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The nurse has explained some of the biologic theories of causation to a client diagnosed with borderline personality disorder and his family. The nurse determines that the client and family have understood the instructions when they state which of the following?
- A. The disorder may be caused by increased serotonin activity.
- B. The disorder is caused by decreased dopamine activity in my brain.
- C. A frontal lobe dysfunction may be causing this condition.
- D. A decrease in hormonal substances increases the risk for this illness.
Correct Answer: C
Rationale: Frontal lobe dysfunction (C), particularly in areas like the prefrontal cortex, is implicated in BPD due to its role in emotional regulation and impulsivity. Increased serotonin activity (A) is not typically associated, decreased dopamine (B) is more relevant to other disorders, and hormonal decreases (D) lack specific evidence in BPD causation.
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A nurse is observing a client diagnosed with borderline personality disorder on the inpatient unit. Which of the following would the nurse most likely note?
- A. Actively participating in several different groups
- B. Openly verbalizing feelings
- C. Participating in relationships in which the client has control
- D. Adhering to the personal boundaries of others
Correct Answer: C
Rationale: Clients with BPD often seek control in relationships (C) due to fears of abandonment and emotional instability. Active group participation (A), open verbalization (B), and boundary adherence (D) are less likely due to impulsivity and interpersonal difficulties.
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 with borderline personality disorder has difficulty maintaining boundaries of the professional relationship. Which of the following would be most effective for the nurse to do? Select all that apply.
- A. Punish the client with seclusion for violating established boundaries.
- B. Respond to the client?s arrogance in a neutral, nonconfrontational manner.
- C. Discuss the purpose of the limits in the therapeutic relationship.
- D. State the parameters of the limits and boundaries clearly.
- E. Ensure that any established limits are maintained consistently.
Correct Answer: B,C,D,E
Rationale: Effective strategies for managing boundary issues in BPD include responding neutrally to arrogance (B), discussing the purpose of limits (C), clearly stating boundaries (D), and maintaining consistency (E). Punishment via seclusion (A) is inappropriate and non-therapeutic.
A nurse is assessing a client with borderline personality disorder. Which question would be most appropriate to assess the client?s level of impulsivity?
- A. What things bother you and make you feel happy?
- B. Have you ever felt sorry after acting as you did on the spur of the moment?
- C. How do you view other people around you?
- D. Have you ever felt like you were separated from your body?
Correct Answer: B
Rationale: Asking about regret after spontaneous actions (B) directly assesses impulsivity, a core BPD trait. Questions about emotions (A), perceptions of others (C), or dissociation (D) are less specific to impulsivity.
The nurse is assessing a client who has borderline personality disorder. Which of the following would be a priority?
- A. Nutrition patterns
- B. Personal hygiene practices
- C. Physical functioning
- D. Somatic complaints
Correct Answer: C
Rationale: Physical functioning (C) is a priority in BPD assessment due to the risk of self-harm or impulsivity affecting safety and health. Nutrition (A), hygiene (B), and somatic complaints (D) are important but secondary, as they are less immediately tied to life-threatening risks like self-injury.