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How does personality disorder differ from personality traits?
Personality disorder causes impairment in social and occupation-
al functioning, whereas traits do not.
Personality disorder is usually evident earlier in the person's Personality disorder causes impairment in social and occupation-
development than are traits. al functioning, whereas traits do not.
Personality traits usually cause the person a great deal of difficulty
but only sporadically.
Personality disorder is usually more long term than are traits.
A personality disorder is defined as a collection of traits that do
what?
Cause behavioral dysfunction and inner distress
Cause behavioral dysfunction and inner distress
Are malleable and poorly defined
Lead to aggression and violence
Lead to withdrawn and antisocial behavior
Which statement accurately reflects the prognosis for a client with
a personality disorder?
Clients make the most improvement with short-term insight-ori-
ented therapy.
The prognosis for personality disorders is poor, even with very Prognosis varies based on the degree of functional impairment
long-term therapy. and the client's motivation to change.
Clients with personality disorders have a fairly good prognosis
even without therapy.
Prognosis varies based on the degree of functional impairment
and the client's motivation to change.
While shopping in a grocery store, a client with borderline per-
sonality disorder (BPD) greets the sibling of a neighbor with a
great big hug. Then about 5 minutes later, the client walks past the
sibling and ignores the sibling. The client is demonstrating what?
Affective instability
Dichotomous thinking
Affective instability
Dissociation
Identity diffusion
For a person to be diagnosed with antisocial personality disorder,
the individual must be a minimum of what age?
7 years
18 years
13 years
18 years
21 years
The use of pharmacotherapy in the treatment of personality dis-
orders is optimized if this intervention is what?
Used in addition to psychotherapy
Used in addition to psychotherapy
The primary treatment modality
Only minimally effective due to severe side effects
Well accepted by the clients
The nurse is conducting an admission assessment of a
41-year-old client. Each time that the nurse asks the client a ques-
tion, the client defers to the client's spouse to answer the question.
Such behavior is consistent with which personality disorder?
Dependent personality disorder
Borderline personality disorder
Histrionic personality disorder
Dependent personality disorder
Antisocial personality disorder
Which occurs when thinking, feeling, or behaviors occur outside
a person's awareness?
Affective instability
Dissociation
Impulsivity
Dissociation
Dichotomous thinking

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Which occurs when a client tends to adore and idealize other
people even after a brief acquaintance but then quickly leaves
them if these others do not meet the client's expectations in some
way?
Splitting
Splitting
Thought stopping
Decatastrophizing
Positive self-talk
A mental health nurse is working with a client with antisocial
personality disorder. The nurse has just reviewed the unit rule
of one cigarette per break. While telling the client about the unit
rules, the client asks, "Well, if I have not done anything bad all
day, can I have two cigarettes instead of one?" Which would be
the most therapeutic nursing response? "No, only one cigarette is allowed per break time."
"Well, that's a good question. I need to check with the team."
"No, only one cigarette is allowed per break time."
"This is a good example of trying to push your limits."
"It depends on whether or not we can make that exception that
day."
Which statement by a client with borderline personality disorder
(BPD) is an example of catastrophizing?
"This is the most awful thing that has ever happened to me."
"This is the most awful thing that has ever happened to me."
"No one ever listens to me."
"I never get what I want."
"If I had not made him mad, he wouldn't have hit me."
When teaching a client with antisocial personality disorder
(ASPD), which approach would be most appropriate for the nurse
to use?
Direct Direct
Lecture
Challenging
Confrontational
A nurse is preparing a presentation for a group of staff nurses
on personality disorders. When describing antisocial personality
disorders (ASPD), the nurse would explain that for a person to be
diagnosed with the disorder, the person must be at least which
age? 18 years
15 years
18 years
21 years
25 years
Which personality disorder is characterized by a pervasive pattern
of grandiosity, need for admiration, and a lack of empathy?
Narcissistic
Narcissistic
Histrionic
Dependent
Obsessive-compulsive
For clients with borderline personality disorder, there is a tenden-
cy to see the world as either good or bad. As a result, these clients
use the primitive defense of what?
Regression Splitting
Denial
Splitting
Compensation
A client with borderline personality disorder starts flirting with the
nurse, saying the client dreams about the nurse at night and wants
to kiss the nurse. What would be the best response by the nurse? "I feel uncomfortable with what you said. My role is to support you
"That is very sweet of you to say." in recovery."
"I feel uncomfortable with what you said. My role is to support you
in recovery."
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"I feel flattered that you think that much of me, but nurses don't
date clients."
"Let's talk about something else now."
