Nokea
The nurse is planning the type of approach that will be most effective in developing a therapeutic relationship with the client. The nurse should use a matter-of-fact approach with clients with which types of personality disorders? Select all that apply.
- A. Paranoid
- B. Antisocial
- C. Schizotypal
- D. Narcissistic
- E. Avoidant
Correct Answer: A,B,D
Rationale: A matter-of-fact approach with limit setting is effective for paranoid, antisocial, and narcissistic personalities to maintain boundaries.
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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 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.
Which techniques are important for nurses caring for clients with personality disorders to use in order to effectively provide care? Select all that apply.
- A. Discuss feelings of anger or frustration with colleagues to help them recognize and cope with their own feelings.
- B. Considering the client to be a personal friend.
- C. Employ ongoing communication with team members to remain firm and consistent about expectations for clients.
- D. Solving the problems of the client.
- E. Understanding that behavior changes in clients with personality disorders can occur quickly.
Correct Answer: A,C
Rationale: Discussing frustrations and maintaining team consistency are key to managing countertransference and preventing manipulation.
Which is the main reason why the periodic team meetings are important when caring for a client with antisocial personality?
- A. The team needs to consider updating treatment recommendations as the client improves.
- B. Rotating team members need to be apprised of the care planned for the client.
- C. Staff frustrations in caring for the client need to be processed.
- D. Team consistency is important to prevent manipulation by the client.
Correct Answer: D
Rationale: Consistency in team approach prevents manipulation, as clients with antisocial personality disorder exploit inconsistencies.
When planning care for a client with passive-aggressive personality disorder, the nurse will need to include interventions for which behavior?
- A. Avoidance of anxiety-provoking situations
- B. Compulsive needs for perfection and praise
- C. Dependence on others for decisions
- D. Procrastination and subtle resistance
Correct Answer: D
Rationale: Passive-aggressive behavior is characterized by procrastination and subtle resistance, requiring targeted interventions.