.Option A: Confronting the client’s behavior could exacerbate anger and trigger explosive behavior.Option C: Telling the client to calm down minimizes the client’s problems.and the mention of restraints may be perceived as threatening to the client.Option D: Touch may also be perceived as threatening; it is not recommended for a client who may become explosive.

3. Nurse Aldrich is working with the family of Mary Ann.a client with a personality disorder. Which of the following should Nurse Aldrich encourage the family members to work on?

Avoiding direct expressions of problems with family

Changing Mary Ann’s problem behaviors

Improving self-functioning

Supporting Mary Ann’s defenses.

Family members typically benefit from working on ways to improve self-functioning. This facilitates ownership of problems among individuals involved in ongoing relationship difficulties.Option A: The direct expression of problems is helpful and therefore should not be avoided.Option B: It would be impossible to change the client’s behavior; encouraging family members to do so would frustrate them.Option D: The client’s defenses are likely to blame others for problems; consequently.supporting his blaming others is not helpful.

Explanation

Family members typically benefit from working on ways to improve self-functioning. This facilitates ownership of problems among individuals involved in ongoing relationship difficulties.Option A: The direct expression of problems is helpful and therefore should not be avoided.Option B: It would be impossible to change the client’s behavior; encouraging family members to do so would frustrate them.Option D: The client’s defenses are likely to blame others for problems; consequently.supporting his blaming others is not helpful.

4. Tyrion describes himself as "very religious.with strong opinions about what is right and what is wrong." He is quite judgmental about beliefs and lifestyles that are "unacceptable." Which statement supports the nurse's analysis that this client's behavior is typical of someone with a personality disorder?

Inflexible behaviors.along with the use of rigid defense mechanisms.are characteristic.

Judgmental behavior.including self-insight.is common.

Religious fanatics often have personality disorders.

Strong belief systems are common and can help identify evidence of instability.

Individuals with personality disorder have inflexible behavior patterns and rigid defense mechanisms. They are unlikely to change over time.Option B: Such individuals generally lack self-insight and are more likely to have external locus of control thinking (blaming others for problems).Option C: Religious fanatics may be motivated by other psychodynamics (possibly psychotic states).Option D: However.strong belief systems do not necessarily mean mental instability. A mentally healthy person may have belief systems that are strong and that govern conduct.

Explanation

Individuals with personality disorder have inflexible behavior patterns and rigid defense mechanisms. They are unlikely to change over time.Option B: Such individuals generally lack self-insight and are more likely to have external locus of control thinking (blaming others for problems).Option C: Religious fanatics may be motivated by other psychodynamics (possibly psychotic states).Option D: However.strong belief systems do not necessarily mean mental instability. A mentally healthy person may have belief systems that are strong and that govern conduct.

5. Which statement about an individual with a personality disorder is true?

Psychotic behavior is common during acute episodes.

Prognosis for recovery is good with therapeutic intervention.

The individual typically remains in the mainstream of society.although he has problems in social and occupational roles.

The individual usually seeks treatment willingly for symptoms that are personally distressful.

An individual with a personality disorder usually is not hospitalized unless a coexisting Axis I psychiatric disorder is present. Generally.these individuals make marginal adjustments and remain in society.although they typically experience relationship and occupational problems related to their inflexible behaviors.Option A: Personality disorders are chronic.lifelong patterns of behavior; acute episodes do not occur. Psychotic behavior is usually not common.although it can occur in either schizotypal personality disorder or borderline personality disorder.Option B: Because these disorders are enduring and evasive and the individual is inflexible.the prognosis for recovery is unfavorable.Option D: Generally. the individual does not seek treatment because he does not perceive problems with his own behavior. Distress can occur based on other people’s reaction to the individual’s behavior.

Explanation

An individual with a personality disorder usually is not hospitalized unless a coexisting Axis I psychiatric disorder is present. Generally.these individuals make marginal adjustments and remain in society.although they typically experience relationship and occupational problems related to their inflexible behaviors.Option A: Personality disorders are chronic.lifelong patterns of behavior; acute episodes do not occur. Psychotic behavior is usually not common.although it can occur in either schizotypal personality disorder or borderline personality disorder.Option B: Because these disorders are enduring and evasive and the individual is inflexible.the prognosis for recovery is unfavorable.Option D: Generally. the individual does not seek treatment because he does not perceive problems with his own behavior. Distress can occur based on other people’s reaction to the individual’s behavior.