A client is admitted to the psychiatric unit with a diagnosis of bor-
derline personality disorder. What finding does the nurse expect
the assessment to reveal?
acute discomfort in relationships acute discomfort in relationships
disregard for the rights of others
preoccupation with orderliness
attention-seeking behaviors
A client is admitted with a diagnosis of schizotypal personality dis-
order. Which characteristic would this client exhibit during social
situations?
Paranoid thoughts Paranoid thoughts
Perfectionism
Trusting behaviors
Dependency needs
A client is a 25-year-old who has a long history of being suspicious
of the client's friends and spouse. The client persistently accuses
the client's spouse of being unfaithful. The client accuses friends
of making statements that are insulting to the client's character.
Which is the most accurate description of the client's personality? Paranoid
Schizoid
Paranoid
Schizotypal
Antisocial
A nurse is reviewing the medical record of a female client diag-
nosed with borderline personality disorder (BPD). Which would
the nurse identify as one of the strongest risk factors for this
disorder?
Abuse as a child
Abuse as a child
Parental alcohol abuse
Poverty
History of depression
A 43-year-old female client is observed walking and dancing
around the unit dressed in red high heels and a provocative style
of dress. The client is seen sitting on the lap of a male client on the
unit, and they are laughing. Which is the most therapeutic nursing
intervention?
"I need for you to get off his lap, this behavior is not appropriate."
"Why are you sitting on the nurse's lap?"
"You need to go to your room because you are engaging in
sexually provocative behavior again!"
"I need for you to get off his lap, this behavior is not appropriate."
"Why don't we go play a game of ping-pong?"
A nurse is providing care to a client with antisocial personality
disorder. As part of the plan of care, the client is to participate in a
problem-solving group. The nurse understands that this interven-
tion is effective based on which rationale?
It helps to reinforce self-responsibility.
It requires the client to develop attachments.
It sets up specific boundaries for the client.
It helps to reinforce self-responsibility.
It avoids confrontation about dysfunctional patterns.
Gambling, binge eating, and engaging in unsafe sex are examples
of what?
Identity diffusion
Impulsivity
Dissociation
Affective instability
Impulsivity

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Clients with borderline personality disorder (BPD) are usually
admitted to the inpatient setting because they exhibit what?
Aggression
Self-harm
Splitting
Self-harm
Impulsivity
The nurse in charge of an inpatient psychiatric unit is irritated
with a client who has borderline personality disorder. Which step
should the nurse take?
Confront the client firmly about how the client's behavior makes
the nurse feel. Discuss the feelings with a colleague to promote coping.
Direct the client to another staff member when the client tries to
interact.
Discuss the feelings with a colleague to promote coping.
Arrange for the client to be transferred to another unit.
The nurse is interviewing a client with a history of violence. The
client boasts that the client "put a kid in a wheelchair" once
when the client was younger and has maimed others. The client
states, "Who cares? Life's tough." Violence and insensitivity are
associated with which personality disorder? Antisocial personality disorder
Schizoid personality disorder
Antisocial personality disorder
Histrionic personality disorder
Borderline personality disorder
The adult children of a client with narcissistic personality disorder
meet with the therapist as part of their parent's treatment. The
nurse is aware that which statement by the daughter is consistent
with behavior typically associated with this personality disorder?
"My parent never really seemed to see me as a person with my
"My parent was always timid and fearful."
own thoughts and problems."
"My parent never had any family or friends over to the house."
"My parent was constantly threatening to commit suicide."
"My parent never really seemed to see me as a person with my
own thoughts and problems."
The nurse is in the process of planning the care of a psychi-
atric-mental health client and has specified the following outcome:
The client will be free from self-inflicted harm. What is this client's
most likely diagnosis?
Borderline personality disorder
Dependent personality disorder
Borderline personality disorder
Antisocial personality disorder
Schizoid personality disorder
Which would be the priority nursing diagnosis for a client diag-
nosed with borderline personality disorder (BPD)?
Risk for self-mutilation
Risk for self-mutilation
Ineffective coping
Disturbed thought process
Chronic low self-esteem
The nurse is conducting an education group for women at risk for
self-mutilation. What is the most important goal for this group?
Learning strategies to refrain from self-harm
Learning strategies to refrain from self-harm
Learning problem solving
Discussing feelings about self-harm
Expressing angry feelings
A 30-year-old client who has not paid rent in 4 months is being
evicted from an apartment. The client is brought to the hospital
after the client uses a kitchen knife to cut the client's wrist in
response to the stress of the eviction. The client's behavior is Borderline personality disorder
consistent with what?
Paranoid personality disorder
Borderline personality disorder
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Schizotypal personality disorder
Antisocial personality disorder
A client on an inpatient psychiatric unit has features of borderline
personality disorder. The client is frequently angry, has an unsta-
ble sense of self, and is highly impulsive. The client can be verbally
abusive to staff, who feel manipulated by the client's behaviors.
