Nokea
A nursing student appears to cooperate with the group but does not complete agreed upon tasks at the appropriate time repeatedly and then displays negativity. The nursing student may be showing signs of which personality disorder or behavior?
- A. Paranoid
- B. Borderline
- C. Narcissistic
- D. Passive-aggressive behavior
Correct Answer: D
Rationale: Passive-aggressive behavior involves superficial cooperation with underlying resistance and negativity, unlike the other disorders listed.
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The nurse is talking to a client with schizoid personality disorder about finding a job. Which suggestion by the nurse would be most helpful?
- A. Being a loner really limits your employment opportunities.
- B. Maybe your friend could see if there is a night position available at the convenience store.
- C. Perhaps working part-time at a fast-food restaurant would be something you could do.
- D. There is a job posting at the hospital for a file clerk in medical records.
Correct Answer: D
Rationale: A low-interaction job like file clerk suits the client's preference for minimal interpersonal contact.
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.
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.
A nurse is teaching a client with borderline personality disorder to reshape thinking patterns. Which is an example of a cognitive restructuring technique that would be helpful for this client?
- A. When negative thoughts begin, tell yourself â??stop.'
- B. Learn to look at situations realistically rather than assuming the worst.
- C. Recognize negative thoughts and replace them with positive ones.
- D. Express needs using â??I' statements.
Correct Answer: C
Rationale: Cognitive restructuring involves identifying and replacing negative thoughts with positive ones to alter maladaptive thinking patterns.
Which are important in the limit-setting technique to deal with manipulative behavior? Select all that apply.
- A. Stating the behavioral limit
- B. Identifying the consequences if the limit is exceeded
- C. Identifying the expected or desired behavior
- D. Providing choices
- E. Allowing flexibility
Correct Answer: A,B,C
Rationale: Limit-setting involves clearly defining unacceptable behavior, consequences, and expected behavior to manage manipulation effectively.