NCLEX Questions: Personality Disorder Exam Test

1. When working with the nurse during the orientation phase of the relationship. a client with a borderline personality disorder would probably have the most difficulty in:

Controlling anxiety

Terminating the session on time

Accepting the psychiatric diagnosis

Setting mutual goals for the relationship

Clients with borderline personality disorders frequently demonstrate a pattern of unstable interpersonal relationships. impulsiveness. affective instability. and frantic efforts to avoid abandonment; these behaviors usually create great difficulty in establishing mutual goals.

Explanation

Clients with borderline personality disorders frequently demonstrate a pattern of unstable interpersonal relationships. impulsiveness. affective instability. and frantic efforts to avoid abandonment; these behaviors usually create great difficulty in establishing mutual goals.

2. The nursing diagnosis that would be most appropriate for a 22-year old client who uses ritualistic behavior would be:

Ineffective coping

Impaired adjustment

Personal identity disturbance

Sensory/perceptual alterations

Ineffective coping is the impairment of a person’s adaptive behaviors and problem-solving abilities in meeting life’s demands; ritualistic behavior fits under this category as a defining characteristic.

Explanation

Ineffective coping is the impairment of a person’s adaptive behaviors and problem-solving abilities in meeting life’s demands; ritualistic behavior fits under this category as a defining characteristic.

3. A hospitalized client. diagnosed with a borderline personality disorder. consistently breaks the unit's rules. This behavior should be confronted because it will help the client:

Control anger

Reduce anxiety

Set realistic goals

Become more self-aware

Client’s must first become aware of their behavior before they can change it. Occurs after the client is aware of the behavior and has a desire to change the behavior.

Explanation

Client’s must first become aware of their behavior before they can change it. Occurs after the client is aware of the behavior and has a desire to change the behavior.

4. A psychiatrist prescribes an anti-obsessional agent for a client who is using ritualistic behavior. A common anti-anxiety medication used for this type of client would be:

Fluvoxamine (Luvox)

Benztropine (Cogentin)

Amantadine (Symmetrel)

Diphenhydramine (Benadryl)

This drug blocks the uptake of serotonin.

Explanation

This drug blocks the uptake of serotonin.

5. A 20-year old college student has been brought to the psychiatric hospital by her parents. Her admitting diagnosis is borderline personality disorder. When talking with the parents. which information would the nurse expect to be included in the client's history? Select all that apply.

Impulsiveness

Lability of mood

Ritualistic behavior

Psychomotor retardation

Self-destructive behavior

1.11E+17

Explanation

1.11E+17

Submit

6. A young. handsome man with a diagnosis of antisocial personality disorder is being discharged from the hospital next week. He asks the nurse for her phone number so that he can call her for a date. The nurse's best response would be:

“We are not permitted to date clients.”

“No. you are a client and I am a nurse.”

“I like you. but our relationship is professional.”

“It’s against my professional ethics to date clients.”

This accepts the client as a person of worth rather than being cold or implying rejection. However. the nurse maintains a professional rather than a social role.

Explanation

This accepts the client as a person of worth rather than being cold or implying rejection. However. the nurse maintains a professional rather than a social role.

7. The client with antisocial personality disorder:

Suffers from a great deal of anxiety

Is generally unable to postpone gratification

Rapidly learns by experience and punishment

Has a great sense of responsibility toward others

Individuals with this disorder tend to be self-centered and impulsive. They lack judgment and self-control and do not profit from their mistakes.

Explanation

Individuals with this disorder tend to be self-centered and impulsive. They lack judgment and self-control and do not profit from their mistakes.

8. A client with a diagnosis of borderline personality disorder has negative feelings toward the other clients on the unit and considers them all to be "bad." The nurse understands this defense is known as:

Splitting

Ambivalence

Passive aggression

Reaction formation

Splitting is the compartmentalization of opposite-affect states and failure to integrate the positive and negative aspects of self or others.

Explanation

Splitting is the compartmentalization of opposite-affect states and failure to integrate the positive and negative aspects of self or others.

9. The nurse reviews the activity schedule for the day and plans which activity for the manic client?

Brown-bag luncheon and book review

Tetherball

Paint-by-number activity

Deep breathing and progressive relaxation group

The lack of superego control allows the ego and the id to control the behavior. Self-motivation and self-satisfaction are of paramount concern.

Explanation

The lack of superego control allows the ego and the id to control the behavior. Self-motivation and self-satisfaction are of paramount concern.

10. When caring for a client with a diagnosis of schizotypal personality disorder. the nurse should:

Set limits on manipulative behavior

Encourage participation in group therapy

Respect the client’s needs for social isolation

Understand that seductive behavior is expected.

These clients are withdrawn. aloof. and socially distant; allowing distance and providing support may encourage the eventual development of a therapeutic alliance. Group therapy would increase this client’s anxiety; cognitive or behavioral therapy would be more appropriate.

Explanation

These clients are withdrawn. aloof. and socially distant; allowing distance and providing support may encourage the eventual development of a therapeutic alliance. Group therapy would increase this client’s anxiety; cognitive or behavioral therapy would be more appropriate.