Which intervention does the nurse determine as priority? Setting limits
Social skills training
Setting limits
Stress management techniques
Increased recreational therapy
A nurse is preparing an inservice program for a group of mental
health nurses on the topic of borderline personality disorder.
When discussing the need for hospitalization, which would the
nurse include as the most likely reason for inpatient hospitaliza-
tion? Nonsuicidal self-injury
Dichotomous thinking
Identity diffusion
Affective instability
Nonsuicidal self-injury
The most serious consequence of behaviors seen in borderline
personality disorder includes what?
Identity diffusion
Self-injury
Impulsivity
Self-injury
Dissociation
The nurse is caring for a client with antisocial personality disorder.
Which statement is most appropriate for the nurse to make when
explaining unit rules and expectations to the client?
"You'll be expected to attend group therapy each day."
"I and other members of the health care team would like you to "You'll be expected to attend group therapy each day."
attend group therapy each day."
"You'll find your condition will improve much faster if you attend
group therapy each day."
"Please try to attend group therapy each day."
A nursing instructor is teaching about the importance of bonding
and how an easy temperament can serve as a protective factor
against psychopathology. Which statement made by a student
demonstrates a need for further instruction?
"Temperament is malleable." "Temperament is not changeable."
"Temperament is not changeable."
"Temperament seen in infancy is often seen later in life."
"Temperamental differences among children can be observed
very early in life."
The nurse is counseling a 28-year-old client with avoidant per-
sonality disorder. Despite being employed, the client verbalizes
having low quality of life due to anxiety and isolation. Which
therapeutic goals does the nurse establish as priority?
The client will experience increased self-esteem.
The client will be able to accept a job promotion.
The client will experience increased self-esteem.
The client will engage in less risk-taking behavior
The client will form a romantic relationship.
Treatment approaches for clients with personality disorders gen-
erally rely on which modality?
Pharmacotherapy
A combination of approaches
Cognitive-behavioral therapy
Individual therapy
A combination of approaches

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The nurse is assessing a client who is diagnosed with borderline
personality disorder. Which client statement indicates the client is
at risk for self-injurious behavior?
"I have felt so down lately. I don't enjoy doing anything anymore."
"I do what I do because others tell me to do so." "I have felt so down lately. I don't enjoy doing anything anymore."
"When I feel extremely anxious, it is like my mind goes somewhere
else."
"It is almost as if as soon as I think of doing something, I imme-
diately do it."
A client admitted on the inpatient mental health unit has been
suspicious of other clients on the unit. This client is often angry
at others' comments, and carries a grudge against a roommate
for accidentally using the client's bath towel. Which personality
disorder is most likely the client's diagnosis? Paranoid
Antisocial
Borderline
Paranoid
Histrionic
Which cluster of personality disorders is represented by individ-
uals who appear anxious or fearful?
Cluster A
Cluster C
Cluster B
Cluster C
Cluster D
Which diagnosis is associated with a pervasive disregard for and
violation of the rights of others?
Antisocial personality
Antisocial personality
Borderline personality
Passive-aggressive personality
Schizoid personality
After reviewing information about different personality disorders, a
group of nursing students demonstrates understanding when they
identify which as associated with schizoid personality disorder?
Introverted Introverted
Overly friendly
Highly social
Exuberant
After teaching a group of nurses about borderline personality
disorder, the leader determines that the education was successful
when the group identifies that symptoms typically begin in which
age group?
Adolescence
Adolescence
Young adulthood
Middle-age individuals
Late adulthood
A client asks the nurse to go to lunch with the client one day next
week after the client is discharged. Which statement is the most
therapeutic response?
"My role here is to help you recover. Let's talk about what else you
can be doing after discharge." "My role here is to help you recover. Let's talk about what else you
"That sounds good. Call the unit when you decide which day, and can be doing after discharge."
we can set it up."
"I'd love to do that, but I'm on vacation next week."
"I'm sorry, it is not within my role to have any affiliation with you
after your discharge."
Into which personality disorder category are individuals placed
whose behavior appears odd or eccentric?
Cluster A
Cluster A
Cluster B

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Cluster C
Cluster D
Which personality disorder is diagnosed more often in women?
Histrionic
Schizoid Histrionic
Antisocial
Narcissistic
Avoidant, dependent, and obsessive-compulsive personality dis-
orders are characterized by what?
