NCLEX Personality Disorders Quiz: Test Your Knowledge

This client's behavior of being insensitive to others, engaging in abusive behaviors, and lacking remorse aligns with the symptoms of Antisocial Personality Disorder. People with this disorder often disregard the rights of others, show a pattern of deceit and manipulation, and have a disregard for societal norms. They may also display a lack of empathy and remorse for their actions.

The manifestations of lack of self-esteem, strong dependency needs, and impulsive behavior support the diagnosis of borderline personality disorder. Borderline personality disorder is characterized by unstable self-image, intense fear of abandonment, and impulsive and reckless behavior. These manifestations align with the symptoms commonly associated with borderline personality disorder, indicating that Maria's diagnosis is supported by these symptoms.

Clients with personality disorders are characterized by enduring patterns of inflexible behaviors. These patterns are deeply ingrained and pervasive, making it difficult for individuals to adapt to different social and occupational situations. Therefore, it is most likely that clients with personality disorders will manifest these enduring patterns of inflexible behaviors rather than recovering with therapeutic intervention, responding to anti-anxiety medication, or seeking treatment willingly for personally distressing symptoms.

Clients who are suspicious primarily use projection to deal with feelings and thoughts that are not acceptable. Projection is a defense mechanism where individuals attribute their own undesirable thoughts, feelings, or characteristics onto others. By projecting these unacceptable aspects onto others, the individual can distance themselves from these feelings and maintain a sense of self-integrity. This allows them to avoid facing their own uncomfortable emotions and thoughts, creating a sense of relief or denial.

Reaction formation is a defense mechanism where an individual expresses exaggerated opposite behavior or attitudes to hide their true feelings or desires. In this case, the client who frequently preaches against abuse may be using reaction formation to hide their own abusive tendencies or past experiences with abuse. By preaching against abuse, they are trying to convince themselves and others that they are not capable of such behavior.

The client is likely manifesting pseudoparkinsonism. Pseudoparkinsonism is a side effect of antipsychotic medications such as Haldol, characterized by symptoms similar to Parkinson's disease. Pill rolling tremors and muscle rigidity are classic symptoms of pseudoparkinsonism. Tardive dyskinesia refers to involuntary movements of the face and limbs, akinesia refers to a lack of movement, and dystonia refers to abnormal muscle contractions.

When a client behaves in a very hostile manner towards a staff member for no apparent reason, it is likely that the client is manifesting transference. Transference refers to the unconscious redirection of feelings and emotions from past relationships onto a current person or situation. In this case, the client may be unconsciously projecting their negative feelings or hostility from a previous relationship onto the staff member, causing them to behave in a hostile manner.

The nurse's best response in this case would be "I don't know anything about that. You are afraid of being harmed." This response acknowledges the client's fear and validates their feelings without confirming or denying the client's belief. It shows empathy and allows for further exploration of the client's concerns.

The plan of care for clients with borderline personality should include ensuring she adheres to certain restrictions. This is because individuals with borderline personality disorder often struggle with impulsivity and difficulty in maintaining boundaries. By enforcing certain restrictions, it helps provide structure and stability in their lives, which can be beneficial in managing their symptoms and promoting overall well-being.

Ego integrity vs. despair is the correct answer because this developmental task occurs in late adulthood, typically around the age of 65 and beyond. It involves reflecting on one's life and accepting the choices and experiences that have led to a sense of fulfillment and satisfaction. In contrast, individuals who are unable to achieve ego integrity may experience feelings of regret, despair, and a sense of failure. Given that the client in the question is only 42 years old, it is unlikely that he would have reached this stage of development yet.