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A group of nursing students is reviewing possible risk factors for development of borderline personality disorder. The students demonstrate understanding of the information when they identify which of the following as a risk factor? Select all that apply.
- A. Childhood sexual abuse
- B. Parental loss
- C. Substance abuse
- D. Family history
- E. Genetics
Correct Answer: A,B,D,E
Rationale: Risk factors for BPD include childhood sexual abuse (A), parental loss (B), family history (D), and genetics (E), reflecting environmental and hereditary influences. Substance abuse (C) is a common comorbidity but not a primary risk factor for developing BPD.
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A nurse is engaged in role-playing with a client with borderline personality disorder to assist the client in learning how to communicate effectively. Which of the following would the nurse encourage the client to use? Select all that apply.
- A. Me statements
- B. Validating perceptions with others
- C. Paraphrasing before responding
- D. Listening passively
- E. Compromising
Correct Answer: B,C,E
Rationale: Effective communication in BPD includes validating others? perceptions (B), paraphrasing before responding (C), and compromising (E) to foster mutual understanding. ?Me? statements (A) are less specific than ?I? statements, and passive listening (D) is less effective than active engagement.
A woman with borderline personality disorder has been admitted to the inpatient unit because she has been engaging in wrist cutting. The client?s sister is visiting, and the sister asks the nurse to explain why her sister sometimes does this to herself. Which response by the nurse would be most appropriate?
- A. Sometimes the self-injurious behavior is undertaken to relieve stress.
- B. Self-injurious behavior often calms and sedates people with this diagnosis.
- C. Sometimes they do it to avoid the onslaught of delusional thinking.
- D. The self-mutilation often slows the mood swings your sister experiences.
Correct Answer: A
Rationale: Self-injurious behavior in BPD, such as wrist cutting, is often a maladaptive coping mechanism to relieve intense emotional stress or distress (A). It does not typically calm or sedate (B), is unrelated to delusions (C), and does not directly address mood swings (D), which are more characteristic of bipolar disorder.
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?
- A. I have felt so down lately. I don?t enjoy doing anything anymore.
- B. I do what I do because others tell me to do so.
- C. When I feel extremely anxious, it is like my mind goes somewhere else.
- D. It is almost as if as soon as I think of doing something, I immediately do it.
Correct Answer: C
Rationale: The statement about the mind going somewhere else during extreme anxiety (C) suggests dissociation, a common precursor to self-injurious behavior in borderline personality disorder (BPD) as a way to cope with intense emotions. Feeling down (A) indicates depression, following others (B) suggests suggestibility, and impulsivity (D) is a risk but less directly linked to self-injury than dissociation.
A nursing instructor is preparing a class discussion on personality disorders and characteristics. Which term would the instructor include to differentiate personality disorders from normal personality? Select all that apply.
- A. Inflexible
- B. Short term
- C. Pervasive
- D. Unstable over time
- E. Distressing
Correct Answer: A,C,E
Rationale: Personality disorders are characterized by inflexible (A), pervasive (C), and distressing (E) patterns of behavior that deviate from normal personality traits. They are not short-term (B) but enduring, and while unstable relationships or emotions may occur, ?unstable over time? (D) is not a defining feature of the disorder itself.
A client diagnosed with borderline personality disorder tells the nurse that she frequently spaces out. Which response by the nurse would be most appropriate?
- A. Do you feel stressed most of the time?
- B. Does this frighten you when it happens?
- C. What?s happening around you when this occurs?
- D. Do you feel as if you are out of your body?
Correct Answer: D
Rationale: The client?s description of ?spacing out? suggests dissociation, common in BPD. Asking if she feels out of her body (D) directly assesses the nature of this dissociative experience. Asking about stress (A), fear (B), or external events (C) is less specific to confirming dissociation.