Odd or eccentric behaviors
Anxious or fearful behaviors
Dramatic or erratic behaviors
Anxious or fearful behaviors
Manic or withdrawn behaviors
A client with borderline personality disorder has been admitted
to the inpatient unit because the client has been engaging in
wrist cutting. The client's sibling is visiting, and the sibling asks
the nurse to explain why the client sometimes does this. Which
response by the nurse would be most appropriate?
"Sometimes the self-injurious behavior is undertaken to relieve
"Sometimes the self-injurious behavior is undertaken to relieve
stress."
stress."
"Self-injurious behavior often calms and sedates people with this
diagnosis."
"Sometimes they do it to avoid the onslaught of delusional think-
ing."
"The self-mutilation often slows the mood swings your sibling
experiences."
A nurse is caring for a client diagnosed with borderline personality
disorder. The nurse has instructed the client about using the
communication triad. The nurse determines that the client has
understood this technique when stating what?
"I should start by stating my feelings as an 'I' statement."
"Maybe I should start by describing the situation that has me "I should start by stating my feelings as an 'I' statement."
upset."
"I should first tell the other person what I'd like to be different about
the situation."
"I should begin by telling the other person what has triggered my
emotion."
A client is diagnosed with a personality disorder manifested by
odd, eccentric behavior. Which personality disorder would be
associated with this manifestation?
Avoidant Paranoid
Dependent
Obsessive-compulsive
Paranoid
A client is admitted to the mental health unit after the client's
spouse brings the client to the emergency department. Upon
arrival, the spouse explained that the client had been crying all
weekend and stating that the client wanted to die. Upon further
assessment, the spouse reports that the client always has diffi-
culty controlling anger and frequently worries that the spouse will
leave the client. Recently, the client has been getting drunk every Borderline personality disorder
night, which the client never used to do. What diagnosis should
the nurse suspect applies to this client?
Bipolar disorder
Borderline personality disorder
Depression
Mania
When providing care to a client who consistently attempts to
manipulate the staff, the nurse can best maintain the therapeutic
milieu by doing what?
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Instructing the staff to enforce all unit rules consistently
Encouraging questions and discussing the client's concerns
Instructing the staff to enforce all unit rules consistently
Promoting social ostracism of the client's exhibiting manipulation
Scheduling staff one-on-one time with the client
A nurse working with a client with borderline personality disorder
could establish which as outcome criteria?
Display anger more frequently.
Tolerate stress without self-mutilation.
Act out neediness.
Filter concerns and insecurities through the nurse.
Tolerate stress without self-mutilation.
Which personality disorder is most often treated within the inpa-
tient psychiatric setting?
Antisocial
Borderline
Borderline
Dependent
Schizotypal
The psychiatric nurse expects similar experiences among all
clients diagnosed with a Cluster A personality disorder related to
...
episodic manic behavior. interpersonal relationships.
lack of employable skills.
interpersonal relationships.
tendency to be distrustful.
When conducting a social history with a client diagnosed with a
borderline personality disorder (BPD), which question would be
most important to ask the client related to impulsivity?
"Do you think of yourself as physically attractive?" "Do you always practice safe sex?"
"Are you pleased with your medications?"
"Do you always practice safe sex?"
"Are you interested in making your partner happy?"
The nurse-therapist is conducting a group therapy session in
which one of the participants is an adult who has been diagnosed
with narcissistic personality disorder. The nurse recognizes the
significance of childhood experiences in the etiology of personali-
ty disorders, which for this client may have included what pattern?
The client's parent was in a constant state of crisis and depended
heavily on the client for emotional support. The client's parent catered to the client's every need and the client
The client's parent catered to the client's every need and the client used temper tantrums to successfully get the client's way.
used temper tantrums to successfully get the client's way.
The client's parent was a rigid disciplinarian who demanded
complete subservience from both the client and the client's other
parent.
The client's parents had excessively high performance expecta-
tions of the client and failure was met with severe sanctions.
The nurse is providing care for a client who has been diagnosed
with antisocial personality disorder. Which outcome should the
nurse prioritize when planning this client's care?
The client will establish an adequate balance of rest, sleep, and
activity. The client will to express anger in an adaptive, nonviolent manner
The client will use the support system without becoming overly
dependent on it.
The client will to express anger in an adaptive, nonviolent manner
The client will be free from self-inflicted harm.
What does the nurse recognize as the most likely explanation for
the self-mutilating behaviors that occur with borderline personality
disorder?