6. Mrs. B is diagnosed with borderline personality disorder has a nursing diagnosis of Risk for self-directed violence.which is related to the client's self-mutilation behavior (burning arms with cigarettes). Which client behavior would indicate a positive outcome of intervention?

Mrs. B denies feelings of wanting to harm anyone.

Mrs. B expresses feelings of anger towards others.

Mrs. B requests cigarettes at appropriate times.

Mrs. B tells the nurse about wanting to burn herself.

The fact that Mrs. B directly tells the nurse about wanting to self-mutilate.rather than acting on these feelings.is evidence of her responding to nursing intervention.

Explanation

The fact that Mrs. B directly tells the nurse about wanting to self-mutilate.rather than acting on these feelings.is evidence of her responding to nursing intervention.

7. A client with antisocial personality disorder was admitted in a unit at Nurseslabs Hospital. The newly admitted client stole money from an elderly in the unit. Which of the following is the most appropriate for the nurse to say to this client?

“Why did you take the money?”

“Let’s talk about how you felt when you took the money.”

“The consequences of stealing are a loss of privileges.”

“This client is defenseless against you.”

The most appropriate response is to reinforce the consequences of behavior that disregard the rights of others.Option A is incorrect because this client is likely to rationalize and excuse the behavior.Option B is also incorrect because the nurse should not encourage the client to provide excuses or explanations of behaviors that are clearly against the rules.Option D: A client with antisocial personality disorder is unlikely to have compassion for others and typically lacks respect for the rights of others.

Explanation

The most appropriate response is to reinforce the consequences of behavior that disregard the rights of others.Option A is incorrect because this client is likely to rationalize and excuse the behavior.Option B is also incorrect because the nurse should not encourage the client to provide excuses or explanations of behaviors that are clearly against the rules.Option D: A client with antisocial personality disorder is unlikely to have compassion for others and typically lacks respect for the rights of others.

8. Nurse Danita is working with clients who have personality disorders. Which of the following techniques would the nurse use to deal with her own feelings that interfere with therapeutic performance?

Active listening techniques

Challenging the client’s assertions

Forming social relations

Seeking peer or supervisor direction

The nurse is likely to have strong reactions to clients with personality disorders.especially those who display intense emotions and manipulative behaviors. Seeking the direction of peers and supervisors can help clarify issues and determine the best nursing responses to difficult behaviors.

Explanation

The nurse is likely to have strong reactions to clients with personality disorders.especially those who display intense emotions and manipulative behaviors. Seeking the direction of peers and supervisors can help clarify issues and determine the best nursing responses to difficult behaviors.

9. When a client with personality disorder begins demonstrating manipulative behavior.which of the following nursing actions are most appropriate? Select all that apply.

Ask the client to think about the consequences of behavior.

Allow the client time to perform specific rituals.

Develop a consistent team approach to handle the client’s behaviors.

Help the client to express anxiety verbally rather than with specific symptoms.

Provide immediate feedback concerning the client’s specific behaviors.

Set limits in a clear, direct manner.

These interventions allow the nurse to immediately confront the client’s manipulative behavior and provide consistent structure (through limit-setting and team approach).Option B is appropriate for the client with obsessive-compulsive behavior.Option D.for someone with somatization problem.

Explanation

These interventions allow the nurse to immediately confront the client’s manipulative behavior and provide consistent structure (through limit-setting and team approach).Option B is appropriate for the client with obsessive-compulsive behavior.Option D.for someone with somatization problem.

Submit

10. Nurse Florence assesses Mrs. B with borderline personality disorder. Which of the following behaviors are common to this diagnosis? Select all that apply.

Intense fear of being alone

Evidence of self-mutilating attempts

Evidence of suspiciousness and mistrust of others

Indifferent attitude toward approval of criticism

Unstable moods with impulsive behaviors

Presence of odd mannerisms, speech, and behaviors

These are all common characteristics of an individual with borderline personality disorder.Suspiciousness and mistrust of others (option C) are characteristic of paranoid personality disorder.Options D and F are characteristic of someone with schizoid personality disorder.which is generally aloof in relationships and has unusual speech and mannerisms.

Explanation

These are all common characteristics of an individual with borderline personality disorder.Suspiciousness and mistrust of others (option C) are characteristic of paranoid personality disorder.Options D and F are characteristic of someone with schizoid personality disorder.which is generally aloof in relationships and has unusual speech and mannerisms.

Submit