Question 1

A client exhibits dependency on staff and peers and expresses fear of abandonment.Using Mahler's theory of object relations,which should the nurse expect to note in this client's childhood?

Accepted Answer

During phase 3 (5 to 36 months)of Margaret Mahler's individuation theory,there should be a strengthening of the ego and an acceptance of "self" with independent ego boundaries.Inconsistency by the maternal figure during individuation may in later years result in feelings of helplessness when the client is alone because of exaggerated fears of being unable to care for self.

Question 2

Which nursing statement reflects a common characteristic of a client diagnosed with paranoid personality disorder?

Accepted Answer

A client diagnosed with paranoid personality disorder has a pervasive distrust and suspiciousness of others.Anticipating humiliation and betrayal,the paranoid individual characteristically learns to attack first.

Question 3

While improving,a client demands to have a phone installed in the intensive care unit (ICU)room.When a nurse states,"This is not allowed; it is a unit rule," the client angrily demands to see the doctor.Which approach should the nurse use in this situation?

Accepted Answer

Clients who demand special privileges may be diagnosed with narcissistic personality disorder.The best approach in this situation is for the nurse to identify the function that anger,frustration,and rage serve for the client.The verbalization of feelings may help the client to gain insight into his or her behavior.

Question 4

Which characteristics should a nurse recognize as being exhibited by individuals diagnosed with any personality disorder?

Accepted Answer

Clients who are diagnosed with personality disorders accept and are comfortable with their altered behaviors.Personalities that develop in a disordered pattern remain somewhat unstable and unpredictable throughout the lifetime.

Question 5

Which client is a nurse most likely to admit to an inpatient facility for self-destructive behaviors?

Accepted Answer

The nurse should expect that a client diagnosed with borderline personality disorder would be most likely to be admitted to an inpatient facility for self-destructive behaviors.Clients diagnosed with this disorder often exhibit repetitive,self-mutilative behaviors.Most gestures are designed to evoke a rescue response.

Question 6

The nurse should recognize which factors that distinguish personality disorders from psychosis?

Accepted Answer

Major disturbances of thought are absent in personality disorders and are a classic symptom of psychosis.

Question 7

A client diagnosed with Cluster C traits sits alone and ignores other's attempts to converse.When ask to join a group the client states,"No,thanks." In this situation,which should the nurse assign as an initial nursing diagnosis?

Accepted Answer

Clients diagnosed with Cluster C traits are described as anxious and fearful.The DSM-5 divides Cluster C personality disorders into three categories: avoidant,dependent,and obsessive-compulsive.Anxiety and fear contribute to social isolation.

Question 8

Which statements represent positive outcomes for clients diagnosed with narcissistic personality disorder? Select all that apply.

Accepted Answer

The nurse should determine that appropriate outcomes for a client diagnosed with narcissistic personality disorder include relating empathetic statements to other clients,identifying one personal limitation,and acknowledging one strength in another client.An exaggerated sense of self-worth,a lack of empathy,and exploitation of others are characteristics of narcissistic personality disorder.

Question 9

Which client statement would demonstrate a common characteristic of Cluster "B" personality disorder?

Accepted Answer

Antisocial personality disorder is included in the Cluster "B" personality disorders.In this disorder there is a pervasive pattern of disregard for and violation of the rights of others.

Question 10

A nurse is caring for a group of clients within the DSM-5 Cluster B category of personality disorders.Which factors should the nurse consider when planning client care? Select all that apply.

Accepted Answer

The nurse should consider that individuals diagnosed with cluster B-type personality disorders have deeply ingrained personality traits,use manipulation,have poor impulse control,and often have secondary diagnoses of substance abuse and/or depression.This cluster includes antisocial,borderline,histrionic,and narcissistic personality disorders.

Question 11

The nurse plans to confront a client about secondary gains related to extreme dependency on her spouse.Which nursing statement would be most appropriate?

Accepted Answer

When a client goes to excessive lengths to obtain nurturance and support from others,the client is seeking secondary gains.Secondary gains provide clients the support and attention that they might not otherwise receive.

Question 12

When a client on an acute care psychiatric unit demonstrates behaviors and verbalizations indicating a lack of guilt feelings,which nursing intervention would help the client to meet desired outcomes?

Accepted Answer

Because the client,due to a lack of guilt,cannot or will not impose personal limits on maladaptive behaviors,these limits must be delineated and enforced by staff.

Question 13

When planning care for clients diagnosed with personality disorders,what should be the anticipated treatment outcome?

Accepted Answer

The outcome of treatment for clients diagnosed with personality disorders should be to reduce inflexibility of personality traits that interfere with functioning and relationships.Personality disorders are often difficult and,in some cases,seem impossible to treat.

Question 14

A nurse would expect a client diagnosed with schizotypal personality disorder to exhibit which characteristic?

Accepted Answer

Clients who are diagnosed with schizotypal personality disorder experience odd beliefs or magical thinking that influences behavior and is inconsistent with cultural norms.This results in incorrect interpretations of external events.

Quiz 32: Personality Disorders