An expression of intense anger or helplessness in order to block
The result of an inherited disorder that manifests itself as an
emotional pain
incapacity to tolerate stress
Use of projective identification to reduce anxiety
An expression of intense anger or helplessness in order to block
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emotional pain
A constitutional inability to regulate affect that predisposes clients
to psychic disorganization
A client comes to the clinic for a follow-up visit. Despite being
warm and friendly with the nurse on a previous visit, today the
client presents with anger and sarcastic undertones with the same
nurse. The client is presenting which behavior commonly seen in
borderline personality disorder? Affective instability
Identity diffusion
Depression
Affective instability
Dichotomous thinking
A nurse is providing care to a client with borderline personality
disorder. When providing for the client's biopsychosocial needs,
the nurse would address which in the biologic domain?
Establishing a therapeutic relationship Assisting with sleep measures
Establishing boundaries
Assisting with problem solving
Assisting with sleep measures
A nurse is preparing a teaching plan for a client with antisocial
disorder. Which would the nurse most likely employ to promote
successful education?
Engaging the client in a discussion to direct the topic to the client. Engaging the client in a discussion to direct the topic to the client.
Establishing general goals for teaching.
Allowing the client to guide the teaching to other topics.
Using a lecture approach to provide information.
A client who has a diagnosis of histrionic personality disorder is
admitted to an inpatient mental health unit. The client leaves the
unit briefly without notifying the nurse or other members of the
health care team. The client's nurse uses confrontation to remind
the client of the rules of coming and going from the unit. The client
has responded, "But those rules are more for the schizophrenics
and crazy people, right?" How should the nurse respond?
"Your safety is the priority while you are admitted to this unit.
"Your safety is the priority while you are admitted to this unit.
Please ensure you notify your nurse prior to leaving."
Please ensure you notify your nurse prior to leaving."
"Even though there's no real safety risk in your case, I'd appreciate
it if you tried to remember next time."
"What would make you think that? You're supposed to behave the
same as anyone else here."
"If you want an exemption, I can ask the psychiatrist but there are
no guarantees."
A nurse is reviewing the medical record of a client diagnosed with
antisocial personality disorder. The nurse notes that the client has
had numerous episodes involving irritability, aggressiveness, and
impulsivity and has exhibited callousness toward others. Based
on this information, which nursing diagnosis would the nurse
Risk for other-directed violence
identify as a priority?
Risk for suicide
Risk for other-directed violence
Risk for self-injury
Risk for self-directed violence
Which personality disorder is categorized as a Cluster B disorder?
Paranoid personality disorder
Obsessive-compulsive personality disorder Narcissistic personality disorder
Schizoid personality disorder
Narcissistic personality disorder
A nurse is caring for a client with schizoid personality trait. When
developing a plan of care for the client, which would a nurse most
Social skills training
likely include?
Coping skills training
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Relaxation techniques
Social skills training
Anger management training
A nursing instructor is teaching about using behavioral interven-
tions when caring for clients with borderline personality disorder.
Which statement by a student indicates a need for further instruc-
tion?
"Sometimes it is best to confront a client about irritating behav-
"Grossly disrespectful behaviors are better ignored."
iors."
"In some instances, negative responses can be viewed as positive
reinforcement."
"Grossly disrespectful behaviors are better ignored."
"Sometimes it is best to just ignore a client's irritating behaviors."
A mental health nurse is planning a psychotherapy group for
clients with personality disorders. The nurse knows the group will
be comprised of a significant number of clients from Arab and
Asian ethnicity. Which should the nurse consider when planning
this group?
Be cautious to treat both populations with respect to their cultur-
Be aware of the how each client's personality has been affected
ally driven health care preferences.
by his or her cultures values and beliefs.
Ensure cultural sensitivity when discussing client problems with
their family members
Expect that most people of Arab descent will have posttraumatic
stress.
Be aware of the how each client's personality has been affected
by his or her cultures values and beliefs.
A client with paranoid personality disorder is admitted to a psy-
chiatric facility. Which statement by the nurse would best establish
rapport and encourage the client to confide in the nurse?
"It bothers me when I think people are talking about me." "I get upset once in a while, too."
"It's normal not to trust anyone."
"I know how you feel. I'd feel the same way in your situation."
"I get upset once in a while, too."
Which personality disorder is characterized by an alteration be-
tween hostile self-assertion, such as stubbornness, and exces-
sive dependence?
Dependent Passive-aggressive
Histrionic
Narcissistic
Passive-aggressive
When clients diagnosed with borderline personality disorder
(BPD) see nurses as either all good or all bad, the client is using
which primitive defense?
Projective identification Splitting
Defending
Splitting
Invalidating
Clients with borderline personality disorder (BPD) are usually
admitted to an inpatient setting because of what?
Splitting
Threats of self-harm
Threats of self-harm
Agitation
Medication noncompliance
Based on psychological theories, which is believed to be critical
to understanding personality disorders?
Functional attachments
Difficult temperament
Chaotic families
Abuse
Difficult temperament

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Which is considered a part of the social domain of the biopsy-
chosocial interventions for the client diagnosed with borderline
personality disorder (BPD)?
