INSTITUTE OF CHILD HEALTH FACULTY OF NURSING INSTITUTE OF CHILD HEALTH FACULTY OF NURSING

B.Sc. Nursing 6th Semester B.Sc. Nursing 6th Semester

Mental Health Nursing II (Education Module) Mental Health Nursing II (Education Module)
Question Paper Question Paper
Unit: Personality Disorders Unit: Personality Disorders
Full Marks: 100 Full Marks: 100
Time: 3 Hours Time: 3 Hours
Section A – Objective Type (10 Marks) Section A – Objective Type (10 Marks)

I. True/False (5 × 1 = 5 Marks) I. True/False (5 × 1 = 5 Marks)

1. Borderline Personality Disorder is characterized by instability in relationships and 1. Borderline Personality Disorder is characterized by instability in relationships and
self-image. ( ) self-image. ( )
2. Antisocial Personality Disorder patients usually show empathy and concern for 2. Antisocial Personality Disorder patients usually show empathy and concern for
others. ( ) others. ( )
3. Schizoid Personality Disorder is marked by detachment from social relationships. 3. Schizoid Personality Disorder is marked by detachment from social relationships.
( ) ( )
4. Histrionic Personality Disorder patients often seek attention and approval. ( ) 4. Histrionic Personality Disorder patients often seek attention and approval. ( )
5. Obsessive-Compulsive Personality Disorder is the same as Obsessive-Compulsive 5. Obsessive-Compulsive Personality Disorder is the same as Obsessive-Compulsive
Disorder. ( ) Disorder. ( )

II. Fill in the Blanks (5 × 1 = 5 Marks) II. Fill in the Blanks (5 × 1 = 5 Marks)
1. Personality Disorders are grouped into ____ clusters according to DSM-5. 1. Personality Disorders are grouped into ____ clusters according to DSM-5.
2. Patients with ____ Personality Disorder have an excessive need to be admired and 2. Patients with ____ Personality Disorder have an excessive need to be admired and
lack empathy. lack empathy.
3. Suspiciousness and distrust of others are features of ____ Personality Disorder. 3. Suspiciousness and distrust of others are features of ____ Personality Disorder.
4. The primary nursing goal for Personality Disorders is to promote ____ and 4. The primary nursing goal for Personality Disorders is to promote ____ and
improve interpersonal relationships. improve interpersonal relationships.
5. ____ therapy is considered effective in Borderline Personality Disorder. 5. ____ therapy is considered effective in Borderline Personality Disorder.
Section B (2 × 10 = 20 Marks) Section B (2 × 10 = 20 Marks)

