Nokea
A client with antisocial personality disorder is begging to use the phone to call his wife, even though it is against the unit rules. The client begs, 'It is just this once, and she will be so hurt if I don't call her.' Which would be the most appropriate response by the nurse?
- A. Only to help your wife, you can call this time.
- B. I will get in trouble with my supervisor if I let you call.
- C. You may not use the phone to call your wife.
- D. You cannot call because you need to focus on your recovery while you are here, not your wife.
Correct Answer: C
Rationale: A firm, matter-of-fact refusal prevents manipulation without engaging in arguments or justifications.
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Which disorder is characterized by pervasive mistrust and suspiciousness of others?
- A. Paranoid personality disorder
- B. Schizoid personality disorder
- C. Histrionic personality disorder
- D. Dependent personality disorder
Correct Answer: A
Rationale: Paranoid personality disorder is defined by pervasive mistrust and suspiciousness of others, distinguishing it from other personality disorders.
A client with borderline personality disorder says to the nurse, 'I feel so comfortable talking with you. You seem to have a special way about you that really helps me.' Which would be the most appropriate response by the nurse?
- A. I'm glad you feel comfortable with me.
- B. I'm here to help you just as all the staff are.
- C. Do you feel others don't understand you?
- D. I cannot be your friend; we need to be clear on that.
Correct Answer: B
Rationale: This response reinforces the professional role of the nurse, maintaining boundaries with a client prone to idealization.
A client with dependent personality disorder has a goal to increase her problem-solving skills. Which client behavior would indicate progress toward meeting that goal?
- A. Asking questions
- B. Being polite
- C. Controlling emotional outbursts
- D. Requesting assistance appropriately
Correct Answer: A
Rationale: Asking questions demonstrates assertiveness and initiative, key steps in improving problem-solving for dependent clients.
Which challenges are posed when working with clients with personality disorders? Select all that apply.
- A. Clients with personality disorders are obviously unable to function more effectively.
- B. It can take a long time to change their behaviors, attitudes, or coping skills.
- C. The nurse can easily but mistakenly believe the client simply lacks motivation or the willingness to make changes.
- D. Clients with personality disorders challenge the ability of therapeutic staff to work as a team.
- E. Team members may have differing opinions about individual clients.
Correct Answer: B,C,D,E
Rationale: Long-term change, perceived lack of motivation, and team dynamics are significant challenges in treating personality disorders.
Which of the following is a realistic outcome for the care of a person with a personality disorder?
- A. Outcomes that focus on satisfaction with daily life
- B. Outcomes that focus on the client's perception of others
- C. Outcomes that focus on increased client insight
- D. Outcomes that focus on change in behavior
Correct Answer: D
Rationale: Behavioral change is a realistic and primary focus for treatment, as insight or perception changes are less achievable.