Medication administration Establishing boundaries
Establishing boundaries
Self-harm prevention
Nutritional management
A psychiatric-mental health nurse is reviewing information about
the possible theories associated with narcissistic personality dis-
order. The nurse demonstrates understanding of the information
by identifying which concept as being associated with the devel-
opment of this personality disorder? Parental overindulgence of a child
Deficiency of serotonin and dopamine
Alteration in brain structures
Parental overindulgence of a child
Complete emotional separation from a caregiver
A client who has a history of displaying passive aggressive be-
havior has a pattern of being late for counseling appointments
or cancelling at the last minute. As a result, the counselor has
set a limit with the client specifying that the client will forfeit
the appointment if the client is more than 5 minutes late for an
appointment. Today, the client has come to the counselor's office
more than 10 minutes late, at which point the counselor has
reminded the client of this limit. Which response would be most "Oh my gosh, I'm so sorry but it totally wasn't my fault because
consistent with this client's diagnosis? traffic was a complete nightmare."
"Whatever. No skin off my back."
"I apologize completely and this time I really promise that it will
never happen again."
"Oh my gosh, I'm so sorry but it totally wasn't my fault because
traffic was a complete nightmare."
"You're still getting paid for this appointment so what difference
does it make?"
The nurse is assessing a client who has borderline personality
disorder. Which would be the priority considering the comorbid
conditions associated with this disorder?
Somatic complaints Nutrition patterns
Physical functioning
Nutrition patterns
Personal hygiene practices
A client with borderline personality disorder tells a nurse, "I'm
afraid to get on a train because we'll probably get into a wreck."
Which response by the nurse would be most appropriate?
"What are the chances of that actually happening?" "What are the chances of that actually happening?"
"Now you know that won't happen."
"Have you had a bad experience riding a train?"
"Have you thought about going by automobile?"
A 17-year-old client comes to the community crisis clinic with mul-
tiple superficial cuts on the wrist. The client is crying uncontrollably
and states that the client's romantic partner has left and the client
doesn't want to live without the partner. What would be the most
therapeutic initial nursing response?
"Many partners change their minds about relationships, this is "I can see that you are feeling anxious. I will stay with you until you
really quite normal." feel better."
"There's plenty of fish in the sea. Don't worry, at your age you will
find someone else."
"Let's set some boundaries on your behavior here."
"I can see that you are feeling anxious. I will stay with you until you
feel better."
A nurse is working with a client diagnosed with antisocial person-
ality disorder. The nurse needs to keep in mind which about the

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therapeutic relationship?
The client continuously focuses on new topics during the relation-
ship.
The relationship initially is superficial because of a lack of client
The relationship initially is superficial because of a lack of client
commitment.
commitment.
The client uses the relationship to change the problem behavior.
The goal is to alleviate dysfunctional thinking.
A client in the emergency department has self-inflicted wounds
on both arms. Assessment reveals that the client was diagnosed
with borderline personality disorder 6 months ago, for which the
client has been receiving outpatient treatment. The client tells the
nurse that the client recently found out the client's therapist is
moving and will no longer be able to work with the client. What Self-mutilation
is the priority nursing diagnosis for this client?
Self-mutilation
Anxiety
Stress
Loneliness
Which personality disorder is characterized by mistrust and sus-
piciousness of others?
Histrionic
Paranoid
Narcissistic
Paranoid
Dependent
A client attends an outpatient mental health clinic accompanied by
the client's spouse for an assessment. The client's spouse reports
the client is easily irritated if the home is not maintained in a
specific order and when the client is unable to complete a "to do"
list on time. The client has a serious and formal demeanor. Which
Obsessive-compulsive personality disorder
personality disorder best describes this client?
Narcissistic personality disorder
Avoidant personality disorder
Paranoid personality disorder
Obsessive-compulsive personality disorder
A client with a personality disorder is upset and calls the nurse a
"stupid cow." Which is an effective initial response to this client's
behavior?
Discuss displacement of anger and set limits.
Discuss displacement of anger and set limits.
Walk away from the client.
Demonstrate empathy by reaching out to touch the client.
Report the behavior to the health care provider so that consisten-
cy and consequences can be followed.
Which addresses the psychological domain of biopsychosocial
interventions for a client with borderline personality disorder?
Prevention of self-harm
Withdrawing attention as much as possible
Environmental management
Communication skills
Withdrawing attention as much as possible
Which is a technique used to help the client with borderline
personality disorder gain control over self-critical thoughts?
Communication triad
Thought stopping
Affective instability
Thought stopping
Delay gratification
A client diagnosed with schizoid personality disorder is described
by family members as what?