Answer any two of the following: Answer any two of the following:
1. A 24-year-old woman with Borderline Personality Disorder presents with frequent 1. A 24-year-old woman with Borderline Personality Disorder presents with frequent
self-harm attempts and unstable relationships. As a nurse, how would you assess, self-harm attempts and unstable relationships. As a nurse, how would you assess,
plan, and implement care for her using the Nursing Process? plan, and implement care for her using the Nursing Process?
2. A 32-year-old man with Antisocial Personality Disorder shows aggressive 2. A 32-year-old man with Antisocial Personality Disorder shows aggressive
behavior and lack of remorse. Discuss the nursing interventions you would apply in behavior and lack of remorse. Discuss the nursing interventions you would apply in
managing his behavior, ensuring patient and staff safety. managing his behavior, ensuring patient and staff safety.
Section C – Short Notes (4 × 5 = 20 Marks) Section C – Short Notes (4 × 5 = 20 Marks)
Answer any four of the following: Answer any four of the following:
1. Histrionic Personality Disorder 2. Obsessive-Compulsive Personality Disorder 1. Histrionic Personality Disorder 2. Obsessive-Compulsive Personality Disorder
(OCPD 3. Role of nurse in the management of Personality Disorders (OCPD 3. Role of nurse in the management of Personality Disorders
4. Difference between Schizoid and Schizotypal Personality Disorder 4. Difference between Schizoid and Schizotypal Personality Disorder
5. Nursing interventions for patients with Narcissistic Personality Disorder 5. Nursing interventions for patients with Narcissistic Personality Disorder
6. Classification of Personality Disorders according to DSM-5 6. Classification of Personality Disorders according to DSM-5
 MENTAL HEALTH II MODULE b) Enforce consistent limits and consequences
MCQs on Personality Disorders c) Show unconditional trust
(50*1= 50) d) Avoid confronting manipulation
1. A patient avoids eye contact, speaks in a monotonous tone, and prefers to stay 10. In a psychiatric ward, a patient manipulates staff to get cigarettes. The
alone despite repeated encouragement to join group therapy. Which personality nurse’s best response is:
disorder is most likely? a) Refuse firmly and explain unit rules consistently
a) Schizoid b) Schizotypal c) Paranoid d) Avoidant b) Give cigarettes to avoid escalation
2. While caring for a paranoid personality disorder patient, the nurse should: c) Bargain for good behavior
a) Use humor to reduce suspicion d) Ignore manipulation completely
b) Give personal opinions freely 11. A histrionic patient frequently changes outfits and demands attention. The
c) Maintain clear, consistent boundaries best nursing approach is:
d) Encourage physical closeness a) Ignore the behavior completely
3. A client says, “I know the nurses are plotting against me.” What is the most b) Provide consistent attention only for healthy interactions
therapeutic nursing response? c) Compliment their appearance often
a) “That’s not true, we care for you.” d) Allow full freedom to maintain self-esteem
b) “What makes you think we are plotting?” 12. The key nursing intervention for narcissistic personality disorder is:
c) “You should stop thinking like that.” a) Criticize unrealistic self-image
d) “I’ll ask the team to explain their actions.” b) Encourage expression of feelings without judgment
4. In schizotypal personality disorder, which nursing intervention is most c) Overpraise achievements to build rapport
appropriate? d) Ignore self-centeredness
a) Encourage elaborate fantasies 13. A patient with borderline personality disorder threatens suicide after a
b) Promote reality testing in gentle ways minor argument. The nurse should:
c) Challenge beliefs directly a) Provide close supervision and safety measures
d) Use confrontation to break delusions b) Ignore the threat as manipulation
5. A schizoid patient refuses group activities. The nurse’s best plan is to: c) Tell them to “calm down”
a) Insist on mandatory attendance d) Transfer them immediately to ICU
b) Respect the need for distance while offering 1:1 interactions 14. Which behavior is MOST characteristic of antisocial personality disorder?
c) Assign them as group leader to boost confidence a) Extreme shyness and avoidance
d) Leave them alone completely b) Lack of remorse for hurting others
6. A client with borderline personality disorder frequently cuts herself. The c) Magical thinking and odd beliefs
nurse’s immediate priority is to: d) Excessive emotionality and drama
a) Explore childhood trauma 15. A client with borderline personality disorder tells the nurse, “I feel empty
b) Ensure wound care and safety and hate myself.” The nurse’s best response is:
c) Confront her about attention-seeking a) “Don’t say that, you are a good person.”
d) Allow her to ventilate feelings without intervention b) “Tell me more about what makes you feel empty.”
7. Which therapeutic approach is most effective for borderline personality c) “You should be grateful for what you have.”
disorder? d) “Stop focusing on the negative.”
a) Cognitive restructuring b) Dialectical behavior therapy (DBT) 16. A patient avoids all group activities, fearing rejection. This is most
c) Electroconvulsive therapy (ECT) d) Aversion therapy consistent with:
8. During shift handover, a patient with borderline personality disorder tells a) Avoidant personality disorder b) Dependent personality disorder
you, “You are the only nurse who understands me. The night nurse was c) Schizoid personality disorder d) Obsessive-compulsive personality disorder
horrible.” This behavior reflects: 17. A client with dependent personality disorder constantly asks the nurse to
a) Splitting b) Projection c) Denial d) Regression make decisions. The best response is:
9. A client with antisocial personality disorder shows manipulative behavior. a) Provide choices and encourage decision-making
The nurse should: b) Decide everything for the client
a) Provide multiple chances for rule-breaking c) Ignore repeated requests
d) Criticize dependency directly d) Encourage acting out feelings physically
18. While caring for an obsessive-compulsive personality disorder patient, the 26. A 23-year-old cuts her wrist after a breakup. Which nursing diagnosis is
nurse should: most appropriate?
a) Allow extra time for decision-making a) Chronic low self-esteem
b) Encourage flexible thinking and problem-solving b) Risk for self-directed violence
c) Punish perfectionism c) Disturbed thought processes
d) Force group participation d) Ineffective denial
19. A dependent patient says, “I can’t take medicine unless you are here.” The 27. A 45-year-old repeatedly sues his neighbors for minor disputes and lacks
nurse’s best strategy is: empathy. Which disorder fits best?
a) Provide step-by-step teaching to foster independence a) Narcissistic b) Antisocial c) Paranoid d) Histrionic
b) Continue administering every dose personally 28. A 28-year-old says, “I want everyone to like me. I can’t say no.” Which
c) Criticize the client for being weak diagnosis is most likely?
d) Ignore the request completely a) Dependent personality disorder
20. A client with avoidant personality disorder avoids group therapy. The b) Histrionic personality disorder
nurse’s best initial plan is: c) Avoidant personality disorder
a) Assign them to speak in front of the group d) Borderline personality disorder
b) Begin with 1:1 sessions to build trust 29. A nurse observes that a patient with antisocial personality disorder lies
c) Confront avoidance immediately frequently. The best intervention is:
d) Exempt them from therapy a) Document behavior and enforce consequences consistently b) Confront with anger
21. Which approach helps reduce manipulative behavior in antisocial clients? c) Ignore lying to maintain rapport d) Allow lying if harmless
a) Firm limit-setting and consistency 30. During a community visit, a client with schizotypal disorder expresses belief
b) Ignoring rules to build trust in “magical powers.” The nurse’s best response is:
c) Rewarding manipulation a) Challenge the belief directly
d) Encouraging bargaining b) Ask gently how these beliefs affect daily life
22. During group therapy, a borderline patient suddenly storms out. The c) Encourage further magical thinking
nurse’s best action is: d) Avoid discussing beliefs
a) Follow immediately and persuade return 31. Which intervention prevents self-harm in borderline clients?
b) Allow cool-down, then process feelings later a) Frequent safety checks and removing sharp objects b) Encouraging isolation
c) Punish by excluding from next session c) Ignoring suicidal statements d) Giving freedom without monitoring
d) Ignore and continue group 32. While teaching family members of a narcissistic patient, the nurse
23. Which nursing outcome is MOST appropriate for schizoid personality emphasizes:
disorder? a) Set clear, consistent boundaries
a) Develops close personal relationships quickly b) Always agree with their views
b) Participates in solitary but meaningful activities c) Avoid giving any feedback
c) Becomes highly sociable d) Overpraise to reduce criticism
d) Eliminates all social withdrawal 33. Which nursing outcome is best for avoidant personality disorder?
24. Which discharge teaching is MOST essential for borderline personality a) Participates in at least one group interaction per week
disorder? b) Eliminates all anxiety
a) Importance of medication adherence c) Develops multiple intimate relationships quickly
b) Safety planning and crisis hotline numbers d) Stops feeling shy permanently
c) Avoidance of group therapy 34. A dependent personality patient is being discharged. Which statement shows
d) Encouragement to isolate when upset effective learning?
25. The most effective way to manage anger in borderline patients is: a) “I will ask others to make decisions for me.”
a) Ignore aggression b) “I will practice making small decisions independently.”
b) Teach coping strategies like deep breathing c) “I will avoid making choices to stay safe.”
c) Restrain immediately for all outbursts d) “I will let my family take full control.”
35. Which medication is sometimes prescribed for impulsivity in borderline 43. A schizoid patient agrees to attend art therapy. Which outcome is most
personality disorder? realistic?
a) SSRIs a) Expresses feelings through creative work b) Develops multiple friendships
b) Benzodiazepines c) Becomes outgoing and social d) Eliminates withdrawal completely
c) Antipsychotics 44. A borderline client develops attachment to the nurse and threatens self-
d) MAOIs harm if transferred. The best intervention is:
36. A forensic nurse evaluates a client with antisocial traits. Which sign suggests a) Maintain professional boundaries and prepare for transition
treatment progress? b) Stay assigned permanently c) Ignore the threat
a) Expresses remorse for past crimes d) Punish with isolation
b) Demands special privileges 45. A patient with antisocial personality disorder continues stealing from others.
c) Continues aggressive behavior Which is the best nursing goal?
d) Avoids all interaction a) Demonstrates acceptable social behavior
37. A borderline patient idealizes one nurse while devaluing another. This b) Becomes emotionally expressive
behavior is best managed by: c) Participates in solitary activities
a) Staff consistency and team approach d) Eliminates all aggression permanently
b) Assigning preferred nurse only 46. Which nursing strategy is MOST important across all personality
c) Ignoring the behavior disorders?
d) Encouraging favoritism a) Maintaining consistent boundaries
38. A histrionic client often flirts with staff. The best nursing action is: b) Ignoring all maladaptive behaviors
a) Redirect attention to appropriate topics c) Allowing unlimited freedom
b) Flirt back to build trust d) Providing immediate cures
c) Ignore and walk away 47. A client with borderline personality disorder asks for extra sleeping pills.
d) Confront harshly The nurse should:
39. The main difference between OCD (anxiety disorder) and obsessive- a) Refuse and explain safety concerns
compulsive personality disorder (OCPD) is: b) Provide to ensure compliance
a) OCPD patients lack insight into rigidity c) Ignore the request
b) OCD patients enjoy rituals d) Give half dose secretly
c) OCPD involves hallucinations 48. Which skill is MOST important for a nurse managing personality disorder
d) OCD is always untreatable clients?
40. A nurse notes that a dependent client is reluctant to sign consent forms. The a) Therapeutic communication and limit-setting
priority intervention is: b) Advanced medical procedures
a) Provide information and support for autonomous decision-making c) Avoiding emotional involvement
b) Let family sign instead d) Giving frequent advices
c) Refuse treatment until decision is made 49. Which behavior in avoidant personality disorder indicates progress?
d) Ignore hesitation a) Attends small group session despite anxiety
41. Which intervention helps prevent staff burnout when caring for borderline b) Avoids all eye contact
clients? c) Refuses all interactions
a) Regular team meetings and supervision d) Leaves therapy early
b) Avoid discussing patient behaviors 50. Which is the PRIORITY nursing diagnosis for borderline personality
c) Work with patient alone disorder?
d) Ignore manipulations silently a) Risk for self-directed violence
42. Which statement shows improvement in narcissistic personality disorder? b) Impaired mobility
a) “I realize I’m not perfect and can accept feedback.” c) Imbalanced nutrition
b) “I deserve special treatment from everyone.” d) Deficient fluid volume
c) “Nobody understands me except myself.”
d) “I must be admired all the time.”