Eccentric and a loner
Eccentric and a loner
Dramatic and emotional
Nervous and fearful
Tired and sad

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Which of the following interventions should the nurse include in a
plan of care for a client with histrionic personality disorder?
Accept the client's behavior
Set limits on attention-seeking behavior
Assist the client to eliminate passive behavior
Set limits on attention-seeking behavior
Try to meet the client's needs for attention
Brain dysfunction associated with borderline personality disorder
(BPD) occurs in the limbic system and which lobe of the brain?
Frontal
Frontal
Temporal
Parietal
Occipital
A nurse is developing a nurse-client relationship with a client di-
agnosed with borderline personality disorder (BPD). Which state-
ment by the nurse demonstrates that the nurse understands the
client's fears of abandonment and intimacy?
"I'm here to help you for as long as I can." "I will be seeing you during the daytime this week."
"I will be seeing you during the daytime this week."
"We will work on things until your physician says you can go
home."
"Let's see how things go first and then how long you need me."
A client has a diagnosis of borderline personality disorder and
lives at home with the client's parents. The client has been in the
psychiatric unit for 2 weeks and is scheduled to be discharged
tomorrow. Which would be most therapeutic when the client's
parents come in to discuss discharge plans?
Attempt to discuss placing the client into an assisted living envi-
Ask the parents to keep a written schedule of activities for each
ronment
day for the client
Ask the parents how they have coped with the client's behaviors
over the years
Ask the parents to keep a written schedule of activities for each
day for the client
Encourage the parents to discuss the possibility of the client going
into a day-care program when the client goes home
Which of the following occurs when self-definition is poorly devel-
oped?
Identity diffusion
Identity diffusion
Affective instability
Dichotomous thinking
Dissociation
A client with antisocial personality disorder is begging to use the
phone to call the client's spouse, even though it is against the
unit rules. The client begs, "It is just this once, and my spouse will
be so hurt if I don't call." Which would be the most appropriate
response by the nurse?
"You may not use the phone to call your spouse."
"Only to help your spouse, you can call this time."
"I will get in trouble with my supervisor if I let you call."
"You may not use the phone to call your spouse."
"You cannot call because you need to focus on your recovery
while you are here, not your spouse."
Which is a psychosocial explanation for the development of per-
sonality disorders?
Highly self-directed people reflect uncooperativeness and intoler-
ance.
Failure to complete a developmental task jeopardizes future per-
Cooperative people become increasingly helpless over time.
sonality development.
Failure to complete a developmental task jeopardizes future per-
sonality development.
Self-transcendence contributes to self-consciousness and mate-
rialism.

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When facilitating change in the behavior of a client diagnosed
with a personality disorder, the nurse knows which intervention
will have the greatest impact on success?
collaborating with the client when establishing treatment goals
educating the client to the importance of complying with treatment
collaborating with the client when establishing treatment goals
interventions
evaluating the client's understanding of the etiology of the pre-
scribed medications
conducting regular assessments so the treatment can be
changed when necessary
A nurse is conducting a mental status exam of a client with
borderline personality disorder (BPD). The client verbalizes state-
ments that demonstrate a view of things as absolute, with no per-
ception of compromise. The nurse interprets this type of thinking,
documenting it as which of the following? Dichotomous
Dichotomous
Abstract
Irrational
Disorganized
Which defense mechanism is used by people diagnosed with bor-
derline personality disorder to protect their fragmented self-im-
age?
Compensation Projective identification
Projective identification
Regression
Repression
A nurse is assessing a client with borderline personality disorder.
During the assessment the nurse notes that the client is using
projective identification. Which of the following would support this
interpretation?
Client attributes own feelings falsely to others.
Client attributes own feelings falsely to others.
Client lacks a definitive sense of self
Client misinterprets environmental stimuli
Client is unable to control emotional reactions in social situations
After educating a group of nursing students on comorbidities
associated with borderline personality disorder, the instructor
determines a need for additional education when the students
identify which of the following as a common comorbid condition?
Schizophrenia
Mood disorder
Substance abuse disorder
Eating disorder
Schizophrenia
A psychiatric nurse is providing care to a client with borderline
personality disorder. The nurse implements strategies when the
client is frustrated and stressed to help control which emotion?
Anger Anger
Depression
Anxiety
Shyness
After teaching a group of nurses about problems commonly ex-
perienced by clients with borderline personality disorder (BPD),
the nurse determines that additional teaching is needed when the
group identifies which problem?
Having exaggerated self-esteem
Maintaining intimate relationships
Having exaggerated self-esteem
Keeping a job
Living within the law
Which of the following personality characteristics is most likely to
predispose an individual to medication abuse?
Low self-esteem
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Desire to inflict pain upon oneself
Passive-aggressive personality disorder Low self-esteem
Histrionic personality disorder
The client is a 29-year-old who is having a great deal of difficulty
with a new job. The client has been unable to make decisions
individually and feels overwhelmed when the client needs to begin
a new project. The client often relies on one of her coworkers to
help with decisions and projects. Which would describe the client
Dependent personality
correctly?
Narcissistic personality
Dependent personality
Schizotypal personality
Histrionic personality
A nurse caring for a client with borderline personality disorder
(BPD) consistently informs the client of the length of the relation-
ship and routinely prepares the client for termination and the end
of hospitalization. Which is the nurse trying to prevent?
Maladaptive expression of emotions
Poor social skills
Depression
Mania
Maladaptive expression of emotions
A nurse is describing histrionic personality disorder to a group of
new nurses. Which term would the nurse most likely use?
Attention seeking
Attention seeking
Psychopath
Sociopath
Lacking empathy
Impulsivity and difficulty controlling anger are characteristic of
which mental health diagnosis?
Depression
Borderline personality disorder
Schizophrenia
Posttraumatic stress disorder
Borderline personality disorder
A nurse is interviewing a client and suspects that the client may
have narcissistic personality disorder. Which statement by the
client would help support the nurse's suspicions?
"I have a very important position in life; everyone I know wants to
"I have a very important position in life; everyone I know wants to
be like me."
be like me."
"My spouse is poisoning my food to get rid of me and marry my
spouse's boss."
"I like to work alone because then I can let my thoughts wander."
"I'm always the life of the party, making new friends all the time."
A client with borderline personality disorder has been admitted
to the inpatient unit after being found in the client's parents'
bedroom, burning the client's arm with an iron. This injury required
a brief stay in the hospital's burn unit prior to transfer to your
psychiatric unit. Which is the nursing care priority for this client
Protection from self-mutilation
during the first 24 hours of admission?
Suicidal assessment
Working on self-esteem
Impulse control
Protection from self-mutilation
The nurse in charge of an inpatient psychiatric unit is frustrated
and angry with a client who has borderline personality disorder.
Which steps should the nurse take?
Confront the client firmly but compassionately about how the Examine the nurse's own feelings to discover the source of the
client's behavior makes the nurse feel. nurse's anger.
Direct the client to another staff member when the client tries to
interact.
Examine the nurse's own feelings to discover the source of the
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nurse's anger.
Ignore the feelings and move on from the client.
Emotional regulation skills are taught to those diagnosed with
borderline personality disorder to manage what?
Problem solving
Impulsive behaviors
Impulsive behaviors
Physical disability
Psychotic behaviors
The nurse is admitting a client with histrionic personality disorder
to the inpatient unit. The nurse would anticipate that this client
may exhibit which behavior?
Manipulation Self-dramatization
Distrust
Perfection
Self-dramatization
A 70-year-old client comes to the clinic with the client's daughter
for group therapy. The client wants the daughter to do everything
with the client, is afraid to be left alone, and is having difficulty
making any individual decisions. Interventions for this client would
center around the diagnosis of which personality disorder? Dependent
Narcissistic
Dependent
Antisocial
Schizoid
When documenting observations of the behaviors exhibited by a
client diagnosed with borderline personality disorder, the nurse
can correctly use which terms?
Impulsive, self-destructive, unstable Impulsive, self-destructive, unstable
Impulsive, aggressive, and manipulative
Perfectionistic, rigid, and controlling
Emotional, dramatic, and theatrical
A group of nursing students is reviewing information about antiso-
cial personality disorder. The students demonstrate understand-
ing of this disorder when they state what?
The disorder occurs more frequently in women. The individual must be at least 18 years of age.
The individual must be at least 18 years of age.
The disorder is found primarily in Asian individuals.
Alcohol abuse disorder rarely accompanies this disorder.
As part of a client's treatment plan for borderline personality
disorder, the client is engaged in dialectical behavior therapy. As
part of the therapy, the client is learning how to control and change
behavior in response to events. The nurse identifies the client as
learning which type of skills? Self-management skills
Emotion regulation skills
Mindfulness skills
Distress tolerance skills
Self-management skills
A nurse is assessing a client and suspects that the client may
have obsessive-compulsive personality disorder based on which
statement?
"I need to have everything perfect. My life is organized down to the
"I need to have everything perfect. My life is organized down to the
second."
second."
"I don't have any friends and I don't like to do anything socially."
"I can't trust anybody that I meet, no matter where it is or who they
are."
"I am better than everyone and they should emulate me."

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